**Acknowledgements**

many population-based observational studies, which suggest that preventive and therapeu‐

Most vascular risk factors and related disorders are modifiable or treatable that can serve as targets in the development of primary preventative strategies against dementia. For exam‐ ple, antihypertensive therapy has been shown to reduce the risk of dementia in observatio‐ nal studies, and this finding was partly confirmed by clinical trials. Furthermore, studies have confirmed that obesity and diabetes can be prevented by changing dietary habits and lifestyles, and that health education may help quit smoking. Finally, preventing recurrent cerebrovascular disease and maintaining sufficient cerebral blood perfusion seems to be crit‐ ical for postponing expression of the dementia syndrome in older people. Thus, controlling high blood pressure and obesity, especially from middle age, and preventing diabetes and recurrent stroke could be the primary preventive measures against late-life dementia.

High educational achievements in early life can provide cognitive reserve that benefits the whole life in terms of cognitive health and delaying the onset of late-life dementia. Extensive social networks and active engagements in intellectually stimulating activities such as read‐ ing, doing crosswords, and playing board games may significantly lower the risk of demen‐ tia by providing cognitive reserve or by reducing psychosocial stress. It is likely that mentally and socially integrated lifestyles could postpone the onset of dementia [119]. Regu‐ lar physical exercise may reduce the risk of the dementias resulting from cerebral atheroscle‐ rosis. Leisure activities with all three components of physical, mental, and social activities may have the most beneficial effect on dementia prevention. Many of the risk factors for de‐ mentia, such as hypertension, diabetes, and obesity, may be modified by diet. In addition, a diet high in antioxidants may reduce inflammation, which is associated with the risk of de‐ mentia. Thus, it is reasonable to suggest that the risk of dementia itself could be modified by diet. The treatment of depression also seems to improve cognitive function in people who are depressed. Taking together, the most promising strategy for the primary prevention of dementia may be to encourage people implementing multiple preventative measures throughout the life course, including high educational attainment in childhood and early adulthood, an active control of vascular factors (e.g., smoking) and disorders (e.g., hyperten‐ sion and diabetes) in adulthood, and maintenance of mentally, physically, and socially ac‐

Alzheimer's disease is a major cause of functional dependence, institutionalisation, and mortality among elderly people. Population-based studies have made a great contribution to our knowledge of Alzheimer's disease. Although many aspects of Alzheimer's disease are

tic interventions have great potential [150].

*5.1.2. Intervention towards psychosocial factors and lifestyles*

tive lifestyles during middle age and later in life.

**6. Conclusions**

*5.1.1. Vascular factors and related disorders*

346 Understanding Alzheimer's Disease

Research grants were received from the Swedish council for working life and social re‐ search, the Swedish Research Council in Medicine and the Swedish Brain Power. This study was also supported in part by funds from the Loo and Hans Ostermans Foundation and the Foundation for Geriatric Diseases at Karolinska Institutet, the Gamla Tjänarinnor Founda‐ tion, Demensfonden and the Bertil Stohnes Foundation.
