New Dementia Risk Factors.

A new report found that high cholesterol and untreated vision loss put you at higher risk of developing dementia. (Photo: TEK IMAGE/SCIENCE PHOTO LIBRARY via Getty Images

Researchers Have Discovered 2 New Dementia Risk Factors. Here’s What They Are.

by Jillian Wilson

Strides have been made in the world of dementia research compared with even just a few years ago. There’s now a blood test that can diagnose Alzheimer’s accurately 90% of the time, and more is understood about the factors (many of which are lifestyle habits) that can put you at higher risk for the condition.

In a new dementia report published in The Lancet journal by researchers who are part of The Lancet Commission, two new modifiable risk factors have been identified: high cholesterol after 40 and untreated vision loss.

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In 2020, these same researchers determined 12 modifiable risk factors that are known to put folks at higher risk of developing dementia. These are:

Physical inactivity
Smoking
Excessive alcohol consumption
Air pollution
Head injury
Infrequent social contact
Less education
Obesity
Hypertension
Diabetes
Depression
Hearing impairment

According to the report, these 12 factors, along with the two new ones, account for 49% of dementia cases across the world. Researchers determined these two new risk factors by looking at recent meta-analyses and studies on the topics; they looked at 14 papers on vision loss and 27 on high cholesterol.

“It makes a lot of mechanistic sense,” said Dr. Arman Fesharaki-Zadeh, a behavioral neurologist and neuropsychiatrist at Yale Medicine in Connecticut. “A lot of these factors are very much interrelated.” (Fesharaki-Zadeh is not affiliated with the report.)

“There are many sources of vision loss, of course, but it tends to be a lot more common in folks who have metabolic risk factors such as high blood pressure, such as poorly controlled diabetes, such as high cholesterol, which is the other risk factor [identified in the report],” he said.

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Moreover, vision is our primary sensory organ — it’s how we process the world around us — and when you can’t see clearly, you’re less likely to spend time doing brain-boosting activities like puzzles, reading or even spending time with other people, said Fesharaki-Zadeh. And these activities are known to help prevent dementia.

When it comes to high LDL cholesterol (the so-called bad cholesterol), it can lead to the hardening of the blood vessels in the heart and brain, Fesharaki-Zadeh said, adding that high blood pressure and uncontrolled diabetes also affect the blood vessels.

This can make it more difficult for oxygen to get to the brain, which over time can lead to neuron damage — “and dementia is essentially an end product of the neurons dying out, so it’s a neurodegenerative process,” Fesharaki-Zadeh explained.

“I can’t tell you how often I see in our patient populations, especially folks above the age of 60, there are certain parts of the brain that are more vulnerable to damage … and these are the areas that are especially vulnerable to hardening of blood vessels. Someone who has … high cholesterol, the correlation between that and hardening of blood vessels is quite high, and we see it in our clinical setting very frequently as well.”

“The saying that I like to use with patients quite often is what affects your heart will affect your brain, and we see that time and time again,” the doctor said.

If you suffer from vision loss, it’s important to manage it for the sake of your future health.

You can lower your risk. First, have a good medical team and primary care doctor.

“I cannot highlight the importance of a collaborative model between primary care physicians and specialties,” said Fesharaki-Zadeh. Having a primary care doctor who understands your health and is willing to share pertinent information with specialists, like cardiologists and neurologists, will help you stay on top of any issues putting your well-being at stake.

Your primary care doctor should also be proactively working to help you control the risk factors — like high cholesterol and high blood pressure — whether that’s through medication, diet or exercise.

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Fesharaki-Zadeh said you and your doctor should focus on these lifestyle changes as early as possible, at least in midlife, not when you’re at the point when dementia starts to show up.

“The front line of medical care are primary care physicians. These are the folks that, by having early discussions … can go a long distance to prevent the onset of dementia,” he explained.

There are also tests that can detect early signs of neurodegeneration and genetic markers of the disease. A primary care doctor can help you learn about these options.

