Lifestyle changes can reduce dementia risk, study says | Hacker News Reader

Lifestyle changes can reduce dementia risk, study says

bbc.com

65 pointsyitchelle67 comments

Looking past all the numbers and the correlation/causation concern, I think the most important takeaway is that "of building a "cognitive reserve", which means strengthening the brain's networks so it can continue to function in later life despite damage."

All the factors listed have something to do with staying mentally engaged and constant learning and I think that's the overarching message we should be taking away.

How do you distinguish the effects of "Physical Inactivity" from "Obesity", "High Blood Pressure", "Diabetes"? It seems like it would be difficult to untangle the effects these conditions/lifestyles have on one another.

There are plenty of very active people that are overweight and obese (some play in the NFL) and plenty of normal weight people who are inactive. I don't see why this would be any harder to isolate than any other risk factors.

Mid-life hearing loss is very high on the list. But how does one prevent it?

Wear hearing protection?

You don't need to wear hearing protection 24/7, because the world isn't loud 24/7. But if you go to concerts or play music, or work with power tools or construction equipment, hearing protection is a no-brainer. I bring earplugs almost every time I go to a concert, jam session, and when I go to clubs.

The connection with dementia does not surprise me. If you can't hear what people are saying, you won't be able to use those big chunks of your brain for language processing. They say that the first sign of hearing loss is that your wife starts mumbling.

(Yes, gendered language—men tend to be more at risk for hearing loss, and hearing loss starts with higher frequencies, and women speak at a higher pitch. So for many men, they'll start complaining that their wife mumbles a lot, and the real problem is hearing loss.)

I know I have hearing loss but nothing is going to convince me my wife doesn't mumble at times! LOL

I go so far as to wear the spongy orange ear plugs when I vacuum and do any thing with power tools at home. I already have (what I think of as) pretty bad tinnitus, so I am trying to mitigate future deterioration.

It is surprisingly difficult to convince people this is a good idea though. I played in a band for a good 5 years, and while we practiced in a 15' x 15' room, with our amps cranked to 11, I could not cajole anyone else in to wearing ear plugs. It irked me that I could not get my friends to wear earplugs, even when it was just the 4 of us, because it was "uncool". And these are smart guys in their mid-thirties.

Have you had your tinnitus checked out? It can be caused by earwax build up/impactedness.

Tinnitus can also be caused by wearing ear plugs too often or for too long.

Only secondary. The cause is either ear wax build-up, infection (easier in a sealed environment) or badly designed plugs not working in changing air pressure with consequent minor barotrauma.

I can highly recommend switching to ear muffs instead of plugs. They tend to seal better, don't get gunky, and don't give your ears trouble because of them being sealed off. It's more comfortable too IMO.

What's the point of going to a concert if you are to wear ear plugs?

Good ear protection reduces the volume by an acceptable level, not entirely, and reduces the volume by a relatively flat amount across frequencies, so it still sounds normal, but just not ear-damagingly loud.

What's the point of going to a really loud concert to kill your ears from machines blasting sound just because you happen to be situated in a certain part of the audience? It's just a tradeoff for the designers of the show - not a time honored tradition - but it's your ears.

And even if it is a time honored tradition like hazing rituals - would you smoke if everyone did it?

Finally, what's the point of going to loud bar "just to catch up" with your friend? I never understood those people who stand there talking to their friend in the loudest bars.

I probably would smoke if everyone did it. That's basically the only reason I started drinking, after all.

Some concerts are much more enjoyable with ear plugs -- because it's not overwhelming your ears you can actually hear it better than you can without ear plugs.

You can also get things called musician's ear plugs which attenuate all frequencies at similar levels so it doesn't change the music.

Can recommend the ER20s from Etymotic Research - been using those for 10+ years for both gigs and cinema trips.

Recently got some Flare Audio which I'm trying out but their foam tips don't really fit into my ears that well (despite supplying a range of sizes.)

Also, many (most?) venues are not really designed for acoustics, and arenas are especially bad because of the concrete walls: the sound get reflected around a lot. Wearing earplugs attenuates those reflections so you hear the primary signal much better.

To avoid suffering from strong tinnitus 15+ years later because - trust me - that's really not something you want.

There are more than a few people who have committed suicide, leaving notes along the lines of "what's the point of living if you can't hear anything and have terrible tinnitus?"

I love music, I want to be able to listen to music ten, twenty, thirty, and forty years from now.

Can confirm that tinnitus is an insidious thing. Although mine is only really strong when the environment is quiet - listening to music can mostly drown it out - it is infuriating especially when trying to sleep.

This is definitely one way of prevention.

I know several people in their 50s suffer from hearing loss, for no obvious cause. They didn't play band, didn't go concert or club, nothing suspicious. And doctors have yet to find the cause. That got me thinking if, apart from loudness, there are other obvious culprit for degenerating hearing

Vascular degeneration. (Otosclerosis.)

do you have any recommendations on earplugs? i go to a lot of concerts/festivals and i'm starting to realize my hearing is getting worse.

Every ear canal is different. That includes left vs right! Try a couple different types and you'll find one that works for you.

