Given these findings, the authors suggest that public health initiatives should focus on encouraging literacy at all ages irrespective of ability, prompt treatment of depressive symptoms, and early screening for glucose intolerance and insulin resistance (early stages in the development of diabetes).

While these calculations can only provide a crude estimate of impact on incidence, they do make a significant statement about public health priorities in disease prevention in the face of current knowledge, conclude the authors. Further studies including younger adults are clearly needed to test the impact of intervention measures.

A second study, also published on bmj today, finds that death rates are more than three times higher in people with dementia than in those without dementia in the first year after diagnosis. The study also says that earlier and better detection of dementia in primary care is needed. An accompanying editorial suggests that key areas to focus on include better education and training in primary care, developing more integrated systems of care, and ensuring that policy makers and commissioners plan services that reflect the effects of dementia on primary care and other services.

Source: BMJ-British Medical Journal

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