“The Nationwide clinic has had a lasting impact”
Jane shares her experience of attending a Nationwide dementia clinic and the lasting positive impact it has had on her and her husband, Brian, who is living with dementia.
While there is no guaranteed way to prevent dementia, there is evidence that there are some things you can do to reduce the risk. Some of these changes are easier to make than others; however, research suggests that up to one in three cases of dementia could be prevented through a healthy lifestyle.
Our dementia specialist Admiral Nurses explain what steps you can take to reduce your risk of developing dementia.
Why cannot dementia be prevented yet?
Dementia cannot yet be prevented because currently, we do not fully understand all the causes and why or how it develops. There are many different types, and each has its own complex causes, symptoms and progression.
How to lower your risk of dementia
While dementia cannot currently be prevented, there is strong evidence that certain healthy lifestyle choices could reduce the risk. These are known as ‘modifiable risk factors’.
Eat healthily
Eating a healthy, balanced diet is one of the most important things you can do to reduce the risk of dementia. This is because it helps to prevent other health conditions that could lead to dementia, for example heart disease, high blood pressure, high cholesterol and type two diabetes.
Take a look at your diet to identify where you could make improvements – for example by eating more fruit, vegetables and wholegrain foods (eg brown bread, wholewheat pasta and brown rice), less sugar and fat, and fewer processed foods like sausages, bacon, white bread, pastry products and ready meals. The NHS Eatwell Guide has lots of information on following a healthy diet.
Take regular exercise
Regular exercise could reduce the risk of developing dementia by helping to prevent other health conditions that are linked to dementia, such as heart disease, type two diabetes and obesity.
NHS guidelines say that ideally, adults should exercise for a total of 150 minutes a week. All types of physical activity count, such as walking/hiking, yoga, swimming, running, cycling, exercise classes and team sports. It also includes moderate intensity household tasks like gardening and vacuuming. You can break it up into shorter bursts throughout the day or week.
If it is difficult to take part in structured exercise, try to be more physically active in your daily life, for example by taking the stairs rather than the lift or escalator, and standing up regularly if you spend long periods sitting.
Stop smoking
Smoking can lead to problems with your heart and blood vessels, which increases the risk of dementia, so if you smoke, it is important to try to stop. Your GP can tell you what support is available, and there is advice on the NHS website, including a free ‘Quit smoking’ app.
Reduce your alcohol intake
There is strong evidence that drinking too much alcohol increases the risk of dementia. There is no completely safe level of alcohol intake, but if you regularly drink more than the recommended limit, you are at increased risk of alcohol-related brain damage and other health problems that are linked to dementia, like problems with the arteries that reduce blood flow to the brain.
The most alcohol anyone should drink is 14 units a week, with at least four alcohol-free days each week and no binge drinking. You can check how much alcohol you are drinking and find out about support to cut down or stop at Drinkaware.
Avoid social isolation
It is not fully known why social isolation increases the risk of dementia, but it could be because it is linked to other risk factors. For example, people who are isolated or lonely are more likely to smoke, exceed the recommended alcohol limits, be less physically active and experience depression, which is associated with dementia.
People who have plenty of social contact later in life tend to have better memory and thinking skills, so take time to connect with family and friends, ideally in person but also by phone, video call or message. You can also look for ways to meet new people, such as exercise classes, community groups or volunteering.
Maintain a healthy weight
Being overweight, especially in midlife and beyond, is linked to a higher risk of dementia, most likely because it increases the chances of developing heart and circulatory diseases that are associated with the condition.
You can maintain a healthy weight through a combination of a balanced diet and regular physical activity. If you are overweight, it is a good idea to seek support to lose weight through improving your diet, increasing your physical activity and monitoring any weight gain – especially if your weight has increased over the years. Your GP can give you advice on this, or you can download a free NHS 12-week weight loss plan.
Lower your blood pressure
Continuous, untreated high blood pressure can increase the risk of dementia. It can affect the blood flow to the brain by damaging the blood vessels, and also increases the likelihood of a stroke or mini stroke, known as a transient ischaemic attack (TIA), which is a common cause of vascular dementia.
It is important to have your blood pressure checked regularly. You can do this through your GP surgery, at many pharmacies or using a home monitor.
Maintaining an overall healthy lifestyle is the best way to keep your blood pressure within a safe range. This includes eating a balanced diet, taking regular physical activity, keeping alcohol consumption within the recommended limits and not smoking.
Manage diabetes
Type two diabetes is linked to an increased risk of dementia. It is associated with other conditions that may lead to dementia, such as high blood pressure and cholesterol. It can also cause changes in the brain similar to those in Alzheimer’s disease.
Eating a healthy, balanced diet and exercising regularly helps to reduce the risk of type two diabetes or keep it under control if you already have it. It is also important to take any diabetes medication you are prescribed and attend regular diabetes reviews (usually annually).
