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True_Garen OP t1_ixxveug wrote

The most prominent modifiable risk factors for Alzheimer disease and related dementias (ADRD) in the US changed during the past decade, with midlife obesity overtaking physical inactivity at the top of the list.

An analysis of data from 378 615 respondents in the 2018 US Behavioral Risk Factor Surveillance System annual survey evaluated the relative contribution of 8 modifiable risk factors—physical inactivity, current smoking, depression, low education, diabetes, midlife obesity, midlife hypertension, and hearing loss—to ADRD risk.


RainaElf t1_ixxxgt2 wrote

since when is depression modifiable? or do they mean people on medication?


OPengiun t1_ixy2l7i wrote

Probably refers to untreated depression, in the same way it is referring to untreated hearing loss.

So... active therapy, CBT, medicine, etc


RainaElf t1_ixz9t2v wrote

it's just ambiguous the way it's written


OPengiun t1_iy0mgad wrote

Yeah, and a bit demoralizing for the folk that have depression, I'd imagine.


RainaElf t1_iy0tmzv wrote

which is why I asked. I've had chronic depression since high school. about forty years if not longer.


ChungusChess t1_ixxxoy8 wrote

You just need someone to say "cheer up" or "you should try smiling". I've never been happier.


RainaElf t1_ixxzuyg wrote

is that like "just stop being poor"?


subzero112001 t1_ixyno70 wrote

Well, if you stopped being poor then you wouldn’t have poor people problems. Sounds pretty logical to me.


wdcpdq t1_ixyzpf8 wrote

Being poor makes treating hearing loss, depression, low education, etc a challenge.


kthulhu666 t1_ixxyx0f wrote

Have medical "professionals" tell you, "It's all in your head." Problem solved.


RainaElf t1_ixxzvkl wrote

is that like "just stop being poor"?


uninstallIE t1_ixy2t3c wrote

Most depression is/can be alleviated through therapy that is coaching you to making lifestyle changes. Some people get on drugs, but this isn't necessary for a lot of cases depression


JazzlikeZucchini2855 t1_ixz3nba wrote

I’d venture to say that a lot of depression could be alleviated by society not being the way it is.


Spreadwarnotlove t1_ixzox7a wrote

Yeah. Society is too kind. People need life and death struggles to feel alive.


hiricinee t1_ixz25so wrote

It depends on your definition of modifiable. There's plenty of people who are obese that would insist its not modifiable, and plenty of people who changed their behavior and were able to fix their depression or at least reduce it.

Tbh, if there is literature that exists suggesting you can correct something with changes in behavior, it's at least I'm part modifiable, and that literature DOES exist regarding depression.


InTheEndEntropyWins t1_ixyc47l wrote

Good diet, exercise and sleep have as much if not more impact on depression than medication. Your brain needs good diet, exercise and sleep to function properly, it's no surprise that you will have brain disfunction like depression or dementia if you aren't doing all three.

>The diet may have a significant effect on preventing and treating depression for the individual. A diet that protects and promotes depression should consist of vegetables, fruits, fibre, fish, whole grains, legumes and less added sugar, and processed foods. In the public health nurse’s preventative and health-promoting work, support and assistance with changing people’s dietary habits may be effective in promoting depression. From
>Current evidence supports the finding that omega-3 PUFAs with EPA ≥ 60% at a dosage of ≤1 g/d would have beneficial effects on depression Https://


>People with insomnia , for example, may have a tenfold higher risk of developing depression From

Studies show that exercise is just as effective as medicine.

>Four trials (n = 300) compared exercise with pharmacological treatment and found no significant difference (SMD -0.11, -0.34, 0.12). From


Hypernova1912 t1_iy0977h wrote

Diet and particularly exercise are effective, but keep in mind that when you're depressed it can be very hard to find the energy or motivation to cook, eat healthy meals, or exercise. Medication is useful even if it just gets you far enough to be able to do those.

Sleep is way more complicated. Insomnia predicts depression, yes, but they're also pathophysiologically linked in ways we don't quite understand. It's a symptom of depression as well as a cause. Sleep architecture changes are known, there are circadian factors, full-night sleep deprivation has a very powerful antidepressant effect until you sleep again, the list goes on. (Don't have any citations at the moment, sorry.) Of course not sleeping won't help matters, but treating depression like pure insomnia doesn't work very well.


