Prevention of dementia and cognitive decline: Notes from the NIH-State-of-the-science conference

The National Institutes of Health (NIH)-State-of-the-Science Conference on Preventing Alzheimer's Disease and Cognitive Decline sought to review the available evidence and provide carefully reasoned recommendations. The preliminary draft statement of the conference panel found insufficient evidence to support any definitive recommendations to prevent Alzheimer's disease or the cognitive impairment related to advancing age. Equally disappointing was the conclusion that present diagnostic criteria for both Alzheimer's disease and cognitive decline lack the consensus necessary for uniform application and risk identification. Nonetheless, a number of promising predictors of both increased and decreased risk emerged. In addition, they overlap substantially with recommendations for the prevention of heart disease and stroke. As a result, the tentative prevention recommendations put forth by the Alzheimer's Association remain not only the best available but the most promising as well.