Reducing the risk of dementia
The ‘Dementia prevention, intervention, and care: 2020 report of the Lancet Commission’1 identified 12 potentially modifiable risk factors for dementia—addressing these factors may prevent or delay dementia:
- air pollution (including second-hand smoke exposure)
- hazardous alcohol consumption
- depression
- diabetes
- poor education
- head injury
- hearing impairment
- hypertension
- obesity
- physical inactivity
- smoking
- social isolation.
Furthermore, addressing these risk factors can prevent other chronic diseases (eg smoking, poor nutrition and inadequate physical activity are risk factors for cardiovascular disease).
[NB1] [NB2]
Reduce alcohol intake
Remain cognitively and socially active [NB3]
Eat a healthy diet [NB4]
Protect the head from injury (eg wear a helmet when cycling)
Prevent hearing loss (eg wear high-quality earplugs or ear muffs when exposed to loud noise) [NB5]
Regularly undertake physical activity [NB6]
Avoid or stop smoking and avoid second-hand smoke exposure
Maintain a healthy weight.
NB1: For further information on reducing the risk of dementia, see the Dementia Australia website.
NB2: Enjoyable practices that can be integrated into daily life are more likely to be maintained.
NB3: At the time of writing, it is unknown if commercial computerised brain-training games and programs reduce dementia risk.
NB4: For advice on a healthy diet, see Australian Dietary Guidelines.
NB5: If hearing is impaired, use a hearing aid.
NB6: For advice on physical activity, see Australia’s Physical Activity and Sedentary Behaviour Guidelines and the Australian 24-Hour Movement Guidelines
Despite a considerable amount of research, no drug, or herbal or dietary supplement has been shown to prevent dementia or cognitive impairment. Some studies have shown higher rates of adverse effects with drugs trialled to prevent dementia (eg hormone replacement therapy, acetylcholinesterase inhibitors) than placebo. Consequently, do not prescribe drugs, or herbal or dietary supplements to prevent dementia or cognitive impairment.
The use of benzodiazepines or drugs with anticholinergic properties in later life may increase the risk of dementia—avoid prescribing these drugs and, if people take them, discuss deprescribing. For advice on deprescribing benzodiazepines used for insomnia, see here, or anxiety, see here.