A major new study suggests that cutting risk factors such as smoking and air pollution could prevent or delay millions of dementia cases, but outside experts warn such measures alone can only go so far.
This devastating disease, which progressively robs people of memory, cognitive ability, language skills and independence, currently affects more than 55 million people worldwide.
Dementia is caused by a variety of diseases, the most common of which is Alzheimer’s disease.
Extensive reviews of the available evidence have been published. lance A journal study published Wednesday found that the treatment has “high potential for prevention” in the fight against dementia.
The study follows a previous report from 2020 that stressed the importance of prevention.
At the time, an international research team estimated that 40 percent of dementia cases were linked to 12 risk factors.
These factors included low education levels, hearing problems, high blood pressure, smoking, obesity, depression, lack of physical activity, diabetes, excessive alcohol consumption, traumatic brain injury, air pollution and social isolation.
The latest update adds two additional risk factors: vision loss and high cholesterol.
The study found that “eliminating these 14 risk factors could theoretically prevent up to half of dementia cases.”
EU rejects new drug approval
Despite decades of research and billions of dollars invested, there has been no success in curing dementia or developing a drug that is actually effective.
But since early last year, two Alzheimer’s treatments have been approved in the United States: Biogen’s recanemab and Eli Lilly’s donanemab.
The drug works by targeting the accumulation of two proteins—tau and amyloid beta—that are thought to be key drivers of the disease’s progression.
However, the drugs are often minimally effective, have serious side effects, and are very expensive.
In contrast to the United States, the European Union’s medicines regulator last week refused to approve recanemab, while it is still considering approval for donanemab.
Some researchers hope that the mere fact that a new drug works opens the way to more effective treatments in the future.
Some people want to focus on how to prevent dementia above all else.
Focusing on risk factors would be “far more cost-effective than developing cutting-edge treatments that have so far had disappointing effects on people with dementia,” said Masood Hussain, a neuroscientist at the University of Oxford in the UK.
‘How much more can we do?’
The Lancet study was welcomed by experts in the field, many of whom disagree on the importance of prevention.
However, some argue that we should be more objective about the idea that nearly half of all dementia cases could be prevented.
The researchers acknowledged that it has not been proven that risk factors directly cause dementia.
For example, could depression be caused by dementia, or could it be the other way around?
Although researchers have tried, it is difficult to separate risk factors from each other.
In some cases, they are intrinsically linked, such as depression and isolation, or smoking and high blood pressure.
Above all, many of the risks are social catastrophes that have long proven nearly impossible to completely address.
The study suggests a range of recommendations, from individual recommendations, such as wearing a helmet when riding a bicycle, to government-level recommendations, such as improving access to education.
“It’s not clear whether we can completely eliminate these risk factors,” Charles Marshall, a neurologist at Queen Mary University of London, told AFP.
“We already have public health programs in place to reduce smoking and high blood pressure. So how much more can we do?”
“It’s important that we don’t blame people with dementia on their brain disease,” said Tara Spires-Jones, a neuroscientist at the University of Edinburgh.
She added: “It is clear that a significant proportion of dementia is preventable, due to factors beyond a person’s control, such as genetics or early educational opportunities.”
© Agence France-Presse
