Hsu David, Marshall Gad A
Department of Neurology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, United States.
Alzheimer Research and Treatment, Brigham and Women's Hospital, 60 Fenwood Road, 9016P, Boston, MA 02115, United States.
Curr Alzheimer Res. 2017;14(4):426-440. doi: 10.2174/1567205013666160930112125.
The field of Alzheimer disease (AD) prevention has been a culmination of basic science, clinical, and translational research. In the past three years since the new 2011 AD diagnostic guidelines, large-scale collaborative efforts have embarked on new clinical trials with the hope of someday preventing AD. This review will shed light on the historical and scientific contexts in which these trials were based on, as well as discuss potential challenges these trials may face in the coming years. Primary preventive measures, such as lifestyle, multidomain, medication, and supplemental interventions, will be analyzed. Secondary prevention as represented by disease-modifying interventions, such as antiamyloid therapy and pioglitazone, will also be reviewed. Finally, hypotheses on future directions for AD prevention trials will be proposed.
阿尔茨海默病（AD）预防领域是基础科学、临床研究和转化研究的结晶。自2011年新的AD诊断指南发布后的过去三年里，大规模合作项目已开展了新的临床试验，希望有朝一日能预防AD。本综述将阐明这些试验所基于的历史和科学背景，并讨论这些试验在未来几年可能面临的潜在挑战。将分析一级预防措施，如生活方式、多领域、药物和补充干预措施。还将回顾以疾病修饰干预（如抗淀粉样蛋白疗法和吡格列酮）为代表的二级预防。最后，将提出关于AD预防试验未来方向的假设。
