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2024 Lancet Commission underscores the potential for dementia risk reduction, identifying 14 modifiable risk factors across the life course
The standing Lancet Commission on Dementia Prevention, Intervention, and Care published its 2024 report, repeatedly emphasising the potential for dementia risk reduction.
High midlife LDL-cholesterol and late-life vision loss have been added to the existing list of dementia risk factors with strong scientific evidence (low education, hearing loss, hypertension, smoking, obesity, depression, physical inactivity, diabetes, excessive alcohol consumption, traumatic brain injury, air pollution and social isolation).
Population attributable fractions have been estimated to amount to 45%, meaning that nearly half of future dementia cases could potentially be prevented if all 14 risk factors were eliminated.
Alzheimer Europe welcomes the conclusions of the Lancet Commission and calls for governments to incorporate this new evidence into public health practice. The organisation furthermore emphasises the importance of honest, empathic and compassionate communication regarding risk factor status.
Luxembourg, 1 August 2024 – Yesterday, the standing Lancet Commission on Dementia Prevention, Intervention, and Care published the results of their 2024 report, highlighting the potential for dementia risk reduction and prevention by tackling modifiable risk factors. During a dedicated session at the Alzheimer’s Association International Conference in Philadelphia, US, the Commission shared the main updates and changes from the 2020 report.
Since its establishment in 2017, the Commission has evaluated evidence concerning potentially modifiable dementia risk factors, triangulating scientific evidence from various meta-analyses and intervention studies. The 2024 report reaffirms the potential for dementia risk reduction by addressing the existing 12 risk factors across the life course: low education, hearing loss, hypertension, smoking, obesity, depression, physical inactivity, diabetes, excessive alcohol consumption, traumatic brain injury, air pollution and social isolation. Moreover, new meta-analyses for depression and hearing loss were conducted and population attributable fractions recalculated.
In addition to the 12 existing factors, the Commission now includes higher LDL cholesterol as a midlife risk factor for dementia, based on new evidence from large cohort studies involving more than 1 million participants and a Mendelian meta-analysis of 27 studies. The Commission furthermore added untreated vision loss as a risk factor, citing evidence from two large meta-analyses. Population attributable fractions of all 14 risk factors have been calculated using data of the Norwegian Trøndelag Health Study (HUNT). According to the updated estimates, 45% of future dementia could potentially be prevented if all 14 risk factors were eliminated, with high midlife LDL cholesterol and untreated vision loss in late life contributing 7% and 2%, respectively.
Jean Georges, Executive Director of Alzheimer Europe, stated: “Alzheimer Europe welcomes this updated report and the hopeful message that nearly half of all future dementia cases could potentially be prevented. The organisation calls on national governments to include these findings in their local public health and risk reduction campaigns. As some of the risk factors originate at the societal level, large-scale policy changes are necessary to seize the full potential of risk mitigation and prevention.”
The updated report includes a number of recommended measures to mitigate dementia risk at the population level. In addition to ensuring high-quality education for everyone and taking necessary actions to limit air-pollution exposure, the Commission recommends that hearing aids and eye tests should be made accessible for all. On an individual level, treating depression, hypertension, high midlife LDL cholesterol, obesity and diabetes is recommended, as is the cessation of smoking and the reduction of alcohol consumption, along with engagement in physical, social and cognitive activities.
Although Alzheimer Europe supports the conclusions of the Commission, the organisation also wishes to emphasise the importance of honest, empathetic and compassionate disclosure regarding the status of individual risk factors. Alzheimer Europe’s 2023 position paper1 on this topic underlines the need for risk disclosure to include clear expectations regarding the benefits of lifestyle modification and comprehensive information on how positive lifestyle changes can be put into practice. In addition, Alzheimer Europe emphasises the need to ensure representativeness of research studies to ensure applicability of their findings across diverse populations and groups, supporting the Commission’s call for research on dementia risk reduction in under-represented cultures and ethnicities.
Luxembourg, 1 August 2024 – Yesterday, the standing Lancet Commission on Dementia Prevention, Intervention, and Care published the results of their 2024 report, highlighting the potential for dementia risk reduction and prevention by tackling modifiable risk factors. During a dedicated session at the Alzheimer’s Association International Conference in Philadelphia, US, the Commission shared the main updates and changes from the 2020 report.