NICE Guidelines On Delaying And Preventing Dementia In Later Life

The National Institute for Health and Care Excellence (NICE) has today (Tuesday 20 October) launched recommendations on approaches in mid-life to delay or prevent the onset of dementia, disability and frailty in later life. They aim to increase the amount of time that people can be independent, healthy and active.

Mid-life is defined as adults aged 40–64 years, or those aged 39 years or under from disadvantaged populations as this group is at increased risk of ill health and more likely to develop multiple health conditions.

The guidance, ‘Disability, Dementia and Frailty in Later Life – Mid-Life Approaches to Prevention’, suggests the risk of dementia, disability and frailty can be due to unchangeable factors, such as inherited conditions or injury. However, by changing specific risk factors and behaviours it is possible to reduce the risk of dementia, disability and frailty for many people.

By 2025, around 23% of the UK population will be aged 65 and over. Despite living longer, these years are not always spent in good health. It is estimated that men will face around 8 years of ill health, and a further 7 years with a disability, towards the end of their lives. On average women will have 9 years both of ill health and living with a disability, NICE say.

The guidance recommendations include:

• helping people stop smoking, be more active, reduce alcohol consumption, improve their diet and, if necessary, lose weight and maintain a healthy weight
• reducing the incidence of other non-communicable chronic conditions, such as diabetes, that can contribute to onset of dementia, disability and frailty
• increasing people’s resilience, for example by improving their social and emotional wellbeing

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.

“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.”