General questions about Mind your Mind:
Q What is the Mind your Mind program?
A Mind your Mind is Alzheimer’s Australia’s dementia risk reduction program. It is designed to help people reduce their risk of developing dementia. Seven signposts for dementia risk reduction have been identified.
These are:
- Mind your Brain
- Mind your Diet
- Mind your Body
- Mind your Health Checks
- Mind your Social Life
- Mind your Habits
- Mind your Head
Whilst there is no guarantee that following the Mind your Mind signposts will prevent you from developing dementia, it may help to reduce your risk or delay the onset of dementia.
Q Why did Alzheimer’s Australia develop the Mind your Mind program?
A Alzheimer’s Australia is committed to valuing and supporting people with dementia, as well as to doing all it can to help prevent dementia. We know that the changes in the brain that result in dementia may start decades before any symptoms appear and that following a ‘brain-healthy’ lifestyle may reduce the risk of developing dementia or delay its onset. People need to know what a ‘brain-healthy’ lifestyle is, that it’s important to follow this lifestyle throughout life, and that it’s particularly important once middle age and beyond is reached. That’s why we developed the Mind your Mind program.
Furthermore, a shift in public awareness of dementia and risk reduction through the Mind your Mind program has the potential to help millions of Australians to reduce their risk of dementia, which could result in significant savings to the health system.
Q What does the Mind your Mind program involve?
A Mind your Mind is a public health program designed to increase awareness about the lifestyle factors that can help to reduce the risk of developing dementia. The program includes community education sessions; a range of communication activities, including media placements and website information; and provision of information for health professionals and key stakeholders.
Q Who is the Mind your Mind program aimed at?
A Following a brain healthy lifestyle is important throughout all stages of life but particularly important from mid-life onwards. Research shows that the changes in the brain that result in dementia may start decades before any symptoms appear. So it’s important for people in mid-life to be aware of what they can do to reduce their risk of dementia and commit to living a brain healthy life.
Q How is ‘mid-life’ defined?
A A number of the risk factors for dementia, particularly vascular risk factors such as high blood pressure, have been shown to be of most relevance to dementia risk when measured at mid-life. Mid-life is considered to be people in the forties age group and
possibly into the fifties age group. For dementia risk reduction, it’s very important that once people reach their forties, they adopt a brain healthy lifestyle, if they haven’t done so already.
Q What about people who already have dementia, will Mind your Mind be useful for them?
A Even though a person already has dementia, following the Mind your Mind signposts is still useful for overall health and wellbeing. Following the Mind your Mind signposts may help someone with dementia to live healthier for longer.
Q Isn’t Mind your Mind just like other public health programs?
A Mind your Mind has been developed based on the evidence available for dementia risk reduction. A number of the Mind your Mind signposts are similar to messages in other public health programs, but this is very positive because it means that following the signposts is beneficial for overall health, not just brain health. With Mind your Mind it is the focus on a healthy brain and the combination of these signposts that sets it apart from other programs.
Q My (person with dementia) did all the right things and he/she still got dementia. Why?
A Unfortunately there are no guaranteed ways to prevent dementia. Evidence indicates that leading a brain healthy lifestyle may help reduce your risk of developing dementia, but it can’t guarantee that you won’t get it.
Doing all the right things may have helped him/her delay the onset of dementia and have more years of good health than they would have otherwise had.
Q Are the Mind your Mind signposts useful for reducing risk of all forms of dementia?
A There is an increasing body of research to support making lifestyle changes to help reduce the risk of dementia. Studies of large groups of people do show that those who adopt ‘brain-healthy’ lifestyles have a reduced risk. Much research to date has focused on Alzheimer’s disease as the most common type of dementia, but there is also a lot of evidence that risk of dementia from other causes is lower in people who follow a brain healthy lifestyle.
Q If I follow the Mind your Mind signposts does that mean that I won’t get dementia?
