Risk for Dementia Goes Down with Steps to Prevent Heart Attacks

You can reduce your risk for suffering from dementia by up to 70 percent when you follow the same healthful habits that help to prevent heart attacks (JAMA, Aug 21, 2018;320(7):657-664). A study of 6,600 people over 65, followed for 8.5 years, found that each lifestyle risk factor for heart attacks is also a risk factor for dementia, and that correcting each heart attack risk factor reduces risk for dementia. The seven healthful habits used in the study were:

• avoid smoking and smoke

• avoid overweight (body mass index <25)

• exercise regularly

• eat fruits and vegetables at least three times a day and fish twice a week

• have total cholesterol below 200 mg/dL (untreated)

• have fasting blood sugar below 100 mg/dL (untreated)

• have blood pressure <120/80 mm Hg at bedtime (untreated) Changing from an unhealthful factor to a healthful one reduced risk for dementia by 10 percent for each factor, compared to those who had none of the positive factors. The people who scored well on all seven of the factors had a 70 percent lower risk for dementia.

MRI Study: Healthier Heart, Healthier Brain In the same issue of JAMA, an MRI study of 125 healthy people, ages 18 to 40, showed that those who had fewer heart attack risk factors also had far less brain damage and risk for dementia: more blood vessels in their brains, a greater blood flow to their brains, and far fewer white-matter hyper-intensity lesions associated with brain damage (JAMA, Aug 21, 2018;320(7):665-673). Reduced risk for a heart attack was defined as:

• not overweight (body mass index <25)

• high level of exercise and physical fitness

• taking fewer than eight alcoholic drinks per week

• nonsmoker for at least six months

• blood pressure <130/80 mm Hg and peak exercise diastolic blood pressure not greater than <90 mm Hg

• total cholesterol <200 mg/dL

• fasting blood sugar <100mg/dL

Autopsy Study Similar findings associating the Western diet with brain damage were just presented at the July 22, 2018 Alzheimer's Association International Conference in Chicago, Illinois (Poster P1-199). The typical western diet, with large amounts of red and processed meats, fried foods, sugar added foods and sugared drinks, has repeatedly been linked to increased risk for cognitive decline, dementia and Alzheimer's disease. People who lived in Chicago retirement communities and in subsidized housing, whose average age at time of death was 90 years, had their diets evaluated every year with food questionnaires. The brains of 468 of these people were examined when they died. Unhealthful westernized diet patterns were associated with higher levels of markers for Alzheimer's disease: higher amyloid levels, more plaques in nerves and more small blood vessel disease.

Never Too Late to Change Your Lifestyle We know that everyone loses brain cells as they age. Scientists used to think that as you age you cannot make new brain cells, but an exciting study from Columbia University showed that you do make new brain cells as you age and that loss of brain function is primarily caused by lack of adequate blood flow and nourishment of these brain cells (Cell Stem Cell, April 5, 2018;22(4):589–599). The authors found that all age groups from young to old have the same number of neural progenitor cells and immature neurons that make new nerve cells in the hippocampus, the part of the brain that governs memory. However, contrary to a previous study that showed no new nerve growth with aging (Nature, March 2018), this new study found that the brains of older people have progressive loss of new blood vessels with aging and with that, the loss of the ability of brains cells to connect with each other. If dementia is caused by lack of blood flow to brain cells, prevention of dementia should include diet changes to decrease plaques from blocking blood flow to the brain, and exercise -- the most effective way to increase growth of new blood vessels.

Lack of Exercise Is a Major Risk Factor for Dementia Many studies show that exercise increases blood flow to the brain to stimulate growth of new blood vessels and cells and reduces risk for diabetes and obesity which can damage the brain. Older adults who do not exercise have a markedly increased rate of dementia and loss of white matter in their brains that helps them to retain memory and make wise decisions (Journal of Alzheimer's Disease, Dec 19, 2017;61(2):729-739). See How Exercise Reduces Dementia Risk

My Recommendations If you don't already eat a healthful plant-based diet and engage in a regular exercise program, check with your doctor and then try to start a new diet and exercise program as soon as possible.

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