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106.Mental Illness and Dementia
Age is the single biggest risk factor for dementia, with the odds doubling about every five years after age 65. But many things influence those odds for a given individual. Genetic vulnerability is a contributor, as are so-called modifiable risk factors such as smoking, cardiovascular disease, social isolation, and impaired hearing and vision. Certain mental conditions, particularly depression and schizophrenia, have also been linked to dementia. But because depression can itself be a sign of cognitive decline, the causality has been a bit muddy. Earlier this year an analysis of data from New Zealand provided the most convincing evidence to date linking many kinds of = mental illness with dementia. That study raises important questions about the reasons for this increased risk and what could be done to reduce it.
The study looked at the health records of 1.7 million New Zealanders born between 1928 and 1967 covering a 30-year period ending in mid-2018. It found that those with a diagnosed mental disorder—such as anxiety disorders, depression or bipolar disorder—had four times the rate of ultimately developing dementia compared with people without such a diagnosis. For those with a psychosis such as schizophrenia, it was six times the rate. Among people who developed dementia, those with a psychiatric disorder were a" ected 5.6 years earlier, on average.
The study did not examine biological, social or other reasons for the increased risk, but research on dementia points to several possible explanations. “There might be shared genetic risk factors,” suggests psychologist Leah Richmond-Rakerd of the University of Michigan, lead author of the study. Recent studies have found some overlap in genetic markers associated with Alzheimer’s disease and those linked to bipolar disorder and to major depression. Long-term use of psychiatric medications could also be playing a role in dementia, but Richmond-Rakerd and her coauthors do not think it is a major contributor.
They suspect that a more significant risk factor is the chronic stress associated with having a psychiatric disorder, which may degrade brain health over time. Studies in animals as well as human autopsy studies have linked chronic stress to a loss of neural connections in the hippocampus, the brain’s memory center, which is where Alzheimer’s takes a heavy toll. Evidence suggests that stress drives inflammation and immune dysregulation in the body and brain, impacting brain connectivity, says Harvard University neurologist and dementia researcher Steven Arnold. “If you have fewer connections and synapses to begin with because of stress, then you can’t a" ord to lose as many with aging before it starts to show up as what we might call dementia.” In other words,people with mental illnesses may have less “cognitive reserve”— brainpower that is su# ciently robust to withstand normal aging without obvious losses of function.
Vulnerability in this population may also be linked to their finding it more di# cult to lead healthy lives, physically and socially, Richmond-Rakerd says. “They might exercise less, or drink alcohol excessively, or have trouble staying socially connected”—all of which increase the risk for dementia. People with certain psychiatric conditions tend to have higher-than-average rates of smoking and fewer years of education, which are also risk factors.
Could a more holistic approach to treating mental illness mitigate the risk for dementia? Researchers tend to think so. In 2020 the British-based Lancet Commission on dementia prevention estimated that four in 10 cases could be prevented or delayed if society did a better job of addressing 12 modifiable risk factors, including such psychosocial contributors as depression, poor social support and low education level. Progress on some of these factors may explain why dementia rates have already fallen 15 percent per
decade for the past 30 years in high-income countries. “We think there are two main reasons: better cardiovascular risk factor control and a big increase in education level,” says Kenneth Langa of the University of Michigan, associate director of the Health and
Retirement Study, one of the major e" orts tracking these trends.
In an ideal world, Langa and other researchers say, e" orts to prevent dementia would begin in childhood with strong
investments in education and the inculcation of healthy habits. Suche" orts would be incorporated into the treatment of depression and other mental illnesses that often emerge in the teen and early adult years. Sadly, we do not live in that ideal world; mental illness continues to be stigmatized and undertreated. But given the high costs to society and the personal tolls exacted by both mental illness and dementia, it’s hard to imagine a wiser investment.
dementia [dɪˈmenʃə] n. 痴呆
psychiatric adj. 精神病的，精神病学的
multiply v. 乘； 大大增加
(Alzheimer’s Disease affects more than 4 million Americans today, and
the number is expected to multiply rapidly as the population ages.)
cognitive decline 认知能力减退
分词的形式： 现在分词(V ing) 过去分词(V ed/en)
分词的作用： 做定语(单个分词作定语可以放在名词之前； 分词短语要放在名词后面)
(现在分词： 主动&进行 过去分词： 被动&完成)
(developing country developed country) ( an annoying man an annoyed man)
(a respected leader a leader respected by his teammates )
作状语(单独分词作状语； 名词+分词作状语； with+名词+分词作状语)(前两种情况的分词作状语可以表示时间、条件、原因、让步、结果、伴随等等；
第三种情况的状语一般表示伴随、补充说明、举例、原因)
(Holding his letter, I burst into tears.)
