Abstract：
Alzheimer\'s disease (AD) is a degenerative disease of the central nervous system with insidious onset and chronic progression. The pathogenesis of AD is complex, which is currently considered to be the result of the interaction between genetic and environmental factors. The APOE ɛ4 is the strongest genetic risk factor for sporadic AD and a risk factor for progression from mild cognitive impairment (MCI) to AD. So far, no effective drugs have been found for the progression of MCI. However, the effects of nonpharmacological interventions such as nutrition, cognitive, and physical exercises on early AD have received increasing attention. We followed up cognitive assessment scales, Aβ-PET and MRI examination of a patient with MCI for 4 years, who carried APOE ɛ4 homozygous with a clear family history. After 4 years of multi-domain lifestyle interventions including nutrition, socialization, and physical exercises, the patient\'s cognitive function, especially memory function, improved significantly. Intracerebral amyloid deposition was decreased, and hippocampal atrophy improved. Based on this case, this study reviewed and discussed the interaction of APOE ɛ4 with the environment in AD research in recent years, as well as the impact and mechanisms of non-pharmaceutical multi-domain lifestyle interventions on MCI or early AD. Both the literature review and this case showed that multi-domain lifestyle interventions may reduce the risk of disease progression by reducing Aβ deposition in the brain and other different pathologic mechanisms, which offers promise in brain amyloid-positivity or APOE ɛ4 carriers.
摘要：
阿尔茨海默病(Alzheimer’sdisease,AD)是一种隐匿起病、慢性进展的中枢神经系统退行性疾病。AD的发病机制复杂,目前被认为是遗传因素和环境因素相互作用的结果。APOEº4是散发性AD的最强遗传风险因素，也是轻度认知障碍（MCI）进展为AD的风险因素。到目前为止,尚未发现治疗MCI进展的有效药物。然而,非药物干预如营养的影响，认知，早期AD的体育锻炼日益受到重视。我们跟踪了认知评估量表，对1例MCI患者进行了4年的Aβ-PET和MRI检查，携带APOEä4纯合子，有明确的家族史。经过4年的多领域生活方式干预，包括营养，社会化,和体育锻炼，患者的认知功能，尤其是记忆功能，明显改善。脑内淀粉样蛋白沉积减少，海马萎缩改善。基于这个案子,本研究回顾和讨论了近年来在AD研究中,以及非药物多领域生活方式干预对MCI或早期AD的影响和机制。文献综述和这个案例都表明，多领域的生活方式干预可能通过减少大脑中的Aβ沉积和其他不同的病理机制来降低疾病进展的风险。这在脑淀粉样蛋白阳性或APOEº4携带者中提供了希望。
