STRESS MANAGEMENT
Higher perceived stress is associated with a 19% increased risk of mild cognitive impairment (MCI) and a 44% increased risk of all-cause dementia.
Managing stress levels is critical for preventing dementia and optimizing brain health. Chronic stress activates the hypothalamic-pituitary-adrenal (HPA) axis, leading to prolonged release of glucocorticoids such as cortisol. Elevated cortisol levels are associated with neuronal loss, particularly in the hippocampus, which is critical for memory and learning. Stress also contributes to neuroinflammation and the accumulation of amyloid-β and tau proteins, which are hallmark pathologies of Alzheimer's disease. These mechanisms collectively result in cognitive decline and increased risk of dementia
By reducing stress, these pathological processes can be mitigated, thereby lowering the risk of dementia. Effective, evidenced-based stress management includes mindfulness, psychoeducation, and tenants of cognitive behavioral therapy.
SLEEP
Sleeping less than six hours per night can increase dementia risk by 30% for adults aged ≥50 years.
The CDC recommends obtaining 7 hours of sleep/night to optimize cognitive and everyday functioning. Developing a framework to obtain healthy sleep can improve daytime functioning, health outcomes and support overall well-being. Evidence shows that inadequate sleep increases the risk of developing chronic conditions such as obesity, diabetes, and cardiovascular disease, and impacts cognitive functioning and mental resilience.
Over-the-counter sleep aids containing anticholinergic drugs like diphenhydramine (e.g., Benadryl, Dramamine, Tylenol PM) have also been associated with an increased risk of dementia, particularly with long-term use. One study out of UCSF found that frequent use of sleep medication was associated with a 79 percent higher chance of developing dementia. Cognitive Behavioral Therapy for Insomnia (CBT-I) is the first-line treatment for persistent sleep issues in older adults. If medications are ultimately needed, melatonin and brain-safe sleep drugs can be considered.