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Primary prevention of dementia: from modifiable risk factors to a public brain health agenda?

Social Psychiatry and Psychiatric Epidemiology volume 53, pages 1289–1301 (2018)Cite this article

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.

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Acknowledgements

This paper was supported by a grant from the Hans and Ilse Breuer Foundation. The authors thank Elise Paul, Ph.D. for her editing of this manuscript.

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  1. Institute of Social Medicine, Occupational Health and Public Health (ISAP), University of Leipzig, Ph.-Rosenthal-Str. 55, 04103, Leipzig, Germany

    Felix S. Hussenoeder & Steffi G. Riedel-Heller

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  1. Felix S. Hussenoeder
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  2. Steffi G. Riedel-Heller
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Correspondence to Steffi G. Riedel-Heller.

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Hussenoeder, F.S., Riedel-Heller, S.G. Primary prevention of dementia: from modifiable risk factors to a public brain health agenda?. Soc Psychiatry Psychiatr Epidemiol 53, 1289–1301 (2018). https://doi.org/10.1007/s00127-018-1598-7

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Keywords

  • Dementia
  • Risk factors
  • Systematic review
  • Brain health agenda
  • Prevention