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Lin P, LaMonica HM, Naismith SL, Mowszowski L. Identifying subtle functional change in individuals with mild cognitive impairment: development and validation of the Healthy Brain Ageing - Functional Assessment Questionnaire. NEUROPSYCHOLOGY, DEVELOPMENT, AND COGNITION. SECTION B, AGING, NEUROPSYCHOLOGY AND COGNITION 2023; 30:536-554. [PMID: 35345965 DOI: 10.1080/13825585.2022.2057910] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Accepted: 03/21/2022] [Indexed: 05/10/2023]
Abstract
Accumulating research suggests that individuals with Mild Cognitive Impairment (MCI) experience subtle functional changes, but that available functional assessment tools are insensitive to this. To address this gap, we describe the development and validation of the self-report, "Healthy Brain Ageing Functional Assessment Questionnaire" (HBA-FAQ). We examined the factor structure and psychometric properties of the HBA-FAQ in 503 participants with normal cognition, subjective cognitive decline (SCD), MCI or dementia. Our results found the HBA-FAQ to have good reliability, validity and stronger discriminative ability between healthy control participants and those with SCD (0.734, p = .001), MCI (0.666, p = .012) and dementia (0.798, p < .001) compared to a widely-used instrumental activities of daily living screener. In conclusion, the HBA-FAQ is a valid, reliable self-report tool, providing an efficient and sensitive approach to identifying subtle changes in daily functioning in older people at risk of dementia.
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Affiliation(s)
- Pinghsiu Lin
- Healthy Brain Ageing Program, Brain and Mind Centre, The University of Sydney, Sydney, Nsw, Australia
- School of Psychology, Faculty of Science, The University of Sydney, Sydney, Nsw, Australia
| | - Haley M LaMonica
- Healthy Brain Ageing Program, Brain and Mind Centre, The University of Sydney, Sydney, Nsw, Australia
- Translational Research Collective, The University of Sydney, Nsw, Australia
| | - Sharon L Naismith
- Healthy Brain Ageing Program, Brain and Mind Centre, The University of Sydney, Sydney, Nsw, Australia
- School of Psychology, Faculty of Science, The University of Sydney, Sydney, Nsw, Australia
- Charles Perkins Centre, the University of Sydney, Sydney, Nsw, Australia
| | - Loren Mowszowski
- Healthy Brain Ageing Program, Brain and Mind Centre, The University of Sydney, Sydney, Nsw, Australia
- School of Psychology, Faculty of Science, The University of Sydney, Sydney, Nsw, Australia
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Rymo I, Fässberg MM, Kern S, Zetterberg H, Skoog I, Waern M, Sacuiu S. Mild cognitive impairment is associated with passive suicidal ideation in older adults: A population-based study. Acta Psychiatr Scand 2023; 148:91-101. [PMID: 36994943 DOI: 10.1111/acps.13549] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Revised: 02/28/2023] [Accepted: 03/17/2023] [Indexed: 03/31/2023]
Abstract
OBJECTIVE To investigate the association between MCI and passive/active suicidal ideation in a population-based sample of older adults. METHOD The sample included 916 participants without dementia acquired from the two population-based studies Prospective Population Study of Women (PPSW) and the H70-study. Cognitive status was assessed using a comprehensive neuropsychiatric examination and classified according to the Winblad et al. criteria: 182 participants were classified as cognitively intact, 448 had cognitive impairment but did not fulfill MCI criteria and 286 were diagnosed with MCI. Passive/active suicidal ideation was assessed using the Paykel questions. RESULTS Passive or active suicidal ideation (any level) was reported by 16.0% of those with MCI and 1.1% of those who were cognitively intact. MCI was associated with past year life-weariness (OR 18.32, 95% CI 2.44-137.75) and death wishes (OR 5.30, 95% CI 1.19-23.64) in regression models adjusted for covariates including major depression. Lifetime suicidal ideation was reported more frequently in MCI (35.7%) than in cognitively intact participants (14.8%). MCI was associated with lifetime life-weariness (OR 2.90, 95% CI 1.67-5.05). Among individuals with MCI, impairments in memory and visuospatial ability were associated with both past year and lifetime life-weariness. CONCLUSION Our findings suggest reports of past year as well as lifetime passive suicidal ideation to be more frequent among individuals with MCI compared to those cognitively intact, indicating that individuals with MCI may constitute a high-risk group for suicidal behavior.
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Affiliation(s)
- Irma Rymo
- Neuropsychiatric Epidemiology Unit, Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, Centre for Ageing and Health AGECAP at the University of Gothenburg, Gothenburg, Sweden
- Addiction Disorders Clinic, Sahlgrenska University Hospital, Region Västra Götaland, Gothenburg, Sweden
| | - Madeleine Mellqvist Fässberg
- Neuropsychiatric Epidemiology Unit, Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, Centre for Ageing and Health AGECAP at the University of Gothenburg, Gothenburg, Sweden
| | - Silke Kern
- Neuropsychiatric Epidemiology Unit, Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, Centre for Ageing and Health AGECAP at the University of Gothenburg, Gothenburg, Sweden
- Psychiatry Cognition and Old Age Psychiatry Department in Mölndal, Sahlgrenska University Hospital, Region Västra Götaland, Sweden
| | - Henrik Zetterberg
- Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy at the University of Gothenburg, Gothenburg, Sweden
- UCL Institute of Neurology, Department of Neurodegenerative Disease, Queen Square, London, UK
- UK Dementia Research Institute at UCL, London, UK
- Hong Kong Center for Neurodegenerative Diseases, Clear Water Bay, Hong Kong, China
| | - Ingmar Skoog
- Neuropsychiatric Epidemiology Unit, Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, Centre for Ageing and Health AGECAP at the University of Gothenburg, Gothenburg, Sweden
- Psychiatry Cognition and Old Age Psychiatry Department in Mölndal, Sahlgrenska University Hospital, Region Västra Götaland, Sweden
| | - Margda Waern
- Neuropsychiatric Epidemiology Unit, Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, Centre for Ageing and Health AGECAP at the University of Gothenburg, Gothenburg, Sweden
- Psychosis Department, Sahlgrenska University Hospital, Region Västra Götaland, Gothenburg, Sweden
| | - Simona Sacuiu
- Neuropsychiatric Epidemiology Unit, Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, Centre for Ageing and Health AGECAP at the University of Gothenburg, Gothenburg, Sweden
- Psychiatry Cognition and Old Age Psychiatry Department in Mölndal, Sahlgrenska University Hospital, Region Västra Götaland, Sweden
- Cognitive Disorders Clinic, Theme Inflammation and Aging, Karolinska University Hospital, Stockholm, Sweden
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253
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Zhang S, Dong H, Bian J, Li D, Liu C. Targeting amyloid proteins for clinical diagnosis of neurodegenerative diseases. FUNDAMENTAL RESEARCH 2023; 3:505-519. [PMID: 38933553 PMCID: PMC11197785 DOI: 10.1016/j.fmre.2022.10.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Revised: 10/16/2022] [Accepted: 10/19/2022] [Indexed: 11/05/2022] Open
Abstract
Abnormal aggregation and accumulation of pathological amyloid proteins such as amyloid-β, Tau, and α-synuclein play key pathological roles and serve as histological hallmarks in different neurodegenerative diseases (NDs) such as Alzheimer's disease (AD) and Parkinson's disease (PD). In addition, various post-translational modifications (PTMs) have been identified on pathological amyloid proteins and are subjected to change during disease progression. Given the central role of amyloid proteins in NDs, tremendous efforts have been made to develop amyloid-targeting strategies for clinical diagnosis and molecular classification of NDs. In this review, we summarize two major strategies for targeting amyloid aggregates, with a focus on the trials in AD diagnosis. The first strategy is a positron emission tomography (PET) scan of protein aggregation in the brain. We mainly focus on introducing the development of small-molecule PET tracers for specifically recognizing pathological amyloid fibrils. The second strategy is the detection of PTM biomarkers on amyloid proteins in cerebrospinal fluid and plasma. We discuss the pathological roles of different PTMs in diseases and how we can use the PTM profile of amyloid proteins for clinical diagnosis. Finally, we point out the potential technical challenges of these two strategies, and outline other potential strategies, as well as a combination of multiple strategies, for molecular diagnosis of NDs.
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Affiliation(s)
- Shenqing Zhang
- Bio-X Institutes, Key Laboratory for the Genetics of Developmental and Neuropsychiatric Disorders (Ministry of Education), Shanghai Jiao Tong University, Shanghai 200030, China
- School of Life Sciences and Biotechnology, Shanghai Jiao Tong University, Shanghai 200030, China
| | - Hui Dong
- Interdisciplinary Research Center on Biology and Chemistry, Shanghai Institute of Organic Chemistry, Chinese Academy of Sciences, Shanghai 201210, China
- University of the Chinese Academy of Sciences, Beijing 100049, China
| | - Jiang Bian
- Bio-X Institutes, Key Laboratory for the Genetics of Developmental and Neuropsychiatric Disorders (Ministry of Education), Shanghai Jiao Tong University, Shanghai 200030, China
- School of Life Sciences and Biotechnology, Shanghai Jiao Tong University, Shanghai 200030, China
| | - Dan Li
- Bio-X Institutes, Key Laboratory for the Genetics of Developmental and Neuropsychiatric Disorders (Ministry of Education), Shanghai Jiao Tong University, Shanghai 200030, China
- Bio-X-Renji Hospital Research Center, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai 200240, China
- Zhangjiang Institute for Advanced Study, Shanghai Jiao Tong University, Shanghai 200240, China
| | - Cong Liu
- Interdisciplinary Research Center on Biology and Chemistry, Shanghai Institute of Organic Chemistry, Chinese Academy of Sciences, Shanghai 201210, China
- State Key Laboratory of Bio-Organic and Natural Products Chemistry, Shanghai Institute of Organic Chemistry, Chinese Academy of Sciences, Shanghai 200032, China
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254
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Krell-Roesch J, Zaniletti I, Syrjanen JA, Kremers WK, Algeciras-Schimnich A, Dage JL, van Harten AC, Fields JA, Knopman DS, Jack CR, Petersen RC, Vassilaki M, Geda YE. Plasma-derived biomarkers of Alzheimer's disease and neuropsychiatric symptoms: A community-based study. ALZHEIMER'S & DEMENTIA (AMSTERDAM, NETHERLANDS) 2023; 15:e12461. [PMID: 37529120 PMCID: PMC10387518 DOI: 10.1002/dad2.12461] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Revised: 05/31/2023] [Accepted: 06/21/2023] [Indexed: 08/03/2023]
Abstract
INTRODUCTION We examined associations between plasma-derived biomarkers of Alzheimer's disease (AD) and neuropsychiatric symptoms (NPS) in community-dwelling older adults. METHODS Cross-sectional study involving 1005 persons ≥50 years of age (mean 74 years, 564 male, 118 cognitively impaired), who completed plasma-derived biomarker (amyloid beta 42 [Aβ42]/Aβ40, phosphorylated tau 181 [p-tau181], p-tau217, total tau [t-tau], neurofilament light [NfL]), and NPS assessment. RESULTS P-tau181 (odds ratio [OR] 2.06, 95% confidence interval [CI] 1.41-3.00, p < 0.001), p-tau217 (OR 1.70, 95% CI 1.10-2.61, p = 0.016), and t-tau (OR 1.44, 95% CI 1.08-1.92, p = 0.012) were associated with appetite change. We also found that p-tau181 and p-tau217 were associated with increased symptoms of agitation (OR 1.93, 95% CI 1.20-3.11, p = 0.007 and OR 2.04, 95% CI 1.21-3.42, p = 0.007, respectively), and disinhibition (OR 2.39, 95% CI 1.45-3.93, p = 0.001 and OR 2.30, 95% CI 1.33-3.98, p = 0.003, respectively). Aβ42/Aβ40 and NfL were not associated with NPS. CONCLUSION Higher plasma-derived p-tau181 and p-tau217 levels are associated with increased symptoms of appetite change, agitation, and disinhibition. These findings may support the validity of plasma tau biomarkers for predicting behavioral symptoms that often accompany cognitive impairment. HIGHLIGHTS We studied 1005 community-dwelling persons aged ≥ 50 yearsHigher plasma tau levels are associated with increased neuropsychiatric symptomsAβ42/Aβ40 and NfL are not associated with neuropsychiatric symptomsClinicians should treat neuropsychiatric symptoms in persons with high plasma-derived tau.
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Affiliation(s)
- Janina Krell-Roesch
- Institute of Sports and Sports Science Karlsruhe Institute of Technology Karlsruhe Germany
- Department of Quantitative Health Sciences Mayo Clinic Rochester Minnesota USA
| | - Isabella Zaniletti
- Department of Quantitative Health Sciences Mayo Clinic Scottsdale Arizona USA
| | - Jeremy A Syrjanen
- Department of Quantitative Health Sciences Mayo Clinic Rochester Minnesota USA
| | - Walter K Kremers
- Department of Quantitative Health Sciences Mayo Clinic Rochester Minnesota USA
| | | | - Jeffrey L Dage
- Department of Neurology and Stark Neurosciences Research Institute Indiana University School of Medicine Indianapolis Indiana USA
| | - Argonde C van Harten
- Alzheimer Center, Department of Neurology Vrije Universiteit Amsterdam Amsterdam the Netherlands
| | - Julie A Fields
- Department of Psychiatry and Psychology Mayo Clinic Rochester Minnesota USA
| | | | | | - Ronald C Petersen
- Department of Quantitative Health Sciences Mayo Clinic Rochester Minnesota USA
- Department of Neurology Mayo Clinic Rochester Minnesota USA
| | - Maria Vassilaki
- Department of Quantitative Health Sciences Mayo Clinic Rochester Minnesota USA
| | - Yonas E Geda
- Department of Neurology and the Franke Barrow Global Neuroscience Education Center Barrow Neurological Institute Phoenix Arizona USA
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255
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Al Olaimat M, Martinez J, Saeed F, Bozdag S. PPAD: a deep learning architecture to predict progression of Alzheimer's disease. Bioinformatics 2023; 39:i149-i157. [PMID: 37387135 PMCID: PMC10311312 DOI: 10.1093/bioinformatics/btad249] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/01/2023] Open
Abstract
MOTIVATION Alzheimer's disease (AD) is a neurodegenerative disease that affects millions of people worldwide. Mild cognitive impairment (MCI) is an intermediary stage between cognitively normal state and AD. Not all people who have MCI convert to AD. The diagnosis of AD is made after significant symptoms of dementia such as short-term memory loss are already present. Since AD is currently an irreversible disease, diagnosis at the onset of the disease brings a huge burden on patients, their caregivers, and the healthcare sector. Thus, there is a crucial need to develop methods for the early prediction AD for patients who have MCI. Recurrent neural networks (RNN) have been successfully used to handle electronic health records (EHR) for predicting conversion from MCI to AD. However, RNN ignores irregular time intervals between successive events which occurs common in electronic health record data. In this study, we propose two deep learning architectures based on RNN, namely Predicting Progression of Alzheimer's Disease (PPAD) and PPAD-Autoencoder. PPAD and PPAD-Autoencoder are designed for early predicting conversion from MCI to AD at the next visit and multiple visits ahead for patients, respectively. To minimize the effect of the irregular time intervals between visits, we propose using age in each visit as an indicator of time change between successive visits. RESULTS Our experimental results conducted on Alzheimer's Disease Neuroimaging Initiative and National Alzheimer's Coordinating Center datasets showed that our proposed models outperformed all baseline models for most prediction scenarios in terms of F2 and sensitivity. We also observed that the age feature was one of top features and was able to address irregular time interval problem. AVAILABILITY AND IMPLEMENTATION https://github.com/bozdaglab/PPAD.
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Affiliation(s)
- Mohammad Al Olaimat
- Department of Computer Science and Engineering, University of North Texas, Denton, TX, United States
| | - Jared Martinez
- Department of Computer Science and Engineering, University of North Texas, Denton, TX, United States
| | - Fahad Saeed
- School of Computing and Information Sciences, Florida International University, Miami, FL, United States
| | - Serdar Bozdag
- Department of Computer Science and Engineering, University of North Texas, Denton, TX, United States
- Department of Mathematics, University of North Texas, Denton, TX, United States
- BioDiscovery Institute, University of North Texas, Denton, TX, United States
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256
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Tulliani N, Bye R, Bissett M, Coutts S, Liu KPY. The feasibility and acceptability of an app-based cognitive strategy training programme for older people. Pilot Feasibility Stud 2023; 9:109. [PMID: 37391842 DOI: 10.1186/s40814-023-01334-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2022] [Accepted: 06/07/2023] [Indexed: 07/02/2023] Open
Abstract
BACKGROUND Increasing numbers of people are living with mild cognitive impairment in later life and seeking therapy to maintain cognition to remain as independent as possible in daily life. Based on a review of the literature, an app-based programme using perceptual-encoding strategies called Enhancing Memory in Daily Life (E-MinD Life) was developed. An expert panel reviewed the programme's appropriateness for older people with and without mild cognitive impairment. As part of the design process, the feasibility and acceptability of the E-MinD Life programme were then assessed in relation to its use by healthy older adults, with findings informing the application of the programme to older people with mild cognitive impairment in the future. METHODS Phase 1: The E-MinD Life programme was reviewed by an expert panel of occupational therapists. Experts rated the programme on a Likert scale and answered open-ended questions in relation to feasibility, clarity, and relevancy. Phase 2 involved field-testing the 9-week programme with a sample of nine healthy older people. Participants rated the acceptability of the programme on a Likert scale questionnaire. Data on recruitment rates and retention, and adherence and duration of sessions were collected to determine the feasibility of the programme. Responses to the Likert scale were analysed using descriptive statistics. Open-ended responses were categorised qualitatively using a constant comparative approach. RESULTS Phase 1: Experts indicated that the E-MinD Life programme was feasible and included relevant activities for community living. Although experts felt that an older user with mild NCD would be able to independently complete the programme, the qualitative analysis suggests formatting changes in future iterations of the programme to enhance visual clarity. Phase 2: All participants completed the 9-week programme. The average number of self-administered sessions attempted over the 9-week period was 13.44 (SD = 6.73) out of 18 scheduled sessions. Overall, most participants found the programme relevant, logical and easy to understand, and perceived it to be effective for functional cognitive problems. CONCLUSION The E-MinD Life programme shows promise for inclusion into trial designs to determine the effectiveness of the cognitive strategy programme for older people with and without cognitive impairment. TRIAL REGISTRATION ClinicalTrials.gov, NCT03430401. Registered 1 February 2018.
