Researchers in Finland followed 3,596 children (3-18) for 31 years to see whether cardiovascular risk factors in childhood and adolescence were associated with cognitive performance later in life (Circulation, published online May 10, 2021). Cognitive testing was performed in 2,026 of the participants at 34-49 years of age, and the researchers found that early heart attack risk factors were also major risk factors for reduced mental function, particularly:
• high systolic blood pressure
• high blood cholesterol
• smoking
• obesity
The more heart attack risk factors a child had, the greater the risk for loss of mental function in midlife.

Risk factors for heart attacks in midlife such as diabetes, high blood pressure, and smoking cigarettes are also risk factors for dementia (JAMA Neurology, August 7, 2017; Neuropsychiatr Dis Treat, 2019;15:167–175). Other risk factors for both dementia and heart attacks include:
• alcohol use
• high HBA1c (a blood test that measures sugar stuck on cells)
• high blood homocysteine
• excess fat in your belly and liver
• lack of exercise
• unhealthful diet

Preventing Diabetes to Lower Risk for Dementia and Heart Attacks
Up to 70 percent of North Americans will become diabetic and up to 30 percent of diabetics will never be diagnosed because the standard test of having a normal fasting blood sugar (lower than 100 mg/dL) does not rule out type II diabetes. You can damage your cells whenever your blood sugar rises too high after meals, and you are diabetic if your blood sugar rises higher than 145 mg/dL one hour after you eat (Diabetes Care, 2001;24(8):1448-1453). Anyone who stores fat primarily in their belly should get a test of blood sugar levels one hour after a meal. Having extra fat in your belly usually means that you have extra fat in your liver, and extra fat in your liver prevents your cells from responding to insulin (J Clin Invest, September 26, 2016). This is called insulin resistance. Exercise helps to prevent and treat insulin resistance by strengthening and enlarging muscles (JCI Insight, February 21, 2019;4(4)).

My Recommendations
To lower your risk for dementia in later life, try to follow all of the rules for preventing heart attacks and diabetes from a very early age.
• Try to exercise every day
• Follow a high-plant diet that restricts sugar-added foods and drinks, mammal meat, processed meats, and fried foods
• Avoid being overweight
• Avoid alcohol
• Avoid smoking and second hand smoke
• Keep your vitamin D levels above 30 ng/mL