Prevention of Alzheimer disease. Encouraging evidence.
OBJECTIVE
To review the evidence regarding prevention of Alzheimer disease (AD) in order to highlight the role of family medicine.


METHODS
Most of the evidence relating to prevention of AD is derived from observational (cross-sectional, case-control, or longitudinal) studies. Evidence from randomized controlled trials (RCTs) is available only for blood pressure control and for hormone replacement therapy for menopausal women.


RESULTS
Many preventive approaches to AD have been identified, but no RCTs support their efficacy. Evidence from RCTs supports the effectiveness of blood pressure control in reducing incidence of AD, but demonstrates that postmenopausal women's use of estrogen is ineffective in reducing it. Observational studies suggest that some preventive approaches, such as healthy lifestyle, ongoing education, regular physical activity, and cholesterol control, play a role in prevention of AD. These approaches can and should be used for every patient because they carry no significant risk. Currently, no effective pharmacologic interventions have been researched enough to support their use in prevention of AD.


CONCLUSIONS
Health professionals should educate patients, especially patients at higher risk of AD, about preventive strategies and potentially modifiable risk factors.
Scalco
Monica Zavaloni
MZ
Whitby Mental Health Centre, Department of Psychiatry, Ontario. scalcom@wmhc.ca
van Reekum
Robert
R
D000544:Alzheimer Disease / Q000517:prevention & control*; D019317:Evidence-Based Medicine; D005194:Family Practice; D006293:Health Promotion; D006801:Humans; D018570:Risk Assessment; D012307:Risk Factors