A healthy lifestyle can significantly lower the risk of dementia – especially in middle age, between 40 and 75 years old. This connection has now been well researched. But how can this far-reaching scientific finding be communicated to the general public? A Europe-wide network of dementia researchers has developed a position paper for this purpose.
The Interdem-Researchers led by Jan Steyaert from the University of Antwerp first emphasize the great importance of modifiable risk factors for dementia, which have been studied in numerous studies in recent years. These include, for example, diet, exercise, alcohol, smoking, and hearing loss. In view of the new findings, the authors see the possibility of significantly reducing the number of future dementia cases through a preventive, “brain-healthy” lifestyle.
New Challenge in the Dementia Field
The new challenge would now be to strengthen public awareness of brain health, develop strategies to promote an appropriate lifestyle, and counter increasing health inequalities. One difficulty: motivating the general public for something that will only become relevant in the future, possibly in 15-20 years. “How can people be motivated to invest in a brain-healthy lifestyle when the benefits are decades away?” ask the authors.
Comparison to smoking
The researchers repeatedly draw a comparison to smoking in their work: it took decades for the scientifically established knowledge about the connection between smoking and lung cancer to seep into public consciousness. It's no wonder, then, that many citizens are still hardly aware of the relatively new findings on dementia prevention. A study conducted in Flanders and the Netherlands also shows this. In Flanders, only just over a third of respondents aged between 40 and 75 believed that their lifestyle could influence their risk of dementia. In the Netherlands, this figure was 44 percent. However, 70 percent of respondents expressed interest in more information about brain health. “Lack of knowledge was the main barrier for people not to engage in a brain-healthy lifestyle,” stated the Interdem authors. “Therefore, raising public awareness is a primary goal for any dementia prevention strategy.”
Low-budget campaign boosted public awareness
A low-budget campaign that ran in Flanders from summer 2018 to spring 2019 shows that this goal can be achieved. During this campaign, 40,000 “vaccine boxes” were distributed at train stations, markets, and pharmacies. The boxes contained brochures about the connection between a brain-healthy lifestyle and dementia. Additionally, the campaign was promoted in the news and on social media. According to the researchers, this increased public awareness about dementia prevention by 10 percent.
How can public awareness for dementia prevention be specifically strengthened? The authors again draw a comparison to smoking – as an example of how complex the upcoming challenge is. After all, the link between smoking and lung cancer was clear and causal, and the message was simple: reduce smoking to prevent lung cancer. And yet, after decades of education and numerous campaigns, 20 percent of adults still smoke, according to the authors.
The message is more complex than with smoking.
Regarding the risk factors for dementia, the message is less straightforward, as there is not a single cause but a whole basket of factors, and the causality is weaker than between smoking and lung cancer. A simple message that is easy to communicate is needed, without disregarding the complexity. Generally, unlike with smoking, researchers do not recommend relying on fear and stigmatization, partly to avoid further increasing the existing stigma associated with dementia.
Many public health campaigns, according to the authors, focus on the individual, urging them, for example, to drink less alcohol. However, they forget that a healthy lifestyle involves many components, with individual, societal, and environmental factors interacting. Therefore, the goal must be to empower people through knowledge while simultaneously working towards changes at the societal level.
Inequality as a Special Challenge
Against this background, the researchers call the “health gap,” and thus inequality in healthcare, a particular challenge: studies have shown that in Western countries, people living in poverty, as well as immigrants with non-Western backgrounds, have a significantly higher risk of dementia. However, it is precisely these groups that are much harder to reach through health campaigns.
Consequently, the authors see the key in directing health campaigns at the general public, but using various formats to reach high-risk and hard-to-reach groups as well. “It is now time to put the research wealth of the past decade into practice and build a brain-healthy society,” the authors demand, calling for bridges to be built between the various groups involved in care, research, and public health. “Such bridges have helped reduce lung cancer rates by reducing smoking in recent decades; let's achieve the same for dementia.”
You can find the study here:
Putting primary prevention of dementia on everyone's agenda June 2020
