Reducing the risk of dementia: can we prevent almost 50% of cases?

4.4 min readPublished On: 25. September 2024By Categories: Prevention

On September 21, 2024, World Alzheimer’s Day, the global community once again focused on raising awareness of dementia and its far-reaching consequences. The number of people living with dementia is increasing worldwide, but an effective drug solution remains elusive.

Against this background, the current report of the Lancet Commission on Dementia Prevention, Intervention and Care particularly relevant.
This comprehensive update of the Commission’s previous reports emphasizes the importance of prevention strategies to reduce the risk of dementia. The 12 risk factors known to date, which were already reported in 2020 [1], include:

  1. Low education
  2. Head injuries
  3. Lack of exercise
  4. Smoking
  5. Excessive alcohol consumption
  6. High blood pressure
  7. Obesity
  8. Diabetes
  9. Hearing loss
  10. Depression
  11. Social isolation
  12. Air pollution

The current report from 2024 [2] also identifies two new modifiable risk factors for dementia: Visual impairment and high cholesterol bringing the total number of risk factors to 14.

Untreated visual impairment is particularly emphasized in the report, as it can severely impair the affected person’s social engagement and cognitive stimulation, which in turn increases the risk of dementia.
Timely treatment of vision problems could therefore not only improve quality of life, but also reduce the risk of dementia.
According to the Commission’s calculations, there would be 2% fewer cases of dementia without the risk factor of vision loss.

High cholesterol, or more precisely high LDL cholesterol in the serum, was also defined as a new risk marker.
This plays a significant role in the promotion of vascular disease, which according to the Commission’s calculations is associated with a 7% higher risk of dementia.

According to the Commission’s model calculations, a total of 45% of dementia cases could theoretically be avoided if all 14 risk factors were eliminated. Conversely, this means that a targeted reduction of these factors has the potential to prevent or at least delay dementia. The Lancet Commission therefore recommends that risk reduction measures should begin early in life and be continued on an ongoing basis.

What specifically should be done?

The Lancet Commission appeals to national and international institutions to offer public health programs for the general population with a special focus on high-risk groups. This includes a comprehensive catalog of measures, which is highlighted below.

Promotion of high-quality education: High-quality education should be made available to all children from an early age in order to reduce the risk of dementia in the long term.
This also includes the promotion of cognitively stimulating activities in middle age.

Early detection and treatment of hearing and vision loss: Hearing loss and visual impairments should be recognized and treated at an early stage. Hearing aids and visual aids must be accessible to all, and noise protection measures are essential to prevent hearing damage.
These measures can help to minimize social isolation and cognitive impairment.

Detection and treatment of depression: Early detection and treatment of depression, even in childhood and adolescence, should be supported in order to reduce the risk of later cognitive disorders.

Fo promote physical activity and protect against head injuries: Physical activity should be promoted in kindergartens and schools, as it is an important protective factor against dementia. In addition, protective measures against head injuries, such as compulsory helmets in certain sports and safety equipment at work, should be established.

Measures to reduce smoking and alcohol abuse: Price controls, smoking bans in public places and smoking cessation programs should be implemented to reduce the risk of dementia from smoking. Similar measures to reduce alcohol abuse are equally important.

Prvention and treatment of cardiovascular diseases: Control of blood pressure, LDL cholesterol and body weight as well as prevention and early treatment of diabetes should be promoted from middle age to prevent vascular damage and reduce the risk of dementia.

Promoting age-friendly communities: Building communities that promote social participation and activities is crucial to prevent social isolation, which is considered a risk factor for dementia.

Reducing air pollution: National and international measures to reduce air pollution should be taken to reduce the risk of dementia and promote general health.

What can each individual do?

A closer look at the list of risk factors shows that many of them are preventable (e.g. smoking, lack of exercise, alcohol consumption), or at least treatable (e.g. poor eyesight and hearing loss, depression, social isolation). Due to the plasticity of the brain (= remodeling of neuronal structures depending on their activity, i.e. expansion/improvement of brain functions when stimulated), a lower level of education could also be counteracted in adulthood with appropriate brain training.

The list also includes the “diseases of civilization” diabetes, obesity, high blood pressure and high blood lipids – all pathological changes that are linked to each other as part of the metabolic syndrome and are usually caused by an unhealthy lifestyle. This illustrates once again that dementia is not a disease of the brain, but a generalized metabolic disease with many causes.

With this knowledge, each individual is able to actively and preventively make good decisions for their own brain health by avoiding or minimizing as many of these risk factors as possible. This can be achieved through a healthy lifestyle that includes a brain-healthy diet, regular physical activity, stress reduction, sufficient sleep, social and intellectual activities and contact with nature.

A diagnostic assessment by means of a holistic laboratory diagnostic examination from the age of 45, the so-called cognoscopy to identify the individual risk factors that endanger your personal brain health. The latter is particularly recommended if you already have cases of dementia in your family.

Conclusion:

The message of this year’s Lancet Commission report is: Dementia prevention is possible!
In addition to avoiding the 14 identified risk factors, you can actively strengthen your brain health by adopting a healthy lifestyle, as described on our website and in the foundation’s project
Knowledge stops Dementia is recommended. Dementia does not just start in old age, but the ground for it is prepared at a young age through an unhealthy lifestyle and negative environmental influences. The good news is that dementia does not have to be a fate, but it is in your hands to recognize risk factors and actively prevent it.

World Alzheimer’s Day
World Alzheimer’s Day was established in 1994 by Alzheimer’s Disease International(ADI) with the support of the World Health Organization (WHO) was launched. ADI, the international association of Alzheimer’s societies in 95 countries, coordinates the activities worldwide.

 

References:

  1. Livingston, G., Huntley, J., Sommerlad, A., Ames, D., Ballard, C., Banerjee, S. et al. (2020). Dementia prevention, intervention, and care: 2020 report of the Lancet Commission. The lancet,396(10248), 413-446.
  2. Livingston, G., Huntley, J., Liu, K. Y., Costafreda, S. G., Selbæk, G., Alladi, S., et al. (2024). Dementia prevention, intervention, and care: 2024 report of the Lancet standing Commission. The Lancet,404(10452), 572-628.

Photo by GR Stocks on Unsplash

Individual Alzheimer's prevention is possible: carry out a cognoscopy in time
Ein Laib BrotFrom bread to dementia