Approaches for preventive psychiatry in the geriatric population

In the last couple of decades, researchers have focused on finding strategies for the prevention of cognitive decline in the geriatric age group. Equivocal evidence is available from high-quality randomized controlled studies regarding causative role of modifiable midlife risk factors in cognitive decline and dementia. Among the cardiovascular risk factors, hypertension, hyperlipidemia, obesity, high saturated fat intake, and cigarette smoking have been found to be present in more than 50% of the cases of dementia and cognitive decline. Adopting healthy lifestyle changes with diet, regular moderate levels of physical activity, and abstinence from substance use have been found to have consistent evidence in the prevention of cognitive decline among other ambiguous findings across cultures. Studies assessing preventive and beneficial role of pharmacological treatment strategies such as preemptive use of disease modifying drugs, cerebroactive drugs, and nutritional supplements have been inconclusive. Psychological intervention strategies have shown some promising results. This review attempts to understand some of the perplexing issues in the prevention of cognitive decline in old age