‘Never Too Early, Never Too Late’

To mark World Alzheimer’s Month, the Gibraltar Alzheimer’s and Dementia Society (GADS) is raising awareness with a month-long campaign. Every week on Thursdays through the month of September the Chronicle will be publishing articles provided by GADS.

The theme for this years’ World Alzheimer’s Month is Never Too Early, Never Too Late. The campaign aims to underscore the pivotal role of identifying risk factors and adopting proactive risk reductions measures to delay, and potentially even prevent, the onset of dementia. This includes ongoing risk reduction strategies for individuals who have already received a diagnosis.

Daphne Alcantara, GADS Chairperson says: “After a century of little to no drug-based therapies for dementia, advancements in medical therapies have started to increase in the last year. While new therapies are being developed, there is still a long way to go until these treatments are available, affordable, and accessible to all. In the meantime, risk reduction remains an important tool to potentially reduce the risk of developing dementia. It is never too early, never too late to manage your own risk.”

“With someone in the world developing dementia every 3 seconds, reducing dementia risk is more important than ever. Let us work together to educate, inform, and make a tangible change to our lives. For even in the absence of a universal available treatment or cure, there are actions that we can all take to help ensure that everyone lives well for longer.”

“With the global number of people living with dementia expected to triple by 2050, there has never been a more urgent need to understand and respond to the risk associated with this condition”.

There are many factors which have been linked to the development of dementia. Some are risk factors, while others appear to be protective.

Risk factors are characteristics that appear to have some relationship to the development of a disease. If these risk factors are present, there is an increased chance, but not a certainty, that the disease will develop. For example, not everyone who smokes develops heart disease and not everyone with heart disease has been a smoker. However, smoking is a strong risk factor for heart disease.

Some risk factors can be modified, for example lowering blood pressure reduces the risk of a stroke. Other risk factors cannot be modified, such as age or family history.

Risk factors for dementia

The greatest risk factor for Alzheimer disease and other dementias is increasing age. Although age increases risk, dementia is not a normal part of ageing.

We know there are more than 20 genes which affect a person’s risk of developing dementia. The gene APOE was the first known to increase a person’s risk of developing Alzheimer’s disease, and it is still the strongest risk gene known. There are also genes which directly cause dementia, but these deterministic genes are rare – they are estimated to account for less than 1% of dementia cases and cause young-onset forms in which symptoms usually develop before the age of 60.
Women are more likely to develop Alzheimer’s disease than men, even accounting for the fact that women live longer on average; the reasons for this are unclear.

Modifiable risk factors

Although we cannot change our genes or stop ageing, there are chances that we can make to reduce our risk of dementia, either lifestyle changes as individuals or wider changes across society. A growing body of research evidence exists for 12 potentially modifiable risk factors. We might prevent or delay up to 40% of cases of dementia if we were able to modify all the risk factors.

Although behaviour change is difficult, individuals have a huge potential to reduce their dementia risk. Many of the risk factors are also shared with other non-communicable diseases such as heart disease, cancer, diabetes, and chronic respiratory diseases.

Keeping active, eating well, and engaging in social activities all promote good brain health and may reduce your risk of developing dementia. Keeping your heart healthy, including by avoiding smoking and excessive alcohol consumption, can lower your risk of dementia and other diseases too.

The following is a list of risk factors for dementia, along with suggestions of how to counteract them and reduce risk :

Physical inactivity

Regular physical activity is one of the best ways to reduce your risk of dementia. It is good for your heart, circulation, weight, and mental wellbeing. It is recommended that adults aim for either 150 minutes of moderate aerobic activity or 75 minutes of vigorous aerobic activity each week.

Smoking

Smoking greatly increases your risk of developing dementia. You are also increasing your risk of other conditions, including type 2 diabetes, stroke, and lung and other cancers. It is never too late – stopping smoking later in life also reduces the risk of dementia.

Excessive alcohol consumption

Alcohol misuse and drinking more than 21 units weekly increases the risk of dementia. The harmful use of alcohol is a casual factor in more than 200 diseases and injury conditions. There is a causal relationship between harmful use of alcohol and a range of mental and behavioural disorders, other non-communicable diseases as well as injuries.

Air pollution

A growing amount of research evidence shows that air pollution increases the risk of dementia. Policymakers should expedite improvements in air quality, particularly in areas with high air pollution.

Head injury

Head injuries are most caused by car, motorcycle and bicycle accidents, military exposures, boxing, football, hockey and other sports, firearms, and violent assaults and falls. Policymakers should use public health and other policy measure to reduce head injuries.

Infrequent social contact

It is well established that social connectedness reduces the risk of dementia. Social contact enhances cognitive reserve or encourages beneficial behaviours. Joining a club or community group is a good way to stay socially active.

Less education

A low level of education in early life affects cognitive reserve and is one of the most significant risk factors for dementia. Policy makers should prioritise childhood education for all.

Obesity

Particularly in mid-life, obesity is associated with an increased risk of dementia. Obesity is also associated with other non-communicable diseases and can generally be addressed through lifestyle changes such as diet and exercise.

Hypertension

Hypertension (high blood pressure) in mid-life increases as a person’s risk of dementia, as well as causing other health problems. Medication for hypertension is the only known effective preventive medication for dementia.

Diabetes

Type 2 diabetes is a clear risk factor for development of future dementia. Whether any medication helps with this is unclear, but treatment of diabetes is important for other health reasons.

Depression

Depression is associated with dementia incidence. It is part of the prodrome of dementia (a symptom that occurs before the symptoms that are used for diagnosis). It is not clear to what extent dementia may be caused by depression or the reverse, and both may be the case. In any case, it is important to manage and treat depression because it is associated with increased disability, physical illnesses, and worse outcomes for people with dementia.

Hearing impairment

People with hearing loss have a significantly increased risk of dementia, using hearing aids seems to reduce the risk. As hearing loss is one of the risk factors which affects the most people, addressing it could result in a large impact on the number of people developing dementia.

On Saturday 16th September 2023, GADS will be holding an Awareness Event at The Piazza in Main Street from 9.00am to 2.00pm and will be joined by health, medical and social care professionals from the GHA, ERS, Care Agency and Meddoc . We will be providing literature, information, advice, and support for people affected by Alzheimer’s and other dementias. There will be a display of crafted items made by residents from Mount Alvernia, John Cochrane Ward, Hillsides, John Mac Home and by services users from Waterport Day Centre (Care Agency).

Purple T-shirts will be on sale for the Memory Walk on Thursday 21st September 2023 (World Alzheimer’s Day) starting from Campion Park at 7.00pm.

The Gibraltar Alzheimer’s & Dementia Society (GADS) offers support group meetings to families and caregivers; we extend practical information on care giving, ways of coping, talk through challenges, share experiences, and offer advice on care and support services available in Gibraltar.

For advice and support, contact :
The Gibraltar Alzheimer’s & Dementia Society
Email : gadschairman@gibtelecom.net
Tel : (00350) 56001422
Facebook : www.//gibraltaralzheimersanddementiasociety