National campaign hopes to change how Australians think about dementia

Two News Corp Australia mainstays have come together this Dementia Action Week to launch a national dementia advocacy campaign aimed at changing the way Australians think about brain health.

News.com.au and The Australian's ‘Think Again’ series, in partnership with Specsavers Audiology, brings everyday stories of dementia to a national stage, hoping to both normalise the experience and build more understanding and supportive communities across the country.

“Our brain health impacts how we think, feel, and function, yet it’s often overlooked. We want to change that. We want to change the narrative that dementia only impacts the elderly and is an inevitable part of ageing. We want to make it easier for people to talk about their brain health, just as they do about their mental health or heart health,” the publication said.

“We want to inspire people to make small changes today that will have a big impact on their brain health in later life – and to seek help early if something doesn’t feel right.”

The number of people living with dementia worldwide is projected to reach about 153 million by 2050, while in Australia, it is estimated more than 433,000 people are living with the condition.

That number is projected to nearly double to 812,500 by 2054, and tip over a million by 2065.

“Talking openly about brain health can also help reduce stigma. People living with dementia and their loved ones often feel isolated or judged,” News.com.au said.

“When more people understand how important our brain health is, it’s easier to advocate for policies and programs that make a difference. And it prompts governments to act.

“This will lead to better resources and support for everyone.”

Getting a headstart

For years, the prevailing school of thought on whether or not a person would develop dementia was that it was an unlucky lottery we entered as we aged. Or it was regarded as an inevitability for those able to run the gauntlet of other age-related illness and make it into their seventh or eighth decade.

These assumptions are being rapidly overthrown, in part due to the discovery of 14 separate lifestyle modifiers, which could lead to the prevention of 45 per cent of cases.

According to the World Health Organisation, dementia – including Alzheimer’s disease, which is believed to make up 60 to 70 per cent of all dementia cases worldwide – is the seventh leading cause of death globally, and it is now officially the number-one cause of death in Australia.

“Dementia is currently the leading cause of death for females over the age of 75 in Australia, and within a few years will become the leading cause of death for all Australians over 75,” Neuroscience Research Australia (NeuRA) CEO and Institute Director Professor Matthew Kiernan told news.com.au.

“It represents a huge disability and cost burden to the community and there is a lot of pressure on governments to address it,” he said.

Established in 2017 in part as a result of this pressure, The Lancet Commission on Dementia Prevention, Intervention, and Care is responsible for reviewing the vast amount of existing evidence on what can be done to prevent and manage dementia, as well as to guide policymakers and healthcare professionals.

The key premise is that a significant proportion of dementia cases are potentially preventable by addressing modifiable risk factors.

While The Lancet Commission had previously identified 12 lifestyle modifiers, its 2024 report found evidence to suggest the addition of two more.

Spread across three separate life stages, these modifiable risk factors include a variety and combination of sometimes surprising factors

EARLY LIFE

Not completing secondary education
Low educational attainment increases the risk in cognitive decline, which experts theorise is partially due to having lower cognitive reserves to maintain brain function into ageing. Conversely, lifelong learning has a protective effect.

MIDLIFE

High LDL cholesterol
One of the recent updates to the Lancet Commission’s findings was the inclusion of high LDL cholesterol as a risk factor for dementia. Not only have studies found excess brain cholesterol to be associated with a higher incidence of stroke, it is also associated with higher deposits in the brain of proteins associated with Alzheimer’s disease. People who took medication to lower their cholesterol were not at a higher risk.

Depression
While depression at all ages increases the risk of developing dementia, evidence suggests midlife depression has the most significant impact, with experts theorising this could be because of the way in which depression can shrink the hippocampus, the part of the brain responsible for forming memory.

Hearing loss
A number of studies have established the link between hearing loss and dementia risk, with data suggesting that a person’s risk of dementia increases by four per cent to 24 per cent for every 10 decibel reduction in hearing.

“While hearing loss is a natural part of the ageing process, those most affected are normally in the late 60s, early 70s and beyond,” Specsavers chief audiologist Nick Taylor said.

“Untreated adult-onset hearing loss can result in communication difficulties that can lead to social isolation and withdrawal, depression, and reduced quality of life. But hearing loss is often thought of as an invisible disability as there are no clear external symptoms, very different from the need for reading glasses when your arm isn’t long enough to focus on small writing.

“Therefore, we recommend that adults from the age of 50 have their hearing health checked on a regular basis (every two years) to identify any early signs of hearing loss and be aware of the support available.”

Traumatic brain injury
Knocks to the head in sport, concussion, motor vehicle accidents and other traumatic injuries can also increase dementia risk, with one study concluding this type of traumatic brain injury could bring on an earlier onset of Alzheimer’s by two to three years.

Obesity
In an analysis of 16 studies that looked at more than five million people, researchers found those in the overweight or obese category were at greater risk of cognitive impairment and dementia than those in a healthy weight range.

Sedentary lifestyle/physical inactivity
The World Health Organisation recommends 150 to 300 minutes of moderate physical activity per week, and studies have shown this can benefit brain health in a myriad ways. Improving blood flow, increasing production of healthy proteins in the brain, reducing inflammation and maintaining a healthy weight are some of the benefits thought to reduce dementia risk.

Type 2 diabetes
Type 2 diabetes has been previously linked to an increased dementia risk, but the time of onset matters. Those who develop Type 2 diabetes in midlife are more likely to develop dementia, while those who develop it later in life do not appear to increase their risk profile. Maintaining healthy blood sugar levels and managing pre-diabetes/insulin resistance is a crucial step.

Smoking
The fact that smoking is linked to poor health outcomes is not revolutionary, however the toxic chemicals found in cigarettes, along with smoking’s impact on vascular health, significantly increase a person’s risk of developing dementia. Quitting can reduce this risk.

High blood pressure (hypertension)
Having high blood pressure in midlife is linked with an increased risk of dementia – both Alzheimer’s and vascular. In studies, those who received blood pressure medication had better cognitive function than those who were not treated, which is why regular blood pressure checks and treatment is crucial.

Alcohol
Heavy alcohol use (usually defined as more than 10 standard drinks per week, or more than four standard drinks in one day) is linked with dementia, increasing the risk of developing it by up to threefold, according to one study.

LATE LIFE

Social isolation
Loneliness, particularly in later life, can increase a person’s risk of dementia significantly, as well as increasing their risk factors for other health disorders related to dementia risk. Fewer social contacts and less time spent socialising can also speed up progression of symptoms.

Untreated vision loss
New evidence published in the Lancet Commission’s 2024 report found vision loss (untreated) did increase dementia risk, when previously there was not sufficient evidence on the subject. A 2021 meta-analysis of 14 prospective cohort studies on over six million people confirmed the increased risk.

Air pollution
Exposure to polluted air has been shown to increase dementia risk, and while in some instances this type of environmental exposure is unavoidable, experts recommend taking measures to avoid heavily polluted areas or days when air pollution is particularly bad, as well as closing air vents when sitting in traffic to avoid car exhaust.

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