World first effort to prevent dementia in high-risk people

Dementia will soon engulf more than 100 million people across the globe, but an international research group is leading a world-first effort to prevent dementia in people who are at high risk of this insidious disease.

Dementia includes a constellation of illnesses causing a progressive decline in a person's mental functioning but most commonly is due to Alzheimer's disease. It can affect memory, thinking, orientation, comprehension, calculation, learning capacity, language and judgment.

Using a suite of new electronic and web-based interventions, researchers will employ low cost, high impact interventions targeting dementia risk factors in 40,000 people aged 50 to 80 years. Dementia risk factors include hypertension, diabetes, cardiovascular disease, smoking, depression, physical inactivity and obesity.

"Intervening early is critical to the success of averting the onset of dementia," says research leader, A/Prof Sharon Naismith of the Brain and Mind Research Institute at the University of Sydney.

"Many preclinical, neurodegenerative changes in the brain occur for at least a decade before dementia symptoms become fully apparent. Therefore, it is vital that we address dementia risk factors before people show signs of brain degeneration and cognitive impairment that are on the slippery slope to dementia."

"Electronic health programs have several advantages over traditional face to face public health interventions," says Dr Naismith.

"They have a record of success, and people prefer them because of their anonymity and their capacity to be used privately.

"This will improve our capacity to reach and assist many more people with preventive and treatment opportunities."

While the researchers hope the range of interventions on offer will largely slow or delay the onset of dementia in the cohort of 40,000 people participating in the research trial, those who begin showing signs of cognitive impairment will be offered more intensive, targeted treatments.

These people will be randomly assigned to one of two large research trials assessing the relative merits of antihypertensive drugs and omega-3 fatty acids as therapies to slow cognitive decline.

The researchers will establish a registry of individuals aged 50 to 80 years who are risk of persistent cognitive decline.

Promoted through healthcare providers and health consumer agencies, the registry will provide a mechanism for identifying people with dementia risk factors, offering preventive and early programs, and tracking their long term progress. With an initial target of 40,000 people, the registry will have an ongoing recruitment of 10,000 people yearly.

Fast facts - dementia

• More than 330,000 Australians are living with dementia
• More than 1,700 new cases of dementia are diagnosed in Australia weekly
• Without effective prevention or a cure, more than a million Australians will be living with dementia by 2050
• Caring for dementia patients is overwhelming for caregivers. The stresses include physical, emotional and economic pressures. Caregivers require support from health, social, financial and legal systems.
• Dementia will become the third greatest source of health and residential aged care spending within two decades.