As the population ages, the number of people with dementia is expected to increase in the coming decades, with consequences at the societal and individual levels. In this narrative review, we provide a summary of the scientific evidence concerning dementia prevention, with a focus on the following three strategies: 1) Targeting the body to protect the brain, including prevention and treatment of cardiovascular morbidity; 2) Compensatory interventions to counteract brain ageing, including education and life-long engagement in cognitively and socially stimulating activities; and 3) Lifespan health promotion, such as a physically active lifestyle, smoking cessation, and a healthy and balanced diet. Next, we consider the biological mechanisms by which these strategies may act by taking into account the main pathways implicated in the development and progression of dementia: neurodegeneration, brain resilience, vascular damage, neuroinflammation, and oxidative stress. Based on the current evidence, and in line with the declining trends of dementia incidence in high-income countries, we conclude that timely multidomain preventive actions are promising strategies to reduce the dementia epidemic worldwide. There is still a considerable gap between the epidemiological evidence and its underlying biological mechanisms. Filling this gap will be crucial to move forward in dementia prevention worldwide.

随着人口老龄化，预计痴呆症患者的人数在未来几十年内将会增加，从而对社会和个人造成影响。在这篇叙述性综述中，我们提供了有关预防痴呆症的科学证据的摘要，重点是以下三种策略：1）针对身体以保护大脑，包括预防和治疗心血管疾病；2）补偿性干预措施以抵消脑部老化，包括教育和终身参与认知和社会刺激活动；3）终身健康促进，例如积极运动的生活方式，戒烟和健康均衡的饮食。下一个，我们考虑了与痴呆症的发生和发展有关的主要途径，即这些途径可能起作用的生物学机制：神经变性，脑适应力，血管损伤，神经炎症和氧化应激。根据目前的证据，并与高收入国家痴呆症发病率下降的趋势相一致，我们得出结论，及时采取多领域预防措施是减少全世界痴呆症流行的有希望的战略。流行病学证据与其潜在的生物学机制之间仍然存在相当大的差距。填补这一空白对于在全球范围内预防痴呆至关重要。并与高收入国家痴呆症发病率下降的趋势一致，我们得出结论，及时采取多领域预防措施是减少全世界痴呆症流行的有希望的战略。流行病学证据与其潜在的生物学机制之间仍然存在相当大的差距。填补这一空白对于在全球范围内预防痴呆至关重要。并与高收入国家痴呆症发病率下降的趋势一致，我们得出结论，及时采取多领域预防措施是减少全世界痴呆症流行的有希望的战略。流行病学证据与其潜在的生物学机制之间仍然存在相当大的差距。填补这一空白对于在全球范围内预防痴呆至关重要。