As you age, you may have concerns about the increased risk of dementia. You may have questions, too. Are there steps I can take to prevent it? Is there anything I can do to reduce my risk? There are currently no approaches that have been proven to effectively treat or prevent Alzheimer’s disease and related dementias. However, as with many other diseases, there may be steps you can take to help reduce your risk.

A risk factor is something that may increase the chance of developing a disease. Some risk factors can be controlled while others cannot. For example, a person is not able to control their age, which is the greatest known risk factor for Alzheimer’s and related dementias. Another uncontrollable risk factor is a person’s genes. Genes are structures in our body’s cells that are passed down from a person’s birth parents. Changes in genes — even small changes — can cause diseases.

Race and gender are also factors that influence risk. Research shows that African Americans, American Indians, and Alaska Natives have the highest rates of dementia, and that risk factors may differ for women and men. Researchers are investigating what’s behind these differences.

However, people do have control over their behavior and lifestyle, which can influence their risk for certain diseases. For example, high blood pressure is a major risk factor for heart disease. Lowering blood pressure with lifestyle changes or medication can help reduce a person’s risk for heart disease and heart attack.

To determine which risk factors may prevent a disease or condition, researchers first conduct observational studies to make associations. They then conduct carefully controlled clinical trials.

For example, researchers identified an association between high blood pressure and heart attacks and then completed clinical trials to determine that lowering a person’s blood pressure would indeed lower the likelihood of having a heart attack. This is not to say that people who lower their blood pressure definitely won’t have a heart attack. But it significantly lowers the chances.

For Alzheimer’s and related dementias, no behavior or lifestyle factors have risen to the level of researchers being able to say: This will definitely prevent these diseases. But there are promising avenues.

The number of older Americans is rising, so the number of people with dementia is predicted to increase. However, some studies have shown that incidence rates of dementia — meaning new cases in a population over a certain period of time — have decreased in some locations, including in the United States. Based on observational studies, factors such as healthy lifestyle behaviors and higher levels of education may be contributing to such a decline. But the cause and effect is uncertain, and such factors need to be tested in a clinical trial to prove whether they can prevent dementia.

A review of published research evaluated the evidence from clinical trials on behavior and lifestyle changes to prevent or delay Alzheimer’s or age-related cognitive decline. The review found “encouraging but inconclusive” evidence for three types of behavioral changes (called interventions): physical activity, blood pressure control, and cognitive training. The findings mean that interventions in these areas are promising enough that researchers should keep studying them to learn more. Researchers continue to explore these and other interventions to determine whether — and in what amounts or forms — they might prevent dementia.

Eating healthfully and having an active lifestyle can support healthy aging.

Simple adjustments can go a long way toward building a healthier eating pattern. Follow these tips to get the most out of foods and beverages while meeting your nutrient needs and reducing the risk of disease:

Enjoy a variety of foods from each food group to help reduce the risk of developing diseases such as high blood pressure, diabetes, and heart disease. Choose foods with little to no added sugar, saturated fats, and sodium.

To get enough protein throughout the day and maintain muscle, try adding seafood, dairy, or fortified soy products along with beans, peas, and lentils to your meals. Learn more about protein and other important nutrients.

Add sliced or chopped fruits and vegetables to meals and snacks. Look for pre-cut varieties if slicing and chopping are a challenge for you.

Try foods fortified with vitamin B12, such as some cereals, or talk to your doctor about taking a B12 supplement. Learn more about key vitamins and minerals.

Reduce sodium intake by seasoning foods with herbs and citrus such as lemon juice.

Drink plenty of water throughout the day to help stay hydrated and aid in the digestion of food and absorption of nutrients. Avoid sugary drinks.

It can be hard for some people to follow through on smart food choices. Read about common roadblocks and how to overcome them and check out the USDA’s tips for older adults.

Eating habits can change as we grow older. The USDA has developed Food Patterns to help people understand different ways they can eat healthy. The food patterns include:

Healthy U.S.-Style Eating Pattern: This is based on the types of foods Americans typically consume. The main types of food in this eating pattern include a variety of vegetables, fruits, whole grains, fat-free or low-fat dairy, seafood, poultry, and meat, as well as eggs, nuts, seeds, and soy products. Check out this sample menu to get started.

Healthy Mediterranean-Style Eating Pattern: This one contains more fruits and seafood and less dairy than the Healthy U.S.-Style Eating Pattern.

