THE PREVENTION OF DEMENTIA BEFORE AND AFTER STROKE

Introduction: Dementia is an important public health problem, the only cause of death that can not be treated or cured. The number of people who are diagnosed with dementia is increasing, over 55 million patients in 2021(about 5% of the world population), more than that a new case is diagnosed every 3 seconds, according World Health Organization. Prevalence of dementia is increasing, both before and after stroke. Aim: The purpose of this paper is to emphasize the importance of early identification of the risk factors associated with cognitive decline and the role of the complex health care approach. Method: The retroactive study involved analyzing the medical record of 60 subjects with stroke and cognitive impairments, hospitalized between july -december 2021. Furthermore we searched the latest PubMed database and Cochrane Library regarding the risk factors common for this two pathologies. The outcome showed that more women are affected by this debilitating disease, of which 72% were over 80 years old. The following modifiable risk factors were identified: 63% of patients had hypertension, 42% had recurrent stroke, 37% atrial fibrillation, 26% type II diabetes, 22% dyslipidemia, and 10% obesity. It is believed that one third of cases can be prevented by early identification of risk factors, especially cardiovascular, and by increasing the efficiency recovery after stroke. This can be done before the onset of the disease, growing the mental and emotional health, specificaly the cognitive abilitiy, including the executive function and the memory of people prone to neurodegeneration or cerebrovascular lesions. In elderly subjects, healthy diet, moderate physical activity, chronic stress reduction, social interaction along with improvement in cardiovascular risk factors, could be considered the first line of defense against the development and progression of dementia. Conclusions: The pathological process begins long before it manifests itself clinically, thus providing the opportunity to identify or combat the prodromal stages of the disease forward. We recommend multifactorial intervention to prevent cognitive impairment and dementia.