Zanto Theodore P, Gazzaley Adam
Department of Neurology, University of California San Francisco, San Francisco, CA, United States; Neuroscape, University of California San Francisco, San Francisco, CA, United States.
Department of Neurology, University of California San Francisco, San Francisco, CA, United States; Departments of Physiology and Psychiatry, University of California San Francisco, San Francisco, CA, United States; Neuroscape, University of California San Francisco, San Francisco, CA, United States.
Handb Clin Neurol. 2019;163:369-389. doi: 10.1016/B978-0-12-804281-6.00020-3.
Healthy aging is associated with numerous deficits in cognitive function, which have been attributed to changes within the prefrontal cortex (PFC). This chapter summarizes some of the most prominent cognitive changes associated with age-related alterations in the anatomy and physiology of the PFC. Specifically, aging of the PFC results in deficient aspects of cognitive control, including sustained attention, selective attention, inhibitory control, working memory, and multitasking abilities. Yet, not all cognitive functions associated with the PFC exhibit age-related declines, such as arithmetic, comprehension, emotion perception, and emotional control. Moreover, not all older adults exhibit declines in cognition. Multiple life-course and lifestyle factors, as well as genetics, play a role in the trajectory of cognitive performance across the life span. Thus many adults retain cognitive function well into advanced age. Moreover, the brain remains plastic throughout life and there is increasing evidence that most age-related declines in cognition can be remediated by various methods such as physical exercise, cognitive training, or noninvasive brain stimulation. Overall, because cognitive aging is associated with numerous life-course and lifestyle factors, successful aging likely begins in early life, while maintaining cognition or remediating declines is a life-long process.
健康老龄化与认知功能的诸多缺陷相关，这些缺陷归因于前额叶皮层（PFC）内的变化。本章总结了一些与PFC解剖学和生理学中与年龄相关变化相关的最突出的认知变化。具体而言，PFC的老化导致认知控制方面的缺陷，包括持续注意力、选择性注意力、抑制控制、工作记忆和多任务处理能力。然而，并非所有与PFC相关的认知功能都会出现与年龄相关的衰退，例如算术、理解、情感感知和情绪控制。此外，并非所有老年人的认知都会衰退。多种生命历程和生活方式因素以及基因，在整个生命周期的认知表现轨迹中都发挥着作用。因此，许多成年人在高龄时仍能保持良好的认知功能。此外，大脑在一生中都保持可塑性，越来越多的证据表明，大多数与年龄相关的认知衰退可以通过各种方法得到改善，如体育锻炼、认知训练或非侵入性脑刺激。总体而言，由于认知老化与多种生命历程和生活方式因素相关，成功老龄化可能始于早年，而维持认知或改善衰退是一个终身过程。
