Hundreds of thousands of people could ward off dementia by adopting a healthy lifestyle, a major study has found.
Some 40 per cent of cases could be avoided or delayed, a comprehensive review of the evidence concludes.
Eating less, exercising more, and cutting out alcohol and cigarettes significantly reduce the risk of developing dementia in later life, researchers said.
Hundreds of thousands of people could ward off dementia by adopting a healthy lifestyle, a major study has found (stock picture)
The 12 major factors
- Education – better schooling gets you in the habit of using your brain more throughout your life, which is proven to increase ‘cognitive reserve’ and reduce dementia risk. Poor education increases an individual’s dementia risk by 60 per cent. Responsible for 7 per cent of cases
MIDDLE AGE (aged 45-65)
- Hearing loss – now proven to be linked to dementia. Hearing aids reduce this risk, suggesting UK rationing could have a major effect in years to come. Increases individual risk by 90 per cent, responsible for 8 per cent of all cases.
- Brain injury – a major study last year showed footballers were at significantly increased dementia risk due to repeated heading of the ball. Increases individual risk by 80 per cent, responsible for 3 per cent of all cases.
- High blood pressure – a systolic reading of more than 140mgHH increases an individual’s risk by 60 per cent. Responsible for 2 per cent of cases.
- Drinking – more than 21 units (about nine pints of beer or 15 small glasses of wine) a week increases individual risk by 20 per cent. Responsible for 1 per cent of cases.
- Obesity – a body mass index of more than 30 increases a person’s chance of developing dementia by 60 per cent. Responsible for 1 per cent of cases.
OLD AGE (65+)
- Smoking – tobacco use increases individual dementia risk by 60 per cent. Responsible for 5 per cent of cases.
- Social isolation – coronavirus lockdown has shown the devastating impact of isolation. Increases dementia risk by 60 per cent and is responsible for 4 per cent of cases.
- Depression – psychological distress increases the risk of depression by 90 per cent, and antidepressants do not help. Accounts for 4 per cent of all cases.
- Lack of exercise – physical activity increases blood flow, speeds up metabolism and increases the health of blood vessels. Inactive people are 40 per cent more likely to develop dementia. Responsible for 2 per cent of cases.
- Diabetes – Britain has a booming diabetes problem, with 4 million diagnoses with the disease. They are at 50 per cent increased dementia risk. Responsible for 1 per cent of cases.
- Air pollution – increasing evidence shows people living near main roads are vulnerable to neurological decline. Increases dementia risk by 10 per cent. Responsible for 2 per cent of cases.
These lifestyle habits – together with environmental factors, medical history and education – are responsible for roughly 340,000 out of Britain’s 850,000 dementia cases, the study suggests.
A team of 28 world-leading dementia experts, who conducted the review for the Lancet medical journal, identified 12 different controllable factors which contribute to dementia risk.
For decades experts believed dementia was a matter of fate – a cruel quirk of genetics and ageing.
But in recent years scientists have become increasingly aware that dementia is not inevitable, and in fact the way people live their lives increases the risk of developing the condition in old age.
There is now a growing understanding that poor blood circulation – which is hugely influenced by diet, exercise and drinking – has a significant impact on the brain.
Education is also now known to have a protective effect, with those who receive a better schooling more likely to continue to carry out complex thinking throughout their lives – which reduces dementia risk by keeping the brain active.
Air pollution, as well as depression and social in old age, also increases the risk.
In 2017 a previous Lancet review identified nine elements which contributed to dementia risk.
The new paper updates this and adds three new risk factors – alcohol intake, air pollution and head injuries.
The researchers – who include world-leading British scientists from University College London, Cambridge, Exeter, Edinburgh and Manchester – stressed that the majority of dementia risk is down to genetics and other uncontrollable factors.
But they said the new findings show people have a huge degree of power to determine their own fate.
Politicians, meanwhile, must take responsibility for reducing some of the risk, they said – particularly by addressing the growing problem of air pollution.
Researcher Professor Clive Ballard of the University of Exeter, said: ‘Our findings present an exciting opportunity to improve millions of lives across the world by preventing or delaying dementia, through healthier lifestyle to include more exercise, being a healthy weight and stopping smoking, and good medical treatment of risk factors like high blood pressure.
