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Chapter 12 - Reducing Risk Factors for Mild Cognitive Impairment and Early Dementia

from Section 3 - Intervention

Published online by Cambridge University Press:  25 October 2024

Simon Gerhand
Simon Gerhand
Affiliation:
Hywel Dda Health Board, NHS Wales
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Summary

Although there is no single cause for dementia, there are various factors which increase or reduce the likelihood of it developing. Some of these are things which it is possible to change, which means it is possible to reduce the likelihood of developing dementia or slow down its progress. This chapter reviews the main risk factors, with a focus on those which are possible to change. This includes vascular risk factors, such as high blood pressure, elevated cholesterol, and diabetes, all of which can be addressed pharmacologically. It then reviews lifestyle risk factors and how these can potentially be addressed via lifestyle changes. This includes giving up smoking, reducing alcohol consumption, taking regular exercise, modifying diet, and improving quality and quantity of sleep. Evidence is reviewed for the effectiveness of making such changes.

Keywords

brain healthhealthy livinglifestyle modificationsrisk factors
Type
Chapter
Information
The Neuropsychology of Dementia
A Clinician's Manual
 , pp. 148 - 158
Publisher: Cambridge University Press
Print publication year: 2024

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References

Abbasi, J. Interest in the ketogenic diet grows for weight loss and type 2 diabetes. (2018). JAMA, 319 (3), 215–217.CrossRefGoogle ScholarPubMed
Ahlskog, J. E., Geda, Y. E., Graff-Radford, N. R. and Petersen, R. C. (2011). Physical exercise as a preventive or disease-modifying treatment of dementia and brain aging. Mayo Clinic Proceedings, 86 (9), 876–84.CrossRefGoogle ScholarPubMed
Almeida, O. P., Hankey, G. J., Yeap, B. B., Golledge, J., & Flicker, L. (2017). Depression as a modifiable factor to decrease the risk of dementia. Translational Psychiatry, 7 (5), e1117–e1117.CrossRefGoogle ScholarPubMed
Andrieu, S., Guyonnet, S., Coley, N., et al. (2017). Effect of long-term omega 3 polyunsaturated fatty acid supplementation with or without multidomain intervention on cognitive function in elderly adults with memory complaints (MAPT): A randomised, placebo-controlled trial. The Lancet Neurology, 16 (5), 377–89.CrossRefGoogle ScholarPubMed
Bartels, C., Wagner, M., Wolfsgruber, S., et al. (2018). Impact of SSRI therapy on risk of conversion from mild cognitive impairment to Alzheimer’s dementia in individuals with previous depression. American Journal of Psychiatry, 175 (3), 232–41.CrossRefGoogle Scholar
Bennett, S., & Thomas, A. J. (2014). Depression and dementia: Cause, consequence or coincidence?. Maturitas, 79 (2), 184–190.CrossRefGoogle ScholarPubMed
Bezabhe, W. M., Bereznicki, L. R., Radford, J., et al. (2022). Oral anticoagulant treatment and the risk of dementia in patients with atrial fibrillation: A population-based cohort study. Journal of the American Heart Association, 11 (7), e023098.CrossRefGoogle ScholarPubMed
Bredesen, D. (2017). The End of Alzheimer’s Programme: The Practical Plan to Prevent and Reverse Cognitive Decline at Any Age. London: Vermillion.Google Scholar
