認知症の危険因子と環境要因

Environmental Risk Factors for Dementia

昨今の画像診断技術・バイオマーカーの開発により，アルツハイマー病のpreclinical stageからの経過が明らかになってきた。発症20年以上前から脳内にアミロイドβが沈着し，その広がりとともに，神経原線維変化が大脳新皮質へと出現して認知機能低下を引き起こす。この過程を抑制することが，アルツハイマー病の病態制御につながるが，現時点では，疫学的研究から明らかにされた環境要因への介入が最も現実的な手段であり，効果も大きいと考えられる。

Abstract

Owing to recent advancements in imaging techniques and biomarker research, the natural history of Alzheimer's disease (AD) has become clear from the very first preclinical stage. According to the study, more than 20 years before the onset of AD, Aβ starts to accumulate in the brain. This induces neurofibrillary tangle formation in the cerebral isocortex, leading to cognitive decline. If this process is suppressed, disease activity can be controlled. However, at this point, the best and most realistic way to deal with AD is to target the environmental factors that have been identified as risk factors by epidemiological studies.