Public health interventions aimed at reducing dementia risk factors could potentially save up to £4 billion in England by lowering dementia rates and enhancing overall health and longevity, according to recent findings by researchers from University College London (UCL).
The findings, published in The Lancet Healthy Longevity, indicate that various interventions—such as reformulating food products to decrease sugar and salt consumption, implementing low emission zones to improve urban air quality, and introducing minimum pricing per unit of alcohol to curb consumption—could yield significant benefits beyond their direct health impacts.
Dr Naaheed Mukadam from UCL Psychiatry, the study’s lead author, stated, “Extensive research suggests that dementia incidence could be reduced by addressing risk factors throughout a person’s life. Numerous risk factors, including smoking, alcohol consumption, and high blood pressure, increase the likelihood of developing dementia later in life and can be effectively mitigated through public health strategies. Although many of these initiatives aim not to reduce dementia, their substantial impact on dementia risk suggests that they could be financially justifiable by the savings in dementia-related costs alone, which should be a routine consideration in cost-benefit analyses.”
The economic modelling conducted in the study assessed the potential impact of population-wide interventions on dementia rates and associated costs, projecting over 70,000 gains in Quality Adjusted Life Years (QALY) across the population. These interventions targeted six key risk factors: smoking, alcohol use, obesity, hypertension, head injuries, and air pollution.
A prior study in 2022, also co-authored by Dr Mukadam, established that various interventions targeting such risk factors are cost-effective without even accounting for their impact on dementia by reducing costs associated with other health issues like hypertension and diabetes. The latest research further suggests that these interventions become even more cost-effective when factoring in the costs associated with dementia.
In their examination of public health strategies, the researchers estimated that modifying food products to reduce salt and sugar intake could save £2.4 billion and £1.1 billion and achieve QALY gains of 39,433 and 17,985, respectively. Additionally, a 10% hike in cigarette prices could save £157 million in dementia-related costs, and mandating bicycle helmets for children could prevent head injuries, potentially saving £91 million in dementia costs in the future.
Dr. Mukadam’s earlier 2020 study found that individual measures like hearing aids, nicotine gum for smoking cessation, or medication to manage high blood pressure could annually save £1.9 billion in England.
This latest research aligns with the findings from the third Lancet Commission on dementia prevention, intervention, and care, led by Professor Gill Livingston of UCL Psychiatry, which posits that nearly half of dementia cases could be prevented or delayed by addressing 14 risk factors throughout life.
Professor Livingston, the senior author of the economic modelling paper, noted, “While the quest for effective dementia treatments is a significant challenge for scientists, clinicians, and governments, there is hope. Moreover, we can prevent many instances of dementia by targeting risk factors early. As the population ages and the societal costs of dementia escalate, the need for public health measures to prevent dementia becomes increasingly urgent.”
Dr. Mukadam further emphasized the need for policy-based approaches that alleviate individual responsibility, stating, “People can reduce their own risk of dementia through lifestyle changes, but effective public policies are essential. These interventions, while initially costly, more than pay for themselves over time by reducing future health and social care expenses. Studies suggest that such interventions could be particularly impactful in reducing health disparities in low- and middle-income countries or among lower-income groups, thereby improving the health of the entire population.”
Samantha Benham-Hermetz, Executive Director of Alzheimer’s Research UK, also highlighted the economic and societal toll of dementia, noting the staggering costs and doubling hospital expenditures over the past decade primarily due to emergency admissions. With an ageing population, these costs are set to rise further. She pointed out, “Up to 45% of dementia cases are preventable, and there are cost-effective public health measures available that could significantly reduce the risk of dementia. This presents a dual opportunity for the government to extend healthy life expectancy while optimizing the use of public funds.”
More information: Naaheed Mukadam et al, Benefits of population-level interventions for dementia risk factors: an economic modelling study for England, The Lancet Healthy Longevity. DOI: 10.1016/S2666-7568(24)00117-X
Journal information: The Lancet Healthy Longevity Provided by University College London
