title: Prevention of Age-Related Cognitive Decline: Which Strategies, When, and for Whom?
abstract: Brain aging is characterized by the progressive and gradual accumulation of detrimental changes in structure and function, which increase risk of age-related cognitive decline and dementia. This devastating chronic condition generates a huge social and economic burden and accounts for 11.2% of years of disability. The increase in lifespan has contributed to the increase in dementia prevalence; however, there is currently no curative treatment for most causes of dementias. This paper reviews evidence-based strategies to build, enhance, and preserve cognition over the lifespan by examining approaches that work best, proposing when in the life course they should be implemented, and in which population group(s). Recent work shows a tendency to decreased age-specific prevalence and incidence of cognitive problems and dementia among people born later in the first half of the 20th century, citing higher educational levels, improvements in lifestyle, and better handling of vascular risk factors. This implies that we can target modifiable environmental, lifestyle, and health risk factors to modify the trajectory of cognitive decline before the onset of irreversible dementia. Because building cognitive reserve and prevention of cognitive decline are of critical importance, interventions are needed at every stage of the life course to foster cognitive stimulation, and enable healthy eating habits and physical activity throughout the lifespan. Preventive interventions to decrease and delay cognitive decline and its consequences in old age will also require collaboration and action on the part of policy-makers at the political and social level.
authors.affiliation: Département de nutrition, Université de Montréal, Montréal, Québec, Canada.|Centre de recherche, Institut universitaire de gériatrie de Montréal, CIUSSS Centre-est-de-l'Île-de-Montréal, Montréal, Québec, Canada.
authors.forename: Bryna
authors.initials: B
authors.lastname: Shatenstein
authors.affiliation: University of Bordeaux, ISPED, Centre INSERM U897-Epidemiologie-Biostatistique, Bordeaux, France.|INSERM, ISPED, Centre INSERM U897-Epidemiologie-Biostatistique, Bordeaux, France.
authors.forename: Pascale
authors.initials: P
authors.lastname: Barberger-Gateau
authors.forename: Patrizia
authors.initials: P
authors.lastname: Mecocci
mesh_terms: D003072:Cognition Disorders / Q000209:etiology* / Q000517:prevention & control*; D000066492:Cognitive Aging; D058245:Cognitive Reserve; D016206:Databases, Bibliographic / Q000706:statistics & numerical data; D004777:Environment; D006801:Humans; D008019:Life Style; D012307:Risk Factors
keywords: Alzheimer’s disease; cognition; cognitive reserve; dementia; early intervention; education; life course; lifestyle; prevention; psychosocial factors; social policies