2024-08-04 10:05:46
New risk factors identified
Why prevention of dementia is so important – and how it works
Updated on 02.08.2024Reading time: 4 min.
There is still no cure for dementia, which makes prevention all the more important. A new Lancet report shows how best to do this.
According to the German Alzheimer’s Society, an estimated 1.8 million people in Germany live with dementia. The term covers various diseases, including Alzheimer’s, which lead to a loss of mental abilities. There is currently no cure.
Nevertheless, there are risk factors that can promote the development of dementia. These include smoking, hearing loss, obesity, loneliness, air pollution and some other factors.
Now a new report from the international Lancet Commission has added high cholesterol and declining eyesight to this list. If all of the 14 modifiable risk factors listed there were eliminated, in theory almost half (45 percent) of dementia cases worldwide could be prevented or at least delayed, according to the report. But the calculation is not quite that simple.
The international group had already presented twelve of these risk factors in 2020:
- low education
- Hearing loss
- high blood pressure
- Smoke
- obesity
- Depression
- Lack of exercise
- Diabetes
- excessive alcohol consumption
- traumatic head bruises
- Air pollution
- social isolation
The report has now added two further factors that are associated with nine percent of all dementia cases: an estimated seven percent of these are due to high LDL cholesterol levels from the age of about 40 and two percent are due to untreated vision loss in late life.
There are basically two types of cholesterol: LDL cholesterol (low density lipoprotein) and HDL cholesterol (high density lipoprotein), which are considered in relation to each other. A normal total cholesterol level for an adult is 200 to 220 milligrams per deciliter of blood (mg/dl). You can read more about this here.
Conversely, this means: “If you correct the declining eyesight and reduce the LDL to optimal levels in middle age, you can actually reduce the risk of dementia,” explains Peter Berlit, Secretary General of the German Society of Neurology (DGN). These connections were to be expected, but have now been confirmed by the Lancet report and should be taken into account in medical treatment by family doctors, for example.
The neurologist emphasizes the interrelationships between the various risks: If the declining hearing and vision are not corrected in time, it affects communication, which has an impact on cognitive abilities and social interactions: “Regular cognitive training and loneliness are factors that also play a role in the development of dementia.”
- also read: Ten simple habits that protect your brain from dementia
Berlit is accordingly cautious about the prevention potential quantified by the Lancet Commission: The 45 percent result from the addition of all the risk factors mentioned and under the assumption that these have been avoided since childhood: “That is of course unrealistic.” Nevertheless, significant effects could be achieved overall if each individual and politicians took appropriate measures.
Stefan Teipel from the German Center for Neurodegenerative Diseases (DZNE) in Rostock also says that the total number of preventable dementia cases across all risk factors is likely to be lower: “The study adds up the individual modifiable risks to just under 45 percent. However, if you influence several risk factors, there are synergistic effects, so you cannot simply add up the effects of risk reduction for individual individuals.”
Berlit stresses that preventing dementia on an individual level does not just involve brain training in the form of crossword puzzles, learning foreign languages or musical instruments: “All of these are important. But it has also been proven that the right diet, for example in the form of the Mediterranean diet, as little alcohol as possible, sufficient physical exercise and a healthy body weight reduce the risk of dementia.” All of this benefits not only the brain, but also the heart. Such behavior could be encouraged in the form of bonus payments by funding bodies such as health insurance companies.
However, politics is called upon to address risk factors such as air pollution and access to education – corresponding recommendations can also be found in the report. Children from disadvantaged families in particular need to be supported from kindergarten onwards, says Berlit. Another political task in this context is to combat the consequences of the climate crisis: “We already know that the risk of stroke is increased by the lack of cooling at night.” In the area of dementia, the evidence is not yet large enough, but corresponding studies are already underway and will probably play a role in future Lancet reports.