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Affiliation(s)
- Nikki Tulliani
- School of Health Sciences, Western Sydney University, NSW, Penrith, Australia.
| | - Rosalind Bye
- School of Health Sciences, Western Sydney University, NSW, Penrith, Australia
| | - Michelle Bissett
- Faculty of Health, Southern Cross University, QLD, Gold Coast, Australia
| | - Samantha Coutts
- School of Health Sciences, Western Sydney University, NSW, Penrith, Australia
| | - Karen P Y Liu
- School of Health Sciences, Western Sydney University, NSW, Penrith, Australia
- Translation Health Research Institute, Western Sydney University, Penrith, NSW, Australia
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hung Hom, Hong Kong
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257
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Hautecloque-Raysz G, Sellal F, Bousiges O, Phillipi N, Blanc F, Cretin B. Epileptic Prodromal Alzheimer's Disease Treated with Antiseizure Medications: Medium-Term Outcome of Seizures and Cognition. J Alzheimers Dis 2023:JAD221197. [PMID: 37355889 DOI: 10.3233/jad-221197] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/26/2023]
Abstract
BACKGROUND The medium term outcome (over more than one year) of epileptic prodromal AD (epAD) patients treated with antiseizure medications (ASMs) is unknown in terms of seizure response, treatment tolerability, and cognitive and functional progression. OBJECTIVE To describe such medium term outcome over a mean of 5.1±2.1 years. METHODS We retrospectively compared 19 epAD patients with 16 non-epileptic prodromal AD (nepAD) patients: 1) at baseline for demographics, medical history, cognitive fluctuations (CFs), psychotropic medications, MMSE scores, visually rated hippocampal atrophy, CSF neurodegenerative biomarkers, and standard EEG recordings; 2) during follow-up (FU) for psychotropic medications, MMSE progression, and conversion to dementia. In the epAD group, we analyzed baseline and FU types of seizures as well as each line of ASM with the corresponding efficacy and tolerability. RESULTS At baseline, the epAD group had more CFs than the nepAD group (58% versus 20%, p = 0.03); focal impaired awareness seizures were the most common type (n = 12, 63.1%), occurring at a monthly to quarterly frequency (89.5%), and were well controlled with monotherapy in 89.5% of cases (including 63.1% seizure-free individuals). During FU, treated epAD patients did not differ significantly from nepAD patients in MMSE progression or in conversion to dementia. CONCLUSION Epilepsy is commonly controlled with ASMs over the medium term in epAD patients, with similar functional and cognitive outcomes to nepAD patients. Pathophysiologically, epilepsy is likely to be an ASM-modifiable cognitive aggravating factor at this stage of AD.
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Affiliation(s)
- Geoffroy Hautecloque-Raysz
- Centre Mémoire, de Ressources et de Recherche d'Alsace (Strasbourg-Colmar), France
- Service de Neurologie, Hospices Civils de Colmar, France
| | - François Sellal
- Centre Mémoire, de Ressources et de Recherche d'Alsace (Strasbourg-Colmar), France
- Service de Neurologie, Hospices Civils de Colmar, France
- Unité INSERM U-1118, Faculté de Médecine de Strasbourg, France
| | - Olivier Bousiges
- Service de Neurologie, Hospices Civils de Colmar, France
- University Hospital of Strasbourg, Laboratory of Biochemistry and Molecular Biology, and CNRS, Laboratoire de Neurosciences Cognitives et Adaptatives (LNCA), UMR7364, Strasbourg, France
| | - Nathalie Phillipi
- Centre Mémoire, de Ressources et de Recherche d'Alsace (Strasbourg-Colmar), France
- Unité de Neuropsychologie, Service de Neurologie des Hôpitaux Universitaires de Strasbourg, Strasbourg, France
- University of Strasbourg and CNRS, ICube laboratory UMR 7357 and FMTS (Fédération de Médecine Translationnelle de Strasbourg), team IMIS/Neurocrypto Strasbourg, France
- Centre de Compétences des démences rares des Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | - Frédéric Blanc
- Centre Mémoire, de Ressources et de Recherche d'Alsace (Strasbourg-Colmar), France
- Unité de Neuropsychologie, Service de Neurologie des Hôpitaux Universitaires de Strasbourg, Strasbourg, France
- University of Strasbourg and CNRS, ICube laboratory UMR 7357 and FMTS (Fédération de Médecine Translationnelle de Strasbourg), team IMIS/Neurocrypto Strasbourg, France
- Centre de Compétences des démences rares des Hôpitaux Universitaires de Strasbourg, Strasbourg, France
| | - Benjamin Cretin
- Centre Mémoire, de Ressources et de Recherche d'Alsace (Strasbourg-Colmar), France
- Unité de Neuropsychologie, Service de Neurologie des Hôpitaux Universitaires de Strasbourg, Strasbourg, France
- University of Strasbourg and CNRS, ICube laboratory UMR 7357 and FMTS (Fédération de Médecine Translationnelle de Strasbourg), team IMIS/Neurocrypto Strasbourg, France
- Centre de Compétences des démences rares des Hôpitaux Universitaires de Strasbourg, Strasbourg, France
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258
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Bao Q, Liu Y, Zhang X, Li Y, Wang Z, Ye F, He X, Xia M, Chen Z, Yao J, Zhong W, Wu K, Wang Z, Sun M, Chen J, Hong X, Zhao L, Yin Z, Liang F. Clinical observation and mechanism of acupuncture on amnestic mild cognitive impairment based on the gut-brain axis: study protocol for a randomized controlled trial. Front Med (Lausanne) 2023; 10:1198579. [PMID: 37415772 PMCID: PMC10321407 DOI: 10.3389/fmed.2023.1198579] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2023] [Accepted: 05/31/2023] [Indexed: 07/08/2023] Open
Abstract
Background Amnestic mild cognitive impairment (aMCI) is a pre-dementia condition associated with declined cognitive function dominated by memory impairment. The occurrence of aMCI is associated with the gut-brain axis. Previous studies have shown cognitive improvements in MCI after acupuncture treatment. This study evaluates whether acupuncture can produce a therapeutic effect in patients with aMCI by modulating the gut-brain axis. Methods and design This is a prospective, parallel, multicenter randomized controlled trial. A total of 40 patients with aMCI will be randomly assigned to an acupuncture group (AG) or a waiting-list group (WG), participants in both groups will receive health education on improving cognitive function at each visit, and acupuncture will be conducted twice a week for 12 weeks in the AG. Another 20 matched healthy volunteers will be enrolled as normal control. The primary outcome will be the change in Alzheimer's Disease Assessment Scale-cognitive scale score before and after treatment. Additionally, functional magnetic resonance imaging data, faeces, and blood will be collected from each participant to characterize the brain function, gut microbiota, and inflammatory cytokines, respectively. The differences between patients with aMCI and healthy participants, and the changes in the AG and WG groups before and after treatment will be observed. Ultimately, the correlation among brain function, gut microbiota, inflammatory cytokines, and clinical efficacy evaluation in patients with aMCI will be analyzed. Discussion This study will identify the efficacy and provide preliminary data on the possible mechanism of acupuncture in treating aMCI. Furthermore, it will also identify biomarkers of the gut microbiota, inflammatory cytokines, and brain function correlated with therapeutic effects. The results of this study will be published in peer-reviewed journals. Clinical trial registration http://www.chictr.org.cn, identifier ChiCTR2200062084.
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Affiliation(s)
- Qiongnan Bao
- School of Acu-Mox and Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu, China
- Sichuan Provincial Acupuncture Clinical Medicine Research Center, Chengdu, China
| | - Yiwei Liu
- The West China Hospital, Chengdu, China
| | - Xinyue Zhang
- School of Acu-Mox and Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu, China
- Sichuan Provincial Acupuncture Clinical Medicine Research Center, Chengdu, China
| | - Yaqin Li
- School of Acu-Mox and Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Ziqi Wang
- The Fourth People's Hospital of Chengdu, Chengdu, China
| | - Fang Ye
- The Sichuan Province People's Hospital, Chengdu, China
| | - Xia He
- The Rehabilitation Hospital of Sichuan Province, Chengdu, China
| | - Manze Xia
- School of Acu-Mox and Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu, China
- Sichuan Provincial Acupuncture Clinical Medicine Research Center, Chengdu, China
| | - Zhenghong Chen
- School of Acu-Mox and Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu, China
- Sichuan Provincial Acupuncture Clinical Medicine Research Center, Chengdu, China
| | - Jin Yao
- School of Acu-Mox and Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu, China
- Sichuan Provincial Acupuncture Clinical Medicine Research Center, Chengdu, China
| | - Wanqi Zhong
- School of Acu-Mox and Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu, China
- Sichuan Provincial Acupuncture Clinical Medicine Research Center, Chengdu, China
| | - Kexin Wu
- School of Acu-Mox and Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu, China
- Sichuan Provincial Acupuncture Clinical Medicine Research Center, Chengdu, China
| | - Ziwen Wang
- School of Acu-Mox and Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu, China
- Sichuan Provincial Acupuncture Clinical Medicine Research Center, Chengdu, China
| | - Mingsheng Sun
- School of Acu-Mox and Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu, China
- Sichuan Provincial Acupuncture Clinical Medicine Research Center, Chengdu, China
| | - Jiao Chen
- School of Acu-Mox and Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu, China
- Sichuan Provincial Acupuncture Clinical Medicine Research Center, Chengdu, China
| | - Xiaojuan Hong
- School of Acu-Mox and Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu, China
- Sichuan Provincial Acupuncture Clinical Medicine Research Center, Chengdu, China
| | - Ling Zhao
- School of Acu-Mox and Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu, China
- Sichuan Provincial Acupuncture Clinical Medicine Research Center, Chengdu, China
| | - Zihan Yin
- School of Acu-Mox and Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu, China
- Sichuan Provincial Acupuncture Clinical Medicine Research Center, Chengdu, China
| | - Fanrong Liang
- School of Acu-Mox and Tuina, Chengdu University of Traditional Chinese Medicine, Chengdu, China
- Sichuan Provincial Acupuncture Clinical Medicine Research Center, Chengdu, China
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259
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Baek JH, Kang JS, Song M, Lee DK, Kim HJ. Glutamine Supplementation Preserves Glutamatergic Neuronal Activity in the Infralimbic Cortex, Which Delays the Onset of Mild Cognitive Impairment in 3×Tg-AD Female Mice. Nutrients 2023; 15:2794. [PMID: 37375700 DOI: 10.3390/nu15122794] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Revised: 06/16/2023] [Accepted: 06/17/2023] [Indexed: 06/29/2023] Open
Abstract
It was recently found that glutamine (Gln) supplementation activates glutamatergic neurotransmission and prevents chronic-stress-induced mild cognitive impairment (MCI). In this study, we evaluated the effects of Gln on glutamatergic activity in the medial prefrontal cortex and the onset of cognitive impairment in a triple-transgenic Alzheimer's disease mouse model (3×Tg-AD). Female 3×Tg-AD mice were fed a normal diet (3×Tg) or a Gln-supplemented diet (3×Tg+Gln) from 2 to 6 months of age. Glutamatergic neuronal activity was analyzed at 6 months, and cognitive function was examined at 2, 4, and 6 months. 3×Tg mice exhibited a decrease in glutamatergic neurotransmission in the infralimbic cortex, but 3×Tg+Gln mice did not. The 3×Tg group showed MCI at 6 months of age, but the 3×Tg+Gln group did not. The expressions of amyloid peptide, inducible nitric oxide synthase, and IBA-1 were not elevated in the infralimbic cortex in the 3×Tg+Gln group. Therefore, a Gln-supplemented diet could delay the onset of MCI even in a mouse model predisposed to cognitive impairment and dementia through genetic modification.
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Affiliation(s)
- Ji Hyeong Baek
- Department of Anatomy and Convergence Medical Sciences, Institute of Health Sciences, Tyrosine Peptide Multiuse Research Group, Anti-Aging Bio Cell Factory Regional Leading Research Center, Gyeongsang National University Medical School, 15 Jinju-daero 816 Beongil, Jinju 52727, Gyeongnam, Republic of Korea
| | - Jae Soon Kang
- Department of Anatomy and Convergence Medical Sciences, Institute of Health Sciences, Tyrosine Peptide Multiuse Research Group, Anti-Aging Bio Cell Factory Regional Leading Research Center, Gyeongsang National University Medical School, 15 Jinju-daero 816 Beongil, Jinju 52727, Gyeongnam, Republic of Korea
| | - Miyoung Song
- Department of Anatomy and Convergence Medical Sciences, Institute of Health Sciences, Tyrosine Peptide Multiuse Research Group, Anti-Aging Bio Cell Factory Regional Leading Research Center, Gyeongsang National University Medical School, 15 Jinju-daero 816 Beongil, Jinju 52727, Gyeongnam, Republic of Korea
| | - Dong Kun Lee
- Department of Physiology, Institute of Health Sciences, Gyeongsang National University Medical School, 15 Jinju-daero 816 Beongil, Jinju 52727, Gyeongnam, Republic of Korea
| | - Hyun Joon Kim
- Department of Anatomy and Convergence Medical Sciences, Institute of Health Sciences, Tyrosine Peptide Multiuse Research Group, Anti-Aging Bio Cell Factory Regional Leading Research Center, Gyeongsang National University Medical School, 15 Jinju-daero 816 Beongil, Jinju 52727, Gyeongnam, Republic of Korea
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260
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Martínez-Nicolás I, Martínez-Sánchez F, Ivanova O, Meilán JJG. Reading and lexical-semantic retrieval tasks outperforms single task speech analysis in the screening of mild cognitive impairment and Alzheimer's disease. Sci Rep 2023; 13:9728. [PMID: 37322073 PMCID: PMC10272227 DOI: 10.1038/s41598-023-36804-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2023] [Accepted: 06/12/2023] [Indexed: 06/17/2023] Open
Abstract
Age-related cognitive impairment have increased dramatically in recent years, which has risen the interes in developing screening tools for mild cognitive impairment and Alzheimer's disease. Speech analysis allows to exploit the behavioral consequences of cognitive deficits on the patient's vocal performance so that it is possible to identify pathologies affecting speech production such as dementia. Previous studies have further shown that the speech task used determines how the speech parameters are altered. We aim to combine the impairments in several speech production tasks in order to improve the accuracy of screening through speech analysis. The sample consists of 72 participants divided into three equal groups of healthy older adults, people with mild cognitive impairment, or Alzheimer's disease, matched by age and education. A complete neuropsychological assessment and two voice recordings were performed. The tasks required the participants to read a text, and complete a sentence with semantic information. A stepwise linear discriminant analysis was performed to select speech parameters with discriminative power. The discriminative functions obtained an accuracy of 83.3% in simultaneous classifications of several levels of cognitive impairment. It would therefore be a promising screening tool for dementia.
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Affiliation(s)
| | | | - Olga Ivanova
- Faculty of Philology, University of Salamanca, 37008, Salamanca, Spain
| | - Juan J G Meilán
- Faculty of Psychology, University of Salamanca, 37008, Salamanca, Spain
- Institute of Neuroscience of Castilla y León, 37007, Salamanca, Spain
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261
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Vinceti M, Urbano T, Chiari A, Filippini T, Wise LA, Tondelli M, Michalke B, Shimizu M, Saito Y. Selenoprotein P concentrations and risk of progression from mild cognitive impairment to dementia. Sci Rep 2023; 13:8792. [PMID: 37258587 DOI: 10.1038/s41598-023-36084-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Accepted: 05/29/2023] [Indexed: 06/02/2023] Open
Abstract
There is a growing literature investigating the effects of selenium on the central nervous system and cognitive function. However, little is known about the role of selenoprotein P, the main selenium transporter, which can also have adverse biological effects. We conducted a prospective cohort study of individuals aged 42-81 years who received a clinical diagnosis of mild cognitive impairment. Using sandwich ELISA methods, we measured full-length selenoprotein P concentrations in serum and cerebrospinal fluid to assess the relation with dementia incidence during a median follow-up of 47.3 months. We used Cox proportional hazards regression and restricted cubic splines to model such relation. Of the 54 participants, 35 developed dementia during follow-up (including 26 cases of Alzheimer's dementia). Selenoprotein P concentrations in serum and cerebrospinal fluid were highly correlated, and in spline regression analyses they each showed a positive non-linear association with dementia risk, particularly after excluding dementia cases diagnosed within 24 months of follow-up. We also observed differences in association according to the dementia subtypes considered. Risk ratios of dementia peaked at 2-6 at the highest levels of selenoprotein P, when compared to its median level, also depending on matrix, analytical methodology and dementia subtype. Findings of this study, the first to assess selenoprotein P levels in the central nervous system in vivo and the first to use a prospective study design to evaluate associations with dementia, suggest that higher circulating concentrations of selenoprotein P, both in serum and cerebrospinal fluid, predict progression of MCI to dementia. However, further confirmation of these findings is required, given the limited statistical precision of the associations and the potential for residual confounding.
