Reducing Dementia Risk in Individuals with Family History

In the 21st century, one of the greatest challenges faced by society is the functioning of dementia, a condition that poses significant societal challenges. Estimates suggest that the number of people affected by dementia will rise to 82 million by 2030 and 152 million by 2050 (1). Dementia not only leads to a significant loss in quality of life but also emerged as the leading cause of death in the Netherlands in 2018 (2). Following diagnosis, dementia patients typically live for four to eight years with the disease (3-6), becoming increasingly dependent on others as the illness progresses (7).

The impact of dementia extends beyond the individual, affecting caregivers and society as a whole. Consequently, dementia accounted for 10.3% (9.1 billion euros) of the Netherlands' total healthcare expenses in 2017, making it the most expensive disease in the country (8). While there is currently no cure for dementia, delaying its onset or progression could help address the rising rates and associated costs (9).

Recognizing the urgency of the issue, the World Health Organization (WHO) has established a global action plan. This plan aims to make dementia a public health priority, increase awareness about dementia, and reduce the risk factors associated with the condition.

Emerging evidence indicates that the onset of dementia is a progressive pathological process that initiates around ten to twenty years prior to its clinical diagnosis (11-13). While advancing age represents a prominent risk factor for cognitive decline, it does not necessarily result in the development of dementia. Extensive research highlights the potential to mitigate dementia risk through various measures (14-16). The Lancet commission on dementia prevention, intervention, and care emphasizes the significance of identifying risk factors such as limited education, hearing loss, midlife hypertension, midlife obesity, smoking, depression, physical inactivity, diabetes, low social engagement, excessive alcohol consumption, traumatic brain injury, and air pollution (17). Furthermore, supporting evidence suggests that hyperlipidemia, coronary heart disease, renal dysfunction, adherence to a Mediterranean diet, cognitive stimulation, and stress management are relevant factors in reducing dementia risk (16,18,19). Notably, many studies have shown that lifestyle modifications, including refraining from smoking, managing depression, engaging in regular physical activity, maintaining social connections, and controlling diabetes, can significantly decrease the likelihood of developing dementia (17,20). However, research indicates that a substantial portion of the general population in the Netherlands remains unaware of the potential to lower their dementia risk through positive changes in health behavior (20)