Risk reduction of dementia: role of Primary Care

Category: Speakers

Proposed Symposium Title: Risk reduction of dementia: role of Primary Care

Learning Objectives: . To identify the major modifiable and non-modifiable risk factors for dementia . To discuss the possible key interventions that may delay or slow the cognitive decline and dementia . To ascertain the role of Primary Care on the risk reduction of dementia

Abstract: Dementia is one of the greatest global challenges for health and social care in the 21st century. Today, about 50 million people worldwide are affected by dementia and the number of people with dementia is expected to increase to 82 million in 2030 and 152 million by 2050. Dementia is a major cause of disability and dependency among older people worldwide, and it has a significant impact not only on individuals but also on carers, families, communities and societies. Most health systems are ill-equipped and under-resourced to respond to the current needs associated with dementia. Thus, societal ageing and the associated increases in dementia prevalence will likely have major health-service implications for the care of people with dementia and support for affected families. Non-modifiable risk factors for dementia include gene polymorphisms, age, gender, race/ethnicity and family history. Age is the strongest known risk factor for cognitive decline, but dementia is not a natural or inevitable consequence of ageing. During the last two decades, several studies have shown a relationship between the development of cognitive impairment and dementia with educational attainment, and lifestyle-related risk factors, such as physical inactivity, tobacco use, unhealthy diets and harmful use of alcohol. Further, certain medical conditions are associated with an increased risk of developing dementia, including hypertension, diabetes, hypercholesterolemia, obesity and depression. Social isolation and cognitive inactivity are other modifiable risk factors. The current focus on modifiable risk factors is justified by their potential to be targeted for prevention of dementia, and/or the delay of the progression of cognitive decline. The existence of potentially modifiable risk factors means that prevention of dementia is possible through a public health approach, including the implementation of key interventions that delay or slow cognitive decline or dementia. The role of Primary Care is necessarily the best place where all efforts should start to prevent the risk factors of dementia, to initiate the proper assessment of patient’s and carer’s needs and to deliver the good care for all in need.

Key References or Resources: - ADI. World Alzheimer Report 2009 - ADI. World Alzheimer Report 2011: the benefits of early diagnosis and intervention - ADI. World Alzheimer Report 2014. Dementia and risk reduction: an analysis of protective and modifiable factors - WHO. Risk reduction of cognitive decline and dementia. WHO, Geneva, 2019. - Livingston G et als. Dementia prevention, intervention, and care: 2020 report of the Lancet Commission. The Lancet online July 30, 2020. https://doi.org/10.1016/S0140-6736(20)30367-6