9.21 World Alzheimer's Day Special Edition Stroke: Can you not be demented when you are old? AHA announces the most comprehensive prevention and control factors!

Pay attention to the new frontier of nerves - AD frontier column, and care for the Alzheimer's population together!

According to the World Alzheimer Report 2015, there were about 50 million people with dementia worldwide in 2015, and it is expected that there will be 132 million people with dementia by 2050, and about 63% to 70%

Recently, the American Heart Association (AHA) published "The Primary Care Agenda for Brain Health" in stroke, summarizing 13 modifiable risk factors for cognitive decline in order to provide effective information

High blood pressure is recognized as a risk factor

International guidelines for evidence-based prevention of AD recommend that people under 65 years of age should maintain a healthy lifestyle and avoid hypertension (Class I recommended, Level A4 evidence); In patients with orthostatic hypotension, their cognitive status (grade I recommended, grade A4 evidence) should be closely monitored

Smoking is the third most important modifiable risk factor for dementia, after hypertension and low

International guidelines for evidence-based prevention of AD recommend: do not smoke, but also avoid exposure to tobacco smoke in the environment; People who smoke should be counselled, nicotine replacement therapy, and other medications to accompany behavioral programs or regular smoking cessation programs (Level I recommendations, Level B evidence

Multiple epidemiological studies have shown that lack of exercise is associated

International guidelines for evidence-based prevention of AD recommend that everyone (especially those over 65 years of age) should adhere to regular physical activity (Level I recommended, Level B evidence).

The association between diabetes and dementia is well established, and a systematic analysis of prospective cohort studies showed a 50%

International guidelines for evidence-based prevention of AD recommend: maintain a healthy lifestyle and avoid diabetes; Patients with diabetes mellitus should be closely monitored for cognitive decline (grade I recommended, grade A4 evidence).

Several studies suggest that dietary patterns are associated

International guidelines for evidence-based prevention of AD suggest that dietary intake of vitamin C may be helpful (grade I recommended, grade B evidence).

Extensive epidemiological research evidence suggests that mid-life obesity is significantly associated with an increased risk of cognitive impairment, and that obesity is a recognized risk factor

International guidelines for evidence-based prevention of AD recommend that people under 65 years of age maintain or lose weight, with a view to achieving and maintaining a BMI in the range of 18.

One meta-analysis found that elevated total cholesterol levels in middle age were associated

The American Heart Association recommends that total cholesterol levels should < 200 mg/dL in people aged 20 years and older, and < 170 mg/dL

Long-term excessive alcohol consumption causes neurotoxicity, brain nutrient deficiencies, neuroinflammation, and neurotransmitter system changes, which in turn lead to brain damage, and long-term excessive alcohol consumption
is avoided as much as possible.

Multiple observational studies have shown that sleep disturbances can lead to cognitive decline
.
For example, obstructive sleep apnea can cause hypoxia, systemic inflammation, endothelial dysfunction, hypertension, and atrial fibrillation, leading to vascular dementia
.
There is growing evidence that poor sleep can cause a variety of neurodegenerative diseases
.

International guidelines for evidence-based prevention of AD recommend: ensure adequate and good sleep; Sleep disturbances should be treated with a doctor or prompt treatment (grade I recommended, grade B evidence).

Research evidence suggests that social isolation and loneliness are risk factors
for cognitive decline and dementia.
The Swedish Betula study found that loneliness increased the risk of all-cause dementia by 51 percent
.
Randomized controlled trials have shown that greater participation in social activities helps improve cognitive function
.

Meta-analyses showed that age-related hearing loss was associated
with an increased risk of cognitive impairment and dementia.
Notably, about one-third of older adults with accompanying hearing impairment have not yet received treatment
.
Randomized controlled trials suggest that hearing intervention improves memory
.

Depression and dementia are risk factors
for each other.
A large cohort study found that after 28 years of follow-up, participants who developed depressive symptoms later had a higher risk of developing dementia, suggesting that depressive symptoms may be an early marker
of dementia.

International guidelines for evidence-based prevention of AD recommend: maintain good mental health; In patients with pre-existing depressive symptoms, their cognitive status should be closely monitored (grade I recommended, grade A4 evidence).

A meta-analysis of 13 cohort studies found that low levels of education (≤8 years) increased the risk of dementia or cognitive impairment by 80%.

Studies have found that a high level of education can prevent cognitive decline in
the elderly.
A high level of education is better in cognitive reserves, which is conducive to maintaining cognitive function
.

International guidelines for evidence-based prevention of AD recommend that as much education as possible in the early years (Level I recommended, Level A4 evidence).

A healthy brain is essential to improve the length of life and quality of life, so we need to maintain a healthy lifestyle as much as possible, eliminate modifiable risk factors, and thus reduce the likelihood
of dementia.