Can dementias and mild cognitive impairment be influenced in their course by diseases and risk factors? This is the subject of a study reported by Thorleif Etgen and co-authors in the current issue of Deutsches Ärzteblatt International (Dtsch Arztebl Int 2011; 108: 743-50).
Increasingly larger numbers of people are affected by mild cognitive impairments and even dementia, which means that early detection of possible precursors as well as diagnosis and therapy of risk factors that can actually be influenced are gaining in importance. The term "mild cognitive impairment" describes impairments in memory, attention, and intellectual capacity that are common at an advanced age. It is notably below the usual standard for the age group and educational level under investigation, without presenting substantial limitations to people's everyday lives. Mild cognitive impairment may occur as a precursor stage to actual dementia.
The current data situation is based on less conclusive cross sectional studies and longitudinal studies. In spite of the fact that interventional studies have been negative so far, the authors are of the opinion that a biologically plausible association exists between cognitive degeneration and hypertension, diabetes, and hyperlipidemia. Chronic renal failure has been identified as a new somatic risk factor in recent years. Epidemiological data indicate a protective effect for a Mediterranean diet, physical activity, and moderate alcohol consumption. Smoking, on the other hand, raises the risk for developing cognitive impairments.