随着老龄人口基数和比重增加,老年痴呆症已经对世界许多国家经济和社会可持续发展带来挑战,因而被WHO赋予全球公共卫生优先权.目前临床上尚无药物治愈痴呆症,但流行病学研究表明,在人一生不同阶段暴露于心血管危险因素及社会心理因素等明显影响晚年痴呆症发病的危险性,其中,吸烟、糖尿病和中青年期高血压、肥胖和高胆固醇等心血管危险因素可通过导致脑血管损害和神经退行性病变促使痴呆临床发病,而青少年期接受较高文化教育和成年期积极参加社交、体力和智力刺激活动等社会心理因素则可通过增加认知储存保持晚年认知功能.因此,理论上在人生不同阶段针对这些因素实施干预措施有可能延迟痴呆症发病年龄.近年来,国外人群干预研究初步显示,强化心血管危险因素监控、平衡饮食、体力锻炼和认知训练等多模干预方案有助于保持痴呆高危人群的认知功能.我国痴呆症人群干预对策研究亟待加强,需探索出适合我国人群特征的干预方案,为制定有效应对痴呆症挑战的国家行动计划提供依据.%As the number and proportion of aging population increase,dementia has posed tremendous challenges to the sustainable social and economic development of many countries in the world.Thus,dementia has been identified as a global public health priority.Clinically,there is currently no cure for dementia.However,in the past decades epidemiological research has suggested that cardiovascular risk factors and psychosocial factors over the life-course could significantly affect the risk of dementia occurrence later in life.Of these factors,smoking,diabetes,and midlife hypertension,obesity,and high cholesterol might contribute to the clinical onset of late-life dementia by causing cerebral macro-and microvascular damage and neurodegeneration,whereas high educational attainments in early life and social engagement,physical and mentally-stimulating activities during adulthoods might help maintain late-life cognitive function by increasing cognitive reserve.Thus,theoretically clinical onset of dementia is likely to be postponed by implementing interventions targeting these factors over the lifespan.In recent years,evidence from research in Europe and North America has emerged that multimodal interventions that consist of intensive control of cardiovascular risk factors,balanced diets,physical activity,and cognitive training may help maintain cognitive function among individuals at risk for dementia.We call that population intervention research against dementia should be strengthened in China.Identifying the intervention programmes against dementia that are effective specifically among Chinese population is of high relevance for developing the national dementia action plan,and thus effectively dealing with the huge challenges by dementia.
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