Steps to Prevent Dementia
What are you doing to prevent dementia? Yes, you can reduce your risk!
An influential report, the Lancet Commission Report of Dementia Prevention, updated in 2024, details 14 risk-reducing steps. I have 3 steps to add to that list.
Why bother?
Dementia is a big problem that you don’t want to get:
- It affects a large number of people, and it is devastating. Over age 65, there are 1 in 14 people with dementia, and for over 80’s it rises to 1 in 6.
- Women are twice as likely to suffer.
- Dementia is currently the most important contributor to death in the United Kingdom, ahead of heart disease and stroke.
What do you need to do?
Tackle the problems: these 17 risk factors are all modifiable and allow you to reduce your risk of dementia by at least 50%, and at the minimum, delay the onset. Worth doing, don't you think? Addressing some personal weaknesses, keeping slim and active with all your health issues under optimum control will make the difference.
Some Detail on the 14 topics
- Poisons [2]: smoking and excess alcohol consumption. Cut out the cigarettes
altogether [lots of NHS help available if you need it]. Alcohol, have one or two alcohol-free days a week, drink in moderation, no
binges.
- Social isolation [3]: deafness and sight loss and
limited social contact increase risk via social isolation. Get your hearing
tested! Use a hearing aid, treat cataract and other sight issues, without
delay. Take on new social engagements, memberships or volunteering so you are
out doing something at least 3 days a week.
- ‘Lifestyle’ medical issues
[3]: these three are obesity, depression and inactivity.
You need to act and your Dr can help with the first two. Starting a structured
and supported exercise regimen [do something daily] will boost mood and be the
simplest and most effective anti dementia strategy of all. If you can have
supervision from a Personal Trainer you will double your effectiveness. For
advice on now to start exercise see this blog post "Exercise - The New You" [https://vitalitashealth.blogspot.com/2023/01/exercise-new-you.html].
- ‘Major’ metabolic problems
[3]: high cholesterol, specifically LDL
cholesterol [the risk is better measured by Apo B concentration if available];
raised blood pressure; prediabetes or diabetes. All are restorable to fit young
person levels with medication, exercise and diet and a degree of persistence.
- Public Health matters [3]: Head injury, air pollution and having had a poor education. Too
late for sure to avoid heading footballs or playing competitive rugby but you
might be able to move to the country and do some late life learning.
- What are the extras I
suggest? Hormones, shingles protection and oral
health work with microbiome restoration.
HRT for women and TRT for men both show preliminary evidence of protective effect. A large study published in 2021 showed HRT was associated with reduced risk of all neurodegenerative diseases including AD and dementia, with greater duration of therapy and natural steroid formulations associated with greater efficacy [i]. A review of TRT establishes that low testosterone is a risk factor for dementia [ii]. There is sufficient background to make this a credible proposition in both sexes. As yet proof of benefit from treatment in susceptible or affected individuals is not available because intervention studies have not been done.
For infection, there is evidence that severe infection increases dementia [iii] and interestingly, use of the live attenuated Shingles vaccine reduces the risk [iv]. Data from three large independent studies of women and men showed that shingles infection was associated with higher long-term risk of cognitive decline , and the risk may differ by APOE ε4-carrier status [v].
The oral microbiome. See this blog post "Not Just Bad Breath!" [https://vitalitashealth.blogspot.com/2023/04/not-just-bad-breath-your-oral.html]. There is a clear association between poor oral hygiene and AD [vi]. Visit a hygienist for an objective view of how you are doing and advice on doing better. - Is there anything else novel? Recently it has become clear that GLP-1 inhibitors [the weight
loss drugs such as Ozempic and Mounjaro] significantly reduce dementia
occurrence. A review establishes that these are effective but antidiabetic
drugs are not [vii].
More about dementia
Is it genetically determined?
Want help working on reducing your dementia risk ? Book a coaching session.
[i] Kim YJ, Soto M, Branigan GL,
et al. Association between menopausal hormone therapy and risk
of neurodegenerative diseases: Implications for precision hormone
therapy. Alzheimer's Dement. 2021; 7:e12174. https://doi.org/10.1002/trc2.12174
[ii] Yeap BB, Flicker L. Testosterone, cognitive decline and dementia in
ageing men. Rev Endocr Metab Disord. 2022 Dec;23(6):1243-1257. doi:
10.1007/s11154-022-09728-7. Epub 2022 May 28. PMID: 35633431; PMCID:
PMC9789006.
[iii] Hospital-treated infectious diseases and the risk of dementia: a
large, multicohort, observational study with a replication cohort Sipilä, Pyry
N et al.The Lancet Infectious Diseases, Volume 21, Issue 11, 1557 - 1567
[iv] Taquet, M., Dercon, Q., Todd, J.A. et al. The
recombinant shingles vaccine is associated with lower risk of dementia. Nat
Med 30, 2777–2781 (2024).
https://doi.org/10.1038/s41591-024-03201-5
[v] Yeh, TS., Curhan, G.C., Yawn, B.P. et al. Herpes
zoster and long-term risk of subjective cognitive decline. Alz Res
Therapy 16, 180 (2024).
https://doi.org/10.1186/s13195-024-01511-x
[vi] Borsa L, Dubois M, Sacco G, Lupi L. Analysis the Link between
Periodontal Diseases and Alzheimer's Disease: A Systematic Review. Int J
Environ Res Public Health. 2021 Sep 3;18(17):9312. doi: 10.3390/ijerph18179312.
PMID: 34501899; PMCID: PMC8430572.
[vii] Seminer A, Mulihano A, O’Brien C, et al. Cardioprotective
Glucose-Lowering Agents and Dementia Risk: A Systematic Review and
Meta-Analysis. JAMA Neurol. 2025;82(5):450–460.
doi:10.1001/jamaneurol.2025.0360
No comments:
Post a Comment