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Five choices to make in the fight against dementia

All too often, folks think that a big reward demands a big effort. True, the astounding view from the top of Mount Everest is in direct proportion to the life-risking difficulty of the climb. But down here near sea level, the risk-reward ratio is often on your side — little or no risk, huge rewards. Wearing a bike helmet reduces your risk of a serious head injury by 70%. Walk your dog daily and, according to one international study, you’ll make 15% fewer annual doctor visits than someone without a dog. Another risk-free/big-reward deal: Five easy steps can slash your risk of dementia!

That should mean a lot to a lot of you — and you (and you)! In 2015, Alzheimer’s Disease International reported that globally, nearly 47 million people are living with dementia; about 10 million new cases are diagnosed annually, and by 2050 there will be 11.74 million folks in North America with dementia — a 145% increase from 2015.

Why is the risk of dementia increasing? Because of increasing lifestyle challenges: obesity, heart disease, diabetes and sedentary habits, as well as smoking, excess alcohol intake and environmental toxins. Genetic predisposition also plays a part, although it’s far from destiny.

Fortunately, if you use your head, you can protect your brain. In a massive study published in JAMA, researchers looked at almost 200,000 people over age 60 (52% were women) for eight years and found that you can significantly lower your risk for dementia by making four smart choices day to day. Even if you have a family history of Alzheimer’s, the researchers found that “a favorable lifestyle was associated with a lower dementia risk among participants with high genetic risk” — a 60% lower risk! Those smart choices are:

1. No smoking.

2. Regular physical activity.

3. A healthy diet.

4. Moderate alcohol consumption.

We add a fifth dementia-fighter to that list:

5. Social interaction and involvement with people and activities that inspire and comfort you.


>> Physical activity. Go for at least 150 minutes of moderate activity weekly, 75 minutes of vigorous activity weekly or an equivalent combination.

>> A healthful diet. That was defined in the JAMA study as increased regular consumption of foods essential for cardio- metabolic health: fruits, nonstarchy vegetables, nuts, leg­umes, fish, vegetable oils and minimally processed whole grains; and the reduction or elimination of red and processed meats and foods loaded with refined grains, starch, added sugars, salt and trans fat.

>> Moderate alcohol consumption. Chronic excess alcohol consumption changes brain structure and leads to problems with memory, focus, mood and sleep. In the JAMA study, “moderate consumption” was defined as around 7 ounces of alcohol weekly for men and half that for women — much less than the usual recommendation of one drink a day for women and two for men, with a 4-ounce glass of wine delivering 1 ounce of alcohol.

>> No smoking (anything). According to the World Health Organization, 14% of Alzheimer’s disease worldwide is attributable to smoking. If you are a current smoker, you can get help quitting at and

>> Social engagement. According to a 2018 study published in the Journal of Gerontology: Psychological Sciences that looked at 12,000 folks who were 50 and older over 10 years, chronic loneliness increases your risk for dementia by 40%!

1. Reach out to help others. If you’re restricted because of mobility issues, there are lots of online sites that offer you the chance to volunteer and interact with a community.

2. Sign up for a class (that can be online, too). Join a book club or a walking club.

3. Work on being open to new people and experiences by being more trusting of others.

You might have to push yourself a bit at first, but the rewards are so enjoyable that you’ll get into the swing of things pretty quickly.

Mehmet Oz, M.D., is host of “The Dr. Oz Show,” and Mike Roizen, M.D., is chief wellness officer and chairman of the Wellness Institute at Cleveland Clinic. Email questions to

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