The ageing brain undergoes biochemical, molecular,structural and functional changes, rendering it vulner-able to a range of neuropsychiatric disorders. Untilrecently, little has been understood regarding the natureof these changes, the factors promoting them and theirrelationship to mental health. With the rapid growth inthe proportion of old and very old in our community,the need for a comprehensive understanding of brainageing has taken on a sense of urgency. Recent advancesin the neurosciences have allowed some insights intothis ageing process, together with research into ageassociated diseases such as Alzheimer’s disease (AD).Although the changes associated with brain ageing arecomplex and multifaceted, a clearer understanding of this process is now possible. It is hoped that furtheradvancement in our knowledge of the mechanisms of brain ageing may lead to interventions designed to slowthe ageing process, thus reducing the burden of neuro-psychiatric disorder in our old and very old populations.Our review aims to summarize the literature pertainingto brain ageing from the molecular to the functionallevels.
Brain ageing in the new millennium
Julian N. Trollor, Michael J. Valenzuela
This paper examines the current literature pertaining to brain ageing. Theobjective of this review is to provide an overview of the effects of ageing on brain structureand function and to examine possible mediators of these changes.
AMEDLINE search was conducted for each area of interest. Aselective reviewwas undertaken of relevant articles.
Although fundamental changes in fluid intellectual abilities occur with age, globalcognitive decline is not a hallmark of the ageing process. Decline in fluid intellectual abilityis paralleled by regionally specific age related changes apparent from both structural andfunctional neuroimaging studies. The histopathological mediators of these changes do notappear to be reduction in neuronal number, which, with the exception of selected hippo-campal regions, remain relatively stable across age. At the molecular level, several mech-anisms of age related change have been postulated. Such theoretical models awaitrefinement and may eventually provide a basis for therapy designed to reduce effects of theageing process. The role of possible protective factors such as ‘brain reserve’, neuro-protective agents and hormonal factors in modifying individual vulnerability to the ageingprocess has been the focus of a limited number of studies.
Our understanding of the functional and structural changes associated withboth healthy and pathological ageing is rapidly gaining in sophistication and complexity. Anawareness of the fundamental biological substrates underpinning the ageing process willallow improved insights into vulnerability to neuropsychiatric disease associated withadvancing age.
brain ageing, cognition, dementia, neuroimaging.
Australian and New Zealand Journal of Psychiatry 2001; 35:788–805
Michael J. Valenzuela, Research Psychologist (Correspondence); Julian N.Trollor, Conjoint Lecturer and Staff Specialist
School of Psychiatry, University of New South Wales and Neuro-psychiatric Institute, The Prince of Wales Hospital, Sydney, New SouthWales, Australia. Email: email@example.com
Received 13 July 2001; accepted 16 July 2001.