Fratiglioni Laura, Wang Hui-Xin
Aging Research Center, Department NVS, Karolinska Institute, and Stockholm Gerontology Research Center, Stockholm, Sweden.
J Alzheimers Dis. 2007 Aug;12(1):11-22. doi: 10.3233/jad-2007-12103.
The concept of brain reserve refers to the ability to tolerate the age-related changes and the disease related pathology in the brain without developing clear clinical symptoms or signs. A considerable body of biological research has documented that a number of factors including education, work complexity, social network, and leisure activities may contribute to this reserve allowing cognitive function to be maintained in old ages. Epidemiological studies have also related these factors to the development of dementia, suggesting that intellectual challenges experienced across the whole life span may increase the brain reserve and be crucial for the occurrence of dementia symptoms in late life. This paper is a systematic review of the published epidemiological studies on this topic. The availability of numerous epidemiological and biological data investigating the reserve hypothesis in dementia permits some preliminary conclusions. High education, adult-life occupational work complexity, as well as a mentally and socially integrated lifestyle in late life could postpone the onset of clinical dementia and AD. The relevance of physical activity itself remains in debate, as most physical activities include also social and mental stimulation. Leisure activities with all three components--physical, mental and social--seem to have the most beneficial effect. Delaying dementia onset by five years would halve dementia prevalence and substantially decrease the number of dementia cases in the community.
脑储备的概念是指大脑耐受与年龄相关的变化以及与疾病相关的病理状态而不出现明显临床症状或体征的能力。大量生物学研究表明，包括教育程度、工作复杂性、社交网络和休闲活动在内的一些因素可能有助于形成这种储备，使认知功能在老年时得以维持。流行病学研究也将这些因素与痴呆症的发生联系起来，表明一生中经历的智力挑战可能会增加脑储备，对晚年痴呆症状的出现至关重要。本文是对已发表的关于该主题的流行病学研究的系统综述。大量调查痴呆症储备假说的流行病学和生物学数据使得得出一些初步结论成为可能。高学历、成年期职业工作复杂性以及晚年精神和社会融合的生活方式可以推迟临床痴呆症和阿尔茨海默病的发病。体育活动本身的相关性仍存在争议，因为大多数体育活动也包括社交和精神刺激。包含身体、精神和社交这三个要素的休闲活动似乎具有最有益的效果。将痴呆症发病推迟五年将使痴呆症患病率减半，并大幅减少社区中的痴呆症病例数量。
