It’s important to take control of any underlying medical conditions that could be putting you at an increased risk for cognitive decline. You should see your physician regularly, follow medical recommendations and take medications as prescribed.

Poor glucose control has been associated with a decline in cognitive function (WHO 2019). The presence of cognitive impairment can make it challenging for clinicians to help their patients reach individualized glycemic, blood pressure and lipid targets (ADA 2019-2023). Proper management of diabetes in the form of medications and/or lifestyle interventions are recommended for adults with diabetes to reduce the risk of cognitive decline and/or dementia. Glucose monitoring, adjusting insulin doses and appropriately maintaining the timing and content of diet are suggested. When clinicians are managing patients with cognitive impairment, it is critical to simplify drug regimens and involve caregivers in all aspects of care (ADA 2019-2023).

Treating hypertension can reduce the risk of cognitive decline and/or dementia. In particular, a pattern of increased blood pressure during mid-life followed by a rapid decrease in blood pressure later in life has been found in individuals who go on to develop dementia.  Hypertension can be prevented through a range of lifestyle factors, including eating a healthy diet, maintaining a healthy weight and participating in an adequate amount of physical activity. It can also be controlled through antihypertensive medication (WHO 2019).

Observational evidence has linked dyslipidaemia (cholesterol and triglycerides) to an increased risk of dementia and/or cognitive decline and found an association between the control of dyslipidemia and the reduction of dementia and/or cognitive decline risk. In mid-aged adults, weight reduction and decreasing saturated fats in the diet are recommended. The use of statin and the control of cholesterol are also suggested (WHO 2019).

In addition to other health benefits, tobacco cessation may reduce the risk of cognitive decline and dementia. Behavioral interventions and pharmacological interventions including nicotine replacement therapy, bupropion, varenicline are recommended (WHO, 2019).

Excessive alcohol consumption and smoking can lead to a significantly increased risk of dementia and/or cognitive impairment. In addition to other health care benefits, reducing or ceasing hazardous and harmful drinking in adults with normal cognition and mild cognitive impairment can reduce the risk of cognitive decline and/or dementia. Some recommendations include behavioral, pharmacological and psychological interventions (WHO 2019).

References:

Center for Disease Control and Prevention, Healthy Brain Initiative, State and Local Public Health Partnerships to Address Dementia: The 2018-2023 Road Map

World Health Organization, Risk Reduction of Cognitive Decline and Dementia: WHO Guidelines, 2019

American Diabetes Association, Diabetes Care 2019;42 (Suppl.1):S139-S147 | https://doi.org/10.2337/dc19s012