Mallinckrodt Institute of Radiology, Washington University in St. Louis, St. Louis, MO.
Cramer Performance Institute, St. Louis, MO.
Am J Geriatr Psychiatry. 2023 Oct;31(10):853-866. doi: 10.1016/j.jagp.2023.06.001. Epub 2023 Jun 11.
Obesity, depression and Alzheimer's disease (AD) are three major interrelated modern health conditions with complex relationships. Early-life depression may serve as a risk factor for AD, while late-life depression may be a prodrome of AD. Depression affects approximately 23% of obese individuals, and depression itself raises the risk of obesity by 37%. Mid-life obesity independently increases AD risk, while late-life obesity, particularly metabolically healthy obesity, may offer protection against AD pathology. Chronic inflammation serves as a key mechanism linking obesity, AD, and depression, encompassing systemic inflammation from metabolic disturbances, immune dysregulation through the gut microbiome, and direct interactions with amyloid pathology and neuroinflammation. In this review, we explore the biological mechanisms of neuroinflammation in relation to obesity, AD, and depression. We assess the efficacy of therapeutic interventions targeting neuroinflammation and discuss current and future radiological imaging initiatives for studying neuroinflammation. By comprehending the intricate interplay among depression, obesity, and AD, especially the role of neuroinflammation, we can advance our understanding and develop innovative strategies for prevention and treatment.
肥胖、抑郁和阿尔茨海默病(AD)是三种相互关联的现代重大健康问题,它们之间存在复杂的关系。早发性抑郁可能是 AD 的一个风险因素,而晚发性抑郁可能是 AD 的前驱症状。大约 23%的肥胖者患有抑郁,而抑郁本身会使肥胖的风险增加 37%。中年肥胖会独立增加 AD 的风险,而晚年肥胖,特别是代谢健康型肥胖,可能对 AD 病理有保护作用。慢性炎症是将肥胖、AD 和抑郁联系在一起的关键机制,包括代谢紊乱引起的全身炎症、肠道微生物组引起的免疫失调,以及与淀粉样蛋白病理和神经炎症的直接相互作用。在这篇综述中,我们探讨了与肥胖、AD 和抑郁相关的神经炎症的生物学机制。我们评估了针对神经炎症的治疗干预措施的疗效,并讨论了当前和未来用于研究神经炎症的放射影像学计划。通过了解抑郁、肥胖和 AD 之间的复杂相互作用,特别是神经炎症的作用,我们可以加深对这些疾病的理解,并开发出预防和治疗这些疾病的创新策略。