Reducing the risk and impact of dementia
THE EVIDENCE IS VERY STRONG THAT THE RISK AND IMPACT OF DEMENTIA CAN BE SIGNIFICANTLY REDUCED
The Lancet Commission on Dementia, Prevention, Intervention and Care has been reviewing the evidence from high quality research for ten years and publishes evidence that this condition is both preventable, with a reduction of risk of at least a third, and treatable even though there are, as yet, no drug treatments available. The World Health Organisation has also produced guidelines on dementia and came to the same conclusion, namely that there is strong evidence that the risk of dementia can be reduced, in their estimate by about 45%.
There are three different types of risk factor
The risk factors listed above can also be described as factors which affect the rate of decline and therefore the rate of decline can be slowed if these factors are tackled, so they are therapeutic as well as preventive.There is treatment for dementi. Unfortunately when the word treatment is used people tend to think immediately of drugs so the fact that there is no drug treatment for standard use it is common for people with dementia and their families to be told something like "I'm sorry it is dementia, unfortunately there is no treatment , we will see you in a years time". As a result the person becomes depressed and more isolated or they may or have any problem with sion and hearing ignored or assumed to be the result of the dementia, to mention only four of the 'risk factors' which could also be described as accelerating factors.
To help people already diagnosed with dementia and their families cope with the challenge local communities need to be developed and the Alzheimer's Society W:ISH technology will identify people who the GP has diagnosed with Dementia or MCI, Mild Cognitive Impairment and link them to learning resources beig developed by Learning With Experts in partnership with the Alzheimer's Society
The book titled Increase your Brainability- reduce the risk and impact of dementia, sets out the evidence and the action that an indiividual can take to reduce their risk of dementia or slow the rate of decline if it has developed
Good work is being done on the prevention of falls and frailty and ecause there is a very significant overlap with the risk factors for dementia so every Neighbourhood could develop a Falls, Frailty and Dementia (FFD) prevention strategy. For all three conditions the focus should be on the whole population particularly for dementia because there is no clear means of identifying a high risk subgroup so the whole population needs to learn how the risk of dementia can be reduced.
THE NEED FOR A POPULATION BASED APPROACH
In many countries a decrease in population based rates of dementia have been observed but an important study in the Lancet Public Health in 2023 raised concerns because it showed that the decline was not taking place in all sections of society and their conclusion was that Our study indicates that dementia incidence started to increase in England and Wales after 2008. Inequalities in the dementia incidence trend were found to be widening between education groups. Continued monitoring of the incidence trend will be important in shaping social care policy. Based on the estimated upward incidence trend, we project that the number of people with dementia in England and Wales will be 1·7 million in 2040, indicating that the burden on health and social care might be considerably larger than current forecasts predicted
Obviously, low levels of education attainment is an indicator that there are other risk factors that are higher, obesity for example, and people with lower levels of educational attainment are more likely to be affected by deprivation and live in communities in which the pressures of deprivation are high. So as well as ensuring that every individual is informed about the risk factors and given professional support if necessary, for example to reduce or reverse Type 2 diabetes, it is essential to develop a population based strategy to identify sections of the population affected by deprivation and develop a community based approach as well as reaching individuals
The population based approached therefore needs
W:ISH
W:ISH is working with Learning with Experts which is developing resources for people at risk of dementia, that is everyone from 60 on, although younger people can also have access because some people are worried because they have a ‘family history’ of dementia, namely a parent or grandparent having had dementia but, with the exception of relatively rare genetic forms of Alzheimer’s disease, a ‘family history’ does not indicate increased risk. This programme has been developed by the authors of the book Increase Your Brainability; reduce the risk and impact of dementia and the authors are giving their royalties to the Alzheimer’s Society
Recognising that people at highest risk are in the most deprived subgroups and are therefore less likely to respond to an invitation to participate in a learning programme, even though the language used is designed for all levels of literacy, there are also resources for discussing dementia with groups in the community , for example a mosque or awalking football club
The work of the Lancet Commission of Dementia Prevention, Intervention and Care has also highlight the fact that the ‘risk factors’ are also factors that influence the rate of decine after diagnosis has been made although too many people are still ebing told ”there is no treatment”. Excellent work is being done by the Alzheimer’s Society to develop local support groups. This will be complemented byan online learning programme being developed as not for profit service by the Oxford company Learning With Experts and this will be made available as soon as possible
The Lancet Commission on Dementia, Prevention, Intervention and Care has been reviewing the evidence from high quality research for ten years and publishes evidence that this condition is both preventable, with a reduction of risk of at least a third, and treatable even though there are, as yet, no drug treatments available. The World Health Organisation has also produced guidelines on dementia and came to the same conclusion, namely that there is strong evidence that the risk of dementia can be reduced, in their estimate by about 45%.
