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痴呆症的社会决定因素:一项范围综述。

Social determinants of dementia: A scoping review.

作者信息

Walsh Sebastian, Klee Matthias, Hui Esther K, Saeed Usman, Waters Sheena, Kuhn Isla, Siette Joyce, Orgeta Vasiliki, Stafford Jean, Smith Laura J, Tamburin Stefano, Jensen Daria E A, Mantovani Elisa, Chandra Avinash, James Sarah-Naomi, Tang Eugene Y H, Llewellyn David J, Foote Isabelle F, Chiesa Scott T, Geraets Anouk F J

机构信息

Cambridge Public Health, University of Cambridge, Forvie Site, Cambridge, UK.

Department of General Internal Medicine and Psychosomatics, University Medical Centre Heidelberg, Heidelberg, Germany.

出版信息

Alzheimers Dement. 2025 Jul;21(7):e70524. doi: 10.1002/alz.70524.

Abstract

Dementia risk is influenced by the social conditions in which people live. These social determinants of dementia (SDOD) are potential targets for prevention. We conducted a comprehensive scoping review to identify current evidence on SDOD in two stages: (1) review of systematic reviews on SDOD; and (2) review of primary literature to address identified gaps in the evidence base. Of the 3445 articles screened, 26 reviews and 74 primary studies were included. Evidence from reviews provide clear and consistent patterns for some SDOD (e.g., education, air pollution, socioeconomic status, ethnicity), while evidence for others is still emerging (e.g., housing quality/stability), or lacking entirely (e.g., incarceration). SDOD are important over the life course. Additional evidence is needed for understudied domains and to unravel the complex interactions between determinants, whilst education and air pollution stand out as key targets for public health interventions. HIGHLIGHTS: There is clear and consistent evidence for some social determinants of dementia (SDOD) across diverse domains. Evidence for other SDOD (e.g., housing, incarceration) is still emerging or lacking. Evidence for SDOD comes mainly from high-income countries. The complex intercorrelations between SDODs demand a nuanced analytical approach. Standardized measures and longer follow-up to study SDOD are recommended.

摘要

痴呆症风险受人们生活的社会环境影响。这些痴呆症的社会决定因素(SDOD)是预防的潜在目标。我们进行了一项全面的范围审查,分两个阶段确定关于SDOD的现有证据:(1)审查关于SDOD的系统评价;(2)审查原始文献以填补证据基础中已确定的空白。在筛选的3445篇文章中,纳入了26篇综述和74项原始研究。综述证据为一些SDOD(如教育、空气污染、社会经济地位、种族)提供了清晰一致的模式,而其他一些SDOD的证据仍在不断涌现(如住房质量/稳定性),或完全缺乏(如监禁)。SDOD在整个生命过程中都很重要。对于研究不足的领域以及揭示各决定因素之间复杂的相互作用,还需要更多证据,而教育和空气污染是公共卫生干预的关键目标。要点:在不同领域,对于一些痴呆症的社会决定因素(SDOD)有清晰一致的证据。其他SDOD(如住房、监禁)的证据仍在不断涌现或缺乏。SDOD的证据主要来自高收入国家。SDOD之间复杂的相互关联需要细致入微的分析方法。建议采用标准化措施并进行更长时间的随访来研究SDOD。

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