A new report from the 2024 Lancet Commission has found nearly half of dementia cases could be prevented or delayed by addressing 14 risk factors starting in childhood, including two new risks – vision loss and high cholesterol.
Based on the latest available evidence, the report revealed 2% of all dementia cases are attributable to untreated vision loss in later life.
The 12 risk factors previously identified by the Lancet Commission in 2020 include lower levels of 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 commission, authored by 27 world-leading dementia experts, including Australian Professor David Ames from the National Ageing Research Institute and the University of Melbourne Academic Unit for Psychiatry of Old Age, calls for governments and individuals to be ambitious about tackling risks across the life course for dementia, arguing that the earlier risk factor levels can be addressed and reduced, the better.
The report outlines a new set of policy and lifestyle changes to help prevent and better manage dementia.
Among its recommendations to reduce the risk of dementia, the commission outlines the need for accessible screening and treatment for vision impairment for all.
“Our new report reveals that there is much more that can and should be done to reduce the risk of dementia. It’s never too early or too late to take action, with opportunities to make an impact at any stage of life,” lead author Professor Gill Livingston from University College London said.
“We now have stronger evidence that longer exposure to risk has a greater effect and that risks act more strongly in people who are vulnerable. That’s why it is vital that we redouble preventive efforts towards those who need them most, including those in low- and middle-income countries and socio-economically disadvantaged groups. Governments must reduce risk inequalities by making healthy lifestyles as achievable as possible for everyone.”
In a separate study published in The Lancet Healthy Longevity journal alongside the commission, Prof Livingston, lead author Dr Naaheed Mukadam, and co-authors modelled the economic impact of implementing some of these recommendations, using England as an example.
The study’s findings suggest that using population-level interventions of known effectiveness to address various dementia risk factors including excess alcohol use, brain injury, air pollution, smoking, obesity, and high blood pressure could achieve cost savings of more than £4 billion (AU$7.84b) and over 70,000 quality-adjusted life-year gains.
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