重视阿尔茨海默病和老年痴呆症的人群干预研究

doi:10.6040/j.issn.1671-7554.0.2017.317

摘要/Abstract

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。

关键词: 老年痴呆症, 危险因素, 流行病学, 阿尔茨海默病, 认知储存, 人群干预研究

Abstract: As the absolute number and the proportion of elderly people increase, Alzheimers disease(AD)or senile dementia poses tremendous economic and societal burden to the modern aging society, and has been considered a global public health priority. While there is currently no cure for dementia or AD, epidemiological studies have identified several modifiable factors including cardiovascular risk factors and related disorders and psychosocial factors for the occurrence, development and clinical expression of dementia and AD. Cardiovascular risk factors(e.g., smoking, hypertension, diabetes)can promote the clinical onset of dementia by causing cerebrovascular and neurodegenerative pathologies, whereas psychosocial factors(e.g., educational attainment, rich social network, mentally-stimulating activity)can help maintain late-life cognitive functioning by increasing cognitive reserve. Therefore, in theory, intervention methods targeting these modifiable factors may prevent or postpone the onset of dementia or AD. Recent large-scale intervention studies abroad preliminarily demonstrated that a multidomain intervention program that integrated vascular risk factor monitoring, healthy diet, physical exercise and cognitive training could help maintain cognitive functioning in at-risk elderly people. Our country should attach importance to population intervention studies in order to develop effective intervention programs against AD and dementia that are tailored to ethnic populations in China and thus provide the basis for making proper national strategies against dementia.

Key words: Alzheimers disease, Senile dementia, Epidemiology, Risk factors, Cognitive reserve, Population intervention studies

中图分类号:

R741.02

仇成轩, 杜怡峰. 重视阿尔茨海默病和老年痴呆症的人群干预研究[J]. 山东大学学报（医学版）, 2017, 55(10): 1-6.

QIU Chengxuan, DU Yifeng. A call for action to strengthen research on population interventions against Alzheimers disease and senile dementia[J]. JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES), 2017, 55(10): 1-6.

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