营养干预对阿尔茨海默病相关认知障碍影响的研究进展

Research progress in the effect of nutritional intervention on cognitive impairment related to Alzheimer's disease

阿尔茨海默病(Alzheimer’s disease,AD)是一种与年龄相关的神经退行性疾病,其发病隐匿、病程进展缓慢。AD从仅有大脑病理改变到临床可识别的认知功能改变,受生物体内外的多种环境因素的影响,可持续数十年。认知障碍是AD的一个重要临床特征,影响老年人晚年生存质量,而现有的AD治疗药物尚不能治愈该疾病,提示早期预防AD相关认知障碍的重要性。目前关于营养与AD的关系的研究,大部分支持营养干预为AD相关认知障碍的一种预防方法。饮食的补充或限制对AD相关认知障碍的作用与多条途径相关。值得注意的是,肠道微生物群作为饮食对宿主作用的重要介质,可通过“微生物群-肠道-大脑轴”影响大脑认知功能。某些食物具有的抗氧化、抗炎症的性质有利于改善大脑认知功能。该文分析近些年相关研究,对某些单一营养成分(维生素、多酚、长链多不饱和脂肪酸)和整体饮食模式(地中海饮食、高血压防治饮食、延缓神经退行性疾病的地中海饮食模式、生酮饮食)对认知功能的影响进行讨论,以期为AD相关认知障碍的预防和治疗提供思路和参考。

Alzheimer's disease(AD)is an age-related neurodegenerative disease with insidious onset and slow progression.The progression of AD from only brain pathological changes to clinically identifiable cognitive changes is affected by a variety of environmental factors inside and outside the organism and can last for decades.Cognitive impairment is an important clinical feature of AD that impairs the quality of life of the elderly in their later years,and the available drugs for the treatment of AD have failed to cure the disease,indicating the importance of early prevention of AD-related cognitive impairment.Most current research on the relationship between nutrition and AD takes nutritional intervention as a preventive method for AD-related cognitive impairment.The role of dietary supplement or restriction on AD-related cognitive impairment is related to multiple pathways.It is worth noting that the gut microbiome,as an important medium in the effect of dietary on the host,can influence cognitive function through the"microbial-gut-brain axis".The antioxidant and anti-inflammatory properties of some foods are beneficial for improving cognitive function.In this paper,relevant studies in recent years were analyzed to discuss the effects of certain single nutrients(vitamins,polyphenols,and long chain polyunsaturated fatty acids)and overall nutritional patterns(Mediterranean diet,dietary approaches to stop hypertension diet,Mediterranean-DASH intervention for neurodegenerative delay,and ketogenic diet)on cognitive function,so as to provide ideas and reference for the prevention and treatment of AD-related cognitive impairment.