Lifestyle has a large impact on our overall health and on our risk of cognitive decline and dementia later in life. Research has consistently shown that the risk of cognitive decline and dementia later in life can be predicted by several factors. Based on previous research, the 2024 report of the Lancet standing Commission describes 14 modifiable risk factors for dementia.1 These 14 risk factors are: low educational attainment, hearing loss, hypertension, smoking, obesity, depression, physical inactivity, diabetes, excessive alcohol consumption, traumatic brain injury, air pollution, social isolation, untreated vision loss, and high cholesterol. The report provides the population attributable fractions for each of the risk factors based on prevalences and their relation with dementia.
In theory, the prevalence of dementia could be nearly halved by eliminating these 14 factors. There is a high potential for prevention of dementia in low- and middle-income countries and among ethnic minorities and lower socioeconomic groups who often have a higher burden of modifiable risk factors. It is generally beneficial to reduce or avoid risk factors as early as possible, but some risk factors need to be addressed throughout life. While some of the risk factors are modifiable on an individual level, there is also a need for policy interventions. For instance, hearing loss is a modifiable risk factor for dementia. While individuals can try to prevent hearing problems and see a healthcare professional when they experience hearing problems, it is also important to reduce the risk of developing hearing problems in certain professions for instance by having clear regulation on hearing protection for certain jobs. In addition, as some hearing loss is due to untreated infection, it is also important to enable and encourage people to see a healthcare professional when they experience an infection, for instance by providing free or affordable healthcare.
At the end of 2024, we at MoCA started to develop the MoCA Cognitive Health Questionnaire (MoCA-CHQ). Our starting point was the 2024 report of the Lancet standing Commission that identified the above described 14 modifiable risk factors for dementia. We have translated these risk factors into a questionnaire and added a number of other factors that can indirectly affect dementia risk, such as diet and sleep. The different risk factors have been grouped into five categories: physical health, emotional well-being, diet, exercise, and cognitive and social engagement. Based on the population attributable fractions for each of the risk factors, we developed an algorithm to provide both a total brain health score and a score for each of the five categories. After completing the MoCA-CHQ, users will not only receive these scores, but also personalised recommendations about how they can improve their lifestyle to reduce their individual risk of cognitive decline or dementia. The MoCA-CHQ is intended for people of any age and can be completed again in the future to keep track of any changes in lifestyle and their impact on dementia risk.
Users will also be encouraged to complete the MoCA XpressO which is a quick digital cognitive test. In the future, we plan to combine data from the MoCA-CHQ and the MoCA XpressO to provide users with more accurate risk predictions.
The MoCA-CHQ will be updated with new findings in the future.
The MoCA-CHQ is for everyone who wants to know more about what they can do to stay healthy. You can find the MoCA-CHQ here: https://portal.mocacognition.com/cognitive-health
- Livingston, G., Huntley, J., Liu, K.Y., Costafreda, S.G., Selbaek, G., Alladi, S., Ames, D., Banerjee, S., Burns, A., Bryan, C., Fox, N.C., Ferri, C.P., Gitlin, L.N., Howard, R., Kales, H.C., Kivimäki, M., Larson, E.B., Nakasujja, N., Rockwood, K.,…Mukadam, N. (2024). Dementia prevention, intervention, and care: 2024 report of the Lancet standing Commission. Lancet, 404, 572-629. ↩︎