Frontiers in Aging Neuroscience

INTRODUCTION: Tau pathology in Alzheimers disease preferentially afflicts excitatory neurons in the limbic and association cortices that utilize high levels of calcium signaling to perform cognitive operations. This includes the layer III pyramidal cells in the dorsolateral prefrontal cortex (dlPFC) that subserve higher cognition, which express the calcium-binding protein, calbindin, when young and healthy, but lose calbindin and develop tangles and degenerate in Alzheimers disease (AD). These data suggest that loss of calbindin may be associated with the emergence of tau pathology. However, the relationship between calbindin and early-stage, soluble tau pathology is challenging to study in human brains, as soluble pTau dephosphorylates within 15min postmortem. In contrast, the relationship between calbindin and soluble pT217-tau expression can be studied in aging macaques with naturally-occurring tau pathology, where perfusion fixation is possible to capture phosphorylation state in situ. METHODS: The current study used multiple-label-immunofluorescence to label MAP2-positive dlPFC layer III pyramidal cells for calbindin and pT217-tau in macaque brains across the adult age span (8-34.5yrs). The study employed a semi-automated CellProfiler workflow to identify labeled pyramidal cell dendrites the cellular compartment where tau pathology begins in AD. RESULTS: Calbindin expression decreased with age, while pT217Tau increased with age. Specifically, the ratio of calbindin/pT217-tau within a dendrite decreased with age, and was especially prominent in the aged macaques with long-term inflammatory disorders. DISCUSSION: These data suggest that the loss of calbindin in dendrites with advancing age, and especially with inflammation, contributes to the rise of tau pathology and the risk of AD.

BACKGROUND: Accumulations of AD and LATE-NC both contribute to changes in hippocampal volume, possibly via distinct and/or overlapping mechanisms. Microglia-driven inflammation is a shared pathway associated with both AD and LATE-NC. However, the extent to which microglia inflammation is associated with hippocampal volume is less understood. OBJECTIVE: Examine the relationship between AD and LATE-NC with hippocampal volume in persons with differing levels of microglia inflammation. METHODS: Cerebral hemispheres from 441 older adults who came to autopsy were studied. All hemispheres underwent ex-vivo MRI and detailed neuropathologic examination for neurodegenerative and cerebrovascular pathologies. Microglia were quantified in the hippocampal CA1/subiculum region using machine learning-based classifiers trained on digitized CR3-43-stained images via the HALO digital pathology platform. First, linear regression models examined the association of microglia with hippocampal volume, adjusting for demographics, postmortem interval (PMI), and common age-related pathologies. Second, linear regression models were employed to examine whether microglia density modified associations of {beta}-amyloid, tangle, or LATE-NC on hippocampal volume. RESULTS: Participants had a mean age of 90 years at death with 75% being women. Intermediate or high likelihood ADNC was present in 64% and LATE-NC (stage 2/3) was present in 52%. In linear regression models, adjusting for demographics and PMI, higher microglia density was associated with a lower hippocampal volume to hemisphere ratio (estimate = -0.021 SE=0.01, p=0.002); however, after adjusting for common age-related pathologies the association was attenuated (p=0.70). {beta}-amyloid, tangles, and LATE-NC remained independently associated with a lower hippocampal volume. The association of LATE-NC with hippocampal volume was stronger in brains with greater microglia burden (estimate for the interaction term = -0.016; SE=0.01, p=0.002). No interactions were seen between {beta}-amyloid or tangles with microglia on hippocampal volume. In stratified analyses, microglial density modified the association between LATE-NC and hippocampal volume, independent of AD neuropathologic status. CONCLUSION: Microglia-driven inflammation strengthens the association of LATE-NC, but not AD pathology, on hippocampal volume loss. These findings emphasize the importance of inflammatory pathways [when interpreting MRI-based neurodegeneration markers] in aging and mixed pathology.

