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Reducing the risk of dementia: A new, but growing, evidence base

Dr Matthew Norton

Alzheimer’s Research UK is delighted to have recently joined the UK Health Forum (UKHF) and taken part in the annual general meeting this week. The UKHF is a centre of expertise, working with and through its members to contribute to the prevention of the avoidable non-communicable diseases, including dementia.

UKHF-red-backgroundThe fact that we were asked to join the organisation says much about the growth of evidence and interest around the possibilities of reducing the risk of developing dementia. Although age remains the single biggest factor and, for some conditions, genetics influence your chances, there is a growing body of research literature that identifies key lifestyle factors which appear to be implicated in the development of dementia.

Lifestyle factors that are likely to be involved

These lifestyle risk factors, many of which are similar to those for cardiovascular conditions, include smoking, unmanaged hypertension, diabetes and lack of education. Other factors have been proposed, although currently the evidence base is less certain, including obesity, alcohol consumption, physical inactivity, sports-related head injuries and depression.

Given the potential for lifestyle factors to reduce the risk of dementia, Alzheimer’s Research UK plans to engage with public messaging and campaigns that support more healthy lifestyles.

There is considerable interest within the media around ways to prevent dementia, many of which are not necessarily based on causal evidence. Therefore it is important that Alzheimer’s Research UK provides clear, evidence-based messages that help the public to make appropriate decisions. We remain mindful of the relatively weak evidence base for some of the risk factors. However, given they support good cardiovascular health, even if a causal relationship to dementia does not exist, at worst we are promoting healthier lifestyles. However, we can’t say with any certainty the extent to which lifestyle factors contributed to any one individual’s development of dementia. As with cancer, or any other prominent disease where lifestyle factors can be involved, there is a need to ensure that our messages do not imply blame in terms of those individuals who now have dementia, who perhaps did not follow a healthy lifestyle, nor give false hope to those currently following health lifestyles that they will definitely avoid dementia.

More research…

To date there has been limited research investment into risk reduction of dementia, both by Alzheimer’s Research UK and other research funders. The lack of investment extends beyond a simple lack of money – there are more knotty issues around the quality of proposals within this area, and the challenge of developing robust approaches to ultimately deliver high quality evidence. This is especially challenging when research may need to consider decades of exposures to risk modifiers, which is beyond the length of most types of grant funding.

To answer this challenge and support improved research in the area we have created a Prevention Fund as part of the Defeat Dementia campaign. Through this fund we will aim to fund more prevention research and we will also use our influence to encourage other funders to increase their investment in prevention research.

Through a combination of thought leadership, awareness raising, and increased funding we hope we can increase our understanding of how we all might reduce our risk of developing dementia and spread that message of the multitude of benefits of healthy lifestyle choices.

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