15 science-based ways to reduce your risk of dementia

A disturbing new study has predicted that new cases of dementia will double by 2060, estimating that 1 million adults will develop the memory-destroying brain disease that ultimately renders people unable to handle the routine tasks of daily life, such as eating, bathing and dressing, driving and paying bills.

There is no cure, and it can’t be prevented. But you can reduce your risk. Many factors influence dementia, including family history and genetics. You can’t do anything about those, but experts say you can take lifestyle steps, including many things we should already be doing for good health. These include physical and mental exercise, not smoking or stopping, and managing chronic conditions that can lead to heart disease.

“All of the things that we know are good for health in general are good for preventing dementia,” said Christine E. Kistler, an associate professor in the University of Pittsburgh’s division of geriatric medicine. “Quitting smoking at any age is good for you. Starting to exercise at any age is good for you. We need to keep our brains working and that helps keep our brains healthy.”

Here are some of the measures that experts recommend:

Go heavy on plant-based foods. Research suggests that high vegetable intake can slow the rate of age-related cognitive decline. Another study found that eating minimally processed plant-based foods along with regular exercise, stress reduction and support groups may improve symptoms of mild cognitive impairment and early Alzheimer’s disease in those already diagnosed.

“Eating a Mediterranean menu of foods is certainly important, as is engaging in regular aerobic exercise for at least 30 minutes, five days each week,” said Andrew Budson, the chief of cognitive and behavioral neurology at VA Boston Healthcare System. “Diet and exercise will help people to maintain a healthy body weight.” Research suggests that being overweight is a risk factor for dementia.

“I tell every patient we need to stop with the ice cream, French fries and bacon,” said Paul Schulz, a professor of neurology at UTHealth Houston.

Exercise controls weight and reduces the risk of heart disease and other health conditions — including dementia. “Our older patients can’t usually do more vigorous activity, but even walking is effective at reducing Alzheimer’s disease risk,” Schulz said.

There is growing evidence that staying current with your vaccines can help prevent Alzheimer’s and other dementias. Studies of the shingles and flu vaccines have found a reduced risk in vaccinated people.

Experts aren’t sure why, but speculate that infectious agents — such as herpes viruses that later cause shingles in older people — play a role, and that protecting against them will help. Another theory is that vaccines tamp down the immune system’s response to amyloid plaque, the protein found in high levels in those with Alzheimer’s. This may sound counterintuitive, but when the immune system attacks plaque, it also raises the probability of chronic brain inflammation and cell death.

A daily multivitamin may slow memory loss among those 60 and older by about two years, according to a study, one of several examining the cognitive benefits of multivitamins.

Evidence suggests that exposure to pollutants increases the risk, and that improved air quality lowers it. This is especially important in the context of climate change and the growing dangers from wildfires.

Older people often hit their heads when they fall. Other causes include crashes — in a car, or on a bicycle or motorcycle — or being hit by an object. Research has shown that even a moderate injury — and even when you are young — can increase the risk of developing dementia when you are older.

“I tell every client to use their seat belt and wear a helmet when biking or skiing,” Schulz said. “The same applies for football, soccer and basketball.”

Protect your ears from hearing loss. Use earplugs, sound-blocking headphones or earmuffs to guard against loud noises. Wear hearing aids if you have them. Get them if you need them. Those with hearing loss may shy away from socializing, which may increase their risk of dementia.

Research suggests that those who stay socially connected are less likely to develop dementia than those who are isolated and feel lonely. Experts believe the enforced isolation during the pandemic, for example, may have contributed to the risk.

One study pointed out that older people who feel lonely, rather than being alone, may be at higher risk. You can aim to counter feelings of loneliness by nurturing the social connections you already have, finding like-minded people and trying cognitive behavioral therapy.

Hypertension can damage the heart, blood vessels and brain, and increases the danger of stroke. Having a stroke disrupts blood flow to the brain, which raises the risk of vascular dementia.

High blood sugar leads to diabetes, which can increase the risk of heart disease, stroke and cognitive impairment.

Also, lowering your cholesterol can reduce the risk of dementias, Schulz said.

Research suggests that insomnia and daytime sleepiness are associated with a greater risk of developing Alzheimer’s disease.

Alcohol can exacerbate such health disorders as diabetes, hypertension, stroke and memory deficits, all of which raise the risk of dementia. Also, drinking too much raises the danger of falls, car crashes and other accidents — which can result in traumatic brain injuries — and liver disease.

If you don’t smoke, don’t start. Smoking is linked to numerous serious health conditions that raise the risk of dementia, including heart disease and stroke.

“Smoking can have several effects, including reducing blood flow,” Schulz said. Experts say there is solid evidence to connect smoking to the risk of dementia.

There is some evidence tying these pills to the risk of dementia, although there have been “no randomized control trials to say definitively,” Kistler said. Yet “there is overwhelming biological plausibility” that they could, she said.

Schulz noted that “people also take sleeping pills who don’t realize that they have other sleep disorders, like sleep apnea, that may cause their insomnia and increase their risk for dementia.”

The underlying pathology that leads to dementia begins at least 20 years before symptoms of the disease become apparent, so to determine the effects of sleep aids, “one would have to study sleeping-pill use more than 20 years before the onset of dementia, which is difficult to do,” he said.

Activities that engage your brain can help. Read, write, and play board games. Studies show that such pastimes make a big difference.

“I now think of the brain like a muscle, meaning that if we don’t exercise it, it performs less well,” Schulz said.

During the pandemic, social isolation meant people were not exercising their brains by talking to others, debating and having to recall things, he said. “We saw a lot of Alzheimer’s disease and other dementia patients progress much faster than expected,” he said.