The number of people with dementia is increasing worldwide, and no curative treatment currently exists. This thesis explored risk factors and possible interventions to better understand and potentially slow cognitive decline and dementia. Low blood pressure, BMI, and non-HDL cholesterol in later life were strongly associated with higher dementia risk, especially when combined. Multidomain lifestyle interventions showed no clear effect on cognitive decline, except possibly in those with already reduced cognition. Certain blood pressure medications, especially calcium channel blockers and angiotensin-II-receptor blockers, were associated with a lower dementia risk. Blood pressure variability over time was associated with increased risk only at very old age, making a direct cause less likely. Finally, immunotherapy targeting beta-amyloid showed no clinically relevant effect in Alzheimer’s disease. These results emphasize the complexity of preventing dementia and the need for further targeted research.
Melina den Brok (1992) obtained her medical degree from the University of Amsterdam in 2018. She worked as a neurology resident (ANIOS) at Noordwest Ziekenhuisgroep in Alkmaar. In 2019, she began her PhD research at Radboud university medical center and Amsterdam UMC. Since 2022, she has been working as a neurology resident in training (AIOS) at the Radboud university medical center.