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One in Three Dementia Cases Could Be Prevented

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About 35 percent of cases of Alzheimer’s disease and other forms of dementia could be delayed or prevented, according to a new analysis, if people adopted certain measures beginning early in life that can modify the course of the disease. Those factors include stopping smoking, preventing hearing loss and remaining physically active.

The report, published in the Lancet, a British medical journal, combines advice from 24 international experts who reviewed existing evidence on dementia prevention. The authors estimate that some 47 million people around the world live with dementia, with that number expected to triple to 131 million by 2050 unless effective measures to treat or delay the onset of disease are found.

“Acting now will vastly improve life for people with dementia and their families, and in doing so, will transform the future of society,” said the lead author Professor Gill Livingston of University College London. “Although dementia is diagnosed in later life, the brain changes usually begin to develop years before, with risk factors for developing the disease occurring throughout life, not just in old age. We believe that a broader approach to prevention of dementia which reflects these changing risk factors will help to prevent the rising number of dementia cases globally.”

One of the most important measures early in life, the report notes, is to stay in school. People who stayed in school for more than eight years, and past the age of 15, reduced the risk of dementia in old age by 8 percent, the researchers estimate. Formal education may help to strengthen brain connections and delay the onset of memory loss and other symptoms years down the road.

In midlife, between the ages of 45 and 65, stemming a decline in hearing was estimated to reduce lifetime dementia risk by as much as 9 percent. Good hearing sparks stimulation from the environment and can help people maintain social connections, which is thought to play an important role in keeping the mind sharp. Keeping blood pressure in check in middle age was estimated to reduce risk by about 2 percent, while reducing obesity reduced risk by about 1 percent.

Later in life, stopping smoking was estimated to reduce dementia risk by 5 percent. Other factors that can reduce the risk of Alzheimer’s or other forms of dementia later in life were avoiding depression or diabetes, staying physically active, and remaining socially connected.

The study estimates that eliminating all these risk factors could prevent more than one in three cases of dementia overall. To help reduce dementia risk, the researchers suggest public health interventions to promote childhood education and, later in life, to encourage people to engage in mentally stimulating activities like pursuing a hobby, going to the cinema, restaurants or sporting events, reading, doing volunteer work, playing games and having a busy social life. In addition, protecting hearing and treating hearing loss in mid-life may be an important way to prevent dementia.

Among the report’s other recommendations were that cholinesterase inhibitor drugs, such as Aricept, should be offered to patients with Alzheimer disease, and the drug memantine should be offered to patients with severe dementia. While such drugs cannot prevent the downward progression of disease, they may ease symptoms for a time.

The authors also recommend that those caring for a family member with Alzheimer’s should be offered counseling and other measures to help reduce the risk of depression that may ensue as a toll of caretaking.

By www.ALZinfo.org, The Alzheimer’s Information Site. Reviewed by Marc Flajolet, Ph.D., Fisher Center for Alzheimer’s Research Foundation at The Rockefeller University.

Source: Lancet Commission on Dementia Prevention and Care, July 2017.

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