Abstract：
A helpful method to understand cognitive decline in older people is to consider this entity as increasing cognitive frailty caused by a number of interacting pathological processes. Over the last 20 years, multiple lifestyle, environmental and constitutional factors have been linked to the development of cognitive decline. For two interventions based on these factors, increasing physical activity and the control of hypertension, there is class 1 evidence for benefit. Other interventions based on these factors do not have the support of high-level evidence for the alteration of cognitive decline, but their other benefits would argue for their implementation. These interventions include increasing education, smoking cessation, avoiding head injuries, decreasing exposure to air pollution and increased social connections. As cognitive decline is experienced almost universally with ageing, and serious cognitive decline is experienced by substantial numbers of low-risk individuals, whole-of-population intervention strategies are the most effective and efficient. For other interventions to help prevent cognitive decline there is not sufficient evidence for their implementation to be recommended. These include alteration of alcohol ingestion, correction of hearing loss, treatment of depression, dietary interventions, menopausal hormone treatment and monoclonal antibodies directed against amyloid-β.
摘要：
了解老年人认知能力下降的一种有用方法是将此实体视为由许多相互作用的病理过程引起的认知虚弱增加。在过去的20年里,多种生活方式,环境和体质因素与认知衰退的发展有关。对于基于这些因素的两项干预措施，增加体力活动和控制高血压，有一级证据证明有好处。基于这些因素的其他干预措施没有高水平的证据支持认知能力下降的改变，但他们的其他好处将为他们的实施辩护。这些干预措施包括增加教育，戒烟,避免头部受伤,减少接触空气污染和增加社会关系。由于认知能力下降几乎普遍伴随着衰老，大量的低风险个体经历了严重的认知能力下降，全人群干预策略是最有效和高效的。对于帮助预防认知能力下降的其他干预措施，没有足够的证据可以推荐其实施。这些包括改变酒精摄入，纠正听力损失，治疗抑郁症,饮食干预，更年期激素治疗和针对β淀粉样蛋白的单克隆抗体。
