However, no clear etiological model has been defined. POCD may likely be of multifactorial etiology, with many factors contributing

small effects to the added risk. Future studies will hopefully shed light on these factors and their Interactions.
Dementia is one of the major causes of loss of autonomy, and the main reason for the Institutionalization of the elderly. Epidemiological studies conducted in the last 10 years have shown that the prevalence of dementia is close to 5% in the population over 65 years of age. These studies Inhibitors,research,lifescience,medical have also shown that its prevalence increases sharply with age, and as a result of the expected shift in population demographics, the incidence and prevalence of dementia are expected to increase dramatically over the coming decades. The number of demented patients worldwide is projected to increase from 243 million in 2001 to 81.1 million in 2040.1 Significantly, Inhibitors,research,lifescience,medical the vast majority of new cases are expected to appear in developing countries. For example, the number of demented persons in China and India will increase by 300% during this period.1 Inhibitors,research,lifescience,medical Prevention and management of dementia are therefore a major public health challenge in the majority of countries around the world. As a general rule, the occurrence

of dementia is not a sudden phenomenon. It is the final stage of cognitive Inhibitors,research,lifescience,medical deterioration, the speed of which varies from one individual to the other. However, even in cases where its development is rapid, the process is measured in terms of months. Taking into account the life expectancy of individuals at risk, retarding the development of dementia for a few months may have important consequences on the prevalence of dementia.2 Such expectations have been raised in recent Inhibitors,research,lifescience,medical years with the discovery of a relationship between hypertension and dementia. Overall, published studies suggest that high blood pressure increases the risk

of cognitive decline and dementia, and therefore, that lowering blood pressure might reduce this risk. This paper will review the evidence for this, and will discuss some of the important questions that remain unanswered. Hypertension and cognitive decline: evidence from observational Mephenoxalone studies It has been known for decades that there is a direct, causal relationship between high blood pressure and the risk of stroke, and therefore the risk of dementia (Figure 1). It is common knowledge that large strokes or multiple strokes contribute directly to cognitive decline and to the risk of dementia, consequently called vascular dementia. However, it is only in the past 10 years that studies have reported that hypertension may be related to cognitive decline and dementia without the signaling pathway occurrence of a stroke. Figure 1. Diagrammatic representation of the consequences of hypertension on the brain.