Working on 12 modifiable aspects of life could prevent or delay 40% of dementia cases, according to to a relationship of the Lancet Commission on dementia prevention, intervention and care which has recently been enriched and updated. If on some risk factors that predispose you to develop dementia, like the genetic ones, we cannot intervene, we can instead work on the lifestyle.
Let’s focus on this. An earlier version of the analysis argued that about one-third of the world’s cases of dementia are preventable or delayed by intervening on new risk factors: reduced education, hypertension, premature hearing loss, smoking, obesity, depression, physical inactivity, diabetes, poor social contacts. The 2020 edition of the report adds three more: excessive alcohol consumption, exposure to head injuries, air pollution.
Taken together, addressing these 12 modifiable factors could prevent 40% of dementia cases, or at least delay them. There is therefore ample scope for action, in particular – underlines the study – in middle and low-income countries where cases of dementia are increasing more rapidly, thanks to the spread of some of the risk factors mentioned (low schooling, loss of hearing and diseases linked to malnutrition, such as hypertension, diabetes and obesity).
Start immediately. Perhaps most interesting from the study is that it is never too early or too late to prevent the risk of dementia. As the authors of the study write, the risks that can be placed at a young age, before the age of 45 – such as less schooling – affect cognitive reserve, that is, on the brain’s ability to recover from brain damage. The factors that distinguish middle age and old age affect cognitive reserve and can also trigger neuropathological developments.
The three new risk factors found are associated, overall, with 6% of total dementia cases; 3% is attributable to brain injuries during middle age – for example those associated with dangerous jobs; 1% of cases are related alcohol consumption greater than 21 units (one alcohol unit is that contained in a glass of wine or a can of beer) per week; 2% exposure to air pollution, especially in old age.
Always the same point. People at risk of dementia are also particularly exposed to the risk of CoViD-19 due to age, previous illnesses and difficulties in adhering to preventive measures, such as physical distancing. Acting on poverty and inequality (for example, promoting quality education for all, especially in countries where school is not prioritized, or guaranteeing the possibility of proper nutrition) would also make it possible to benefit from the prevention of dementia.
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