The incidence of dementia is rapidly increasing not only in developed countries but also in developing countries
with rising aging populations. This trend is expected to worsen, with the number of cases possibly tripling in the
coming decades. Over the last few decades, epidemiological studies have revealed that vascular-or lifestyle-related factors
are associated with an increased risk of Alzheimer’s disease (AD) and dementia. Researches into the pathophysiological
processes of AD have revealed that the pathological brain lesions of AD begin decades before the onset of symptoms.
Many prevention studies have indicated that physical activity and/or mental training can improve cognition and daily life
in subjects with AD or mild cognitive impairment (MCI). However, issues with early detection and preclinical staging and
effective preventive approaches that are based on these stages remain unresolved. Therefore, we propose different strategies
for AD prevention based on its preclinical stages: one involves physical and mental training that targets the risk factors
in subjects without pathophysiological changes, and the second approach combines nonpharmacological and pharmacological
methods and aims to treat MCI in individuals with amyloid deposits and/or neurodegeneration with drugs that
target the amyloid cascade. The results of several ongoing and promising trials are expected in the next few years.
Keywords: Alzheimer’s disease, amyloid cascade, mental training, preclinical, prevention strategies, risk factors.
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