Challenges of longevity in developed countries: vascular prevention of dementia as an immediate clue to tackle an upcoming medical, social and economic stretch.

Aging of societies, with increasing life expectancies, results in surging health care expenditures, as older age is closely associated with an increasing number of chronic and often resource-consuming diseases. Among those, dementia has the greatest impact on an individual's quality of life, the level of burden on the family and expenditures to finance nursing. Currently, pharmacological dementia treatment is exclusively focused on neurotransmitter-modulating medicines. Unfortunately, their effectiveness is not interminable, and the effect size limited. Novel approaches such as vaccinations are currently under vigorous investigation, but still far from translation into clinical practice. Thus, the consequent exploitation of opportunities which are already known is pivotal. Dementia prevention can become effective without delay if the vascular components of dementia are aggressively targeted through life style modifications as well as the treatment of vascular risk factors (e.g. hypertension). Longevity will become a significant burden for developed countries already within the next 10-20 years. By 2020, the 80+ generation will increase by at least 30% and in 2030 by at least 50%, compared to 2010. If the associated dementia challenge is not adequately tackled, longevity may no longer remain desirable for aged societies.