A successful primary-care program designed to prevent stroke and dementia supports the feasibility and effectiveness of such an initiative, reducing a patient’s risk of developing long-term-care (LTC) dependence.

Stroke and dementia are the major causes of LTC dependence in old age, wrote Horst Bickel, PhD, and associates in Journal of the American Heart Association. Their Intervention Project on Cerebrovascular Disease and Dementia in the District of Ebersberg (INVADE) trial compared a multidomain prevention program for stroke and dementia with usual medical care in reducing the need for LTC in Germany.

A total of 3,908 members of a health plan, aged 55 to 102 years (mean age 67.7 years), were the recipients of relatively simple interventions for improving vascular health. For example, they were encouraged to be more physically active, eat more healthfully, quit smoking, and reduce their blood pressure and cholesterol.

Compared with 13,301 patients in a neighboring area who received usual care without the focus on stroke and dementia prevention, significantly fewer new cases of LTC dependence arose in the intervention district than expected during the 5 years after completion of the recruitment phase of the study. The incidence of LTC dependence was reduced by 10% among women and by 9.6% among men. Mortality decreased as well.

In a statement, Bickel expressed confidence that the results could occur in the United States and other western populations that suffer from similar sedentary-lifestyle-related illnesses. “At the population level, even simple measures can lead to substantial achievements,” remarked Bickel. “Our results are only one example of how health risks can be reduced through uncomplicated, routine treatment of risk factors in the framework of a real-world setting.”

Cocoa consumption may be yet another strategy for the prevention of stroke and dementia, according to the findings of two separate studies. A team led by Giovambattista Desideri, MD, reported in the journal Hypertension that eating cocoa flavanols daily may improve mild cognitive impairment. A systematic review for The Cochrane Library by Dr. Karin Ried and fellow investigators indicated that in short-term trials, persons who were given dark chocolate or cocoa powder every day had a slight drop in BP compared with a control group.