For Your Health — What to Know About Dementia — and Ways to Prevent It

Dementia touches many lives — in many different ways. And most of us likely have some firsthand experience with it, whether it’s with an aging family member or friend or neighbor.

Over 6 million people in the U.S. have some type of dementia, and these numbers are expected to accelerate in the coming years as the population gets older.

“Dementia is an umbrella term characterized by a decline in memory, thinking, language or judgment that’s serious enough to interfere with everyday life and independence,” said Dr. Jorge Llibre-Guerra, a behavioral neurologist at WashU Medicine who specializes in dementia and Alzheimer’s disease research.

It can be caused by many different conditions that affect the brain, with Alzheimer’s disease being the most common by far in the U.S. Other causes can include stroke and other problems that hurt blood flow in the brain, called vascular dementia, as well as abnormal protein deposits in the brain, called Lewy body dementia.

As people get older, there can often be more than one cause of dementia, and its impact often deepens over time, Llibre-Guerra added. With Alzheimer’s disease, memory loss can be one of the first symptoms, then problems doing everyday activities, and eventually problems with the most basic self-care.

“Beyond the clinical presentation there’s also a real emotional impact for patients and families — including frustration, fear, grief and for many the distress of sensing those changes in themselves,” he said.
Dementia is rare in midlife and becomes more common as people age. Rates begin to increase quickly in those 75 and older.

There are steps, though, that we can take to boost our brain health and help lower the risk of developing dementia. A recent international report estimated that close to half of cases could be prevented or delayed — and mostly from changes many of us can make.

These include familiar healthy behaviors: not smoking, avoiding alcohol, being physically active and keeping blood pressure, blood sugar and blood cholesterol in check. Other steps that can also have important benefits, though, include treating depression, keeping up social connections, staying mentally active, wearing helmets during sports and treating hearing and vision loss.

Some of these help avoid the damage and changes in the brain that can lead to dementia. Others can build something called “cognitive reserve,” which can help us function well, and for longer, even if there are changes in the brain.

“Cognitive reserve is one of the most important ideas in this field,” Llibre-Guerra continued. “Two people can have very similar amounts of Alzheimer’s-related changes in the brain, yet one has symptoms and the other doesn’t. The difference between the two is often the level of cognitive reserve.”

Some activities that may specifically help build cognitive reserve include maintaining good hearing and vision by getting them checked and treated if needed; staying mentally active with classes, puzzles, art, building projects or similar interests; and regularly connecting with others through meetups or phone calls with family and friends, walking or book clubs, volunteering or other social functions.

Many of the same behaviors that help boost brain health also have the added benefit of helping lower the risk of other important diseases, from stroke and heart disease to diabetes and cancer. And the biggest benefits come when we start them early and keep them up throughout life.

Dementia can be a hard topic to think about, especially if we have relatives and others close to us who are getting older. But research leads to new discoveries every year, and that holds promise both for today and the years ahead.

“We are in a unique moment in the field,” Llibre-Guerra concluded. “There’s real and growing evidence for earlier detection and new treatments — and prevention remains a powerful tool.”