HQ Team
August 5, 2024: Researchers have added two additional risk factors — untreated vision loss and high LDL cholesterol — to 12 other steps to identify dementia, projected to affect 153 million people by 2050.
The Lancet Commission 2024 Update, added “the new compelling evidence that untreated vision loss and high LDL cholesterol are risk factors for dementia.”
A 2020 report by the commission came up with evidence for identifying risk factors of dementia — less education, hearing loss, hypertension, smoking, obesity, depression, physical inactivity, diabetes, and excessive alcohol consumption.
The list also included traumatic brain injury, air pollution and social isolation.
“The potential for prevention is high and, overall, nearly half of dementias could theoretically be prevented by eliminating these 14 risk factors,” the authors wrote in the report.
High LDL cholesterol
A study of 1, 189, 090 participants in the UK reported that high LDL cholesterol (greater than 3 mmol/L) was associated with an increased risk of dementia, according to the report.
“Our Commission has not previously considered vision loss as a risk factor for dementia, but considerable new evidence has emerged.
“This evidence includes a meta-analysis of 14 prospective cohort studies, with follow-up of 3·7–14·5 years, including 6 204,827 older adults who were cognitively intact at baseline, of whom 171, 888 developed dementia.”
The evidence for specific risk factors suggested that all children should be educated, and a long duration of education is beneficial.
The report stated that it was important to be cognitively, physically, and socially active in midlife (aged 18–65 years) and late life (aged above 65 years), with new evidence showing that midlife cognitive activity makes a difference even in people who received little education.
Treating hearing loss decreases the risk of dementia “is now stronger than when our previous Commission report was published,” the authors wrote.
Depression, smoking
The use of hearing aids appeared to be particularly effective in people with hearing loss and additional risk factors for dementia. “New evidence also suggests that treating depression and smoking cessation might both reduce dementia risk.”
Reducing air pollution is linked with improved cognition and a reduction in dementia risk, according to the report. Policymakers should implement strategies to improve air quality, particularly in areas with high air pollution.
Traumatic brain injury, “at any age and from any source,” continued to be a risk factor for dementia, and new and improved evidence suggests that contact sports pose a risk.
“Additional evidence suggests that these changes are often cost-saving and, for the first time, it is clear that risk can be modified even in people with increased genetic risk of dementia.”
The number of people living with dementia worldwide in 2019 was estimated at 57 million and is projected to increase to 153 million by 2050.
Individualised treatment
The proportion of people with dementia has increased over time in lower-income countries due to a greater percentage increase in longevity than in high-income countries.
For people living with dementia interventions should be individualised, considering the person’s life circumstances, and include family and other carers.
Data from some high-income countries suggested that age-specific dementia incidence rates have decreased over the past two decades, which emphasises that prevention is possible.
