The Lancet Commission on Dementia Prevention, Intervention, and Care has updated evidence on modifiable risk factors the prevention of dementia, and the “life-course model of dementia prevention”. There were nine modifiable risk factors for reducing the risk of dementia originally; this model has subsequently been extended with an updated 12 risk factor life-course model of dementia prevention.
The potential for dementia prevention may be higher in low-income and middle-income countries (LMIC) where dementia is more prevalent.
Information on multimorbidity, hospital admissions, pharmacological, non- pharmacological, psychological, and social interventions has been updated, with a new section on dementia and COVID-19.
Livingston, G. Huntley, J. [and] Sommerlad, A. [et al]. (2020). Dementia prevention, intervention, and care: 2020 report of the Lancet Commission. Lancet. July 29th 2020; [Epub ahead of print].
“ …up to 35% of dementia cases could be prevented by modifying nine risk factors [around 40% for the 12 risk factors]: low education, midlife hearing loss, obesity, hypertension, late-life depression, smoking, physical inactivity, diabetes, and social isolation”.
Some commentators suggest the strength of the evidence in favour of interventions to promote this good advice may be more modest than expected.
Montero-Odasso, M. Ismail, Z. [and] Livingston, G. (2020). One third of dementia cases can be prevented within the next 25 years by tackling risk factors. The case “for” and “against”. Alzheimer’s Research and Therapy. July 8th 2020, Vol.12(1), 81.
Possibly also of interest:
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Kivipelto, M. Mangialasche, F. [and] Snyder, HM. [et al]. (2020). World-Wide FINGERS Network: a global approach to risk reduction and prevention of dementia. Alzheimer’s and Dementia: the journal of the Alzheimer’s Association. July 2020; Vol.16(7): pp.1078-1094.
Regarding Risk Factors Reduction for Alzheimer’s Disease
“Distribution of modifiable factors with Class I recommendation throughout the course of life… Class I suggestions: risk factors include 10 factors with Level A evidence (cognitive activity, hyperhomocysteinaemia, increased BMI in late life, depression, stress, diabetes, head trauma, hypertension in midlife, orthostatic hypotension and education) and 9 factors (obesity in midlife, weight loss in late life, physical exercise, smoking, sleep, CVD, frailty, atrial fibrillation and vitamin C) with Level B evidence”.
Yu, JT. Xu, W. [and] Tan, CC. [et al]. (2020). Evidence-based prevention of Alzheimer’s disease: systematic review and meta-analysis of 243 observational prospective studies and 153 randomised controlled trials. Journal of Neurology, Neurosurgery, and Psychiatry. July 20th 2020 [Epub ahead of print].
Possibly also of interest, a literature review prepared for, and presented at, the “Healthy Ageing 2020” International Conference, organised by GeriCaRe (Geriatric Care and Research Organisation) on August 8th 2020.
Jolley, D. (2020). Approaches to reduce the incidence of cognitive decline and dementia. Journal of Geriatric Care and Research (JGCR). August 22nd 2020. [Epub ahead of print].
Prevention of Cardiovascular Disease (CVD): the CVDPREVENT National Primary Care Audit
The idea behind CVDPREVENT is to extract data from primary care, to better understand how many patients with the high-risk conditions – hypertension (high blood pressure), high cholesterol and atrial fibrillation (AF) – are undiagnosed, under-treated or over-treated.
The CVDPREVENT Implementation Steering Group comprises representatives from RCGP, NHS Digital, NICE, Public Health England, NHS England and NHS Improvement, British Heart Foundation, Royal Pharmaceutical Society, Primary Care Cardiovascular Society and GPs.
CVDPREVENT. London: NHS England, August 2020.