Con­trol 12 risk fac­tors to pre­vent de­men­tia

Weekly Trust - - Health - Judd-Leonard Okafor

At least 12 risk fac­tors con­trib­ute to the chances of get­ting de­men­tia, and mod­i­fy­ing them over the course of a life­time could de­lay or pre­vent 40% of de­men­tia cases, a new study has found.

The study is an up­date to the 2017 Lancet Com­mis­sion on de­men­tia pre­ven­tion, in­ter­ven­tion and care, and is be­ing pre­sented at the Alzheimer’s As­so­ci­a­tion In­ter­na­tional Con­fer­ence (AAIC 2020).

The previous com­mis­sion iden­ti­fied nine risk fac­tors to which three new risk fac­tors have been added— ex­ces­sive al­co­hol in­take, head in­jury in mid-life, and ex­po­sure to air pol­lu­tion in later life.

The three new risk fac­tors com­bined are as­so­ci­ated with six in 100 of all de­men­tia cases.

The re­main­ing nine risk fac­tors are as­so­ci­ated with 34 in 100 of all de­men­tia cases.

The fac­tors as­so­ci­ated with the great­est pro­por­tion of de­men­tia cases in the pop­u­la­tion are less ed­u­ca­tion in early life, hear­ing loss in mid-life, and smok­ing in later life.

Here’s how the 12 risks stand out against the es­ti­mated per­cent­age of de­men­tia cases as­so­ci­ated with them:

· early life ed­u­ca­tion con­trib­utes 7%, · mid-life hear­ing loss 8%, · mid-life brain in­jury 3%, · mid-life hy­per­ten­sion 2%, · con­sum­ing more than 21 units of al­co­hol per week in mid-life con­trib­utes 1%, · mid-life obe­sity 1%, · smok­ing 5%, · de­pres­sion 4%, · so­cial iso­la­tion 4%, · phys­i­cal in­ac­tiv­ity 2%, · di­a­betes 1%, and · air pol­lu­tion 2%. De­men­tia is not a sin­gle dis­ease it­self. It is a broad term to de­scribe symp­toms of im­pair­ment in mem­ory, com­mu­ni­ca­tion and think­ing.

Around 50 mil­lion live with it world­wide, and the num­ber is pro­jected to in­crease to 152 mil­lion by 2050.

Two out of ev­ery three peo­ple with de­men­tia live in low-in­come and mid­dle-in­come coun­tries, and the big­gest rise in de­men­tia preva­lence is pro­jected there.

Its im­pacts on in­di­vid­u­als, their fam­i­lies and the econ­omy raises global cost of de­men­tia to about $1 tril­lion each year.

“In low- and mid­dle-in­come coun­tries, the higher preva­lence of de­men­tia risk fac­tors means an even greater pro­por­tion of de­men­tia is po­ten­tially pre­ventable than in ‘higher-in­come coun­tries,” said the re­port co-au­thor, Pro­fes­sor Ades­ola Ogun­niyi, Univer­sity of Ibadan.

“In this con­text, na­tional poli­cies ad­dress­ing de­men­tia risk fac­tors, like pri­mary and sec­ondary ed­u­ca­tion for all and stop­ping smok­ing poli­cies, might have the po­ten­tial for large re­duc­tions in de­men­tia and should be pri­ori­tised. We also need more de­men­tia re­search com­ing from low- and mid­dle-in­come coun­tries, so we can bet­ter un­der­stand the risks par­tic­u­lar to these set­tings.”

The Lancet re­port, led by 28 world-lead­ing de­men­tia experts, calls for na­tions and in­di­vid­u­als to be am­bi­tious about pre­vent­ing de­men­tia and lays out a set of poli­cies and lifestyle changes to help pre­vent de­men­tia.

“Our re­port shows that it is within the power of pol­icy-mak­ers and in­di­vid­u­als to pre­vent and de­lay a sig­nif­i­cant pro­por­tion of de­men­tia, with op­por­tu­ni­ties to make an im­pact at each stage of a per­son’s life,” says lead au­thor Pro­fes­sor Gill Liv­ingston, Univer­sity Col­lege Lon­don, UK.

“In­ter­ven­tions are likely to have the big­gest im­pact on those who are dis­pro­por­tion­ately af­fected by de­men­tia risk fac­tors, like those in low- and mid­dle-in­come coun­tries and vul­ner­a­ble pop­u­la­tions, in­clud­ing Black, Asian and Mi­nor­ity Eth­nic com­mu­ni­ties.

“As so­ci­eties, we need to think be­yond pro­mot­ing good health to pre­vent de­men­tia, and be­gin tack­ling in­equal­i­ties to im­prove the circumstan­ces in which peo­ple live their lives. We can re­duce risks by cre­at­ing ac­tive and healthy en­vi­ron­ments for com­mu­ni­ties, where phys­i­cal ac­tiv­ity is the norm, bet­ter diet is ac­ces­si­ble for all, and ex­po­sure to ex­ces­sive al­co­hol is min­imised.”

To ad­dress risk of de­men­tia, the Lancet re­port list nine rec­om­men­da­tions for pol­icy mak­ers and in­di­vid­u­als:

· Aim for blood pres­sure of 130mmHg or less from aground age 40

· En­cour­age use of hear­ing aids for hear­ing loss and re­duce hear­ing loss by pro­tect­ing ears from high noise lev­els.

· Re­duce ex­po­sure to air pol­lu­tion and sec­ond-hand tobacco smoke.

· Pre­vent head in­jury (par­tic­u­larly by tar­get­ing high risk oc­cu­pa­tions and trans­port)

· Pre­vent al­co­hol mis­use and limit drink­ing to less than 21 units per week (one unit equal 10ml of pure al­co­hol)

· Stop smok­ing up­take and sup­port in­di­vid­u­als to stop smok­ing (which the au­thors stress is ben­e­fi­cial at any age).

· Pro­vide all chil­dren with pri­mary and sec­ondary ed­u­ca­tion.

· Lead an ac­tive life into mid, and pos­si­bly later life. · Re­duce obe­sity and di­a­betes. These ac­tions are es­pe­cially im­por­tant in LMICs where de­men­tia rates are ris­ing more rapidly than in high-in­come coun­tries. This is a re­sult of in­creas­ing life ex­pectancy, and a higher fre­quency of cer­tain de­men­tia risk fac­tors - such as lower rates of ed­u­ca­tion; high rates of hy­per­ten­sion, obe­sity, and hear­ing loss, and rapidly grow­ing rates of di­a­betes.

Newspapers in English

Newspapers from Nigeria

© PressReader. All rights reserved.