There are a multitude of risk factors for Alzheimer’s disease.  As I have often written, the best treatments are proactive rather than reactive.  Risk factors help you be aware that you need to evaluate and monitor your memory and incorporate external memory supports, strategic planning, and life style enhancements to better protect your future.

Age is the clearest risk factor for a diagnosis of Alzheimer’s disease.  Age trumps all other factors.  Most of those diagnosed with Alzheimer’s disease are 65 and older.  The risk reaches nearly 50%by age 85.  Anyone over the age of 65 should consider a thorough memory evaluation to establish a baseline.

Genetics.  If you have a first-degree relative (parents or siblings) with Alzheimer’s disease, your risk is about 3-4 times that of those who do not have a first-degree relative.  But the genetics are complex and unclear.  Genetic testing is not currently reliable enough to pursue.  Positive outcomes may cause needless emotional distress.

Head trauma.  There is a strong link between head trauma – especially serious and repeated – and Alzheimer’s disease.  Buckle your seatbelt and wear a helmet for sports and motorcycle riding.

Heart disease increases the risk for dementia.  Aggressively manage blood pressure and heart risk factors and maintain good physical conditioning (aim at 2.5 hours of at least moderate exercise per week).  Don’t smoke.  Moreover, recent research suggests that the combination of smoking and heavy drinking (more than two alcoholic beverages per day) accelerates cognitive decline (British Journal of Psychiatry, July 11, 2013).

Diabetes.  Many have suggested that Alzheimer’s disease may reflect a “type 3” diabetes in the brain.  This is an active direction for current and future research and indicates that you can manage this risk by diligent monitoring for diabetes, eating a healthy diet, and exercising.  Indeed, recent research has suggested a link between high blood glucose (115) and increased dementia even in those who do not meet the criteria for diabetes (New England Journal of Medicine, August 08, 2013).

Depression.  Depression, especially in mid-life or latter is a risk factor for Alzheimer’s disease.  There is no evidence of which I am aware of the effects of treating the depression on future risk.

Behaviors during adolescence.  A new study suggests that “young onset dementia” (before age 65) in men is associated with alcohol intoxication/abuse, stroke, depression, use of antipsychotic medications, dementia in father, drug use, and high systolic blood pressure, low cognitive function, and low height (JAMA Internal Medicine, August 12, 2013).  The risk is greater when 2 or more of these factors are found together.  I assume that at least some of the factors are relevant also for women and influence cognition in those over 65.   This finding is interesting as it suggests that life style interventions can never start too early.