An international, multidisciplinary group updates dementia guidelines

  • Livingston G & al.
  • Lancet
  • 8 Aug 2020

  • curated by Susan London
  • Clinical Essentials
Access to the full content of this site is available only to registered healthcare professionals. Access to the full content of this site is available only to registered healthcare professionals.

Takeaway

  • An international, multidisciplinary group has updated guidelines for dementia prevention, intervention, and care.

Why this matters

Key results

  • Guidelines list 9 previously identified modifiable risk factors and 3 new ones:
    • Less education.
    • Hypertension.
    • Hearing impairment.
    • Smoking.
    • Obesity.
    • Depression.
    • Physical inactivity.
    • Diabetes.
    • Infrequent social contact.
    • Excessive alcohol consumption.
    • Head injury.
    • Air pollution.
  • Up to 40% of dementia cases could be prevented or delayed by modifying these 12 risk factors.
  • Guidelines-recommended actions to address risk factors include:
    • Maintain normal systolic BP.
    • Encourage use of hearing aids for hearing loss.
    • Limit alcohol use.
    • Reduce obesity and diabetes.
    • Sustain midlife and possibly later-life physical activity.
  • Guidelines also endorse interventions to address inequality in risk factors to protect people with dementia.
  • Guidelines-recommended actions for dementia care:
    • Provide holistic postdiagnostic care.
    • Manage neuropsychiatric symptoms.
    • Care for family caregivers.

Study design

  • International, multidisciplinary commission reviewed the best available evidence on dementia.
  • Main outcome: updated guidelines.
  • Funding: University College London; Alzheimer’s Society, UK; Economic and Social Research Council; Alzheimer’s Research UK.

Limitations

  • Assumptions were used in calculating new model.
  • Varying prevalence of risk factors across countries.
  • Inability to determine whether risk factors are additive or synergistic.