The number of dementia cases in Europe and America is decreasing

The number of dementia cases in Europe and America is decreasing – the importance of prevention

Stuart Lambie remembers the moment about five years ago when Alzheimer’s began to take his father away. As the illness worsened, the man, who served in the wartime Royal Navy and later ran a successful business, began verbally abusing the wife he adored.

Lambie had never heard his father Ian swear before. “It was unbelievable that it was the same person. But it wasn’t the same person, it was a disease.”

Dementia, with its ability to alter personality, is one of the most terrifying diseases of our time. However, the good news, writes the “Financial Times”, is that global data on new dementia cases offer hope.

Despite the widespread belief that dementia is destined to increase exponentially as the world’s population ages, experts believe that, at least in the developed world, the prospects for avoiding dementia are stronger than a generation ago.

A study published in 2020, which pooled multiple health-monitoring surveys of 50,000 people over 65, found that the rate of new dementia cases in Europe and North America had fallen by 13% per decade over the past 25 years – a decline. consistent across studies.

Lower risk

For Albert Hoffman, who chairs the Department of Epidemiology at the Harvard TH Chan School of Public Health, the research leads to one conclusion: “The absolute risk of developing dementia is lower now than it was 30 years ago.”

Now there are early signs that the same phenomenon may be happening in Japan, a remarkable development in one of the world’s oldest populations that suggests the downward trend is spreading.

Hoffman acknowledges that the idea of ​​a declining burden of dementia may be at odds with the sheer number of people still affected by the disease.

The analysis, based on the Global Burden of Disease database, considered one of the most respected surveys of its kind, estimates that the number of people with dementia will increase from 57.4 million cases worldwide in 2019 to 152.8 million cases in 2050.

Even here, however, the prevalence appears to remain stable when the aging population is taken into account.

While Hoffman emphasizes that the reasons for the decline are not yet fully understood, he believes that improved cardiovascular health is likely to be an important factor.

The importance of prevention

“For fifty years in North America and Western Europe, there has been a great emphasis on the prevention of cardiovascular disease … leading to heart attacks and strokes,” he says.

At least 1/3 of the population over 50 now takes pills to control high blood pressure, he points out, and the use of statins, a class of cholesterol-lowering drugs, has skyrocketed.

Studies show that the decline in dementia rates was greatest among men who tried to reduce cardiovascular problems in the 1970s and 1980s, when women were mistakenly thought to be less vulnerable.

There are no magic solutions

Hoffman says that preventing dementia in practice can mean delaying it long enough for people to live their lives without being affected by its effects.

One of the most powerful insights scientists have gained in recent years is the importance of better vascular health, how efficiently your body transports blood to and from the heart, in the fight against dementia.

This may not only play a role in protecting against vascular dementia, which is diagnosed in up to 30% of patients with the condition, but may also help prevent the development of symptomatic Alzheimer’s disease, which appears to result from the accumulation of two toxic proteins. tau and amyloid beta in the brain.

Hoffman does not believe in magic solutions. But after years of working in a field where breakthroughs have often proved elusive, he allows himself to be cautiously optimistic: “Overall, there is reason for hope.”

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