The September 21st it is celebrated World Alzheimer’s Day. And there is no shortage of good news, especially in terms of prevention. Some studies have in fact shown how by intervening on risk factors modifiable, one can hope to prevent the signs of cognitive decline, or at least delay its appearance.
The experts of the Italian Society of Neurology (SIN) have reported this in view of the G7 meeting on dementia scheduled in Ancona on October 8th.
The “new” risk factors
Check your eyes, avoiding finding yourself with severe drops in vision at an advanced age without necessary treatment. And keep the blood levels of LDL cholesterol, which is generically defined as “bad”, at acceptable levels, preferably as low as possible. These two elements are added to those already known and must be considered carefully, even in people who present genetic characteristics that favor the appearance of cognitive decline.
These new risk factors They add to the risk factors previously identified by the Lancet Commission in 2020 (low levels of education, hearing problems, high blood pressure, smoking, obesity, depression, physical inactivity, insulin resistance and diabetes, excessive alcohol consumption, head trauma, air pollution and social isolation), which are linked to 40% of all dementia cases.
In addition to these, however, food contamination and adulteration, alterations of the intestinal and oral microbiota, sleep disorders, Herpes virus infections and probably immune aging or immunosenescence must also be taken into account.
Why we need to act
SIN calls on governments and society to commit toaddressing the risks of dementia throughout life, supporting the idea that a promotional action in favour of primary and secondary prevention represents the real weapon to win the challenge with dementia, while at the same time increasing the social and health support for the benefit of the sick and their families.
Due to the rapidly aging population in Italy, it is expected that The number of people with dementia will nearly triple by 2050going from 1.2 million in 2019 to over 3 million, with estimated direct and indirect costs of 23 billion to more than 60 billion euros.‘increasing life expectancy It will also lead to an increase in the number of people with dementia in low-income and poverty-stricken countries. However, even in our country, the percentage of elderly people with dementia has decreased, particularly among those living in environmentally and socio-economically advantaged areas.
The decline in people developing dementia is likely due in part to cognitive and physical resilience and less vascular damage as a result of improvements in health care and lifestyle changes, demonstrating the importance of implementing prevention approaches as early as possible.
The key recommendations
“Much more can and must be done to reduce the risk of Alzheimer’s – explains Alessandro Padovani, President of SIN. We have convincing evidence that longer exposure to different risk factors has a greater effect and that the risks act more in vulnerable people. This is why it is essential to incentivize preventive efforts towards those who need them most, including those living in low- and middle-income areas and in socio-economically disadvantaged groups. It is a task that concerns everyone and must aim to reduce inequalities of risk by making healthy lifestyles as accessible as possible to everyone.”
To reduce the risk of dementia throughout life, the SIN outlines various recommendationsLet’s try to see them together.
- First of all, we need to start from the schooloffering good quality school education by encouraging higher education. It is also important to study lifelong learning paths at different stages of life supporting the Third Age Universities and voluntary association activities.
- On the environmental frontit is necessary to promote theuse of helmet and head protection in the use of scooters and bicycles, in risky workplaces and in contact sports activities, as well as reduce exposure to environmental and food pollution through rigorous policies for a clean and healthy environment.
- Chapter alcohol and smoking. It is recommended to expand measures aimed at reducing cigarette smoking, such as price controls, raising the minimum age for purchasing and banning smoking in public places, including outdoors.
- On the front of the alcoholic beverages the aim could be to expand measures to reduce excessive consumption of spirits in meeting places.
- On the front psychophysicalthe importance of promoting the fight against isolation and loneliness at all ages by encouraging the creation of community environments and Supportive accommodation to combat social distress.
- Furthermore, in addition to protecting mental health, one must pay attention to do not “isolate” people due to vision or hearing impairments. How? By promoting ophthalmological and audiological screenings from the age of 65.
- Finally, in addition to safeguarding the Dental healthit is necessary to check (and possibly act) on cholesterol And pressure from a young age, pay attention to thefood and sleepor, identify early the mood disorders.
The importance of lifestyle and prevention on the economy
“A healthy lifestyle – continues Padovani – that includes regular physical exercise, not smoking, regular sleep, providing cognitive and mental stimulation even outside of formal education and that avoids excessive use of alcohol and promotes a balanced diet rich in vegetables and fruit, is not only able to reduce the risk of dementia, but can also delay its onset as well as slow its progression. This has enormous implications on the quality of life for individuals and benefits in terms of cost savings for companies“.
Just think: in this way Italy could obtain savings on current costs in 20 years equal to approximately 10 billion euros to be used to carry out support activities for the sick and their families.
In a study published in the journal The Lancet Healthy Longevity Naaheed Mukadam (UCL Psychiatry), the co-authors modelled the economic impact of implementing some of these recommendations, using England as an example. The study’s findings suggest that the use of interventions at the population level of known effectiveness in addressing dementia risk factors could have a profound effect on dementia prevalence and inequalities, as well as significant cost savings.
Finally, the SIN also asks for a more support for people with dementia and their families. In many regions and areas of our country, effective interventions that are known to benefit people with dementia are not yet available or are not a priority.
Likewise, the needs of many caregiver are not adequately considered and satisfied.
It would be important to provide interventions of coping for family caregivers and who are at risk of depression and anxiety, ensuring in addition to financial benefits and support, also emotional support, planning for the future and information on medical and social-health resources.
All the more reason why it is more necessary than ever to promote concerted actions in support of lonely and isolated people as well as all people fragilegiven the evidence that these are at greater risk of developing Alzheimer’s disease.
