Postgraduate Program in Gerontology, College of Medical Sciences, State University of Campinas, Campinas, Brazil.
Postgraduate Program in Medical Pathophysiology, Faculty of Medical Sciences, State University of Campinas, Campinas, Brazil.
Arch Gerontol Geriatr. 2024 Aug;123:105395. doi: 10.1016/j.archger.2024.105395. Epub 2024 Mar 4.
Little is known about changes in the brain associated with frailty, in particular, which brain areas could be related to frailty in older people without cognitive impairment. This scoping review mapped evidence on functional and/or structural brain changes in frail older adults without cognitive impairment. The methodology proposed by the JBI® was used in this study. The search in PubMed, PubMed PMC, BVS/BIREME, EBSCOHOST, Scopus, Web of Science, Embase, and PROQUEST was conducted up to January 2023. Studies included following the population, concepts, context and the screening and data extraction were performed by two independent reviewers. A total of 9,912 records were identified, 5,676 were duplicates and were excluded. The remaining articles were screened; 31 were read in full and 17 articles were included. The results showed that lesions in white matter hyperintensities, reduced volume of the hippocampus, cerebellum, middle frontal gyrus, low gray matter volume, cortical atrophy, decreased connectivity of the supplementary motor area, presence of amyloid-beta peptide (aβ) in the anterior and posterior putamen and precuneus regions were more frequently observed in frail older adults, compared with non-frail individuals. Studies have suggested that such findings may be of neurodegenerative or cerebrovascular origin. The identification of these brain alterations in frail older adults through neuroimaging studies contributes to our understanding of the underlying mechanisms of frailty. Such findings may have implications for the early detection of frailty and implementation of intervention strategies.
关于与虚弱相关的大脑变化，特别是与认知功能正常的老年人虚弱相关的大脑区域，人们知之甚少。本范围综述旨在绘制无认知障碍的虚弱老年人功能性和/或结构性大脑变化的证据图。本研究采用了 JBI® 提出的方法。对 PubMed、PubMed PMC、BVS/BIREME、EBSCOHOST、Scopus、Web of Science、Embase 和 PROQUEST 进行了截至 2023 年 1 月的检索。研究纳入符合人群、概念、背景标准，并由两名独立评审员进行了筛查和数据提取。共确定了 9912 条记录，其中 5676 条为重复记录，被排除在外。对剩余的文章进行了筛选，阅读全文的文章有 31 篇，纳入了 17 篇文章。结果表明，与非虚弱个体相比，无认知障碍的虚弱老年人更常出现白质高信号病变、海马体、小脑、额中回体积减少、灰质体积低、皮质萎缩、辅助运动区连接减少、前、后壳核及楔前叶部位的淀粉样β肽（aβ）存在。这些发现可能与神经退行性或脑血管原因有关。通过神经影像学研究识别这些虚弱老年人的大脑变化有助于我们了解虚弱的潜在机制。这些发现可能对虚弱的早期检测和干预策略的实施具有重要意义。
