Desideri Giovambattista, Bocale Raffaella
Department of Life, Health and Environmental Sciences, University of L'Aquila, L'Aquila, Italy.
Division of Endocrine Surgery, "Agostino Gemelli" School of Medicine, University Foundation Polyclinic, Catholic University of the Sacred Heart, Rome, Italy.
Eur Heart J Suppl. 2021 Oct 8;23(Suppl E):E73-E76. doi: 10.1093/eurheartj/suab095. eCollection 2021 Oct.
The number of people suffering from dementia in the world is progressively increasing due to the expansion of the geriatric population in which this clinical condition is more frequent. The appearance of a variable degree of cognitive decline up to full-blown dementia does not, however, represent the inevitable fate of those who age, as the studies conducted in the centenarians clearly indicate. Indeed, the age-specific incidence of dementia has progressively decreased in many geographical areas, probably due to an improvement in lifestyles and health care. In fact, a growing number of scientific evidence shows how chronic exposure over the course of life, starting from young adulthood, to various risk factors-arterial hypertension, diabetes mellitus, obesity, tobacco smoke, sleep disorders-contribute significantly to the development of cognitive decline and dementia in the course of senescence. These risk factors, in fact, can trigger and amplify the various neuropathological mechanisms underlying the development of decline, progressively reducing the functional reserve of the brain. Although definitive evidence deriving from intervention studies is not currently available, it is legitimate to assert that the early control of cardiovascular risk factors can represent today the most effective tool for the prevention of dementia.
由于老年人口的增加,世界上患有痴呆症的人数正在逐渐增加,而这种临床疾病在老年人群中更为常见。然而,从轻度认知衰退到全面痴呆症的不同程度的出现,并不代表老年人的必然命运,正如对百岁老人进行的研究所明确表明的那样。事实上,在许多地理区域,痴呆症的年龄特异性发病率已逐渐下降,这可能是由于生活方式和医疗保健的改善。实际上,越来越多的科学证据表明,从年轻时起,一生中长期暴露于各种风险因素——动脉高血压、糖尿病、肥胖、吸烟、睡眠障碍——会显著促进衰老过程中认知衰退和痴呆症的发展。事实上,这些风险因素会触发并放大导致衰退的各种神经病理机制,逐渐减少大脑的功能储备。尽管目前尚无来自干预研究的确凿证据,但可以合理地断言,早期控制心血管风险因素如今可能是预防痴呆症最有效的工具。