The Lancet Commission has identified three new modifiable risk factors for dementia. Find out how to use these and other findings to keep our brains healthy as we age.
Three more risk factors for dementia have been reported by The Lancet Commission.
Identifying modifiable risk factors is always good news. Some risk factors, like age and genetics, are impossible to change. They are unmodifiable. At least for now.
But modifiable factors are under our control.
All we need to do is adjust or improve our behavior and lifestyle. Granted, it may not be easy to make these changes, but a little perseverance goes a long way.
Appropriate interventions may help delay or prevent a large percentage of dementia cases.
3 New Modifiable Factors for Dementia
An update from the Lancet Commission on dementia prevention, intervention, and care expands the number of factors.
New evidence supports adding three modifiable risk factors that are:
- Excessive alcohol consumption
- Head injury or traumatic brain injury (TBI)
- Air pollution
It’s never too early or too late to take action and lower the risk of dementia. Contributions to the risk begin early in life and continue throughout our lifespan.
Promoting safety measures could help cut down the number of head injuries. Ad campaigns could help lower harmful alcohol drinking. These types of public health initiatives could reduce young-onset and later-life dementia cases.
Together the modifiable risk factors account for around 40% of worldwide dementias. Worldwide, around 50 million people have dementia and modifying these risk factors could prevent or delay up to 20 million cases.
Learn more about other known risk factors such as high blood pressure, cardiovascular disease, diabetes, high cholesterol and hearing loss. Click to read Dr. Matt Huentelman’s explanation of modifiable and non-modifiable factors.
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Reducing Dementia Risk: Avoid Excessive Alcohol Consumption
Limit alcohol use. Alcohol abuse and drinking more than 21 units per week increase the risk of dementia.
To put these numbers in perspective, 21 units of alcohol are about 1.5 bottles of wine or 12-16 bottles of beer. These units of alcohol measure the alcoholic content of an alcoholic beverage. (1 unit of alcohol=10 mL or 8 g pure alcohol)
For centuries we have known that heavy drinking is linked to:
- changes in the brain
- learning and memory performance
More evidence has come up on the impact of alcohol on cognition and dementia outcomes. Alcohol is strongly associated with cultural patterns and other sociocultural and health-related factors. This makes research results difficult to understand.
Let’s see. On one hand we have a 5-year study that finds alcohol abuse increases the risk of dementia.
In this study of 31 million people, the relationship was evident. For earlier onset dementias, 56.6% of the participants had an alcohol use disorder.
Another study reported light to moderate drinking may protect against Alzheimer’s and dementia. But beware, evidence doesn’t suggest we should start drinking to protect against dementia.
Drinking less than 21 units of alcohol per week might be associated with a lower risk of dementia.
What can we do to help lower the risk of dementia due to excessive alcohol consumption? Avoid or discourage harmful alcohol drinking habits.
New Modifiable Risk Factors for Dementia: Head Injury
Prevent head injury. Minimizing traumatic brain injuries could reduce young-onset and later-life dementia.
TBI can be mild as in a concussion or severe such as in skull fracture, edema, brain injury or bleed. These are some common causes of head injury:
- car, motorcycle and bicycle accidents
- military exposures
- sports like boxing
- domestic violence
Modifiable risk factors for dementia in midlife, such as brain injuries, can play a part in increasing dementia risk.
Military veterans have a high risk of occupational TBI. Their formal record keeping allows long-term follow-up.
Single, severe TBI is related to widespread loss of normal tau function, one of the hallmarks of Alzheimer’s disease. A single, mild head injury increases the risk of dementia less than a severe TBI. More than one TBI will increase the risk further.
A study of older adults with concussion found their risk of dementia doubled. But those taking statins had a 13% reduced risk of dementia compared to those who were statin-free. Future clinical trials with statins might discover if statin use could mitigate:
- injury-related brain edema or swelling
- oxidative stress
- amyloid protein aggregation
- neuroinflammation (inflammatory response within the brain or spinal cord)
All factors that contribute to the development of dementia.
This is still a conjecture, but a sports head injury could increase the risk of dementia.
Preventing head injuries helps reduce damage to the nervous system (amyloid or tau-mediated, vascular or caused by inflammation). This, in turn, will help lower the potentially modifiable risk for dementia.
We can help prevent brain injuries by:
- wearing protective gear when working in construction or playing sports
- taking the necessary precautions to avoid falls
- wearing a helmet when motorcycle riding or participating in other motorsports
- implementing prevention and early intervention efforts to reduce domestic violence and child abuse behavior
Research shows that programs that teach healthy relationship skills, such as communication, effectively managing feelings, and conflict-solving can prevent violence.
Potentially Modifiable Risk Factors for Dementia: Air Pollution
Governments should speed up improvements in air quality, particularly in areas with high air pollution.
Air pollution and particulate pollutants are associated with poor health outcomes. But do we know what their potential effect is on the brain?
Some examples of air pollutants are:
- High nitrogen dioxide concentration
- fine ambient particulate matter from traffic exhaust and from residential wood burning
- second-hand smoke
Studies found that exposure to all these pollutants increases the risk of dementia. Furthermore, smoking increases aerosol particles, and has vascular and toxic effects. In a similar manner, air pollution might act via vascular mechanisms.
What can we do to lower the risk of developing dementia due to air pollution? Try to reduce exposure to it and to second-hand tobacco smoke. Stop smoking.
While dementia may affect us in old age, it isn’t a given. In fact, we know there are modifiable risks for dementia. It’s never too soon to take appropriate action. The best time to start is now.
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