A new study concluded people who avoid problems in middle age — about 56 or so — with high blood pressure, Type 2 diabetes and smoking will delay dementia by 13 years.
KERA’s Sam Baker talks how and why with Dr. Ryan Cheung, a neurohospitalist with Texas Health Plano.
Dr. Cheung: So, the most important point of the study is not that there's a 13-year treatment effect. It looked at a bunch of people in big cohort, and it was an observational study. And it found that people who had none of these three midlife vascular risk factors lived about 13 more years, both alive and free of dementia, than people who have all three.
An observational association, but it does give patients a tangible message that healthier blood vessels in midlife are associated with more years of a healthy brain life later in life.
Baker: But are these things you should be avoiding at any age, period?
Dr. Cheung: Yes, these conditions injure the vascular system through many different pathways. And in this particular study, they looked at patients in their midlife, so roughly around 55 years, and they followed them for 20 to 30 years afterwards.
And so high blood pressure, we know damages small blood vessels and raises your risk for stroke and heart disease and other things.
Diabetes adds metabolic and endothelial, also blood vessel injury, and smoking accelerates atherosclerosis and inflammation.
So, over decades, all of these can produce sometimes silent strokes or overt strokes, small vessel disease, and gives your brain less reserve as it ages. And there's been a strong association with dementia.
Baker: Why this focus, though, on age 56 or even middle age? I mean, is this the point at which signs of dementia often begin to show up?
Dr. Cheung: No, actually, these are much earlier than you would expect dementia to show up. This message is geared towards people in their midlife saying that if we can work to control these things as well as to stay away from them, then potentially we can give ourselves on average, maybe 13 more healthy brain years.
Baker: Are there other treatments or actions you could undergo or do to delay or avoid dementia?
Dr. Cheung: The broader evidence does support improving cardiovascular health at any age. So, working on your activity level, making sure you follow up with your doctor, that you monitor your numbers, whether it's blood pressure, cholesterol, diabetes, and that you avoid bad habits, things like smoking. And so, good control of these things still matter for heart disease, brain health, and stroke prevention. So, the goal is really not perfection, but to do what we can to reduce our cumulative risk.
Baker: Doctors reacting to this study say lifestyle choices you make, getting enough sleep or maybe managing stress, exercise and diet for instance, still make a great deal of difference.
Dr. Cheung: These are very basic things. They're not necessarily glamorous, but they are powerful and the data continues to point to that. So regular physical activity, heart, healthy diet, good sleep, not smoking, management of blood pressure, diabetes, cholesterol, all of these things are really helpful in making sure that we age with grace and that our brains stay healthy and it's from these repeated habits and not just one single intervention or supplement or food.
Baker: So you shouldn't become frightened, but you should not become careless?
Dr. Cheung: Absolutely. There's no need to cause for alarm. And what we're supposed to do is to help take care of our brains and to give us the best chance at living a healthy life that's dementia free.
Baker: Is there anything you'd like to add?
Dr. Cheung: I would just say that brain health is important at all stages in life, and the study doesn't prove that treating these risk factors will delay dementia by 13 years, but it reinforces that good health in the early and mid-life is strongly associated with more years of life without dementia, and so controlling blood pressure, preventing or managing diabetes, and not smoking are things that we can actually act upon throughout our life, And so brain health is really a long-term game. And the early and midlife is a good place to start.
RESOURCES:
Dementia: 3 factors linked with developing the disease sooner | CNN
