World Alzheimer's Day 2024: Can we delay or prevent dementia in our society?
Under the aegis of Alzheimer’s Disease International (ADI), people coming together from all around the world celebrate the month of September as World Alzheimer’s Month and commemorates World Alzheimer's Day every year on September 21st. This campaign advocates for an International awareness-raising effort for Alzheimer’s disease (AD) and other dementias.
The theme for World Alzheimer’s Day 2024 is “Know Dementia, Know Alzheimer’s.” Considering the ‘human longevity revolution’ and the ‘human ageing time bomb’; the dementia crisis has been designated as the “the epidemic of our century”. It is estimated that more than 57 million people have dementia worldwide. More than two-thirds of them were in low-and middle income countries (LMICs). In India, data From the Longitudinal Aging Study in India (LASI) estimated that 8.8 million Indians older than 60 years live with dementia. The two most common causes of dementia are Alzheimer´s disease (AD) and vascular dementia. AD accounts for 50-70% of all cases of dementia, about 20-30% have either vascular dementia (VaD) or a combination of VaD and AD, the other dementia syndromes being Frontotemporal dementia (FTD and Dementia with Lewy Body (DLB).
Although ageing is one of the main risk factor for dementia, Dementia is not inevitable with ageing and is best depicted as a disorder on the “continuum of aging casualty”. We need to re- think dementia to be a "lifestyle disorder." Research has shown that AD develops in the life-course of 20-30 years on the background of ageing intricately and inexorably interacting with lifestyle risk factors (LSRFs), behavioural risk factors (BRFs), and Vascular Risk Factors (VRFs) along with other metabolic risk factors resulting in dementia.
The dementia process and brain pathology associated with dementia inexorably creeps in from early-life (20-40 years age group) to mid-life (40-59 years age group). AD is therefore a slow neurodegenerative neuropathological process resulting from cumulative brain pathology over a decades-long process, and is not an event that occurred de novo as a in late-life disorder. By the time AD manifest as symptomatic dementia, the brain neurodegeneration can no longer be prevented. Current treatment into AD is ‘too late’ and offers symptomatic treatment only.
Being a neurologist trained in Memory/Cognitive Disorders and Dementia, I am not being a therapeutic nihilist when much research is underway for novel anti-dementia, anti-amyloid and other drug targets are in the pipeline. However, I wish to reiterate that until such effective, curative or disease modifying drugs are available, both in the developed and developing countries easily/cheaply, preventive neurology strategies will remain the Holy Grail in addressing the dementia epidemic. I fervently believe that Epidemics can only be eradicated by prevention, not by therapy!
Optimism for a life-course perspective to dementia prevention stems from evidence in a recent study published in 2020 as the Lancet Commission Report on dementia prevention. Similar to the much practiced Preventive cardiology and the evidence from the Framingham Risk Score (FRS) that estimates a patient's 10-year risk of cardiovascular disease (CVD); there is now research evidence to similar riskometer tools in dementia. This includes Mid-Life Dementia Risk Score and Late-Life Dementia Risk Index, which can accurately predict the likelihood of older adults developing dementia in the future life-course. This novel approach for the prediction of dementia risk could help to identify individuals who might benefit from intensive brain healthy lifestyle interventions that could stave off dementia in the future.
The evidence from the 2020 Lancet Commission report lends credence that about 40% of dementia cases worldwide could theoretically be prevented or delayed by eliminating 14 modifiable risk factors during an individual's life course. Hence, it’s never too early or too late to act, to make such risk factor strategies at any stage during early or mid-life course. The 14 risk factors cited in the 2020 Lancet Commission report are low education, hearing loss, hypertension, smoking, obesity, depression, physical inactivity, diabetes, excessive alcohol consumption, traumatic brain injury (TBI), air pollution, social isolation, vision impairment, and high LDL cholesterol.
A life-span approach with a life-course approach focussing on Brain healthy Lifestyles, the promotion of Brain health and well-being, and healthy brain ageing (HBA) strategies would exert brain protection by preserving the brain’s cognitive reserve, brain neuroplasticity, brain resilience, and pave the route to a Dementia free life expectancy (DemFLE) operant on ‘The Scaffolding Theory of Aging and Cognition’ (STAC) conceptual model. The brain healthy lifestyles would mandate staying physically fit, adopting an active socially integrated lifestyle, (leisure activities, walking, bicycling, gardening ,playing musical instruments, social networking, visiting friends and relatives, going to movies, Hobbies) staying mentally and cognitively active( brain gym activities such as learning, reading, playing games, sudokos, puzzle games, meditation, yoga), being spiritually active, finding a ‘purpose in life’ (PIL or ‘Ikigai’) ensuring eudaimonic well-being (EWB), eating smart adhering to brain healthy diet (the Asian-Mediterranean diet, diets high in fish, fruit, and vegetables fruits), sleeping well, quitting tobacco and alcohol, and coping stress, depression and anxiety, and by promoting mental resilience for subjective psychological well-being.
In fact, the World Brain Day on July 22nd this year the German Society of Neurology and the German Brain Foundation lend some evidence that too much sugar can harm the brain and impact AD. We should also be ‘Heart Smart’ to be ‘Brain Smart’ by controlling high blood pressure, treating diabetes mellitus, and preventing obesity to maintain a healthy BMI. My advocacy underscores that by improving lifestyle choices apart from controlling the modifiable risk factors would indeed be a public health roadmap for preventing and staving off the risk for future dementia in the next generation, a promise for tomorrow’s generation for DemFLE
This article would not have a 360° perspective by not addressing a sustainable dementia education for our children, grandchildren and for the next generation. Dementia education in children, school professionals, teenagers, adults, and the elderly in our society is quintessential to ‘know dementia, know Alzheimer’s’ as a lifestyle disorder. Our communities and society should be made aware of the “cradle-to- grave’ life-course perspective in preserving brain health, and adopting proactive brain healthy lifestyles as a public health initiative to dementia prevention in India.
