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Jeon SY, Byun MS, Yi D, Lee JH, Choe YM, Ko K, Sohn BK, Choi HJ, Lee JY, Lee DY. Influence of hypertension on brain amyloid deposition and Alzheimer's disease signature neurodegeneration. Neurobiol Aging 2019; 75:62-70. [DOI: 10.1016/j.neurobiolaging.2018.11.001] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2018] [Revised: 11/07/2018] [Accepted: 11/08/2018] [Indexed: 02/01/2023]
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Peters R, Booth A, Rockwood K, Peters J, D’Este C, Anstey KJ. Combining modifiable risk factors and risk of dementia: a systematic review and meta-analysis. BMJ Open 2019; 9:e022846. [PMID: 30782689 PMCID: PMC6352772 DOI: 10.1136/bmjopen-2018-022846] [Citation(s) in RCA: 123] [Impact Index Per Article: 24.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
OBJECTIVE To systematically review the literature relating to the impact of multiple co-occurring modifiable risk factors for cognitive decline and dementia. DESIGN A systematic review and meta-analysis of the literature relating to the impact of co-occurring key risk factors for incident cognitive decline and dementia. All abstracts and full text were screened independently by two reviewers and each article assessed for bias using a standard checklist. A fixed effects meta-analysis was undertaken. DATA SOURCES Databases Medline, Embase and PsycINFO were searched from 1999 to 2017. ELIGIBILITY CRITERIA For inclusion articles were required to report longitudinal data from participants free of cognitive decline at baseline, with formal assessment of cognitive function or dementia during follow-up, and an aim to examine the impact of additive or clustered comorbid risk factor burden in with two or more core modifiable risk factors. RESULTS Seventy-nine full-text articles were examined. Twenty-two articles (18 studies) were included reporting data on >40 000 participants. Included studies consistently reported an increased risk associated with greater numbers of intraindividual risk factors or unhealthy behaviours and the opposite for healthy or protective behaviours. A meta-analysis of studies with dementia outcomes resulted in a pooled relative risk for dementia of 1.20 (95% CI 1.04 to 1.39) for one risk factor, 1.65 (95% CI 1.40 to 1.94) for two and 2.21 (95% CI 1.78 to 2.73) for three or more, relative to no risk factors. Limitations include dependence on published results and variations in study outcome, cognitive assessment, length of follow-up and definition of risk factor exposure. CONCLUSIONS The strength of the reported associations, the consistency across studies and the suggestion of a dose response supports a need to keep modifiable risk factor exposure to a minimum and to avoid exposure to additional modifiable risks. Further research is needed to establish whether particular combinations of risk factors confer greater risk than others. PROSPERO REGISTRATION NUMBER 42016052914.
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Affiliation(s)
- Ruth Peters
- Neuroscience Research Australia, Sydney, New South Wales, Australia
- School of Public Health, Imperial College London, London, UK
- University of New South Wales, Sydney, New South Wales, Australia
| | - Andrew Booth
- School of Health and Related Research (ScHARR), University of Sheffield, Sheffield, UK
| | | | - Jean Peters
- School of Health and Related Research (ScHARR), University of Sheffield, Sheffield, UK
| | - Catherine D’Este
- Australian National University (ANU), Canberra, Australian Capital Territory, Australia
- University of Newcastle, Callaghan, New South Wales, Australia
| | - Kaarin J Anstey
- Neuroscience Research Australia, Sydney, New South Wales, Australia
- University of New South Wales, Sydney, New South Wales, Australia
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Characteristic changes in the default mode network in hypertensive patients with cognitive impairment. Hypertens Res 2018; 42:530-540. [PMID: 30573810 DOI: 10.1038/s41440-018-0176-4] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2018] [Revised: 08/24/2018] [Accepted: 09/17/2018] [Indexed: 02/04/2023]
Abstract
Hypertension has a close affinity to brain degeneration and cognitive decline during the aging process. The default mode network (DMN) is usually affected in various diseases related to cognitive impairment (CI). The present research aimed to explore the alterations in the DMN and its subcomponents in hypertensive patients with and without CI and to investigate the associations between cognitive performance and network abnormalities. Resting-state functional magnetic resonance imaging and neuropsychological tests were performed in 74 subjects, namely, 30 hypertensive patients with normal cognition (HTN-NC), 25 hypertensive patients with CI (HTN-CI), and 19 healthy controls. Seed-based functional connectivity (FC) analysis was performed to identify the DMN patterns. The group differences in the DMN were mainly shown in brain regions related to the core subsystem and the dorsal medial subsystem of the DMN. Post hoc analysis revealed a trend of dissociation among the DMN subsystems in the HTN-NC group. In contrast, the HTN-CI group displayed extensively increased FC in both subsystems. Importantly, increased FC of the dorsal medial subsystem in the HTN-CI patients was associated with poor cognitive performance, such as scores on Mini-Mental State Examination (ρ = -0.438, P = 0.029) and Montreal Cognitive Assessment (ρ = -0.449, P = 0.025). The findings suggest that extensively increased connectivities in the core subsystem and the dorsal media subsystem of the DMN may distinguish hypertension with CI from hypertension with normal cognition. The characteristic change in the dorsal medial subsystem may become an early imaging biomarker for the diagnosis and treatment of cognitive impairment associated with hypertension.
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Abstract
This study was performed to identify the association between smoking and Alzheimer's disease (AD). To perform this meta-analysis based on case-control and cohort studies, PubMed, Google Scholar, and the CNKI electronic databases were searched through April 30, 2017. Our meta-analysis included 27 studies, including 16 that reported odds ratios (ORs) and 11 that reported hazard ratios (HRs) or ratio risks. No significant association was found between smoking and AD among the studies that reported ORs (1.020, 95% confidence interval [CI] = 0.812-1.281, I = 67.9%, random model, p < 0.001). A subgroup analysis revealed no significant difference between different smoking statuses. The pooled HRs revealed a significant association between smoking and AD (HR = 1.520, 95% CI = 1.194-1.934, I = 83.6%, random model, p < 0.001). Cumulative meta-analysis of the HRs revealed that the effect of smoking on AD tended to be stable over time. Smoking may confer an increased risk of AD, and this effect has tended to be stable over time.
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Nylander R, Kilander L, Ahlström H, Lind L, Larsson EM. Small Vessel Disease on Neuroimaging in a 75-Year-Old Cohort (PIVUS): Comparison With Cognitive and Executive Tests. Front Aging Neurosci 2018; 10:217. [PMID: 30061827 PMCID: PMC6054972 DOI: 10.3389/fnagi.2018.00217] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2018] [Accepted: 06/26/2018] [Indexed: 12/28/2022] Open
Abstract
Background and Purpose: Signs of small vessel disease (SVD) are commonly seen on magnetic resonance imaging (MRI) of the brain in cognitively healthy elderly individuals, and the clinical relevance of these are often unclear. We have previously described three different MRI manifestations of SVD as well as cerebral perfusion in a longitudinal study of non-demented 75-year-old subjects. The purpose of the present study was to evaluate the relationship of these findings to cognition and executive function at age 75 and changes after 5 years. Methods: In all, 406 subjects from the Prospective Investigation of the Vasculature in Uppsala Seniors (PIVUS) study were examined with MRI of the brain at age 75 years. Two-hundred and fifty of the subjects were re-examined 5 years later. White matter hyperintensities (WMHs) and lacunar infarcts (LIs) were assessed on both occasions, but microbleeds (MBs) and perfusion only at age 75. Cognitive function was screened by the Mini Mental State Examination (MMSE). Trail Making Test A and B (TMT-A and TMT-B) were performed at baseline and at follow-up at age 80. Results: At baseline, 93% performed >27 points in the MMSE. The TMT-B at age 75 was significantly related to WMH visual scoring after adjustment for sex, education and cerebrovascular disease risk factors (+80 s (95% CI 0.3-161 s), P < 0.05 for grade 2-3 vs. grade 0). Neither MMSE nor TMT-A was significantly related to WMH scoring. There was no relation between any test performance and WMH volume, white matter volume, number of MBs or brain perfusion at age 75. Subjects who had sustained a new LI (n = 26) showed a greater increase of the time to perform TMT-A at the 5-year follow-up (+25 s vs. +4 s in LI-free subjects, P = 0.003). Changes in MMSE or TMT-A and -B test performance between ages 75 and 80 were not related to changes in WMH scoring or volume during the 5 years follow-up, or to brain perfusion at age 75. Conclusion: In this cognitively healthy community-based population, moderate-severe WMHs and incident LIs on brain MRI in individuals aged 75-80 years were associated with a mild impairment of processing speed and executive function.
