Dementia as a preventable disease

This month The Lancet published their Commission on dementia. The case for attention on dementia is unquestionable - nearly 50 million people have dementia worldwide today, this will increase nearly 3 fold in the next 35 years; it affects not only the individual but their families and caregivers too; the cost of dementia is colossal - the current global cost of care is estimated to be US$800 billion/year. 

Despite these huge numbers, I do believe we are in an era where the tide is turning. 

Firstly, there is a recognition of the problem as evidenced by the focus that it is receiving not just by academics, but by the leaders of the world in the G8 and WHO ministerial conference in 2013 and 2015 respectively. This year UCL was awarded the Dementia Research Institute - a £250m national award to become a national and international hub for dementia research; building on incredible work done by the Dementia Research Institute at UCL and others. 

Secondly, although the two big drug trials of Biogen's aducanumab and Merck's verubecestat failed to show efficacy, there is much to be gained from these studies. Furthermore, the feeling of academics, industry and policy makers at this year's World Neuroscience Innovation Forum at the Crick Institute in London, was that despite the overall failure of these two drugs in the people they were tried in, we are on the cusp of success. 

Thirdly, and what this report really stresses strongly, is that although we may get new and very exciting but expensive drugs to stop or prevent some forms of dementia. So much can be done, for very little cost, to prevent it in the first place. 

DOI: http://dx.doi.org/10.1016/S0140-6736(17)31363-6

Dementia prevention, intervention, and care

Published: July 20, 2017

Executive Summary

Dementia is the greatest global challenge for health and social care in the 21st century: around 50 million people worldwide have dementia and this number is predicted to triple by 2050. The LancetCommission on dementia aims to review the best available evidence and produce recommendations on how to best manage, or even prevent, the dementia epidemic.

Dementia is not an inevitable consequence of ageing and the Commission identifies nine potentially modifiable health and lifestyle factors from different phases of life that, if eliminated, might prevent dementia. Although therapies are currently not available to modify the underlying disease process, the Commission outlines pharmacological and social interventions that are able to help manage the manifestations of dementia.