The number of individuals living with dementia is expected to approach 150 million by 2050, more than tripling the 2019 projection of 50 million. Rates are rising fastest in low- and middle-income countries (LMICs), which are less able to deal with the huge economic and social effects of this terrible disease.

In 2020, the Lancet Commission Report projected that up to forty percent of dementia risk might be ascribed to twelve modifiable risk factors, the majority of which are more prevalent in LMICs. Less education, high blood pressure, obesity, diabetes, depression, hearing loss, smoking, binge drinking, physical inactivity, lack of social interaction, traumatic brain damage, and air pollution are a few of these. 

While there was little to no difference between the genders in terms of the prevalence of risk factors for dementia, women were more likely to be diagnosed with the illness in economically disadvantaged regions.

While earlier studies have indicated that women had a higher lifetime risk of acquiring dementia than males, in part because they typically live longer, lead author Jessica Gong of The George Institute for Global Health argued that age alone may not completely explain for this difference.

The majority of studies predicting dementia incidence up to this point has been done in high-income nations, she said, with very little information being accessible in the nations that truly suffer the burden of the disease.

When age-related factors were taken into account, dementia rates were found to be greatest in low- to lower-middle income nations and higher in women than in males.

With an estimated 50 million individuals suffering from dementia in 2019, experts predict that figure will triple to almost 150 million by 2050. Most of the increase is happening in LMICs, which are ill-equipped to deal with the terrible economic and social effects of the illness.

As much as 40% of dementia risk may be attributable to 12 modifiable risk factors, several of which are more prevalent in LMICs, according to the Lancet Commission Report in 2020. Low levels of education, obesity, diabetes, depression, difficulty hearing, smoking, excessive alcohol use, sedentary lifestyles, lack of social interaction, TBI, and air pollution are all contributors.

When they “looked for sex differences in these risk factors, we found that, older age, diabetes, depression, hearing impairment and having a certain genetic variation involved in fat metabolism in the brain – known as APOE4 – were associated with a greater risk of dementia in both women and men,” adds Ms. Gong.

While bigger hip circumference, more years of schooling, current alcohol consumption (as opposed to never drinking), and high levels of physical exercise (as opposed to none to minimum activity) were linked to a decreased risk of dementia in both genders.

However, there was “moderate evidence” that the number of years spent in school varied by sex, with males having a larger protective link than women.

The authors noted that greater educational attainment and cognitively challenging employment have been demonstrated to be protective against dementia, despite the fact that women, especially in LMICs, have not had similar educational and occupational chances to males.

According to Associate Professor Sanne Peters, a Senior Lecturer at The George Institute for Global Health UK in collaboration with Imperial College London and a member of the research team, institutional factors that limit women’s opportunities, limited access to appropriate healthcare and risk management programs, and other factors like domestic violence – particularly for women from lower socioeconomic settings – can cause psychological stress and leave them in vulnerable situations.

According to her, “in general, the geographical patterns that we saw for increased dementia risk in women seemed to echo those of gender disparity.”

These results provide justification for funding initiatives to increase gender equality in brain health throughout the lifespan, especially in areas that have been underrepresented in dementia research.

Source: 10.1002/alz.12962

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