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Affiliation(s)
- Ruta Nylander
- Department of Surgical Sciences, Radiology, Uppsala University, Uppsala, Sweden
| | - Lena Kilander
- Department of Public Health and Caring Sciences, Geriatrics, Uppsala University, Uppsala, Sweden
| | - Håkan Ahlström
- Department of Surgical Sciences, Radiology, Uppsala University, Uppsala, Sweden
| | - Lars Lind
- Department of Medical Sciences, Uppsala University, Uppsala, Sweden
| | - Elna-Marie Larsson
- Department of Surgical Sciences, Radiology, Uppsala University, Uppsala, Sweden
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Lin E, Tsai SJ, Kuo PH, Liu YL, Yang AC, Kao CF, Yang CH. The rs1277306 Variant of the REST Gene Confers Susceptibility to Cognitive Aging in an Elderly Taiwanese Population. Dement Geriatr Cogn Disord 2018; 43:119-127. [PMID: 28142142 DOI: 10.1159/000455833] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/04/2017] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND/AIMS There is growing evidence that the RE1-silencing transcription factor (REST) gene may contribute to cognitive aging and Alzheimer diseases. In this replication study, we reassessed whether single nucleotide polymorphisms (SNPs) within the REST gene are linked with cognitive aging independently and/or through complex interactions in an older Taiwanese population. METHODS A total of 634 Taiwanese subjects aged over 60 years from the Taiwan Biobank were analyzed. Mini-Mental State Examination (MMSE) scores were performed for all subjects to weigh cognitive functions. RESULTS Our data showed that the REST rs1277306 SNP was significantly associated with cognitive aging among all subjects (p = 0.0052). Furthermore, the association remained significant for individuals without APOE ε4 allele (p = 0.0092), but not for individuals with at least 1 APOE ε4 allele. This association remained significant after Bonferroni correction. Additionally, we found the interactions between the rs1713985 and rs1277306 SNPs on cognitive aging (p = 0.016). However, the 3-marker haplotype derived from the rs1713985, rs3796529, and rs7680734 SNPs in the REST gene demonstrated no association with cognitive aging. CONCLUSION Our study indicates that the REST gene may contribute to susceptibility to cognitive aging independently as well as through SNP-SNP and APOE-REST interactions.
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Affiliation(s)
- Eugene Lin
- TickleFish Systems Corporation, Seattle, WA, USA
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Ren L, Bai L, Wu Y, Ni J, Shi M, Lu H, Tu J, Ning X, Lei P, Wang J. Prevalence of and Risk Factors for Cognitive Impairment Among Elderly Without Cardio- and Cerebrovascular Diseases: A Population-Based Study in Rural China. Front Aging Neurosci 2018; 10:62. [PMID: 29643801 PMCID: PMC5882828 DOI: 10.3389/fnagi.2018.00062] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2017] [Accepted: 02/20/2018] [Indexed: 11/13/2022] Open
Abstract
This study aimed to evaluate the prevalence of cognitive impairment and the distribution of its risk factors among residents aged ≥60 years without cardiovascular and cerebrovascular diseases in rural areas of northern China screened with the Chinese version of the Mini-Mental State Examination (MMSE). Between 2012 and 2013, a questionnaire survey was conducted to collect basic information from participants. Cognitive function was assessed using the MMSE. In the univariate analysis, risk factors for cognitive disorders were female sex, low education and central obesity, while drinking was found to be a protective factor. In the multivariate analysis, risk factors were old age (odds ratio [OR], 1.888; 95% confidence interval [CI]: 1.256–2.838; P = 0.002 for the 70-year-old group compared with the 60-year-old group; OR, 3.593; 95% CI, 2.468–5.230; P < 0.001 for the ≥75-year-old group compared with the 60-year-old group), low education (OR, 3.779; 95% CI: 2.218–6.440; P < 0.001 for the illiterate group compared with the group with ≥9 years of education; OR, 1.667; 95% CI, 1.001–2.775; P = 0.05 for the group with less than primary school compared with the group with ≥9 years of education), and higher blood pressure (BP; OR, 1.655; 95% CI: 1.076–2.544; P = 0.002 for individuals with stage III hypertension compared with those with normal BP). These findings suggest that it is crucial to manage and control level of BP, and improve educational attainment in order to reduce the prevalence and burden of cognitive impairment among low-income residents in rural China.
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Affiliation(s)
- Li Ren
- Department of Neurology, Tianjin Medical University General Hospital, Tianjin, China.,Tianjin Neurological Institute, Key Laboratory of Post-Neuroinjury Neuro-Repair and Regeneration in Central Nervous System, Ministry of Education and Tianjin City, Tianjin, China
| | - Lingling Bai
- Department of Neurology, Tianjin Medical University General Hospital, Tianjin, China.,Tianjin Neurological Institute, Key Laboratory of Post-Neuroinjury Neuro-Repair and Regeneration in Central Nervous System, Ministry of Education and Tianjin City, Tianjin, China.,Department of Epidemiology, Tianjin Neurological Institute, Tianjin, China.,Department of Neurology, Liaocheng People's Hospital, Liaocheng, China
| | - Yanan Wu
- Department of Neurology, Tianjin Medical University General Hospital, Tianjin, China.,Tianjin Neurological Institute, Key Laboratory of Post-Neuroinjury Neuro-Repair and Regeneration in Central Nervous System, Ministry of Education and Tianjin City, Tianjin, China.,Department of Epidemiology, Tianjin Neurological Institute, Tianjin, China
| | - Jingxian Ni
- Department of Neurology, Tianjin Medical University General Hospital, Tianjin, China.,Tianjin Neurological Institute, Key Laboratory of Post-Neuroinjury Neuro-Repair and Regeneration in Central Nervous System, Ministry of Education and Tianjin City, Tianjin, China.,Department of Epidemiology, Tianjin Neurological Institute, Tianjin, China
| | - Min Shi
- Department of Neurology, Tianjin Medical University General Hospital, Tianjin, China.,Tianjin Neurological Institute, Key Laboratory of Post-Neuroinjury Neuro-Repair and Regeneration in Central Nervous System, Ministry of Education and Tianjin City, Tianjin, China.,Department of Epidemiology, Tianjin Neurological Institute, Tianjin, China
| | - Hongyan Lu
- Department of Neurology, Tianjin Medical University General Hospital, Tianjin, China.,Tianjin Neurological Institute, Key Laboratory of Post-Neuroinjury Neuro-Repair and Regeneration in Central Nervous System, Ministry of Education and Tianjin City, Tianjin, China
| | - Jun Tu
- Department of Neurology, Tianjin Medical University General Hospital, Tianjin, China.,Tianjin Neurological Institute, Key Laboratory of Post-Neuroinjury Neuro-Repair and Regeneration in Central Nervous System, Ministry of Education and Tianjin City, Tianjin, China.,Department of Epidemiology, Tianjin Neurological Institute, Tianjin, China
| | - Xianjia Ning
- Department of Neurology, Tianjin Medical University General Hospital, Tianjin, China.,Tianjin Neurological Institute, Key Laboratory of Post-Neuroinjury Neuro-Repair and Regeneration in Central Nervous System, Ministry of Education and Tianjin City, Tianjin, China.,Department of Epidemiology, Tianjin Neurological Institute, Tianjin, China.,Center of Clinical Epidemiology, Tianjin Medical University General Hospital, Tianjin, China
| | - Ping Lei
- Department of Geriatrics, Tianjin Medical University General Hospital, Tianjin, China
| | - Jinghua Wang
- Department of Neurology, Tianjin Medical University General Hospital, Tianjin, China.,Tianjin Neurological Institute, Key Laboratory of Post-Neuroinjury Neuro-Repair and Regeneration in Central Nervous System, Ministry of Education and Tianjin City, Tianjin, China.,Department of Epidemiology, Tianjin Neurological Institute, Tianjin, China.,Center of Clinical Epidemiology, Tianjin Medical University General Hospital, Tianjin, China
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Ren L, Zheng Y, Wu L, Gu Y, He Y, Jiang B, Zhang J, Zhang L, Li J. Investigation of the prevalence of Cognitive Impairment and its risk factors within the elderly population in Shanghai, China. Sci Rep 2018; 8:3575. [PMID: 29476112 PMCID: PMC5824836 DOI: 10.1038/s41598-018-21983-w] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2017] [Accepted: 02/14/2018] [Indexed: 11/26/2022] Open
Abstract
To investigate the prevalence of cognitive impairment and its risk factors among Chinese elders aged over 80 years, a community-based, cross-sectional study was conducted from May to June 2016 in Shanghai, China. Cognitive function was measured by using Mini-Mental Status Examination. Multiple logistic regression assessed associations between risk factors and cognitive impairment. Of 480 participants, 30% were diagnosed with cognitive impairment. Women [adjusted odds ratio (AOR): 1.71, 95% confidence interval (CI): 1.03-2.83], solitary life (AOR: 3.15, 1.89-5.26), monthly income less than 2000 Chinese yuan (AOR: 3.47, 1.18-10.23) were significantly associated with increased risk of cognitive impairment, compared with men, non-solitary life, and monthly income greater than 4000 Chinese yuan, respectively. Overweight (AOR: 0.59, 0.36-0.97), being physically active at least 60 minutes per day (AOR: 0.59, 0.35-0.95), antihypertensive drugs users (AOR: 0.45, 0.28-0.72), and lipid lowering drugs users (AOR: 0.21, 0.06-0.76) significantly lowered the risk of cognitive impairment, compared with normal weight, inadequate outdoor activity, and non-medication users, respectively. Accordingly, this study found that women, solitary life, lower income was associated with increased risk of cognitive impairment, while overweight, being physically active, and antihypertensive and lipid lowering drugs usage might lower the risk.
