Prevention of cognitive decline

Abstract

Effective strategies to prevent cognitive decline in the context of normal aging, mild cognitive impairment, and dementia are imperative. Existing studies have provided some clues into the puzzle of prevention, yet it is rare that the evidence is unquestionable. Specific dietary changes rich in vegetables, fruits, and fish and low in carbohydrates and saturated fat are advisable, with particular emphasis in patients at risk of developing Alzheimer's disease (AD) or vascular dementia. Patients should remain active physically and mentally. Physical exercise is among the best of all potential interventions against AD. There is no evidence that hormonal supplementation can decrease the incidence of dementia. Some agents that are touted as having cognitive protective effects should only be used under physician supervision. AD patients should be considered for medical therapy unless contraindicated. Promising novel therapies include active and passive immunization against Aβ peptides and gamma secretase inhibitors to reduce A b production. In this chapter, we review strategies used to prevent age related cognitive decline.