An important component of the neuronal ...

An important component of the neuronal degeneration is an age-related prevalence of processes of neuronal damage on their own reparative brain processes (hypothesis of "wear"). Worked out ways to implement the neuroprotective strategies to maintain the neurons during the middle years of life in old age. Cerebrovascular disease is not proven, that cerebrovascular disorders lead to reduced mental ability in old age. Dementia often begins after a stroke, perhaps this is the usual mechanism for vascular dementia. Cerebrovascular changes in themselves or in combination with Alzheimer's disease is likely to cause 25-50% of all advanced dementia. Well-known risk factors for cerebrovascular disease (hypertension, smoking, obesity, hyperlipidemia, stroke, family history of diabetes, unbalanced diet). Removal of such factors undoubtedly reduces the risk of stroke / vascular dementia in the elderly [3] and can positively affect patients with already impaired cognitive function [4]. Correction of hypertension does not lead to a deterioration of mental activity, even in people with cognitive impairment (hypertension is not inherent in the old brain), so that there are grounds to control even a moderate increase in pressure in the elderly [5]. Diabetes is well known vascular complications arising from diabetes, it is not surprising that a correlation between diabetes and dementia. Neuropsychological studies show deficits in fragile, non-insulin-dependent diabetes, possibly due to the mechanism of injury of vascular endothelium. Rochester registration tally sheet has allowed a high degree of accuracy, calculate how much higher risk of developing Alzheimer's disease in diabetes, starting in middle age (relative risk in men 2,3%, female 1.4%). Treatment of diabetes in old age reduces the risk of developing vascular dementia and possibly Alzheimer's disease. Special diet, stress-dose, oral hypoglycemic agents and insulin provide effective treatment. Any program for the prevention of dementia should include identification and treatment of patients with unrecognized diabetes, which as a result of therapeutic intervention should occur restoring cognitive function. Hormone replacement therapy (HRT). There are age-dependent changes in hormonal regulation of glucose metabolism, which may be associated with changes in insulin sensitivity and increase growth hormone. In addition, women have significantly reduced production of estrogen. Beneficial effect of estrogen replacement therapy is expressed in reducing the risk of osteoporosis, coronary artery disease, stroke and even Alzheimer's disease. Figure 2. Possible strategies to prevent dementia data of some early studies showed a benefit of estrogen in older women with dementia, even before it was found that the use of estrogen in the period of increased risk of developing Alzheimer's disease significantly reduces the probability of disease [7, 8].