DOSE: a lifestyle philosophy for dementia prevention informed by drug development and epidemiology

Abstract

This article aims to bridge the gap between drug development and lifestyle modification strategies for dementia prevention. First, it focuses on three lessons from drug development to inform lifestyle changes: dementia treatment-resistance, the importance of maximizing therapeutic dose, and obtaining actionable feedback from drug trials. Moreover, epidemiology reveals a mismatch between promising associations and later interventions, the specificity of different dementias, and the ethics of health promotion. The article will argue that lifestyle choices for dementia risk should be understood through the lens of a life philosophy rather than a testable scientific hypothesis. This philosophy known by "DOSE" has four components: Diet — Other life priorities — Stimulation — Exercise. Striking the balance between a healthy lifestyle and non-health priorities is a fundamentally personal question and challenge, particularly in resource-limited contexts. Finally, individual behaviors are only the tip of the iceberg of modifiable dementia risk, inviting collective action to ensure equitable prevention.