这三个风险因素可能对痴呆症病例影响最大

Nearly half of all dementia cases in the U.S. 可能与十几个可改变的风险因素有关——最明显的是高血压, obesity and physical inactivity, according to new research. 研究结果表明，很大一部分痴呆病例是可以预防的, especially among Black and Hispanic adults, who had the highest percentage of combined risk factors.

“人们可以做一些事情来提高或降低患痴呆症的个人风险”, said Mark Lee, a PhD candidate at the University of Minnesota in Minneapolis. He led the study 该研究于周五在美国心脏协会的流行病学和预防会议上发表, Lifestyle and Cardiometabolic Health conference.

As the population ages, the number of dementia cases in the U.S. has been climbing. Currently about 5.8 million U.S. 成年人患有阿尔茨海默病和相关的痴呆症 Centers for Disease Control and Prevention. That number is expected to hit 14 million by 2060, with Black and Hispanic adults seeing the largest increases. Among Hispanic adults, cases are expected to rise sevenfold, while cases among aging Black adults are expected to quadruple.

黑人和西班牙裔人群的高发率可能是由于心脏病和糖尿病的高发率, which are linked to dementia risk. Social determinants of health – such as lower levels of education, 更高的贫困率和更大的歧视风险也发挥了作用.

先前的研究确定了12种可改变的风险因素，这些因素被认为是导致全球约40%痴呆症病例的原因. A 2020 report by the Lancet Commission listed these as lower education level, hearing loss, traumatic brain injury, high blood pressure, excessive alcohol consumption, obesity, smoking, depression, social isolation, not getting the recommended amount of physical activity, diabetes and air pollution.

In the new study, 研究人员想知道是否某些风险因素对痴呆症发病率的影响比其他因素更大，以及黑人之间的差异, Hispanic, Asian and white adults. 他们从疾病预防控制中心的国家健康和营养检查调查和其他五个数据集中收集数据.

Overall, 42.4% of dementia cases in the U.S. were attributable to the 12 factors, 三个与心脏有关的因素导致了种族间的风险. High blood pressure, also known as hypertension, contributed to 6.7% of those cases; obesity to 7%; and physical inactivity to 6.7%.

这三种风险因素导致的痴呆病例比例在黑人成年人中最高. 但所有12种风险因素加起来的比例在西班牙裔人群中最高. Asian people had the lowest percentage of combined risk factors.

在一篇完整的论文发表在同行评议的期刊上之前，研究结果被认为是初步的.

The findings, Lee said, 指出需要更好的策略来减少与心脏相关的风险因素, which would in turn reduce dementia risk population-wide.

This can, in part, be done through lifestyle changes, combined with medication as needed, said Priya Palta, 他是纽约市哥伦比亚大学欧文医学中心医学科学和流行病学助理教授.

“保持认知和身体活跃的生活方式，并从药物上控制风险因素水平, when necessary, 在一个人的整个生命历程中，大脑健康是至关重要的，可能会影响本研究中所研究的许多风险因素," said Palta, who was not involved in the research.

李说，下一步是确定哪种干预措施对减少12种可改变的痴呆风险因素最有效. 他还表示，需要对种族差异背后的健康社会决定因素进行更深入的调查, 比如黑人成年人中不成比例的高高血压率.

“如果我们真的想要实现卫生干预措施的公平性，这是一个非常重要的方向."

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