The common types are the disposable foam ones (just a simple cylinder or rounded cylinder cut out of foam), the molded flexible ones (kind of like earbuds, you can reuse them), and the moldable ones (wax or silicone balls). My personal preference is for the disposable foam, they're the most comfortable and reliable for my ears. The cheapest disposable foam ones I find are a little hard to use and sometimes uncomfortable, so spending a couple extra bucks on a better brand made a big difference. But different people like different kinds.

The silicone balls and foam earplugs can be bought at the local drugstore and they're fairly inexpensive. The reusable ones you'll find at hardware stores or musical instrument stores. The ones at musical instrument stores are designed to let you hear the music accurately, just quieter. If you want to spend a bit of extra $$ for something great and comfortable, you can get custom-molded earplugs designed to fit your ear canal. If you're a musician who plays live you'll probably want to drop the $700 or so it costs to get custom in-ear monitors.

There's also a bit of technique involved putting the things in so that they stay put, they're comfortable, and they still let you have a conversation. For the disposable foam plugs you can buy everywhere, I roll them into a tiny cylinder, tilt my head at a certain angle, and use my other hand to pull back on my ear to put the plug in. After using them enough times, I've gotten a pretty good feel for three different depths: medium depth for normal loud music, decent comfort, and stays in well; a shallow depth if I need to have conversations with other people while I'm wearing them, but they fall out sometimes; and the deepest depth for when I want to sleep in the middle of a bunch of noise.

Also: don't make a habit out of sleeping with earplugs.

I've definitely been in a few situations where I've gotten shit for wearing earplugs, but as I've gotten older I've stopped caring that other people think I'm lame for wearing them. I always tell them that I love music, and I want to be able to listen to music four decades from now. Just a few stories from people with hearing loss or tinnitus is enough to scare you into wearing earplugs. Just ask Craig Gill.

Here is some related info about reversing dementia.

Short overview:

http://www.today.com/health/new-brain-program-may-fight-alzh...

Article/Study:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4221920

The interventions (from the article/study):

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4221920/table/T1...

Video presentation by the doctor:

https://www.youtube.com/watch?v=QqQ_X3mD16U

While the MEND protocol is interesting and may be useful, it is a product [0] being sold with very little scientific evidence to support its use. Furthermore, Aging, the journal in which the sole study supporting MEND was published in, is not always considered a high quality source.

[0]: https://museslabs.com/

[1]: https://en.wikipedia.org/wiki/Aging_(journal)

> Failure to complete secondary education was a major risk factor, and the authors suggest that individuals who continue to learn throughout life are likely to build additional brain reserves.

Somewhat related, but I wonder how video games will affect this also. People from the 70s and up who grew up on video games, and continue to play them into their 30s and up, are engaging their brains more than older folks who probably watch a lot of TV. Especially daily playing of competitive or difficult games, like Overwatch or Dark Souls, that can tire you out mentally.

Cannot agree more.

As a major gamer in my teens and early twenties I stopped for 10 years and only just resumed.

I found my hand and eye coordination for titles like Batman Arkham Knight and Spelunky were surprisingly bad and this is despite remaining relatively fit and active throughout the past decade.

I think games as with any pastime when used judiciously can really be a benefit to the mind.

I've heard anecdotally that video games do a better job of keeping surgeons sharp than surgery simulation software. I wonder how much of this is just due to engagement -- video games are more compelling (and you can do them outside work hours).

I think this is a great point. Video games get a bad rep because they're a distraction for kids (which is mostly fair), but I think that it's a really good alternative to simply watching TV among the older population in terms of reducing dementia risk because it requires constant mental engagement and also some degree of learning to progress.

Overwatch difficult?

I can see Chess.com being a relevant "game" that builds reserves. But is Overwatch mentally draining in useful ways? It's a twitchy sort of game, and if you aren't doing team vox communication there isn't much strategy.

I could have worded that better, but my phrasing was meant to say that Overwatch is the competitive game and Dark Souls is the difficult one.

Edit - To clarify, I think competitive games (like Overwatch) stimulate the brain just like playing a heated game of basketball stimulates the brain even though it's a physical activity. Competition makes you concentrate.

No, they aren't near as effective. Your motor neurons don't get nearly as much workout. Not to mention s) real exercise tends to reduce later vascular or heart problems, which on the whole would reduce rates of strokes, thus dementia.

Does anybody know why there might be a link between high blood pressure and dementia?

Some forms of dementia are the result of vascular disorders, and high blood pressure is more likely to exacerbate, or directly contribute to that kind of failure in older age.

"vascular disorders" As in lack of blood to the brain? Wouldn't high blood pressure do the opposite, or is their something I am missing.

Think of it this way: High BP can lead to strokes and general damage to the vascular system, and that in turn can lead to dementia.

http://www.webmd.com/stroke/guide/vascular-dementia#1

https://www.alzheimers.org.uk/info/20007/types_of_dementia/5...

Narrowing of the blood vessels supplying oxygen to the brain, caused by things like high blood pressure.

Also, strokes and mini-strokes.

Thanks, that was just what I was looking for.

