Towards dementia prevention: Risk factors and lifestyle behaviour change

Part I of this thesis focuses on lifestyle behaviour change for the prevention of dementia. Chapter 2 describes current evidence for dementia prevention and provides outlines for future prevention strategies. As the expected increase in dementia prevalence will mostly occur in low- and middle-income countries, dementia prevention interventions should be easily accessible and inexpensive. The Prevention Of Dementia using Mobile Phone Applications (PRODEMOS) trial assesses the effectiveness and implementation of a coach-supported mobile health intervention for self-management of dementia risk factors over 18 months in British and Chinese older adults. Chapter 3 describes the PRODEMOS study protocol. In order to design an intervention that fits the needs and wishes of the target population, we performed interviews with low SES older adults in the Netherlands (chapter 4) and with Chinese older adults living in Beijing (chapter 5). In an iterative process, input from these interviews and other consultations served as a guideline for further app development (chapter 6).
Part II of this thesis focuses on dementia prevention in the oldest old, as associations between dementia and certain risk factors likely change with ageing. Chapter 7 describes that low values for blood pressure, cholesterol and BMI rather than high values are risk factors for dementia. Dementia risk was highest in older adults with low blood pressure, low cholesterol and low BMI. In chapter 8, we observed that, after 10 years of follow-up, certain types of antihypertensive medication are associated with lower dementia risk compared to use of other classes.