Lifestyle modification could reduce world dementia by third

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According to the report presented at the Alzheimer’s Association International Conference in London, it would be plausible to prevent one third of the world’s dementia cases if we start addressing certain factors such as hypertension, hearing loss, diet, depression and education during the person’s lifetime.

The first Lancet Commission on Dementia Prevention and Care composed this report by bringing together 24 experts from around the world. Experts then reviewed scores of studies and synthesize them into a model showing how lifestyle modification could reduce dementia risk.

At the moment, 47 million people worldwide have dementia, it is expected to be tripled by 2050. The global cost of dementia was estimated to be around $818 billion in 2015, those numbers are also expected to rise.

This report included 9 risk factors over a person’s lifespan, those are: years of education before age 15, hearing loss, smoking, obesity in middle age, physical inactivity, depression, diabetes in late life and social isolation. To calculate how much modificatin of each of this factors could potentially affect a person’s dementia risk,the Lancet team examined each factor separately and lookd at their relations between one another.

Many researches in the last few years showed that controllable life factors are integral to reducing the risk of cognitive decline. Combating dementia is similar to combating hearth diseases, it requires lifestyle changes and a multipronged, or “cocktail” approach combining drugs.

“The message is that conditions like dementia are not immutable and are substantially modifiable by the environment,” said Lon Schneider, professor of psychiatry and the behavioral sciences at the Keck School of Medicine at the University of Southern California and a co-author of the Lancet report.

Modifying all nine factors could reduce the risk by 35 percent, he said, “Compare that to how we’re developing drugs to treat dementia. Dementia is not a condition that’s ever going to be such that a single drug can be considered a cure for the illness.” Lifestyle modification is inexpensive, he said, and 35 percent reduction of risk is “far larger than anything you can ever expect for drugs.”

Report by the National Academies of Sciences, Engineering, and Medicine found that evidence of lifestyle modification efficacy derived from randomized controlled trials “remains relatively limited and has significant shortcomings.” In this report different methodologies were used than in the Lancet Commission’s, and it showed that just three types of intervention offered “encouraging but inconclusive” evidence: blood pressure management for hypertension, cognitive training, and increased physical exercise.

The report was presented on Wednesday at the conference by director of the Mayo Clinic Alzheimer’s Disease Research Center and the Mayo Clinic Study of Aging Ronald C. Petersen. It said that big trials are currently ongoing or forthcoming, and that they could support the effects of lifestyle intervention by providing more evidence. In 2018 the Alzheimer’s Association plans to launch a $20 million two-year clinical trial to see if lifestyle changes can prevent cognitive decline.

The study will test whether two year long intervention that includes physical exercise, nutritional counseling, social and cognitive stimulation, and improved self-management with 2,500 older adults at risk for cognitive decline can help them in reducing the risk. Participants will be 60 to 79 years old.