Impendulo emfushane
I-Lancet Commission ka-2024 yabiza izici ezi-14 zobungozi be-dementia ezingase zishintshwe: imfundo encane, ukulahlekelwa yikhono lokuzwa, i-cholesterol ye-LDL ephezulu, ukudangala, ukulimala kwekhanda, ukungenzi umsebenzi womzimba, isifo sikashukela, ukubhema, umfutho wegazi ophezulu, ukukhuluphala ngokweqile, ukuphuza kakhulu utshwala, ukungaxhumani nabantu, ukungcola komoya nokulahlekelwa yikhono lokubona okungelashiwe. Ndawonye zihlotshaniswa namacala acishe abe ngama-45% emhlabeni wonke, ngaphandle kwesiqiniseko kunoma yimuphi umuntu oyedwa.
- Izici ezi-14 zihlanganisa impilo yonke: esisodwa ekuqaleni kwempilo, eziyishumi maphakathi nempilo nezintathu ebudaleni.
- Ukulahlekelwa yikhono lokuzwa ne-cholesterol ye-LDL ephezulu maphakathi nempilo kuhlotshaniswa ngayinye nama-7% amacala e-dementia emhlabeni wonke ngokulinganiselwa, izingxenye ezinkulu kunazo zonke zanoma yisiphi isici esisodwa.
- Lawa maphesenti yizilinganiso zabantu bonke ezicabanga ukuthi kunembangela nomphumela. Ezinye izixhumanisi zingase zibe yimbangela ngokwengxenye kuphela.
- Iminyaka namajini, okungekho ongakushintsha, nakho kuyizici ezinkulu zobungozi. Ukwehlisa izici ezi-14 akuqinisekisi ukuthi noma ubani uzigweme i-dementia.
- Izinyathelo eziningi ezihilelekile, njengokuhlola umfutho wegazi, ukuzwa nokubona, zinhle empilweni ngezinye izindlela futhi kufanele zixoxwe nodokotela.
Kuleli khasi (izingxenye ezingu-7)
Isici sobungozi yinto ehlotshaniswa nethuba eliphakeme lokuba nesimo esithile sezempilo. Akuyona imbangela ezimeni zonke, futhi ukuba nesinye akusho ukuthi nizoba ne-dementia. Leli khasi libala izici ezi-14 zobungozi be-dementia ezishiwo yi-Lancet Commission ka-2024 ukuthi zingase zishintshwe, lokho ucwaningo oluzihlobanisa nakho, nalokho enikungaxoxa ngakho nodokotela.
Ukuze nibone isithombe esikhulu, kuhlanganise nalokho izilingo ezinkulu ezakuthola, qalani ngokuthi I-dementia ingavinjwa? Lokho okushiwo ucwaningo. Lolu ulwazi olujwayelekile, hhayi iseluleko sezokwelapha; bheka isaziso sethu sezokwelapha.
Yiziphi izici ezi-14 zobungozi be-dementia?
I-Lancet Commission ka-2024, eyabhalwa abacwaningi be-dementia abangu-27, yalinganisela ukuthi izici ezi-14 zobungozi ezingase zishintshwe ndawonye zibangela amacala e-dementia acishe abe ngama-45% emhlabeni wonke. Iphesenti lesici ngasinye ngezansi yisilinganiso se-Commission sengxenye yamacala emhlabeni wonke ehlotshaniswa naso, ligoqelwe ezinombolweni ezigcwele. Izibalo ziyahlangana, ngoba abantu abaningi banezici eziningi zobungozi ngesikhathi esisodwa, yingakho ziyisamba ngama-45% kunokuba zibe ngaphezulu.