Background: Alzheimer's Disease and Related Dementias (ADRD) is a growing global public health challenge, and caregivers experience high rates of burden, unmet needs, and system failures. These challenges vary by caregiver role and relationship to the care recipient, reflecting the heterogeneous nature of caregiving. Yet prior work has largely studied burden, unmet needs, and system failures as separate domains rather than examining how they co-occur within individual caregivers. Methods: We applied an LLM-based classification framework (Claude 3.5 Sonnet) to 7,198 posts from three ALZConnected caregiver forums (general, spouse/partner, and adult child caregivers), coding each post for burden, unmet needs, and system failures across 9, 12, and 10 categories respectively. We compared expression rates by caregiver role (primary vs. secondary) and relationship to the care recipient (spousal vs. child) and used post-level co-occurrence networks to map how categories cluster within and across domains. Results: Burden was expressed in 89.0% of posts and unmet needs in 93.3%, while system failures appeared in 34.8%. Primary caregivers reported burden more often than secondary caregivers (91.6% vs. 84.7%), while secondary caregivers reported more unmet needs (94.6% vs. 92.5%) and more system failures (37.2% vs. 33.4%). Child caregivers reported higher rates than spousal caregivers across all three domains. Co-occurrence networks showed dense within-domain clustering (density 0.61-0.65) and 84 significant cross-domain connections, with the strongest links between behavioral/safety burden and safety-management needs (21.7% of posts) and between emotional burden and emotional-support needs (20.9%). Conclusion: Burden, unmet needs, and system failures are not independent problems but form interconnected challenge ecosystems that vary by caregiver role and relationship. This suggests caregiver support should be designed around these connected patterns rather than treated as separate, single-domain interventions.

Alzheimers Disease (AD) and related dementias (AD/RDs) impact cortical motor and sensory biology whereas the precise changes to these systems, and their clinical relevance, remain under debate. We hypothesized that cortical representations of complex and simple movements are differently altered during disease progression in 5XFAD mice, a well-established model of AD. Motor cortex somatotopy was determined in 5XFAD and Wild-Type Control (WT Control) mice at 6 and 12 months (mos.) of age using long-duration intracortical microstimulation (LD-ICMS) to systematically identify cortical sites evoking complex and simple forelimb movements. At 6 mos. of age, 5XFAD mice exhibited a significant expansion of motor cortical sites representing simple movements, specifically Elbow Flexion (p=0.0004) and Wrist Flexion (p=0.024). The over-sized territory for Elbow Flexion significantly distinguished 5XFAD from WT mice (Receiver Operating Characteristic [ROC] area under the curve [AUC]= 0.94, p= 0.0009) whereas discriminative performance of Wrist Flexion was a non-significant trend (AUC=0.75, p=0.059). By 12 mos. of age, motor cortex organization was markedly reorganized in 5XFAD mice, with significantly fewer cortical sites evoking complex Advance movement (p<0.0001) as well as simple Shoulder (p=0.0001), Elbow Extension (p=0.024), and Wrist Extension (p=0.003) movements. The number of sites for simple Wrist Flexion was significantly increased (p=0.011) in 12 mo. old 5XFAD mice. At 12 mos., territory size of several of these movement zones highly distinguished 5XFAD from WT mice, including Advance (AUC= 0.96, p= 0.0005), Shoulder (AUC= 0.97, p= 0.0004), Elbow Extension (AUC=0.78, p=0.034), Wrist Extension (AUC=0.85, p= 0.0082), and Wrist Flexion (AUC=0.80, p= 0.023). These findings demonstrate progressive, age-dependent remodeling of motor cortex somatotopy in 5XFAD mice, characterized by early expansion of specific simple movement cortical sites followed by deterioration of both complex and simple motor cortical maps as disease advances. Motor cortex somatotopic remodeling may provide a sensitive biomarker of AD/RDs progression.

Introduction: Individuals diagnosed with mild cognitive impairment (MCI) have an increased risk of developing dementia. Since there are currently no curative pharmacological therapies for MCI, nonpharmacological and exercise-related medical therapies represent a promising approach. This study aims to evaluate the effects of nonpharmacological interventions on cognitive performance in individuals with MCI. Methods and analysis: The study will be a prospective, randomized, sham-controlled, single-centre superiority trial with a parallel-group design. A total of 100 patients aged 60 years with MCI will be randomly assigned to one of the three intervention groups or the control group. The three intervention arms comprise high-intensity interval training (HIIT), yoga, and intermittent hypoxia-hyperoxia exposure (IHHE), whereas participants in the control group will receive a sham application of IHHE (IHHE-S). The primary outcome is the cognitive function after 3-month intervention period assessed by Montreal Cognitive Assessment. The secondary outcomes and the evaluation of modifiable risk factors for dementia include quality of life, laboratory data, physical activity, anthropometric data, and cardiorespiratory fitness. All harms and (serious) adverse events will be assessed systematically at each study visit. Ethics and dissemination: This study has been approved by the Ethics committee of the Medical Faculty of the University of Tuebingen (494/2025BO1). Research findings will be published in peer-reviewed journals and presented to stakeholders and at scientific conferences.

