Preventing Alzheimer's Disease: What Do We Know?

Changes in the brain occur many years before the first symptoms of Alzheimer’s disease appear.

在阿尔茨海默病的最初症状出现之前很多年，大脑就发生了变化。

These early brain changes point to a possible window of opportunity to prevent or delay memory loss and other symptoms of dementia.

这些早期大脑变化为预防或延缓记忆丧失和其他痴呆症状提供了可能的机会。

While nothing has been proven yet to prevent Alzheimer’s, researchers have identified promising strategies and are learning more about what might — and might not — work.

虽然目前还没有任何证据证明可以预防阿尔茨海默病，但研究人员已经找到了有希望的策略，并且正在更多地了解哪些可能有效，哪些可能无效。

A 2017 review of research looked carefully at the evidence from clinical research on ways to prevent, delay, or slow Alzheimer’s and mild cognitive impairment (MCI) or delay or slow age-related cognitive decline .

2017 年的一项研究回顾仔细研究了临床研究的证据，探讨了预防、延缓或减缓阿尔茨海默病和轻度认知障碍 (MCI) 或延缓或减缓与年龄相关的认知衰退的方法。

Clinical trials are often considered to be the “gold standard” for providing the strongest level of evidence that a treatment or medical approach works.

临床试验通常被认为是提供治疗或医疗方法有效的最强证据的“黄金标准”。

Led by a committee of experts from the National Academies of Sciences, Engineering, and Medicine (NASEM), the review found “encouraging but inconclusive” evidence for three types of interventions: blood pressure management in people with high blood pressure, increased physical activity, and cognitive training.

该审查由美国国家科学、工程和医学院 (NASEM) 的专家委员会领导，发现了三种干预措施的“令人鼓舞但不确定”的证据：高血压患者的血压管理、增加体力活动和认知训练。

Within the context of this study, this meant that the three areas showed promise, but more results from clinical trials would be needed to determine whether these interventions could help prevent these conditions.

在这项研究的背景下，这意味着这三个领域显示出希望，但需要更多的临床试验结果来确定这些干预措施是否有助于预防这些疾病。

Researchers are also continuing to explore other possible preventive and risk reduction strategies, including certain foods and diets , diabetes management , sleep quality interventions, and hearing restorative devices , for which we have some but not as much evidence.

研究人员还在继续探索其他可能的预防和降低风险策略，包括某些食物和饮食、糖尿病管理、睡眠质量干预措施和听力恢复设备，对此我们有一些但不那么多的证据。

The video below highlights conclusions and recommendations from the NASEM review, and the following sections go into more depth on what we know about the most promising interventions to date.

下面的视频重点介绍了 NASEM 审查的结论和建议，以下部分将更深入地介绍我们所了解的迄今为止最有希望的干预措施。

Controlling high blood pressure is known to reduce a person's risk for heart disease and stroke , and it also might help prevent or delay Alzheimer's.

众所周知，控制高血压可以降低患心脏病和中风的风险，还可能有助于预防或延缓阿尔茨海默病。

High blood pressure, particularly in midlife, is considered a risk factor for later-life cognitive decline.

高血压，尤其是中年时期的高血压，被认为是晚年认知能力下降的危险因素。

A large, multiyear clinical trial called SPRINT-MIND (Systolic Blood Pressure Intervention Trial: Memory and Cognition in Decreased Hypertension) looked at the effects of lowering blood pressure in more than 8,000 older adults who were 50 years or older and at high risk for cardiovascular disease.

一项名为 SPRINT-MIND（收缩压干预试验：降低高血压中的记忆和认知）的大型、多年临床试验研究了降低血压对 8,000 多名 50 岁或以上且心血管疾病高风险老年人的影响。

Results showed that lowering systolic blood pressure (i.e., the “top” blood pressure number) to below 120 mmHg, rather than the standard 140 mmHg, significantly reduced the risk of MCI.

结果显示，将收缩压（即“最高”血压值）降低至 120 mmHg 以下，而不是标准的 140 mmHg，可以显着降低 MCI 的风险。

Further, brain scans also showed that this intensive lowering slowed the buildup of white matter lesions — abnormal changes in the brain associated with dementia.

