(HealthDay)—Ten risk factors should be targeted to prevent Alzheimer disease, according to a review published online July 20 in the Journal of Neurology, Neurosurgery & Psychiatry.

Jin-Tai Yu, M.D., Ph.D., from Shanghai Medical College at Fudan University, and colleagues conducted a systematic literature review to identify prospective studies evaluating the prevention of Alzheimer disease. The authors reviewed 153 randomized controlled trials, which evaluated 104 modifiable factors and 11 interventions.

The researchers identified 10 interventions with level A strong evidence on preventing Alzheimer disease: education, cognitive activity, high body mass index in late life, hyperhomocysteinemia, depression, stress, diabetes, head trauma, hypertension in midlife, and orthostatic hypotension. There were nine other interventions supported with level B weaker evidence: obesity in midlife, weight loss in late life, physical exercise, smoking, sleep, cerebrovascular disease, frailty, atrial fibrillation, and vitamin C. Two interventions—estrogen replacement therapy (level A2) and acetylcholinesterase inhibitors (level B)—were not recommended.

“These evidence-based suggestions should be particularly noted by nondemented but high-risk individuals (e.g., people with [APOE]ε4, a high polygenic score, a family history of dementia or amyloid-positive evidence) and family doctors to give optimal recommendations to their patients in terms of what they might do to get the best protection against Alzheimer disease,” the authors write.

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