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Report suggests addressing these 14 factors to lower dementia risk
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Over 55 million people Dementia patients worldwideThat figure is expected to nearly triple by 2050. But a major report by 27 dementia experts says that almost half of cases could be prevented or delayed by addressing 14 risk factors, starting from early childhood and spanning the lifespan.
Wednesday, based on a review of the latest evidence. The Lancet Commission Report The Dementia Prevention, Intervention and Care report adds two new risk factors – high cholesterol and poor eyesight – to the 12 previously identified in the 2020 report. Existing risk factors include low education level, head trauma, physical inactivity, smoking, excessive alcohol consumption, high blood pressure, obesity, diabetes, hearing loss, depression, air pollution and low social contacts.
“We hope to gather evidence to provide individuals and governments with accessible, reliable information to help inform research agendas by highlighting what we don't know,” Dr. Gill Livingston, lead author of the report, said in an email. “Progress in preventing and treating dementia is accelerating.”
Livingstone, professor of geriatric psychiatry at University College London, said that while the original 12 risk factors were associated with 40 per cent of dementia cases, the new report suggests that addressing 14 risk factors could eliminate or delay 45 per cent of dementia cases.
High cholesterol in middle age, around age 40, was associated with 7% of dementia cases, and untreated vision loss in later life was associated with 2% of cases.
The authors found that the risk factors associated with the largest proportion of people developing dementia worldwide were high cholesterol, hearing loss, lack of education in childhood, and social isolation in later life.
This “important” update calls attention to two risk factors that preventive neurologist Richard Isaacson, M.D., has evaluated in his clinical practice for more than a decade. “Now the evidence has caught up with what we recommend to our patients,” said Isaacson, director of research at the Florida Institute for Neurodegenerative Diseases, who was not involved in the new study.
The report does not conclusively say that these risk factors directly cause dementia, experts said, and some may be precursors to a dementia diagnosis, so eliminating them does not necessarily reduce a person's risk of developing dementia, Dr. Klaus Ebmeyer, president of the Oxford University Foundation for Geriatric Psychiatry, who was not involved in the study, said in a news release.
However, other studies have offered theories about links between these vulnerabilities and dementia risk.
The connection with excess Body fat and dementiaOne reason may be that body fat is involved in metabolic and vascular processes linked to the accumulation of beta-amyloid protein, a hallmark sign of Alzheimer's disease.
Exercise may help prevent dementia by boosting levels of a protein known to strengthen communication between brain cells, according to a study. January 2022 surveyExercise also helps reduce inflammation Killing nerve cellsSocial participation reduces stress and helps you live a better life. Access to healthcare.
Education is so important for a number of reasons. “Most importantly, education makes the brain more resistant to damage so people can function normally despite changes,” Livingston says. “Education also helps people make the right choices because it allows them to think about evidence in a more educated way. Education is also associated with getting better jobs, and having money gives you more options, for example in terms of healthcare and where to live.”
The full mechanisms of these risk factors require further investigation, said Glenn R. Finney, PhD, a fellow at the American Academy of Neurology, who was not involved in the study.
Finney, director of Geisinger's Memory and Cognition Program in Wilkes-Barre, Pennsylvania, added that the explanation for the findings is “the combination of promoting the brain's physical development and health, preventing brain damage, and enhancing and maintaining brain stimulation, which in itself aids in brain health and function.”
This may explain the potential increased risks posed by reduced vision and hearing, and air pollution.
How well a person hears and sees affects their ability to engage with their surroundings, have meaningful interactions with others and be physically active, all of which are sensory inputs that stimulate the brain and increase cognitive reserve, Isaacson said.
“If you don't use it, you lose it,” he said, giving patients hearing aids or glasses. The beginning of a new life.
Researchers are still trying to figure out which components of air pollution are linked to dementia risk, but particles have been found in the buildup of amyloid plaque in the brains of people with Alzheimer's, Isaacson said. Living near highways has also been linked to an increased dementia risk.
Many of these risk factors are within individuals' control, Dr. Susan Kohlhaas, executive director of Alzheimer's Research UK, said in a news release.
“But there are also problems that are bigger than individuals and communities, like air pollution and early childhood education,” said Koolhaas, who was not involved in the study. “Addressing those requires structural changes in society to give everyone the best chance of living a healthy life free from the effects of dementia. Public health leaders cannot ignore this message.”
The authors also recommended 13 policy and lifestyle changes that can help prevent or better manage dementia, based on risk factors.
Policy guidelines for government agencies include ensuring quality education is available to all, providing information on the risks of smoking and excessive drinking and how to prevent them, controlling prices, and preventing smoking in public places.
Individuals should engage in cognitively stimulating activities, use head protection when playing contact sports or cycling, and exercise regularly.
Maintaining a healthy weight and treating obesity as early as possible also help prevent the risk of diabetes. The authors also recommend keeping systolic blood pressure below 130 mmHg (millimeters of mercury) starting at age 40.
Treating depressionhearing impairment, visual impairment High cholesterol is also important.
If you can't move to a less polluted area, what can you do? Use a HEPA filter Experts say people should avoid using ovens and space heaters that burn wood or coal inside their homes.
The global health and social impact of dementia is estimated to exceed $1 trillion per year, but implementing some of these guidelines could save England, for example, around €4.2 billion. Modeling studies It was published along with the report.
“Even in cases of dementia that cannot be prevented by these measures, quality of life improves for people who address their risks,” Finney said in an email. “Dementia-specific medications such as acetylcholinesterase inhibitors and memantine can and should be helpful. We must fight neurological nihilism; we can and should protect and help the brain!”
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