Dear Dr. Mirkin,

What can prevent dementia in older people as they start to forget things?

Answer: Older people suffering from mild memory and cognition problems are far less likely to progress to Alzheimer's disease if they are treated to protect their blood vessels: for high blood pressure, high triglycerides and cholesterol, low good HDL cholesterol, abdominal obesity, diabetes and heart disease (Neurology, published online April 13, 2011).

In 2004, researchers started to follow 837 people, ages 55 and older, who were forgetful but did not have dementia. More than half had the signs of blood vessel disease listed above. After five years, 35 percent developed Alzheimer's, and the majority were from the group who had signs of blood vessel disease.

Those with blood vessel disease who received treatment were 40 percent less likely to develop Alzheimer's. Slightly less than ten percent of people with cognitive impairment progress to Alzheimer's each year.

All people, whether they are forgetful or not, should prevent blood vessel disease by getting their bad LDL cholesterol below 100, the diabetic test HBA1C below 5.7, blood pressure below 120/80, triglycerides below 120, and a pinch of their abdominal flesh smaller than one inch.

They should exercise every day, lose weight if overweight, avoid refined carbohydrates, cut out sugared drinks,  limit  red meat, and eat plenty of fruits, vegetable, whole grains, beans, seeds and nuts. They should also try to get their vitamin D3 level above 75 nmol/L.

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