Influences of Early and Later Life Events on Cognition and All-Cause Dementia in China

摘要 预期寿命的增长正在推动老年人口规模的迅速增长，预计将导致阿尔茨海默病和与阿尔茨海默病相关的痴呆症急剧上升，从目前的全球约4700万人，到2050年可能超过1.4亿人。然而，最近的人口研究发现，在一些国家，阿尔茨海默病和阿尔茨海默病相关痴呆的发病率低于以前的预测，但在另一些国家则更高。生活方式因素和环境因素可能会降低或增加个人患痴呆症的风险。我们建议加深对中国晚年认知功能减退和阿尔茨海默病及阿尔茨海默病相关痴呆(以下简称痴呆)的保护性因素和危险因素的认识。我们在柳叶刀委员会最近提出的模型的基础上，提出了一个新的风险因素生命过程模型，该模型在历史、制度和物理环境的背景下，将痴呆症风险与早年和中年因素联系起来，包括肥胖、糖尿病听力损失、视力损害、吸烟、饮酒、抑郁、缺乏运动、社会孤立和社会经济地位。具体地说，本项目旨在利用中国新的、回溯性的生活史访谈数据，进一步研究可能导致晚年认知和痴呆症风险的个人、家庭、社区和外部因素。

Abstract Rising life expectancy is contributing to rapid increases in the size of the older population and is expected to lead to a sharp rise in Alzheimer’s disease and Alzheimer’s disease related dementias from about 47 million people worldwide today, to potentially more than 140 million in 2050. However, recent population studies have found that the incidence of Alzheimer’s disease and Alzheimer’s disease related dementias is lower than that indicated by previous projections in some countries, but greater in others. Lifestyle factors as well as environmental factors might reduce or increase an individual’s risk of developing dementia. We propose to advance our understanding of protective and risk factors for late-life cognitive decline and Alzheimer’s disease and Alzheimer’s disease-related dementias (hereafter referred to as dementia) in China. We propose a novel life-course model of risk factors, building on the recently proposed model by the Lancet commission, which links dementia risk to early and mid-life factors, within the context of historical, institutional, and physical environments, including obesity, diabetes hearing loss, visual impairment, smoking, drinking, depression, physical inactivity, social isolation, and socioeconomic status. Specifically, this project aims to further study early and mid-life personal, family, community, and external factors that may contribute to late-life cognition and dementia risk using new, retrospective life-history interview data in China.