Dementia Reducing Your Risk

Overview

Dementia is not one single illness. It is a group of symptoms caused by damage to the brain over time. The most common symptoms are problems with memory, thinking, and doing everyday tasks. There are many different causes, and Alzheimer's disease is the most common. The good news is that research now shows there is a lot you can do to lower your chances of developing dementia, or to delay it. This is called risk reduction. It means looking after your heart, your body, and your mind, and making small changes that add up over the years.

Yes, dementia is common. Around 1 million people in the UK are living with dementia, and worldwide the number is estimated at more than 55 million. The numbers are rising mainly because people are living longer. Age is the strongest known risk factor, but dementia is not an unavoidable part of getting older.

Dementia mostly affects people over 65, but it can affect younger people too. When symptoms start before age 65 it is called young onset dementia. Women are affected more often than men, partly because they tend to live longer. Some groups of people have a higher risk, often linked to heart health, living conditions, and access to good healthcare. Anyone can take steps to lower their risk, whatever their age or background.

Symptoms

Common symptoms

• Memory slips that are becoming more noticeable, such as repeating questions or forgetting recent events
• Struggling to find the right word, or losing the thread of a conversation
• Finding it harder to follow a plan or solve problems, such as managing bills or cooking a familiar meal
• Getting confused about time or place, or getting lost somewhere familiar
• Misplacing things in odd places and not being able to retrace steps
• Changes in mood, personality, or judgment, such as becoming withdrawn, irritable, or unusually careless with money

Symptoms in children

• Dementia is very rare in children. There are rare childhood conditions that cause similar brain changes, but these are looked after by specialist children's teams.
• The information on this page is about adults. If you are worried about a child's memory, learning, or development, speak to their doctor.

Symptoms in older adults

• Age is the strongest known risk factor, but dementia is not a normal part of ageing. Many people live into their 90s with clear thinking.
• Normal ageing can bring slower recall of names and a tendency to misplace keys. Dementia is different: it affects daily life and gets worse over time.
• Older adults may also have other conditions, such as hearing loss, depression, or infections, that can cause confusion. These are worth checking, because they are often treatable.
• A sudden change in confusion in an older person is a medical matter, not just 'old age'. Seek help the same day.

Causes

Main causes

• Alzheimer's disease, where abnormal proteins build up in the brain over many years
• Vascular dementia, caused by reduced blood flow to the brain, often after small strokes
• Lewy body dementia, linked to unusual protein clumps in the brain
• Frontotemporal dementia, where damage starts in the front and side parts of the brain, sometimes affecting behaviour or language first
• Mixed dementia, where more than one of these changes is present at the same time

Risk factors

• Age: the strongest single risk factor, though it cannot be changed
• Genes and family history: rare inherited forms exist, and some genes raise risk slightly. Having a relative with dementia does not mean you will get it.
• High blood pressure, especially in midlife
• Smoking, drinking too much alcohol, and being physically inactive
• Type 2 diabetes, high cholesterol, and being overweight
• Hearing loss that is not managed with hearing aids
• Depression, long-term stress, and feeling socially isolated
• Head injuries, especially repeated ones, such as from contact sports
• Lower levels of education in early life, and air pollution in some studies

When to see a doctor

See a doctor urgently if:

• A sudden change in someone's confusion or alertness, which could be an infection, a stroke, or a reaction to a medicine
• New memory problems after a fall or bang to the head
• Someone with memory problems who is no longer safe at home, for example leaving the cooker on or getting lost outside

Book a routine appointment if:

• You or someone close to you has noticed memory or thinking changes that are affecting daily life and have lasted more than a few weeks
• You keep repeating questions, getting lost in familiar places, or struggling with tasks you used to find easy
• Family or friends have commented on changes in your personality, mood, or judgment
• You feel anxious about your memory and would like it checked, even if you think it is probably nothing

Diagnosis

There is no single test for dementia. Your GP will start by talking with you, and usually with someone who knows you well, about how your memory and thinking have changed and how it affects daily life. They will ask about your health, medicines, mood, and sleep, and check your blood pressure. They may do some short pen-and-paper memory and thinking tests, and arrange blood tests to rule out other causes. If dementia is still possible, you will usually be referred to a memory clinic or a specialist doctor for a fuller assessment.

Tests that may be done

• A conversation about your symptoms, often with a family member or friend present
• Short cognitive tests: simple questions and tasks that check memory, attention, and language
• Blood tests to check thyroid, vitamin levels, kidney and liver function, and other treatable causes
• A brain scan, such as a CT or MRI scan, to look for strokes, tumours, or patterns of brain change
• A review of your medicines to spot anything that could be affecting your thinking
• In specialist clinics, occasionally other tests such as a more detailed memory assessment or a lumbar puncture

What to expect at your appointment

The process can take several weeks because it happens in stages. You may be asked to bring someone with you, which really helps. Being told you have dementia can feel frightening, but a diagnosis also opens the door to support, treatment, and planning. If the tests show something else, such as depression or a thyroid problem, that can be treated. Either way, you should be given clear explanations and time to ask questions.

