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Reducing the Risk of Dementia

Not everyone appreciates that dementia is a preventable illness. Across the population, the risk of dementia can be reduced by about half, though the risk for an individual varies from person to person depending on their lifestyle and family history. Even for someone with a high genetic chance of developing dementia, the risk can be reduced.

Important factors are (click on boxes for more information):

a man wearing ear protection headphone, text reads "Look after your hearing" a wman getting a blood pressure check, text reads "Look after your heart" a group of people walking together, text reads "exercise" image of a cigarette with a no smoking sign on it, text reads "smoking"

a head sillouette with flowers coming out of it's brain, text reads "look after your mental health" a group of people with gardening gloves on putting their hands together in a circle, text reads "social isolation" a man wearing a hard hat, text reads "Avoid head injuries" a blue sky with clouds in, text reads "look after breathing"

a selection of healthy foods, text reads "look after metabolism" bottles of beer and crisps in front of a tv playing football, text reads "reduce alcohol" a selection of healthy foods, text reads "eat well" a man playing the guitar, text reads "lifelong learning"

What can a workplace do to help it's people reduce their chances of getting dementia?

Develop a brain healthy culture:

  • Ear protection
  • Head protection
  • Airway protection
  • Time to stand in meetings, movement breaks or ‘snacks’
  • Healthy meals, snacks and treats
  • Encourage smoking cessation
  • At celebrations, offer an alternative to events arranged around food and alcohol – a coastal walk, a trip to the cinema, a games night, a sporting event
  • Encourage active transport
  • Offer reduced gym membership
  • Offer a health incentive scheme (e.g. discount for smart watch, free things for keeping up steps, doing exercise). Vitality offers this as part of health insurance, may be others available.

 

Important Factors for Risk Reduction:

Look after your hearing

  • If all hearing loss were treated / prevented, there would be 8% less dementia.
  • Wear ear protectors if the environment is noisy. Consider ear plugs and ear muffs too
  • Keep headphone volume to a minimum
  • Follow the 60/60 rule – when you listen to music, do not exceed 60% of your device’s volume for more than 60 minutes
  • Give your ears a break from noisy environments, and if you are somewhere very loud, give your ears time to readjust before exposing them again
  • Tinnitus can be a sign of temporary or permanent hearing damage. If it occurs after exposure to loud noise, wait for it to go before exposing yourself to the noise again, and review the measures you are taking to protect yourself
  • Get your hearing tested if you notice a change
  • If you need hearing aids, wear them

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Look after your heart

  • Get your blood pressure checked, and if it is high, discuss how to reduce it with your doctor. Sometimes simple lifestyle measure work, sometimes people need medication. Keeping your blood pressure within healthy limits reduces your risk of both vascular and Alzheimer’s dementia, as well as the risk of heart disease, stroke and kidney disease.
  • Keep your cholesterol in the healthy range. This might be manageable with changes of diet but some people need medication. People with genes that put them at risk of dementia are much less likely to get it if their cholesterol is at the lower end of the spectrum.

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Exercise

  • Exercise is probably the best medicine for your brain, and helps to protect it in several different ways
  • It keeps the heart healthy, so that blood can keep pumping, bringing nutrients and removing toxins
  • It develops muscles which help regulate blood sugar (higher sugar levels are toxic to the brain)
  • Muscles release chemical signals which tell the brain to look after itself – to dispose of waste, prune what is not needed, develop what is needed
  • Exercise improves sleep quality, which allows the brain to refresh itself
  • What do you need to do?
    • Aim for 150 minutes per week of moderate activity (or more) – exercise where you can talk but not sing, eg  brisk walking, cycling, swimming. Alternatively, do 75 minutes per week of vigorous activity such as running, competitive sport. If you are doing nothing, even a little will make a big difference, but aim for as much as you can
    • Build strength with resistance training on at least 2 days per week, eg a weight regime at home, going to the gym, lifting heavy bags, doing yoga
    • Try not to sit for long periods. Develop a culture where no meeting lasts longer than 30mins without a suggestion that people stand up  and move for a minute. Watch TV while doing something else.
    • Don’t let injury, illness or age put you off! Aim to add something new every year.
  • People who exercise more have brains that shrink less or even grow a tiny amount, even in late life.

