我们从最年长的人群的认知中学到了什么。
What have we learned from cognition in the oldest-old.
机构信息
Department of Neurology and Department of Neurobiology & Behavior, University of California, Irvine, Irvine, California, USA.
Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC and Department of Internal Medicine, Spaarne Gasthuis, Haarlem, the Netherlands.
出版信息
Curr Opin Neurol. 2021 Apr 1;34(2):258-265. doi: 10.1097/WCO.0000000000000910.
PURPOSE OF REVIEW
People over 90 are the fastest growing segment of the population with the highest rates of dementia. This review highlights recent findings that provide insight to our understanding of dementia and cognition at all ages.
RECENT FINDINGS
Risk factors for Alzheimer's disease (AD) and dementia differ by age, with some factors, like the development of hypertension, actually becoming protective in the oldest-old. At least half of all dementia in this age group is due to non AD pathologies, including microinfarcts, hippocampal sclerosis and TDP-43. The number of pathologic changes found in the brain is related to both risk and severity of dementia, but many people in this age group appear to be 'resilient' to these pathologies. Resilience to Alzheimer pathology, in part, may be related to absence of other pathologies, and imaging and spinal fluid biomarkers for AD have limited utility in this age group.
SUMMARY
Studies of dementia in the oldest-old are important for our understanding and eventual treatment or prevention of dementia at all ages.
目的综述：90 岁以上人群是人口增长最快的年龄段，痴呆症发病率最高。本综述重点介绍了最近的研究结果，这些结果使我们对各年龄段的痴呆症和认知有了更深入的了解。
最新发现：阿尔茨海默病（AD）和痴呆症的风险因素因年龄而异，一些因素（如高血压的发展）在最年长的人群中实际上具有保护作用。该年龄段至少有一半的痴呆症是由非 AD 病理引起的，包括微梗死、海马硬化和 TDP-43。大脑中发现的病理改变数量与痴呆症的风险和严重程度有关，但该年龄段的许多人似乎对这些病理具有“弹性”。部分 AD 病理的弹性可能与其他病理的缺失有关，AD 的影像学和脑脊液生物标志物在该年龄段的应用有限。
总结：对最年长人群的痴呆症研究对于我们理解和最终治疗或预防所有年龄段的痴呆症非常重要。
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