High low-density lipoprotein (LDL) cholesterol and untreated vision loss have been identified as new risk factors for dementia by a major new report.
The 2024 update of the Lancet Commission on dementia, suggested that 45% of cases could be prevented or delayed by tackling 14 risk factors, starting in childhood.
A previous dementia commission in 2020 identified 12 of those risk factors – which included hypertension, smoking and traumatic brain injury – while the two new risks were revealed yesterday.
The report, written by 27 dementia experts, brought together findings of new research since 2020, with a focus on systematic reviews and meta-analyses.
It states that if high LDL cholesterol and untreated vision loss were eliminated, there would be a 7% and 2% decrease in dementia cases for the two risk factors respectively.
Based on this and other findings, the Lancet commission has made 13 recommendations to individuals and governments to reduce dementia risk, such as detecting and treating high LDL cholesterol from around 40 years of age and making screening and treatment for vision impairment accessible for all.
Other recommendations include treating depression effectively, using head protection in contact sports and improving air quality.
According to the research, the number of people with dementia is set to almost triple by 2050 as people live longer.
However, the authors pointed out that in high-income countries such as the UK the proportion of older people with dementia has fallen.
They suggest that this reduction is due to people building ‘cognitive and physical resilience’ as well as having ‘less vascular damage’ as a result of healthier lifestyles.
The 14 dementia risk factors are now as follows:
- Less education
- Hearing loss
- Hypertension
- Smoking
- Obesity
- Depression
- Physical inactivity
- Diabetes
- Excessive alcohol consumption
- Traumatic brain injury
- Air pollution
- Social isolation
- Untreated vision loss
- High LDL cholesterol.
The report also estimated that the risk factors associated with the greatest proportion of people developing dementia in the global population were hearing impairment, high LDL cholesterol, less education in early life and social isolation in later life.
Professor Gill Livingstone, the lead author from University College London, said the report ‘reveals that there is much more that can and should be done to reduce the risk of dementia’.
She continued: ‘We now have stronger evidence that longer exposure to risk has a greater effect and that risks act more strongly in people who are vulnerable.
‘That’s why it is vital that we redouble preventive efforts towards those who need them most, including those in low- and middle-income countries and socio-economically disadvantaged groups. Governments must reduce risk inequalities by making healthy lifestyles as achievable as possible for everyone.’
NHS England’s national clinical director for dementia Dr Jeremy Isaacs said the report’s findings ‘offer real hope’ for reducing the number of people who live with the illness.
He said: ‘This research is really important as it suggests there are additional risk factors for dementia, which means that there are more opportunities for all of us to take action throughout our lives to reduce our risk of developing dementia or delay its onset.’
Dr Isaacs also emphasised the importance of a ‘timely diagnosis’ of dementia and said NHS staff have ‘worked hard’ to ensure the number of people with a diagnosis has risen to ‘a record level’ over the last year.
A version of this article was originally published by our sister publication Pulse.
