Updated: Jun 16
Keywords: risk factors, modifiable risk factors, dementia, cognitive, cognitive reserve, pathological, preventative
Addressing dementia should begin early in life, far before a diagnosis is ever made. This takes the form of preventative measures, which in many cases — up to 40% of cases, according to recent research by Gill Livingston, MD et al. — can prevent or delay the onset of dementia. While there are some dementia risk factors that cannot be controlled, it is possible to engage in interventions for those modifiable risk factors we can control. And there are many!
Risk factors, as described by UCSF Health, are variables affecting your likelihood of developing a disease. Modifiable risk factors are those which you have the power to address and actually do something about. These variables are identifiable, and through your day to day choices, your risk level can be lowered. Current research has identified 12 risk factors which you can work on with your integrative health care provider to help prevent cognitive decline.
Modifiable Risk Factors for Dementia
A 2020 Lancet Commission update study has just identified alcohol consumption, head injury, and air pollution as “newly identified” modifiable risk factors for dementia.The Lancet Commission added these three factors to their existing list of nine, which were developed in a 2017 version of the study. The following is a list of recommended dementia-mitigating interventions which was summarized by the Commission:
Reduce hypertension (ie, systolic pressure of 130 mm Hg at 40 years or older via antihypertensive medications)
Avoid head injury + treat any concussions right away
Stop (or don’t start) smoking
Decrease exposure to air pollution (including second-hand smoke)
Decrease midlife obesity
Treatment of hearing impairment (ie, use of hearing aids and avoidance of excessive noise levels)
Develop and maintain social contact
Attain higher levels of education
Engage in frequent exercise
Avoid excessive levels of alcohol
If you are wondering where to start on your own interventions, I recommend beginning with any of the above. It certainly makes a difference if you exercise more each and every day, challenge your mind, get psychological help to maintain mental wellness + connect with friends and family in a meaningful way. Feel free to consult my post on exercise & neuroplasticity available on IleneNaomiRusk.com.
Each of these intervention steps qualifies either as a strategy for what the authors call, “reduced pathological damage,” for increasing (or at least maintaining) cognitive reserve, or both.
Pathological damage refers to any of the numerous physical health factors that can make us more susceptible to neurological disease or increase amyloid or tau in the brain. Reducing underlying pathology can have intrinsic health benefits, so ask your functional medicine doctor or integrative provider to test for mold, infections like Lyme and coinfections as well as a host of toxins which are often present in our bodies because of the toxins we are exposed to in our environment. My colleague, integrative neurologist Dr. Suzanne Gazda, has recently published an excellent paper on pollution as a risk factor for neurologic illness.
Harvard Health Publishing describes cognitive reserve as the brain’s ability to adapt around failures or obstacles that appear in brain function. Your cognitive reserve is like the bank account in your brain and you want that bank account to be full of stores of information.
I have previously shared resources discussing how to build your cognitive reserve on IleneNaomiRusk.com.
As we can see with the identification of three new modifiable risk factors for dementia from the time this study was first conducted in 2017 to its evidence-based additions in 2020, there is no shortage of strategies to engage in as you develop a prevention plan. It may take time to implement these strategies, so it is imperative that you consider addressing your modifiable risk factors today. To ensure your plan can be flexible as new modifiable risk factors are identified, try to work with a professional who can help you implement the latest research findings.
Many peoples’ COVID lifestyle, coupled with all of the anxiety & distress associated with pandemic fear have increased dementia incidence. Now, more than ever, we need to be doing what we can to fortify our minds and support our brains.