Comprehensive prospects of high-altitude cognitive dysfunction and the positive role of traditional Chinese medicine

High altitude cognitive dysfunction (HACD) is a type of cognitive impairment that is associated with exposure to high-altitude environments. This condition is characterized by deficits in attention, memory, learning, executive function, and psychomotor speed. Hypobaric hypoxia, a key characteristic of high-altitude settings, is a significant contributing factor to HACD. However, despite significant research efforts, the precise pathophysiological mechanisms underlying HACD remain largely unknown, and effective treatment options are currently lacking. Notably, traditional Chinese medicine (TCM), an established medical paradigm recognized globally, has a distinctive treatment approach based on systematic theory and practical expertise that could aid in the prevention and management of HACD. Here, we focus on the molecular mechanisms involved in the pathogenesis of HACD, and summarize potential treatment schemes based on TCM and modern therapy. A literature review was carried out using several databases, including the Web of Science, Google Scholar, and PubMed. The pathogenesis of HACD involves various molecular mechanisms, including an impaired compensatory response, mitochondrial injury, energy metabolism disorder, calcium overload, neuroexcitotoxicity, oxidative stress, inflammation, apoptosis, amyloid β and tau accumulation, and the disruption of the microbiome-gut-brain axis caused by hypobaric hypoxia. In this review, we summarize that TCM can alleviate HACD by regulating energy metabolism, anti-inflammation, anti-oxidative stress, anti-calcium overload, anti-neuroexcitotoxicity, anti-apoptosis, anti-amyloidosis, etc. TCM has broad prospects for treating HACD. The combination of TCM and modern therapy may improve the efficacy, and reduce the side effects of some chemical drugs.