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The keynote speaker at the conference was Professor Miia Kivipelto from Karolinska Institutet in Sweden. In her speech, she detailed the current global dementia landscape, emphasising the 14 modifiable risk factors identified by the Lancet Commission on dementia. Professor Kivipelto also highlighted the FINGER study, which demonstrates how addressing multiple lifestyle factors can significantly reduce the risk of cognitive decline.

Miia Kivipelto, Professor, Karolinska Institutet, Sweden:
Keynote lecture: Preventing dementia and promoting brain health

– I believe we are facing what can be called a dementia epidemic. It is a global challenge that requires global solutions.

Keynote speaker Professor Miia Kivipelto made clear the immense scale of the disease, reminding everyone in the room that over 50 million people currently live with dementia, a figure projected to exceed 150 million by 2050. The number of individuals with mild cognitive impairment is even higher, and those carrying the pathological proteins amyloid and tau in their brains – which puts them at risk of developing dementia – could be ten times greater.

– This is a very exciting time in Alzheimer’s research, as we will soon be able to measure amyloid and tau with a simple blood test. I believe this will be a game-changer.

Professor Miia Kivipelto stated that early identification of individuals at risk of developing Alzheimer’s or dementia holds significant potential for both preventing and delaying the onset of the disease. Additionally, prevention could save societies a substantial amount of money. A five-year postponement of the onset of the disease could reduce the number of patients by up to 50%.

– It is never too early and never too late to reduce the risk of dementia. We should prioritise brain health throughout the entire life course.

In her keynote speech, Professor Miia Kivipelto presented the latest report from the Lancet Commission on dementia, published in July 2024.

– The good news is that the potential for prevention is greater than previously believed. Age and genetics still play a big role, but 45% of all dementia seems to be linked to modifiable risk factors. We should be ambitious about prevention. 

The Lancet Commission now identifies 14 modifiable risk factors, with high LDL cholesterol and vision loss being the new additions to the list. The previous 12 risk factors from a life-course perspective, from early age to later life, remain: diabetes, high blood pressure in midlife, obesity in midlife, physical inactivity, depression, smoking, low education, hearing loss, traumatic brain injury, high alcohol consumption, social isolation, and air pollution.

– Miia Kivipelto, Professor, Karolinska Institutet, Sweden

– Protective factors include a healthy diet, education, physical activity, mental activity, and social activity. Implementation could be achieved through policy changes at a societal level, making healthy choices easier. Individually tailored interventions are also important.

Professor Miia Kivipelto has been leading the FINGER research consortium for many years. FINGER is a large, randomised trial showing that cognitive impairment can be prevented by simultaneously addressing multiple modifiable risk factors, including nutrition, exercise, cognitive training, social activities, and vascular risk monitoring in older adults.

– I think the FINGER captures most of the modifiable risk factors presented by the Lancet Commission. The intervention took two years, and now we have been following the participants 11 years, so we start to have a lot of long-term evidence and data.

The results from the FINGER study show significant cognitive benefits, with global cognition increasing by 25%. The intervention also led to improved health in many other areas, highlighting that what works as dementia prevention also serves as prevention for a range of other health problems, including cardiovascular diseases, chronic diseases, and functional decline.

– The good news is that this type of intervention may help to slow down metabolic ageing, and long-term effects are achievable. The impact of lifestyle changes continues even after a dementia diagnosis, providing further evidence to support the idea that it is never too late for preventive measures.

On average, the FINGER study participants saw a reduction of 500 euros per person per year in health care service costs, reflecting substantial potential savings at a societal level.

One important finding was that the dropout rate in the intervention study group from 2015 was very low. This is an indication of why the FINGER model has become popular to implement in practice. The intervention is feasible.

– The Nordic countries are leading the science field, and I believe we can also lead the implementation efforts through collaboration.

Reference: Livingston, G., et al (2024). Dementia prevention, intervention, and care: 2024 report of the Lancet standing Commission. Lancet (London, England), 404 (10452), 572–628. Transformed figure, Nordic Welfare Centre, November 2024