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Affiliation(s)
- Longbing Ren
- Shanghai East Hospital, Key Laboratory of Arrhythmias, Ministry of Education, Tongji University School of Medicine, Tongji University, Shanghai, 200120, China
- Institute of Clinical Epidemiology and Evidence-based medicine, Tongji University School of Medicine, Shanghai, 200092, P.R. China
| | - Yongtao Zheng
- Shanghai East Hospital, Key Laboratory of Arrhythmias, Ministry of Education, Tongji University School of Medicine, Tongji University, Shanghai, 200120, China
- Institute of Clinical Epidemiology and Evidence-based medicine, Tongji University School of Medicine, Shanghai, 200092, P.R. China
| | - Lezhou Wu
- Department of Data Science, Children's Hospital of Philadelphia, Philadelphia, PA, 19147, USA
| | - Yijun Gu
- Shanghai East Hospital, Key Laboratory of Arrhythmias, Ministry of Education, Tongji University School of Medicine, Tongji University, Shanghai, 200120, China
- Institute of Clinical Epidemiology and Evidence-based medicine, Tongji University School of Medicine, Shanghai, 200092, P.R. China
| | - Yusheng He
- Department of Neurology, Tongji Hospital, Tongji University, Shanghai, China
| | - Bo Jiang
- Shanghai East Hospital, Key Laboratory of Arrhythmias, Ministry of Education, Tongji University School of Medicine, Tongji University, Shanghai, 200120, China
- Institute of Clinical Epidemiology and Evidence-based medicine, Tongji University School of Medicine, Shanghai, 200092, P.R. China
| | - Jie Zhang
- Shanghai East Hospital, Key Laboratory of Arrhythmias, Ministry of Education, Tongji University School of Medicine, Tongji University, Shanghai, 200120, China
- Institute of Clinical Epidemiology and Evidence-based medicine, Tongji University School of Medicine, Shanghai, 200092, P.R. China
| | - Lijuan Zhang
- Shanghai East Hospital, Key Laboratory of Arrhythmias, Ministry of Education, Tongji University School of Medicine, Tongji University, Shanghai, 200120, China.
- Institute of Clinical Epidemiology and Evidence-based medicine, Tongji University School of Medicine, Shanghai, 200092, P.R. China.
| | - Jue Li
- Shanghai East Hospital, Key Laboratory of Arrhythmias, Ministry of Education, Tongji University School of Medicine, Tongji University, Shanghai, 200120, China.
- Institute of Clinical Epidemiology and Evidence-based medicine, Tongji University School of Medicine, Shanghai, 200092, P.R. China.
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Allicin ameliorates cognitive impairment in APP/PS1 mice via Suppressing oxidative stress by Blocking JNK Signaling Pathways. Tissue Cell 2018; 50:89-95. [DOI: 10.1016/j.tice.2017.11.002] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2017] [Revised: 11/16/2017] [Accepted: 11/26/2017] [Indexed: 01/02/2023]
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Guo CP, Wei Z, Huang F, Qin M, Li X, Wang YM, Wang Q, Wang JZ, Liu R, Zhang B, Li HL, Wang XC. High salt induced hypertension leads to cognitive defect. Oncotarget 2017; 8:95780-95790. [PMID: 29221166 PMCID: PMC5707060 DOI: 10.18632/oncotarget.21326] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2017] [Accepted: 08/17/2017] [Indexed: 01/01/2023] Open
Abstract
Although increasing evidences suggest a relationship between hypertension and brain function for years, it is still unclear whether hypertension constitutes a risk factor for cognitive decline and its underlying mechanism. In the present study, an experimental animal model of hypertension simply by feeding rats with high salt diet was employed. We found that long-term high salt intake caused a marked increase of systolic blood pressure linked to a declined regional cerebral blood flow. Fear conditioning and morris water maze behavioral test revealed that high salt diet induced hippocampal dependent spatial reference memory deficits, while a decreased synaptogenesis without neuronal loss in hippocampus was observed in high salt treated rats. Furthermore, we found that high salt induced a decrease of intracellular calcium, which inactivated CaMK II and resulted in dephosphorylation of CREB at Ser133. These findings suggest a novel etiopathogenic mechanism of cognitive deficit induced by hypertension, which is initiated by high salt diet.
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Affiliation(s)
- Cui-Ping Guo
- Department of Pathophysiology, School of Basic Medicine, Key Laboratory of Ministry of Education of China for Neurological Disorders, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Zhen Wei
- Department of Pathophysiology, School of Basic Medicine, Key Laboratory of Ministry of Education of China for Neurological Disorders, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Fang Huang
- Department of Pathophysiology, School of Basic Medicine, Key Laboratory of Ministry of Education of China for Neurological Disorders, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Min Qin
- Department of Pathophysiology, School of Basic Medicine, Key Laboratory of Ministry of Education of China for Neurological Disorders, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Xing Li
- Department of Pathophysiology, School of Basic Medicine, Key Laboratory of Ministry of Education of China for Neurological Disorders, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Yu-Man Wang
- Department of Pathophysiology, School of Basic Medicine, Key Laboratory of Ministry of Education of China for Neurological Disorders, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Qun Wang
- Department of Pathophysiology, School of Basic Medicine, Key Laboratory of Ministry of Education of China for Neurological Disorders, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Jian-Zhi Wang
- Department of Pathophysiology, School of Basic Medicine, Key Laboratory of Ministry of Education of China for Neurological Disorders, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China.,Division of Neurodegenerative Disorders, Co-innovation Center of Neuroregeneration, Nantong University, Nantong, JS 226001, China
| | - Rong Liu
- Department of Pathophysiology, School of Basic Medicine, Key Laboratory of Ministry of Education of China for Neurological Disorders, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Bin Zhang
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Hong-Lian Li
- Department of Histology and Embryology, School of Basic Medicine, Key Laboratory of Ministry of Education of China for Neurological Disorders, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Xiao-Chuan Wang
- Department of Pathophysiology, School of Basic Medicine, Key Laboratory of Ministry of Education of China for Neurological Disorders, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China.,Division of Neurodegenerative Disorders, Co-innovation Center of Neuroregeneration, Nantong University, Nantong, JS 226001, China
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Velickaite V, Giedraitis V, Ström K, Alafuzoff I, Zetterberg H, Lannfelt L, Kilander L, Larsson EM, Ingelsson M. Cognitive function in very old men does not correlate to biomarkers of Alzheimer's disease. BMC Geriatr 2017; 17:208. [PMID: 28886705 PMCID: PMC5591537 DOI: 10.1186/s12877-017-0601-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2017] [Accepted: 08/24/2017] [Indexed: 11/23/2022] Open
Abstract
Background The Alzheimer’s disease (AD) brain displays atrophy with amyloid-β (Aβ) and tau deposition, whereas decreased Aβ42 and increased tau are measured in cerebrospinal fluid (CSF). The aim of this study was to relate cognitive performance to the degree of brain atrophy, CSF biomarker levels and neuropathology in a cohort of aged men. Methods Fifty-eight 86–92-year-old men from the Uppsala Longitudinal Study of Adult Men (ULSAM) cohort underwent cognitive testing, brain computed tomography and lumbar puncture. Atrophy was graded with established scales. Concentrations of CSF Aβ42, t-tau and p-tau were measured by ELISA. Thirteen brains were examined post mortem. Results Forty-six of the individuals were considered non-demented, whereas twelve were diagnosed with dementia, either at baseline (n = 4) or during follow-up (n = 8). When comparing subjects with and without dementia, there were no differences in the degree of atrophy, although the mini mental state examination (MMSE) scoring correlated weakly with the degree of medial temporal atrophy (MTA) (p = 0.04). Moreover, the CSF biomarker levels did not differ significantly between healthy (n = 27) and demented (n = 8) subjects (median values 715 vs 472 pg/ml for Aβ42, 414 vs 427 pg/ml for t-tau and 63 vs 60 pg/ml for p-tau). Similarly, there were no differences in the biomarker levels between individuals with mild (n = 24) and severe (n = 11) MTA (median values 643 vs 715 pg/ml for Aβ42, 441 vs 401 pg/ml for t-tau and 64 vs 53 pg/ml for p-tau). Finally, the neuropathological changes did not correlate with any of the other measures. Conclusion In this cohort of aged men only a weak correlation could be seen between cognitive performance and MTA, whereas the various neuroradiological, biochemical and neuropathological measures did not correlate with each other. Thus, AD biomarkers seem to be less informative in subjects of an advanced age.
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Affiliation(s)
- V Velickaite
- Department of Surgical Sciences, Radiology, Uppsala University, Uppsala, Sweden
| | - V Giedraitis
- Department of Public Health and Caring Sciences/Geriatrics, Uppsala University, Uppsala, Sweden
| | - K Ström
- Department of Public Health and Caring Sciences/Geriatrics, Uppsala University, Uppsala, Sweden
| | - I Alafuzoff
- Department of Immunology, Genetics and Pathology, Uppsala University, Uppsala, Sweden.,Department of Pathology Uppsala University Hospital, Uppsala, Sweden
| | - H Zetterberg
- Department of Psychiatry and Neurochemistry, the Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden.,Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden.,Department of Molecular Neuroscience, UCL Institute of Neurology, Queen Square, London, UK
| | - L Lannfelt
- Department of Public Health and Caring Sciences/Geriatrics, Uppsala University, Uppsala, Sweden
| | - L Kilander
- Department of Public Health and Caring Sciences/Geriatrics, Uppsala University, Uppsala, Sweden
| | - E-M Larsson
- Department of Surgical Sciences, Radiology, Uppsala University, Uppsala, Sweden
| | - M Ingelsson
- Department of Public Health and Caring Sciences/Geriatrics, Uppsala University, Uppsala, Sweden.
