21 ways to reduce your Alzheimer's risk, backed by research 研究支持的21种降低老年痴呆症的方法

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There are 21 known ways to reduce your risk of developing Alzheimer's, and 10 of those are backed by strong scientific evidence, new research has revealed.

研究表明有21种已知的方法可以降低你患有老年痴呆症的几率，其中10种方法有科学证据的有力支持。

The preventative steps with the most impact are mentally stimulating activities, including reading and chess; avoiding stress, depression and head trauma; and avoiding diabetes, high blood pressure and weight gain in midlife and beyond, according to a meta-analysis released Monday.

影响最大的预防步骤是精神刺激活动，包括阅读和下棋，还有避免压力，沮丧和头部创伤。根据周一发布的报告分析，步入中年后避免糖尿病、高血压和长胖对减少患有老年痴呆症也有帮助。

Regular physical exercise, quality sleep, no smoking, maintaining good heart health in later life and including vitamin C in the diet are among the nine preventative actions with slightly weaker but still supportive evidence.

常规的体育锻炼，好的睡眠质量，不吸烟，以及在生活中保持心理健康病，并在饮食中补充维生素C，这些都在9种预防措施之内，虽然作用有限，但也有帮助。

"If risk factors can be modified, the evidence suggests that at least one out of every three cases of Alzheimer's may be preventable, " said neurologist Dr. Richard Isaacson, director of the Alzheimer's Prevention Clinic at Weill Cornell Medicine.

威尔·康奈尔大学（Weill Cornell Medicine）的阿尔茨海默症预防诊所主任神经病学家Richard Isaacson博士说：“如果可以改变危险因素，则有证据表明每三例阿尔茨海默症中至少有一例可以预防。”

"People can take different roads to Alzheimer's disease," said Isaacson, who was not involved in the study. "This paper helps to provide an evidence-based framework for doctors and patients to consider when managing a person's Alzheimer's risk."

没有参与这项研究的Isaacson说：“人们在阿尔茨海默氏病上走的路可能各不相同。” “本文有助于为医生和患者提供一个基于证据的治疗框架，以便在管理一个人患有的老年痴呆症风险时可以参考。”

The study published in the Journal of Neurology, Neurosurgery & Psychiatry.

该研究发表在《Neurology, Neurosurgery & Psychiatry》杂志上。

Top-tier preventions
顶级预防

Two-thirds of the most promising interventions focused on healthy lifestyle changes and targeting risk factors for cardiovascular disease, such as high blood pressure and cholesterol levels.

最有希望的预防措施中有三分之二都着眼于向健康生活方式改变和降低心血管疾病的致病风险，例如高血压和胆固醇水平。

The study analyzed 395 observational prospective studies and randomized controlled trials. These efforts, the researchers said, were the "most comprehensive and large-scale systematic review and meta-analysis for Alzheimer's disease to date."

该研究分析了395项观察性的研究和随机对照试验。研究人员说，这些努力是“迄今为止对老年痴呆症最全面，最大规模的系统评价和全面分析”。

The top 10 preventative actions backed by science that the study found included:

研究发现，科学支持的十大预防措施包括：

Keeping blood sugars and weight in check to avoid diabetes
保持血糖和体重，避免患上糖尿病

Maintaining weight at a healthy level, typically below a body mass index (BMI) of 25
把体重维持在健康水平，通常保证BMI低于25

Obtaining as much education as possible in early life
年轻时尽可能多接受教育

Avoiding head trauma (such as concussions)
避免脑部受伤（如脑震荡）

Staying cognitively active by reading and learning new things
通过阅读和学新东西来保持思维活跃

Avoiding or managing depression
避免抑郁或控制情绪

Managing bad stress that raises cortisol levels
管理会提高皮质醇水平的坏情绪

Treating "orthostatic hypotension" when you regularly feel light headed or dizzy when standing up from sitting
当你一下子从坐着站起来时会感到头晕时，治疗这种“体位性低血压”

Keeping blood pressure under control in midlife
中年时期，注意控制血压

Avoiding high levels of homocysteine, an amino acid that can contribute to blood clots in your blood vessels and artery damage.
避免高水平的半胱氨酸，因为这种氨基酸会让你导管里的血凝结，并对动脉造成损伤。

"One of the most important and commonly overlooked modifiable factors is a high level of homocysteine in the blood," Isaacson said. In his New York-based preventative clinic, he said he will often suggest B-complex vitamins to combat elevated homocysteine levels.

