Zhou Bin
Translational Research Informatics Center, Foundation for Biomedical Research and Innovation, Kobe, Japan.
Curr Alzheimer Res. 2015;12(6):504-6. doi: 10.2174/1567205012666150530202923.
The incidence of dementia is rapidly increasing not only in developed countries but also in developing countries with rising aging populations. This trend is expected to worsen, with the number of cases possibly tripling in the coming decades. Over the last few decades, epidemiological studies have revealed that vascular-or lifestyle-related factors are associated with an increased risk of Alzheimer's disease (AD) and dementia. Researches into the pathophysiological processes of AD have revealed that the pathological brain lesions of AD begin decades before the onset of symptoms. Many prevention studies have indicated that physical activity and/or mental training can improve cognition and daily life in subjects with AD or mild cognitive impairment (MCI). However, issues with early detection and preclinical staging and effective preventive approaches that are based on these stages remain unresolved. Therefore, we propose different strategies for AD prevention based on its preclinical stages: one involves physical and mental training that targets the risk factors in subjects without pathophysiological changes, and the second approach combines nonpharmacological and pharmacological methods and aims to treat MCI in individuals with amyloid deposits and/or neurodegeneration with drugs that target the amyloid cascade. The results of several ongoing and promising trials are expected in the next few years.
痴呆症的发病率不仅在发达国家迅速上升，在老龄化人口不断增加的发展中国家也是如此。这种趋势预计会恶化，未来几十年病例数可能会增加两倍。在过去几十年里，流行病学研究表明，血管或生活方式相关因素与阿尔茨海默病（AD）和痴呆症风险增加有关。对AD病理生理过程的研究表明，AD的病理性脑损伤在症状出现前几十年就已开始。许多预防研究表明，体育活动和/或脑力训练可以改善AD或轻度认知障碍（MCI）患者的认知能力和日常生活。然而，早期检测和临床前分期问题以及基于这些阶段的有效预防方法仍未得到解决。因此，我们基于AD的临床前阶段提出了不同的预防策略：一种是针对没有病理生理变化的受试者的危险因素进行身心训练，第二种方法结合了非药物和药物方法，旨在用针对淀粉样蛋白级联反应的药物治疗有淀粉样蛋白沉积和/或神经退行性变的个体的MCI。预计未来几年将有几项正在进行且前景良好的试验结果。