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Walker KA, Power MC, Gottesman RF. Defining the Relationship Between Hypertension, Cognitive Decline, and Dementia: a Review. Curr Hypertens Rep 2017; 19:24. [PMID: 28299725 DOI: 10.1007/s11906-017-0724-3] [Citation(s) in RCA: 257] [Impact Index Per Article: 36.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Hypertension is a highly prevalent condition which has been established as a risk factor for cardiovascular and cerebrovascular disease. Although the understanding of the relationship between cardiocirculatory dysfunction and brain health has improved significantly over the last several decades, it is still unclear whether hypertension constitutes a potentially treatable risk factor for cognitive decline and dementia. While it is clear that hypertension can affect brain structure and function, recent findings suggest that the associations between blood pressure and brain health are complex and, in many cases, dependent on factors such as age, hypertension chronicity, and antihypertensive medication use. Whereas large epidemiological studies have demonstrated a consistent association between high midlife BP and late-life cognitive decline and incident dementia, associations between late-life blood pressure and cognition have been less consistent. Recent evidence suggests that hypertension may promote alterations in brain structure and function through a process of cerebral vessel remodeling, which can lead to disruptions in cerebral autoregulation, reductions in cerebral perfusion, and limit the brain's ability to clear potentially harmful proteins such as β-amyloid. The purpose of the current review is to synthesize recent findings from epidemiological, neuroimaging, physiological, genetic, and translational research to provide an overview of what is currently known about the association between blood pressure and cognitive function across the lifespan. In doing so, the current review also discusses the results of recent randomized controlled trials of antihypertensive therapy to reduce cognitive decline, highlights several methodological limitations, and provides recommendations for future clinical trial design.
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Affiliation(s)
- Keenan A Walker
- Department of Neurology, Johns Hopkins University School of Medicine, Phipps 446D 600 North Wolfe St., Baltimore, MD, 21287, USA
| | - Melinda C Power
- Department of Epidemiology and Biostatistics, George Washington University Milken Institute School of Public Health, Washington, DC, USA
| | - Rebecca F Gottesman
- Department of Neurology, Johns Hopkins University School of Medicine, Phipps 446D 600 North Wolfe St., Baltimore, MD, 21287, USA. .,Department of Epidemiology, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
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Franzon K, Byberg L, Sjögren P, Zethelius B, Cederholm T, Kilander L. Predictors of Independent Aging and Survival: A 16-Year Follow-Up Report in Octogenarian Men. J Am Geriatr Soc 2017; 65:1953-1960. [DOI: 10.1111/jgs.14971] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Kristin Franzon
- Division of Geriatrics; Department of Public Health and Caring Sciences; Uppsala University; Uppsala Sweden
| | - Liisa Byberg
- Division of Orthopedics; Department of Surgical Sciences; Uppsala University; Uppsala Sweden
| | - Per Sjögren
- Division of Clinical Nutrition and Metabolism; Department of Public Health and Caring Sciences; Uppsala University; Uppsala Sweden
| | - Björn Zethelius
- Division of Geriatrics; Department of Public Health and Caring Sciences; Uppsala University; Uppsala Sweden
- Medical Products Agency; Uppsala Sweden
| | - Tommy Cederholm
- Division of Clinical Nutrition and Metabolism; Department of Public Health and Caring Sciences; Uppsala University; Uppsala Sweden
| | - Lena Kilander
- Division of Geriatrics; Department of Public Health and Caring Sciences; Uppsala University; Uppsala Sweden
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66
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Risk factors associated with the onset and progression of Alzheimer’s disease: A systematic review of the evidence. Neurotoxicology 2017; 61:143-187. [DOI: 10.1016/j.neuro.2017.03.006] [Citation(s) in RCA: 162] [Impact Index Per Article: 23.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2017] [Accepted: 03/22/2017] [Indexed: 12/25/2022]
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Albanese E, Launer LJ, Egger M, Prince MJ, Giannakopoulos P, Wolters FJ, Egan K. Body mass index in midlife and dementia: Systematic review and meta-regression analysis of 589,649 men and women followed in longitudinal studies. ALZHEIMER'S & DEMENTIA: DIAGNOSIS, ASSESSMENT & DISEASE MONITORING 2017; 8:165-178. [PMID: 28761927 PMCID: PMC5520956 DOI: 10.1016/j.dadm.2017.05.007] [Citation(s) in RCA: 149] [Impact Index Per Article: 21.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
INTRODUCTION We conducted a meta-analysis of the conflicting epidemiologic evidence on the association between midlife body mass index (BMI) and dementia. METHODS We searched standard databases to identify prospective, population-based studies of dementia risk by midlife underweight, overweight, and obesity. We performed random-effects meta-analyses and meta-regressions of adjusted relative risk (RR) estimates and formally explored between-study heterogeneity. RESULTS We included 19 studies on 589,649 participants (2040 incident dementia cases) followed up for up to 42 years. Midlife (age 35 to 65 years) obesity (BMI ≥ 30) (RR, 1.33; 95% confidence interval [CI], 1.08-1.63), but not overweight (25 < BMI < 30) (RR, 1.07; 95% CI, 0.96-1.20), was associated with dementia in late life. The association with midlife underweight (RR, 1.39; 95% CI, 1.13-1.70) was potentially driven by residual confounding (P from meta-regression = .004), selection (P = .046), and information bias (P = .007). DISCUSSION Obesity in midlife increases the risk of dementia. The association between underweight and dementia remains controversial.
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Affiliation(s)
- Emiliano Albanese
- Department of Psychiatry, University of Geneva, Switzerland
- Corresponding author. Tel.: +41-0-793750629; Fax: +41-0-22 372 5754.
| | - Lenore J. Launer
- National Institute on Aging, National Institutes of Health, Bethesda, MD, USA
| | - Matthias Egger
- Institute of Social and Preventive Medicine (ISPM), University of Bern, Switzerland
| | - Martin J. Prince
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
| | | | - Frank J. Wolters
- Department of Epidemiology, Erasmus MC, Rotterdam, The Netherlands
| | - Kieren Egan
- Faculty of Health and Medical Sciences, University of Surrey, Guildford, UK
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Zmudka JA, Sérot JM, Dao S, Sorel C, Macaret AS, Balédent O. Specific Effects of Anti-Hypertensive Treatment in an Older Patient with Dementia. Open Neurol J 2017; 11:15-19. [PMID: 28567135 PMCID: PMC5420187 DOI: 10.2174/1874205x01711010015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2016] [Revised: 02/15/2017] [Accepted: 02/17/2017] [Indexed: 11/22/2022] Open
Abstract
Dementia is one of the most common health problems in the world. Alzheimer’s disease (AD) is the most common form of dementia. The presence of vascular risk factors such as hypertension (HT) may increase the risk of AD [1,2]. The relation between blood pressure (BP) and dementia has been the subject of numerous epidemiological studies, midlife HT is a risk factor for dementia and AD [3-7] but the association between HT and risk of dementia is lower in the older population [8]. A fair modulation of an antihypertensive treatment, based on the cognitive status of the elderly, can avoid multiple complications. A case of an older for whom cognitive improvement and reduced risk of falls were noticed after mild blood pressure elevation is reported.
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Affiliation(s)
- Jadwiga Attier Zmudka
- Department of Gerontology, General Hospital Saint Quentin, BioFlowImage, University of Picardy Jules Verne, Amiens, France
| | - Jean Marie Sérot
- Department of Gerontology, General Hospital Saint Quentin, BioFlowImage, University of Picardy Jules Verne, Amiens, France
| | - Salif Dao
- Department of Radiology, General Hospital Saint Quentin, Saint Quentin, France
| | - Claire Sorel
- Department of Cardiology, General Hospital Saint Quentin, Saint Quentin, France
| | - Anne-Sophie Macaret
- Department of Neurology, General Hospital Saint Quentin, Saint Quentin, France
| | - Olivier Balédent
- BioFlowImage Image processing unit, University Hospital & University of Picardy Jules Verne, Amiens, France
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Sibbett RA, Russ TC, Deary IJ, Starr JM. Risk factors for dementia in the ninth decade of life and beyond: a study of the Lothian birth cohort 1921. BMC Psychiatry 2017; 17:205. [PMID: 28578665 PMCID: PMC5455126 DOI: 10.1186/s12888-017-1366-3] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2017] [Accepted: 05/19/2017] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND With increasing numbers of people surviving beyond eighty years, this section of the population demands attention to reduce the impact of dementia. In order to develop effective preventative strategies, it is essential to understand age-specific risk factor profiles for dementia: do risk factors for dementia in those in their sixties and seventies persist into oldest age? The aims of this study were to determine incident dementia and to investigate the risk profile for dementia from age 79 to 95 years in a well-characterised cohort. METHODS Participants underwent intelligence testing at age 11 and were followed-up from at 79 years of age. Variables included: age, sex, age 11 IQ, APOE ɛ4, education, diabetes, hypertension, statin use, physical activity at leisure and in occupation, symptoms of depression, height, number of teeth, body mass index, blood pressure, cholesterol and HbA1c. Dementia cases were ascertained from death certificates, electronic patient records and clinical reviews. Logistic regression analysis determined the degree of risk for dementia associated with each variable. Analyses were completed both with and without the physical activity variables due to the significant number of missing data for these variables. RESULTS Of the eligible cohort, n = 410 participants remained dementia-free and n = 110 had developed probable dementia. When logistic regression analyses contained all variables, complete data was available for n = 234 (n = 48 with dementia). Results demonstrated that positive APOE ɛ4 carrier status (OR: 2.15, 95% CI: 1.04, 4.42) and greater lifetime physical activity (OR: 1.14, 95% CI: 1.02, 1.28) increased the risk for dementia. A reduction in risk for dementia was seen for hypertension (OR: 0.47, 95% CI: 0.23, 0.98). When physical activity variables were excluded, the number with complete data increased to n = 377 (n = 80 with dementia). APOE ɛ4 remained significant (OR: 2.37; 95% CI: 1.37, 4.07), as did hypertension (OR: 0.55; 95% CI: 0.32, 0.93). CONCLUSIONS Dementia incidence was consistent with expected rates. The risk profile for dementia in this cohort of participants aged 79-95 confirmed previous findings that risk factors differ for those over 79 years. Further evidence is recommended in order that the risk profile for this age group can be accurately determined.
