LAUSR

Background: During the past 40 years, dementia prevention approaches have ranged from searching for a drug to prevent progression to Alzheimer’s disease to preventing dementia through multidomain lifestyle interventions. Current Approaches: The search for a silver bullet has yielded good science but no clinical results. The multi-model lifestyle intervention approach has shown encouraging results. The largest proportion of resources in prevention have been devoted to finding a drug to prevent, mitigate, or delay what is being called “Alzheimer’s disease of late onset.” The reality is that Alzheimer’s pathology is common among the elderly, but it seldom only occurs alone. The only treatable and preventable pathology currently is vascular. Hence arose the concept of “vascular cognitive impairment” meaning any vascular cause or risk factor associated with cognitive impairment. The majority of cases of cognitive impairment in the elderly have a vascular component that is treatable and preventable and identifiable by several means, including a simple ischemic score. Conclusion: Since environmental, socioeconomic, and individual risk factors contribute to dementia, we proposed a Comprehensive, Customized, Cost-effective APProach (the CCC-APP) implemented in actionable units with the focus on promoting brain health (eumentia). Key Messages: We should implement dementia prevention approaches in actionable units around optimal brain health or eumentia. Heart disease, stroke, and dementia share mostly the same risk and protective factors; thus, their joint prevention is desirable. We need a comprehensive, customized, and cost-effective approach to joint prevention of stroke, heart disease, and dementia. We call for literal and virtual meetings of researchers of all the relevant disciplines to work on operational definitions and interdisciplinary collaborations.