Over 55 million people worldwide are living with dementia, with nearly 10 million new cases each year. This number is expected to increase to 139 million by 2050 [1]. Health and long-term care costs are also projected to skyrocket to $360 billion in 2024 and nearly $1 trillion by 2050 [2]. But what exactly do we know about dementia? What does the latest research reveal about spotting cognitive decline early and preserving our cognitive health? Let’s dive into the research to find out.
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What are the risk factors for dementia?
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Dementia is a broad term that describes a decline in cognitive function, including memory, thinking, and reasoning abilities. Dementia is not a single disease but a set of symptoms caused by various underlying conditions, with each specific disease leading to different manifestations. While dementia is most commonly associated with Alzheimer’s disease (AD), which is the most common specific disease leading to dementia, there are other types like vascular dementia, Lewy body dementia (a progressive form characterized by the presence of lewy bodies—abnormal protein clumps in the brain—causing symptoms such as visual hallucinations, sleep disturbances, and parkinsonian features), and frontotemporal dementia (caused by neuronal damage in areas of the brain responsible for thinking, planning, emotions, behaviors, and movement).
Dementia symptoms and risk factors can vary but often include memory loss, confusion, difficulty with language, and mood changes. This condition primarily affects older adults, with most cases occurring in individuals over 65. However, early-onset dementia can occur in people as young as 30 to 50 years old, even though it’s rare [3]. Neurological and behavioral signs of diseases like Alzheimer’s can also appear by middle age, making this a significant period for early detection and risk assessment.
One study found that about 10% of adults over the age of 65 are affected by some form of dementia, making age one of the strongest risk factors [4]. Various environmental, lifestyle, genetic, and health-related factors can increase a person's risk of developing dementia. Other risk factors for dementia include,
Health conditions
Conditions such as heart disease, type 2 diabetes, sleep apnea, or obesity may increase your risk of dementia [5, 6, 7, 8]. High cholesterol, especially elevated levels of low density lipoprotein (LDL) cholesterol, is also a risk factor for vascular dementia and Alzheimer's disease, as it contributes to arterial plaque buildup and reduces blood flow to the brain. Vascular disease, including atherosclerosis, can impair blood flow to the brain and further increase the risk of dementia. Notably, one’s heart health at age 50 is a predictor of dementia risk in later years [9]. Hearing loss is another important risk factor for dementia, as it increases cognitive strain and reduces social engagement; managing hearing loss, such as with hearing aids, can help reduce this risk. Various medical conditions and chronic health problems can also impact dementia risk, making regular health checks and management of underlying issues essential.
Lifestyle
A sedentary lifestyle, poor diet, excessive alcohol consumption, smoking, insufficient sleep, social isolation, and exposure to air pollution can significantly elevate your risk [10, 11, 12].
If you regularly drink alcohol, it is important to do so within recommended limits, as drinking too much alcohol increases the risk of dementia and can cause brain damage. Quitting smoking at any age can help reduce your risk of dementia and prevent brain damage. Engaging in regular physical activity is also important, as it can help lower your risk of developing dementia.
Family history
Individuals with a parent or sibling diagnosed with Alzheimer’s disease have a 30% higher risk of developing this form of dementia [13].
Certain genetic disorders, such as Huntington's disease and Creutzfeldt-Jakob disease, are also associated with a higher risk of developing dementia.
Race
Research indicates that African Americans, American Indians, and Alaska Natives experience the highest incidence of dementia, whereas Asian Americans show the lowest rates [14]. Studies also suggest that dementia risk factors may vary between men and women within these groups [15, 16].
Genetics
Possessing one copy of the APOE4 gene can triple your risk of developing the disease while having two copies increases the risk by 10 to 15 times. However, having this gene does not mean you’ll develop the disease [13]. Less than 1% of Alzheimer's cases are attributed to deterministic genes—rare genetic mutations like APP, PSEN1, or PSEN2—that guarantee a person will develop the disease if they inherit them [17].
Head injuries
Experiencing severe or multiple head injuries can also increase your risk. Research indicates that individuals with a history of one head injury have a 1.25 times higher risk of developing dementia. Those with two or more head injuries face more than double the risk [18].
Medications
Though some medications, such as benzodiazepines (used for sleep and anxiety) and anticholinergics (for allergies, high blood pressure, and colds), have been associated with dementia, the findings are inconsistent. Some studies show no link, while others indicate an increased risk of dementia, especially in older adults, when these medications are used long-term [19, 20].
