Healthy Habits Urged to Help Prevent Dementia



A healthy lifestyle may help to prevent dementia as well as problems such as heart disease and diabetes, a new report says. The report comes from Alzheimer's Disease International. It is being issued in advance of World Alzheimer's Day, September 21. The report focuses on factors related to dementia risk that people can control. The main message: "What is good for your heart is good for your brain." Some of the strongest links between health conditions and dementia include high blood pressure in middle age and smoking and diabetes at any age. For example, diabetes may increase the risk of dementia 50%, the report says. Quitting smoking lowers risk. The report's authors reviewed research on smoking and dementia. They found that ex-smokers have a dementia risk similar to those who have never smoked. Controlling weight and exercising may help by reducing the risk of high blood pressure, diabetes and heart disease. Low education in early life also is linked with dementia risk. The report urges that brain health be included in public health campaigns. Part of the message would be that it's never too late -- to quit smoking, for example. HealthDay News wrote about the report September 17.

What Is the Doctor's Reaction?

The numbers are staggering. The current cost of caring for people with dementia in the United States is greater than $600 billion. Within 15 years, the cost is expected to rise to $1 trillion.

Worldwide, experts predict that 135 million people will be living with dementia by 2050. To bring increased public awareness of the looming epidemic, Alzheimer's Disease International has declared September 21 World Alzheimer's Day.

Each year a status report is issued around the same date. This year's report focuses on health factors that we can change to help prevent dementia.

This past year we have heard about multiple disappointing trial results for drugs to treat Alzheimer's disease. But the authors of this report do not just review the status of new drug research. They should be applauded for emphasizing what we can do now to help lower our risk of Alzheimer's and other dementias.

More than 90% of dementias are caused by 2 diseases. Alzheimer's disease is responsible for 65% to 70% of cases. Vascular dementia accounts for about 20% to 25%.

People with dementia often have features of both types. And ways to help prevent them are similar. 

What Changes Can I Make Now?

A higher risk of dementia is linked to several factors. The ones with the strongest links include:

Low levels of exercise and physical activityDiabetesSmoking, current and pastHigh blood pressureFewer educational opportunities early in life

This year's report lists the best ways to help prevent, or at least delay, Alzheimer's disease and other types of dementia. Here's what you can do:

Exercise regularly. Make it your goal to get at least 150 minutes of moderate-intensity exercise per week. Then strive to become even more fit.Don't smoke or use other tobacco products.  Use alcohol in moderation. That means no more than one drink per day for women, and no more than two per day for men.Maintain a healthy body weight. In particular, try not to let your waist expand. People with more fat in the middle have a higher risk of developing dementia, even if their body weight is normal.Keep your blood pressure in the normal range. To do this, get regular exercise, eat lots of fruits and vegetables, and cut down on salt. Your doctor can prescribe medicines if needed.Stay socially engaged with family and friends.

Some studies suggest that a Mediterranean-style diet may be especially good for the brain.

These suggestions should look familiar. They are the same ones that will help keep your heart healthy, decrease your risk of stroke and lower the chance of developing some types of cancer.

What Can I Expect Looking to the Future?

Most past studies of new potential drugs to treat Alzheimer's disease include people who already have symptoms of the disease. This is likely too late. The brain changes seen in Alzheimer's disease begin many years before we see symptoms.

Some exciting studies have been launched this year. For example, researchers in one study identified older adults with brain changes that looked like those in Alzheimer's. But they didn't have any symptoms. These changes can be seen on special brain scans. People enrolled in the study are being given a drug that can attack these changes. Researchers want to see if it prevents dementia symptoms from happening later on.

By Howard LeWine, M.D.
Harvard Medical School

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