山东大学学报(医学版) ›› 2017, Vol. 55 ›› Issue (10): 1-6.doi: 10.6040/j.issn.1671-7554.0.2017.317
• 阿尔茨海默病防治专题 • 下一篇
仇成轩1,2, 杜怡峰3
QIU Chengxuan1,2, DU Yifeng3
摘要: 随着老龄人口的基数和所占比重增加,阿尔茨海默病(AD)和老年痴呆症给现代老龄社会带来巨大的经济和社会负担,并成为全球公共卫生领域优先考虑的课题。老年痴呆症和AD目前尚无药物治愈方法,但流行病学研究表明,心血管危险因素及相关心血管疾病和社会心理因素等可控因素在痴呆症和AD的发生、发展及临床表现中起重要作用,其中,心血管危险因素(吸烟、高血压、糖尿病等)可通过导致脑血管性和神经退行性疾病促使老年痴呆临床发病,而社会心理因素(文化程度、丰富社交网和智力刺激活动等)则可通过增加认知储存有助于保持晚年认知功能。因此,理论上针对这些可控因素实施干预有可能预防或延迟老年痴呆症和AD发病。近年来,国外大规模人群干预研究初步显示,强化对心血管危险因素的监控、平衡饮食、体力锻炼和认知训练等多模干预方案有助于保持老年痴呆症高危老龄人群的认知功能。我国应重视老年痴呆症和AD的人群干预研究,以期探索出适合我国种族人群特征的有效干预方案,为制定有效应对老年痴呆症挑战的国家行动计划提供依据。
中图分类号:
[1] Qiu C, Kivipelto M, von Strauss E. Epidemiology of Alzheimers disease: occurrence, determinants, and strategies toward intervention[J]. Dialogues Clin Neurosci, 2009, 11(2): 111-128. [2] Winblad B, Amouyel P, Andrieu S, et al. Defeating Alzheimers disease and other dementias: a priority for European science and society[J]. Lancet Neurol, 2016, 15(5): 455-532. [3] Viswanathan A, Rocca WA, Tzourio C. Vascular risk factors and dementia: how to move forward?[J]. Neurology, 2009, 72(4): 368-374. [4] Alzheimers Disease International(ADI). World Alzheimer Report 2015, the global impact of dementia: an analysis of prevalence, incidence, cost and trends[EB/OL].(2015-08)[2017-04-08]. http: //www.alz.co.uk/research/world-report-2015. [5] Chan KY, Wang W, Wu JJ, et al. Epidemiology of Alzheimers disease and other forms of dementia in China, 1990-2010: a systematic review and analysis[J]. Lancet, 2013, 381(9882): 2016-2023. [6] Xu J, Wang J, Wimo A, et al. The economic burden of dementia in China, 1990-2030: implications for health policy[J]. Bull World Health Organ, 2017, 95(1): 18-26. [7] Organization WH. Dementia: a public health priority here[J]. Perspect Public Health, 2012, 5(3): 123-125. [8] Loy CT, Schofield PR, Turner AM, et al. Genetics of dementia[J]. Lancet, 2014, 383(9919): 828-840. [9] Qiu C, Xu W, Fratiglioni L. Vascular and psychosocial factors in Alzheimers disease: epidemiological evidence toward intervention[J]. J Alzheimers Dis, 2010, 20(3): 689-697. [10] Qiu C, Fratiglioni L. A major role for cardiovascular burden in age-related cognitive decline[J]. Nat Rev Cardiol, 2015, 12(5): 267-277. [11] 李娅, 龙慧, 楚兰, 等. 阿尔茨海默病与血管性危险因素关系研究: 中国学者海外报道[J]. 中国现代神经疾病杂志,2015, 15(7): 518-523. LI Ya, LONG Hui, CHU Lan, et al. Studies on the association between Alzheimers disease and vascular risk factors: reports from China[J]. Chin J Contemp Neurol Neurosurg, 2015, 15(7): 518-523. [12] 仇成轩. 社会心理因素、遗传易感性及其交互影响在认知老化过程中的作用[J]. 