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Global Health
September 15, 2020

Nearly Half of Dementia Cases Could Be Prevented or Delayed

JAMA. 2020;324(11):1025. doi:10.1001/jama.2020.16210

International dementia experts have expanded their list of risk factors that, if reduced or eliminated, could prevent or delay 40% of dementia cases worldwide.

International experts have identified 12 modifiable risk factors that could prevent or delay dementia.

In its 2017 report, The Lancet Commission on Dementia Prevention, Intervention, and Care identified 9 preventable risk factors for dementia: having little or no education, hypertension, untreated hearing impairment, smoking, obesity, depression, physical inactivity, diabetes, and low social contact. Since then, the commission has reported that emerging evidence points to 3 more preventable dementia risk factors: head injuries or excessive alcohol consumption in midlife and air pollution exposure in later life.

To prevent or delay dementia, the commission recommended that countries provide primary and elementary education for all children, take steps to prevent obesity and diabetes, and reduce air pollution and secondhand smoke exposure. They also recommended programs to prevent smoking initiation, hearing loss, and head injuries, and to encourage hearing aid use and smoking cessation. Additional preventive measures include maintaining systolic blood pressure of 130 mm Hg or lower in midlife, limiting alcohol to fewer than 21 servings per week, and maintaining an active lifestyle.

“Interventions are likely to have the biggest impact on those who are disproportionately affected by dementia risk factors, like those in low- and middle-income countries and vulnerable populations, including Black, Asian and minority ethnic communities,” Gill Livingston, MD, chair of the expert panel and professor of psychiatry of older people at University College London, said in a statement. It’s time to “begin tackling inequalities to improve the circumstances in which people live their lives,” she added.

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