Dementia can be prevented in part because there are circumstances that can be acted upon, but there are factors that we cannot change. The main one is age. After the age of 65, the risk of dementia increases, and that cannot be changed. Another very important factor is sex: women are more at risk of suffering from Alzheimer’s, for example. And then there are the genetic factors that we cannot modify either: it is known, for example, that people who carry one or both alleles 4 of apolipoprotein E (APOE) have between 2 and 3 times more risk of suffering from Alzheimer’s. There are other genetic factors associated with very early dementia, such as the so-called “familial Alzheimer’s”, which appears in younger people and which represents approximately 1% of dementias, and which have well-defined genetics.
We cannot change age, sex and genetics, but there are other factors that we can act on. They are modifiable factors and we know more and more about them.
For example, a low educational level is a factor in having dementia. For this reason, educating oneself and keeping the brain active until the final ages of life provides a protection that we call “cognitive reserve”. The advice to prevent dementia is that learning new things, learning a language and others, works as prevention.
There are other factors linked to vascular risk, first of all, hypertension. It has been seen that people who are hypertensive in middle ages of life have a higher risk of presenting dementia in the future. This is more controversial when hypertension appears in advanced ages. And the same goes for obesity; obese people in middle age are also at higher risk of dementia in later life. And diabetes is another very important risk factor. People with type 2 diabetes have a risk of dementia up to 2 or 3 times more than non-diabetics. In addition to these factors, there are smoking and alcohol consumption, which also increase the risk.
Associated with vascular risks there are a series of conditions that can also be preventative. For example, it has been seen that maintaining a Mediterranean diet reduces the risk, and this is so because this diet affects vascular risk factors. If what you eat brings high blood pressure, obesity and diabetes under control, at the same time you are reducing the risk of dementia. And the other protective factor is physical exercise, because it also reduces those vascular risk factors.
There are other factors that can affect dementia, such as depression. What happens is that it is not known if it is cause or effect, because it has been proven that, for example, it is common for patients with dementia to become depressed even before the disease appears. The relationship is complex, but depression is also identified as a risk factor.
And then there are other factors such as social isolation, which is also a proven risk factor. That is why interaction with other people is advised during old age, because isolation is associated with a greater risk of dementia. A population with a higher risk of dementia is the one that suffers from hearing loss and this is so due to the social isolation that deafness entails.
Natalia Garcia Casares She is a neurologist, tenured professor and researcher at the Faculty of Medicine of the University of Malaga, an expert in cognitive neurology and dementia.
Question sent by Manuela Pasaro
Coordination and writing:Victoria Bull
we answer is a weekly scientific consultancy, sponsored by theDr. Antoni Esteve Foundationand the programL’Oreal-Unesco ‘For Women in Science’, which answers readers’ questions about science and technology. They are scientists and technologists, members ofAMIT (Association of Women Researchers and Technologists), which answer those questions. Send your questions to[email protected]or by Twitter #werespond.
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