Johns Hopkins University, Baltimore, MD, USA.
Neurol Sci. 2019 Aug;40(8):1527-1540. doi: 10.1007/s10072-019-03863-x. Epub 2019 Apr 13.
Alzheimer's disease (AD) is the commonest cause of dementia, with approximately 5 million new cases occurring annually. Despite decades of research, its complex pathophysiology and etiopathogenesis presents a major hindrance to the development of an effective treatment and prevention strategy. Aging is the biggest risk factor for the development of AD, and the total number of older people in the population is going to significantly increase in the next decades, suggesting that AD incidence and prevalence is likely to increase in the future. This makes the need for a better understanding of the disease to be extremely urgent.
A search was done by accessing PubMed/Medline, EBSCO, and PsycINFO databases. The search string used was "(dementia* OR Alzheimer's) AND (pathophysiology* OR pathogenesis)". New key terms were identified (new term included "vitamin D, thyroid hormone, mitochondria dysfunction, oxidative stress, testosterone, estrogen, melatonin, progesterone, luteinizing hormone, amyloid-β (Aβ), and hyperphosphorylated tau"). The electronic databases were searched for titles or abstracts containing these terms in all published articles between January 1, 1965, and January 31, 2019. The search was limited to studies published in English and other languages involving both animal and human subjects.
Mitochondria dysfunction and oxidative stress play a critical role in AD etiopathogenesis and pathophysiology.
AD treatment and prevention strategies must be geared towards improving mitochondrial function and attenuating oxidative stress.
阿尔茨海默病（AD）是痴呆症最常见的病因，每年约有 500 万例新发病例。尽管经过几十年的研究，但其复杂的病理生理学和病因发病机制仍是开发有效治疗和预防策略的主要障碍。衰老 是 AD 发展的最大危险因素，且人口中老年人口的总数在未来几十年将显著增加，这表明 AD 的发病率和患病率未来可能会增加。这使得人们对这种疾病的了解变得极为紧迫。
通过访问 PubMed/Medline、EBSCO 和 PsycINFO 数据库进行搜索。使用的搜索字符串为“（痴呆或阿尔茨海默病）和（病理生理学或发病机制）”。确定了新的关键词（新术语包括“维生素 D、甲状腺激素、线粒体功能障碍、氧化应激、睾丸激素、雌激素、褪黑素、孕酮、黄体生成素、β淀粉样蛋白（Aβ）和过度磷酸化的 tau”）。在 1965 年 1 月 1 日至 2019 年 1 月 31 日期间，在所有已发表的文章的标题或摘要中搜索这些术语的电子数据库。搜索仅限于以英语和其他语言发表的涉及动物和人类受试者的研究。
线粒体功能障碍和氧化应激在 AD 的病因发病机制和病理生理学中起关键作用。
AD 的治疗和预防策略必须着眼于改善线粒体功能和减轻氧化应激。