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Affiliation(s)
- Marco Vinceti
- Department of Biomedical, Metabolic, and Neural Sciences, CREAGEN - Environmental, Genetic, and Nutritional Epidemiology Research Center, University of Modena and Reggio Emilia, Modena, Italy.
- Department of Biomedical, Metabolic, and Neural Sciences, Center for Neurosciences and Neurotechnology, University of Modena and Reggio Emilia, Modena, Italy.
- Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA.
| | - Teresa Urbano
- Department of Biomedical, Metabolic, and Neural Sciences, CREAGEN - Environmental, Genetic, and Nutritional Epidemiology Research Center, University of Modena and Reggio Emilia, Modena, Italy
- Department of Biomedical, Metabolic, and Neural Sciences, Center for Neurosciences and Neurotechnology, University of Modena and Reggio Emilia, Modena, Italy
| | - Annalisa Chiari
- Department of Biomedical, Metabolic, and Neural Sciences, Center for Neurosciences and Neurotechnology, University of Modena and Reggio Emilia, Modena, Italy
- Neurology Unit, University Hospital, Modena, Italy
| | - Tommaso Filippini
- Department of Biomedical, Metabolic, and Neural Sciences, CREAGEN - Environmental, Genetic, and Nutritional Epidemiology Research Center, University of Modena and Reggio Emilia, Modena, Italy
- Department of Biomedical, Metabolic, and Neural Sciences, Center for Neurosciences and Neurotechnology, University of Modena and Reggio Emilia, Modena, Italy
- School of Public Health, University of California Berkeley, Berkeley, CA, USA
| | - Lauren A Wise
- Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA
| | - Manuela Tondelli
- Neurology Unit, University Hospital, Modena, Italy
- Primary Care Department, Local Health Unit of Modena, Modena, Italy
| | - Bernhard Michalke
- Research Unit Analytical BioGeoChemistry, Helmholtz Center Munich German Research Center for Environmental Health GmbH, Neuherberg, Germany
| | - Misaki Shimizu
- Laboratory of Molecular Biology and Metabolism, Graduate School of Pharmaceutical Sciences, Tohoku University, Sendai, Japan
| | - Yoshiro Saito
- Laboratory of Molecular Biology and Metabolism, Graduate School of Pharmaceutical Sciences, Tohoku University, Sendai, Japan
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262
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César-Freitas KG, Berardis ACP, Pretto TVM, Viagi AM, Lourençon V, Zanini LYK, Barbosa ICC, Machado RP, Cunha NGM, Watanabe MJL, Cecchini MA, Brucki SMD, Nitrini R. Follow-up of participants with subjective cognitive decline from Tremembé epidemiologic study, Brazil. Dement Neuropsychol 2023; 17:e20220064. [PMID: 37261255 PMCID: PMC10229081 DOI: 10.1590/1980-5764-dn-2022-0064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Revised: 02/07/2023] [Accepted: 03/09/2023] [Indexed: 06/02/2023] Open
Abstract
Subjective cognitive decline is defined as a self-perceived cognitive decline but with normal performance in neuropsychological assessments. Objective To verify the evolution of patients diagnosed with subjective cognitive decline compared to the cognitively normal group without any concern. Methods This is a follow-up study based on data analysis from the Tremembé epidemiologic study, in Brazil. The 211 individuals classified as cognitively normal and 174 diagnosed as having subjective cognitive decline at baseline were invited to participate. Results After a median follow-up time of five years, 108 subjective cognitive decline participants (62.0%) were reassessed. Of these, 58 (53.7%) kept this diagnosis, whereas 14 individuals (12.9%) progressed to mild cognitive impairment and 5 (4.6%) to dementia. In the cognitively normal group, 107 (50.7%) were reassessed, of which 51 (47.7%) were still classified likewise, 6 (5.6%) evolved to mild cognitive impairment and 9 (8.4%) to dementia. The presence of cognitive decline had a significant association with increasing age and depression symptoms. Considering the total number of baseline participants in each group: the subjective cognitive decline group showed higher percentage of mild cognitive impairment (p=0.022) and no difference was found in progression to dementia (p=0.468) between the groups after follow-up assessment. Conclusion Most subjective cognitive decline participants at baseline kept their cognitive complaint at follow-up and this group progressed more to mild cognitive impairment than the other group. No difference in the progression to dementia was found, despite the higher incidence of dementia in the cognitively normal group.
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Affiliation(s)
- Karolina Gouveia César-Freitas
- Universidade de São Paulo, Faculdade de Medicina, Unidade de Neurologia Cognitiva e Comportamental, Departamento de Neurologia, São Paulo SP, Brazil
- Universidade de Taubaté, Departamento de Medicina, Taubaté SP, Brazil
| | | | | | | | - Vitorio Lourençon
- Universidade de Taubaté, Departamento de Medicina, Taubaté SP, Brazil
| | | | | | | | | | | | - Mario Amore Cecchini
- Universidade de São Paulo, Faculdade de Medicina, Unidade de Neurologia Cognitiva e Comportamental, Departamento de Neurologia, São Paulo SP, Brazil
| | - Sonia Maria Dozzi Brucki
- Universidade de São Paulo, Faculdade de Medicina, Unidade de Neurologia Cognitiva e Comportamental, Departamento de Neurologia, São Paulo SP, Brazil
| | - Ricardo Nitrini
- Universidade de São Paulo, Faculdade de Medicina, Unidade de Neurologia Cognitiva e Comportamental, Departamento de Neurologia, São Paulo SP, Brazil
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263
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Adam CE, Fitzpatrick AL, Leary CS, Hajat A, Ilango SD, Park C, Phelan EA, Semmens EO. Change in gait speed and fall risk among community-dwelling older adults with and without mild cognitive impairment: a retrospective cohort analysis. BMC Geriatr 2023; 23:328. [PMID: 37231344 PMCID: PMC10214622 DOI: 10.1186/s12877-023-03890-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Accepted: 03/14/2023] [Indexed: 05/27/2023] Open
Abstract
BACKGROUND Although slow gait speed is an established risk factor for falls, few studies have evaluated change in gait speed as a predictor of falls or considered variability in effects by cognitive status. Change in gait speed may be a more useful metric because of its potential to identify decline in function. In addition, older adults with mild cognitive impairment are at an elevated risk of falls. The purpose of this research was to quantify the association between 12-month change in gait speed and falls in the subsequent 6 months among older adults with and without mild cognitive impairment. METHODS Falls were self-reported every six months, and gait speed was ascertained annually among 2,776 participants in the Ginkgo Evaluation of Memory Study (2000-2008). Adjusted Cox proportional hazards models were used to estimate hazard ratios (HR) and 95% confidence intervals (CI) for fall risk relative to a 12-month change in gait speed. RESULTS Slowing gait speed over 12 months was associated with increased risk of one or more falls (HR:1.13; 95% CI: 1.02 to 1.25) and multiple falls (HR:1.44; 95% CI: 1.18 to 1.75). Quickening gait speed was not associated with risk of one or more falls (HR 0.97; 95% CI: 0.87 to 1.08) or multiple falls (HR 1.04; 95% CI: 0.84 to 1.28), relative to those with a less than 0.10 m/s change in gait speed. Associations did not vary by cognitive status (pinteraction = 0.95 all falls, 0.25 multiple falls). CONCLUSIONS Decline in gait speed over 12 months is associated with an increased likelihood of falls among community-dwelling older adults, regardless of cognitive status. Routine checks of gait speed at outpatient visits may be warranted as a means to focus fall risk reduction efforts.
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Affiliation(s)
- Claire E Adam
- School of Public and Community Health Sciences, University of Montana, Missoula, USA.
- Center for Population Health Research, University of Montana, Missoula, USA.
| | - Annette L Fitzpatrick
- Department of Family Medicine, University of Washington, Seattle, USA
- Department of Epidemiology, School of Public Health, University of Washington, Seattle, USA
- Department of Global Health, University of Washington, Seattle, USA
| | - Cindy S Leary
- School of Public and Community Health Sciences, University of Montana, Missoula, USA
- Center for Population Health Research, University of Montana, Missoula, USA
| | - Anjum Hajat
- Department of Epidemiology, School of Public Health, University of Washington, Seattle, USA
| | - Sindana D Ilango
- Department of Epidemiology, School of Public Health, University of Washington, Seattle, USA
| | - Christina Park
- Department of Epidemiology, School of Public Health, University of Washington, Seattle, USA
| | - Elizabeth A Phelan
- Division of Gerontology and Geriatric Medicine, University of Washington, Seattle, USA
- Department of Health Systems and Population Health, University of Washington, Seattle, USA
| | - Erin O Semmens
- School of Public and Community Health Sciences, University of Montana, Missoula, USA
- Center for Population Health Research, University of Montana, Missoula, USA
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264
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Ogurtsova K, Soppa VJ, Weimar C, Jöckel KH, Jokisch M, Hoffmann B. Association of long-term air pollution and ambient noise with cognitive decline in the heinz nixdorf recall study. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2023:121898. [PMID: 37244536 DOI: 10.1016/j.envpol.2023.121898] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Revised: 05/12/2023] [Accepted: 05/24/2023] [Indexed: 05/29/2023]
Abstract
Little is known about the impact of long-term ambient air pollution (AP) and noise exposure on change in cognitive function over years in the elderly. In this study, we wanted to examine the association between long-term exposure to AP and noise with the rate of cognitive decline in a population aged 50 and older and susceptible groups with mild cognitive impairment or at a genetically higher risk of Alzheimer's disease (Apolipoprotein E ε4 positive). Participants in the German population-based Heinz Nixdorf Recall study carried out five neuropsychological tests. Individual tests scores at the first (T1 = 2006-2008) and second (T2 = 2011-2015) follow-up for each test were used as outcomes after standardization using predicted means adjusted for age and education. Global cognitive score (GCS) was defined as sum of five standardized scores of individual tests. Long-term exposures to particulate matter (PM2.5, PM10, PM2.5 absorbance), accumulation mode particle number (PNacc), a proxy of ultrafine particles, and nitrogen dioxide were estimated by the land-use regression and chemistry transport models. Noise exposures were assessed as outdoor weighted nighttime road traffic noise (Lnight) means. We performed linear regression analyses adjusted for sex, age, individual and neighborhood socio-economic status, and lifestyle variables. Effect modification in vulnerable groups was estimated using multiplicative interaction terms between exposure and a modifier. Overall, 2554 participants (49.5% men, median age is 63 (IQR = 12)) were included. We found weak associations between higher exposure to PM10 and PM2.5 with faster decline in the immediate verbal memory test. Adjustment for potential confounders and for co-exposures did not change the results. We saw no effects on GCS, and no effect of noise exposure. In susceptible groups, higher AP and noise exposure were tended to be associated with faster decline in GCS. Our results suggest that AP exposure may accelerate cognitive decline in older ages, particularly in susceptible groups.
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Affiliation(s)
- Katherine Ogurtsova
- Environmental Epidemiology Group, Institute of Occupational, Social and Environmental Medicine, Centre for Health and Society, Medical Faculty and University Hospital Düsseldorf, Heinrich Heine University Düsseldorf, Düsseldorf, Germany.
| | - Vanessa J Soppa
- Environmental Epidemiology Group, Institute of Occupational, Social and Environmental Medicine, Centre for Health and Society, Medical Faculty and University Hospital Düsseldorf, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Christian Weimar
- BDH Clinic Elzach, Elzach, Germany; Institute of Medical Informatics, Biometry and Epidemiology (IMIBE), University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Karl-Heinz Jöckel
- Institute of Medical Informatics, Biometry and Epidemiology (IMIBE), University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Martha Jokisch
- Institute of Medical Informatics, Biometry and Epidemiology (IMIBE), University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Barbara Hoffmann
- Environmental Epidemiology Group, Institute of Occupational, Social and Environmental Medicine, Centre for Health and Society, Medical Faculty and University Hospital Düsseldorf, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
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265
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Kong SDX, Gordon CJ, Hoyos CM, Wassing R, D’Rozario A, Mowszowski L, Ireland C, Palmer JR, Grunstein RR, Shine JM, McKinnon AC, Naismith SL. Heart rate variability during slow wave sleep is linked to functional connectivity in the central autonomic network. Brain Commun 2023; 5:fcad129. [PMID: 37234683 PMCID: PMC10208252 DOI: 10.1093/braincomms/fcad129] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2022] [Revised: 02/20/2023] [Accepted: 05/18/2023] [Indexed: 05/28/2023] Open
Abstract
Reduced heart rate variability can be an early sign of autonomic dysfunction in neurodegenerative diseases and may be related to brain dysfunction in the central autonomic network. As yet, such autonomic dysfunction has not been examined during sleep-which is an ideal physiological state to study brain-heart interaction as both the central and peripheral nervous systems behave differently compared to during wakefulness. Therefore, the primary aim of the current study was to examine whether heart rate variability during nocturnal sleep, specifically slow wave (deep) sleep, is associated with central autonomic network functional connectivity in older adults 'at-risk' of dementia. Older adults (n = 78; age range = 50-88 years; 64% female) attending a memory clinic for cognitive concerns underwent resting-state functional magnetic resonance imaging and an overnight polysomnography. From these, central autonomic network functional connectivity strength and heart rate variability data during sleep were derived, respectively. High-frequency heart rate variability was extracted to index parasympathetic activity during distinct periods of sleep, including slow wave sleep as well as secondary outcomes of non-rapid eye movement sleep, wake after sleep onset, and rapid eye movement sleep. General linear models were used to examine associations between central autonomic network functional connectivity and high-frequency heart rate variability. Analyses revealed that increased high-frequency heart rate variability during slow wave sleep was associated with stronger functional connectivity (F = 3.98, P = 0.022) in two core brain regions within the central autonomic network, the right anterior insular and posterior midcingulate cortex, as well as stronger functional connectivity (F = 6.21, P = 0.005) between broader central autonomic network brain regions-the right amygdala with three sub-nuclei of the thalamus. There were no significant associations between high-frequency heart rate variability and central autonomic network connectivity during wake after sleep onset or rapid eye movement sleep. These findings show that in older adults 'at-risk' of dementia, parasympathetic regulation during slow wave sleep is uniquely linked to differential functional connectivity within both core and broader central autonomic network brain regions. It is possible that dysfunctional brain-heart interactions manifest primarily during this specific period of sleep known for its role in memory and metabolic clearance. Further studies elucidating the pathophysiology and directionality of this relationship should be conducted to determine if heart rate variability drives neurodegeneration, or if brain degeneration within the central autonomic network promotes aberrant heart rate variability.
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Affiliation(s)
- Shawn D X Kong
- Correspondence to: Shawn Dexiao KongHealthy Brain Ageing ProgramBrain and Mind Centre, University of Sydney100 Mallett St, Camperdown, NSW 2050, Australia E-mail:
| | - Christopher J Gordon
- CIRUS, Centre for Sleep and Chronobiology, Woolcock Institute of Medical Research, University of Sydney, Glebe, NSW 2037, Australia
- Faculty of Medicine and Health, University of Sydney, Camperdown, NSW 2050, Australia
| | - Camilla M Hoyos
- Healthy Brain Ageing Program, Brain and Mind Centre, University of Sydney, Camperdown, NSW 2050, Australia
- Charles Perkins Centre, University of Sydney, Camperdown, NSW 2050, Australia
- School of Psychology, Faculty of Science, University of Sydney, Camperdown, NSW 2050, Australia
- CIRUS, Centre for Sleep and Chronobiology, Woolcock Institute of Medical Research, University of Sydney, Glebe, NSW 2037, Australia
| | - Rick Wassing
- CIRUS, Centre for Sleep and Chronobiology, Woolcock Institute of Medical Research, University of Sydney, Glebe, NSW 2037, Australia
| | - Angela D’Rozario
- Healthy Brain Ageing Program, Brain and Mind Centre, University of Sydney, Camperdown, NSW 2050, Australia
- School of Psychology, Faculty of Science, University of Sydney, Camperdown, NSW 2050, Australia
- CIRUS, Centre for Sleep and Chronobiology, Woolcock Institute of Medical Research, University of Sydney, Glebe, NSW 2037, Australia
| | - Loren Mowszowski
- Healthy Brain Ageing Program, Brain and Mind Centre, University of Sydney, Camperdown, NSW 2050, Australia
- Charles Perkins Centre, University of Sydney, Camperdown, NSW 2050, Australia
- School of Psychology, Faculty of Science, University of Sydney, Camperdown, NSW 2050, Australia
| | - Catriona Ireland
- Healthy Brain Ageing Program, Brain and Mind Centre, University of Sydney, Camperdown, NSW 2050, Australia
| | - Jake R Palmer
- Healthy Brain Ageing Program, Brain and Mind Centre, University of Sydney, Camperdown, NSW 2050, Australia
| | - Ronald R Grunstein
- CIRUS, Centre for Sleep and Chronobiology, Woolcock Institute of Medical Research, University of Sydney, Glebe, NSW 2037, Australia
- Faculty of Medicine and Health, University of Sydney, Camperdown, NSW 2050, Australia
- Royal Prince Alfred Hospital, University of Sydney, Camperdown, NSW 2050, Australia
| | - James M Shine
- Royal Prince Alfred Hospital, University of Sydney, Camperdown, NSW 2050, Australia
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266
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Henzen NA, Reinhardt J, Blatow M, Kressig RW, Krumm S. Excellent Interrater Reliability for Manual Segmentation of the Medial Perirhinal Cortex. Brain Sci 2023; 13:850. [PMID: 37371329 DOI: 10.3390/brainsci13060850] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Revised: 05/15/2023] [Accepted: 05/18/2023] [Indexed: 06/29/2023] Open
Abstract
Objective: Evaluation of interrater reliability for manual segmentation of brain structures that are affected first by neurofibrillary tau pathology in Alzheimer's disease. Method: Medial perirhinal cortex, lateral perirhinal cortex, and entorhinal cortex were manually segmented by two raters on structural magnetic resonance images of 44 adults (20 men; mean age = 69.2 ± 10.4 years). Intraclass correlation coefficients (ICC) of cortical thickness and volumes were calculated. Results: Very high ICC values of manual segmentation for the cortical thickness of all regions (0.953-0.986) and consistently lower ICC values for volume estimates of the medial and lateral perirhinal cortex (0.705-0.874). Conclusions: The applied manual segmentation protocol allows different raters to achieve remarkably similar cortical thickness estimates for regions of the parahippocampal gyrus. In addition, the results suggest a preference for cortical thickness over volume as a reliable measure of atrophy, especially for regions affected by collateral sulcus variability (i.e., medial and lateral perirhinal cortex). The results provide a basis for future automated segmentation and collection of normative data.
