Читать книгу Pathy's Principles and Practice of Geriatric Medicine - Группа авторов - Страница 141

The ageing process is associated with structural and functional changes in the nervous system. Understanding the mechanisms and consequences of brain ageing has important implications for a number of reasons. First, the disorders of the ageing brain are one of the largest global healthcare issues. Age‐associated neurological diseases (e.g. stroke, Alzheimer’s disease [AD] and other dementias, Parkinson’s disease [PD]) represent a major cause of mortality and disability worldwide.¹ Their public health impact will further increase in the future as a consequence of ongoing sociodemographic transitions. Moreover, most neurodegenerative conditions share some pathophysiological processes, neuropathological modifications, and phenotypic manifestations with the physiological ageing process.² Therefore, understanding the neurobiological bases of brain ageing can drive fundamental advances in the development of effective therapies aimed at preventing or postponing neurodegenerative pathologies.³ Finally, brain functions and dysfunctions (even when they do not configure overt diseases) are crucial determinants for the main health‐related outcomes, such as mortality and functional dependence. They are also strongly associated with the frailty status of the individual: that is, with their risk of developing unfavourable health trajectories.⁴ Accordingly, identifying and promoting interventions and lifestyle modifications that might allow the maintenance or improvement of such competencies is essential for healthy ageing.

This chapter focuses on the main morphological changes and biological modifications occurring in the ageing brain. In addition, the central age‐related alterations at the neurological examination and in terms of cognitive functioning are addressed.