This is a series of articles based on the wonderful report created by the Alzheimer Society of Canada, called the Many Faces of Dementia in Canada (2024). In six parts, we will do a deep dive into the latest findings about dementia, and the impact on our families and communities.
Part 2: Modifiable and Non-Modifiable Dementia Risk Factors
Modifiable and Non-Modifiable Dementia Risk Factors: What Caregivers Need to Know
Caring for aging loved ones brings a host of emotional and practical responsibilities, especially when dementia risk is involved. Understanding the factors that contribute to dementia—both those we can and cannot change—empowers caregivers to make informed choices for their loved ones. This article explores dementia’s risk factors, providing actionable advice to help families take preventive measures where possible.
Understanding Risk Factors for Dementia
Dementia develops due to a complex interplay of factors that influence brain health over a lifetime. These risk factors fall into two categories:
- Non-modifiable factors: Traits we are born with or develop that cannot be altered.
- Modifiable factors: Lifestyle and environmental elements that we can influence to reduce the risk.
A balanced understanding of these factors helps caregivers focus on areas within their control while acknowledging the limitations of prevention.
Non-Modifiable Risk Factors
1. Advancing Age
- Age is the strongest known risk factor for dementia.
- After 65, the risk doubles approximately every five years; by 85, nearly 1 in 4 people are diagnosed with dementia.
- While aging is inevitable, caregivers can take steps to support healthy aging, such as fostering active engagement and providing a nutritious diet.
2. Sex at Birth
- Women are disproportionately affected by dementia, accounting for almost two-thirds of cases.
- Factors contributing to this disparity include differences in longevity, hormonal changes, and societal roles.
3. Genetics
- Family history plays a role in certain types of dementia, particularly Alzheimer’s. Genes like APOE ε4 increase susceptibility, although they do not guarantee a diagnosis.
- While genetic testing can provide insights, it is not definitive. Encouraging healthy habits can still mitigate other risks.
Modifiable Risk Factors
Modifiable factors offer opportunities for prevention, even if they don’t eliminate the risk entirely. According to the Lancet Commission on Dementia Prevention, Intervention, and Care, up to 40% of dementia cases may be preventable by addressing these factors.
Lifestyle and Health-Related Factors
1. Physical Inactivity
- Sedentary lifestyles increase the risk of cognitive decline.
- Actionable Tip: Encourage regular, moderate exercise such as walking, yoga, or swimming. These activities improve cardiovascular health, which is linked to better brain function.
2. Social Isolation
- Loneliness and lack of social engagement are major risk factors.
- Actionable Tip: Facilitate social activities for your parent, whether through community groups, family gatherings, or even virtual connections.
3. Hearing Loss
- Untreated hearing loss can lead to social withdrawal and cognitive overload, increasing dementia risk.
- Actionable Tip: Ensure your parent uses hearing aids if needed and encourage routine auditory check-ups.
4. Diet
- Poor nutrition impacts brain health. Diets high in refined sugars and unhealthy fats are particularly harmful.
- Actionable Tip: Incorporate brain-healthy foods like leafy greens, fatty fish (rich in omega-3s), and whole grains into their meals.
5. Smoking and Alcohol Consumption
- Smoking and heavy alcohol use are linked to vascular damage, increasing the likelihood of vascular dementia.
- Actionable Tip: Work with healthcare professionals to support smoking cessation and moderate alcohol intake.
Medical Conditions
1. Hypertension and Cardiovascular Health
- High blood pressure damages blood vessels, reducing blood flow to the brain.
- Actionable Tip: Regularly monitor blood pressure and follow medical advice on diet, medication, and exercise.
2. Diabetes
- Poorly managed diabetes affects brain function and can increase dementia risk by up to 50%.
- Actionable Tip: Encourage balanced blood sugar levels through healthy eating, exercise, and medication adherence.
3. Depression
- Depression in later life is linked to higher dementia risk.
- Actionable Tip: Prioritize mental health by seeking therapy, fostering meaningful activities, and managing medications.
4. Traumatic Brain Injury
- Head injuries, particularly repeated ones, raise the risk of dementia.
- Actionable Tip: Take precautions to prevent falls or accidents, such as installing handrails or ensuring proper footwear.
Environmental and Social Determinants
- Education and Cognitive Engagement
- Lower levels of education correlate with higher dementia risk. Lifelong learning strengthens cognitive reserves.
2. Air Pollution
- Chronic exposure to polluted environments may accelerate cognitive decline.
- Actionable Tip: Where possible, reduce exposure by using air purifiers or spending time in cleaner environments.
3. Socioeconomic Factors
- Access to quality healthcare, nutritious food, and safe housing significantly affects brain health.
- Actionable Tip: Advocate for resources and support systems that address these disparities.
The Role of Social Determinants
While modifiable factors offer hope, they are deeply influenced by broader social determinants like income, education, and systemic inequities (2024). For example:
- Indigenous and racialized populations in Canada face unique challenges, including higher rates of diabetes and limited access to culturally appropriate care.
- Addressing these determinants requires systemic change alongside individual efforts.
Taking Action as a Caregiver
- Assess Risks Holistically
- Consider both non-modifiable and modifiable risks. A holistic approach ensures that you address lifestyle factors without feeling powerless about genetic predispositions.
- Encourage Preventive Healthcare
- Routine check-ups can identify and manage conditions like hypertension or diabetes early.
- Foster a Dementia-Friendly Environment
- Make your parent’s home safe and stimulating. Use labels for memory aids, create clutter-free spaces, and encourage sensory-rich activities like music or art.
- Advocate for Systemic Change
- Support local initiatives or policies aimed at improving dementia care and addressing social determinants.
The Bigger Picture: Hope in Prevention
While there is no cure for dementia, research underscores the value of preventive measures. Even small changes, like regular exercise or hearing aid use, can delay onset and improve quality of life. For caregivers, focusing on modifiable risks offers a proactive way to support loved ones while recognizing the broader societal challenges.
By addressing what can be changed and accepting what cannot, families can better navigate the complexities of dementia risk. As we continue to learn from studies like Canada’s Landmark Study, the path forward becomes clearer: prevention, early action, and compassion remain at the heart of caregiving.
In Part 3 of this series, we will discuss navigating a diagnosis of dementia. Home Instead can provide additional support to your family and provide respite for those doing the caregiving. Give us a call today at 416-972-5096 to find out more about our services and how we can help.
Source: The Alzheimer Society of Canada (2024). The Landmark Study: People. The Many Faces of Dementia in Canada. The Alzheimer Society of Canada. https://alzheimer.ca/en/the-many-faces-of-dementia-in-canada-landmark-study-volume-2
