Abstract

Cognitive decline is strongly associated with several risk factors which relate to lifestyle behaviors. Diet, exercise, alcohol consumption and smoking are among the factors that lead to an increase in the risk of developing cognitive impairment. As such, this research paper addresses these risk factors to demonstrate that there is a high and positive correlation between the lifestyle chosen by people and the incidence of dementia. The study evaluated the problem through a literature analysis of relevant studies. The outcomes of the reviews are analyzed to identify the relationship between lifestyle behavior and dementia. Findings from the research provided evidence that physical activity is significantly correlated with the incidence of cognitive impairment. With the ability to impact neuroplasticity and other health conditions such as cardiovascular diseases which are related to dementia, physical activities have a direct and indirect impact on cognitive impairment. Alcohol consumption and smoking is also found to increase the possibility of developing dementia, particularly in the aged population. The findings also indicate that dietary patterns have an impact on cognitive performance. Adhering on a Mediterranean diet is found to be effective in reducing the likelihood of cognitive impairment. These results indicate public health strategies need to be designed to focus on lifestyle behaviors since they have a significant impact on the health of the public.

Introduction

The severe decline in cognitive abilities to the extent that daily living activities are disrupted is described as dementia. The most common type of dementia is the Alzheimer disease (AD) which is a neurodegenerative condition that is among the most prevalent health conditions in people over the age of 65 years. Cognitive abilities that are progressively disabled by dementia include language, memory, judgment, attention, comprehension, and reasoning. Selective short term memory is one of the most common symptoms. The most common presenting symptom is selective short-term memory loss. Dementia is steadily progressive, and thus the cognitive decline deteriorates with time. The condition has no cure although the symptoms are improved through available treatment methods.

There appears to be a rise in early dementia onset across the world as well as an increased prevalence even among the aged population. Given the current prevalence rates, it is essential to question the cause of dementia occurrence at an early age as well as the overall rate of increase. To understand the incidence of dementia, it is essential to evaluate the risk factors leading to the development of the condition. Additionally, it is critical to consider how the lifestyle of certain people impacts their risk of developing dementia. Studies indicate that certain risk factors increase the possibility of developing dementia either in early age or later during old age. Although researchers have put a lot of effort into investigating the actual cause of the Alzheimer disease and the mechanism of its development, the exact causes are not distinctly defined. However, just like other chronic conditions, the risk factors for Alzheimer are identified, personal actions and choices are among those that contribute to the onset of the disease. Alcohol consumption, lack of exercise, obesity, and smoking increase the possibility of developing dementia and particularly at an early age.

Dementia is now among the most feared diseases like cancer, and now that the risk of middle-aged people developing the disease is high, there is a significant concern by the public. Worse, dementia lacks a permanent cure and tends to be progressive; therefore the diagnosis of the condition leaves people helpless as the situation is considered fatal. Prevention of the Alzheimer disease is not well described given that the mechanism and cause of the disease are not clear. Current research is now focusing on studying people’s behavior to determine its effect on disease occurrence. Altering behavior may help in preventing or delaying the occurrence of Alzheimer. Emerging evidence suggests that some symptoms of dementia are preventable through the adoption of healthy lifestyles. Thus, it seems that there is an association between dementia onset and the lifestyle behaviors of an individual.

Rationale: it is vital to identify the factors that increase the risk of developing dementia. Additionally, research that seeks to examine techniques for delaying the onset or progression of dementia is essential for the overall public health. Failure to find the factors to manipulate and delay the onset or progression of dementia will lead to adverse health impact in the future. The prevalence of Alzheimer is likely to increase, and the number of people suffering from the condition may shift to include a huge number of middle-aged people. If factors that increase the possibility of dementia onset are not controlled, the number of patients with Alzheimer disease is likely to increase up to 13 million by 2050 in the United States (Blondell, Hammersley-Mather & Veerman, 2014). The cost of healthcare is also likely to increase if the occurrence of dementia is not controlled. In the US, the costs incurred in providing healthcare for AD patients and related factors is about 100 billion dollars making the disease to be among the most costly health conditions among cancer and heart disease (Hojman et al., 2017).

Additionally, as the number of dementia patients increases the costs projections direct to an increase in patient care costs, increased burden on the health provider as well as the needs to improve the infrastructure of facilities to cater for both inpatient and outpatients suffering from AD. Given the high financial burden involved in caring for AD patients, it is essential to focus on delaying and reducing the progress rate of the disease. Subsequently, the costs will be drastically reduced, and public health will improve.

