Described in the early 1980s as “The Silent Epidemic,” dementia in the elderly will soon become a clarion call for public health experts worldwide. The epidemic is largely explained by the prevalence of dementia in persons 8- years of age or older. In most countries around the world, especially wealthy ones, this “old old” population will continue to grow, and since it accounts for the largest proportion of dementia cases, the dementia epidemic will grow worldwide. Eventually, we will have results of studies conducted over longer periods with presumably more definitive findings. But for now, the evidence supports the theory that better education and greater economic well-being enhance life expectancy and reduce the risk of late-life dementias in people who survive to old age. The results also suggest that controlling vascular and other risk factors during midlife and early old age has unexpected benefits. That is, individual risk-factor control may provide substantial public health benefits if it leads to lower rates of late-life dementias.