The statistics on Americans with dementia, particularly Alzheimer's disease, are extremely sobering: The CDC has reported that the overall rate of deaths from dementia has more than doubled in less than two decades, especially among the elderly. In 2017 there were 261,914 American deaths from dementia – and nearly half of those were due to Alzheimer’s disease. One of those deaths was my mother’s, so this is a topic that means a lot to me personally as well as professionally.
The brightest ray of light through this dark cloud can be found in the brain’s plasticity, and how to use that to change certain risk factors for Alzheimer’s. There is no guarantee that any individual can prevent Alzheimer’s disease, but you can change your odds. I have long been convinced that living a brain-healthy life will lead to improved overall health in old age – and that includes cognitive health.
I recently talked with Dr. Richard Isaacson on my podcast, This Is Your Brain With Dr. Phil Stieg. Dr. Isaacson is a neurologist who is one of the world’s top experts on Alzheimer’s, and he is the founder and director of the Alzheimer’s Prevention Clinic here at NewYork-Presbyterian Weill Cornell Medicine. (Listen to that episode below to hear what he has to say about distinguishing between "senior moments" and signs of dementia.) Earlier this year his team published an article in the academic journal Frontiers in Neurology called Alzheimer's “Prevention” vs. “Risk Reduction:” Transcending Semantics for Clinical Practice.
The paper describes risk factors that no one can change: You may have a heightened risk for Alzheimer’s due to your family history and genetics, which are beyond your control, and much as you might like to you can’t change your age – and the older you are, the greater your risk. But there are other risk factors that you can change.
I was pleased to read that so many of those modifiable risk factors are the same brain-healthy habits I’ve been advocating for years. Dr. Isaacson’s paper lists seven of these modifiable risk factors:
- Smoking. The evidence is overwhelming that smoking is a terrible habit, not only for your heart and lungs but also your brain. The fact that so many people smoke despite the known dangers is an indicator of just how addictive it is. It’s worth the effort to find a smoking cessation program, or talk to your doctor about finding help quitting.
- Midlife obesity. If your body mass index (BMI) is greater than 30 in middle age, you are at increased risk for dementia when you’re older. Calculate your BMI here – if your score is over 30, take steps to get your weight down into a safe range. Download my Guide to Optimal Brain Health for help improving your nutrition.
- Physical inactivity. Earlier generations walked a lot more than we do now – we don’t even have to get off the couch to make a phone call or change the TV channel. A 2010 study showed that walking 72 blocks a week – that’s just about 10 blocks a day – increased the volume of gray matter in the brain; greater gray matter volume reduced the risk for cognitive impairment twofold.
- Low educational attainment. Neuroscientists have been talking for several decades about the concept of a “cognitive reserve” that can delay the onset of dementia. Those individuals with higher educational levels, or who are intellectually curious and continue to learn throughout adulthood, show fewer symptoms of cognitive decline, starting later, than those who are less well educated or less interested in lifelong learning.
- Diabetes mellitus. Good nutrition is so closely allied with brain health that some scientists are now referring to Alzheimer’s as Type 3 Diabetes. If you already have Type 2, you are at greater risk for later dementia so be sure to keep your blood sugar under control. If you don’t have diabetes, make the lifestyle changes you need to reduce your risks for it.
- Hypertension. Just about everything you do to improve your heart health is also good for your brain. Likewise, anything that puts your heart at risk is also bad for your brain. High blood pressure is called “the silent killer” because it often has no symptoms – so have yours checked, and keep it under control.
- Major depressive disorder. Granted, you can’t help it if you become depressed – and those in the midst of a depressive episode are often ill equipped to reach out for treatment. If you have a history of depression, or if you have a loved one prone to depression, you need to be hyper-aware of the signs of an encroaching episode. There are effective treatments for depression, and they not only make patients feel better now, but they can help stave off dementia later.
Dr. Isaacson’s data suggest that when all seven of these risk factors are addressed, there can be a 30 percent reduction in the incidence of dementia. In medicine, a 30 percent change is quite remarkable – and when we find anything that makes such a significant a change in the risk of dementia, it’s worth paying attention.
