Identifying Novel Factors Linked to Dementia Prevention: Discoveries of 3 Modifiable Risk Elements
In a groundbreaking report by the 2024 Lancet Commission, two new modifiable risk factors for dementia have been identified. These factors, untreated vision loss and high levels of low-density lipoprotein (LDL) cholesterol, join a list of existing risks that already includes high blood pressure, diabetes, smoking, hearing loss, social isolation, and others.
Untreated vision loss, a condition that can be prevented or delayed through regular eye exams and timely treatment of conditions such as cataracts, glaucoma, age-related macular degeneration, and diabetic retinopathy, is estimated to account for approximately 2% of dementia cases worldwide.
High LDL cholesterol, a risk factor linked to about 7% of dementia prevalence, can be managed through lifestyle changes (diet and exercise) and medications like statins.
By addressing these new factors, as well as the existing ones, public health efforts focusing on early diagnosis and management of these risks could potentially prevent or delay a significant number of dementia cases. In fact, it is estimated that about 45% of dementia cases globally are potentially preventable by addressing all 14 modifiable factors.
Meanwhile, military veterans are at a high risk of occupational traumatic brain injury (TBI), with a single, mild head injury increasing the risk of dementia less than a severe TBI. Multiple TBIs increase the risk further. A study of older adults with concussion found their risk of dementia doubled, but statin use in this group was associated with a 13% reduced risk of dementia. Minimizing traumatic brain injuries, including concussions and severe injuries such as skull fractures, edema, or brain injury/bleed, can potentially reduce the risk of young-onset and later-life dementia.
Exposure to air pollutants like high nitrogen dioxide concentration, fine ambient particulate matter, and second-hand smoke increases the risk of dementia. Reducing exposure to air pollution and second-hand tobacco smoke can help lower the risk of developing dementia due to these factors.
Interestingly, a single, severe TBI is related to widespread loss of normal tau function, one of the hallmarks of Alzheimer's disease.
Lastly, programs that teach healthy relationship skills, such as communication, effectively managing feelings, and conflict-solving, can potentially reduce the risk of domestic violence and child abuse behaviour.
In conclusion, regular vision care and cholesterol management, along with controlling other known risks, could potentially prevent or delay a significant number of dementia cases. Public health initiatives targeting these factors, as well as promoting healthy lifestyles and reducing exposure to air pollution and tobacco smoke, could significantly reduce the burden of dementia.
- Science has identified two new modifiable risk factors for dementia prevention: untreated vision loss and high levels of LDL cholesterol.
- Management of high LDL cholesterol can be achieves through lifestyle changes in health-and-wellness such as diet and fitness-and-exercise, and in some cases, medicines like statins.
- Addressing these new factors, along with existing ones, could potentially prevent or delay a significant number of dementia cases, as much as 45% of global dementia cases are potentially preventable.
- Environmental science plays a role in dementia prevention as exposure to air pollutants like nitrogen dioxide, particulate matter, and second-hand smoke increases dementia risk.
- Mental health and well-being are also crucial in dementia prevention, with programs promoting healthy relationship skills potentially reducing the risk of domestic violence and child abuse behavior.
