Vision loss and high cholesterol increase the likelihood of developing dementia, according to a new report that says nearly half of dementia cases could be delayed or prevented by addressing 14 risk factors.

The Lancet Commission, composed of 27 dementia experts, previously identified 12 lifestyle struggles responsible for 40% of dementia cases, with hearing loss, little education in early life and social isolation in later life topping the list.

The addition of vision loss and high cholesterol as risk factors comes as the number of people living with dementia around the world is expected to increase from 57 million in 2019 to 153 million by 2050.


The Lancet Commission identifies 14 modifiable dementia risk factors in a new report. Andrey Popov – stock.adobe.com

“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 take action, with opportunities to make an impact at any stage of life,” said lead report author Gill Livingston from University College London.

In 2017, the Lancet Commission highlighted nine lifestyle factors it blamed for 35% of dementia cases. Three more risky behaviors were added when the report was updated in 2020. Now there are 14 modifiable risk factors.

14 dementia risk factors

  • Lower levels of education
  • Hearing loss
  • High blood pressure
  • Smoking
  • Obesity
  • Depression
  • Physical inactivity
  • Diabetes
  • Excessive alcohol consumption
  • Traumatic brain injury
  • Air pollution
  • Social isolation
  • Vision loss
  • High cholesterol

The number of people living with dementia around the world is expected to increase from 57 million in 2019 to 153 million by 2050.
The number of people living with dementia around the world is expected to increase from 57 million in 2019 to 153 million by 2050. LIGHTFIELD STUDIOS – stock.adobe.com

High cholesterol in midlife (starting around 40) and untreated vision loss in later life are responsible for an estimated 7% and 2% of dementia cases, respectively.

The Lancet Commission recommends tackling these concerns as soon as possible, even if you’re at high genetic risk for dementia.

“Healthy lifestyles that involve regular exercise, not smoking, cognitive activity in midlife (including outside formal education) and avoiding excess alcohol can not only lower dementia risk but may also push back dementia onset,” Livingston explained.

“So, if people do develop dementia, they are likely to live less years with it,” she continued. “This has huge quality of life implications for individuals as well as cost-saving benefits for societies.”

The new report — presented Wednesday at the Alzheimer’s Association International Conference in Philadelphia — outlines 13 recommendations to help reduce the risk of dementia.

13 Lancet Commission recommendations

  • Ensure everyone gets a quality education and encourage stimulating activities in midlife to protect brain health
  • Make hearing aids accessible for people who need them and decrease harmful noise exposure to reduce hearing loss
  • Treat depression
  • Support use of helmets and head protection in contact sports and on bicycles
  • Encourage exercise because athletes and gym goers are less likely to develop dementia
  • Reduce the prevalence of smoking through education campaigns, price hikes and restriction of cigarettes in public places
  • Lower high blood pressure, especially from 40 years old and on
  • Detect and treat high cholesterol from midlife
  • Maintain a healthy weight and treat obesity as early as possible, which also helps to prevent diabetes
  • Reduce alcohol abuse through price control and increased awareness of risks of overconsumption
  • Prioritize supportive community environments and lessen social isolation by facilitating participation in activities
  • Make screening and treatment of vision loss accessible for all
  • Reduce exposure to air pollution

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