Wilson Robert S, Bennett David A
Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL 60612, USA.
Department of Neurological Sciences, Rush University Medical Center, Chicago, IL 60612, USA.
Brain Sci. 2017 May 23;7(6):56. doi: 10.3390/brainsci7060056.
With the aging of the U.S. population, the number of cognitively disabled persons is expected to substantially increase in coming decades, underscoring the urgent need for effective interventions. Here, we review the current evidence linking psychosocial factors to late-life cognitive loss and consider the study design needed to illuminate the biologic bases of the associations. We then examine an ongoing study that includes several of the key design elements, the Rush Memory and Aging Project. In this longitudinal clinical-pathological cohort study, indicators of personality, social connectedness, and psychological well-being were shown to predict late-life cognitive outcomes. Participants who died underwent a uniform neuropathologic examination to quantify common dementia-related pathologies. Some psychosocial indicators were associated with cerebral infarction; some indicators modified the association of neurodegenerative pathologies with cognitive loss; and the association of some indicators with cognitive outcomes appears to be independent of the pathologies traditionally associated with late-life dementia. These findings suggest that psychosocial behavior influences late-life cognitive health through multiple neurobiologic mechanisms. A better understanding of these mechanisms may lead to novel strategies for preserving cognitive health in old age.
随着美国人口老龄化，预计未来几十年认知障碍者的数量将大幅增加，这凸显了有效干预措施的迫切需求。在此，我们回顾了将心理社会因素与晚年认知衰退联系起来的现有证据，并考虑了阐明这些关联生物学基础所需的研究设计。然后，我们考察了一项正在进行的研究，即拉什记忆与衰老项目，该研究包含了几个关键的设计要素。在这项纵向临床病理队列研究中，人格、社会联系和心理健康指标被证明可以预测晚年认知结果。死亡的参与者接受了统一的神经病理学检查，以量化常见的痴呆相关病变。一些心理社会指标与脑梗死有关；一些指标改变了神经退行性病变与认知衰退的关联；一些指标与认知结果的关联似乎独立于传统上与晚年痴呆相关的病变。这些发现表明，心理社会行为通过多种神经生物学机制影响晚年认知健康。更好地理解这些机制可能会带来维护老年人认知健康的新策略。
