The 2020 report of the Lancet Commission on Dementia Prevention, Intervention, and Care lists 12 modifiable risk factors that could help prevent dementia. This new report provides some important updates to the previous document, published in 2017.

The 2017 report had already recognized that acting on certain modifiable factors could help reduce a person’s risk of developing dementia. These factors are:

  • a lower level of education
  • hearing loss
  • hypertension
  • obesity
  • smoking
  • depression
  • low social contact
  • physical inactivity
  • diabetes

To the original nine factors, the new report has added 3 more:

  • head injuries
  • excessive alcohol intake
  • air pollution

Head injuries – Traumatic brain injuries are usually caused by car, motorcycle, and bicycle accidentes; military exposures; firearms; boxing, horse riding, and other recreational sports, most of them occurring during midlife. Falls are the most common cause of brain injuries later in life.

Excessive alcohol intake – Even though it has been previously shown that low doses of alcohol can prevent cardiovascular diseases, heavy drinking is associated with brain changes, cognitive impairment, and dementia – a risk known for centuries. Drinking more  than 21 units of alcohol per week (1 unit of alcohol=10 ml or 8 g pure alcohol) is  associated with a high  risk of dementia. 

Air pollution – Airborne particulate pollutants accelerate neuro- degenerative processes through cerebrovascular and cardiovascular disease, Aβ deposition, and amyloid precursor protein processing. High nitrogen dioxide (NO2) concentration, fine ambient particulate matter (PM)  from traffic exhaust and PM  from residential wood burning are associated with increased dementia incidence.

Together, the 12 modifiable risk factors account for around 40% of worldwide dementias, which consequently could theoretically be prevented or delayed. 

It is clear that the contribution of risk factors to the development of dementia begins early and continues throughout life, so it is never too early or too late to initiate any measures that will mitigate the negative effect of the 12 risk factors. Changes in any risk factor alone can prevent or delay dementia symptoms and should always be encouraged.

What can be done?

Preventive actions require both policy and individual engagement. Public health programs should be developed to increase social, cognitive and physical activities and to improve cardio-vascular health.  

Furthermore, the entire food system (including production and marketing) should be revised and changed: the goal is to stimulate the consumption of natural and nutritious foods and to reduce the consumption of sugary and ultra-processed foods.

Public health programs should be offered to the general population (with special attention to high-risk groups), including:

  • hypertension and diabetes treatment in midlife
  • prevention of head injury through traffic awareness campaigns and use of safety equipment at work and sports
  • support smoking cessation
  • reduce air pollution, promoting use of bicycles and public transport. Reduce second-hand tobacco smoke exposure.
  • encourage use of hearing aids for hearing loss and reduce hearing loss by protection of ears from excessive noise exposure
  • provide all children with primary and secondary education
  • support treatment and prevention of depression
  • limit alcohol intake.

At individual level, a healthy lifestyle including a balanced diet, regular physical activity, social and intellectual activities throughout life and prioritizing contact with nature should be sought. 

Conclusion: At this point the project “Knowledge stops Dementia” can help by keeping you up to date on what is known and new about dementia prevention and treatment! On our webpage you find an increasing amount of information covering the topics above, hopefully supporting you in the implementation of personal measures for prevention and recovering.

We are happy to support you in living a healthy life and minimising your personal risk of dementia. At the same time, we also offer support for your loved ones who are already suffering from some form of dementia. Don’t forget to register for our newsfeed! Not only you but also your children and grandchildren can only win!

Photo by Deva Darshan on Unsplash

Reference:

Livingston G, Huntley J, Sommerlad A, et al. Dementia prevention, intervention, and care: 2020 report of the Lancet Commission. Lancet. 2020;396(10248):413-446.

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