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Prevention of progression to dementia in the elderly: Rationale and proposal for a health-promoting memory consultation (an IANA task force)

  • Published:
The Journal of Nutrition Health and Aging

Abstract

Alzheimer’s disease (AD) is the most frequent form of dementia and according to the most recent estimation it affects nearly 27 million people in the world. The onset of the disease is generally insidious. It is becoming increasingly evident that the underlying pathophysiological mechanisms are active long before the appearance of the clinical symptoms of the disease. In the current context, it is important to develop strategies to delay the onset of cognitive decline. Delaying the onset by 5 years would reduce the prevalence by half at term, and a delay of 10 years would reduce it by three-quarters. The effectiveness of currently suggested preventive approaches remains to be confirmed, but certain strategies could be applied straight away to at-risk subjects. We propose that a health-promoting memory consultation should be set up for elderly persons who have attended a specialized memory consultation and in whom the diagnosis of dementia and of AD in particular, has not been established by standardized tools. Through this consultation, they would be offered full multidimensional investigation of all aspects of their health status, follow-up could be organized, general practitioners in private practice could be made more conscious of this population and the elderly could be made more aware of the risk factors to which they are exposed. The development of an information policy for the elderly would meet a present need. In our reflection, we must take into account the question of how to give this preventive consultation its due place in the healthcare pathway of the elderly person in order to ensure coordinated follow-up with all the other health professionals involved. The principle of the health-promoting memory consultation is undergoing validation in a large French multicentre preventive trial in 1200 frail elderly persons aged 70 years followed for three years, the Multidomain Alzheimer Preventive Trial (MAPT).

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Authors and Affiliations

  1. Gérontopôle, Pôle Gériatrie Gérontologie, Hôpital La Grave-Casselardit, Toulouse

    S. Gillette-Guyonnet, G. Abellan Van Kan, F. Lala, F. Nourhashemi, P. J. Ousset, Y. Rolland, C. Sanz, M. Soto & B. Vellas

  2. Inserm U558, Toulouse

    S. Gillette-Guyonnet, S. Andrieu, F. Nourhashemi, P. J. Ousset, Y. Rolland & B. Vellas

  3. Département Epidémiologie et Santé Publique, Faculté de Médecine, Toulouse

    S. Andrieu

  4. Clinique de la Porte Verte, Versailles

    J. P. Aquino

  5. Médecine Générale, Toulouse

    C. Arbus, J. P. Becq & S. Bismuth

  6. Inserm E0361, Hôpital La Colombière, Montpellier

    C. Berr

  7. Médecine Interne et Hypertension Artérielle, Hôpital Rangueil, Toulouse

    B. Chamontin

  8. Hôpital Dupuytren, Limoges

    T. Dantoine

  9. ISPED, Inserm U593, Université Victor Segalène, Bordeaux

    J. F. Dartigues

  10. Centre de Neuropsychologie, Pavillon Paul Castaigne, Hôpital Salpétrière, Paris

    B. Dubois & T. Hergueta

  11. Hôpital Purpan, Toulouse

    B. Fraysse & S. Lagleyre

  12. Diabétologie, Maladies Métaboliques, Nutrition, Hôpital Rangueil, Toulouse

    H. Hanaire

  13. Centre de Prévention et de Traitement des Maladies liées au Vieillissement, Centre Antonin Balmès, Montpellier

    C. Jeandel

  14. Département de Neurologie, Hôpital Gui de Chauliac, Montpellier

    F. Portet & J. Touchon

  15. Service de Médecine B, CHU Angers, France

    P. Ritz

  16. CMRR, Inserm JE 2441 Neurobiologie et Psychopathologie, Nice

    P. Robert

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  1. S. Gillette-Guyonnet
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Gillette-Guyonnet, S., Van Kan, G.A., Andrieu, S. et al. Prevention of progression to dementia in the elderly: Rationale and proposal for a health-promoting memory consultation (an IANA task force). J Nutr Health Aging 12, 520–529 (2008). https://doi.org/10.1007/BF02983204

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