Prevention strategies for Alzheimer's disease

被引：17
作者：
Gauthier S. [1 ,3 ]
Wu L. [2 ]
Rosa-Neto P. [1 ]
Jia J. [2 ]
机构：
[1] McGill Center for studies in Aging, McGill University, Montreal
[2] Neurological Department, Xuanwu Hospital, Capital University, Beijing
[3] McGill Centre for Studies in Aging (MCSA), McGill University, Montreal, QC, H4H 1R3, 6825, Boul. LaSalle Blvd
来源：
Translational Neurodegeneration | / 1卷 / 1期
基金：
中国国家自然科学基金;
关键词：
Alzheimer disease; Clinical practice; Clinical trial; Prevention; Risk factor;
D O I：
10.1186/2047-9158-1-13
中图分类号：
学科分类号：
摘要：
Symptomatic treatment during the dementia stage of Alzheimer's disease(AD) cannot delay or halt the progression of this disease. Therefore, prevention in the preclinical stage is likely the most effective way to decrease the incidence of this age-associated neurodegenerative condition, and its associated burden for individuals and society. Age, gender, family history, ApoE4, systolic blood pressure, body mass index, total cholesterol level and physical activity are all used as component of dementia risk score. There have been numerous challenges in conducting primary prevention trials in AD. Enrichment strategies for prevention studies include studying those subjects with more risk factors for AD, such as older age, those with a positive family history of late onset AD, and those who are ApoE4 positive. Each of these strategies is designed to increase the probability of developing AD thereby decreasing the sample size or the duration of follow up. Another strategy would be to target directly the pathophysiology of AD in its preclinical stages and use the biomarkers in prevention trial as surrogate markers. This will be done first in carriers of dominantly inherited early onset AD. As this research takes place networks of memory clinics must prepare to transfer new knowledge to persons interested in a preventive approach to AD. © 2012 Gauthier et al.; licensee BioMed Central Ltd.
引用
收藏
相关论文
共 31 条
[1]  
Ballard C., Gauthier S., Corbett A., Brayne C., Aarsland D., Jones E., Alzheimer's disease, Lancet, 377, pp. 1019-1031, (2011)
[2]  
Mangialasche F., Solomon A., Winblad B., Mecocci P., Kivipelto M., Alzheimer's disease: clinical trials and drug development, Lancet Neurol, 9, pp. 702-716, (2010)
[3]  
Khachaturian Z.S., Petersen R.C., Gauthier S., Buckholtz N., Corey-Bloom J.P., Evans B., Et al., A roadmap for the prevention of dementia: the inaugural Leon Thal Symposium, Alzheimer's & dementia : the journal of the Alzheimer's Association, 4, pp. 156-163, (2008)
[4]  
Kivipelto M., Helkala E.L., Laakso M.P., Hanninen T., Hallikainen M., Alhainen K., Et al., Apolipoprotein E epsilon4 allele, elevated midlife total cholesterol level, and high midlife systolic blood pressure are independent risk factors for late-life Alzheimer disease, Ann Intern Med, 137, pp. 149-155, (2002)
[5]  
Kivipelto M., Ngandu T., Laatikainen T., Winblad B., Soininen H., Tuomilehto J., Risk score for the prediction of dementia risk in 20 years among middle aged people: a longitudinal, population-based study, Lancet Neurol, 5, pp. 735-741, (2006)
[6]  
Poirier J., Davignon J., Bouthillier D., Kogan S., Bertrand P., Gauthier S., Apolipoprotein E polymorphism and Alzheimer's disease, Lancet, 342, pp. 697-699, (1993)
[7]  
Reisberg B., Gauthier S., Current evidence for subjective cognitive impairment (SCI) as the pre-mild cognitive impairment (MCI) stage of subsequently manifest Alzheimer's disease, Int Psychogeriatr, 20, pp. 1-16, (2008)
[8]  
Vellas B., Andrieu S., Cantet C., Dartigues J.F., Gauthier S., Long-term changes in ADAS-cog: what is clinically relevant for disease modifying trials in Alzheimer?, J Nutr Health Aging, 11, pp. 338-341, (2007)
[9]  
Jack C.R., Knopman D.S., Jagust W.J., Shaw L.M., Aisen P.S., Weiner M.W., Et al., Hypothetical model of dynamic biomarkers of the Alzheimer's pathological cascade, Lancet Neurol, 9, pp. 119-128, (2010)
[10]  
Sperling R.A., Aisen P.S., Beckett L.A., Bennett D.A., Craft S., Fagan A.M., Et al., Toward defining the preclinical stages of Alzheimer's disease: recommendations from the National Institute on Aging-Alzheimer's Association workgroups on diagnostic guidelines for Alzheimer's disease, Alzheimer's & dementia : the journal of the Alzheimer's Association, 7, pp. 280-292, (2011)
1234