Dementia is a growing problem worldwide, due to an ageing population. It has significant human and economic costs. There is no effective medical treatment. The paper aims to discuss these issues.
Using earlier reviews, the author discussed the difference between dementia and cognitive ageing and the different types of dementia, in terms of manifestation and pathology. The author reviewed non-modifiable risk factors for dementia, such as age, gender, genetics and education. Education can possibly have lifelong protective effects, as it may promote cognitive reserve. This paper focussed on lifestyle interventions to further increase brain reserve capacity. Findings from earlier reviews were summarised to provide guidelines for policymakers and practioners.
The reviews suggested that most nutritional approaches may have limited effectiveness, and should be implemented in midlife, before dementia symptoms are present and probably only in people who are actually nutritionally deficient. The author found a reasonable positive evidence base of engagement in cognitive and physical activities to prevent dementia, which may also help reduce symptoms of dementia.
From the studies reviewed, it was suggested that keeping physically and mentally active may help in all stages of life to prevent, but also reduce dementia symptoms. A focus on nutrition and treating heart disease risk factors is possibly limited to midlife, or before dementia symptoms are present.
The author used an evidence based approach to review which lifestyle interventions could help prevent dementia or reduce dementia symptoms. The main outcome of this paper was that stage of life and ability (dementia present or not) may interact with success of the intervention.
The author would like to thank Professor Tri Budi Rahardjo at the University of Indonesia; Professor A.D. Smith at the OPTIMA, University of Oxford; Professor C. Brayne at the MRC CFAS, University of Cambridge; Professor Orrell at the PRIDE, UCL/Nottingham university. This work was supported with grants from the MRC, Wellcome Trust, RIA, NDA, ESRC/NIHR, ARUK, and the Newton fund/British Council.
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