Exploring Dementia with Professor Graham Stokes: Identifying the risk factors and staying healthy

Graham, is there a way of reducing our risk of getting Dementia?

There’s no certain way to prevent dementia, but evidence shows there are things we can do to help reduce our own risk, even though some dementia risk factors are difficult or impossible to change.

What are the risks we cannot change?

A risk factor is something that increases your likelihood of developing a condition. The dementia risks we cannot alter are -

• Age: This is the biggest risk factor for dementia. The older you are, the more likely you are to develop dementia. However, dementia is not a natural part of ageing.

 
        The growing dementia risk with age
 
Above the age of 65, a person's risk of developing dementia doubles roughly every 5 years.
 
Under the age of 65 years around 1:1,000 adults are living with dementia.
 
        Thereafter the numbers are –
 
         65 - 69 years: 1:50
         70 – 79 years: 1:20
         80 – 89 years: 1:5   
         90 years and older: 1:3
 
This means that just over 7% of all people over 65 have dementia.
 

• Genes: In general, genes alone are not thought to cause dementia. However, certain genetic factors are involved with some of the less common types, such as Familial Alzheimer’s disease and frontotemporal dementia. These less common dementias most often occur in younger people.
•  Lower levels of education: Poor education is consistently associated with a greater risk of dementia. A good education (measured by years spent in school and college) may offer a protective effect against developing dementia later in life possibly because education increases the size of the brain or improves how the brain functions.

 
So, what are the modifiable dementia risks?
 

• Smoking – people who smoke are at higher risk of dementia than non-smokers. Smoking causes arteries to become narrower, which can raise blood pressure. It also increases the risk of cardiovascular disease. The World Health Organisation estimates that 14% of cases of dementia worldwide are associated with smoking, whilst a recent Commission on dementia prevention ranked smoking second among modifiable risk factors for dementia.
•  Excessive alcohol consumption - drinking more than 21 units weekly in middle age increases the risk of dementia.
• Diabetes - type 2 diabetes contributes to increased dementia risk. The risk of dementia increases with the duration and severity of diabetes.
• Hypertension (high blood pressure) – persistent high blood pressure throughout middle age increases the risk of dementia in later life.
• Physical inactivity - older adults who do not exercise are at greater risk of being diagnosed with dementia. A lack of regular physical activity can increase the risk of heart disease, becoming obese and type 2 diabetes, which are all linked to a higher risk of dementia.
• Obesity - being obese can increase blood pressure and the risk of type 2 diabetes, both of which are risk factors for dementia. Obesity in midlife predicts the likelihood of dementia in later years.
• Hearing loss – impairment in midlife can contribute to increased dementia risk. The previously mentioned Commission on dementia prevention ranked hearing loss as the most significant modifiable risk factor for dementia.
• Depression - the relationship between dementia and depression is complex because depression can happen as part of the overall syndrome of dementia itself, but it appears that in later life depression is associated with the risk of developing dementia. This is possibly because depression can affect someone’s ability to be socially active and engage in mentally stimulating activities.
• Social isolation – lifelong social isolation, as well as isolation in late middle-age and older increases the risk of dementia, whilst social contact has a protective effect.

 
Ok, what can we do?
 
Along with poor education, modifiable risk factors account for around 40% of dementia worldwide, which consequently could theoretically be prevented or delayed.
 
Overall the recommendation from experts is to keep intellectually, physically and socially active in middle age and later life, along with the key health message –
 
 “What is good for your heart, is good for your brain”.
 

1. Be physically active

Exercise and physical activity is one of the best ways to reduce your risk of dementia. It’s good for your heart, circulation and weight, as well as your mental wellbeing. Brisk walking, cycling, dancing, gardening and yoga all count, but when possible why not also sit less, take the stairs, walk up escalators or park the car further away from the supermarket entrance.

2. Eat healthily

Eating a healthy, balanced diet might influence dementia risk by protecting from the excess risk of cardiovascular risk factors, such as hypertension, high cholesterol, obesity and the linked condition of diabetes. World Health Organisation guidelines recommend a Mediterranean diet to reduce the risk of intellectual decline or dementia, as it might help and does no harm.

 

3. Keep blood pressure at a healthy level
 

In addition to eating a healthy diet and exercising, if your blood pressure is high get advice from your GP to see if medicine is recommended.

4. Don't smoke
 

If you smoke, you’re putting yourself at much higher risk of developing dementia. Stopping smoking is beneficial regardless of age.

5. Drink less alcohol
 

Avoid drinking 21 or more units of alcohol per week, always bearing in mind that the recommended limit of drinking is no more than 14 units of alcohol a week for both men and women.

6. Exercise your mind and stay in touch with people

There is the possibility that keeping your mind active can reduce your risk of dementia. A way to think about it is ‘Use it or lose it’. Whilst studying, learning a language and playing music are obvious activities to consider, travel, social outings and even just talking and communicating with other people may also help to maintain intellectual abilities.
 

7. Prevent and manage hearing impairment

 
Dementia risk is reduced by the use of hearing aids, as well as preventing hearing loss by protecting your ears from excessive noise exposure. People may need help to wear hearing aids as many find them unacceptable, too difficult to use, or ineffective.

 
Professor Graham Stokes: an expert in memory care
 
Professor Graham Stokes is a clinical psychologist with more than 30 years’ experience in dementia care. He is one of the most influential people working in dementia in the UK and has been involved with many leading initiatives in his field. In his previous article, Graham explored the different types of dementia and debunked some of the common myths, which you can read here: https://www.hc-one.co.uk/Our-News/Corporate-News/Exploring-Dementia-with-Professor-Graham-Stokes-%E2%80%93.aspx 

Memory care at HC-One
 
Many of our homes at HC-One offer dedicated memory care services for Residents living with dementia. Our Colleagues are specially trained to care and understand the needs and aspirations of each individual living and to provide them with the kindest possible care and person-centred support. We also have homes offering nursing care for older people living with dementia, who have additional health needs that require care and support from qualified nurses.
 
For more information about homes in your area, please contact our friendly Careline team on: 0333 999 8699