A major study presented at the Alzheimer’s Association International Conference (AAIC 2024) and published in The Lancet suggests that nearly half of dementia cases could be prevented or delayed by addressing 14 modifiable risk factors throughout life.
As people live longer, the number of dementia cases is set to rise dramatically worldwide, making this research particularly urgent.
Dementia currently affects over 55 million people globally, a number expected to almost triple to 153 million by 2050. This increase is driven by an aging population and rising life expectancy, especially in low-income countries. The global cost of dementia-related health and social care exceeds $1 trillion annually.
The third Lancet Commission on dementia prevention, intervention, and care builds on previous findings, adding two new risk factors: high low-density lipoprotein (LDL) cholesterol and untreated vision loss.
High LDL cholesterol accounts for an estimated 7% of dementia cases starting around age 40, while untreated vision loss in later life accounts for 2% of cases.
These new factors are in addition to the 12 identified in 2020: lower levels of education, hearing impairment, high blood pressure, smoking, obesity, depression, physical inactivity, diabetes, excessive alcohol consumption, traumatic brain injury (TBI), air pollution, and social isolation. Together, these 14 risk factors contribute to nearly half of all dementia cases.
The study highlights that the risk factors with the greatest impact globally are hearing impairment and high LDL cholesterol (each contributing 7% of cases), less education in early life, and social isolation in later life (each contributing 5% of cases). Addressing these risks early and throughout life can significantly reduce dementia cases.
Professor Gill Livingston from University College London, the lead author, emphasizes the importance of tackling these risk factors early. The earlier we address and reduce these risk factors, the better the outcomes.
This approach includes both personal and policy changes, such as ensuring children receive quality education, providing hearing aids for those with hearing loss, detecting and treating high cholesterol, and making vision impairment treatments accessible.
The report underscores the need for more action worldwide to reduce dementia risks. In high-income countries like the U.S. and UK, the proportion of older people with dementia has declined, likely due to improved healthcare and lifestyle changes.
However, most national dementia plans do not address diversity, equity, or inclusion for people from underserved cultures and ethnicities, who are disproportionately affected by dementia risks.
The Lancet Commission outlines 13 recommendations for reducing dementia risk:
- Provide good quality education for all children and encourage cognitive activity in midlife.
- Make hearing aids available and reduce harmful noise exposure.
- Detect and treat high LDL cholesterol from around age 40.
- Ensure accessible screening and treatment for vision impairment.
- Treat depression effectively.
- Promote the use of helmets and head protection in contact sports and biking.
- Foster supportive community environments to increase social contact.
- Reduce exposure to air pollution with clean air policies.
- Expand measures to reduce smoking, such as price control and smoking bans.
- Reduce sugar and salt content in food.
- Encourage regular exercise and a healthy diet.
- Limit excessive alcohol consumption.
- Address and reduce obesity.
The study emphasizes that these actions can increase healthy life years and reduce the time spent in ill health for those who develop dementia.
A separate study published alongside the Commission’s report modeled the economic impact of these recommendations in England. The findings suggest that tackling dementia risk factors could save over £4 billion and result in significant health benefits.
Given the higher burden of dementia risk factors in low- and middle-income countries, there is an urgent need for policy-based preventative approaches. These measures could have substantial benefits, far exceeding the costs.
The report also highlights the need for advances in research and support for people living with dementia. Promising developments in blood biomarkers and anti-amyloid β antibodies for Alzheimer’s disease could improve diagnosis and treatment. However, more research is needed to understand the long-term effects of these treatments.
Support for people living with dementia and their caregivers is also crucial. Effective interventions known to benefit people with dementia, such as activity interventions and cholinesterase inhibitors, are often not available.
Caregivers’ needs, including emotional support and planning for the future, must be addressed.
In conclusion, addressing 14 modifiable risk factors from childhood onward can prevent or delay nearly half of dementia cases. This comprehensive approach requires both personal and policy changes to improve global health outcomes and reduce the burden of dementia.
If you care about dementia, please read studies about dietary strategies to ward off dementia, and how omega-3 fatty acids fuel your mind.
For more health information, please see recent studies about Choline deficiency linked to Alzheimer’s disease, and what to eat (and avoid) for dementia prevention.
The research findings can be found in The Lancet.
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