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This presentation will focus on potentially modifiable risk factors associated with a higher or lower risk of cognitive decline and Alzheimer’s dementia. First, two prospective community-based analytic cohort studies in which all participants are brain donors will be described: the Religious Orders Study and the Rush Memory and Aging Project. Next, it will discuss the continuum of normality to mild cognitive impairment to Alzheimer’s dementia, and highlight the importance of studying cognitive decline in order to understand the neurobiology of dementia. Third, the relation of mixed neurodegenerative and vascular disease pathologies to cognitive decline and Alzheimer’s dementia will be described, as well as the concept of neural reserve or resilience defined as cognitive decline not explained by known brain pathologies. Then, data will be presented that illustrate a range of experiential (e.g., cognitive, physical, and social activities), psychological (e.g., neuroticism, loneliness, purpose in life), and medical (e.g., diabetes, sleep, diet) factors associated with cognitive decline and discuss their associations with brain pathologies and/or resilience. Finally, a slate of recommendations on how our behaviors during life can lead to better cognitive health in old age will be provided.
Describe the scientific value of studying cognitive decline to better understand the neurobiology of Alzheimer’s dementia.
Explain how Alzheimer’s dementia results from a combination of multiple pathologies and resilience factors.
List risk factors for Alzheimer’s dementia.
Discuss advice for patients and other stakeholders regarding how to maintain cognitive health in old age.