Geriatric Unit and Gerontology-Geriatric Research Laboratory, IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy.
Curr Alzheimer Res. 2011 Aug;8(5):492-509. doi: 10.2174/156720511796391818.
At present, the search for preventive strategies for cognitive decline and dementia appears to be of crucial importance, given that the therapeutic options currently available have demonstrated limited efficacy. Cumulative epidemiological evidence suggested that vascular and vascular-related factors may be important for the development of age-related cognitive decline (ARCD), mild cognitive impairment (MCI), and cognitive decline of degenerative (Alzheimer's disease, AD) or vascular origin (vascular dementia, VaD). Among vascular-related factors, metabolic syndrome (MetS) has been associated with the reduced risk of predementia syndromes (ARCD and MCI), overall dementia, and VaD, but contrasting findings also exist on the possible role of MetS in AD. In the next future, trials could then be undertaken to determine if modifications of these risks including inflammation, another factor probably related to MetS, could lower risk of developing cognitive decline. If MetS is associated with increased risk of developing cognitive impairment, then early identification and treatment of these individuals at risk might offer new avenues for disease course modification. Future research aimed at identifying mechanisms that underlie comorbid associations will not only provide important insights into the causes and interdependencies of predementia and dementia syndromes, but will also inspire novel strategies for treating and preventing these disorders. At present, vascular risk factor management could be decisive in delaying the onset of dementia syndromes or in preventing the progression of predementia syndromes.
目前，鉴于目前可用的治疗方法效果有限，寻找预防认知能力下降和痴呆的策略似乎至关重要。累积的流行病学证据表明，血管和血管相关因素可能对与年龄相关的认知能力下降（ARCD）、轻度认知障碍（MCI）以及退行性（阿尔茨海默病，AD）或血管性（血管性痴呆，VaD）认知能力下降的发展很重要。在血管相关因素中，代谢综合征（MetS）与痴呆前综合征（ARCD 和 MCI）、总体痴呆和 VaD 的风险降低有关，但 MetS 在 AD 中可能发挥作用的相反发现也存在。在未来，然后可以进行试验，以确定是否可以改变这些风险，包括炎症，这是另一个可能与 MetS 相关的因素，从而降低发生认知能力下降的风险。如果 MetS 与认知障碍风险增加相关，那么早期识别和治疗这些高危人群可能会为改变疾病进程提供新的途径。旨在确定潜在共病关联机制的未来研究不仅将提供有关痴呆前和痴呆综合征的原因和相互依存关系的重要见解，而且还将为治疗和预防这些疾病提供新策略。目前，血管危险因素管理对于延缓痴呆综合征的发作或预防痴呆前综合征的进展可能是决定性的。
