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梳理脉络:性别、性取向及社会因素对认知衰老和阿尔茨海默病的影响

Connecting the Dots: Gender, Sexuality, and Societal Influences on Cognitive Aging and Alzheimer's Disease.

作者信息

Verma Swati, Paliwal Sarvesh, Paramanick Debashish, Narayan Chaitanay Vinayak, Saini Manasvi

机构信息

Department of Pharmacy, ITS College of Pharmacy, Muradnagar, Ghaziabad, India.

Department of Pharmacy, Banasthali Vidyapith, Banasthali 304022, Rajasthan, India.

出版信息

Curr Aging Sci. 2025;18(1):14-28. doi: 10.2174/0118746098299754240530111755.

Abstract

Alzheimer's disease (AD) has many etiologies and the impact of gender on AD changes throughout time. As a consequence of advancements in precision medical procedures and methodology, Alzheimer's disease is now better understood and treated. Several risk factors may be addressed to lower one's chances of developing Alzheimer's disease or associated dementia (ADRD). The presence of amyloid-α protein senile plaques, intracellular tau protein neurofibrillary tangles (NfTs), neurodegeneration, and neuropsychiatric symptoms (NPS) characterizes Alzheimer's disease. NPS is common in persons with Alzheimer's disease dementia, although its presentation varies widely. Gender differences might explain this clinical variability. The fundamental goal of this review is to 1) emphasize the function of old age, sex, and gender in the development of Alzheimer's disease, dementia, and ADRD, and 2) explain the importance of sexual hormones, education, and APOE (Apolipoprotein E) status. This is a narrative summary of new ideas and concepts on the differences in the chance of developing dementia or Alzheimer's disease between men and women. A more thorough examination of risk and protective variables in both men and women might hasten research into the epidemiology of neurological illnesses such as dementia and Alzheimer's disease. Similarly, future preventive efforts should target men and women separately.

摘要

阿尔茨海默病(AD)有多种病因,且性别对AD的影响随时间而变化。由于精准医疗程序和方法的进步,现在对阿尔茨海默病有了更好的理解和治疗。可以针对几个风险因素来降低患阿尔茨海默病或相关痴呆症(ADRD)的几率。淀粉样蛋白-α蛋白老年斑、细胞内tau蛋白神经原纤维缠结(NfTs)、神经退行性变和神经精神症状(NPS)的存在是阿尔茨海默病的特征。NPS在患有阿尔茨海默病痴呆症的患者中很常见,尽管其表现差异很大。性别差异可能解释了这种临床变异性。本综述的基本目标是:1)强调老年、性别和性在阿尔茨海默病、痴呆症和ADRD发生发展中的作用;2)解释性激素、教育和载脂蛋白E(APOE)状态的重要性。这是关于男性和女性患痴呆症或阿尔茨海默病几率差异的新观点和概念的叙述性总结。对男性和女性的风险和保护变量进行更全面的研究可能会加速对痴呆症和阿尔茨海默病等神经疾病流行病学的研究。同样,未来的预防措施应分别针对男性和女性。

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