The ability to remember and plan are central to what makes life beautiful, and thus, understandably, many of us fear developing dementia as we get older.
What is dementia?
Dementia refers to several chronic and progressive disorders that impact brain function, like Alzheimer's disease, which is the most common form. Dementia involves a decline in memory, planning, language and judgment.
Dementia can also impact physical abilities and mood.
Researchers suspect dementia is due to abnormal proteins in the brain, reduced blood supply to the brain and nerve cells in the brain that stop working properly, according to the Public Health Agency of Canada (PHAC).
In Canada, between April 2017 and March 2018, almost 452,000 people over 65 were living with diagnosed dementia. Nearly 85,000 people older than 65 were newly diagnosed with dementia, according to the PHAC.
Many more folks are likely living with it but have not been diagnosed.
The rates of Alzheimer's disease and related dementias among Indigenous people in Canada are expected to grow more rapidly than among non-Indigenous people due to higher rates of many of the risk factors in Indigenous populations.
While there is a lack of studies specifically on Indigenous populations, one study suggests the rates of dementia are expected to increase by 4.2 times for First Nations and 3.3 times for Inuit between 2006 and 2031.
“Indigenous older adults are considered to be among Canada’s most vulnerable citizens. They often face complex health issues stemming from socio-economic marginalization and a legacy of colonialism, and their ability to access healthcare is impacted by a host of barriers related to poverty, cultural and linguistic differences, racism and geography,” reads The National Collaborating Centre for Aboriginal Health (NCCAH) report Alzheimer’s disease and related dementias in Indigenous populations in Canada: Prevalence and risk factors.
What can be done?
Individuals can't control some dementia risk factors — like aging and genetics.
And the larger society and government, too, must play a role in reducing the risks for Indigenous populations, as the report concludes:
“This highlights the need for integrated multisectoral approaches to address the socio-economic inequities and health disparities Indigenous people are experiencing in order to stave off the potential for a dementia ‘epidemic’ among this population.”
But individuals aren’t powerless to reduce their risk.
And according to the PHAC, most cases of dementia aren't related to genetics or inherited.
"Usually people fear the genetics," said Jay Ingram, former co-host of Discovery Channel's science show, Daily Planet, who is a spokesperson for the PHAC on dementia. His late mother had it, he said.
"Broadly speaking, genetics accounts for maybe 60% of whatever your risk is. But 40% are these factors that, for the most part, you can control."
The Lancet Commission estimates that 12 [changeable] risk factors account for 40% of cases of dementia worldwide.
What are the risk factors?
- Hypertension can increase the risk of dementia by 60%
- Obesity can increase the risk of dementia by 60%
- Social isolation can increase the risk of dementia by 60%
- Smoking can increase the risk of dementia by 60%
- Physical inactivity can increase the risk of dementia by 40%
- Excessive alcohol consumption can increase the risk of dementia by 20%
- Depression increases the risk by 90%
- Diabetes increases the risk by 50%
- Leaving school early increases the chances of developing dementia in later years by 60%
- Hearing loss increases the risk by 90%
- Traumatic brain injury increases the risk by 80%
- Air pollution increases the risk by 10%
Some of these factors, like air pollution, are harder for individuals to control than others.
"Air pollution ... is something that you can't really — unless you move to the country — personally control, but support government moves to lower emissions from cars and that sort of thing," Ingram said.
For parents, the message is that education matters. The years spent learning in school help stave off dementia later, it seems.
The other risk factors are ones folks can tackle more immediately.
You can reduce your risk by staying active and social, eating a balanced diet, avoiding smoking and managing health conditions such as diabetes.
If you have many lifestyle risk factors, the prospect of reducing your risk can seem overwhelming, Ingram acknowledges, but it doesn't have to be.
"If you only do one thing to lower your risk for dementia, that's physical exercise — specifically, walk half an hour to 40 minutes a day," said Ingram in a news release, quoting research done by the Ontario Brain Institute. "This takes people by surprise because they don't really see the direct connection between physical activity and the brain, but in fact, it enhances blood flow, it probably lowers blood pressure, both of which are contributing factors. "
Ingram is promoting the hashtag #onehabit
One small change at a time can make a big difference, he said.
If you suspect you have hearing loss, for example, get a hearing test, and if you need a hearing aid, get one, Ingram said.
And to prevent hearing loss, wear earplugs in noisy environments.
To prevent traumatic brain injury, wear a helmet when cycling and the like.
Ingram stressed that it is never too late to mitigate some risk factors.
"Even if you quit smoking late, like 65, that will reduce your risk," he said.
Wherever you are at, make one small change to reduce your risk, he said.
"Even if instead of never getting Alzheimer's or dementia ... you got it five years later. Five years not only means ... five years of happier contact with your family and friends and loved ones, and easing the burden on caregivers, easing the burden on the healthcare system. It's worth it," he said.
"This disease that seems so pervasive and overwhelming can actually be manipulated by relatively simple things. So that, to me, is the crucial message."
Specifically for Sḵwx̱wú7mesh Úxwumixw (Squamish Nation) members, the Nation offers a series of health and wellness services that can help on the road to a healthy physical and mental future.