Department of Psychiatry, University of Cambridge, Cambridge Biomedical Campus, Cambridge, CB2 2QQ, UK.
BMC Med. 2013 Nov 19;11:246. doi: 10.1186/1741-7015-11-246.
Dementia is a major public health problem that poses an increasing burden on the health and wealth of societies worldwide. Because the efficacy of current treatments is limited, increasing efforts are required to prevent the diseases that cause dementia.
We consider the evidence that lifelong prevention strategies may be an effective way to tackle the national burden of dementia in the absence of a cure. The links between lifestyle and cardiovascular disease are widely understood and accepted, but health professionals and patients remain unconvinced about the extent to which risk for dementia can be modified. However, there is strong evidence that at least half of risk for dementia is attributable to lifestyle factors such as diet, exercise and smoking. Moreover, the disease processes that result in dementia develop over several decades, implying that attempts to ameliorate them need to start early in life. Some modifiable risk factors for dementia act from the earliest stages of life, including in utero.
Rebalancing efforts from the development of treatments to increased emphasis on prevention may be an alternative means to reducing the impact of dementia on society.
痴呆是一个主要的公共卫生问题，在全球范围内给社会的健康和财富带来了越来越大的负担。由于目前治疗方法的疗效有限，需要加大力度预防导致痴呆的疾病。
我们认为，在没有治愈方法的情况下，终身预防策略可能是应对国家痴呆负担的有效方法。生活方式与心血管疾病之间的联系已被广泛理解和接受，但卫生专业人员和患者仍然不相信痴呆风险在多大程度上可以改变。然而，有强有力的证据表明，至少一半的痴呆风险归因于生活方式因素，如饮食、锻炼和吸烟。此外，导致痴呆的疾病过程需要几十年的时间才能发展，这意味着需要在生命早期就开始尝试改善这些因素。一些可改变的痴呆风险因素从生命的最早阶段就开始起作用，包括胎儿期。
将精力从开发治疗方法重新平衡到更加强调预防，可能是减轻痴呆对社会影响的另一种手段。