“When meditating over a disease, I never think of finding a remedy for it, but instead a means of preventing it”- Louis Pasteur; 1884
Prof Dr.B.P.Shelley, MBBS, MD, DM, FRCP
Fellowship in Behavioural Neurology, Institute of Neurology, London, UK
Fellowship in Cognitive Neurology, Addenbrooke’s Cambridge University Hospitals, UK
Professor and Head - Department of Neurology
Yenepoya Medical College
Yenepoya (Deemed to be University), Mangaluru, Karnataka
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Shah Rukh Khan, Kajol unveil ‘DDLJ’ sculpture at London’s Leicester Square
London (PTI): Bollywood stars Shah Rukh Khan and Kajol huddled under an umbrella on a rainy Thursday in London to unveil their bronze likeness from an iconic ‘Dilwale Dulhania Le Jayenge’ scene.
The sculpture of the duo joins Leicester Square’s ‘Scenes in the Square’ trail depicting memorable shots from some of the world’s most famous films, with ‘DDLJ’ marking a Bollywood first and the 30th anniversary of the 1995 box-office hit. It is in this popular London square that SRK as Raj and Kajol as Simran first cross paths unknowingly.
“DDLJ was made with a pure heart. We wanted to tell a story about love, how it can bridge barriers and how the world would be a better place if it had a lot of love in it, and I think this is why 'DDLJ' has had a lasting impact for over 30 years now," said Khan.
“Personally, 'DDLJ' is part of my identity, and it is humbling to see film, and Kajol and me, receiving so much love since it was released,” he said.
He expressed his gratitude to the Heart of London Business Alliance, behind the cinematic trail at Leicester Square, for celebrating ‘DDLJ’ and “immortalising” its lead stars.
“Seeing ‘DDLJ’ become the first Indian film to be honoured in the iconic Scenes in the Square trail is an emotional moment and has brought back so many memories.
"I feel immense pride knowing the film has been embraced around the world, and I want to share this moment with the entire cast and crew of ‘DDLJ’, my friend and director Aditya Chopra and the Yash Raj Films family. This is a moment I will never forget,” added Khan.
Kajol, joined by her daughter Nysa and son Yug, posed with Khan in front of the statue as she braved the rain in a green saree.
“It’s incredible to see ‘Dilwale Dulhania Le Jayenge’ continue to receive so much love, even 30 years later. Watching the statue being unveiled in London felt like reliving a piece of our history - a story that has truly travelled across generations,” said Kajol.
“Seeing it find its rightful place in Leicester Square, a location of such enormous significance to ‘DDLJ’, makes this moment even more special. For the film to be honoured in this way in the UK – the first Indian film to receive such recognition – is something that will forever stay in the hearts and minds of all the ‘DDLJ’ fans across the world,” she said.
Their statue, captured in a dancing pose from the hit song ‘Mehndi Laga Ke Rakhna’, joins the likes of Harry Potter, Bridget Jones, Mary Poppins, and Batman in what is dubbed as an ever-growing celebration of movie magic in a square packed with multiplex cinema screens.
“When ‘Dilwale Dulhania Le Jayenge’, DDLJ, was released 30 years ago, the film became a defining moment for Indian cinema and changed the face of the industry, capturing the hearts of everyone who saw it all over the globe," said Akshaye Widhani, CEO of Yash Raj Films.
“We’re thrilled to be the first Indian film to be represented in ‘Scenes in the Square’. It also marks 30 years of DDLJ, a film that has spread love and joy globally, and shows the cultural impact it has had in UK.
“We are honoured that our superstars and our film are being recognised on the world stage alongside the Hollywood elite, from Gene Kelly to Laurel & Hardy to Harry Potter. This statue will be a great way to express the international appeal of Indian movies and build bridges amongst communities through cinema,” he said.
Since its release in 1995, ‘DDLJ’ has become the longest-running film in Hindi cinema history.
Ros Morgan, Chief Executive at Heart of London Business Alliance, said: “We’re proud to welcome global megastars Shah Rukh Khan and Kajol to our Scenes in the Square trail.
"Dilwale Dulhania Le Jayenge is a cinematic phenomenon that has shaped generations, and London’s first tribute to Indian cinema honours a story whose magic continues to captivate audiences worldwide.”
It is a particularly special year for the film, with a musical based on the romance playing to packed houses at Manchester’s Opera House earlier this year. Aditya Chopra reprised his role as director of the English language stage production, ‘Come Fall In Love – The DDLJ Musical’, which revolved around the love story of Simran and Roger.
The script was a nod to the original as it followed Simran as a young British Indian woman who finds herself engaged to a family friend in India in an arranged marriage. However, the plot thickens when she falls in love with a British man named Roger.
Bade Bade Deshon Mein, Aisi Chhoti Chhoti Baatein Hoti Rehti Hain, Senorita!
— Shah Rukh Khan (@iamsrk) December 4, 2025
Thrilled to unveil the bronze statue of Raj & Simran at London’s Leicester Square today, celebrating 30 years of Dilwale Dulhania Le Jayenge (DDLJ)!
Incredibly delighted that DDLJ is the first Indian… pic.twitter.com/8wjLToBGYc
