22 Tips to Reduce Dementia Risk

Hey there, everybody, and welcome to this presentation on 20 plus ways to reduce your risk of dementia. I'm your host, Dr. Donnellice Snipes. June is Alzheimer's and Dementia Awareness Month. A lot of people think that dementia is something that cannot be prevented or treated, and that's really not true. More than 50% of dementia cases theoretically could be prevented or reduced by targeting these risk factors. The first one they identify is lack of early life education or enrichment. And one of the reasons they theorize this is a risk factor is because the person who lacks early life education and enrichment is often growing up in an impoverished environment that is high stress and both physically and emotionally. But additionally, the person is not developing what they call cognitive reserve or additional knowledge and stuff that they're storing. Midlife hypertension. Now, this is one of those that we can address. Even if we are, you know, adults, we can address our blood pressure and high blood pressure is associated with an increased risk of stroke. Increased risk of stroke means that oxygen and blood supply cut off to the brain and that can lead to. Can lead to dementia. So it's important to recognize that midlife hypertension is a big risk factor. If you are hypertensive, what can you do? There are nutritional strategies, there are medications, there are cognitive strategies like relaxation, meditation, etc. That all can be used to help you manage your blood pressure. Hypoxia is another issue that is somewhat addressable. If you've got chronic obstructive pulmonary disease, you may not be able to prevent it completely, but it's important to wear your oxygen when you're supposed to and do what you can to make sure that you're getting plenty of oxygenation. Other issues include depressant misuse when you use depressants, and these include opioids. Any drug that is going to slow your system way down. If you're misusing it, it can reduce your circulation, it can actually reduce your respiration, your breathing, and contribute to hypoxia or a lack of oxygen to the brain. And stroke, As I mentioned earlier, stroke is a big risk factor for the development of vascular dementia. Therefore, doing what we can to reduce our risk of stroke is a huge step in preventing dementia. They found a significant correlation between obesity and the development of dementia. They hypothesize, and that this might be in part because people who are obese, they have a higher level of body fat than is considered healthy for them, tend to have more inflammation systemically, their estrogen levels tend to be higher, and just in general, there's more inflammation But a lot of times people who are obese will often also complain of joint pains and other issues that are caused by the excessive weight. And those pains bring with it, with bring with them, oftentimes inflammation. Systemic inflammation contributes to a neurotoxic environment in the brain. Diabetes has also been found to be associated with the development of dementia. If you have diabetes, it doesn't mean you're going to get dementia. What you really want to look at is controlling that A1C level, that blood sugar level, in order to make sure that you are not contributing to influence systemic inflammation. When your blood sugar levels are all over the place, your body tends to have more systemic inflammation. Interestingly enough, hypothyroidism is also associated with the development of dementia. A lot of people develop hypothyroid. It's not something you're necessarily born with, it's something that can happen at any point in life. If you start experiencing symptoms of extreme fatigue, dry skin, constipation, depressive type symptoms, it's important to get it assessed, get your thyroid assessed, get your hormones assessed to see if there's an underlying physiological cause. Hypothyroid means the system. Your system tends to be functioning more slowly, which means slower circulation, which means less oxygenation to the brain and an increased risk of dementia. Hypothyroidism is very easy to treat and improves the quality of life of a lot of people once they realize, hey, you know, my thyroid's out of whack. Hearing loss. This is another interesting thing. 9% of people with dementia or they attribute hearing loss as a factor in the development of dementia for 9% of people. Why might that be? Hearing loss in somebody who has been hearing can contribute to stress and isolation. When people are having difficulty understanding what other people are saying, they're missing things, it can feel very frustrating. That triggers a sense of stress, isolation, depression, all of that. All of those can be associated with activation of the threat response system and increased systemic inflammation. We know that as depression goes up, inflammation goes up. Therefore, hearing loss is secondary, I guess, to a risk factor for dementia, which is inflammation. Hearing loss is common in a lot of people as they age and it's one of those things that is totally addressable. Smoking. Smoking contributes to a variety of changes in your blood vessels, in your vasculature, which can contribute to an increased risk of COPD, hypoxia, stroke, etc. Depression or anxiety. Depression is associated with higher levels of inflammation, as I just said. Also reduced levels of physical activity and increased body weight in A lot of