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Studies: Preventing Dementia Begins Early

By Jaime Collins

Saying goodbye to my mother-in-law for the last time was heartbreaking. Especially so because the person I said goodbye to wasn’t really her. The woman I knew so well was already gone.

Dementia takes more than a person’s memory. It also steals their ability to communicate and to perform daily tasks, and in the process, it steals their freedom.

While there is no cure, we do now know, thanks to a large body of recent science, that some simple steps can go a long way to preventing this tragic disease. Thanks to three new studies presented just last week July 30th at the Alzheimer’s Association International Conference (AAIC) 2020, we also now know that basic lifestyle factors and education as early as our teens and 20s significantly impact our risk of cognitive decline and dementia later in life.

“It’s very rare to find a study that follows individuals across early adolescence to middle age, and then as seniors,” says Maria Carillo PhD, chief science officer for the Alzheimer’s Association. When I read about these studies on the CNN website later that same day, I understood this new science is important, and everyone deserves to know about this. We need to give everyone their best chance at countering these modifiable risks in order to improve their lives and the lives of their family members.

Let’s back up for a moment to last year at AAIC 2019 where researchers reported in no fewer than five separate studies that healthy lifestyle choices – including healthy diet, exercise, and stimulation of mental activity – significantly decrease risk of cognitive decline and dementia.  Researchers found these lifestyle factors even reduce risk despite other risks, such as genetics and pollution. Importantly, they also reported these lifestyle factors provide maximum memory benefit when they’re combined with each other. These proven, modifiable risk factors provide a way anyone can realistically take their own actions to reduce their likelihood of dementia later in life. Incidentally, because there are so many other important benefits to these lifestyle choices, we all stand to live far healthier, better lives by applying this science.

At AAIC 2020, scientists reported in three separate studies that poor health and lack of education in one’s teen years and in their 20s, raises the risk of dementia and cognitive decline later in life. Being unhealthy early in life, including eating poorly, being overweight, high blood pressure and diabetes, all increase dementia risk later in life. Lack of sustained, quality education was also cited as a significant risk factor.

“All those risk factors are most likely to impact low-income people of color,” says Carillo. Indeed, we already know African Americans and Latinos are much more likely (150% more likely, in fact) than the white population to develop Alzheimer’s and dementia. Now these studies are also demonstrating that developing those risk factors even as a young person can have serious impacts later in life.

Two of the three studies presented this year examined poor health conditions (blood pressure, weight, cardiovascular health) and the impact of those factors on risk for dementia later in life. Let’s look at some details.

One study analyzed dementia risk and body mass index (BMI). Looking at long-term studies of more than 5,000 people of all genders, researchers found that youth who were overweight or obese in their twenties had a higher risk that those who were overweight only in mid-life.

Compared with women of a healthier, lower BMI those with a BMI of 25 or more at age 20 had a 180 percent higher risk for dementia later in life. Those with a BMI of 30 or more had a 250 percent higher risk. However, for those who developed a higher BMI only later in life, there appeared to be no increased risk.

The results were a little different for men. Though obesity at age 20 resulted in the same 250 percent higher risk later in life, not being obese until they were into their 30s or later still increased their risk. It simply reduced that risk from 250 percent to 150 percent higher if they were overweight in their 30s or older and 200 percent if they were considered obese.

The second of the studies looking at poor health conditions focused on blood pressure and diabetes in over 700 black adolescents, following them into young adulthood and through midlife. Researchers found that poor heart health does increase risks of cognitive problems in late life and that this occurred across genders and education factors. Thus, researchers encouraged not waiting to begin preventive care for blood pressure and diabetes in midlife and to begin in adolescence, instead.

The third study looked at early education and followed 4,100 people over 25 years, examining school term length, student to teacher ratio, school enrollment age, drop out age, and student attendance. Researchers determined that more rapid cognitive declines in later life correlated with those who attended schools with low quality education standards. Likewise, higher-quality education standards were associated with lower risk of dementia later in life.

Researchers suggest quality education helps create a cognitive reserve, a physical structure of tissues and connections that is lost as we age. The more that’s developed early in life, the more we have in our later years as brain functionality is lost as a natural progression of aging.

High-quality schools are likely only a part of the issue. Being able to afford quality day care or after-school programs or having the time and resources to augment education with books, music, and art may also make a difference. As for health factors, the quality of diets at home, the availability of healthy foods, and the culture of food around a child are factors that impact health as are health insurance and public health programs, including meals at school.

Other key considerations are the impact of stress in children’s lives, violence at home and in the community, and the effects of racism, bullying, and other forms of discrimination. Says Carillo, “We know that stress in particular is very closely connected to challenges with cognition and increases in the risk of dementia.”

What can be done?

Evidence from the eight total research studies presented at AAIC 2019 and 2020 suggest these steps:

  • Adopt healthy lifestyle changes. One or two changes can help, but five or six will boost your health and greatly reduce your risk.
  • Healthy lifestyle changes also counteract your genetic risk for dementia.
  • Healthy lifestyles among adults will help the younger members of the family adopt and learn behaviors that will help keep them healthy of mind and body throughout life.
  • Keep kids in class through high school and nurture within them a healthy relationship with learning.
  • In addition to keeping kids active, challenge them to keep learning through their childhood and adolescence and all the way into their later years. Never stop learning.

Most of us already want to live healthy and well and to see our children learn and grow. Change is not easy, and we often need a little extra inspiration to help motivate and sustain healthy change in our lives. Maybe this important research on dementia risks is just the thing we need to give us that extra boost.

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