Q&A: Lifelong strategies for preventing dementia

Dear Mayo Clinic: Do puzzles and other activities or apps that claim to lower one's risk of developing dementia actually work? Are there other things people can do to decrease the risk?

A: Doing activities that stimulate your brain may reduce your risk of developing dementia. But it's more complex than taking up puzzles or computer games at age 65. Research suggests that the value of cognitively stimulating activities builds up over a lifetime. That means acquiring a good education; working in a job that is mentally stimulating; and engaging in pastimes, hobbies and social activities that are mentally engaging are all part of reducing your risk for developing dementia.

For example, studies have shown that the more years of education a person has, the lower the dementia risk. This appears to be because people who spend more time engaged in learning across their lifetime tend to develop more robust networks of nerve cells and connections between those nerve cells within their brains. Those networks are better equipped to handle the cell damage that can happen as a result of brain disorders that may lead to dementia.

Before continuing, it would be wise to define "dementia." Dementia describes symptoms that affect a person's memory, thinking and social abilities to the point that it's difficult to perform normal daily activities. Dementia is caused by brain disease. Alzheimer's disease is the most common and one of the most well-known. Diseases that affect the blood vessels - the same diseases that cause heart attacks and stroke - are the second most common cause of dementia.

So, in addition to participating in activities that are mentally engaging, avoiding conditions that increase heart attacks and strokes also reduces your risk of dementia. Maintaining healthy levels of cholesterol and blood pressure, avoiding diabetes, not smoking, staying at a healthy weight and exercising regularly all have been shown to improve cognitive health later in life. Again, however, it's best if you make them components of a healthy lifestyle in your younger years and sustain them as you get older. That's because all of them affect the health of the blood vessels in your brain.

If your brain blood vessels stay in good condition throughout your young adulthood and midlife, they are more likely to be able to remain healthy as you age. If the health of those blood vessels deteriorates when you are younger, it's difficult to mend the damage later. And damage to the brain's blood vessels can be a factor in dementia.

This is not to say that incorporating healthy choices into your lifestyle if you are older won't make any difference. They can positively affect your cognitive and physical health. But to gain the most benefit for your brain, it's best to have them in place as soon as possible.

Social interaction is an area where anyone can make a change at any time, and it will likely have positive cognitive benefits. Regularly interacting with others - family, friends, neighbors, co-workers, community members - can lift your mood, improve your outlook and engage your brain. All of these positively affect your cognitive abilities, and being socially engaged has been shown to ease symptoms of dementia.

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