PREVENTION OF DEMENTIA - POSSIBLE OR NOT

Dementia is a clinical syndrome with many causes. Dementia of the Alzh eimer type and vascular dementia account alone or in combination for t he vast majority of the dementia in the elderly population. Primary pr evention depends on the knowledge of etiopathogenetic mechanisms and t he possibility to change contributing factors. In the case of dementia of the Alzheimer type (DAT) contributing factors (risk factors) are e merging. However, they are not easily altered. The protective effect o f certain micronutrients, such as antioxidants, remains speculative. T he well-established cardiovascular risk factors such as hypertension, diabetes, and overweight are effective in the etiopathogenesis of vasc ular dementia. Their treatment by diet and drugs is therefore indicate d. The protective role of antioxidants is better established in vascul ar dementia. Antioxidant micronutrients could be an important part of the primary preventive strategy. Whether mental training is effective in primary prevention or not remains controversial. Better training al lows the individuals to optimize their resources. In secondary prevent ion, mental training was shown to be effective in mild dementia (MMS g reater than or equal to 123), maintaining or even improving function ( vascular dementia) and maintaining function for a given time in DAT. I n the population with advanced age, mixed forms of dementia become inc reasingly common. Hence, patients with mild dementia should receive me ntal training as well as a vigorous treatment of established risk fact ors.