Nearly half of dementia cases could be delayed by tackling 14 risk factors

Dementia, a progressive neurological disorder characterized by cognitive decline and impaired daily functioning, poses significant challenges to individuals and society. Recent research suggests that nearly half of all dementia cases could potentially be delayed through the strategic management of 14 modifiable risk factors. These factors include hypertension, obesity, physical inactivity, diabetes, smoking, depression, low educational attainment, social isolation, hearing loss, excessive alcohol consumption, traumatic brain injury (TBI), air pollution exposure, and inadequate sleep. Addressing these determinants not only enhances individual health outcomes but also alleviates the broader societal burden associated with dementia care.

The implications of this finding are profound. By recognizing that nearly 50% of dementia cases can be postponed through lifestyle modifications and interventions targeting these risk factors, public health initiatives can focus on preventative strategies. For instance, promoting physical activity and healthy eating habits in communities can mitigate obesity and diabetes prevalence—two significant contributors to cognitive decline. Similarly, enhancing educational opportunities and fostering social connections may reduce isolation and depression while improving mental resilience.

The report adds two new modifiable risk factors for dementia — high cholesterol and vision loss — to the 12 risk factors identified in the 2020 Lancet Commission report, which were linked to about 40% of all dementia cases. 

The original Lancet Commission report, published in 2017, identified nine modifiable risk factors that were estimated to be responsible for one third of dementia cases. 

"Our new report reveals that there is much more that can and should be done to reduce the risk of dementia. It's never too early or too late to act, with opportunities to make an impact at any stage of life," lead author Gill Livingston, MD, from University College London, UK, said in a statement. 

Research suggests people who get a strong early-life education, as well as those who work mentally stimulating jobs during midlife, are at decreased risk of developing dementia later on. But even if neither of those are the case for you, there’s still plenty you can do to keep your mind sharp.

Aim to have plenty of new and varied experiences that get the brain working in different ways, Livingston suggests—things like learning a new skill, reading a book (especially one outside your usual genre), or traveling somewhere you’ve never been. Variety is key, Livingston emphasizes. “If you just do Sudoku, you become good at Sudoku, but that doesn’t generalize to the rest of your brain,” she says. “Your brain has lots of different functions, so the idea is to keep them all engaged.”

Explanations for the findings could boil down to a “combination of promoting the physical development and health of the brain, preventing damage to the brain, and enhancing and maintaining stimulation of the brain, which in and of itself aids brain health and function,” added Finney, director of the Geisinger Memory and Cognition Program in Wilkes Barre, Pennsylvania.

That may explain the increased risk potentially imparted by vision or hearing loss and air pollution.

How well a person can hear or see influences their ability to engage with their surroundings, have meaningful interactions with other people and be physically active, all of which are sensory inputs that stimulate the brain and build up its cognitive reserve, Isaacson said.

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Sarah H

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