There are three different types of risk factor
- those that affect the brain tissue directly such as excessive alcohol and physical inactivity
- those which reduce the risk of vascular dementia, which are the same as the risk factors for heart disease
- those which increase isolation such as vision and hearing impairment
The risk factors listed above can also be described as factors which affect the rate of decline and therefore the rate of decline can be slowed if these factors are tackled, so they are therapeutic as well as preventive.There is treatment for dementi. Unfortunately when the word treatment is used people tend to think immediately of drugs so the fact that there is no drug treatment for standard use it is common for people with dementia and their families to be told something like "I'm sorry it is dementia, unfortunately there is no treatment , we will see you in a years time". As a result the person becomes depressed and more isolated or they may or have any problem with sion and hearing ignored or assumed to be the result of the dementia, to mention only four of the 'risk factors' which could also be described as accelerating factors.
To help people already diagnosed with dementia and their families cope with the challenge local communities need to be developed and the Alzheimer's Society W:ISH technology will identify people who the GP has diagnosed with Dementia or MCI, Mild Cognitive Impairment and link them to learning resources beig developed by Learning With Experts in partnership with the Alzheimer's Society
The book titled Increase your Brainability- reduce the risk and impact of dementia, sets out the evidence and the action that an indiividual can take to reduce their risk of dementia or slow the rate of decline if it has developed
Good work is being done on the prevention of falls and frailty and ecause there is a very significant overlap with the risk factors for dementia so every Neighbourhood could develop a Falls, Frailty and Dementia (FFD) prevention strategy. For all three conditions the focus should be on the whole population particularly for dementia because there is no clear means of identifying a high risk subgroup so the whole population needs to learn how the risk of dementia can be reduced.
THE NEED FOR A POPULATION BASED APPROACH
In many countries a decrease in population based rates of dementia have been observed but an important study in the Lancet Public Health in 2023 raised concerns because it showed that the decline was not taking place in all sections of society and their conclusion was that Our study indicates that dementia incidence started to increase in England and Wales after 2008. Inequalities in the dementia incidence trend were found to be widening between education groups. Continued monitoring of the incidence trend will be important in shaping social care policy. Based on the estimated upward incidence trend, we project that the number of people with dementia in England and Wales will be 1·7 million in 2040, indicating that the burden on health and social care might be considerably larger than current forecasts predicted
Obviously, low levels of education attainment is an indicator that there are other risk factors that are higher, obesity for example, and people with lower levels of educational attainment are more likely to be affected by deprivation and live in communities in which the pressures of deprivation are high. So as well as ensuring that every individual is informed about the risk factors and given professional support if necessary, for example to reduce or reverse Type 2 diabetes, it is essential to develop a population based strategy to identify sections of the population affected by deprivation and develop a community based approach as well as reaching individuals
The population based approached therefore needs
- a plan for ensuring that every individual from 50 on knows about the risk factors for dementia and how to reduce them
- resources that communities can use to raise the issue of demntia prevention in communities
- a programme for identifying and supporting every person with dementia and their families
W:ISH
W:ISH is working with Learning with Experts which is developing resources for people at risk of dementia, that is everyone from 60 on, although younger people can also have access because some people are worried because they have a ‘family history’ of dementia, namely a parent or grandparent having had dementia but, with the exception of relatively rare genetic forms of Alzheimer’s disease, a ‘family history’ does not indicate increased risk. This programme has been developed by the authors of the book Increase Your Brainability; reduce the risk and impact of dementia and the authors are giving their royalties to the Alzheimer’s Society
Recognising that people at highest risk are in the most deprived subgroups and are therefore less likely to respond to an invitation to participate in a learning programme, even though the language used is designed for all levels of literacy, there are also resources for discussing dementia with groups in the community , for example a mosque or awalking football club
The work of the Lancet Commission of Dementia Prevention, Intervention and Care has also highlight the fact that the ‘risk factors’ are also factors that influence the rate of decine after diagnosis has been made although too many people are still ebing told ”there is no treatment”. Excellent work is being done by the Alzheimer’s Society to develop local support groups. This will be complemented byan online learning programme being developed as not for profit service by the Oxford company Learning With Experts and this will be made available as soon as possible