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Affiliation(s)
- Ruth A. Sibbett
- 0000 0004 1936 7988grid.4305.2Alzheimer Scotland Dementia Research Centre, The University of Edinburgh, Edinburgh, EH8 9JZ UK ,0000 0004 1936 7988grid.4305.2Centre for Cognitive Ageing and Cognitive Epidemiology, The University of Edinburgh, 7 George Square, Edinburgh, EH8 9JZ UK
| | - Tom C. Russ
- 0000 0004 1936 7988grid.4305.2Alzheimer Scotland Dementia Research Centre, The University of Edinburgh, Edinburgh, EH8 9JZ UK ,0000 0004 1936 7988grid.4305.2Centre for Cognitive Ageing and Cognitive Epidemiology, The University of Edinburgh, 7 George Square, Edinburgh, EH8 9JZ UK ,0000 0004 1936 7988grid.4305.2Division of Psychiatry, The University of Edinburgh, Edinburgh, UK
| | - Ian J. Deary
- 0000 0004 1936 7988grid.4305.2Alzheimer Scotland Dementia Research Centre, The University of Edinburgh, Edinburgh, EH8 9JZ UK ,0000 0004 1936 7988grid.4305.2Centre for Cognitive Ageing and Cognitive Epidemiology, The University of Edinburgh, 7 George Square, Edinburgh, EH8 9JZ UK ,0000 0004 1936 7988grid.4305.2Department of Psychology, The University of Edinburgh, Edinburgh, UK
| | - John M. Starr
- 0000 0004 1936 7988grid.4305.2Alzheimer Scotland Dementia Research Centre, The University of Edinburgh, Edinburgh, EH8 9JZ UK ,0000 0004 1936 7988grid.4305.2Centre for Cognitive Ageing and Cognitive Epidemiology, The University of Edinburgh, 7 George Square, Edinburgh, EH8 9JZ UK
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Hoscheidt SM, Kellawan JM, Berman SE, Rivera-Rivera LA, Krause RA, Oh JM, Beeri MS, Rowley HA, Wieben O, Carlsson CM, Asthana S, Johnson SC, Schrage WG, Bendlin BB. Insulin resistance is associated with lower arterial blood flow and reduced cortical perfusion in cognitively asymptomatic middle-aged adults. J Cereb Blood Flow Metab 2017; 37:2249-2261. [PMID: 27488909 PMCID: PMC5464714 DOI: 10.1177/0271678x16663214] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Insulin resistance (IR) is associated with poor cerebrovascular health and increased risk for dementia. Little is known about the unique effect of IR on both micro- and macrovascular flow particularly in midlife when interventions against dementia may be most effective. We examined the effect of IR as indexed by the Homeostatic Model Assessment of Insulin Resistance (HOMA-IR) on cerebral blood flow in macro- and microvessels utilizing magnetic resonance imaging (MRI) among cognitively asymptomatic middle-aged individuals. We hypothesized that higher HOMA-IR would be associated with reduced flow in macrovessels and lower cortical perfusion. One hundred and twenty cognitively asymptomatic middle-aged adults (57 ± 5 yrs) underwent fasting blood draw, phase contrast-vastly undersampled isotropic projection reconstruction (PC VIPR) MRI, and arterial spin labeling (ASL) perfusion. Higher HOMA-IR was associated with lower arterial blood flow, particularly within the internal carotid arteries (ICAs), and lower cerebral perfusion in several brain regions including frontal and temporal lobe regions. Higher blood flow in bilateral ICAs predicted greater cortical perfusion in individuals with lower HOMA-IR, a relationship not observed among those with higher HOMA-IR. Findings provide novel evidence for an uncoupling of macrovascular blood flow and microvascular perfusion among individuals with higher IR in midlife.
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Affiliation(s)
- Siobhan M Hoscheidt
- 1 Wisconsin Alzheimer's Disease Research Center, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | | | - Sara E Berman
- 1 Wisconsin Alzheimer's Disease Research Center, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Leonardo A Rivera-Rivera
- 3 Department of Medical Physics, University of Wisconsin, Madison, WI, USA.,4 Department of Radiology, University of Wisconsin, Madison, WI, USA
| | - Rachel A Krause
- 1 Wisconsin Alzheimer's Disease Research Center, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Jennifer M Oh
- 1 Wisconsin Alzheimer's Disease Research Center, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Michal S Beeri
- 5 The Joseph Sagol Neuroscience Center, Sheba Medical Center, Israel.,6 The Icahn School of Medicine, Mount Sinai, NY, USA
| | - Howard A Rowley
- 1 Wisconsin Alzheimer's Disease Research Center, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA.,4 Department of Radiology, University of Wisconsin, Madison, WI, USA
| | - Oliver Wieben
- 3 Department of Medical Physics, University of Wisconsin, Madison, WI, USA.,4 Department of Radiology, University of Wisconsin, Madison, WI, USA
| | - Cynthia M Carlsson
- 1 Wisconsin Alzheimer's Disease Research Center, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA.,7 Geriatric Research Education and Clinical Center, Wm. S. Middleton Veterans Hospital, Madison, WI, USA.,8 Wisconsin Alzheimer's Institute, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Sanjay Asthana
- 1 Wisconsin Alzheimer's Disease Research Center, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA.,7 Geriatric Research Education and Clinical Center, Wm. S. Middleton Veterans Hospital, Madison, WI, USA.,8 Wisconsin Alzheimer's Institute, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Sterling C Johnson
- 1 Wisconsin Alzheimer's Disease Research Center, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA.,7 Geriatric Research Education and Clinical Center, Wm. S. Middleton Veterans Hospital, Madison, WI, USA.,8 Wisconsin Alzheimer's Institute, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - William G Schrage
- 2 Department of Kinesiology, University of Wisconsin, Madison, WI, USA
| | - Barbara B Bendlin
- 1 Wisconsin Alzheimer's Disease Research Center, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA.,8 Wisconsin Alzheimer's Institute, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
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Uemura MT, Ihara M, Maki T, Nakagomi T, Kaji S, Uemura K, Matsuyama T, Kalaria RN, Kinoshita A, Takahashi R. Pericyte-derived bone morphogenetic protein 4 underlies white matter damage after chronic hypoperfusion. Brain Pathol 2017; 28:521-535. [PMID: 28470822 PMCID: PMC6099372 DOI: 10.1111/bpa.12523] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2016] [Accepted: 04/18/2017] [Indexed: 01/03/2023] Open
Abstract
Subcortical small vessel disease (SVD) is characterized by white matter damage resulting from arteriolosclerosis and chronic hypoperfusion. Transforming growth factor beta 1 (TGFB1) is dysregulated in the hereditary SVD, CARASIL (cerebral autosomal recessive arteriopathy with subcortical infarcts and leukoencephalopathy). However, very little is known about the role of the largest group in the TGFB superfamily - the bone morphogenetic proteins (BMPs) - in SVD pathogenesis. The aim of this study was to characterize signaling abnormalities of BMPs in sporadic SVD. We examined immunostaining of TGFB1 and BMPs (BMP2/BMP4/BMP6/BMP7/BMP9) in a total of 19 post-mortem human brain samples as follows: 7 SVD patients (4 males, 76-90 years old); 6 Alzheimer's disease (AD) patients (2 males, 67-93 years old) and 6 age-matched disease controls (3 males, 68-78 years old). We subsequently investigated the effects of oxygen-glucose deprivation and BMP4 addition on cultured cells. Furthermore, adult mice were subjected to chronic cerebral hypoperfusion using bilateral common carotid artery stenosis, followed by continuous intracerebroventricular infusion of the BMP antagonist, noggin. In the SVD cases, BMP4 was highly expressed in white matter pericytes. Oxygen-glucose deprivation induced BMP4 expression in cultured pericytes in vitro. Recombinant BMP4 increased the number of cultured endothelial cells and pericytes and converted oligodendrocyte precursor cells into astrocytes. Chronic cerebral hypoperfusion in vivo also upregulated BMP4 with concomitant white matter astrogliogenesis and reduced oligodendrocyte lineage cells, both of which were suppressed by intracerebroventricular noggin infusion. Our findings suggest ischemic white matter damage evolves in parallel with BMP4 upregulation in pericytes. BMP4 promotes angiogenesis, but induces astrogliogenesis at the expense of oligodendrocyte precursor cell proliferation and maturation, thereby aggravating white matter damage. This may explain white matter vulnerability to chronic hypoperfusion. The regulation of BMP4 signaling is a potential therapeutic strategy for treating SVD.
