Aging and Health Research Center, National Yang Ming University, Taipei, Taiwan.
Center for Geriatrics and Gerontology, National Yang Ming University, Taipei, Taiwan.
Aging (Albany NY). 2020 Nov 25;12(24):25319-25336. doi: 10.18632/aging.104135.
Both physical and cognitive deficits occur in the aging process. We operationally defined the phenomenon as physio-cognitive decline syndrome (PCDS) and aimed to decipher its corresponding neuroanatomy patterns and neurocircuit. High resolution 3T brain magnetic resonance imaging (MRI) images from a community-dwelling longitudinal aging cohort were analysed. PCDS was defined as weakness (handgrip strength) and/or slowness (gait speed) concomitant with impairment in any cognitive domain (defined by 1.5 standard deviation below age, sex-matched norms), but without dementia or disability. Among 1196 eligible ≥ 50-year-old (62±9 years, 47.6%men) subjects, 15.9% had PCDS. Compared to the other participants, individuals with PCDS had significantly lower gray-matter volume (GMV) in the bilateral amygdala and thalamus, right hippocampus, right temporo-occipital cortex, and left cerebellum VI and V regions. The regions of reduced GMV in people with PCDS were similar between the middle-aged and older adults; whereas larger clusters with more extensive GMV-depleted regions were observed in ≥65-year-olds with PCDS. Diffusion-weighted tractography showed disrupted hippocampus-amygdala-cerebellum connections in subjects with PCDS. The neuroanatomic characteristics revealed by this study provide evidence for pathophysiological processes associated with concomitant physio-cognitive decline in the elderly. This neurocircuit might constitute a target for future preventive interventions.
在衰老过程中会出现身体和认知功能的衰退。我们将这种现象定义为生理认知衰退综合征（PCDS），并旨在解析其对应的神经解剖结构和神经回路。我们对来自社区居住的纵向老龄化队列的高分辨率 3T 脑磁共振成像（MRI）图像进行了分析。PCDS 定义为虚弱（握力）和/或缓慢（步态速度），同时伴有任何认知领域的障碍（定义为低于年龄、性别匹配的正常水平 1.5 个标准差），但没有痴呆或残疾。在 1196 名符合条件的≥50 岁（62±9 岁，47.6%为男性）参与者中，有 15.9%患有 PCDS。与其他参与者相比，患有 PCDS 的个体双侧杏仁核和丘脑、右侧海马体、右侧颞枕叶皮质和左侧小脑 VI 和 V 区的灰质体积（GMV）明显较低。在中年人及老年人中，PCDS 患者 GMV 减少的区域相似；而在≥65 岁的 PCDS 患者中，观察到更大的簇，GMV 耗竭区域更广泛。扩散加权轨迹显示 PCDS 患者的海马体-杏仁核-小脑连接中断。本研究揭示的神经解剖学特征为老年人同时发生的生理认知衰退相关的病理生理过程提供了证据。该神经回路可能成为未来预防干预的目标。
