Researchers from University of South Florida presented a review of strategies that might help reduce the risk of cognitive decline and dementia in older people. The report was published in the inaugural issue of the journal Aging Health.
According to the scientists of the study, finding ways to reduce the risk of dementia and Alzheimer's disease in later life has implications for the future of nursing homes, controlling health care costs and reducing the care-giving burden. More effective prevention would also help guarantee better well-being in later years.
Researchers have explored numerous modifiable factors and preventive strategies that may slow cognitive decline and reduce the risk for cognitive impairment. When early life, midlife and more general factors were reviewed, having fewer siblings, suburban residence, more years of education and advantageous socioeconomic status of parents were among early life factors that seem to protect against cognitive impairment later, possibly by establishing cognitive reserve. Intellectual stimulation, in leisure or in occupation, was identified as a potential protective factor in midlife that may help maintain cognitive reserve in adult life.
With respect to more general and life-course factors, poor cardiovascular fitness, vascular disease and diabetes, as well as personality type and stress levels, were found to increase risk of cognitive impairment later in life. Low levels of folic acid and vitamin B12, high levels of low-density lipoproteins and low levels of high-density lipoproteins emerged as important for risk of cognitive impairment.
On several other factors, both low and high levels (compared to medium levels) seemed to be associated with increased risk of cognitive impairment. For example, too low or too high caloric intake, blood sugar, diastolic blood pressure, as well as too low or too high levels of antioxidants (particularly vitamin E) and drinking too much alcohol, or not drinking alcohol at all, were risk factors for cognitive impairment.
More controversial strategies to reduce the risk of cognitive impairment, such as taking gingko biloba, non-steroidal anti-inflammatory drugs, estrogen replacement therapy and the use of cholinesterase inhibitors in cognitively intact populations, were also discussed. The authors also examined the possibility that increased risk of dementia might be associated with high or low (as opposed to medium) levels on several risk factors including blood glucose, blood pressure, alcohol drinking or exercise.