Dementia Prevention in Clinical Practice

Abstract

Over 55 million people globally are living with dementia and, by 2050, this number is projected to increase to 131 million. This poses immeasurable challenges for patients and their families and a significant threat to domestic and global economies. Given this public health crisis and disappointing results from disease-modifying trials, there has been a recent shift in focus toward primary and secondary prevention strategies. Approximately 40% of Alzheimer's disease (AD) cases, which is the most common form of dementia, may be prevented or at least delayed. Success of risk reduction studies through addressing modifiable risk factors, in addition to the failure of most drug trials, lends support for personalized multidomain interventions rather than a “one-size-fits-all” approach. Evolving evidence supports early intervention in at-risk patients using individualized interventions directed at modifiable risk factors. Comprehensive risk stratification can be informed by emerging principals of precision medicine, and include expanded clinical and family history, anthropometric measurements, blood biomarkers, neurocognitive evaluation, and genetic information. Risk stratification is key in differentiating subtypes of dementia and identifies targetable areas for intervention. This article reviews a clinical approach toward dementia risk stratification and evidence-based prevention strategies, with a primary focus on AD.

Aortic Stiffness: A Major Risk Factor for Multimorbidity in the Elderly

“…Dementia is a syndrome defined by the deterioration of cognitive function beyond that expected as a result of biological aging, which presents as a disturbance of multiple higher cortical functions including learning and memory, complex attention, executive function, language, motor perception, and social cognition, affecting the patient’s ability to perform daily activities independently [ 98 ]. Dementia is an umbrella term for a range of conditions characterized by progressive cognitive impairment and behavioral changes that interact with daily functioning [ 99 , 100 ].…”

Association between Subjective Cognitive Complaints and Sleep Disturbance among Community-Dwelling Elderly Individuals in Japan

“…Dementia imposes a huge burden on individuals, families, and society as a whole [3]. Currently, dementia remains an incurable disease; accordingly, early interventions for preventing the onset of dementia are crucial [4].…”

A novel framework of MOPSO-GDM in recognition of Alzheimer's EEG-based functional network

“…The prevalence of AD increases rapidly at age 65. It currently affects ~55 million people worldwide and could increase twofold by 2050 (Niotis et al, 2022 ). But in fact, the disease often has a latent phase that is extremely difficult to detect.…”

“…But in fact, the disease often has a latent phase that is extremely difficult to detect. In recent years, the diagnosis and treatment of AD in its early stages has led to growing concern (Elmaleh et al, 2019 ; Zvěřová, 2019 ; Pais et al, 2020 ; Niotis et al, 2022 ). Clinically, the probable AD patients are normally evaluated with standardized neuropsychological tests such as the MMSE (Mini-Mental State Examination) (Tombaugh, 2004 ; Grassi et al, 2019 ; Qiu et al, 2019 ; Abbate et al, 2021 ).…”