It has been estimated in 2013 that 44 million people live with dementia worldwide. With an aging population, an estimated 7.7 million new cases are diagnosed per year. At this rate, the number of people living with dementia will double every 20 years and will reach 135 million by 2050. 
Currently there is still no effective treatment to modify the course of dementia. Prevention is an urgent priority, both to reduce incidence and to slow down progression.
THE MOST IMPORTANT MODIFIABLE FACTOR FOR PREVENTION: LIFESTYLE CHANGES
A recently published review of 98 studies, reviews, and meta-analyses on diet and cognition looked at how our dietary patterns affect memory loss and progression to dementia.
The prevailing mechanism that is believed to play a role in the development of age related diseases, including memory loss and dementia, are oxidative stress, inflammation, and vascular risk factors.
These are ideal targets for a nutritional intervention with a Mediterranean diet, which is rich in antioxidants and mono-unsaturated fatty acids, with a balanced ratio between omega 3 and omega 6 fatty acids.
The results of the review suggest that better adherence to a Mediterranean diet is associated with less cognitive decline, dementia, or Alzheimer disease. 
Some people are carriers of the main genetic risk factor for sporadic late-onset of Alzheimer’s Dementia (AD): the ApoE ε4 allele (ApoE4). The ApoE4 increases the risk of AD by 15 times in Caucasian homozygotes, who have both genes (ApoE4). Neuro-pathological changes in the brain associated with AD occur as early as 30 years of age, which is decades before the clinical onset of the disease.
The good news is not all ApoE4 carriers develop Alzheimer’s Dementia and they are particularly sensitive to environmental factors, in particular dietary fat. Studies showed that moderate intake of poly-unsaturated fatty acids, like fish oil, especially DHA at midlife was associated with decreased risk of dementia, while moderate intake of saturated fats was associated with an increased risk in the Cardiovascular Risk Factors, Aging, and Incidence of Dementia. 
For more information on how to keep your brain sharp, please schedule an appointment with Dr. Koganski at 215-750-7000 or www.NewtownInternalMedicine.com
 Alzheimer’s Disease International. Policy brief for heads of government: the global impact of dementia 2013–2050. London: Alzheimer’s Disease International; 2013.
 Ondine van de Rest, et al. Dietary Patterns, Cognitive Decline, and Dementia: A Systematic Review. Adv Nutr. March 2015 vol. 6:154-168, 2015. doi: 10.3945/an.114.007617.
 Laitinen MH, et al. Fat intake at midlife and risk of dementia and Alzheimer’s disease: a population-based study. Dement Geriatr Cogn Disord. 2006;22:99–107.
 Pascale Barberger-Gateau,et al. Dietary omega 3 polyunsaturated fatty acids and Alzheimer’s disease: interaction with apolipoprotein E genotype. Curr Alzheimer Res. 2011 Aug; 8(5): 479–491.