Towards Combinatorial Approaches for Preserving Cognitive Fitness in Aging. Issue 12 (December 2018)

• Record Type: Journal Article
• Authors: Brem, Anna-Katharine; Sensi, Stefano L.
• Is Part Of: Trends in neurosciences. Volume 41:Issue 12(2018)
• Page Start: 885
• Page End: 897
• Publication Date: 2018-12
• Subjects: aging -- cognitive enhancement -- neurotransmitter signaling -- brain-derived neurotrophic factor (BDNF) -- noninvasive brain stimulation (NIBS) -- cognitive training; Neurology -- Periodicals; Neurophysiology -- Periodicals; Neurobiology -- Periodicals; 612.8
• DOI: 10.1016/j.tins.2018.09.009
• Languages: English
• ISSNs: 0166-2236

Abstract

Abstract : Aging-related cognitive decline represents a critical risk factor for the development of dementia and is associated with global neurophysiological changes. It is imperative to act early, while the neural reserve is still sufficient, to prevent or postpone cognitive decline. Given that no significant modifying pharmacological intervention is available, a focus on pharmacological agents alone seems insufficient. We argue that combinations of different approaches are most effective in stimulating long-lasting molecular changes that restore, promote, and preserve cognition through the modulation of cognitively relevant neurotransmitter systems that ultimately converge in driving neurotrophic signaling. Considering recent technological advances, several interventions apart from cognitive enhancing drugs, including noninvasive brain stimulation, physical exercise/vascular interventions, and cognitive training, seem well positioned to possibly prolong optimal brain functioning upon aging. Highlights: In view of the forecasted demographic change, research on cognitive enhancement in aging healthy and patient populations is a rapidly emerging field. The former primary focus on pharmacological agents is increasingly complemented with nonpharmacological approaches. Progress using single methods targeting single cognitive functions is promising, but we argue that combined effects could yield stronger and broader cognitive effects. Recent results point toward a common pathway via BDNF signaling, which could be exploited concomitantly via pharmacological and nonpharmacological methods. Given the rapid advances in personalized medicine, this avenue should be further explored. Major challenges remain, including ethical and health-related issues concerning the long-term effects of cognitive enhancement.