Walk 10,000 steps a day, cut back on alcohol, sleep better at night, stay socially active – we’re told changes like these can prevent up to 40 per cent of dementia cases worldwide.
As dementia remains one of the most feared diseases, why don’t we put pressure on our doctors and governments to support these lifestyle changes through new programs and policy initiatives?
The truth, however, is more complex. We know that making lifestyle changes is difficult. Ask anyone who’s tried to keep their New Year’s resolution of hitting the gym three times a week. It can be doubly difficult when the changes we need to make now don’t work for years, or even decades, and we don’t really understand why they work.
Taking control of your health
Anyone who has seen a loved one live with dementia, facing small and large indignities and impairments that eventually leave them unable to eat, communicate or remember, knows that it is a devastating illness.
There are several new medications coming to the market for Alzheimer’s disease (one of the most common forms of dementia). However, they are still far from being a cure and are currently only effective for patients with early-stage Alzheimer’s.
Therefore, lifestyle changes may be our best hope of delaying dementia or not developing it at all. Actor Chris Hemsworth knows it. He watched his grandfather live with Alzheimer’s and is making lifestyle changes for him after learning that he has two copies of the APOE4 gene. This gene is a risk factor for Alzheimer’s and having two copies significantly increases the risk of developing the same condition.
Research has identified modifiable risk factors that contribute to increased risk of dementia:
- physical inactivity
- excessive alcohol use
- less sleep
- Social isolation
- hearing loss
- less cognitive engagement
- poor diet
- traumatic brain injury
- of smoking
- the air pollution
Our understanding of the biological mechanisms of these risk factors is varied, and some are more clearly understood than others.
But there are many things we do know, and this is what you need to know too.
Cognitive reserve and neuroplasticity.
Cognitive reserve is the brain’s ability to resist damage or neurodegenerative diseases. If there is loss of tissue or function in one part of the brain, other brain cells (neurons) work harder to compensate. In theory, this means that lifelong experiences and activities create a dam against the damage of disease and aging to the brain.
Neuroplasticity is the brain’s amazing ability to adapt, learn and reorganize itself, creating new pathways or reconfiguring existing ones to recover from damage. The key takeaway is that neuroplasticity can occur at any time and at any age, meaning that learning and activities must last a lifetime.
Many of the risk factors related to dementia are likely to work in combination, so taking a comprehensive approach to lifestyle is crucial. For example, studies have shown that exercise, cognitive and social participation stimulate the brain and maintain its plasticity by developing new neural connections and developing cognitive reserve.
The mechanism behind this is a combination of factors: increased blood and oxygen flow to the brain, stimulation of growth factors that keep neurons healthy, and reduced inflammation.
The opposite is also true. Lack of sleep, diet, social isolation, and untreated depression are linked to decreased cognitive reserve.
The same reasoning applies to hearing loss, a key emerging risk factor for dementia. As a person’s hearing declines, it may be difficult to interact socially with others, resulting in a loss of sensory information. The brain has to work harder to compensate for this, potentially reducing your cognitive reserve and leaving you less able to resist dementia.
The role of stress and inflammation.
Stress and inflammation responses are the body’s complex response to injury. Inflammation is an important component of the body’s immune system, helping to defend against threats and repair tissue damage. While short-term inflammation is a good and natural response, chronic or prolonged inflammation disrupts normal functioning and causes damage to brain cells.
For example, one of the commonalities between dementia and untreated depression is the inflammatory process. Prolonged exposure to stress hormones can lead to chronic inflammation. Hypertension, physical inactivity, smoking and air pollution are also associated with chronic inflammation and stress, which can damage blood vessels and neurons in the brain.
In a newer area of research that is still being explored, social isolation has also been linked to inflammation. As we learned during the COVID-19 pandemic, the brain is programmed to respond to social engagement as a means of bonding and emotional support, especially in times of distress.
Surveys show that more than one in three Canadians feel isolated, lack of social connection and loneliness can trigger the body’s stress response and neuroendocrine changes, and prolonged exposure to this inflammatory process can damage the brain.
Similar pathways in multiple diseases
Several of these risk factors and their biological pathways affect multiple chronic diseases. Accumulated evidence from decades of research supports the concept of “what’s good for the heart is good for the head.”
This means that making these lifestyle changes not only reduces the risk of dementia, but also the risk of diabetes, hypertension and heart problems. This highlights the complex nature of dementia, but also offers a united strategy to address multiple health problems that can arise as people age.
It is never too late
In reality, it is never too late to change. The human brain and body have a remarkable capacity for adaptation and resilience throughout life.
While there are benefits to being physically and socially active at any age, some research shows that the payoff of those benefits may be greater after age 40, when the body’s metabolism slows, risk factors increase, and cognitive reserve declines. becomes even more essential to help protect against cognitive decline. .
If making lifestyle changes means you can watch your child navigate adulthood, walk 20 blocks to their favorite coffee every day, and continue living in their own home, it may be worth walking the 10,000 steps a day, change your diet and keep your network of friends strong. At worst, you will be healthier and more independent with or without dementia. At best, you could avoid dementia and other serious illnesses entirely and continue living your best life.
This article is republished from The Conversation under a Creative Commons license. Read the original article.