Chronic Postsurgical Pain Raises Risk of Dementia
European Journal of Pain,
Journal Year:
2025,
Volume and Issue:
29(4)
Published: Feb. 21, 2025
ABSTRACT
Purpose
This
study
aimed
to
investigate
the
association
between
chronic
postsurgical
pain
(CPSP)
and
risk
of
dementia,
addressing
a
significant
gap
in
existing
literature
highlighting
potential
implications
for
clinical
practice
public
health.
Patients
Methods
Utilising
data
from
Taiwan's
National
Health
Insurance
Research
Database,
propensity
score‐matched
cohort
was
conducted
involving
142,682
patients
who
underwent
major
surgery
2004
2018.
CPSP
defined
as
prolonged
analgesic
use
post‐surgery,
dementia
diagnosis
tracked
until
December
31,
2022.
Multivariable
Cox
regression
models
were
employed
calculate
adjusted
hazard
ratios
(aHRs)
versus
non‐CPSP
groups.
Results
Before
score
matching,
(
n
=
37,438)
exhibited
higher
with
aHRs
1.35
(95%
CI:
1.30–1.40).
After
aHR
remained
elevated
at
1.31
1.26–1.37),
indicating
risk.
Subgroup
analysis
confirmed
this
across
various
demographic
factors,
sensitivity
reinforcing
robustness
findings.
Conclusion
establishes
an
independent
predictor
risk,
importance
postoperative
management
mitigating
long‐term
cognitive
outcomes.
Approximately
30%
post‐CPSP
presents
opportunity
reduction
through
effective
strategies,
emphasising
need
targeted
interventions
address
critical
healthcare
issue.
Significance
provides
compelling
evidence
that
significantly
increases
previously
underexplored
connection
decline.
By
establishing
our
findings
underscore
strategies
surgical
patients,
particularly
mitigate
heightened
improve
Language: Английский
Sleep disturbance and cognition in the elderly: a narrative review
Anesthesiology and Perioperative Science,
Journal Year:
2024,
Volume and Issue:
2(3)
Published: Aug. 5, 2024
Abstract
Sleep
is
an
essential
physiological
process
that
promotes
physical
recovery
and
helps
consolidate
learning
memory.
Common
manifestations
of
sleep
disturbances
include
insomnia,
hypersomnia,
circadian
rhythm
disorders,
parasomnias,
all
which
impair
cognitive
function,
particularly
in
the
elderly.
Cognitive
impairment
a
significant
factor
threatens
quality
life
elderly,
there
currently
no
effective
treatment
for
conditions
such
as
dementia.
The
relationship
between
cognition
complex.
Studies
have
shown
disorders
adversely
affect
function
increase
incidence
decline.
This
article
focuses
on
their
effects
elderly
by
reviewing
research
conducted
over
past
20
years
describing
potential
mechanisms.
Additionally,
we
explore
during
perioperative
period,
aiming
to
identify
strategies
optimizing
quality.
We
believe
this
review
provides
deeper
understanding
association
offers
new
perspective
management.
Language: Английский
Cell-specific transcriptional signatures of vascular cells in Alzheimer’s disease: perspectives, pathways, and therapeutic directions
Molecular Neurodegeneration,
Journal Year:
2025,
Volume and Issue:
20(1)
Published: Jan. 29, 2025
Abstract
Alzheimer’s
disease
(AD)
is
a
debilitating
neurodegenerative
that
marked
by
profound
neurovascular
dysfunction
and
significant
cell-specific
alterations
in
the
brain
vasculature.
Recent
advances
high
throughput
single-cell
transcriptomics
technology
have
enabled
study
of
human
vasculature
at
an
unprecedented
depth.
Additionally,
understudied
niche
cerebrovascular
cells,
such
as
endothelial
mural
their
subtypes
been
scrutinized
for
understanding
cellular
transcriptional
heterogeneity
AD.
Here,
we
provide
overview
rich
signatures
derived
from
recent
single-nucleus
transcriptomic
studies
vascular
cells
implications
targeted
therapy
We
conducted
in-depth
literature
search
using
Medline
Covidence
to
identify
pertinent
AD
utilized
technologies
post-mortem
tissue
focusing
on
differences
cell
types
cognitively
normal
older
adults.
also
discuss
impaired
crosstalk
between
neuroglial
units,
well
astrocytes
contextualize
findings
distinct
smooth
muscle
fibroblasts,
pericytes
highlight
pathways
potential
therapeutic
interventions
concerted
multi-omic
effort
with
spatial
technology,
neuroimaging,
neuropathology.
Overall,
detailed
account
crucial
unit.
Graphical
Endothelial
mediate
dysregulated
cell-cell
interactions
The
unit
(NVU)
composed
various
types,
including
(pericytes,
cells),
fibroblast
neurons,
microglia,
astrocytes.
Dysregulated
involve
multiple
pathways,
notably
immune
responses,
angiogenesis
common
both
cells.
involving
neuroinflammation
amyloid
clearance
are
prominent
while
exhibit
related
growth
factors,
cytoskeletal
remodeling
synaptic
function.
In
addition,
within
NVU
gliovascular
(GVU)
altered
AD,
communication
evident,
increased
pericytes,
decreased
astrocytes,
neurons.
Figure
created
BioRender.com.
Abbreviations:
Alzheimer's
disease;
NVU,
Neurovascular
unit;
CNS,
Central
Nervous
System.
Language: Английский
Shared Mechanisms of Blood-Brain Barrier Dysfunction and Neuroinflammation in COVID-19 and Alzheimer’s Disease
American Journal Of Pathology,
Journal Year:
2025,
Volume and Issue:
unknown
Published: April 1, 2025
The
COVID-19
pandemic,
caused
by
SARS-CoV-2,
has
highlighted
the
virus's
impact
on
central
nervous
system
(CNS)
and
its
potential
to
exacerbate
neurodegenerative
diseases
like
Alzheimer's
disease
(AD).
Emerging
evidence
suggests
that
SARS-CoV-2
infection
contributes
chronic
neuroinflammation,
a
key
driver
in
etiopathogenesis
of
AD.
Shared
mechanisms,
including
blood-brain
barrier
(BBB)
dysfunction,
systemic
inflammation,
activation
immune
pathways,
may
link
AD
onset
and/or
progression,
particularly
among
vulnerable
individuals,
such
as
those
advanced
age.
This
review
explores
convergent
pathways
involving
renin-angiotensin-aldosterone
(RAAS),
Wnt/β-catenin
signaling,
NFκB
activation,
interferon
(IFN)
focusing
their
roles
BBB
integrity
neuroinflammation.
SARS-CoV-2-mediated
ACE2
depletion
disrupts
RAAS
homeostasis,
favoring
proinflammatory
signaling
parallels
vascular
dysfunction
Dysregulation
exacerbates
permeability,
while
IFN
contribute
breakdown
propagate
CNS
inflammation
via
endothelial
cell
activation.
These
interactions
amplify
prodromal
pathology
initiate
pathogenesis.
By
identifying
mechanistic
overlaps
between
AD,
this
underscores
need
for
therapeutic
strategies
targeting
shared
dysfunction.
Understanding
these
connections
is
critical
mitigating
long-term
neurological
sequelae
reducing
burden
Language: Английский