Over a Third of Dementia Cases Tied to Modifiable Risk Factors

By Kelly Young

Edited by André Sofair, MD, MPH, and William E. Chavey, MD, MS

Roughly 35% of dementia cases could be delayed or prevented with attention given to nine modifiable risk factors, according to a report from a dementia commission published in the Lancet.

These risk factors include less early education, midlife hypertension and obesity, hearing loss, depression in later life, diabetes, physical inactivity, smoking, and social isolation. The authors recommend addressing these conditions to reduce dementia incidence.

Among the report's other recommendations:

• Cholinesterase inhibitors should be offered to patients with Alzheimer disease or dementia with Lewy bodies and memantine to patients with severe dementia.

• Dementia care should be tailored to each patient's circumstances and needs.

• Family caregivers should be offered interventions [e.g., STrAtegies for RelaTives (START) or Resources for Enhancing Alzheimer’s Caregiver Health intervention (REACH)] to reduce depression risk and treat symptoms of depression.

• Risk assessment and management of the disease should be balanced against a patient's autonomy.

• Patients' neuropsychiatric symptoms should be managed, with pharmacological treatments reserved for severe symptoms.