NICE publish guidelines on delaying and preventing dementia in later life

The National Institute for Health and Care Excellence (NICE) has launched recommendations on approaches in mid-life to delay or prevent the onset of dementia, disability and frailty in later life.

The report, titled ‘Disability, Dementia and Frailty in Later Life – Mid-Life Approaches to Prevention’, has suggested that the risk of dementia, disability and frailty can be due to lifestyle and health risk factors as well unchangeable factors, such as inherited conditions or injury.

Jeremy Hughes, chief executive at Alzheimer’s Society, said: “These guidelines are a hugely welcome shift in public health thinking, highlighting the need for a change in mid-life behaviour and lifestyle choices to reduce the risk of dementia.

“This advice needs to be extended to encourage those who go on to develop dementia to live well and prevent the condition deteriorating more quickly.”

By 2035, the World Health Organisation (WHO) estimate that 23 per cent of the population will be aged 65 or over.

Estimates of life expectancy, suggest that on average, a man aged 65 can expect to live a further 17 years, but could face seven of those in ill-health and living with a disability towards the end of life.

Similarly, a woman aged 65 can expect to live a further 20 years but could face eight years living with a disability or ill-health.

Increases in life expectancy and in the proportion of older people in the UK population suggest that dementia incidence is set to rise.

Dementia, disability and frailty in later life can affect individuals, families and society as a whole, causing reduced quality of life, ill-health, long-term care and premature mortality.

However, NICE suggest that it is possible to reduce the risk of developing dementia, disability and frailty for many people aged 40 to 64 years.

The published guidelines aim to increase the number of people who can lead independent, healthy and active lives by:

• Reducing the prevalence of behaviours that increase the risk of dementia, disability and frailty, including a healthy diet and reduced alcohol consumption.

• Reducing the incidence of dementia, disability and frailty and delaying their development in people who experience them.

• Reducing the incidence of a range of chronic non-communicable conditions that can contribute to disability and frailty (such as cardiovascular diseases, diabetes, chronic obstructive pulmonary disease and some cancers).

NICE suggest that the recommendations can be achieved by promoting a change in various behaviours. These include: encouraging people to stop smoking, helping them to become more physically active and helping them to improve their diet.

Commenting on the guidelines, Mr Hughes added: “NICE rightly highlight the significance and evidence for cardiovascular risk factors but this focus must not overshadow the additional importance of psychological and social risks, such as stress, depression, social isolation and lack of mental activity.

"There is already sufficient research in this area to show these factors have an impact and equally, these need to be addressed.”