Risk factors The number of associated risk factors for dementia was increased from nine to twelve in 2020. The three newly added risks are over-indulgence in alcohol, traumatic brain injury, and air pollution. The other nine risk factors are: lower levels of education; high blood pressure; hearing<unk> ; smoking; obesity; depression; inactivity; diabetes, and low social contact. Many of these identified risk factors including, the lower level of education, smoking, physical inactivity and diabetes, are modifiable. Several of the group are known vascular risk factors that may be able to be reduced or eliminated. Managing these risk factors can reduce the risk of dementia in individuals in their late midlife or older age. A reduction in a number of these risk factors can give a positive outcome. The decreased risk achieved by adopting a healthy lifestyle is seen even in those with a high genetic risk. Based on the English Longitudinal Study of Ageing (ELSA), research found that loneliness in older people increased the risk of dementia by one-third. Not having a partner (being single, divorced, or widowed) doubled the risk of dementia. However, having two or three closer relationships reduced the risk by three-fifths. The two most modifiable risk factors for dementia are physical inactivity and lack of cognitive stimulation. Physical activity, in particular aerobic exercise, is associated with a reduction in age-related brain tissue<unk> , and neurotoxic factors thereby preserving brain volume and neuronal integrity. Cognitive activity strengthens neural plasticity and together they help to support cognitive reserve. The neglect of these risk factors diminishes this reserve. Studies suggest that sensory impairments of vision and hearing are modifiable risk factors for dementia. These impairments may precede the cognitive symptoms of Alzheimer's disease for example, by many years. Hearing<unk>  may lead to social isolation which negatively affects cognition. Social isolation is also identified as a modifiable risk factor. Age-related hearing<unk>  in midlife is linked to cognitive impairment in late life, and is seen as a risk factor for the development of Alzheimer's disease and dementia. Such hearing<unk>  may be caused by a central auditory processing disorder that makes the understanding of speech against background noise difficult. Age-related hearing<unk>  is characterised by slowed central processing of auditory information. Worldwide, mid-life hearing<unk>  may account for around 9% of dementia cases. Evidence suggests that frailty may increase the risk of cognitive decline, and dementia, and that the inverse also holds of cognitive impairment increasing the risk of frailty. Prevention of frailty may help to prevent cognitive decline. A 2018 review however concluded that no medications have good evidence of a preventive effect, including blood pressure medications. A 2020 review found a decrease in the risk of dementia or cognitive problems from 7.5% to 7.0% with blood pressure lowering medications. Economic disadvantage has been shown to have a strong link to higher dementia prevalence, which cannot yet be fully explained by other risk factors. Dental health Limited evidence links poor oral health to cognitive decline. However, failure to perform tooth brushing and gingival inflammation can be used as dementia risk predictors. Oral bacteria The link between Alzheimer's and gum disease is oral bacteria. In the oral cavity, bacterial species include P. gingivalis, F. nucleatum, P. intermedia, and T. forsythia. Six oral treponema spirochetes have been examined in the brains of Alzheimer's patients. Spirochetes are neurotropic in nature, meaning they act to destroy nerve tissue and create inflammation. Inflammatory pathogens are an indicator of Alzheimer's disease and bacteria related to gum disease have been found in the brains of Alzheimer's disease sufferers. The bacteria invade nerve tissue in the brain, increasing the permeability of the blood-brain barrier and promoting the onset of Alzheimer's. Individuals with a plethora of tooth plaque risk cognitive decline. Poor oral hygiene can have an adverse effect on speech and nutrition, causing general and cognitive health decline. Oral viruses Herpes simplex virus (HSV) has been found in more than 70% of those aged over 50. HSV persists in the peripheral nervous system and can be triggered by stress, illness or fatigue. High proportions of viral-associated proteins in amyloid plaques or neurofibrillary tangles (NFTs) confirm the involvement of HSV-1 in Alzheimer's disease pathology. NFTs are known as the primary marker of Alzheimer's disease. HSV-1 produces the main components of NFTs. Diet Diet is seen to be a modifiable risk factor for the development of dementia. Thiamine deficiency is identified to increase the risk of Alzheimer's disease in adults. The role of thiamine in brain physiology is unique and essential for the normal cognitive function of older people. Many dietary choices of the elderly population including, the higher intake of gluten-free products, compromise the intake of thiamine as these products are not fortified with thiamine. The Mediterranean and DASH diets are both associated with less cognitive decline. A different approach has been to incorporate elements of both of these diets into one known as the MIND diet. These diets are generally low in saturated fats while providing a good source of carbohydrates, mainly those that help stabilize blood sugar and insulin levels. Raised blood sugar levels over a long time, can damage nerves and cause memory problems if they are not managed. Nutritional factors associated with the proposed diets for reducing dementia risk, include unsaturated fatty acids, antioxidants vitamin E vitamin C and flavonoids, vitamin B, and vitamin D. The MIND diet may be more protective but further studies are needed. The Mediterranean diet seems to be more protective against Alzheimer's than DASH but there are no consistent findings against dementia in general. The role of olive oil needs further study as it may be one of the most important components in reducing the risk of cognitive decline and dementia. In those with celiac disease or non-celiac gluten sensitivity, a strict gluten-free diet may relieve the symptoms given a mild cognitive impairment. Once dementia is advanced no evidence suggests that a gluten free diet is useful. Omega-3 fatty acid supplements do not appear to benefit or harm people with mild to moderate symptoms. However, there is good evidence that omega-3 incorporation into the diet is of benefit in treating depression, a common symptom, and potentially modifiable risk factor for dementia.
complications of Hearing loss
medical cause of Hearing loss
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symptom of Pierre Robin sequence
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symptom of Congenital heart defect