Dementia - reducing your risk

Dementia cannot yet be prevented or cured, but the choices you make in midlife can help to keep your brain healthy as you age. Research shows that those who adopt a ‘brain healthy’ lifestyle have a reduced risk of dementia in later life.

Living a brain healthy lifestyle is particularly important once you reach middle age, as this is when changes in the brain start to occur.

Changes in the brain that cause dementia may start decades before symptoms appear. This means it is important to look after your brain throughout your life. It’s never too late – or too early – to live a brain-healthy lifestyle, as brain function can be improved at any age.

Risk factors for dementia

Some risk factors for developing dementia, such as getting older and your inherited genes, cannot be controlled. So it is important to do what you can with the things you can control, such as your lifestyle and habits.

Understanding the risk factors for developing dementia can help you to make decisions about potential strategies for risk reduction. Risk factors can be separated into a number of groups.

Risk factors that cannot be controlled

The non-modifiable risk factors include:

• age – the incidence of Alzheimer’s disease increases with age, with one in 30 Australians aged 70 to 74 years estimated to have dementia, increasing to one in eight aged 80 to 84 years and one in three of those aged 90 to 94 years
• genetics – the genetics of dementia is not fully understood, but there are inherited genes in some forms of dementia, including familial Alzheimer’s disease, Down syndrome and familial frontotemporal dementia.

Brain risk factors that can be controlled

The modifiable brain risk factors include:

• mental activity – regularly challenging your brain with mentally stimulating activities through education, occupation or leisure is linked with lower risk of cognitive (memory and thinking skills) decline and dementia
• social activity – participating in social activities and being connected with your community, family and friends is linked with a lower risk of dementia.

Body risk factors that can be controlled

The modifiable body risk factors include:

• alcohol – too much alcohol can damage your brain and lead to an increased risk of developing dementia
• diet – the available evidence suggests a healthy diet can play a role in promoting brain health
• physical activity – regular physical exercise is associated with better brain function and reduced risk of cognitive decline and dementia.

Heart risk factors that can be controlled

The modifiable heart factors include:

• Blood pressure – untreated high blood pressure is associated with an increased risk of developing dementia. Effective long-term treatment can reduce dementia risk
• Body weight – obesity in midlife is associated with an increased risk of developing cognitive impairment and dementia
• Cholesterol – A history of high cholesterol is associated with an increased risk of developing dementia
• Diabetes – type 2 diabetes in midlife and later is associated with an increased risk of developing cognitive impairment and dementia
• Smoking – smoking is a risk factor for dementia and some studies have shown that a history of passive smoking may also increase dementia risk.

Tips for living a brain-healthy lifestyle

A range of lifestyle and health strategies may keep your brain healthy and reduce your risk of developing dementia.

Exercise your brain

Any activity that involves thinking and learning canimprove your brain health and help protect against dementia. Evidence suggests that greater benefit comes from more complex and challenging mental activities. The more brain activities you do, the more frequently you do them and the more complex the activity, the lower your risk of dementia is likely to be.

The best activities are those that you enjoy – boredom and frustration are not good for your brain. The types of activities include:

• enjoying hobbies like painting, woodwork, sewing or writing
• doing a short course
• doing a jigsaw, crossword, number or word puzzle
• learning to dance, play an instrument or speak a new language
• going to the theatre, movies, museum, gallery or a concert.

Stay socially engaged

Regular and enjoyable interactions with friends, family and others may help reduce your risk of dementia. There are many ways to interact with others, but some suggestions include:

• dancing – enjoy it with others, get some great exercise and use your brain and body to learn new moves
• travelling – also enjoyed with others and usually involving a lot of walking or other physical activities
• volunteering with a local group or your favourite charity
• walking with friends or family
• joining a group such as a book club or walking group
• organising games nights with friends
• taking dancing or singing lessons
• catch up with friends and talk to your neighbour

Avoid excess alcohol consumption

Drinking an excessive amount of alcohol can damage your brain and increase your risk of dementia. Long-term excessive alcohol consumption can cause brain damage and lead to a condition called alcohol-related dementia. It may also increase the risk of Alzheimer’s disease and other dementias.

If you do drink alcohol, do so in moderation. Follow the Australian guidelines to reduce health risks from drinking alcohol. The guidelines recommend no more than two standard drinks per day for both men and women. Every drink above this level increases your lifetime risk of a number of conditions, including dementia.

Some evidence suggests that drinking in moderation might decrease the risk of dementia slightly more than not drinking alcohol at all. Alcohol can increase health risks for people with some conditions, or if they are taking certain medications. More research is needed in this area, so ask your doctor if you have any questions.

