Dementia is sweeping the globe, affecting 5 to 8% of the world’s population over 60 years old. And sadly, those numbers are only growing. But there’s good news: Although there’s no known cure for dementia, there are scientifically proven steps you can take to reduce your risk. A new report by the Lancet Commission outlines 12 modifiable risk factors for dementia, which together account for 40% of dementia cases worldwide. The authors, an international cohort of 28 leading dementia experts, note that this data can help people of all ages. “It is never too early and never too late in the life course for dementia prevention,” they write in the report’s summary.
"This report suggests that many people have the potential to reduce their risk of cognitive decline, and perhaps dementia, through simple, healthful behavior changes,” says Maria Carrillo, Ph.D., chief scientific officer at the Alzheimer's Association in Chicago (who is not affiliated with the report). Plus, she says, these recommendations could help public health experts advocate for policy changes to help prevent dementia on a wider scale.
Here’s how to take action now to preserve your memory in the future.
In early life (under 40):
- Pursue your education (and encourage your children to do so). The authors found that primary and secondary education are important for all children’s brain health and development. “The risk is of low education in early life,” explains Lon Schneider, M.D., report co-author, co-director of the USC Alzheimer Disease Research Center’s clinical core in Los Angeles. “People who leave their formal education before age 15 [or] people who do not graduate high school are those who have a substantial increased risk of dementia occurring earlier in life.”
If this sounds hard to believe, that’s understandable. “It’s pretty hard to wrap your arms around [the fact that] what we’re doing in early childhood actually is effective at preventing dementia 60 years later,” Dr. Schneider says. “That’s conceptually a leap, but it’s pretty true.” Previous research in JAMA found that an increase in educational attainment was correlated with a decline in dementia rates in the early 2000s.
In midlife (40-65):
- Keep an eye on your blood pressure. The new report identifies hypertension in midlife as a risk factor for cognitive decline later on. Want to know if you’re in the green zone? A blood pressure reading below 120/80 mm Hg is within the normal range, according to the American Heart Association. More specifically, this Lancet Commission report notes that a systolic blood pressure of 130 mmHg or lower is sufficient to delay or prevent dementia.
- Avoid hearing loss. Dr. Schneider says you can do this by avoiding situations that contribute to hearing loss (hello, loud concerts every weekend!), or by having your hearing loss diagnosed and mitigated with hearing aids. (PS: Next time you’re out at a loud event, try using hearing protection. The CDC has a guide of which products work best.)
- Maintain a healthy weight. Obesity prevention is another way to prevent memory loss. The CDC recommends keeping track of your BMI, maintaining an active lifestyle (150 minutes a week of moderate intensity exercise), and keeping track of the nutrition content of your foods. If you’re concerned about your weight, your doctor can be a helpful resource to tailor a plan that works for you.
- Moderate your alcohol intake. The report authors found that alcohol consumption should be limited to no more than 21 drinks per week, or 3 per day. For optimal health, keep your consumption even lower – the 2015-2020 Dietary Guidelines for Americans defines moderate drinking as one drink per day for women and two per day for men.
- Avoid head injury. We know what you’re probably thinking: How can I avoid an unpredictable head injury? “Head injury comes about from constantly putting oneself at risk,” Dr. Schneider explains. “Some of that is certain sports, like horseback riding, contact sports, soccer, [or] riding motorcycles.” Need we say it? Wear helmets whenever your sport recommends them!
In later life (65 and older):
- Stop smoking. It’s smart to quit smoking at any age, but for dementia prevention, it’s time to call it quits by the time you reach your mid-60s. Use this CDC-approved list of tips to kick the habit for good. Dr. Schneider hopes this recommendation helps spur broader societal change to lower smoking rates in populations.
- Prevent diabetes or manage it well if you have it. The Alzheimer’s Association notes that there is growing research to suggest a connection between type 2 diabetes and Alzheimer’s disease, with high blood pressure serving as an early warning sign. High insulin levels may also disrupt the complicated chemistry of your brain. If you’re already living with type 2, work with your doctor to keep your disease well-managed and your blood sugar under control.
- Get treatment for depression. Again, this is important at any stage of life, but especially as we age. “Of course, depression, social isolation, physical inactivity should be addressed throughout the lifespan,” Dr. Schneider says. “We’re just putting the dementia piece on this as well.”
- Maintain an active lifestyle. This is especially hard due to COVID-19 quarantine, but you should know that physical inactivity is a risk factor for cognitive decline in older adults. Try to move your body at least once per day, even if it’s just a brisk walk around the block. The U.S. Physical Activity Guidelines for Americans recommend aiming for 150 minutes of moderate intensity exercise per week, along with balance training and muscle-strengthening workouts. If you have a chronic condition that prevents you from moving this much, just try to get as much exercise as your body safely allows.
- Keep up your social circle. Again, this is a tough one due to pandemic safety precautions – but there’s nothing wrong with virtual interactions! A 2020 report from the National Academies of Sciences, Engineering, and Medicine found that one-quarter of community-dwelling Americans aged 65 and older are considered to be socially isolated, and that older adults are more likely to experience effects of chronic illness and sensory impairment due to that isolation. Schedule time to talk on the phone with people you love.
- Minimize your exposure to air pollution. This may also seem like something you have no control over, and that’s somewhat true on an individual level. But Dr. Schneider notes that communities can take action together on this issue. “The pandemic, for example, has demonstrated how in cities, air pollution can be changed dramatically,” he says, referring to the sharp decrease in air pollution following the nationwide shutdown. Advocate within your city and state for better air protection laws to keep citizens safe.
Dr. Schneider hopes these recommendations lead to long-term changes in individual and community behavior. “We hope that healthcare systems, individuals, and policy makers can take these recommendations to heart,” he says. “Individuals need encouragement to mitigate risk, and policy makers need to be able to facilitate this.”
One exciting research project currently underway is the U.S. POINTER study from the Alzheimer’s Association. It’s a two-year clinical trial to evaluate whether specific lifestyle interventions (like those suggested here) can clearly and significantly protect cognitive function. “More research is needed to confirm this hope, and to develop a specific, recommendable ‘recipe’ to prevent cognitive decline and dementia, including Alzheimer’s dementia,” Carrillo says.
Interested in getting involved? Submit your information to find out if you’re a candidate for this study and others like it. You and your family can play a role in helping to stop this disease in its tracks.