people, and sometimes the erratic blood sugar because they tend. People who are depressed tend to gravitate towards high fat, high sugar foods that will prompt the release of dopamine and serotonin. Anxiety is a stress related emotion, one of the fight or flee emotions. When you're feeling anxious, your threat response system, that HPA axis is activated. You're in fight or flee mode, which when it happens just occasionally, not a big deal. But when somebody is persistently or anxious continually, then instead of doing what it's supposed to do, cortisol loses its effectiveness and we start to see increases in systemic inflammation. Depression or anxiety are modifiable through counseling as well as through medical intervention. Many of the symptoms of depression and or anxiety can be caused by a variety of physiological things, not the least of which are changes in testosterone or estrogen levels and imbalances in hormone, thyroid hormones. Either being hyper or hypothyroid. Those are very easily addressable by a medical professional. So if you're feeling depressed or anxious, it's so helpful to get it assessed and addressed sooner rather than later. Physical inactivity. Well, we keep talking about oxygenation and circulation. Your brain needs nutrients, your brain needs oxygen. And the more fresh oxygen and nutrients and stuff that you can bathe your brain in, if you want to think of it just kind of grossly oversimpt, grossly oversimplified, the healthier your brain's gonna be. Physical inactivity often leads to reduced circulation, which means that all that good stuff isn't as efficiently getting up to your brain. They found a significant improvement in cognitive functioning in older people, even those without dementia, when they started engaging in physical activity, whether it be yoga or Tai chi, and this can be chair yoga or chair Tai Chi. It doesn't mean you have to get up even using one of the little pedal machines that you put in front of the sofa. I recognize that a lot of people don't have the same level of mobility anymore. That doesn't mean that you have to be completely sedentary. Social isolation is associated with feelings of depression and sleep alterations, which, as we mentioned earlier, can lead to inflammation and increase the risk of dementia. Social isolation is addressable and preventable, but sometimes you have to get creative. If you live out in the middle of Timbuktu on a farm, you know, kind of like we do, it's not as easy as walking to the neighbor's house to talk to somebody. So you may have to set up times, you may have to arrange with family members or friends to Pick you up and go into town to do something. But social interaction is really important for stress management. Social interaction promotes the release of dopamine and oxytocin and endogenous opioids and all kinds of good chemicals that help to regulate the system and suppress inflammation. So there are a lot of benefits. It's just a matter of figuring out what is it that you want to do and what is contributing to your sense of social isolation. Like I said, it could be where you're at, you're in the, you know, in the middle of a very rural area. Or it could be you don't feel like you are connected or you don't feel like you fit in places. And that's when it becomes a matter of figuring out where might I enjoy meeting people? Where might I fit in? Alcohol and drug misuse are also risk factors for dementia drug use, especially stimulants. Interestingly enough, anticholinergics like Benadryl and benzodiazepines are all associated with an increased risk of developing dementia later in life. Now that doesn't mean that taking a Benadryl occasionally is going to be a big deal or a short course of benzodiazepines anti anxiety medication is going to is a big deal. But they found that long term use of anticholinergics or benzodiazepines is associated with a pretty significant increased risk of dementia. Heavy alcohol use is also associated with an increased risk of dementia. Alcohol use itself promotes. Drumroll please. Systemic inflammation. Heavy alcohol use can also lead to something called Korsakoff syndrome which is a thiamine deficiency. Korsakoff syndrome can become Weirnicke's encephalopathy which is a swelling of the brain if it's left untreated. People who have been drinking heavily and stop people, people who have had and this isn't alcohol related. People who've had bariatric surgery and people with eating disorders are at much higher risk of developing Korsakoff syndrome which can lead to what is typically called alcohol related dementia. Cirrhosis is another consequence of heavy alcohol use and cirrhosis can lead to hepatic encephalopathy. When the liver quits working as well, then you start getting toxins backing up into the system which causes swelling in the brain which is associated with increased risk of dementia. The take home alcohol use, if you're going to drink, obviously use in moderation or extreme moderation. Same thing with anticholinergics and anti anxiety medications. If you, if you're working with A physician, especially a geriatric physician, they should be very aware of this. As you get older, unfortunately, your liver's ability to clear stuff out of your system decreases. So what you were able to tolerate as a young person, you may not be able to tolerate once you get into your, you know, upper 50s, 60s, 70s. And there are certain medications that just