From: Dementia prevention: current epidemiological evidence and future perspective
Risk factors | Protective factors | Combined effects |
---|---|---|
Genetic | Psychosocial factors | Increased |
   ApoE ε4 |    High education and socioeconomic status | 1. Genetic and environmental factors in mid-life |
   Familial aggregation |  |    ApoE ε4 magnifies the effect of high alcohol intake, smoking, physical inactivity, and high intake of saturated fat. |
 |    High work complexity |  |
Vascular |    Rich social network and social engagement | 2. Vascular factors in mid-life |
   Cerebrovascular lesions |  |    Hypertension, obesity, hypercholesterolemia, and physical inactivity have an additive effect when they co-occur. |
 |    Mentally stimulating activity |  |
   Cardiovascular diseases |  | 3. Vascular factors/diseases in late life |
   Diabetes mellitus and prediabetes | Lifestyle |    Higher risk in individuals with brain hypoperfusion profile: chronic heart failure, low pulse pressure, and low diastolic pressure |
 | Physical activity |    Higher risk in individuals with atherosclerosis profile: high systolic pressure, diabetes mellitus or prediabetes, and stroke |
Positive association in mid-life but negative association in late life | Diet | Decreased |
   Hypertension |    Mediterranean diet | 1. Genetic and environmental factors in mid-life |
   High BMI (excessive weight and obesity) |    Polyunsaturated and fish-related fats |    High education reduces the negative effect of ApoE ε4. |
 |  |    Physical activity counteracts the risk due to ApoE ε4. |
   High serum cholesterol |    Vitamins B6 and B12 and folate Antioxidant vitamins (C and E) | 2. Environmental factors in mid-life |
 |  |    High work complexity modulates the increased dementia risk due to low education. |
Lifestyle | Â | Â |
   Smoking |  |  |
   High alcohol intake |  |  |
Diet | Â | Â |
   Saturated fats |  |  |
   Homocysteine |  |  |
Others | Â | Â |
   Depression |  |  |