Dementia Isn’t a Certainty: Learn How to Modify Your Risk

June 21, 2022

Swedish Neuroscience Team

Senior woman playing puzzle game

[5 MIN READ]

For many of us, one of the most anxiety-provoking aspects of getting older is slowly losing our cognitive function — the ability to think, reason and remember well. It’s a condition generally known as dementia, and if you’ve watched it happen to a loved one or friend, you know how frustrating and frightening it can be. Worldwide, dementia affects 55 million people, including 6.5 million people in the United States.

While that number is expected to grow over the next 40 years, there are things you can do to help keep your mind sharp. In fact, up to 40% of dementia cases are preventable. June is Alzheimer’s and Brain Awareness Month, and it’s a good time to learn more about your cognitive health.

“We need to do a better job at busting the myth that our genes are our destiny. We are not our parents. We are not our genes,” says Nancy Isenberg, M.D., MPH, a neurologist with Swedish Edmonds and the Swedish Center for Healthy Aging. “Just because your mother or father has dementia doesn’t mean you will, too. Instead, your mindset and beliefs can shape your behaviors, your health, and your lifespan in invisible, yet powerful, ways. By incorporating positive health behaviors, you can live a longer life and significantly reduce your dementia risk.

Knowing what changes to make, she says, is the key to potentially living a longer, healthier life.

What is dementia?

“Dementia is an umbrella term used to describe the loss of cognitive abilities in two or more areas that impacts your daily life. For example, remembering to take medications, or paying bills is no longer possible,” Dr. Isenberg says.

Getting older is the biggest risk factor for developing dementia. According to recent data, roughly 3% of people between ages 65 and 74 have dementia, but it affects nearly one-third of people in their 90s. More women are affected than men, and communities of color are disproportionately affected as well. So it is important to improve access and outreach to communities at risk.

Someone who has developed dementia may show these signs:

Memory loss, confusion and poor judgment
Wandering, getting lost in familiar places
Repeating questions
Difficulty speaking
Confusion with reading and writing
Taking longer to finish or losing interest in normal tasks
Difficulty with money
Hallucinations or paranoia
Referring to familiar objects with unusual words
Being impulsive
Disregard for others
Balance and mobility problems

There is good news, however. Several of the things that increase your dementia risk are behaviors you can control, Dr. Isenberg, affirms.

What are the types of dementia?

Not all types of dementia are the same. They can affect the brain and body in different ways. It’s possible to develop one of many versions of this condition:

Alzheimer’s disease: This is the most common type of dementia. It happens mostly in older adults and is caused by a build-up of proteins, called amyloid and tau and neurodegeneration in the brain.
Lewy body dementia: This type of dementia presents with parkinsonism, abnormal movements like slow or rigid movements and tremors, along with visual hallucinations, and fluctuations of attention. A high level of another protein called alpha-synuclein (called Lewy bodies) builds up in the brain with this type of dementia.
Vascular dementia: Damage to blood vessels that interrupt the flow of oxygen and blood to the brain cause this type of dementia.
Frontotemporal dementia: This rare dementia appears more often in people under age 60.
Mixed dementia: It’s possible to have brain changes linked to several types of dementia at the same time. In some cases, signs of Alzheimer’s, vascular dementia and Lewy body dementia appear together.

Ways the reduce risk

Doctors don’t have a way to stop dementia from progressing once it develops, Dr. Isenberg says. So the best way to fight against it is to be proactive and live a healthy lifestyle.

“We don’t have any disease-modifying therapies for dementia,” she adds. “Consequently, we really have to focus our lens on primary dementia prevention, planning for the future and a person- and family-centered strength-based approach to manage dementia in the community.

Eating a heart-healthy diet, such as the Mediterranean diet, is one of the best things you can do, she says. You can help keep dementia at bay by loading up on fresh fruits and vegetables, fish, whole grains, and olive oil.

“Remember that heart health is brain health,” says Dr. Isenberg. “Anything that keeps the arteries healthy reduces dementia risk.”

Want to further decrease your risk? Focus on these 12 behaviors:

Exercise for at least 150 minutes weekly (cardiovascular and weight-bearing)
Stop smoking
Wear hearing aids to reduce hearing loss
Maintain a healthy weight
Maintain healthy blood pressure
Drink less alcohol
Get social — spend more time with family and friends
Talk to your doctor about any feelings of depression
Challenge yourself to learn new things regularly, such as recipes or a different language
Avoid air pollution
Protect your head from injury as much as possible
Take steps to control diabetes

“If you focus on incorporating these positive health behaviors, along with stress reduction, good sleep, staying social, life-long learning and having a positive mindset about aging,” she says, ”then you will optimize your chances of a longer, healthier life.”

Innovative therapies

Although there isn’t a cure for Alzheimer’s or other types of dementia, doctors are looking at ways to detect it earlier. Investigators are studying whether a blood test can identify if a patient has a protein associated with Alzheimer’s called p-tau217. It’s a work in progress, but if it’s successful, it may make it easier to diagnose and treat Alzheimer’s with more personalized therapies.

In the meantime, learning how to practice more healthy behaviors is the best therapy available. To teach patients how to do that, Swedish neurologists at the Center for Healthy Aging are trying a new approach. They’ve created an interactive group visit model that brings together eight to 20 patients with their caregivers. During these sessions, the group shares their experiences and learns about new treatment options.

“It’s an opportunity for patients to learn from their care team and from one another,” Dr. Isenberg says. “We incorporate the science of behavior change to support the development of healthy habits to prevent or delay dementia, along with memory strategies and supports to better manage memory loss."

In addition, the Center also offers the Women’s Brain Health Clinic to female patients. It’s a wellness initiative that provides high-quality and collaborative care for women going through accelerated aging in midlife. The Women’s Brain Health Clinic offers gender-based approaches focused on empowerment, lifestyle medicine and evidence-based treatments.

Dementia and genetics

Some people do inherit a gene that causes early-onset Alzheimer’s. It’s rare, Dr. Isenberg says. But if you have a parent or sibling who developed Alzheimer’s before age 65 and you’re concerned, you can talk with your doctor about seeing a genetic counselor for possible genetic testing.

Carrying a gene that makes you more vulnerable to developing Alzheimer’s is more common. This gene — APoE4 — is linked to late-onset Alzheimer’s, and about 25% of people have it. Having the gene doesn’t mean you’ll develop the condition. If you practice the behaviors listed above, it can help reduce the likelihood you’ll experience dementia.

“If you’re engaging in healthy behaviors, you can lower your susceptibility to developing Alzheimer’s even if you have the APoE4 gene,” she says. “Mediterranean foods are medicine. Movement is medicine. Social connection is medicine. Sleep is medicine, lifelong learning is medicine and a positive attitude about aging is medicine.”

Find a doctor

If you have questions about dementia, contact the Primary Care or Neurology Department at Swedish. We can accommodate both in-person and virtual visits.

Whether you require an in-person visit or want to consult a doctor virtually, you have options. Swedish Virtual Care connects you face-to-face with a nurse practitioner who can review your symptoms, provide instruction and follow up as needed. If you need to find a doctor, you can use our provider directory.

Join our Patient and Family Advisory Council.