12 risk factors associated with 40% of cases of dementia

new To report From Lancet Committee on Dementia Prevention Identified 12 risk factors associated with 40% of all cases of dementia and added 3 new risk factors in the Commission’s initial 2017 To report, Sue Hughes Report Medscape..

Case Study: Keeping Dementia Patients Safe at Home and in Communities

Report details

A 2017 report identified nine modifiable risk factors estimated to account for one-third of all cases of dementia. The Lancet Commission included the same nine risk factors in its report this year, but the Commission updated the weighted population contribution attributable to the risk factors. they are:

• 8.2% of middle-aged hearing loss and dementia cases
• Secondary education has not been completed, accounting for 7.1% of cases.
• Late smoking, accounting for 5.2% of cases.
• Depression in later years, accounting for 3.9% of cases.
• Lack of exercise in later life, accounting for 1.6% of cases.
• Social isolation in later life, accounting for 3.5% of cases.
• Middle-aged hypertension accounts for 1.9% of cases.
• Diabetes in later life, accounting for 1.1% of cases. And
• Middle-aged obesity accounts for 0.7% of cases.

The committee also included three new modifiable elements in the updated report.

• Excessive alcohol intake in middle age, accounting for 0.8% of cases.
• Traumatic brain injury (TBI) in middle age, accounting for 3.4% of cases. And
• Air pollution in late years, accounting for 2.3% of cases.

The evidence behind new factors

Gil Livingston, Report Lead Author, and Professor University of LondonWhen the first report was published in 2017, the committee said, “Because there are nine risk factors, they are only part of the story, and some other factors are likely to be involved. I knew.” She added, “More public data is now being provided that provides sufficient evidence to justify the addition of the three new factors.”

Regarding alcohol consumption, “evidence is growing about the complex relationship between cognition and dementia outcomes and alcohol from various sources, including detailed cohorts and studies based on large records,” the report said. States. For example, the report states that one French study involving more than 31 million people who discovered alcohol use disorders was associated with a three-fold increase in dementia risk. However, the report also cites research showing that moderate alcohol consumption may reduce risk.

Livingston has declared that the committee is not saying “it’s bad to drink,” but saying it’s bad to drink more than 21 units. [of alcohol] one week. “

For TBI, this is commonly caused by vehicle injury, military exposure, firearms, falls, or recreational sports such as boxing or horseback riding. The report cites multiple national studies linking these injuries with a significant increase in the risk of long-term dementia.

Livingston said that, like alcohol consumption, the Commission does not “advise people to participate in sports because it is healthy to do so” rather than “to help people properly protect themselves. Encourage them to take precautions.”

On the other hand, regarding air pollution, animal studies have found that particulate pollutants in the air may accelerate the neurodegenerative process. In addition, high levels of nitrogen dioxide, as well as ambient particulate matter from the exhaust from the burning of traffic and residential firewood, are associated with an increase in dementia incidents, the report says.

How to reduce the risk of dementia

The report also lists nine recommendations from the Commission for Parliamentarians and individuals to reduce the risk of dementia, including individual population-based recommendations. At the population level, these recommendations include the following calls:

• Prioritize early childhood education.
• Implement social and public health policies that reduce the risk of high blood pressure.
• Develop policies that enhance social, cognitive, and physical activity throughout life.
• Assess the risk of people with hearing loss for life.
• Suppress TBI risk with relevant settings.
• Implement national and international policies to reduce public exposure to air pollution. And
• Strengthen national and international efforts to control exposure to smoking, reduce intake, and support smoking cessation.

For individuals, the Commission has asked people to:

• At the beginning of middle age, we aim to have systolic blood pressure below 130 mm Hg.
• Use hearing aids for hearing loss.
• Limit drinking to at least 21 units per week.
• Prevent head trauma at high risk to the individual.
• Quit smoking;
• It reduces obesity and diabetes by ensuring that healthy foods are available and allowing the environment to promote exercise. And
• Stay active in your life after middle age.

Livingston says these preventive efforts are especially important in low- and middle-income countries, where the incidence of dementia is increasing more rapidly than in high-income countries. “People in low- and middle-income countries are now living longer, have more dementia, and have a higher incidence of many risk factors, including smoking and lower education levels,” she said. “There is great potential for prevention in these countries.”

comment

Livingston also noted that since the first report was published, the evidence base supporting some of the original risk factors has increased, and that the Commission’s guidance has been fine-tuned.

For example, citing a study found to target a systolic blood pressure of 120 mmHg, Livingston said that the committee was previously “thought to be under 140” but now “130 Dementia to reduce the risk at less than.”

Similarly, with respect to early childhood education, she is well known that education for people under the age of 11 is associated with a reduced risk of dementia, but now education up to the age of 20 makes a significant difference. Is said to be able to bring.

Livingston also cited a new study showing that the use of hearing aids can counter the increased risk of dementia associated with hearing loss. Hearing loss “causes a significant amount in the case of dementia, as it has a high relative risk of dementia and is a common problem,” she said. “This is something that can be reduced relatively easily by actually encouraging the use of hearing aids. They need to be more accessible, more comfortable and more acceptable.”

Livingston also said that while studies on whether diet and sleep are associated with dementia have increased since the 2017 report was published, the Commission said, “We have accumulated enough to build up evidence. They were not included as risk factors in this year’s report because they didn’t think of them, and they are in the list of modifiable risk factors.”

Meanwhile, the Commission also included a section of the report on Covid-19, a disease caused by the new coronavirus, in people with dementia, due to age, comorbidities, and difficulties in social compliance. Pointed out that the risk of is particularly high. Distance requirements (fuse, Medscape, 8/3).