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健康饮食、规律运动和更好的生活方式能否延缓老年人痴呆症的进展?

Can Healthy Diets, Regular Exercise, and Better Lifestyle Delay the Progression of Dementia in Elderly Individuals?

机构信息

Garrison Institute on Aging, Texas Tech University Health Sciences Center, Lubbock, TX, USA.

Internal Medicine Department, Texas Tech University Health Sciences Center, Lubbock, TX, USA.

出版信息

J Alzheimers Dis. 2019;72(s1):S37-S58. doi: 10.3233/JAD-190232.

Abstract

Alzheimer's disease (AD) is a progressive neurodegenerative disease characterized by memory loss and multiple cognitive impairments. Current healthcare costs for over 50 million people afflicted with AD are about $818 million and are projected to be $2 billion by 2050. Unfortunately, there are no drugs currently available that can delay and/or prevent the progression of disease in elderly individuals and in AD patients. Loss of synapses and synaptic damage are largely correlated with cognitive decline in AD patients. Women are at a higher lifetime risk of developing AD encompassing two-thirds of the total AD afflicted population. Only about 1-2% of total AD patients can be explained by genetic mutations in APP, PS1, and PS2 genes. Several risk factors have been identified, such as Apolipoprotein E4 genotype, type 2 diabetes, traumatic brain injury, depression, and hormonal imbalance, are reported to be associated with late-onset AD. Strong evidence reveals that antioxidant enriched diets and regular exercise reduces toxic radicals, enhances mitochondrial function and synaptic activity, and improves cognitive function in elderly populations. Current available data on the use of antioxidants in mouse models of AD and antioxidant(s) supplements in diets of elderly individuals were investigated. The use of antioxidants in randomized clinical trials in AD patients was also critically assessed. Based on our survey of current literature and findings, we cautiously conclude that healthy diets, regular exercise, and improved lifestyle can delay dementia progression and reduce the risk of AD in elderly individuals and reverse subjects with mild cognitive impairment to a non-demented state.

摘要

阿尔茨海默病(AD)是一种进行性神经退行性疾病,其特征是记忆力减退和多种认知障碍。目前,全球有超过 5000 万人患有 AD,其医疗费用约为 8.18 亿美元,预计到 2050 年将达到 20 亿美元。不幸的是,目前尚无药物可延缓和/或阻止老年人和 AD 患者疾病的进展。突触丧失和突触损伤与 AD 患者的认知能力下降密切相关。女性患 AD 的终身风险较高,占总 AD 患者的三分之二。只有约 1-2%的总 AD 患者可以通过 APP、PS1 和 PS2 基因突变来解释。已经确定了几种风险因素,如载脂蛋白 E4 基因型、2 型糖尿病、创伤性脑损伤、抑郁和激素失衡,与迟发性 AD 有关。强有力的证据表明,富含抗氧化剂的饮食和规律运动可以减少有毒自由基,增强线粒体功能和突触活动,改善老年人群的认知功能。目前对 AD 小鼠模型中抗氧化剂的使用以及老年人群饮食中抗氧化剂补充剂的使用进行了调查。还对 AD 患者随机临床试验中抗氧化剂的使用进行了批判性评估。根据我们对现有文献和发现的调查,我们谨慎地得出结论,健康的饮食、规律的运动和改善的生活方式可以延缓痴呆的进展,降低老年人患 AD 的风险,并使轻度认知障碍的患者恢复到非痴呆状态。

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