此外，脑部扫描还显示，这种强烈的降低速度减缓了白质病变的形成——与痴呆症相关的大脑异常变化。

In a study that reviewed data from six individual community-based cohorts, researchers examined the long-term data (average follow-up between seven and 22 years) from roughly 31,000 adults over age 55 that provided further evidence to support the potential of this strategy.

在一项审查来自六个单独社区队列的数据的研究中，研究人员检查了大约 31,000 名 55 岁以上成年人的长期数据（平均随访 7 至 22 年），为支持这一策略的潜力提供了进一步的证据。

The study results showed that managing high blood pressure with blood pressure medication reduced the risk of dementia to the level of a person with normal blood pressure not on blood pressure medication.

研究结果表明，使用降压药物控制高血压可以将患痴呆症的风险降低到血压正常但不服用降压药物的人的水平。

However, an observational study of more than 17,000 adults showed that higher systolic blood pressure (particularly at about 185 mmHg) was associated with a lower risk of dementia among those age 60 to 70, which is inconsistent with the findings from SPRINT-MIND.

然而，一项针对 17,000 多名成年人的观察性研究表明，60 至 70 岁人群中较高的收缩压（尤其是约 185 mmHg）与较低的痴呆风险相关，这与 SPRINT-MIND 的研究结果不一致。

Among those 75 years and older, data showed what’s called a U-shaped association, in which both high and low blood pressure were associated with lower risk.

在 75 岁及以上的人群中，数据显示出所谓的 U 形关联，即高血压和低血压都与较低的风险相关。

These findings and others point to the need for further research in how blood pressure levels relate to dementia risk at different ages, as well as cardiovascular risk factors.

这些发现和其他发现表明需要进一步研究血压水平与不同年龄的痴呆风险以及心血管危险因素之间的关系。

While research continues, experts recommend that people control high blood pressure to lower their risk of other serious health problems.

在研究仍在继续的同时，专家建议人们控制高血压，以降低患其他严重健康问题的风险。

Learn more about ways to control your blood pressure .

了解更多有关控制血压的方法。

Researchers need volunteers to take part in the hundreds of active clinical trials and studies that are testing ways to better understand, diagnose, treat, and prevent Alzheimer’s.

研究人员需要志愿者参与数百项活跃的临床试验和研究，这些试验和研究正在测试更好地理解、诊断、治疗和预防阿尔茨海默病的方法。

Researchers need people of different ages, sexes, races, and ethnicities to ensure that their studies apply to wide groups of people.

研究人员需要不同年龄、性别、种族和民族的人，以确保他们的研究适用于更广泛的人群。

By joining a study, you can learn more about Alzheimer’s and help researchers learn more about causes and risk factors for the disease.

通过加入研究，您可以更多地了解阿尔茨海默病，并帮助研究人员更多地了解该疾病的原因和风险因素。

People often wonder if a certain diet or specific foods can help prevent Alzheimer’s.

人们常常想知道某种饮食或特定食物是否有助于预防阿尔茨海默病。

The NASEM review of research did not find enough evidence to recommend a certain diet, but some healthy eating patterns and diets have been associated with cognitive benefits.

NASEM 的研究审查没有找到足够的证据来推荐某种饮食，但一些健康的饮食模式和饮食与认知益处有关。

Learn more at What Do We Know About Diet and Prevention of Alzheimer’s Disease?

了解更多信息，请参阅我们对饮食和阿尔茨海默氏病的预防了解多少？

Physical activity has many health benefits, such as reducing falls , maintaining mobility and independence, and promoting heart health.

身体活动对健康有很多好处，例如减少跌倒、保持活动能力和独立性以及促进心脏健康。

It reduces the risk of depression , diabetes , high blood pressure , and stroke — health conditions that can contribute to age-related cognitive decline.

它可以降低患抑郁症、糖尿病、高血压和中风的风险，这些健康状况可能导致与年龄相关的认知能力下降。

Years of animal and human observational studies suggest that exercise may help with brain health and cognitive performance, or how well you think, learn, and remember.

多年的动物和人类观察研究表明，运动可能有助于大脑健康和认知能力，或者改善你的思考、学习和记忆能力。

No clear link between physical activity and preventing Alzheimer’s has been documented .

