Millennials are less prone to dementia than boomers. The rate of new cases is lower now than it was for previous generations. Still, more people live with dementia today than ever before, as the world’s population keeps growing and more people live into older ages. This consensus is based on 7 experts answers from this question: Are dementia rates in the US declining?

As we blow out those birthday candles year after year, we get older. So do the people near us, and when one looks around it would seem that more and more of them are getting dementia as the years go by. Unhelpfully, news often seem to present a rather dystopian future where most of us may inevitably get Alzheimer’s in a few years or decades. But are we any more likely to suffer dementia than were those from our parents’ generation? We have put this question to our experts and all of them agreed on quite the opposite: Dementia rates are declining. And yet, our perception may be right - more people do live with it in today’s world than ever before. Here is how to reconcile both facts.

More and more live with dementia...

The prevalence of a disease is the total amount of people that have it at any given time. For dementia, the overall number of patients living with it is on the rise - and is expected to keep increasing in the coming years. John Goss, a global health expert from the University of Canberra, explains that this is due to the growth of the population (whereby the more people there are, the more dementia patients there will be in total) and the fact that people live longer now.

By far, the largest risk factor for dementia is simply getting older, and the oldest among us are those most at risk of developing symptoms. It is not entirely clear why this should be the case, but it is generally thought that the brain loses resilience over the years, and a number of studies have described age-related changes in how the brain cells behave. On top of that, brain damage may slowly accumulate - and it is when the brain can no longer overcome the injuries that the first symptoms start to kick in.

If older people are more likely to get dementia and today’s population is older overall than a few decades back, there will be more total cases as a result: with people living longer than ever before, it is perhaps unsurprising that more of us have dementia now than 20 or 30 years ago. However, at any given age, according to Antony Bayer from Cardiff University, the number of people suffering from dementia has fallen. Epidemiology expert Jennifer A Deal from John Hopkins University explains that studies from various countries support this conclusion - once adjusting for age, the amount of patients has decreased from previous generations.

...but less and less get it every year

There are more of us living with dementia today than there were decades ago, but our experts agree that less new cases appear now. This is called incidence. By contrast to the prevalence of a disease, its incidence is the sum of the people that get it over a particular time period. In other words, we can think of it as the number of new patients that are diagnosed every year.

If we were to imagine each case of dementia as a drop of water in a bath, the level of water in the bath would indicate the prevalence of the disease while the pressure at which water comes out of the tap would be its incidence. Today, the bath is increasingly full and we have so far failed to come up with a treatment to cure dementia (or a drain to empty the bath in our metaphor). However, we are effectively closing the tap by slightly reducing the incidence of dementia, and so less fresh water goes into the bath every time.

But how come incidence rates are going down? There is no consensus to date as to what may be causing this, but some speculate that improvements in education and healthcare can play a role. Indeed, education has been suggested for years to help towards delaying dementia - presumably by boosting patients’ resilience to brain damage. A 2017 study, for example, showed that people that learn a second language show symptoms of Alzheimer’s almost 5 years later than people who only speak their mother tongue. On the other hand, there is now growing evidence linking dementia to cardiovascular health, and altered blood flow in the brain is indeed one of the earliest changes taking place during Alzheimer’s. Thus, the development of better treatments for cardiovascular conditions (such as hypertension) may be helping these patients stay away from dementia.

You can’t avoid ageing, but you can still control other risk factors. Be mentally and physically active - it may help you avoid (or at least delay) dementia.

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