Primary prevention

The World Health Organization and the UK National Institute for Health and Care Excellence recommends lifestyle and behavioural interventions (stopping smoking, reducing alcohol consumption, increased physical activity, eating healthily, maintaining a healthy weight) to decrease the risk of frailty and dementia.[51]​​[52]

Evidence that physical activity/exercise can prevent or delay cognitive decline in people without a diagnosis of dementia is equivocal.[53][54][55][56][57] One retrospective cohort study with nearly 200,000 participants concluded that a healthy lifestyle (defined by a weighted score that included exercise, no current smoking, healthy diet, and moderate alcohol consumption) was associated with a lower risk of dementia, irrespective of genetic risk for dementia (low, intermediate, high).[58]

Managing cardiovascular risk factors in middle age has been associated with a decrease in all-cause dementia (i.e., both vascular dementia and AD).[59][60][61]

Moderate alcohol consumption (1-14 units/week) may protect against dementia.[21][24]

An international consensus statement based on a literature review concluded that lowering homocysteine helps to decrease dementia risk.[62]

Systematic reviews of randomised controlled trials found insufficient evidence to support the following preventive interventions:[63][64][65][66] [ Cochrane Clinical Answers logo ]

  • Medicine (anti-hypertensives, statins, non-steroidal anti-inflammatory drugs, aspirin, anti-diabetic drugs, or cholinesterase inhibitors)

  • Over-the-counter supplements (omega-3 fatty acids, ginkgo biloba, B vitamins, vitamin D with calcium, beta-carotene, or multivitamins)

  • Cognitive training.

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