In populations with well-preserved cognitive function, cognitive screening total scores tend to cluster near the ceiling, making it difficult to characterize age-group differences from total scores alone. We compared the temporal structure of word production, acoustic features, and the magnitude and timing of forehead total-hemoglobin (total-Hb) responses during a phonemic verbal fluency task in adults in their 40s and 70s. A total of 254 healthy participants (115 in their 40s, 139 in their 70s) completed a 60-s phonemic verbal fluency task requiring words beginning with the Japanese syllable /ka/, administered as part of the Japanese version of the Montreal Cognitive Assessment (MoCA-J). We derived the total word count, word counts in 10-s bins, mean inter-word pause duration, speech offset time, smoothed cepstral peak prominence (CPPS), jitter, and shimmer. Area under the curve (AUC) and time-to-peak (TTP) were computed from forehead total-Hb signals recorded with a wearable single-wavelength near-infrared spectroscopy device. MoCA-J scores clustered near the ceiling in both groups, although the age-group difference was significant. The 70s group produced fewer words (14.00 vs 17.09) and showed longer inter-word pauses (1.60 vs 0.72 s). CPPS was lower, AUC was higher, and TTP was longer (32.97 vs 15.63 s) in the 70s group, whereas jitter did not differ. Word counts across 10-s bins showed an age group time-bin interaction. Within each age group, participants who produced more words showed longer TTP. Age-group differences in TTP and AUC persisted after adjustment for speech offset time (proportions mediated, 6.7% and 0.5%) and in a subsample matched on speech offset time. Even when screening scores clustered at the ceiling, the temporal structure of word production and forehead total-Hb responses differed between age groups, and these two classes of measures dissociated. Because the sample was selectively recruited and single-wavelength total-Hb signals do not index localized neural activity, the findings are descriptive and motivate longitudinal, multi-axis characterization of speech in aging.

Background Understanding the mechanisms underlying brain aging and age-related pathological changes is essential for advancing brain health research. Our group previously developed a mechanistic mathematical model of healthy brain, Chamberland et al. (2024) that integrates key biological processes involved in normal aging, from which Alzheimer's disease (AD) related changes may emerge naturally. Objectives To characterize and validate this brain model by evaluating its sensitivity, calibrating its parameters, and assessing generalizability in independent populations. Methods The model represents the evolution of key biological processes associated with brain aging, including amyloid beta (A{beta}), tau pathologies, neuroinflammation, and neuronal death. After identifying the 30 most influential parameters, we calibrated the model using cognitively normal (CN) participants from the AD Neuroimaging Initiative (ADNI) database (n = 211) by minimizing a loss function composed of three outcomes (AB) plaques, tau tangles, and neuronal density). The calibrated model was then applied to the UK Biobank cohort (n = 35,899) of normal controls (aged 44-82 years). The effects of sex and APOE were evaluated using stratified simulations. Results Parameter calibration significantly reduced the prediction errors for A{beta} and tau. Neuronal density predictions showed strong agreement in the UK Biobank cohort. The variance decomposition identified APOE status as a major contributor to variability in A{beta}. Conclusion Our validated brain health model links mechanistic pathways with population data and reproduces neuronal density patterns in an independent cohort. These findings support its use as a framework for studying brain aging and investigating how Alzheimer's disease related pathological changes may emerge with aging.