| Isici sobungozi | Isigaba sempilo | Ingxenye yamacala | Okuhlobene nakho ocwaningweni | Enikwazi ukukwenza |
|---|---|---|---|---|
| Imfundo encane | Ekuqaleni kwempilo | 5% | Iminyaka embalwa yokufunda isikoleni ihlotshaniswa nobungozi obuphakeme. Ukusebenzisa ingqondo maphakathi nempilo nakho kubonakala kuvikela, ngisho nakubantu abafunde kancane. | Qhubekani nokufunda nokwenza izinto ezisebenzisa ingqondo kunoma yisiphi isikhathi sempilo: ukufunda, amahobhi, amaklasi, imidlalo nabanye. |
| Ukulahlekelwa yikhono lokuzwa | Maphakathi nempilo | 7% | Ukulahlekelwa yikhono lokuzwa okungelashiwe kuhlotshaniswa nobungozi obuphakeme. Izifundo ezilandelela abantu isikhathi eside zihlobanisa ukusebenzisa izinsiza-kuzwa nobungozi obuphansi. | Hlolisani ukuzwa kwenu. Buzani ukuthi izinsiza-kuzwa zingasiza yini, nizigqoke uma zinconywe. Vikelani izindlebe emsindweni ophezulu. |
| I-cholesterol ye-LDL ephezulu | Maphakathi nempilo (kusukela cishe eminyakeni engu-40) | 7% | I-cholesterol ye-LDL (“embi”) ephezulu maphakathi nempilo ihlotshaniswa nobungozi obuphakeme. Izifundo zokuqapha zihlobanisa ukusebenzisa i-statin nobungozi obuphansi, kodwa izilingo ebudaleni azikukhombisanga lokho. | Buzani udokotela ukuthi i-cholesterol yenu kufanele ihlolwe yini nokuthi yini, uma ikhona, okufanele yenziwe ngayo. |
| Ukudangala | Maphakathi nempilo | 3% | Ukudangala kuhlotshaniswa nobungozi obuphakeme. Ebudaleni, ukudangala kungaba futhi uphawu lokuqala lwe-dementia. | Tshelani udokotela ngokudangala noma ukulahlekelwa isithakazelo okuhlala ngaphezu kwamasonto amabili. Ukudangala kuyelashwa. |
| Ukulimala kobuchopho | Maphakathi nempilo | 3% | Ukulimala kwekhanda kunoma yisiphi isikhathi sempilo nokuvela kunoma yini, kuhlanganise nemidlalo yokuthintana, kuhlotshaniswa nobungozi obuphakeme. | Gqokani isigqoko sokuvikela uma nigibela ibhayisikili nasemidlalweni yokuthintana. Buzani ngokuvimbela ukuwa. Phumulani futhi nihlolwe ngemva kokulimala kwekhanda. |
| Ukungenzi umsebenzi womzimba | Maphakathi nempilo | 2% | Abantu abazivocavocayo nabadlala imidlalo banethuba elincane lokuba ne-dementia. Ubufakazi bezilingo busalinganiselwe. | Buzani ukuthi ngumuphi umsebenzi ophephile kini, bese nithola into eniyijabulelayo. Bheka umhlahlandlela wethu wokuzivocavoca. |
| Isifo sikashukela | Maphakathi nempilo | 2% | Isifo sikashukela, ikakhulukazi uma siqala maphakathi nempilo noma sihlala isikhathi eside, sihlotshaniswa nobungozi obuphakeme. | Hlolisani ushukela egazini. Uma ninesifo sikashukela, sebenzisanani neqembu lenu lokunakekela ukuyiphatha ngokuphepha. |
| Ukubhema | Maphakathi nempilo | 2% | Ukubhema kuhlotshaniswa nobungozi obuphakeme. Izifundo zithola ukuthi osekwayeke ukubhema akanayo ingozi ephakeme efanayo nabaqhubeka nokubhema. | Buzani ngosizo lokuyeka. Kufanelekile ukuyeka kunoma yisiphi isikhathi sempilo. |
| Umfutho wegazi ophezulu | Maphakathi nempilo | 2% | Umfutho wegazi ophezulu maphakathi nempilo uhlotshaniswa nobungozi obuphakeme. Izilingo zemithi yomfutho wegazi ziphakamisa ubungozi obuncane obuphansi be-dementia noma bokuphazamiseka kokucabanga. | Yazini izinombolo zenu. I-Commission iphakamisa inombolo ephezulu engu-130 noma ngaphansi kusukela cishe eminyakeni engu-40; buzani ukuthi yisiphi inhloso efanele nina. |
| Ukukhuluphala ngokweqile | Maphakathi nempilo | 1% | Ukukhuluphala ngokweqile maphakathi nempilo kuhlotshaniswa nobungozi obuphakeme, futhi kukhulisa nobungozi besifo sikashukela. | Buzani udokotela ngesisindo esinempilo kini. Abantu abadala akufanele benze idayethi ukunciphisa isisindo ngaphandle kweseluleko sikadokotela. |
| Utshwala obuningi | Maphakathi nempilo | 1% | Ukuphuza kakhulu utshwala kuhlotshaniswa nobungozi obuphakeme. Ukunciphisa ukuphuza kakhulu kuhlotshaniswa nobungozi obuphansi. | Buzani ukuthi yini imbandela evikelekile kini, ikakhulukazi uma nisebenzisa imithi. |
| Ukungaxhumani nabantu | Ebudaleni | 5% | Ukuxhumana okuncane nabanye abantu kuhlotshaniswa nobungozi obuphakeme. | Hlalani nixhumene nabantu ngezindlela eniziyijabulelayo. Bheka umhlahlandlela wethu wokuxhumana nabantu. |
| Ukungcola komoya | Ebudaleni | 3% | Ukuhlala endaweni enomoya ongcolile kakhulu kuhlotshaniswa nobungozi obuphakeme. Izifundo zihlobanisa umoya ohlanzekile nobungozi obuphansi. | Ikakhulukazi into yenqubomgomo yomphakathi. Hlolani izexwayiso zomoya wendawo bese nincipha isikhathi ngaphandle ezinsukwini ezingcole kakhulu. |
| Ukulahlekelwa yikhono lokubona okungelashiwe | Ebudaleni | 2% | Izinkinga zokubona ezingalungisiwe zihlotshaniswa nobungozi obuphakeme. Isifundo esisodwa esikhulu sase-US sihlobanisa ukuhlinzwa kwe-cataract nobungozi obuphansi. | Hlolisani amehlo njalo. Buzani ukuthi izinkinga ezifana ne-cataract zingelashwa yini. |
Kufanele ngiwafunde kanjani lawa maphesenti?