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Affiliation(s)
- Nicolas A Henzen
- University Department of Geriatric Medicine FELIX PLATTER, 4055 Basel, Switzerland
- Faculty of Psychology, University of Basel, 4001 Basel, Switzerland
| | - Julia Reinhardt
- Division of Diagnostic and Interventional Neuroradiology, Department of Radiology, University Hospital Basel, University of Basel, 4031 Basel, Switzerland
- Department of Cardiology and Cardiovascular Research Institute Basel (CRIB), University Hospital Basel, University of Basel, 4031 Basel, Switzerland
- Department of Orthopedic Surgery and Traumatology, University Hospital of Basel, University of Basel, 4031 Basel, Switzerland
| | - Maria Blatow
- Section of Neuroradiology, Department of Radiology and Nuclear Medicine, Neurocenter, Cantonal Hospital Lucerne, University of Lucerne, 6000 Lucerne, Switzerland
| | - Reto W Kressig
- University Department of Geriatric Medicine FELIX PLATTER, 4055 Basel, Switzerland
- Faculty of Medicine, University of Basel, 4056 Basel, Switzerland
| | - Sabine Krumm
- University Department of Geriatric Medicine FELIX PLATTER, 4055 Basel, Switzerland
- Faculty of Medicine, University of Basel, 4056 Basel, Switzerland
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267
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Zheng L, Eramudugolla R, Cherbuin N, Drouin SM, Dixon RA, Anstey KJ. Gender specific factors contributing to cognitive resilience in APOE ɛ4 positive older adults in a population-based sample. Sci Rep 2023; 13:8037. [PMID: 37198167 DOI: 10.1038/s41598-023-34485-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Accepted: 05/02/2023] [Indexed: 05/19/2023] Open
Abstract
Although APOE ɛ4 has been identified as the strongest genetic risk factor for Alzheimer's Disease, there are some APOE ɛ4 carriers who do not go on to develop Alzheimer's disease or cognitive impairment. This study aims to investigate factors contributing to this "resilience" separately by gender. Data were drawn from APOE ɛ4 positive participants who were aged 60 + at baseline in the Personality and Total Health Through Life (PATH) Study (N = 341, Women = 46.3%). Participants were categorised into "resilient" and "non-resilient" groups using Latent Class Analysis based on their cognitive impairment status and cognitive trajectory across 12 years. Logistic regression was used to identify the risk and protective factors that contributed to resilience stratified by gender. For APOE ɛ4 carriers who have not had a stroke, predictors of resilience were increased frequency of mild physical activity and being employed at baseline for men, and increased number of mental activities engaged in at baseline for women. The results provide insights into a novel way of classifying resilience among APOE ɛ4 carriers and risk and protective factors contributing to resilience separately for men and women.
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Affiliation(s)
- Lidan Zheng
- School of Psychology, The University of New South Wales, Sydney, NSW, Australia.
- Neuroscience Research Australia (NeuRA), Randwick, NSW, Australia.
- UNSW Ageing Futures Institute, Kensington, NSW, Australia.
| | - Ranmalee Eramudugolla
- School of Psychology, The University of New South Wales, Sydney, NSW, Australia
- Neuroscience Research Australia (NeuRA), Randwick, NSW, Australia
- UNSW Ageing Futures Institute, Kensington, NSW, Australia
| | - Nicolas Cherbuin
- Centre for Research on Ageing, Health and Wellbeing, Australian National University, Canberra, ACT, Australia
| | - Shannon M Drouin
- Department of Psychology, University of Alberta, Edmonton, Canada
| | - Roger A Dixon
- Department of Psychology, University of Alberta, Edmonton, Canada
- Neuroscience and Mental Health Institute, University of Alberta, Edmonton, Canada
| | - Kaarin J Anstey
- School of Psychology, The University of New South Wales, Sydney, NSW, Australia
- Neuroscience Research Australia (NeuRA), Randwick, NSW, Australia
- UNSW Ageing Futures Institute, Kensington, NSW, Australia
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268
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Bancks MP, Lovato J, Balasubramanyam A, Coday M, Johnson KC, Munshi M, Rebello C, Wagenknecht LE, Espeland MA. Association of Type 2 Diabetes Subgroups With Cognitive Status Without Modification From Lifestyle Intervention. J Clin Endocrinol Metab 2023; 108:e334-e342. [PMID: 36472933 PMCID: PMC10413427 DOI: 10.1210/clinem/dgac706] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Revised: 11/16/2022] [Accepted: 12/02/2022] [Indexed: 12/12/2022]
Abstract
CONTEXT Type 2 diabetes is a risk factor for incident dementia but whether risk and treatment/prevention strategies differ by diabetes subgroup is unknown. OBJECTIVE We assessed (1) whether specific type 2 diabetes (T2D) subgroups are associated with mild cognitive impairment (MCI) or probable dementia (PD), and (2) whether T2D subgroups modified the association of the Action for Health in Diabetes (Look AHEAD) multidomain intensive lifestyle intervention (ILI) with MCI/PD. METHODS We included 3760 Look AHEAD participants with T2D and overweight or obesity randomly assigned to 10 years of ILI or diabetes support and education. We used k-means clustering techniques with data on age of diabetes diagnosis, body mass index, waist circumference, and glycated hemoglobin (HbA1c) to characterize diabetes subgroups at randomization. Prevalent MCI/PD were centrally adjudicated based on standardized cognitive tests and other health information 10 to 13 years after randomization. We estimated marginal probabilities for prevalent MCI/PD among T2D subgroups with adjustment for potential confounders and attrition and examined whether ILI modified any associations. RESULTS Four distinct T2D subgroups were identified, characterized by older age at diabetes onset (43% of sample), high HbA1c (13%), severe obesity (23%), and younger age at onset (22%). Unadjusted prevalence of MCI/PD (314 cases, 8.4%) differed across T2D subgroup (older onset = 10.5%, severe obesity = 9.0%, high HbA1c = 7.9%, and younger onset = 4.0%). Adjusted probability for MCI/PD within T2D subgroup was highest for the severe obesity subgroup and lowest for the younger onset subgroup but did not differ by ILI arm (interaction P value = 0.84). CONCLUSIONS Among individuals with T2D and overweight or obesity, probability of MCI/PD differed by T2D subgroup. Probability of MCI/PD was highest for a subgroup characterized by severe obesity. CLINICALTRIALS.GOV IDENTIFIER NCT00017953.
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Affiliation(s)
- Michael P Bancks
- Department of Epidemiology and Prevention, Wake Forest University School of Medicine, Winston-Salem, NC 27157, USA
| | - James Lovato
- Department of Biostatistics and Data Science, Wake Forest University School of Medicine, Winston-Salem, NC 27157, USA
| | | | - Mace Coday
- Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis, TN 38163, USA
| | - Karen C Johnson
- Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis, TN 38163, USA
| | - Medha Munshi
- Joslin Diabetes Center, Harvard Medical School, and Division of Gerontology, Beth Israel Deaconess Medical Center, Boston, MA 02445, USA
| | - Candida Rebello
- Pennington Biomedical Research Center, Louisiana State University System, Baton Rouge, LA 70808, USA
| | - Lynne E Wagenknecht
- Division of Public Health Sciences, Wake Forest University School of Medicine, Winston-Salem, NC 27157, USA
| | - Mark A Espeland
- Departments of Internal Medicine-Gerontology and Geriatric Medicine and Biostatistics and Data Science, Wake Forest University School of Medicine, Winston-Salem, NC 27157, USA
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269
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Ding K, Zeng J, Zhang X, Wang Y, Liang F, Wang L, Guo T, Moore JB, Li R. Changes in Plant-based Dietary Quality and Subsequent Risk of Cognitive Impairment among Older Chinese Adults: A National Community-based Cohort Study. Am J Clin Nutr 2023:S0002-9165(23)57911-9. [PMID: 37187294 DOI: 10.1016/j.ajcnut.2023.05.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2023] [Revised: 05/08/2023] [Accepted: 05/11/2023] [Indexed: 05/17/2023] Open
Abstract
BACKGROUND It is unclear how changes in plant-based dietary quality are linked to subsequent risk of cognitive impairment. This study aims to evaluate this relationship using data from the Chinese Longitudinal Healthy Longevity Survey (CLHLS). METHODS A total of 6662 participants free of cognitive impairment in 2008 were included and followed up to 2018. Plant-based dietary quality was assessed by three indices: overall plant-based diet index (PDI), healthful plant-based diet index (hPDI), and unhealthful plant-based diet index (uPDI). Changes in plant-based diet quality from 2008 to 2011 were classified into quintiles. We assessed incident cognitive impairment (from 2011 to 2018) by using the Mini-Mental State Examination (MMSE). Cox proportional-hazards models were performed. RESULTS We recorded 1571 incident cases of cognitive impairment during a median of 10 years of follow-up. Compared with participants whose plant-based diet had no change or was relatively stable over three years, the full-adjusted hazard ratios (HRs) with 95% confidence intervals (CI) for cognitive impairment were 0.77 (0.64, 0.93), 0.72 (0.60, 0.86), and 1.50 (1.27, 1.77) among participants with a large increase in PDI, hPDI, and uPDI, respectively. The HRs with 95% CI were 1.22 (1.02, 1.44), 1.30 (1.11, 1.54), and 0.80 (0.67, 0.96) among participants with a large decrease in PDI, hPDI, and uPDI, respectively. Every 10-point increase in PDI and hPDI was associated with 26% and 30% lower risk of cognitive impairment, while every 10-point increase in uPDI was associated with 36% higher risk. CONCLUSIONS Older adults with increased adherence to an overall plant-based diet and a healthful plant-based diet over three years have a lower risk of cognitive impairment, while those with increased adherence to an unhealthy plant-based diet had a higher risk of cognitive impairment.
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Affiliation(s)
- Kai Ding
- School of Public Health, Wuhan University, Wuhan 430071, China
| | - Jing Zeng
- School of Public Health, Wuhan University, Wuhan 430071, China
| | - Xinge Zhang
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong Faculty of Medicine, Hong Kong Special Administrative Region, China
| | - Yechuang Wang
- School of Public Health, Wuhan University, Wuhan 430071, China
| | - Fang Liang
- School of Public Health, Wuhan University, Wuhan 430071, China
| | - Lei Wang
- School of Public Health, Wuhan University, Wuhan 430071, China
| | - Taotao Guo
- School of Public Health, Wuhan University, Wuhan 430071, China
| | - Justin B Moore
- Department of Epidemiology & Prevention, Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, NC 27157, USA
| | - Rui Li
- School of Public Health, Wuhan University, Wuhan 430071, China; Center for Nurturing Care Research, School of Nursing; Center for Healthy Aging, School of Nursing, Wuhan University, Wuhan 430071, China.
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270
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Grewal KS, Gowda-Sookochoff R, Kirk A, Morgan DG, O'Connell ME. Base rates of low neuropsychological test scores in older adults with subjective cognitive impairment: Findings from a tertiary memory clinic. APPLIED NEUROPSYCHOLOGY. ADULT 2023:1-7. [PMID: 37155741 DOI: 10.1080/23279095.2023.2208699] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
Base rates of low scores are typically determined from normative samples, which differ from clinical samples. We examined base rates of spuriously low scores for 93 older adults with subjective cognitive impairment presenting to a memory clinic. Crawford's Monte Carlo simulation algorithm was used to estimate multivariate base rates by calculating the percentage of cognitively intact memory clinic patients who produced normed scores at or below the 5th percentile. Neuropsychological tests included: Weschler Adult Intelligence Scale block design, digit span backwards, coding, Weschler Memory Scale logical memory immediate/delayed; California Verbal Learning Test immediate/delayed memory; Brief Visuospatial Memory Test immediate/delayed; and Delis-Kaplan Executive Functioning category switching, letter number sequencing, and inhibition/switching. An estimated 33.58% of the cognitively intact memory clinic population would have one or more low scores, 14.7% two or more, 6.55% three or more, 2.94% four or more, and 1.31% 5 or more due to chance. Base rates were then applied to a subset of clinical data: all with dementia and most with MCI had low scores that exceeded the base rates. Determining base rates of spuriously low scores on a neuropsychological battery in clinical samples could reduce false positives by using empirical adjustments for expected low scores.
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Affiliation(s)
- Karl S Grewal
- Department of Psychology, University of Saskatchewan, Saskatoon, Canada
| | | | - Andrew Kirk
- Department of Medicine, University of Saskatchewan, Saskatoon, Canada
| | - Debra G Morgan
- Canadian Centre for Health and Safety in Agriculture, University of Saskatchewan, Saskatoon, Canada
| | - Megan E O'Connell
- Department of Psychology, University of Saskatchewan, Saskatoon, Canada
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271
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Almkvist O, Nordberg A. A biomarker-validated time scale in years of disease progression has identified early- and late-onset subgroups in sporadic Alzheimer's disease. Alzheimers Res Ther 2023; 15:89. [PMID: 37131241 PMCID: PMC10152764 DOI: 10.1186/s13195-023-01231-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Accepted: 04/14/2023] [Indexed: 05/04/2023]
Abstract
BACKGROUND It is possible to calculate the number of years to the expected clinical onset (YECO) of autosomal-dominant Alzheimer's disease (adAD). A similar time scale is lacking for sporadic Alzheimer's disease (sAD). The purpose was to design and validate a time scale in YECO for patients with sAD in relation to CSF and PET biomarkers. METHODS Patients diagnosed with Alzheimer's disease (AD, n = 48) or mild cognitive impairment (MCI, n = 46) participated in the study. They underwent a standardized clinical examination at the Memory clinic, Karolinska University Hospital, Stockholm, Sweden, which included present and previous medical history, laboratory screening, cognitive assessment, CSF biomarkers (Aβ42, total-tau, and p-tau), and an MRI of the brain. They were also assessed with two PET tracers, 11C-Pittsburgh compound B and 18F-fluorodeoxyglucose. Assuming concordance of cognitive decline in sAD and adAD, YECO for these patients was calculated using equations for the relationship between cognitive performance, YECO, and years of education in adAD (Almkvist et al. J Int Neuropsychol Soc 23:195-203, 2017). RESULTS The mean current point of disease progression was 3.2 years after the estimated clinical onset in patients with sAD and 3.4 years prior to the estimated clinical onset in patients with MCI, as indicated by the median YECO from five cognitive tests. The associations between YECO and biomarkers were significant, while those between chronological age and biomarkers were nonsignificant. The estimated disease onset (chronological age minus YECO) followed a bimodal distribution with frequency maxima before (early-onset) and after (late-onset) 65 years of age. The early- and late-onset subgroups differed significantly in biomarkers and cognition, but after control for YECO, this difference disappeared for all except the APOE e4 gene (more frequent in early- than in late-onset). CONCLUSIONS A novel time scale in years of disease progression based on cognition was designed and validated in patients with AD using CSF and PET biomarkers. Two early- and late-disease onset subgroups were identified differing with respect to APOE e4.
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Affiliation(s)
- Ove Almkvist
- Division of Clinical Geriatrics, Department of Neurobiology Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.
- Theme Inflammation and Aging, Karolinska University Hospital, Stockholm, Sweden.
