Question
What are the modifiable risk factors for dementia?
Answer
I want to direct your attention to the Livingston and colleagues 2024 article, which discusses the fact that nearly 45% of dementias could theoretically be prevented by eliminating 14 modifiable risk factors. These risk factors include controlling diabetes and LDL cholesterol, treating blood pressure, preventing head injury, reducing air pollution, addressing and treating depression, stopping smoking, maintaining a healthy weight, avoiding excessive alcohol, addressing vision loss, addressing hearing loss, promoting social connections and avoiding isolation, encouraging cognitively stimulating activities, and encouraging exercise. These 14 factors work through several mechanisms: reducing neuropathology, decreasing vascular damage, reducing inflammation and stress, and improving and maintaining cognitive reserve.
I want to make clear why these belong in a group intervention program. By conducting group sessions, we are simultaneously addressing several of these factors. We are promoting social connections and helping individuals avoid isolation. We are encouraging cognitively stimulating activities. We are providing the knowledge and motivation to address others. These wellness education topics fit naturally into the group format and are substantive. When we talk about this research with our participants, we are not just delivering information. We are giving people a sense of agency over their own futures.
I also want to reinforce a message I carry through all of our programming: you need to empower and educate older adults with subjective cognitive decline and mild cognitive impairment that they indeed have some control over what happens next. That empowerment is itself a clinical tool. Evidence is building that almost half of dementias could be prevented by addressing these 14 risk factors, and communicating that to our participants with clarity and conviction changes how they engage with the program and with their own health behaviors.
This Ask the Expert is an edited excerpt from the course, Mild Cognitive Impairment (MCI): Assessment and Treatment, presented by Kim McCullough, PhD, CCC-SLP.
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