Ngokucophelela. Umbiko we-Commission uqobo unezinto eziningana okufanele zigcinwe engqondweni:
- Zichaza abantu bonke, hhayi abantu ngabanye. Isifinyezo sombiko se-University College London sithi ukwehlisa ubungozi kusebenza kubantu bonke futhi akuqinisekisi ukuthi noma yimuphi umuntu oyedwa uzigweme i-dementia.
- Zicabanga ukuthi kunembangela nomphumela. Ababhali bafaka kuphela izici ezinobufakazi obuqinisekisayo, kodwa bathi ezinye izixhumanisi zingase zibe yimbangela ngokwengxenye kuphela.
- Yizibalo zomhlaba wonke. Idatha eningi ivela emazweni anemali engenayo ephakeme, futhi ingxenye yangempela yanoma yiliphi izwe noma umphakathi izohluka.
- Amaphesenti amancane angabaluleka. Isici esihlotshaniswa nama-2% amacala emhlabeni wonke sisathinta inani elikhulu kakhulu labantu.
Yiziphi izici ezingeziwe ngo-2024?
Umbiko ka-2024 wengeze izici ezimbili kweziyi-12 ezabizwa ngo-2020:
- I-cholesterol ye-LDL ephezulu maphakathi nempilo, ehlotshaniswa nama-7% amacala, ngokulinganiselwa.
- Ukulahlekelwa yikhono lokubona okungelashiwe ebudaleni, okuhlotshaniswa nama-2% amacala, ngokulinganiselwa.
Yiziphi izici zobungozi okungenakushintshwa?
I-National Institute on Aging ithi iminyaka iyisici esikhulu kakhulu esaziwayo sobungozi be-Alzheimer’s, futhi akekho ongayishintsha. Amajini nawo anengxenye; ijini elilodwa elaziwayo elithonya ubungozi be-Alzheimer’s libizwa nge-APOE. I-NIA yengeza ukuthi ososayensi abakaqondi ngokuphelele ukuthi yini ebangela i-Alzheimer’s kubantu abaningi. I-Lancet Commission ithi izici zobungozi ezingase zishintshwe zingehliswa noma ngabe ubungozi bomuntu bamajini bungakanani.
Ngenxa yokuthi iminyaka namajini kunengxenye enkulu kangaka, abantu abaningi abangenazo izici ezi-14 zobungozi basazoba ne-dementia. Lokho akulona iphutha lomuntu.
Uthini ubufakazi bezilingo mayelana nokushintsha lobu bungozi?
Ukuhlobanisa isici sobungozi ne-dementia akufani nokufakazela ukuthi ukusishintsha kwehlisa ubungozi be-dementia. Izibonelo ezimbalwa zokuthi ubufakazi bezilingo bumi kuphi:
- Umfutho wegazi. Ocwaningweni lwe-SPRINT MIND, inhloso ephansi yomfutho wegazi yehlise ngokubalulekile ukuphazamiseka okuncane kokucabanga (mild cognitive impairment). Ayizange yehlise ngokubalulekile i-dementia ecatshangwa ukuthi ikhona (probable dementia), nakuba ucwaningo lungase lube luncane kakhulu ukuba lukhombise lokho (SPRINT MIND ku-JAMA).
- Izinsiza-kuzwa. I-Lancet Commission ichaza ucwaningo lweminyaka emithathu lwezinsiza-kuzwa olwathola ukuthi akukho siphumela esiphelele ekucabangeni, kodwa kunenzuzo eqenjini elincane labantu abasengozini ephakeme. Izifundo ezilandelela abantu isikhathi eside zihlobanisa ukusebenzisa izinsiza-kuzwa nobungozi obuphansi. Umhlahlandlela wethu wokuzwa unolwazi oluningi.
- Umsebenzi womzimba. I-National Institute on Aging ithi akukho bufakazi obuphelele bezilingo zomtholampilo ukuphetha ukuthi ukuzivocavoca kungavimbela noma kulibazise ukuphazamiseka okuncane kokucabanga noma i-Alzheimer’s, nakuba ezinye izifundo ziphakamisa ukuthi kungase kusize ekwehleni okuhlobene neminyaka (I-NIA mayelana nokuvimbela i-Alzheimer’s).