Brookmeyer, R., Johnson, E., Ziegler-Graham, K., & Arrighi, H. M. (2007). Forecasting the global burden of Alzheimer’s disease. Alzheimer’s & Dementia, 3 (3), 186–91.Google ScholarPubMed
Bubu, O. M., Brannick, M., Mortimer, J., et al. (2017). Sleep, cognitive impairment, and Alzheimer’s disease: A systematic review and meta-analysis. Sleep, 40 (1), zsw032.CrossRefGoogle ScholarPubMed
Butters, M. A., Becker, J. T., Nebes, R. D., et al. (2000). Changes in cognitive functioning following treatment of late-life depression. American Journal of Psychiatry, 157 (12), 1949–54.CrossRefGoogle ScholarPubMed
Choi, D., Choi, S., & Park, S. M. (2018). Effect of smoking cessation on the risk of dementia: A longitudinal study. Annals of Clinical and Translational Neurology, 5 (10), 1192–9.CrossRefGoogle ScholarPubMed
Conklin, H. W. (1922). Cause and treatment of epilepsy. Journal of the American Osteopathy Association, 26, 11–14Google Scholar
Cunningham, E. L., Todd, S. A., Passmore, P., Bullock, R., & McGuinness, B. (2021). Pharmacological treatment of hypertension in people without prior cerebrovascular disease for the prevention of cognitive impairment and dementia. Cochrane Database of Systematic Reviews, 5 (5), CD004034. https://doi.org/10.1002/14651858.CD004034.pub4.Google ScholarPubMed
Dahl, A. K., Löppönen, M., Isoaho, R., Berg, S., & Kivelä, S. L. (2008). Overweight and obesity in old age are not associated with greater dementia risk: Journal of the American Geriatrics Society, 56 (12), 2261–6.CrossRefGoogle Scholar
Dalya, T., & Mastroleob, I. (2022). The first survivors of Alzheimer’s: How patients recovered life and hope in their own words by Dale Bredesen, Avery, 2021, 272 pp. Journal of Alzheimer’s Disease, 86, 49–52.Google Scholar
Forbes, S. C., Holroyd-Leduc, J. M., Poulin, M. J., & Hogan, D. B. (2015). Effect of nutrients, dietary supplements and vitamins on cognition: A systematic review and meta-analysis of randomized controlled trials. Canadian Geriatrics Journal, 18 (4), 231.CrossRefGoogle ScholarPubMed
Fratiglioni, L., & Wang, H. X. (2007). Brain reserve hypothesis in dementia. Journal of Alzheimers Disease, 12 (1), 11–22.CrossRefGoogle ScholarPubMed
Fratiglioni, L., Wang, H. X., Ericsson, K., Maytan, M., & Winblad, B. (2000). Influence of social network on occurrence of dementia: a community-based longitudinal study. Lancet, 355, 1315–19.CrossRefGoogle ScholarPubMed
Friberg, L., & Rosenqvist, M. (2018). Less dementia with oral anticoagulation in atrial fibrillation. European Heart Journal, 39 (6), 453–60.CrossRefGoogle ScholarPubMed
Hachinski, V., Einhäupl, K., Ganten, D., et al. (2019). Preventing dementia by preventing stroke: The Berlin Manifesto. Alzheimer’s & Dementia, 15(7), 961–84.CrossRefGoogle ScholarPubMed
Hassing, L. B., Dahl, A. K., Thorvaldsson, V., et al. (2009). Overweight in midlife and risk of dementia: A 40-year follow-up study. International Journal of Obesity, 33 (8), 893–8.CrossRefGoogle ScholarPubMed
Hellmuth, J. (2020). Can we trust The End of Alzheimer’s? The Lancet. Neurology, 19 (5), 389.Google Scholar
Hellmuth, J., Rabinovici, G. D., & Miller, B. L. (2019). The rise of pseudomedicine for dementia and brain health. JAMA, 321 (6), 543–4.CrossRefGoogle ScholarPubMed
Huang, X., Zhao, X., Li, B., et al. (2022). Comparative efficacy of various exercise interventions on cognitive function in patients with mild cognitive impairment or dementia: A systematic review and network meta-analysis. Journal of Sport and Health Science, 11, 212–23CrossRefGoogle ScholarPubMed
