You Can’t Change Your Genes, So What *Can* You Do if Dementia Runs in Your Family?

A family history of dementia is a risk factor for developing it yourself, according to the Mayo Clinic. With Alzheimer’s disease, for instance, even having an extended relative (like a cousin) with the disease is linked to an increase in your own risk, according to an April 2019 study in Neurology¹.

But if dementia's floating around in your gene pool, keep in mind this is just one risk factor. Even if you have a family history, you may never have dementia symptoms. And on the other hand, people with zero family history could still develop the condition, per the Mayo Clinic.

Think of it this way: Eating saturated fats increases your risk for heart disease—but we’ve all heard stories of centenarians who habitually begin their day with several slices of bacon for breakfast.

We know we can't change our genes (not yet, anyway), but many people want to know what they can do to lower their risk of dementia if it runs in their family—we know because we polled our readers about their biggest health questions for our Real Talk Rx series.

Here's what our panel of doctors had to say.

What should I do if dementia runs in my family?

"The most important thing anybody with a dementia risk can do is develop a relationship with a family medicine physician early on. A family medicine physician provides primary care and takes care of you throughout your whole lifespan. In some instances, we’re taking care of entire families. So I might know your parent or grandparent who has dementia and be able to give you really personalized advice.

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Once you have that relationship, let your doctor know about your family history. That way they can get into a more nuanced discussion with you about how to protect your brain health and when additional testing might be necessary.

General wellness habits are the best way to protect your brain. That includes setting a regular sleep schedule—even on the weekend, as tempting as it is to sleep in, try to set the same bedtime and same wake-up time every day. Make sure you’re getting a sufficient amount of sleep. That’s different from one person to another, but in general it’s six to eight hours.

In addition to the sleep, you want to make sure you’re eating nutritious foods, and eating a variety of foods, so you know you're getting enough nutrients.

And you want to be physically active. That doesn’t mean you have to run a marathon, but maybe 30 minutes of walking outside a day. It’s not only good for your brain, your heart, and your bones, but it’s also good for your mental health.

Finally, you also want to make sure you keep your brain engaged. So you want to engage with people socially and maintain your social networks. And you may want to pick up a hobby that challenges you to think. So maybe that’s doing puzzles, woodworking … look for things that are in some way challenging your mental capabilities as well as your physical capabilities."

"Aim to do something new all the time, no matter what age you are." —Divesh Goel, MD

"The best thing you can do if you’re concerned about getting dementia is twofold. Number one, follow the food rules. Try to cut out high-sugar, highly processed foods [think: pastries, desserts, sweetened drinks] that are known to be inflammatory and can negatively affect the body and the brain.

The second thing that can be very effective to slow down or keep you from developing dementia is to actively work and engage your brain. And that is through either reading or regular interactions and conversations with friends and family members, learning skills, doing brain games—things that challenge you."

"It really depends. If a lot of people in your family are below the age of 65 and they're getting dementia, then I think you could talk to your primary care doctor, and they may like to send you to a specialist for some genetic testing. But it's really reserved for a very small sliver of the population.

Good mental hygiene is what's going to prevent dementia for most people if they're healthy already, such as physical and mental exercise, which means doing new cognitive tasks. [Aim] to do something new all the time, no matter what age you are. That's a challenge: I think we're averse to new tasks, especially when we're older, because we're set in our ways.

Keep in mind, family members with dementia may have developed it for a whole slew of reasons, such as vascular risk factors, and that doesn't necessarily mean you'll develop it too."

The takeaway

There’s nothing you can do to change your genetic makeup, but there are many other dementia risk factors—such as your activity level, alcohol intake, and social interactions, according to the World Health Organization—that are more within your control.

Research on dementia is still evolving, so there’s no known preventive tactic that can definitely prevent the disease, per Alzheimers.gov. But anyone can make certain lifestyle adjustments that look promising when it comes to reducing dementia risk, regardless of their family history. These adjustments include the following, according to Alzheimers.gov:

• Eat a healthy diet
• Control high blood pressure and manage blood sugar levels
• Maintain a healthy weight
• Avoid smoking
• Reduce alcohol intake
• Stay physically and mentally active
• Treat hearing loss
• Get enough sleep
• Keep up with friendships

In the end, everyone should take steps to protect their brain health, whether or not they have a family history of dementia. Many of the same habits recommended for overall health and aging well—such as eating nutritious foods, being physically active, and safeguarding your sleep—are also good for your cognitive health.

Our experts also recommend actively engaging your brain. That means prioritizing social interactions as well as doing new things that require your brain to stretch, like learning a new language or picking up a new hobby.

‌Confused about your health? Get answers to more common questions in our Real Talk Rx series.

—reviewed by Jennifer Gilbert, MD, MPH