Nearly half of dementia cases could be delayed or prevented altogether by addressing 14 underlying risk factors, such as poor eyesight and high cholesterol.
This is the main finding of a new study published by us and our colleagues in the Lancet.
Dementia is a rapidly growing global challenge, affecting an estimated 57 million people worldwide, and this number is expected to increase to 153 million worldwide by 2050. While the prevalence of dementia is declining in high-income countries, it continues to increase in low- and middle-income countries.
This third and latest report from the Lancet Dementia Commission carries good news and a powerful message: policymakers, clinicians, individuals and families can motivate themselves to prevent dementia and reduce the risk of it, and for people with dementia and their carers, they can use evidence-based approaches to support their quality of life.
This new report confirms 12 potentially modifiable risk factors identified in two previous reports published in 2017 and 2020. It also provides new evidence supporting two additional modifiable risk factors: poor vision and high levels of low-density lipoprotein (LDL) cholesterol, often referred to as “bad” cholesterol.
A review of published evidence found that collectively addressing 14 modifiable risk factors could reduce dementia prevalence by 45% worldwide. Even greater risk reductions are likely to be possible in low- and middle-income countries, and in low-income populations in high-income countries, given the high prevalence of dementia, health disparities and risk factors in these populations.
The report further noted that reducing these 14 risks could potentially extend the healthy lifespan of people with dementia and shorten the period of poor health.
Additionally, the report cites clinical trials showing that non-pharmacological approaches, such as activities tailored to interests and abilities, can reduce dementia-related symptoms and improve quality of life.
We are general physicians, applied social scientists and intervention scientists whose research focuses on memory and health in older people. Under the guidance of Professor of Psychiatry, Dr Gill Livingstone, and together with 25 other internationally recognised dementia experts, we have carefully reviewed the evidence to arrive at recommendations for prevention, intervention and care.
Why is this important?
Rapid population ageing around the world is a testament to improvements in public and individual health across the lifespan, but with no cure for dementia yet, the report highlights the importance of preventing dementia and supporting the quality of life of those diagnosed.
In a new report, our team proposes an ambitious programme to prevent dementia that can be implemented at individual, community and policy levels, and across the lifespan, from early childhood through middle age and old age. Key points include:
Improve general education during childhood.
In midlife, we address hearing loss, high LDL cholesterol, depression, traumatic brain injury, lack of exercise, diabetes, smoking, high blood pressure, obesity, and excessive alcohol consumption.
In later life, it reduces social isolation, air pollution and vision loss.
Together, these lead to the Lancet Dementia Commission’s estimate that dementia risk could be reduced by 45%, and a growing body of new research shows that addressing risk factors such as exposure to air pollution is likely to improve cognitive performance and reduce dementia risk.
Emerging evidence supports the idea that in high-income countries, reducing the risk of dementia could lead to more healthy years for people who develop dementia, more dementia-free years, and fewer years of ill health.
What we don’t know yet
The 45% reduction in dementia risk in the global population is based on calculations that assume risk factors are causal and can be eliminated, showing how important dementia prevention is and the impact it can have on individuals and families.
The committee emphasized the need for further research to identify additional risk factors, test changes in risk factors in clinical trials, provide guidance for public health actions, and identify and evaluate strategies to implement and expand evidence-based programs to support people with dementia and their caregivers.
Updated reports have impacted public health and research worldwide and are widely distributed, serving as guidelines for clinicians and policy makers and outlining new research directions.
Research Briefs are short articles about interesting academic research.
This article is republished from The Conversation, a nonprofit, independent news organization providing facts and trusted analysis to help us make sense of a complex world. Authors: Eric B. Larson, University of Washington and Laura Gitlin, Drexel University
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Eric B. Larson has received funding from the National Institutes of Health, the National Institute on Aging, and UpToDate for the chapters he wrote and updated.
Laura N. Gitlin has received funding from the National Institute on Aging, the Department of Veterans Affairs, and various book royalties, and has developed several online courses to train health care professionals in the evidence-based care programs that she and her team have tested and shown to be effective, for which she and her academic colleagues are entitled to training fees.
