Almost half of all Alzheimer’s cases could be prevented by tackling 14 lifestyle factors from childhood, a landmark study suggests.
World-leading experts found two new risk factors — high cholesterol and suffering vision loss — were, combined, behind almost one in ten dementia cases globally.
They join 12 existing factors, ranging from genetics to smoking status, that experts have identified as increasing the risk a person would suffer dementia.
Experts said the study, published in the prestigious journal The Lancet, provides more hope than ‘ever before’ that the memory-robbing disorder that blights the lives of millions can be tackled.
According to the third Lancet Commission on dementia risks, addressing these factors in childhood and throughout life gives people the best chance of preventing or delaying dementia, even if they have high genetic risk.
Experts today called on public health leaders to ‘seize this enormous opportunity’ and take nationwide action to help thwart the onset of the disease.
Prof. Gill Livingston, lead author of the review and an expert in the psychiatry of older people at University College London, said the report shows hope that we can prevent people getting dementia ‘more than ever before’.
‘When I first became a doctor, and for some time after, we thought that dementia was just one of these things that hit you in a sort of relatively random way, and there was nothing that you could do,’ she said.
‘And if you were going to get it, you were going to get it.
‘But, now we know that that’s not true, that even if you have genes which predispose you towards it, these lifestyle changes increase the number of years in good health, and it takes longer for you to get it.’
She added; ‘It’s never too early or too late to take action, with opportunities to make an impact at any stage of life.
Prof. Livingston added that one of the easiest things people can do to reduce their risk of dementia, is incorporate some exercise into their day.
‘Give yourself a chance,’ she said.
‘What you do will not only decrease the chance of dementia, it will increase the quality of your life now, and may increase the quantity of your life and increase the quantity of your healthy life.
‘I think that what people dread is a long and unhealthy life, but it should increase the quantity of your healthy life.’
Meanwhile, Dr Susan Kohlhaas, executive Director of Research at Alzheimer’s Research UK, said: ‘Many of these factors are things individuals can do something about, such as smoking.
However, she added it was critical policy makers look at addressing those factors that, while changeable, are beyond the power of a single person to change.
‘But others, like air pollution and early childhood education, are bigger than individuals and communities,’ she said.
‘Tackling them will need structural changes to society to give everyone the best chance of a healthy life, free from the impact of dementia.
‘Public health leaders must not ignore this message if they are truly committed to seizing this enormous opportunity.
‘Alzheimer’s Research UK wants to see the Public Health and Prevention Minister, Andrew Gwynne MP, establish a prevention strategy that addresses the health and lifestyle factors linked to dementia — from what we eat and drink, to the air we breathe and the education we receive.’
The report, presented at the Alzheimer’s Association International Conference (AAIC), in Philadelphia found high, bad cholesterol from the age of 40 could be responsible for around 7 percent of all dementia cases.
Untreated vision loss in later life accounted for 2 per cent, about one in 50, of all cases.
To reduce dementia risk throughout life, the commission also made 13 recommendations for both people and governments.
These include making hearing aids available for all those with hearing loss, reducing harmful noise exposure, and increased detection and treatment access for high cholesterol among the over-40s.
Making screening and treatment for vision impairment accessible for all, providing children with good quality education and encouraging being cognitively active in midlife were among other recommendations.
Other experts, who were not involved in the research today, however, cautioned that the findings may give people ‘false hope’ by ‘putting them under the impression that dementia is at least partly a “lifestyle choice”’.
Prof. Klaus Ebmeier, foundation chair of old age psychiatry at the University of Oxford, said: ‘The headline “half of all dementia cases are preventable”, which leads to “fake news” and false hopes, and gives patients the impression that dementia is at least partly a “lifestyle choice” because they have not taken adequate care of their health.
He added: ‘The diagnosis of dementia comes at the end of a decades-long disease development, which is often accompanied by behavioural changes such as social withdrawal, depression, and sensory changes (reduced sense of smell, hearing, and speech comprehension disorders).
‘Early changes in the central nervous system during development before a diagnosis of dementia can, for example, lead to disorders of speech comprehension and to hearing aids being perceived as too difficult and frustrating to use.
‘This may be the reason why hearing loss is only associated with later dementia if patients do not use hearing aids.
‘It is therefore possibly not the lack of hearing aid use that leads to dementia, but an early limitation of information processing in people who later develop dementia prevents them from being able and wanting to use their hearing aids.’
Prof. Charles Marshall, an expert in clinical neurology at Queen Mary University of London, said: ‘It’s worth emphasising though that most of what determines whether an individual develops dementia is outside their control, and we should be careful not to imply that people with dementia could have avoided it if they’d made different lifestyle choices.
‘It’s also important to note that when the report refers to the proportions of dementia cases that could be prevented, this is notional, and based on observational evidence.
‘We don’t really have evidence that dementia cases are prevented by addressing any of these risk factors.
Dr Jeremy Isaacs, NHS national clinical director for dementia, added: ‘This research is really important as it suggests there are additional risk factors for dementia, which means that there are more opportunities for all of us to take action throughout our lives to reduce our risk of developing dementia or delay its onset.
‘The findings also offer real hope that we can reduce the number of people who experience this devastating illness.
‘Ensuring that people with dementia receive a timely diagnosis is a priority and NHS staff have worked hard to ensure the number of people with a dementia diagnosis has risen significantly over the last year, and is now at a record level, but we know there is more work to be done.’
Separate research presented at the AAIC today showed the longer-term benefits of Alzheimer’s disease drug, lecanemab, suggesting there are no additional safety concerns associated with using the medication over three years.
Instead, early clinical data shows more than 50 percent of patients who started treatment in the earlier stage of Alzheimer’s may continue to show improvement after three years of treatment, according to pharmaceutical company Eisai, and biotechnology company Biogen.
Lecanemab is part of group of newly developed drugs that slows down early stages of the disease.
-Daily Mail.UK
