Helen C. Kales, chair of the Department of Psychiatry and Behavioral Sciences, is one of 26 international experts named to the Lancet Commission on dementia prevention, intervention and care. The commission has released two influential reports highlighting the growing body of scientific evidence that identifies modifiable risk factors for the disease.

This is the third time Kales, a geriatric psychiatrist and an expert in caring for people with dementia, has been named to the prestigious commission.

“Participation in this commission is so exciting because with every meeting, we have advanced the understanding of modifiable risk factors for dementia,” Kales said. She cites finding from the first panel that hearing loss in mid-life is a risk for dementia.

“Subsequent studies have found that by use of hearing aids, the risk of cognitive impairment can be reduced. This is huge because it is unlikely that there will be a ‘magic bullet’ cure for dementia anytime soon, particularly given the myriad causes that are involved,” Kales said.

In addition to hearing impairment, risk factors for dementia identified in the 2017 report include less education, hypertension, smoking, obesity, depression, physical inactivity, diabetes and low social contact.

The 2020 report added three more risk factors: excessive alcohol consumption, traumatic brain injury and air pollution.

Just as with heart disease — which has been reduced markedly over the decades with work on risk factors in the population — we are increasingly convinced we can reduce or delay many cases of dementia.” —Helen C. Kales

The contributors note, “Together, the 12 modifiable risk factors account for around 40% of worldwide dementias, which could theoretically be prevented or delayed. The potential for prevention is high and might be higher in low-income and middle-income countries where more dementias occur.”

The World Health Organization estimates there are 55 million people living with dementia globally, with 10 million new cases diagnosed every year.

The two reports are in the top 20 all-time papers for the Lancet. Combined, they have over 5,400 citations and have been reported on by hundreds of news outlets.

“Just as with heart disease — which has been reduced markedly over the decades with work on risk factors in the population — we are increasingly convinced we can reduce or delay many cases of dementia by identifying and then researching and implementing ways to reduce these modifiable risks,” Kales said.

As with previous reports, the Lancet Commission on dementia prevention, intervention and care will be led by Gill Livingston, professor of psychiatry at University College, London. The cohort for the new report features researchers and physicians from Brazil, Japan, China, India, France, Uganda, Australia, Canada, Norway, Finland, United States and the United Kingdom. The commission will meet at University College, London, in May to work on recommendations for the new report.

Resources

• Dementia prevention, intervention, and care: 2020 report of the Lancet Commission
• Dementia prevention, intervention, and care (2017 report)