Lowering the Incidence of Dementia.
by Steven Sandberg-Lewis, ND, DHANP
Dementia is a general term for the impaired ability to remember, think, or make everyday decisions. Alzheimer’s disease is the most common type of dementia. It mostly affects older adults but it is not part of the normal aging process.
Some changes seen in people who are developing dementia include forgetting the name of close friends and family and important events in their past, not knowing the word for common objects, getting lost in places that are familiar and not being able to complete simple tasks of daily living.
In the U.S.A it is projected that dementia will affect nearly 14 million people over the age of 65 by 2060. Dementia is rising more in low-income and middle-income countries than in high-income countries due to the presence of more modifiable risk factors.
Previously, there were nine well researched risk factors for dementia. An article published in the September 2023 edition of The Lancet, a prestigious British medical journal, added three newly recognized modifiable risk factors:
New evidence supports adding three modifiable risk factors—excessive alcohol consumption, head injury, and air pollution—to our 2017 Lancet Commission on dementia prevention, intervention, and care life-course model of nine factors (less education, hypertension, hearing impairment, smoking, obesity, depression, physical inactivity, diabetes, and infrequent social contact).
The research was done in Australia and suggests that improving the 12 risk factors could prevent or delay up to 40% of dementias. Below are their specific recommendations for prevention:
Aim to maintain systolic BP of 130 mm Hg or less in midlife from around age 40 years (antihypertensive treatment for hypertension is the only known effective preventive medication for dementia).
Encourage use of hearing aids for hearing loss and prevent or at least reduce hearing loss by protection of ears from excessive noise exposure.
Reduce exposure to air pollution and second-hand tobacco smoke.
Prevent head injury. (I would add – treat traumatic brain injury with neurofeedback and high dose fish oil).
Limit alcohol use, as alcohol misuse and drinking more than 21 units weekly increase the risk of dementia.
Avoid smoking uptake and support smoking cessation to stop smoking, as this reduces the risk of dementia even in later life.
Provide all children with primary and secondary education.
Reduce obesity.
Prevent diabetes. (I would add – treat it to either reverse type 2 diabetes or manage blood sugars well to protect the blood supply to the nervous system.)
Sustain physical activity throughout lifespan.
Addressing other risk factors for dementia, like sleep, through lifestyle interventions, will improve general health.
Tackle inequality. Many risk factors cluster around inequalities, which occur particularly in Black, Asian, and minority ethnic groups and in vulnerable populations. Examples include creating environments that have physical activity as a norm. Reduce stressors and improve nutrition to improve blood pressure. Create more peaceful environments, reducing stress and excessive noise exposure.
Recognize depression as a risk factor which is in part related to promoting social engagement and avoiding social isolation.
Acting promptly on these guidelines for dementia prevention, intervention, and care is essential to improve brain health. This is important for those over 65, their families, and society in general.
Sources:
https://www.cdc.gov/aging/dementia/index.html
Livingston G, et al. Dementia prevention, intervention, and care : 2020 report of the Lancet Commission. Lancet. 2020 Aug 8;396(10248):413-446. PMID: 32738937
See RS et al. Potentially modifiable dementia risk factors in all Australians and within population groups: an analysis using cross-sectional survey data. Lancet Public Health. 2023 Sep;8(9):e717-e725. PMID: 37633680
Steven Sandberg-Lewis, ND, DHANP, has been in clinical practice since his 1978 graduation from NUNM. He has been a professor since 1985, teaching a variety of courses but primarily focusing on gastroenterology and GI physical medicine. He is the author of Let’s Be Real About Reflux - Getting to the Heart of Heartburn and the textbook CLINICAL GASTROENTEROLOGY, available on all online bookstores such as Powell’s.
Hive Mind Medicine blog posts are for educational purposes only and are not intended as medical advice. Please consult with your health care practitioner for personalized guidance.