Dementia Insights: Primary Prevention of Dementia

An estimated 44 to 47 million people are living with dementia worldwide.1 Dementia is a significant cause of morbidity and mortality among the aging population,1 with high economic costs and significant burden on caregivers.2 No disease-modifying treatment for dementia yet exists. Although primary prevention remains an elusive goal, modifiable risk factors may account for up to 35% of the dementia burden.3

The study of lifestyle factors and dementia risk is inherently challenging because of residual confounding in observational studies and attrition in clinical trials of lifestyle interventions. Although there is insufficient evidence to establish public health guidelines for primary prevention of dementia,4 the extant epidemiologic evidence justifies counseling patients to make lifestyle changes both for global health benefits and potential dementia risk modification.

In this selective review we aim to provide an update of current knowledge on primary prevention of dementia with a practical focus on counseling patients on making relevant lifestyle modifications. Specifically, we focus on clinical management of comorbidities (vascular risk/protective factors), counseling on diet, cognitive activities, and sleep. We also offer suggestions for fielding common questions on the relationship between lifestyle factors and dementia risk.