You might be interested in…Dementia Prevention

Globally, dementia is rapidly becoming a leading cause of death and disability, presenting significant social, health, and economic challenges. The prevalence of dementia is on the rise, with one in every 14 people over the age of 65 in the UK living with dementia. While much of dementia research has focused on treatment and care, there is a growing need to prioritize prevention.

General Practitioners (GPs) are playing an increasingly crucial role in proactively preventing dementia. According to The Lancet Commission in 2020, targeting 12 modifiable risk factors throughout life could prevent or delay dementia in 40% of patients. These risk factors include less education, hypertension, hearing impairment, smoking, obesity, depression, physical inactivity, diabetes, low social contact, excessive alcohol consumption, traumatic brain injury, and air pollution.

Dr Ray O’Connor

The Lancet's 2024 report has updated the research on dementia prevention, emphasizing how cognitive and physical reserve develop throughout life and how reducing vascular damage can lower the incidence of age-related dementia. The report also highlights untreated vision loss and high LDL cholesterol as new risk factors for dementia.

A qualitative study aimed to explore GPs' perceptions of their role in dementia prevention and the associated barriers. The study found that GPs seldom discuss dementia risk explicitly with patients, despite acknowledging the importance of dementia prevention in their role. They suggest adopting a team-based approach in primary care to improve communication about dementia risk factors.

An intervention study focused on reducing dementia risk factors in underserved populations through a coach-supported mobile health (mHealth) program. The study showed promising results in reducing dementia risk in individuals with low socioeconomic status in the UK and China.

While no randomized clinical trial has definitively proven that interventions can prevent dementia, addressing risk factors may still offer other health benefits. Governments are urged to invest in a life-course approach to dementia prevention, particularly in low and middle-income countries where resources and research on aging and dementia are limited.

References:

1. Livingston G et al. Dementia prevention, intervention, and care: 2020 report of the Lancet Commission. Lancet 2020; 396(10248): 413–446. doi: 10.1016/S0140-6736(20)30367-6


2. Livingstone G et al. Dementia prevention, intervention, and care: 2024 report of the Lancet standing Commission. The Lancet Commissions Volume 404, Issue 10452p572-628August 10, 2024. doi: 10.1016/S0140-6736(24)01296-0


3. Jones D et al. Dementia prevention and the GP’s role: a qualitative interview study. Br J Gen Pract 2024 Mar 27;74(741):e242-e249. doi: 10.3399/BJGP.2023.0103 Print 2024 Apr.


4. Moll van Charante E et al. Prevention of dementia using mobile phone applications (PRODEMOS): a multinational, randomised, controlled effectiveness–implementation trial. Lancet Healthy Longev 2024; 5: e431–42 Published Online May 16, 2024 https://doi.org/10.1016/S2666-7568(24)00068-0


5. Reuben D et al. Dementia Prevention and Treatment A Narrative Review. JAMA Intern Med. 2024;184(5):563-572. doi:10.1001/jamainternmed.2023.8522


6. Stephan B et al. Population attributable fractions of modifiable risk factors for dementia: a systematic review and meta-analysis. Lancet Healthy Longev 2024; 5: e406–21. doi: 10.1016/S2666-7568(24)00061-8