Quitting smoking, lowering blood pressure and wearing a hearing aid could cut dementia rates

Programmes addressing the lifestyle habits that may contribute towards dementia could cut rates of the disease by 8.5%, research suggests.

Dementia is an umbrella term for a range of conditions that cause a decline in brain function, with Alzheimer’s being the most common.

The cause is often complex and unclear, however, it has been linked to smoking, high blood pressure and hearing loss.

In July, scientists from University College London (UCL) identified modifiable risk factors that could ward off dementia.

The same team has since found encouraging smokers to quit, treating high blood pressure and issuing hearing aids when necessary, could prevent almost one in 10 (8.5%) dementia cases in England.

Combining the three interventions would cost £1.08bn ($1.4bn) a year, however, it would save £1.86bn ($2.4bn) in healthcare expenses, according to the scientists.

Dementia affects 850,000 people in the UK, a figure which is expected to rise to 1.6 million by 2040.

“It is becoming increasingly clear that dementia can be prevented in many cases by addressing various health factors throughout the lifespan,” said lead author Dr Naaheed Mukadam.

“As the number of people with dementia is expected to increase to 131 million worldwide by 2050, there is an urgent need to develop evidence-based interventions to prevent dementia, or delay it to enable more years of healthy life.

“Here, we have found dementia prevention strategies can be cost-effective and cost saving, and should be implemented to reduce the societal burden of dementia.”

It is generally considered that “what is good for the heart is good for the brain”. A healthy diet, regular exercise and moderate drinking have therefore been linked to a reduced risk of dementia.

Hearing loss, untreated depression, loneliness and even prolonged sitting have been flagged as potential risk factors for cognitive decline.

Nevertheless, the NHS stresses “there’s no certain way to prevent all types of dementia”.

To better understand if the disease can be warded off, the UCL scientists looked at studies analysing nine “pre-specified potentially modifiable risk factors” – high blood pressure, diabetes, hearing loss, obesity, physical inactivity, social isolation, depression, smoking and “less childhood education”.

The team looked for “robust evidence the intervention improved risk”, as well as whether it is “feasible to enact in an adult population”.

Results – published in the journal The Lancet Healthy Longevity – suggest giving nicotine gum to older smokers, prescribing drugs to lower high blood pressure in middle age and issuing hearing aids for people with moderate deafness in mid-life could cut dementia rates in England by 8.5%.

The scientists predicted these three interventions would reduce dementia-related social care costs by £866m ($1.1bn) and the expense of family care by £1.05bn ($1.3bn).

This outweighs the price of implementing smoking cessation and hearing loss services, they added.

The three interventions also meet the cost-effectiveness standards set out by the National Institute for Health and Care Excellence, measured by cost per quality adjusted life year.

“We have found there’s a strong case for implementing dementia prevention programmes,” said co-author Professor Gill Livingston.

“They are cost-saving for their impact on reducing dementia rates alone, without even factoring in the additional benefits in reducing other health issues such as stroke or heart disease.”

Fiona Carragher from the Alzheimer’s Society, which partially funded the study, added: “The evidence shows it’s a no-brainer to invest in programmes to stop smoking, manage blood pressure and treat hearing loss, particularly given the cost of dementia to the economy is set to skyrocket as numbers of people with the condition increase.

“There isn’t a fail-safe way to prevent dementia later in life but taking steps to reduce our risk has the potential to buck this worrying trend and give families the chance to have more precious, healthy years together.

“We look to the government to act on these findings by making sure everyone knows what steps they can take to reduce their risk of dementia, and at the same time honour their commitment to double dementia research funding so we can continue this life-changing work.”