These few simple lifestyle changes in your 30s and 40s could save you from dementia as you age, new research shows.
These few simple lifestyle changes in your 30s and 40s could save you from dementia as you age, new research shows.

Top tips: How to avoid dementia

Getting older comes with all sorts of creaks and groans and ailments. And dementia. We all get that in the end, right?

Actively preventing dementia in our 30s and 40s is probably not top of our to-do list but a leading psychogeriatrician - a specialist in old-age psychiatry - says that's exactly what we should be doing.

Dr Kailas Roberts, a Brisbane-based consultant psychiatrist with more than 10 years' experience in his specialty, says strategies to protect our brains begin in childhood, with active preventive measures ideally put in place decades before the disease usually develops.

His advice, published in his first book, Mind Your Brain, comes as a 2020 report commissioned by respected medical journal The Lancet has found 40 per cent of cases of dementia worldwide could potentially be delayed or prevented by changes in lifestyle.

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Roberts says cognitive decline is not a given and that there is much that can be done to reduce the risk of developing dementia, to delay its onset and also to make the journey easier if it is established.

In Australia, more than 400,000 people have dementia and, globally, some 50 million people are known to have the condition that has no cure.

With people living longer than ever, this number is projected to "increase massively'' over the coming decades, predicted to treble by 2050.

Roberts, 45, says preventive measures against dementia begin in childhood with education offering a protective effect. Safeguarding against repeated head injuries is also vital.

"I think people are aware of the 'use it or lose it' saying. But people don't know how much they can potentially modify their behaviour," he says.

"There are things you can do early in life - even in childhood - that are helpful.

"So right from your early years, education and head protection are important. We know education is protection against the clinical manifestations of dementia later in life and that starts in childhood.

"And repeated head injuries - there have been studies done on professional footballers and CTE (chronic traumatic encephalopathy) in gridiron players - that seem to show increased risk of later dementia.

"We might not be able to stop dementia developing entirely but these interventions may push it back by 10 years or so. That might be the difference between getting it at 85 rather than 75 and that's 10 more years of good quality life. Pushing it back is definitely something we should be striving for."

Roberts works out of the Walters Green Clinical Psychology Practice at Toowong and also practices in general adult psychiatry and addiction. He sees patients aged from their early 50s to more than 100.

He says he was compelled to write a book about dementia because he was "constantly surprised" how little his patients and their carers knew about the disease.

In his book, he examines the science of dementia - how the healthy brain functions, how it changes as we age, the causes of cognitive decline and preventive measures such as managing stress, getting adequate sleep, exercising regularly, following a healthy diet, being "alcohol aware", socialising, using your brain in challenging ways, getting your vascular health checked and correcting hearing loss.

Eat well for brain health and to lower your dementia risk.
Eat well for brain health and to lower your dementia risk.

Roberts says "you get much more bang for your buck" from preventive measures earlier, rather than later, in life.

"Education about dementia is so important and it's never too early to do these things - at least from mid life," he says.

"Dementia is irreversible but you can, to a certain extent, change the trajectory of the illness. There are some studies that suggest dietary changes and physical exercise might make the trajectory of the decline shallower and not advance so quickly.

"A lot of the problems we have identified as midlife problems - midlife obesity and vascular disease - exert this chronic effect over decades.

"I don't want to say you can't do some things later on but most things we can do to help are far better being put in place earlier rather than later."

Roberts wrote his book over the course of 2019 and also writes about the "lived experience" of dementia from being assessed and diagnosed, symptoms, challenges, legal and ethical issues, residential care options and end-of-life care.

 

The key pillars of preventing cognitive decline include plenty of restorative sleep. Roberts admits this is a point he is personally "obsessive" about, aiming for between seven to nine hours of quality sleep each night.

Sleep is a reparative process and a chance for the body to clear itself of damaging toxins.

He says sleep consolidates memory and has been associated with the growth of new nerve cells in the brain. The brain's glymphatic system - a network of specialised cells in the brain - is thought to be a drainage system for clearing inflammatory molecules and beta-amyloid and tau proteins from the brain. These proteins are associated with Alzheimer's disease and studies have shown poor sleep leads to impaired clearance of amyloid and tau.

"The amount of beta-amyloid in the brain increases after just one night of sleep deprivation, and chronically poor sleep has been associated with an increase in tau," Roberts writes.

Regular exercise can improve brain function and protect against dementia.
Regular exercise can improve brain function and protect against dementia.

Diet is also "one of the most encouraging areas" of research into preventing or delaying cognitive decline and dementia with a lower risk of dementia associated with a lower intake of saturated and trans-unsaturated fats (the bad fats in junk food), a higher intake of omega 3, mono-unsaturated and polyunsaturated fats (oily fish, some nuts and seeds, olive oil, avocados), a higher intake of vegetables and fruit, and adequate B group vitamins.

Intermittent fasting, while more research is needed, may also be beneficial, while studies have shown a high sugar intake can hasten cognitive decline, perhaps through promoting insulin resistance and inflammatory changes.

"We're getting increasing evidence that even if you don't get formal diabetes, blood sugar spikes and high blood sugars in normal healthy people are still not good for your brain," he says.

"Repeated spikes and chronically high blood sugar seems to be associated with higher levels of inflammation in the body generally and also in the brain."

Hearing loss is perhaps not a factor many people associate with dementia but, for reasons not completely understood, mild hearing loss is associated with a doubling of the risk of dementia and up to a fivefold risk when it is severe. Correcting hearing loss is important.

Cognitive impairment is more likely to occur with chronic physical inactivity and may account, Roberts writes, for as much as 14 per cent of overall risk.

 

A recent University of Queensland study found regular exercise can improve brain function and may protect against dementia. Women were found to benefit almost twice as much as men. The study, out of the School of Economics and Centre for the Business and Economics of Health, used longitudinal data to investigate 16,700 people aged between 54 and 75 over 13 years. Study co-author Professor Brenda Gannon says: "Ultimately, we have found that physical activity has a potential, direct protective effect on cognitive decline and dementia, and women benefit more than men."

Roberts says that without a cure for dementia, increasing our so-called "healthspan" is vital.

"The damage that may eventually result in dementia can occur years or decades before the disease is apparent," Roberts says. "Addressing the things we can all do to protect our brain function is a realistic and worthwhile goal."


Mind Your Brain by Dr Kailas Roberts, University of Queensland Press, $35

 

 

Originally published as Top tips: What to do in your 30s and 40s to avoid dementia



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