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Risk factors
By Mayo Clinic staffMany factors can eventually lead to dementia. Some, such as age, can't be changed. Others can be addressed to reduce your risk.
Risk factors that can't be changed
- Age. The risk of Alzheimer's disease, vascular dementia and several other dementias increases significantly with age. However, dementia isn't a normal part of aging.
- Family history. People with a family history of dementia are at greater risk of developing it. However, many people with a family history never develop symptoms, and many people without a family history do. If you have specific genetic mutations, you're at significantly greater risk of developing certain types of dementia. Tests to determine whether you have such genetic mutations are available, but only for the disorders in which the specific mutation is known, for example, Huntington's disease.
- Down syndrome. By the time they reach middle age, most people with Down syndrome develop the plaques and tangles characteristic of Alzheimer's disease, according to studies. Many, but not all, also develop dementia.
Risk factors you can change
To reduce your risk of dementia, you can take steps to control the following factors.
- Alcohol use. Consuming large amounts of alcohol appears to increase the risk of dementia. Although studies have shown that moderate amounts of alcohol — one drink a day for women and two for men — especially red wine, have a protective effect, abuse of alcohol puts you at increased risk of developing dementia.
- Atherosclerosis. This buildup of fats and other substances in and on your artery walls (plaques) is a significant risk factor for vascular dementia because it interferes with blood flow to your brain. This can lead to stroke. Studies have also shown a possible link between atherosclerosis and Alzheimer's disease.
- Blood pressure. Blood pressure that's too high, and also possibly too low, can put you at risk of developing Alzheimer's disease and vascular dementia.
- Cholesterol. High levels of low-density lipoprotein (LDL) cholesterol, the "bad" cholesterol, can significantly increase your risk of developing vascular dementia. Some research has also linked it to an increased risk of developing Alzheimer's disease.
- Depression. Although not yet well understood, late-life depression, especially in men, may be an indication for the development of Alzheimer's-related dementia.
- Diabetes. If you have type 2 diabetes, you're at increased risk of developing both Alzheimer's disease and vascular dementia.
- High estrogen levels. High levels of total estrogen in women have been associated with greater risk of developing dementia. This can be determined through a blood test.
- Homocysteine blood levels. Elevated blood levels of homocysteine — a type of amino acid produced by your body — may increase your risk of developing Alzheimer's disease and vascular dementia. When working properly, your body breaks down homocysteine using vitamins B-6, B-12 and folic acid. If this isn't happening properly, it may be because you don't metabolize these vitamins well, or you don't have enough of them in your diet. Blood tests can determine whether you have elevated homocysteine levels.
- Smoking. Smoking likely increases the risk of developing dementia because it puts you at a higher risk of atherosclerosis and other types of vascular disease.
References
- Dementia: Hope through research. National Institute of Neurological Disorders and Stroke. http://www.ninds.nih.gov/disorders/dementias/detail_dementia.htm#1318919213. Accessed Jan. 25, 2010.
- Dementia. Alzheimer's Association. http://www.alz.org/alzheimers_disease_dementia.asp. Accessed Jan. 25, 2011.
- Alternative treatments. Alzheimer's Association. http://www.alz.org/alzheimers_disease_alternative_treatments.asp. Accessed Jan. 25, 2011.
- A guide to dementia diagnosis and treatment. The American Geriatrics Society. http://www.americangeriatrics.org/press/listservs/december_10_2010427672/id:1442 Accessed Jan. 25, 2011.
- NIH State-of-the-science conference statement on preventing Alzheimer's disease and cognitive decline. National Institutes of Health. http://consensus.nih.gov/2010/docs/alz/alz_stmt.pdf. Accessed Jan. 7, 2011.
- Ritchie K, et al. Designing prevention programmes to reduce incidence of dementia: Prospective cohort study of modifiable risk factors. British Medical Journal. 2010;341:c3885.
- Rusanen M, et al. Heavy smoking in midlife and long-term risk of Alzheimer disease and vascular dementia. Archives of Internal Medicine. In press. Accessed Jan. 25, 2011.
- Siedlecki KL, et al. Comparison of patient and caregiver reports of patient activity participation and its relationship to mental health in patients with Alzheimer's disease. Journal of Gerontology: Psychological Services. 2009;64B:687.
- Scarmeas N, et al. Physical activity, diet, and risk of Alzheimer's disease. Journal of the American Medical Association. 2009;302:627.
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