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As a single person who relies on my brain to make my living, my worst fear is dementia.
Fortunately, no one in my family has had dementia. But that doesn't mean as much as you might like to think. Less than one percent of all Alzheimer’s patients, as far as we now know, have a genetic vulnerability that makes the disease inevitable. (At this moment, a large clinical trial is testing whether receiving specific medication will help.) For the vast majority of patients, something else is going on.
The biggest risk is heart disease; about 80 percent of people who die with Alzheimer’s also had cardiovascular disease, according to some autopsy studies. It’s possible that cardiovascular disease is one of the triggers for Alzheimer’s symptoms. Controlling high blood pressure and blood sugar levels will help (both increase heart risk).
Which brings us to regular physical exercise. The World Health Organization (WHO) has pinpointed aerobic exercise as protective for the brain. The Harvard Aging Brain Study followed older adults and documented their physical activity as well as measures of brain health. In 2019, its researchers affirmed other studies suggesting that physical activity was linked to less cognitive decline and less brain volume loss. This study measured cognition with a test that is sensitive to problems before dementia arrives. Beyond supporting heart health, exercise may increase the levels of desirable chemicals called neuroprotective growth factors, spur new brain cells, or reduce inflammation in the brain, some research suggests.
Diet matters. In its advice for avoiding mental decline, WHO supports nutrition along the lines of the Mediterranean diet, which emphasizes fish and olive oil over red meat and dairy. The DASH diet, prescribed to patients with high blood pressure, is fairly similar and also may be helpful. Be sure to eat enough fruits and vegetables to gain valuable antioxidants.
Wear hearing aids. In a 2019 study of Medicare HMO patients, researchers found that among seniors, those who got a hearing aid for newly diagnosed hearing trouble had less risk of developing dementia, depression, or anxiety in the next three years. Left untreated, hearing loss accelerates cognitive decline, much research shows. For example, in a study of nearly 4,500 seniors without dementia, 16.3 percent of the volunteers with hearing loss developed the illness, compared to 12.1 percent of those with normal hearing. The group with hearing loss also developed dementia about two years earlier, on average.
Hearing aids do seem to help, according to a large study from the University of Michigan of data for nearly 115,000 American seniors with hearing loss. If you do have hearing trouble, you could cut your risk of developing dementia in the next three years by 18 percent if you wore a hearing aid. You could also cut your risk of depression or anxiety by 11 percent.
Hearing aids will help you stay socially connected, which may be the one most important step you can take for your overall health, especially as you age. Being isolated is associated specifically with dementia risk. If you don’t get—and use—hearing aids, you become unable to enjoy social groups and even one-on-one conversation. You may begin to withdraw without realizing it.
Those hearing aids will also help you avoid falls. If you hit your head and lose consciousness, you increase your Alzheimer’s risk. Wearing a hearing aid cut people's risk of a fall-related injury by 13 percent in the Michigan study.
It's true that people vary. You can do everything right and get ill or ignore all advice and stay sharp past 100. No one can be held responsible for becoming ill with Alzheimer’s. But shouldn't you hold yourself responsible for trying?
A version of this story appears on Your Care Everywhere.
