Rakesh Gopalkumar, Szabo Steven T, Alexopoulos George S, Zannas Anthony S
Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, USA.
Department of Psychiatry, Weill Cornell Institute of Geriatric Psychiatry, Weill Cornell Medical College, White Plains, NY, USA.
Ther Adv Chronic Dis. 2017 Aug;8(8-9):121-136. doi: 10.1177/2040622317712442. Epub 2017 Jun 27.
Dementia is a common and debilitating syndrome with enormous impact on individuals and societies. Preventing disease onset or progression would translate to public health and societal benefits. In this review, we discuss the latest evidence on interventions that may show promise for the prevention of cognitive decline. We appraise existing evidence primarily drawn from randomized controlled trials, systematic reviews, and meta-analyses, but also highlight observational studies in humans and relevant work in model organisms. Overall, there is currently limited evidence to support a cause-effect relationship between any preventive strategy and the development or progression of dementia. However, studies to date suggest that a multifactorial intervention comprising regular exercise and healthy diet, along with the amelioration of vascular risk factors, psychosocial stress, and major depressive episodes may be most promising for the prevention of cognitive decline. We discuss the challenges, future directions, and implications of this line of research.
痴呆症是一种常见且使人衰弱的综合征,对个人和社会有着巨大影响。预防疾病的发生或进展将转化为公共卫生和社会效益。在本综述中,我们讨论了可能对预防认知衰退有前景的干预措施的最新证据。我们主要评估来自随机对照试验、系统评价和荟萃分析的现有证据,但也强调人类观察性研究和模式生物的相关研究。总体而言,目前支持任何预防策略与痴呆症发生或进展之间存在因果关系的证据有限。然而,迄今为止的研究表明,包括定期锻炼、健康饮食以及改善血管危险因素、心理社会压力和重度抑郁发作的多因素干预措施可能对预防认知衰退最有前景。我们讨论了这一研究方向的挑战、未来方向及意义。