Can we prevent dementia?
This is a question many have been asking, and now we have a clearer answer thanks to the latest report from the Lancet Commission. The commission announced a new discovery that opens the door to preventing half of all cases of dementia, according to the commission’s latest report published after years of research.
Experts have revealed 14 factors that, if modified, could reduce the risk of developing this devastating brain disease by up to 50%. From daily habits to health conditions, the report provides a comprehensive roadmap to protecting and keeping our brains healthy.
It can prevent or delay treatment of 14 issues, starting in childhood and continuing throughout life, according to the Lancet Commission report on dementia prevention, intervention and care, which is being presented at the Alzheimer’s Association International Conference and published on July 31.
The Lancet Commission is an independent, global scientific body that seeks to provide evidence-based recommendations to improve public health worldwide. The Lancet is comprised of a group of world-class medical experts and issues comprehensive reports on global health issues, with a focus on prevention, treatment and the root causes of disease.
New factors
The new report, based on the latest available evidence, adds two new risk factors that are linked to 9% of all dementia cases – with an estimated 7% of cases attributable to high low-density lipoprotein (LDL) or “bad” cholesterol in midlife from around age 40, and 2% of cases attributable to untreated vision loss later in life.
These new factors add to 12 risk factors previously identified by the Lancet Commission in 2020 (low education levels, hearing impairment, high blood pressure, smoking, obesity, depression, lack of physical activity, diabetes, excessive alcohol consumption, traumatic brain injury, air pollution, and social isolation), which are linked to 40% of all cases of dementia.
The new report estimates that the risk factors associated with the largest proportion of people developing dementia globally are hearing impairment and high low-density lipoprotein (7% each), along with less education in early life and social isolation later in life (5% each).
The Commission, made up of 27 of the world’s leading dementia experts, calls on governments and individuals to be ambitious in tackling dementia risk factors across the lifespan, because the sooner we address and reduce levels of risk factors, the better. The report sets out a new set of policy and lifestyle changes to help prevent and better manage dementia.
More work needed worldwide to reduce the risk of dementia
As the world’s elderly population grows rapidly, the number of people living with dementia is expected to nearly triple by 2050, rising from 57 million in 2019 to 153 million. Increased life expectancy is also leading to an increase in the number of people with dementia in low-income countries. The global health and social costs of dementia are estimated at more than $1 trillion each year.
However, in some high-income countries, including the United States and the United Kingdom, the proportion of older people with dementia has declined, particularly among people living in socioeconomically advantaged areas. The report authors say this decline in the number of people developing dementia is partly due to building cognitive and physical resilience over the life course and reducing vascular damage as a result of improvements in health care and lifestyle changes, highlighting the importance of implementing prevention approaches as early as possible.
“Our new report reveals that there is much that can and should be done to reduce the risk of dementia,” says lead author Professor Gill Livingstone from University College London, UK, according to EurekAlert. “It is never too early or too late to take action, as there are opportunities to make an impact at any stage of life.”
“We now have stronger evidence that longer exposure to risk has a greater impact and that risks work more strongly in people who are most at risk,” she adds. “That’s why it’s essential that we redouble prevention efforts towards those who need them most, including people in low- and middle-income countries and socio-economically disadvantaged groups. Governments must reduce risk gaps by making healthy lifestyles accessible to all.”
13 Recommendations to Protect Against Dementia
To reduce the risk of dementia throughout life, the Commission outlines 13 recommendations for governments and individuals to adopt, including:
- Providing good education for all children and cognitive activity in middle age.
- Providing hearing aids to all people with hearing loss and reducing exposure to harmful noise.
- Detection of bad cholesterol in middle age, from about the age of 40, and treatment of its high level.
- Making screening and treatment for vision loss accessible to all.
- Treat depression effectively.
- Wear helmets and head protection in contact sports and on bicycles.
- Prioritize supportive community environments and housing to increase social connection.
- Reduce exposure to air pollution through strict clean air policies.
- Expand measures to reduce smoking, such as price controls, raising the minimum purchase age, and smoking bans.
- Reducing the sugar and salt content of foods sold in stores and restaurants.
These measures are particularly important given emerging evidence that reducing the risk of dementia not only increases healthy life years, but also reduces the time people who develop dementia spend in poor health.
“Healthy lifestyles that include regular exercise, not smoking, and being cognitively active in middle age (including outside formal education) can not only reduce the risk of dementia, but may also delay the onset of dementia,” explains Professor Livingstone. “So, if people do develop dementia, they are likely to live fewer years with it. This has significant implications for the quality of life for individuals as well as cost-saving benefits for societies.”