More than six million North Americans suffer from dementia, which affects three percent of people age 65-74, 17 percent of age 75-84, and 32 percent of those age 85 and older. Anything that damages brain cells can cause dementia and many of the causes are treatable, so everyone who notices increasing forgetfulness, confusion or uncontrollable anger should get a medical evaluation for the cause as soon as possible.

Known Risk Factors for Dementia
• Aging.
• Family history of dementia.
• Diabetes. A high rise in blood sugar after meals causes sugar to stick to and damage cells everywhere in your body including your brain, so dementia risk is increased by all the risk factors for diabetes such as excess fat in the liver and high insulin levels (Arteriosclerosis, Thrombosis and Vascular Biology, Mar 1, 1986;6:123–130). Women who store fat primarily in their livers are at significant risk for dementia later in life (Int J of Epidemiology, June 23, 2020).
• Heavy alcohol use (Neuropsychiatr Dis Treat, Jan 9, 2020;16:87–99).
• Smoking (Annals of Clin and Transl Neurol, Sept 5, 2018).
• History of head injuries.
• Everything associated with damaged arteries, such as heart attacks, strokes, and clots and their risk factors: high blood pressure, high cholesterol, diabetes and so forth (AMA Neurol, Oct 1, 2017;74(10):1246-1254).
Inflammation (Annals of Neurology, July 23, 2002). An immune system that stays active all the time eventually can attack and destroy the brain. Infections, lack of exercise and a pro-inflammatory diet increase inflammation.
• Vitamin deficiencies. Lack of B12, folic acid, pyridoxine or vitamin D can damage nerves and brain cells (BMJ Case Reports CP, May 14, 2019;12:e229044).
• Thyroid disease (Neurobiol Aging, Apr 2009;30(4):600–606).
• Certain drugs taken long-term are associated with increased risk for dementia. These include drugs to treat thought disorders, Parkinson’s disease, depression, chronic obstructive lung disease, overactive bladder, allergies, gastrointestinal disorders, seizures and antidepressants (JAMA Intern Med, 2019;179(8):1084-1093; BMJ, Sept. 9, 2014;351; BMC Geriatrics, March 15, 2015);15(31)).

A Healthful Lifestyle Helps to Prevent Dementia
Finnish researchers showed that they were able to slow the onset of dementia in people at high risk, with a program that included a healthful lifestyle aimed at preventing heart attacks, heart attack risk monitoring, and exercises to improve memory (Lancet, March 11, 2015). Factors that predict increased risk for heart attacks also predict risk for dementia (Neurology, April 2, 2013). For example, arteriosclerosis that damages the arteries leading to the heart also damages the arteries that lead to the brain to cause ministrokes and strokes.

Tests Your Doctor Should Order Immediately If You Suffer from Failing Memory
• Complete blood count (CBC)
• Metabolic panel
• Lipid panel
• HbA1c (for diabetes) and blood sugar one hour after eating a meal (if >145 mg/dL, your sugar is too high)
• Tests for inflammation: antinuclear antibody, sed rate, C reactive protein
• Vitamins B12, B9, B6, and D
• If B12 deficient, check homocysteine and methyl malonic acid
• Syphilis screen with reflex
• Thyroid hormones: T3, T4, TSH
• ApoE genotype (a genetic cause of dementia)
• MRI of brain

Some of the Many Famous People Who Suffered from Dementia
Charlton Heston, Ronald Reagan, Glen Campbell, Rita Hayworth, Perry Como, Norman Rockwell, Sugar Ray Robinson, Dina Merrill, Aaron Copeland, E.B. White, Robin Williams, Abe Burrows, Mike Pyle, Barry Goldwater, Molly Picon, Gene Wilder , Charles Bronson, Arlene Francis, Jerry Quarry, Burgess Meredith, Otto Preminger, Gordie Howe, Rudolph Bing, Charmain Carr , Margaret Thatcher, Harold Wilson.

My Recommendations
Many causes of dementia are reversible if you receive treatment early enough. If you suffer from memory loss, get a medical work up for known and treatable causes immediately. Ask your doctor if any drugs you are taking can cause forgetfulness. All of the steps you can take to reduce risk for a heart attack can also help to prevent dementia:
• exercising and growing larger muscles
• losing weight if overweight, particularly if you store fat in your belly
• eating lots of fruits, vegetables, whole grains, beans, nuts and other seeds
• restricting red meat, fried foods, sugared drinks, sugar-added foods, refined carbohydrates and alcohol
• avoiding smoking and second hand smoke
• treating vitamin deficiencies, particularly B6, B9, B12 and D
• treating infections and other sources of inflammation