Last month, we started our multi-part series on dementias by defining what dementias are, and what they aren’t. We discussed the difference between Alzheimer’s disease, Parkinson’s disease and vascular dementias from stroke, and we made perhaps the most important point of all, one that I’ll repeat often: dementias are not normal aging.
In this issue and the next, we’ll talk about risk and prevention.
When scientists study dementia risk, we break that risk into two buckets: non-modifiable risk and modifiable risk. Non-modifiable risk includes genetics, age, sex, race and ethnicity – things we can’t change. Modifiable risk factors are all the things we can change, even if those things are hard to change, like what we eat, how much sleep we get and how much stress we feel.
Every year, teams of scientists and health care providers come together to report the state of the science on a variety of major diseases, like Alzheimer’s disease. These reports are then published in The Lancet, one of the most influential medical journals. In 2024, The Lancet Commission on dementias published a report showing that about 45 percent of dementia cases may be preventable by addressing 14 modifiable risk factors.
Fourteen is a big, daunting number, but 45 percent is a big, hopeful number – big enough that prevention should be taken more seriously by all of us and our doctors.
Prevention begins by remembering that although all 14 risk factors should be addressed, improving just one behavior can address multiple risk factors. For example, The Lancet Commission report suggests that reducing diabetes, cholesterol, high blood pressure and obesity (four of the 14 modifiable risk factors) can decrease damage to blood vessels serving the brain and protect brain cells from stress and inflammation.
Good nutrition is one of the foundations for reducing all these risk factors. People who eat heart healthy diets are less likely to be obese and less likely to have high blood pressure, high cholesterol and diabetes.
The commodities you grow have a big part to play in preventing dementias, for you and for everyone who eats them. Research shows that peanuts are heart- and brain-healthy foods that are an important part of all four of those prevention goals. In other words, your work makes everyone healthier.
In past issues, I wrote about protecting your senses and eating what you grow. It turns out that vision and hearing loss are another two of the 14 risk factors in The Lancet Commission report. In just a few issues, we’ve now addressed six modifiable risk factors, with just two behaviors: eat what you grow, and wear your hearing and vision protection. In the next issue, as summer starts to wind down, we’ll finish our discussion of prevention by talking about mental health and injury – two additional modifiable risk factors that may affect your brain more strongly than you realize.
Modifiable risk factors from the 2024 Lancet Commission report
1. Reduce diabetes
2. Manage cholesterol
3. Minimize hypertension
4. Stop smoking
5. Reduce obesity
6. Reduce air pollution
7. Prevent head injury
8. Prevent or treat depression
9. Improve physical activity
10. Minimize alcohol intake
11. Higher education or continue cognitive activity
12. Prevent and address hearing loss
13. Address visual loss
14. Increase social contact
By Lisa M. Renzi Hammond
Institute of Gerontology | College of Public Health
University of Georgia