shouldn't be prescribed to people that are over the age of 65 because the liver just really can't clear it very well at all. Which is why using a geriatric specialist is very, very helpful to preventing inadvertent problems. Poor diet is associated with increased inflammation as well as lack of nutrients that are needed in order to keep the brain, keep the body and brain functioning well. Poor diet is associated with dementia. Long standing, poor diet definitely is associated with neurocognitive changes that can lead to dementia. Low testosterone or low estrogen can be caused by chronic stress or exposure to toxins. These are also associated with an increased risk of dementia. As I mentioned earlier. Testosterone, estrogen, these things are really easily identifiable and addressable by your physician. It's one of those that can be easily modified. Chronic stress can lead to what we call chronic hypercortisolism. When your brain is constantly, when the receptors are constantly exposed to cortisol, eventually they just become resistant. They basically say, I just, I don't have the energy to listen to you right now. So cortisol loses its ability to, to act as a anti inflammatory and so inflammatory processes start running rampant. Adverse childhood experiences, trauma and ptsd, these things may not be able to be prevented. However, addressing them through therapy, emdr, whatever process necessary to, to reduce the symptoms of trauma and PTSD can go a long way to reducing dementia risk. Autoimmune disorders are associated with systemic inflammation. Inflammation is associated with a greater risk of dementia. If you have an autoimmune disorder, this again is not something that you can probably get rid of at this point. We don't know how to do that. However, you can reduce the frequency and intensity of your flares and that will go a long way to reducing overall systemic inflammation and reducing your risk for dementia. Gut health we talk a lot about gut health these days and the microbiome, the bacteria in your gut that break down foods in order to make the building blocks for the nutrients you need to survive. That microbiome is very sensitive to stress, to inflammation, to nutritional changes. And changes in those bacteria can either cause an increase in inflammation or a decrease in inflammation can cause a improved balance of neurotransmitters or a worsening balance of neurotransmitters. So gut health is really important, making sure that you're eating a reasonably healthy diet. Sleep apnea is another risk factor for dementia, mainly because when people have sleep apnea, they go through periods, five or more periods every hour, where they actually stop breathing. And that lack of oxygen contributes to hypoxia, which contributes to your risk for dementia. Sleep apnea has a lot of different treatments out there. CPAP machines is one of the biggest ones right now that's been found to be effective. I know there are also some surgeries, et cetera, that are out there. But sleep apnea is another one that is relatively easy to address and can make a huge difference in your risk for dementia. AIDS dementia complex contributes to the development of dementia in 7% of people who are not taking HIV drugs. Obviously, if you don't have hiv, then taking HIV drugs is not going to do anything. You're not at risk for this. But if you do have hiv, taking the HIV drugs will go a long way to reducing your risk for AIDS related dementia. Carbon monoxide poisoning how many of you have a carbon monoxide detector in your house? If you don't, you need one. They have found in multiple studies that chronic exposure to high levels of carbon monoxide increase the risk of dementia. Additionally, even one episode of significant carbon monoxide poisoning has long term effects that can increase people's risk of dementia. Carbon monoxide detectors are relatively inexpensive and compared to, you know the consequences, definitely worth the money. Repeated head trauma. Whether it is from peewee football or from boxing as an adult, or multiple car accidents, repeated head traumas cause every time you have a head trauma, it causes swelling. That swelling can contribute to changes in the structure of the brain, which can make you put you at greater risk for dementia. The takeaway. Some of those can't be prevented. But ideally, you know, if you're engaged in something where you may take head traumas, adhering to best practices as parents, if our children are engaged in sports in which they may experience head traumas, ensuring that the league is enforcing appropriate guidelines to minimize head trauma is going to be important. This is also true a lot of people don't think about it, but those who are taking martial arts also may experience significant or frequent blows to the head. So it's not just something like football, it can be taekwondo or other things. Anything where the head is getting hit can be a problem. There are nearly two dozen strategies to reduce your risk for dementia. Some are as easy as getting a carbon monoxide monitor, a CPAP machine or hearing aids. Others, like addressing PTSD or CPTSD or depression, may take more time. This month, eliminate as many of the easy ones as possible. Get a physical, get a carbon monoxide monitor, etc. Beginning next month, start tackling one risk factor per month to see how many of your risk factors for dementia that you can actually reduce or eliminate.