生命历程视角下认知障碍的风险因素管理:来自柳叶刀痴呆症委员会和最新的循证证据  

Risk factor management for cognitive impairment from a life-course perspective:evidence from the Lancet Commission on Dementia and latest evidence-based findings

作　　者：艾亚婷[1] 王云翠[1] 胡慧[1] Ai Yating;Wang Yuncui;Hu Hui(Hubei University of Chinese Medicine,Wuhan 430065,China)

机构地区：[1]湖北中医药大学,武汉430065

出　　处：《中华老年医学杂志》2025年第1期1-9,共9页Chinese Journal of Geriatrics

基　　金：国家自然科学基金(82405530,72374068,81973921);湖北省教育厅科学技术研究项目(B2023098)。

摘　　要：2024年《柳叶刀》痴呆症委员会更新了自2020年报告以来的新研究成果,为痴呆症预防、干预和护理提供了新的令人鼓舞的证据。本文深入探讨了报告中关于风险管理的主要内容。目前,较明确的认知障碍风险因素包括受教育程度较低、听力下降、高血压、吸烟、肥胖、抑郁症、缺乏身体活动、糖尿病、过量饮酒、创伤性脑损伤、社会孤立和空气污染,此外,视力障碍和高浓度低密度脂蛋白胆固醇也被新增入风险因素之列。本文对这14个明确的风险因素的最新循证证据及其潜在机制进行了梳理,提炼了预防认知障碍的潜在机制和贯穿生命历程的风险管理模型。通过消除这14个风险因素,理论上可预防高达45%的痴呆症。最后,我们对未来认知障碍风险因素管理和研究方向提出了展望与建议。The 2024 update of the Lancet Commission on Dementia synthesizes new research findings since the 2020 report,presenting promising evidence for the prevention,intervention,and care of dementia.This paper explored the key elements of risk factor management as delineated in the report.Currently recognized risk factors associated with cognitive impairment include less education,hearing loss,hypertension,smoking,obesity,depression,physical inactivity,diabetes,excessive alcohol consumption,traumatic brain injury,social isolation,and air pollution.Furthermore,the updated report identifies vision loss and elevated LDL cholesterol as significant contributors to cognitive decline.This article reviewed the most recent evidence-based findings and examines potential underlying mechanisms related to these 14 identified risk factors.It aims to extract strategies for preventing cognitive impairment and proposes a life-course model for managing these risks.Theoretically,addressing these 14 risk factors could avert up to 45%of dementia cases.The paper concluded with forward-looking recommendations for the effective management of cognitive impairment risk factors and outlines directions for future research.

关 键 词：认知障碍 风险因素 痴呆 循证 

分 类 号：R749.1[医药卫生—神经病学与精神病学]