Tips from doctors
To get a handle on whether dementia can be prevented, I asked six dementia experts for their advice.
All agreed that adopting a healthy lifestyle would go a long way to lowering your risk of dementia, delaying its onset, or slowing down its progression if you already have it.
1. Good sleep, less stress
“Take care of your sleep, mood and exercise.
You need sleep to encode what you’ve done during the day, to register the information, and for general health and well-being.
Some studies show that reduced sleep worsens the clearance of proteins that may be harmful to the brain. This may possibly lead to the accumulation of these toxic proteins, leading to dementia.
High stress normally affects your sleep, and this leads to high cortisol, which is the stress hormone, and inflammation. All this is linked to brain degeneration.
Research has shown that people who exercise regularly may be less likely to develop dementia than those who don’t. Physical activity usually refers to aerobic activity performed for 20 to 30 minutes at a time, three to five times a week. But it can also mean doing regular daily activities such as going for walks, gardening, or daily physical tasks like cleaning.
A diet high on antioxidants, such as the Mediterranean diet rich in oily fish like salmon and mackerel, helps.
Working, especially in high-functioning jobs, also builds up your cognitive reserve so if you were going to get dementia, you are more likely to develop symptoms later.”
- Associate Professor Adeline Ng, senior consultant at the department of neurology, National Neuroscience Institute. She leads the dementia programme there.
2. 40% of dementia can be prevented
“Whether one gets dementia or not is a combination of genetic predisposition, vascular risk factors, lifestyle factors, and level of brain reserve, which varies from person-to-person.
Forty per cent of dementia can be prevented by targeting risk factors such as diabetes mellitus, hypertension, cholesterol, smoking, vision and hearing.
For prevention of dementia, it’s best to start in middle age (40-60 years)
My main advice would be to ensure adequate cognitive stimulation with a variety of new, challenging yet interesting tasks.
Studies have shown that cognitive stimulation can activate brain areas crucial for cognitive processes. This results in improved cognitive reserve.
Every individual would need a different amount of time and complexity of stimulation. This would depend on their personal, educational and occupational profile. The level of difficulty should be tailored to ability and interest. Tasks that stimulate several cognitive processes are better. Use a combination of visual tasks and verbal tasks.”
- Associate Professor Nagaendran Kandiah, director of the Dementia Research Centre (Singapore),
Lee Kong Chian School of Medicine, Nanyang Technological University
3. Never too late to get healthy
“Adopt a healthy lifestyle that involves proactive management of overall health.
This includes staying up to date with regular health check-ups and managing chronic conditions, like hypertension and diabetes, which can directly impact brain vascular health. Good brain vascular health means the blood vessels are healthy and functioning well to deliver oxygen and nutrients to the brain.
Maintaining a balanced diet, staying physically active and prioritising mental well-being are also essential for developing cognitive reserves, which is the brain’s “capacity” and hence reflects its resistance to damage that it may encounter.
The higher the cognitive reserves, the more resilient it is to damage. This can explain why people differ in their ability to cope with changes or damages that result from ageing, disease or brain injury. People with higher cognitive reserves may be able to cope with more brain damage before showing symptoms of dementia.
It is never too late to adopt a healthy lifestyle, even at 60. While dementia risk is lowest in people who have healthy behaviours in mid-life (aged 40 to 65), adopting a healthy lifestyle at an older age can still lower your risk of getting dementia, delay the onset of dementia, and slow down the progression of dementia if you have it already.”
- Dr Arthi Premkumar, associate consultant and specialist in geriatric medicine at Alexandra Hospital
4. Be careful when you hit middle age
“Pay more attention to your health, especially when you hit middle age (35-65 years).
Studies have shown an association between dementia and cardiovascular diseases. So, a good prevention strategy would be to avoid cardiovascular risk factors such as hypertension, diabetes, smoking and obesity. Conditions like hypertension and diabetes tend to set in in middle age. Go for regular screenings so you can detect them early and act.
Refrain from smoking and keep a healthy BMI (body mass index) through exercise and a balanced diet.
Dementia is associated with cognitive decline, so keeping our minds active is important. It helps the rest of the brain to compensate better even if some parts are damaged due to reasons such as stroke or degeneration. I suggest mind-stimulating games such as crossword puzzles, chess or Sudoku, or learning a new skill.
It has been found that inactive but otherwise healthy seniors who begin an exercise programme experience significantly improved cognitive function. Exercise must be regular and tend toward the more vigorous side.
Controlling the above risk factors not only reduces the risk of dementia but also keeps us healthy and helps prevent strokes and heart diseases.”
- Dr Yao Fengyuan, Senior consultant and chief, department of geriatric psychiatry, Institute of Mental Health
5. Healthy lifestyle and diet your best bet
“Dementia currently has no cure.
There are medications to improve the symptoms. There are also new drugs that appear to halt the process but have yet to show long-term benefits. Hence, preventing or delaying the onset of dementia will be the most useful course of action now.
Scientific evidence has shown an inverse relationship between some components of a healthy lifestyle and the incidence of dementia. These include physical exercise, social interactions and mental activities. But it is not known if instituting these interventions reduce dementia risk.
There is currently no evidence that any form of ‘brain training’ has prevented dementia in the long term.
More robust scientific evidence shows that cardiovascular risk factors, such as hypertension, increase the risk of dementia. Again, reduction of hypertension has not reproducibly shown a reduction of the onset of dementia.
Dietary factors have been shown to reduce the risk of dementia. Observational studies of a Mediterranean diet have shown it to reduce the onset of Alzhimer’s dementia. But these are confounded by population factors.
All this suggests that the cause of dementia is multifactorial, and reducing a single risk factor is insufficient. A combination of healthy lifestyle and good nutrition is probably the best bet.”
- Dr Tu Tian Ming, neurologist at Mount Elizabeth Novena Hospital
6. Lifestyle impacts brain health
“Our lifestyle has a profound impact on our brain health. Transforming the way we live can improve our brain and mind and reduce the risk and progression of dementia.
Physical exercise is important, as is mental exercise.
I encourage my patients who are retired to follow a daily routine filled with activities and to avoid being mentally sedentary. Cognitive stimulation activities such as Sudoku, mahjong, bridge and chess are beneficial. I also implore them to never stop learning: pick up new skills, or revisit old hobbies.
We need adequate sleep (at least 8 hours per night). In a busy world, it’s important to learn to balance and manage stress. Opt for a balanced, Mediterranean-based diet and avoid processed and fried foods.
Take care of overall medical health, especially cardiovascular health. Control risk factors such as high blood pressure, high cholesterol levels, diabetes and obesity.
Finally, staying socially active improves the quality of our lives and relationships and has huge benefits in protecting against cognitive decline.”
- Dr Jennifer Hung, associate consultant, division of neurology, department of medicine, at National University Hospital
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