González-Gross M, Marcos A, Pietrzik K
Institut für Ernährungswissenschaft, Abteilung Pathophysiologie der Ernährung, Rheinische Friedrich-Wilhelms-Universität, D-53115 Bonn, Germany.
Br J Nutr. 2001 Sep;86(3):313-21. doi: 10.1079/bjn2001388.
As the number of older people is growing rapidly worldwide and the fact that elderly people are also apparently living longer, dementia, the most common cause of cognitive impairment is getting to be a greater public health problem. Nutrition plays a role in the ageing process, but there is still a lack of knowledge about nutrition-related risk factors in cognitive impairment. Research in this area has been intensive during the last decade, and results indicate that subclinical deficiency in essential nutrients (antioxidants such as vitamins C, E and beta-carotene, vitamin B(12), vitamin B(6), folate) and nutrition-related disorders, as hypercholesterolaemia, hypertriacylglycerolaemia, hypertension, and diabetes could be some of the nutrition-related risk factors, which can be present for a long time before cognitive impairment becomes evident. Large-scale clinical trials in high-risk populations are needed to determine whether lowering blood homocysteine levels reduces the risk of cognitive impairment and may delay the clinical onset of dementia and perhaps of Alzheimer's disease. A curative treatment of cognitive impairment, especially Alzheimer's disease, is currently impossible. Actual drug therapy, if started early enough, may slow down the progression of the disease. Longitudinal studies are required in order to establish the possible link of nutrient intake--nutritional status with cognitive impairment, and if it is possible, in fact, to inhibit or delay the onset of dementia.
随着全球老年人数量迅速增长，而且老年人的寿命显然也在延长，认知障碍最常见的病因——痴呆症正成为一个日益严重的公共卫生问题。营养在衰老过程中发挥着作用，但对于认知障碍中与营养相关的风险因素仍缺乏了解。在过去十年中，该领域的研究一直很密集，结果表明，必需营养素（如维生素C、维生素E和β-胡萝卜素、维生素B12、维生素B6、叶酸等抗氧化剂）的亚临床缺乏以及与营养相关的疾病，如高胆固醇血症、高甘油三酯血症、高血压和糖尿病，可能是一些与营养相关的风险因素，这些因素在认知障碍变得明显之前可能已经存在很长时间。需要在高危人群中进行大规模临床试验，以确定降低血液同型半胱氨酸水平是否能降低认知障碍风险，并可能延缓痴呆症乃至阿尔茨海默病的临床发病。目前，对认知障碍，尤其是阿尔茨海默病进行治愈性治疗是不可能的。如果尽早开始实际的药物治疗，可能会减缓疾病的进展。需要进行纵向研究，以确定营养素摄入——营养状况与认知障碍之间可能存在的联系，以及实际上是否有可能抑制或延缓痴呆症的发病。