Health behaviors play a crucial role in determining the incidence of dementia because lifestyle choices are found to be associated with the condition. Being aware that lifestyle influences the development of dementia allows people to understand the effects of their actions on health and wellbeing. For instance, initiating physical activity as part of everyday life has an impact on numerous health factors. Lifestyle behavior is crucial because it impacts health either positively or negatively, now that dementia is influenced by lifestyle, it is vital to examine behavior choices which may affect the onset of dementia.

Research on health behavior indicates that healthy lifestyles such as eating balanced diets, avoiding drug and substance abuse significantly reduce the risk of developing cardiovascular diseases, delays the occurrence of disability and reduces mortality. Many conditions that are positively affected by health behaviors have a correlation with AD; these diseases include coronary heart events, vascular disease, strokes, and diabetes. Therefore there is a direct and indirect connection between lifestyle behavior and AD occurrence. By influencing diseases that are linked to AD through lifestyle behavior, AD is preventable, and its progression can be delayed.

The correlation between lifestyle and dementia is increasingly becoming acceptable mainly due to research findings directing that there is a relationship between dementia and lifestyle diseases such as type 2 diabetes, heart disease, obesity, and stroke. Furthermore, the connection between AD and lifestyle is strengthened by studies which demonstrate that environmental factors play a critical role in the development of declining cognitive abilities. Many interconnected factors are associated with lifestyle choices, and they are observed to be related to the development of AD. This paper hypothesizes that dementia has a high and positive correlation with the type of lifestyle chosen by an individual.

Literature review

A population-based longitudinal study was performed by Zhou, Fu, Hong, Wang, and Fang (2017). The focus of the study was to examine the causal relationship between the risk of dementia and exercise among Chinese adults aged 65 and above. The total number of participants in the study was 7501, and within the nine-year follow-up the number of participants who developed dementia was 336. The exercise was found to significantly reduce the probability of developing dementia after controlling other variables such as health status and demographic factors. These findings are consistent with the results of many other studies investigating the association between exercise and dementia. Through neurotropic mechanisms exercise is capable of providing protection against dementia and this explains the effect of exercise on reducing the risk of dementia. Therefore, exercise impacts neuroplasticity and subsequently cognitive ability. Additionally, the research found that metabolic and cardiovascular risk factors are influenced by exercise; these factors are also associated with an increased risk of developing dementia. So, through exercise, these risk factors are reduced and therefore contributing to a decreased risk of developing dementia.

A systemic review to assess physical activity and Alzheimer disease is conducted by Stephen, Hongisto, Solomon, and Lönnroos (2017). A database search was conducted in CINAHL, and PubMed databases and 24 studies were included in the research. Most of the studies demonstrated that exercise has a positive effect on the risk of developing dementia; a total of 18 studies provided such results. Specifically, the risk of AD was reduced with the practice of leisure-time physical activity; however, the studies indicated that commuting and occupational physical activity lacked a clear association with a reduced risk of developing AD. The risk of AD was not associated with the either commuting events or occupational exercise, this, therefore, suggests that protection against AD may not be achieved through work-related activities. The outcomes of the systemic review are consistent with the results of other meta-analyses which report the benefits of physical activity on the risk of dementia. Older adults that are physically active have a statistically significant reduced risk of developing dementia with an effect risk ration of 61% at 95 % confidence interval in comparison to their non-active counterparts(Beckett, Ardern & Rotondi, 2015). The study indicates an inverse relationship between the risk of dementia development and physical activity. Also, it is asserted that including cognitive and social stimulation in the physical exercises may be more beneficial to those at risk of developing dementia.

Brasure et al. (2017) perform a systematic review to evaluate the efficacy of physical activity interventions in reducing the rapid progression of cognitive decline as well as delaying the early onset of dementia. The review used papers searched from various databases which include EMBASE, MEDLINE, and PsycINFO together with the Cochrane Library.  The search identified control trials and found 32 studies that were eligible for inclusion. The review found that a single physical activity intervention is not sufficient in preventing a decline in cognitive ability. Preventing cognitive decline was most sufficient with a combination of physical activity, cognitive training, and diet, primarily, addressing several lifestyle factors at the same time achieving better results. These findings suggest that physical activity benefits cognitive skills in the long term and this is similar to man cohort studies which demonstrate the positive association between physical exercise and reduced risk of cognitive decline. For the best results, lifestyle behaviors need to be addressed from an early point in life, physical activity requires to be introduced and sustained as a lifestyle behavior. Lifestyle behavior introduced as interventions for reducing cognitive decline later in life tend to be insufficient in preventing cognitive decline or the incidence of dementia onset.

