Precision prevention of Alzheimer's and other dementias: Anticipating future needs in the control of risk factors and implementation of disease-modifying therapies

Giovanni B. Frisoni*, José Luis Molinuevo, Daniele Altomare, Emmanuel Carrera, Frederik Barkhof, Johannes Berkhof, Julien Delrieu, Bruno Dubois, Miia Kivipelto, Agneta Nordberg, Jonathan M. Schott, Wiesje M. van der Flier, Bruno Vellas, Frank Jessen, Philip Scheltens, Craig Ritchie

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

Empirical evidence suggests that a fair proportion of dementia cases are preventable, that some preventive actions can be taken immediately, and others may soon be implemented. Primary prevention may target cognitively normal persons with modifiable risk factors through lifestyle and multiple domain interventions (including general cardiovascular health). While the effect on individuals may be modest, it might have a large societal impact by decreasing overall dementia incidence by up to 35%. Secondary prevention will target cognitively normal persons at high risk of dementia due to Alzheimer's disease pathology with future anti-amyloid, anti-tau, or other drugs. This approach is likely to have major benefits to both individuals and society. Memory clinics will need structural and functional changes to adapt to novel technologies and increased patients’ demands, and brand-new services may need to be developed with specific skills on risk profiling, risk communication, and personalized risk reduction plans.
Original languageEnglish
JournalAlzheimer's and Dementia
DOIs
Publication statusE-pub ahead of print - 2020

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