(The Chinese word for crisis is divided into two characters, one meaning danger and
the other meaning opportunity.)
(With schooling beginning earlier and becoming increasingly exam-orientated, children are
likely to have less time to play.)
Children experiencing an auditory function deficit can often find speech and communication very difficult to isolate and process when set against high levels of background noise.
Today, glass making is big business. It has become a modern, hi-tech industry operating in a fiercely competitive global market where quality, design and service levels are critical to maintaining market share.
-
odds n. 可能性(the probability that a particular thing will or will not happen)
(Given the poor economic climate, the odds of success are slim.)(good/high/excellent odds)
(The odds were overwhelmingly in favour of the other team.) (What are the odds of…?)
double n.&adj.&adv. 两倍； v. 加倍
(Company profits have doubled since the introduction of new technology.)
given adj. 特定的，指定的(already decided, arranged, or agreed)
(His team found larger brains, for a given body size, are linked to greater playfulness.)
contributor n. 因素(one of the reasons why sth happens)
(Good management has been a big contributor to the company’s success.)
modifiable adj. 可改变的 (modify v. 改变)
cardiovascular [ˌkɑːrdioʊˈvæskjələr] adj. 心血管的
isolation n. 隔离，孤立， 孤独 (isolated adj.)
impair v. 损害
(Lack of sleep impairs the ability to think clearly.)
schizophrenia [ˌskɪtsəˈfriːniəˌ] n. 精神分裂症
causality [kɔːˈzæləti] n. 因果关系
muddy adj. 泥泞的，模糊的 -
bipolar adj. 两极的
ultimately adv. 最终(finally/ eventually)
psychosis [saɪˈkoʊsɪs] n. 精神疾病
The study looked at the health records of 1.7million New Zealanders born between 1928 and 1967 covering a 30-year period ending in mid-2018.
It found that those with a diagnosed mental disorder—such as anxiety disorders, depression or bipolar disorder—had four times the rate of ultimately developing dementia compared with people without such a diagnosis. -
overlap n.&v. 重叠
(My musical tastes don’t overlap with him at all.)
(There are some overlaps between the products of the two companies.)
genetic marker 遗传标记
medication n. 药物，药物治疗
(I’m on medication for my heart condition.)
play a role 发挥作用 (paly a key/crucial/significant/vital/important/essential role)
(Artificial dyes continue to play a crucial role today.)
(It is only when the faculty of smell is impaired for some reason that we begin to realize the essential role the sense of smell plays in our sense of well-being.)
Recent studies have found some overlap in genetic markers associated with Alzheimer’s disease and those linked to bipolar disorder and to major depression. -
degrade v. 降低，贬低
autopsy [ˈɔːtɑːpsi] n. 尸检
hippocampus [ˌhɪpəˈkæmpəs] n. 海马体
take a/its toll 造成伤害(to cause harm or damage)
(If you keep working so hard, the stress will eventually take its toll.)
(Too much sunlight can take a heavy toll on your skin.)
inflammation [ˌɪnfləˈmeɪʃn] n. 发炎，炎症
dysregulation n. 调节异常
synapse [ˈsɪnæps] n. 突触
reserve v. 预定；保留(to keep sth for a particular purpose or time)； n. 储备
(These seats are reserved for the elderly and women with babies.)
(I reserve judgment on this issue until we have more information.)
(We still have a reserve of food in case of emergency.)
robust [roʊˈbʌst] adj. 强壮的；结实的；浓烈的 -
excessively adv. 过分地，过量地
(exceed v. 超过 excess n. 过度 excessive adj. 过度的 ) -
holistic adj. 整体的，全面的
mitigate v. 减轻，缓和 -
inculcation [ˌɪnkʌlˈkeɪʃn] n. 教诲(the process of fixing beliefs or ideas in someone’s mind, especially by repeating them often)
incorporate v. 包含，合并(to include sth as part of sth larger)
stigmatize [ˈstɪɡmətaɪz] v. 污蔑，侮辱
toll n. 伤亡人数；不良影响；通行费
exact adj. 确切的，精准的； v. 强取；造成重大损失
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以上文章版本转载自：【外刊精读106 / Scientific American / 精神健康与老年痴呆（分词讲解）】 老师讲的非常棒，建议将文章打印出来对照多看看。