Reducing 12 risk factors could delay or prevent 40 per cent of dementia cases, a leading study suggests.
The research, published in the prestigious Lancet medical journal, discovered three new risk factors for dementia, along with the nine listed in a 2017 paper.
The three new factors were excessive alcohol intake, head injury in mid-life and exposure to air pollution in later life, which together were associated with 6 per cent of all dementia cases.
An estimated 3 per cent of cases were attributable to head injuries in mid-life, 1 per cent of cases to high alcohol consumption (more than 21 units a week) in mid-life, and 2 per cent to air pollution in later life.
The remaining risk factors were associated with 34 per cent of all dementia cases.
The factors associated with the greatest proportion of dementia cases were less education in early life, hearing loss in middle age and smoking in later life (7, 8 and 5 per cent, respectively).
About 50 million people live with dementia globally, and this is projected to increase to 152 million by 2050, particularly in low-income and middle-income countries where about two thirds of all people with dementia live.
The neurodegenerative illness affects people, their families and the economy, at an estimated global cost of about $1 trillion (Dh3.67trn) a year.
But in certain countries the proportion of older people with dementia has fallen.
This is thought to be caused by improvements in education, nutrition, health care and lifestyle changes, demonstrating the possibility of reducing dementia through prevention.
The new report, published by 28 leading dementia academics, laid out a set of policies and lifestyle changes to help prevent the condition.
“Our report shows that it is within the power of policymakers and individuals to prevent and delay a significant proportion of dementia, with opportunities to make an impact at each stage of a person’s life,” said lead author Professor Gill Livingston of University College London.
“Interventions are likely to have the biggest impact on those who are disproportionately affected by dementia risk factors, like those in low and middle-income countries and vulnerable populations, including black, Asian and minority ethnic communities.
“As societies, we need to think beyond promoting good health to prevent dementia, and begin tackling inequalities to improve the circumstances in which people live their lives.
"We can reduce risks by creating active and healthy environments for communities, where physical activity is the norm, better diet is accessible for all and exposure to excessive alcohol is minimised.
The report highlighted nine recommendations to help reduce the risk of dementia, including primary and secondary education for all children, decreasing harmful alcohol drinking, preventing head injuries, using hearing aids, protecting ears from damagingly loud noise and drastically improving air quality.
Based on the nine risk factors, scientists believe the potential to prevent cases of dementia is high.
While globally the original nine risk factors were estimated to contribute to 35 per cent of all dementia cases, in developing regions that number was higher: in China they might account for 40 per cent of cases, 41 per cent in India and 56 per cent in Latin America.
“In this context, national policies addressing dementia risk factors, like primary and secondary education for all and stopping smoking policies, might have the potential for large reductions in dementia and should be prioritised,” said the report's co-author Professor Adesola Ogunniyi of the University of Ibadan in Nigeria.
“We also need more dementia research coming from low and middle-income countries so we can better understand the risks particular to these settings.”
The study authors said that dementia sufferers were also at higher risk from Covid-19 than the general population because of their age and pre-existing illnesses such as hypertension.
Physical distancing can also be challenging for dementia patients, who may find it difficult to adhere to, or not understand, the guidelines.
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HIV on the rise in the region
A 2019 United Nations special analysis on Aids reveals 37 per cent of new HIV infections in the Mena region are from people injecting drugs.
New HIV infections have also risen by 29 per cent in western Europe and Asia, and by 7 per cent in Latin America, but declined elsewhere.
Egypt has shown the highest increase in recorded cases of HIV since 2010, up by 196 per cent.
Access to HIV testing, treatment and care in the region is well below the global average.
Few statistics have been published on the number of cases in the UAE, although a UNAIDS report said 1.5 per cent of the prison population has the virus.
Mercer, the investment consulting arm of US services company Marsh & McLennan, expects its wealth division to at least double its assets under management (AUM) in the Middle East as wealth in the region continues to grow despite economic headwinds, a company official said.
Mercer Wealth, which globally has $160 billion in AUM, plans to boost its AUM in the region to $2-$3bn in the next 2-3 years from the present $1bn, said Yasir AbuShaban, a Dubai-based principal with Mercer Wealth.
“Within the next two to three years, we are looking at reaching $2 to $3 billion as a conservative estimate and we do see an opportunity to do so,” said Mr AbuShaban.
Mercer does not directly make investments, but allocates clients’ money they have discretion to, to professional asset managers. They also provide advice to clients.
“We have buying power. We can negotiate on their (client’s) behalf with asset managers to provide them lower fees than they otherwise would have to get on their own,” he added.
Mercer Wealth’s clients include sovereign wealth funds, family offices, and insurance companies among others.
From its office in Dubai, Mercer also looks after Africa, India and Turkey, where they also see opportunity for growth.
Wealth creation in Middle East and Africa (MEA) grew 8.5 per cent to $8.1 trillion last year from $7.5tn in 2015, higher than last year’s global average of 6 per cent and the second-highest growth in a region after Asia-Pacific which grew 9.9 per cent, according to consultancy Boston Consulting Group (BCG). In the region, where wealth grew just 1.9 per cent in 2015 compared with 2014, a pickup in oil prices has helped in wealth generation.
BCG is forecasting MEA wealth will rise to $12tn by 2021, growing at an annual average of 8 per cent.
Drivers of wealth generation in the region will be split evenly between new wealth creation and growth of performance of existing assets, according to BCG.
Another general trend in the region is clients’ looking for a comprehensive approach to investing, according to Mr AbuShaban.
“Institutional investors or some of the families are seeing a slowdown in the available capital they have to invest and in that sense they are looking at optimizing the way they manage their portfolios and making sure they are not investing haphazardly and different parts of their investment are working together,” said Mr AbuShaban.
Some clients also have a higher appetite for risk, given the low interest-rate environment that does not provide enough yield for some institutional investors. These clients are keen to invest in illiquid assets, such as private equity and infrastructure.
“What we have seen is a desire for higher returns in what has been a low-return environment specifically in various fixed income or bonds,” he said.
“In this environment, we have seen a de facto increase in the risk that clients are taking in things like illiquid investments, private equity investments, infrastructure and private debt, those kind of investments were higher illiquidity results in incrementally higher returns.”
The Abu Dhabi Investment Authority, one of the largest sovereign wealth funds, said in its 2016 report that has gradually increased its exposure in direct private equity and private credit transactions, mainly in Asian markets and especially in China and India. The authority’s private equity department focused on structured equities owing to “their defensive characteristics.”
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