Dementia prevention starts when?

The lifestyle decisions you make in middle age have a huge impact on your likelihood of developing dementia, according to the latest research. The ongoing study also finds that a key factor in preventing dementia starts with the early identification of Alzheimer’s.

Dementia affects about 50 million people around the world – 425,000 of them in Australia – and is the second leading cause of death in Australia. Recent estimates show that dementia costs the healthcare system around $15 billion a year.

Craig Ritchie, Professor of Psychiatry and Ageing at the University of Edinburgh and a world-leading dementia expert, says research shows that middle age is where the fight begins.

“Alzheimer’s disease has its genesis in your 50s, 40s, even earlier,” said the lead researcher of the PREVENT project, a major international consortium working towards identifying early risk factors.

Speaking at an International Dementia Conference in Sydney, he said that while it was highly unlikely Alzheimer’s dementia could be cured –  explaining that it was the “final end point” of Alzheimer’s disease – “if you detect Alzheimer’s disease in its earliest stages, who’s to say you can’t cure that?”

“The evidence we’re seeing now suggests that decisions you make in mid-life can impact your chances of getting dementia, as well as your brain health after diagnosis.”

The keys to minimising the risk of dementia, he said, were a good exercise routine, weight control, a balanced diet, and not smoking from an early age.

“Taking on new cognitive challenges that kept the brain active was also likely to be protective.”

In 2017, the Lancet Commission released a life-course model for dementia risk. Key recommendations included:

  • Be ambitious about prevention. Interventions for established risk factors may have the potential to delay or prevent one-third of dementias
  • Individualise dementia care. Good dementia care spans medical, social and supportive care and should be tailored to individual and cultural needs, preferences and priorities
  • Care for family carers. Family carers are at high risk of depression. Effective interventions reduce the risk and treat the symptoms, and should be made available
  • Plan for the future. People with dementia and their families value discussions about the future and important upcoming decisions
  • Manage neuropsychiatric symptoms. Management of the neuropsychiatric symptoms of dementia – including agitation, low mood or psychosis – is usually psychological, social and environmental, with drug treatment reserved for more severe symptoms
  • Consider end of life. One-third of older people die with dementia, so it is essential that professionals working in end-of-life care consider whether a patient has dementia, as they may be unable to make decisions about their care or express their needs and wishes.

Do you closely follow developments in dementia research? Have you had experience in caring for a loved one with dementia?

Written by Janelle Ward

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