Brain health should be top of mind as we age.

Nearly 7 million Americans have been diagnosed with dementia, which slowly erodes memory, thinking skills and the ability to perform basic tasks.

Now, economists at the nonprofit research organization RAND have identified several factors that can strongly predict at 60 if you’ll develop cognitive impairment and dementia by 80, including never drinking alcohol — or drinking too much — and being less conscientious or responsible.

“Understanding risk factors can enable health care providers and policymakers to identify groups at the highest risk so they can direct resources to delay cognitive decline or address its effects,” said Peter Hudomiet, the lead author of the Tuesday report and a senior economist at RAND.

The think tank used a survey of about 20,000 adults over 50 to examine 181 potential risk factors, including demographics, socioeconomic status and health behaviors, to see which were most associated with developing dementia.

Strong predictors of dementia

  • Being in poor physical health
  • Suffering a stroke
  • Not having a private health insurance plan at age 60
  • Never having worked or having worked only a few years
  • Having diabetes or a body mass index of 35 or more at 60
  • Never exercising
  • Scoring low on physical tests (like breathing, grip strength, walking speed and balance)
  • Never drinking alcohol or drinking excessively
  • Having a less conscientious personality
  • Having certain genes
  • Not really engaging in hobbies or activities that involve learning

Weak predictors of dementia

  • Parental health
  • Family size
  • Marital history
  • Race and ethnicity

The researchers recommend older people consider making lifestyle changes, like exercising more, consuming alcohol in moderation, working additional years, taking up hobbies after retirement and maintaining good physical health.

They also suggest seeking cognitive assessments during annual check-ups. RAND found that out-of-pocket costs were the strongest barrier to undergoing a cognitive test, returning for follow-up appointments and receiving dementia treatments.

The researchers pointed out that early detection of Alzheimer’s disease and related dementias is critical for better treatment outcomes.

“Broadening the use of cognitive assessments is an important strategy to identify patients who may benefit from current and future treatments for Alzheimer’s and related dementias,” said Susann Rohwedder, a senior economist at RAND. “Assessments provided individuals with information that may facilitate actions to prepare for the future.”

The RAND report comes four months after the Lancet Commission, composed of 27 dementia experts, revealed 14 modifiable lifestyle factors it identified as accounting for nearly half of dementia cases.

The factors are lower levels of education, hearing loss, high blood pressure, smoking, obesity, depression, physical inactivity, diabetes, excessive alcohol consumption, traumatic brain injury, air pollution, social isolation, vision loss and high cholesterol.

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