Abstract
The proportion of the elderly population in the world is increasing every year. As accepted by the World Health Organization (WHO), early old age between the ages of 65-75, middle age between the ages of 75-85, and advanced old age after 85 years . According to the United Nations world population estimates, the world population for 2022 is estimated to be 7 billion 975 million 105 thousand 156 people, while the elderly population is 782 million 998 thousand 642 people. According to these estimates, 9.8% of the world’s population was composed of the elderly population. The top three countries with the highest proportion of elderly population were Japan with 29.9%, Italy with 24.1% and Finland with 23.3%. Turkey ranked 66th among 184 countries. While the rate of population aged 65 and over was 9.9% in 2022, it is expected to increase to 11.0% in 2025. Aging is chronological, biological, characteristic, psychological, socio-cultural, economic and social classified by different sizes.
Today, parallel to the increase in the elderly population, increasing diseases related to aging have become a serious public health problem. Improving the life expectancy and quality of life of the aging population is the main aim of current studies. With the increase in preventive health services in recent years, the average life expectancy in the elderly and the prevalence of neurodegenerative diseases have increased accordingly. Neurodegenerative diseases are incurable and debilitating conditions that result in progressive degeneration and/or death of nerve cells. Dementias are the most common of the neurodegenerative diseases and represent approximately 60-70% of Alzheimer’s dementia cases. The worldwide prevalence of dementia is around 50 million. According to the 2015 World Alzheimer’s Report, the odds of developing some form of dementia in an older adult rises from 2-4% at age 65 to 15% at age 80. As the population ages, current estimates predict more than 130 million cases by 2050. According to Turkey’s death and cause of death statistics, the number of elderly people who lost their lives due to Alzheimer’s disease increased from 13 thousand 642 in 2017 to 12 thousand 239 in 2021.
With advancing age, many physiological changes occur in the organism and the risk of non-communicable diseases such as heart and respiratory diseases, cancer and diabetes increases. Due to inflammation, metabolic syndrome and cardiovascular diseases are frequently seen in the elderly. Chronic diseases, which have been reported as a serious health problem in the 21st century by the United Nations and the World Health Organization, are considered among the important causes of death all over the world. It is estimated by the World Health Organization that 75% of deaths in 2020 will be caused by chronic diseases. It has been reported by the Turkish Statistical Institute (2021) that 37.6% of individuals aged 65 and over died due to circulatory system diseases, 15.0% due to respiratory system diseases and 12.0% due to benign or malignant tumors (2).
Improving the life expectancy and quality of life of the aging population is the main objective of current studies. In recent years, human gut microbiotatargeted aging management has been considered as a new approach to health and prevention of aging.
Nutrition is the most important factor in providing adequate cognitive and physical functions and minimizing the risks of chronic diseases in elderly individuals. Functional foods have an important place in a healthy and balanced diet and contribute to reducing the risks of diet-related diseases. Some of these functional foods are pomegranate, strawberry and hazelnut. Urolithin A, a natural compound, is produced in the intestines from polyphenols such as ellagitannins and ellagic acid found in these foods. Urolithin A is the metabolite compound produced from the conversion of ellagitannins by intestinal bacteria. Urolithin A (UroA) has positive effects on aging and age-related diseases by reducing inflammation, improving mitochondrial function and activating mitophagy. Urolithins are produced from foods containing ellagic acid that undergo intestinal microbial transformation, and their concentrations vary between individuals. When foods containing ellagic acid (EA) reach the intestine, they are converted to the metabolite UroA and its conjugates. Unlike its parent compound EA, UroA displays anti-inflammatory and antiangiogenic activities. As UroA studies have emerged, researchers have reported that specific gut metabotypes are associated with the release of specific uroliths, including UroA, iso-UroA, and UroB. Metabolically healthy individuals (without metabolic syndrome conditions) secrete higher concentrations of active UroA. Based on correlations between metabolites and metabolites, it has been reported that gut microbiota may play a greater role in determining active UroA production. It has been stated that Akkermansia muciniphila levels are related to UroA levels, but there may be differences in UroA activity depending on the microbiota between individuals. Based on this evidence, UroA production and activity can be correlated with gut microbiota and metabotype classification. UroA is capable of conferring various health benefits to the host due to its specific chemical structure acting as an estrogenic agonist identified through ligand chelation; this suggests that UroA modulates endocrine activity. In addition, UroA is a human selective aryl hydrocarbon receptor ligand derived from a natural microbiota and is expressed by numerous cells, including aryl hydrocarbon receptors and immune cells. As UroA research progresses, the use of UroA therapeutics emerges, emphasizing the importance of the bioavailability and efficacy of this metabolite. UroA has been shown to reach peripheral tissues by both oral administration and injections; however, few studies have linked the actions of UroA to its conjugation with a glucuronide, aglycone, or sulfation. Urolithin A has therapeutic potential for various metabolic diseases with its immunomodulatory properties. Recent advances in Urolithin A research report that administration of Urolithin A reduces inflammation in various tissues, including brain, fat, heart, and liver tissues, and potentially helps delay or prevent the onset of Alzheimer’s disease, type 2 diabetes mellitus, and non-alcoholic diabetes (19). This review study was prepared to explain the relationship of Urolithin A with diseases frequently seen in old age. It shows that Urolithin A supplementation is protective against aging and age-related conditions in humans that affect the brain, joints, and other organs. This review has been prepared by examining English experiment studies and reviews in Google academic and pubmed.
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