What New Science Says: Reduce the Risk—How Education and Lifestyle Can Delay Dementia

 

In the battle against dementia, it’s reassuring to learn that all it takes is a rigid diet, daily workouts, advanced degrees, and possibly living in a bubble—piece of cake! But who would’ve guessed that keeping our minds sharp means steering clear of life’s pleasures like bacon, booze, and lounging around? It’s as if dementia prevention is nature’s way of making us pay for having fun!

If a healthy lifestyle can prevent or delay almost half of dementia cases, and many risk factors for dementia are modifiable, then individuals and society must prioritize these changes to mitigate the looming threat of this condition. Dementia, long feared for its inevitable impact on aging populations, can be fought—not with a silver bullet, but with a collective commitment to healthier living and systemic change. The latest report from the Lancet Commission on dementia, published on July 31, 2024, offers a glimmer of hope in a field often clouded by the despair of incurability. It highlights that as many as 45% of dementia cases are preventable or can be significantly delayed. This breakthrough is particularly poignant given that, according to the World Health Organization, over 55 million people worldwide are living with dementia, a number expected to double by 2050. The report identifies 14 modifiable risk factors, including newly added ones such as untreated vision loss and high levels of LDL cholesterol, further emphasizing that lifestyle choices play a pivotal role in the battle against dementia.

One of the most significant findings of the Lancet Commission's report is the impact of hearing loss on dementia risk. People with untreated hearing loss are about twice as likely to develop dementia as those with normal hearing. This stark statistic underscores the importance of early intervention and the use of hearing aids as a simple yet effective measure to reduce dementia risk. The Commission's earlier report from 2020 had already flagged untreated hearing loss as the most significant modifiable risk factor, and the latest findings only reinforce this conclusion.

In addition to hearing loss, the report also sheds light on the importance of maintaining good vision. Poor eyesight, particularly when left untreated, has now been added to the list of risk factors for dementia. The exact mechanism by which impaired vision and hearing contribute to dementia risk remains unclear. Some researchers speculate that these sensory deficits increase cognitive load, making it harder for individuals to navigate their environment, while others suggest that social isolation and depression, which often accompany sensory impairments, may play a role.

The role of education in reducing dementia risk cannot be overstated. The Lancet report highlights that higher levels of educational attainment are associated with a lower risk of developing dementia. This finding aligns with numerous studies showing that cognitive reserve, built up through education and lifelong learning, can protect against the onset of dementia. For instance, a study published in the journal ‘Neurology’ in 2020 found that individuals with higher levels of education had a 26% lower risk of developing dementia compared to those with less education.

Physical health also plays a crucial role in dementia prevention. The Lancet Commission identifies several modifiable risk factors related to lifestyle, including smoking, obesity, physical inactivity, high blood pressure, and excessive alcohol consumption. These risk factors are not only detrimental to cardiovascular health but also significantly increase the likelihood of developing dementia. Regular physical exercise, for example, has been shown to reduce dementia risk by improving blood flow to the brain and promoting neurogenesis, the process by which new neurons are formed.

Diet is another critical component of dementia prevention. The report recommends a diet rich in fruits, vegetables, and fish, with minimal consumption of processed meats and sugar-sweetened beverages. This dietary pattern is consistent with the Mediterranean diet, which has been widely studied for its protective effects against cognitive decline. A 2017 study published in the journal ‘Frontiers in Nutrition’ found that adherence to the Mediterranean diet was associated with a 33% reduction in the risk of cognitive impairment.

The Lancet report also highlights the importance of brain-stimulating activities, such as learning a musical instrument or a new language, and engaging in mental exercises like crossword puzzles and Sudoku. These activities help build cognitive reserve, which can delay the onset of dementia symptoms. This concept is supported by research published in the journal ‘JAMA Neurology’ in 2014, which found that individuals who engaged in mentally stimulating activities throughout their lives had a lower risk of developing dementia.

While individual efforts to reduce dementia risk are crucial, systemic changes are equally important. Air pollution, for example, has been identified as a significant risk factor for dementia. Fine particulate matter, known as PM2.5, can enter the bloodstream and affect the brain's vascular system, potentially increasing dementia risk. A 2021 study published in ‘The Lancet Planetary Health’ found that long-term exposure to air pollution was associated with a higher risk of dementia, particularly among older adults.

Despite the clear evidence linking modifiable risk factors to dementia, the prevalence of the condition continues to rise, particularly in rapidly aging populations like those in China and Japan. In Japan, the age-adjusted prevalence rate of dementia doubled from 4.9% in 1985 to 9.6% in 2014. Similarly, the China Alzheimer Report of 2022 highlighted a steady increase in Alzheimer's cases, making it the fifth-most important cause of death in the country that year. These trends underscore the urgent need for public health initiatives focused on dementia prevention.

The Lancet Commission's findings should serve as a wake-up call to governments and healthcare systems worldwide. Dementia-risk reduction must become a global policy priority, with strategies that include improving access to education, promoting healthy lifestyles, and reducing exposure to environmental pollutants. The stakes are high, and the time for action is now.

In plain terms, while we cannot change our age, gender, or genetic inheritance, there is much we can do to reduce the risk of developing dementia. The Lancet Commission's report provides a roadmap for individuals and policymakers alike to take proactive steps toward a future where dementia is no longer an inevitable consequence of aging. However, the challenge lies not only in disseminating this information but also in ensuring that people are willing to adopt these healthier lifestyles. After all, it is easier to blame bad genes than to put down that sugary drink or take up jogging. As we all know, it is far more enjoyable to scroll through cat videos than to struggle through a Sudoku puzzle. But in the battle against dementia, the choice is clear: adapt or be left behind.