A Dementia cannot yet be prevented or cured. Following the Mind your Mind signposts does not guarantee that you won’t develop dementia. The two biggest risk factors for dementia are genetics and age – two things you can’t do anything about. However, following the Mind your Mind signposts may help to reduce the risk of developing dementia and may delay the onset of dementia.
People who have followed a ‘brain-healthy’ lifestyle all of their lives can still get dementia.
Specific questions about Mind your Brain:
Q Will keeping my brain active reduce my risk of dementia?
A The evidence shows that mentally stimulating activities can help to keep your brain healthy and that people who do more of them have a reduced risk of developing dementia. Older adults who engage in mentally challenging activities have better memory and other brain functions.
Q How does keeping your brain active reduce your risk of dementia?
A Research suggests that keeping your brain active enhances connections between brain cells helping keep you mentally sharp. This may help to delay or offset the effects of dementia.
Q What brain exercises will be helpful/What brain exercises should I do?
A There is no evidence to suggest that any particular mental exercise is better than another. Alzheimer’s Australia recommends all sorts of brain exercises such as doing jigsaws, crosswords, sudoku, reading, learning a language, learning a musical instrument, visiting a museum, listening to the radio or enrolling in a new course. Our advice is that any type of mental activity may be beneficial, but it should be reasonably complex, frequent, varied and interesting.
However, it is also wise not to take on anything which is so difficult that it makes you stressed and anxious.
Q What about a person who left school as a teenager, and then starts doing brain exercises in their 40’s or later. Will their risk of dementia be reduced?
A Research shows that people who take part in mentally stimulating activities through education, work or leisure have a reduced risk of dementia. It’s important for everyone regardless of their education level or age, to commit to keeping their brain active. We know that keeping your brain active is associated with reduced risk of developing dementia on average, but there is no guarantee for any individual.
Q Is it important to do new brain activities or is it okay to keep doing the same things?
A The research shows that challenging the brain in new ways helps to build up connections between brain cells and improves brain function. Like physical exercise, brain exercise should be done regularly and include a variety of activities. So keep doing things that you enjoy but also give new activities a go.
Q How long do I have to do brain exercises for – is it a certain amount of time every day or can I just do something once a week for an hour?
A It’s likely that the more you do the better, but we don’t have any evidence to recommend specific amounts. We do recommend that the brain activities you choose should be reasonably complex, interesting and varied (so don’t just do one thing like crosswords for example), and that you exercise your brain frequently.
Specific questions about Mind your Diet:
Q Will taking vitamin supplements help to reduce my risk of dementia?
A The best source of vitamins is food. It’s important to eat a wide variety of foods to make sure you get adequate amounts of all the vitamins and minerals you need for good health. Speak with your doctor before taking vitamin supplements.
Q I’ve heard that taking Vitamin E supplements can help to reduce my risk of dementia, is this true?
A Some research studies have suggested that Vitamin E may help reduce the risk of dementia but other studies haven’t supported this. Based on current evidence, the recommendation is to obtain Vitamin E from foods rather than taking supplements. If you are thinking of taking Vitamin E supplements, check with your doctor first as taking too much can cause health problems and may interact negatively with certain medications.
Q Does eating some types of foods increase my risk of dementia?
A A high intake of saturated fats is known to be a risk factor for Alzheimer’s disease and also vascular dementia. It’s important to reduce the amount of saturated fats you eat by choosing oils such as sunflower, safflower, olive and canola oils, using margarine spreads instead of butter, choosing reduced fat dairy products and lean meat and limiting pastries, cakes, biscuits and deep fried foods.
Q What about margarine – it’s a processed food so how can it be better than butter?
A Research shows that diets high in saturated fat are associated with an increased risk of dementia. Butter is high in saturated fat, whereas margarines made from polyunsaturated or monounsaturated oils are lower in saturated fat than butter. Choose margarines made from oils such as canola, olive, sunflower or safflower oils.
