[Inflammation and oxidation: predictive and/or causative factors]. / Inflamación y oxidación: factores predictivos y/o causales.

Brain ageing leads to a series of changes that reduce the processes of adaptation and response. These transformations can end in cognitive impairment and/or dementia. Although the cause of these changes is diverse, inflammation and oxidative stress explain some of the pathophysiological mechanisms of these anomalies of brain functioning. Neuroinflammation triggers neuronal injury through the presence of inflammatory cytokines and the activation of microglia through membrane receptors and nuclear activation factors. This neuroinflammatory phenomenon also affects neuron plasticity, altering the genesis and maintenance of long-term potentiation, leading to impairment of hippocampus-dependent memory. Oxidative stress and the production of free oxygen radicals also cause toxic effects in aged brains, largely due to lipid peroxidation and DNA damage. The identification of the molecular mechanisms involved in the pathogenesis of these events could shed new light on possible therapeutic targets and offer strategies for the prevention of diseases related to brain ageing, cognitive impairment and dementia.

Inflamación y oxidación: factores predictivos y/o causales / Inflammation and oxidation: predictive and/or causative factors

En el envejecimiento cerebral ocurren una serie de cambios que conllevan la disminución de los procesos de adaptación y respuesta. Estas transformaciones pueden finalizar en el padecimiento de deterioro cognitivo y/o demencia. Aunque el origen de estas modificaciones es diverso, la inflamación y el estrés oxidativo explican parte de los mecanismos fisiopatológicos de dichas anomalías del funcionamiento cerebral. La neuroinflamación desencadena daño a nivel neuronal mediante la presencia de citocinas inflamatorias y la activación de la microglía, a través de receptores de membrana y factores de activación nuclear. Este fenómeno neuroinflamatorio también afecta la plasticidad neuronal, alterando la génesis y el mantenimiento de la potenciación a largo plazo ocasionando deterioro en la memoria dependiente del hipocampo. El estrés oxidativo y la producción de radicales libres de oxígeno, también originan efectos tóxicos en los cerebros envejecidos, en gran parte debido a la peroxidación lipídica y daños en el ADN. La identificación de los mecanismos moleculares implicados en la patogénesis de estos sucesos puede arrojar nueva luz sobre posibles dianas terapéuticas y ofrecer estrategias para la prevención de las patologías relacionadas con el envejecimiento cerebral, el deterioro cognitivo y la demencia (AU)

Brain ageing leads to a series of changes that reduce the processes of adaptation and response. These transformations can end in cognitive impairment and/or dementia. Although the cause of these changes is diverse, inflammation and oxidative stress explain some of the pathophysiological mechanisms of these anomalies of brain functioning. Neuroinflammation triggers neuronal injury through the presence of inflammatory cytokines and the activation of microglia through membrane receptors and nuclear activation factors. This neuroinflammatory phenomenon also affects neuron plasticity, altering the genesis and maintenance of long-term potentiation, leading to impairment of hippocampus-dependent memory. Oxidative stress and the production of free oxygen radicals also cause toxic effects in aged brains, largely due to lipid peroxidation and DNA damage. The identification of the molecular mechanisms involved in the pathogenesis of these events could shed new light on possible therapeutic targets and offer strategies for the prevention of diseases related to brain ageing, cognitive impairment and dementia (AU)

Análisis longitudinal de parámetros nutricionales en una cohorte de ancianos con y sin demencia / Longitudinal analysis of nutrition parameters in a cohort of elderly people with and without dementia