Hulse, G. K., Lautenschlager, N. T., Tait, R. J., & Almeida, O. P. (2005). Dementia associated with alcohol and other drug use. International Psychogeriatrics, 17 (s1), S109–S127.CrossRefGoogle ScholarPubMed
Iwagami, M., Qizilbash, N., Gregson, J., et al. (2021). Blood cholesterol and risk of dementia in more than 1.8 million people over two decades: A retrospective cohort study. The Lancet Healthy Longevity, 2 (8), e498–e506.CrossRefGoogle ScholarPubMed
Karp, A., Paillard-Borg, S., Wang, H. X., et al. (2006). Mental, physical and social components in leisure activities equally contribute to decrease dementia risk. Dementia and Geriatric Cognitive Disorders, 21 (2), 65–73.CrossRefGoogle ScholarPubMed
Koenig, A. M., Mechanic-Hamilton, D., Xie, S. X., et al. (2017). Effects of the insulin sensitizer metformin in Alzheimer disease: Pilot data from a randomized placebo-controlled crossover study. Alzheimer Disease & Associated Disorders, 31(2), 107–13.CrossRefGoogle ScholarPubMed
Kroon, E., Kuhns, L., & Cousijn, J. (2021). The short-term and long-term effects of cannabis on cognition: Recent advances in the field. Current Opinion in Psychology, 38, 49–55.CrossRefGoogle ScholarPubMed
Kutlu, M. G., & Gould, T. J. (2015). Nicotinic receptors, memory, and hippocampus. The Neurobiology and Genetics of Nicotine and Tobacco, 23, 137–63.CrossRefGoogle ScholarPubMed
Lim, A. S., Kowgier, M., Yu, L., Buchman, A. S., & Bennett, D. A. (2013). Sleep fragmentation and the risk of incident Alzheimer’s disease and cognitive decline in older persons. Sleep, 36 (7), 1027–32.CrossRefGoogle ScholarPubMed
Livingston, G., Huntley, J., Sommerlad, A., et al. (2020). Dementia prevention, intervention, and care: 2020 report of the Lancet Commission. The Lancet, 396 (10248), 413–46.CrossRefGoogle ScholarPubMed
Ma, Y., Ajnakina, O., Steptoe, A., & Cadar, D. (2020). Higher risk of dementia in English older individuals who are overweight or obese. International Journal of Epidemiology, 49 (4), 1353–65.CrossRefGoogle ScholarPubMed
Mander, B. A., Winer, J. R., & Walker, M. P. (2017). Sleep and human aging. Neuron, 94(1), 19–36.CrossRefGoogle ScholarPubMed
Meier, M. H., Caspi, A. R., Knodt, A., et al. (2022). Long-term cannabis use and cognitive reserves and hippocampal volume in midlife. American Journal of Psychiatry, 179 (5), 362–74.CrossRefGoogle ScholarPubMed
Moroshko, I., Brennan, L., & O’Brien, P. (2011). Predictors of dropout in weight loss interventions: A systematic review of the literature. Obesity Reviews, 12 (11), 912–34.CrossRefGoogle Scholar
Morris, M. C., Tangney, C. C., Wang, Y., et al. (2015). MIND diet associated with reduced incidence of Alzheimer’s disease. Alzheimer’s & Dementia, 11(9), 1007–14.CrossRefGoogle ScholarPubMed
Ngandu, T., Lehtisalo, J., Solomon, A., et al. (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. The Lancet, 385 (9984), 2255–63.CrossRefGoogle Scholar
Ott, A., Breteler, M. M., De Bruyne, M. C., et al. (1997). Atrial fibrillation and dementia in a population-based study: The Rotterdam Study. Stroke, 28 (2), 316–21.CrossRefGoogle Scholar
Ott, A., Stolk, R. P., Hofman, A., et al. (1996). Association of diabetes mellitus and dementia: The Rotterdam Study. Diabetologia, 39, 1392–7.CrossRefGoogle ScholarPubMed
