Progress in Dementia Research
Significant advances have been made in dementia research lately, particularly compared to just a few years ago. For instance, there’s a new blood test that can diagnose Alzheimer’s with 90% accuracy. Additionally, we’ve gained insight into lifestyle factors that can increase the risk of developing dementia.
A recent dementia report published in The Lancet journal, which involved researchers from The Lancet Commission, identified two new modifiable risk factors: high cholesterol after the age of 40 and untreated vision loss.
Back in 2020, these researchers had already established a list of 12 modifiable risk factors linked to a higher risk of developing dementia, which includes:
- Physical inactivity
- Smoking
- Excessive alcohol consumption
- Air pollution
- Head injury
- Infrequent social contact
- Less education
- Obesity
- Hypertension
- Diabetes
- Depression
- Hearing impairment
Together with the newly identified factors, these 14 risks account for about 49% of dementia cases worldwide. Researchers reached these findings by examining numerous studies—14 on vision loss and 27 on high cholesterol.
“It makes a lot of mechanistic sense,” noted Dr. Arman Fesharaki-Zadeh, a behavioral neurologist at Yale Medicine in Connecticut. He points out that many of these factors are interconnected. For instance, vision loss is more common among individuals with metabolic risk factors such as hypertension and poorly controlled diabetes, which also relates to high cholesterol.
Vision, being our primary sensory organ, plays a crucial role in how we engage with the world. If you struggle to see clearly, you might miss out on stimulating activities like puzzles and reading or socializing—all of which can help ward off dementia.
Regarding high LDL cholesterol (the “bad” cholesterol), it contributes to the hardening of blood vessels in the heart and brain. Fesharaki-Zadeh adds that high blood pressure and uncontrolled diabetes can also impact vascular health. Over time, this can hinder oxygen flow to the brain, potentially causing neuron damage and leading to dementia, which is a result of neuron degradation.
“I frequently observe in patients over 60 that certain brain areas are more susceptible to damage, particularly those associated with vascular hardening. The correlation between high cholesterol and this hardening is substantial, and we observe this in clinical settings often,” he explained.
“I often remind my patients that what affects your heart will also affect your brain, and we witness this repeatedly,” he said.
You Can Reduce Your Risk
“I cannot emphasize enough the importance of cooperation between primary care physicians and specialists,” said Fesharaki-Zadeh. A primary care doctor familiar with your health can relay important information to specialists, including neurologists and cardiologists, helping you address risks early on.
Your primary care physician should also proactively help you manage risk factors, such as high cholesterol and blood pressure, whether through medication, diet, or exercise.
Ideally, you and your doctor should focus on these lifestyle adjustments as soon as possible—preferably in midlife—not waiting until dementia symptoms appear.
“Primary care physicians are on the front lines of medical care. By initiating early discussions, they can significantly help in dementia prevention,” he noted.
There are also assessments available to identify early signs of neurodegeneration and genetic predispositions. A primary care doctor can guide you through these options.
“Research shows that up to 40% of dementia cases may be preventable,” he added, though it’s important to recognize that genetics can complicate prevention strategies. Still, those diagnosed with dementia or mild cognitive impairment can benefit from managing these risks.
“The evidence suggests that individuals with conditions like hypertension, high cholesterol, and diabetes tend to experience a quicker progression of dementia compared to those without these metabolic issues,” Fesharaki-Zadeh explained.
It’s never too late to implement health changes. Whether you’re in your 80s or 90s, or even if you’re young and seemingly healthy, it’s possible to make positive adjustments.
“Our brains are highly adaptable,” Fesharaki-Zadeh emphasized. By making healthy lifestyle changes, your brain can improve at any age.
