Reduce your risk of dementia

Many of us know about Chris Hemsworth – best known for his movie star role of the superhero character, Thor. (Think long blonde hair, chiseled jaw, and giant mallet) Recently, I saw headlines about his documentary where he discovered he had two copies of apolipoprotein E (APOE) e4 gene, which is linked to an increased risk of Alzheimer’s disease. The APOE gene is responsible for producing a protein that carries cholesterol and other fats throughout your blood stream.

I can imagine the worry he must have felt after finding he had two of these alleles. However, there is positive news – knowing that he carries these two alleles, he can make lifestyle changes now that can reduce the risk of developing Alzheimer’s disease. The time to make these adjustments is NOW when you are in your 40s-60s – not when you have a diagnosis of Alzheimer’s disease.

Firstly, what is dementia? What is the difference between Alzheimer’s and dementia?

Dementia is a general, umbrella term used to describe a group of neurodegenerative conditions that are characterized by a worsening cognitive ability that can interfere with a person’s ability to function from day-to-day. Different types/causes of dementia include Alzheimer’s disease, vascular dementia, Lewy Body’s dementia etc. Alzheimer’s disease is the most common type of dementia and is caused by the buildup of a protein called amyloid beta that can ultimately cause cell death. People with Alzheimer’s disease have significant memory problems (difficulty learning new information), language and eventually loss of function.

Alzheimer’s disease is a devastating disease, but there has been growing evidence suggesting that there are modifiable risk factors – changes we can make to improve brain health that you can start in midlife - way before the thought of even having Alzheimer’s enters your mind. In other words, there are things you can do to delay or even prevent the risk of developing dementia in the future. In 2020, the Lancet Commission on Dementia Prevention and Care showed that there several modifiable risk factors suggesting that up to 40% of dementia cases could be prevented through lifestyle changes. Some of these include:

Cardiovascular risk – Having medical conditions such as hypertension, obesity, high cholesterol, and diabetes can increase a person’s risk of developing dementia. However, lifestyle changes including consistent exercise/physical activity, and improving nutrition can help.

Depression – Clinical depression can include debilitating symptoms such as low mood, fatigue, loss of motivation, changes in sleep/appetite, and feelings of hopelessness that can cause significant distress and affect relationships and work/school. Additionally, many people with clinical depression find themselves socially isolated, which is also a risk factor for dementia. Psychotherapy and medications may help alleviate depression.

Sleep – Additionally, other studies also determined the importance of sleep and its impact on cognition. Conditions like sleep apnea (when untreated) may also increase the risk of dementia. Cognitive Behavioral Therapy for insomnia (CBT-i) is considered a “first line” treatment to address sleep difficulties by targeting perpetuating factors that contribute to poor sleep. Practicing good sleep hygiene (and using your bipap or cpap machine when recommended by your doctor) can greatly improve your sleep and brain health in the long run.

Managing these conditions can greatly reduce dementia risk and promote good brain health.

Livingston, G., Huntley, J., Sommerlad, A., Ames, D., Ballard, C., Banerjee, S., Brayne, C., Burns, A., Cohen-Mansfield, J., Cooper, C., Costafreda, S. G., Dias, A., Fox, N., Gitlin, L. N., Howard, R., Kales, H. C., Kivimäki, M., Larson, E. B., Ogunniyi, A., Orgeta, V., … Mukadam, N. (2020). Dementia prevention, intervention, and care: 2020 report of the Lancet Commission.  Lancet (London, England) ,  396 (10248), 413–446. https://doi.org/10.1016/S0140-6736(20)30367-6

Livingston, G., Huntley, J., Sommerlad, A., Ames, D., Ballard, C., Banerjee, S., Brayne, C., Burns, A., Cohen-Mansfield, J., Cooper, C., Costafreda, S. G., Dias, A., Fox, N., Gitlin, L. N., Howard, R., Kales, H. C., Kivimäki, M., Larson, E. B., Ogunniyi, A., Orgeta, V., … Mukadam, N. (2020). Dementia prevention, intervention, and care: 2020 report of the Lancet Commission.  Lancet (London, England) ,  396 (10248), 413–446. https://doi.org/10.1016/S0140-6736(20)30367-6

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