Metabolic determinants of Alzheimer's disease: A focus on thermoregulation

Ageing Res Rev. 2021 Dec:72:101462. doi: 10.1016/j.arr.2021.101462. Epub 2021 Sep 15.

Abstract

Alzheimer's disease (AD) is a complex age-related neurodegenerative disease, associated with central and peripheral metabolic anomalies, such as impaired glucose utilization and insulin resistance. These observations led to a considerable interest not only in lifestyle-related interventions, but also in repurposing insulin and other anti-diabetic drugs to prevent or treat dementia. Body temperature is the oldest known metabolic readout and mechanisms underlying its maintenance fail in the elderly, when the incidence of AD rises. This raises the possibility that an age-associated thermoregulatory deficit contributes to energy failure underlying AD pathogenesis. Brown adipose tissue (BAT) plays a central role in thermogenesis and maintenance of body temperature. In recent years, the modulation of BAT activity has been increasingly demonstrated to regulate energy expenditure, insulin sensitivity and glucose utilization, which could also provide benefits for AD. Here, we review the evidence linking thermoregulation, BAT and insulin-related metabolic defects with AD, and we propose mechanisms through which correcting thermoregulatory impairments could slow the progression and delay the onset of AD.

Keywords: Alzheimer’s disease; Body temperature; Brown adipose tissue; Insulin; Metabolism; Thermoregulation; β-adrenergic agonist.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Adipose Tissue, Brown / metabolism
  • Aged
  • Alzheimer Disease* / metabolism
  • Body Temperature Regulation
  • Energy Metabolism
  • Humans
  • Neurodegenerative Diseases* / metabolism
  • Thermogenesis