Beaumont Research Institute, Department of Neurology, Beaumont Health, Royal Oak, MI, USA.
J Alzheimers Dis. 2021;80(1):1-27. doi: 10.3233/JAD-201182.
There is an extensive literature relating to factors associated with the development of Alzheimer's disease (AD), but less is known about factors which may contribute to its progression. This review examined the literature with regard to 15 factors which were suggested by PubMed search to be positively associated with the cognitive and/or neuropathological progression of AD. The factors were grouped as potentially modifiable (vascular risk factors, comorbidities, malnutrition, educational level, inflammation, and oxidative stress), non-modifiable (age at clinical onset, family history of dementia, gender, Apolipoprotein E ɛ4, genetic variants, and altered gene regulation), and clinical (baseline cognitive level, neuropsychiatric symptoms, and extrapyramidal signs). Although conflicting results were found for the majority of factors, a positive association was found in nearly all studies which investigated the relationship of six factors to AD progression: malnutrition, genetic variants, altered gene regulation, baseline cognitive level, neuropsychiatric symptoms, and extrapyramidal signs. Whether these or other factors which have been suggested to be associated with AD progression actually influence the rate of decline of AD patients is unclear. Therapeutic approaches which include addressing of modifiable factors associated with AD progression should be considered.
有大量文献涉及与阿尔茨海默病（AD）发展相关的因素，但对于可能导致其进展的因素知之甚少。本综述通过 PubMed 检索，针对可能与 AD 的认知和/或神经病理学进展相关的 15 个因素进行了文献回顾。这些因素被分为潜在可改变的因素（血管危险因素、合并症、营养不良、教育水平、炎症和氧化应激）、不可改变的因素（发病年龄、痴呆家族史、性别、载脂蛋白 Eɛ4、遗传变异和基因调控改变）和临床因素（基线认知水平、神经精神症状和锥体外系体征）。尽管大多数因素的结果存在矛盾，但几乎所有研究都发现了 6 个因素与 AD 进展之间存在正相关关系：营养不良、遗传变异、基因调控改变、基线认知水平、神经精神症状和锥体外系体征。这些或其他被认为与 AD 进展相关的因素是否确实影响 AD 患者的衰退速度尚不清楚。应考虑采用包括针对与 AD 进展相关的可改变因素的治疗方法。