体力活动与预防阿尔茨海默病之间没有明确的联系。

However, preliminary research findings suggest that physical activity may help reduce the risk of age-related cognitive decline.

然而，初步研究结果表明，体力活动可能有助于降低与年龄相关的认知能力下降的风险。

One study compared cognitive performance in 454 older adults two years prior to death, on average at age 90, and found that higher levels of physical activity were associated with better cognitive function , even after accounting for signs of Alzheimer’s in participants’ brain tissue.

一项研究比较了 454 名老年人在死亡前两年（平均年龄为 90 岁）的认知表现，发现较高水平的体力活动与更好的认知功能相关，即使在考虑了参与者脑组织中阿尔茨海默病的迹象后也是如此。

In another study of 1,159 adults age 65 and older that included participants with high levels of tau protein (a hallmark of Alzheimer’s), those who engaged in more physical activity had a slower rate of cognitive decline .

另一项对 1,159 名 65 岁及以上成年人进行的研究中，参与者中含有高水平的 tau 蛋白（阿尔茨海默氏症的标志），结果发现，从事更多体力活动的人认知能力下降速度较慢。

While there is not enough evidence from clinical trials to conclude that exercise can prevent or slow MCI or Alzheimer’s, some studies suggest that it may help delay or slow age-related cognitive decline.

虽然临床试验没有足够的证据表明运动可以预防或减缓 MCI 或阿尔茨海默病，但一些研究表明，它可能有助于延缓或减缓与年龄相关的认知能力下降。

For example, one study compared aerobic exercise, such as brisk walking or running on a treadmill, to stretching and balance exercises in 65 participants age 50 to 89 with MCI and prediabetes .

例如，一项研究对 65 名年龄在 50 岁至 89 岁之间患有 MCI 和糖尿病前期的参与者进行了有氧运动（例如快走或在跑步机上跑步）与伸展和平衡运动的比较。

After six months, the aerobic group had better executive function — the ability to plan and organize — than the stretching/balance group, but not better short-term memory.

六个月后，有氧运动组比拉伸/平衡组具有更好的执行功能（计划和组织能力），但短期记忆并没有更好。

Researchers continue to explore physical activity as a possible way to help prevent or delay Alzheimer’s.

研究人员继续探索体育活动作为帮助预防或延缓阿尔茨海默氏症的可能方法。

Many questions remain, including whether physical activity can prevent dementia, which types of physical activity, how much, and how often.

仍然存在许多问题，包括体力活动是否可以预防痴呆症、体力活动的类型、活动量和频率。

In the meantime, it’s safe to say that experts already encourage exercise for its many benefits.

与此同时，可以肯定地说，专家们已经鼓励锻炼，因为锻炼有很多好处。

Read more about exercise and physical activity for older adults or watch a video on the progress of research on exercise and brain health .

阅读有关老年人锻炼和身体活动的更多信息，或观看有关锻炼和大脑健康研究进展的视频。

Hearing loss has been linked to greater risk of developing dementia.

听力损失与患痴呆症的风险增加有关。

A recent analysis of several studies found that people who used hearing restorative devices (such as hearing aids and cochlear implants ) had a lower risk of long-term cognitive decline compared to people with uncorrected hearing loss.

最近对多项研究的分析发现，与未矫正听力损失的人相比，使用听力恢复设备（例如助听器和人工耳蜗）的人长期认知能力下降的风险较低。

Additionally, a recent clinical trial showed that use of hearing aids reduced the rate of cognitive decline in older adults who were at higher risk for dementia.

此外，最近的一项临床试验表明，使用助听器可以降低患痴呆症风险较高的老年人认知能力下降的速度。

Learn more about hearing loss, its health effects, and devices to help .

了解有关听力损失、其健康影响以及提供帮助的设备的更多信息。

There is evidence suggesting cognitive training may help delay or slow age-related cognitive decline.

有证据表明认知训练可能有助于延缓或减缓与年龄相关的认知能力下降。

Cognitive training involves structured activities designed to enhance memory, reasoning, and speed of processing.

认知训练涉及旨在增强记忆、推理和处理速度的结构化活动。

Studies, such as the Advanced Cognitive Training for Independent and Vital Elderly (ACTIVE) clinical trial, have shown that specific cognitive training can improve cognitive performance.