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Affiliation(s)
- Maiko T Uemura
- Department of Neurology, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Masafumi Ihara
- Department of Neurology, National Cerebral and Cardiovascular Center Hospital, Osaka, Japan
| | - Takakuni Maki
- Department of Neurology, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Takayuki Nakagomi
- Institute for Advanced Medical Sciences, Hyogo College of Medicine, Hyogo, Japan
| | - Seiji Kaji
- Department of Neurology, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Kengo Uemura
- Department of Neurology, Ishiki Hospital, Kagoshima, Japan
| | - Tomohiro Matsuyama
- Institute for Advanced Medical Sciences, Hyogo College of Medicine, Hyogo, Japan
| | - Raj N Kalaria
- Institute of Neuroscience, Newcastle University, Campus for Ageing and Vitality, Newcastle Upon Tyne, UK
| | - Ayae Kinoshita
- School of Human Health Sciences, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Ryosuke Takahashi
- Department of Neurology, Kyoto University Graduate School of Medicine, Kyoto, Japan
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Olsson E, Byberg L, Karlström B, Cederholm T, Melhus H, Sjögren P, Kilander L. Vitamin D is not associated with incident dementia or cognitive impairment: an 18-y follow-up study in community-living old men. Am J Clin Nutr 2017; 105:936-943. [PMID: 28202477 DOI: 10.3945/ajcn.116.141531] [Citation(s) in RCA: 64] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2016] [Accepted: 01/12/2017] [Indexed: 11/14/2022] Open
Abstract
Background: Vitamin D has been implicated as being important for maintaining cognitive function in old age. Results from longitudinal studies examining the association of vitamin D with incident dementia and cognitive impairment have been inconsistent.Objective: We investigated the relation between vitamin D, assessed in 3 different ways, and the risk of dementia.Design: We measured plasma 25-hydroxyvitamin D [25(OH)D] with the use of high-performance liquid chromatography-mass spectrometry, assessed dietary vitamin D intake with the use of 7-d dietary records, and created a vitamin D-synthesis genetic risk score (GRS) at baseline (1991-1995) in a cohort of 1182 Swedish men (mean age: 71 y). In a maximum of 18 y (median: 12 y) of follow-up, 116 men developed Alzheimer disease, 64 men developed vascular dementia, and 250 men developed all-cause dementia. An additional 80 men declined in cognitive function as assessed with the use of the Mini-Mental State Examination. Adjusted HRs and ORs were calculated with the use of Cox and logistic regressions.Results: The mean ± SD plasma 25(OH)D concentration was 68.7 ± 19.1 nmol/L. Plasma 25(OH)D, dietary vitamin D intake, and vitamin D-synthesis GRS were not associated with any cognitive outcomes (crude and adjusted HRs and ORs were ∼1.0 for all continuous exposures). The adjusted HR for all-cause dementia was 0.88 (95% CI: 0.59, 1.31) in men with plasma 25(OH)D concentrations ≤50 compared with >75 nmol/L. The adjusted HR for all-cause dementia was 0.92 (95% CI: 0.63, 1.32) for the lowest compared with highest tertiles of vitamin D intake. The adjusted HR for the continuous GRS for all-cause dementia was 1.04 (95% CI: 0.91, 1.19).Conclusion: In this cohort study, we show that there is no association between baseline vitamin D status and long-term risk of dementia or cognitive impairment over an 18-y period of time.
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Affiliation(s)
- Erika Olsson
- Departments of Public Health and Caring Sciences/Clinical Nutrition and Metabolism,
| | | | - Brita Karlström
- Departments of Public Health and Caring Sciences/Clinical Nutrition and Metabolism
| | - Tommy Cederholm
- Departments of Public Health and Caring Sciences/Clinical Nutrition and Metabolism
| | - Håkan Melhus
- Medical Sciences, Clinical Pharmacogenomics and Osteoporosis, and
| | - Per Sjögren
- Departments of Public Health and Caring Sciences/Clinical Nutrition and Metabolism
| | - Lena Kilander
- Public Health and Caring Sciences/Geriatrics, Uppsala University, Uppsala, Sweden
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Abstract
This report describes the public health impact of Alzheimer's disease, including incidence and prevalence, mortality rates, costs of care, and the overall impact on caregivers and society. It also examines in detail the financial impact of Alzheimer's on families, including annual costs to families and the difficult decisions families must often make to pay those costs. An estimated 5.4 million Americans have Alzheimer's disease. By mid-century, the number of people living with Alzheimer's disease in the United States is projected to grow to 13.8 million, fueled in large part by the aging baby boom generation. Today, someone in the country develops Alzheimer's disease every 66 seconds. By 2050, one new case of Alzheimer's is expected to develop every 33 seconds, resulting in nearly 1 million new cases per year. In 2013, official death certificates recorded 84,767 deaths from Alzheimer's disease, making it the sixth leading cause of death in the United States and the fifth leading cause of death in Americans age ≥ 65 years. Between 2000 and 2013, deaths resulting from stroke, heart disease, and prostate cancer decreased 23%, 14%, and 11%, respectively, whereas deaths from Alzheimer's disease increased 71%. The actual number of deaths to which Alzheimer's disease contributes is likely much larger than the number of deaths from Alzheimer's disease recorded on death certificates. In 2016, an estimated 700,000 Americans age ≥ 65 years will die with Alzheimer's disease, and many of them will die because of the complications caused by Alzheimer's disease. In 2015, more than 15 million family members and other unpaid caregivers provided an estimated 18.1 billion hours of care to people with Alzheimer's and other dementias, a contribution valued at more than $221 billion. Average per-person Medicare payments for services to beneficiaries age ≥ 65 years with Alzheimer's disease and other dementias are more than two and a half times as great as payments for all beneficiaries without these conditions, and Medicaid payments are 19 times as great. Total payments in 2016 for health care, long-term care and hospice services for people age ≥ 65 years with dementia are estimated to be $236 billion. The costs of Alzheimer's care may place a substantial financial burden on families, who often have to take money out of their retirement savings, cut back on buying food, and reduce their own trips to the doctor. In addition, many family members incorrectly believe that Medicare pays for nursing home care and other types of long-term care. Such findings highlight the need for solutions to prevent dementia-related costs from jeopardizing the health and financial security of the families of people with Alzheimer's and other dementias.
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Lin CH, Lin E, Lane HY. Genetic Biomarkers on Age-Related Cognitive Decline. Front Psychiatry 2017; 8:247. [PMID: 29209239 PMCID: PMC5702307 DOI: 10.3389/fpsyt.2017.00247] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2017] [Accepted: 11/07/2017] [Indexed: 12/29/2022] Open
Abstract
With ever-increasing elder populations, age-related cognitive decline, which is characterized as a gradual decline in cognitive capacity in the aging process, has turned out to be a mammoth public health concern. Since genetic information has become increasingly important to explore the biological mechanisms of cognitive decline, the search for genetic biomarkers of cognitive aging has received much attention. There is growing evidence that single-nucleotide polymorphisms (SNPs) within the ADAMTS9, BDNF, CASS4, COMT, CR1, DNMT3A, DTNBP1, REST, SRR, TOMM40, circadian clock, and Alzheimer's diseases-associated genes may contribute to susceptibility to cognitive aging. In this review, we first illustrated evidence of the genetic contribution to disease susceptibility to age-related cognitive decline in recent studies ranging from approaches of candidate genes to genome-wide association studies. We then surveyed a variety of association studies regarding age-related cognitive decline with consideration of gene-gene and gene-environment interactions. Finally, we highlighted their limitations and future directions. In light of advances in precision medicine and multi-omics technologies, future research in genomic medicine promises to lead to innovative ideas that are relevant to disease prevention and novel drugs for cognitive aging.
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Affiliation(s)
- Chieh-Hsin Lin
- Graduate Institute of Biomedical Sciences, China Medical University, Taichung, Taiwan.,Department of Psychiatry, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung, Taiwan.,Center for General Education, Cheng Shiu University, Kaohsiung, Taiwan
| | - Eugene Lin
- Graduate Institute of Biomedical Sciences, China Medical University, Taichung, Taiwan.,Department of Electrical Engineering, University of Washington, Seattle, WA, United States.,TickleFish Systems Corporation, Seattle, WA, United States
| | - Hsien-Yuan Lane
- Graduate Institute of Biomedical Sciences, China Medical University, Taichung, Taiwan.,Department of Psychiatry, Brain Disease Research Center, China Medical University Hospital, Taichung, Taiwan
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Abstract
Alzheimer’s disease (AD) is characterised by a progressive loss of cognitive functions. Histopathologically, AD is defined by the presence of extracellular amyloid plaques containing Aβ and intracellular neurofibrillary tangles composed of hyperphosphorylated tau proteins. According to the now well-accepted amyloid cascade hypothesis is the Aβ pathology the primary driving force of AD pathogenesis, which then induces changes in tau protein leading to a neurodegenerative cascade during the progression of disease. Since many earlier drug trials aiming at preventing Aβ pathology failed to demonstrate efficacy, tau and microtubules have come into focus as prominent downstream targets. The article aims to develop the current concept of the involvement of tau in the neurodegenerative triad of synaptic loss, cell death and dendritic simplification. The function of tau as a microtubule-associated protein and versatile interaction partner will then be introduced and the rationale and progress of current tau-directed therapy will be discussed in the biological context.
