Abstract：
Recent decades have seen exponential growth in research on modifiable risk factors for dementia across the lifespan, which has considerably advanced our understanding of brain health. Not all modifiable risk factors are equal, however, in the ease with which they can be addressed. Some individuals and populations face significant barriers to engaging in dementia risk-reduction behaviors. With the evolution of the dementia prevention field, there is a need to broaden our approach from identifying individual risk factors toward addressing inclusive and globally effective intervention strategies. Here, we argue for a greater awareness of individual and socioeconomic barriers to behavior change-oriented dementia risk reduction. We caution against inadvertently increasing health inequities through \"lifestyle\" stigma and call for an approach that both harnesses current dementia risk-reduction knowledge and effectively addresses barriers to change. A greater focus on more positive aspects of reducing dementia risk, such as enhancing mental well-being, may also be beneficial. Evidence for the negative ramifications of stigma in dementia is discussed as well as overly simplistic media representations of dementia as a disease, which one can \"stave off\" through lifestyle. Further, we explore potential negative implications for research funding and policy resulting from stigma. More research regarding the experience of stigma in dementia is needed, across diverse cultural and socioeconomic groups.
摘要：
近几十年来，关于痴呆症可改变的危险因素的研究呈指数增长，这大大提高了我们对大脑健康的理解。并非所有可改变的风险因素都是平等的，然而,在他们可以轻松解决的情况下。一些个人和人群在从事降低痴呆症风险的行为方面面临重大障碍。随着痴呆症预防领域的发展，有必要扩大我们的方法，从确定个人风险因素到解决包容性和全球有效的干预战略。这里,我们主张提高个体和社会经济障碍对行为改变的认识,以降低痴呆风险为导向.我们警告不要通过“生活方式”的耻辱无意中增加健康不平等，并呼吁采取一种既利用当前降低痴呆症风险的知识，又有效解决变革障碍的方法。更加关注降低痴呆症风险的更积极方面，比如增强心理健康，也可能是有益的。讨论了痴呆症中污名的负面影响的证据，以及对痴呆症作为一种疾病的过分简单的媒体表示，人们可以通过生活方式“避免”。Further,我们探讨了污名化对研究经费和政策的潜在负面影响。需要更多关于痴呆症患者的耻辱经历的研究，跨越不同的文化和社会经济群体。
