Dementia risk rises with age and people are living longer than ever before. This feeds the perception that developing dementia is a foregone conclusion. However, while age is a risk factor for dementia, it does not directly cause it, and there are ways to modify your risk.
A new study, published in the journal Neurology, emphasises the agency you have over developing dementia.
It pinpoints seven healthy habits and lifestyle factors that may play a role in lowering the risk of dementia in people with the highest genetic risk.
The seven cardiovascular and brain health factors, known as the “American Heart Association’s Life’s Simple 7”, are: being active, eating better, losing weight, not smoking, maintaining a healthy blood pressure, controlling cholesterol, and reducing blood sugar.
“These healthy habits in the Life’s Simple 7 have been linked to a lower risk of dementia overall, but it is uncertain whether the same applies to people with a high genetic risk,” said study author Adrienne Tin, PhD, of the University of Mississippi Medical Center in Jackson.
“The good news is that even for people who are at the highest genetic risk, living by this same healthier lifestyle are likely to have a lower risk of dementia.”
How did the researchers gather their findings?
The study looked at 8,823 people with European ancestry and 2,738 people with African ancestry who were followed for 30 years. People had an average age of 54 at the beginning of the study.
Study participants reported their levels in all seven health factors.
Total scores ranged from 0 to 14, with 0 representing the most unhealthy score and 14 representing the most healthy score. The average score among those with European ancestry was 8.3 and the average score amongst those with African ancestry was 6.6.
The group with the lowest risk had the APOE e2 variant, which has been associated with a decreased risk of dementia.
By the end of the study, 1,603 people with European ancestry developed dementia and 631 people with African ancestry developed dementia.
For people with European ancestry, researchers found that people with the highest scores in the lifestyle factors had a lower risk of dementia across all five genetic risk groups, including the group with the highest genetic risk of dementia.
For each one-point increase in the lifestyle factor score, there was a nine percent lower risk of developing dementia. Among those with European ancestry, compared with the low category of the lifestyle factor score, the intermediate and high categories were associated with 30 percent and 43 percent lower risk for dementia, respectively. Among those with African ancestry, the intermediate and high categories were associated with six percent and 17 percent lower risk for dementia, respectively.
Among people with African ancestry, researchers found a similar pattern of declining dementia risk across all three groups among those with higher scores on the lifestyle factors. But researchers said the smaller number of participants in this group limited the findings, so more research is needed.
“Larger sample sizes from diverse populations are needed to get more reliable estimates of the effects of these modifiable health factors on dementia risk within different genetic risk groups and ancestral backgrounds,” Ms Tin said.
A limitation of the study was the smaller sample size among people with African ancestry and that many African American participants were recruited from one location.
Commenting on the findings, Doctor Rosa Sancho, Head of Research at Alzheimer’s Research UK, said: “Dementia risk depends on many factors. Some, like our age and genetic make-up, we cannot change, while others, like diet and exercise, we can. This study supports the idea that what is good for the heart is also good for the brain – and that this holds true even for people with a higher genetic risk of dementia, at least for participants of European ancestry.
“Although the researchers monitored participants for all forms of dementia, when grouping people according to genetic risk they focused only on genes that increase risk of Alzheimer’s disease, just one cause of dementia. Also, health scores were taken at the start of the study, but what we don’t know is whether the participants’ healthy habits lasted for the duration of the study.
“For a better understanding of how healthy living could help to overcome genetic risk, future research will need to incorporate risk genes for all forms of dementia. Ideally future studies should also include continually monitoring health habits in the participants to assess long-term effects of a healthy lifestyle.
“The lower number of African American participants means that the findings for this group are less clear. We will need further studies to assess how good heart health affects dementia risk in the wider population, with sufficient people from ethnically diverse backgrounds.
“We do know that it’s never too early or too late in life to take steps to reduce our risk of dementia and improve our brain health. Not smoking, only drinking in moderation, staying mentally, physically and socially active, eating a balanced diet, and keeping cholesterol and blood pressure levels in check can all help to keep our brains healthy as we age. Find information and advice on brain health at www.thinkbrainhealth.org.uk.”
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