Alzheimer's disease can be prevented! 18 suggestions should be followed

Alzheimer's disease, also known as senile dementia, is characterized by the continuous deterioration of cognitive and memory functions, progressive decline in daily living ability, and various neuropsychiatric symptoms and behavioral disorders.

Professor Jia Jianping's team from Xuanwu Hospital reported in the Lancet Neurology sub-journal that China is estimated to have more than 10 million dementia patients, 31 million patients with mild cognitive impairment, and 9.5 million patients with post-stroke dementia, totaling more than 50 million people with dementia and cognitive impairment.

According to the China Disease Burden Report, over the past 11 years, the number of deaths due to Alzheimer's disease has increased by 57.8%, ranking fifth among all diseases.

More and more epidemiological studies have shown that Alzheimer's disease is preventable and that effective control of risk factors can significantly reduce the occurrence and development of Alzheimer's disease.

Recently, the clinical research team of Professor Yu Jintai from the Department of Neurology at Huashan Hospital Affiliated to Fudan University took the lead in organizing well-known scholars in this field at home and abroad to conduct a systematic review and meta-analysis of existing research evidence, which was published in the Journal of Neurology, Neurosurgery and Psychiatry, a subsidiary of the British Medical Journal (BMJ).

This study lasted more than five years and selected 243 observational prospective studies and 153 randomized controlled trials that met the criteria from 44,676 studies. 104 modifiable influencing factors and 11 intervention measures were systematically studied and meta-analyzed.

Based on this and in accordance with evidence-based medicine standards, 18 guideline recommendations for the prevention of Alzheimer's disease were put forward, nearly two-thirds of which are closely related to cardiovascular disease risk factors and lifestyle.

1. Maintain a healthy weight

People aged ≤65 years should maintain or lose weight by achieving and maintaining a body mass index between 18.5 and 24.9 through a balanced mix of physical activity, caloric intake, and a regular behavioral program.

People over 65 years old should not be too thin.

If people over 65 years old show a trend of weight loss, their cognitive function status should be closely monitored.

2. Get more physical exercise

Everyone, especially those over 65, should engage in regular physical exercise.

3 Cognitive activities

Engage in more stimulating mental activities, such as reading, playing chess, etc.

4. Quit smoking

Do not smoke and avoid exposure to tobacco smoke in the environment; smokers should quit smoking.

5. Get enough good sleep

6. Prevent and treat diabetes

Maintain a healthy lifestyle and avoid diabetes; people with diabetes should closely monitor their cognitive decline.

7. Prevent and treat cerebrovascular diseases

Maintain a healthy lifestyle, use medications appropriately, keep the cerebrovascular system in good condition, and avoid atherosclerosis, cerebral hypoperfusion or other cerebrovascular diseases;

For stroke patients, especially those with cerebral microbleeds, their cognitive function changes should be closely monitored, and effective preventive measures should be taken to protect their cognitive function.

8. Protect your head from trauma

9. Stay healthy and strong in old age

For people who are becoming increasingly frail, their cognitive status should be closely monitored.

10. Control blood pressure

People under 65 should maintain a healthy lifestyle to avoid developing high blood pressure.

Patients with orthostatic hypotension should be closely monitored for cognitive function.

11. Maintain a good mental state

Maintain good mental health; for patients who already have depressive symptoms, their cognitive function status should be closely monitored.

12 Preventing and treating atrial fibrillation

This journal has also found that providing appropriate anticoagulant therapy and maintaining a higher therapeutic window time can help prevent and delay the occurrence of cognitive dysfunction or dementia in patients with atrial fibrillation.

13. Relax and avoid mental stress

14 Get as much education as possible in your early years

15. Regularly test blood homocysteine ​​levels

Patients with hyperhomocysteinemia should be treated with vitamin B12 and/or folic acid and their cognitive function should be closely monitored.

Currently, homocysteine-lowering therapy is considered the most promising preventive measure.

16. Vitamin C Supplement

Dietary intake or supplemental vitamin C may help.

17 Estrogen replacement therapy is not recommended

Estrogen replacement therapy is not recommended for postmenopausal women to prevent Alzheimer's disease.

18 Acetylcholinesterase inhibitors are not recommended

Acetylcholinesterase inhibitors are not recommended for prevention of Alzheimer's disease in patients with cognitive impairment

The authors suggest that the combined application of multiple evidence-based clinical recommendations may be the best option for preventing Alzheimer's disease.

source:

[1]Yu JT, Xu W, Tan CC, et al. Evidence-based prevention of Alzheimer's disease: systematic review and meta-analysis of 243 observational prospective studies and 153 randomized controlled trials. J Neurol Neurosurg Psychiatry. 2020 Jul 20.

[2] Zeng Xinying, Qi Jinlei, Yin Peng, et al. Report on the disease burden in China and provincial administrative regions from 1990 to 2016. Chinese Journal of Circulation, 2018, 33:1147-1158.

[3]Jia L, et al. Dementia in China: epidemiology, clinical management, and research advances. Lancet Neurol. 2019 Sep 4. pii: S1474-4422(19)30290-X.

[3] Hui Xiang, Fan Qingqing, Xu Hang, et al. Meta-analysis of the effect of anticoagulant therapy on cognitive dysfunction or dementia in patients with atrial fibrillation. Chinese Journal of Circulation, 2019, 29: 1103-1109.

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