中华行为医学与脑科学杂志, 2012, 21(4): 295-298. QIU Chengxuan. Psychosocial factors, genetic susceptibility and their interaction in cognitive aging[J]. Chin J Behav Med Brain Sci, 2012, 21(4): 295-298. [13] Xu W, Tan L, Wang HF, et al. Meta-analysis of modifiable risk factors for Alzheimers disease[J]. J Neurol Neurosurg Psychiatry, 2015, 86(12): 1299-1306. [14] 杜怡峰. 应加强我国阿尔茨海默病的早期防治研究[J].中华神经科杂志, 2016, 49(9): 667-672. DU Yifeng. Researches on early intervention of Alzheimers disease should be strengthened[J]. Chin J Neurol, 2016, 49(9): 667-672. [15] Qiu C, Sigurdsson S, Zhang Q, et al. Diabetes, markers of brain pathology and cognitive function: the age, gene/environment susceptibility-reykjavik study[J]. Ann Neurol, 2014, 75(1): 138-146. [16] Stern Y. Cognitive reserve in ageing and Alzheimers disease[J]. Lancet Neurol, 2012, 11(11): 1006-1012. [17] 何燕,余林,闫志民,等. 认知储备的测量及其在认知老化中的应用[J].心理科学进展, 2015, 23(3): 430-438. HE Yan, YU Lin, YAN Zhimin, et al. Quantification of cognitive reserve and application research in cognitive aging[J]. Adv Psychol Sci, 2015, 23(3): 430-438. [18] Brayne C, Ince PG, Keage HA, et al. Education, the brain and dementia: neuroprotection or compensation?[J]. Brain, 2010, 133(Pt 8): 2210-2216. [19] Morbelli S, Nobili F. Cognitive reserve and clinical expression of Alzheimers disease: evidence and implications for brain PET imaging[J]. Am J Nucl Med Mol Imaging, 2014, 4(3): 239-247. [20] Bennett DA, Schneider JA, Tang Y, et al. The effect of social networks on the relation between Alzheimers disease pathology and level of cognitive function in old people: a longitudinal cohort study[J]. Lancet Neurol, 2006, 5(5): 406-412. [21] Wu YT, Fratiglioni L, Matthews FE, et al. Dementia in Western Europe: epidemiological evidence and implications for policy making[J]. Lancet Neurol, 2016, 15(1): 116-124. [22] Matthews FE, Stephan BC, Robinson L, et al. A two decade dementia incidence comparison from the cognitive function and ageing studies I and II[J]. Nat Commun, 2016,7: 11398. doi: 10.1038/ncomms11398. [23] Langa KM, Larson EB, Crimmins EM, et al. A comparison of the prevalence of dementia in the United States in 2000 and 2012[J]. JAMA Intern Med, 2017, 177(1): 51-58. [24] Yang G, Wang Y, Zeng Y, et al. Rapid health transition in China, 1990-2010: findings from the global burden of disease study 2010[J]. Lancet, 2013, 381(9882): 1987-2015. [25] Solomon A, Mangialasche F, Richard E, et al. Advances in the prevention of Alzheimers disease and dementia[J]. J Intern Med, 2014, 275(3): 229-250. [26] Ngandu T, Lehtisalo J, Solomon A, et