AD危险因素及干预因素.ppt

AD的危险因素与干预运动锻炼与AD关系 目的：whether an activity specific exercise program could improve ability to perform basic mobility activities in long-term care residents with AD.方式：An activity specific exercise program was compared to a walking program and to an attention control.评估方法：assessed using the subscales of the Acute Care Index of Function;functional mobility was measured using the 6-Minute Walk test.The program was designed to be implemented 5 times per week by a nursing assistant or family member under the supervision of a physical therapist.this study suggest that walking programs may not be sufficient to improve mobility limitations in individuals who are dependent in transfers and support the benefit of a targeted,simple exercise program in reducing mobility limitations in institutionalized patients with moderate to severe cognitive impairment.-A Randomized Controlled Trial of an Activity Specific Exercise Program for Individuals With Alzheimer Disease in Long-term Care Settings.J Geriatr Phys Ther 2011;34:50-56.regular leisure exercise may decrease the risk of developing dementia in late-life-APOE 4 allele,cognitive dysfunction,and obstructive sleepapnea in children.Neurology.2007;69(3):243-9.Vascular Factors与AD 高血压:There is fairly robust evidence linking midlife hypertension to the development of dementia in later life.individuals with raised systolic blood pressure(160 mm Hg)at midlife had a significantly higher risk of AD later in life-Midlife vascular risk factors and Alzheimers disease in later life:longitudinal,population based study.Brit Med J.2001;322:1447-51.cerebrovascular atherosclerosis and increased burden of subcortical white matter lesions commonly found in AD.卒中或TIA增加发生AD：The risk of developing AD,and not merely vascular dementia,is significantly increased in individuals with stroke or transient ischemic attacks-The role of cerebral ischemia in Alzheimers disease.Neurobiol Aging.2000;21:321-30.Cerebral hypoxia accruing from sleep apnea has been linked toAD-Midlife respiratory function and incidence of Alzheimers disease:A29-year longitudinal study in women.Neurobiol Aging.2007;28(3):343-50.营养、饮食与AD“Mediterranean”diet:The diet has recently been linked to a reduced risk of late-life cognitive decline123,124,MCI,AD,and conversion from MCI to AD-Mediterranean diet and mild cognitive impairment.Arch Neurol.2009;66(2):216-25.Omega-3 fatty acids:large observational studies support the notion that fish consumption,a major source of omega-3 fatty acids,may substantially diminish the risk of AD and other dementias-Donepezil and vitamin E in the treatment of mild cognitive impairment.N Engl J Med.2005;352:2379-88.Thiamine(Vitamin B1)：Thiamine deficiency has been linked to AD in some studies-Thiamine and Alzheimers disease:a pilot study.Arch Neurol.1988;45(8):833-5.Coffee:Several studies have found that coffee consumption at midlife is associated with a decreased risk of dementia/AD later in life-Alzheimers disease and coffee:a quantitative review.Neurol Res.2007;29(1):91-5(5).Alcohol:consumption of moderate quantities of red wine(250-500 mL/day)was associated with a lower risk of AD(RR,0.53)and all-cause dementia(RR,0.56)-Nutritional factors and risk of incident dementia in the PAQUID longitudinal cohort.J Nutr Health Aging.2004;8(3):150-4.Vitamins C and E:Low blood levels of folic acid and increased plasma homocysteine have been posited as risk factors for the development of AD and dementia.The accelerated rate of brain atrophy in elderly with mild cognitive impairment can be slowed by treatment with homocysteine-lowering B vitamins.-Homocysteine-lowering by B vitamins slows the rate of accelerated brain atrophy in mild cognitive impairment:a randomized controlled trial.PLoS One.2010 Sep 8;5(9):e12244.Workplace/environmental exposures环境/工作场所暴露 Heavy Metals:Exposure to heavy metals has been associated with cognitive deficits and AD.retained cumulative dose of iron resulting from previous environmental exposure was associated with lower test scores in seven cognitive domains.Some studies have linked aluminum exposure in drinking water to increased risk of AD104,though this topic remains controversial.-Aluminium as a risk factor in Alzheimers disease,with emphasis on drinking water.Brain Res Bull.2001;55(2):187-96.Pesticides/herbicides:exposure to fumigants or defoliants significantly increased the incidence of AD-Risk factors for Alzheimers disease:a population-based,longitudinal study in Manitoba,Canada.Int J Epidemiol.2001;30:590-7.药物与AD Nonsteroidal anti-inflammatory drugs(NSAIDs):there is currently insufficient evidence to recommend prescribing NSAIDs for the specific intention of reducing the risk of dementia or AD-Primary prevention of dementia.Alzheimers Dementia.2007;3(4):348-54.社会因素与AD Social Stimulation:loneliness,defined as the feeling of being disconnected from others,may increase risk of late-life dementia and rates of cognitive decline in the elderly-Loneliness and risk of Alzheimer disea