Laboratory of Functional Neuroscience, Pablo de Olavide University, Seville, Spain; Network Center for Biomedical Research in Neurodegenerative Diseases (CIBERNED), Spain.
Laboratory of Functional Neuroscience, Pablo de Olavide University, Seville, Spain.
Sleep Med Rev. 2018 Dec;42:171-183. doi: 10.1016/j.smrv.2018.08.002. Epub 2018 Aug 16.
Aging is characterized by a progressive increase in proinflammatory status. This state, known as inflammaging, has been associated with cognitive decline in normal and pathological aging. However, this relationship has been inconsistently reported, likely because it is conditioned by other factors also affected by the aging process. Sleep and adiposity are two factors in particular that show significant alterations with aging and have been related to both cognitive decline and inflammaging. Given the consequences this state also has for brain integrity and cognition, we discuss here evidence supporting the potential mediating role of chronic low-grade systemic inflammation in the complex relationship between impaired sleep, dysfunctional adiposity, and cognitive decline through the common pathway of neuroinflammation. This review proposes a multi-factor model of aging-related cognitive decline that highlights the reciprocal interactions between sleep, the circadian system, and inflammation on the one hand, and between sleep, adiposity, and hormone resistance on the other. The model identifies sleep and adiposity as modifiable lifestyle factors that can be targeted to maximize cognitive function and quality of life in the elderly.
衰老是由促炎状态的逐渐增加所决定的。这种状态，被称为“炎老化”，与正常和病理性衰老的认知能力下降有关。然而，这种关系的报道并不一致，这可能是因为它受到其他因素的影响，而这些因素也受到衰老过程的影响。睡眠和肥胖是两个特别显著的因素，它们随着衰老而发生显著改变，并且与认知能力下降和炎老化都有关。鉴于这种状态对大脑完整性和认知也有影响，我们在这里讨论支持慢性低度系统性炎症在睡眠受损、脂肪功能障碍和认知能力下降之间复杂关系中可能具有潜在中介作用的证据，这种关系是通过神经炎症的共同途径发生的。本综述提出了一个与衰老相关的认知能力下降的多因素模型，该模型强调了睡眠、昼夜节律系统和炎症之间的相互作用，以及睡眠、肥胖和激素抵抗之间的相互作用。该模型确定了睡眠和肥胖是可改变的生活方式因素，可以针对这些因素进行干预，以最大限度地提高老年人的认知功能和生活质量。
