Dementia (Including Alzheimer's Disease) can be Prevented: Statement Supported by International Experts

• The commonest dementia (Alzheimer’s disease) is irreversible and develops slowly over many years. • So far drugs have only relieved symptoms, but have not been effective against disease progression. • About half of the large decline in deaths from heart disease and stroke over the past 50 years has been the result of public health measures to modify risk factors. We are confident that the same approach will work for dementia. • We propose that a concerted effort be made to discover modifiable risk factors for dementia and to exploit those already identified. • International collaboration is needed on largescale clinical trials to test whether modifying risk factors will lead to prevention of dementia. • Health authorities should aim to identify high risk individuals at an early stage, when intervention is more likely to help. • There is already sufficient evidence to justify immediate action. Trials in those at risk of developing dementia should be done of the following: exercise; controlling blood sugar, including diabetes treatment; depression treatment; high blood pressure treatment; B vitamins; omega-3 fatty acids; cognitive training; and social activities. • Public health policies should encourage middleaged people to stop smoking; exercise; eat diets rich in fruit and vegetables and fish (Mediterranean foods); avoid becoming obese and diabetic; avoid excessive alcohol intake; treat high blood pressure. In other words – tell people that adopting a healthy lifestyle may help to ward off dementia as it does for other diseases. • It is notable that the prevalence of dementia and cognitive impairment in some Western countries is now less than anticipated, possibly as a result of changes in lifestyle and the reduction in cardiovascular risk factors, although this may not necessarily mean that worldwide trends in the burden of dementia will be substantially reduced. • We estimate that about half of Alzheimer’s disease cases worldwide might be attributable to known risk factors. Taking immediate action on the known risk factors could perhaps prevent up to one-fifth of predicted new cases by 2025. • The worldwide costs of dementia in 2010 have been estimated to be $604 billion, most of it in G8 countries. Prevention of dementia would thus not only prevent a lot of human suffering but would save huge sums of money. • We call upon the Health Ministers of the G8 countries to greatly increase government funding for research on the prevention of dementia.