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Prevention of dementia

Authors
Daniel Press, MD
Michael Alexander, MD
Section Editors
Steven T DeKosky, MD, FAAN, FACP, FANA
Kenneth E Schmader, MD
Deputy Editor
Janet L Wilterdink, MD

INTRODUCTION

Dementia is an increasing problem as the global population ages. Alzheimer disease (AD) is the most common form of dementia in older adults, accounting for 60 to 80 percent of cases. Asymptomatic individuals often present with concerns about developing dementia, especially when they have a family history.

Two major reports released in 2017 review the literature on potentially modifiable risk factors for dementia and highlight strengths and weaknesses in the available data to support the impact of risk factor modification on dementia incidence [1,2]. While the overall evidence is generally of low quality and does not support any single intervention as effective in delaying or preventing dementia, there is optimism that intensive risk factor modification, especially during midlife (age 45 to 65 years), has the potential to delay or prevent a substantial number of dementia cases worldwide. In support of this, large population-based studies indicate that the incidence of dementia has declined in high-income countries over the last several decades [3-8].

Related material concerning risk factors for dementia is discussed separately. The risk factors, treatment, and prevention of vascular dementia are discussed separately. (See "Risk factors for cognitive decline and dementia" and "Epidemiology, pathology, and pathogenesis of Alzheimer disease" and "Etiology, clinical manifestations, and diagnosis of vascular dementia" and "Treatment and prevention of vascular dementia".)

LIFESTYLE AND ACTIVITY

Based on epidemiologic evidence and biologic plausibility regarding the relationship between a healthy lifestyle and dementia risk (as well as other health benefits), we encourage patients to maintain or increase physical activity, exercise, cognitive leisure activities, and social interaction.

Observational evidence supports an inverse association between various components of a healthy lifestyle (eg, social interaction, education and mental activities, physical exercise) and the incidence of dementia, even after adjusting for relevant confounders [9-31]. However, it is not known whether these interventions effectively reduce dementia risk, and most trials have looked at relatively short-term interventions and outcomes.

                         
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Literature review current through: Oct 2017. | This topic last updated: Aug 21, 2017.
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