Chimpanzees share a number of age-related brain changes with humans, such as reductions in neurons and increases in neuropathology. To date, there are no published studies of peripheral biomarkers related to Alzheimers pathology and their associations with age and cortical atrophy in chimpanzees. Here we examined cross-sectional differences and longitudinal changes in biomarkers of pathological protein aggregation, neuroinflammation, and microglial function measured in serum. We examined the relationships between biomarkers and clinically relevant biomarker ratios with both age and cortical atrophy. We found linear and quadratic relationships between age and several biomarkers and ratios. Most biomarkers increased with age. While controlling for sex, we found significant negative associations between age and sulci surface area, mean depth, and gray matter thickness and a positive association with fold opening. A{beta}42 and A{beta}40 showed higher biomarker values associated with lower surface area, mean depth, and gray matter thickness and higher fold opening values. The clinically relevant biomarker ratios were also associated with cortical atrophy - A{beta}42/A{beta}40 was negatively associated with gray matter thickness, and pTau217/A{beta}42 (both total and brain-derived) was positively associated with surface area and gray matter thickness and negatively associated with fold opening. Consistent with our hypotheses and previous findings in humans, many peripheral biomarkers associated with neurodegeneration and Alzheimers disease increase as chimpanzees age. We believe this is the first evidence demonstrating an association between these clinically relevant biomarkers of Alzheimers disease and phenotypes of brain aging in nonhuman primates, underscoring their importance as models of aging and neurodegenerative disease.

In-vivo examination of neurites to understand microstructural properties of white matter tissue utilizing neurite orientation dispersion and density imaging (NODDI) has shown sensitivity to healthy aging as well as disease biomarkers and status. Neurite density index (NDI), which is a proxy for the amount of neurites, in white matter tissue typically decreases with age. However, orientation dispersion index (ODI), which is a proxy for neurite dispersion or fanning, has been mixed with studies finding both increases and decreases with age. Furthermore, white matter tracts are not uniform and hold its own unique spatial pattern or gradient in microstructural properties. In addition to the spatial pattern of the microstructural property, age-related effects have also shown spatial patterns with stronger age effects in the medial, anterior, and dorsal portions of white matter tissue. However, spatial gradients along cardinal axes within an individual's tract have yet to be examined with age in an adult lifespan sample. The current aim of the study was to examine whether average and spatial gradients of neurite microstructural properties within tracts related to the cortico-striato-pallido-thalamic (CSPT) loop were age-sensitive. An adult lifespan sample aged 20-90 years old was recruited from the Dallas-Fort Worth metroplex (N = 104, 62% females) as part of the Dallas Area Longitudinal Lifespan Area Study (DALLAS). Participants completed an MRI session that included a structural T1-weighted image as well as multi-shell diffusion weighted imaging (MS-DWI). MS-DWI were preprocessed and tracts of interest related to the CSPT loop were obtained using probabilistic tractography. For most tracts, a significant inverted-U association with age was found for both average NDI and ODI. Most tracts revealed a reliable spatial gradient of NDI and ODI in the medial-to-lateral, posterior-to-anterior, and ventral-to-dorsal direction. Tracts related to CSPT loop were age-sensitive such that the spatial gradient was becoming more homogenous with age. This loss of spatial gradients with age is analogous to network-level dedifferentiation observed in BOLD functional connectivity. These findings highlight that age effects in a fundamental circuit for both basic and higher-order function is significantly age sensitive and while organized into spatial gradients, these gradients are also vulnerable to aging.

Sleep oscillations during non-rapid eye movement (NREM) sleep support memory consolidation but decline with age. Phase-locked auditory stimulation (PLAS) enhances slow-wave activity, yet its effects on distinct oscillatory components and memory in older adults remain unclear. Sixteen healthy older adults (60 years or older; mean age = 65.06 +/- 3.53 years) participated in a randomized, single-blind, sham-controlled crossover study. Participants completed two stimulation nights and two sham nights in a sleep laboratory. Changes in slow oscillations (0.5-1.25 Hz), frontal theta (4-8 Hz), centrofrontal slow spindles (12-14 Hz), and centroparietal fast spindles (14-16 Hz) were compared between stimulation and sham conditions. Declarative memory was assessed using a word-pair recall task that required overnight retention, and broader cognitive performance was evaluated using the Creyos cognitive assessment battery. PLAS enhanced sleep oscillatory activity without altering sleep architecture. Compared with sham, stimulation increased slow oscillation, frontal theta, centrofrontal slow spindle, and centroparietal fast spindle power across both stimulation nights. Although word-pair recall did not improve at the group level, individual differences in stimulation-induced increases in fast spindle power were positively associated with individual differences in overnight memory improvement. Closed-loop auditory stimulation enhances multiple NREM oscillations in healthy older adults while preserving sleep architecture. Moreover, stimulation-induced increases in fast spindle activity track individual differences in overnight memory improvement, suggesting fast spindles as a physiological marker of successful sleep-dependent memory consolidation and a potential target for sleep-based neuromodulation in aging.

