According to a new report led by researchers from UCL, addressing 14 modifiable risk factors throughout life could potentially prevent or delay almost half of dementia cases. The report, presented at the Alzheimer's Association International Conference (AAIC 2024), highlights the urgent need to take action against these risk factors, even in individuals with a high genetic predisposition for dementia.

The report builds upon the findings of The Lancet Commission on dementia prevention, intervention, and care conducted in 2020, which identified 12 risk factors linked to 40% of all dementia cases. The new report adds two additional risk factors associated with around 9% of cases - high levels of low-density lipoprotein (LDL) cholesterol in midlife and untreated vision loss in later life.

Hearing impairment and high LDL cholesterol are identified as the risk factors with the greatest proportion of people developing dementia globally, each accounting for 7% of cases. Additionally, lower levels of education in early life and social isolation in later life are found to contribute to 5% of cases each. The report emphasizes that these risk factors can be addressed and reduced at any stage of life, with the potential for significant impact.

Lead author Professor Gill Livingston from UCL Psychiatry stresses the importance of preventive efforts, particularly in vulnerable populations, including those in low- and middle-income countries and socio-economically disadvantaged groups. The report calls for ambitious actions by governments and individuals to implement policy and lifestyle changes in order to reduce the risk of dementia.

The potential impact of these measures is highlighted in a study published alongside the Commission, which analyzed the economic implications of implementing the recommendations in England. The findings indicate that a population-level approach to tackling dementia risk factors could result in cost savings of up to £4 billion.

The report also acknowledges advancements in blood biomarkers and anti-amyloid β antibodies for Alzheimer's disease. Blood biomarkers offer a promising and less intrusive method for accurate diagnosis, while anti-amyloid β antibody treatments show potential in clinical trials. However, the authors emphasize the need for further research and transparency regarding the short and long-term side effects of these treatments.

Furthermore, the report emphasizes the necessity for increased support and interventions for people living with dementia and their caregivers. Effective interventions, such as activity programs and cognitive decline inhibitors, should be made widely available. Additionally, family caregivers should receive comprehensive mental health support and access to adequate resources.

While the majority of evidence on dementia comes from high-income countries, the report acknowledges the growing evidence and interventions from low- and middle-income countries. However, interventions need to be tailored to the diverse cultures, beliefs, and environments of these regions.

It is important to note that the prevention estimates provided in the report focus on population-level changes and do not guarantee that any individual will avoid dementia. However, by targeting and addressing these modifiable risk factors, the report presents an opportunity to significantly reduce the burden of dementia worldwide.

The alarming rise in the number of people living with dementia, combined with the immense personal and economic costs associated with it, emphasizes the urgency for governments and individuals to take proactive measures to prevent and manage dementia effectively.