Healthy Vegetarian Eating Pattern: This pattern contains no meat, poultry, or seafood, but does contain fat-free or low-fat dairy. Compared with the Healthy U.S.-Style Eating Pattern, it contains more soy products, eggs, beans and peas, nuts and seeds, and whole grains.

Visit the USDA Food Patterns webpage for more information on each eating pattern and recommended daily intake amounts for each food group.

Use these tips to plan healthy and delicious meals:

Plan in advance. Meal planning takes the guesswork out of eating and can help ensure you eat a variety of nutritious foods throughout the day.

Find budget-friendly foods. Create a shopping list in advance to help stick to a budget and follow these SNAP-friendly recipes.

Consider preparation time. Some meals can be made in as little as five minutes. If you love cooking, or if you’re preparing a meal with or for friends or family, you may want to try something a little more challenging.

Keep calories in mind. The number of calories people need each day varies by individual.

Always discuss your weight and fitness goals with your health care provider before making big changes. Read about calorie goals and healthy food swaps.

Happy New Year! Looking for a way to stay on top of your health in 2023? Medicare covers many preventive and screening services. These services can help keep you from getting sick, and can help find health problems early when treatment is most likely to work best. Talk to your doctor about which ones might be right for you.

See What’s Covered

If you have Original Medicare (Part A and/or Part B), sign in to your secure Medicare account to see a personalized list of current and upcoming preventive services. If you don’t already have an account, it’s free — and easy — to sign up.

If you’re in a Medicare Advantage Plan, contact your plan for a list of covered preventive services. MA Plans must cover all the same preventive services as Original Medicare, and some may offer additional services.

Good news: Now people with Medicare Part D drug coverage will pay nothing out-of-pocket for even more vaccines, including the shingles vaccine, that are recommended by the Advisory Committee on Immunization Practices.

Here’s to your health in the new year!

Sincerely,

The Medicare Team

Alzheimer’s disease and related dementias affect more than 46 million people worldwide. Safe and affordable treatments to prevent cognitive decline in older adults are urgently needed. In response to this need, certain dietary supplements have been touted as having protective effects on cognition.

Normal brain function requires various vitamins, minerals, and other nutrients. Deficiencies in these nutrients may increase the risk for cognitive decline and dementia with age. Yet clinical trials of individual nutrients’ effects on cognition have yielded mixed results. Prior research suggests that flavanols in particular — compounds found in high levels in unprocessed cocoa — might benefit cognition.

Much of the research on flavanols was based on observational studies, rather than clinical trials. And previously, the effects of a multivitamin on cognition in older adults had been studied only in a few short clinical trials (less than 12 months) and a single longer trial that included older male physicians.

An NIH-funded research team led by Drs. Laura Baker and Mark Espeland at Wake Forest University School of Medicine aimed to fill the gaps in our understanding of these supplements’ effects on cognition. They examined more than 2,200 participants, ages 65 and older, who enrolled in the study from August 2016 to August 2017. The participants’ average age was 73.

Participants were given a cocoa extract supplement and/or a multivitamin-mineral supplement daily for three years, or an inactive placebo for comparison. They completed a battery of cognitive tests over the phone at the beginning of the study and once a year afterward. The researchers evaluated participants on global cognition (a wide range of cognitive measures), memory, and executive function (attention, planning, and organization). Results appeared in the journal Alzheimer’s & Dementia on Sept. 14, 2022.

The team found no difference in global cognition between those who took cocoa extract and those who did not. But participants taking the multivitamin had higher global cognition scores than those who didn’t. The improvement was most pronounced in those with a history of cardiovascular disease. Significant improvements with daily multivitamin use were also seen in memory and executive function. Cocoa extract had no effect on either.

The results suggest that a safe and affordable daily multivitamin-mineral supplement might improve cognition in older adults or protect cognitive health with age. Yet the researchers caution that the results, while promising, are still preliminary.

“It’s too early to recommend daily multivitamin supplementation to prevent cognitive decline,” Baker says. “While these preliminary findings are promising, additional research is needed in a larger and more diverse group of people. Also, we still have work to do to better understand why the multivitamin might benefit cognition in older adults.”

— by Brian Doctrow, Ph.D.

This research was supported in part by NIA grant R01-AG050657.