RESEARCHERS ARE ADDING new pieces to the puzzle of dementia prevention. A large report published in July 2020 in The Lancet medical journal identifies three new risk factors that can play a role in the development of the disease. Excessive alcohol consumption, traumatic brain injury, and air pollution were all found to be new potential contributing causes of dementia.

The report comes out of updates to the Lancet Commission on Dementia Prevention, Intervention, and Care, which was originally created in 2017 by a group of two-dozen experts from around the world. The three new modifiable risk factors join nine others initially identified by the commission. These include less education, hypertension, hearing impairment, smoking, obesity, depression, physical in- activity, diabetes and low social contact. According to the paper, modifying these 12 risk factors may prevent or delay up to 40 per cent of dementias.

Dr. Kenneth Rockwood is a professor of geriatric medicine at Dalhousie University and sits on the commission. He says the blueprint for limiting the rise in dementia cases is becoming more and more clear just as many baby boomers begin to reach the age when most dementia cases are diagnosed (between 75 and 90).

“Generally, it looks like dementia risk is decreasing on an individual basis,” says Rockwood. “But because the population

is ageing at such a rapid rate, this will still mean net very large increases in the risk of dementia.”

The report also analyzed existing literature from around the world. The quality and consistency of evidence for the three new risk factors has strengthened in recent years, allowing the commission to add them to the list.

Rockwood says the findings should affect dementia prevention on two levels: policy and individual. On the public policy side, governments can take steps such as implementing protocols to limit air pollution. Individuals, meanwhile, may need to modify their own behaviour. This is especially important for adults who are at greater risk, such as individuals with a family history of dementia.

“We’re going to advise them, for example with respect to head injuries, that now would be the wrong time to pick a fight in league hockey. Wear your seat belt and if you’re riding a bike, wear a helmet,” says Rockwood.

When it comes to alcohol, the report suggests limiting consumption to no more than 21 units of alcohol per week. While some of the risk factors, such as having less education, need to be addressed early in life, researchers stress that most of the risk factors can be tackled at any age.

“It’s never too late to start a dementia prevention lifestyle,” says Rockwood. [ ]