Open AccessDementia risk reduction: why haven't the pharmacological risk reduction trials worked? An in‐depth exploration of seven established risk factors
Author(s) -
Peters Ruth,
Breitner John,
James Sarah,
Jicha Gregory A.,
Meyer PierreFrancois,
Richards Marcus,
Smith A. David,
Yassine Hussein N.,
Abner Erin,
Hainsworth Atticus H.,
Kehoe Patrick G.,
Beckett Nigel,
Weber Christopher,
Anderson Craig,
Anstey Kaarin J.,
Dodge Hiroko H.
Publication year - 2021
Publication title -
alzheimer's and dementia: translational research and clinical interventions
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.49
H-Index - 30
ISSN - 2352-8737
DOI - 10.1002/trc2.12202
Subject(s) - medicine , dementia , observational study , hyperhomocysteinemia , disease , dyslipidemia , clinical trial , psychological intervention , epidemiology , diabetes mellitus , risk factor , intensive care medicine , environmental health , psychiatry , endocrinology
Abstract Identifying the leading health and lifestyle factors for the risk of incident dementia and Alzheimer's disease has yet to translate to risk reduction. To understand why, we examined the discrepancies between observational and clinical trial evidence for seven modifiable risk factors: type 2 diabetes, dyslipidemia, hypertension, estrogens, inflammation, omega‐3 fatty acids, and hyperhomocysteinemia. Sample heterogeneity and paucity of intervention details (dose, timing, formulation) were common themes. Epidemiological evidence is more mature for some interventions (eg, non‐steroidal anti‐inflammatory drugs [NSAIDs]) than others. Trial data are promising for anti‐hypertensives and B vitamin supplementation. Taken together, these risk factors highlight a future need for more targeted sample selection in clinical trials, a better understanding of interventions, and deeper analysis of existing data.