A new report shows that about one-third of the world’s dementia and Alzheimer’s cases are preventable by addressing several factors, such as hypertension, diet, hearing loss, education, and depression, early in life. The new report was presented Thursday at the Alzheimer’s Association International Conference in London and was published Wednesday in The Lancet.
Over 50 million people in the world have dementia, and experts believe the number could triple by 2050. The cost of caring for these patients could be as high as $818 billion.
A team of researchers identified nine potentially modifiable health and lifestyle factors that affect people over the course of their lifetimes, and which, if eliminated, could prevent dementia and Alzheimer’s.
Nine potentially modifiable factors could prevent dementia and Alzheimer’s
The report was conducted by the first ever Lancet Commission on Dementia Prevention and Care, which was made up by 24 experts from different countries. According to the experts, most of the preventable factors present themselves during childhood, and they continue to be present over the course of a person’s lifetime.
However, the researchers said if these factors were addressed, about 35 percent of people with dementia and Alzheimer’s disease could retain their memories and body functions that are affected by these diseases.
The experts listed nine preventable risks factors that present themselves during a person’s lifetime: years of education before age 15, hypertension, obesity and hearing loss in middle age, and physical inactivity, social isolation, depression, smoking, and diabetes in late life. In the report, each factor was carefully analyzed separately, though the researchers also looked at how they relate to one another to estimate how much modification of each could potentially affect an individual’s dementia risk.
The Commission concluded that there must be a considerable effort to prevent these factors. The experts believe that doctors, communities, and governments worldwide should implement measures like universal preschool, senior visiting clubs, cities should be rebuilt to encourage physical activity, and preventive health care should be expanded.
While the Commission admits such an effort would be next to impossible, it would be worth it, and millions of people would get benefits from these changes.
Treating dementia requires a combination of drugs and lifestyle changes
Previous studies indicate that controllable lifestyle factors could be crucial to reducing the risk of cognitive decline. The researchers noted that, much like with heart disease, combating cognitive decline diseases likely requires a multipronged approach that combines drugs and lifestyle changes.
Dr. Lon Schneider, a professor of psychiatry and behavioral sciences at the Keck School of Medicine at the University of Southern California and co-author of the new report, said that conditions like dementia “are not immutable” and could be substantially modified by the environment, specifically by the nine factors cited above.
“Compare that to how we’re developing drugs to treat dementia,” said Schneider, according to The Washington Post. “Dementia is not a condition that’s ever going to be such that a single drug can be considered a cure for the illness.”
Schneider noted that lifestyle modification is practically inexpensive and that reducing the risk of these diseases by 35 percent is far larger than anything you could ever expect for drugs.
To compile the report, the experts produced a sort of roadmap to reducing the global burden of dementia, said Schneider. They found that there are several “roads” that influence these conditions. For example, out of all the midlife preventable factors, hearing loss –which is fixable- increases the risk of dementia by 9 percent.
In fact, Schneider noted there’s even a possible link between air pollution and Alzheimer’s disease, as a recent study found. However, that study was released recently and couldn’t be included in the Lancet Commission’s report.
New randomized trial will assess how lifestyle changes can prevent cognitive decline
Earlier last month, another report by the National Academies of Sciences, Engineering, and Medicine also looked at how lifestyle changes could prevent dementia. But the researchers cautioned that evidence of the lifestyle changes’ efficacy derived from randomized trials that remain relatively limited and have significant shortcomings.
That report found but three types of modifications that offered “encouraging but inconclusive evidence”: cognitive training increased physical exercise and blood pressure management for hypertension. The report was sponsored by the National Institute on Aging.
The report was also presented at the Alzheimer’s Association International Conference by Ronald C. Petersen, director of the Mayo Clinic Alzheimer’s Disease Research Center. According to Petersen, large trials that are currently ongoing or that will start soon could provide more evidence regarding the effects of lifestyle modifications.
During the conference, it was announced that in 2018, the Alzheimer’s Association plans to kick off a $20 million two-year clinical trial to assess whether lifestyle modifications can indeed prevent cognitive decline.
Source: The Washington Post