Is It Possible to Delay or Prevent Age-Related Cognitive Decline?

Area of Science:

• Neuroscience
• Public Health
• Gerontology

Background:

• Dementia, including Alzheimer's disease, affects millions globally, with projections indicating a significant increase in prevalence.
• The World Health Organization and Alzheimer's Disease International recognize cognitive decline prevention as a critical public health priority.
• Despite decades of research, successful dementia drug discovery remains elusive, highlighting the need for alternative strategies.

Purpose of the Study:

• To review identified risk factors for dementia and evaluate the effectiveness of interventions aimed at prevention or delay.
• To assess the impact of modifiable lifestyle factors on cognitive decline.
• To analyze the results of randomized controlled trials (RCTs) for dementia prevention strategies.

Main Methods:

• Analysis of numerous longitudinal studies and meta-analyses to identify dementia risk and protective factors.
• Review of randomized controlled trials (RCTs) evaluating single lifestyle interventions and multimodal interventions.
• Examination of interventions targeting beta-amyloid compounds.

Main Results:

• Ninety-three risk factors for dementia have been identified, with seven major modifiable factors including low education, sedentary lifestyle, midlife obesity, smoking, hypertension, diabetes, and depression.
• Additional modifiable risk factors include midlife hypercholesterolemia, late-life atrial fibrillation, and chronic kidney disease.
• While single lifestyle interventions showed promise in observational studies, RCTs before 2014 yielded negative results; however, recent multimodal intervention RCTs show increased optimism.

Conclusions:

• Modifiable risk factors present a target for dementia prevention strategies.
• Multimodal interventions demonstrate potential for delaying cognitive decline and preventing dementia.
• Further research into interventions, including those targeting beta-amyloid, is ongoing.