Dementia has significant, growing UK and global social, economic and health impact. We previously modelled the costs and cost-effectiveness of strategies to target dementia risk factors, focusing on interventions that were effective in individuals (reference Mukadam et al and Livingston et al). We found that hearing aids, antihypertensives and smoking cessation for everyone who needs them in England would prevent up to 8.5% of dementia cases, saving £1.9 billion/annum. Previous dementia prevention estimates of relative risks from available data, are mainly from White and socially advantaged groups. However, dementia risk accumulates in those most socioeconomically disadvantaged: people in the two lowest socioeconomic quintiles in England are 50% more likely to develop dementia than those in the highest quintile. Similarly, minority ethnic groups are at increased risk.
We published work investigating dementia risk factors in people from minority ethnic groups and estimated the impact of socioeconomic characteristics on dementia risk. Public Health England commissioned work to identify barriers and facilitators to primary dementia prevention. The NHS Long Term Plan aims to prevent 150,000 heart attacks, strokes and dementias. In 2021 Alzheimer’s Research UK (ARUK) launched a Brain Health Awareness campaign, and published a report citing our work and their commitment to work with stakeholders and policy makers to prevent dementia by tackling risk. We then led discussions for ARUK with primary care, NHSE, public health, third sector organisations, charities and policy think tanks about dementia prevention, public messaging and policy priorities. The conclusion was that there is no clear consensus on which dementia risk factors to target and how to target them, but that these organisations were interested in dementia prevention particularly for those at greatest risk.
A new way ahead for identifying the risk factors to target is by studying populations participating in natural experiments of changes in risks and their effect on dementia prevalence, and to weight data as needed for those less represented groups. With this funding, we would continue this work to address gaps in dementia prevention knowledge, using data sets, qualitative interviews and people with dementia and their carers, building capacity in minority ethnic groups to ensure impact for all society sectors. We will collaborate with Alzheimer’s Society, ARUK and Alzheimer’s Disease International with whom we have close links.
We will answer the following questions:
- What dementia risk factors are most suitable to tackle clinically and/or with policy change? We will particularly consider the evidence in underserved areas and groups.
- What are the associated costs and benefits?
- What are the barriers and facilitators to implementing proposed changes?
- How best can prevention be tailored to minority ethnic and socially disadvantaged people.
Our outputs will include policy briefings and we will work with NHSE on implementation to reduce dementia prevalence.