al. A 2 year multidomain intervention of diet, exercise, cognitive training, and vascular risk monitoring versus control to prevent cognitive decline in at-risk elderly people(FINGER): a randomized controlled trial[J]. Lancet, 2015, 385(9984): 2255-2263. [27] Moll van Charante EP, Richard E, Eurelings LS, et al. Effectiveness of a 6-year multidomain vascular care intervention to prevent dementia(preDIVA): a cluster-randomised controlled trial[J]. Lancet, 2016, 388(10046): 797-805. [28] Qiu C. Preventing Alzheimers disease by targeting vascular risk factors: hope and gap[J]. J Alzheimers Dis, 2012, 32(3): 721-731. [29] Norton S, Matthews FE, Barnes DE, et al. Potential for primary prevention of Alzheimers disease: an analysis of population-based data[J]. Lancet Neurol, 2014, 13(8): 788-794. [30] Jia J, Wang F, Wei C, et al. The prevalence of dementia in urban and rural areas of China[J]. Alzheimers Dement, 2014, 10(1): 1-9. [31] Brookmeyer R, Gray S, Kawas C. Projections of Alzheimers disease in the United States and the public health impact of delaying disease onset[J]. Am J Public Health, 1998, 88(9): 1337-1342. [32] Brodaty H, Breteler MM, Dekosky ST, et al. The world of dementia beyond 2020[J]. J Am Geriatr Soc, 2011, 59(5): 923-927. |
[1] | 闫鹏 王蓉 杜怡峰 沈伦乾. 老年性痴呆患者尿中AD7c-NTP含量的研究[J]. 山东大学学报(医学版), 2209, 47(6): 106-. |
[2] | 孙启晶,陈方方,李春晓,张才擎. PNI及HGB评估中晚期非小细胞肺癌患者预后的临床价值[J]. 山东大学学报(医学版), 2017, 55(4): 55-59. |
[3] | 李蒙蒙,王苗苗,刁雪琴,田克立,徐霞,任桂杰. 阿尔茨海默病细胞模型中lncRNA RP11-543N12.1对CDH13表达的调控作用[J]. 山东大学学报(医学版), 2017, 55(3): 12-18. |
[4] | 唐毅. 阿尔茨海默病诊断标准:从临床诊断到病理生理诊断[J]. 山东大学学报(医学版), 2017, 55(10): 14-20. |
[5] | 杜蘅,袁晓东. 阿尔茨海默病病因及发病机制研究进展[J]. 山东大学学报(医学版), 2017, 55(10): 21-27. |
[6] | 杜怡峰,井然. 阿尔茨海默病的诊断与治疗[J]. 山东大学学报(医学版), 2017, 55(10): 7-13. |
[7] | 王艺桦,马琳,阚艳敏,王文韬. 剖宫产术后早期子宫切口缺陷的超声观察及相关因素分析[J]. 山东大学学报(医学版), 2016, 54(5): 39-44. |
[8] | 李懋禹,唐诗,杜怡峰. TRB3在APP/PS1转基因小鼠脑内的表达及其意义[J]. 山东大学学报(医学版), 2016, 54(10): 1-5. |
[9] | 尹小芳,葛海波. 住院肺结核合并糖尿病患者流行病学特征[J]. 山东大学学报(医学版), 2016, 54(1): 58-61. |
[10] | 刘正琴, 吴树明, 庞昕焱. 亚砷酸导致恶性心律失常1例[J]. 山东大学学报(医学版), 2015, 53(11): 95-96. |
[11] | 赵雪莲, 于君, 谢兆宏, 曹彦军, 刘震, 王晓, 徐琳琳, 杨慧, 郑晓磊, 沈阳, 毕建忠. 线粒体自噬在阿尔茨海默病细胞模型中的作用机制[J]. 山东大学学报(医学版), 2015, 53(10): 1-5. |
[12] | 葛树建, 林炜炜, 丛琳, 张涛, 韩晓娟, 张清华, 杜怡峰. 基于Web构建山东省阿尔茨海默病临床数据库[J]. 山东大学学报(医学版), 2015, 53(10): 42-45. |
[13] | 李梅, 孟庆慧, 蔡巧英, 徐雁, 范晓婷. 乙酰葛根素对Aβ25-35诱导BV-2小胶质细胞Caspase-3表达的影响[J]. 山东大学学报(医学版), 2015, 53(10): 32-36. |
[14] | 何昶江. 普外科手术切口感染因素探讨[J]. 山东大学学报(医学版), 2014, 52(S2): 23-23. |
[15] | 王金红, 李文涛, 于树田, 董丽. 多奈哌齐对阿尔茨海默病模型大鼠下丘脑-垂体-肾上腺轴的影响[J]. 山东大学学报(医学版), 2014, 52(7): 11-15. |
|