In an opinion article published in the Orlando Sentinel1, 4 past surgeons general noted that the crisis of dementia will have an impact that extends beyond the affected individual and involves nonprofessional caregivers, particularly friends and family who provide most of the care for those with dementia. Combined with the lack of appropriate care infrastructure, the impact on society will be devastating, making it the nation’s “top public health crisis.” The 4 former surgeons general — Dr Richard Carmona, Dr Jocelyn Elders, Dr Antonia Novello, and Dr David Satcher — served between 1990 and 2006.
The United States has a rapidly ageing population, and 14 million people are projected to live with dementia by 2050. The issue is particularly serious in communities of color, and by 2030 nearly 40% of Americans living with dementia will be Latino or African American.
The surgeons general noted that 35% of dementia is attributable to 9 risk factors: low levels of education, midlife hypertension, midlife obesity, hearing loss, late-life depression, diabetes, physical inactivity, smoking, and social isolation. A 2016 study by the National Institutes of Health2 indicated that diets high in natural plant-based foods and low in saturated fats reduce the risk for cognitive decline, while a 2017 study published by the Lancet Commission3 found that increased physical activity may have protective effects. Yet another study published in 2019 by the American Academy of Neurology4 demonstrated that both physical and cognitive activity reduced the risk for dementia.
The authors stressed the importance of individuals making lifestyle changes to reduce their risk for dementia. They maintain that dementia “behaves more like cardiovascular disease” and that proactive detection, assessment, and diagnosis may improve outcomes. Specifically, the authors raised the concept of an annual cognitive assessment to be incorporated into routine check ups, as well as a “culture of brain health.”
- Carmona R, Elders J, Novello A, Satcher D. U.S. surgeons general: Dementia is our top public health crisis. Commentary. Orlando Sentinel. October 10, 2019.
- Smith PJ, Blumenthal JA. Dietary Factors and Cognitive Decline. J Prev Alzheimers Dis. 2016;3(1):53–64.
- Livingston G, Sommerlad A, Orgeta V, et al. Dementia prevention, intervention, and care. Lancet. 2017;390(10113):2673-2734.
- Najar J, Östling S, Gudmundsson P, et al. Cognitive and physical activity and dementia. Neurology. 2019;92(12):e1322-e1330.