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住院老年人的肠道微生物群与运动认知功能减退

Gut microbiota and motoric-cognitive frailty in hospitalized older persons.

作者信息

Lauretani Fulvio, Longobucco Yari, Maggio Marcello

机构信息

Department of Medicine and Surgery, University of Parma.

Medicine and Geriatric-Rehabilitation Department of Parma, Cognitive and Motor Center, University-Hospital of Parma, Parma, Italy.

出版信息

Curr Opin Clin Nutr Metab Care. 2021 May 1;24(3):209-215. doi: 10.1097/MCO.0000000000000739.

Abstract

PURPOSE OF REVIEW

In older people, many systems spontaneously change without diseases. Because of the ageing process, the gut microbiota undergoes a reduced species richness, altered balance between species, with an increased interindividual variability. The result is the reduced resilience in the presence of diseases and medications. These changes are more evident in older persons with neurodegenerative diseases and cognitive-motoric frailty.

RECENT FINDINGS

A relationship between liver alteration, gut microbiota and the presence of viruses and gram-bacteria is conceivable. They determine the acceleration of neurodegenerative diseases with cognitive and motoric frailty. Hospitalization represents one of the stressors for the gut microbiota, producing dysbiosis and increasing the representation of pathobionts. The gut microbiota alterations during hospitalization may be associated with negative clinical outcomes. This phenomenon together with liver dysfunction could produce an acceleration of the trajectory of cognitive-motoric frailty towards disability and mortality. The observation that predisability is associated of both losses of cognition and motoric performance, has allowed introducing a new syndrome, the motoric-cognitive risk syndrome, which is a condition of increased risk of dementia and mobility-disability.

SUMMARY

The interaction between liver and gut microbiota may accelerate the neurodegenerative diseases and represents a promising marker of prognostic trajectories in older patients.

摘要

综述目的

在老年人中,许多系统会在无疾病状态下自发改变。由于衰老过程,肠道微生物群的物种丰富度降低,物种间平衡改变,个体间变异性增加。结果是在患病和用药时恢复力下降。这些变化在患有神经退行性疾病和认知运动功能衰弱的老年人中更为明显。

最新发现

肝脏改变、肠道微生物群以及病毒和革兰氏菌的存在之间的关系是可以想象的。它们决定了伴有认知和运动功能衰弱的神经退行性疾病的加速发展。住院是肠道微生物群的应激源之一,会导致生态失调并增加致病共生菌的比例。住院期间肠道微生物群的改变可能与不良临床结局相关。这种现象与肝功能障碍一起,可能会加速认知运动功能衰弱向残疾和死亡的发展轨迹。易致残性与认知和运动功能丧失均相关这一观察结果,促使引入了一种新的综合征,即运动认知风险综合征,这是一种患痴呆症和行动能力残疾风险增加的状态。

总结

肝脏与肠道微生物群之间的相互作用可能会加速神经退行性疾病的发展,并且是老年患者预后轨迹的一个有前景的标志物。

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