Ageing is the main risk factor for dementia and has long been considered ‘non-modifiable’. Emerging geroscience interventions that target ageing itself, may reduce the risk of and progression of dementia. These interventions also delay the onset of other age-related diseases, ranging from cardiovascular disease to cancer. Geroscience interventions span non-pharmacological (e.g. diet, exercise, sleep, psychosocial) and pharmacological (e.g. repurposed therapeutic drugs, nutraceuticals and novel compounds).
The frameworks proposed by gerontologists and geriatricians to promote healthy ageing are also applicable to dementia prevention. Maximising intrinsic capacity through multidisciplinary approaches to disease prevention, disease management and injury prevention; and extrinsic capacity through social engagement can help optimise physical and cognitive function, preventing dementia. Many of the strategies for healthy ageing address the known ‘modifiable’ risk factors for dementia.
Traditionally geriatricians have focused on providing wholistic healthcare to frail older people. This includes prevention and management of geriatric syndromes, such as delirium, which may precipitate the onset of dementia. With ageing of the population, geriatric medicine skills are increasingly needed in prevention of the geriatric giants, including cognitive impairment.
Furthermore, lessons learnt from geroscience, gerontology and geriatric medicine can inform bench to bedside dementia prevention research and its translation into practice. This includes relevant preclinical models, strategies for safe recruitment and involvement of older adults in research, measurement of meaningful outcomes for older adults and provision of accessible multifactorial, multidisciplinary interventions.