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In 2020, the Lancet Commission on dementia prevention, intervention, and care published an updated report on potentially modifiable risk factors for dementia across the life course (Livingston et al., 2020). Notably, three new factors were added—excessive alcohol consumption, head injury, and air pollution—to the nine previously identified in 2017: less education, hypertension, hearing impairment, smoking, obesity, depression, physical inactivity, diabetes, and infrequent social contact. Although at the population level, interventions to reduce dementia prevalence are recommended throughout early, mid, and later life, at the individual level, older adults can take steps to maximize cognitive health and reduce dementia risk: “It is never too early or too late” (Livingston, 2020, p. 2). Since 2020, evidence has continued to build with important implications for nursing care of older adults. In this editorial, we briefly discuss the latest evidence in mitigating dementia risk, including what interventions may be considered based on each individual's needs and health status. We focus on risk factors for which interventions have shown potential cognitive benefits, including the latest evidence since the Lancet Commission's 2020 report.
Modifiable Risk Factors Affecting Dementia Risk
Lifestyle modification, namely increasing physical activity and social interaction, is an approach for reducing dementia risk that is relevant to most older adults. Globally, approximately one half of older adults aged >60 years do not meet physical activity recommendations (Hallal et al., 2012). Physically active older adults are up to 40% less likely to develop dementia compared to their sedentary counterparts (Alty et al., 2020), and the intensity of physical activity may also play a role. Moderate to vigorous exercise is consistently associated with lower dementia risk, with more vigorous aerobic exercise potentially the most beneficial for those who are safely able to engage in that level of intensity (Livingston et al., 2020). For clinicians, multiple patient-facing resources on incorporating physical activity into daily life are available (Centers for Disease Control and Prevention, 2023; National Institute on Aging, 2023). These resources can be included in patient education or community outreach efforts while highlighting the cognitive benefits of physical activity in aging.
The cognitive benefits of social interaction and social connectedness continue to be supported, with recent evidence refining our...