Around 1 in 3 cases of dementia is preventable by tackling the appropriate lifestyle factors, such as by doing more physical exercise or leading an active social life, a new report shows.
The most common type of dementia, Alzheimer's disease, affects around 5 million people in the United States aged 65 and older, according to the National Institute on Aging (NIA). However, this is only one of many forms of the condition, and the NIA estimate that between 20 percent and 40 percent of people diagnosed with the disorder have it in one of its other forms.
The first Lancet Commission on Dementia Prevention and Care have now looked into how these and other factors could be managed at different stages of a person's life to help prevent the onset of dementia.
Their report was presented at the Alzheimer's Association International Conference 2017, held in London, United Kindgom, by Dr. Lon Schneider, from the Keck School of Medicine of the University of Southern California in Los Angeles, alongside other commission members. Their findings are also published in The Lancet.
Twenty-four experts from institutions worldwide came together through the Lancet Commission to review studies on dementia and put together a set of recommendations targeting treatment and prevention.
The researchers identified six lifestyle factors, the appropriate management of which could help to prevent dementia. Alongside those, they also indicated three nonmedical interventions with the same effect.
Approximately 35 percent of (or 1 in 3) dementia cases hinge on these nine factors, the report asserts.
Never too early for prevention
The specialists say that risk factors should be tackled at every phase of life, from childhood through to old age. Young people, they say, will benefit from education in this sense, while those who are middle-aged should strive to manage hearing loss, hypertension, and obesity. Combined, these steps could reduce the occurrence rate of dementia by up to 20 percent, the report highlights.
In old age, it is important to avoid smoking, tackle depression, manage diabetes, do more physical exercise, and have a more active social life. This, the researchers add, could diminish the incidence of dementia by a further 15 percent.
"There's been a great deal of focus on developing medicines to prevent dementia, including Alzheimer's disease," says Dr. Schneider. But despite efforts to find improved medication for patients, he thinks that nonpharmacologic measures, as well as conscientious endeavors to diminish the risk factors listed above, may have a better success rate.
"The potential magnitude of the effect on dementia of reducing these risk factors is larger than we could ever imagine the effect that current, experimental medications could have," he adds.
Socialization beats antipsychotics
Another key aspect considered by the report was the effectiveness of socialization in the treatment of patients diagnosed with a form of dementia.
Often, aggressive and agitated behavior on the part of the patients becomes a concern when it comes to their safety and well-being. This is when, as a rule, antipsychotics come into play.
The benefits of antipsychotic drugs are increasingly questioned by specialists, who note that side effects can be brutal and damaging, as Medical News Today have recently reported.
"Antipsychotic drugs are commonly used to treat agitation and aggression, but there is substantial concern about these drugs because of an increased risk of death, cardiovascular adverse events, and infections, not to mention excessive sedation."
Dr. Lon Schneider
The evidence reviewed by the commission pointed to a more effective use of social involvement, as opposed to tranquilizers. It showed that increased social contact and communal activities are more successful in addressing aggression and agitation.
Group cognitive stimulation therapy, focusing on games, discussions, and interactive approaches, was also deemed beneficial.
The report features recommendations for professionals, advising on everything from dementia prevention, the treatment of cognitive symptoms, and targeted care of patients, to supporting caregivers, equipping newly diagnosed patients to plan ahead, and handling neuropsychiatric symptoms.
"Mitigating risk factors provides us a powerful way to reduce the global burden of dementia," Dr. Schneider says, expressing his confidence in the report's usefulness to patients and medical professionals alike.