Answers to some common questions about dementia, memory, risk factors and treatments.
It is normal to have questions about dementia and the diseases that cause it. Here we aim to address some of those questions and hope to challenge some common myths and misconceptions.
The word dementia is used to describe a set of symptoms. Dementia is caused by diseases that affect the brain, and the symptoms of dementia can vary a great deal. They can include problems with memory, decision-making, communication, confusion, changes in mood and behaviour, and hallucinations.
Dementia can be caused by a number of different diseases, with Alzheimer’s disease being the most common. Other causes of dementia include vascular dementia, dementia with Lewy bodies and frontotemporal dementia. In some cases, a person’s dementia is caused by more than one disease, such as Alzheimer’s disease and vascular dementia. This is often called mixed dementia. You can contact us or speak with your doctor for more information about the different causes of dementia, or read more here.
Most of us forget things every day, like people’s names or where we put our keys, but this is not necessarily a sign of dementia. In dementia, memory loss is more serious than forgetting things every now and then. It is memory loss that starts to interfere with everyday life, for example getting lost when going to the local shop.
There are many reasons why people experience memory problems. Some medicines and drugs can affect memory. Depression, anxiety, stress, vitamin deficiency, infections and thyroid problems can also make people forgetful. If you are worried about your memory and it’s getting worse, or getting in the way of everyday life, then you should talk to your doctor.
Dementia becomes more common as people get older. Many of us will have a relative living with the condition – but this does not mean we will develop it too. Most of the time the genes passed down from our parents will only have a small effect on our risk of developing dementia. Our likelihood of developing dementia will usually depend on our age and lifestyle, as well as the genes we have.
In rare cases, someone may inherit a gene that directly causes a specific type of dementia. Some rare types of early-onset Alzheimer’s and frontotemporal dementia are caused by faulty genes which run in families. Directly inherited dementia accounts for just 1% of all dementia cases with symptoms often starting in a person’s 40s or 50s. For more information, visit ‘Genes and dementia’.
No, but most people with dementia are over the age of 65. In the UK over 42,000 people with dementia are under 65, around 5% of everyone affected. Many of these people are likely to be in their 50s or early 60s but some rare types of dementia can affect people even younger. This is called early- or young-onset dementia.
Although it may feel more common, the incidence of dementia (number of new cases in the population) is actually falling. This is believed to be due to people leading healthier lifestyles. However, prevalence of dementia (number of people with dementia in the population) is increasing. This is due to a few factors, such as longer life expectancy and a change in attitude and understanding of dementia. This means people may be more likely to go to their doctor about memory problems.
A higher prevalence can make it seem as though dementia is ‘on the rise’ when in fact rates are decreasing. However, due to increased life expectancy and increases in conditions like obesity and diabetes which are risk factors for dementia, it is possible we’ll see an increase in both incidence and prevalence in the future.
Yes. In the UK, 65% of people with dementia are female and 35% are male. This is mostly because women tend to live longer than men and as dementia becomes more common as we age, there are more women to develop the condition. Research is underway to investigate whether men and women may have different risk factors for the condition.
At the moment, screening the population for dementia does not happen. This is mainly because there is no simple and accurate way to identify people with early dementia. There is also not yet enough evidence to suggest that screening people who don’t have concerns about their memory is beneficial to them in the long term.
Scientists have found changes in the brain of people with Alzheimer’s disease up to 20 years before symptoms start. Researchers are working hard to find a way to detect these changes to allow for earlier and more accurate diagnosis. Being able to diagnose dementia as early as possible means that new treatments are likely to work more effectively, slowing down the disease progression and helping to preserve people’s memory and function for longer.
Questions about risk
A risk factor is something that increases your likelihood of getting a disease. Your risk can be affected by things you can’t control such as your age and your genetics. However, factors you can change such as how active you are or whether you smoke can also alter your risk.
The biggest risk factor for developing dementia is age. The older you are the more likely you are to develop the condition. Over half of the people with Alzheimer’s disease in the UK are over the age of 90, but it is important to know that dementia is not a normal part of ageing.
There is currently no known way to prevent dementia. However, we do know some of the risk factors for the condition are within our control. These risk factors are the same as for cardiovascular disease, like heart disease and stroke. By leading a healthy lifestyle and doing regular exercise you will be lowering your risk of cardiovascular disease and you will lower your risk of developing dementia too.
To keep your heart and brain healthy:
- don’t smoke
- control high blood pressure
- keep active and exercise regularly
- maintain a healthy weight
- eat a healthy balanced diet
- drink fewer than 14 units of alcohol per week.
- keep cholesterol at a healthy level.
Have regular appointments with your doctor or practice nurse to monitor your cholesterol and blood pressure. This is especially important from mid-life onwards.
Research suggests it may be particularly important to keep healthy in mid-life to maintain good brain health and to lower your risk of dementia. For more information, visit ‘Reducing your risk of dementia’.
Questions about diet
A balanced diet is an important way to keep healthy. This should include eating:
- plenty of fruit and vegetables
- starchy foods like potatoes, pasta, rice, and bread
- some milk and other dairy foods
- some meat, fish, eggs, beans, and other non-dairy sources of protein
- but limiting food that is high in fat and sugar.
Eating healthily is also important for people with dementia. Dietary deficiencies and dehydration may worsen a person’s symptoms and contribute to poor health.
There is some growing evidence to suggest that certain diet patterns, such as the Mediterranean diet, may be protective for the brain and reduce the risk of developing dementia. A Mediterranean diet involves lots of fruit, vegetables, oily fish, and nuts. It is low in processed, and red meats, alcohol, and simple carbohydrates like white bread. Research is still ongoing in this area.