A new research avenue being explored in the etiology of dementia is altered permeability in the blood brain barrier (BBB) too. High blood pressure [0], and some other maladies listed in the study, are linked to changes in the BBB. This may be important, as some new research shows that some dementia may be immunological in nature.

This is all pretty new science though. Back when I went to school in the early 2000s instructors didn't even teach that the BBB permeability could change.

[0]: https://www.scirp.org/journal/PaperInformation.aspx?PaperID=...

Wait, how do you prevent mid life hearing loss?

Well, be careful what volume you listen to music at. Seriously.

But if you've got it, get a hearing aid. Get an amplified phone. See, the problem (probably) is not hearing loss per se; it's that hearing loss cuts you off from the world (both the physical and social worlds). If you can prevent that, you can (I suspect) prevent the hearing loss contribution to dementia.

Avoid live concerts (the volume is always way too loud), wear appropriate hearing protection when working in a loud environment, listen to music at a reasonable level.

Every so often I'll be sitting on a bus or plane and be able to clearly hear the music of someone 2-3 rows away through their earbuds or headphones that they are wearing (i.e. not just around their neck, but actually on / in their ears)

It seems one of thise lifestyle choices is to take up cannabis after 60!

10. Trouble distinguishing correlation from causation.

This! Hearing loss could mean those nerves started dying out before other (cognitive) brain regions. Usually the sense of smell dulls first (peanut-butter test).

I have a poor sense of smell (used to have a good one as a child) and my grandmother had dementia. What is the peanut-butter test?

Possibly this? https://en.wikipedia.org/wiki/Peanut_butter_test

"The researchers concluded that patients with Alzheimer's were not able to smell the peanut butter as well through their left nostril as their right one"

That's the one. My grandfather had dementia. And my father now has signs of brain atrophy, although still no cognitive decline. But he is in his 60s and has had hearing issues for the last decade, combined with ptsd, depression, anxiety and alcoholism. All of it (including mental illness in my family) is most probably somehow connected. I've also found some resources on how having bad teeth (which I do) is also correlated. For now I'm trying to be fitter and take bigger doses of B-vitamins and some other "nootropics". Also, looking forward to the new generation of meds now being tested, such as aducanumab.

It says that it could not be replicated :/

The authors seem to think that early hearing loss contributes to isolation and lack of socialization. If properly treated, this shouldn't happen to a person.

Having trouble with dementia? Try going back and completing secondary school! Our "study" shows it's the second largest factor in cause of dementia!

If you read the linked paper (access is free), you will note that the authors are quite clear that they have a limited ability to determine causation. They say there seems to be some evidence that some of these risk factors are forward causes, but acknowledge it may be correlation based on another cause, or bicausal where the risk factor increases dementia which in turn reinforces the risk factor.

As usual, the popular news article goes straight to the causality argument because calls to action are more effective at getting people to read something.

"No, correlation does not imply causation, but it sure as hell provides a hint."

http://www.slate.com/articles/health_and_science/science/201...

"Please avoid introducing classic flamewar topics unless you have something genuinely new to say about them."

https://news.ycombinator.com/newsguidelines.html

Correlation vs causation isn't a flamewar topic. It's a pervasive problem in science journalism and public understanding that leads to bad decisions and bad policy. Blatant mistakes in understanding, very clear in the news article (not the original paper) deserve to be called out.

I think this article ignores some very important risk factors.

Does it assumes idiopathic Dementia?, what about dementia caused by AIDS, Syphilis, or late-stage Lyme disease?, to mention a few?.

I'm not sure "getting rid of your AIDS" counts as a "lifestyle change"...

You think that preventing a STD, or a tick bite wouldn't count as a lifestyle change?, really?.

I think the point is more that people already try to not get HIV / AIDS - and once they have it, they can't just "get rid of it".

The article is about lifestyle _changes_ you can make to mitigate existing risk factors. You can't _change_ whether or not you have AIDS once you already have it, not yet at least.

And if you make a _special_ effort to avoid getting AIDS because it has a minor impact on your risk of getting dementia in old age... your priorities are WAY out of whack.

Someone told me recently that there's a link between red dye and these illnesses. I wouldn't be surprised.

I drink things with red dye in them when I go on long car trips because it has a rather strong effect on my short term memory (it seems to reduce it's capacity to almost nothing) which in turn means I really don't get bored (and don't fall asleep out of boredom.) Of course, once I get where I'm going I really can't do anything useful because I can't focus for long enough to think about anything.

>Someone told me recently that there's a link between red dye and these illnesses. I wouldn't be surprised.

I'd be absolutely shocked, and wonder how something so common is causing such selective effects and only in the elderly. As for reduction of short term memory, I'd start considering other mechanisms that don't involve food coloring if I were you.

I never heard that but it it's possible : "There's been evidence for almost 40 years that food dyes trigger hyperactivity or inattention in children. [1]

There was a call for a total ban but after intense lobbying there was just a legal mention added [2]

[1] http://www.wbur.org/hereandnow/2014/03/28/artificial-dyes-ca...

[2] http://news.bbc.co.uk/2/hi/health/7340426.stm

What food product has red dye in it?

Yeah, um, drinking things that kill your short-term memory might not be the wisest thing to do, long term...

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