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Affiliation(s)
- Lidia Bakota
- Department of Neurobiology, University of Osnabrück, Barbarastrasse 11, 49076, Osnabrück, Germany
| | - Roland Brandt
- Department of Neurobiology, University of Osnabrück, Barbarastrasse 11, 49076, Osnabrück, Germany.
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77
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Metabolic parameters and cognitive function in a cohort of older diabetic patients. Aging Clin Exp Res 2016; 28:1105-1112. [PMID: 26727913 DOI: 10.1007/s40520-015-0515-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2015] [Accepted: 12/06/2015] [Indexed: 01/21/2023]
Abstract
BACKGROUND Dementia is one of the most disabling conditions associated with old age. With increasing life expectancy, prevalence of both dementia and diabetes is rising. The complex pathological relationship between diabetes mellitus (DM) and dementia has been studied, but is not yet fully understood. AIMS The main objective of this study was to investigate the relationship between metabolic parameters and the cognitive function in older diabetics. METHODS A total number of 360 diabetic subjects, age 65 years and over, and 300 older people controls were included. Clinical and biological parameters, together with the cognitive function, were assessed every 6 months over a 18-month period, for each study participant. RESULTS By employing a multivariate linear regression analysis, several significant relationships have been identified: between Clock Drawing Test (CDT) scores and HbA1c (R 2 = 0.68); between CDT scores (R 2 = 0.51) and overall MMSE scores (R 2 = 0.43) on one hand, and DM duration in years, on the other hand; also between CDT scores and BMI (R 2 = 0.59). There was no significant association between fasting serum glucose (FSG), total serum cholesterol, LDL cholesterol or triglycerides levels and cognitive function scores (p > 0.05). CONCLUSIONS The close detailed monitoring of the cognitive function and a rigorous metabolic control are important, especially in the very early stages of DM. Addressing factors such as weight control in older diabetic patients could contribute to better cognitive outcomes.
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Tadic M, Cuspidi C, Hering D. Hypertension and cognitive dysfunction in elderly: blood pressure management for this global burden. BMC Cardiovasc Disord 2016; 16:208. [PMID: 27809779 PMCID: PMC5093934 DOI: 10.1186/s12872-016-0386-0] [Citation(s) in RCA: 75] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2016] [Accepted: 10/26/2016] [Indexed: 12/17/2022] Open
Abstract
Arterial hypertension and stroke are strong independent risk factors for the development of cognitive impairment and dementia. Persistently elevated blood pressure (BP) is known to impair cognitive function, however onset of new cognitive decline is common following a large and multiple mini strokes. Among various forms of dementia the most prevalent include Alzheimer’s disease (AD) and vascular dementia (VaD) which often present with similar clinical symptoms and challenging diagnosis. While hypertension is the most important modifiable vascular risk factor with antihypertensive therapy reducing the risk of stroke and potentially slowing cognitive decline, optimal BP levels for maintaining an ideal age-related mental performance are yet to be established. Cognition has improved following the use of at least one representative agent of the major drug classes with further neuroprotection with renin angiotensin inhibitors and calcium channel blockers in the hypertensive elderly. However, a reduction in BP may worsen cerebral perfusion causing an increased risk of CV complications due to the J-curve phenomenon. Given the uncertainties and conflicting results from randomized trials regarding the hypertension management in the elderly, particularly octogenarians, antihypertensive approaches are primarily based on expert opinion. Herein, we summarize available data linking arterial hypertension to cognitive decline and antihypertensive approach with potential benefits in improving cognitive function in elderly hypertensive patients.
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Affiliation(s)
- Marijana Tadic
- University Clinical Hospital Centre "Dr. Dragisa Misovic", Heroja Milana Tepica 1, 11000, Belgrade, Serbia.
| | - Cesare Cuspidi
- University of Milan-Bicocca and Istituto Auxologico Italiano, Clinical Research Unit, Viale della Resistenza 23, 20036, Meda, Italy
| | - Dagmara Hering
- Dobney Hypertension Centre, School of Medicine and Pharmacology-Royal Perth, Hospital Unit, The University of Western Australia, Rear 50 Murray Street, 6000, Perth, Australia
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Liu J, Huang Y, Chen G, Liu X, Wang Z, Cao Y, Li H, Song L, Li C, Zhao H, Chen S, Wang Y, Zhang R, Wang A, Wu S. Cumulative systolic blood pressure exposure in relation to cognitive function in middle-aged and elderly adults: A prospective, population-based study. Medicine (Baltimore) 2016; 95:e5514. [PMID: 27902618 PMCID: PMC5134811 DOI: 10.1097/md.0000000000005514] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
The association between systolic blood pressure (SBP) and cognitive function is controversial in elderly adults. In addition, few studies focused on the cumulative effect of SBP. We aimed to investigate the association between cumulative SBP exposure and cognitive function among middle-aged and elderly adults.The analysis was based on the Asymptomatic Polyvascular Abnormalities Community (APAC) study. The primary predictor was the cumulative SBP calculated by consecutive SBP values measured through baseline (2006-2007) up to the fourth examination (2012-2013). The cognitive function was estimated by mini-mental state examination (MMSE) in the fourth examination. Linear regression and logistic regression analyses were used to investigate the association between cumulative SBP and cognitive function.Among 2211 participants (41.4% female, aged 40-94 years), 167 (7.55%) were diagnosed with cognitive impairment (MMSE score < 24). Higher cumulative exposure to SBP (per SD increment) was independently associated with poor cognitive performance after controlling for multiple factors (P < 0.001). We observed nondifferential association between men and women. However, higher cumulative SBP in the adults aged ≥60 years had a stronger association with poor cognitive performance compared with that in adults aged 40 to 60 years.Greater exposure to cumulative SBP is associated with worse cognitive performance among middle-aged and elderly adults. This association is similar between men and women, but stronger in elderly adults.
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Affiliation(s)
- Jie Liu
- Department of Cardiology, North China University of Science and Technology Affiliated Hospital
| | - Yuling Huang
- Department of Cardiology, North China University of Science and Technology Affiliated Hospital
| | - Guojuan Chen
- Department of Neurology, Tangshan Gongren Hospital
| | - Xiaoxue Liu
- Department of Cardiology, Tangshan People's Hospital
| | - Zhijun Wang
- Department of Cardiology, North China University of Science and Technology Affiliated Hospital
| | - Yibin Cao
- Department of Neurology, Tangshan Gongren Hospital
| | - Haitao Li
- Department of Cardiology, North China University of Science and Technology Affiliated Hospital
| | | | | | | | | | - Yiming Wang
- Department of Hepatobiliary Surgery, Kailuan Hospital, North China University of Science and Technology, Tangshan
| | | | - Anxin Wang
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
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Zhang Y, Wang LL, Wu Y, Wang N, Wang SM, Zhang B, Shi CG, Zhang SC. Paeoniflorin attenuates hippocampal damage in a rat model of vascular dementia. Exp Ther Med 2016; 12:3729-3734. [PMID: 28101164 DOI: 10.3892/etm.2016.3849] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2015] [Accepted: 04/14/2016] [Indexed: 12/11/2022] Open
Abstract
Paeoniflorn (PF), the principal bioactive component of Paeoniae radix prescribed in traditional Chinese medicine, possesses a wide range of biological effects and exhibits neuroprotective effects in numerous diseases. Previous studies have demonstrated that PF significantly attenuates memory impairment in rats with vascular dementia (VD). In the present study, a bilateral common carotid artery occlusion (BCCAO) rat model was used to explore the underlying mechanisms of PF. The expression levels of neuron-specific enolase (NSE), S100β, B-cell lymphoma 2 (Bcl-2), Bcl-2 associated X protein, cytochrome c and brain-derived neurotrophic factor (BDNF) in the hippocampus were measured by western blot analysis. The results showed that administration of PF for 28 days significantly decreased the expression levels of NSE and S100β, both sensitive markers for brain damage, in vascular dementia (VD) model rats. In addition, PF inhibited the initiation of apoptotic cell death and attenuated the decreased expression levels of BDNF induced by bilateral common carotid artery occlusion. These data confirm the neuroprotective effects of PF on VD and provide a novel insight into the long-term use of PF as a potential treatment in the stages of early cognitive impairment in VD.
