The social causes of Dementia

Table of Contents

Last Updated on September 26, 2024 by Karl Thompson

Roughly 55 million people are currently living with Dementia, worldwide. 10 million new dementia cases are diagnosed annually.

The Alzheimer’s Society estimates there are almost one million people in the UK currently living with dementia, projected to grow to 1.4 million by 2040. The current costs of dementia are estimated to be £42 billion a year.

According to secondary research by the Lancet Commission on Dementia almost half of these dementia cases are due to preventable causes, things we can change. The report draws on a range of studies from across the world and conducts meta analysis to draw conclusions.

Dementia is not inevitable

The 2024 dementia report identified 14 lifestyle, medical and environmental factors that were together responsible for 45% of dementia cases.

The report breaks down which factors are most highly correlated with dementia in later life.

The most significant correlated factors are:

Lower levels of education in early life (5%)
Hearing loss and High Cholesterol in mid life (both 7%)

Social isolation in later life (5%)

Other factors are high blood pressure, smoking, obesity, depression, physical inactivity, diabetes, excessive alcohol consumption, traumatic brain injury, and exposure to air pollution.

Methodological challenges with the study

The authors are very clear about the problems of researching dementia.

One of the trickiest things is the slow build up to a dementia diagnosis. Someone might be in slow cognitive decline for years before they get a dementia diagnosis. Others may be undiagnosed and just putting their increased tiredness and confusion (for example) down to factors such as job stress. In other words, there may be millions of people out there technically with dementia but who are not on record as having dementia.

Then there are problems of isolating the variables. For example with education, is it just lack of early years education or the consequences of that (such as reading less or a whole range of other things) which may lead to dementia?

And then there’s the very tricky issue of correlation and causation. It may be that medical conditions such as high cholesterol don’t ‘cause’ dementia as such. It could be that they are just coincidentally correlated, or it could be that having dementia means you are more likely to eat the kinds of comfort food that give you high cholesterol.

However, overall many of the correlated factors identified are worth reducing because they are correlated with other negative health factors too, besides dementia.

Implications of dementia for society

Dementia affects individuals differently. Some people with dementia can carry on with work and relationships in much the same way as before a diagnosis.

However, in more severe cases, people will have to stop work and some will require care, hence the huge financial cost to society of managing dementia.

Dementia may not lead to early death, but it can certainly compromise one’s quality of life as it progresses. So it may not reduce life expectancy but it can certainly reduce healthy life expectancy.

For the sake of both individuals and society reducing the rates of dementia seems like something we should be prioritising.

Social Policies to tackle dementia

The Lancet study clearly identifies several risk factors that it would be desirable to reduce at a societal level.

Many of these would be longer term interventions which have further social benefits alongside reducing dementia rates.

Some obvious social policy interventions would be…

Improving early years education for the most disadvantaged.

Promoting health eating, given that both high cholesterol and obesity are correlated with dementia in later life
Tackling social isolation in later life.

Of all of these, tackling social isolation seems like it could have the most immediate effect.

Specific Actions

Social Policy suggestions to lower the rates of dementia.

The report suggests a number of social and individual lifestyle interventions that could reduce the rates of dementia. For example: