Four in 10 dementia cases could be prevented or delayed

Modifying 12 risk factors from childhood to late life could delay or prevent 40% of dementia cases, according to a new report led by UCL researchers.
The study is an update to The Lancet Commission on dementia prevention, intervention, and care, and adds head injury and harmful alcohol drinking in mid-life, and air pollution exposure in later life, to the list of preventable causes of dementia.
Combined, the three new risk factors are associated with 6% of all dementia cases – with an estimated 3% of cases attributable to head injuries in mid-life, 1% of cases to excessive alcohol consumption (of more than 21 units per week) in mid-life, and 2% to exposure to air pollution in later life.
The remaining risk factors are associated with 34% of all dementia cases. The factors associated with the greatest proportion of dementia cases in the population are less education in early life, hearing loss in mid-life, and smoking in later life (7%, 8%, and 5%, respectively).
Led by 28 world-leading dementia experts, the report builds on the nine risk factors identified in the 2017 Lancet Commission, and provides an up-to-date analysis of the best evidence on the prevention of dementia. It calls for nations and individuals to be ambitious about preventing dementia and lays out a set of policies and lifestyle changes to help prevent dementia.
To address dementia risk, the authors call for nine ambitious recommendations to be undertaken by policymakers and by individuals: Aim to maintain systolic blood pressure of 130 mm Hg or less in midlife from around age 40 years; Encourage use of hearing aids for hearing loss and reduce hearing loss by protecting ears from high noise levels.; Reduce exposure to air pollution and second-hand tobacco smoke; Prevent head injury (particularly by targeting high risk occupations and transport); Prevent alcohol misuse and limit drinking to less than 21 units per week; Stop smoking uptake and support individuals to stop smoking (which the authors stress is beneficial at any age); Provide all children with primary and secondary education; Lead an active life into mid, and possibly later life; Reduce obesity and diabetes.
The report was presented July 30, 2020 at the Alzheimer’s Association International Conference (AAIC 2020).
Source: Dementia prevention, intervention, and care: 2020 report of the Lancet Commission. G Livingston, Jonathan Huntley, A Sommerlad, D Ames, C Ballard, S Banerjee, et al. The Lancet Commissions Online First 2020