Clinical Psychology and Psychotherapy, University of Zurich, Zurich, Switzerland; URPP Dynamics of Healthy Aging Research Priority Program, University of Zurich, Zurich, Switzerland.
Clinical Psychology and Psychotherapy, University of Zurich, Zurich, Switzerland; Biopsychology, TU Dresden, Dresden, Germany.
Psychoneuroendocrinology. 2019 Jul;105:64-78. doi: 10.1016/j.psyneuen.2018.09.035. Epub 2018 Sep 29.
Nowadays, people spend a considerable amount of their lives as older adults, but this longer lifespan is often accompanied by an increase in chronic conditions and disease, resulting in reduced quality of life and unprecedented societal and economic burden. Healthy aging is therefore increasingly recognized as a healthcare priority. Physical and mental adaptations to changes over the life course, and the maintenance of well-being, represent pivotal challenges in healthy aging. To capture the complexity of healthy aging, we propose a specific phenotype based on body composition, cognition, mood, and sexual function as indicators of different dimensions of healthy aging. With increasing age, sex hormones as well as glucocorticoids undergo significant alterations, and different patterns emerge for women and men. This review describes age-related patterns of change for women and men, and sheds light on the underlying mechanisms. Furthermore, an overview is provided of the challenges for healthy aging resulting from these age-related steroid alterations. While clinical practice guidelines recommend hormonal treatment only in the case of consistently low hormone levels and symptoms of hormone deficiency, physical exercise and a healthy lifestyle emerge as preventive strategies which can counter age-related hormonal changes and at best prevent chronic conditions.
如今，人们在老年阶段度过了相当长的一段时间，但这种长寿往往伴随着慢性疾病和疾病的增加，导致生活质量下降和前所未有的社会和经济负担。因此，健康老龄化越来越被视为医疗保健的重点。身体和心理适应生命过程中的变化，以及保持幸福感，是健康老龄化的关键挑战。为了捕捉健康老龄化的复杂性，我们提出了一个基于身体成分、认知、情绪和性功能的特定表型，作为健康老龄化不同维度的指标。随着年龄的增长，性激素和糖皮质激素会发生显著变化，女性和男性的模式也会不同。本文描述了女性和男性与年龄相关的变化模式，并揭示了潜在的机制。此外，还概述了这些与年龄相关的类固醇变化对健康老龄化带来的挑战。虽然临床实践指南仅建议在持续低激素水平和激素缺乏症状的情况下进行激素治疗，但身体运动和健康的生活方式作为预防策略，可以对抗与年龄相关的激素变化，并在最佳情况下预防慢性疾病。