Some people think that margarine isn’t a healthy choice because margarines used to contain high levels of trans fats. Trans fats have similar effects on health to saturated fat and are not recommended. However, butter also contains trans fats and most margarines in Australia now contain only low levels of trans fats, so margarine is a healthier choice than butter.
Q I eat a lot of fish. Will this stop me from getting dementia?
A No food can prevent dementia. Some research has found that foods, such as fish, which are rich in omega-3 fats may help to reduce the risk of dementia, but there is no guarantee.
Q What about foods with added omega 3 - are they useful to include in my diet?
A Research shows that omega 3 fats may help to reduce the risk of developing dementia. Omega 3 fats are found in plant foods such as flaxseed and canola oils, canola margarine and walnuts and in animal foods such as salmon, sardines, mackerel, tuna and eggs. To make it easier for people to include omega 3 fats in their diet, omega 3 fats may be added to certain foods such as milk, margarine, juice and bread. To make sure you get enough omega 3 fats in your diet include fish or fish oils, foods and drinks with added omega 3 and plant sources of omega 3.
Q I’ve heard that certain herbs and spices help memory and reduce the risk of Alzheimer’s disease. Is this true?
A Research studies are underway investigating the health benefits of certain herbs and spices. This research is very new and it’s impossible to say at this stage whether any of them are useful for dementia risk reduction. When it comes to herbs and spices the best advice is to use a variety in cooking as they may provide health benefits and they make food taste great.
Q Will throwing out my aluminium cookware lower my risk of dementia?
A There is no evidence that using aluminium cookware increases the risk of having dementia.
Q I’ve heard that green tea reduces dementia risk – is this true?
A Green tea contains antioxidants. Research shows that antioxidants may help to reduce the risk of developing dementia. All types of tea contain antioxidants – they just contain different antioxidants in different amounts. If you like green tea, then drink it.
Q Will drinking coffee have any effect on dementia?
A The general health recommendation for coffee is to drink it in moderation. The association between drinking coffee and developing or reducing the risk of dementia is still unclear.
Q What’s the link between antioxidants and dementia?
A There are many different types of antioxidants. Antioxidants are found in a range of food and drinks including fruit, vegetables, nuts, spices, vegetable oils, tea, fruit juices and wine. Research shows that antioxidants help to protect brain cells from being damaged and may help to reduce the risk of dementia.
Q What are trans fats and how are they produced?
A Trans fats are a type of fat that have similar effects on health to saturated fat – they increase total and LDL blood cholesterol and can also lower the good HDL cholesterol thereby increasing the risk of heart disease, stroke and dementia. Trans fats are found naturally in the fat of ruminant animals like cattle, sheep and goats and they are also formed during hydrogenation - a process used to harden liquid vegetable oils into hard or semi-hard fats. Hydrogenated fats are used to make pastries, biscuits and cakes so these products will contain trans fats. It’s best to limit these types of foods.
Q Is there a relationship between folate and Vitamin B12 and dementia?
A Folate and Vitamin B12 are necessary for cell function and deficiencies have been associated with poorer brain function and dementia. Vitamin B12 and folate deficiencies are also associated with elevated levels of homocysteine.
Deficiencies of Vitamin B12 or Folate should be identified and treated medically.
It is not yet known whether Vitamin B12 or Folate supplementation will reduce the risk of developing dementia. Therefore it is recommended that people eat a variety of foods to ensure adequate folate and Vitamin B12 intakes, rather than taking supplements. Anyone considering taking supplements should first check with their doctor.
Food sources of folate include: Green leafy vegetables (such as broccoli and spinach), some fruits and dried beans and peas.
Food sources of Vitamin B12 include: Milk, yoghurt and cheese, Meat, chicken and fish, Eggs and foods with added Vitamin B12 e.g. some soy milks.
Q What is homocysteine and how is it related to dementia?
A Homocysteine is an amino acid in the blood. Amino acids are the building blocks of protein. Studies have shown that high levels of homocysteine in the blood are associated with an increased risk of Alzheimer’s disease.
