Department of Neurology, University of Pittsburgh School of Medicine, Pittsburgh, PA 15215, USA.
J Alzheimers Dis. 2013;33 Suppl 1(0 1):S427-38. doi: 10.3233/JAD-2012-129015.
Alzheimer's disease (AD) is the most frequent form of dementia in elderly individuals and its incidence and prevalence increases with age. This risk of AD is increased in the presence of genetic and demographic factors including apolipoprotein E 4 allele, lower education, and family history of AD. There are medical risk modifiers including systemic hypertension, diabetes mellitus, cardiovascular disease, and cerebrovascular disease that increase the vulnerability for AD. By contrast, there are lifestyle risk modifiers that reduce the effects of AD risk factors include diet and physical and cognitive activity. Our research has consistently shown that it is the interactions among these risk factors with the pathobiological cascade of AD that determine the likelihood of a clinical expression of AD-either as dementia or mild cognitive impairment. However, the association between "vulnerability" and "protective" factors varies with age, since the effects of these factors on the risk for AD may differ in younger (age < 80) versus older (age > 80) individuals. The understanding of the dynamic of these factors at different age periods will be essential for the implementation of primary prevention treatments for AD.
阿尔茨海默病（AD）是老年人最常见的痴呆症形式，其发病率和患病率随着年龄的增长而增加。存在载脂蛋白 E4 等位基因、受教育程度较低和 AD 家族史等遗传和人口统计学因素会增加患 AD 的风险。还有一些医疗风险修饰因子，包括系统性高血压、糖尿病、心血管疾病和脑血管疾病，这些都会增加患 AD 的脆弱性。相比之下，还有一些生活方式风险修饰因子可以减轻 AD 风险因素的影响，包括饮食、身体活动和认知活动。我们的研究一直表明，正是这些风险因素与 AD 的病理生物学级联反应之间的相互作用，决定了 AD 临床表型（无论是痴呆症还是轻度认知障碍）出现的可能性。然而，“脆弱性”和“保护”因素之间的关联因年龄而异，因为这些因素对 AD 风险的影响在年龄较小（<80 岁）和年龄较大（>80 岁）的个体中可能不同。了解这些因素在不同年龄阶段的动态变化对于实施 AD 的初级预防治疗至关重要。
