Brain Institute of Rio Grande do Sul (BraIns),Pontifical Catholic University of Rio Grande do Sul,Porto Alegre,Brazil.
Int Psychogeriatr. 2018 Dec;30(12):1813-1825. doi: 10.1017/S1041610218000431. Epub 2018 Apr 18.
ABSTRACTObjectives:to perform a comprehensive literature review of studies on older adults with exceptional cognitive performance.
We performed a systematic review using two major databases (MEDLINE and Web of Science) from January 2002 to November 2017.
Quantitative analysis included nine of 4,457 studies and revealed that high-performing older adults have global preservation of the cortex, especially the anterior cingulate region, and hippocampal volumes larger than normal agers. Histological analysis of this group also exhibited decreased amyloid burden and neurofibrillary tangles compared to cognitively normal older controls. High performers that maintained memory ability after three years showed reduced amyloid positron emission tomography at baseline compared with high performers that declined. A single study on blood plasma found a set of 12 metabolites predicting memory maintenance of this group.
Structural and molecular brain preservation of older adults with high cognitive performance may be associated with brain maintenance. The operationalized definition of high-performing older adults must be carefully addressed using appropriate age cut-off and cognitive evaluation, including memory and non-memory tests. Further studies with a longitudinal approach that include a younger control group are essential.
摘要目的：对认知表现异常的老年人进行综合文献回顾研究。
我们使用两个主要数据库（MEDLINE 和 Web of Science）进行了系统评价，时间范围为 2002 年 1 月至 2017 年 11 月。
定量分析包括 4457 项研究中的 9 项，结果表明，表现优异的老年人具有皮质的整体保存，尤其是前扣带区和海马体体积大于正常年龄者。与认知正常的老年对照组相比，该组的组织学分析还显示出淀粉样蛋白负担和神经原纤维缠结减少。与认知能力下降的表现优异者相比，在三年后仍保持记忆能力的表现优异者，其基线时的淀粉样蛋白正电子发射断层扫描结果较低。一项关于血浆的研究发现了一组 12 种代谢物，可预测该组的记忆保持能力。
认知表现优异的老年人的大脑结构和分子保存可能与大脑维持有关。必须使用适当的年龄截止值和认知评估（包括记忆和非记忆测试）来仔细解决表现优异的老年人的操作性定义。进一步的研究需要采用纵向方法，并纳入年轻对照组。
