Research on dementia risk modification highlights the importance of adopting a life-course perspective to identify “windows of opportunity” for addressing modifiable risk factors. A recent article in The Lancet Healthy Longevity, led by Dr Francesca Farina (University of Chicago) and the Next Generation Brain Health team, underscores the need to focus on such factors as early as young adulthood to maximise opportunities for risk reduction. The study emphasises that a variety of health behaviours, many of which emerge in young adulthood, may potentially have long-term effects on brain health. In particular, it is underlined that a significant proportion of young people (and in particular young women) do not have access to formal education, one of the strongest and most studies protective factors for cognitive decline and dementia. At the same time, unhealthy behaviours such as exposure to loud noise, cigarette smoking, alcohol use, and sedentary lifestyles are relatively common during this life stage. Young adults also face heightened exposure to other factors linked to dementia, including traumatic brain injury, depression, social isolation, obesity, diabetes, and hypertension. Furthermore, exposure to air pollution has been associated with neuropathology in young adults. Emerging risk factors such as dietary patterns, drug use, sleep problems, and stress are also highlighted as areas requiring further research.
In order effectively address modifiable risk factors in young adulthood, the authors call for mapping the most salient prevention targets and propose a series of action points:
1. Education and awareness-raising campaigns to highlight the benefits of brain-healthy lifestyles and inform young people about modifiable dementia risk factors.
2. Adequate taxation policies targeting products associated with unhealthy behaviours, such as tobacco and alcohol.
3. Creation of an advisory council of young adult representatives from diverse backgrounds to ensure policies reflect their realities and needs.
4. Development of a brain health charter, outlining clear policy actions to address contextual concerns affecting brain health in young adulthood.
In line with the recommendations raised by the Next Generation Brain Health team, Alzheimer Europe calls upon the European institutions and national governments to incorporate measures for dementia risk reduction and prevention across the life course, as part of fully funded dementia strategies.