Similar to the study by Zhou et al. (2017), physical activity promotes a slow progression of cognitive decline by increasing blood flow to the brain, further it indirectly impact other health factors such as cardiovascular diseases and diabetes with have an association with dementia. Therefore, exercise has both a direct and indirect impact in preventing dementia. However, the findings of the study are limited by the small sample size employed the studies and the follow-up period was not long enough to provide sufficient results.

The effects of smoking and alcohol consumption on the incidence of AD is assessed by a follow-up study by Zhou et al. (2014). The results of their study showed a statistically significant relationship between the incidence of dementia and a lifestyle of smoking and consuming alcohol. With an adjustment of vascular risk factors, age, education, and BMI, smoking was associated with an elevated risk of developing dementia; similarly, alcohol was found to be highly associated with an increased risk of developing AD.

A cross-sectional analysis of dietary assessment is performed by McEvoy, Guyer, Langa, and Yaffe (2017) in an attempt to evaluate the impact of adhering to a Mediterranean diet on cognitive performance. A MedDiet is hypothesized to be neuroprotective, and so the researchers sought to find the association between cognitive ability and dietary patterns particularly among the aged population.

Evidence from their analysis indicates that in the assessed elderly population cognitive performance was significantly associated with MedDiet. Research findings showed that those who adhered to the diet had a lower risk of developing cognitive impairment by up to 35%. The results of the study, therefore, support the hypothesis that dietary patterns have an impact on cognitive ability. Therefore, diet modification is proposed as an important public health strategy to reduce cognitive decline, particularly within the aged population.

Discussion

The need to promote physical exercise among the elderly is an important activity that cannot be underscored considering that the incidence of dementia has an inverse relationship with physical activities. As the aged population presents many health problems it is important to understand the best strategies to manage the challenges. A decline in cognitive abilities aggravates the difficulties faced in providing care to aged patients, nevertheless, this can be overcome by initiating practices that prevent or reduce the rate of cognitive decline. Promoting exercise is beneficial as many studies identify the positive impact of physical activities.

Similar studies to those of Stephen et al. (2017) and Zhou et al. (2017) promote physical activities as effective interventions in reducing the likelihood of dementia occurrence. It is expected that physical exercise will have an impact on the health of an individual; thus, it is anticipated to influence cognitive function. The issues addressed that relate physical activities to cognitive performance is the promotion of neuroplasticity by increasing blood flow to the brain. Additionally, the impact of exercise on cardiovascular disease indirectly affects the development of dementia given that there is an association between cardiovascular diseases and the incidence of dementia. However, noteworthy finding from the analyzed studies is the inefficiency of occupation-related exercise in preventing dementia. As such, leisure time physical activity is demonstrated as the best strategy towards preventing dementia incidence through physical activity.

The combination of physical activity with other lifestyle practices is found to produce better results in preventing dementia. It is expected that lifestyle behaviors which have a positive effect on health yield better health outcomes when utilized together. Additionally, beginning physic exercise at an early age is found to have a greater impact on reducing the risk of developing dementia.

Smoking and alcohol consumption is a lifestyle behavior which has a direct impact on the incidence of dementia. Generally, smoking and alcohol consumption has adverse effects on the health of everyone. As such, these factors are considered high risk factors for the development of AD considering that they also affect other health issues that are related to dementia. Alcohol and smoking increase the risk of cardiovascular disease and other chronic illnesses which in turn correlated with an increased risk of developing dementia.

Other lifestyle factors that significantly affect one’s health is dietary patterns. Diet impacts the rate of recovery from a disease as well as the probability of developing a health condition. As such the evaluation of dietary patterns on old patients to determine the association between food and cognitive performance sheds light on an important aspect of healthcare. Particularly, considering that the results confirm the impact of food on cognitive impairment. The adherence to MedDiet shows an increase in cognitive performance, especially in older adults. The results imply that dietary strategies need to be implemented in an attempt to care for the aged population.

Conclusion

The selected lifestyle behavior is confirmed to be correlated with the incidence of dementia. Going by the described studies, the behaviors adopted by an individual play a significant role in determining their cognitive performance. The point in time when the behavior is embraced also has an effect on health outcomes. Sticking to a MedDiet and engaging in physical exercise from an early age is more effective than when the behavior is adopted later in life. The impact of lifestyle choice on cognitive ability is tremendous as the impact can either be direct or indirect. As such, lifestyle behaviors have a complex mechanism for impacting cognitive health. The association of lifestyle disease with dementia facilitate the connection between lifestyle choices and the incidence of dementia. Diet has an impact on diabetes, cardiovascular disease, and other chronic health problems, on the other and, these health conditions are risk factors for dementia. So, any lifestyle behavior that affects any of this health condition also impacts the probability of developing dementia.