Institute for Ageing and Health, Newcastle University, Campus for Ageing and Vitality, Newcastle Upon Tyne NE4 5PL, UK.
Nutr Rev. 2010 Dec;68 Suppl 2(Suppl 2):S74-87. doi: 10.1111/j.1753-4887.2010.00352.x.
The integrity of the vascular system is essential for the efficient functioning of the brain. Aging-related structural and functional disturbances in the macro- or microcirculation of the brain make it vulnerable to cognitive dysfunction, leading to brain degeneration and dementing illness. Several faltering controls, including impairment in autoregulation, neurovascular coupling, blood-brain barrier leakage, decreased cerebrospinal fluid, and reduced vascular tone, appear to be responsible for varying degrees of neurodegeneration in old age. There is ample evidence to indicate vascular risk factors are also linked to neurodegenerative processes preceding cognitive decline and dementia. The strongest risk factor for brain degeneration, whether it results from vascular or neurodegenerative mechanisms or both, is age. However, several modifiable risks such as cardiovascular disease, hypertension, dyslipidemia, diabetes, and obesity enhance the rate of cognitive decline and increase the risk of Alzheimer's disease in particular. The ultimate accumulation of brain pathological lesions may be modified by genetic influences, such as the apolipoprotein E ε4 allele and the environment. Lifestyle measures that maintain or improve cardiovascular health, including consumption of healthy diets, moderate use of alcohol, and implementation of regular physical exercise are important factors for brain protection.
血管系统的完整性对于大脑的高效运作至关重要。随着年龄的增长，大脑的宏观或微循环出现结构和功能紊乱，使大脑易受到认知功能障碍的影响，导致大脑退化和痴呆。几个失控的控制机制，包括自动调节、神经血管耦联、血脑屏障渗漏、脑脊液减少和血管张力降低，似乎都与衰老过程中不同程度的神经退行性变有关。有充分的证据表明，血管危险因素也与认知能力下降和痴呆之前的神经退行性过程有关。无论是血管还是神经退行性机制引起的大脑退化的最强危险因素是年龄。然而，一些可改变的危险因素，如心血管疾病、高血压、血脂异常、糖尿病和肥胖症，会加速认知能力下降的速度，并特别增加患阿尔茨海默病的风险。大脑病理损伤的最终积累可能会受到遗传因素的影响，例如载脂蛋白 E ε4 等位基因和环境。保持或改善心血管健康的生活方式措施，包括健康饮食的摄入、适度饮酒和定期体育锻炼，是大脑保护的重要因素。
