Kerminen Hanna, Marzetti Emanuele, D'Angelo Emanuela
Faculty of Medicine and Health Technology, Gerontology Research Center (GEREC), Tampere University, Arvo Ylpön katu 34, 33520 Tampere, Finland.
Department of Geriatrics, Orthopedics and Rheumatology, Università Cattolica del Sacro Cuore, L.go F. Vito 1, 00168 Rome, Italy.
J Clin Med. 2024 Jan 30;13(3):806. doi: 10.3390/jcm13030806.
Dementia is a major cause of poor quality of life, disability, and mortality in old age. According to the geroscience paradigm, the mechanisms that drive the aging process are also involved in the pathogenesis of chronic degenerative diseases, including dementia. The dissection of such mechanisms is therefore instrumental in providing biological targets for interventions and new sources for biomarkers. Within the geroscience paradigm, several biomarkers have been discovered that can be measured in blood and that allow early identification of individuals at risk of cognitive impairment. Examples of such markers include inflammatory biomolecules, markers of neuroaxonal damage, extracellular vesicles, and DNA methylation. Furthermore, gait speed, measured at a usual and fast pace and as part of a dual task, has been shown to detect individuals at risk of future dementia. Here, we provide an overview of available biomarkers that may be used to gauge the risk of cognitive impairment in apparently healthy older adults. Further research should establish which combination of biomarkers possesses the highest predictive accuracy toward incident dementia. The implementation of currently available markers may allow the identification of a large share of at-risk individuals in whom preventive interventions should be implemented to maintain or increase cognitive reserves, thereby reducing the risk of progression to dementia.
痴呆症是导致老年人生活质量低下、残疾和死亡的主要原因。根据老年科学范式，驱动衰老过程的机制也参与了包括痴呆症在内的慢性退行性疾病的发病过程。因此，剖析这些机制有助于提供干预的生物学靶点和生物标志物的新来源。在老年科学范式内，已经发现了几种可以在血液中测量的生物标志物，这些生物标志物能够早期识别有认知障碍风险的个体。这类标志物的例子包括炎症生物分子、神经轴突损伤标志物、细胞外囊泡和DNA甲基化。此外，以平常和快速步伐测量的步态速度，以及作为双重任务一部分测量的步态速度，已被证明能够检测出未来有患痴呆症风险的个体。在这里，我们概述了可用于评估看似健康的老年人认知障碍风险的现有生物标志物。进一步的研究应该确定哪种生物标志物组合对新发痴呆症具有最高的预测准确性。实施目前可用的标志物可能有助于识别很大一部分有风险的个体，对这些个体应实施预防性干预措施，以维持或增加认知储备，从而降低发展为痴呆症的风险。
