Reducing The Risk Of Developing Dementia: Over 55 Million Projected Dementia Cases By 2050 Could Be Delayed Or Avoided

• Despite advances in drug development, Alzheimer’s Disease International (ADI) warns that risk reduction remains the only proven prevention tool
• ADI is calling on governments to urgently fund more research on risk-reduction, introduce strategies, education, and support services, to delay or prevent over 55 million of the projected 139 million cases of dementia by 2050
• Most governments have already signed up to prioritise dementia risk reduction with the World Health Organization, however, evidence suggests that most have forgotten or ignored this commitment so far.

By 2050, 139 million people are forecast to be living with dementia worldwide. Alzheimer’s Disease International (ADI) says that 55.6 million, or 40 percent, of projected dementia cases could be delayed or potentially even avoided by addressing just 12 risk factors1.

ADI, the global federation of over 100 Alzheimer’s and dementia associations, is calling on governments around the world to urgently fund dementia risk-reduction research, education, and support services and for governments to make risk reduction a core element of National Dementia Plans.

“Even though new treatments are now on the horizon, they will not be instantly available or suitable in the majority of cases,” says ADI CEO, Paola Barbarino.

“As we now know a lot more about reducing the risk of developing dementia, this is one of the best ways to tackle the escalating numbers. There’s clear evidence that demonstrates pre-and-post-diagnosis risk-reduction works.”

ADI say tackling dementia risk factors for individuals, both before and after a diagnosis, can reduce or slow down the oncoming 139 million projected dementia cases by 2050 in a way that is accessible and affordable for people across the globe.

There are many proven risk factors* for dementia, many of which individuals have a degree of personal control over. These include smoking, excessive alcohol consumption, physical inactivity, infrequent social contact, head injuries, and conditions including diabetes, hearing loss, depression, obesity, and hypertension.

The remaining risk factors include air pollution and restricted access to early education, which governments are responsible for addressing.

Furthermore, governments are responsible for providing other services that can help improve the lives of those living with dementia, such as affordable access to health and long-term care, and mental health services.

Many governments have already agreed to prioritise dementia risk reduction and support for those living with dementia and their carers through their commitment to the WHO Global Action Plan on the public health response to dementia. Yet, evidence suggests that many have forgotten or ignored this commitment.

“We are calling on governments worldwide to invest in both research and support services, to reduce dementia risk, and to invest in risk reduction awareness campaigns; clear, persuasive campaigns that cut through the noise and confusion of much of the healthcare messaging”, says Barbarino.

“This is a critical step, in the absence of treatment or a cure, to prevent as many cases as possible. We must ensure populations are aware of dementia risk-reduction strategies, at all ages, and have access to necessary information, advice, and support services.”

Advances in dementia drug development – why we can’t wait.

Barbarino acknowledged that this year we have seen exciting advancements in the dementia drug therapy space that have brought hope to many people living with dementia and their carers. However, she stressed her concerns around the suitability of the treatments for all those living with dementia, and potential accessibility issues for some who needed treatment most.

“Despite advances in dementia drug development, risk reduction remains the only truly globally accessible strategy available to us now and in the immediate future for decades to come,” she says.

She says there are several issues that need to be addressed before dementia drugs can have an impact.

“Time and the lack of equitable access in the eventual roll-out of these emerging treatments is a major issue. Barries such as cost, may impede access to life-extending treatments, even when they are available for distribution.”

Only 40 governments worldwide have so far developed national dementia plans, with even fewer of these including risk reduction strategies. As a result, governments are missing out on a vital tool to delay or prevent future cases.

Bearing the burden alone – The need for urgent government investment

Although individuals can implement lifestyle changes to reduce their risk of developing dementia, or slow the progress of dementia, governments have a clear role to play in reducing societal risk.

Barbarino says the urgency for government involvement in response to rising dementia cases is clear.

“We want to see governments include robust risk reduction strategies as part of their National Dementia Plans, and to clearly make connections between dementia and other conditions to enable full integration in areas like stroke strategies, healthy eating programmes, quit-smoking services, clean air programmes, and early education.”

“Doing this now is likely going to be more cost effective than bearing the exponentially growing societal and economic cost of dementia later down the track.”

The funding of such initiatives may even cross over with other governmental goals such as reducing smoking and obesity rates, addressing mental health issues such as depression, or improving access to hearing aids, the use of which has been shown to slow cognitive decline in those experiencing hearing loss.

“So often, those who have been diagnosed with dementia tell us they were unaware that there are modifiable risk factors for dementia and wish they knew how to reduce the risk much earlier in life. Often, it isn’t until after diagnosis that they realise how practical dementia prevention can be both for preventing or delaying the onset, but also to potentially slow the progression of the condition,” says Barbarino.

Emily Ong, a woman from Singapore living with dementia says that risk reduction post-diagnosis is incredibly important even after a diagnosis

“I have always been passionate about cooking and before my diagnosis would frequently cook extensive and complex meals. Unfortunately, one of the first signs that something was wrong was when I forgot how to cook our regular family breakfast and began to struggle to follow recipes,” she says.

Since diagnosis, Ong has focused on cooking healthy, simple meals to take control and slow the progression of her condition, while maintaining her passion for cooking. Making mindful decisions around food choice is one modifiable risk factor that can help reduce the risk and progression of dementia.

“We can offer this information freely now around the world, and with governments’ help give individuals the tools and access to services they need to reduce their personal risk,” says Barbarino. “It’s never too early, and it’s never too late to reduce dementia risk.”

*Livingston G, Huntley J, Sommerlad A, Ames D, Ballard C, Banerjee S, Brayne C, Burns A, Cohen-Mansfield J, Cooper C, Costafreda SG, Dias A, Fox N, Gitlin LN, Howard R, Kales HC, Kivimäki M, Larson EB, Ogunniyi A, Orgeta V, Ritchie K, Rockwood K, Sampson EL, Samus Q, Schneider LS, Selbæk G, Teri L, Mukadam N. Dementia prevention, intervention, and care: 2020 report of the Lancet Commission. Lancet. 2020 Aug 8;396(10248):413-446. doi: 10.1016/S0140-6736(20)30367-6. Epub 2020 Jul 30. PMID: 32738937; PMCID: PMC7392084.

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