Prevent Dementia By Addressing These Risk Factors

Dementia is a neurological condition that causes a decline in cognitive functions such as memory, reasoning, and thinking. Signs of dementia can occur as early as 45 years old, however, most diagnoses occur in people 85 and older.

The most common form of dementia is Alzheimer’s disease. Other types of dementia include Lewy body dementia, vascular dementia, and frontotemporal dementia. The risk of developing dementia is higher if you have a history of dementia in your family, rare genetic variants, or certain preexisting conditions. Dementia is a leading cause of death in Black Americans and continues to be a significant risk factor for Latino, Indigenous, and Asian communities in the United States.

Modifiable Risk Factors

Fortunately, there are ways to lower your risk of dementia by addressing and reducing your exposure to modifiable risk factors. Modifiable risk factors are changes a person can make in their daily life to prevent or delay the onset of a disease. Avoiding or limiting these risk factors is especially important for people of color and low-income communities, who face a higher likelihood of developing dementia.

Diet and Nutrition

To prevent dementia, researchers recommend consuming a diet that is low in cholesterol and saturated fats as studies suggest having high levels of high-density lipoprotein (HDL) can increase the amount of a toxic protein found in the brains of people with Alzheimer's disease called beta-amyloid.

Maintaining a healthy cholesterol level improves heart health, which can also improve your brain function. Eating a diet high in leafy greens, fruits, and healthy omega-3 fats can help reduce inflammation in the brain, which can increase your risk of dementia.

Some doctors recommend the Mediterranean diet as ideal for cardiovascular and brain health. This includes eating foods such as:

• Fish
• Berries
• Nuts
• Lentils
• Legumes
• Olive oil

Fruits and vegetables are full of vitamins and nutrients including vitamin B12, which promotes healthy red blood cell production. Eating more fruits and vegetables instead of processed foods can lower the likelihood of developing type 2 diabetes and heart disease, which can lead to dementia later in life.

To maintain a heart-healthy diet, it is important to have access to nutritious, affordable food options. In a lot of neighborhoods, particularly in areas of the country known as the “Stroke Belt” the risk for hypertension and cardiovascular disease is high. Many of these neighborhoods became food deserts, communities lacking adequate access to a wide variety of nutritious, fresh foods because of a lack of funding in predominantly Black and Brown communities.

Hypertension

Hypertension, or high blood pressure, is a major risk factor for Alzheimer’s disease and other types of dementia. High blood pressure is classified by the American Heart Association as a systolic reading (the upper number) of ≥130 millimeters of mercury (mm Hg) or a diastolic reading (the lower number) of ≥80 mm Hg. Hypertension can make it harder for your brain to get the blood and oxygen it needs to function properly. Decreased blood flow to the brain increases the risk of vascular dementia.

Having undiagnosed, persistent hypertension in middle age can increase your risk of dementia as well as other health issues like kidney disease, heart disease, arrhythmia, and stroke.

When it comes to preventing high blood pressure, healthcare providers often recommend following a low-sodium diet, staying physically active, and monitoring your blood pressure. A lack of access to affordable care can make it harder for people to seek care for the early signs of hypertension. Black Americans and South Asians in low and middle-income neighborhoods in the U.S. have significantly higher rates of hypertension and cardiovascular disease, making consistent monitoring and early intervention crucial for these groups.

Sleep

Getting an adequate amount of sleep is important for all aspects of your health, especially your cardiovascular and vascular health. Your brain needs at least seven hours of sleep to function properly.

When you are asleep, your brain filters out proteins and metabolic waste. The quality of sleep you get can impact this function, especially if you get too much or too little sleep. Consistent noise pollution and stress can also disrupt your sleep-wake cycle and increase your chances of developing other health conditions and circadian rhythm sleep disorders.

Many low and middle-class Black Americans in the United States live in communities next to large, loud industry sites and condensed neighborhoods where noise is frequent, especially in urban areas. Constant sleep interruption can increase inflammation in the brain and make it difficult to get quality sleep that rejuvenates the brain.

“If you’re dealing with violence or crime or noise or any other types of social problems in your neighborhood, or in your community, or because you’re Black, it creates this stress reactivity that leads to a lot of dysregulation just being able to fall asleep,” Karen Lincoln, PhD, University of California, Irvine professor of environmental and occupational health, told Health.

These sleep disturbances make it harder for middle-aged Black Americans approaching old age to maintain optimal cognitive health.

Physical Activity

Staying physically active, especially in old age, reduces the risk of dementia by keeping the brain engaged.

Research shows that elder adults who exercise regularly are less likely to develop dementia and other health conditions. Staying physically active strengthens the regions of the brain in charge of problem-solving, learning, memory, and emotional stability. Physical activities like workout classes, yoga, walking, or even doing household chores can stimulate brain activity. It is recommended that adults spend at least 75 minutes a week doing intense physical activity for the best health outcomes.

