Alzheimer's disease

被引：5746

作者：

Scheltens, Philip ^{[1
,2
,6
]}

De Strooper, Bart ^{[7
,8
,9
]}

Kivipelto, Miia ^{[10
,11
,12
,13
]}

Holstege, Henne ^{[1
,3
]}

Chetelat, Gael ^{[14
]}

Teunissen, Charlotte E. ^{[4
]}

Cummings, Jeffrey ^{[15
,16
]}

van der Flier, Wiesje M. ^{[1
,5
]}

机构：

[1] Amsterdam Univ Med Ctr, Alzheimer Ctr Amsterdam, Amsterdam, Netherlands

[2] Amsterdam Univ Med Ctr, Dept Neurol, NL-1081 HX Amsterdam, Netherlands

[3] Amsterdam Univ Med Ctr, Dept Clin Genet, Amsterdam, Netherlands

[4] Amsterdam Univ Med Ctr, Dept Clin Chem, Amsterdam, Netherlands

[5] Amsterdam Univ Med Ctr, Dept Epidemiol & Datasci, Amsterdam, Netherlands

[6] Life Sci Partners, Amsterdam, Netherlands

[7] VIB Ctr Brain & Dis Res, Leuven, Belgium

[8] Katholieke Univ Leuven, Dept Neurol, Leuven, Belgium

[9] UCL, Dementia Res Inst, London, England

[10] Karolinska Univ Hosp, Div Clin Geriatr, Stockholm, Sweden

[11] Karolinska Univ Hosp, Ctr Alzheimer Res, Stockholm, Sweden

[12] Karolinska Univ Hosp, Dept Neurobiol Care Sci & Soc, Stockholm, Sweden

[13] Univ Eastern Finland, Inst Publ Hlth & Clin Nutr, Kuopio, Finland

[14] Univ Caen, Normandie Univ, INSERM, Gtp Interet Publ Cyceron, Caen, France

[15] Univ Nevada, Dept Brain Hlth, Chambers Grundy Ctr Transformat Neurosci, Las Vegas, NV 89154 USA

[16] Cleveland Clin, Lou Ruvo Ctr Brain Hlth, Las Vegas, NV USA

来源：

LANCET | 2021年 / 397卷 / 10284期

关键词：

POSITRON-EMISSION-TOMOGRAPHY; AMYLOID-BETA; CEREBROSPINAL-FLUID; VASCULAR DYSFUNCTION; DEMENTIA; DIAGNOSIS; TAU; INTERVENTION; MICROGLIA; VARIANTS;

D O I：

10.1016/S0140-6736(20)32205-4

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

In this Seminar, we highlight the main developments in the field of Alzheimer's disease. The most recent data indicate that, by 2050, the prevalence of dementia will double in Europe and triple worldwide, and that estimate is 3 times higher when based on a biological (rather than clinical) definition of Alzheimer's disease. The earliest phase of Alzheimer's disease (cellular phase) happens in parallel with accumulating amyloid beta, inducing the spread of tau pathology. The risk of Alzheimer's disease is 60-80% dependent on heritable factors, with more than 40 Alzheimer's disease-associated genetic risk loci already identified, of which the APOE alleles have the strongest association with the disease. Novel biomarkers include PET scans and plasma assays for amyloid beta and phosphorylated tau, which show great promise for clinical and research use. Multidomain lifestyle-based prevention trials suggest cognitive benefits in participants with increased risk of dementia. Lifestyle factors do not directly affect Alzheimer's disease pathology, but can still contribute to a positive outcome in individuals with Alzheimer's disease. Promising pharmacological treatments are poised at advanced stages of clinical trials and include anti-amyloid beta, anti-tau, and anti-inflammatory strategies.

引用

页码：1577 / 1590

页数：14

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