Department of Psychiatry, University of Pittsburgh, 3501 Forbes Ave, Pittsburgh, PA, 15213, USA.
Adv Biol (Weinh). 2023 Nov;7(11):e2200237. doi: 10.1002/adbi.202200237. Epub 2022 Nov 20.
Disruptions in circadian rhythms can occur in healthy aging; however, these changes are more severe and pervasive in individuals with age-related and neurodegenerative diseases, such as dementia. Circadian rhythm alterations are also present in preclinical stages of dementia, for example, in patients with mild cognitive impairments (MCI); thus, providing a unique window of opportunity for early intervention in neurodegenerative disorders. Nonetheless, there is a lack of studies examining the association between relevant changes in circadian rhythms and their relationship with cognitive dysfunctions in MCI individuals. In this review, circadian system alterations occurring in MCI patients are examined compared to healthy aging individuals while also considering their association with MCI neurocognitive alterations. The main findings are that abnormal circadian changes in rest-activity, core body temperature, melatonin, and cortisol rhythms appear in the MCI stage and that these circadian rhythm disruptions are associated with some of the neurocognitive deficits observed in MCI patients. In addition, preliminary evidence indicates that interventions aimed at restoring regular circadian rhythms may prevent or halt the progress of neurodegenerative diseases and mitigate their related cognitive impairments. Future longitudinal studies with repeated follow-up assessments are needed to establish the translational potential of these findings in clinical practice.
昼夜节律紊乱可能发生在健康衰老中;然而,在与年龄相关的和神经退行性疾病(如痴呆症)的个体中,这些变化更为严重和普遍。昼夜节律改变也存在于痴呆症的临床前阶段,例如在轻度认知障碍(MCI)患者中;因此,为神经退行性疾病的早期干预提供了独特的机会窗口。尽管如此,仍然缺乏研究来检查昼夜节律相关变化与其与 MCI 个体认知功能障碍之间的关系。在这篇综述中,我们研究了 MCI 患者中发生的昼夜节律系统改变与健康衰老个体的比较,同时还考虑了它们与 MCI 神经认知改变的关系。主要发现是,在 MCI 阶段出现了异常的昼夜节律变化,包括静息-活动、核心体温、褪黑素和皮质醇节律的变化,这些昼夜节律紊乱与 MCI 患者观察到的一些神经认知缺陷有关。此外,初步证据表明,旨在恢复正常昼夜节律的干预措施可能预防或阻止神经退行性疾病的进展,并减轻其相关的认知障碍。需要进行未来的纵向研究,进行重复随访评估,以确定这些发现在临床实践中的转化潜力。