InTheEndEntropyWins t1_iy0ciwt wrote

There are probably all sorts of feedback loops between sleep, diet, exercise.

Depression is likely to cause poor sleep, which can then cause poor diet and people not feeling like exercising, etc.

It's important to try and concentrate on breaking some of these loops. The vast majority of people do almost everything wrong when it comes to their circadian rhythm, so by fixing all that can help improve things.


bcatrek t1_ixy600w wrote

They might mean untreated depression (I didn’t read the article).


KittyKat122 t1_ixz7ui9 wrote

This is behind a paywall so I can't read the actual study. Are they saying that those they count as obese ARE physically active? I would assume a large portion of those who are obese would also be physically inactive and therefore physically activity would still be higher.


l4mbch0ps t1_iy09w2n wrote

Obesity and inactivity will have high comorbidity, but won't have a 1:1 correlation, so their independent effects can still be teased out.


CalCOMLA t1_ixxxe7y wrote

But I was under the impression that we can be healthy at any size.


Clapeyron1776 t1_ixxz3az wrote

I was about to make the same comment. The body positivity movement has a point that people who are not guilted about their weight are more likely to successfully keep weigh off, but it still requires obese people to lose weight.


bcatrek t1_ixy63z4 wrote

I mean, it’s not healthy to be overweight and/or obese, compared to being normal weight and/or fit.


ABena2t t1_ixxw11k wrote

is diabetes a risk factor?


mikasjoman t1_ixym739 wrote

I'm actually thinking of asking my doctor to prescribe me metformin (most commonly used and cheap diabetes drug) just as a precaution. My mom has dementia and my father has Alzheimers, so I'm in the risk group.

So I'm worried, and I tried to make some use of my two masters degrees to figure out what research actually know about what to do to reduce the risk.

So here's the interesting thing and what I'm doing...

  • FASTING: after looking in to the research, strangely enough it seems like intermittent fasting has a huge positive effect on the so called zombie cells that both increases inflamtions in our bodies (cause of most age related diseases including dementia). This from what I can find is the only thing that can actually turn our biological clock backwards in time. So I'm only eating lunch at 12 and dinner at 6pm. It doesn't really feel like fasting but it technically is. In one study fasting for five days three times in a year pulled back the groups biological age 2.5 years on an average. This turned out to way easier than I feared, probably because eating three times a day is a pretty modern invention and not something our bodies really need. When it comes to longevity and reducing the risk for dementia, this is probably the non medical strongest card there is to prevent dementia.

  • SLEEP! Sleep is probably the thing most people don't think about when it comes to health and preventive medicine. If we sleep well though, it has a huge impact in the way the body can restore itself and keep the brain young. Getting bad sleep is like banging ones head with a bat and asking to get dementia and a shorter life. There's a strong link between people getting bad sleep getting all sorts of physical and mental problems including reducing the risk of Dementia. On the upside it also keeps you having a positive mood, being able to focus, learn, retain what you learn. It's strange to me that people dont talk more about how incredibly important good sleep is for health. It's the base. If you have shitty sleep forget about eating healthy or exercising.

  • EXERCISE. Well do I need to say more? I think everyone by now know that exercising a few times a week has a huge positive impact on a lot of things, including inflammatory responses. Comparing it with the above, it's still not as good at reducing the risks as the above. I use my spinn bike 2 days a week and do HIIT between 15-30 minutes with my wife (favorite YT channel: growingananas).

Then we come to the wild card...

  • METFORMIN:There was a huge study (20k participants) where the people WITH diabetes actually as a group 17% lived longer with diabetes than the healthy group. This was wild because it should have been the opposite. The reason: metformin. The most commonly used and cheap diabetes drug in the world. It both shows an affect in longevity AND reduces risk to get dementia related diseases. Its basically the anti aging drug that was accidentally found. I'm really hoping it's next study on healthy people only will get its full funding (I find it wild that a drug that's cheap and seems to keep us healthier doesn't get a ton of money from the government). Given that we both haven't gotten the money for the study l and the fact that it's not been performed yet - this is still a bit of a wildcard but I know a lot of scientist in longevity research eats this daily. The tricky thing is that I'll probably not get this prescribed because like another drug thats highly popular within the medical community (Statin: greatly reduces the risk of cardiovascular diseases) it needs to be prescribed.