- Department of Psychology, Stockholm University, Stockholm, Sweden.
| | - Agneta Nordberg
- Division of Clinical Geriatrics, Department of Neurobiology Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
- Theme Inflammation and Aging, Karolinska University Hospital, Stockholm, Sweden
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272
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Heikkinen AL, Paajanen TI, Hublin C, Valtonen T, Krüger J, Tikkanen V, Saari T, Koivisto AM, Hänninen T, Remes AM. The Cognitive Function at Work Questionnaire in memory clinic setting: a validation study. J Clin Exp Neuropsychol 2023; 45:365-376. [PMID: 37561064 DOI: 10.1080/13803395.2023.2239508] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2023] [Accepted: 07/14/2023] [Indexed: 08/11/2023]
Abstract
INTRODUCTION As there is a trend toward more people seeking medical help due to cognitive symptoms, validated and targeted questionnaires are increasingly important in the clinical evaluation process. The Cognitive Function at Work Questionnaire (CFWQ) was developed to identify and rate subjective cognitive symptoms of individuals active in working life. However, its psychometric characteristics have not been previously studied in a memory clinic setting. METHOD The factorial structure, internal consistency, test-retest reliability, and convergent validity of the CFWQ were studied in a memory clinic setting (N = 113). We also investigated the instrument's ability to identify cognitive symptoms in a cohort of early-onset dementia (EOD, N = 22), mild cognitive impairment-neurological (MCI-n, N = 18), MCI due to mood, sleep, or other physical health problems (MCI-o, N = 59), and subjective cognitive decline (SCD, N = 14) patients. RESULTS Based on factor analysis, eight cognitive subscales were identified covering main cognitive domains: Memory, Language, Executive Function, Speed of Processing, Cognitive Control, Name Memory, Visuospatial/Praxis and Attention. The internal consistency (α = .93) and the test-retest reliability (ICC = .91) were high. Several correlations (r = .19 - .33, p < .05) were documented between neuropsychological impairment level and CFWQ scores. EOD, MCI-n, MCI-o, and SCD groups did not differ statistically significantly in the levels of cognitive symptoms as measured by the CFWQ Total score. EOD group scored higher (p = .009) than other patient groups on the Visuospatial/Praxis subscale, but the difference between EOD and MCI-o groups turned insignificant after correcting for multiple testing. CONCLUSIONS The results of the study support the validity and reliability characteristics of the CFWQ in a memory clinic setting. The instrument is easy-to-use and has clinical utility in capturing the subjective cognitive symptoms of patients active in working life and who need a referral to a more detailed evaluation.
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Affiliation(s)
- Anna-Leena Heikkinen
- Research Unit of Clinical Medicine, Neurology, University of Oulu, Oulu, Finland
- MRC, Oulu University Hospital, Oulu, Finland
- Neurocenter, Neurology, Oulu University Hospital, Oulu, Finland
- Work Ability and Working Careers, Finnish Institute of Occupational Health, Helsinki, Finland
| | - Teemu I Paajanen
- Work Ability and Working Careers, Finnish Institute of Occupational Health, Helsinki, Finland
| | - Christer Hublin
- Work Ability and Working Careers, Finnish Institute of Occupational Health, Helsinki, Finland
| | - Teppo Valtonen
- Work Ability and Working Careers, Finnish Institute of Occupational Health, Helsinki, Finland
| | - Johanna Krüger
- Research Unit of Clinical Medicine, Neurology, University of Oulu, Oulu, Finland
- MRC, Oulu University Hospital, Oulu, Finland
- Neurocenter, Neurology, Oulu University Hospital, Oulu, Finland
| | - Veera Tikkanen
- Research Unit of Clinical Medicine, Neurology, University of Oulu, Oulu, Finland
- MRC, Oulu University Hospital, Oulu, Finland
- Neurocenter, Neurology, Oulu University Hospital, Oulu, Finland
| | - Toni Saari
- Neurocenter, Neurology, Kuopio University Hospital, Kuopio, Finland
- Unit of Neurology, Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland
| | - Anne M Koivisto
- Neurocenter, Neurology, Kuopio University Hospital, Kuopio, Finland
- Unit of Neurology, Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland
- Department of Geriatrics, Helsinki University Hospital, Helsinki, Finland
- Clinical Neurosciences, University of Helsinki, Helsinki, Finland
| | - Tuomo Hänninen
- Neurocenter, Neurology, Kuopio University Hospital, Kuopio, Finland
| | - Anne M Remes
- Research Unit of Clinical Medicine, Neurology, University of Oulu, Oulu, Finland
- MRC, Oulu University Hospital, Oulu, Finland
- Neurocenter, Neurology, Oulu University Hospital, Oulu, Finland
- Clinical Neurosciences, University of Helsinki, Helsinki, Finland
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273
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Lin YR, Chi CH, Chang YL. Differential decay of gist and detail memory in older adults with amnestic mild cognitive impairment. Cortex 2023; 164:112-128. [PMID: 37207409 DOI: 10.1016/j.cortex.2023.04.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2022] [Revised: 02/19/2023] [Accepted: 04/11/2023] [Indexed: 05/21/2023]
Abstract
Amnestic mild cognitive impairment (aMCI) has been identified as a risk factor for dementia due to Alzheimer's disease. The medial temporal structures, which are crucial for memory processing, are the earliest affected regions in the brains of patients with aMCI, and episodic memory performance has been identified as a reliable way to discriminate between patients with aMCI and cognitively normal older adults. However, whether the detail and gist memory of patients with aMCI and cognitively normal older adults decay differently remains unclear. In this study, we hypothesized that detail and gist memory would be retrieved differentially, with a larger group performance gap in detail memory than in gist memory. In addition, we explored whether an increasing group performance gap between detail memory and gist memory groups would be observed over a 14-day period. Furthermore, we hypothesized that unisensory (audio-only) and multisensory (audiovisual) encoding would lead to differences in retrievals, with the multisensory condition reducing between and within-group performance gaps observed under the unisensory condition. The analyses conducted were analyses of covariance controlling for age, sex, and education and correlational analyses to examine behavioral performance and the association between behavioral data and brain variables. Compared with cognitively normal older adults, the patients with aMCI performed poorly on both detail and gist memory tests, and this performance gap persisted over time. Moreover, the memory performance of the patients with aMCI was enhanced by the provision of multisensory information, and bimodal input was significantly associated with medial temporal structure variables. Overall, our findings suggest that detail and gist memory decay differently, with a longer lasting group gap in gist memory than in detail memory. Multisensory encoding effectively reduced or overcame the between- and within-group gaps between time intervals, especially for gist memory, compared with unisensory encoding.
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Affiliation(s)
- Yu-Ruei Lin
- Department of Psychology, College of Science, National Taiwan University, Taipei, Taiwan
| | - Chia-Hsing Chi
- Department of Psychology, College of Science, National Taiwan University, Taipei, Taiwan
| | - Yu-Ling Chang
- Department of Psychology, College of Science, National Taiwan University, Taipei, Taiwan; Department of Neurology, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan; Neurobiology and Cognitive Science Center, National Taiwan University, Taipei, Taiwan; Center for Artificial Intelligence and Advanced Robotics, National Taiwan University, Taipei, Taiwan.
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274
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Granot-Hershkovitz E, Spitzer B, Yang Y, Tarraf W, Yu B, Boerwinkle E, Fornage M, Mosley TH, DeCarli C, Kristal BS, González HM, Sofer T. Genetic loci of beta-aminoisobutyric acid are associated with aging-related mild cognitive impairment. Transl Psychiatry 2023; 13:140. [PMID: 37120436 PMCID: PMC10148805 DOI: 10.1038/s41398-023-02437-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Revised: 04/14/2023] [Accepted: 04/19/2023] [Indexed: 05/01/2023] Open
Abstract
We studied the genetic associations of a previously developed Metabolomic Risk Score (MRS) for Mild Cognitive Impairment (MCI) and beta-aminoisobutyric acid metabolite (BAIBA)-the metabolite highlighted by results from a genome-wide association study (GWAS) of the MCI-MRS, and assessed their association with MCI in datasets of diverse race/ethnicities. We first performed a GWAS for the MCI-MRS and BAIBA, in Hispanic/Latino adults (n = 3890) from the Hispanic Community Health Study/Study of Latinos (HCHS/SOL). We identified ten independent genome-wide significant (p value <5 × 10-8) variants associated with MCI-MRS or BAIBA. Variants associated with the MCI-MRS are located in the Alanine-Glyoxylate Aminotransferase 2 (AGXT2 gene), which is known to be associated with BAIBA metabolism. Variants associated with BAIBA are located in the AGXT2 gene and in the SLC6A13 gene. Next, we tested the variants' association with MCI in independent datasets of n = 3178 HCHS/SOL older individuals, n = 3775 European Americans, and n = 1032 African Americans from the Atherosclerosis Risk In Communities (ARIC) study. Variants were considered associated with MCI if their p value <0.05 in the meta-analysis of the three datasets and their direction of association was consistent with expectation. Rs16899972 and rs37369 from the AGXT2 region were associated with MCI. Mediation analysis supported the mediation effect of BAIBA between the two genetic variants and MCI (p value = 0.004 for causal mediated effect). In summary, genetic variants in the AGXT2 region are associated with MCI in Hispanic/Latino, African, and European American populations in the USA, and their effect is likely mediated by changes in BAIBA levels.
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Affiliation(s)
- Einat Granot-Hershkovitz
- Division of Sleep and Circadian Disorders, Brigham and Women's Hospital, Boston, MA, USA
- Department of Medicine, Harvard Medical School, Boston, MA, USA
| | - Brian Spitzer
- Division of Sleep and Circadian Disorders, Brigham and Women's Hospital, Boston, MA, USA
- Department of Medicine, Harvard Medical School, Boston, MA, USA
| | - Yunju Yang
- Brown Foundation Institute of Molecular Medicine, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Wassim Tarraf
- Institute of Gerontology, Wayne State University, Detroit, MI, USA
| | - Bing Yu
- Human Genetics Center, School of Public Health University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Eric Boerwinkle
- Brown Foundation Institute of Molecular Medicine, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX, USA
- Human Genome Sequencing Center, Baylor College of Medicine, Houston, TX, USA
| | - Myriam Fornage
- Brown Foundation Institute of Molecular Medicine, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Thomas H Mosley
- Department of Neurology, School of Medicine, University of Mississippi Medical Center, Jackson, MS, USA
| | - Charles DeCarli
- Alzheimer's Disease Center, Department of Neurology, University of California, Davis, Sacramento, CA, USA
| | - Bruce S Kristal
- Division of Sleep and Circadian Disorders, Brigham and Women's Hospital, Boston, MA, USA
- Department of Medicine, Harvard Medical School, Boston, MA, USA
| | - Hector M González
- Department of Neurosciences, University of California, San Diego, La Jolla, CA, USA
| | - Tamar Sofer
- Division of Sleep and Circadian Disorders, Brigham and Women's Hospital, Boston, MA, USA.
- Department of Medicine, Harvard Medical School, Boston, MA, USA.
- Department of Biostatistics, Harvard T.H Chan School of Public Health, Boston, MA, USA.
- Division of Cardiology, Beth Israel Deaconess Medical Center, Boston, MA, USA.
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275
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Rennie A, Ekman U, Wallert J, Muehlboeck JS, Eriksdotter M, Wahlund LO, Ferreira D, Westman E. Comparing three neuropsychological subgrouping approaches in subjective and mild cognitive impairment from a naturalistic multicenter study. Neurobiol Aging 2023; 129:41-49. [PMID: 37269645 DOI: 10.1016/j.neurobiolaging.2023.04.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Revised: 04/20/2023] [Accepted: 04/22/2023] [Indexed: 06/05/2023]
Abstract
Subjective cognitive impairment (SCI) and mild cognitive impairment (MCI) are two clinical groups with an increased risk to develop dementia, but they are highly heterogeneous. This study compared three different approaches to subgroup SCI and MCI patients and investigated their capacity to disentangle cognitive and biomarker heterogeneity. We included 792 patients from the MemClin-cohort (142 SCI and 650 MCI). Biomarkers included cerebrospinal fluid measures of beta-amyloid-42 and phosphorylated tau, as well as visual ratings of medial temporal lobe atrophy and white matter hyperintensities on magnetic resonance imaging. We found that a more inclusive approach identified individuals with a positive beta-amyloid-42 biomarker; a less inclusive approach captured individuals with higher medial temporal lobe atrophy; and a data-driven approach captured individuals with high white matter hyperintensities burden. The three approaches also captured some neuropsychological differences. We conclude that choice of approach may differ depending on the purpose. This study helps to advance our current understanding of the clinical and biological heterogeneity within SCI and MCI, particularly in the unselected memory clinic setting.
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Affiliation(s)
- Anna Rennie
- Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences, and Society, Karolinska Institute, Stockholm, Sweden; Theme Inflammation and Aging, Karolinska University Hospital, Stockholm, Sweden.
| | - Urban Ekman
- Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences, and Society, Karolinska Institute, Stockholm, Sweden; Medical Unit, Medical Psychology, Women's Health and Allied Health Professional Theme, Karolinska University Hospital, Stockholm, Sweden
| | - John Wallert
- Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences, and Society, Karolinska Institute, Stockholm, Sweden; Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska University Hospital, Karolinska Institute, Stockholm, Sweden
| | - J-Sebastian Muehlboeck
- Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences, and Society, Karolinska Institute, Stockholm, Sweden
| | - Maria Eriksdotter
- Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences, and Society, Karolinska Institute, Stockholm, Sweden; Theme Inflammation and Aging, Karolinska University Hospital, Stockholm, Sweden
| | - Lars-Olof Wahlund
- Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences, and Society, Karolinska Institute, Stockholm, Sweden
| | - Daniel Ferreira
- Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences, and Society, Karolinska Institute, Stockholm, Sweden
| | - Eric Westman
- Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences, and Society, Karolinska Institute, Stockholm, Sweden; Department of Neuroimaging, Centre for Neuroimaging Sciences, Institute of Psychiatry, Psychology and Neuroscience: King's College London, London, UK.
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276
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Lin CS, Liu LK, Chen LK, Fuh JL. Association between masseter muscle volume, nutritional status, and cognitive status in older people. Arch Gerontol Geriatr 2023; 113:105038. [PMID: 37116259 DOI: 10.1016/j.archger.2023.105038] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 04/14/2023] [Accepted: 04/15/2023] [Indexed: 04/30/2023]
Abstract
OBJECTIVES Clinical evidence has suggested that oral function is associated with cognitive, physical, and nutritional status of older people. A smaller volume of masseter, a crucial muscle for mastication, was associated with frailty. It has remained unknown if smaller masseter is associated with cognitive impairment. The current study investigated the association between masseter muscle volume, nutritional status, and cognitive status in older people. MATERIALS AND METHODS We recruited 19 patients with mild cognitive impairment (MCI), 15 patients with Alzheimer's disease (AD), and 28 sex and age-matched non-cognitive impairment (non-CI) older subjects. The number of missing teeth (NMT), masticatory performance (MP), maximal hand-grip force (MGF), and calf circumference (CC) were assessed. The masseter volume index (MVI) was calculated based on the masseter volume measured using magnetic resonance imaging. RESULTS The MVI was significantly lower in the AD group, compared to the MCI as well as the non-CI group. Multiple regression analyses revealed that the MVI was significantly associated with nutritional status (as indexed by CC) in the analysis of combination of NMT, MP, and the MVI. Moreover, the MVI was a significant predictor of CC only in patients with cognitive impairment (i.e., MCI+AD) but not in the non-CI group. CONCLUSIONS Our findings suggested that in addition to the NMT and MP, masseter volume is a critical oral factor associated with cognitive impairment. CLINICAL RELEVANCE Reduction of MVI should be carefully monitored for patients with dementia and frailty, to whom a lower MVI may indicate worse nutrient intake.
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Affiliation(s)
- Chia-Shu Lin
- Department of Dentistry, College of Dentistry, National Yang Ming Chiao Tung University, Hsin-Chu, Taiwan; Institute of Brain Science, National Yang Ming Chiao Tung University, Hsin-Chu, Taiwan; Brain Research Center, National Yang Ming Chiao Tung University, Hsin-Chu, Taiwan.
| | - Li-Kuo Liu
- Center for Healthy Longevity and Aging Sciences, National Yang Ming Chiao Tung University, Hsin-Chu, Taiwan; Center for Geriatrics and Gerontology, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Liang-Kung Chen
- Center for Healthy Longevity and Aging Sciences, National Yang Ming Chiao Tung University, Hsin-Chu, Taiwan; Center for Geriatrics and Gerontology, Taipei Veterans General Hospital, Taipei, Taiwan; Taipei Municipal Gan-Dau Hospital (Managed by Taipei Veterans General Hospital), Taipei, Taiwan
| | - Jong-Ling Fuh
- Brain Research Center, National Yang Ming Chiao Tung University, Hsin-Chu, Taiwan; Department of Neurology, Neurological Institute, Taipei Veterans General Hospital, Taipei, Taiwan; School of Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
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277
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Soo SA, Kumar D, Leow YJ, Koh CL, Saffari SE, Kandiah N. Usefulness of the Visual Cognitive Assessment Test in Detecting Mild Cognitive Impairment in the Community. J Alzheimers Dis 2023; 93:755-763. [PMID: 37092224 DOI: 10.3233/jad-221301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/25/2023]
Abstract
BACKGROUND A delay in the detection of mild cognitive impairment (MCI) in the community delays the opportunity for early intervention. Accurate tools to detect MCI in the community are lacking. The Visual Cognitive Assessment Test (VCAT) is a visual based cognitive test useful for multilingual populations without the need for translation. OBJECTIVE Here, we evaluate the usefulness of VCAT in detecting MCI in a community population in Singapore. METHODS We recruited 301 participants from the community who completed a detailed neuropsychological assessment and 170 of them completed a 3T magnetic resonance imaging (MRI) brain scan. We performed a receiver operating characteristics analysis to test the diagnostic performance of VCAT compared to Montreal Cognitive Assessment (MoCA) in distinguishing MCI from cognitively normal (CN) by measuring area under the curve (AUC). To test for the association of VCAT with structural MRI, we performed a Pearson's correlation analysis for VCAT and MRI variables. RESULTS We recruited 39 CN and 262 MCI participants from Dementia Research Centre (Singapore). Mean age of the cohort was 63.64, SD = 9.38, mean education years was 13.59, SD = 3.70 and majority were women (55.8%). VCAT was effective in detecting MCI from CN with an AUC of 0.794 (95% CI 0.723-0.865) which was slightly higher than MoCA 0.699 (95% CI 0.621-0.777). Among subjects with MCI, VCAT was associated with medial temporal lobe atrophy (ρ = -0.265, p = 0.001). CONCLUSIONS The VCAT is useful in detecting MCI in the community in Singapore and may be an effective measure of neurodegeneration.