Peprah, K., & McCormack, S. (2019). Medical cannabis for the treatment of dementia: a review of clinical effectiveness and guidelines. Review from Canadian Agency for Drugs and Technologies in Health, Ottawa (ON). www.ncbi.nlm.nih.gov/books/NBK546328/.Google Scholar
Peters, R., Peters, J., Warner, J., Beckett, N., & Bulpitt, C. (2008). Alcohol, dementia and cognitive decline in the elderly: A systematic review. Age and Ageing, 37(5), 505–12.CrossRefGoogle ScholarPubMed
Phillips, M. C., Deprez, L. M., Mortimer, G., et al. (2021). Randomized crossover trial of a modified ketogenic diet in Alzheimer’s disease. Alzheimer’s Research & Therapy, 13 (1), 1–12.Google ScholarPubMed
Scherrer, J. F., Morley, J. E., Salas, J., et al. (2019). Association between metformin initiation and incident dementia among African American and white veterans’ health administration patients. The Annals of Family Medicine, 17(4), 352–62.CrossRefGoogle ScholarPubMed
Schultz, B. G., Patten, D. K., & Berlau, D. J. (2018). The role of statins in both cognitive impairment and protection against dementia: A tale of two mechanisms. Translational Neurodegeneration, 7, 1–11.CrossRefGoogle ScholarPubMed
Sierra, C. (2020). Hypertension and the risk of dementia. Frontiers in Cardiovascular Medicine, 7, 5.CrossRefGoogle ScholarPubMed
Skoog, I., Nilsson, L., Persson, G., et al. (1996). 15-year longitudinal study of blood pressure and dementia. The Lancet, 347 (9009), 1141–5.CrossRefGoogle ScholarPubMed
Stern, Y. (2006). Cognitive reserve and Alzheimer disease. Alzheimer Disease and Associated Disorders, 20 (3)(suppl 2), S69–S74.CrossRefGoogle ScholarPubMed
van Charante, E. P. M., Richard, E., Eurelings, L. S., et al. (2016). Effectiveness of a 6-year multidomain vascular care intervention to prevent dementia (preDIVA): A cluster-randomised controlled trial. The Lancet, 388(10046), 797–805.CrossRefGoogle Scholar
Wagstaff, L., Mitton, M., Arvik, B., & Doraiswamy, P. (2003). Statin-associated memory loss: Analysis of 60 case reports and review of the literature. Pharmacotherapy, 23, 871–80.CrossRefGoogle ScholarPubMed
Walker, M. (2017). Why We Sleep. Allen Lane.Google Scholar
Wang, H. X., Karp, A., Winblad, B., & Fratiglioni, L. (2002). Late-life engagement in social and leisure activities is associated with a decreased risk of dementia: A longitudinal study from the Kungsholmen Project. American Journal of Epidemiology, 155, 1081–7.CrossRefGoogle ScholarPubMed
Wiegmann, C., Mick, I., Brandl, E. J., Heinz, A., & Gutwinski, S. (2020). Alcohol and dementia – what is the link? A systematic review. Neuropsychiatric Disease and Treatment, 16 87–99.CrossRefGoogle ScholarPubMed
Williams, B. D., Pendleton, N., & Chandola, T. (2020). Cognitively stimulating activities and risk of probable dementia or cognitive impairment in the English Longitudinal Study of Ageing. SSM – Population Health, 12, 100656.CrossRefGoogle ScholarPubMed
Wong, W. B., Lin, V. W., Boudreau, D., & Devine, E. B. (2013). Statins in the prevention of dementia and Alzheimer’s disease: A meta‐analysis of observational studies and an assessment of confounding. Pharmacoepidemiology and Drug Safety, 22(4), 345–58.CrossRefGoogle Scholar
Zhong, G., Wang, Y., Zhang, Y., Guo, J. J., & Zhao, Y. (2015). Smoking is associated with an increased risk of dementia: A meta-analysis of prospective cohort studies with investigation of potential effect modifiers. PloS One, 10 (3), e0118333.CrossRefGoogle ScholarPubMed

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