‘Slip, slop, slap for brain health': Australia needs a major prevention campaign for dementia, doctor says

The Guardian

2 days ago

A 'slip, slap, slop'-style preventative campaign is needed for dementia, as new research shows cases of the disease could be delayed with no added cost, a leading doctor has told the National Press Club on Wednesday.
In the speech titled 'Hope Beckons', Prof Henry Brodaty, a co-director of the Centre for Healthy Brain Ageing (CHeBA) at the University of New South Wales, said there was much more Australia could be doing to help prevent dementia in its ageing population by addressing risk factors that can be managed, such as poor diet.
Australia has a 'very proud record of prevention' when it comes to health, such as the 'slip slap slop' and 'life be in it' campaigns, as well as smoking reduction and heart health awareness, Brodaty said.
'But we don't have an awareness in our community we can do the same thing for dementia, where half the risk factors for dementia is caused by environmentally modifiable factors that we can all do something about.
'We all have the power to do more exercise, to keep our brains active, keep socially connected. We can monitor and treat high blood pressure, high cholesterol. We can compensate for hearing loss. We can try to avoid obesity. We can reduce the risk of diabetes and head injury. We can live in environments free of air pollution. We can not smoke and avoid excess alcohol.'
Brodaty told the press club 'We need the slip, slop, slap of brain health now.'
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The National Dementia Action Plan 2023–2034 was released, but $166m in funding is too little for what Australia needs, he said. 'Where are the navigators to guide patients and families after a diagnosis? Think about breast cancer … We can do this too in dementia, and it can be cost neutral,' Brodaty said.
A study on which Brodaty was senior author, published on Wednesday in the Journal of Prevention of Alzheimer's Disease, found that CHeBA's internet-based dementia prevention program tailored to an individual's risk profile shows cost-effectiveness for improving cognition and reducing dementia risk.
Between 2018 and 2021, the trial followed 6,104 Australians aged 55 to 77 without dementia but who carried at least two modifiable dementia risk factors such as being overweight or suffering from anxiety. CHeBA's 'Maintain Your Brain' online had coaching modules for four of these factors: physical activity, nutrition, cognitive training, and depression or anxiety.
Half of the participants were assigned to the online program, where they were allocated between two to four of the modules depending on their dementia risk profile, while the other half of participants in the trial (the control group) were given access to curated but freely available information sheets regarding dementia risk reduction.
After three years, the researchers analysed the differences in costs for both the direct healthcare that participants received and the program costs, and the effectiveness (cognitive outcomes and dementia risk) between the two groups.
They found the participants who received the online coaching showed significant improvements in cognitive performance and greater reductions in dementia risk compared with those who received general health information alone.
The difference was highly significant, which would have a 'major effect' at a population level, delaying the onset of dementia, Brodaty said. 'Every year that we can delay the onset of dementia reduces the prevalence of dementia by 10% because it pushes the disease to later in life.'
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They also found there was no significant difference in cost per person over the trial period because those who participated in the program used fewer healthcare resources which offsets the cost of delivering it.
The researchers noted that the online program would become cheaper per person in future because some research and development costs had already been borne.
The researchers also acknowledged limitations within the study: the participants were primarily Caucasian, better educated than average and had a higher socioeconomic status than the general population. They also noted risk-reduction practices may reap greater benefits in higher-risk populations.
As the study, they said, considered short-term measures of effectiveness only, 'the true long-term cost savings will only be known if the sample is followed long enough to identify whether cases of incident dementia are prevented'.
Prof Scott Ayton, a director in dementia research at the Florey Institute of Neuroscience and Mental Health, who was not involved in the research, said 'evidence accumulated over the past decade indicates that lifestyle and risk factor-targeted prevention strategies can meaningfully lessen dementia risk'.
'The large Maintain Your Brain trial stands as a leading exemplar, showing that straightforward, cost-effective, risk-factor targeted interventions can delay onset or reduce overall risk without adding pressure to the health budget,' Ayton said.