Your doctor can give advice about how much alcohol is safe for you and help you to reduce your drinking if you are consuming too much. Your doctor can write you a low-risk drinking prescription (with an individual plan to help you reduce your drinking), prescribe medications or refer you to specialist help if needed.

Enjoy a brain healthy diet

Research suggests the foods that are good for your heart and body may also be good for brain health and protect against dementia. Australian dietary guidelines provide advice about what to include, and avoid, in your healthy diet.

Based on current evidence, nutritionists recommend that you:

• Eat a variety of foods, including fruits and vegetables, to ensure adequate nutrient intake.
• Reduce your intake of saturated fats by choosing fish, lean red meat, chicken without skin and reduced-fat dairy products. Limit butter, deep fried foods, pastries, cakes and biscuits.
• Choose unsaturated fats such as olive, canola, sunflower and safflower oils.
• Consider including foods rich in omega-3 fats in your diet, such as soy, canola and flaxseed oils, and fish.

Stay physically active

People who are physically active have a lower risk of heart disease and stroke. These conditions are both associated with an increased risk of developing dementia.

Research suggests that even small amounts of exercise (including simple exercise like walking) seem to be good for brain health and protects against dementia. Any physical activity you can build into your daily routine will help.

The National physical activity and sedentary behaviour guidelines for Australian adults recommends at least 30 minutes of moderate-intensity physical activity on most, preferably all, days to achieve health benefits. For general fitness, the most important types of activity are aerobic training, resistance or weight training, and flexibility exercises.

The type and amount of exercise you are able to do will depend on your age, physical capability, level of fitness and any medical conditions you have. Make sure to get advice from your doctor on what is the best program of activity for you. If you’ve been inactive, start slowly and gradually build up as you get fitter.

Examples of activities include:

• brisk walking
• cycling
• dancing, aerobics or yoga
• swimming, rowing or surfing
• golf or bushwalking
• gardening, washing the car.

The National physical activity and sedentary behaviour guidelines for Australian adults suggest that you:

• are active every day in as many ways as you can
• think of movement as an opportunity, not an inconvenience
• incorporate movement and activity into your normal daily routine
• are active with a friend or family member
• choose activities you enjoy
• if you can, enjoy regular vigorous exercise for extra health and fitness.

Your doctorcan advise you on what type and level of physical activity is best for you. They can write you a physical activity prescription and provide regular follow-up to help you maintain your program.

Look after your heart

Research shows that people who have high blood pressure, high cholesterol, diabetes, or are obese, particularly around middle age, have a greater risk of developing dementia later in life. Leaving these conditions untreated can lead to damaged blood vessels in the brain, which in turn damages brain cells and leads to impaired thinking functions.

Although there are no guarantees that keeping your heart healthy will prevent dementia, you will give yourself the best chance of avoiding or delaying dementia.

Promisingly, studies have shown that the treatment of high blood pressure reduces that risk. Other studies indicate that treating high cholesterol and diabetes may also reduce the risk of developing dementia, although more research is needed in this area.

It is recommended you have regular check-ups to assess your:

• blood pressure – effective long-term treatment of high blood pressure can reduce dementia risk, so all adults, especially once they reach middle age, should have their blood pressure regularly checked by their doctor
• body weight – research shows that people who are obese in midlife are more likely to develop dementia compared to those of normal body weight so, to reduce the risk of dementia, all adults should try to maintain a healthy body weight
• cholesterol – even mildly elevated cholesterol is associated with increased risk of dementia, so it is important to do everything you can to keep your cholesterol in the healthy range
• blood sugar levels – high blood sugar is an indicator of type 2 diabetes that can increase your risk of dementia
• smoking – is a risk factor for dementia so, if you smoke, try to quit and avoid other people’s smoke.

To reduce your risk of dementia, you should have regular check-ups with your doctor, especially at midlife, and always follow the advice of your doctor.

Protect your head against injury

Head injury, particularly severe injury (causing unconsciousness for an extended period of time) is a risk factor for the development of Alzheimer’s disease.

Avoid head injury by taking care as a pedestrian, wearing seat belts in cars, and using protective headgear when cycling or for high-risk activities.

Where to get help

• Your GP (doctor)
• Your local council
• Your local community health centre
• National Dementia Helpline, Dementia Australia Tel. 1800 100 500
• Aged Care Assessment Services Tel. 1300 135 090
• My aged care Tel. 1800 200 422
• Cognitive Dementia and Memory Service (CDAMS) clinics
• Carers Victoria Tel. 1800 514 845
• Carer Gateway Tel. 1800 422 737
• Dementia Behaviour Management Advisory Service (DBMAS) Tel. 1800 699 799 – for 24-hour telephone advice for carers and care workers