Hi Dr Jen - thank you for such an actionable list. And perhaps some advice for you - if its only the streamers you're having issues with sound on and not general television, then it is likely an audio setting in the app that needs changing. There are loads of youtube vids online that will explain how to find the right menu and test out other options.
Love your measured approach to the hype of “MHT is good for everyone”. We absolutely need to be recommending these things to our patients. And be able to reassure our patients not on MHT that their brain is not going to shrivel up.
Grateful for this actionable list. Still dealing with some peri menopause brain fog and making mistakes at work which I’m sure is related to my difficulties getting enough sleep (hrt hasn’t helped so continue to employ other tools as well).
It's so important that we educate the general population about the concept of "modifiable risk factors" for dementia. I've spoken with countless people who don't actually realize that there are things they can do to lower their risk—for dementia or many other conditions.
In healthcare, we recognize the importance of modifiable risk factors, but my experience has taught me that it's not "common knowledge." Many believe that it's purely genetic... Some think it's luck-of-the-draw. Most think they have no say in the matter.
I strongly believe that the first step in lowering the incidence of certain diseases is making the term "modifiable risk factors" more mainstream, otherwise it'll be hard to move the needle in the right direction. Once people recognize that they have some degree of control, they might be more open to behavioral changes..
Thank you for the information. Can you explain the connection between being underweight and increased dementia risk? I have always been tall, thin, and slightly underweight, but very healthy. I have great LDL, glucose numbers, blood pressure, normal bone mineral density, etc. I’m physically active and well-educated. The thought of trying to do everything right yet still being at increased risk is very disturbing.
The studies don't explain the particular reason, but being underweight is likely a marker for having another illness, as many people lose weight when they are quite sick. The cut-off in many studies is a BMI under 18.5. There are always outliers, but I suspect if someone has a very healthy lifestyle, it's not likely a marker. Being underweight is a risk factor for osteoporosis though and in my practice I recommend a bone density for that reason.
Even light drinking was associated with an increase in cancer deaths among older adults in Britain, researchers reported on Monday in a large study. But the risk was accentuated primarily in those who had existing health problems or who lived in low-income areas...NY Times
Not intended as specific to the above post but as a more general cautionary FYI.
( the imbedded hyper-link may not redirect the reader)
The study defined light drinking as a mean alcohol intake of up to 20 grams a day for men and up to 10 grams daily for women. (In the United States, a standard drink is 14 grams of alcohol.)
Last year, the Canadian Centre on Substance Use and Addiction issued a new guidance stating that no amount or kind of alcohol is good for health and that “even a small amount of alcohol can be damaging to health. {Jan 2023, updated its Guidance on Alcohol and Health.
Unlike the previous guidelines from 2011, the new guidelines define a 'continuum of risk associated with weekly alcohol' rather than a recommended maximum number of drinks per week.}
”People who consume one to two drinks a week “are likely to avoid alcohol-related consequences,” the center said. But the risk of cancer increases with three to five weekly drinks, and the risk of heart disease and stroke increases with seven or more weekly drinks, according to the Canadian guidelines.
This article discourages me. My father was a graduate of MIT and a wide ranging reader and commentator all his life. He exercised daily. He did have heart disease. He had a very bad vascular dementia at the end of his life. He had some head injuries.
I, myself, have had several very bad head injuries. I drowned as a toddler and was anoxic when found with a stopped heart. I was in a coma for a week afterward. As a younger person I was in a car wreck( in the old days before required seat belt use) and was knocked unconscious when my forehead hit the dash. Later I was hit on the head by an attacker while out jogging. I saw stars and went down but woke up immediately kicking, screaming and biting-which did the trick for an escape . As a much older person now I have fallen a couple of times and conked my head. I feel that I have a huge target on my head which is now not subject to moderation.
I ty to work on the rest of the factors. I take anti hypertensives, exercise, control my weight. I never drank heavily and never smoked. I did grow up on the Gulf of Mexico coast and we had refineries that we could see from the house. I now live in Oklahoma and again there is a very big refinery in our area. We need petroleum though.
I'm 72 and still manage my life, read widely, drive cautiously. But I have seen dementia up close and truly I spend a lot of moments terrified.
Thank you so much for this post! My mother was recently diagnosed with Alzheimer’s and so this is a topic that has been top of mind for me.
So sorry to hear this.
Thank you. As a 68-year-old, I appreciate the tips for those over 65.
I can’t find them! I only saw the midlife tips — 18-65. Help please! Thank you
The 65 interventions mentioned are hecking vision and social connection
As always an excellent post! You help sort through all the “noise”.
Another great post with actionable steps! Thank you!!
(PS: the subtitle thing is not just you-- it's how most shows are produced for streaming services, and it sucks. Here's some info about it: https://youtu.be/VYJtb2YXae8?si=C8ZMNzBFPcoxBrEH )
Thanks!
Thank you for this clear and reassuring post!
Thank you so much for this post!
