One-third of the world’s dementia cases could be prevented, a new report is warning. And there are nine factors, starting as early as childhood, that could be increasing your risk of being diagnosed with the disease.
Some of the risk factors are obvious, including social isolation and physical inactivity, but others are novel such as hearing loss and less childhood education.
The findings were published Thursday morning in the prestigious journal, The Lancet, and stem from an international commission of 24 leading experts from around the world.
“Dementia is the most feared disease of older people. It causes not only disability and dependency for people with it but it can have a profoundly detrimental effect on family carers who are at high risk of developing depression and anxiety disorders,” Dr. Gill Livingston, a University College London professor who led the commission, said in a podcast accompanying the study.
“Our overall message is acting now in dementia will vastly improve living and dying for people with dementia and their families. There’s so much we can do now rather than focusing solely on the possibility of future care, a path which up to now has been rather disappointing,” Livingston said.
Fifty million people are living with dementia around the world and that statistic is expected to escalate to a whopping 131 million by 2050.
The cost of caring for people with dementia worldwide is more than US$800 billion. By 2030, the price tag is projected to reach US$2 trillion.
Livingston’s commission conducted thorough research and worked through European and American data to come up with their list of risk factors and recommendations.
The nine risk factors include:
- Less childhood education
- Hearing loss
- Physical inactivity
- Social isolation
Potential risk factors:
- Visual loss
“Over a third of dementias are theoretically preventable so that’s huge. These factors worked on the brain either by changing resiliency making people more or less liable to have a problem when the pathology occurs or by direct damage on the brain,” Livingston said.
Livingston’s team created a “life course model,” which situates risk of dementia by age group so experts will know when to tackle specific risk factors.
“Our analysis overall shows it’s never too early and it’s never too late for intervention to prevent or delay dementia,” she said.
Of the 35 per cent of all dementia cases that could potentially be prevented, the three most common were increasing education in early life (tied to reducing eight per cent of cases), reducing hearing loss (tied to cutting nine per cent of cases), and stopping smoking later in life (tied to a five per cent cut in cases if people quit).
As people accumulate more risk factors, the likelihood of developing the disease increases.
Turns out, the “biggest factor” was a lack of childhood education, which affects those in low to middle-income countries most.
Education – in childhood and later on in life – is pivotal to building and maintaining brain resiliency.
Smoking, obesity, physical inactivity, hypertension and diabetes also bundle together. As a group, they make for a larger risk factor than any other individual cause.
Hearing loss and lack of social contact work against a “cognitively enriched environment,” the researchers say.
These factors overlap: if you’re hearing impaired, you may have difficulty with social isolation or grapple with depression, for example.
Other risk factors surfaced but weren’t taken into account on the list because the evidence is still emerging. They include visual loss and pollution.
Dementia is a chronic condition with steadily rising rates around the world. That’s why the global scientific community is working hard to try to find treatment options to fight the disease. There is no cure.
About 25,000 new cases of dementia are diagnosed each year, according to the Alzheimer Society of Canada. It estimates that 564,000 Canadians have dementia right now. By 2031, in just 14 years, it’s warning that 937,000 Canadians will have dementia.
“There are no guarantees that we can prevent dementia, but there is a growing body of scientific evidence that supports lifestyle changes that can work in our favour,” Rosanne Meandro, spokesperson for the society, said in an emailed statement.
“Maintaining good cardiovascular health, doing more physical activity, lifelong learning, eating a Mediterranean diet, staying socially connected, quitting smoking and managing stress, all of these things are not only vital for our overall health but they will also help reduce our risk of dementia,” Meandro told Global News.
While the mechanisms behind Alzheimer’s disease aren’t fully understood yet, scientists say that in its early stages, it’s tied to beta amyloid plaque, a protein that clumps together hurting brain cells and tampering with normal brain function.
There are some limitations to the study too, the researchers concede. They didn’t take diet and alcohol intake into account, for example.
Tweaking policy to address staving off dementia earlier in life is key, the researchers say.
Public health officials need to promote the importance of secondary education, and encourage kids to take up engaging hobbies, going to the movies, trying new restaurants, taking up sports, reading and volunteering. These habits need to carry on into adulthood and the golden years.
Your brain is just like your heart. They’re both muscles that need to be given a workout to stay healthy whether through learning a new language, playing an instrument or joining a weekly book club.
Protecting hearing and treating hearing loss is also crucial, they say.
Early diagnosis is important, too. This gives patients the tools needed to work through their symptoms and master tactics to maintain their autonomy before they’ve lost control of their cognitive health.
Intervention won’t necessarily delay, prevent or cure dementia cases but the prevalence of the disease would be cut in half if onset is delayed by five years, the experts estimate.
As many as 50 per cent of Canadians with dementia are not diagnosed early enough, losing valuable time when intervention can help these people with managing their daily lives.
Read the full study published in the Lancet.
The Alzheimer Society documents a list of 10 signs to watch for:
- Memory loss affecting day-to-day abilities — forgetting things often or struggling to retain new information.
- Difficulty performing familiar tasks — forgetting how to do something you’ve been doing your whole life, such as preparing a meal or getting dressed.
- Problems with language — forgetting words or substituting words that don’t fit the context.
- Disorientation in time and space — not knowing what day of the week it is or getting lost in a familiar place.
- Impaired judgment — not recognizing a medical problem that needs attention or wearing light clothing on a cold day.
- Problems with abstract thinking — not understanding what numbers signify on a calculator, for example, or how they’re used.
- Misplacing things — putting things in strange places, like an iron in the freezer or a wristwatch in the sugar bowl.
- Changes in mood and behaviour — exhibiting severe mood swings from being easy-going to quick-tempered.
- Changes in personality — behaving out of character such as feeling paranoid or threatened.
- Loss of initiative — losing interest in friends, family and favourite activities.
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