Isaacson说：“最重要但常会被忽视的因素是调节血液中的高半胱氨酸水平。” 在纽约的预防诊所中，他说自己常会建议使用B族复合维生素来防止高半胱氨酸水平升高。

"However, past research has shown that B-vitamin supplementation 'works' better if these people also have sufficient levels of Omega3s, which are a brain-healthy fat found in fatty fish, for example," Isaacson explained.

Isaacson解释说：“但是，过去的研究表明，如果这些人也具有足够的Omega3，B族维生素补充剂可以更好地“工作”。Omega3是在鱼类中发现的一种有益大脑健康的脂肪。

Other positive measures
其他的积极举措

Nine actions that had weaker, but still positive, impacts on reducing the risk of developing Alzheimer's were:

下面9项行动对降低患有老年痴呆症的影响较弱，但依然是积极举措：

Getting regular physical exercise
定期进行体育锻炼

Eliminating obesity in midlife
在中年消除肥胖

Avoiding weight loss in late life
避免在晚年减肥

Not smoking and avoiding secondhand smoke
不吸烟，并且避免抽二手烟

Getting plenty of good quality sleep
获得充足且高质量的睡眠

Avoiding cerebrovascular disease, which includes stroke and diseases that affect the blood flow in the brain
避免脑血管疾病，包括中风和其他会影响大脑血液流动的疾病

Avoiding frailty in later life
在之后的生活中避免体虚

Managing atrial fibrillation, which is an irregular, rapid heart rate due to chaotic electrical signals in the heart
控制心房颤动，这种一种由于心脏内电信号混乱而导致的心律不齐，心跳加快

Eating foods with vitamin C or taking supplements
吃富含维生素C的食物或服用维C补充剂

Of the 21 study recommendations, the last two were actions that physicians should avoid when working with patients at risk of Alzheimer's disease. Strong evidence was found against giving postmenopausal women estrogen replacement therapy to improve cognition.

在这21条建议中，最后两条是医师在与老年痴呆症高风险患者一起工作时应该避免采取的行动。已发现有力证据表明，绝经后妇女不能接受雌激素替代疗法来提高认知能力。

"I wholly agree with this statement but for women in the peri-menopause and early menopause, hormone replacement therapy may sometimes be considered based on a variety of other factors," Isaacson said.

Isaacson说：“我完全同意这一说法，但对于绝经前后和绝经早期的女性，基于其他因素，有时可能会考虑使用激素替代疗法。”

Finally, weaker evidence indicated that acetylcholinesterase inhibitors -- drugs like donepezil and galantamine, which are often prescribed to treat memory loss in people with diagnosed Alzheimer's disease -- should not be used as a prevention tactic.

最后，有弱证据表明，不应将乙酰胆碱酯酶抑制剂（如多奈哌齐和加兰他敏等药物，通常用于治疗阿兹海默症患者的记忆力减退）当作是一种预防策略。

"Those are drugs for symptomatic people with mild or worse dementia," Isaacson said. "Those drugs work for symptoms but don't slow disease progression."

Isaacson说：“这些药物给有轻度或重度痴呆患者服用的药物。” 这些药物可以缓解症状，但不能控制病情恶化。”

People who are concerned about their risk of developing Alzheimer's should work with a doctor trained in the field to develop an individualized plan to reduce their risk, Isaacson said.

Isaacson说，担心自己是阿兹海默症高患风险的人应与经过现场培训的医生合作，制定个性化计划以降低患病风险。

"It's also important to note that there is not a single 'magic pill' or action that can prevent Alzheimer's," he said.

他说：“同样重要的是得注意，没有一个'魔术药'或药物可以预防老年痴呆症。”

"Risk reduction care is not 'one size fits all' -- it needs to be comprehensive and individually tailored, ideally under a doctor's supervision."

“减少患病风险的计划并非‘一刀切’ —它需要全面地且根据具体情况而制定，最好是在医生的监督下进行。