Too much homocysteine in the blood is also related to a higher risk of heart disease, stroke and blood vessel disease.
Adequate intakes of folate, Vitamin B6 and B12 can help to reduce high levels of homocysteine.
Q I’ve heard that taking Ginkgo biloba reduces dementia risk- is this true?
A Results from research studies investigating the effect of Ginkgo biloba on dementia risk have been mixed. Recent studies indicate that Ginkgo biloba doesn’t reduce the risk of dementia. Anyone thinking of taking Ginkgo biloba should check with their doctor first as it may interfere with some medications and it can have side effects.
Specific questions about Mind your Body:
Q How does physical activity help your brain?
A Physical activity has numerous health benefits and is associated with a lower risk of dementia. Physical activity may do this in a number of ways. For example, people who are physically active are less likely to have heart disease and stroke which are both risk factors for dementia. Physical activity is also important for reducing high blood pressure, type 2 diabetes and obesity, all of which are risk factors for dementia. Physical activity may also directly help keep the brain healthy through increasing blood and oxygen flow to the brain.
Q How often and how much should you exercise?
A Being active on most, preferably all days of the week for at least 30 minutes is recommended for general good health and to reduce your risk of developing dementia. This activity can be done in one block or three bouts of 10 minutes and you will still get health benefits.
Q What type of physical activity is best for reducing the risk of dementia?
A All types of activities are recommended including walking, cycling, dancing, swimming, yoga, pilates, playing sport, having a gym workout, doing housework and gardening. Doing something you enjoy and will be happy to stick at is important.
Specific questions about Mind your Health Checks:
Q What aspects of health need to be monitored for dementia risk reduction?
A The key health issues that need to be monitored are: blood pressure, blood cholesterol, blood sugar and body weight. It’s important to have these checked by your doctor and if any of them are too high, to make sure they are treated and managed well.
Q Why are health checks important for reducing the risk of dementia?
A Research shows that high blood pressure, high blood cholesterol, diabetes and being overweight, particularly in middle age, are all risk factors for dementia. So it’s important to have these checked by your doctor to make sure they are all at a healthy level, and to treat any problems that may arise.
Q What about low blood pressure – does that affect the risk of developing dementia?
A Current research shows that high blood pressure in mid life is a risk factor for dementia and that treatment of high blood pressure helps to reduce the risk of developing dementia. There is also some evidence that low blood pressure in later life may increase dementia risk but at this stage, the evidence is much stronger for high blood pressure. People should see their doctor to have their blood pressure checked and if it’s high make sure it is treated.
Q Does blood cholesterol affect the risk of developing dementia?
A High blood cholesterol in mid life is associated with an increased risk of developing dementia. A few studies have also shown that low cholesterol in later life may be associated with an increased risk of developing dementia, but the evidence isn’t clear as yet. People who have reached middle age should speak with their doctor about their blood cholesterol level and whether it is in the healthy range for them.
Q Is there any link between taking hormone therapy for menopause and risk of developing dementia?
A While there are some conflicting research findings, at this stage the evidence suggests that taking hormone therapy at menopause may reduce the risk of developing dementia. The research also suggests that starting hormone therapy later in life may be detrimental. There is not enough evidence to recommend hormone therapy at menopause for the prevention of dementia. Women are advised to speak with their doctor about whether hormone therapy is useful for them.
Q What about depression?
A Depression is a risk factor for dementia. When talking about depression we mean when a person is feeling very low, sad or moody for long periods of time and when these feelings are very intense. Everyone will have low points, feel sad or have mood changes throughout their lives - this isn’t depression. As yet, no study has shown that treatment of depression reduces the risk of developing dementia. However, depression is a very serious illness and it is associated with an increased risk of dementia. People experiencing or showing signs of depression should see their doctor as it is important to identify and treat depression.
Specific questions about Mind your Social Life:
Q Is keeping an active social life good for your brain?
