Wen Boye, Han Xiaodong, Gong Jin, Wang Pin, Sun Wenxian, Xu Chang, Shan Aidi, Wang Xin, Luan Heya, Li Shaoqi, Li Ruina, Guo Jinxuan, Chen Runqi, Li Chuqiao, Sun Yao, Lv Sirong, Wei Cuibai
Innovation Center for Neurological Disorders and Department of Neurology, Xuanwu Hospital, Capital Medical University, National Clinical Research Center for Geriatric Diseases, Xicheng District, Beijing, China.
College of Integrated Traditional Chinese and Western Medicine, Changchun University of Chinese Medicine, Jingyue National High-tech Industrial Development Zone, Changchun, China.
Alzheimers Dement. 2025 Feb;21(2):e14547. doi: 10.1002/alz.14547. Epub 2025 Jan 27.
Alzheimer's disease (AD) is a degenerative disease characterized by progressive cognitive dysfunction. The strong link between nutrition and the occurrence and progression of AD pathology has been well documented. Poor nutritional status accelerates AD progress by potentially aggravating amyloid beta (Aβ) and tau deposition, exacerbating oxidative stress response, modulating the microbiota-gut-brain axis, and disrupting blood-brain barrier function. The advanced stage of AD tends to lead to malnutrition due to cognitive impairments, sensory dysfunctions, brain atrophy, and behavioral and psychological symptoms of dementia (BPSD). This, in turn, produces a vicious cycle between malnutrition and AD. This review discusses how nutritional factors and AD deteriorate each other from the early stage of AD to the terminal stages of AD, focusing on the potential of different levels of nutritional factors, ranging from micronutrients to diet patterns. This review provides novel insights into reducing the risk of AD, delaying its progression, and improving prognosis. HIGHLIGHTS: Two-fifths of Alzheimer's disease (AD) cases worldwide have been attributed to potentially modifiable risk factors. Up to ≈26% of community-dwelling patients with AD are malnourished, compared to 7%∼76% of institutionalized patients. Undernutrition effects the onset, progression, and prognosis of AD through multiple mechanisms. Various levels of nutritional supports were confirmed to be protective factors for AD via specific mechanisms.
阿尔茨海默病（AD）是一种以进行性认知功能障碍为特征的退行性疾病。营养与AD病理发生和进展之间的紧密联系已有充分记载。营养状况不佳可能通过加重β-淀粉样蛋白（Aβ）和tau蛋白沉积、加剧氧化应激反应、调节微生物群-肠道-脑轴以及破坏血脑屏障功能来加速AD进展。AD晚期由于认知障碍、感觉功能障碍、脑萎缩以及痴呆的行为和心理症状（BPSD）往往会导致营养不良。这反过来又在营养不良和AD之间产生恶性循环。本综述讨论了从AD早期到晚期营养因素与AD如何相互恶化，重点关注从微量营养素到饮食模式等不同水平营养因素的潜在作用。本综述为降低AD风险、延缓其进展以及改善预后提供了新的见解。要点：全球五分之二的阿尔茨海默病（AD）病例归因于潜在可改变的风险因素。与7%至76%的机构化患者相比，高达约26%的社区居住AD患者存在营养不良。营养不足通过多种机制影响AD的发病、进展和预后。通过特定机制证实，不同水平的营养支持是AD的保护因素。