Hi Dr Jen - thank you for such an actionable list. And perhaps some advice for you - if its only the streamers you're having issues with sound on and not general television, then it is likely an audio setting in the app that needs changing. There are loads of youtube vids online that will explain how to find the right menu and test out other options.
Thank you!
Love your measured approach to the hype of “MHT is good for everyone”. We absolutely need to be recommending these things to our patients. And be able to reassure our patients not on MHT that their brain is not going to shrivel up.
The discourse lately seems out of control. I am writing about that in an upcoming post.
Grateful for this actionable list. Still dealing with some peri menopause brain fog and making mistakes at work which I’m sure is related to my difficulties getting enough sleep (hrt hasn’t helped so continue to employ other tools as well).
CBT-I, if available, is a great tool for insomnia. It is a good add on if hormones aren't helping.
It's so important that we educate the general population about the concept of "modifiable risk factors" for dementia. I've spoken with countless people who don't actually realize that there are things they can do to lower their risk—for dementia or many other conditions.
In healthcare, we recognize the importance of modifiable risk factors, but my experience has taught me that it's not "common knowledge." Many believe that it's purely genetic... Some think it's luck-of-the-draw. Most think they have no say in the matter.
I strongly believe that the first step in lowering the incidence of certain diseases is making the term "modifiable risk factors" more mainstream, otherwise it'll be hard to move the needle in the right direction. Once people recognize that they have some degree of control, they might be more open to behavioral changes..
Can you explain what Build cognitive and brain reserve refers to?
Working your brain and learning more. Basically, intellectual stimulation builds more pathways.
Thank you for the information. Can you explain the connection between being underweight and increased dementia risk? I have always been tall, thin, and slightly underweight, but very healthy. I have great LDL, glucose numbers, blood pressure, normal bone mineral density, etc. I’m physically active and well-educated. The thought of trying to do everything right yet still being at increased risk is very disturbing.
The studies don't explain the particular reason, but being underweight is likely a marker for having another illness, as many people lose weight when they are quite sick. The cut-off in many studies is a BMI under 18.5. There are always outliers, but I suspect if someone has a very healthy lifestyle, it's not likely a marker. Being underweight is a risk factor for osteoporosis though and in my practice I recommend a bone density for that reason.
Thank you! That’s reassuring.
Even light drinking was associated with an increase in cancer deaths among older adults in Britain, researchers reported on Monday in a large study. But the risk was accentuated primarily in those who had existing health problems or who lived in low-income areas...NY Times
Not intended as specific to the above post but as a more general cautionary FYI.
JAMA Netw Open. 2024;7(8):e2424495. doi:10.1001/jamanetworkopen.2024.24495
( the imbedded hyper-link may not redirect the reader)
The study defined light drinking as a mean alcohol intake of up to 20 grams a day for men and up to 10 grams daily for women. (In the United States, a standard drink is 14 grams of alcohol.)
Last year, the Canadian Centre on Substance Use and Addiction issued a new guidance stating that no amount or kind of alcohol is good for health and that “even a small amount of alcohol can be damaging to health. {Jan 2023, updated its Guidance on Alcohol and Health.
Unlike the previous guidelines from 2011, the new guidelines define a 'continuum of risk associated with weekly alcohol' rather than a recommended maximum number of drinks per week.}
”People who consume one to two drinks a week “are likely to avoid alcohol-related consequences,” the center said. But the risk of cancer increases with three to five weekly drinks, and the risk of heart disease and stroke increases with seven or more weekly drinks, according to the Canadian guidelines.
Yes, I follow the Canadian guidelines: less, never more than 1-2 drinks/week and I also recommend that
I believe you're Canadian trained
Great and actionable post, as usual. Does this apply to Alzheimer's as well? Or is dementia something completely different?
It applies to all causes of dementia, including Alzheimer's
Alzheimer's is the most common type of dementia. So all Alzheimer's is dementia but not all dementia is Alzheimer's
Thank you, Jeanette and Dr. Jen!
This article discourages me. My father was a graduate of MIT and a wide ranging reader and commentator all his life. He exercised daily. He did have heart disease. He had a very bad vascular dementia at the end of his life. He had some head injuries.
I, myself, have had several very bad head injuries. I drowned as a toddler and was anoxic when found with a stopped heart. I was in a coma for a week afterward. As a younger person I was in a car wreck( in the old days before required seat belt use) and was knocked unconscious when my forehead hit the dash. Later I was hit on the head by an attacker while out jogging. I saw stars and went down but woke up immediately kicking, screaming and biting-which did the trick for an escape . As a much older person now I have fallen a couple of times and conked my head. I feel that I have a huge target on my head which is now not subject to moderation.
I ty to work on the rest of the factors. I take anti hypertensives, exercise, control my weight. I never drank heavily and never smoked. I did grow up on the Gulf of Mexico coast and we had refineries that we could see from the house. I now live in Oklahoma and again there is a very big refinery in our area. We need petroleum though.
I'm 72 and still manage my life, read widely, drive cautiously. But I have seen dementia up close and truly I spend a lot of moments terrified.