The latest in dementia research
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The encouraging news is that $3.8 billion is currently invested annually in dementia research [21]. Here are just some of the latest discoveries in dementia research:
Word games and puzzles boost cognitive function
A recent study found that older adults with mild cognitive impairments who engage in activities like word games, puzzles, and reading exhibit better memory, working memory, attention, and processing speed compared to those who do not participate in such activities [22]. Participants in the high-level activity group consistently demonstrated superior cognitive function over those in the middle and low-level groups. Consequently, it appears that older adults could significantly benefit from engaging in these stimulating activities at least three to four times a week.
Falling for scams linked to early Alzheimer's disease risk
Falling victim to financial scams may indicate early signs of AD, according to a recent study [23]. Researchers discovered that older adults with reduced thickness in brain regions like the entorhinal cortex—a key area for memory and navigation commonly impacted by AD—are more susceptible to such scams. They found that individuals with thinner entorhinal cortices, particularly individuals aged 70 and older, were at greater risk of falling for financial scams, aligning with previous research linking these brain changes to mild cognitive impairment and dementia.
Neuron size may hold the key to memory
Researchers found that memory in older adults is linked to the size of dendritic spine heads—tiny neuron protrusions responsible for signal transmission. Those with larger spine heads showed better memory, even with Alzheimer’s-related changes. This suggests spine size may be key to preserving memory as we age, and the good news is that brain-healthy habits like regular exercise, a nutrient-rich diet, and mental stimulation can help support and maintain these crucial neural structures [24].
A connection between COVID and cognitive decline
Some older adults who suffered from severe COVID-19 experienced a rapid cognitive decline for approximately one year post-infection, after which the decline slowed. Long-term cognitive decline was predominantly observed in those who had severe COVID-19, showed cognitive impairment six months after infection, and had hypertension [25].
How does dementia impact our health?
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Dementia, while often recognized for its impact on cognitive function, has far-reaching effects on physical health. Dementia results from damage to or loss of nerve cells and their connections in the brain, with the specific brain involved in learning, memory, decision-making, and language being affected depending on the type of dementia. Impairments in problem solving are also a common feature, especially in certain types of dementia such as vascular dementia. As the condition progresses, it disrupts various bodily systems, increasing vulnerability to other diseases and conditions:
Falls and fractures
There is an increased risk of falls and fall-related injuries, such as hip fractures, in older adults with dementia. Several studies show that people living with dementia have a 2-8 times higher risk of falling [26].
Nutritional deficiencies
As dementia advances, the loss of sensory or motor functions can result in swallowing difficulties, known as dysphagia, making eating more challenging. Additionally, individuals with dementia may often miss hunger cues or forget if they have already eaten [27].
Increased infection risk
Dementia increases susceptibility to infections due to alterations in the immune system. A frequent cause of death among individuals with AD is aspiration pneumonia, resulting from inhaling food or liquid into the lungs [28]. Conversely, research indicates that hospitalizations due to infections—especially those affecting the blood, circulatory system, and urinary tract—can increase the risk of developing dementia [29, 30].
Heart disease
Individuals with dementia face an increased risk of heart attack and stroke, as plaque buildup in the brain can also cause the heart's ventricles to thicken [31].
Sleep disorders
Dementia induces changes in the brain that can disrupt an area of the brain responsible for managing our internal clock. When this area becomes impaired, individuals with dementia struggle to maintain a normal sleep-wake cycle. Consequently, they may wake frequently, experience inadequate or excessive sleep, nap often, or encounter sundowning—characterized by increased irritability and confusion as evening approaches [32].
Dementia’s impact on mind and longevity
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Dementia affects more than just memory and cognitive function; it also impacts overall health and longevity. Dementia is characterized by progressive mental decline that interferes with daily life, making it a leading cause of disability in older adults. Research indicates that non-Alzheimer’s dementias are linked to shorter lifespans and higher mortality rates compared to AD [33]. On average, individuals with AD live 5.8 years post-diagnosis, while those with non-Alzheimer’s dementia have a life expectancy of 3.2 to 4.9 years after diagnosis [33].
Early detection is crucial, as identifying early symptoms—such as subtle memory loss or changes in thinking—can help differentiate dementia from other causes of cognitive issues and allow for timely intervention. Furthermore, the disease likely begins to develop decades before obvious symptoms arise.
Recent studies have also begun to investigate how aging hallmarks contribute to dementia. Five key hallmarks of aging—cellular senescence, genomic instability, altered gene expression, mitochondrial dysfunction, and changes in the gut microbiome—have been associated with dementia. Here’s what researchers have uncovered:
Individuals with AD exhibit a greater abundance of senescent markers in their brains compared to those without the disease [34]. These senescent-like neurons also experience metabolic dysfunction, increased cancer risk, and inflammation.
DNA breaks within neurons are a classic sign of neurodegenerative diseases such as AD. These DNA breaks can lead to genomic instability, or mutations within the genome [35].
