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Preventing Alzheimer's Disease and Cognitive Decline

Preventing Alzheimer's Disease and Cognitive Decline

Evidence Reports/Technology Assessments - Agency for Healthcare Research and Quality (US)

Version: April 2010


Among the many factors examined in this review, only some are amenable to being evaluated in randomized controlled trials (RCTs), and only a subset of these have actually been studied in high-quality RCTs as potential interventions for preventing or delaying the onset of Alzheimer’s disease (AD) and cognitive decline. Effects of interventions in important subgroups, such as minority populations, were evaluated infrequently. A few of the factors considered in this report have shown potential promise in observational studies for both AD and cognitive decline, and in RCTs for at least one of the outcomes of interest. Moreover, several of the factors reviewed have demonstrated benefits beyond the potential of preserved cognition; that is, they promote overall health. Thus, there may be other reasons to recommend an intervention (e.g., increased physical activity) while further research is completed on its role in cognition.

Executive Summary

Dementia is a loss of cognitive abilities in multiple domains that results in impairment in normal activities of daily living and loss of independence. Alzheimer’s disease (AD) is the most common cause of dementia, responsible for 60 to 80 percent of all dementia. AD causes severe suffering for patients, including progressive functional impairment, loss of independence, emotional distress, and behavioral symptoms. Families and caregivers often experience emotional and financial stress.


Figure 2 summarizes the results of our literature search and screening process. We identified a total of 6713 citations from the electronic search and an additional 194 citations from other sources. After applying inclusion/exclusion criteria at the title-and-abstract level, 1626 full-text articles were retrieved and screened. Of these, we excluded 1035 that did not meet our inclusion criteria. Appendix G provides a complete listing of articles excluded at the full-text stage, with reasons for exclusion.

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