An update to the Lancet Commission on dementia prevention, intervention and care has added excessive alcohol intake, head injury and air pollution to nine previously identified modifiable risks.

Led by 28 world-leading dementia experts, the report builds on the 9 risk factors identified in the 2017 Lancet Commission, and provides an up-to-date analysis of the best evidence on the prevention of dementia.

To address dementia risk, the authors call for 9 ambitious recommendations to be undertaken by policymakers and by individuals:

• Aim to maintain systolic blood pressure of 130 mm Hg or less in midlife from around age 40 years
• Encourage use of hearing aids for hearing loss and reduce hearing loss by protecting ears from high noise levels
• Reduce exposure to air pollution and second-hand tobacco smoke
• Prevent head injury (particularly by targeting high risk occupations and transport)
• Prevent alcohol misuse and limit drinking to less than 21 units per week
• Stop smoking uptake and support individuals to stop smoking (which the authors stress is beneficial at any age)
• Provide all children with primary and secondary education
• Lead an active life into mid, and possibly later life
• Reduce obesity and diabetes

Gill Livingston, professor of psychiatry of older people at University College London and a co-author of the report said “Dementia is potentially preventable – you can do things to reduce your risk of dementia, whatever stage of life you are at”.