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通过危险因素治疗预防认知功能减退和痴呆

[Prevention of cognitive decline and dementia by treatment of risk factors].

作者信息

Escher Claus, Jessen Frank

机构信息

Klinik für Psychiatrie und Psychotherapie, Uniklinik Köln, Medizinische Fakultät, Kerpener Straße 62, 50937, Köln, Deutschland.

Deutsches Zentrum für neurodegenerative Erkrankungen (DZNE), Bonn, Deutschland.

出版信息

Nervenarzt. 2019 Sep;90(9):921-925. doi: 10.1007/s00115-019-0759-6.

Abstract

BACKGROUND

In Germany, approximately 1.6 million people are currently suffering from dementia. The prevalence of the disease is expected to double by 2060. To date there is no treatment that can prevent the onset of dementia. For this reason, the development of prevention strategies for cognitive decline and dementia is crucial.

OBJECTIVE

Presentation of studies on dementia prevention by treatment of arterial hypertension. Overview of current multidomain interventional studies on dementia prevention.

MATERIAL AND METHODS

Narrative review.

RESULTS

Whereas in three previous randomized controlled trials on antihypertensive treatment a reduction of dementia risk could not be found, the recent SPRINT-MIND study demonstrated a reduced risk of mild cognitive impairment (MCI) and in the trend for dementia by intensified hypotensive treatment. Multidomain interventional studies suggest preventive effects, particularly in specific risk groups and also highlight the challenge of adherence to lifestyle modifications.

CONCLUSION

The treatment of modifiable risk factors can have a preventive effects on cognitive decline and dementia. More research is needed to identify subgroups with the greatest likelihood of benefits.

摘要

背景

在德国,目前约有160万人患有痴呆症。预计到2060年,该疾病的患病率将翻倍。迄今为止,尚无能够预防痴呆症发病的治疗方法。因此,制定认知衰退和痴呆症的预防策略至关重要。

目的

介绍通过治疗动脉高血压预防痴呆症的研究。概述当前关于痴呆症预防的多领域干预研究。

材料与方法

叙述性综述。

结果

尽管此前三项关于抗高血压治疗的随机对照试验未发现痴呆风险降低,但最近的SPRINT-MIND研究表明,强化降压治疗可降低轻度认知障碍(MCI)风险,并呈降低痴呆症风险的趋势。多领域干预研究显示出预防效果,尤其是在特定风险群体中,同时也凸显了坚持生活方式改变的挑战。

结论

治疗可改变的风险因素对认知衰退和痴呆症具有预防作用。需要更多研究来确定最有可能受益的亚组。

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