从卒中防控到脑健康共管:WHO新版痴呆风险降低指南的中国实践路径OA

In July 2026,the World Health Organization(WHO)released the second edition of the WHO guidelines on risk reduction of cognitive decline and dementia,following a systematic update of the 2019 edition.The updated guideline further establishes the public health position of dementia risk reduction and emphasizes a life-course approach to risk management,multidomain interventions,and integration of relevant risk-reduction measures into existing health policies,health services,and public health programs.This article reviews the major updates in the revised guideline,highlighting key changes from the 2019 edition:an expanded spectrum of risk factors,clearer delineation of the evidence base,and greater integration of risk-reduction strategies into health services and health systems.Against this background,the relationship between stroke and dementia is examined from the perspectives of cerebrovascular injury,shared risk factors,and long-term functional outcomes.Although stroke and dementia have distinct underlying pathophysiological mechanisms,they share important targets for risk reduction and long-term health maintenance,providing a rationale for integrated prevention and management.Building on the existing practice base of stroke prevention and control in China,including screening,risk-factor management,acute care,rehabilitation,and follow-up,we propose using integrated stroke and dementia prevention and management as an entry point for brain health management.Cognitive health-related services could be progressively incorporated into existing disease prevention and management services,followed by expansion of the target population from populations at increased risk of,or living with,stroke and dementia to populations across different stages of the life course.Through coordination with primary public health services,medical care,rehabilitation,and other health services,this approach could progressively establish a life-course brain health management system.Further clinical research and real-world evaluation are needed to assess its feasibility,effectiveness,cost-effectiveness,and health equity,thereby providing an evidence base for developing a brain health co-management model aligned with the characteristics of China's health service system.