Risk Factors for Cognitive Decline

As we've covered on the podcast, the world is heading toward a dementia crisis. The number of people living with dementia is projected to nearly triple by 2050, and low- and middle-income countries will be hit hardest.

But there is real hope for changing that trajectory: prevention.

The 2024 Lancet Commission estimates that nearly half of dementia cases could be prevented or delayed by addressing 14 modifiable risk factors, including hearing loss, hypertension, physical inactivity, and social isolation. And our guest's research points to something striking: nearly half of individual differences in Alzheimer's risk may be attributable to environmental influences, and his own study found that walkability, green space, and light pollution were linked to cognitive performance regardless of biomarker status.

In this course, we'll talk with Ganesh Babulal, PhD, OTD, MSCI, MOT, OTR/L, FAOTA, about addressing those risk factors, recognizing cognitive decline early, and whether early intervention can slow, or in some cases even reverse, decline.

We'll close with a vision for a team approach to care, where public data on environmental risk is synced into the EMR, physicians recognize risk earlier, and a therapy referral helps mitigate that risk before problems arise.

1. You will be able to identify assessment options for catching early cognitive decline that can be utilized by therapy professionals.

2. You will be able to recognize modifiable and environmental risk factors for cognitive decline that therapy professionals can address through intervention.

3. You will be able to recognize how a physician's role in identifying dementia risk complements the therapy professional's contribution to early assessment and risk reduction.

1. Tell me your journey to researching cognitive decline.

2. Let’s start with some foundational knowledge. What is normal aging? What is pre-clinical cognitive decline and early cognitive decline? (And, what are the other stages?)

3. How can we capture the changes in the clinic?

4. If we catch cognitive decline early is there any hope of slowing or reversing it? Will it lead to Alzheimer's?

5. Why is it important for therapists to understand the risk factors of cognitive decline?

6. Explain what you’ve learned about the environmental influences on cognitive decline.

7. Can you walk me through each result in your paper:

   1. Walkability, green space, and tree canopy were significantly associated with better cognitive performance, while light pollution negatively impacted cognition. Biomarker positivity was not a significant predictor.

8. How can you see therapists using this information?

9. How could we present this information along with the lifestyle modifications like Life’s Essential 8 (AHA).

10. What role could you see therapists playing in prevention of dementia?

• Association of environmental exposome and cognitive function among older adults with and without preclinical Alzheimer's disease 

• Community Matters: How Neighborhood Cohesion Buffers Against Cognitive Impairment via Mental Health Pathways in Black Older Adults

• The Population Neuroscience-Dementia Syndemics Framework to better understand global sex and gender-based risk in low- and middle-income countries

• Dementia prevention, intervention, and care: 2024 report of the Lancet standing Commission

It is the policy of OT Potential to disclose any financial and non-financial interest the provider or instructor may have in a product or service mentioned during an activity. This is to ensure that the audience is made aware of any bias of the speaker.

OT Potential pays guest speakers an honorarium for their participation, either directly or to an institution of the speaker’s choosing at their request. We invite guests whose expertise often comes from practices, programs, or building products in their field. Where a speaker has a financial interest in the subject of a course, we disclose it below so you can weigh it for yourself.

OT Potential’s interest in this topic: We have no financial stake in this topic.

Speaker interests: Ganesh Babulal is an author of Association of Environmental Exposome and Cognitive Function Among Older Adults With and Without Preclinical Alzheimer’s Disease, a study discussed in this course. He conducts grant-funded research on cognition, driving, and dementia risk and has no financial interest in this topic to disclose.