Efforts to prevent dementia may be placing too much responsibility on people's choices while overlooking the wider social and environmental conditions that shape brain health, according to new Curtin University research published in The Lancet Public Health.
Researchers mapped 61 potentially modifiable dementia risk and protective factors to assess whether prevention efforts are overlooking the broader social, environmental and policy influences that shape lifelong brain health.
The study revealed a strong emphasis on factors addressed through individual motivation and behaviour change, despite many dementia risks being influenced by conditions beyond a person's direct control.
Researchers found far less attention is paid to social and environmental influences such as education, housing, neighbourhood safety, healthcare access, clean air and social connection — despite growing evidence these factors affect people's ability to protect their brain health.
Dementia affects an estimated 57 million people worldwide, and this is projected to reach 139 million by 2050.
In Australia, about 446,500 people are living with dementia, with the number expected to exceed one million by 2065. Dementia is now the leading cause of death for Australians.
Lead author Dr Jennifer Dunne from Curtin University's Dementia Centre of Excellence said the findings challenged the way dementia prevention has traditionally been framed.
"Much of dementia prevention is focused on what individuals can do to reduce their risk — exercise more, eat well, stay socially connected and manage their health," Dr Dunne said.
"These are obviously important for a range of reasons, but our study shows that many of the factors that shape dementia risk do not sit solely within an individual's control.
"Where people live, the education they receive, the healthcare they can access, the air they breathe and the social and economic conditions they experience across their lives can all shape brain health.
"If we focus predominantly on individual behaviour, we risk asking people to make healthier choices without addressing the conditions that make those choices possible."
Chair in Dementia at Curtin's enAble Institute and co-author Professor Blossom Stephan said the findings showed dementia prevention needed to take a broader, population-wide approach.
"The next step is turning this evidence into action. Dementia prevention should support healthy choices while also improving education, neighbourhoods, healthcare access and other social conditions that shape brain health across the population throughout a person's life," Professor Stephan said.
Other collaborating institutions included NeuRA, UNSW Sydney and Dementia Australia.
Dementia Australia Chief Executive Officer Professor Tanya Buchanan said with 78 million people expected to be living with dementia worldwide by 2030, it was vital to make sure everyone was supported to lower their risk of dementia.
"Dementia risk reduction is a collective responsibility and it is vital everyone has access to the supports and services they need to support their brain health," Professor Buchanan said.
"Alongside addressing brain health behaviour at an individual level, we need policies and actions from governments and organisations to make it easier for everyone to lower their risk of dementia."
The paper, 'Beyond individual-level approaches to dementia prevention: a socioecological reappraisal' published in The Lancet Public Health journal, can be found here .
