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. This section aims to outline some of these risk factors, and how we may be able to reduce our risk of developing the condition.

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 smoking, diet and not getting enough exercise, which you could try to do something about.

We know that many people live a healthy and active life but still develop dementia. However, research suggests that some cases of dementia could be avoided by helping people address health and lifestyle factors.

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 19 in 100 for those aged 85 to 89.

In most cases, it is likely that our age, genes, medical history and lifestyle all contribute to our risk of dementia. Certain black, Asian and minority ethnic (BAME) groups may be more likely to develop dementia than others.

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 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 steps we can all take to help lower our risk.

Risk factors for cardiovascular disease (like heart disease and stroke) are also risk factors for dementia, so what is good for your heart is good for your brain. 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 Chief Medical Officers’ guidelines
  • keep cholesterol and blood pressure at a healthy level.

Maintaining a healthy lifestyle in your forties and fifties seems to be particularly important for helping to lower your risk of dementia.

NHS Health Checks

The NHS Health Check is a free check-up of your overall health. It can help you reduce your risk of developing heart disease, diabetes, kidney disease, stroke and dementia. If you are aged 40-74 and do not already have any of these conditions, you will be invited for a check-up every five years.

At the NHS Health Check, a doctor or nurse will:

  • ask you some simple questions about your lifestyle and family history.
  • measure your height and weight.
  • check your blood pressure and cholesterol levels.

The doctor or nurse will go through the test results with you and give you advice to help you stay healthy.

If you are outside the age range and worried about your health, you can request a health check-up at your doctor’s surgery.  You can find more information at www.nhs.uk/nhshealthcheck

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.

Getting expert help from your local stop smoking service can boost your chances of success by up to four times. The NHS Smokefree National Helpline is free to call on 0300 123 1044, or you can talk to your GP for advice. You can find out more at www.nhs.uk/smokefree

It’s never too late to stop smoking. Quitting greatly improves your chances of enjoying a disease-free, healthy old age.

Keeping physically active

Regular physical activity can have many health benefits, including the prevention and management of over 20 long-term 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.

Being active needn’t mean going to the gym or running a marathon. 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.

There are many ways to build physical activity into your weekly routine.  Just getting off the bus a stop or two earlier 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!

You can find lots of ideas and information on the NHS Choices website or ask your doctor 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. Others have linked spending more time in education with a lower risk. It’s not clear which activities may be most beneficial but it’s a good idea to do things you enjoy, whether that’s reading, tackling the crossword or playing an instrument.

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.

Healthy eating

Use the Eatwell Guide to help you get the balance right. It shows how much of what you eat should come from each food group.

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

Foods like sausages and other processed meats, butter and cakes are high in saturated fat. This can raise cholesterol levels and cause you to put on weight, 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. Try to eat sugary snacks such as sweets, chocolate, cakes and fizzy drinks 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 doctor’s surgery if you need advice about healthy eating.

Drinking alcohol

If you drink alcohol there are many good health reasons to keep your consumption low. Alcohol is linked to a number of medical conditions including cancer.

For your overall health, the best advice is to follow the Chief Medical Officers’ low-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, but also have alcohol-free days each week.

While there is little evidence that alcohol causes Alzheimer’s disease, it is linked with other types of dementia. Long-term heavy drinking is known to cause alcohol-related dementia, including Wernicke-Korsakoff Syndrome (WKS). WKS is caused by a lack of vitamin B1. Early treatment with this vitamin can reverse the symptoms, but without treatment the condition can lead to permanent memory loss. If you are concerned, talk to your GP for advice.

Units-cropped

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 most 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 £8.3 million of pioneering research into the prevention of dementia. We have also launched a Prevention and Risk Reduction Fund to answer the biggest questions in prevention. To read more about the studies we are funding, visit our research projects page.

This information was written in July 2017 and is due for review in July 2019.

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

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