As we gain more knowledge of Alzheimer’s disease and related dementias, researchers are discovering that health care professionals can encourage patients to take steps to prevent the onset of these debilitating cognitive conditions. The data to date is encouraging and outlines opportunities to take control of the risk factors to delay or mitigate many cases of dementia.
New research shows almost half of all U.S. adults aged 45 and older have modifiable risk factors for Alzheimer’s disease and related dementias (ADRD), including hypertension, low levels of physical activity, and obesity.
Data from the Centers for Disease Control and Prevention reveal that, amongst nearly 162,000 adults aged 45 and older surveyed in 2019 as part of the Behavioral Risk Factor Surveillance System (BRFSS), nearly half had high blood pressure and did not achieve aerobic physical activity recommendations. These were the two most common modifiable risk factors for ADRD. In addition, more than one-third (35%) of adults were obese, 19% had diabetes, 18% had depression, 15% were smokers, 11% had hearing loss, and 10% were binge drinkers.
These findings are published online in the CDC’s Morbidity and Mortality Weekly Report: https://www.cdc.gov/mmwr/volumes/71/wr/mm7120a2.htm?s_cid=mm7120a2_w
A missed prevention opportunity
More than 1 in 10 (11.3%) adults surveyed reported a subjective cognitive decline (SCD), an early indicator of possible future ADRD. The prevalence of SCD increased from about 4% among adults with no Internal Medicine modifiable risk factors for ADRD to 25% for those with four or more risk factors. Adults with SCD were more apt to report having almost all modifiable risk factors and were more likely to report four or more risk factors (34%) than were peers without SCD (13%).
The prevalence of SCD ranged from a high of about 29% in those with depression to 25% in those with hearing loss and 11% in those who reported binge drinking.
In line with previous research, the findings indicate that American Indian or Alaska Native, Black or African American, and Hispanic populations were more likely to have modifiable risk factors for ADRD than other racial groups, the researchers reported. The CDC’s National Healthy Brain Initiative supports culturally tailored interventions that address ADRD risk factors specifically in these populations. In 2021, the federal government updated the National Plan to Address Alzheimer’s Disease to include a new goal to reduce risk factors for ADRD.
“Given the prevalence of modifiable risk factors for ADRD and anticipated growth of the older adult population and those with ADRD, this new goal has the potential to benefit a large proportion of U.S. adults,” the investigators wrote.
“In addition to helping patients discuss concerns about memory loss, health care professionals should screen patients for modifiable risk factors, counsel patients with risk factors, and refer them to effective programs and interventions where recommended,” they advised.
A recent report from the Lancet Commission on Dementia Prevention, Internal Medicine Intervention, and Care found that modifying 12 risk factors over the life course could delay or prevent 40% of dementia cases.
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