Primary prevention recommendations to reduce the risk of cognitive decline

Abstract

Few resources address steps clinicians can take to help patients reduce their risk of dementia, despite growing recognition that brain health can be optimized and that risk reduction for cognitive decline can be accomplished by lifestyle modifications. Methods:To address this gap, UsAgainstAlzheimer's convened a risk reduction workgroup (RRWG) to review existing evidence and develop recommendations for primary care clinicians discussing cognitive decline and risk reduction with their patients. Results:The RRWG produced 11 consensus-based recommendations and implementation strategies across six topics: neurovascular risk management, physical activity, sleep, nutrition, social isolation, and cognitive stimulation.Discussion: These recommendations are a first step for clinicians to address brain health with patients and potentially help them prevent cognitive decline. To ensure there is routine care for brain health, proper incentives and policies must be instituted and more education for consumers should be provided.

A Randomized Controlled Trial Study of a Multimodal Intervention vs. Cognitive Training to Foster Cognitive and Affective Health in Older Adults

“…Regarding “fluid intelligence” performance, post hoc analysis suggests that the MMI but not the CT group profited from the intervention, but also that the WCG significantly increased their test performance. One possible reason for this performance gain could be the increased activity and variability of activities which might have stimulated intellectual behavior ( Sabbagh et al, 2022 ). Alternatively, motivation or a simple re-test effect is possible explanations.…”

“…This study accordingly aimed to bolster cognitive and affective health factors in older adults and to prevent degenerative diseases with a MMI. Based on the latest meta-analysis, we combined six intervention areas shown to be particularly beneficial against cognitive decline (for a recent meta-analysis, see Astrup et al, 2019 ; WHO Guidelines, 2019 ; Sabbagh et al, 2022 ). Compared to the large research field of CT, a comprehensive cognitive and affective intervention approach offers further potential for research and for the elderly.…”

Dementia Risk Reduction in Primary Care: A Scoping Review of Clinical Guidelines Using a Behavioral Specificity Framework

“…Guidelines were prepared by professional bodies, peak consumer bodies, research centers, executive public bodies of government departments, and non-profit organizations. Eight guidelines explicitly stated that they were prepared by, or in consultation with, people working in primary care [36,[45][46][47][48][49][50][51]. Input from consumers or consumer bodies (e.g., Kidney Health Australia, the Italian Association for Alzheimer's Disease) was explicit in nine guidelines [36,38,[48][49][50][51][52][53][54].…”

“…Eight guidelines explicitly stated that they were prepared by, or in consultation with, people working in primary care [36,[45][46][47][48][49][50][51]. Input from consumers or consumer bodies (e.g., Kidney Health Australia, the Italian Association for Alzheimer's Disease) was explicit in nine guidelines [36,38,[48][49][50][51][52][53][54]. A description of the guidelines and the organizations that produced them is available in Supplementary Material 4.…”

“…In the general practice context, the Australian National University Alzheimer's Disease Risk Index is intended to be completed by patients to record their current risk profile for discussion with their PCP at their next medical appointment [60]. For the "discuss" action, all but two guidelines [38,53] recommended providing some form of DRR education [36,37,39,46,49,51,[54][55][56][57] and/or advice [2,36,39,45,47,48,[50][51][52]57]. Four guidelines recommended tailoring the general education [48,50] to the patient's personal circumstances and making the advice brief, non-judgmental and evidence-based [46,48,50,51].…”