Centre for Human Psychopharmacology,Swinburne University of Technology,Melbourne,VIC,Australia.
Proc Nutr Soc. 2018 Feb;77(1):73-83. doi: 10.1017/S0029665117004025. Epub 2017 Dec 11.
Effective pharmaceutical treatments for age-related cognitive decline have proved elusive. There is, however, compelling evidence that nutritional status and supplementation could play crucial roles in modifying the expression of cognitive change through the lifespan. Subjective memory impairment and mild cognitive impairment can be harbingers of dementia but this is by no means inevitable. Neurocognitive change is influenced by a variety of processes, many of which are involved in other aspects of systemic health, including cardiovascular function. Importantly, many of these processes are governed by mechanisms which may be modified by specific classes of bioactive nutrients. There is increasing, converging evidence from controlled trials that nutritional interventions can improve mood and cognitive function in both clinical and healthy populations. Specific examples include selected botanical extracts such as the flavonoids. Some nutritional supplements (e.g. broad-spectrum micronutrient supplementation) appear to support improved cognitive function, possibly through redressing insufficient nutrient status (i.e. suboptimal but above the threshold for frank deficiency). Recent mechanistic research has unveiled physiologically plausible, modifiable, cognition-relevant targets for nutrition and nutraceuticals. These include processes involved in both systemic and central vascular function, inflammation, metabolism, central activation, improved neural efficiency and angiogenesis. The advent and development of human neuroimaging methodology have greatly aided our understanding of the core central mechanisms of cognitive change. Different imaging modalities can provide insights into modifiable central mechanisms which may be targeted by bioactive nutrients. The latter may contribute to slowing age-related decline through supporting neurocognitive scaffolding mechanisms.
对于与年龄相关的认知能力下降，有效的药物治疗方法一直难以捉摸。然而，有确凿的证据表明，营养状况和补充剂可以通过改变认知变化在整个生命周期中的表达来发挥关键作用。主观记忆障碍和轻度认知障碍可能是痴呆的先兆，但这绝不是不可避免的。神经认知变化受到多种过程的影响，其中许多过程与心血管功能等其他系统健康方面有关。重要的是，许多这些过程受到可能通过特定类别的生物活性营养素来改变的机制的影响。越来越多的对照试验证据表明，营养干预可以改善临床和健康人群的情绪和认知功能。具体的例子包括一些植物提取物，如类黄酮。一些营养补充剂（例如广谱微量营养素补充剂）似乎可以支持认知功能的改善，可能是通过纠正营养不足的状态（即不足但高于明显缺乏的阈值）。最近的机制研究揭示了与营养和营养保健品相关的具有生理意义、可改变的认知相关目标。这些目标包括涉及全身和中枢血管功能、炎症、代谢、中枢激活、提高神经效率和血管生成的过程。人类神经影像学方法的出现和发展极大地帮助我们理解了认知变化的核心中枢机制。不同的成像方式可以深入了解可改变的中枢机制，这些机制可能是生物活性营养素的靶点。后者可能通过支持神经认知支架机制来减缓与年龄相关的衰退。