Introducción. La evaluación nutricional longitudinal, debido a sus frecuentes alteraciones, es especialmente relevante en al anciano con deterioro cognitivo. El objetivo del presente estudio es valorar a lo largo del tiempo el efecto y la posible interacción del deterioro cognitivo y del envejecimiento en los parámetros nutricionales. Material y métodos. Estudio longitudinal prospectivo de 2 años de seguimiento en 301 ancianos (233 mujeres y 68 varones) en el medio residencial, 51 de los cuales tienen criterios de demencia. Los parámetros antropométricos y bioquímicos se obtuvieron según técnicas normalizadas. Resultados. Los ancianos con demencia presentan, en todos los parámetros estudiados, valores inferiores respecto a los ancianos sin demencia. En los pacientes con deterioro cognitivo los valores medios de los parámetros nutricionales permanecen estables y sin diferencias significativas tras 2 años de seguimiento: índice de masa corporal 24,5 ± 4,9 vs 24,2 ± 4,1; pliegue tricipital 15,0 ± 6,0 vs 14,7 ± 6,9; circunferencia braquial 25,9 ± 3,3 vs 25,7 ± 3,5, y albúmina 3,7 ± 0,3 vs 3,7 ± 0,3. En los pacientes sin deterioro cognitivo los valores al final del estudio han descendido respecto a los valores basales, excepto el pliegue bicipital y los triglicéridos. Conclusiones. Tras 2 años de seguimiento no se observa descenso de los parámetros nutricionales estudiados en los ancianos con demencia; sin embargo, sí aparece un descenso en los ancianos sin deterioro cognitivo. Las causas de estas diferencias pueden ser múltiples. Son necesarios más estudios, con mayor número de ancianos y un mayor periodo de seguimiento, para validar estos hallazgos (AU)

Introduction. It is important to assess longitudinal nutritional parameters during the ageing process in order to determine body composition changes. This procedure is more relevant when dealing with institutionalised geriatric patients suffering from cognitive impairment. The aim of this study was to assess the interactions, if any, between mental status and several nutritional parameters in a cohort of elderly people. Material and methods. A longitudinal prospective two years follow-up evaluation was performed on 301 elderly residents (233 females and 68 males) in a nursing home, of whom 51 of them fulfilled the clinical criteria for dementia. Both anthropometric and biochemical parameters were obtained annually, according to standard procedures. Results. The dementia group had lower values when compared to the non-dementia group. Furthermore, nutritional values remained constant in the group with cognitive impairment (no significant differences were observed throughout the study period). BMI 24.5 ± 4.9 vs 24.2 ± 4.1; tricipital skinfold 15.0 ± 6.0 vs 14.7 ± 6.9; brachial circumference 25.9 ± 3.3 vs 25.7 ± 3.5, and albumin 3.7 ± 0.3 vs 3.7 ± 0.3. At the end of the study, the group without cognitive impairment showed lower values in all the parameters analysed when compared to the baseline ones, except for bicipital fold and plasma triglycerides. Conclusions. Our study shows that there are no variations in the elderly with cognitive impairment, as regards the nutritional, anthropometric and biochemist parameters analysed. On the contrary, the group with normal cognitive status showed a reduction in most of the parameters. Further studies analysing larger populations of elderly people and over longer periods of time will provide more information to improve our knowledge on this important issue (AU)

[Longitudinal analysis of nutrition parameters in a cohort of elderly people with and without dementia]. / Análisis longitudinal de parámetros nutricionales en una cohorte de ancianos con y sin demencia.

INTRODUCTION: It is important to assess longitudinal nutritional parameters during the ageing process in order to determine body composition changes. This procedure is more relevant when dealing with institutionalised geriatric patients suffering from cognitive impairment. The aim of this study was to assess the interactions, if any, between mental status and several nutritional parameters in a cohort of elderly people. MATERIAL AND METHODS: A longitudinal prospective two years follow-up evaluation was performed on 301 elderly residents (233 females and 68 males) in a nursing home, of whom 51 of them fulfilled the clinical criteria for dementia. Both anthropometric and biochemical parameters were obtained annually, according to standard procedures. RESULTS: The dementia group had lower values when compared to the non-dementia group. Furthermore, nutritional values remained constant in the group with cognitive impairment (no significant differences were observed throughout the study period). BMI 24.5±4.9 vs 24.2±4.1; tricipital skinfold 15.0±6.0 vs 14.7±6.9; brachial circumference 25.9±3.3 vs 25.7±3.5, and albumin 3.7±0.3 vs 3.7±0.3. At the end of the study, the group without cognitive impairment showed lower values in all the parameters analysed when compared to the baseline ones, except for bicipital fold and plasma triglycerides. CONCLUSIONS: Our study shows that there are no variations in the elderly with cognitive impairment, as regards the nutritional, anthropometric and biochemist parameters analysed. On the contrary, the group with normal cognitive status showed a reduction in most of the parameters. Further studies analysing larger populations of elderly people and over longer periods of time will provide more information to improve our knowledge on this important issue.