CCCDTD5: Reducing the risk of later‐life dementia. Evidence informing the Fifth Canadian Consensus Conference on the Diagnosis and Treatment of Dementia (CCCDTD‐5)

Abstract

The Fifth Canadian Consensus Conference on the Diagnosis and Treatment of Dementia (CCCDTD‐5) was a year‐long process to synthesize the best available evidence on several topics. Our group undertook evaluation of risk reduction, in eight domains: nutrition; physical activity; hearing; sleep; cognitive training and stimulation; social engagement and education; frailty; and medications. Here we describe the rationale for the undertaking and summarize the background evidence—this is also tabulated in the Appendix. We further comment specifically on the relationship between age and dementia, and offer some suggestions for how reducing the risk of dementia in the seventh decade and beyond might be considered if we are to improve prospects for prevention in the near term. We draw to attention that a well‐specified model of success in dementia prevention need not equate to the elimination of cognitive impairment in late life.

Social connectedness and dementia prevention: Pilot of the APPLE-Tree video-call intervention during the Covid-19 pandemic

“…This delivery mode worked well and the intervention was experienced as helpful. Our pragmatic approach mirrors calls in a recent Canadian report, for an integrated approach to later life dementia prevention, which addresses multiple, proximal risk factors, is cost-effective and priced so as to be widely available ( Rockwood et al, 2020 ).…”

Decision making under uncertainty in the diagnosis and management of Alzheimer's Disease in primary care: A study protocol applying concepts from neuroeconomics

“…Since 1989, the Canadian Consensus Conference on the Diagnosis and Treatment of Dementia (CCCDTD) has been generating clinical guidelines for dementia care, with the 5 th iteration published in 2020 ( 2 ). Eight topics were addressed including: (1) utility of the National Institute on Aging research framework for clinical Alzheimer's disease (AD) diagnosis ( 14 ); (2) updating diagnostic criteria for vascular cognitive impairment, and its management ( 15 ); (3) dementia case finding and detection ( 16 , 17 ); (4) neuroimaging and fluid biomarkers in diagnosis ( 18 ); (5) use of non-cognitive markers of dementia for better dementia detection ( 19 ); (6) risk reduction/prevention ( 20 ); (7) psychosocial and non-pharmacological interventions ( 21 ); and (8) deprescription of medications used to treat dementia ( 22 ). Many of these themes and recommendations can be implemented primary care.…”

Examining a Healthy Lifestyle as a Moderator of the Relationship between Psychological Distress and Cognitive Decline among Older Adults in the NuAge Study

“…Engaging in healthy lifestyle behaviors is currently the leading recommendation for staving off cognitive decline with aging [13]. For example, consuming a nutrient-rich diet, keeping physically active, and being socially engaged are lifestyle behaviors that are protective against cognitive decline in later life [14,15].…”