Graham Mackenzie, Rossor Martin, Lawlor Brian, Naci Lorina
Wellcome Centre for Ethics and Humanities, Oxford University, Oxford, UK.
Dementia Research Centre, University College London, London, UK.
J Alzheimers Dis. 2024 Dec;102(4):891-896. doi: 10.1177/13872877241292370. Epub 2024 Nov 8.
Research has shown that up to 40% of dementia incidence can be accounted for by 12 modifiable lifestyle risk factors. However, the predictive value of these risks factors at an individual level remains uncertain. Ethical considerations that are typically invoked with respect to the disclosure of individual research results-beneficence and non-maleficence, respect for autonomy, and justice-do not provide conclusive justification for, or against, disclosing modifiable risk factors for future dementia to cognitively unimpaired research participants. We argue for a different approach to evaluating the disclosure of individual-level modifiable risk factors for dementia. Rather than focusing on individual-level disease prediction and prevention, we suggest that disclosure should be evaluated based on the impact of behavioral and lifestyle changes on current brain health.
研究表明，高达40%的痴呆症发病率可归因于12种可改变的生活方式风险因素。然而，这些风险因素在个体层面的预测价值仍不确定。通常在披露个体研究结果时所援引的伦理考量——行善和不伤害、尊重自主性和公正——并未为向认知未受损的研究参与者披露未来痴呆症的可改变风险因素提供支持或反对的决定性理由。我们主张采用一种不同的方法来评估痴呆症个体层面可改变风险因素的披露。我们建议，披露不应侧重于个体层面的疾病预测和预防，而应基于行为和生活方式改变对当前大脑健康的影响来进行评估。
