对阿尔茨海默病循证预防国际指南作了解读。概述了阿尔茨海默病预防的具体策略、人群差异、现状及前景。根据指南，通过健康的生活方式（包括体重管理、体育锻炼、认知活动、良好睡眠、远离烟草等），良好的共病管理（糖尿病、高血压、高同型半胱氨酸血症、心脑血管疾病、头部外伤、抑郁等），提高教育程度以及维生素C摄入等可以预防阿尔茨海默病的发病。
Recently, our paper entitled "evidense-based prevention of Alzheimer's disease" published in Journal of Neurology, Neurosurgery & Psychiatry (JNNP) has attached much attention. In this review, we will discuss the contents of this paper including the prevention strategies, the population difference, the current status and the future prospect of the AD, to guide the clinical practice of the AD primary prevention, such as the healthy lifestyles (the weight control, the physical exercise, the cognitive activity, sufficient and good quality sleep, and staying away from smoking), and the management of comorbidities (the diabetes, the high blood pressure, the hyperhomocysteinaemia, the cardiovascular disorders, the head trauma, and the depression), and it is shown that the high education and the vitamin C intake can reduce the incidence risk of the Alzheimer's disease (AD).
[1] Patterson C. The state of the art of dementia research:New frontiers[R]. London:Alzheimer's Disease International (ADI), 2018.
[2] Graham W V, Bonito-Oliva A, Sakmar T P. Update on Alzheimer's disease therapy and prevention strategies[J]. Annual Review of Medicine, 2017, 68(1):413-430.
[3] Daviglus M L. NIH consensus development conference statement on preventing Alzheimer's disease and cognitive decline office of the director[J]. NIH Consens State Sci Statements, 2010, 27(4):1-30.
[4] Norton S, Matthews F E, Barnes D E, et al. Potential for primary prevention of Alzheimer's disease:An analysis of population-based data[J]. The Lancet Neurology, 2014, 13(8):788-794.
[5] Yu J T, Xu W, Tan C C, et al. Evidence-based prevention of Alzheimer's disease:Systematic review and metaanalysis of 243 observational prospective studies and 153 randomised controlled trials[J]. Journal of Neurology, Neurosurgery & Psychiatry, 2020, 91(11):1201-1209.
[6] Guyatt G H, Oxman A D, Vist G E, et al. GRADE:An emerging consensus on rating quality of evidence and strength of recommendations[J]. BMJ, 2008, 336(7650):924-926.
[7] WHO. Global health risks:Mortality and burden of disease attributable to selected major risks[R]. Geneva:WHO, 2009.
[8] Ahmadi-Abhari S, Guzman-Castillo M, Bandosz P, et al. Temporal trend in dementia incidence since 2002 and projections for prevalence in England and Wales to 2040:Modelling study[J]. BMJ, 2017, 358:1-15.
[9] Mukadam N, Sommerlad A, Huntley J, et al. Population attributable fractions for risk factors for dementia in lowincome and middle-income countries:An analysis using cross-sectional survey data[J]. The Lancet Global Health, 2019, 7(5):e596-e603.
[10] Langa K M, Larson E B, crimmins E M, et al. Acomparison of the prevalence of dementia in the United States in 2000 and 2012[J]. JAMA Internal Medicine, 2017, 177(1):51-58.
[11] Patricia J M, Robert J H. Reducing risks for mental disorders:Frontiers for preventive intervention research[M]. Washington:National Academies Press, 1994.
[12] Livingston G, Sommerlad A, Orgeta V, et al. Dementia prevention, intervention and care[J]. The Lancet, 2017, 390(10113):2673-2734.
[13] Crous-Bou M, Minguillón C, Gramunt N, et al. Alzheimer's disease prevention:From risk factors to early intervention[J]. Alzheimer's Research and Therapy, 2017, 9(1):1-9.
[14] 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]. The Lancet, 2015, 385(9984):2255-2263.
[15] Kane R L, Butler M, Fink H A, et al. Interventions to prevent age-related cognitive decline, mild cognitive impairment, and clinical Alzheimer's-type dementia[J]. Comparative Effectiveness Reviews, 2017, 188(188):86-91.
[16] Andrieu S, Coley N, Lovestone S, et al. Prevention of sporadic Alzheimer's disease:Lessons learned from clinical trials and future directions[J]. The Lancet Neurology, 2015, 14(9):926-944.
[17] Wang J, Tan L, Yu J T. Prevention trials in Alzheimer's disease:Current status and future perspectives[J]. Journal of Alzheimer's Disease, 2016, 50(4):927-945.
[18] Feng L, Li J, Yu J T, et al. Editorial:Prevention of Alzheimer's disease in Chinese populations:Status, challenges and directions[J]. The Journal of Prevention of Alzheimer's Disease, 2018, 5(2):90-94.
[19] Yee A, Tsui N B Y, Chang Y N, et al. Alzheimer's disease:Insights for risk evaluation and prevention in the Chinese population and the need for acomprehensive programme in Hong Kong/China[J]. Hong Kong Medical Journal, 2018, 24(5):492-500.
[20] Yang L, Jin X Q, Yan J, et al. Comparison of prevalence and associated risk factors of cognitive function status among elderly between nursing homes andcommoncommunities of China:A STROBE-compliant observational study[J]. Medicine, 2019, 98(49):e18248.
[21] Kivimäki M, Luukkonen R, Batty G D, et al. Body mass index and risk of dementia:Analysis of individual-level data from 1.3 million individuals[J]. Alzheimer's and Dementia, 2018, 14(5):601-609.
[22] Solomon A, Mangialasche F, Richard E, et al. Advances in the prevention of Alzheimer's disease and dementia[J]. Journal of Internal Medicine, 2014, 275(3):229-250.
[23] Hsu D, Marshall G. Primary and secondary prevention trials in Alzheimer disease:Looking back, moving forward[J]. Current Alzheimer Research, 2017, 14(4):426-440.
[24] WHO. Risk reduction of cognitive decline and dementia:WHO guidelines[M]. Geneva:WHO, 2019.
