Prevention of dementia

Prevention of dementia

Prevention of dementia is hugely beneficial for a large number of individuals as well as on the society as a whole

• prevention could be:
  • primary prevention - to prevent early pathological changes of dementia
  • secondary prevention - to delay the pathological process
• even a delay in the onset of disease can be regarded as a preventive strategy since there is evidence of the prevalence decreasing by half when the onset is delayed by 5 years
• a knowledge about dementia risk factors is necessary for the preventive strategies
• early identification of the disease will lead to early interventions in secondary prevention

In patients with risk factors the following steps could be undertaken

• vascular and other modifiable risk factors (e.g. - smoking, excessive alcohol intake, obesity, DM) in middle-aged and older people should be reassessed and treated if necessary
• refer the patient for genetic counseling along with their unaffected relatives with a likely genetic cause for dementia e.g. - familial autosomal dominant AD
• people with signs of MCI should be referred for assessment by memory assessment services to identify dementia early

The following interventions are not recommended for primary prevention of the disease:

• statins
• hormone replacement therapy
• vitamin E
• non-steroidal anti-inflammatory drugs

Reference:

• 1. National Collaborating center for mental health 2007: Dementia: A NICE-SCIE guideline on supporting people with dementia and their carers in health and social care