A Yes. Research shows that people who are more socially engaged have a lower risk of dementia. Social connections contribute to a healthy brain, so stay socially engaged in activities that exercise the mind and body to reduce your risk of dementia.
Q What sorts of social activities may be helpful for a healthy brain?
A All types of social activities are useful. Involve yourself in activities that interest you and that you enjoy. Examples include joining a club, church or interest group, spending time with friends or relatives, doing volunteer work, playing cards, or going dancing.
Q What about people who are happy to be on their own and don’t like to socialise?
A Research shows that people who are more socially engaged have a lower risk of dementia. However, being socially connected is only one factor that may help reduce the risk of developing dementia. Other factors include staying mentally active, eating healthily, being physically active, managing blood pressure, cholesterol, blood sugar and weight, not smoking, drinking alcohol in moderation and protecting your head from injury. If a person is happy with their own company then it’s important for them to focus on other factors for reducing dementia risk and to join in social activities when they want.
Specific questions about Mind your Habits:
Q Does drinking alcohol protect you from getting dementia?
A A high intake of alcohol increases your risk of developing dementia. If you drink alcohol, a moderate intake of alcohol may lower the risk of dementia. However, there is no evidence to suggest that non-drinkers should take up drinking alcohol.
Q What type of alcohol is best to drink?
A The health benefits associated with moderate alcohol intake, such as reduced risk of developing dementia, come from any type of alcohol. If you drink alcohol, then choose the type of alcohol that you enjoy drinking but only drink in moderation.
Q Will I get alcohol related dementia if I drink alcohol?
A Alcohol related dementia is caused by excessive drinking of alcohol over a long period of time. Drinking alcohol in moderation, that is no more than two standard drinks per day, will not cause alcohol related dementia.
Q If I give up smoking will it stop me getting dementia?
A Quitting smoking will help to reduce your risk of developing dementia as well as your risk of a range of other chronic diseases. It’s important to remember that there are a number of risk factors for dementia, of which smoking is only one. So quitting smoking can’t guarantee that you won’t get dementia.
Q I’ve heard that nicotine improves brain function so why isn’t smoking recommended?
A Some research studies suggest that nicotine may have short term benefits for brain health. While this may be the case, it must be remembered that any benefit from nicotine in cigarettes is far outweighed by the harmful effects of cigarettes. Smoking is associated with an increased risk of dementia as well as a range of other chronic diseases.
Q How does sleep affect my risk of developing dementia?
A Lack of sleep and sleep disturbance that can sometimes result from snoring has been associated with poorer brain function. Further research is needed but if a person is having sleeping problems and feels concerned they should see their doctor.
Q I suffer from sleep apnoea, does that mean I will get dementia?
A Daytime sleepiness and sleep disorders have been linked to poorer brain function. However, this doesn’t mean that everyone who suffers from sleep disorders will develop dementia. Severe, ongoing sleeping problems or sleep apnoea require medical treatment and should be discussed with your doctor.
Q What about illegal drugs?
A We don’t know yet what effect taking illegal drugs has or will have on your risk of developing dementia. Not enough research has been done to give us the answers. We do know that certain illegal drugs can have a negative effect on brain function, however other illegal drugs are relatively new and their effects on different aspects of brain function are not well known.
Q Does stress increase dementia risk?
A At this stage, there is little evidence that stress increases the risk of dementia. Alzheimer’s Australia suggests that people seek medical advice if they are having significant problems with stress.
Specific questions about Mind your Head:
Q If I hit my head will I get dementia?
A Serious head injury, such as that leading to unconsciousness has been shown to increase the risk of dementia. Alzheimer’s Australia encourages people to be mindful of protecting their head such as taking care not to fall, taking care as a pedestrian, wearing a seatbelt and using protective head gear when cycling, rollerblading or playing particular sports.
Q Does your risk of dementia increase if you are knocked out for even a short time?
