The global burden of age-related brain diseases is staggering. More than 55 million people worldwide currently live with dementia, a number projected to nearly triple by 2050. Stroke-related deaths may double by the same year, and 10% to 20% of adults will experience depression later in life. These statistics paint a grim picture, but recent research offers a glimmer of hope. A comprehensive review published in the Journal of Neurology, Neurosurgery, and Psychiatry identifies 17 modifiable factors that contribute to dementia, stroke, and late-life depression. Addressing these factors can significantly reduce the risk of developing any of these conditions.

The Scope of the Problem

The sheer magnitude of these health challenges underscores the urgency of finding effective prevention strategies. Dementia, stroke, and late-life depression are not only devastating for individuals and families but also place a significant burden on healthcare systems worldwide. The traditional approach has often focused on treating these conditions individually, but this siloed strategy overlooks the interconnected nature of these diseases. Many of the risk factors for dementia, stroke, and late-life depression overlap, suggesting that a holistic approach could yield substantial benefits.

The 17 Modifiable Factors

The review, led by Dr. Sanjula Singh from Harvard Medical School, identifies 17 factors that contribute to the risk of dementia, stroke, and late-life depression. These factors include:

1. Blood pressure

2. Body mass index (BMI)

3. Kidney disease

4. Blood sugar

5. Total cholesterol

6. Alcohol use

7. Diet

8. Hearing loss or impairment

9. Pain

10. Physical activity

11. Purpose in life

12. Sleep

13. Smoking

14. Social engagement

15. Stress

16. Cognitive activity during leisure time

17. Depressive symptoms

Singh emphasizes that the power of lifestyle and behavioral changes in mitigating age-related brain diseases is profound. “Ultimately, we hope that people feel like there’s a hopeful message in here—that there are actually so many things that you can work on, and then not only your risk of stroke is lower, but also of dementia and/or of late-life depression,” she said.

The Impact of Blood Pressure

Among the 17 factors, blood pressure stands out as the most significant. Individuals with a blood pressure level of 140/90 mm Hg or higher are more than twice as likely to have a stroke, 20% more likely to develop dementia, and 16% more likely to experience depression. This highlights the critical importance of maintaining a healthy blood pressure level, ideally below 120/80 mm Hg.

Practical Steps for Prevention

Addressing these risk factors may seem daunting, but the study suggests a menu of options from which individuals can choose a few items and work their way through the list over time. Many of these factors overlap, meaning that improving one area can have a cascading effect on others. For example, adopting a healthy diet and regular exercise can improve blood pressure, blood sugar, sleep, and cholesterol levels.

Lowering High Blood Pressure

High blood pressure reduces blood flow to the brain, directly contributing to stroke and dementia and indirectly to depression by reducing neurotransmitters. To manage blood pressure, individuals can:

- Regularly monitor their levels using home devices or at a doctor’s office.

- Reduce salt intake and increase potassium consumption.

- Engage in regular physical activity.

- Maintain a healthy weight.

- Manage stress through techniques like mindfulness and meditation.

- Seek medical advice if sleep apnea is suspected.

Quitting Smoking

Smoking is a major risk factor for stroke and dementia. Individuals can take immediate steps to quit by:

- Identifying triggers and developing strategies to avoid them.

- Learning from relapses and adjusting their approach.

- Using helplines and mobile apps for support.

- Consulting healthcare providers for personalized treatment plans.

Improving Fitness

Any amount of physical activity is better than none. The World Health Organization provides guidelines for exercise based on age, emphasizing the importance of regular physical activity to maintain overall health.

Ensuring Adequate Sleep

Older adults need at least seven hours of sleep per night. Tips for better sleep include:

- Keeping the bedroom cool, quiet, and dark.

- Avoiding alcohol and caffeine before bedtime.

- Limiting screen time in the evening.

- Establishing a consistent bedtime routine.

Regulating Blood Sugar

Maintaining healthy blood sugar levels is crucial for brain health. This can be achieved through:

- Regular exercise.

- Weight management.

- A healthy diet that limits refined carbohydrates and added sugars.

The Role of the Brain Care Score

The findings from this study inform the existing Brain Care Score, a tool developed in 2023 at the McCance Center for Brain Health at Massachusetts General Hospital. This score helps individuals gauge and manage their risk for dementia or stroke without medical procedures. The 21-point score assesses how a person fares on 12 health-related factors, including physical, lifestyle, and social-emotional components. The new study adds pain, depressive symptoms, hearing loss, cognitive activity, and kidney disease to this list. An updated version of the Brain Care Score is anticipated later this year.

Empowering Individuals through Knowledge

The research underscores a hopeful message: Many age-related brain diseases are not genetically predetermined but can be delayed or prevented through lifestyle and behavioral changes. By addressing the 17 modifiable factors identified in the study, individuals can significantly reduce their risk of developing dementia, stroke, and late-life depression. The key is to take small, manageable steps and gradually work towards a healthier lifestyle. As Dr. Richard Isaacson, a preventive neurologist, noted, “Data studies like this can help empower people to make meaningful changes in their day-to-day lives.” The future of brain health lies in prevention, and the power to change lies within each of us.