Lancet: 9 risk factors for dementia, 40% in China! The Lancet publishes its latest prevention report.

On July 31st, Beijing time, the Lancet's Dementia Prevention, Intervention and Care Commission published a new report that changes 12 risk factors in the life cycle can delay or prevent 40% of dementia cases.
the report was also presented at the Alzheimer's Society's annual international conference (AAIC 2020).
(AAIC also published: Two new studies: Vaccination against influenza and/or pneumonia to reduce the risk of dementia) Report, led by 28 of the world's leading dementia experts, provides a new analysis of the best evidence against dementia based on nine risk factors identified by the Lancet Committee in 2017.
the new report calls for greater confidence in the prevention of dementia among countries and individuals, and a range of policies and lifestyle changes to help prevent it.
combined, three new risk factors are associated with 6 percent of people with dementia: an estimated 3 percent of cases are attributed to head injuries in middle age, 1 percent to excessive drinking, and 2 percent to exposure to air pollution in later life.
the rest of the risk factors are associated with 34% of dementia cases.
the risk factors with the highest proportion of dementia cases in the population were less early education, hearing loss in middle age and smoking in old age (7%, 8% and 5%, respectively).
currently has about 50 million people worldwide suffering from dementia, and that number is expected to increase to 152 million by 2050, especially in low- and middle-income countries, where about two thirds of people with dementia live.
dementia affects individuals, their families and the economy, the global burden is estimated at about $1 trillion a year.
But in some countries, the proportion of people with Alzheimer's disease has begun to decline, possibly due to changes in education, nutrition, health care and lifestyle, suggesting that dementia can be reduced through preventive measures. Professor Gill Livingsto, of University College London,
the report's newsletter, said: "Policy makers and individuals have the ability to prevent and delay a significant proportion of dementia and have the opportunity to make an impact at every stage of our lives.
interventions are likely to have the greatest impact on those most affected by risk factors for dementia, such as low- and middle-income countries and vulnerable groups, including black, Asian and minority ethnic communities.
", he continued: "As a society, we need to think not only about promoting good health to prevent dementia, but also about tackling inequality in order to improve the environment in which people live."
we can reduce risk by creating a positive and healthy environment for the community, where physical activity is the norm, where everyone can get a better diet and minimize alcohol consumption.
" to address the risk of dementia, the authors call on policy makers and individuals to adopt nine recommendations: to keep systolic pressure below 130 mmHg from around the age of 40; to encourage the use of hearing aids to treat hearing loss and reduce hearing loss by protecting the ears from high noise; to reduce exposure to air pollution and second-hand smoke; to prevent head injuries (especially for high-risk occupations); to stop smoking and support individuals to quit smoking (the authors stress that this is beneficial to children of all ages);
these actions are particularly important in low- and middle-income countries, where the incidence of dementia is rising faster than in high-income countries.
this is due to increased life expectancy and the higher frequency of certain risk factors for dementia, such as lower rates of education, higher rates of hypertension, obesity and hearing loss, and the rapid growth of diabetes.
based on their models of nine risk factors in the past, the authors estimate that low- and middle-income countries can prevent more cases of dementia than globally.
globally, these nine risk factors are estimated to account for 35 per cent of all dementia cases, compared with 40 per cent in China, 41 per cent in India and 56 per cent in Latin America.
the authors warn that the estimate could be higher because they have a conservative estimate of the prevalence of these risk factors in these populations and do not take into account three new risk factors.
authors also point out that almost all evidence of dementia comes from studies in high-income countries, so the risks in low- and middle-income countries may be different and interventions may need to be modified to best support different cultures and environments.
the authors point out that their prevention assessment models in global and low- and middle-income countries assume a causal link between risk factors and dementia, but they are careful to include only risk factors with strong evidence. "In low- and middle-income countries, the high incidence of dementia risk risk means that the potential rate of dementia prevention is even higher than in high-income countries," said Professor Adesola Ogunniy of the University of Ibadan in Nigeria,
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in this regard, national policies to address risk factors for dementia, such as universal primary and secondary education and anti-smoking policies, may have the potential to significantly reduce dementia and should be given priority.
We need more dementia research in low- and middle-income countries so that we can better understand the risks in these particular environments.
" In the final part of the report, the authors advocate the adoption of holistic and personalized evidence-based care to address physical and mental health, social care, and support that can meet complex needs.
it is important to maintain the health of people with dementia, but they often suffer from other diseases that can be difficult to control on their own, leading to potentially harmful and preventable hospitalizations.
authors point out that people with dementia (due to age and pre-existing conditions, such as high blood pressure) are particularly at risk of developing new coronary pneumonia, and that social isolation is a challenge for people with dementia because they need to be with caregivers and family.
authors call for people with unknown new coronary virus infections not to be allowed in nursing homes, regular testing of staff and asymptomatic and asymptomatic residents, and more research into how to protect people with dementia in the current pandemic and future public health emergencies.
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