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Affiliation(s)
- See Ann Soo
- Dementia Research Centre (Singapore), Lee Kong Chian School of Medicine-Nanyang Technological University, Singapore
| | - Dilip Kumar
- Dementia Research Centre (Singapore), Lee Kong Chian School of Medicine-Nanyang Technological University, Singapore
| | - Yi Jin Leow
- Dementia Research Centre (Singapore), Lee Kong Chian School of Medicine-Nanyang Technological University, Singapore
| | - Chen Ling Koh
- Dementia Research Centre (Singapore), Lee Kong Chian School of Medicine-Nanyang Technological University, Singapore
| | - Seyed Ehsan Saffari
- Center for Quantitative Medicine, Duke-NUS Medical School, National University of Singapore, Singapore
| | - Nagaendran Kandiah
- Dementia Research Centre (Singapore), Lee Kong Chian School of Medicine-Nanyang Technological University, Singapore
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278
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Marselli G, Favieri F, Casagrande M. Episodic and Semantic Autobiographical Memory in Mild Cognitive Impairment (MCI): A Systematic Review. J Clin Med 2023; 12:jcm12082856. [PMID: 37109193 PMCID: PMC10144761 DOI: 10.3390/jcm12082856] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Revised: 03/09/2023] [Accepted: 03/15/2023] [Indexed: 04/29/2023] Open
Abstract
INTRODUCTION Mild cognitive impairment (MCI) is a syndrome defined as a decline in cognitive performance greater than expected for an individual according to age and education level, not interfering notably with daily life activities. Many studies have focused on the memory domain in the analysis of MCI and more severe cases of dementia. One specific memory system is represented by autobiographical memory (AM), which has been largely studied in Alzheimer's disease and its effect on AM; however, the impairment of AM in moderate forms of decline, such as MCI, is still controversial. OBJECTIVE The main aim of this systematic review is to analyze the functioning of autobiographical memory in patients with MCI, considering both the semantic and the episodic components. MATERIALS The review process was conducted according to the PRISMA statement. The search was conducted until 20 February 2023 in the following bibliographical databases: PubMed, Web of Science, Scopus, and PsycInfo, and twenty-one articles were included. RESULTS The results highlight controversial findings concerning the semantic component of AM since only seven studies have found a worse semantic AM performance in patients with MCI compared to the HC group. The results of impaired episodic AM in individuals with MCI are more consistent than those concerning semantic AM. CONCLUSIONS Starting from the evidence of this systematic review, further studies should detect and investigate the cognitive and emotional mechanisms that undermine AM performance, allowing the development of specific interventions targeting these mechanisms.
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Affiliation(s)
- Giulia Marselli
- Department of Psychology, "Sapienza" University of Rome, 00185 Rome, Italy
| | - Francesca Favieri
- Department of Dynamic and Clinical Psychology and Health Studies, "Sapienza" University of Rome, 00185 Rome, Italy
| | - Maria Casagrande
- Department of Dynamic and Clinical Psychology and Health Studies, "Sapienza" University of Rome, 00185 Rome, Italy
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279
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Sun Y, Hefu Z, Li B, Lifang W, Zhijie S, Zhou L, Deng Y, Zhili L, Ding J, Li T, Zhang W, Chao N, Rong S. Plasma Extracellular Vesicle MicroRNA Analysis of Alzheimer's Disease Reveals Dysfunction of a Neural Correlation Network. RESEARCH (WASHINGTON, D.C.) 2023; 6:0114. [PMID: 37223486 PMCID: PMC10202186 DOI: 10.34133/research.0114] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/31/2022] [Accepted: 03/20/2023] [Indexed: 05/25/2023]
Abstract
Small extracellular vesicle (sEV) is an emerging source of potential biomarkers of Alzheimer's disease (AD), but the role of microRNAs (miRNAs) in sEV is not well understood. In this study, we conducted a comprehensive analysis of sEV-derived miRNAs in AD using small RNA sequencing and coexpression network analysis. We examined a total of 158 samples, including 48 from AD patients, 48 from patients with mild cognitive impairment (MCI), and 62 from healthy controls. We identified an miRNA network module (M1) that was strongly linked to neural function and showed the strongest association with AD diagnosis and cognitive impairment. The expression of miRNAs in the module was decreased in both AD and MCI patients compared to controls. Conservation analysis revealed that M1 was highly preserved in the healthy control group but dysfunctional in the AD and MCI groups, suggesting that changes in the expression of miRNAs in this module may be an early response to cognitive decline prior to the appearance of AD pathology. We further validated the expression levels of the hub miRNAs in M1 in an independent population. The functional enrichment analysis showed that 4 hub miRNAs might interact with a GDF11-centered network and play a critical role in the neuropathology of AD. In summary, our study provides new insights into the role of sEV-derived miRNAs in AD and suggests that M1 miRNAs may serve as potential biomarkers for the early diagnosis and monitoring of AD.
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Affiliation(s)
- Yuzhe Sun
- Department of Nutrition and Food Hygiene, School of Public Health, Medical College,
Wuhan University of Science and Technology, Wuhan, China
- BGI-Shenzhen, Shenzhen, China
- Shenzhen Key Laboratory of Neurogenomics, BGI-Shenzhen, Shenzhen 518120, China
| | - Zhen Hefu
- BGI-Shenzhen, Shenzhen, China
- Shenzhen Key Laboratory of Neurogenomics, BGI-Shenzhen, Shenzhen 518120, China
| | - Benchao Li
- Department of Nutrition and Food Hygiene, School of Public Health, Medical College,
Wuhan University of Science and Technology, Wuhan, China
| | - Wang Lifang
- BGI-Shenzhen, Shenzhen, China
- Shenzhen Key Laboratory of Neurogenomics, BGI-Shenzhen, Shenzhen 518120, China
| | - Song Zhijie
- BGI-Shenzhen, Shenzhen, China
- College of Life Sciences,
University of Chinese Academy of Sciences, Beijing 100049, China
| | - Li Zhou
- Department of Nutrition and Food Hygiene, School of Public Health, Medical College,
Wuhan University of Science and Technology, Wuhan, China
| | - Yan Deng
- Department of Nutrition and Food Hygiene, School of Public Health, Medical College,
Wuhan University of Science and Technology, Wuhan, China
| | - Liu Zhili
- BGI-Shenzhen, Shenzhen, China
- College of Life Sciences,
University of Chinese Academy of Sciences, Beijing 100049, China
| | - Jiahong Ding
- BGI-Shenzhen, Shenzhen, China
- Shenzhen Key Laboratory of Neurogenomics, BGI-Shenzhen, Shenzhen 518120, China
| | - Tao Li
- BGI-Shenzhen, Shenzhen, China
| | - Wenwei Zhang
- BGI-Shenzhen, Shenzhen, China
- Shenzhen Key Laboratory of Neurogenomics, BGI-Shenzhen, Shenzhen 518120, China
| | - Nie Chao
- BGI-Shenzhen, Shenzhen, China
- Shenzhen Key Laboratory of Neurogenomics, BGI-Shenzhen, Shenzhen 518120, China
| | - Shuang Rong
- Department of Nutrition and Food Hygiene, School of Public Health, Medical College,
Wuhan University of Science and Technology, Wuhan, China
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280
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Schmicker M, Frühling I, Menze I, Glanz W, Müller P, Noesselt T, Müller NG. The Potential Role of Gustatory Function as an Early Diagnostic Marker for the Risk of Alzheimer’s Disease in Subjective Cognitive Decline. J Alzheimers Dis Rep 2023; 7:249-262. [PMID: 37090958 PMCID: PMC10116167 DOI: 10.3233/adr220092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Accepted: 02/23/2023] [Indexed: 04/07/2023] Open
Abstract
Background: Patients with subjective cognitive decline (SCD) report memory deterioration and are at an increased risk of converting to Alzheimer’s disease (AD) although psychophysical testing does not reveal any cognitive deficit. Objective: Here, gustatory function is investigated as a potential predictor for an increased risk of progressive cognitive decline indicating higher AD risk in SCD. Methods: Measures of smell and taste perception as well as neuropsychological data were assessed in patients with subjective cognitive decline (SCD): Subgroups with an increased likelihood of the progression to preclinical AD (SCD+) and those with a lower likelihood (SCD–) were compared to healthy controls (HC), patients with mild cognitive impairment and AD patients. The Sniffin’ Sticks test contained 12 items with different qualities and taste was measured with 32 taste stripes (sweet, salty, bitter, sour) of different concentration. Results: Only taste was able to distinguish between HC/SCD– and SCD+ patients. Conclusion: This study provides a first hint of taste as a more sensitive marker than smell for detecting preclinical AD in SCD. Longitudinal observation of cognition and pathology are necessary to further evaluate taste perception as a predictor of pathological objective decline in cognition.
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Affiliation(s)
- Marlen Schmicker
- German Center for Neurodegenerative Diseases (DZNE), Magdeburg, Germany
- Institute of Cognitive Neurology and Dementia Research, Otto von Guericke University, Magdeburg, Germany
| | - Insa Frühling
- German Center for Neurodegenerative Diseases (DZNE), Magdeburg, Germany
- Medical Faculty, Otto von Guericke University, Magdeburg, Germany
| | - Inga Menze
- German Center for Neurodegenerative Diseases (DZNE), Magdeburg, Germany
- Institute of Cognitive Neurology and Dementia Research, Otto von Guericke University, Magdeburg, Germany
| | - Wenzel Glanz
- German Center for Neurodegenerative Diseases (DZNE), Magdeburg, Germany
| | - Patrick Müller
- German Center for Neurodegenerative Diseases (DZNE), Magdeburg, Germany
- Medical Faculty, Otto von Guericke University, Magdeburg, Germany
- University Clinic for Cardiology and Angiology, Medical Faculty, Otto von Guericke University, Magdeburg, Germany
- Center for Intervention and Research on adaptive and maladaptive brain Circuits underlying mental health (C-I-R-C)
| | - Toemme Noesselt
- Biological Psychology, Faculty of Natural Science, Otto von Guericke University, Magdeburg, Germany
- Center for Behavioral Brain Sciences, Otto von Guericke University, Magdeburg, Germany
| | - Notger G. Müller
- German Center for Neurodegenerative Diseases (DZNE), Magdeburg, Germany
- Medical Faculty, Otto von Guericke University, Magdeburg, Germany
- Research Group Degenerative and Chronic Diseases, Movement, Faculty of Health Sciences Brandenburg, University of Potsdam, Potsdam, Germany
- Center for Behavioral Brain Sciences, Otto von Guericke University, Magdeburg, Germany
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281
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Urbano T, Chiari A, Malagoli C, Cherubini A, Bedin R, Costanzini S, Teggi S, Maffeis G, Vinceti M, Filippini T. Particulate matter exposure from motorized traffic and risk of conversion from mild cognitive impairment to dementia: An Italian prospective cohort study. ENVIRONMENTAL RESEARCH 2023; 222:115425. [PMID: 36740156 DOI: 10.1016/j.envres.2023.115425] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Revised: 02/01/2023] [Accepted: 02/02/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND Based on epidemiologic and laboratory studies, exposure to air pollutants has been linked to many adverse health effects including a higher risk of dementia. In this study, we aimed to evaluate the effect of long-term exposure to outdoor air pollution on risk of conversion to dementia in a cohort of subjects with mild cognitive impairment (MCI). METHODS We recruited 53 Italian subjects newly-diagnosed with MCI. Within a geographical information system, we assessed recent outdoor air pollutant exposure, by modeling air levels of particulate matter with equivalent aerodynamic diameter ≤10 μm (PM10) from motorized traffic at participants' residence. We investigated the relation of PM10 concentrations to subsequent conversion from MCI to any type of dementia. Using a Cox-proportional hazards model combined with a restricted cubic spline model, we computed the hazard ratio (HR) of dementia with its 95% confidence interval (CI) according to increasing PM10 exposure, adjusting for sex, age, and educational attainment. RESULTS During a median follow up of 47.3 months, 34 participants developed dementia, in 26 cases diagnosed as Alzheimer's dementia. In non-linear restricted spline regression analysis, mean and maximum annual PM10 levels positively correlated with cerebrospinal fluid total and phosphorylated tau proteins concentrations, while they were inversely associated with β-amyloid. Concerning the risk of dementia, we found a positive association starting from above 10 μg/m3 for mean PM10 levels and above 35 μg/m3 for maximum PM10 levels. Specific estimates for Alzheimer's dementia were substantially similar. Adding other potential confounders to the multivariable model or removing early cases of dementia onset during the follow-up had little effect on the estimates. CONCLUSIONS Our findings suggest that exposure to outdoor air pollutants, PM10 in particular, may non-linearly increase conversion from MCI to dementia above a certain ambient air concentration.
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Affiliation(s)
- Teresa Urbano
- Environmental, Genetic and Nutritional Epidemiology Research Center (CREAGEN), Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Annalisa Chiari
- Neurology Unit, University Hospital of Modena, Modena, Italy
| | - Carlotta Malagoli
- Environmental, Genetic and Nutritional Epidemiology Research Center (CREAGEN), Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | | | - Roberta Bedin
- Neurology Unit, University Hospital of Modena, Modena, Italy; Center for Neurosciences and Neurotechnology, Department of Biomedical, Metabolic, and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Sofia Costanzini
- DIEF - Department of Engineering 'Enzo Ferrari', University of Modena and Reggio Emilia, Modena, Italy
| | - Sergio Teggi
- DIEF - Department of Engineering 'Enzo Ferrari', University of Modena and Reggio Emilia, Modena, Italy
| | | | - Marco Vinceti
- Environmental, Genetic and Nutritional Epidemiology Research Center (CREAGEN), Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy; Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA.
| | - Tommaso Filippini
- Environmental, Genetic and Nutritional Epidemiology Research Center (CREAGEN), Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy; School of Public Health, University of California Berkeley, Berkeley, CA, USA
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282
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Xue S, Shen T, Li M, Leng B, Yao R, Gao Y, Sun H, Li Z, Zhang J. Neuronal glutamate transporters are associated with cognitive impairment in obstructive sleep apnea patients without dementia. Neurosci Lett 2023; 802:137168. [PMID: 36894020 DOI: 10.1016/j.neulet.2023.137168] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2022] [Revised: 01/30/2023] [Accepted: 03/05/2023] [Indexed: 03/09/2023]
Abstract
Increasing evidence supports a link between obstructive sleep apnea (OSA) and cognition, and the mechanism is complex and still not well understood. We analyzed the relationship between the glutamate transporters and cognitive impairment in OSA. For this study 317 subjects without dementia, including 64 healthy controls (HCs), 140 OSA patients with mild cognitive impairment (MCI) and 113 OSA patients without cognitive impairment were assessed. All participants who completed polysomnography, cognition and white matter hyperintensity (WMH) volume were used. Plasma neuron-derived exosomes (NDEs) excitatory amino acid transporter 2 (EAAT2) and vesicular glutamate transporter 1 (VGLUT1) proteins were measured by ELISA kits. After 1 year of continuous positive airway pressure (CPAP) treatment, we analyzed plasma NDEs EAAT2 level and cognition changes. Plasma NDEs EAAT2 level was significantly higher in OSA patients than in HCs. Higher plasma NDEs EAAT2 level were significantly associated with cognitive impairment than normal cognition in OSA patients. Plasma NDEs EAAT2 level was inversely associated with the total Montreal Cognitive Assessment (MoCA) scores, visuo-executive function, naming, attention, language, abstraction, delayed recall and orientation. One year after CPAP treatment, plasma NDEs EAAT2 level (P = 0.019) was significantly lower, while MoCA scores (P = 0.013) were significantly increased compared with baseline. Upregulation of neuronal glutamate transporters at baseline may reflect a self-compensatory mechanism to prevent further neuronal damage, while plasma NDEs EAAT2 level was decreased after one year of CPAP therapy, which may be due to the loss of astrocytes and neurons.
