By the year 2050, the number of Americans over 65 who are living with Alzheimer's disease is expected to approach 14 million, according to the Alzheimer's Association. Because the brain changes in Alzheimer's may start years or even decades before symptoms emerge, many researchers, doctors, and advocates focus on trying to prevent the disease before it begins. Here's what they advise.
Protect your heart. A 2020 international medical review identified 12 major risk factors for dementia, and four were directly related to heart health: high blood pressure, obesity, diabetes, and smoking. “We know that what's bad for the heart is bad for the brain,” says John Morris, MD, FAAN, endowed professor of neurology at Washington University in St. Louis' Knight Alzheimer Disease Research Center. “When we look at lifestyle factors that might help prevent Alzheimer's disease, there's a lot of interest in heart health, diet, and staying very active.” Your doctor can suggest medication and lifestyle changes to get your blood pressure and cholesterol to healthy levels. If you are overweight or obese, ask your doctor for guidance in losing weight, and talk with a nutritionist about a healthy eating plan. If you have diabetes, work closely with your doctor to manage your blood sugar levels. And if you smoke, talk to your doctor about how to quit.
Know your risk factors. Older Black Americans have higher rates of dementia than non-Hispanic Whites, and Black Americans also have higher rates of high blood pressure, high cholesterol, diabetes, heart disease, and stroke. A 2015 study found that Black patients who had Alzheimer's disease were more likely to have classic signs like beta-amyloids, as well as more frequent and more severe blood vessel disease. Ask your doctor for help in keeping your blood pressure, cholesterol, blood sugar, and weight at healthy levels.
Get moving. Inactivity is another of the 12 major dementia risk factors identified by the 2020 review. “Exercise can be the brain's first defense against amyloid plaque, which builds up in the brains of people with Alzheimer's disease,” says Richard Isaacson, MD, FAAN, a neurologist and director of the Alzheimer's Prevention Clinic at Weill Cornell Medical College and New York–Presbyterian Hospital. “Burning body fat and building muscle mass can boost metabolism, which helps maintain brain health over time,” Dr. Isaacson says. Any type of activity—walking, dancing, bicycling—can make a difference. Aim for 30 minutes a day if you can.
Stay socially and mentally active. Get together regularly with family and friends; work or volunteer with community groups; meet new people; read or do puzzles daily. Even more important, take a class or learn a new skill. “Learning something new, like another language, helps build vital backup pathways in the brain,” Dr. Isaacson says.
Avoid head injury. A recent review added traumatic brain injury (TBI) to the list of modifiable risk factors. A 2018 study looked at how head trauma—both severe injury, as in a car accident or a fall, and repeated mild injury, like a concussion from sports—increases the risk of dementia. Protect yourself by wearing a seat belt, staying safe when playing sports, and treating any head injury right away.
Treat depression, hearing loss, and substance abuse. Primary risk factors for dementia include problems as varied as excessive alcohol consumption, hearing loss, and depression. A 2018 review of three dozen studies found links between hearing loss in midlife and developing dementia; if you can get hearing aids, wear them as much as possible. If you drink alcohol, do so in moderation. And if you believe you may have symptoms of depression—such as frequent or extreme sadness, self-isolating tendencies, or thoughts of harming yourself—reach out to anyone you can for help: friends, family, co-workers, your doctor, or services like the National Suicide Prevention Lifeline (800-273-8255) or the Substance Abuse and Mental Health Services Administration's national help line (800-662-HELP [4357]).
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