‘One important less well known risk factor is hearing loss in mid-life, with emerging evidence that wearing hearing aids may be protective.
‘This presented an important public health message – if you’re having hearing problems, getting tested in mid life and wearing a hearing aid if needed could have multiple benefits.
‘This analysis shows there’s real potential to improve brain health by taking action.’
The researchers said one of the biggest controllable factors is poor education, which is responsible for 7 per cent of dementia cases.
Hearing loss in middle age is responsible for 8 per cent of cases and brain injury for 3 per cent.
High blood pressure from middle age contributes 2 per cent, obesity 1 per cent and drinking more than 21 units a week 1 per cent.
Smoking in old age contributes 5 per cent of cases, physical inactivity 2 per cent, diabetes 1 per cent, depression 4 per cent, isolation 4 per cent and air pollution 2 per cent.
Study leader Professor Gill Livingston of UCL, who presented the paper yesterday to the Alzheimer’s Association International Conference, said politicians could do much to reduce these risks.
‘Our report shows that it is within the power of policy-makers and individuals to prevent and delay a significant proportion of dementia, with opportunities to make an impact at each stage of a person’s life.
What do the experts recommend?
- Aim to maintain systolic blood pressure (the top number reading on a blood pressure test) of 130mm Hg or less in midlife from around the age of 40
- Use 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
- Provide all children with primary and secondary education
- Lead an active life into mid, and possibly later life
- Reduce obesity and diabetes
‘We can reduce risks by creating active and healthy environments for communities, where physical activity is the norm, better diet is accessible for all, and exposure to excessive alcohol is minimised.’
Fiona Carragher, director of research at the Alzheimer’s Society, which part-funded the study, said: ‘While we don’t have all the answers yet, we can take action now to tackle the risk factors within our control, including excessive drinking, obesity and high blood pressure.
‘Meanwhile, we need public health policies to address other factors, such as air pollution and inequalities in childhood education.’
Dr Rosa Sancho, head of research at Alzheimer’s Research UK, added: ‘While there’s no sure-fire way of preventing dementia, the best way to keep your brain healthy as you age is to stay physically and mentally active, eat a healthy balanced diet, not smoke, drink only within the recommended limits and keep weight, cholesterol and blood pressure in check.
‘With no treatments yet able to slow or stop the onset of dementia, taking action to reduce these risks is an important part of our strategy for tackling the condition.
‘This report underlines the importance of acting at a personal and policy level to reduce dementia risk.’
Professor Jennifer Rusted of the University of Sussex, added: ‘The big picture here is that an individual’s dementia risk is a complex of many factors that impact differently through the lifespan, and lifestyle choices and changes can quite significantly reduce risk of dementia in later life.
‘If you can work to mitigate any of these multiple factors then you can at least push back the age at which cognitive impairment emerges to affect your independent living and quality of life.’
WHAT IS DEMENTIA? THE KILLER DISEASE THAT ROBS SUFFERERS OF THEIR MEMORIES
Dementia is an umbrella term used to describe a range of neurological disorders
A GLOBAL CONCERN
Dementia is an umbrella term used to describe a range of progressive neurological disorders (those affecting the brain) which impact memory, thinking and behaviour.
There are many different types of dementia, of which Alzheimer’s disease is the most common.
Some people may have a combination of types of dementia.
Regardless of which type is diagnosed, each person will experience their dementia in their own unique way.
Dementia is a global concern but it is most often seen in wealthier countries, where people are likely to live into very old age.
HOW MANY PEOPLE ARE AFFECTED?
The Alzheimer’s Society reports there are more than 850,000 people living with dementia in the UK today, of which more than 500,000 have Alzheimer’s.
It is estimated that the number of people living with dementia in the UK by 2025 will rise to over 1 million.
In the US, it’s estimated there are 5.5 million Alzheimer’s sufferers. A similar percentage rise is expected in the coming years.
As a person’s age increases, so does the risk of them developing dementia.
Rates of diagnosis are improving but many people with dementia are thought to still be undiagnosed.
IS THERE A CURE?
Currently there is no cure for dementia.
But new drugs can slow down its progression and the earlier it is spotted the more effective treatments are.
Source: Alzheimer’s Society