Along with cancer, dementia is probably the diagnosis my patients fear most. It is important to bear in mind that dementia isn't an immediate disaster - many people with dementia can continue to live fulfilling lives for several years. On average, following a diagnosis of dementia, people will have mild symptoms for one to two years; have moderate symptoms, where they can live independently with help for 2-3 year and be dependent on carers by about 4-5 years after diagnosis. However, in some cases this progress is much slower.
How can I beat the odds?
It's still not surprising that as a GP, I am very often asked by patients how they can cut their risk of dementia. It's not always possible to avoid dementia – sometimes it happens no matter how healthy your lifestyle is. Sometimes dementia runs in families – and you can't change your genes. But everyone can take steps to skew the odds in their favour.
A big review by the academic journal the Lancet has brought together all the latest science on how your lifestyle can affect your risk of dementia. They came up with nine risk factors you can do something about.
Another study from international researchers who analysed data from almost 200,000 people looked into the genetic factors that increase the risk of dementia. They grouped participants into high, medium or low risk depending on their genes. Then they considered how healthy lifestyle changes affected the chance of developing dementia in people within these groups. Reassuringly, they found that regardless of your inherited risk, having a healthy lifestyle could still help stave off dementia.
Here are some of the key facts the two studies identified:
We all know smoking increases your risk of heart attack, as well as making you prone to lung cancer and the chronic lung condition COPD. But it's not just the arteries supplying blood to your heart that get clogged by smoking – it can damage the blood vessels supplying your brain. As well as increasing your risk of stroke, this can make you prone to dementia. There are lots of NHS services available to help you quit – and you can refer yourself free any time.
Your brain and the rest of your body are closely linked and keeping physically active helps keep your brain sharp too. Even though COVID-19 has resulted in many of us having to self-isolate at home, there's no reason you need to stop being active. There are plenty of exercises you can do in your home, or even from your chair. During the early stages of the pandemic, thousands of people joined Joe Wicks' daily indoor workouts – and there are online resources for every type of exercise and every age. You don't need special equipment either - use cans of beans instead of dumb-bells to do arm curls. Use the stairs for climbing and balance exercises. Every little helps.
This is perhaps the most surprising inclusion on the list. 1 in 6 people in the UK have hearing loss, rising to 4 in 10 among over 50s.
If you have mild hearing loss, you’re three times more likely to have a fall than if your hearing is normal. In addition, mild hearing loss is linked with an almost doubled risk of dementia – the risk is three times higher if you have moderate hearing loss and five times higher if it’s severe.
That’s partly because having hearing loss cuts you off from the world. Your brain is less stimulated and you’re more likely to be socially isolated. On average, it takes people 10 years to seek help for hearing loss. Yet the vast majority of people with hearing loss can benefit from hearing aids for hearing loss. Get yours checked!
The secrets to a lower risk of dementia according to research include having as many as possible of the food groups below in your diet:
- Fruits: at least 3 servings/day
- Vegetables: at least 3 servings/day
- Fish: at least 2 servings/week
- Whole grains: 3 or more servings/day
The same study found limiting other food groups was linked to a lower risk.
- Refined grain (white flour etc): stick to a maximum of 1.5 servings/day
- Processed meats (bacon, cured meat, sausages etc): consider cutting intake to 1 serving/week
- Unprocessed red meats: no more than 1.5 servings/week
Research has found that limiting alcohol to no more than 1 drink a day for women and 2 for men was associated with a lower risk of dementia.
There's good evidence that bringing your weight down if you’re overweight will slash your risk of dementia. Unfortunately, a survey from Public Health England showed that during the pandemic about 2 in 5 adults have gained weight – an average of half a stone. Snacking and comfort eating were the main reasons given – but it that's you, it's not too late to change. There's lots of free online advice from the NHS weight loss plan, broken down into 12 weeks to allow you to make healthier food choices, plan meals, set weight loss goals and use their body mass index (BMI) calculator to customise your plan. Even losing a few pounds can help.
About 90% of the people in the UK with diabetes have type 2 diabetes. Having diabetes is linked to a higher risk of developing dementia – but you can reverse the trend. For instance, most people with type 2 diabetes are overweight – so the steps above are particularly important for you.
Keeping your blood sugar (glucose) well controlled can dramatically reduce your risk of dementia if you have diabetes. Taking your medication regularly is important, but so is your diet. Many people with type 2 diabetes have found that cutting carbs (especially ‘refined’ carbs like sugary foods and white bread and potatoes) have helped them both lose weight and normalise their blood glucose. In fact, a high proportion have even found they can put their type 2 diabetes into 'remission' – where blood glucose is within normal range even though they no longer take medication to bring it down.
Depression and lack of social contact
Never has this combination been more of a challenge. Being isolated is closely linked to depression. It also means your brain is less likely to be stimulated. And just like your muscles, your brain needs regular exercise.
With so many of us working from home and vulnerable people self-isolating to reduce their risk of COVID-19, there’s a real risk that depression – already a major threat for our population – will get worse. It's a particular issue for older folk, who are often less adept at using technology.
There’s nothing at all to stop you using the phone. But if you’re remotely tech-savvy, computers or tablets are inexpensive and it’s easy to install Skype or FaceTime, so you can have ‘virtual’ face to face contact. Why not plan a regular catch up with friends and family?
Lack of education
Just because you didn’t get many O levels is no reason to panic. It’s never too late to exercise your mind. Crosswords or word puzzles; an audio course to learn a new language; or reading books and discussing them with friends all count.