Oily fish, which contains omega-3 fatty acids, is an important part of a healthy diet. Some studies have linked higher omega-3 intake with a lower risk of developing dementia. However, current evidence does not support the use of omega-3 supplements to prevent memory and thinking problems.
Saturated fats found in processed meat, dairy and fried foods are linked to poor cardiovascular health. Having poor cardiovascular health increases your risk of developing dementia, and a range of other health conditions.
Fats found in oily fish, nuts, olive oil and avocados are called poly and monounsaturated fats. These can be enjoyed as part of a healthy balanced diet in moderate amounts. However, there is no evidence to suggest that consuming high levels of these fats plays a protective role against the development of dementia.
These natural products are believed to have anti-inflammatory properties which may mean they are protective against inflammation in the brain. Research results so far have been mixed. The products are being studied in early-stage research to see if they can help, but there is currently no conclusive evidence that they could prevent or treat dementia.
The NHS lower-risk guidelines recommend that both men and women drink no more than 14 units of alcohol a week, spread over three or more days. Regularly drinking more than this increases your risk of developing dementia by around 17% according to recent studies.
Very heavy drinking causes alcohol-related brain damage (ARBD), a group of conditions including Wernicke-Korsakoff syndrome and alcoholic dementia.
The UK Chief Medical Officer advises that even drinking within the recommended limits can cause a low risk of harm to general health, from diseases including cancer, stroke, and liver disease.
High levels of the amino acid homocysteine have been linked to an increased risk of Alzheimer’s disease. Certain B vitamin deficiencies, such as vitamin B12 and folic acid, can cause high homocysteine levels if left untreated.
If you are concerned you have a B vitamin deficiency, which can cause similar symptoms to dementia, you can ask your doctor for a blood test. The latest evidence suggests that while supplements of folic acid and vitamin B12 can reduce homocysteine levels, they do not affect memory and thinking skills in healthy older people.
One study showed that high doses of folic acid and vitamin B12 could slow brain shrinkage in people with early memory problems and high homocysteine, but there is currently not enough evidence to suggest that B vitamin supplements will slow the onset or progression of dementia.
Questions about metals
Despite occasional publicity, there is no convincing evidence that everyday exposure to aluminium increases the risk of developing Alzheimer’s disease or other causes of dementia. During the 1960s and 1970s, aluminium was suspected as a cause of Alzheimer’s, but since then studies have failed to confirm a direct connection. The amount of aluminium we are exposed to on a day-to-day basis is so low, our bodies can safely remove this, and it is not thought to pose any threat.
Small amounts of metals, including mercury and aluminium are often found in vaccines as an adjuvant. An adjuvant improves how well the vaccine works. There has been extensive research into the safety of these vaccines. There is no evidence to suggest that the trace amount of metals in vaccines have any long-term health effects. Recent research has even found that people who receive the flu vaccine have a lower risk of Alzheimer’s disease.
Questions about keeping active
Regular physical activity has many health benefits. It helps to lower and maintain healthy blood pressure, which is good for heart health, and reduces the risk of stroke. It also helps you keep your weight in check, which will reduce 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, obesity and diabetes are known risk factors for dementia. Therefore, staying active may not only help maintain a healthy body, but has knock-on benefits for our brain health too.
Mentally-stimulating activities may include doing crossword puzzles or Sudoku, learning a new skill, or taking up a new hobby. It’s not clear which, of these things could be most beneficial, but it’s a good idea to do things you enjoy to keep your mind active.
Several studies have suggested a link between mentally-stimulating activities and a lower risk of dementia. Other studies have found that spending more time in education is associated with a lower risk. Research is ongoing in these areas to see which activities might be most beneficial.
Other medical conditions and dementia
There is evidence that the following conditions can increase the risk of dementia:
- Parkinson’s disease
- type 2 diabetes
- high blood pressure
- recurrent depression
- Down’s syndrome
- early memory and thinking problems known as mild cognitive impairment or MCI.
For advice on these conditions, you can talk to your doctor or visit out page ‘Support for people affected by dementia’ for a list of organisations that can help.
Research has found that a serious head injury or trauma may increase the risk of developing Alzheimer’s disease and other types of dementia. Mild or repeated head injury, such as a concussion or through playing contact sports, has also been linked to an increased risk of dementia. Research is ongoing in this area to understand more about the relationship between head injuries and dementia.
Statins are used to treat high cholesterol. High cholesterol levels have been linked to an increased risk of developing dementia, particularly vascular dementia, and Alzheimer’s. However, recent large trials have not provided evidence that statins could prevent dementia. If you are concerned about high cholesterol, you can discuss with your doctor about having a blood test.
Anticholinergic drugs are a family of drugs which can be used to treat allergies, bladder disorders, depression and more. Some research has found that taking multiple anticholinergic drugs for a prolonged period, more than three years, may increase someone’s risk of developing dementia. Further research is needed to investigate this relationship, and if you are concerned about the medicines you take, you can speak with a pharmacist or doctor.
This is not recommended. Medicines known as non-steroidal anti-inflammatory drugs (NSAIDs), which include aspirin and ibuprofen, have been tested to find out whether they could reduce Alzheimer’s risk. Clinical trials have found no evidence that low-dose NSAIDs can prevent dementia. There are also concerns about side-effects, so it is not advised to take these drugs to protect against Alzheimer’s.
If you are worried about your health or memory, you should discuss it with your doctor who will listen to your concerns, organise tests, offer advice and refer you to a specialist if necessary.
You can also visit our page Support for people affected by dementia to find contact details of organisations that can help you with practical and emotional support.
This information was updated in November 2020 and is due for review in November 2022.
Please contact us if you would like a version with references.