Systematic review finds ten lifestyle factors that clearly impact the probability of developing Alzheimer’s disease (AD)

Although there’s still no cure, researchers are con­tin­u­ing to devel­op a bet­ter under­stand­ing of what increas­es a person’s risk of devel­op­ing Alzheimer’s dis­ease. A recent study that looked at 396 stud­ies has even been able to iden­ti­fy ten risk fac­tors that are shown to increase the like­li­hood of devel­op­ing the disease.

Here are the fac­tors researchers iden­ti­fied – and why they’re asso­ci­at­ed with a high­er risk.

1. Lower education level

A low­er edu­ca­tion lev­el is asso­ci­at­ed with an increased risk of Alzheimer’s dis­ease. Pre­vi­ous evi­dence shows the longer you spend in edu­ca­tion, the low­er your risk of devel­op­ing demen­tia. Research look­ing at the brains of peo­ple from dif­fer­ent edu­ca­tion­al back­grounds also showed that peo­ple who were more edu­cat­ed had heav­ier brains. As you lose one third of your brain weight because of demen­tia, a heav­ier brain may make you more resilient.

2. Lower cognitive activity

Evi­dence shows that keep­ing our brains active can also fight against demen­tia. Activ­i­ties such as word puz­zles stim­u­late your brain and can strength­en con­nec­tiv­i­ty between brain cells. This con­nec­tiv­i­ty is bro­ken down in dementia.

This lat­est study shows that we need to con­tin­ue keep­ing our brains active, even in old­er age. Oth­er stud­ies agree that chal­leng­ing our brains does indeed reduce our chances of devel­op­ing dementia.

3. Hypertension in mid-life

Healthy hearts have long been linked to a healthy brain. Here, the cur­rent study indi­cates that high blood pres­sure (hyper­ten­sion) in mid­dle age increas­es Alzheimer’s risk.

High­er inci­dence of heart dis­ease in those suf­fer­ing from high blood pres­sure impacts on the blood and nutri­ent sup­ply to the brain. Inter­est­ing­ly, this asso­ci­a­tion still exists even for those who have high blood pres­sure on its own. The bot­tom line is that reduced blood sup­ply to the brain is linked with Alzheimer’s.

4. Orthostatic hypotension

The study also high­light­ed ortho­sta­t­ic hypoten­sion as a risk fac­tor. This is when some­one expe­ri­ences low blood pres­sure when stand­ing after sit­ting or lying down.

Because the body is unable to main­tain suf­fi­cient blood sup­ply to the brain dur­ing pos­ture changes, this can have a long-term debil­i­tat­ing influ­ence on brain activ­i­ty, as a result of lack of oxy­gen to the brain, which increas­es risk of dementia.

5. Diabetes

The study found dia­betes was asso­ci­at­ed with high­er inci­dence of Alzheimer’s. As dia­betes makes our body unable to prop­er­ly reg­u­late insulin, this changes both the way our brain cells com­mu­ni­cate and our mem­o­ry func­tion – both of which are dis­rupt­ed in Alzheimer’s disease.

Insulin is essen­tial, as it reg­u­lates the metab­o­lism of car­bo­hy­drates, fats and pro­tein by help­ing blood glu­cose absorb into the liv­er, fat and mus­cles. Alzheimer’s dis­ease appears to dis­rupts the brain’s abil­i­ty to react to insulin.

6. High BMI

A high­er body mass index (BMI) in under 65s is linked to increased risk of demen­tia. The study sug­gests a body mass index between 18.5 and 24.9 for those under 65 – a healthy weight, in oth­er words – may low­er demen­tia risk. How­ev­er, being under­weight in mid­dle age and lat­er life can increase demen­tia risk.

It’s thought that a mix­ture of genet­ics, car­dio­vas­cu­lar dis­eases and inflam­ma­tion all con­tribute to this asso­ci­a­tion between BMI and dementia.

7. Head trauma

Past head trau­ma is a risk fac­tor – and there is clear evi­dence that head trau­ma, such as a con­cus­sion, can con­tribute to the devel­op­ment of demen­tia. This link was first observed in 1928.

How­ev­er, it’s uncer­tain whether sin­gle or repet­i­tive head trau­ma is the con­tribut­ing fac­tor. It’s clear that brain dam­age from head trau­ma is sim­i­lar to that of demen­tia. This makes peo­ple more sus­cep­ti­ble to fur­ther dam­age lat­er from dementia.

8. High levels of homocysteine

High lev­els of the chem­i­cal homo­cys­teine are a risk fac­tor. Homo­cys­teine is a nat­u­ral­ly occur­ring amino acid involved in the pro­duc­tion of our body’s defence mech­a­nisms, includ­ing antiox­i­dants that pre­vent cel­lu­lar damage.

Ele­vat­ed blood lev­els of homo­cys­teine in peo­ple with demen­tia was first report­ed in 1998. Stud­ies have since shown that reduc­ing lev­els of homo­cys­teine may pro­tect against dementia.

Ani­mal stud­ies sug­gest ele­vat­ed lev­els of homo­cys­teine dam­age brain cells by inter­fer­ing with their ener­gy pro­duc­tion. Con­sum­ing more folate and vit­a­min B12 can low­er homo­cys­teine lev­els – and may reduce demen­tia risk.

9. Repeated episodes of depression

Those liv­ing with Alzheimer’s also often suf­fer from depres­sion, though it’s uncer­tain if depres­sion caus­es Alzheimer’s or is just a symp­tom of the dis­ease. How­ev­er, a wealth of evi­dence sup­ports that depres­sion is indeed a risk fac­tor, as this lat­est study has found. Research has even indi­cat­ed a link between the num­ber of depres­sive episodes – espe­cial­ly ten years pri­or to demen­tia onset – and high­er risk.

Depres­sion increas­es lev­els of harm­ful chem­i­cals in our brain. An imbal­ance in these chem­i­cals can lead to loss of brain cells. This, cou­pled with the loss of brain cells in demen­tia, increas­es like­li­hood of Alzheimer’s.

10. High-levels of long-term stress

Last­ly, stress was iden­ti­fied as a risk fac­tor. Long term stress tar­gets our body’s immune cells, which are impor­tant in keep­ing demen­tia at bay. In par­tic­u­lar, the hor­mone cor­ti­sol is shown to con­tribute to stress and can impact on mem­o­ry. Aim­ing to reduce stress and cor­ti­sol lev­els can there­fore reduce the chances of devel­op­ing dementia.

This study offers a com­plex pic­ture of how we can com­bat the onset of Alzheimer’s – as well as ten areas that sci­en­tists need to con­cen­trate on research­ing in the future. Though the find­ings may seem bleak, there is some promise in that many of these risk fac­tors can be man­aged or mod­i­fied through lifestyle changes, includ­ing diet and exercise.

Mark Dal­las is an Asso­ciate Pro­fes­sor in Cel­lu­lar Neu­ro­science at Uni­ver­si­ty of Read­ingThis arti­cle is repub­lished from The Con­ver­sa­tion under a Cre­ative Com­mons license.

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SHARPBRAINS es un think-tank y consultoría independiente proporcionando servicios para la neurociencia aplicada, salud, liderazgo e innovación.

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