Dementia is the ‘top public health crisis,’ declare 4 former surgeons general

Around 50 million people worldwide have dementia and that number is predicted to triple by 2050. (Photo: Getty Images)
Around 50 million people worldwide have dementia, and that number is predicted to triple by 2050. (Photo: Getty Images)

Dementia is the “top public health crisis,” according to four former U.S. surgeons general in an effort to call attention to the rapid rise of the disease.

Richard Carmona, MD, Joycelyn Elders, MD, Antonia Novello, MD, and David Satcher, MD, penned an Oct. 10 opinion piece in the Orlando Sentinel sounding the alarm on dementia, stating that “its scale is unprecedented, and its numbers, already tragic, are growing rapidly.”

A 2019 report in the journal Lancet, echoes that statement, noting, “Dementia is one of the fastest-growing public health problems,” while a 2017 Lancet Commission report on dementia called it “the greatest global challenge for health and social care in the 21st century.”

Around 50 million people worldwide have dementia, according to the Lancet Commission, but that number is predicted to triple by 2050.

“For those over the age of 65, the number living with the disease doubles every five years,” wrote the surgeons general in the op-ed. “Five years is also how long we have before half of all Baby Boomers are over the age of 65 — paving the way for 14 million people living with dementia by 2050. This number is exploding, particularly in communities of color. In fact, by 2030, nearly 40 percent of all Americans living with dementia will be Latino or African American.”

What is dementia?

Dementia is an umbrella term that covers several medication conditions, including Alzheimer’s disease. “It basically means there’s a progressive cognitive decline that’s more than what you’d expect with age and sufficient enough that it’s causing a loss of function,”Jacob Hall, MD, a neurology specialist at Stanford Health Care, tells Yahoo Lifestyle. “Far and away, the most common cause of dementia for people over 65 is Alzheimer’s disease,” says Hall.

One of the telltale signs of dementia is memory loss that disrupts daily life, such as forgetting recently learned information, along with important dates and events (versus remembering them later, which is a typical age-related change), according to the Alzheimer’s Association. Other signs include difficulty concentrating or trouble with planning or completing tasks that had been familiar before (such as making a grocery shopping list or driving to a well-known destination), as well as mood changes.

What causes dementia?

Dementia is caused by brain cells that are “sick and dying,” says Hall. “As a result, the brain is shrinking and you’re losing cognitive networks.” Hall explains that this is caused by a combination of inflammation and a build-up of toxic proteins that the body can’t properly dispose of. According to the National Institute on Aging, “many neurons stop functioning, lose connections with other neurons,and die,” and with Alzheimer’s disease, the neurons and their connections in parts of the brain involved in memory are typically destroyed first.

What can you do to reduce your risk?

The disease isn’t “inevitable” and there are ways you can reduce your dementia risk. In the opinion piece, the former surgeons general called attention to the latest research that shows dementia “isn’t simply the inevitable result of statistical predetermination or old age, like gray hair or wrinkles.”

They state that, according to the recent Lancet Commission report, “around 35 percent of dementia is attributable to a combination of the following nine risk factors: education to a maximum age of 11-12 years, midlife hypertension, midlife obesity, hearing loss, late-life depression, diabetes, physical inactivity, smoking and social isolation.”

And that’s good news because — unlike aging and genetics, which are key factors in the development of dementia — several of those nine risk factors are within your control. “High blood pressure, diabetes, obesity, high cholesterol — that’s the biggest cluster of risk factors that contributes to later risk of dementia,” says Hall, who adds that smoking and excessive alcohol intake can also up the risk.

For example, several studies show that regular exercise lowers the odds of dementia. One 35-year study published in PLOS One found that exercise is “the strongest mitigating factor” in reducing dementia risk. The Mayo Clinic recommends exercising for 30 to 60 minutes several times a week.

Research also shows that lowering high blood pressure can reduce dementia risk. A meta-analysis published in the journal Lancet Neurology found that people using any antihypertensive medication had a reduced risk for developing dementia.

“The strongest recommendation is to get regular exercise — aerobic exercise in particular seems to be associated with a reduced risk of cognitive decline — and follow a healthy diet,” says Hall, such as the heart-healthy Mediterranean diet.

The former surgeons general say these research findings offer “hope,” while stressing the importance of physicians performing annual cognitive assessments and brain health check-ups. “What the latest science is therefore telling us is that brain health should be as much on people’s minds as heart health, breast cancer and the war on smoking have been for decades,” they wrote.

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