Can you avoid dementia when you are old?

*Only for medical professionals to read for reference.
To avoid dementia when you are old, pay attention to these 13 risk factors.

Have you ever seen old people like this: they don’t speak well and often lose their minds; they look around when they clearly hold things in their hands; some can’t even find their way home.
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With age and lifestyle, Affected by various factors such as genes, our brains become more and more fragile, more vulnerable to injuries, cognitive ability generally declines, and even cause cognitive impairment and dementia.

In the world, one person is diagnosed with dementia every 3 seconds.
According to the statistics of the World Health Organization (WHO), one person in the world is diagnosed with dementia every 3 seconds [1], among which Alzheimer's disease (Alzheimer disease) , AD), which accounted for the majority of senile dementia.
Other types of dementia include vascular dementia, frontotemporal dementia, and Lewy body dementia.

The number of dementia patients in China is close to 1/4 of the global number of dementia patients [2].

In December 2020, the data published by Professor Jia Jianping’s team from Xuanwu Hospital on The Lancet Public Health showed that among the Chinese aged 60 years or older, 15.
07 million had dementia, of which 9.
83 million had AD and 3.
92 million had vascular dementia.
, 1.
32 million suffer from other dementias [3].

In addition, with the increase of age, the prevalence of dementia has shown a significant upward trend [3].

Figure 1: The prevalence of dementia among the elderly in different age groups in China.
Dementia has a huge impact on individuals, families, and the economy.
Studies have shown [2] that dementia is the fifth leading cause of death in the world, which has surpassed the well-known tumor cause of death.

However, there is currently no specific therapy that can prevent or reverse the progression of Alzheimer's disease.

Could it be that we can only sit and wait like this, let this "silent killer" take away our memories and our health little by little? Do not! At least we can prevent it! How to avoid dementia when you are old? Controlling these 13 factors can prevent prevention.
In 2017, the American Heart Association (AHA)/American Stroke Association summarized the 7 major factors affecting brain health-"Life's Simple 7", including blood pressure control, cholesterol level control, and diabetes risk reduction , Regular exercise, healthy eating habits, weight control and no smoking.

Recently, AHA published the "Brain Health Primary Care Agenda" on Stroke.
Based on "Life's Simple 7," it analyzed 6 factors, including alcoholism, sleep disorders, social isolation, hearing loss, depression, and education.
The degree is low.

The statement summarized 13 kinds of changeable risk factors that will affect brain health and lead to impaired cognitive function, and provide effective information for protecting brain health and preventing Alzheimer’s [4].

Figure 2: Article published online in Stroke1 Hypertension-Controlling Blood Pressure Hypertension is a recognized risk factor for stroke and vascular dementia.

A systematic evaluation and meta-analysis involving 7 studies found that systolic blood pressure> 160 mmHg was associated with a 25% increase in AD risk; systolic blood pressure> 140 mmHg was associated with an 18% increase in AD risk.

The AD (hereinafter referred to as "AD Prevention Guidelines") recommended by Professor Yu Jintai of Huashan Hospital and published online in the top international journal BMJ sub-Journal "Journal of Neurology, Neurosurgery and Psychiatry") recommends that people under 65 should keep Live a healthy lifestyle and avoid hypertension (level I recommendation, level A4 evidence); for patients with orthostatic hypotension, their cognitive function status should be closely monitored (level I recommendation, level A4 evidence) [5].

2 Smoking-Don't smoke.
Smoking is the third most important changeable risk factor in dementia, second only to high blood pressure and low levels of education.

Most cohort studies have shown that the more smoking, the longer the time, the higher the risk of cognitive decline.

A meta-analysis involving more than 900,000 subjects showed that although smokers have a significantly increased risk of dementia, the risk will be reduced after quitting smoking, and is close to the level of people who have never smoked.

AD prevention guidelines recommend not to smoke and to avoid exposure to tobacco smoke in the environment (level I recommendation, level B evidence).

3 Lack of exercise-regular exercise Many epidemiological studies have shown that lack of exercise is associated with an increased risk of cognitive decline.

Studies have found that high-level exercise early in life (≤30 years old) is associated with stronger cognitive ability in old age (≥60 years old).

AD prevention guidelines recommend that everyone, especially those over 65 years of age, should adhere to regular physical exercise (level I recommendation, level B evidence).

AHA recommends that healthy adults should do at least 150 minutes of moderate-intensity exercise or 75 minutes of high-intensity exercise every week.

4 Diabetes-Avoidance of diabetes The association between diabetes and increased risk of severe cognitive decline (dementia) has been proven, but the association with mild cognitive impairment has not been thoroughly evaluated.

A prospective cohort study found that compared with individuals without diabetes, the risk of cognitive decline in people with diabetes was 50% higher.

In the middle-aged population, compared with individuals without diabetes, diabetic patients have a 19% higher risk of cognitive decline within 20 years.

Type 1 and type 2 diabetes and metabolic syndrome are associated with an increased risk of mild cognitive impairment and the progression of dementia.

AD prevention guidelines recommend maintaining a healthy lifestyle and avoiding diabetes; patients with diabetes should be closely monitored for cognitive decline (level I recommendation, level B evidence).

5 Diet patterns-healthy eating.
A number of studies have found that healthy diet patterns, such as DASH Diet, Mediterranean Diet, and a combination of the two MIND diets, are associated with decreased cognitive function in middle-aged and elderly people.
Slow down related.

6 Obesity-weight control A large number of epidemiological data show that obesity in middle age is associated with an increased risk of cognitive impairment, and due to its high prevalence, obesity has been identified as one of the most common risk factors for AD and related dementia One.

A cross-sectional study found that obesity is associated with the decline of 20 neurocognitive indicators, including language ability, delayed memory, episodic memory, and cognitive flexibility.