On top of this I'm gonna make sure my life isn't just work and then get I'll. On a population level we have a 20% likelyhood to be dead even before we reach normal retirement age. While the above reduces that risk by a lot, the risk of either being dead or having some age related disease is still not insignificant by age 65. So how to beat the odds? Well retire earlier than 65. I'm aiming at age 50-55. That's actually easier than I thought since saving 1% extra of ones yearly salary usually reduces one year you have to work ( if starting to save at age 30). Given that I do save more than that, I'll probably gonna be able to reduce how much I work from age 47 if I want to.the thing is that I really enjoy my work in tech, I'm absolutely not someone who dislikes work. Also keeping the brain busy is key to avoid dementia. Im probably more of the kind of person who wants to find my optimal balance between work and leisure. I'm guessing that's about three days of work and four days of hobbies. I'll experiment with that as I reach my financial goals to achieve /r/fire (financial independence retire early).

Finally I try my best to always seek balance. If I want a breakfast, I still eat it. If I want to drink beers or stay up late to play PS5 with my friend, I do it. Denying oneself is not a good life and it usually makes it way more difficult to stay on the path I ahve chosen. If I want to splurge on buying something, I do it even if it will delay my goal of reaching partial early retirement. An example of this is my boat that I should have named "Sailing vessel black hole" beucase the amount of money she eats. But my goal is living a good long good life - not to save money (that's just one of the tools to achieve it).

That's my five cents on trying my best to avoid dementia and Alzheimers.


ChicagoLaurie t1_ixyqlva wrote

I’d add having good social connections to this list. IMHO loneliness and social isolation are huge risk factors. If you do the other things you mentioned, you’d greatly reduce your risk without taking an unnecessary medication and assuming the negative effects related to that.


mikasjoman t1_ixyr5cf wrote

Indeed. Social isolation is something that would have a great impact too. Also adding some foods that doesn't spike the blood sugar levels also would make a difference of course but then it becomes more tricky to explain as simple principles.

As an example of that... I just had a great lunch-first with noodles made from sweet potatoes and beef, perfect since my wife is Chinese and it doesn't spike the blood sugar while tasting awesome.


InTheEndEntropyWins t1_ixys1cb wrote

Some useful info here, but the science isn't that clear on Metformin. The latest studies don't show that longevity increase in normal people. Also metformin negatively interferes with the benefits of exercise. So most people in the longevity field have stopped taking metformin. Exercise is just much better for health, dementia and longevity.


mikasjoman t1_ixyw2kg wrote

Yeah. Well we'll have to wait for that bigger study - it's more of an wild card at this point like I wrote. Anything else you'd like to add to the list?


uninstallIE t1_ixy2tro wrote

This corresponds to the concept that Alzheimers is "type 3 diabetes"


severe_thunderstorm t1_ixy1f2m wrote

Yes, honestly seems as though everything is a risk factor for both, or either, cancer and dementia.


ABena2t t1_ixy2nbq wrote

I don't know much about dementia - or diabetes for that matter. But I watched my mother go thru both. I knew dementia was a terrible disease but I had no idea how bad diabetes actually was. It screwed my mom up bad. One day she was fine (relatively). The next we find her on the floor. She couldn't walk. Went legally blind. She had to go into long term care and bc she couldn't walk and really take care of herself she wound up with a UTI. and not for nothing - but I swear that UTI messed her up bad. Once she got that she was never the same. The dementia seemed to kick in overnight (either that or it was so slow noone noticed it). But it became noticeable once she had the UTI. and then it was just a downward spiral from there. Then covid happened. They locked down the facility. we couldn't even visit bc they wouldn't allow people in. Did no good because she got covid anyway. It was literally a nightmare. Worst/Hardest/saddest thing I've ever seen.

it all started with diabetes - but I'm not sure if they were related or not. If she didn't have diabetes would she have got dementia anyway? maybe. Did It set in faster bc of diabetes? probably


severe_thunderstorm t1_ixy77gj wrote

Neither my mom or my grandmother had/s diabetes.

But yes, when someone has dementia any kind of infection sends them off the rails, and it’s usually UTIs.

Studies also show chronic inflammation can cause Alzheimer’s.

Edit to add: with dementia some of the changes and declines are very subtle and slow, sometimes they come like a cliff out of nowhere.


