12 recommendations for preventing dementia


Modifying 12 risk factors over the life course could delay or prevent 40% of dementia cases, a new report suggests.

The report is an update of the Lancet Commission on Dementia Prevention, Intervention, and Care.

The original report, published in 2017, identified nine modifiable risk factors that were estimated to be responsible for one

third of dementia cases. The commission has now added three new modifiable risk factors to the list.

The 2020 report was presented at the Alzheimer's Association International Conference (AAIC) 2020, which was held online

this year because of the COVID-19 pandemic. It was also published online July 30 in The Lancet.

Alcohol, TBI, Air Pollution

The three new risk factors that have been added in the latest update are excessive alcohol intake, traumatic brain injury

(TBI), and air pollution.

The original nine risk factors were not completing secondary education; hypertension; obesity; hearing loss; smoking;

depression; physical inactivity; social isolation; and diabetes.

Together, these 12 risk factors are estimated to account for 40% of the world's dementia cases.

The report includes the following nine recommendations for policymakers and individuals to prevent risk for dementia in the

general population:

Aim to maintain systolic blood pressure of 130 mmHg or less in midlife from around age 40 years.

Encourage use of hearing aids for hearing loss, and reduce hearing loss by protecting ears from high noise levels.

Reduce exposure to air pollution and second-hand tobacco smoke.

Prevent head injury, particularly by targeting high-risk occupations and transport.

Prevent alcohol misuse and limit drinking to less than 21 units per week.

Stop smoking and support individuals to stop smoking, which the authors stress is beneficial at any age.

Provide all children with primary and secondary education.

Lead an active life into midlife and possibly later life.

Reduce obesity and diabetes.

The researchers assessed how much each risk factor contributes to dementia, expressed as the population-attributable

fraction (PAF). Hearing loss had the greatest effect, accounting for an estimated 8.2% of dementia cases. This was followed

by lower education levels in young people (7.1%) and smoking (5.2%).

The Lancet Commission is partnered by University College London, the Alzheimer's Society UK, the Economic and Social

Research Council, and Alzheimer's Research UK, which funded fares, accommodation, and food for the commission

meeting but had no role in the writing of the manuscript or the decision to submit it for publication.