The world’s population is expected to continue to grow over the next 50 to 60 years, peaking at around 10.3 billion people in the mid-2080s, up from 8.2 billion in 2024. By the late 2070s, the number of people aged 65 and over globally is expected to reach 2.2 billion, surpassing the number of people under 18. In fact, by the mid-2030s, there will be 265 million people aged 80 and over, more than the number of people aged 1 year and under. In countries where populations have already peaked or are projected to peak in the coming decades, this has profound implications for health and social care planning and delivery. The most challenging expression of population ageing is the clinical condition of frailty, a state of increased vulnerability to sudden changes in health status triggered by minor stressors, with a resulting increased risk of falls, disability, long-term care, and death. However, if an estimated 31–51 percent of people aged 80 and over are frail, then 49-69 percent of people aged 80 and over may not be frail, raising questions about how frailty develops, how it might be prevented, and how it can be reliably detected. The aging brain is associated with characteristic structural and physiological changes, particularly involving neurons with high metabolic demands, such as the hippocampal pyramidal neurons, that can be affected disproportionally by changes in synaptic function, protein transport, and mitochondrial function. Brain aging is also characterized by structural and functional changes in microglial cells, which are the resident immune cell population of the central nervous system (CNS) and have a macrophage function. They are activated by both brain injury and local and systemic inflammation and become hyper-reactive to even small stimuli with aging, resulting in neuronal damage and death. Growing evidence has supported the hypothesis of a temporal association between frailty, cognitive impairment, and dementia. In particular, evidence from prospective cohort studies showed an independent association between frailty and dementia, where the association of health status deficits that were among the markers of frailty significantly increased the risk of dementia. More specifically, a higher level of physical frailty was associated with a faster decline in cognitive function until the onset of dementia.
Editorial: Reviews in psychiatry 2023: aging psychiatry
Capurso, Cristiano
Writing – Review & Editing
2025-01-01
Abstract
The world’s population is expected to continue to grow over the next 50 to 60 years, peaking at around 10.3 billion people in the mid-2080s, up from 8.2 billion in 2024. By the late 2070s, the number of people aged 65 and over globally is expected to reach 2.2 billion, surpassing the number of people under 18. In fact, by the mid-2030s, there will be 265 million people aged 80 and over, more than the number of people aged 1 year and under. In countries where populations have already peaked or are projected to peak in the coming decades, this has profound implications for health and social care planning and delivery. The most challenging expression of population ageing is the clinical condition of frailty, a state of increased vulnerability to sudden changes in health status triggered by minor stressors, with a resulting increased risk of falls, disability, long-term care, and death. However, if an estimated 31–51 percent of people aged 80 and over are frail, then 49-69 percent of people aged 80 and over may not be frail, raising questions about how frailty develops, how it might be prevented, and how it can be reliably detected. The aging brain is associated with characteristic structural and physiological changes, particularly involving neurons with high metabolic demands, such as the hippocampal pyramidal neurons, that can be affected disproportionally by changes in synaptic function, protein transport, and mitochondrial function. Brain aging is also characterized by structural and functional changes in microglial cells, which are the resident immune cell population of the central nervous system (CNS) and have a macrophage function. They are activated by both brain injury and local and systemic inflammation and become hyper-reactive to even small stimuli with aging, resulting in neuronal damage and death. Growing evidence has supported the hypothesis of a temporal association between frailty, cognitive impairment, and dementia. In particular, evidence from prospective cohort studies showed an independent association between frailty and dementia, where the association of health status deficits that were among the markers of frailty significantly increased the risk of dementia. More specifically, a higher level of physical frailty was associated with a faster decline in cognitive function until the onset of dementia.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