The term Precision Aging describes an approach that focuses on multi-domain profiles of risks impacting individual trajectories of age-related cognitive functioning. The goal of the present study was to identify profiles of risk within a sample of 555 adults, ages 50 to 79, without diagnosis of dementia. Using cluster analyses, we considered 38 risk factors associated with five categories of risk known to negatively impact cognitive aging - cardiovascular insufficiency, glucose dysregulation, inflammation, immune dysfunction, and neuropathology. Results yielded five profiles, including a group with low risk in all five risk categories, and four groups with prominent risks in specific domains. Importantly, all four high risk groups performed more poorly relative to the low risk group on multiple memory measures from a well-established neuropsychological test, the Auditory Verbal Learning Test. The results highlight the importance of considering multiple domains of risk within the same cohort to predict age-related cognitive functioning.

Gait is a scalable biomarker of functional, physical, and brain health, but most studies rely on gait speed alone. Here, we developed and validated gait age clocks that estimate age from multidimensional gait features and quantify deviations as gait age gaps, with gaps >0 (<0) for accelerated (delayed) aging. We included data from 5,681 participants, including healthy controls and clinical groups (Parkinson's disease, neurodegenerative diseases, stroke, diabetes, fallers, and frailty). Normative models trained in healthy controls showed robust age prediction (r=0.851, p<0.001), and full gait models outperformed gait speed alone ({Delta}R2=0.175). Gaps captured accelerated aging across neurological and physical conditions, tracked Parkinson's disease severity, and were associated with frailty, physical performance, white matter hyperintensities, and geriatric depression. Gait age gaps are also related to brain aging, risk/protective lifestyle factors, and mortality risk. These findings support gait age gaps as an interpretable biomarker for aging, risk stratification, and clinical monitoring.

Healthy older adults are more susceptible to false memories than young adults. Traditional false memory paradigms leverage semantic overlap, shared meaning, to induce false memories, but experiences can also overlap temporally whereby they occur close together in time. Prior work shows that older adults have impaired episodic memory, memory for events within a spatiotemporal context, corresponding to an overall shift toward semantic memory and away from episodic memory across the lifespan. We hypothesize that compared to young adults, older adults rely more heavily on semantic versus episodic information, which promotes false memory. We collected behavioral data in young and older adults performing an old/new recognition memory task in which we manipulated the degree of semantic and temporal overlap between study words and included critical lures, unstudied words that semantically overlap with study words. We find that whereas young and older adults are similarly reliant on semantic relative to episodic information to support false memory, the two age groups differ in their reliance on semantic relative to episodic information to support true memory. These results suggest that differences in the orientation of attention -- toward semantic vs. episodic information -- may underlie age-related memory changes.

Purpose: Oxidative stress is thought to contribute to the development of age-related cataracts (ARCs), but the mechanisms by which oxidative damage leads to the opacification of the lens remain unclear. Previous studies suggest that oxidative stress can disrupt lens proteostasis. Therefore, it was hypothesized that ARCs arise from proteomic changes driven by an age-associated decline in oxidative stress defenses that interact with the lens proteostatic state. To test this hypothesis, proteomic analyses of lenses exposed to oxidative stress were performed to examine oxidative and proteostatic stress responses in vivo. Methods: Cataract formation was induced by injecting hydrogen peroxide into the aqueous humor of adult zebrafish. nrf2fh318/fh318 zebrafish were used to model the reduced oxidative stress protection observed in aged human lenses, while cryaba-/- zebrafish were used to model impaired lens proteostasis. Resulting opacities in WT, cryaba-/-, nrf2fh318/fh318, and cryaba-/-; nrf2fh318/fh318 lenses were quantified and proteomic changes in the cortex were analyzed using data independent acquisition Parallel Accumulation Serial Fragmentation mass spectrometry. Results: Hydrogen peroxide treatment induced the formation of cortical cataracts. Proteomic results showed that, dependent on genotype and day, oxidative stress activates the unfolded and mitochondrial unfolded protein responses. Additional changes were also observed in energy metabolism, Ca2+ homeostasis, protein degradation, and cytoskeletal and extracellular matrix remodeling pathways. Conclusions: Treated zebrafish lenses successfully model ARC and mass spectrometry proteomics identified the unfolded and mitochondrial unfolded protein responses as potential therapeutic targets for ARC.

