Forty percent of dementias in the United States are preventable. When I tell people that, they look shocked. Most people have been told that it's all in your genes, and your genetic makeup is your death sentence. But readers of this blog know this is just not true. In Beating the Dementia Monster, we listed the modifiable lifestyle factors that are the biggest drivers of Alzheimer's disease and discussed how you can deal with each.
About two years ago, we discussed an article in the prestigious journal, The Lancet, which was regarded as the definitive analysis of lifestyle and dementia. It was the work of a commission set up to evaluate what can be done to prevent dementia. It found that 40% of dementias were preventable, and 12 risk factors could be modified to prevent dementia. These are:
- physical inactivity,
- excess alcohol consumption,
- obesity,
- smoking,
- hypertension,
- diabetes,
- depression,
- traumatic brain injury,
- hearing loss,
- few years of education,
- social isolation, and
- air pollution.
The commission determined that hearing loss, education, and smoking are most significant.
The evidence supporting the Lancet Commission's conclusions continue to pour in. A recent study published in JAMA (formerly Journal of the American Medical Association) came to very similar conclusions. It was entitled "Variation in Population Attributable Fraction of Dementia Associated With Potentially Modifiable Risk Factors by Race and Ethnicity in the US." The research team was led by Mark Lee, a PhD candidate at the University of Minnesota.
Lee began with the same risk factors from the Lancet Commission report and then determined what portion of dementia in different cohorts is explained by modifiable risk factors. Cohorts were Hispanic, non-Hispanic White, non-Hispanic Black, and non-Hispanic Asian. In all cohorts, high blood pressure, obesity, and lack of exercise were most closely correlated with dementia.
Also, lifestyle differences between cohorts corresponded to different levels of risk due to modifiable factors. The study used self-reporting in survey responses to establish the cohorts. Based on the survey responses, the study attributed the 12 risk factors to 46.7 percent of dementia risk in Hispanic, 45.6 percent in Black, 39.4 in non-Hispanic whites, and 35.8 percent in non-Hispanic Asian populations.
But there's a problem with these 12 risk factors. Many of them correlate with each other in ways that suggest they are not unique. We've said before that there may be commonality between hearing loss and social isolation -- hearing loss may simply be a form of social isolation. And then physical inactivity, obesity, hypertension, and diabetes are often found together. Fewer years of education was more characteristic of some cohorts than others. Do these commonalities indicate that they are all manifestations of something underlying a given set of correlated risk factors?
No matter how you slice and dice it, if you want to do your best to prevent or deal with Alzheimer's disease, making good lifestyle choices is your best bet. And the dementia toolkit we provide in Beating the Dementia Monster is your best guide on making the best choices.
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