AD prevention guidelines suggest that people under the age of 65 should maintain or lose weight, through a reasonable and balanced physical exercise, calorie intake, and formal behavior plan to achieve and maintain the body mass index (BMI) at 18.
5-24.
9kg/m2 (level I recommendation) , Level B evidence).

7 Hyperlipidemia-control cholesterol levels A comprehensive analysis found that high total cholesterol in middle age will increase the risk of AD in later life.

However, there is still a lack of strong evidence to show the relationship between brain health and other fats in the blood, such as high-density lipoprotein cholesterol, triglycerides, trans fats, and saturated fats.

8 Drinking alcohol-Do not drink too much and long-term drinking, it will lead to neurotoxicity, brain nutrient deficiency, neuroinflammation and neurotransmitter system changes, and then lead to brain damage.

There is no safe dosage for drinking.
The WHO has issued a statement stating that there is no scientific basis for the claim that “a small amount of alcohol is good for health” and reiterated that alcohol consumption is the world’s most serious problem that causes health damage.

Therefore, the safest amount of drinking is 0, and not drinking is responsible for your health! 9 Sleep-Ensuring adequate and good sleep.
A large number of observational studies have consistently shown that various sleep disorders can lead to cognitive decline, such as obstructive sleep apnea syndrome and insomnia, which can lead to vascular dementia through a variety of mechanisms.

More and more evidence shows that poor sleep can lead to the progression of neurodegenerative diseases, and effective interventions are to improve sleep.

10 Social isolation-increased social activities Social isolation refers to the fact that there is almost no social contact or a decrease in social contact.

More and more research evidence shows that social isolation is a risk factor for cognitive decline and dementia.

A Swedish study found that social isolation is associated with a 51% increase in the risk of dementia.

In 2020, the “Lancet Specially Invited Major Report: Prevention, Intervention, and Care of Dementia” published by The Lancet pointed out that in middle age and even old age, try to maintain active mental, physical and social activities[ 6].

Non-digital games such as chess, card game, and word-guessing puzzles can not only be flexible in the brain, but also communicate more with peers and reduce loneliness, thus preventing or delaying the occurrence of Alzheimer's [7].

11 Hearing Impairment-Conducting Hearing Interventions A meta-analysis involving 36 studies found that age-related hearing impairment is associated with an increased risk of cognitive impairment and dementia.

Approximately one third of the elderly have hearing impairment, but they are still largely untreated, and its underlying mechanism is still unclear.
It may be related to "sensory deprivation", that is, decreased perception may lead to cognitive decline.

Studies have confirmed that hearing intervention can help slow down cognitive decline.

The "Lancet Specially Invited Major Report: Prevention, Intervention, and Care of Dementia" pointed out that hearing impaired persons are encouraged to use hearing aids and to reduce hearing loss by avoiding strong noises in their ears.

12 Depression-Maintain a good mental health.
Depression and dementia are risk factors for each other.

A large cohort study with a follow-up time of more than 28 years found that the risk of dementia in middle-aged individuals with depressive symptoms did not increase; but the risk of dementia in those who developed depressive symptoms in later years was significantly increased, indicating that depressive symptoms may be It is an early sign of dementia.

AD prevention guidelines recommend that you maintain a good mental health; for patients with depressive symptoms, their cognitive function status should be closely monitored (level I recommendation, level A4 evidence).

13 Low education level-receive as much education as possible in the early years.
Studies have found that a higher level of education can prevent the cognitive decline of the elderly.

A meta-analysis of 13 studies found that low education (≤8 years) is associated with an 80% increase in the risk of dementia or cognitive impairment.

Researchers believe that perhaps as with any risk factor for cognitive decline, changes in education-related risks begin early in life.

That is to say, you should receive as much education as possible from childhood.

This set of simple finger dances can help prevent dementia.
In addition to paying attention to and controlling the above 13 risk factors that affect cognitive function as soon as possible, this set of simple finger exercises by Academician Gu Yudong can also help everyone maintain brain health and prevent dementia [8].

The simple action of "pinching" can move 19 muscles of the hand and exercise the sensory system, which can fully exercise the brain, prevent degenerative brain diseases, and maintain brain health.

Hurry up and learn together, learn to teach parents well~Reference materials: [1]Maria Cohut, Fact checked by Jasmin Collier.
Dementia:10-year risk estimates may inform prevention.
Medical News Today.
5 September 2018.
Available at:https ://www.
medicalnewstoday.
com/articles/322981.
php Last assessed on 2018-09-09.
[2]GBD 2016 Dementia Collaborators.
Global,regional,and national burden of Alzheimer's disease and other dementias,1990-2016:a systematic analysis for the Global Burden of Disease Study 2016.
The Lancet.
Neurology.
2019;18(1):88-106.
[3]Longfei Jia,Yifeng Du,Lan Chu,et al.
Prevalence,risk factors,and management of dementia and mild cognitive impairment in adults aged 60 years or older in China:a cross-sectional study.
The Lancet Public Health.
[4]Ronald M.
Lazar,et al.
,(2021).
A Primary Care Agenda for Brain Health: A Scientific Statement From the American Heart Association.
Stroke,DOI:10.
1161/STR.
0000000000000367.
[5]https://jnnp.
bmj.
com/content/91/11/1201[6] /fulltext[7]Drew M Altschul et al.
,Playing Analog Games Is Associated With Reduced Declines in Cognitive Function:A 68-Year Longitudinal Cohort Study,The Journals of Gerontology:Series B,gbz149,https://doi.
org/ 10.
1093/geronb/gbz149[8] Little Doctor Cartoon, 2019-07-19.
This set of academician Gu Yudong’s finger exercises can prevent Alzheimer’s, and it’s very simple!