The medial temporal lobe (MTL) is crucial for episodic memory. Tau pathology is a hallmark of Alzheimer's disease (AD) and accumulates in layer-specific patterns in the MTL during aging. It is, however, unclear whether early AD pathology relates to mesoscale network signatures distinct from non-pathological aging. To address this gap, we acquired 7 Tesla submillimeter-resolution resting-state fMRI, plasma-based AD biomarkers, glial fibrillary acidic protein (GFAP) levels, APOE genotype, regional [18F]PI-2620 tau PET burden, and longitudinal episodic memory data in 75 cognitively unimpaired older adults. Older age was associated with lower perirhinal-hippocampal connectivity and lower network segregation, whereas higher plasma-based AD pathology was associated with higher perirhinal-hippocampal connectivity. Furthermore, temporal-lobe tau burden was related to altered connectivity patterns in tau-vulnerable MTL subfields and layers, dependent on GFAP levels. Retrosplenial tau burden was associated with higher hippocampal-retrosplenial connectivity consistent with tau spread along canonical hippocampal output pathways. Finally, higher connectivity within the hippocampus attenuated the negative association between temporal-lobe tau burden and memory performance but predicted unfavorable memory trajectories. Our findings show differential associations of age and AD pathology with mesoscale MTL-connectivity patterns. Importantly, increased hippocampal connectivity may support memory function in the short term while contributing to subsequent memory decline.

Background: Hearing loss (HL) may be a risk factor for poor psychosocial outcomes among older adults, but evidence remains mixed. We assessed associations of self-reported and objective HL with and without hearing aid use with social contact, loneliness, and depression pooled across 6 years of follow-up. Methods: We studied 2049 Black and White adults from the Health, Aging, and Body Composition study aged 70-79 at recruitment. Self-reported HL and audiometric HL with and without hearing aid use were assessed at analytic baseline (Year 5, 2001-2002). Outcomes were frequency of contact with family and friends (<weekly vs. at least weekly), depressive symptoms (CESD-10), and loneliness (CESD-10 item "I felt lonely") measured across 6 annual visits. Adjusted for demographic and clinical variables, we used generalized linear regression with generalized estimating equations to assess associations with outcomes pooled across six follow-up waves. Results: Self-reported HL (16%) was associated with more depressive symptoms ({beta}=0.13 SD; 95%CI:0.03,0.24), but no other outcome. Objective HL without hearing aid use (11%) was associated with infrequent contact with friends (OR=1.38; 95%CI:1.07,1.78) and more depressive symptoms ({beta}=0.19 SD; 95%CI:0.07,0.31); objective HL with hearing aid use (9%) was not associated with these outcomes. Objective HL, regardless of hearing aid use, was borderline associated with more frequent feelings of loneliness. Discussion: Objective HL without hearing aid use may be an important risk factor for isolation from friendship networks and depressive symptoms among older adults. Self-reported HL and objective HL with hearing aid use may also be linked to some adverse psychosocial outcomes.

BackgroundParkinsons disease (PD) is driven by -synuclein (-syn) aggregation and affects vulnerable dopaminergic and GABAergic neurons, and its incidence rises dramatically with age. In our -syn mouse model, motor impairment required both syn oligomers and the aging milieu, and pharmacological inhibition of the age hyperactivated Rho GTPase CDC42 with CASIN fully restored motor function, yet the underlying transcriptional pathways mediating this rescue remain to be elucidated. MethodsWe used an inducible -syn oligomer PD mouse model across three age groups (6, 16, and 24 months) with four conditions per group: -syn non-induced (OFF), induced (ON), and each with CASIN treatment (OFF-CASIN, ON-CASIN). Brain tissue from one hemisphere (0 to -5 mm Bregma) was sequenced using 10x Genomics 3 Chromium, with 3-4 mice per condition of both male and female mice. ResultssnRNA-seq demonstrated that CASIN robustly reverted PD-related transcriptional alterations at 24 months whereas aging-related changes were strongest at 16 months. Network and pathway analyses identified CASINs mode of action on two major downstream signaling cascades--MAPK and PI3K/AKT-- in the context of aging and MAPK signaling in PD. ConclusionConvergent gene-, transcription factor-, pathway-, and network-level evidence points to EGFR-PI3K-MAPK signaling as the axis through which CASIN may restore mitochondrial and synaptic function in PD and aging