“Up to 40% of dementias are potentially preventable,” he added, but it’s worth noting that dementia can also be genetic, which makes prevention trickier. But someone who is diagnosed with dementia or mild cognitive impairment can benefit from managing these risk factors, too.

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“The research is also showing that if you have two groups of individuals, someone who has comorbid metabolic diseases such as hypertension, high cholesterol, diabetes, versus somebody who doesn’t, and both of these individuals have dementia, the rates of progression of dementia in somebody who doesn’t have metabolic risk factors tend to be slower,” explained Fesharaki-Zadeh.

It’s never too late to make changes and corrections, he noted, whether you’re a young, seemingly healthy person, in your 80s or 90s, or someone who has already been diagnosed with dementia.

Our brains are highly malleable, Fesharaki-Zadeh said. So if you decide to make healthy lifestyle changes at any point, your brain will respond and be healthier for it.

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Living with dementia can come with frightening and complex challenges; however, facing these challenges with the incredible power of positivity can make a significant difference. This may seem difficult, but the rewards of a positive mindset in dementia care are limitless.

At HarborChase Senior Living, we understand the profound impact of positivity on those living with memory impairment and create environments rooted in a positive mindset. We are exploring the power of positivity and sharing how it makes a difference throughout our memory care communities.

Positivity Slows Cognitive Decline

Although it is not a cure, maintaining a positive environment can potentially slow the progression of dementia by stimulating an individual’s cognitive function. Engaging in regular, positive conversations or cognitive activities can help with memory retention and processing. In fact, studies have shown that positivity can slow cognitive decline in those living with dementia.

Positive Language Makes a Difference

In the context of dementia care, the language we use greatly impacts a person’s self-esteem, mood, and overall emotional health. Using language that labels or belittles individuals can negatively impact their emotional well-being and that of their families and friends.

Conversely, positive language possesses the transformative ability to reshape the dementia landscape. By using words and phrases that empower and respect individuals, we contribute to a cultural shift. Positive language nurtures a sense of value and inclusion, playing a pivotal role in a person’s mental wellness.

For example, an encouraging and positive caregiver can uplift a patient’s spirits, directly affecting their mood and emotional health. At HarborChase Senior Living, we embrace this philosophy, acknowledging that the language we use is a potent tool in creating environments where every resident feels valued.

Positivity Increases Engagement and Socialization

Creating a positive environment can encourage an individual’s participation in various activities, leading to a more fulfilling and active social life.

Intentionally creating moments of joy and implementing creative activities that cater to each resident’s interests can help infuse positivity within memory care communities. From art therapy to music sessions, these interactions are crafted to promote cognitive stimulation, provide emotional fulfillment, uplift spirits, and spread smiles.

Fostering Positivity Among Family Members

The journey of dementia care involves not just the person living with the condition but also their family members. Family members who are actively involved and stay informed and educated create a mindset of forward motion, which breeds positivity. Some of the ways to foster positivity include:

Effective Communication Techniques

Use non-verbal cues such as facial expressions and touch, speak slowly and clearly, and ask simple questions to encourage communication.

Incorporating Meaningful Activities

Engage your loved one in activities they enjoy, whether it’s gardening, baking, or painting. Focusing on their hobbies can bring joy and a sense of accomplishment.

Encouraging Social Connections

Community and social engagement are proven to aid in overall happiness and well-being. Participating in support groups or interactive events can be incredibly beneficial for both the individual and the caregiver.

Providing Emotional Support and Reassurance

It’s crucial to be patient and provide emotional support. Assure your loved one that they are safe and cared for, and avoid dismissing their feelings.

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The journey of caring for someone with dementia is undoubtedly challenging, yet through maintaining a positive and uplifting atmosphere and mindset, you can significantly influence your loved one’s well-being and your own experience.

By recognizing the influence of positivity, embracing practical strategies, and making a slight change in perspective, we can enrich the lives of our loved ones with dementia and ours as well. Remember, each positive interaction, every act of kindness, and any commitment to a hopeful environment are steps toward a brighter and more fulfilling dementia care journey.