The MIND diet is part of the effort to reduce dementia. MIND stands for the Mediterranean-DASH Intervention for Neurodegenerative Delay. It combines aspects of two popular diets, the Mediterranean diet and the Dietary Approaches to Stop Hypertension (DASH) diet as I told you a few weeks ago.
However, a recent report suggests that modifying 12 other risk factors over the course of our lives could delay or prevent 40% of dementia cases.
The report is an update of the 2017 Lancet Commission on Dementia Prevention, Intervention and Care, which had identified nine modifiable risk factors that were estimated to be responsible for one third of dementia cases.
The three new risk factors that have been added in the latest update are excessive alcohol intake, traumatic brain injury (TBI) and air pollution.
The original nine risk factors were high blood pressure, obesity, hearing loss, smoking, depression, physical inactivity, social isolation, diabetes mellitus and not completing secondary education.
The report includes the following nine recommendations for policymakers and individuals to prevent risk for dementia in the general population:
Aim to maintain systolic blood pressure of 130 or less in midlife from around age 40.
Encourage use of hearing aids for hearing loss and reduce hearing loss by protecting ears from high noise levels.
Reduce exposure to air pollution and second-hand tobacco smoke.
Prevent head injury, particularly by targeting high-risk occupations and travel.
Prevent alcohol misuse and limit drinking to less than 21 units per week; a bottle of wine contains 10 units.
Stop smoking and support individuals to stop smoking, which is beneficial at any age.
Provide all children with primary and secondary education.
Lead an active life into midlife and possibly later life.
Reduce obesity and diabetes.
They cited evidence supporting the three new risk factors.
Traumatic brain injury is usually caused by car, motorcycle, and bicycle injuries, military exposures, firearms, falls, boxing, horse riding, and other recreational sports. A single severe TBI is associated in humans and in mouse models with widespread pathological brain changes. Other studies have shown that TBI is linked with a significantly increased risk for long-term dementia.
Regarding excessive alcohol consumption, increasing evidence is emerging on alcohol’s complex relationship with the ability to think and the development of dementia. One French study of more than 31 million individuals showed that alcohol use disorders were associated with a threefold increased dementia risk. However, other studies have suggested that moderate drinking may be protective.
On air pollution, the report notes that in animal studies, airborne particulate pollutants have been found to speed up degeneration of the nervous system. Also, high nitrogen dioxide concentrations, fine particulate matter from traffic exhaust, and residential wood burning have been shown in past research to be associated with increased dementia incidence.
The researchers assessed how much each risk factor contributes to dementia, expressed as the population-attributable fraction. Hearing loss had the greatest effect, accounting for an estimated 8.2% of dementia cases. This was followed by lower education levels in young people (7.1%), smoking (5.2%), depression (3.9%), social isolation (3.5%), TBI (3.4%), air pollution (2.3%), high blood pressure (1.9%), physical inactivity (1.6%), diabetes (1.1%), excessive alcohol (0.8%) and obesity (BMI over 30) (0.7%).
The evidence that hearing loss is one of the most important correctable risk factors for dementia is very strong. New studies show that correcting hearing loss with hearing aids negates any increased risk.
Two risk factors that have not yet made it onto their list are diet and sleep because the evidence has not stacked up enough to include these on the list of modifiable risk factors.
There are studies that suggest that both more sleep and less sleep are associated with increased risk for dementia, which did not make sense to the authors. In addition, other underlying factors involved in sleep, such as depression, apathy, and different sleep patterns, may be symptoms of early dementia.
As far as diet is concerned, the evidence is quite clear that there is not any individual vitamin deficit that is associated with dementia. Diets like the MIND diet mentioned above can probably make a difference, but there does not seem to be any particular element that is needed.
Once again, we come back to recommending an active lifestyle with plenty of activity and a healthy diet to maintain a healthy weight.
Oh, and maybe hearing aids.
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August 16, 2020 at 11:00AM
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