Alok Khunteta1,2, Vikas Pareek2*
1Registrar, Rajasthan Pharmacy Council,
2 Department of Pharmaceutics,
Lal Bahadur Shastri College of Pharmacy,
Rajasthan University of Health Sciences, Jaipur, Rajasthan
* Vikaspareek@yahoo.com

Age-related cognitive decline is a well-known phenomenon, called by various means such as age-associated memory impairment and age associated cognitive impairment. Since cerebral aging is idiopathic, so due to lack of pure reasons it’s diagnosis is typical and also it’s not being recognized at early ages by person too.  As per the reports by 2050, it is anticipated that Americans aged 65 or older will number nearly 89 million people, or more than double the number of older adults in the United States in 2010, these stats are complementary to global scenario. The review is to collectively cast Cerebral aging with reasons and solutions. The detail of theories regarding cerebral aging and its related deficits is provided. Pharmacological action of both Allopathic and Ayurvedic medicines are illustrated. The role of yoga and pranayam being a quencher of Reactive oxygen species (ROS) thus reducing cerebral aging is also provided further in review.


PharmaTutor (ISSN: 2347 - 7881)

Volume 2, Issue 7

Received On: 07/05/2014; Accepted On: 12/05/2014; Published On: 01/07/2014

How to cite this article:  A Khunteta, V Pareek; Cerebral Aging and Neurological Disorders; PharmaTutor; 2014; 2(7); 29-39

Cerebral aging or age related cognitive decline is a well known natural phenomena which was subsumed under a variety of terms, such as Age related memory impairment(whenever the decline is restricted to memory functions) and Age associated cognitive impairment (whenever the cognitive decline relates to memory and/or other cognitive functions).[1]

A neurological disorder is a disorder of the body's nervous system. Cerebral aging is well associated with major of neurological disorders and thus cerebral aging is the topic on which special emphasis is laid. Various neurological disorders are enlisted below,
(1) Aphasia (language disorder)
(2) Dysarthria(speech disorder)
(3) Apraxia(disorder in patterns or sequences of movements)
(4) Agnosia(difficulty in identifying things/peoples)
(5) Amnesia (memory disorder)
(6) Neuropathic pain
(7) Delirium and dementia
(8) Dizziness and Vertigo
(9) Stupor and Coma
(10) Multiple Sclerosis (MS) and other de-myelinating diseases.
(11)Complex regional pain syndrome (CRPS: A chronic pain condition)
(12) Epilepsy
(13) Parkinson’s Disease
(14) Alzheimer’s Disease.

Cerebral Aging is mostly related to the Geriatrics i.e. to the old people since aging get more profound in this quarter of life and can be easily recognized by cognitive disorders.[2]

Various organizations stated that individual over age 60 alternatively 65 is estimated by the World Health Organization to increase to above billion worldwide by the year 2020. Europe is expected to it’s percentage of aged residents from 20% to 25%. The population of Japan is expected to be over 30% aged. Projections for North America, East Asia, Latin America, and South Asia are 23%, 17%, 12%, & 10%, respectively. The most rapid increases are expected in developing countries. Causes of death in developing countries are expected to be largely age related by 2020. In addition, the number of individuals overage 85 will rise dramatically. The US Government expects these “oldest of old” to grow by 56% to 5.7 million upto2012 as compared to 13% increase in those aged 65-84.[3]

The given below chart will provide for the increase in geriatrics (oldies) overall in the world and this will rise up and thus worsened.

Important conclusions of the chart: there is continuous increase in the geriatric person decade wise.

54.6 million Population of geriatrics is postulated for 2020 and influencing increase till 2030 of 71.5 million is expected.[4]

Figure.1: Bar graph showing yearly increase in geriatrics expecting 71.5 million old people in 2030.[4,5]

With neurological disorders the normal cerebral aging pattern got altered and the more serious effects can be seen in the individuals early in the ages. Some of the neurological disorders and their related cognitive impairment (dementia i.e. forgetfulness) is correlated under:

Data giving a reason, neurological disorders are closely studied with the phenomena of cerebral aging. The best scholars are working on the reasons of cerebral aging and possible therapies to cure them. The recent advancement of technologies like Proton Emission Tomography, Radiography, etc. provided best diagnosis to relate structural changes (from molecular to organ level) to the Cognitive impairment and neurological disorders.[6]

Further, researches in preclinical and clinical level had provided the pharmacotherapy for the individual. One of the newest drug for Cerabral aging is TRIVASTAL LA by Serdia Parma.(Biperiden) is marketed with dose of 50mg, pharmacological action is selective D2/D3 dopamine receptor agonist with additional α2-noradrenergic properties.[7]

Cerebral aging is the natural phenomena, explained by different scholars in view of different mechanisms given below:
(1) Single Mechanism: Explains that particular reason is the cause of cerebral aging.
Salthouse says, increase in age is the cause of cerebral aging. Baltes & lidenberg says that, decrease in crude measure of sensory function of visual and auditory is the reason of cerebral aging related impairments.

(2) Specific Cognitive Mechanism: explains that executive functions i.e. ability to switch in tasks, inhibitory functions & working memory processes decreases with age.[8]

Executive functions are required for:
• Reasoning
• Encoding
• Strategy
• Retrieval of information from long term memory.

Figure.2: Various executive functions that are being impaired in cerebral aging process.[9]

Cerebral aging related cognitive disorders are mostly recognized as,
(a)Decrease in working memory: Working memory is the centrally executive system, which is important to run all the cognitive tasks requiring effortful processes.

Working memory works by the two passive storage subsystems which are specific for verbal and visio-spatial domains. So, the impairment to these subsystems is the prior cause of inefficiency of working memory.

(b)Loss of Specificity or Differentiation in brain recruitment while performing an array of cognitive targets. Also different parameters of analysis are day to day decrease in personal efficiency to do the work efficiently.[10]

(1) Role of Inhibition
: Geriatrics are less effective at inhibiting irrelevant information and so these will form “mental clutter”, a dumped place in working memory. This shows that while working memory space is same but due to mental clutter it seems diminished. So, improper inhibition results decrease of working memory and thus execution of cognitive action.

(2) Brain atrophy: With age brain shrinks and cause volumetric changes but the change is not uniform, frontal cortex shrinks more, medio-temporal areas less and the occipital cortex at least.

This lead to decline in memory requires executive functions i.e. tasks requiring, strategic and effortful processes. While the other functions related to recognize and listening remains intact a bit.

(3) Oxidative Stress: Caused due to vasoconstriction leading to decrease in blood    supply further causing parenchymatous damage. Parenchymatous damage further causes decrease in metabolic demand worsening blood supply further.[11]

(4) Lipid Peroxidation & accumulation of lipofuscin pigment in brain regions.

(5) Neurotransmitter deficiency:

1. Cholinergic deficiency:
It relates to decrease in acetylcholine in nervous system due to many reasons like decrease in cholineacetyl transferase, less choline content in body. In this condition the cholinergic receptors remain intact but the decrease in Ach will lead to impairment.

Cholineacetyl transferase (chat) deficiency is mild in normal patients but more profound in Alzheimer’s disease (here frontotemporal cortex and hippocampus are majorly affected).

2. Noradrenergic deficiency:
Deficit of Adrenaline and Noradrenalin (the major excitatory and responsive neurotransmitter) will lead to the basic causes of geriatric related cognitive impairment. [12]


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