Dementia forecast highlights urgency of prevention

Projections forecast that one million Australians will have dementia by 2056 — more than double current figures for the condition. In light of this estimation, Dr Terence Chong, psychiatrist and Senior Research Fellow at the University of Melbourne, and colleagues have highlighted that dementia prevention needs to be Australia’s next public health area of focus. With a Perspective piece published in the Medical Journal of Australia, Dr Chong and his co-authors (including the National Health and Medical Research Council [NHMRC] National Institute for Dementia Research [NNIDR] Prevention Special Interest Group) are advocating for substantial, timely and sustained investment in dementia prevention.

“Dementia is the greatest cause of disability in Australians aged over 65 years, the second leading cause of mortality, and the highest in women,” Chong and colleagues wrote. The authors highlighted that, currently, more than 459 000 Australians live with dementia, and this number is expected to exceed one million by 2056, yet between 40% and 48% of dementia risk is considered modifiable.

The authors explained that, in Australia, the population-attributable risk of dementia risk factors are physical inactivity (17.9%), mid-life obesity (17.0%), low educational attainment in early life (14.7%), mid-life hypertension (13.7%), depression (8.0%), smoking (4.3%) and diabetes mellitus (2.4%). They also pointed to emerging research, which suggests that a suboptimal diet, cognitive inactivity and sleep–wake disturbance can also influence modifiable dementia risk.

Chong and colleagues have developed a multilayered action plan with eight recommendations:

1. Create public health and clinical practice guidelines for dementia prevention across the lifespan for the Australian setting.
2. Equip and resource primary care providers to be the clinical spearheads for dementia prevention throughout life.
3. Support multidisciplinary memory clinics and specialists to implement secondary prevention programs for those at high risk.
4. Fund research for evidence-based interventions for modifiable risk factors for dementia across the life cycle to reduce the evidence-to-practice gap.
5. Implement findings from dementia risk reduction and implementation research through translation into health promotion programs.
6. Strengthen dementia prevention public health campaigns embracing Australians’ diversity, particularly Aboriginal and Torres Strait Islander Australians.
7. Resource and coordinate a whole-of-community approach including government, public and private health care, community services and education sectors to operationalise guidelines and multifaceted dementia prevention programs throughout life.
8. Mobilise peak health advocacy bodies to promote and coordinate public health messaging on dementia risk factors that cut across chronic conditions.

“Australia has excellent health infrastructure and an international reputation for dementia prevention due to our depth of clinical, research, and knowledge translation expertise,” Chong and colleagues wrote. “If we are committed to achieving the ambitious targets of reduced dementia prevalence and incidence, we must shine a spotlight on dementia prevention across all levels of society. To achieve this, the NNIDR Dementia Prevention Special Interest Group proposes this Dementia Prevention Action Plan for Australia.

“It is time for a call to action in the fight against dementia: dementia prevention needs to be the next international public health area of focus, with Australia playing a leading role.”

Image credit: ©stock.adobe.com/au/Andrea Danti