Not all dementias can be mitigated, but there are some factors that have been scientifically identified as controllable. This is from an online article sent to doctors:

"These numbers are staggering, according to the authors of a 2020 update of the 2017 Lancet Commission on dementia prevention. (40% of us will develop some dementia.)The good news is that dementia is not necessarily a foregone conclusion as we age. In fact, neurocognitive health is highly dependent on many lifestyle decisions that we can control.

The Lancet study authors point to 12 modifiable risk factors fleshed out by the research—an increase from the nine cited in 2017. Let’s take a closer look.

What can be done?

According to the Commission, the 12 modifiable risk factors account for about 40% of worldwide dementia that can be prevented or delayed.

The authors categorize prevention strategies as: 1) reduced pathological damage (eg, amyloid-/tau-mediated, vascular, or inflammatory mechanisms), and 2) increased/maintained cognitive reserve.

The authors cite the following interventions:

Reduce diabetes
Reduce hypertension (ie, systolic pressure of 130 mm Hg at 40 years or older via antihypertensive medications)
Avoid head injury
Stop (or don’t start) smoking
Decrease exposure to air pollution (including second-hand smoke)
Decrease midlife obesity
Additionally, the authors recommend the following for maintaining/boosting cognitive reserve:
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
As for factors that relate to pathological damage and cognitive reserve, the authors recommended the following:
Engage in frequent exercise
Address depression
Avoid excessive levels of alcohol"

Share this with loved ones who are showing early signs, with family members and caregivers (so they understand the changes that must be made), and with medical personel who do not seem to understand that interventions really can help.

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So, here's the thing, some people smoke 3 packs / day, are overweight, and roll right in to old age. But if you get a 1,000 people doing that, and a 1,000 who aren't, it'll be clear which is the better group to be a part of.

As several people have noted, this does not apply to all types of dementia. For example Alzheimers, Fronto-temporal dementia, Lewy body, Parkinsons are not caused by any of these factors. Ignoring these metabolic issues will exacerbate the brain disorder but controlling them does not change the course of the disease.

Sometimes the most we can hope for is to slow those changes and have a few more good hours each day. First my father and now my mother had (have) progressive dementia, so I am talking also as a daughter/caregiver. For my parents, making some changes slowed their progression and kept them more stable emotionally. That was the best I could do.

Yeah well, my mother did all of those things her whole life, never smoked, drank, ate healthy foods, exercised, was a social butterfly, no diabetes, high bp, yada yada, and was dxed with progressive dementia in 2016 at 89. My father led the same lifestyle and had NO dementia at all by the time He was 91+.

There is no way to ward off dementia by doing certain things or eating a Mediterranean diet and all that hogwash. Nor is it true that all old people will get dementia.

The medical experts aren't experts at all on the mechanisms of the brain and in reality, they don't know their butts from a hole in the ground on the topic of dementia and Alzheimer's. Its misleading to even suggest that interventions can help. Its common sense to avoid smoking and excess drinking, to avoid ALL disease, but perhaps we should all move to a cave in the Sahara so we can avoid air pollution. 😥

I agree that these environmental factors may prolong the onset of AD. However, as cwillie mentions, the disease is believed to begin long before any symptoms appear. It would seem, then, that these interventions would be too late for older people. The interventions may reverse pseudodementia and, if begun early in life, may forestall the onset of AD. Cognitive reserve is often a function of one's educational level and intelligence, so I don't know if one can better their CR later in life.

ALZ, I feel, cannot be put in this category. Of all the Dementias, this effects the brain differently and it is hereditary. My grandmother had it and so did 2 of her 8 children. Some died young but may have been prone to it. Her sister had it as did her daughter.

I agree with the smoking and drinking. But my daughter, who has worked in NHs feels that its the intelligent ones who seem to contract a Dementia. And you hear that on this formum, "Dad/Mom are highly intelligent". I will admit that people who tend to be loners may be prone to Dementia but I have seen people who have been involved have Dementia too.

Excuse me for being a skeptic but I can't see that many of these risk factors are modifiable, and given that it is thought alzheimer's begins decades before we start to notice the lifestyle changes would have to be made many, many years prior to diagnosis.
And then there are always going to be the outliers that turn the statistics on their head - the healthy, athletic vegans with dementia and the smoking, drinking couch potatoes that live well into their 90's.

not to mention the impact of social media on the young mind which can be its own virus by any other name...

Looks good to me! I’m not 100% consistent with all the recommendations, but I embrace and approach each of them.

It will be an interesting study for someone in the field of geriatrics to identify and assess the horrible effects of Covid - infection, isolation, the whole mess, at timed intervals from now into the next 20 or 30 years.

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