- One in three dementia cases are preventable by managing lifestyle factors
- Nonpharmacologic interventions like social contact and exercise help prevent dementia
- Increasing education in early life can reduce the incidence of dementia by 20 percent
One-third of the world's dementia cases can be prevented by managing lifestyle factors such as hearing loss, smoking, hypertension and depression, reveals a new study reported by the first Lancet Commission on Dementia Prevention and Care.
The beneficial effects of nonpharmacologic interventions such as social contact and exercise for people with dementia have been highlighted in the reoprt. The study was presented at the Alzheimer's Association International Conference (AAIC) 2017 and published in The Lancet.
Lon Schneider, MD, professor of psychiatry and the behavioral sciences, commission member and AAIC presenter at the Keck School of Medicine of USC said, "There's been a great deal of focus on developing medicines to prevent dementia, including Alzheimer's disease, but we can't lose sight of the real major advances we've already made in treating dementia, including preventive approaches."
Worldwide, about 47 million people have dementia. It is expected to rise as high as 66 million by 2030 and 115 million by 2050.
Reducing Dementia Risk that Begins in Childhood
Nine risk factors in early, mid-and-late life that increase the likelihood of developing dementia have been identified and reported by the commission. The report says that, one in three cases, i.e., about 35 percent of dementia cases, are attributed to these risk factors.
The incidence of dementia can be reduced by 20 percent, by increasing education in early life and addressing issues which are related to hearing loss, hypertension and obesity in midlife.
The incidence of dementia can be reduced by another 15 percent in late life by quitting smoking, treating depression, managing diabetes, increasing exercise regimen and social contact.
Schneider says, "The potential magnitude of the effect on dementia of reducing these risk factors is larger than we could ever imagine the effect that current, experimental medications could have."
He also said that reducing these risk factors provides a powerful way to lower the global burden of dementia.
Treat Dementia with a Nonpharmacologic Approach
The effect of nonpharmacologic interventions for people with dementia has been examined by the commission. They concluded that nonpharmacologic interventions played a crucial role in the treatment, especially when trying to address agitation and aggression.
Schneider said that to treat agitation and aggression, antipsychotic drugs are commonly used. But a considerable concern has been posed about these drugs due to the increased risk of death, cardiovascular adverse events and infections, and excessive sedation.
For treating dementia-related agitation and aggression, it was found that psychological, social and environmental interventions which include social contact and activities were superior to antipsychotic medications.
Nonpharmacologic interventions such as group cognitive stimulation therapy and exercise benefits cognition, as conferred by the commission.
In the commission's full report, detailed recommendations are provided in the areas of prevention and treating cognitive symptoms, individualizing dementia care, caring for caregivers, managing neuropsychiatric symptoms, planning for the future after diagnosed by dementia and considering the end of life.
- Lon S Schneider, et al. Dementia prevention, intervention, and care. The Lancet July 2017.