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Excellent, thanks, I’ll email you!

Wow, thanks!

Meanwhile, on a population level, policies could improve education & healthy food, cut smoking & air pollution. And researchers agree that dementia risk reduction should start early in life & focus on those at most risk ie LMICs and poorer backgrounds in HICs. 10/10 www.nature.com/articles/d41...

How to avoid dementia — what the science really saysAmbitious studies have been examining the protective effects of diet, exercise and socializing — with surprising results.www.nature.com

So what does that mean we should do ourselves? Researchers agree it makes sense to eat healthily, exercise, socialize, keep our brains active. The evidence is uncertain about whether it will lower dementia risks - but it does help prevent strokes/heart attacks and make us feel better. 9/10

And, despite the almost accepted wisdom that the shingles vaccine lowers dementia risk, there is debate here too. New analyses from ‪@mendelrandom.bsky.social‬ & others did not find the vaccine linked to lower dementia diagnoses. 8/10 www.youtube.com/watch?v=qlTn...

Another worry is that there’s too much emphasis in dementia on personal responsibility, when many important risk factors — such as air pollution, education, access to healthy food — are outside our control. These things require policy action. 7/10

Proponents argue that any reduction in cognitive decline is worthwhile on a population level. Critics are concerned that the programmes are costly and won’t move the needle much. 6/10

These intensive interventions have small effects — a benefit equivalent to a small/modest boost on some cognitive tests, at best. None has been shown to reduce incidence of dementia. There is a lively debate about what the effect sizes mean in terms of actual impact on the brain. 5/10

A growing number of ambitious clinical trials (e.g. FINGER, POINTER ) have tested the effects of ‘lifestyle interventions’, which provide intensive help to overhaul people’s diet, exercise, socializing, heart and brain health. The goal is to reduce risks of cognitive decline and dementia. 4/10

BTW high alcohol intake means, roughly, above two bottles of wine per week.🍷 (>21 UK units or >12 US units) 3/10

A synthesis of evidence (Lancet Commission) listed 14 modifiable dementia risk factors: physical inactivity, hypertension, obesity, diabetes, smoking, depression, brain injury, pollution, less education, social isolation, hearing loss, untreated vision loss, high LDL cholesterol, high alcohol 2/10

Phil, thank you so much for taking the time to read this and your kind words - it means so much coming from you.

Thanks Cheryl, a great point. There is so much more to say about bad actors and poor quality science - too much for this one article!

Yes, that's likely fuelled distrust around climate change and some other divisive issues

Some surveys do suggest that the public are now more aware of and cautious about the biases and commerical interests of scientists. eg this survey showed a drop in trust in researchers working for companies www.britishscienceassociation.org/news/public-...

My feature is part of a special collection of articles on trust in science that @nature.com is publishing today to examine this important issue. 9/9 www.nature.com/immersive/d4...

And people are increasingly questioning evidence on divisive issues such as vaccines - another big problem. That’s partly because scientific information is being drowned out on social media. Some say scientists are losing influence, not trust. 8/9 My story: www.nature.com/articles/d41...

The threat now, say some researchers, is that the Trump administration is using the idea that science is not trustworthy as one reason to justify cuts to research and the undermining of evidence-based approaches such as vaccines. 7/9

The pandemic accelerated & amplified the US partisan divergence, as some people grew sceptical of regulations on COVID vaccines, lockdowns etc that science suggested could limit infections. There are signs of political polarization elsewhere in the world, but it varies by country. 6/9

And trust in science is becoming politically polarized in the US. Confidence has fallen among Republican leaning people but not Democrats. This has partly been powered by the populist view that scientists are part of an intellectual elite who do not represent the views of ordinary people. 5/9