Prospects for delaying the rising tide of worldwide, late-life dementias.
Prospects for delaying the rising tide of worldwide, late-life dementias.
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DOI：
10.1017/s1041610210001080
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发表时间：
2010-12
影响因子：
7
通讯作者：
Larson EB
中科院分区：
文献类型：
--
作者：
Larson EB
在世界范围内，寿命正在延长。与此同时，老年痴呆症越来越普遍，在国际上对个人和公共卫生构成挑战。65岁以后，发达国家的痴呆症发病率每五年翻一番，发展中国家每七年翻一番。老年痴呆症，特别是阿尔茨海默氏病，对老年人及其照顾者有深远的影响。多学科研究探索了各种预防或延迟老年痴呆症发作的方法的潜力。概述了这项研究，包括我们团队的成人思想变化和Kame研究，这篇综述得出结论，延迟这些痴呆症的发作似乎是可行的，尽管绝对预防可能不是。今天，最有希望的方法似乎包括控制高血压等血管危险因素，以及在工作之余进行体育锻炼，可能还有脑力锻炼。如果人们能够延迟痴呆症的发作，他们就可以更长时间地过上更充实的生活，减少患痴呆症的时间，让他们的家人花更少的时间来应对这种疾病。有可能，在认知健康如此重要的社会中，向更知识化的社会发展的趋势可能会越来越多地施加进化压力，有利于更大更健康的大脑，以及“认知病态的压缩”，直到老年。公共卫生的伟大胜利，寿命的延长，应该给世界上更多的人带来多年无痴呆症生活的回报，而不是多年的功能障碍，依赖性和痴呆症的痛苦所带来的个人困难和公共卫生负担，一些干预措施可能会延迟阿尔茨海默病和其他痴呆症的发作。
Worldwide, lifespan is lengthening. Concomitantly, late-life dementias are increasingly common, challenging both personal and public health internationally. After age 65, rates of dementia tend to double every five years in developed countries and every seven in developing ones. The late-life dementias, particularly Alzheimer’s disease, have profound effects on aging individuals and their caregivers. Multidisciplinary research has explored the potential for various approaches to prevent or delay the onset of late-life dementias. Outlining that research, including our team’s Adult Changes in Thought and Kame studies, this review concludes that delaying these dementias’ onset appears feasible, although absolute prevention may not be. Today the most promising methods appear to include controlling vascular risk factors like hypertension and engaging in physical exercise—and possibly mental exercise—on and off the job. If people can delay the onset of dementias, they can lead more fulfilling lives for longer—spending less time suffering from dementia and letting their families spend less time coping with the disease. It is possible that trends toward more knowledge-based societies, where cognitive health is so vital, may increasingly exert evolutionary pressure favoring larger and healthier brains—and a “compression of cognitive morbidity”—well into old age. Public health’s great triumph, increased lifespan, should give more of the world’s people the reward of many years of dementia-free life—rather than the personal difficulties and public health burdens of many years of functional impairment, dependency, and suffering with dementia some interventions may delay the onset of Alzheimer’s disease and other dementias.