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<正>随着全球人口老龄化进展，认知功能衰退和痴呆的患病人数日益增多，给社会带来了巨大的负担[1]。如何预防认知衰退和痴呆已经成为了老年健康领域亟待解决的难题。《柳叶刀》2024年更新的痴呆防治专家委员会报道了14个可改变的痴呆风险因素，并且提出，如果能有效控制和消除这些风险因素，理论上有望使全球痴呆患病人数降低45%[2]。可见，从公共卫生视角，减少可改变的风险因素有望成为痴呆预防的关键策略。2015年《柳叶刀》发表了芬兰预防认知障碍和残疾的老年干预研究(FINGER)结果表明，为期两年的多种生活方式干预可以改善或维持高危老年人的认知能力[3]。自此，基于多种途径的生活方式干预措施受到全球广泛关注，全球FINGERS研究协作网(World-Wide FINGERS Network,WW-FINGERS)在多个国家推进研究，探索其控制认知衰退和预防痴呆的效果[4-5]。其中，在美国开展的US POINTER研究结果于2025年7月28日在加拿大多伦多召开的美国阿尔茨海默病协会国际学术会议公布，并同步发表在《美国医学会杂志》上[6]。
Abstract：[1] GBD 2019 Dementia Forecasting Collaborators. Estimation of the global prevalence of dementia in 2019 and forecasted prevalence in2050:an analysis for the Global Burden of Disease Study 2019[J].Lancet Public Health, 2022, 7(2):e105-e125. DOI:10.1016/S2468-2667(21)00249-8.
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[3] Ngandu T, Lehtisalo J, Solomon A, et al. A 2 year multidomain intervention of diet, exercise, cognitive training, and vascular risk monitoring versus control to prevent cognitive decline in at-risk elderly people(FINGER):a randomised controlled trial[J]. Lancet, 2015,385(9984):2255-2263. DOI:10.1016/S0140-6736(15)60461-5.
[4] Kivipelto M, Mangialasche F, Snyder HM, et al. World-Wide FINGERS Network:a global approach to risk reduction and prevention of dementia[J]. Alzheimers Dement, 2020, 16(7):1078-1094.DOI:10.1002/alz.12123.
[5] Rosenberg A, Mangialasche F, Ngandu T, et al. Multidomain interventions to prevent cognitive impairment, Alzheimer’s Disease, and Dementia:From FINGER to World-Wide FINGERS[J]. J Prev Alzheimer’s Dis, 2020, 7(1):29-36. DOI:10.14283/jpad.2019.41.
[6] Baker LD, Espeland MA, Whitmer RA, et al. Structured vs self-guided multidomain lifestyle interventions for global cognitive function:the US POINTER Randomized Clinical Trial[J]. JAMA,2025, 334(8):681-691. DOI:10.1001/jama.2025.12923.
[7] Jutten RJ, Papp KV, Hendrix S, et al. Why a clinical trial is as good as its outcome measure:a framework for the selection and use of cognitive outcome measures for clinical trials of Alzheimer’s disease[J].Alzheimers Dement, 2023, 19(2):708-720. DOI:10.1002/alz.12773.
[8] Weintraub S, Carrillo MC, Farias ST, et al. Measuring cognition and function in the preclinical stage of Alzheimer’s disease[J].Alzheimers Dement(N Y), 2018, 4:64-75. DOI:10.1016/j.trci.2018.01.003.
[9] Langbaum JB, Ellison NN, Caputo A, et al. The Alzheimer’s prevention initiative composite cognitive test:a practical measure for tracking cognitive decline in preclinical Alzheimer’s disease[J].Alzheimers Res Ther, 2020, 12(1):66. DOI:10.1186/s13195-020-00633-2.
[10] Jonaitis EM, Koscik RL, Clark LR, et al. Measuring longitudinal cognition:individual tests versus composites[J]. Alzheimers Dement(Amst), 2019, 11:74-84. DOI:10.1016/j.dadm.2018.11.006.
[11]张海峰，赵玫，季芳嫦，等.基于从业人员视角的认知功能训练工具优化需求质性研究：以《趣味健脑》为例[J].中华精神科杂志，2025,58(10):770-777. DOI:10.3760/cma.j.cn113661-20250109-00015.
[12] Harrison TM, Ward T, Taggett J, et al. The POINTER imaging baseline cohort:associations between multimodal neuroimaging biomarkers, cardiovascular health, and cognition[J]. Alzheimers Dement,2025, 21(1):e14399. DOI:10.1002/alz.14399.
[13] Baiyewu O. How valuable are ecopsychosocial interventions in prevention and treatment of dementia?[J]. Int Psychogeriatr, 2018,30(12):1739-1740. DOI:10.1017/S1041610218001837.
[14] Cations M, Radisic G, Crotty M, et al. What does the general public understand about prevention and treatment of dementia? A systematic review of population-based surveys[J]. PLoS One, 2018, 13(4):e0196085. DOI:10.1371/journal.pone.0196085.
[15] Wang Y, Han X, Zhang X, et al. Health status and risk profiles for brain aging of rural-dwelling older adults:data from the interdisciplinary baseline assessments in MIND-China[J]. Alzheimers Dement(N Y), 2022, 8(1):e12254. DOI:10.1002/trc2.12254.
[16] Walsh S, Wallace L, Kuhn I, et al. Are population-level approaches to dementia risk reduction under-researched? A rapid review of the dementia prevention literature[J]. J Prev Alzheimers Dis, 2024, 11(1):241-248. DOI:10.14283/jpad.2023.57.
基本信息:
中图分类号:R749.1
引用信息:
[1]王华丽,杜怡峰,仇成轩.多措并举生活方式干预与痴呆预防[J].中华老年心脑血管病杂志,2025,27(12):1743-1744.
2025-12-15
2025-12-15