What if I told you we could cut dementia rates across the world by a whopping third?
We can. And it has little to do with genetics, and everything to do with how we live.
The Lancet Commission on Dementia Prevention, Intervention and Care recently released online a comprehensive report on the evidence for reducing dementia risk as well as caring for those with such disorders. When it comes to prevention, their exhaustive analysis of the existing literature led them to conclude that a combination of 9 modifiable risk factors currently account for approximately 35% of dementia cases worldwide.
They point out that conversely eliminating the APO-E4 allele, the gene most closely associated with increased risk, would only eliminate approximately 7% of dementia cases worldwide.
What are the 9 risk factors?
Education. Elementary school education to approximately 11 or 12 years of age was found to potentially be one of the most effective ways to reduce worldwide dementia rates (8%). Higher levels of education are thought to be associated with increased cognitive reserve and reduced dementia risk.
Hypertension. Better control of high blood pressure in midlife matters, however ranked lower in percentage of cases reduced.
Obesity. Reduction of obesity in midlife also significantly reduced dementia risk, however also ranked lower in percentage of cases eliminated.
Hearing Loss. Addressing hearing loss, a highly modifiable risk factor, could reduce population risk by as much as 9%.
Late-life Depression. Depression in older age was found to account for 4% of dementia cases.
Diabetes. While significant, better control of diabetes was reported to reduce dementia cases by only about 1%.
Physical Inactivity. Lack of exercise was reported to account for 3% of dementia cases. Older adults who regularly exercise is significantly more likely to maintain cognitive performance over time.
Smoking. Researchers concluded that elimination of smoking could reduce dementia prevalence by 5% worldwide.
Social Isolation. Social isolation was seen as not only a primary risk factor, but also a secondary one due to its impact on other modifiable factors such as cognitive activity and mood, which the researchers conclude “highlights the importance of considering the social engagement of older people and not only their physical and mental health.”
Read the full Lancet Dementia 2017 Commission:
The Lancet: Dementia prevention, intervention, and care
What’s the takeaway? Clearly this study compels a closer look by the scientific and public policy communities at what preventative measures are really most effective in reducing dementia risk. Educating the public to the cognitive risks associated with providing ways to better cope with lifestyle factors such as hearing loss, depression and social isolation are critical to address, as are public policy matters such as education and smoking. This study also suggests that focusing on primarily on cardiovascular or genetic factors simply may not do enough to eradicate dementia in our lifetime.
Our TBH programs, such as our TBH BRAIN WORKOUT Toolkit courses, have always emphasized a comprehensive approach to brain fitness by teaching better management of these modifiable factors through wellness, socialization and resilience. It is heartening to see studies like this confirm our commitment teaching brain wellness in a way that makes a difference.