Reducing the risk

Alzheimer’s and other dementias are complex diseases. We are making considerable progress in understanding how they develop and it’s clear that they don’t have one single cause.

We still have a lot to learn about the risk factors for dementia, but in most cases, it is likely that our age, genes, medical history and lifestyle all contribute to our risk. This section aims to outline some of the risk factors for dementia and how we may be able to reduce our risk.

What is a risk factor?

A risk factor is something that increases your likelihood of developing a condition. Some risk factors, like age and genetics, can’t be changed. There are others, including lifestyle factors such as smoking, which you could try to do something about.

Risk factors for dementia

The biggest risk factor for dementia is age – the older you are the more likely you are to develop the condition, but it is not an inevitable part of ageing. About two in 100 people aged 65 to 69 years have dementia, and this figure rises to one in five for those aged 85 to 89.

Does dementia run in the family?

As dementia is so common, many of us will have a relative living with the condition – but this does not mean we will develop it too.

If you have a parent or grandparent with Alzheimer’s disease, then your risk may be slightly higher than someone with no family history. However, except in rare cases, the genes we inherit from our parents may only have a small effect on our risk of developing dementia.

In these rare cases, someone may inherit a faulty gene that causes a specific form of dementia. Some rare forms of early-onset Alzheimer’s disease and frontotemporal dementia are caused by faulty genes and can run in families; symptoms of these often start in the 30s, 40s or 50s.

To find out more about the rare, inherited forms of dementia you can speak to your doctor or contact us for further information.

Can I reduce my risk of dementia?

We can’t change our age or our genes and there is currently no way we can completely prevent dementia. However, there may be some simple things we can all do that might help lower our risk.

Risk factors for cardiovascular disease (like heart disease and stroke) are also risk factors for dementia. Leading a healthy lifestyle and taking regular exercise will help lower your risk of cardiovascular diseases, and it’s likely you could be lowering your risk of dementia too, particularly vascular dementia.

For good heart health:

  • don’t smoke
  • keep active and exercise regularly
  • maintain a healthy weight
  • eat a healthy balanced diet
  • only drink alcohol within NHS guidelines
  • keep cholesterol and blood pressure at a healthy level.

Studies suggest it may be particularly important to maintain a healthy lifestyle in your forties and fifties to help lower your risk of dementia.

Smoking and dementia

There are many good health reasons to stop smoking, as it’s linked to multiple medical conditions including cancer, heart disease, stroke and more. There is also evidence that smoking can increase your risk of dementia, particularly Alzheimer’s disease. There are trained advisors who can provide information and medication to help you to stop smoking. The NHS Smokefree Helpline is free to call on 0300 123 1044, or you can talk to your GP for advice.

It’s never too late to stop smoking and kicking the habit greatly improves your chances of enjoying a disease-free, healthy old age. People who quit aged 60 can add three years to their life.

Healthy eating

A balanced diet is an important way to keep healthy. The eatwell plate can help you with this.

eatwell-guide-March-2016
Click to enlarge. (Updated March 2016)

Try to choose options that are lower in salt, saturated fats and added sugars.

Foods like sausages and other processed meats, butter and cakes are high in saturated fat. This can raise cholesterol levels and cause excess weight gain, increasing the risk of heart disease and other health problems linked to dementia. Eating too much sugar can also lead to weight gain, and may increase the risk of type 2 diabetes. Sugary snacks such as sweets, chocolate, cakes and fizzy drinks should be eaten less often and in small amounts.

Some fat in our diet is important, particularly unsaturated fat found in oily fish, nuts, seeds and avocados. Oily fish, like salmon and sardines, contains omega-3 fatty acids. While these are an important part of our diet, current evidence does not support the use of omega-3 or other food supplements to prevent a decline in memory and thinking skills.

Older people may have a smaller appetite and eat less. It may be harder to maintain a balanced diet with enough vitamins and minerals. Contact your GP surgery if you need advice about healthy eating.

Drinking alcohol

Studies investigating whether alcohol consumption is linked to dementia risk have had mixed results and research is ongoing. However, very heavy drinking is known to cause alcohol-related dementia, including Wernicke-Korsakoff Syndrome.

