Can We Prevent Dementia?

40 Lifestyle self-assessments for the over-40s 

Guest Blog by Mohamed Elmasry, PhD – 

I am now an octogenarian.

In talking with my 80-something friends, we all agree that it would be far more dignified to die in a few moments from a massive heart attack or stroke, than to languish in dementia for months or years in a nursing home.

Simply put, the prospect of dementia is scary. I often have a nightmare in which my neighbors discover me one evening running around naked, chasing squirrels in my backyard—or worse still, on a street somewhere across town where I might be captured by a local news videographer!

By 2050, 153 million people worldwide are expected to be living with dementia; that’s nearly three times the 57 million recorded in 2019. The increase is not only due to an aging population—more importantly, it reflects an international rise in negative, but controllable, lifestyle factors such as obesity, elevated blood sugar and cholesterol, social isolation, and stress.

Often mentioned along with dementia is Alzheimer’s disease, which currently affects 1 in 9 Americans aged 65 and older, or about 6.7 million people. In Canada, there are an estimated 500,000 Alzheimer’s sufferers.

In medicine, the term “dementia” describes a progressive decline in memory and cognition that interferes with one’s overall quality of life. Although mainly associated with those over 60, research shows that we should be creating a dementia-deterring lifestyle while still in our 40s, or even earlier.

Common signs of dementia’s onset include an increasing inability to recall names or identities, difficulty in identifying where you are, or becoming unable to complete multi-step tasks. Dementia can grow severe enough that independent living is no longer possible. 

Contrary to what many believe, dementia is not a disease in itself, but rather a cluster of neurological symptoms associated with aging. It can point to an underlying cause such as Alzheimer’s, which is an actual brain disease.

Our memories are fully integrated with the brain’s information processing systems, which means that brain health is of vital concern.

Three factors affect our brain health and ultimately, our longevity—genetic makeup, childhood environment, and lifestyle. The first two, often twinned as “nature and nurture,” are largely out of our control. But the third factor, how we choose to live, is very much under our control.   

Lifestyle includes all the ways in which we can intentionally affect our health—physically, mentally, and spiritually. 

Once barely considered relevant, lifestyle medicine is now a growing branch of the medical and scientific professions devoted to increasing our understanding of the changes necessary in order to live longer and healthier lives (see Lifestyle Medicine: Lifestyle, the Environment and Preventive Medicine in Health and Disease, 3^rd ed., Garry Egger et al, eds. Academic Press, 2017).

Is your current lifestyle working to prevent or greatly reduce the impact of dementia in your senior years?

40 Lifestyle Factors

Try this self-assessment test, which covers 40 Physical, Mental, and Spiritual lifestyle factors (some will overlap, but these three categories were used for convenience).

Each factor and its relationship to dementia is backed by multiple evidence-based research studies. Due to space restraints, they cannot be separately listed here, but the above-mentioned book, Lifestyle Medicine… cites some 1,000 references.

For a compact overview of current knowledge about dementia, I can highly recommend Dementia: A Very Short Introduction by Dr. Kathleen Taylor (Oxford University Press, 2020).  

For each item, rate yourself from 1 to 5, where 1 means Unsatisfactory and 5 is Highly Satisfactory.

Every time you choose 3 or below, note those items as areas to learn more about and work on. Don’t be discouraged; it’s never too late to change things for the better.

If you score 3 or above on every one, congratulations! Keep up those good habits; they show that you’re at a low risk for dementia.

Still not sure? 

Remember, timeliness is the key. You don’t need to wait for more evidence-based studies proving the link between lifestyle and dementia prevention; you could easily wait too long, and it doesn’t cost anything to do this easy self-assessment.

Finding and focusing on areas where you can improve your own habits can do far more good in the long run than looking for more new drugs to treat both dementia and Alzheimer’s. By starting good habits now, you may never need them!

Every improvement or addition you make from these 40 lifestyle factors will positively impact your general well-being and you will enjoy life much more. Happy testing!

Physical

1. Following healthy nutrition and eating habits
2. Daily water intake (hydration)
3. Food supplements/vitamins as needed
4. Weight management 
5. Maintaining dental health
6. Moderating caffeine intake 
7. Not smoking, vaping, or taking recreational drugs
8. Avoiding alcohol
9. Managing cholesterol levels 
10. Managing blood pressure 
11. Managing blood sugar
12. Managing arthritis and joint health 
13. Basic knowledge of body functions 
14. Quality of sleep
15. Mid-day napping 
16. Hearing health and quality 
17. Optical health and quality
18. Regular daily exercise
19. Quality of city air and noise

Mental

20. Managing stress
21. Managing depression 
22. Managing anxiety 
23. Having a sense of humor 
24. Regular hobbies 
25. Travel to places, near or far
26. Regular reading 
27. Spending time with friends 
28. Quality of life in your neighborhood 
29. Quality of your work environment
30. Daily small achievements like watering plants, gardening, spring cleaning, etc.

Spiritual

31. Daily prayer or meditation
32. Doing regular charity or public good
33. Fasting according to your faith
34. Reflecting on and recognizing your self-worth 
35. Connecting with nature and creation
36. Listening to music for relaxation and reflection
37. Appreciating and engaging with family life 
38. Socializing and being supportive of others 
39. Engaging with all your five senses every day 
40. Aging gracefully and confidently; wisdom really does grow with years!

Now, Make an Action Plan

1. All 40 lifestyle factors are important, so start wherever you can.
2. Try to choose factors where you’re most at risk and ready for change.
3. Challenge yourself, but be realistic; change is hard. Begin with one or two items and then move on to add more. You will be surprised at how much you can achieve, just one step at a time.

Thank you for reading — and thank yourself for investing in a healthier future, free from dementia!

Dr. Mohamed Elmasry, FRSC, FIEEE, FCAE, FEIC is Emeritus Professor of Computer Engineering at the University of Waterloo. Among many career publications, he is the author of iMind: Artificial and Real Intelligence (Routledge, 2024) and Spiritual Fitness for Life (Pandora, 2004). He is a world expert in microchip systems and Artificial Neural Networks (ANNs).

Contact: elmasry@uwaterloo.ca