Modifying 12 risk factors over the lifecourse could delay or prevent 40% of dementia cases, according to an update to The Lancet Commission on dementia prevention, intervention, and care, which was presented at the Alzheimer's Association International Conference (AAIC 2020).
Led by 28 world-leading dementia experts, the report builds on the 9 risk factors identified in the 2017 LancetCommission, and provides an up-to-date analysis of the best evidence on the prevention of dementia.
Worldwide around 50 million people live with dementia, and this number is projected to increase to 152 million by 2050, rising particularly in low-income and middle-income countries (LMIC) where around two-thirds of people with dementia live.
To address dementia risk, the authors call for 9 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.
These actions are especially important in LMICs where dementia rates are rising more rapidly than in high-income countries.