独立和活力老年人高级认知训练（ACTIVE）临床试验等研究表明，特定的认知训练可以提高认知表现。

ACTIVE was a large clinical trial which found that cognitive training improved the abilities of healthy older adults over age 65 (with an average age of 73 years at the start of the study), in the area in which they were trained: memory, reasoning, or speed of processing.

ACTIVE 是一项大型临床试验，发现认知训练提高了 65 岁以上健康老年人（研究开始时平均年龄为 73 岁）在接受训练的领域的能力：记忆、推理或处理速度。

Improvements remained in reasoning and speed of processing up to 10 years after the training was completed.

训练完成后长达 10 年，推理和处理速度仍然保持着进步。

It is still unknown whether the long-term benefits of cognitive training can help enable older people to live independently longer.

目前尚不清楚认知训练的长期益处是否可以帮助老年人延长独立生活的时间。

A separate analysis of 215 cognitive training clinical trials involving roughly 12,500 older adults showed that cognitive training improved cognition in cognitively healthy older adults and in those who have MCI.

对涉及约 12,500 名老年人的 215 项认知训练临床试验的单独分析表明，认知训练可以改善认知健康的老年人和患有轻度认知障碍 (MCI) 的老年人的认知能力。

Additionally, participants who received training in multiple cognitive areas also improved in cognitive areas in which they had not received training.

此外，接受多个认知领域培训的参与者在未接受培训的认知领域也有所改善。

Cognitive training areas included memory, reasoning, speed of processing, executive functioning, everyday functioning, and general knowledge.

认知训练领域包括记忆、推理、处理速度、执行功能、日常功能和常识。

Despite the promise of cognitive training, important questions remain around what types and aspects of trainings may be effective and how long the benefits last.

尽管认知训练前景广阔，但关于哪些类型和方面的培训可能有效以及效果能持续多久，仍然存在一些重要问题。

Be wary of claims that playing certain computer and online games can improve your memory and other types of thinking.

警惕玩某些电脑和在线游戏可以提高记忆力和其他思维能力的说法。

There is currently not enough evidence available to suggest that any of the commercially offered computer-based brain training applications have the same impact on cognitive abilities as those seen in clinical trials.

目前没有足够的证据表明任何商业提供的基于计算机的大脑训练应用程序对认知能力的影响与临床试验中所见的影响相同。

NIA and other organizations are supporting research to determine whether different types of cognitive training may have lasting effects.

NIA 和其他组织正在支持研究，以确定不同类型的认知训练是否可能产生持久影响。

Informal or unstructured cognitively stimulating activities, such as reading, may offer cognitive benefits, as well, according to findings from long-term observational studies.

根据长期观察研究的结果，非正式或非结构化的认知刺激活动（例如阅读）也可能带来认知益处。

For example, a study of nearly 2,000 cognitively normal adults 70 and older found that playing games and engaging in craft, computer, and social activities were associated with a lower risk of MCI.

例如，一项针对近 2,000 名 70 岁及以上认知正常成年人的研究发现，玩游戏以及参与手工、计算机和社交活动与较低的 MCI 风险相关。

The same research group also found that playing games and engaging in social activities in both midlife and late life and having a higher number of mentally stimulating activities in late life were associated with reduced MCI risk.

该研究小组还发现，中年和晚年玩游戏和参加社交活动以及晚年进行更多的精神刺激活动与降低 MCI 风险相关。

Furthermore, an analysis of 19 cognitive leisure activity studies showed a link between participation in unstructured cognitively stimulating activities and a reduced risk of cognitive impairment and dementia.

此外，对 19 项认知休闲活动研究的分析显示，参与非结构化认知刺激活动与降低认知障碍和痴呆风险之间存在联系。

Many studies are ongoing to explore cognitive training as a possible way to prevent cognitive decline and dementia.

许多研究正在进行中，探索认知训练作为预防认知能力下降和痴呆症的可能方法。

For now, experts encourage people to make healthy lifestyle choices for cognitive health.

目前，专家鼓励人们选择健康的生活方式以保持认知健康。

Learn more about keeping your mind active .

