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Lewy bodies, a pathological hallmark of Parkinson's disease, are α-synuclein-enriched cytoplasmic inclusions that drive progressive neurodegeneration. A long-standing yet unmet goal has been the visualization of α-synuclein (α-Syn) inclusions in live brain and measurements of their pathological effects on individual neurons. Here, we developed genetically encoded reporters and knock-in mouse lines to achieve this goal. The reporters exhibited a 5-fold increase in fluorescence upon incorporation...

Trained immunity is the ability of the innate immune system to mount a heightened response to an environmental stimulus after a previous encounter with a noxious trigger. This effect is mediated by metabolic rewiring and epigenetic reprogramming in innate immune cells. In the context of neuroinflammation, trained immunity may represent a major contributor to the pathogenesis of neurological diseases, exerting both detrimental and potentially beneficial effects. While the general mechanisms and...

The hippocampus is crucial to learning and memory, functions that decline with age due to impaired mitochondrial bioenergetics and reduced mitophagy, resulting in the accumulation of dysfunctional mitochondria and increased susceptibility to neurodegeneration. Urolithin A (UA), a natural mitophagy activator derived from polyphenols, has demonstrated benefits in Alzheimer's disease models; however, its role in normal aging remains unclear. Here, we investigated whether UA can prevent or reverse...

Young-onset Parkinson's disease (PD), the most common autosomal recessive familial PD, is caused by gene mutations in Parkin (PRKN). These mutations result in Parkin protein loss and reduced enzymatic activity, leading to severe degeneration of dopamine-producing neurons in the substantia nigra pars compacta (SNpc). Adeno-associated virus (AAV) gene therapy can directly address the cause of PRKN-PD by expressing Parkin protein at levels comparable to those observed in healthy humans. AAV9...

Triggering receptor expressed on myeloid cells 2 (TREM2) regulates microglial function and is implicated in Alzheimer's disease (AD) pathogenesis. Here we conducted a phase 2, randomized, double-blind, placebo-controlled trial of a humanized TREM2 agonistic monoclonal antibody in 381 participants with early AD. Participants were randomized (1:1:1:1) to receive AL002 (15 mg kg^(-1), 40 mg kg^(-1) or 60 mg kg^(-1)) or placebo intravenously every 4 weeks for 48-96 weeks. AL002 demonstrated...

No abstract

Clearance of aberrant cerebral amyloid-β (Aβ) deposits represents a promising therapeutic strategy for Alzheimer's disease (AD), yet current anti-Aβ immunotherapy raises safety concerns due to frequent adverse effects. Extracellular targeted protein degradation (eTPD) offers an approach for safe and efficient clearance of disease-causing proteins. Here, we develop a next-generation eTPD platform, synthetic peptide-programmed lysosome-targeting chimeras (SPYTACs), using entirely synthesized...

MS4A4A and MS4A6A are microglia-expressed genes linked to Alzheimer's disease risk. In this issue of Neuron, Rosner et al.¹ show that these proteins cooperatively restrain TREM2 signaling, dampening protective microglial responses and highlighting MS4A inhibition as a potential strategy to rejuvenate the brain's innate immune system in Alzheimer's disease.

Age-related circadian disruptions accelerate physiological decline and shorten lifespan. Enhancing circadian amplitude has emerged as a promising strategy for ameliorating age-associated disorders. Here, we show that the circadian-phase-optimized administration of 3'-deoxyadenosine (3dA) strengthens circadian amplitude in hypothalamic paraventricular nucleus (PVN) neurons, mitigates aging biomarkers, and extends mouse lifespan. 3dA restores clock synchrony and hormonal rhythms, including...

Sleep architecture and continuity deteriorate markedly with aging, yet these changes are frequently approached as isolated sleep disorders rather than as manifestations of systemic biological dysregulation. Accumulating evidence indicates that age-related sleep fragmentation reflects the progressive disruption of interconnected metabolic, inflammatory and circadian networks that are central to the biology of aging. In this context, sleep can be more accurately interpreted as a functional readout...

Sarcopenia is a major health concern in aging populations. Resistance training (RT) is widely recommended to improve muscle mass, strength, and physical function in older adults. In recent years, research on both biological mechanisms and clinical effects of RT has increased. However, these two fields have largely progressed in parallel, with limited evidence linking biological mechanisms to clinical efficacy. This narrative review integrates preclinical and clinical mechanistic evidence on RT...

Geriatricians have struggled to describe a complex and sometimes ambiguous professional identity. Unlike other medical specialties anchored in discrete organ systems, diagnostic and interventional technologies, or clearly defined clinical settings, geriatric medicine encompasses the care of a heterogeneous population of older adults with widely varying clinical needs, priorities, and trajectories relevant to function, multimorbidity, and complexity. This Special Article examines four distinct...

Vascular aging is the accumulation of functional and structural changes of vessels throughout life. While earlier studies have shown that single manifestation of vascular aging is associated with an increased risk of cardiovascular disease (CVD), it is unknown how the different manifestations of vascular aging cluster at the individual level, and whether individuals with different vascular aging patterns have different risk of progression to overt CVD. Here, we identify three patterns of...

The hippocampus is crucial to learning and memory, functions that decline with age due to impaired mitochondrial bioenergetics and reduced mitophagy, resulting in the accumulation of dysfunctional mitochondria and increased susceptibility to neurodegeneration. Urolithin A (UA), a natural mitophagy activator derived from polyphenols, has demonstrated benefits in Alzheimer's disease models; however, its role in normal aging remains unclear. Here, we investigated whether UA can prevent or reverse...

No abstract

CONCLUSIONS: These findings support the integration of GDF-15 into precision geriatric care, though further longitudinal and interventional studies, including those evaluating the incremental value of adding GDF-15 to existing screening tools for frailty, sarcopenia, and functional status, are required to establish its clinical utility.

Cellular senescence contributes to aging and age-related diseases. Deep identifications of the senescence-specific cellular features are crucial to the better understanding of the survival and maintenance of senescence and the development of novel senolytics against senescent cells. By a global proteomic profiling of senescent human BJ fibroblasts induced by ionizing radiation, 178 cellular proteins with at least 4-fold or greater changes in abundance were identified, representing the cellular...

Recent advancements in Alzheimer's disease (AD) therapeutics have validated the use of amyloid beta (Aβ)-clearing antibodies, which reduce Aβ pathology but leave other disease hallmarks largely unaddressed. Since AD involves multiple pathological processes, additional strategies are needed to target complementary mechanisms. One such target is autophagy, a lysosomal mediated degradation pathway essential for cellular homeostasis that removes toxic protein aggregates and damaged organelles. This...

CONCLUSION: Polypharmacy and hyperpolypharmacy remain highly prevalent among older adults in the U.S., with a significant growth in medication expenditures over time among those with hyperpolypharmacy. These findings highlight the critical need for ongoing monitoring and tailored prescribing optimization efforts targeting subgroups with the high prescribing burden to reduce the clinical and economic burdens of polypharmacy and hyperpolypharmacy in aging populations.

Immunosenescence represents a critical aspect of the aging process. Centenarians, serving as a nature model of "healthy aging," demonstrate a distinctive immune "compensatory adaptation" mechanism that contributes to the maintenance of immune homeostasis. However, the specific immune cell subsets involved and the molecular mechanisms underlying these phenotypic traits remain incompletely understood. In this study, we integrated single-cell RNA sequencing data spanning the entire lifespan of East...