👵 Dementia has started to decline

• New studies show a decline in dementia cases over the past 25 years.
• Improved cardiovascular health linked to lower dementia risk.
• Educational duration may boost cognitive reserve, potentially reducing dementia expression.

Dementia, a term that once conjured images of an inevitable decline with aging, is now being met with a new wave of scientific optimism. In the richer parts of the world, the tide is turning.

A comprehensive study, scrutinizing the well-being of nearly 50,000 individuals aged over 65, unveiled a reduction in new dementia cases by 13 percent per decade across Europe and North America.

At the prestigious Harvard TH Chan School of Public Health, epidemiology department chair Albert Hofman sees the data clearly pointing to a reduced absolute risk of developing dementia compared to 30 years ago. This hopeful trend is not confined to the west; Japan, known for its significant elderly population, is beginning to show similar patterns.

Unraveling the factors

While the exact causes of this decline are still being pieced together, experts like Hofman highlight improved cardiovascular health as a probable contributor, considering the established connection between heart health and dementia risk.

For decades, the West has waged war against cardiovascular diseases, leading to widespread use of blood pressure medications and cholesterol-lowering statins. This emphasis on heart health appears to be paying dividends in mental acuity as well.

The fall in dementia rates has been more pronounced in men, reflecting past public health campaigns that primarily targeted male cardiovascular risks. This gender-specific approach is rooted in the historical — and incorrect — assumption that women were less prone to such conditions.

Another factor in this complex puzzle is the idea of "cognitive reserve" — the brain's ability to withstand dementia's impairments without obvious loss of function. Research indicates a correlation between the duration of formal education and a lower likelihood of dementia manifestation, suggesting that a longer educational journey could fortify the brain against future cognitive decline.

Redefining age-old beliefs

The decline was unexpected, even to seasoned researchers like Carol Brayne from the University of Cambridge. Brayne, who once thought the progression of dementia was inexorably linked to aging, has had to rethink this stance. Since the decline predates any effective medical treatments for dementia, she suggests that lifelong optimization of neurological function through improved brain and physical health might be key.

After years of working in a field where breakthroughs have often proved elusive, he is allowing himself some cautious optimism: “Overall, there is reason for hope", says Albert Hofman to the Financial Times.

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