Tens of thousands of cases could be prevented each year by making simple lifestyle changes. One of the biggest studies carried out revealed that 40 percent of all dementia cases could be averted or delayed if the dozen dangers are avoided. The key factors include excessive drinking in mid-life and exposure to air pollution in later life. It means 83,840 of the UK’s 209,600 annual cases of the incurable brain disease, equivalent to a diagnosis every three minutes, could be halted.
Dr Rosa Sancho, of Alzheimer’s Research UK, said: “This is the most comprehensive overview into dementia risk to date.
“With no treatments yet able to slow or stop the onset of dementia, taking action to reduce risks is an important part of our strategy for tackling the condition.
“While there’s no sure-fire way of preventing dementia, the best way to keep your brain healthy as you age is to stay physically and mentally active, eat a healthy balanced diet, do not smoke, drink only within the recommended limits and keep weight, cholesterol and blood pressure in check.”
Findings by world-renowned experts on the Lancet Commission on Dementia Prevention, Intervention and Care – presented at the Alzheimer’s Association International Conference – show the harrowing condition is potentially avoidable. The report was compiled by 28 dementia experts and builds on the nine risk factors identified by the Lancet Commission in 2017.
Those threats already identified include hearing loss, smoking, poor education in early life, high blood pressure, inactivity, obesity, depression, diabetes and isolation. These are associated with 34 percent of all dementia cases.
The three new risk factors identified by experts – excessive drinking in mid-life, suffering a head injury in mid-life and exposure to polluted air in later life – were linked with six per cent of all dementia cases.
Taken together, experts say simple lifestyle changes have the potential to eliminate more than one in three cases of the cruel condition.
Experts have now demanded a shift in public perception that dementia is not simply a disease that people get in old age but something that can be protected against.
The findings also prompted a funding plea to ensure the UK stays at the forefront of efforts to find a cure.
Professor Bart De Strooper, director of the UK Dementia Research Institute, said: “We are gradually uncovering the molecular processes that go awry in neurodegenerative disorders and we need to use that knowledge to develop effective treatments.
“Ultimately, new medicines and interventions are needed if we really want to control the various diseases that lead to dementia.
“With the right infrastructure and funding, we will be able to fundamentally change the prospects of individuals at risk.”
Fiona Carragher, of Alzheimer’s Society, said: “We can take action now to tackle the risk factors within our control, including excessive drinking, obesity and high blood pressure. Meanwhile, we need public health policies to address other factors, such as air pollution and inequalities in childhood education.
“This Lancet Commission update must spur action from the Government. Greater investment in high quality, in-depth research will help inform how we can effectively tackle these risk factors and is vital if we are to buck the trend of increasing dementia cases.”
Prof Gill Livingston, of University College London and the study’s lead author, said: “Our report shows it is within the power of policy makers and individuals to prevent and delay a significant proportion of dementia, with opportunities to make an impact at each stage of a person’s life.
“We need to think beyond promoting good health to prevent dementia and begin tackling inequalities to improve the circumstances in which people live their lives.
“We can reduce risks by creating active and healthy environments for communities, where physical activity is the norm, better diet is accessible for all, and exposure to excessive alcohol is minimised.”
Prof Clive Ballard, dean and pro-vice chancellor of the University of Exeter, said: “Our findings present an exciting opportunity to improve millions of lives by preventing or delaying dementia through healthier lifestyles.”
He said it should “include more exercise, being a healthy weight and stopping smoking, and good medical treatment of risk factors like high blood pressure.This analysis shows there’s real potential to improve brain health by taking action here in the UK.”
The UK Dementia Research Institute, a collaboration between six British universities, is in a race against time to develop a “disease modifying” therapy to treat the causes of the incurable condition. It said it desperately needs more cash.
Chief operating officer Dr Adrian Ivinson said: “We know the steps required to conquer dementia. “We must dramatically increase the basic research required to better understand the causes and translate that understanding into drugs, tests and services.”
High blood pressure
Persistent midlife hypertension is linked to dementia. Midlife hypertension, from the age of 40, was associated with reduced brain volumes. Blood pressure declines in later life and this is linked to and, potentially caused by, development of dementia. Experts say people should aim to maintain systolic blood pressure of 130mm Hg or less.
The habit is one of the biggest causes of death and illness in the UK with around 78,000 dying and many more living with debilitating illnesses. Smoking increases the risk of developing more than 50 serious health conditions. Kicking the habit would account for five per cent of the total number of dementia cases that could be prevented, according to experts.
Addressing hearing loss may help protect the brain. It could account for eight per cent of the number of new dementia cases that could be prevented. Wearing hearing aids could be protective. People experiencing hearing problems should get tested in mid-life.
Adults aged between 18-64 are advised do at least 150 minutes of moderate-intensity physical activity each week or at least 75 minutes of vigorous-intensity physical activity. Weekly midlife moderate-to-vigorous physical activity (breaking into a sweat) has been associated with reduced dementia risk over a 25-year period. Exercising could account for a two per cent reduction in dementia cases.
Access to primary and secondary education should be a birthright. But many in developing nations and especially those in lower social and economic classes do not receive it. Higher childhood education levels and lifelong higher educational attainment reduce risk. Overall cognitive ability increases with education before reaching a plateau in late adolescence.
Loneliness, particularly in old age, is a serious and deadly. Social contact, now an accepted protective factor, encourages beneficial behaviour. Most people in later life are married but disproportionate numbers of women are widowed as they outlive their husbands, reducing social contact. Marital status is seen an important contributor to social engagement.
A UK study following 10,189 people found symptoms increase dementia risk in later life. A 14-year study of 4,922 healthy men aged 71-89 found depression was linked with 1.5 times the incidence of dementia. This was accounted for by people developing dementia within five years of depression. Antidepressants did not reduce the risk.
Experts advise against taking jobs in high-risk occupations. In a study published last year former professional footballers were found to have a threeand-a-half times higher rate of death due to neurodegenerative disease. Ex-England and West Brom star Jeff Astle developed dementia and died at 59. An inquest found heading balls during his career caused repeated head trauma.
The Type 2 strain, largely brought on by unhealthy diets, is a clear risk factor for dementia. But it is unknown whether any particular medication reduces this risk. Intensive diabetic control does not decrease the risk of dementia. Almost four million people are now blighted by the disease with that number set to rocket to 5.5 million by 2030. It can lead to blindness, amputations, heart disease and kidney failure, with a new diagnosis made every three minutes.
This is associated with various poor health outcomes, including those related to noncommunicable diseases. Animal models suggest airborne pollutants accelerate neurodegenerative processes through brain and heart disease. This is of concern to those who live in built-up areas or near major roads. Experts advise people to cut exposure to air pollution and tobacco smoke.
One-third of adults are classed as clinically obese with a body mass greater than 30. It has forced PM Boris Johnson to launch a war on obesity. Analysis of 20 studies with more than 1,000 overweight adults without dementia, and an average age of 50, found weight loss of 4.4lb or more in people with a body mass greater than 25 was linked to a significant improvement in attention and memory.
Experts recommend limiting drinking to less than 21 units per week – more than the current UK guideline of no more than 14 units a week. That is equal to six pints of average-strength beer or 10 small glasses of low-strength wine. A 750ml bottle wine contains 10 units. The idea of counting alcohol units was introduced in 1987 to help people keep track of their drinking. Most say they pay no attention.
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