Treatment

There is currently no proven way to prevent dementia, and no cure. But there is a lot that helps. The main focus is on lowering your risk and protecting your brain health, and on supporting memory, independence, and wellbeing if memory problems do develop. Your GP can help you review your blood pressure, cholesterol, blood sugar, hearing, mood, and medicines. Specialist teams can offer further assessment and support.

Self-care at home

• Keep physically active: aim for something that raises your heart rate and makes you a little breathless most days, plus some strength work
• Stay socially connected: regular contact with friends, family, or community groups is good for the brain
• Keep your mind active in ways you enjoy, such as reading, puzzles, learning a skill, or volunteering
• Protect your hearing, and get a hearing test if you think you are missing sounds. Use hearing aids if they are recommended
• Get enough sleep, and speak to your GP if you snore heavily or feel very sleepy in the day
• Do not smoke, and keep alcohol within low-risk limits
• Look after your mental health: talk to someone if you feel low, anxious, or isolated

Medical treatments

There is no medicine proven to prevent dementia. For some types of dementia, specialist doctors can prescribe medicines that may help with symptoms for a period of time. These are started and monitored by specialists. Your GP's main role in risk reduction is to check and manage the things that affect blood vessels and brain health, such as high blood pressure, diabetes, high cholesterol, and depression, and to review medicines that might be affecting your thinking. Always talk to your GP or pharmacist before starting or stopping any medicine.

When is surgery considered?

Surgery is not used to treat or prevent dementia. Some people with dementia may need operations for other health problems, and this is planned carefully with the medical team.

Living with this condition

If you are living with memory changes, small routines make a big difference. Keep keys, glasses, medicines, and phone in the same place. Use a diary, a whiteboard, or phone reminders. Label cupboard doors. Keep a list of important numbers by the phone. Tell people you trust so they can help. If you are supporting someone else, encourage them to do what they still can, keep the day predictable, and give information in short, calm sentences. Speak to your GP or local health service about a memory assessment, a care needs assessment, and practical help such as financial and legal advice.

Lifestyle tips

• Move more: walking, gardening, swimming, or dancing all count, and the best exercise is one you will keep doing
• Stay connected: join a group, volunteer, or set a regular time to see friends
• Get your hearing checked and use hearing aids if needed
• Protect your head: wear a helmet for cycling and take falls seriously
• Keep alcohol low and avoid smoking
• Manage stress with simple things like breathing exercises, time outdoors, or talking to someone
• Keep learning: a new skill or hobby challenges the brain in a good way

Diet and exercise

A heart-healthy diet is also a brain-healthy diet. That means plenty of vegetables, fruit, beans, whole grains, nuts, and oily fish, and less processed food, salt, and sugar. Eating this way helps your blood pressure, cholesterol, and blood sugar, which all affect brain health. For activity, aim for at least 150 minutes of moderate movement a week in whatever form suits you, plus some strength and balance work such as carrying shopping or chair exercises. Break it into short chunks if that is easier. Check with your GP first if you have a health condition or have not exercised for a while.

Mental health and emotional wellbeing

Being worried about your memory, or caring for someone with dementia, can bring anxiety, low mood, grief, and loneliness. These feelings are very common and nothing to be ashamed of. Talking to your GP is a good first step. Counselling, peer support groups, and dementia-friendly groups can help a lot. If you or someone else is feeling unsafe or having thoughts of harming yourself, contact your local emergency number or a crisis support line straight away, and tell someone you trust.

Prevention

There is no guaranteed way to prevent dementia, and no single change will protect everyone. But research suggests that around 4 in 10 cases could be delayed or prevented by working on the things we can influence. The most important are keeping blood pressure healthy in midlife, protecting your hearing, staying physically and socially active, not smoking, keeping alcohol low, managing diabetes and cholesterol, protecting your head from injury, and looking after your mental health. Starting small and keeping it up matters more than being perfect.

Vaccines

There is no vaccine against dementia. Keeping up to date with routine vaccinations, such as flu, shingles, and COVID-19, is good for your general health. Some research suggests that infections and inflammation may play a part in long-term brain health, but this is not yet proven to prevent dementia. Ask your GP or pharmacist which vaccinations you are due.

Screening programmes

There is no routine screening test for dementia in the general population, and cognitive tests in people with no symptoms are not currently recommended. In the UK, the NHS Health Check, offered every 5 years to people aged 40 to 74, checks blood pressure, cholesterol, and heart risk, which are also linked to brain health. If you have noticed memory changes, ask your GP about an assessment rather than waiting for screening.

Complications

If left untreated

• Memory and thinking problems usually get worse slowly over time, affecting daily tasks such as managing money, cooking, and getting around
• Higher risk of falls, infections, and hospital stays
• Increased risk of anxiety, depression, and social isolation for the person and their family
• Loss of independence in later stages, with growing need for help with personal care
• Caring can be exhausting, and carers themselves often need support

Long-term outlook

Many people live well for years with dementia, and some types progress more slowly than others. Because there is no cure today, planning ahead and staying active, connected, and well supported matters a great deal. Research into prevention and treatment is moving quickly, and there is real hope that risk reduction and new treatments will change the picture in the coming years. Whatever your situation, there is help, and asking for it early makes a difference.

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