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Is Your Risk for Alzheimer’s Lower Than You Think?

Researchers say rates of brain disease are dropping, and several healthy habits may be why


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Elias Stein

A surprising and mysterious trend has arisen in recent years that may help point us toward a cure for dementia: Rates of Alzheimer’s disease in the U.S. are actually dropping. Indeed, your risk may be lower than that of your parents or grandparents.

The percent of Americans age 65-plus with dementia, including Alzheimer’s, fell 30 percent from 2000 to 2016, a 2022 Rand Corp. study found. “I think what it means is that a diagnosis of dementia is not cast in iron,” says Albert Hofman, M.D., chair of the Department of Epidemiology at the Harvard T.H. Chan School of Public Health. “We can influence this.”

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In a 2019 study, Hofman found rates had fallen 13 percent per decade over the previous 25 years in North America and Europe — a stretch of time when there were no drugs on the market to treat or prevent changes in the brain due to Alzheimer’s.

7 healthy habits may be the reason

Since about 75 percent of people with Alzheimer’s also have problems with the blood vessels in their brain — leaks, narrowing and damage to tiny arteries can kill off brain cells and cause dementia — Hofman suspects “all the things we’ve done in the last 50 years to prevent heart disease and stroke may be related to lower risk for dementia and Alzheimer’s.”

In addition to not smoking, those include:

1. Keeping blood pressure and blood sugar levels healthy. High blood pressure and diabetes increase risk for thinking and memory problems that may precede dementia or Alzheimer’s by 41 percent or more. They can harm brain cells by damaging blood vessels in the brain, boosting inflammation and encouraging the growth of Alzheimer’s plaques and tangles.

2. Getting regular exercise. Staying active can reduce risk for all types of dementia by 28 percent and for Alzheimer’s disease by 45 percent. Exercise increases blood flow to the brain, reduces inflammation, helps control blood sugar and blood pressure and helps brain cells become more resilient.

3. Eating more fruits and vegetables. A produce-packed diet with limited amounts of red meat, saturated fat and added sugar lowered risk for Alzheimer’s disease and dementia by up to 48 percent in a 2020 study of 921 older adults. Berries and spinach may help protect brain cells from damage caused by inflammation and destructive oxygen molecules called free radicals.

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4. Topping those actions with a multivitamin. A daily multi­vitamin had beneficial ­effects on thinking, ­reasoning and memory, ­according to a study published in December 2023 that compared people 60 and older using a multi­vitamin with those who were given a placebo. It’s the third study published in recent years that showed a daily multivitamin had beneficial effects on the brain. Researchers cautioned that a daily pill isn’t a substitute for a healthy diet, but it might offer extra insurance.

5. Taking care of your ears and eyes. Hearing and/or vision loss increased risk for cognitive problems by 20 to 50 percent in a 2022 University of Toronto study of 5.4 million older Americans. Recent studies suggest hearing aids and taking care of vision problems such as cataracts could be protective.

6. Pampering your mental health. Chronic stress, depression, anxiety and loneliness all boost risk for cognitive decline and ­dementia. Getting help for mental health issues and finding ways to socialize more with friends and family can help.

7. Putting yourself on a regular sleep schedule. Difficulty sleeping boosts risk for cognitive problems — in part by interfering with the flow of fluid and wastes out of the brain that normally happens during slumber, says neurologist Brendan Lucey, M.D., section chief for sleep medicine at Washington University School of Medicine. If regular exercise, no caffeine later in the day and a relaxing bedtime routine don’t help, talk with your doctor to rule out problems such as obstructive sleep apnea, Lucey suggests. Ask about cognitive behavioral therapy for insomnia, too, he suggests.

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