Felix S Hussenoeder1, Steffi G Riedel-Heller2. 1. Institute of Social Medicine, Occupational Health and Public Health (ISAP), University of Leipzig, Ph.-Rosenthal-Str. 55, 04103, Leipzig, Germany. 2. Institute of Social Medicine, Occupational Health and Public Health (ISAP), University of Leipzig, Ph.-Rosenthal-Str. 55, 04103, Leipzig, Germany. Steffi.Riedel-Heller@medizin.uni-leipzig.de.
Abstract
INTRODUCTION: With large numbers of people affected, no treatment in sight and continuing demographic change, the prevention of dementia is becoming a central public health issue. METHODS: We conducted a systematic meta-review including systematic reviews and meta-analyses of longitudinal observational studies on modifiable risk and protective factors for dementia published over the last 5 years. RESULTS: Compelling evidence on a number of modifiable risk factors, mostly lifestyle factors, is available from longitudinal observational studies to inform primary preventive efforts. DISCUSSION: Evidence stemming from preventive RCTs is limited. However, multi-domain interventions addressing a variety of risk factors at once seem promising with regard to high-risk individuals (selective preventive approach). However, we argue that it is time to move forward and discuss a public brain health agenda as a universal preventive approach. Based on a risk reduction strategy, the public brain health agenda suggests the following ten key actions: (1) increase physical activity, (2) foster social integration, (3) improve education and foster lifelong learning, (4) provide mentally stimulating workplaces, (5) foster a cognitively active lifestyle, (6) propose a healthy Mediterranean-like diet, (7) reduce alcohol consumption, (8) stop smoking, (9) prevent, diagnose and treat chronic conditions, and (10) reduce anticholinergic medication in the elderly.
INTRODUCTION: With large numbers of people affected, no treatment in sight and continuing demographic change, the prevention of dementia is becoming a central public health issue. METHODS: We conducted a systematic meta-review including systematic reviews and meta-analyses of longitudinal observational studies on modifiable risk and protective factors for dementia published over the last 5 years. RESULTS: Compelling evidence on a number of modifiable risk factors, mostly lifestyle factors, is available from longitudinal observational studies to inform primary preventive efforts. DISCUSSION: Evidence stemming from preventive RCTs is limited. However, multi-domain interventions addressing a variety of risk factors at once seem promising with regard to high-risk individuals (selective preventive approach). However, we argue that it is time to move forward and discuss a public brain health agenda as a universal preventive approach. Based on a risk reduction strategy, the public brain health agenda suggests the following ten key actions: (1) increase physical activity, (2) foster social integration, (3) improve education and foster lifelong learning, (4) provide mentally stimulating workplaces, (5) foster a cognitively active lifestyle, (6) propose a healthy Mediterranean-like diet, (7) reduce alcohol consumption, (8) stop smoking, (9) prevent, diagnose and treat chronic conditions, and (10) reduce anticholinergic medication in the elderly.
Entities:
Keywords:
Brain health agenda; Dementia; Prevention; Risk factors; Systematic review
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