Balthasar_Loscha t1_iy1xnuy wrote

Diabetes causes wasting of vitamins in the urine, lessened uptake of DHA into the CNS, very high oxidative stress, lessened production/utilization of energy, and severe hormonal disorders, the major ones like E, Prog, Thyroid, DHEA, T.


severe_thunderstorm t1_ixy2hmx wrote

I’m not discrediting the study.

My mom, who had taken care of her mom with Alzheimer’s, specifically did everything imaginable to prevent Alzheimer’s: eating healthy, avoiding aluminum, staying social, brain puzzles, didn’t drink or smoke ever.

My mom could no longer work at 62 due to dementia symptoms, she’s now 70 and I’ve been her 24/7/362 caregiver for 5 years.

Life is about quality, not quantity. LIVE!


Fuzzycolombo t1_ixyjpu2 wrote

Given how contentious nutrition is, it very well may have been that what your mother thought was eating healthy really wasn’t.


severe_thunderstorm t1_ixzfr35 wrote

In that case, we don’t ever really know if anything is healthy.

So go live your life! Have fun!


Just_Natural_9027 t1_ixzpa12 wrote

Agree but it seems like a lot of things your mother did increased her quality of life:

>eating healthy, avoiding aluminum, staying social, brain puzzles, didn’t drink or smoke ever.


severe_thunderstorm t1_ixzsppd wrote

My grandmother did the opposite of my mom (ate horribly, lots of pastries, drank and smoked all her life), but was never overweight. She received her diagnosis at 62. My mom gave up a lot hoping to avoid dementia and it didn’t work out for her.

I’ve taken it to the extreme. I grow my own food (which I really enjoy). I know what’s being used for fertilizer and pest control, no hormones in my meat, etc. I use stevia (which I grow) instead of sugar, etc.

Edit to add: we may never know if my way of life prevents dementia. It is a lot of physical work (which I thinking very good for you), but I plan to live pretty dangerously after 60. I don’t really plan to see 62.


Fuzzycolombo t1_ixzpid1 wrote

Even if people disagree on what to eat, we can all agree that eating TOO much is bad (beyond what your metabolism can use as energy and thus must store as fat). Science is objective tho so time will reveal the truth.


severe_thunderstorm t1_ixzt10h wrote

I think more than overeating, it’s being physically active that helps the most. Get that blood pumping. Additionally, I’ve found that dormant viruses which cross the blood brain barrier are a much bigger concern for dementia.


Fuzzycolombo t1_ixzupj2 wrote

Certainly important.

Do you believe that physical activity could defeat the brain viruses?


severe_thunderstorm t1_ixzvlvb wrote

I don’t know. I do believe it helps, but then again the research about dormant viruses found in Alzheimer’s brains may negate any and all efforts. Nobody really knows at this point with so much conflicting research and trials.

I am really happy they’ve started expanding research beyond just amyloid plaque, which everyone has to an extent, and they focused on extensively for 30 years now.


eddie3737 t1_iy0x6em wrote

But this doesn’t mean people shouldn’t take risk factors into account and avoid them


Darkhorseman81 t1_ixyblfk wrote

Researching The Integrated Stress Response, which drives Muscle Wastage and Dementia, I've found quite a few links between it occuring faster than it should and The Western Diet.

Too much Sugar, too little Fibre. P5P depletion, Conjugated Linoleic Acid Depletion, and exposure to excess Palmitate dysregulating GLP-1 + excess palmytolation of proteins which pushes you towards metabolic disorder.

I'm not sure if it's extreme incompetence, or making people sick for profit, but it's getting ridiculous what they've done to the food chain.

At least ISRIB can reverse the animal model of Dementia and Cognitive Decline in as little as three days, so we'll be able to fix it, soon enough.


Efficient_Lecture_98 t1_iy0vl3v wrote

How does the impact of these modifiable risk factors stack up against non-modifiable factors?


True_Garen OP t1_iy0xq9m wrote

The non-modifiable factors of age and family history are much much the stronger. (They didn't need to wait decades to have a study to discern those; they are obvious.)

For contrast, see:

NIH state-of-the-science conference statement: Preventing Alzheimer's disease and cognitive decline (2010) -

Currently, firm conclusions cannot be drawn about the association of any modifiable risk factor with cognitive decline or Alzheimer’s disease.


