Help reduce risk of cognitive decline and Alzheimer’s disease

With 76,000 Canadians being diagnosed with dementia every year, many of us now have a family member living with the condition.¹ But just because someone in your family has dementia, does that mean you’re going to get it, too? Let’s take a look at your risk of developing the disease as well as what you can do to help reduce your overall risk.

Is it Alzheimer’s Disease or just normal aging?

We used to believe that some individuals just became “senile” as they got older. Now we know better. We now understand that dementia is not a normal part of aging. The most common form of dementia is Alzheimer’s disease, a brain disease characterized, in the initial stages by severe, progressive memory. Risk of susceptibility to Alzheimer’s disease increases with age, with the highest likelihood found in people over 85.^{2, 3}

What causes Alzheimer’s Disease?

The vast majority of people with Alzheimer’s disease have what is called late-onset Alzheimer’s disease. This form affects 95% of people with the disease and is by far the most common form of dementia.⁴ Late-onset Alzheimer’s disease is difficult to predict, as your risk is influenced mainly by lifestyle and environmental factors. There is no known single gene attributed to late-onset Alzheimer’s disease.

Only about 1% of all cases of Alzheimer’s disease are due to an autosomal-dominant gene.⁵ For this reason, the Alzheimer Society of Canada does not recommend genetic testing for the late-onset form.

Can you reduce your risk?

We used to think that nothing could be done to prevent or halt the progress of dementia. However, recent research offers good news that actively managing your brain health may protect your brain against dementia, or work to slow down the process.⁶ Making healthy lifestyle changes can help reduce your chances of cognitive decline no matter what your genetic risk might be. For example, there are several cardiovascular and metabolic risk factors that can increase your risk of developing brain disease or cognitive decline over time. These risk factors can be prevented or modified with lifestyle changes, medication, or other interventions. It is very important to regularly consult with your family physician to understand if you have any of these medical risk factors and to monitor and optimally manage them over time.

How can I positively impact my own risk?

Behaviours known to help decrease the risk of cognitive decline and Alzheimer’s disease include:

1. Physical exercise – this is the single most important thing you can do for your brain. To benefit the brain, this does not have to be strenuous or complicated. Simply make sure you are active for at least 20 to 30 minutes per day.

2. Checking your medical risk factors – conditions like hypertension, diabetes, high cholesterol, and obesity can increase the risk of brain disease or cognitive decline over time. Monitor your medical health regularly with your doctor.

3. Focus on a healthy diet – we now know that junk food and processed foods are bad for your brain; your brain benefits from foods that have antioxidant and anti-inflammatory properties that help repair damage and protect against diseases of the brain. Some tips include (1) giving your brain healthy fats for peak cognitive efficiency and repairing damage and (2) make sure you have enough vitamin B12 and D3.

4. Make time for recharging – chronic stress is a risk factor for accelerated brain aging and reduced resilience and wellbeing. It can be helpful to learn meditation and mindfulness exercises but recharging can be as simple as getting out in nature and having some quiet down time each day.

5. Prioritize optimizing your sleep functioning – sleep is very important for optimal cognitive functioning and managing your risk of cognitive decline and chronic disease. If you have questions about your sleep quality, consult your doctor.

6. Spend time engaging in cognitively challenging but enjoyable activities – the best forms of cognitive exercise are activities that have novelty, challenge, and variety.

7. Social engagement – research has consistently shown that people with positive social networks have better cognitive and psychological health over time.⁷ Although social engagement has been highly challenging during the pandemic and many people report feeling socially isolated (and so many of us are experiencing virtual interaction fatigue), it is important to find creative ways to engage with positive social supports.

If you have any concerns about your cognitive health or want to focus on ways to optimize your overall brain health, it can be helpful to consult with a neuropsychologist at one of our TELUS Health Centres. A neuropsychologist can measure your cognitive functioning and can help with creating a cognitive care plan to optimize your brain health.

To learn more about keeping your brain healthy, get in touch with a TELUS Health Care Centres representative today.

References:

1. ^{Public Health Agency of Canada. (2017). Dementia In Canada, Including Alzheimer’s Disease. dementia-highlights-canadian-chronic-disease-surveillance.pdf. Retrieved from} https://www.canada.ca/content/dam/phac-aspc/documents/services/publications/diseases-conditions/dementia-highlights-canadian-chronic-disease-surveillance/dementia-highlights-canadian-chronic-disease-surveillance.pdf^.

