A couple of recent papers related to vascular risk and dementia of interest.

If we act in middle age, we can reduce dementia rates. We know that acting in later life is too late;the damage has already been done.

One study (Wolozin et al, Boston, BMJ) showed that taking an angiotensin receptor antagonist drug led to a 55% reduction in the incidence of Alzheimer's disease and vascular dementia, in comparison with a group taking non-ARB CV drugs.

Another study from Edinburgh, UK, modelled the effect on dementia of targeting four risk areas (obesity, hyperlipidaemia, hypertension and exercise). If treatment were begun from age 35 onwards, a reduction in dementia prevalence of the order of 20% might be possible (Russ and Starr, Clinical Evidence 2010).

These studies seem heartening, although the 'number needed to treat' is likely to be high and difficult to quantify.

Do you think that poly-pharmacy is a price worth paying? Would you take 3 pills a day for 50 years? Who will pay?

Let us know your thoughts below in the comments.