This is the 58th instalment in a series on dementia, including the research into its causes and treatment, advice for carers and stories of hope. Two in every three health and care professionals mistakenly believe dementia is a normal part of ageing. Because of this, your doctor may not recommend steps to reduce your risk of developing the disease or may fail to pick up on signs of it and intervene to slow its progression. A recent report in the journal Neurology highlighted issues doctors should discuss with patients. If yours does not raise them with you, you can flag them. Here is a list of questions to ask and why they are important. 1. Do you get enough sleep? Several studies have found a link between sleep – both too little and too much – and dementia. Researchers at the University College London analysed 8,000 people in their fifties and sixties and found those who were getting six hours of sleep or less a night were 30 per cent more likely to be diagnosed with dementia than those who got seven hours. 2. Do you have concerns about anxiety or stress? Poor mental health can cause dementia or increase your risk of developing it. Depression earlier in life can increase the risk of developing dementia even 20 or 30 years later. There are many theories as to why. It could be that anxiety causes an overproduction of cortisol, an inflammatory agent – the brain does not deal well with inflammation. It could be that illnesses like depression affect the brain’s architecture including the hypothalamus – the memory centre. 3. Are you eating enough healthy food? Diet and brain health are closely linked. The Mediterranean, Mind and Dash diets have all been touted as good for your heart, which makes them good for your head. Conversely, ultra-processed foods – UPFs – are really bad for heart and head. A recent study found a high intake of UPFs to be associated with increased risk of dementia. 4. Do you do enough exercise? Countless studies show how important exercise is in protecting us from dementia. Even a little is better than none at all. A recent study found those who did just 35 minutes of moderate to vigorous exercise a week had a 41 per cent lower risk of developing dementia than those who did no exercise over an average four-year follow-up period. Even among frail older adults, greater activity lowered risk. Researchers also found dementia risk went down as exercise minutes went up: 60 per cent lower for those who did 35-to-69.9 minutes of physical activity per week; 63 per cent lower for those who did 70-to-139.9 minutes per week; and 69 per cent lower for those who did at least 140 minutes per week. 5. Do you have regular contact with friends or family? An analysis of recent studies found close ties between loneliness and dementia. Loneliness is associated with depression, a well-known risk factor for dementia. Less social interaction leaves people vulnerable to cognitive decline. Loneliness can also negatively affect the brain’s physical structure. A 2022 study found loneliness to be associated with faster ageing – the biggest risk factor for dementia – but also smaller hippocampal volumes. The hippocampi – two little seahorse-shaped structures in the brain – play a crucial role in memory and learning. 6. Do you wear seat belts and helmets, and use car seats for children? Head injury earlier in life, particularly repetitive head injuries as one might sustain playing rugby and other contact sports, is linked to dementia risk. The inflammation in the brain resulting from head injury is known to reactivate herpes simplex virus type 1, or HSV-1, infection, which is increasingly linked to dementia. A head injury can increase dementia risk even 25 years after the fact. 7. Do you have high blood pressure? Research shows people with high blood pressure in their early forties to early sixties are significantly more likely to develop dementia including Alzheimer’s disease. High blood pressure damages blood vessels and causes blockages that reduce blood flow to the brain. This in turn diminishes the brain’s ability to get rid of harmful waste products. 8. Are you at risk from genetic and metabolic factors? Do you have trouble controlling your blood sugar or cholesterol? Is there a neurological disease that runs in your family? Be mindful of all the numbers associated with a visit to your family doctor – not just weight and blood pressure, but blood sugar and cholesterol levels. Type 2 diabetes has an impact on the heart and by extension brain health, and hypoglycaemia, or low blood sugar, is known to damage the hippocampus. Dementia is sometimes called type 3 diabetes. 9. Do you take your medication regularly, and can you afford it? Do you have trouble with the cost of your medicines and are you taking them regularly, especially those that help to control chronic conditions such as diabetes, high cholesterol and high blood pressure? 10. Are you up to date on vaccines? A 2024 study found that some infections can predispose a person to dementia many years later. Influenza as well as viral, respiratory and skin infections were associated with greater long-term dementia risk. They were also associated with volume loss in the brain’s temporal lobes. There has been some suggestion that people who have been immunised against tuberculosis with the BCG – Bacillus Calmette-Guérin – vaccine, which has been used for 100 years, may have some protection against dementia. A recent University of Oxford study found at least a 17 per cent reduction in dementia diagnoses in the six years after participants received the shingles vaccination Shingrix. Like what you read? 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