RESUMEN
Factors contributing to increased risk for Alzheimer's disease (AD) include age, sex, genes, and family history of AD. Several risk factors for AD are endogenous; however, accumulating evidence implicates modifiable risk factors in the pathogenesis of AD. Although the continued task of identifying new genes will be critical to learning more about the disease, several research findings suggest that potentially alterable environmental factors influence genetic contributions, providing targets for disease prevention and treatment. Here, we review midlife risk factors for AD, and address the potential for therapeutic intervention in midlife.
Asunto(s)
Enfermedad de Alzheimer/etiología , Enfermedad de Alzheimer/genética , Enfermedades Cardiovasculares/complicaciones , Femenino , Predisposición Genética a la Enfermedad , Humanos , Estilo de Vida , Masculino , Persona de Mediana Edad , Factores de Riesgo , Factores Sexuales , Factores SocioeconómicosRESUMEN
We compared fMRI and cognitive data from nine hormone therapy (HT)-naive women with data from women exposed to either opposed conjugated equine estrogens (CEE) (n = 10) or opposed estradiol (n = 4). Exposure to either form of HT was associated with healthier fMRI response; however, CEE-exposed women exhibited poorer memory performance than either HT-naive or estradiol-exposed subjects. These preliminary findings emphasize the need to characterize differential neural effects of various HTs.
Asunto(s)
Cognición/efectos de los fármacos , Estradiol/farmacología , Estrógenos Conjugados (USP)/farmacología , Imagen por Resonancia Magnética , Cognición/fisiología , Terapia de Reemplazo de Estrógeno/métodos , Femenino , Humanos , Imagen por Resonancia Magnética/métodos , Persona de Mediana Edad , Posmenopausia/efectos de los fármacos , Posmenopausia/fisiologíaRESUMEN
This study examined the functionality of the medial temporal lobe (MTL) and posterior cingulate (PC) in mild cognitive impairment amnestic type (MCI), a syndrome that puts patients at greater risk for developing Alzheimer disease (AD). Functional MRI (fMRI) was used to identify regions normally active during encoding of novel items and recognition of previously learned items in a reference group of 77 healthy young and middle-aged adults. The pattern of activation in this group guided further comparisons between 14 MCI subjects and 14 age-matched controls. The MCI patients exhibited less activity in the PC during recognition of previously learned items, and in the right hippocampus during encoding of novel items, despite comparable task performance to the controls. Reduced fMRI signal change in the MTL supports prior studies implicating the hippocampus for encoding new information. Reduced signal change in the PC converges with recent research on its role in recognition in normal adults as well as metabolic decline in people with genetic or cognitive risk for AD. Our results suggest that a change in function in the PC may account, in part, for memory recollection failure in AD.