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Advances in Psychiatric Treatment (2005) 11: 176-183
© 2005 The Royal College of Psychiatrists

Preventing dementia

Nitin Purandare, Clive Ballard and Alistair Burns

Nitin Purandare is a senior lecturer and honorary consultant in old age psychiatry at the University of Manchester and Manchester Mental Health and Social Care Trust (University of Manchester, School of Psychiatry and Behavioural Sciences, 2nd Floor, Education and Research Centre, Wythenshawe Hospital, Manchester M23 9LT, UK. Tel: 0161 291 5887; fax: 0161 291 5882; e-mail: nitin.purandare{at}man.ac.uk). His main research interest is in the vascular aetiology of dementia. Clive Ballard is Professor of Old Age Psychiatry at King’s College, London. He was recently appointed Director of Research at the Alzheimer’s Society. Alistair Burns is Professor of Old Age Psychiatry and Head of the School of Psychiatry and Behavioural Sciences at the University of Manchester. He was President of the International Psychogeriatric Association between 2001 and 2003.

Epidemiological evidence has identified key strategies that may be used in the prevention of both Alzheimer’s disease and vascular dementia. These strategies may be loosely divided into three areas: treatment of vascular risk factors, neuroprotection and increasing neuronal reserves. Evidence from randomised controlled trials already exists for treatment of hypertension but results for statins have been disappointing. Most of the intervention trials currently in progress focus on one or two risk factors and include cognition or dementia only as a secondary outcome. The potential of intervention strategies awaits confirmation by randomised controlled trials that target multiple risk factors in at-risk people with mild cognitive impairment, with incident dementia as the primary outcome.




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