Stress

High levels of stress can cause inflammation in the brain that can worsen cognitive health as people age as well as raise blood glucose levels, putting you at greater risk for diabetes. Chronically high levels of stress can also increase the rate dementia symptoms develop.

Experiencing traumatic events early in life may contribute to the development of dementia. Research shows a connection between PTSD (post-traumatic stress disorder) and dementia.

Discussing matters related to mental health with aging loved ones can be uncomfortable, especially for those within the Black, Asian, and Latino communities, where these topics are already under-discussed. Older people of color are more likely to experience stress and undiagnosed depression, both of which can contribute to negative health outcomes. Stress also affects caregivers, increasing the likelihood of dementia in those who care for people with the condition.

Fortunately, there are ways to reduce stress. Staying connected with family and friends can help delay cognitive decline in old age and keep your loved one active and engaged. Other ways to prevent stress include:

• Going for a walk outside
• Meditating
• Finding moments of quiet time
• Speaking with a therapist or counselor

Alcohol Use and Smoking

Smoking can injure blood vessels in the brain. Over time, smoking and excessive alcohol use can increase your risk for carotid artery disease, arterial stiffness, high blood pressure, and stroke.

Smoking affects the part of the brain responsible for memory, attention, and learning. Researchers have found that people who smoke less or not at all tend to be more alert and can process information more quickly. Smoking is also associated with incident dementia—dementia seen in a population over time.

Consuming high amounts of alcohol over time can contribute to brain damage. When brain damage is present, it becomes harder for the brain to send signals to other regions and increases the risk of developing other memory disorders. More research is needed to understand the relationship that exists between dementia and alcohol.

Both drinking alcohol and smoking are risk factors that can be prevented in middle adulthood by keeping drinking levels to a minimum and quitting smoking.

Diabetes

High blood sugar, which is common among people with diabetes, can lead to cognitive decline over time. Diabetes occurs when your body cannot generate enough insulin, a hormone created by the pancreas, that regulates the amount of glucose (sugar) in your blood.

Inflammation in the brain from elevated blood sugar levels can cause damage to the blood vessels and tissue in the brain. If you have diabetes, monitoring your blood glucose levels daily can help prevent heart disease and reduce dementia risk.

Non-Modifiable Risk Factors

Non-modifiable risk factors are aspects of daily life in society and our environment that we cannot directly change.

Air Pollution

Air pollution can impact the health of someone at any age. In kids, this can appear in cognitive and cardiovascular issues. For older adults, the impact can be seen in faster cognitive decline and an increased risk for vascular dementia.

Researchers found that higher exposure to particulate pollution led to increased levels of hospitalizations for people with dementia who lived in areas with high air pollution. Particulate pollution can come from first and secondary sources. Primary sources include wood stoves and forest fires. Secondary sources are gases that create particles from emissions from power plants, factories, and cars. Smaller particles can make their way into your bloodstream and lungs.

Many communities of color have been systemically placed in neighborhoods with a higher risk of exposure to dangerous pollutants due to redlining in urban areas. Redlining is a form of housing discrimination that prevented African Americans from getting housing in suburban, middle-class neighborhoods in the 1930s. This practice continues today for many communities of color that exclude them from living in areas with safer levels of air and noise pollution. Research has shown that exposure to higher levels of particulate matter emission contributes to higher rates of dementia in people as they age.

Generational Trauma

Generational trauma comes from changes in DNA due to traumatic experiences. Traumatic events related to war, discrimination, and racism can all alter the way the brain operates for the groups of people who experience them.

In a study of survivors of World War II, those who were children during the war were more likely to develop dementia later in life. This was especially true for participants who came from more disadvantaged backgrounds.

Black Americans may be more likely to develop dementia due to constant cycles of health disparities and systemic racism in the United States contributing to cognitive decline. Systemic racism in the healthcare system and daily life exacerbates stress, increasing inflammation in the body, including the brain.

A Quick Review

You can maintain your cognitive health as you age by eating a heart-healthy diet, getting quality sleep when possible, staying involved in physical activity, monitoring your blood pressure, prioritizing quality sleep, and keeping stress levels low when possible. For older adults with preexisting conditions like diabetes and hypertension, it is important to monitor diet and blood glucose levels as consistently as possible.

One of the biggest hurdles that exists when it comes to reducing the risk of dementia for Black Americans and other communities of color is getting treatment right away. Black Americans are the most likely to be diagnosed with early onset dementia, but 65 percent less likely to receive a diagnosis in their first doctor visit.

Memory loss is not a normal part of aging. If you notice your loved one forgetting how to do everyday tasks or experiencing disorientation, find them care as soon as possible to slow the progression of dementia.