Cambridge Public Health, University of Cambridge, Cambridge, UK.
Epidemiology Research Unit, Caribbean Institute for Health Research, The University of the West Indies, Mona Campus, Kingston, Jamaica.
Alzheimers Dement. 2023 Jul;19(7):3203-3209. doi: 10.1002/alz.12985. Epub 2023 Feb 15.
Dementia is a leading global public health challenge. Prevention approaches have traditionally focused on individual-level strategies. However, such approaches have limited potential, particularly for resource-constrained populations in which exposure to risk factors is greatest, and exposure to protective factors is lowest. A population-level approach to dementia risk reduction is therefore essential to meet the scale of the challenge and to tackle global inequalities in risk and incidence of disease. Such approaches can be highly cost effective. In this viewpoint article, we describe what such an approach should look like, barriers and facilitators to success, and how we should go about achieving it. We include 10 strategic goals to achieve population-level dementia risk reduction and protection enhancement, targeted at researchers, professionals, funders, science communicators, governments, businesses, and policy makers. If we are to significantly reduce the prevalence of dementia there must be increased emphasis on population-level approaches. HIGHLIGHTS: Dementia risk reduction is a global public health priority Population-level approaches change societal conditions to make them less conducive to dementia's modifiable risk factors, and increase exposure to protective factors. Urgent development of population-level approaches is required to reduce the prevalence of, and inequalities in, dementia Action is required from researchers, governments and business, funders, public health professionals, and science communicators.
痴呆症是全球主要的公共卫生挑战之一。预防方法传统上侧重于个人层面的策略。然而，这种方法的潜力有限，特别是对于资源有限的人群，这些人群面临的风险因素最大，而面临的保护因素最低。因此，需要采取一种针对人群的方法来降低痴呆症风险，以应对挑战的规模，并解决全球疾病风险和发病率的不平等问题。这种方法可能非常具有成本效益。在这篇观点文章中，我们描述了这种方法应该是什么样子，成功的障碍和促进因素，以及我们应该如何实现它。我们包括了 10 个实现人群层面的痴呆症风险降低和保护增强的战略目标，针对研究人员、专业人员、资助者、科学传播者、政府、企业和政策制定者。如果我们要显著降低痴呆症的患病率，就必须更加重视人群层面的方法。 重点： 降低痴呆症风险是全球公共卫生的优先事项 人群层面的方法改变社会条件，使它们不太有利于痴呆症的可改变风险因素，并增加对保护因素的接触。 迫切需要制定人群层面的方法来降低痴呆症的患病率和不平等现象 研究人员、政府和企业、资助者、公共卫生专业人员和科学传播者都需要采取行动。