2. ^{Chambers, L. W., Bancej, C., & McDowell, I. (Eds.). (2016). Prevalence and Monetary Costs of Dementia in Canada. Retrieved from} https://web.archive.org/web/20180423221615id_/https://alzheimer.ca/sites/default/files/Files/national/Statistics/PrevalenceandCostsofDementia_EN.pdf^.

3. ^{Dementia numbers in Canada. Alzheimer Society of Canada. (2016). Retrieved from} https://alzheimer.ca/en/about-dementia/what-dementia/dementia-numbers-canada^.

4. ^{Awada, A. A. (2015). Early and late-onset alzheimer's disease: What are the differences? Journal of neurosciences in rural practice. Retrieved from} https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4481819/^.

5. ^{Bekris, L. M., Yu, C.-E., Bird, T. D., & Tsuang, D. W. (2010, December). Genetics of alzheimer disease. Journal of geriatric psychiatry and neurology. Retrieved from} https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3044597/^.

6. ^{Ngandu, T. (2015). A 2 year multidomain intervention of diet, exercise, cognitive training, and vascular risk monitoring versus control to prevent cognitive decline in at-risk elderly people (finger): A randomised controlled trial. Lancet (London, England). Retrieved from} https://pubmed.ncbi.nlm.nih.gov/25771249/^.

7. ^{Carstensen LL, Hartel CR, editor (2005), National Research Council (US) Committee on Aging Frontiers in Social Psychology, Personality, and Adult Developmental Psychology; When I'm 64. 5, Social Engagement and Cognition. Available from:} https://www.ncbi.nlm.nih.gov/books/NBK83766/^.

Additional references:

• ^{Alzheimer Society of Canada. Dementia numbers in Canada.} https://alzheimer.ca/en/about-dementia/what-dementia/dementia-numbers-canada^{. Web, January 6, 2021.}

• ^{Ibid. Genetic testing and Alzheimer’s disease.} https://alzheimer.ca/en/about-dementia/what-alzheimers-disease/genetic-testing-alzheimers-disease^{. Web, June 23, 2021.}

• ^{Ibid. Risk factors for dementia.} https://alzheimer.ca/en/about-dementia/how-can-i-prevent-dementia/risk-factors-dementia^{. Web, June 14, 2021.}

• ^{Harvard Health Publishing. Alzheimer’s in the family.} https://www.health.harvard.edu/mind-and-mood/alzheimers-in-the-family^{. December 2015. Updated January 28, 2019. Web, January 6, 2021.}

• ^{The genetics of Alzheimer disease (AD) are complex and not completely understood. Schellenberg GD. Genetic dissection of Alzheimer disease, a heterogeneous disorder. Proc Natl Acad Sci U S A. 1995;92(19):8552-8559. doi:10.1073/pnas.92.19.8552}

• ^{Alzheimer Society of Canada. Genetic testing and Alzheimer’s disease.} https://alzheimer.ca/en/about-dementia/what-alzheimers-disease/genetic-testing-alzheimers-disease^{. Web, July 1, 2021.}

• ^{Dubois B, Villain N, Frisoni GB, Rabinovici GD, Sabbagh M, Cappa S, Bejanin A, Bombois S, Epelbaum S, Teichmann M, Habert MO, Nordberg A, Blennow K, Galasko D, Stern Y, Rowe CC, Salloway S, Schneider LS, Cummings JL, Feldman HH. Clinical diagnosis of Alzheimer's disease: recommendations of the International Working Group. Lancet Neurol. 2021 Jun;20(6):484-496. doi: 10.1016/S1474-4422(21)00066-1. Epub 2021 Apr 29. PMID: 33933186.}

• ^{Alzheimer Society of Canada. Brain-healthy tips to reduce your risk of dementia.} https://alzheimer.ca/en/about-dementia/how-can-i-prevent-dementia/brain-healthytips- reduce-your-risk-dementia^{. Web, July 1, 2021.}

• ^{Alzheimer Society of Canada. Concerned about dementia? Here are four ways to reduce your risk. Web July 29, 2021.}

• ^{Ngandu, T et al, A 2 year multidomain intervention of diet, exercise, cognitive training, and vascular risk monitoring versus control to prevent cognitive decline in at risk elderly people ( FINGER). Lancet. 2015}