Recent epidemiological studies suggest poor hydration is a modifiable risk factor for aging-related chronic disease. We tested whether serum sodium was associated with accelerated biological aging. We analyzed data from 363,286 adults (18-80 years) from 20 years of electronic medical records from a large healthcare system, as well as 24,611 adults (18-80 years) from National Health and Nutrition Examination Survey (NHANES) continuous (1999-2018). Seven key biomarkers were used to calculate biological age (BA) using the Klemera and Doubal method. We then reran the calculation using only the four variables with highest correlation with age as a robustness check. In both models, there was a significant linear association between age adjusted serum sodium and advanced biological aging, especially in the young cohorts. In the 7-variable model, in the Leumit dataset, the males in the highest sodium level versus the lowest, had a biological age that was 0.88 (95% CI 0.68-1.08) years accelerated and for females 2.32 (2.14-2.51) years. In NHANES dataset biological age of males at the highest sodium level was 1.92 (0.98-2.87) years accelerated as compared to those in the lowest sodium group. For females, the largest difference was for those 41-50 (1 year, .30-1.79). Increased serum sodium in the normal range is associated with accelerated biological aging in the general population, especially among people aged 18-50. Intervention studies are needed to confirm the link between hydration and biological aging.

Vascular dementia (VaD) is a complex clinical syndrome arising from cerebrovascular disease, characterized by cognitive decline and functional impairment, and is projected to double in prevalence over the next three decades. Deficiencies in one-carbon (1C) metabolism are linked to the onset of VaD. Our previous work using mouse models has demonstrated that reduced dietary folic acid intake or genetic disruptions in 1C metabolism exacerbate outcomes in a model of VaD. However, the impact of VaD on one-carbon metabolism remains poorly understood. This study aims to provide a detailed molecular portrait of 1C metabolism within the context of VaD, shedding light on potential molecular mechanisms. In post-mortem medial prefrontal cortex tissue from VaD female and male patients and controls we measured protein expression of the folate receptor (FR) and 1C enzymes including methylenetetrahydrofolate reductase (MTHFR), thymidylate synthase (TS), choline acetyltransferase (ChAT), acetylcholinesterase (AChE), cystathionine {beta}-synthase (CBS) co-localized with NeuN. There was an interaction between VaD and gender for levels of FR. Both male and female VaD had increased levels of ChAT. Female VaD patients had higher levels of MTHFR and CBS when compared to males. VaD is a complex disease; the results of this study demonstrate that VaD impacts neuronal levels of 1C enzymes. Future studies should assess 1C in other cell types of the brain, as well as measure enzyme activity levels.

Despite extensive knowledge of the progressive sequence of cognitive and functional deficits in Alzheimer's Disease (AD), the impact of neurodegeneration on the conscious experience of patients remains largely unexplored. Understanding how the content of consciousness, particularly perceptual awareness, changes with the progression of AD is crucial to enable meaningful person-centred care. This is especially important in severe AD when impairments in language and other cognitive domains mean people are unable to report their experiences. We investigated whether electrophysiological (EEG) and fMRI signatures of perceptual awareness described in healthy older people are present in people with mild-moderate and severe AD using two "no-report" paradigms. Firstly, a visual masking paradigm examined visual awareness negativity (VAN) and late positive (LP) electrophysiological responses and activation in visual cortex and fronto-parietal regions that are characteristically associated with conscious perception of faces; and second, a complex audio-visual (movie) task examined activation in fronto-parietal networks previously associated with perceptual awareness. In healthy older controls we found cortical responses characteristic of awareness in both EEG and fMRI modalities, with VAN and LP markers and widespread occipital, fusiform face area and fronto-parietal activation. In people with mild-moderate AD, there were significant reductions in VAN and LP markers and reduced fronto-parietal activation. In participants with severe AD, who were behaviourally minimally responsive, there was only limited evidence of presence of frontoparietal markers of perceptual awareness, however this may reflect attentional and task insensitivity in people with advanced dementia. These results demonstrate that the brain mechanisms associated with perceptual awareness become increasingly impaired with progression of AD. Specifically, involvement of frontoparietal networks is reduced in AD, which may reflect reduced higher-level awareness. This suggests AD should be considered a disorder of consciousness and should motivate further investigation into the dimensions of awareness affected by the disorder with implications for treatment and management of people with dementia.