In a recent publication in The Lancet eClinicalMedicine, researchers at Cambridge Public Health have identified 26 evidence-based interventions for reducing population dementia risk. With global prevalence of dementia predicted to almost triple by 2050, the study underscores the urgency of implementing population-level interventions.
While individual-level interventions have dominated policy and research spheres, this research fills a critical gap by examining policies and interventions designed to reshape societal conditions to curb the development of dementia.
Analysing 135 articles from both high and low-middle-income countries, the study focuses on 12 modifiable risk factors outlined by the Lancet Commission on dementia (2020): low educational attainment, hearing loss, traumatic brain injury, hypertension, excess alcohol, obesity, tobacco smoking, depression, social isolation, physical inactivity, air pollution, and diabetes.
The findings underscore the effectiveness of 26 population-level interventions in reducing the prevalence of nine of the 12 identified risk factors, with less evidence available for diabetes, depression or social isolation. These interventions span fiscal measures (e.g., removing primary school fees), marketing/advertising (e.g., plain packaging of tobacco products), availability improvements (e.g., cleaner fuel replacement programmes for cooking stoves), and legislative actions (e.g., mandated provision of hearing protective equipment at noisy workplaces).
Using this evidence, the authors have derived a comprehensive population-level intervention framework for dementia risk reduction, containing 26 high- and moderate-confidence policy recommendations. Additionally, the study provides accompanying information and resources for policymakers to implement these recommendations in their own contexts.
The central message of this review is clear: ample evidence exists to address a major global public health challenge. The policies and interventions recommended have relevance at all levels of government, in both high-income and low-middle income countries – the time for policy action is now.