The best advice at the moment is to only drink alcohol within NHS lower-risk guidelines. This means not regularly drinking more than 14 units a week for both men and women. People who drink as much as this should spread their drinking over three or more days. A good way to reduce alcohol intake is to have several alcohol-free days a week.

Units-cropped

Keeping physically active

Regular physical activity can have many health benefits, including the prevention and management of over 20 chronic conditions, reducing stress and improving mental wellbeing. It can also help you maintain a healthy weight, reducing your risk of type 2 diabetes and other conditions. While research is underway to investigate a direct effect of exercise on dementia risk, medical conditions like high blood pressure and diabetes are known risk factors for dementia.. Therefore staying active may not only help maintain a healthy body but could have knock-on benefits for brain health too.

Exercise2-cropped

Being active needn’t mean going to the gym or pounding the streets. You are more likely to stick with it if you find activities that you enjoy. There might be activities you can take part in with other people, like walking, dancing or cycling. Keeping active with others is a good way to encourage each other and make it a social occasion.

Exercise1-cropped

There are many ways to build physical activity into your life, and make it part of your weekly routine. Just getting off the bus a stop or two earlier than usual could help you do more walking. It’s also important to avoid spending long periods sitting down, so try to get up and move around regularly. Any activity is better than none!

What counts, and how much?

Each week, aim for at least 150 minutes of activity in total. As little as 10 minutes of activity at a time can count towards your total, but if you can manage longer periods, as shown in the examples below, even better.

  • 30 mins moderate-intensity activity, five times per week (eg cycling, vacuuming, gardening, walking)

OR

  • 15 mins high-intensity activity, five times per week (eg more strenuous cycling, rugby, football, running)

PLUS

  • Muscle-strengthening exercise, twice per week (eg resistance or weight training, carrying heavy shopping, digging the garden

Older people should aim to be active every day and minimise sitting for extended periods. Try to do activities that improve balance and coordination, like walking, bowls or yoga, at least twice a week.

You can find lots of ideas and information on the NHS Choices website or ask your GP for advice about becoming more active.

Mental activity and wellbeing

Several studies have suggested a link between mentally-stimulating leisure activities and a lower risk of dementia. Other studies have linked spending more time in education with a lower risk and research is ongoing in these areas. It’s not clear which types of activity may be most beneficial but it’s a good idea to do things you enjoy.

Keeping mentally active by learning new skills or joining clubs can also be a good way to connect with other people and improve mental wellbeing, helping you to feel happier and more positive in life.

Other diseases and medical conditions

There is evidence that the following conditions can increase the risk of dementia:

  • Parkinson’s disease
  • stroke
  • type 2 diabetes
  • high blood pressure
  • depression
  • Down’s syndrome
  • mild cognitive impairment (MCI) – early memory and thinking problems considered worse than those associated with normal ageing.

Each year, 5-10% of people who receive a diagnosis of mild cognitive impairment (MCI) in the clinic or in research studies go on to develop dementia. However some people with MCI find their memory problems do not get worse while others find their memory returns to normal.

For advice on these conditions, you can talk to your doctor or contact us for a list of organisations and support groups that can help.

Head injuries and dementia

Some studies have suggested that a serious head injury or trauma could increase the risk of developing dementia, while others have not found this link. There is a specific form of dementia associated with damage from repeated head traumas, called dementia pugilistica. This condition is believed to affect around 20% of retired professional boxers. Outside the boxing ring, the term chronic traumatic encephalopathy (CTE) is used to describe long-term neurological side-effects of repeated head injuries sustained in any context. Several contact sports’ governing bodies are now undertaking research in this area, and have introduced new safety measures in recent years.

Research

Alzheimer’s Research UK has funded over £7.5 million of pioneering research into the prevention of dementia. We are also launching a Prevention Fund to answer the biggest questions in prevention, seed-funding the best ideas. To read more about the studies we are funding, visit our research projects page.

This information was written in July 2015 and is due for review in July 2017.

Please contact us if you would like a version with references.

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