Dementia can be prevented in part because there are circumstances that can be acted upon, but there are factors that we cannot change. The most important thing is age. The risk of dementia increases from the age of 65, and nothing can be done about that. Another very important factor is gender: for example, women are more at risk of developing Alzheimer’s disease. And then there are the genetic factors, which we cannot change either: For example, it is known that people who carry one or both alleles 4 of apolipoprotein E (APOE) have a 2 to 3 times higher risk of developing getting Alzheimer’s. There are other genetic factors associated with very early dementia, such as what is known as ‘familial Alzheimer’s disease’, which occurs in younger people and accounts for about 1% of dementias, and which has well-defined genetics.
We can’t change age, gender, and genetics, but there are other factors we can act on. They are modifiable factors and we know more and more about them.
For example, a low level of education is a factor in dementia. Self-education and keeping the brain active into late life, therefore, provides a protection we call “cognitive reserve.” The advice for preventing dementia is that learning new things, learning a language and others, works as prevention.
There are other factors associated with vascular risk, most notably high blood pressure. It has been found that people who are hypertensive in middle age have a higher risk of developing dementia in the future. This is more controversial when high blood pressure occurs at an advanced age. And the same goes for obesity; Middle-aged obese people also have a higher risk of dementia later in life. And diabetes is another very important risk factor. People with type 2 diabetes are up to 2 to 3 times more likely to develop dementia than non-diabetics. Adding to these factors are smoking and alcohol consumption, which also increase the risk.
There are a number of conditions associated with vascular risks that may also be preventive. For example, maintaining a Mediterranean diet has been found to reduce risk because this diet affects vascular risk factors. Controlling high blood pressure, obesity and diabetes with your diet will also reduce your risk of dementia. And the other protective factor is exercise because it also reduces these vascular risk factors.
There are other factors that can influence dementia, such as depression. However, it is not known whether this is a cause or an effect, as it has been shown, for example, that patients with dementia often become depressed even before the disease occurs. The connection is complex, but depression is also identified as a risk factor.
And then there are other factors like social isolation, which is also a proven risk factor. Therefore, dealing with other people in old age is advisable, because isolation is associated with an increased risk of dementia. One demographic group at higher risk of dementia is those who suffer from hearing loss, due to the social isolation that deafness brings.
Natalia Garcia Casares She is a neurologist, full professor and researcher at the Medical Faculty of the University of Malaga, expert in cognitive neurology and dementia.
Question sent by Manuela Pásaro
Coordination and writing:Victoria Bull
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The advice given by this office is of a general nature and does not replace medical advice. If you have any questions about your specific problem, ask your doctor or pharmacist.
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