Dementia prevention… a reality on the horizon

Eliminating 14 risk factors for dementia could reduce up to 45% globally.

If a drug that promised up to a 45% chance of preventing dementia, pharmacies around the country would be mobbed! But the new Lancet Commission on Dementia prevention, intervention and care report, released in July 2024 has modelled that eliminating 14 risk factors for dementia could reduce up to 45% of dementia cases globally.

They reported that for the first time it is clear that risk can be modified, even for people with a genetic predisposition to dementia.

The original Lancet Commission report on dementia risk factors was released in 2020. Over the last four years, results of new studies have been critiqued and collated, combining results from high quality, rigorous studies (a process called meta-analyses) to give results from millions of participants. For example, when combined, the sixteen studies on the relationship of weight and cognitive impairment had over 5 million participants!

Combining and comparing studies tells an increasingly compelling story of how we build physical and cognitive reserve over our entire life span, and how our environment, lifestyle and access to health care reduces or increases our risk of dementia.

We tend to think of dementia as a disease of older age. However, dementia arises as an accumulation of exposure to risk factors over life – some factors are under our own control, some are not. For example, educational attainment from early in life appear to build brain ‘reserve’ and particulate air pollution in home and external environment is increasingly linked to dementia risk.

Mid-life is a critical time to reduce or eliminate risk factors to live into a healthier old age.
Quitting smoking, eliminating excessive alcohol consumption, addressing weight, obesity and physical inactivity, treating hearing loss, depression, diabetes, high blood pressure, protecting your head – such as seatbelt use when driving and helmet use for bicycle riding or contact sports– and engaging in social activity and cognitively demanding activity – are protective.

In the report, new evidence for two other risk factors emerged including untreated vision loss; and
high LDL cholesterol. The report emphasises a combination of personal action as well as change at national and international government levels is needed to address risk factors across populations and ensure groups at high risk or disadvantage are included.

The risk factors outlined in the report not only address dementia risk, but will have broad positive effects across many other health conditions and social issues.

Article reference
Dementia prevention, intervention, and care: 2024 report of the Lancet standing Commission. Lancet. 2024 Aug. doi: 10.1016/S0140-6736(24)01296-0.