Nearly half of dementia cases could be prevented or delayed by tackling 14 risk factors starting in childhood, including two new risks – high cholesterol and vision loss.
Nearly half of dementia cases have been attributed to 14 modifiable risk factors, which have their roots in early life and develop throughout life. Addressing these risk factors in effective ways at all life stages could therefore prevent or delay a significant number of dementia cases, even as people around the world live longer, according to the third Lancet Commission report on dementia prevention, intervention, and care.
Based on the latest available evidence, the report adds two new risk factors that are associated with 9% of all dementia cases — with an estimated 7% of cases attributable to high low-density lipoprotein (LDL) or “bad” cholesterol in midlife from around age 40 years, and 2% of cases attributable to untreated vision loss in later life.
These two new risk factors are added to 12 risk factors previously identified by the Lancet Commission report in 2020 (less education, hearing impairment, high blood pressure, smoking, obesity, depression, physical inactivity, diabetes, excessive alcohol consumption, traumatic brain injury, air pollution and social isolation), which are linked with 40% of all dementia cases.
The report estimates that the risk factors associated with the greatest proportion of people developing dementia in the global population are hearing impairment and high LDL cholesterol (7% each), along with less education in early life and social isolation in later life (5% each).
The Commission, authored by 27 world-leading dementia experts, including Professor Carol Brayne and Dr Sebastian Walsh from Cambridge Public Health, building on foundational work from Professor Brayne’s group, calls for governments and individuals to be ambitious about tackling risks across the life course for dementia.
Professor Carol Brayne emphasised the importance of addressing these risks: “As populations age, it’s vital that we take steps to lower dementia risk. It’s important that this addresses how risk is associated with inequalities across the life course, influencing later life dementia risk. There is clear evidence showing dementia risk is higher for people from deprived backgrounds and some ethnic minority groups."
Dr. Sebastian Walsh expressed his views on the collective effort involved in the report: “It was a privilege to be part of the Lancet Commission, which incorporates work from Cambridge and around the world, to summarise the best available evidence for dementia prevention, as well as interventions and care to support people with dementia.”
In related research, the same team from Cambridge Public Health has recently published a study in The Lancet eClinicalMedicine, which identifies 26 evidence-based interventions for reducing population dementia risk. This work complements the current findings by providing actionable strategies to mitigate dementia risk at a population level and reduce health inequalities.
Read the full report from the Lancet Commission here: https://www.thelancet.com/commissions/dementia-prevention-intervention-care