Reducing Risk Factors For Dementia

New research suggests that there are actions people can take to improve their health and reduced the likelihood of suffering from dementia. This is in stark contrast to the old thought that dementia was a matter of genetics. The new body of research comes just in time as the baby boomers are beginning to reach their 70’s, the age bracket where dementia is most likely to be diagnosed.

"Now, we've begun to realize in the last 20 years that it looks like we can prevent dementia, to some extent." Dr. Kenneth Rockwood, geriatric medicine Dalhousie University told CTV News.

The Scope

Current worldwide estimates are that some 50 million people live with dementia. The number of dementia cases is expected to hit 152 million by 2050. Here in Canada over half a million Canadians are living with dementia and over 25,000 new cases are diagnosed every year. The current estimate is that by 2031 the total number of Canadians living with dementia is expected to rise to 937,000, an increase of 66 per cent.

As of 2016, the combined health-care system and out-of-pocket caregiver costs are estimated at $10.4 billion per year. 

More Research & Better Diagnosis Are Required

As it stands, the estimate is some 56,000 Canadian are being cared for in hospitals instead of dementia treatment centres. The Standing Senate Committee on Social Affairs, Science and Technology identified the need to increase research budgets as well as training of medical staff. Members of the committee heard estimates suggest that only 50% of dementia cases in the community have been diagnosed. While stigma and fear of the diagnosis partially accounts for this low rate, some witnesses suggested that the medical community could be more proactive in assessing patients as they age. In this regard, the committee heard that regular screening of mental acuity should be considered.

65% Of those diagnosed with dementia over the age of 65 are women

Avoidable Risk Factors for Dementia

Dr. Gill Livingston, a professor of psychiatry of older people at University College London and lead author of a recent research paper published in the Lancet, told CTV News "We've shown that a lot of dementia is potentially preventable and that could give individuals hope of not developing dementia, and also change things for their families and for society,"

Dr. Livingston’s research created a list of avoidable behaviours that were contributing risk factors believed to be responsible for approximately 40 per cent of all dementia cases.

"I think that very few people know that the biggest risk factor for dementia is … hearing loss in mid-life," Dr. Livingston.

Reducing Risk Factors

Dr. Livingston’s research identified several major risk factors that could be prevented. Here are the most significant:

Hearing Loss: most specifically, hearing loss during mid life is a significant risk factor for developing dementia. The suggestion is that hearing loss reduces brain activity in the auditory cortex, the area of the brain that process sounds. The processing does not stop there as the various centres of the human brain are wired together in a way that they activate and rely on information from one another. For example, when listening to someone speak we are watching their facial expressions, maybe even lip movements. Our brain takes that information from the visual cortex, the auditory cortex, and areas required for speech processing to come up with our understanding of speech. As the old saying goes, “use it or lose it”. With inactivity the auditory cortex can begin to lose tissue which results in even greater loss of function that potentially has an affect across the entire brain.

Smoking: especially smoking in later life is a contributing factor. It is known that smoking increases the risk of vascular problems, including strokes or smaller bleeds in the brain, which are also risk factors for dementia. In addition, toxins in cigarette smoke increase oxidative stress and inflammation, which have both been linked to developing of Alzheimer's disease. Smoking is also correlated with the previous most significant risk factor, hearing loss.

Brain injuries: wearing a good quality helmet with appropriate certifications when enjoying sports is incredibly important. Only buy from reputable sources as knock offs are not tested and may provide little protection.

Excessive alcohol consumption: specific mention of mid-life excessive alcohol consumption was an important point brought up by the research. More than 20 units of alcohol per week, or approximately two bottles of wine is considered excessive. A unit of alcohol can be considered  roughly a half-pint of beer, a glass of table wine, sherry, or port, or one measure (shot) of spirits.

Exposure to Air Pollution: while Winnipeg has some of the cleanest outdoor air for a city of its size, air pollution can come in many forms. Inhaled fumes from solvents and paints are one example of pollution to avoid. In fact, some solvents can cause immediate damage from relatively low doses. Always consult WHIMIS safety sheets when working with potentially damaging aromatic compounds.

Lesser risk factors, in order of significance, include depression, social isolation, physical inactivity, mid-life hypertension, mid-life obesity and diabetes.

Nine Recommendations to Help Prevent Dementia

The experts offered nine recommendations to help prevent future cases of dementia. While some of the recommendations are for governments, others are practical advice for individuals.

• Maintaining systolic blood pressure at or below 130 mm Hg from the age of 40 onward
•  Encouraging the use of hearing aids and protecting ears from high noise levels
•  Reducing exposure to air pollution and second-hand smoke
•  Preventing head injuries, in part by targeting high-risk occupations
•  Limiting alcohol consumption to less than 21 units per week
•  Stopping smoking and governmental anti-smoking measures
•  Providing all children with primary and secondary education
•  Leading an active life into the mid-life years, and perhaps even later
•  Reducing obesity and diabetes

The experts say evidence from countries where dementia rates have fallen suggests that taking these actions and addressing the risk factors can make a significant difference in preventing dementia cases.

The Good News

In general, putting these actions into effect not only reduce the risk of dementia, but will lead to a healthier lifestyle that will undoubtedly increase an individual’s quality of life. Additionally, following the recommendations can have a positive impact at any age. It is simply never too late to start improving our health and reducing the risk of dementia.

We Can Help Treat Hearing Loss

The first step to treating hearing loss is to determine the extent of the hearing loss and any difficulties in understanding speech. To do so we recommend scheduling a complete hearing evaluation which includes a hearing test among other diagnostics. To make an appointment please call us at (204) 788-1083 or contact us online.