Reduce cholesterol levels
Cholesterol is a fatty substance in the blood. If your cholesterol levels are high, it can narrow or block the blood vessels; this can affect the blood supply to the brain and increase the risk of dementia.
High cholesterol can be caused by a combination of genetic, dietary and lifestyle factors. It can often be reduced by ensuring your diet is low in saturated and trans fats (eg processed foods, fried foods, margarine, cheese, cream). It is important to increase physical activity and to keep at a healthy weight and waist size. Some people also need to take medication.
Address depression
Untreated depression could increase the risk of developing dementia. The exact reasons are unclear, but it may be because people who are depressed find it harder to maintain a healthy lifestyle. They might struggle to eat well, lack the motivation to be physically and socially active, and be more likely to drink alcohol in excess.
There is some evidence that depression may be a sign of changes in the brain that could lead to dementia – so dementia in its early stages might be misdiagnosed as depression.
If you think you may be depressed, seek help early – do not wait until it becomes worse. Your GP may recommend changes in lifestyle to improve your mental health, talking therapy and/or medication. You can also seek support through organisations like Mind and Samaritans.
Look after your hearing and sight
Hearing loss in mid-life may be an early sign of dementia. It could also mean that the parts of the brain that process sound and speech have to work harder, which could affect thinking and memory.
To look after your hearing, make sure you use noise protection such as earplugs or ear defenders in high volume environments such as concerts or building sites. If you notice any hearing issues, you can ask your GP to refer you to an NHS audiologist, although there may be a waiting list. Many opticians and pharmacies also offer free hearing checks, and you can take RNID’s free online hearing test.
If you are advised to use hearing aids, it is important to wear them as there is evidence that managing hearing loss through using hearing aids reduces the risk of dementia.
Uncorrected sight loss – particularly as a result of cataracts and diabetic retinopathy – is also associated with an increased risk of dementia. This may be because vision impairments sometimes develop as a result of other health conditions that are linked to dementia, such as diabetes. It is also possible that sight loss means the brain receives less stimulation, leading to a decline in cognitive function.
Managing any sight loss, for example by wearing glasses or contact lenses or having surgery, could help to prevent or delay developing dementia, so make sure you keep up with regular eye tests and always see an optician if you notice any changes in your eyesight.
Avoid head injury
Head injuries – especially moderate to severe traumatic brain injuries – can increase the risk of dementia and other forms of progressive cognitive decline.
While some head injuries cannot be predicted or prevented, you can reduce the risk by always wearing a helmet when cycling and using proper head protection if you take part in contact sports.
If you experience a head injury, please seek immediate medical advice – this may involve going to A&E.
Reduce air pollution in your home and environment
There is some evidence that exposure to high levels of air pollution may increase the risk of developing dementia, as well as contributing to other long-term health conditions that affect the heart and lungs.
At home, you can reduce air pollution by avoiding using wood-burning stoves and open fires. It is harder to avoid air pollution outside, but if you exercise regularly outdoors, you can limit your exposure by using routes where there is less traffic or going out earlier in the day when the roads are quieter. In the car, keep your windows closed, especially on busy roads and in slow-moving traffic.
Keep mentally active
Making time for mentally stimulating activities could help keep your brain healthy by maintaining neural pathways (the connections in the brain) and building new ones. It could also help to reduce the risk of other factors that may lead to dementia, such as depression, stress and social isolation.
Activities you might like to try include:
- existing or new hobbies like art, woodwork, knitting or hiking
- learning a language
- brain training apps/video games
- puzzles like crosswords and sudoku
- reading
- meditation, for example yoga
- playing an instrument
Research has shown that adults who take part in continuing education have improved cognitive function (memory, thinking and communication). They are also more likely to be socially active, which reduces the risk of dementia.
Medication
Currently, there is no medication to prevent dementia. There are some medications that may help with managing certain types of dementia, but they are not a preventative or cure and are not suitable for everyone.
It is, however, important to take any other medications as prescribed – for example, medications for high blood pressure, diabetes or high cholesterol – as they can help manage conditions that are linked to dementia, and so reduce the risk.
Make sure you understand what any prescribed medication is for. Always follow the instructions to ensure that you are taking it correctly and attend any check-ups that your GP or other specialist recommends.
Have a health check
Everyone is entitled to a free NHS health check, which you can request from your GP practice. This involves checking things like your blood pressure, blood sugar, cholesterol levels, weight and waist measurement to look for factors that could increase the risk of health conditions such as heart disease, kidney disease, diabetes and stroke. If these are properly treated or managed, the risk of dementia may be reduced.
If you have a long-term health condition like diabetes, heart disease or thyroid problems, it is also important to attend any regular reviews. If these conditions are poorly managed, it could increase the risk of dementia.