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Affiliation(s)
- Song Xue
- Weifang Medical University, Weifang, Shandong, China; Department of Neurology, Weihai Municipal Hospital, Cheeloo College of Medicine, Shandong University, Weihai, Shandong, China
| | - Tengqun Shen
- Department of Neurology, Weihai Municipal Hospital, Cheeloo College of Medicine, Shandong University, Weihai, Shandong, China
| | - Mengfan Li
- Department of Neurology, Weihai Municipal Hospital, Cheeloo College of Medicine, Shandong University, Weihai, Shandong, China
| | - Bing Leng
- Department of Neurology, Weihai Municipal Hospital, Cheeloo College of Medicine, Shandong University, Weihai, Shandong, China
| | - Ran Yao
- Department of Neurology, Weihai Municipal Hospital, Cheeloo College of Medicine, Shandong University, Weihai, Shandong, China
| | - Yanling Gao
- Department of Neurology, Weihai Municipal Hospital, Cheeloo College of Medicine, Shandong University, Weihai, Shandong, China
| | - Hairong Sun
- Department of Neurology, Weihai Municipal Hospital, Cheeloo College of Medicine, Shandong University, Weihai, Shandong, China
| | - Zhenguang Li
- Department of Neurology, Weihai Municipal Hospital, Cheeloo College of Medicine, Shandong University, Weihai, Shandong, China
| | - Jinbiao Zhang
- Department of Neurology, Weihai Municipal Hospital, Cheeloo College of Medicine, Shandong University, Weihai, Shandong, China.
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283
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Li M, Sun C, Xue S, Leng B, Sun H, Shen T, Liu X, Li Z, Shang X, Zhang J. Complement protein levels in serum astrocyte-derived exosomes are associated with cognitive impairment in obstructive sleep apnea. J Clin Sleep Med 2023; 19:727-739. [PMID: 36692174 PMCID: PMC10071385 DOI: 10.5664/jcsm.10412] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Revised: 11/21/2022] [Accepted: 11/22/2022] [Indexed: 01/25/2023]
Abstract
STUDY OBJECTIVES An association between neuroinflammation and cognitive decline has been established. The complement system regulates neuroinflammation. Dysregulation, impairment, or inadvertent activation of complement components contribute to preclinical Alzheimer's disease. The astrocyte-derived exosome (ADE) complement proteins, including C3b and C5b-9, may be predictive biomarkers of mild cognitive impairment conversion to Alzheimer's disease dementia. We hypothesized that complement proteins might be involved in cognitive impairment during obstructive sleep apnea (OSA). The aim of our study was to explore the correlation between the complement system and mild cognitive impairment (MCI) in patients with OSA. METHODS All participants with subjective snoring complaints from the Sleep Medicine Center underwent polysomnography. OSA was defined as apnea-hypopnea index ≥ 5 events/h. MCI was defined as the Montreal Cognitive Assessment < 26 and met the criteria: (1) a subjective cognitive impairment; (2) an objective impairment in 1 or more cognitive domains; (3) complex instrumental daily abilities can be slightly impaired but independent daily living abilities are maintained; and (4) no dementia. The ADEs were isolated immunochemically for enzyme-linked immunosorbent assay quantification of complement proteins, including C3b, C5b-9, and CD55. The participants who received continuous positive airway pressure were followed up and their complement protein levels were reassessed after 1 year of treatment. RESULTS A total of 212 participants (66.98% males; mean age of 56.71 ± 10.10 years) were divided into the OSA+MCI group (n = 90), OSA-MCI group (n = 79), and controls (normal cognitive state without OSA) (n = 43). The ADE levels of C3b and C5b-9 in the OSA+MCI group were higher than those in the OSA-MCI and control groups. The C3b and C5b-9 were independently associated with cognitive impairment in patients with OSA. The relationship between apnea-hypopnea index and Montreal Cognitive Assessment scores was mediated by C3b and C5b-9. We found no linear correlation between the complement proteins and the severity of OSA. The complement proteins were negatively correlated with global cognitive performance and cognitive subdomains. The complement protein levels significantly decreased after continuous positive airway pressure treatment. CONCLUSIONS Complement proteins were implicated in cognitive impairment in patients with OSA and may be promising biomarkers for predicting cognitive impairment in patients with OSA. CLINICAL TRIAL REGISTRATION Registry: Chinese Clinical Trial Registry; Name: Study on early diagnostic markers in patients with dementia and mild cognitive impairment; URL: https://www.chictr.org.cn/; Identifier: ChiCTR1900021544. CITATION Li M, Sun C, Xue S, et al. Complement proteins levels in serum astrocyte-derived exosomes are associated with cognitive impairment in obstructive sleep apnea. J Clin Sleep Med. 2023;19(4):727-739.
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Affiliation(s)
- Mengfan Li
- Department of Neurology, Weihai Municipal Hospital, Cheeloo College of Medicine, Shandong University, Weihai, Shandong, China
| | - Chao Sun
- Department of Neurology, Weihai Municipal Hospital, Cheeloo College of Medicine, Shandong University, Weihai, Shandong, China
| | - Song Xue
- Weifang Medical University, Weifang, Shandong, China
| | - Bing Leng
- Department of Neurology, Weihai Municipal Hospital, Cheeloo College of Medicine, Shandong University, Weihai, Shandong, China
| | - Hairong Sun
- Department of Neurology, Weihai Municipal Hospital, Cheeloo College of Medicine, Shandong University, Weihai, Shandong, China
| | - Tengqun Shen
- Department of Resident Standardized Training Management, Weihai Municipal Hospital, Cheeloo College of Medicine, Shandong University, Weihai, Shandong, China
| | - Xiaoxiao Liu
- Department of Neurology, Weihai Municipal Hospital, Cheeloo College of Medicine, Shandong University, Weihai, Shandong, China
| | - Zhenguang Li
- Department of Neurology, Weihai Municipal Hospital, Cheeloo College of Medicine, Shandong University, Weihai, Shandong, China
| | - Xiuli Shang
- Department of Neurology, The First Affiliated Hospital of China Medical University, Shenyang, Liaoning, China
| | - Jinbiao Zhang
- Department of Neurology, Weihai Municipal Hospital, Cheeloo College of Medicine, Shandong University, Weihai, Shandong, China
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284
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Chatterjee P, Pedrini S, Doecke JD, Thota R, Villemagne VL, Doré V, Singh AK, Wang P, Rainey-Smith S, Fowler C, Taddei K, Sohrabi HR, Molloy MP, Ames D, Maruff P, Rowe CC, Masters CL, Martins RN. Plasma Aβ42/40 ratio, p-tau181, GFAP, and NfL across the Alzheimer's disease continuum: A cross-sectional and longitudinal study in the AIBL cohort. Alzheimers Dement 2023; 19:1117-1134. [PMID: 36574591 DOI: 10.1002/alz.12724] [Citation(s) in RCA: 69] [Impact Index Per Article: 69.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Revised: 05/22/2022] [Accepted: 05/23/2022] [Indexed: 12/29/2022]
Abstract
INTRODUCTION Plasma amyloid beta (Aβ)1-42/Aβ1-40 ratio, phosphorylated-tau181 (p-tau181), glial fibrillary acidic protein (GFAP), and neurofilament light (NfL) are putative blood biomarkers for Alzheimer's disease (AD). However, head-to-head cross-sectional and longitudinal comparisons of the aforementioned biomarkers across the AD continuum are lacking. METHODS Plasma Aβ1-42, Aβ1-40, p-tau181, GFAP, and NfL were measured utilizing the Single Molecule Array (Simoa) platform and compared cross-sectionally across the AD continuum, wherein Aβ-PET (positron emission tomography)-negative cognitively unimpaired (CU Aβ-, n = 81) and mild cognitive impairment (MCI Aβ-, n = 26) participants were compared with Aβ-PET-positive participants across the AD continuum (CU Aβ+, n = 39; MCI Aβ+, n = 33; AD Aβ+, n = 46) from the Australian Imaging, Biomarker & Lifestyle Flagship Study of Ageing (AIBL) cohort. Longitudinal plasma biomarker changes were also assessed in MCI (n = 27) and AD (n = 29) participants compared with CU (n = 120) participants. In addition, associations between baseline plasma biomarker levels and prospective cognitive decline and Aβ-PET load were assessed over a 7 to 10-year duration. RESULTS Lower plasma Aβ1-42/Aβ1-40 ratio and elevated p-tau181 and GFAP were observed in CU Aβ+, MCI Aβ+, and AD Aβ+, whereas elevated plasma NfL was observed in MCI Aβ+ and AD Aβ+, compared with CU Aβ- and MCI Aβ-. Among the aforementioned plasma biomarkers, for models with and without AD risk factors (age, sex, and apolipoprotein E (APOE) ε4 carrier status), p-tau181 performed equivalent to or better than other biomarkers in predicting a brain Aβ-/+ status across the AD continuum. However, for models with and without the AD risk factors, a biomarker panel of Aβ1-42/Aβ1-40, p-tau181, and GFAP performed equivalent to or better than any of the biomarkers alone in predicting brain Aβ-/+ status across the AD continuum. Longitudinally, plasma Aβ1-42/Aβ1-40, p-tau181, and GFAP were altered in MCI compared with CU, and plasma GFAP and NfL were altered in AD compared with CU. In addition, lower plasma Aβ1-42/Aβ1-40 and higher p-tau181, GFAP, and NfL were associated with prospective cognitive decline and lower plasma Aβ1-42/Aβ1-40, and higher p-tau181 and GFAP were associated with increased Aβ-PET load prospectively. DISCUSSION These findings suggest that plasma biomarkers are altered cross-sectionally and longitudinally, along the AD continuum, and are prospectively associated with cognitive decline and brain Aβ-PET load. In addition, although p-tau181 performed equivalent to or better than other biomarkers in predicting an Aβ-/+ status across the AD continuum, a panel of biomarkers may have superior Aβ-/+ status predictive capability across the AD continuum. HIGHLIGHTS Area under the curve (AUC) of p-tau181 ≥ AUC of Aβ42/40, GFAP, NfL in predicting PET Aβ-/+ status (Aβ-/+). AUC of Aβ42/40+p-tau181+GFAP panel ≥ AUC of Aβ42/40/p-tau181/GFAP/NfL for Aβ-/+. Longitudinally, Aβ42/40, p-tau181, and GFAP were altered in MCI versus CU. Longitudinally, GFAP and NfL were altered in AD versus CU. Aβ42/40, p-tau181, GFAP, and NfL are associated with prospective cognitive decline. Aβ42/40, p-tau181, and GFAP are associated with increased PET Aβ load prospectively.
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Affiliation(s)
- Pratishtha Chatterjee
- Macquarie Medical School, Macquarie University, North Ryde, New South Wales, Australia
- School of Medical and Health Sciences, Edith Cowan University, Perth, Western Australia, Australia
| | - Steve Pedrini
- School of Medical and Health Sciences, Edith Cowan University, Perth, Western Australia, Australia
| | - James D Doecke
- Australian eHealth Research Centre, CSIRO, Brisbane, Queensland, Australia
| | - Rohith Thota
- Macquarie Medical School, Macquarie University, North Ryde, New South Wales, Australia
- School of Biomedical Sciences and Pharmacy, College of Health, Medicine and Wellbeing, University of Newcastle, Newcastle, New South Wales, Australia
| | - Victor L Villemagne
- Department of Psychiatry, University of Pittsburgh, Pennsylvania, Pittsburgh, USA
- Department of Molecular Imaging & Therapy, Austin Health, Heidelberg, Victoria, Australia
| | - Vincent Doré
- Australian eHealth Research Centre, CSIRO, Brisbane, Queensland, Australia
- Department of Molecular Imaging & Therapy, Austin Health, Heidelberg, Victoria, Australia
| | - Abhay K Singh
- Macquarie Business School, Macquarie University, North Ryde, New South Wales, Australia
| | - Penghao Wang
- College of Science, Health, Engineering and Education, Murdoch University, Perth, Western Australia, Australia
| | - Stephanie Rainey-Smith
- School of Medical and Health Sciences, Edith Cowan University, Perth, Western Australia, Australia
- Australian Alzheimer's Research Foundation, Sarich Neuroscience Research Institute, Nedlands, Western Australia, Australia
- Centre for Healthy Ageing, Murdoch University, Perth, Western Australia, Australia
- School of Psychological Science, University of Western Australia, Crawley, Western Australia, Australia
| | - Christopher Fowler
- The Florey Institute of Neuroscience and Mental Health, The University of Melbourne, Parkville, Victoria, Australia
| | - Kevin Taddei
- School of Medical and Health Sciences, Edith Cowan University, Perth, Western Australia, Australia
- Australian Alzheimer's Research Foundation, Sarich Neuroscience Research Institute, Nedlands, Western Australia, Australia
| | - Hamid R Sohrabi
- Macquarie Medical School, Macquarie University, North Ryde, New South Wales, Australia
- School of Medical and Health Sciences, Edith Cowan University, Perth, Western Australia, Australia
- Australian Alzheimer's Research Foundation, Sarich Neuroscience Research Institute, Nedlands, Western Australia, Australia
- School of Psychiatry and Clinical Neurosciences, University of Western Australia, Crawley, Western Australia, Australia
- Centre for Healthy Ageing, Health Future Institute, Murdoch University, Murdoch, Western Australia, Australia
| | - Mark P Molloy
- School of Medical Sciences, Faculty of Medicine and Health, University of Sydney, New South Wales, Australia
- Australian Proteome Analysis Facility (APAF), Macquarie University, Sydney, New South Wales, Australia
- Bowel Cancer and Biomarker Research Laboratory, Kolling Institute of Medical Research, Royal North Shore Hospital, St Leonards, New South Wales, Australia
| | - David Ames
- National Ageing Research Institute, Parkville, Victoria, Australia
- Academic Unit for Psychiatry of Old Age, University of Melbourne, Melbourne, Victoria, Australia
| | - Paul Maruff
- The Florey Institute of Neuroscience and Mental Health, The University of Melbourne, Parkville, Victoria, Australia
- Cogstate Ltd., Melbourne, Victoria, Australia
| | - Christopher C Rowe
- Department of Molecular Imaging & Therapy, Austin Health, Heidelberg, Victoria, Australia
- The Florey Institute of Neuroscience and Mental Health, The University of Melbourne, Parkville, Victoria, Australia
| | - Colin L Masters
- The Florey Institute of Neuroscience and Mental Health, The University of Melbourne, Parkville, Victoria, Australia
| | - Ralph N Martins
- Macquarie Medical School, Macquarie University, North Ryde, New South Wales, Australia
- School of Medical and Health Sciences, Edith Cowan University, Perth, Western Australia, Australia
- Australian Alzheimer's Research Foundation, Sarich Neuroscience Research Institute, Nedlands, Western Australia, Australia
- School of Psychiatry and Clinical Neurosciences, University of Western Australia, Crawley, Western Australia, Australia
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285
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Mulhauser K, Giordani B, Kavcic V, May LDN, Bhaumik A, Shair S, Votruba K. Utility of Diffusion Modeling of Cogstate Brief Battery Test Performance in Detecting Mild Cognitive Impairment. Assessment 2023; 30:847-855. [PMID: 35016575 DOI: 10.1177/10731911211069089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Cognitive testing data are essential to the diagnosis of mild cognitive impairment (MCI), and computerized cognitive testing, such as the Cogstate Brief Battery, has proven helpful in efficiently identifying harbingers of dementia. This study provides a side-by-side comparison of traditional Cogstate outcomes and diffusion modeling of these outcomes in predicting MCI diagnosis. Participants included 257 older adults (160 = normal cognition; 97 = MCI). Results showed that both traditional Cogstate and diffusion modeling analyses predicted MCI diagnosis with acceptable accuracy. Cogstate measures of recognition learning and working memory accuracy and diffusion modeling variable of decision-making efficiency (drift rate) and nondecisional time were most predictive of MCI. While participants with normal cognition demonstrated a change in response caution (boundary separation) when transitioning tasks, participants with MCI did not evidence this change.
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Affiliation(s)
| | - Bruno Giordani
- University of Michigan, Ann Arbor, MI, USA
- The Michigan Alzheimer's Disease Center, Ann Arbor, MI, USA
| | | | - L D Nicolas May
- University of Michigan, Ann Arbor, MI, USA
- The Michigan Alzheimer's Disease Center, Ann Arbor, MI, USA
| | - Arijit Bhaumik
- University of Michigan, Ann Arbor, MI, USA
- The Michigan Alzheimer's Disease Center, Ann Arbor, MI, USA
| | - Sarah Shair
- University of Michigan, Ann Arbor, MI, USA
- The Michigan Alzheimer's Disease Center, Ann Arbor, MI, USA
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286
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Schramm S, Krizanovic N, Roggenbuck U, Jöckel KH, Herring A, Keyvani K, Jokisch M. Blood Kallikrein-8 and Non-Amnestic Mild Cognitive Impairment: An Exploratory Study. J Alzheimers Dis Rep 2023; 7:327-337. [DOI: 10.3233/adr-220073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Accepted: 03/13/2023] [Indexed: 04/07/2023] Open
Abstract
Background: Blood kallikrein-8 is supposed to be a biomarker for mild cognitive impairment (MCI) due to Alzheimer’s disease (AD), a precursor of AD dementia. Little is known about the association of kallikrein-8 and non-AD type dementias. Objective: To investigate whether blood kallikrein-8 is elevated in individuals with non-amnestic MCI (naMCI), which has a higher probability to progress to a non-AD type dementia, compared with cognitively unimpaired (CU) controls. Methods: We measured blood kallikrein-8 at ten-year follow-up (T2) in 75 cases and 75 controls matched for age and sex who were participants of the population-based Heinz Nixdorf Recall study (baseline: 2000–2003). Cognitive performance was assessed in a standardized manner at five (T1) and ten-year follow-up. Cases were CU or had subjective cognitive decline (SCD) at T1 and had naMCI at T2. Controls were CU at both follow-ups. The association between kallikrein-8 (per 500 pg/ml increase) and naMCI was estimated using conditional logistic regression: odds ratios (OR) and 95% confidence intervals (95% CI) were determined, adjusted for inter-assay variability and freezing duration. Results: Valid kallikrein-8 values were measured in 121 participants (45% cases, 54.5% women, 70.5±7.1 years). In cases, the mean kallikrein-8 was higher than in controls (922±797 pg/ml versus 884±782 pg/ml). Kallikrein-8 was not associated with having naMCI compared to being CU (adjusted; OR: 1.03 [95% CI: 0.80–1.32]). Conclusion: This is the first population-based study that shows that blood kallikrein-8 tends not to be elevated in individuals with naMCI compared with CU. This adds to the evidence of the possible AD specificity of kallikrein-8.
