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Will you get dementia? What can you do to reduce your risk? Here are 10 controllable risk factors for dementia and the changes in lifestyle that support lifelong mental health.

There is no cure for dementia, but there are controllable risk factors that reduce the risk of developing it. Here are 10 suggestions that may help you achieve a lifetime of brain health.

1. Stay engaged with other people

Join a club. Go to church. Do volunteer work. There is significant evidence that social engagement is associated with lower incidence and slower progression of dementia.

2. Get vigorous exercise regularly

Starting a challenging exercise program (after a doctor's OK) in mid-life is associated with lower rates of dementia in old age. But mild exercise and infrequent exercise don't help preserve cognitive function in a significant way.

3. Don't live too close (within half a mile or about 1000 m) to a major roadway

Studies in Taiwan have found up to 750 percent higher rates of Alzheimer's disease in people who are exposed to the highest levels of particulate matter. One of the major sources of particulate matter is auto and truck exhaust. Soot from charcoal fires and kerosene are also major producers of particulate pollution. Road dust, demolition of buildings, and forest fires also release this form of pollution.

Another reason to avoid living near roadways is nitric oxide pollution. Also released by high-temperature internal combustion, exposure to this pollutant is also strongly correlated with dementia.

4. Get your vitamin D

Several studies confirm that lower vitamin D levels are associated with up to a 60 percent higher risk of developing dementia. Get your vitamin D tested. Any level below 50 ng/mL carries an increased risk of dementia. You may be told your vitamin D level is OK for most health concerns and still not have enough vitamin D for long-term brain health. If you are overweight, simply getting more sun may not be helpful, because the fat underneath your skin will sequester the vitamin as the skin makes it. You will need to take a supplement.

5. Don't take iron supplements unless a blood test shows that you have an iron deficiency

Higher levels of exposure to iron cause damage to the central nervous system that increases the risk of dementia. It is important for men and women who have passed menopause never to take iron supplements unless testing confirms iron-deficiency anemia.

What about aluminum? There is some evidence that aluminum that has been leached into cooking or drinking water may be associated with an increased risk of Alzheimer's disease, but larger studies fail to confirm initial findings. Nonetheless, it may be prudent to avoid aluminum cookware, especially for cooking acidic foods. There are mixed findings for relationships to dementia of arsenic, calcium, cobalt, manganese, molybdenumnickeluranium, and zinc. Generally, the only people for whom a risk of dementia connected to these trace elements are those who grew up in towns where the minerals were mined. If you live in a town where these minerals are found in the municipal water supply, drink bottled water.

6. Wear gloves and a respirator when you use solvents and degreasers

There is a strong relationship between exposure to solvents and degreasers and developing dementia later in life. There are also weaker relationships between dementia and lifetime exposure to pesticides, fertilizers, ink, stains, paint, varnishes, gasoline, diesel, fuel oil, glues, adhesives, rubber, and plastics. If you can't avoid exposure to these manufactured items, pay attention to diet, exercise, and vitamin D.

7. Eat an anti-inflammatory diet

You don't need to fight inflammation with every single bite of every meal, but two diets have been tested and found to generate fewer compounds that cause inflammation that is linked to greater risk of dementia:

  • The DASH diet, which emphasizes greater intake of fruits, vegetables, and low-fat dairy intake, as well as legumes and nuts, along with lower intake of animal protein, sweets, and sodium, and
  • The Mediterranean diet, which emphasizes fruits, vegetables, whole grains, low-fat dairy products, poultry, fish, olive oil, honey, and wine with meals. 
Ginger, garlic, turmeric, oregano, pepper, rosemary, cloves, saffron, and berries also reduce inflammation.

8. Avoid eating 24/7 and try intermittent fasting

There is some initial evidence from laboratory experiments that intermittent fasting reduces memory loss with aging. You don't have to fast for days and days. Simply skipping two meals in a row (for example, dinner and breakfast the next day) without snacking gives your brain a chance to rest from processing free radicals of oxygen released from glucose derived from both the carbs you eat and excess protein. For people who carry variations of the APOE gene associated with greater risk of Alzheimer's, intermittent fasting significantly reduces the probability they will develop the disease.

9. Keep diabetes under control

People who keep their blood sugar levels normal don't suffer the effects of diabetes. A meta-analysis of clinical studies found that diabetes increases the risk that mild cognitive impairment (Stages 3 and 4 of dementia) will progress to more severe forms of dementia. But controlling blood sugars reduces that risk.

10. But don't be a fanatic about weight loss

Obesity is associated with lower rates of dementia. If you can keep your weight low enough to make blood sugar control, blood pressure control, and cholesterol management possible, there is no advantage in trying to be skinny.

What about brain training games and dementia? There is good evidence that non-action video games help older people maintain some aspects of cognitive function. Brain training games increase attention time, improve recall, improve visual memory, and help older people to be more assertive. The jury is out on whether they prevent dementia, but they do seem to improve brain functions.

  • Hayden KM, Beavers DP, Steck SE, Hebert JR, Tabung FK, Shivappa N, Casanova R, Manson JE, Padula CB, Salmoirago-Blotcher E, Snetselaar LG, Zaslavsky O, Rapp SR. The association between an inflammatory diet and global cognitive function and incident dementia in older women: The Women's Health Initiative Memory Study.Alzheimers Dement. 2017 Nov. 13(11):1187-1196. doi: 10.1016/j.jalz.2017.04.004. Epub 2017 May 19. PMID: 28531379.
  • Killin LO, Starr JM, Shiue IJ, Russ TC. Environmental risk factors for dementia: a systematic review. BMC Geriatr. 2016 Oct 12. 16(1):175. Review. PMID: 27729011.
  • Russ TC, Murianni L, Icaza G, Slachevsky A, Starr JM. Geographical Variation in Dementia Mortality in Italy, New Zealand, and Chile: The Impact of Latitude, Vitamin D, and Air Pollution. Dement Geriatr Cogn Disord. 2016. 42(1-2):31–41
  • Photo courtesy of SteadyHealth

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