Safouris Apostolos, Psaltopoulou Theodora, Sergentanis Theodoros N, Boutati Eleni, Kapaki Elisabeth, Tsivgoulis Georgios
Second Department of Neurology, National and Kapodistrian University of Athens, School of Medicine, Iras 39, Gerakas Attikis, Athens, 15344, Greece.
CNS Neurol Disord Drug Targets. 2015;14(2):257-69. doi: 10.2174/1871527314666150217123147.
Alzheimer's disease (AD) is the most common cause of dementia, accounting for more than half of cases with cognitive impairment. With numbers of patients expected to rise sharply over the following years in parallel with the ageing of population, there is intense clinical interest in discovering modifiable risk factors that may contribute to the increasing prevalence of AD. Accumulating data from in vitro and epidemiological studies have highlighted the vascular component of AD and raised hope that treatment of vascular risk factors could eventually lead to primary prevention of AD. Among all the possible pathologic processes that have been tested for an association with AD, diabetes, hypertension and dyslipidemia are the most prominent. Here, we will briefly review the data highlighting a potential correlation of these diseases with AD. Then, we will present observational studies and clinical trials that assessed the impact of their respective approved medical therapies on AD incidence. We conclude by providing clinical information for the physician on potentially effective and non-effective medical treatments. Further research is ongoing and time will show whether AD will cease to be considered a pure, non-preventable neurodegenerative process or whether vascular risk factor management may also result in primary AD prevention.
阿尔茨海默病（AD）是痴呆最常见的病因，占认知障碍病例的一半以上。随着未来几年患者数量预计将随着人口老龄化而急剧增加，人们对发现可能导致AD患病率上升的可改变风险因素产生了浓厚的临床兴趣。来自体外研究和流行病学研究的越来越多的数据突出了AD的血管成分，并带来了希望，即治疗血管危险因素最终可能导致AD的一级预防。在所有已测试与AD相关的可能病理过程中，糖尿病、高血压和血脂异常最为突出。在此，我们将简要回顾突出这些疾病与AD潜在相关性的数据。然后，我们将介绍评估各自批准的药物治疗对AD发病率影响的观察性研究和临床试验。我们通过为医生提供关于潜在有效和无效药物治疗的临床信息来得出结论。进一步的研究正在进行中，时间将表明AD是否将不再被视为纯粹的、不可预防的神经退行性过程，或者血管危险因素管理是否也可能导致AD的一级预防。
