Prevention of brain aging and dementia

The brain is subjected to multiple factors that result in damage to its cellular constituents, the neuron and supporting cells, and the neural networks that form the bases of cognitive ability. Like other systems, the brain has remarkable capacity to repair that damage and to adapt or compensate for the loss of neurons and the disruption of the neural architecture. Brain aging and dementia can be conceptualized as a balance between neuronal injury and repair. This balance can be affected not only by genetic and age-related factors but also by multiple environmental factors. The latter includes many factors, including education, nutrition, exercise, socialization, and stress. As individuals, we have the potential to modify these factors through lifestyle choices. Advances in neuroscience have led to the development of pharmacologic agents that can ameliorate the effects of even genetic (eg, statins and antihypertensive agents) and age-related (eg, antioxidants and estrogen replacement) factors. By altering the balance between neuronal injury and repair, we can delay the expression and progression of the neurodegenerative processes of brain aging, AD, and related dementias.