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This systematic review examines whether reducing anticholinergic medication burden through deprescribing interventions can prevent or slow cognitive decline in older adults. The review compares effectiveness of different deprescribing approaches (pharmacist-led, physician-led, educational) and evaluates optimal intervention duration and sustainability for maintaining cognitive health.
A single-blind RCT in 42 Alzheimer's patients compared animal-assisted therapy combined with cognitive stimulation versus cognitive stimulation alone. Animal-assisted therapy produced a statistically significant improvement in immediate well-being after four weeks, but did not affect cognitive function, behavioral symptoms, or depression/anxiety scores.
This review examines hypertension as a modifiable risk factor for dementia, finding that mid-life hypertension (ages 45-64) correlates with increased cognitive decline and dementia risk, while late-life hypertension shows less consistent associations. Evidence on whether antihypertensive treatment effectively prevents dementia remains conflicting across studies, likely due to methodological differences between observational and randomized controlled trials.
APP transgenic mice model amyloid pathology in Alzheimer's disease and have successfully predicted the efficacy of anti-amyloid immunotherapies, including their adverse effects like amyloid-related imaging abnormalities (ARIA). While incomplete models of full AD pathology, these early transgenic models have accurately predicted therapeutic responses in human clinical trials that reduce amyloid and slow cognitive decline.
This review examines evidence that bilingualism or multilingualism may increase cognitive reserve through executive control mechanisms, potentially delaying clinical dementia symptoms by 4-5 years despite ongoing neuropathology. While multilingual use does not prevent Alzheimer's disease development, it may compensate for brain changes and reduce lifetime disease burden in older adults.