Rev Invest Clin
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Aging is a complex phenomenon leading to numerous changes in the physiological systems of the body. One of the most important changes, called immunosenescence, occurs in the immune system. ⋯ The origin of this inflammaging is not known with certainty, but several concurrent contributing factors have been suggested, such as aging-associated changes in the innate and adaptive immune response, chronic antigenic stimulation, the appearance of endogenous macromolecular changes, and the presence of senescent cells exhibiting a senescence-associated secretory phenotype. A better understanding of the multiple biological phenomena leading to these diseases via the immunosenescence associated with inflammaging provides a powerful target for interventions to increase the healthspan of elderly subjects.
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There are several immunological and non-immunological factors related to renal graft deterioration, and histological lesions such as interstitial fibrosis and tubular atrophy overlap with those observed in aging kidneys. Consequently, it has been proposed that kidney transplant senescence could contribute to graft loss. ⋯ Moreover, renal tissue injury predisposes the older graft not only to progressive deterioration due to glomerular hyperfiltration, but also triggers acute rejection due to increased immunogenicity. In conclusion, renal graft senescence is a complex process, and its better understanding will help the nephrologist in its management in order to achieve a longer graft survival.
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The proportion of persons aged 85 and over, the so-called "oldest old", is increasing dramatically worldwide. While a quarter of this population is affected by dementia, little is known about the specific features of cognitive functioning in the oldest old. In the presence of clinical specificities such as numerous comorbidities, multi-medication and visual and/or auditory loss, which are very frequent in extreme old age, neuropsychological assessment can be particularly challenging. This article presents an overview of the epidemiology of cognitive functioning in the oldest old, and discusses the issues regarding neuropsychological assessment and dementia in this specific elderly population.
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The most common dementias such as Alzheimer's disease, vascular dementia, Lewy body dementia, and frontotemporal dementia are associated with a decline in cognitive and social abilities. Although the molecular mechanisms of tissue damage in these dementias are not completely understood, these neurodegenerative illnesses share certain alterations such as neuroinflammation and gliosis. Increasing evidence suggests that microgliosis and astrogliosis play a key role in neuroinflammation observed in these dementias. Here we provide an overview of the participation of microglia and astrocytes in the neuroinflammatory response in common dementias.
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The relationship between frailty and cognitive impairment has been recognized for decades, but it was not until a few years ago that the interest in this relationship increased and is now being understood. Epidemiological evidence suggests that physical frailty may be linked to cognitive impairment since both conditions share pathophysiological mechanisms at the cellular and systemic levels. ⋯ However, full understanding of the mechanisms underlying the relationship between frailty and vascular cognitive impairment remains fragmented. This review examines the link between frailty and vascular cognitive decline and also explores the role of vascular changes in the genesis of both conditions.