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Prevention of DementiaThe question is often asked whether it is possible to prevent Alzheimer's disease. There are wellestablished risk factors for vascular dementia and some of these have also emerged as being risk factors for Alzheimer's disease. These include raised blood pressure, raised cholesterol, a deficiency of folic acid (often signalled by an Increase in homocysteine in the blood), smoking, (atrial fibrillation (an abnormal beating of the heart which predisposes to clots in the heart which can travel up the blood vessels into the brain) and obesity. There is also good evidence to show that regular physical exercise and mental activity can protect against Alzheimer's disease. A number of studies have shown that moderate alcohol intake can be protective against cardiovascular disease (heart attacks) and cerebrovascular disease (strokes) as well as dementia. Red wine is the most studied drink and there is biochemical evidence to suggest that specific antioxidant activity in red wine may protect blood vessels from damage. The evidence is not sufficiently great to recommend one or all of these strategies for the prevention of dementia, but common sense dictates that the control of risk factors has benefits not only in terms of dementia but also with regard to strokes and blood pressure and that it is sensible to take reasonable and appropriate care of oneself - 'moderation in all things'. Some drugs are said to have a beneficial effect. Aspirin may reduce the risk of strokes and heart attacks and there is some evidence to suggest that it may be good for the prevention of dementia. Oestrogens, once thought to be preventive against dementia, may now actually increase the risk in older women. In the prevention of dementia it is important to remember a few key points:
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