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Advanced Neurology ADRD comorbidities and senescence

stem cell depletion. The concept that the central nervous Acknowledgments
26
system is unaffected by the underlying pathophysiological
changes associated with age-related changes appears The author thanks Dr. Robert Allen, Dr. Alberto Lledo-
meaningless. The results of the present study suggest Macau and Kathy Lang for their thoughtful review and
that increased efforts to evaluate and modulate the comments on the manuscript.
pathophysiological basis of systemic aging as well as Funding
current focus on beta-amyloid are effective approaches to
improve ADRD management. None.
Therapeutic approaches for ADRD that target potentially Conflict of interest
common biological processes related to aging are limited.
For instance, only a single small trial (n = 5) titled “Senolytic The author declares that he has no competing interests.
Therapy to Modulate Progression of Alzheimer’s Disease” Author contributions
using dasatinib and quercetin has been completed. A
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larger trial with 48 individuals is ongoing (NCT04685590). This is a single-authored paper.
A senolytic approach to ADRD has the potential to
significantly improve or delay the progression of multiple Ethics approval and consent to participate
comorbidities associated with ADRD. Not applicable.
Furthermore, physical exercise, cognitive stimulation, Consent for publication
maintenance of normal body weight, socialization, and
avoidance of tobacco and drug abuse are all clinically Not applicable.
relevant approaches for the optimal management of age-
related disorders, including cognitive decline. In fact, Availability of data
exercise is an effective intervention in nearly all age-related Data are available from the corresponding author on
disorders. 27-29 Exercise alone exerts a beneficial effect on reasonable request.
all-cause mortality as well as multiple medical conditions,
such as cardiovascular diseases, depression, obesity, Further disclosure
osteoarthritis, osteoporosis, type 2 diabetes, and ADRD. Parts of the findings had been presented at the Alzheimer’s
The observation that a single intervention can be beneficial Association International Conference on July 31, 2024.
for multiple age-related disorders is also consistent with
the hypothesis that similar pathophysiological components References
underlie several age-related disorders.
1. Li JQ, Tan L, Wang HF, et al. Risk factors for predicting
5. Conclusion progression from mild cognitive impairment to Alzheimer’s
disease: A systematic review and meta-analysis of cohort
Similar pathophysiological components related to studies. J Neurol Neurosurg Psychiatry. 2016;87(5):476-484.
biological aging may underlie several age-related doi: 10.1136/jnnp-2014-310095
disorders. This study emphasizes the need for additional
research on addressing the comorbidities of ADRD to 2. Lanctôt KL, Hahn-Pedersen JH, Eichinger CS, et al. Burden
improve the overall health status and quality of life of of illness in people with Alzheimer’s disease: A systematic
review of epidemiology, comorbidities and mortality. J Prev
patients with ADRD. The current concept that ADRD- Alzheimers Dis. 2024;11(1):97-107.
associated cognition is solely attributable to beta-amyloid
pathophysiology, without optimizing the management doi: 10.14283/jpad.2023.61
of comorbid disorders, should be reconsidered. As 3. Sanderson M, Wang J, Davis DR, Lane MJ, Cornman CB,
part of a comprehensive and integrated care program, Fadden MK. Co-morbidity associated with dementia. Am J
comorbidities should be evaluated and addressed at all Alzheimers Dis Other Demen. 2002;17(2):73-78.
stages of ADRD. Increasing evidence suggests that a doi: 10.1177/153331750201700210
comprehensive clinical management strategy could delay 4. Bauer K, Schwarzkopf L, Graessel E, Holle R. A claims data-
or slow cognitive decline and improve the overall health based comparison of comorbidity in individuals with and
of patients with ADRD. 20,26,30,31 Therefore, future studies without dementia. BMC Geriatr. 2014;14:10.
should determine the extent, if any, to which the optimized
clinical management of ADRD-related comorbidities can doi: 10.1186/1471-2318-14-10
retard the clinical progression of ADRD. 5. Wang JH, Wu YJ, Tee BL, Lo RY. Medical comorbidity

Volume 4 Issue 3 (2025) 107 doi: 10.36922/an.4046