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Smoking

If everyone stopped smoking, dementia rates would reduce by about 5%. There are lots of ways to stop smoking.

  • Allen Carr’s book ‘Easy Way to Stop Smoking’ has been shown to work in clinical trials and is easy to read at your own pace. You continue to smoke while you read the book, and at the end, find you don’t want to continue. Some people need to read it more than once.
  • Alternatively, you can contact Healthy Cornwall for local support or the NHS National Smokefree Helpline 0300 123 1044. You are most likely to quit with a mixture of support and replacement therapy.

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Look after your mental health

  • Depression, especially in midlife is a risk factor for dementia, yet it can be treated and the risk reversed.
  • Signs to look for are a feeling of sadness, being overwhelmed, not being able to cope, losing hope that things will get better, losing energy and drive, less interested in food, tired, but often can’t sleep.
  • If depression is mild, simple measures like
    • looking after your diet (eating food that does not spike your blood sugar, getting plenty of vegetables – about half your plate at every meal, making sure you have enough protein, avoiding ultra-processed food),
    • moving more e.g. going for a walk, talking with a supportive friend or family member can make all the difference.
  • If those measures don’t work, talking therapy might help, or an antidepressant.
  • Don’t be afraid to seek help; speak to your surgery.

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Social isolation

  • Being lonely and seeing few people makes you more likely to develop dementia.
  • The more people in your social network as you get older, the better.
  • Being part of a religious group, volunteering, keeping in touch with your friends and family, working, taking classes are all ways of making sure you see more people on a regular basis.

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Avoid head injuries

  • Head injuries increase the risk of dementia, even when they occurred years ago.
  • Head injuries can damage the brain through one big incident (RTA, fall, assault) or repeated smaller ones (repeated assaults, sport).
  • Ways to reduce your risk include making sure you wear a hard hat when necessary at work or on horseback, or a cycle helmet.
  • If you play contact sports (rugby, boxing, football), follow the latest guidance; don’t head the ball, avoid blows to the head and concussion.

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Look after your breathing

  • Air pollution increases the risk of dementia
  • In the UK, the main risks come from traffic pollution and wood burning
  • Both produce small particles which enter the blood through the lungs and are found in the brain, causing inflammation.

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Look after your metabolism

  • Having high blood sugar damages the brain whether you have diabetes or not.
  • If you have diabetes, keeping your blood sugar in the healthy range will reduce your risk of getting dementia
  • Whether you have diabetes or not, eating low GI meals (foods that don’t spike your blood sugars – low sugar foods, reducing white bread, rice, potatoes etc, lots of veg) and not snacking will help you keep your blood sugar stable
  • If you are obese, losing weight will help you reduce your risk of dementia.

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Reduce alcohol

  • All alcohol is bad for the brain – there is no safe level or type.
  • If you want to reduce your risk of developing dementia, reducing your alcohol intake to recommended levels, or just stopping it, will help.

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Eat well

General principles are:

  • Have half your plate as green / coloured vegetables at midday and evening
  • Eat low GI food
  • Minimise ultra processed food (stuff that comes with packaging and ingredients you don’t recognise)
  • Avoid snacking
  • Make sure you have enough vitamin D (most people in the UK are deficient in winter) – consider taking a supplement.
  • Make sure you have enough vitamin B12, particularly if you are vegan or have pernicious anaemia

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Lifelong learning

  • The more education you have, the more cognitive capacity you develop
  • Keep learning new things and challenging yourself throughout your life
  • Learning a second language or a musical instrument are protective
  • Its never too late to learn something new; it keeps your thinking flexible and stimulates your brain
  • Combining learning with movement e.g. sport, Zumba, aerobics is even better

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