Izilingo ezinde ezilinda ukuthi i-dementia ivele ziyabambezeleka futhi ziyabiza, ngakho ezicini eziningi ubufakazi obungcono buzoqhubeka buvela ezifundweni ezilandelela abantu iminyaka eminingi. Lobo bufakazi buwusizo, kodwa bubuthaka kunobufakazi besilingo.
Kuthiwani ngokulala nokudla?
I-Commission yabuyekeza ukulala nokudla kodwa ayizange ibengeze ohlwini, ngoba ubufakazi bebungaqinile noma bungavumelani ngokwanele. Imihlahlandlela yethu ethi Ukulala neyethi Ukudla ichaza lokho okwaziwayo.
Khulumani nodokotela
Ukuhlolwa konyaka kuyisikhathi esihle sokuphakamisa lezi zihloko. Ningalethe lolu hlu futhi nibuze:
- Zingakanani izinombolo zami zomfutho wegazi, ushukela egazini ne-cholesterol, futhi ingabe ezinye zidinga ukunakwa?
- Kufanele ngihlolise ukuzwa nokubona kwami?
- Ingabe umsebenzi engiwenzayo uphephile futhi wanele kimi?
- Ingabe noma iyiphi imithi yami ingathinta inkumbulo noma ukucabanga?
Ngaphambi kokushintsha imithi, ukudla, ukuzila ukudla, ukuzivocavoca noma izithasiselo, khulumani nodokotela kuqala. Uma nina noma umuntu eniyamnakekelayo eba nokudideka okuzumayo, ubuthakathaka ohlangothini olulodwa, noma enobunzima bokukhuluma, shayelani inombolo yezimo eziphuthumayo yendawo yakini.
Imibuzo evamile
Yiziphi izici ezi-14 zobungozi be-dementia ezingashintshwa?
I-Lancet Commission ka-2024 yabiza imfundo encane, ukulahlekelwa yikhono lokuzwa, i-cholesterol ye-LDL ephezulu, ukudangala, ukulimala kobuchopho, ukungenzi umsebenzi womzimba, isifo sikashukela, ukubhema, umfutho wegazi ophezulu, ukukhuluphala ngokweqile, utshwala obuningi, ukungaxhumani nabantu, ukungcola komoya nokulahlekelwa yikhono lokubona okungelashiwe. Ndawonye zihlotshaniswa nokucishe kube ingxenye yamacala e-dementia emhlabeni wonke.
Yisiphi isici sobungozi be-dementia esibaluleke kakhulu?
Kubantu bomhlaba wonke, i-Commission yalinganisela ukuthi ukulahlekelwa yikhono lokuzwa ne-cholesterol ye-LDL ephezulu maphakathi nempilo kuhlotshaniswa ngayinye nama-7% amacala, kulandelwe imfundo encane nokungaxhumani nabantu ngama-5% ngalinye, ngokulinganiselwa. Ukuthi yiziphi izici ezibaluleke kakhulu kumuntu oyedwa kuncike empilweni yakhe, ngakho udokotela ungumholi omuhle kakhulu.
Ingabe izici ezimbili ezintsha zengezwe ngo-2024?
Yebo. Umbiko ka-2024 wengeze i-cholesterol ye-LDL (embi) ephezulu maphakathi nempilo nokulahlekelwa yikhono lokubona okungelashiwe ebudaleni kuzici eziyi-12 ezabizwa ngo-2020. I-Commission yazihlobanisa nama-7% nama-2% amacala ngokulandelana.
Ingabe iminyaka iyisici sobungozi esingashintshwa?
Cha. Iminyaka iyisici esikhulu kakhulu esaziwayo sobungozi besifo i-Alzheimer's, futhi ayikwazi ukushintshwa. Amajini nawo anengxenye. Izici ezi-14 kuleli khasi yilezo ucwaningo oluphakamisa ukuthi zingase zishintshwe.
Imithombo
Sixhumanisa nezinhlangano nezifundo leli khasi eliklanyelwe kuzo. Lunye lwahlolwa lapho leli khasi libuyekezwa.
- Dementia prevention, intervention, and care: 2024 report of the Lancet standing Commission · The Lancet
- Nearly half of dementia cases could be prevented or delayed by tackling 14 risk factors · University College London
- Preventing Alzheimer's Disease: What Do We Know? · National Institute on Aging
- What Causes Alzheimer's Disease? · National Institute on Aging
- Effect of Intensive vs Standard Blood Pressure Control on Probable Dementia: A Randomized Clinical Trial (SPRINT MIND) · JAMA (via PubMed)