A person’s emotional health, reflected in levels of anxiety, depression, lack of purposeful activities, positive attitude and social interaction, as well as sleep, are associated with increased future risk of cognitive impairment and dementia.
Those reporting anxiety have a 35% higher risk of developing Alzheimer’s disease in a meta-analysis of six studies. Social isolation and depression are risk factors for dementia in later life. Depression is also more prevalent in those with dementia. People with positive age beliefs, which also reduces stress, are less likely to develop dementia. Conversely, negative thinking is associated with accelerated cognitive decline.
A meta-analysis of studies on sleep found that disturbed sleep increases future risk of dementia. Combining 23 studies insomnia was significantly associated with 27% higher risk of cognitive disorders. Those getting too little (six hours or less) or too much (over 8 hours) had greater risk. A recent study of people in their 50s and 60s getting six hours of sleep or less were 30% more likely to be diagnosed with dementia later compared to those getting seven hours.
Potentially beneficial interventions include meditation and mindfulness, which has been shown to lessen depression in those with dementia ; heart rate variability (HRV) biofeedback which has been shown to lessen depression, anxiety, and improve attentional skills as well as sleep quality and stress management in older adults. ; yoga having beneficial effects on cognitive functioning, particularly on attention and verbal memory possibly through improved sleep, mood, and neural connectivity. ; and improved social interactions with facilitated meeting and discussion groups being associated with improved cognition and increased brain volume.
References:
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Livingston G, Huntley J, Sommerlad A, Ames D et al Dementia prevention, intervention, and care: 2020 report of the Lancet Commission. Lancet. 2020 Aug 8;396(10248):413-446. doi: 10.1016/S0140-6736(20)30367-6. Epub 2020 Jul 30. PMID: 32738937; PMCID: PMC7392084.
Kuring, J.K., Mathias, J.L. & Ward, L. Prevalence of Depression, Anxiety and PTSD in People with Dementia: a Systematic Review and Meta-Analysis. Neuropsychol Rev 28, 393–416 (2018). https://doi.org/10.1007/s11065-018-9396-2
Levy BR, Slade MD, Pietrzak RH, Ferrucci L (2018) Positive age beliefs protect against dementia even among elders with high-risk gene. PLoS ONE 13(2): e0191004. https://doi.org/10.1371/journal.pone.0191004
Marchant NL, Lovland LR, Jones R, et al PREVENT-AD Research Group. Repetitive negative thinking is associated with amyloid, tau, and cognitive decline. Alzheimers Dement. 2020 Jul;16(7):1054-1064. doi: 10.1002/alz.12116. Epub 2020 Jun 7. PMID: 32508019.
Xu W, Tan C, Zou J, et al Sleep problems and risk of all-cause cognitive decline or dementia: an updated systematic review and meta-analysis Journal of Neurology, Neurosurgery & Psychiatry 2020;91:236-244.
Sabia S, Fayosse A, Dumurgier J, et al. Association of sleep duration in middle and old age with incidence of dementia. Nat Commun. 2021 Apr 20;12(1):2289. doi: 10.1038/s41467-021-22354-2. PMID: 33879784; PMCID: PMC8058039.
Wang FL, Tang QY, Zhang LL et al. Effects of Mindfulness-based Interventions on Dementia Patients: A Meta-analysis. West J Nurs Res. 2020 Dec;42(12):1163-1173. doi: 10.1177/0193945920916750. Epub 2020 May 14. PMID: 32406791.
Jester DJ, Rozek EK, McKelley RA. Heart rate variability biofeedback: implications for cognitive and psychiatric effects in older adults. Aging Ment Health. 2019 May;23(5):574-580. doi: 10.1080/13607863.2018.1432031. Epub 2018 Jan 30. PMID: 29381375.
Brenes GA, Sohl S, Wells RE, Befus D, et al. The Effects of Yoga on Patients with Mild Cognitive Impairment and Dementia: A Scoping Review. Am J Geriatr Psychiatry. 2019 Feb;27(2):188-197. doi: 10.1016/j.jagp.2018.10.013. Epub 2018 Oct 25. PMID: 30413292; PMCID: PMC6541218.
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