AAIC: Lancet Commission reveals a third of cases of dementia may be preventable – Alzheimer’s Society comment

The report includes new recommendations on both risk reduction and care interventions.  

1.  Risk reduction

The new report reveals that 35% of all dementia cases could be prevented if the following nine modifiable risk factors were fully eliminated – education, hearing loss, hypertension, obesity, smoking, depression, physical inactivity, social isolation and diabetes. This is compared to prevention of one in ten cases (7%) if we found a way to target the major genetic risk factor, ApoE4.

The three most common modifiable risk factors identified were poor early school education, hearing loss in mid-life and smoking.

Dr Doug Brown, Director of Research at Alzheimer’s Society, said:

'The revelation that over a third of dementia cases worldwide are, in theory, entirely preventable is cause for celebration.  But to achieve even close to this kind of reduction in cases we need to consider two important challenges - firstly how risk factors like education, obesity and depression apply not just at a population level, but to individual people who all have their own unique genetic risk profiles, and secondly how we can motivate people in mid to late life to change their behaviour and adopt healthier lifestyle choices.

'Not all of the nine risk factors identified are easily modifiable – factors like poor education and social isolation are incredibly challenging to address. But there are easier wins, particularly cardiovascular factors like lowering blood pressure and smoking cessation.

'Though it’s not inevitable, dementia is currently set to be the 21st century’s biggest killer. We all need to be aware of the risks and start making positive lifestyle changes. Understanding how to bring about changes in behaviour in people at risk of dementia should be a firm priority for future research and policy experts. The NHS Health check pilot we’re supporting, where GP practices are raising awareness of dementia risk reduction amongst people in midlife, is an important first step in raising public awareness and shifting behaviour.'

2.  Care interventions

The report concludes that we have made great strides in understanding how to support people to manage their dementia. With access to the right interventions we have the potential to transform the lives of people with dementia and their families by maximising cognition, decreasing distressing associated symptoms, reducing crises, and improving quality of life.

As the number of people with dementia rises, the global cost of dementia will continue to increase. Nearly 85% of costs are related to family and social care, rather than medical expenses, highlighting the urgent need to improve care across the globe.

Dr Doug Brown, Director of Research at Alzheimer’s Society, said:

'While global efforts largely focus on discovering a disease-modifying treatment for dementia by 2025, we must not overlook the importance of top quality care that enables people living with dementia now to have a better quality of life. The Lancet Commission shows that we are starting to understand what constitutes good care and how it can be delivered.

'Together, current treatments and non-drug interventions can help people to maximise their cognitive abilities, maintain independence for longer and help them cope with some of the more distressing symptoms of dementia, such as agitation and depression. We can also offer support to family carers to better handle the pressures of caring, which can reduce depression in the long term. If we put into practice everything we know and reduce the inequalities in accessing good care, we can make a significant difference to the lives of families affected by dementia.'