Dementia prevention, intervention, and care: 2020 report of the Lancet Commission

Livingston, Gill; Huntley, Jonathan; Sommerlad, Andrew; Ames, David; Ballard, Clive; Banerjee, Sube; Brayne, Carol; Burns, Alistair; Cohen‐Mansfield, Jiska; Cooper, Claudia; Costafreda, Sergi G.; Dias, Amit; Fox, Nick C.; Gitlin, Laura N.; Howard, Robert; Kales, Helen C.; Kivimäki, Mika; Larson, Eric B.; Ogunniyi, Adesola; Orgeta, Vasiliki; Ritchie, Karen; Rockwood, Kenneth; Sampson, Elizabeth L; Samus, Quincy M.; Schneider, Lon S.; Selbæk, Geir; Teri, Linda; Mukadam, Naaheed

doi:10.1016/s0140-6736(20)30367-6

Cited by 6,212 publications

(7,218 citation statements)

References 312 publications

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“…31 It is possible that frailty acted as a partial mediator of the intervention-related cognitive benefits, but this warrants further research. 32 Aside from lifestyle interventions, pharmacological treatments that target biological ageing may hold significant promise, but their development is ongoing. 33 Our study has limitations.…”

Section: Cognitive Neurologymentioning

confidence: 99%

Cumulative health deficits, APOE genotype, and risk for later-life mild cognitive impairment and dementia

Ward

Wallace

Rockwood

2020

J Neurol Neurosurg Psychiatry

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ObjectiveTo determine whether health-deficit accumulation is associated with the risks of mild cognitive impairment (MCI) and dementia independently of APOE genotype.MethodsA frailty index was calculated using the deficit-accumulation approach in participants aged 50 years and older from the National Alzheimer’s Coordinating Center. Cognitive status was determined by clinical evaluation. Using multistate transition models, we assessed the extent to which an increasing degree of frailty affected the probabilities of transitioning between not cognitively impaired (NCI), MCI, and dementia.ResultsParticipants (n=14 490) had a mean age of 72.2 years (SD=8.9 years; range=50–103 years). Among those NCI at baseline (n=9773), each 0.1 increment increase in the frailty index was associated with a higher risk of developing MCI and a higher risk of progressing to dementia. Among those with MCI at baseline (n=4717), higher frailty was associated with a higher risk of progressing to dementia, a lower probability of being reclassified as NCI, and a higher likelihood of returning to MCI in those that were reclassified as NCI. These risk effects were present and similar in both carriers and non-carriers of the APOE ε4 allele.ConclusionAmong older Americans, health-deficit accumulation affects the likelihood of progressive cognitive impairment and the likelihood of cognitive improvement independently of a strong genetic risk factor for dementia. Frailty represents an important risk factor for cognitive dysfunction and a marker of potential prognostic value.

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Section: Cognitive Neurologymentioning

confidence: 99%

Cumulative health deficits, APOE genotype, and risk for later-life mild cognitive impairment and dementia

Ward

Wallace

Rockwood

2020

J Neurol Neurosurg Psychiatry

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“…2 The timeliness of dementia prevention interventions was also emphasised by the publication of guidelines for risk reduction of cognitive decline and dementia by the WHO in 2019 5 and the 2020 report of the Lancet Commission on Dementia Prevention, Intervention and Care. 17 It must, however, be noted that the general public is still largely unaware of the potential of dementia risk reduction, let alone of specific actions to reduce dementia risk. [18][19][20][21] In our own survey among middle-aged adults (n=590), 44% were aware of dementia risk reduction, and only 20%-25% considered vascular conditions to increase the risk.…”

Section: Strengths and Limitations Of This Studymentioning

confidence: 99%

Raising awareness for dementia risk reduction through a public health campaign: a pre-post study

et al. 2020

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ObjectivesEvaluate the effect of a health promotion campaign aimed at increasing awareness about dementia risk reduction in middle-aged community-dwelling individuals in the Netherlands.DesignA 10-month public health campaign using mass media and community participation, supported by eHealth. Population-level difference in awareness before and after the campaign, including variation between demographic groups, was assessed in two independent cross-sectional samples from the same target population.SettingThe public health campaign was launched in the Province of Limburg, the Netherlands, targeting all inhabitants aged 40–75 years old. Three specific districts within the Province were chosen for an additional community participation approach, in which local stakeholders were invited to support the campaign.ResultsNo pre- (n=590) post- (n=602) difference was observed in people agreeing to the statement that dementia risk reduction is possible (X2(1)=1.27, p=0.260). For the individual lifestyle factors, physical activity (7.6% increase (X2(1)=7.48, p=0.006)) and healthy diet (10.5% increase (X2(1)=12.37, p≤0.001)) were identified more often as being protective against dementia after the campaign. Of all risk/protective factors assessed, cognitive activity was identified most often at both preassessment (79.4%) and postassessment (80.4%), but there was no increase in awareness (X2(1)=0.17, p=0.677). Self-reported exposure to the campaign was associated with greater awareness and motivation for behavioural change (X2(1)=6.52, p=0.011). Compared with mass media only, the addition of community participation resulted in better recognition of campaign material and the eHealth platform.ConclusionsThis study was not able to reach a population-level increase of awareness of dementia risk reduction. Two out of the three lifestyle factors that formed the foundation of the campaign were identified more often after the campaign. Those reported having been exposed to the campaign were more aware and more inclined towards behavioural change.

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“…One of the greatest challenges concerning public perceptions about dementia in both the UK and Brazil is that people are often unaware of the existence of modifiable risk factors for dementia. 20 Individuals may therefore believe that there is nothing they can do to prevent dementia. In addition to the lack of public awareness about dementia-related risk factors, public perceptions about them appear to vary according to people's educational level, as mentioned in previous sections.…”

Section: Prevention Awareness and Educationmentioning

confidence: 99%

Challenges in public perception: highlights from the United Kingdom-Brazil Dementia Workshop

Pelegrini

Hall

Hooper

et al. 2020

Dement. neuropsychol.

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ABSTRACT. In July 2019, Belo Horizonte hosted an international workshop for 27 junior researchers, whose participants were from Brazil and the United Kingdom. This three-day meeting organized by the Universidade Federal de Minas Gerais and the University of East Anglia addressed challenges in cognitive impairment and dementia, with particular interest in public perceptions, diagnosis and care management. The purpose of this report is to highlight the outcomes of the above-mentioned workshop regarding the topic of public perceptions (part I). Discussions focused on differences and similarities between countries, as well as on identifying main issues that required collaborative and creative solutions. After these group discussions, four core themes emerged: I) cognitive impairment; II) dementia - beyond Alzheimer’s disease; III) prevention; and IV) stigma. National and international initiatives to deal with public misperceptions about cognitive impairment and dementia were discussed.

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Dementia prevention, intervention, and care: 2020 report of the Lancet Commission

Cited by 6,212 publications

References 312 publications

Cumulative health deficits, APOE genotype, and risk for later-life mild cognitive impairment and dementia

Cumulative health deficits, APOE genotype, and risk for later-life mild cognitive impairment and dementia

Raising awareness for dementia risk reduction through a public health campaign: a pre-post study

Challenges in public perception: highlights from the United Kingdom-Brazil Dementia Workshop

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