By Angela Bradshaw, PhD, Director for Research at Alzheimer Europe
Confronting dementia: a growing challenge demanding a united response
Dementia is one of the most pressing public health challenges facing Europe. Affecting over 9 million people in Europe, dementia is a progressive, neurodegenerative condition that worsens over time, with symptoms including memory loss, confusion, problems with language and understanding, and changes in behaviour. Dementia also has wider impacts on families, caregivers, health and social care systems, with an average annual cost of EUR8,000 to EUR70,000 per affected person in Europe. The prevalence of dementia in Europe is projected to double by 2050 – underscoring the urgent need for coordinated actions across sectors to ensure people affected by dementia can access the care, treatment and support they need to live a life with meaning and dignity. Recognising the scale and complexity of the challenge posed by dementia, Alzheimer Europe was founded in the early 1990’s with a mission to change perceptions, policy, and practice to improve the lives of people affected by this condition. The organisation, with its 41 member associations in 36 countries, is committed to promoting the rights, dignity and autonomy of people living with dementia, their families and caregivers.
Clearing the air for brain health
According to the European Environment Agency, air pollution remains the largest environmental health risk in Europe. Although European air quality has improved in the last two decades, around 94% of the urban population remains exposed to fine particulate matter above World Health Organisation guideline levels. Exposure to air pollution is lifelong, potentially contributing to many long-term conditions across the life course. Emerging evidence shows a clear association between air pollution and increased dementia risk, strengthening the case for further reducing air pollution to improve physical health and prevent cognitive decline.
Findings from clinical trials illustrate the value of dementia risk reduction. They show that onset can be delayed or prevented through interventions targeting its fourteen modifiable risk factors, thought to cause around 45% of cases. A meta-analysis completed as part of the 2024 Lancet Commission on Dementia Prevention, Intervention and Care found that reducing exposure to air pollutants was associated with improved cognitive outcomes and a decreased risk of dementia. Although the biological mechanisms have not been conclusively determined, it is known that air pollutants, especially small particles, can cause inflammation and damage the heart and blood vessels, including blood vessels leading to and within the brain.
The ADAIR (Alzheimer’s Disease Air Pollution) project, a multinational initiative funded by the Joint Programme for Neurodegenerative Disease Research (JPND) between 2020 and 2022, aimed to elucidate the mechanistic links between air pollution and Alzheimer’s disease (AD), which causes around 70% of dementias. Findings from ADAIR indicated that both acute and chronic exposure to air pollutants resulted in significant alterations in immune cell profiles and inflammatory markers, identifying inflammation as a potential mediator of the physical changes leading to AD and dementia.
Invest in risk reduction to bridge evidence with action
As the evidence continues to grow, the need for action becomes increasingly clear. By investing in risk reduction across the life course, including through policies that improve air quality, countries can not only reduce the future burden of dementia, but also promote longer, healthier lives for their inhabitants.