True_Garen OP t1_iy0zt55 wrote

I'll mention here that while this study puts smoking as a risk factor, it has been long observed that smokers have relative immunity to AD. Nicotine is neuroprotective, and lowers the risk of AD by more than half.


SerialStateLineXer t1_iy1xqmv wrote

Evidence on this is mixed at best. While there is some evidence for a neuroprotective effect of nicotine, this appears to be offset by the negative cardiovascular effects of smoke inhalation. Even nicotine itself has a vasoconstrictive effect that could offset the neuroprotective effects seen in vitro.

Smoking does seem to be protective against Parkinson's Disease in particular, though.


True_Garen OP t1_iy21qb7 wrote

>neuroprotective effects seen
>in vitro

We see the benefits for memory in vivo with our own eyes...


eddie3737 t1_iy0wu19 wrote

If only the USDA would recommend low carb high fat instead of junky seed oils and grains


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noahspurrier t1_ixxxytm wrote

Dementia never sounded better.


average-sheep t1_iy0go03 wrote

Who funded this study? Pretty big jump to conclusion here.


NickVuci t1_ixxwuyh wrote

Another inconvenient truth for the gluttonous


storm_borm t1_ixyuog5 wrote

What science is pointing to recently is that at the route of “later-in-life” diseases such as hypertension, dementia, heart disease etc., is a typical western-style diet, i.e., high in ultra-processed foods and sugar/carbohydrates.

I’ve heard notable researchers say that obesity is just the symptom of what is happening, which is metabolic disease caused by sugar. These diseases are also just the downstream affects of chronic insulin irregularity that has shown itself in different tissues/organs, such as the brain (dementia), the heart (heart disease), specific cancers.

Of course there are genetic risk factors and other environmental causes but all of these diseases are increasing in prevalence. This is highlighted by the fact that 40% of the U.S population that isn’t obese or overweight, has metabolic dysfunction, putting them in danger of developing at least one of the major diseases.

Hardly any medical professional is actually talking about this though


InTheEndEntropyWins t1_ixyx5yy wrote

>This is highlighted by the fact that 40% of the U.S population that isn’t obese or overweight, has metabolic dysfunction

That's interesting, do you have a link to a study about this?


storm_borm t1_ixzgw7v wrote

The 40% value was determined by Robert Lustig, I believe, as an approximation based on this study:

Prevalence of Optimal Metabolic Health in American Adults: National Health and Nutrition Examination Survey 2009–2016: (Open access).

The study is based on data from 2009 - 2016 and is a survey of 8,721 people. The researchers defined five factors for metabolic health and surveyed people who were not on medications. They found that only 12.2% of American adults are metabolically healthy. In addition, the researchers found that less than one-third of normal weight adults (defined by BMI) were metabolically healthy.

It isn't saying that you can be overweight or obese and not worry about metabolic health (although there is some research describing a small percentage of people who are overweight yet do not present metabolic syndrome), but it is suggesting that metabolic syndrome can appear in "normal weight" individuals and that obesity is not the only risk factor for developing chronic diseases such as dementia (although it does exacerbate it). It's the upstream problem of metabolic syndrome caused by chronically elevated insulin levels - related to diet.

There is also this study exploring normal-weight individuals who are metabolically unhealthy and risk factors for type 2 diabetes: There's also many papers regarding the TOFI phenotype (thin-outside-fat-inside).

Also a nice open access review here on metabolic syndrome which includes some points I have raised here:

There is a wealth of studies linking western-style diets with all sorts of chronic diseases (including autoimmune disease). Just focusing on obesity alone doesn't cover the whole picture.


InTheEndEntropyWins t1_ixzp8vy wrote

Interesting but isn't this related mainly to people not getting enough exercise rather than it being just related to sugar?

Or if it is diet then it's just processed foods that have high carb/fats.


Dry-Bird-2993 t1_iy0kkpt wrote

So here's a science based prediction for you. Probably a good 10 or 20 years from now scientists will find that racism, sexism, homophobia, transphobia and xenophobia are all directly linked to dementia. Not the victims of those things. But those who believe in them. My prediction is that scientists will of course figure out there's a link. Study it further. And find that it is the top modifiable dementia risk factor ever found. It having direct connections to narcissism and how a person negatively modified their own minds toward it. While finding that at any time if a person works towards not being narcissistic the negative effects back off at the same strength.