A Being knocked unconscious even for a short time is a severe head injury and severe head injury is associated with an increased risk of dementia. However, this doesn’t mean that you will develop dementia. Many factors affect your risk of developing dementia so it’s important to do what you can to reduce your risk. One thing you can do is protect your head from injury.
Q Will using a mobile phone increase my risk of dementia?
A There is no evidence that using a mobile phone increases the risk of dementia.
Q I’ve heard that exposure to electromagnetic radiation from electrical tools is linked to dementia?
A There is some evidence that exposure to strong electromagnetic radiation is linked to an increased risk of dementia. Most modern machinery and tools used today have well shielded motors so exposure to electromagnetic radiation is unlikely to be a problem. When using electrical machinery or tools it is recommended to use those with shielded electric motors where possible.
General questions:
Q What is the evidence for risk reduction?
A Numerous research studies exist and more are in progress investigating what can be done to reduce the risk of dementia. A team of eminent Australian geriatricians and psychogeriatricians have reviewed the available evidence and summarised the various lifestyle factors that may reduce the risk or delay the onset of dementia. Much of the evidence is based on population studies involving large groups of people, and indicates that on average those who adopt a ‘brain healthy’ lifestyle have a reduced risk. More details can be found in Alzheimer’s Australia’s Paper 13: Dementia Risk Reduction: the evidence, Sept 2007.
Q Why is dementia risk reduction so important?
A Dementia is fast becoming the health epidemic of the 21st Century. Greater awareness of risk reduction factors could assist in slowing the growth of the disease. The projections are concerning:
- In Australia more than 250,000 Australians are diagnosed with dementia, with the number predicted to reach almost 1 million by the year 2050, unless there is a medical breakthrough.
- Currently in Australia, nearly one million people are involved in caring for a family member or friend with dementia.
Dementia is a significant and escalating health, social, and economic problem and risk reduction awareness could prove a key to slowing the increase in dementia.
Q What are the risk factors for dementia?
A The two biggest risk factors are genetics and age – two things people can’t do anything about, but there are risk factors that people can change.
These include:
- Lack of mental stimulation/activity
- High saturated fat diet
- Physical inactivity
- Untreated high blood pressure
- Untreated high blood cholesterol
- Untreated diabetes
- Being obese
- Lack of social connections
- Smoking
- Serious head injury
Q Are risk factors specific to one type of dementia?
A Many types of dementia overlap, so risk factors for one type of dementia may also be risk factors for other types of dementia. For example, high blood pressure is a risk factor for both Alzheimer’s disease and vascular dementia.
Q Is there a way to test whether someone is at risk for dementia?
A Where it is known that a gene for Familial Alzheimer’s Disease exists within a family, genetic testing can be done to determine which family members will eventually develop the disease.
The decision to undergo genetic testing for Familial Alzheimer’s Disease is very complex and the advantages and disadvantages must be carefully considered. Consultation with a genetic counselor is essential to enable people to make an informed decision about whether to be tested or not.
With regard to later onset sporadic dementia, no test is available as yet. There is promising research, but there is currently no test which accurately shows a person’s risk for developing dementia.
Q What’s the difference between genetics and family history?
A Every function in the body is controlled by our genes. A person’s genetic make-up is based on the genetic make up of their parents and the mix of genes that are passed onto them. We don’t understand everything about our genes but we know that there are certain types of genes that increase the risk of developing dementia. People who have these ‘risk genes’ for dementia are at greater risk of developing dementia than people who don’t have these genes, but not everyone who has these genes will develop dementia. People with a family history of dementia, i.e. a sibling or parent diagnosed with dementia, are also more likely to develop dementia than people with no family history. But, again not everyone with a family history will develop dementia. However, people who carry the specific genes for familial forms of dementia will develop dementia. Familial forms of dementia include Familial Alzheimer’s disease and Familial fronto-temporal dementia. It is very important to understand that familial forms of dementia are very rare and are due to specific gene mutations. Familial Alzheimer’s disease is not the same as having a family history of Alzheimer’s disease.
