You might be interested in…Dementia Prevention

Globally, dementia is a rapidly growing cause of death and disability, presenting significant social, health, and economic challenges. The prevalence of dementia is increasing, with one in 14 people over the age of 65 in the UK living with dementia. Research on dementia has mostly focused on cure or care, with less emphasis on prevention.

General Practitioners (GPs) are playing a crucial role in actively preventing dementia. The Lancet Commission in 2020 estimated that targeting 12 modifiable risk factors throughout life could prevent or delay dementia in 40% of patients. These risk factors include less education, hypertension, hearing impairment, smoking, obesity, depression, physical inactivity, diabetes, low social contact, excessive alcohol consumption, traumatic brain injury, and air pollution.

The Lancet’s 2024 report has updated this information, highlighting new research that emphasizes the development of cognitive and physical reserve throughout life and the impact of reducing vascular damage on age-related dementia incidence. The report suggests that addressing various dementia risk factors can reduce the risk of developing dementia. Additionally, it identifies untreated vision loss and high LDL cholesterol as new risk factors for dementia.

Despite the growing evidence supporting dementia prevention, there is limited understanding of how GPs perceive their role in this area and the obstacles they face. A qualitative study aimed to explore the role of GPs in dementia prevention, revealing that while GPs acknowledge the importance of dementia prevention, they rarely discuss dementia risk explicitly with patients, citing barriers such as lack of time, knowledge, and education on modifiable risk factors.

Another study focused on reducing dementia risk factors in underserved populations through a coach-supported mHealth intervention. The research involved a randomized controlled trial targeting individuals with at least two dementia risk factors, showing promising results in reducing dementia risk in participants with low socioeconomic status.

While randomized clinical trials have not definitively proven the effectiveness of dementia prevention interventions, addressing risk factors can still offer other health benefits. Governments are encouraged to invest in dementia prevention strategies, particularly in low and middle-income countries where resources for aging and dementia research are limited.

References:

1. Livingston G et al. Dementia prevention, intervention, and care: 2020 report of the Lancet Commission. Lancet 2020; 396(10248): 413–446. doi: 10.1016/S0140-6736(20)30367-6
2. Livingstone G et al. Dementia prevention, intervention, and care: 2024 report of the Lancet standing Commission. The Lancet Commissions Volume 404, Issue 10452p572-628August 10, 2024. doi: 10.1016/S0140-6736(24)01296-0
3. Jones D et al. Dementia prevention and the GP’s role: a qualitative interview study. Br J Gen Pract 2024 Mar 27;74(741):e242-e249. doi: 10.3399/BJGP.2023.0103 Print 2024 Apr.
4. Moll van Charante E et al. Prevention of dementia using mobile phone applications (PRODEMOS): a multinational, randomised, controlled effectiveness–implementation trial. Lancet Healthy Longev 2024; 5: e431–42 Published Online May 16, 2024 https://doi.org/10.1016/S2666-7568(24)00068-0
5. Reuben D et al. Dementia Prevention and Treatment A Narrative Review. JAMA Intern Med. 2024;184(5):563-572. doi:10.1001/jamainternmed.2023.8522
6. Stephan B et al. Population attributable fractions of modifiable risk factors for dementia: a systematic review and meta-analysis. Lancet Healthy Longev 2024; 5: e406–21. doi: 10.1016/S2666-7568(24)00061-8