Massachusetts Veterans Epidemiology Research and Information Center, VA Boston Healthcare System, Massachusetts, USA.
J Gerontol B Psychol Sci Soc Sci. 2011 Jul;66 Suppl 1(Suppl 1):i17-25. doi: 10.1093/geronb/gbr018.
We argue that age is a descriptive, and not explanatory, variable and consequently cannot account for the cognitive changes that often occur with aging. Once age is removed from consideration, other truly causal explanations for "cognitive aging" must be identified. We argue that health and disease represent an important class of explanatory variables for age-related cognitive changes.
METHODS/RESULTS: We make this argument first by reviewing the prevalence of risk factors, disability, and subclinical and frank disease in the elderly population. We emphasize that the complexity of health effects rivals that of age on cognition while noting that most studies of cognitive aging rarely consider this complexity fully. We then consider in more detail the "vascular hypothesis," which proposes that vascular diseases (e.g., stroke, heart disease) and their risk factors (e.g., hypertension) can explain aspects of cognitive decline in aging through their impact on circulatory and brain functions. Clinical implications of this hypothesis suggest that treatment of vascular risk factors might well reduce the incidence or severity of dementia syndromes.
We conclude with a brief summary of approaches to further integrate aspects of health and disease into the study of "cognitive aging."
我们认为年龄是一个描述性的，而不是解释性的变量，因此不能解释随着衰老经常发生的认知变化。一旦不再考虑年龄因素，就必须确定其他真正导致“认知老化”的因果解释。我们认为健康和疾病是与年龄相关的认知变化的一个重要解释变量类别。
方法/结果：我们首先通过回顾老年人群中风险因素、残疾以及亚临床和明显疾病的流行情况来提出这一观点。我们强调，健康对认知的影响与年龄的影响一样复杂，同时注意到大多数认知老化研究很少能充分考虑到这种复杂性。然后，我们更详细地考虑了“血管假说”，该假说提出血管疾病（如中风、心脏病）及其风险因素（如高血压）可以通过影响循环和大脑功能来解释衰老过程中的认知下降。该假说的临床意义表明，治疗血管风险因素可能会降低痴呆综合征的发病率或严重程度。
我们在简短的总结中提出了进一步将健康和疾病的各个方面纳入“认知老化”研究的方法。
