It’s never too late to make a positive change Reply

In a guest post for us, David Pearce, Associate Specialist in Older Person’s Mental Health at Devon Partnership NHS Trust, writes about dementia prevention and behaviour change.

Last year a poll by Saga found that dementia was the medical condition that people over 50 most feared.  Given this you might imagine that there would be widespread action being taken by people to try to reduce their risk of developing this condition.    However, there seems to be a marked lack of knowledge on the part of the public as to the action that they can take.  For instance, if you asked people about the dangers of obesity or smoking, they might say heart disease or cancer, but how many would say dementia?

Yet, according to information published by the World Health Organization, it is estimated that 14% of cases of Alzheimer’s disease world-wide are potentially linked to smoking.  Other modifiable risk factors are what could be regarded as the ‘usual suspects’, with poor diet, physical and cognitive inactivity, obesity,  excess alcohol consumption and so on, all being linked to a higher risk of Alzheimer-type dementia.   Indeed, one research paper projected that if we could all just take action based on what we know now, around a third of Alzheimer’s disease world-wide could be prevented.  These are people who are alive today who can, by relatively simple measures, have a significantly different future.

The present medications available to patients with Alzheimer’s disease, the commonest form of dementia, can provide some symptomatic relief for this potentially devastating condition, but sadly do not seem to influence the underlying course of the disease.  Recent studies on potentially disease-modifying medications, such as the high profile failure of Solanezumab to produce significant results, have also been disappointing.

I wonder if part of the reason behind the lack of public knowledge and action on dementia risk factors is that the progressive nature of dementia and repeated failures to find a cure have led to a fatalism about this particular disease that does not occur in others.  A kind of “If you’re going to get it, you’re going to get it and there’s nothing you can do” attitude.

The evidence suggests otherwise.  In Torbay we have run self-management courses for elderly patients with Mild Cognitive Impairment, which can often be an early stage of Alzheimer’s disease and found that people can, by taking small steps, make positive changes to their lifestyle and improve their confidence to manage their own illness.  And it can be fun, one study reported that amongst leisure activities; reading, playing board games, playing musical instruments and dancing were all associated with a reduced risk of dementia.  Even in elderly smokers another study found that over two years those who quit smoking had slower declines in their thinking ability than those who continued.  It seems that it really is never too late to change.


ASH Scotland is working with other organisations to help spread awareness that living well and healthily can significantly reduce your risk of developing dementia. We are developing a joint Dementia Defence campaign – see more information here, and check back as it develops!

Also, if you’re interested in reading more about the evidence base around smoking and dementia, our website is the place to look. For further information please contact ASH Scotland on 0131 225 4725 or


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