Cognitive decline and late-onset Alzheimer's disease may be approached with a systems-level strategy including a healthy vascular supply, available metabolic substrate for neurons, necessary nutrients for structural integrity, absence of impairing factors, demand on the system to drive adaptation, and periods of recovery and adaptation.

“all of these things are necessary healthy vascular Supply you know some kind of metabolic substrate that is taken up um and and available to neurons of the brain you know that you have the the nutrients required to build uh quality uh structure that you have um the absence of things that may impair some uh repair process like you you mentioned a bunch of them uh which which are clear risk factors like smoking and then you know to kind of tie everything together you create you you require Demand on the system that drives you know creates a stimulus for adaptation those things are required in order to respond to that stimulus and then you have a period of recovery and adaptation that allows for you know concept consolidation and plasticity”