Interventions to Prevent Age-Related Cognitive Decline, Mild Cognitive Impairment, and Clinical Alzheimer's-Type Dementia - Executive Summary | AHRQ Effective Health Care Program

Interventions to Prevent Age-Related Cognitive Decline, Mild Cognitive Impairment, and Clinical Alzheimer's-Type Dementia - Executive Summary | AHRQ Effective Health Care Program

Executive Summary – Mar. 24, 2017

Interventions to Prevent Age-Related Cognitive Decline, Mild Cognitive Impairment, and Clinical Alzheimer's-Type Dementia

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Table of Contents

• Objective
• Key Messages
• Background
• Scope and Key Questions
• Methods
• Results
• Conclusion
• References
• Citation

Objective

To assess the effectiveness of 13 interventions for preventing or delaying the onset of age-related cognitive decline, mild cognitive impairment (MCI), or clinical Alzheimer's-type dementia (CATD).

Key Messages

• Most interventions showed no evidence of benefit to delay or prevent age-related cognitive decline, MCI, and/or CATD.
• Some forms of cognitive training improve the performance of the specific target of training for adults with normal cognition, but little evidence supports transfer of benefits to other cognitive areas or reduced dementia incidence. Benefit for any form of cognitive training beyond 2 years is less certain.
• Some types of physical activity, and vitamin B₁₂ plus folic acid, may benefit cognitive performance in some areas for adults with normal cognition.

Background

Dementia severely erodes individuals' functioning and quality of life, creates burden and stress on the entire family, and is a major predictor of institutionalization. Although the age and sex standardized prevalence of dementia and the rates of incident dementia have fallen over the last several decades,1,2 the number of U.S. adults over 70 with dementia and mild cognitive impairment is rising.3,4 Additionally, dementia-related costs are high, exceeding even those of heart disease and cancer, and are often paid directly by families.5 Given such enormous family and societal burdens, identifying interventions with potential to prevent or delay the onset of dementia is an urgent public health priority. Although many putative risk factors have been identified, the challenge is to identify any interventions that can lead to reductions in dementia incidence and make them more widespread.