Wright C F, Hall A, Matthews F E, Brayne C
PHG Foundation, Cambridge, United Kingdom.
Ann N Y Acad Sci. 2009 Oct;1180:11-9. doi: 10.1111/j.1749-6632.2009.04942.x.
Public health is defined as the organized efforts of society to improve health. This is often framed in terms of prevention, with primary, secondary, and tertiary prevention representing, respectively, fundamental prevention through understanding of causation, to alteration of natural history, through understanding of pathophysiological mechanisms and palliation. Biomarkers play a role in all of these levels of prevention of dementias. The clearest application of biomarkers from a public health perspective is in the setting of screening. Screening has particular meaning for public health and includes early detection as a core element, coupled with treatments or preventative actions to reduce the burden of disease. Here, we will cover the range of evidence required if biomarkers are to play a part in population prevention of dementia, including scientific and technical aspects together with ethical, legal, and social considerations. Ensuring research activity that addresses these wider perspectives is essential.
公共卫生被定义为社会为改善健康状况而做出的有组织的努力。这通常从预防的角度来阐述，一级预防、二级预防和三级预防分别代表通过对病因的理解进行的基础预防、通过对病理生理机制的理解改变疾病自然史以及缓解症状。生物标志物在痴呆症的所有这些预防层面都发挥着作用。从公共卫生角度来看，生物标志物最明确的应用是在筛查方面。筛查对公共卫生具有特殊意义，包括早期检测这一核心要素，以及结合治疗或预防措施以减轻疾病负担。在此，我们将涵盖生物标志物要在痴呆症的人群预防中发挥作用所需的一系列证据，包括科学技术方面以及伦理、法律和社会考量。确保研究活动能考虑到这些更广泛的视角至关重要。
