DOI: 10.66106/lyqaav.20250102 ISSN: 3105-6873

老年医学领域非瑟酮清除衰老细胞改善老年人脑小血管认知损伤机制（Fisetin Removes Senescent Cells to Ameliorate Cognitive Im pairment of Cerebral Small Vessel Disease in Older Adults: A Geriatric Medicine Mechanism Study）

聂佳磊 Jialei Nie
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Abstract：Cellular senescence accumulation and infl ammaging constitute the core pathological characteristics of geriatric medicine. Massive accumulation of senescent cells in cerebral microvascular endothelial cells, neuroglia and vascular pericytes leads to continuous release of senescence-associated secretory phenotype (SASP) factors, disrupting the homeostasis of the neurovascular unit and triggering a spectrum of pathological changes including cerebral white matter lesions, lacunar cerebral infarction and cerebral hypoperfusion. As a highly safe natural fl avonoid senolytic agent, fi setin can specifi cally target and eliminate senescent cells in the body, inhibit overactivated infl ammaging pathways, and repair damaged neurovascular structures. Compared with conventional chemical anti-senescence drugs, it better accommodates the clinical features of the elderly population, such as decreased organ reserve capacity, low drug tolerance and prevalent polypharmacy. Based on the holistic comprehensive management philosophy of geriatric medicine, this paper systematically elaborates the upstream and downstream molecular mechanisms through which fi setin regulates brain cell senescence, improves the cerebral small vessel microenvironment, alleviates neuroinfl ammation and restores cognitive function. It further analyzes its unique application advantages suitable for geriatric clinical scenarios, and proposes follow-up optimization strategies in line with the stratifi ed diagnosis and treatment as well as individualized intervention concepts of geriatric medicine. This study aims to provide innovative theoretical evidence and clinical practical references for targeted anti-senescence therapy of cognitive impairment related to cerebral small vessel disease in older adults.

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