了解更多关于保持思维活跃的信息。

Because Alzheimer's is so devastating, some people are tempted by untried or unproven "cures." Check with your doctor before trying pills or any other treatment or supplement that promises to prevent Alzheimer's.

由于阿尔茨海默病的破坏性如此之大，一些人受到未经尝试或未经证实的“治疗方法”的诱惑。在尝试服用药物或任何其他有望预防阿尔茨海默病的治疗或补充剂之前，请咨询您的医生。

These "treatments" might be unsafe, a waste of money, or both.

这些“治疗”可能不安全、浪费金钱，或两者兼而有之。

They might even interfere with other medical treatments that have been prescribed.

它们甚至可能会干扰已开出的其他医疗方法。

Alzheimer’s is complex, and the best strategy to prevent it may turn out to be a combination of interventions based on a person’s risk.

阿尔茨海默氏症很复杂，预防该病的最佳策略可能是根据个人风险综合采取干预措施。

In the meantime, generally leading a healthy lifestyle, including controlling high blood pressure, being physically active, and making healthy dietary choices, will help reduce your risk of many chronic health conditions and may help reduce your risk of dementia.

与此同时，总体上保持健康的生活方式，包括控制高血压、锻炼身体和选择健康的饮食，将有助于降低患许多慢性疾病的风险，并可能有助于降低患痴呆症的风险。

Social connections are another important part of leading a healthy lifestyle.

社会关系是健康生活方式的另一个重要组成部分。

Staying connected with friends and family can improve your mental well-being and support healthy aging.

与朋友和家人保持联系可以改善您的心理健康并支持健康老龄化。

Researchers can’t say for certain whether making healthy lifestyle changes will protect against dementia, but taking these steps may help reduce your risk.

研究人员无法确定改变健康的生活方式是否可以预防痴呆症，但采取这些措施可能有助于降低风险。

Visit Alzheimers.gov to learn more about reducing your risk of dementia .

访问Alzheimers.gov 了解有关降低痴呆风险的更多信息。

You also can help researchers learn more by participating in research.

您还可以通过参与研究来帮助研究人员了解更多信息。

Clinical trials and studies are looking for all kinds of people — healthy volunteers, cognitively normal participants with a family history of Alzheimer’s, people with mild cognitive impairment, and people diagnosed with Alzheimer’s or a related dementia.

临床试验和研究正在寻找各种人群——健康志愿者、有阿尔茨海默氏症家族史的认知正常参与者、有轻度认知障碍的人以及被诊断患有阿尔茨海默氏症或相关痴呆症的人。

Search the Alzheimers.gov Clinical Trials Finder to find study sites near you.

搜索Alzheimers.gov 临床试验查找器以查找您附近的研究地点。

NIA Alzheimer’s and related Dementias Education and Referral (ADEAR) Center 800-438-4380 adear@nia.nih.gov www.nia.nih.gov/alzheimers The NIA ADEAR Center offers information and publications for download (PDF) about Alzheimer’s and related dementias for families, caregivers, and health professionals.

NIA 阿尔茨海默氏症及相关痴呆症教育和转诊 (ADEAR) 中心 800-438-4380 adear@nia.nih.gov www.nia.nih.gov/alzheimers NIA ADEAR 中心为家庭、护理人员和健康专业人员提供有关阿尔茨海默氏症及相关痴呆症的信息和出版物供下载 (PDF)。

ADEAR Center staff answer telephone, email, and written requests and make referrals to local and national resources.

ADEAR 中心工作人员回答电话、电子邮件和书面请求，并转介当地和国家资源。

Alzheimers.gov www.alzheimers.gov Explore the Alzheimers.gov website for information and resources on Alzheimer’s and related dementias from across the federal government.

Alzheimers.gov www.alzheimers.gov 浏览Alzheimers.gov 网站，获取来自联邦政府的有关阿尔茨海默病和相关痴呆症的信息和资源。

This content is provided by the NIH National Institute on Aging (NIA).

本内容由 NIH 国家老龄化研究所 (NIA) 提供。

NIA scientists and other experts review this content to ensure it is accurate and up to date.

NIA 科学家和其他专家审查此内容以确保其准确且最新。