認知症の一次予防のための集団レベルでの介入:複雑な証拠のレビュー
Sebastian Walsh1, Lindsay Wallace1, Isla Kuhn2
1Cambridge Public Health, University of Cambridge, Cambridge, UK.
Lancet (London, England)
|November 24, 2023
まとめ
集団レベルでの介入は 変形可能な要因に対処することで 認知症のリスクを減らすことができます この見直しでは 政策立案者が実施すべき 26の効果的な戦略を特定し 世界的に認知症の蔓延と健康格差を減らすことを目指しています
科学分野:
- 公衆衛生
- 流行病学について
- ゲロントロジー
背景:
- 認知症は世界的な健康問題です
- 高所得国 (HIC) では年齢特有の罹患率が減少しているかもしれないが,個別レベルの介入は広範囲にわたる罹患率の減少には不十分である.
- 人口レベルでの戦略は 認知症のリスクを効果的に削減し 健康上の不平等を緩和するために不可欠です
研究 の 目的:
- 認知症のリスクを減らすための集団レベルでの介入を 最も強力な証拠ベースで特定する.
- 認知症の予防のための政策開発に情報を提供すること.
- 効果的な公衆衛生戦略の実施のための枠組みを構築する.
主な方法:
- 複雑で多段階の証拠レビューが行われました.
- 12の可変性認知症リスク要因を対象とした介入のためのピアレビューと灰色の文献を対象とした検索です.
- 効果の証拠と文脈的な情報が抽出され,その後,物語の合成と証拠の格付けが行われました.
主要な成果:
- 9つの認知症の危険因子の流行を減らすのに有効であることが示された.
- 介入は,財政,マーケティング/広告,可用性,立法的なレバーを利用した.
- 身体活動,教育,環境要因に関連する介入の証拠が最も強かった. 糖尿病,うつ病,または社会的孤立に対する特定の介入は特定されなかった.
結論:
- 認知症のリスクを減らすための集団レベルでの介入の根拠に基づいた枠組みが策定されています.
- この枠組みは,政策立案者や公衆衛生の専門家が 認知症のリスクを大幅に低減し,健康格差を減らすための戦略を 実施する際に役立つものです.
- 発見を実践にするためにさらなる研究と政策の実施が必要である.
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