Health

According to the Lancet Commission on Dementia, a lifespan approach to Alzheimer’s prevention is emphasized as applying early- or mid-life preventative approaches, such as maintaining overall good health, to lower the risk of dementia in later life.

Several chronic health conditions have been identified as risk factors for dementia and should be avoided or treated. Many of these conditions can only detected at a check-up or through blood tests. Several of these conditions are also risk factors for cardiovascular disease and occurrence in midlife increases risk. These conditions include:

• Type II Diabetes: In a large study of over 10,000 participants, younger onset age of diabetes was associated with increased risk of dementia. The relationship of diabetes onset in late-life to dementia risk is unclear. There is evidence that some but not all treatments may reduce dementia risk.
  
  
• Hypertension: Midlife hypertension increases the risk of dementia, including Alzheimer’s disease and vascular dementia. Interestingly, as dementia approaches, blood pressure often tends to decrease so that many individuals with dementia may have lower blood pressure than those without dementia. Generally, studies show that treatment of hypertension reduces risk of dementia, but less is known about which medications may be most effective.
  
  
• High LDL cholesterol: Studies of large cohorts in the United Kingdom reported increased risk of dementia among those with high LDL cholesterol; risks were higher when cholesterol levels were elevated in adults younger than age 65. In a study conducted in Denmark, lower adherence to healthy dietary guidelines was associated with higher LDL cholesterol levels. After longitudinal follow-up, those with low adherence to dietary guidelines had higher occurrence of non-Alzheimer’s dementia. Notably, individuals who received treatment for cholesterol did not have increased risk of dementia. Other studies have shown reduced risk of dementia and Alzheimer’s disease with treatment for high cholesterol with statin medications.
  
  
• Obesity: Obesity in midlife is a recognized risk factor for dementia. A recent study found that having a larger waist circumference was also a risk factor for cognitive impairment and dementia, with higher risk observed among persons older than age 65. Intervention studies report improvements in cognition with weight loss.