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Mechanisms underlying neuroprotection include enhanced cerebral angiogenesis supporting tissue oxygenation, anti-inflammatory effects reducing secondary injury, antioxidant activity limiting free radical damage, and modulation of neurotransmitter systems including the dopamine/glutamate/NO system

Each approach has trade-offs, and neither is inherently superior

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161 More research is needed to better understand the mechanisms that link social and cognitive engagement to dementia risk, along with types of activities that provide benefit and how often they should take place