Department of Psychiatry, University of California, San Francisco, San Francisco, CA, USA; Department of Neurology, University of California, San Francisco, San Francisco, CA, USA; Department of Epidemiology, University of California, San Francisco, San Francisco, CA, USA; San Francisco Veterans Affairs Medical Center, San Francisco, CA, USA.
Northern California Institute for Research and Education, San Francisco, CA, USA.
Alzheimers Dement. 2014 Jun;10(3 Suppl):S111-21. doi: 10.1016/j.jalz.2014.04.010.
Lifestyle and health-related factors are critical components of the risk for cognitive aging among veterans. Because dementia has a prolonged prodromal phase, understanding effects across the life course could help focus the timing and duration of prevention targets. This perspective may be especially relevant for veterans and health behaviors. Military service may promote development and maintenance of healthy lifestyle behaviors, but the period directly after active duty has ended could be an important transition stage and opportunity to address some important risk factors. Targeting multiple pathways in one intervention may maximize efficiency and benefits for veterans. A recent review of modifiable risk factors for Alzheimer's disease estimated that a 25% reduction of a combination of seven modifiable risk factors including diabetes, hypertension, obesity, depression, physical inactivity, smoking, and education/cognitive inactivity could prevent up to 3 million cases worldwide and 492,000 cases in the United States. Lifestyle interventions to address cardiovascular health in veterans may serve as useful models with both physical and cognitive activity components, dietary intervention, and vascular risk factor management. Although the evidence is accumulating for lifestyle and health-related risk factors as well as military risk factors, more studies are needed to characterize these factors in veterans and to examine the potential interactions between them.
生活方式和与健康相关的因素是退伍军人认知老化风险的关键组成部分。由于痴呆症有一个漫长的前驱期，因此了解整个生命周期的影响可能有助于集中预防目标的时间和持续时间。这种观点对于退伍军人和健康行为尤其重要。服兵役可能会促进健康生活方式行为的发展和维持，但在现役结束后的直接时期可能是一个重要的过渡阶段，也是解决一些重要风险因素的机会。在一个干预措施中针对多个途径可能会使退伍军人的效率和效益最大化。最近对阿尔茨海默病可改变风险因素的综述估计，将包括糖尿病、高血压、肥胖、抑郁、身体不活动、吸烟和教育/认知不活动在内的七种可改变风险因素中的每一种降低 25%，可以预防全世界多达 300 万例病例和美国 49.2 万例病例。针对退伍军人心血管健康的生活方式干预措施可能是一个有用的模式，其中包括身体和认知活动成分、饮食干预和血管风险因素管理。尽管越来越多的证据表明生活方式和与健康相关的风险因素以及军事风险因素，但仍需要更多的研究来描述退伍军人中的这些因素，并研究它们之间的潜在相互作用。
