Moreover, several prospective data demonstrate an association bet

Moreover, several prospective data demonstrate an association between consumption of dietary antioxidants and reduced incidence of dementia. The data do not point to a single antioxidant but rather to a diet such as the Mediterranean diet, which is low in saturated fats and rich in fish, olive oil, and vegetables, particularly leafy ones which contain

vitamin E. Other sources of data confirm that dietary vitamin E,but not supplements, are key to this beneficial effect.23 Another important source of antioxidants can be red wine, and although several studies confirm the beneficial effect of wine if consumed in moderation Inhibitors,research,lifescience,medical (approximately 1 glass per day), no study has demonstrated an advantage of red wine over other alcoholic drinks. One important caveat is the fact that all the abovementioned risk factors (Table I) act during midlife, rather than at an advanced age. This establishes a “window of opportunity” during which the interventions must be used. Apparently once the pathological Inhibitors,research,lifescience,medical process is fullyactive, interventions might not be effective any more. Table I Midlife factors associated with development of dementia in old age. Why is it so difficult to accumulate supporting evidence on the protective effects of antihypertensive or choles terol-lowering drugs against dementia? Firstly, Inhibitors,research,lifescience,medical it is unethical to perform placebo-controlled studies on the treatment of these

disorders in people who are hypertensive or hypercholesterolemia Syst-Eur was possible only because at the time there was no consensus as to whether systolic hypertension per se should be treated in the elderly. In addition, such studies are long and costly, Inhibitors,research,lifescience,medical and thus not appealing to investigators and financing agencies. Strictly speaking, the results of Syst-Eur only applyto treatment of systolic hypertension in the elderly where we are allowed to assume that it will result in reduced incidence of dementia. Although it is logical to extrapolate these results to younger

people, or those with more severe forms of hypertension, technically an effect in these situations has not Inhibitors,research,lifescience,medical been proven. Obesity has also been associated with the occurrence of dementia.10 Of course, no randomized almost studies can ever be performed to establish whether prevention (or treatment) of obesity can reduce the incidence of dementia. Similarly, no class I evidence will ever demonstrate whether physical or intellectual activities, wine drinking or cessation of smoking in midlife can either singly or in combination affect the incidence of dementia several decades later. Nevertheless, nobody is likely to contest the idea that overweight or smoking are bad for health in general, and therefore attempts to reduce obesity and to stop smoking are promoted by physicians even without referring to the cognitive aspects. It is with this view that we have to Fulvestrant mouse approach the other risk factors mentioned above.

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