I receive this question frequently. Some people inquire about genetic testing. At the moment, genetic testing for an inherited form of Alzheimer’s Disease is reserved for research studies because of its rarity. For the other dementias, the interaction between genetic risk and environment are not fully understood.
There are many lifestyle choices that people can make to reduce their risk for dementia. Risk factors that I address in the clinic include weight, exercise, alcohol consumption, tobacco use, positive outlook, sleep, and depression.
- Risk factors associated with heart health makes sense: what’s good for the heart is good for the brain. So avoiding cigarette use, excessive alcohol consumption (which causes heart and liver problems all by itself), and a crappy diet improves heart health and brain health. And guys, tobacco use plus poor heart health equals impotence. At some point, Viagra and Cialis won’t help anymore!
- Exercise increases blood flow (and oxygen) to the brain, which helps keep brain cells happy and working. Exercise may also help minimize the impact of other bad lifestyle choices. I was reading a report (click here for the layperson version) in which persons who were excessive drinkers, but who exercised almost daily had dementia risk similar to non-drinkers who did not exercise. I carefully present that info as proof for the amazing benefits of physical activity, not as a green light to drink excessively as long as you work out!
- Insufficient sleep is linked to dementia risk, but I’m unsure if the brain changes seen in dementia are causing the sleep problems or if the sleep issues are related to other risk factors. People who are negative or who experience poorly controlled depression also have higher risks for dementia.
- Head protection is another good idea. Persons with TBIs are at extremely high risk for chronic traumatic encephelopathy or pugilistic dementia.
- Finally, there is cognitive reserve: the more you engage in enjoyable intellectual or mind-challenging pursuits (not just academic activities but things like learning to juggle, learning languages, playing an instrument), the more you build up neuronal connections and increase brain density. Cognitive reserve explains why pathological changes seen at autopsy do not always match clinical findings. Dr. Snowden’s nun study is a great example. Some nuns donated brains that were classified by the pathologists as having severe damage; the memory and functional testing from these same nuns did not match the pathological findings. That is, the nuns were performing at far higher levels than expected based on the pathologists’ findings. On the other hand, other nuns who were diagnosed as having severe dementia before they died had much less damage found in their brains during autopsy.
The bottom line is that, rarely, there is just ONE culprit for any disease. One person may have no genetic mutations linked to a dementia but lives such an unhealthy lifestyle that he or she starts having memory problems and winds up with dementia. Another person may have a couple of genetic mutations but her healthy lifestyle “turns off” these genes. Do all of those things our moms told us to do (get enough sleep, eat your vegetables, exercise, meditate/pray, smile, be nice to others) and you may drastically lower your risk!