Posted on March 31 2021
Since my first article about dementia here, the Royal Commission into into Aged Care Quality and Safety (ACRC) has released its final report, and a story was featured in the last newsletter about the very important work of the 2018 SA Senior Australian Of the Year, Mrs. Barbara Spriggs. The Final Report has provided impetus for us all to reflect on our aged care system, and although my work more specifically focuses on people with dementia, it also includes people living in residential aged care, or receiving community aged or dementia care.
But perhaps everyone needs to step away from the issues the ACRC has confirmed and consider the possibility of reducing the risk of dementia because getting older does not mean you will get dementia; however, your risk does increase from the age of 65.
The notion of reducing our risk of dementia is a relatively new one, although we know that is has been a strong focus of our health systems to focus on risk reduction for other chronic conditions such as diabetes, heart conditions such as stroke or a heart attack. As someone who has focused on living more positively with dementia than is expected, I have a vested interest in delaying the progression of dementia and have also written or spoken on risk reduction for almost a decade.
Research has now identified many risk factors associated with dementia. It’s impossible to eliminate every single one; after all we can’t avoid age, which is the most significant one.
However, there are things that could affect the risk of developing dementia that we may be able to change. Most often, anecdotal evidence comes before evidence research-based evidence and I have seen good anecdotal evidence for these strategies delaying the progression of the symptoms of a person’s dementia.
Through engaging in self prescribed rehabilitation strategies, including improving my own lifestyle, it has been more than encouraging to see risk reduction for dementia also become a global imperative. Professor Dale Bredesen is a leading researcher in reversing early dementia or MCI (Mild Cognitive Impairment) too, and I highly recommend his books[i].
National dementia advocacy organisations have also been promoting risk reduction strategies for a few years, highlighting further the links between lifestyle factors and dementia, and in 2019, the World Health Organisation (WHO) launched its first Dementia Risk Reduction Guidelines, the “Risk reduction of cognitive decline and dementia: WHO Guidelines”[ii]. These guidelines provide evidence-based recommendations on lifestyle behaviours and multiple other interventions to either delay or prevent cognitive decline and dementia.
Worldwide, there are an estimated 50 million people have dementia and, with one new case every three seconds, and the number of people with dementia is set to triple by 2050. The human cost, and economic cost to individuals and their families, and to governments is high. In Australia, there are more than 1800 new diagnoses of dementia every week, and an estimated 400,000 to 459,000 people currently living with dementia[iii][iv].
The increasing numbers of people with dementia, its significant social and economic impact and lack of curative treatment, make it imperative for countries to focus on reducing modifiable risk factors for dementia. Action area 3 of the Global action plan on the public health response to dementia 2017–2025 is risk reduction.
There is still no curative or disease modifying treatment for any type of dementia, but the proactive management of modifiable risk factors can delay or slow onset or progression of the disease. In May 2017, I was pleased to have attended the Seventieth World Health Assembly where the WHO endorsed a Global Action Plan on the Public Health Response to Dementia 2017–2025[v], urging Member States to develop ambitious national responses to address this challenge. Dementia risk reduction is one of the seven action areas in the global action plan, and Australia signed up to this Action Plan, and is therefore, obliged to implement all seven action points.
These WHO Guidelines are therefore an important tool step to support this, and for health care providers as well as governments, policymakers and other stakeholders to strengthen their response to the dementia challenge. These guidelines include evidence and recommendations including increasing Physical activity, the cessation of Tobacco and other harmful drugs including alcohol, Nutritional interventions, Cognitive interventions, the management of excessive weight including obesity, diabetes, hypertension, dyslipidaemia (unhealthy levels of one or more kinds of lipid (fat) in your blood, e.g. cholesterol), depression and hearing loss. The guidelines also recommend increasing social activities.
So, let’s all t do our best to lead an active lifestyle that combines physical, social and mental activity. Not only will it help to reduce your risk of dementia, but you’ll also enjoy life more as a result!
Kate Swaffer © March 2021
SA Australian Of The Year 2017
CEO & co founder, Dementia Alliance International
Researcher, University of Wollongong
Read more about Kate’s work and activism on her website: https://kateswaffer.com
More information about support and advocacy for people with dementia is available here: https://www.dementiaallianceinternational.org