DESK REVIEWS | 04.06.04.01. Prevention and risk reduction of dementia
DESK REVIEW | 04.06.04.01. Prevention and risk reduction of dementia
Two chapters in the guideline cover the risk reduction and prevention of dementia (Chapter 1.3 & Chapter 4.4). The modifiable and non-modifiable risk factors identified for cognitive impairment include the followings (Department of Health, 2017b, p. 9):
Modifiable risk factors
- Physical inactivity
- Low participation of cognitive activities
- Social isolation
- Diabetes mellitus
- Overweight & obesity
- Low education attainment
- Head injury
Non-modifiable risk factors
- Advancing age
- Family history
For the prevention of cognitive impairment, some advices are provided on enhancing cognitive reserve and reducing modifiable risks of dementia. They include stop smoking, healthy eating, stay physically and socially active, participate in intellectual and leisure activities, prevent head injury, avoid excessive alcohol use, maintain optimal levels of health indicators (e.g., body weight, waistline, blood pressure, blood sugar and blood cholesterol), and collaborate with care providers on the management of other medical conditions (e.g., heart diseases, stroke, and depression). Besides, the guideline recommends that avoiding the long-term use of hypnotics, practicing Tai Chi, early detection of cognitive impairment, and seeking medical advice are important to prevent cognitive impairment (Department of Health, 2017b, p. 32).
Department of Health. (2017b). Hong Kong Reference Framework for Preventive Care for Older Adults in Primary Care Settings: Module on Cognitive Impairment. Retrieved from https://www.fhb.gov.hk/pho/rfs/english/pdf_viewer.html?file=download215&title=string258&titletext=string189&htmltext=string189&resources=07_Module_on_Cognitive_Impairment
a) Alzheimer’s disease
Modifiable risk factors are identified: Depression, Physical inactivity, Hypertension, Obesity, Smoking, Low educational attainment, and Diabetes. And the non-modifiable: advanced age, first-degree family history, autosomal dominant gene presence of apolipoprotein allele E4.
b) Vascular dementia
It is mentioned that cardiovascular risk factors contribute to the development of vascular dementia, and these are classified as modifiable and non-modifiable.
Not modifiable: Age, sex, ethnic group (black, Hispanic, and Asian race), family history.
Modifiable: Hypertension, diabetes mellitus, hyperlipidemia, atrial fibrillation, smoking, obesity, carotid disease, homocysteinaemia.
Yes, see p.150 of Emsley et al., (2013).
Emsley, R., & Seedat, S. (2013). The South African Society of Psychiatrists (SASOP) treatment guidelines for psychiatric disorders. South African Journal of Psychiatry, 19(3), 127–196. https://doi.org/10.4102/sajpsychiatry.v19i3.942