Research has identified altered genetic activity in the brains of individuals with Alzheimer’s disease (AD) that impacts processes from immune function to the clearance of beta-amyloid proteins, which can accumulate and lead to cellular dysfunction in the brain [36].
As mitochondrial function diminishes with age, research indicates that reduced mitochondrial performance in skeletal muscles heightens the risk of mild cognitive impairment and dementia. This suggests that age-related mitochondrial dysfunction may contribute to the onset of dementia [37].
Changes in the gut microbiome occur before cognitive decline in AD, with distinctly different gut bacteria communities in individuals with preclinical AD than in those without [38, 39]. These changes are also linked to amyloid and tau levels in the brain — key factors that, along with other drivers, play a role in the progression of cognitive decline.
Protect your brain: Science-backed tips to reduce dementia risk factors
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We may not be able to change our genes or family history, but we can reduce many risk factors for dementia through simple lifestyle changes. While there is no guaranteed way to prevent dementia, adopting healthy habits such as regular exercise, a balanced diet, and staying mentally and socially active can help lower your risk.
Engaging in social and cognitive activities not only supports emotional well-being but also helps maintain the brain's ability to adapt and function, which may contribute to cognitive resilience.
Public health organizations, such as the CDC, play a key role in disease control by providing statistics and supporting efforts to manage and prevent dementia on a larger scale.
For personalized advice on dementia risk and prevention, it is important to consult a healthcare professional who can guide you based on your individual health profile.
Prioritize regular exercise
Exercise enhances neuroplasticity, boosts cerebral blood flow, and fosters the development of new brain cells. Unsurprisingly, a meta-analysis revealed that regular exercise reduces the risk of developing AD by 45% [40]. Additionally, it found that older adults who exercise are more likely to preserve cognitive function, while low activity levels are a risk factor for AD. Another study demonstrated that a year of moderate-intensity exercise (40-minute sessions, 3 days a week) significantly increased brain regions responsible for memory and learning in healthy older adults [41].
Consume a Mediterranean diet
Adopting an unprocessed or minimally processed diet rich in fruits, vegetables, whole grains, healthy fats, and lean proteins may help protect against cognitive decline. Research indicates that individuals who closely follow the Mediterranean diet have a 23% lower risk of developing dementia, regardless of genetic predisposition [42]. Another study found that consuming predominantly unprocessed, whole foods is linked to fewer signs of Alzheimer's disease in the brain, regardless of other lifestyle factors [43].
Engage in cognitive activities
As we age, it’s important to keep our minds stimulated through puzzles, reading, cognitive games, learning a new skill, or playing a musical instrument. Dedicate time daily to challenges that sharpen cognitive abilities. Research indicates that regular participation in cognitive activities reduces the likelihood of developing AD by 47% [44]. Interestingly, playing a musical instrument was also associated with a lower risk of dementia [45].
Prioritize at least seven hours of sleep, but not too much
Getting enough sleep can also influence dementia risk. Studies have shown that adults in their 50s and 60s who slept six hours or less a night were 30% more likely to develop dementia [46]. Conversely, sleeping 9 hours or more per night was also associated with an increased risk of dementia [47].
Maintain social connections
Spending time with friends and family not only boosts our mood but may also reduce the risk of cognitive decline. Staying socially active is important for maintaining mental well-being and reducing the risk of dementia, as engaging in social activities can help alleviate stress, improve mood, and prevent social isolation. Although the exact mechanism is unclear, researchers suggest that social connectedness may provide the brain with the necessary stimulation to prevent cognitive impairments [48]. Additionally, having a support system might buffer against cognitively damaging life stressors [49]. For those experiencing hearing loss, using hearing aids can help manage hearing difficulties and support continued social engagement, further protecting cognitive health. While many studies focus on white communities, research shows that social engagement also enhances cognitive function in African American adults aged 57-97 [50].
What is dementia?
Dementia is a broad term that describes a decline in cognitive function, including memory, thinking, and reasoning abilities. It is not a single disease but a group of symptoms caused by various underlying conditions, such as Alzheimer's disease, vascular dementia, Lewy body dementia, and frontotemporal dementia.
What are the main risk factors for developing dementia?
Risk factors for dementia include age, family history, genetics (such as the APOE4 gene), head injuries, and certain health conditions like heart disease, diabetes, and obesity. Lifestyle factors—like physical inactivity, poor diet, smoking, excessive alcohol use, and social isolation—also contribute to increased risk.
How can you reduce your risk of dementia?
You can help reduce your risk of dementia by exercising regularly, following a Mediterranean diet, engaging in cognitive activities, getting 7–8 hours of sleep per night, and maintaining strong social connections. These healthy habits support brain function and may protect against cognitive decline.
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Citations
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