Parents can start reducing their children's risk of getting dementia in later life by making them follow a few simple health tips as youngsters, scientists now claim. More than 60 million people worldwide are living with dementia, resulting in over 1.5 million deaths a year and an annual cost to the global healthcare economy of around £1 trillion.
Despite decades of scientific research, dementia still has no cure, but is preventing dementia possible? And if so, at what age should we be taking steps to do so? Last year, the Lancet Commission identified 14 modifiable risk factors for dementia - such as obesity, smoking and lack of exercise - and said addressing them in middle age could prevent or delay up to 45% of all dementia cases.
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The other 11 risk factors were social isolation, air pollution, traumatic brain injury, hearing loss, depression, high blood pressure, diabetes, excessive alcohol consumption, uncorrected vision loss, and high cholesterol.
Now, a trio of scientists have claimed that targeting similar risk factors in our children when they are school age, rather than waiting for when they are older, could provide even greater benefits against dementia.
Dr Scott Chiesa, UCL Institute of Cardiovascular Science;Dr Francesca Farina, Pritzker School of Medicine, University of Chicago andDr Laura Booi, School of Health at Leeds Beckett University, all claim "dementia is not simply an unavoidable consequence of ageing or genetics" in their article inThe Conversation.
They explain: "Let’s work backwards from middle age, starting with the three decades covering adolescence and young adulthood (from ten to 40 years old).
"Many lifestyle-related dementia risk factors emerge during the teenage years, then persist into adulthood. For example, 80% of adolescents living with obesity will remain this way when they are adults.
"The same applies to high blood pressure and lack of exercise. Similarly, virtually all adults who smoke or drink will have started these unhealthy habits in or around adolescence.
"This poses two potential issues when considering middle age as the best starting point for dementia-prevention strategies. First, altering health behaviour that has already been established is notoriously difficult.
"And second, most high-risk individuals targeted in middle age will almost certainly have been exposed to the damaging effects of these risk factors for many decades already.
"As such, the most effective actions are likely to be those aimed at preventing unhealthy behaviour in the first place, rather than attempting to change long-established habits decades down the line."
They explain how increasing evidence suggests the roots of dementia stretch as far back as childhood or infancy and "risk factor exposures in the first decade of life (or even while in the womb) may have lifelong implications for dementia risk."
They add: "To understand why this may be, it’s important to remember that our brain goes through three major periods during our lives – development in early life, a period of relative stability in adult life, and decline (in some functions) in old age.
"Most dementia research understandably focuses on changes associated with that decline in later life. But there is increasing evidence that many of the differences in brain structure and function associated with dementia in older adults may have at least partly existed since childhood.
"For example, in long-term studies where people have had their cognitive ability tracked across their whole lives, one of the most important factors explaining someone’s cognitive ability at age 70 is their cognitive ability when they were 11.
"That is, older adults with poorer cognitive skills have often had these lower skills since childhood, rather than the differences being solely due to a faster decline in older age.
"Similar patterns are also seen when looking for evidence of dementia-related damage on brain scans, with some changes appearing to be more closely related to risk factor exposures in early life than current unhealthy lifestyles.
"Taken together, perhaps the time has come for dementia prevention to be thought of as a lifelong goal, rather than simply a focus for old age."
So the trio suggest a lifelong prevention plan is the best way to shield the next generation from harmful dementia, but warn there is no "one size fits all" approach.
However, they conclude: "But one thing generally agreed upon is that mass medication of young people is not the answer.
"Instead, we, along with 33 other leading international researchers in the field of dementia, recently published a set of recommendations for actions that can be taken at the individual, community and national levels to improve brain health from an early age.
"Our consensus statement and recommendations deliver two clear messages. First, meaningful reductions in dementia risk for as many people as possible will only be achievable through a coordinated approach that brings together healthier environments, better education and smarter public policy.
"Second – and perhaps most importantly – while it’s never too late to take steps to reduce your risk of dementia, it’s also never too early to start."
