We’ve had multiple GeriPal episodes about treatments for dementia, including aducanumab (here, here, and here) and lecanemab (here). As today’s guest, Kristine Yaffe notes, part of the reason for that emphasis is that in the US we prioritize treatment, whereas other countries are ahead of us in prioritizing prevention. Deb Barnes and Kristine Yaffe published a landmark paper in Lancet Neurology finding that up to half of dementia risk is due to modifiable factors. If we focused on prevention, from a public health standpoint, we would achieve far more than spending millions billions on treatment.

Today we talk about steps we can and should take to reduce the risk of dementia, including:

Education and cognitive games (I reveal my embarrassingly poor average time on the NYT mini cross word)
Physical activity
Sleep
Depression
Smoking
Social isolation
Blood pressure control (listen also to our podcast on Sprint Mind with Jeff Williamson)

We also delve into an exciting new trial Kristine led with others on the impact of risk factor reduction on cognition - here’s a link to press about the trial from a fall meeting presentation - article forthcoming.

And because we can’t resist, we dip into aducanumab and lecanemab at the end.

-@AlexSmithMD

Prevention of Dementia: Kristine Yaffe

GeriPal - A Geriatrics and Palliative Medicine Podcast