摘要：Alzheimer’s disease (AD), the leading cause of dementia, has reached epidemic proportions, with majorsocial, medical and economical burdens. With no currently available curative treatments, both theWorld Health Organization and the G8 Dementia Summit recently identified dementia and ADprevention as a major public health priority. Dementia andADhave a wide range of risk factors (genetic,vascular/metabolic and lifestyle-related), which often co-occur and thus interact with each other.Previous intervention efforts aimed at preventing dementia and AD focused on the management ofsingle risk factors, with relatively modest findings. Also, the effect of risk factors depends on age atexposure, indicating that the timing of preventive interventions needs to be carefully considered. In viewof the complex multifactorial nature of AD, as well as its long pre-clinical (asymptomatic) phase,interventions simultaneously targeting multiple risk factors and disease mechanisms at an early stage ofthe disease are most likely to be effective. Three large European multidomain prevention trials havebeen launched with the goal of preventing cognitive decline, dementia and AD in older adults withdifferent risk profiles. Pharmacological trials are also shifting towards prevention of Alzheimerdementia, by targeting at-risk individuals prior to the onset of cognitive symptoms. The current reviewwill summarize and discuss the evidence on risk and protective factors from observational studies,ongoing lifestyle-related and pharmacological randomized controlled trials (RCTs), as well as futuredirections for dementia and AD prevention.
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