New Strategies for AD Prevention

Professor Serge Gauthier from McGill University gave a presentation on new strategies for AD prevention, research. He first analyzed the types and frequency of dementia and MCI in China. In China, the incidence of dementia is 12.1/1000 people per year in people over 65 years old, with AD incidence of 8.2/1000 people per year and VaD incidence of 3.1/1000 people per year. According to data published in 2013, the prevalence of moderate cognitive impairment (MCI) in China was 20.8% in people over 65 years of age, with a higher prevalence in rural areas (23.4 vs 16.8%). Of these, 6.1% were amnestic, 3.8% were associated with vascular disease, 4.9% with vascular risk factors, and 5.9% were caused by other diseases. In contrast, the prevalence in people over 60 years of age was 20.1%, 13.2 were amnestic and 7% were non-amnestic, with a higher prevalence in female APOE4 carriers aged 60-80 years. Risk factors for AD include alcohol abuse, hypertension, obesity, dyslipidemia, diabetes, vascular damage, unhealthy diet, neuronal damage, smoking, APOE and other genes, protective factors include exercise, cognitive and social activities, and the percentage of risk attributed to the above risk factors for AD population is 28.2%. Some studies have intervened in terms of nutrition, exercise, and cognitive training and found that executive function was significantly improved in AD patients. The strategy of immunotherapy with aducanumab to reduce beta amyloid is still under investigation. People with a history of TIA or stroke or with vascular risk factors (hypertension, diabetes, smoking) are at higher risk, and the number of such people is high in China, so this group may be developed as a priority population for primary prevention.