Department of Neurology, HealthPartners Neuroscience Center, St Paul, MN, USA; Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, USA.
Population Health Sciences, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA.
Lancet Healthy Longev. 2023 Jun;4(6):e274-e283. doi: 10.1016/S2666-7568(23)00051-X. Epub 2023 May 15.
Over the past several decades, a worldwide demographic transition has led to an increasing number of older adults with chronic neurological conditions. These conditions, which have a profound effect on the cognitive function and physical ability of older adults, also have a long preclinical phase. This feature provides a unique opportunity to implement preventive measures for high-risk groups and the population as a whole, and therefore to reduce the burden of neurological diseases. The concept of brain health has emerged as the overarching theme to define overall brain function independently of underlying pathophysiological processes. We review the concept of brain health from the ageing and preventive care perspectives, discuss the mechanisms underpinning ageing and brain ageing, highlight the interplay of various forces resulting in deviation from brain health towards brain disease, and provide an overview of strategies to promote brain health with a life-course approach.
在过去几十年中,全球人口结构发生了转变,导致患有慢性神经疾病的老年人数量不断增加。这些疾病对老年人的认知功能和身体能力有深远的影响,而且它们也有一个很长的临床前期。这一特征为高危人群和整个人群实施预防措施提供了独特的机会,从而减轻神经疾病的负担。大脑健康的概念已经出现,作为一个总体主题,用于定义独立于潜在病理生理过程的整体大脑功能。我们从老龄化和预防保健的角度来回顾大脑健康的概念,讨论支持老龄化和大脑老化的机制,强调导致大脑健康偏离到大脑疾病的各种力量的相互作用,并概述通过终生方法促进大脑健康的策略。