According to the World Health Organization (WHO), around fifty million people worldwide have dementia, and about ten million more cases are added every year [1]. This is why preventing dementia is so important.
Despite how common it is, dementia is not a part of normal ageing, and it has a physical, psychological, social, and economic impact on the affected individual, their families, caretakers, and society as a whole.
A significant amount of research over the last several decades has gone into uncovering the causes of dementia in an effort to not simply treat the condition, but to prevent it altogether. New updates have recently been added to The Lancet Commission on dementia prevention, intervention, and care, which have defined twelve risk factors that could be modified over a lifetime to prevent or delay forty percent of dementia cases [2].
Modifiable Risk Factors for Preventing Dementia
In 2017 The Lancet Commission identified nine modifiable risk factors for preventing dementia, which included the following:
- Less education
- Hypertension
- Hearing impairment
- Smoking
- Obesity
- Depression
- Physical inactivity
- Diabetes
- Low social contact [3]
The 2020 report added three new risk factors, which are:
10. Excessive alcohol consumption
11. Traumatic brain injury
12. Air pollution [3]
Together these risk factors account for forty percent of dementia cases worldwide. Theoretically if these risk factors were removed, those cases could be prevented or at least delayed.
Read: How These Greek Islanders May be Avoiding Dementia
Socioeconomic Status and Dementia
In some countries, the proportion of older people with dementia has actually gone down, likely because of improvements in education, nutrition, health care, and lifestyle changes. Unfortunately, dementia is on the rise in low and middle-income countries, where around two thirds of people with dementia live.
Lead author of the report, Professor Gill Livingston of the University College London, UK, explains that these populations are the biggest opportunity for lower the global instance of dementia.
“Interventions are likely to have the biggest impact on those who are disproportionately affected by dementia risk factors, like those in low- and middle-income countries and vulnerable populations, including Black, Asian and Minority Ethnic communities,” Livingston said [2].
She stressed the importance of going beyond simply promoting good health to prevent dementia, and instead address the inequalities that exist within our society that put certain individuals at a greater risk for developing the condition.
“Our report shows that it is within the power of policy-makers and individuals to prevent and delay a significant proportion of dementia, with opportunities to make an impact at each stage of a person’s life,” she explained [2].
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A New Approach to Preventing Dementia
Livingston explained that the risk of developing dementia can be reduced. It’s achieved by creating active and healthy environments for communities where physical activity is the norm, healthy diets are accessible, and where alcohol is minimized.
The authors outlined nine ambitious recommendations for policy makers and individuals to help prevent dementia:
- After 40, Individuals should aim to keep their systolic blood pressure at 130 mm Hg or less.
- Individuals should reduce hearing loss by protecting ears from excessive noise, and should wear a hearing aid if they are already experiencing hearing loss.
- Reduce exposure to air pollution and second hand smoke.
- Prevent head injuries (this should be addressed in particular for high-impact sports and jobs where there is a greater risk for head injury)
- Limit alcohol use (more than 21 units per week is associated with an increased risk of dementia)
- Don’t smoke. For those who already smoke, have support programs in place to help them quit.
- Provide all children with primary and secondary education.
- Reduce obesity and diabetes, and sustain physical activity through mid and later life.
- Address the societal inequalities that put some at greater risk for developing dementia [3].
Addressing Low Income Countries
Report co-author, Professor Adesola Ogunniyi, University of Ibadan, Nigeria, says that because there is a greater prevalence of dementia risk factors in low and middle-income countries, an even greater proportion of the condition is likely preventable than in higher-income countries.
“In this context, national policies addressing dementia risk factors, like primary and secondary education for all and stopping smoking policies, might have the potential for large reductions in dementia and should be prioritized,” she said [2].
She added that there is a need for more dementia research in low and middle-income countries. This is so the specific risks to those people can be better understood.
Recommendations for Individuals with Dementia
At the end of the report, the authors also provide recommendations for people who are already affected by the condition, and they include the following:
- Providing holistic care after diagnosis that addresses physical and mental health, social care, and support.
- Keep people with dementia physically healthy because it is important for their cognition.
- Use psychosocial interventions that are tailored to the patient’s needs to manage neuropsychiatric symptoms [3].
The authors also noted that people with dementia have died disproportionately in the COVID-19 pandemic, because they tend to have more pre-existing health conditions that put them at risk for contracting the disease, and may have more difficulty adhering to social distancing and safety guidelines [3].
These new findings are an encouraging step forward in the fight against dementia. Many of the factors that would put someone at risk of developing the condition are highly preventable. Now, it is up to individuals and policymakers to take the appropriate action to reduce or eliminate these risk factors. Dementia is preventable in every population.
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