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Affiliation(s)
- Ying Zhang
- Research Center of Biomaterial and Novel Drug Delivery Systems, National Research Institute of Family Planning, Beijing 100081, P.R. China
| | - Li-Li Wang
- Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100050, P.R. China
| | - Yan Wu
- Department of Neurobiology, Beijing Institute of Basic Medical Sciences, Beijing 100850, P.R. China
| | - Ning Wang
- Department of Cell Biology, National Research Institute of Family Planning, Beijing 100081, P.R. China
| | - Shang-Ming Wang
- Department of Cell Biology, National Research Institute of Family Planning, Beijing 100081, P.R. China
| | - Bin Zhang
- Department of Cell Biology, National Research Institute of Family Planning, Beijing 100081, P.R. China
| | - Cui-Ge Shi
- Department of Cell Biology, National Research Institute of Family Planning, Beijing 100081, P.R. China
| | - Shu-Cheng Zhang
- Department of Cell Biology, National Research Institute of Family Planning, Beijing 100081, P.R. China
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Calabrese V, Giordano J, Signorile A, Laura Ontario M, Castorina S, De Pasquale C, Eckert G, Calabrese EJ. Major pathogenic mechanisms in vascular dementia: Roles of cellular stress response and hormesis in neuroprotection. J Neurosci Res 2016; 94:1588-1603. [PMID: 27662637 DOI: 10.1002/jnr.23925] [Citation(s) in RCA: 90] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2016] [Revised: 08/25/2016] [Accepted: 08/25/2016] [Indexed: 12/18/2022]
Abstract
Vascular dementia (VaD), considered the second most common cause of cognitive impairment after Alzheimer disease in the elderly, involves the impairment of memory and cognitive function as a consequence of cerebrovascular disease. Chronic cerebral hypoperfusion is a common pathophysiological condition frequently occurring in VaD. It is generally associated with neurovascular degeneration, in which neuronal damage and blood-brain barrier alterations coexist and evoke beta-amyloid-induced oxidative and nitrosative stress, mitochondrial dysfunction, and inflammasome- promoted neuroinflammation, which contribute to and exacerbate the course of disease. Vascular cognitive impairment comprises a heterogeneous group of cognitive disorders of various severity and types that share a presumed vascular etiology. The present study reviews major pathogenic factors involved in VaD, highlighting the relevance of cerebrocellular stress and hormetic responses to neurovascular insult, and addresses these mechanisms as potentially viable and valuable as foci of novel neuroprotective methods to mitigate or prevent VaD. © 2016 Wiley Periodicals, Inc.
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Affiliation(s)
- Vittorio Calabrese
- Department of Biomedical and Biotechnological Sciences, School of Medicine, University of Catania, Catania, Italy.
| | - James Giordano
- Departments of Neurology and Biochemistry and Neuroethics Studies Program, Pellegrino Center for Clinical Bioethics, Georgetown University Medical Center, Washington, DC
| | - Anna Signorile
- Department of Basic Medical Sciences, Neurosciences and Sense Organs, University of Bari, Bari, Italy
| | - Maria Laura Ontario
- Department of Biomedical and Biotechnological Sciences, School of Medicine, University of Catania, Catania, Italy
| | - Sergio Castorina
- Department of Biomedical and Biotechnological Sciences, School of Medicine, University of Catania, Catania, Italy
| | - Concetta De Pasquale
- Department of Medical, Surgical Sciences and Advanced Technologies, University of Catania, Italy
| | - Gunter Eckert
- Institute of Nutrition Sciences, Justus-Liebig-University of Giessen, Giessen, Germany
| | - Edward J Calabrese
- Department of Environmental Health Sciences, University of Massachusetts, Amherst, Amherst, Massachusetts
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Nagata K, Yamazaki T, Takano D, Maeda T, Fujimaki Y, Nakase T, Sato Y. Cerebral circulation in aging. Ageing Res Rev 2016; 30:49-60. [PMID: 27484894 DOI: 10.1016/j.arr.2016.06.001] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2016] [Revised: 05/31/2016] [Accepted: 06/01/2016] [Indexed: 12/20/2022]
Abstract
Cerebral circulation is known to be protected by the regulatory function against the hypoperfusion that will affect the cognitive function as a result of brain ischemia and energy failure. The regulatory function includes cerebrovascular autoregulation, chemical control, metabolic control, and neurogenic control, and those compensatory mechanisms can be influenced by hypertension, atherosclerosis, cardiac diseases, cerebrovascular diseases and aging. On the other hand, large and/or small infarction, intracranial hemorrhage, subarachnoid hemorrhage, atherosclerosis, amylod angiopathy are also more directly associated with cognitive decline not only in those with vascular cognitive impairment or vascular dementia but also those with Alzheimer's disease.
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Affiliation(s)
- Ken Nagata
- Department of Neurology, Clinical Research Institute, Yokohama General Hospital, Yokohama, Japan.
| | - Takashi Yamazaki
- Department of Neurology, Clinical Research Institute, Yokohama General Hospital, Yokohama, Japan
| | - Daiki Takano
- Department of Neurology, Clinical Research Institute, Yokohama General Hospital, Yokohama, Japan
| | - Tetsuya Maeda
- Department of Neurology and Gerontology, Iwate Medical University, Morioka, Japan
| | - Yumi Fujimaki
- Department of Neurology, Research Institute for Brain and Blood Vessels, Akita, Japan
| | - Taizen Nakase
- Department of Neurology, Research Institute for Brain and Blood Vessels, Akita, Japan
| | - Yuichi Sato
- Department of Neurology, Noshiro Yamamoto Medical Association Hospital, Noshiro, Japan
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Di Marco LY, Farkas E, Martin C, Venneri A, Frangi AF. Is Vasomotion in Cerebral Arteries Impaired in Alzheimer's Disease? J Alzheimers Dis 2016; 46:35-53. [PMID: 25720414 PMCID: PMC4878307 DOI: 10.3233/jad-142976] [Citation(s) in RCA: 62] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
A substantial body of evidence supports the hypothesis of a vascular component in the pathogenesis of Alzheimer’s disease (AD). Cerebral hypoperfusion and blood-brain barrier dysfunction have been indicated as key elements of this pathway. Cerebral amyloid angiopathy (CAA) is a cerebrovascular disorder, frequent in AD, characterized by the accumulation of amyloid-β (Aβ) peptide in cerebral blood vessel walls. CAA is associated with loss of vascular integrity, resulting in impaired regulation of cerebral circulation, and increased susceptibility to cerebral ischemia, microhemorrhages, and white matter damage. Vasomotion— the spontaneous rhythmic modulation of arterial diameter, typically observed in arteries/arterioles in various vascular beds including the brain— is thought to participate in tissue perfusion and oxygen delivery regulation. Vasomotion is impaired in adverse conditions such as hypoperfusion and hypoxia. The perivascular and glymphatic pathways of Aβ clearance are thought to be driven by the systolic pulse. Vasomotion produces diameter changes of comparable amplitude, however at lower rates, and could contribute to these mechanisms of Aβ clearance. In spite of potential clinical interest, studies addressing cerebral vasomotion in the context of AD/CAA are limited. This study reviews the current literature on vasomotion, and hypothesizes potential paths implicating impaired cerebral vasomotion in AD/CAA. Aβ and oxidative stress cause vascular tone dysregulation through direct effects on vascular cells, and indirect effects mediated by impaired neurovascular coupling. Vascular tone dysregulation is further aggravated by cholinergic deficit and results in depressed cerebrovascular reactivity and (possibly) impaired vasomotion, aggravating regional hypoperfusion and promoting further Aβ and oxidative stress accumulation.
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Affiliation(s)
- Luigi Yuri Di Marco
- Centre for Computational Imaging and Simulation Technologies in Biomedicine (CISTIB), Department of Electronic and Electrical Engineering, University of Sheffield, Sheffield, UK
| | - Eszter Farkas
- Department of Medical Physics and Informatics, Faculty of Medicine and Faculty of Science and Informatics, University of Szeged, Szeged, Hungary
| | - Chris Martin
- Department of Psychology, University of Sheffield, Sheffield, UK
| | - Annalena Venneri
- Department of Neuroscience, University of Sheffield, Sheffield, UK.,IRCCS, Fondazione Ospedale S. Camillo, Venice, Italy
| | - Alejandro F Frangi
- Centre for Computational Imaging and Simulation Technologies in Biomedicine (CISTIB), Department of Electronic and Electrical Engineering, University of Sheffield, Sheffield, UK
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2016 Alzheimer's disease facts and figures. Alzheimers Dement 2016. [DOI: 10.1016/j.jalz.2016.03.001 and (select 8682 from (select(sleep(5)))aqxj)] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
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2016 Alzheimer's disease facts and figures. Alzheimers Dement 2016. [DOI: 10.1016/j.jalz.2016.03.001 order by 1-- rkdf] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
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2016 Alzheimer's disease facts and figures. Alzheimers Dement 2016. [DOI: 10.1016/j.jalz.2016.03.001 waitfor delay '0:0:5'-- bmov] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
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2016 Alzheimer's disease facts and figures. Alzheimers Dement 2016. [DOI: 10.1016/j.jalz.2016.03.001 order by 1-- bcpd] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
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2016 Alzheimer's disease facts and figures. Alzheimers Dement 2016. [DOI: 10.1016/j.jalz.2016.03.001 waitfor delay '0:0:5'] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
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2016 Alzheimer's disease facts and figures. Alzheimers Dement 2016. [DOI: 10.1016/j.jalz.2016.03.001 and 2364=4691] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
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2016 Alzheimer's disease facts and figures. Alzheimers Dement 2016. [DOI: 10.1016/j.jalz.2016.03.001 and 8336=8336] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
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2016 Alzheimer's disease facts and figures. Alzheimers Dement 2016. [DOI: 10.1016/j.jalz.2016.03.001 and 8336=8336-- yvja] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
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