Peters Ruth, Dodge Hiroko H, James Sarah, Jicha Gregory A, Meyer Pierre-Francois, Richards Marcus, Smith A David, Yassine Hussein N, Abner Erin, Hainsworth Atticus H, Kehoe Patrick G, Beckett Nigel, Anderson Craig S, Anstey Kaarin J
Neuroscience Research, Randwick, New South Wales, Australia.
Department of Psychology, University of New South Wales, Sydney, New South Wales, Australia.
Alzheimers Dement. 2022 Mar;18(3):507-512. doi: 10.1002/alz.12393. Epub 2021 Nov 2.
There is an urgent need for interventions that can prevent or delay cognitive decline and dementia. Decades of epidemiological research have identified potential pharmacological strategies for risk factor modification to prevent these serious conditions, but clinical trials have failed to confirm the potential efficacy for such interventions. Our multidisciplinary international group reviewed seven high-potential intervention strategies in an attempt to identify potential reasons for the mismatch between the observational and trial results. In considering our findings, we offer constructive recommendations for the next steps. Overall, we observed some differences in the observational evidence base for the seven strategies, but several common methodological themes that emerged. These themes included the appropriateness of trial populations and intervention strategies, including the timing of interventions and other aspects of trials methodology. To inform the design of future clinical trials, we provide recommendations for the next steps in finding strategies for effective dementia risk reduction.
迫切需要能够预防或延缓认知衰退和痴呆的干预措施。数十年的流行病学研究已确定了通过修改风险因素来预防这些严重病症的潜在药理学策略，但临床试验未能证实此类干预措施的潜在效果。我们的多学科国际小组审查了七种具有高度潜力的干预策略，试图找出观察性研究结果与试验结果之间存在差异的潜在原因。在考虑我们的研究结果时，我们为后续步骤提供了建设性建议。总体而言，我们观察到这七种策略在观察性证据基础上存在一些差异，但也出现了几个共同的方法学主题。这些主题包括试验人群和干预策略的适宜性，包括干预时机和试验方法的其他方面。为指导未来临床试验的设计，我们为寻找有效降低痴呆风险策略的后续步骤提供了建议。
