Department of Neurology and Psychiatry, Division of Geriatric Psychiatry, Saint Louis University School of Medicine, 1438 South Grand Boulevard, St Louis, MO 63104, USA.
Clin Geriatr Med. 2010 Feb;26(1):1-16. doi: 10.1016/j.cger.2009.12.002.
Optimal cognitive function is vital to independence, productivity, and quality of life, and the debilitation associated with dementias makes them the most feared of conditions related to aging. Effective preventive measures are key components of any response to the potentially overwhelming problem of dementias. Increasing evidence points to the potential risk roles of vascular factors and disorders (eg, midlife obesity, dyslipidemia, diabetes, high blood pressure, cigarette smoking, and cerebrovascular lesions) and the potential protective roles of psychosocial factors (eg, higher education, regular exercise, healthy diet, intellectually challenging leisure activities, and active socially integrated lifestyle) in the pathogenic process and clinical manifestation of dementing disorders. Optimal control of vascular risk factors, secondary prevention of stroke, and manipulation of lifestyle factors have demonstrated efficacy in prevention of stroke and myocardial infarction. Thus, adding dementia prevention and brain function preservation as goals to already existing or planned prevention efforts is appropriate and necessary. Age must be taken into account when assessing the likely effect of such interventions against dementia, which underscores the need to begin prevention efforts early in patients' lives.
最佳认知功能对于独立性、生产力和生活质量至关重要，而与痴呆相关的衰弱使得它们成为与衰老相关的最令人恐惧的疾病。有效的预防措施是应对痴呆这一潜在压倒性问题的任何措施的关键组成部分。越来越多的证据表明，血管因素和疾病（例如，中年肥胖、血脂异常、糖尿病、高血压、吸烟和脑血管病变）具有潜在的风险作用，而社会心理因素（例如，更高的教育程度、定期锻炼、健康饮食、富有挑战性的休闲活动和积极的社交融合生活方式）具有潜在的保护作用，这些因素在痴呆障碍的发病机制和临床表现中发挥作用。最佳控制血管危险因素、中风的二级预防以及生活方式因素的调整已被证明可有效预防中风和心肌梗死。因此，将预防痴呆和保护大脑功能作为现有或计划中的预防措施的目标是恰当且必要的。在评估这些干预措施对痴呆的可能效果时，必须考虑年龄因素，这凸显了需要在患者生命早期就开始预防工作的必要性。
