This week, Alzheimer’s Disease International released the World Alzheimer Report 2014: Dementia and Risk Reduction assessment. We take a look at the key findings.

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A key point of the report is that national programs tackling major non-communicable diseases need to be more inclusive of seniors.

Alzheimer’s Disease International commissioned a team of experts, led by Prof. Martin Prince from King’s College London in the UK, to produce the report as a part of World Alzheimer’s Month.

The report makes the case that the risk of dementia in later life can be reduced among the general population if diabetes and high blood pressure are controlled, and efforts are made to reduce risk of heart disease and to encourage people to quit smoking.

According to the report, diabetes increases the risk of dementia by 50%. By extension, the report also suggests that risk factors for diabetes and high blood pressure, such as obesity and lack of physical activity, should be targeted as part of Alzheimer’s prevention.

Despite cardiovascular health improving among many high-income countries, the report acknowledges that many low- and middle-income countries have rising rates of diabetes, heart disease and stroke.

The report emphasizes the association between smoking cessation and reduced risk of dementia. It quotes studies of dementia incidence among seniors that demonstrate while risk for dementia is similar between ex-smokers and people who have never smoked, those who continue to smoke are at much higher risk.

The impact of education on dementia risk is also assessed in the report, revealing that people with better educational opportunities have a lower risk of dementia in later life. The authors claim evidence suggests that while education does not influence the changes in the brain that result in dementia, it does have an impact on intellectual functioning.

Also important, the authors say, is the need to preserve brain health during mid-life. Studies show that when people enter old age with well-developed, healthy brains, they have a greater chance of leading happier and more independent lives in old age, with a reduced chance of developing dementia.

Although brain health is important at all stages of life, it is particularly important in mid-life, say the authors, as the changes in the brain responsible for dementia can begin decades before symptoms appear.

They add that the future of the global dementia epidemic depends on the success or failure of efforts to improve public health. Combining programs to tackle the burden of non-communicable diseases (NCDs) globally will be strategic, efficient and cost effective, the report claims.

Speaking to Medical News Today, Prof. Prince explains that the actions of NCD prevention in global health policy are focused on cancers, heart disease, stroke and diabetes. However, “the measures – tobacco control, reduced dietary salt, increased physical activity, and better management of cardiovascular risk – should be helpful in reducing the incidence of dementia too.”

Fast facts from 2014 Alzheimer’s Disease Facts & Figures report
  • More than 5 million Americans are living with the disease
  • 1 in 3 seniors die with Alzheimer’s or another dementia
  • There are approximately 500,000 people dying each year because they have Alzheimer’s.

“Therefore,” he says, “one thing that we need to do is to ensure that cognitive health and dementia prevalence are monitored, in addition to the other priority NCDs, to ensure that the program is properly prioritized and kept on track. Dementia is costlier in societal terms than the other four NCDs put together.”

In addition, Prof. Prince says that while the global plan focuses on younger people, in order to prevent premature deaths, evidence suggests that giving up smoking or controlling diabetes in late-life also usefully reduce the incidence of dementia.

“This could be a powerful motivation for older people to change their behavior,” says Prince, “since dementia is apparently now the most dreaded condition. Also, health systems need to focus more on attending to cardiovascular risk in older people, who tend be particularly poorly served by hypertension and diabetes detection and control programs.”

However, recent studies show that public awareness of the modifiable risk factors of dementia is very low.

“Actually, awareness about dementia, full stop, is low,” Prof. Prince says. “In the UK, still only around half of those living with the condition have received a diagnosis. However, this is changing rapidly, and there is an increasing appetite for information on how individual risk may be reduced, reflected in the growth of mainstream news media stories.”

One of the problems, it seems to me, is that a bewildering array of factors have been implicated but with varying degrees of evidence to support the claims. Often single studies have been over-hyped. The public is therefore understandably confused. In this year’s World Alzheimer Report, we have tried to cut through the thicket of evidence, claim and counter claim, to identify those areas where evidence is strongest. We have come up with just four factors – early life education, high blood pressure in mid-life and diabetes and smoking in late-life.”

Prince says that from these four factors emerge two main underlying mechanisms:

  • A well-nourished and well-developed brain may create some “reserve capacity” such that, even in the face of neurodegeneration, an older person may be living normally with no signs of dementia
  • Pathways that increase risk for cardiovascular disease.

“Linked to this is a simple message,” he says, “‘it is never too early, and never too late’ to think about brain health promotion and dementia prevention.”

In addition to the World Alzheimer Report 2014: Dementia and Risk Reduction report, the Alzheimer’s Association have also released the 2014 Alzheimer’s Disease Facts & Figures report as part of World Alzheimer’s Month.

A video containing facts from this report can be viewed below.

Recently, MNT ran a spotlight feature asking whether science is close to finding a cure for Alzheimer’s.