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Affiliation(s)
- Sara Schramm
- Institute for Medical Informatics, Biometry and Epidemiology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Nela Krizanovic
- Institute for Medical Informatics, Biometry and Epidemiology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Ulla Roggenbuck
- Institute for Medical Informatics, Biometry and Epidemiology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Karl-Heinz Jöckel
- Institute for Medical Informatics, Biometry and Epidemiology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Arne Herring
- Institute of Neuropathology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Kathy Keyvani
- Institute of Neuropathology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Martha Jokisch
- Department of Neurology, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
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287
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Liampas I, Siokas V, Lyketsos CG, Dardiotis E. Associations between neuropsychiatric symptoms and incident Alzheimer's dementia in men versus women. J Neurol 2023; 270:2069-2083. [PMID: 36572715 PMCID: PMC10025238 DOI: 10.1007/s00415-022-11541-w] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Revised: 12/16/2022] [Accepted: 12/17/2022] [Indexed: 12/27/2022]
Abstract
OBJECTIVE To examine whether associations between individual neuropsychiatric symptoms (NPS) and incident Alzheimer's dementia (AD) differ in men versus women. METHODS Data were acquired from the National Alzheimer's Coordinating Center (NACC) Uniform Data Set. Two sets of older (≥ 60 years) participants were formed: one of cognitively unimpaired (CU) individuals, and one of participants with mild cognitive impairment (MCI). NPS were assessed using the Neuropsychiatric Inventory Questionnaire. Cox proportional hazards models examined associations between individual NPS and AD incidence separately for each participant set. These models featured individual NPS, sex, NPS by sex interactions as well as a number of covariates. RESULTS The analysis involved 9,854 CU individuals followed for 5.5 ± 3.8 years and 6,369 participants with MCI followed for 3.8 ± 3.0 years. NPS were comparably associated with future AD in men and women with MCI. Regarding CU participants, the following significant sex by NPS interactions were noted: female sex moderated the risk conferred by moderate/severe apathy (HR = 7.36, 3.25-16.64) by 74%, mitigated the risk conferred by moderate/severe depression (HR = 3.61, 2.08-6.28) by 52%, and augmented the risks conferred by mild depression (HR = 1.00, 0.60-1.68) and agitation (HR = 0.81, 0.40-1.64) by 83% and 243%, respectively. CONCLUSIONS Apathy, depression and agitation were differentially associated with incident AD in CU men and women. No individual NPS was associated with different risks of future AD in men versus women with MCI.
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Affiliation(s)
- Ioannis Liampas
- Department of Neurology, Faculty of Medicine, School of Medicine, University Hospital of Larissa, University of Thessaly, Mezourlo Hill, 41100, Larissa, Greece.
| | - Vasileios Siokas
- Department of Neurology, Faculty of Medicine, School of Medicine, University Hospital of Larissa, University of Thessaly, Mezourlo Hill, 41100, Larissa, Greece
| | - Constantine G Lyketsos
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD, 21205, USA
| | - Efthimios Dardiotis
- Department of Neurology, Faculty of Medicine, School of Medicine, University Hospital of Larissa, University of Thessaly, Mezourlo Hill, 41100, Larissa, Greece
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD, 21205, USA
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288
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Burbaite A, Leeworthy S, Hirst L, Mioshi E, Clare L, Ahmed S. Suitability of memory aids and strategies for people with posterior cortical atrophy: protocol for a scoping review. Syst Rev 2023; 12:58. [PMID: 36998057 PMCID: PMC10061751 DOI: 10.1186/s13643-023-02187-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Accepted: 02/06/2023] [Indexed: 03/31/2023] Open
Abstract
Background Posterior cortical atrophy (PCA) is a neurodegenerative syndrome characterised by progressive visuospatial and visuoperceptual impairment. Recent research shows that memory impairment can also occur as an early symptom of the condition and that the impairment can be ameliorated by providing support in the memory recall phase, for example, by presenting a related cue. In Alzheimer’s disease (AD), which is defined by an amnestic syndrome, memory aids and strategies have been used to help support everyday memory, which in turn can have a positive impact on patient and carer outcomes. Similar support for PCA could be achieved by using memory aids and strategies which help to encode and/or retrieve information, yet there are currently no guidelines for memory strategies that may be suitable in PCA. Due to the central visual disorder that defines PCA, careful consideration is needed when making recommendations. Methods A scoping review will be conducted of published studies that have assessed memory aids and strategies in people with AD and related dementias where memory is considered a core or supplementary feature, with the aim of distinguishing those that may be suitable or adaptable for PCA. The systematic search will include the electronic databases MEDLINE, PsycINFO and CINAHL, using search terms for dementia and memory aids and strategies identified in pilot searches. Findings will be mapped and described based on methods used, population, clinical data and memory aids and strategies identified. Discussion The scoping review will give an overview of the memory aids and strategies used in people with AD and related dementias and identify characteristics, modality and pragmatics to evaluate their suitability and adaptability for a PCA population. Tailored memory support strategies for people living with PCA could improve memory performance, with knock-on positive effects on patient and carer outcomes. Supplementary Information The online version contains supplementary material available at 10.1186/s13643-023-02187-4.
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Affiliation(s)
- A. Burbaite
- grid.4991.50000 0004 1936 8948Department of Psychiatry, University of Oxford, Oxford, UK
| | - S. Leeworthy
- grid.410421.20000 0004 0380 7336Department of Paediatric Neuropsychology, University Hospitals Bristol and Weston NHS Trust, Bristol, UK
| | - L. Hirst
- Academy Library, Royal United Hospitals, Bath, UK
| | - E. Mioshi
- grid.8273.e0000 0001 1092 7967School of Health Sciences, University of East Anglia, Norwich, UK
| | - L. Clare
- grid.8391.30000 0004 1936 8024Centre for Research in Ageing and Cognitive Health, University of Exeter, Exeter, UK
| | - S. Ahmed
- grid.9435.b0000 0004 0457 9566School of Psychology and Clinical Language Sciences, University of Reading, Reading, UK
- grid.4991.50000 0004 1936 8948Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
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289
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Jin R, Ning X, Liu X, Zhao Y, Ye G. Porphyromonas gingivalis-induced periodontitis could contribute to cognitive impairment in Sprague–Dawley rats via the P38 MAPK signaling pathway. Front Cell Neurosci 2023; 17:1141339. [PMID: 37056710 PMCID: PMC10086325 DOI: 10.3389/fncel.2023.1141339] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Accepted: 03/13/2023] [Indexed: 03/30/2023] Open
Abstract
BackgroundPeriodontitis is one of the most common oral diseases and has been shown to be a risk factor for systemic diseases. Our aim was to investigate the relationship between periodontitis and cognitive impairment and to explore the role of the P38 MAPK signaling pathway in this process.MethodsWe established a periodontitis model by ligating the first molars of SD rats with silk thread and injecting Porphyromonas gingivalis (P. gingivalis) or P. gingivalis plus the P38 MAPK inhibitor SB203580 at the same time for ten weeks. We assessed alveolar bone resorption and spatial learning and memory using microcomputed tomography and the Morris water maze test, respectively. We used transcriptome sequencing to explore the genetic differences between the groups. The gingival tissue, peripheral blood and hippocampal tissue were assessed for the cytokines TNF-α, IL-1β, IL-6, IL-8 and C reactive protein (CRP) with enzyme-linked immunosorbent assay (ELISA) and reverse transcription polymerase chain reaction (RT–PCR). We observed the presence of P. gingivalis in the hippocampus of rats by paraffin-fluorescence in situ hybridization (FISH). We determined the activation of microglia by immunofluorescence. Finally, Western blot analysis was employed to determine the expression of amyloid precursor protein (APP), β-site APP-cleaving enzyme 1 (BACE1) and P38MAPK pathway activation.ResultsWe demonstrated that silk ligature-induced periodontitis plus injection of P. gingivalis into subgingival tissue could lead to memory and cognitive impairment. Transcriptome sequencing results suggested that there were neurodegenerative diseases in the P. gingivalis group, and the MWM test showed that periodontitis reduced the spatial learning and memory ability of mild cognitive impairment (MCI) model rats. We found high levels of inflammatory factors (TNF-α, IL-1β, IL-6, and IL-8) and CRP in the gingiva, peripheral blood and hippocampus, and the expression of APP and BACE1 was upregulated, as was the P38 MAPK pathway activation. Activated microglia and the presence of P. gingivalis were also found in the hippocampus. P38 MAPK inhibitors mitigated all of these changes.ConclusionOur findings strongly suggest that topical application of P. gingivalis increases the inflammatory burden in the peripheral and central nervous systems (CNS) and that neuroinflammation induced by activation of P38 MAPK leads to impaired learning and memory in SD rats. It can also modulate APP processing. Therefore, P38 MAPK may serve as a linking pathway between periodontitis and cognitive impairment.
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Affiliation(s)
- Ru Jin
- Chongqing Key Laboratory of Oral Disease and Biomedical Sciences and Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Stomatological Hospital, Chongqing Medical University, Chongqing, China
| | - Xiaoqiao Ning
- The First People’s Hospital of Wanzhou, Chongqing, China
| | - Xiang Liu
- Chongqing Key Laboratory of Oral Disease and Biomedical Sciences and Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Stomatological Hospital, Chongqing Medical University, Chongqing, China
| | - Yueyang Zhao
- Department of Anatomy, Chongqing Medical University, Chongqing, China
| | - Guo Ye
- Chongqing Key Laboratory of Oral Disease and Biomedical Sciences and Chongqing Municipal Key Laboratory of Oral Biomedical Engineering of Higher Education, Stomatological Hospital, Chongqing Medical University, Chongqing, China
- *Correspondence: Guo Ye,
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290
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Zhang Y, Liu J, Wei Z, Mei J, Li Q, Zhen X, Zhang Y. Elevated serum platelet count inhibits the effects of brain functional changes on cognitive function in patients with mild cognitive impairment: A resting-state functional magnetic resonance imaging study. Front Aging Neurosci 2023; 15:1088095. [PMID: 37051376 PMCID: PMC10083369 DOI: 10.3389/fnagi.2023.1088095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2022] [Accepted: 02/27/2023] [Indexed: 03/29/2023] Open
Abstract
ObjectiveBrain function remodeling has been observed in patients with mild cognitive impairment (MCI) and is closely associated with cognitive performance. However, it is not clear if this relationship is influenced by complete blood counts. This study investigated the role of complete blood counts in the relationship between brain function and cognitive performance.MethodsTwenty-two MCI patients and eighteen controls were enrolled. All subjects underwent resting-state functional magnetic resonance imaging. A neuropsychological battery [Mini-Mental Status Examination, Auditory Verbal Learning Test (AVLT), Symbol Digit Modalities Test, Boston Naming Test (BNT), Shape Trails Test B (STT-B), Rey Complex Figure Test (RCFT), Hamilton Anxiety Rating Scale (HAMA), and Hamilton Depression Scale] was used to assess cognitive function, and MCI patients received complete blood counts tests for red blood cells (RBC), white blood cells, hemoglobin (HGB), monocytes, and platelet counts (PLT).ResultsCompared with controls, MCI patients demonstrated significantly decreased amplitude of low-frequency fluctuation (ALFF) values in the left dorsolateral superior frontal gyrus, left post orbitofrontal cortex, right medial superior frontal gyrus, right insula, and left triangular inferior frontal gyrus. In the MCI group, there were associations between ALFF values of the left hippocampus (HIP.L) and AVLT (p = 0.003) and AVLT-N5 scores (p = 0.001); ALFF values of the right supramarginal gyrus (SMG.R) and BNT scores (p = 0.044); ALFF values of the right superior temporal gyrus (STG.R) and BNT scores (p = 0.022); ALFF values of the left precuneus (PCUN.L) and STT-B time (p = 0.012); and ALFF values of the left caudate nucleus (CAU.L) and RCFT-time (p = 0.036). Moreover, the HAMA scores were negatively correlated with RBC and HGB levels, and positively correlated with monocyte count. The PLT count was positively correlated with STT-B time. Additionally, high PLT count inhibited the effect of ALFF values of the PCUN. L on STT-B performance in MCI patients (p = 0.0207).ConclusionALFF values of the HIP. L, SMG.R, STG. R, PCUN.L, and CAU. L were associated with decreased memory, language, executive function, and visuospatial ability in MCI patients. Notably, elevated PLT count could inhibit the effect of brain functional changes in the PCUN.L on executive function in MCI patients.
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Affiliation(s)
- Yuechan Zhang
- Department of Neurology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Jing Liu
- Department of Pharmacy, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Zijun Wei
- Department of Neurology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Jianing Mei
- Department of Neurology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Qianqian Li
- Department of Neurology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Xiaomin Zhen
- Department of Neurology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
- *Correspondence: Xiaomin Zhen, ; Yunyun Zhang,
| | - Yunyun Zhang
- Department of Neurology, Yueyang Hospital of Integrated Traditional Chinese and Western Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai, China
- *Correspondence: Xiaomin Zhen, ; Yunyun Zhang,
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291
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Koutentaki E, Basta M, Antypa D, Zaganas I, Panagiotakis S, Simos P, Vgontzas AN. IL-6 Enhances the Negative Impact of Cortisol on Cognition among Community-Dwelling Older People without Dementia. Healthcare (Basel) 2023; 11:healthcare11070951. [PMID: 37046878 PMCID: PMC10094120 DOI: 10.3390/healthcare11070951] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Revised: 03/19/2023] [Accepted: 03/23/2023] [Indexed: 03/29/2023] Open
Abstract
There is growing evidence that high basal cortisol levels and systemic inflammation independently contribute to cognitive decline among older people without dementia. The present cross-sectional study examined (a) the potential synergistic effect of cortisol levels and systemic inflammation on executive function and (b) whether this effect is more prominent among older people with mild cognitive impairment (MCI). A sub-sample of 99 patients with MCI and 84 older people without cognitive impairment (CNI) (aged 73.8 ± 7.0 years) were recruited from a large population-based cohort in Crete, Greece, and underwent comprehensive neuropsychiatric and neuropsychological evaluation and a single morning measurement of cortisol and IL-6 plasma levels. Using moderated regression models, we found that the relation between cortisol and executive function in the total sample was moderated by IL-6 levels (b = −0.994, p = 0.044) and diagnostic group separately (b = −0.632, p < 0.001). Moreover, the interaction between cortisol and IL-6 levels was significant only among persons with MCI (b = −0.562, p < 0.001). The synergistic effect of stress hormones and systemic inflammation on cognitive status appears to be stronger among older people who already display signs of cognitive decline. Targeting hypercortisolemia and inflammation may be a promising strategy toward improving the course of cognitive decline.
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292
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Wu H, Song Y, Yang X, Chen S, Ge H, Yan Z, Qi W, Yuan Q, Liang X, Lin X, Chen J. Functional and structural alterations of dorsal attention network in preclinical and early-stage Alzheimer's disease. CNS Neurosci Ther 2023; 29:1512-1524. [PMID: 36942514 PMCID: PMC10173716 DOI: 10.1111/cns.14092] [Citation(s) in RCA: 13] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2022] [Revised: 12/31/2022] [Accepted: 01/02/2023] [Indexed: 03/23/2023] Open
Abstract
OBJECTIVES Subjective cognitive decline (SCD) and amnestic mild cognitive impairment (aMCI) are known as the preclinical and early stage of Alzheimer's disease (AD). The dorsal attention network (DAN) is mainly responsible for the "top-down" attention process. However, previous studies mainly focused on single functional modality and limited structure. This study aimed to investigate the multimodal alterations of DAN in SCD and aMCI to assess their diagnostic value in preclinical and early-stage AD. METHODS Resting-state functional magnetic resonance imaging (MRI) was carried out to measure the fractional amplitude of low-frequency fluctuation (fALFF), regional homogeneity (ReHo), and functional connectivity (FC). Structural MRI was used to calculate the gray matter volume (GMV) and cortical thickness. Moreover, receiver-operating characteristic (ROC) analysis was used to distinguish these alterations in SCD and aMCI. RESULTS The SCD and aMCI groups showed both decreased ReHo in the right middle temporal gyrus (MTG) and decreased GMV compared to healthy controls (HCs). Especially in the SCD group, there were increased fALFF and increased ReHo in the left inferior occipital gyrus (IOG), decreased fALFF and increased FC in the left inferior parietal lobule (IPL), and reduced cortical thickness in the right inferior temporal gyrus (ITG). Furthermore, functional and structural alterations in the SCD and aMCI groups were closely related to episodic memory (EM), executive function (EF), and information processing speed (IPS). The combination of multiple indicators of DAN had a high accuracy in differentiating clinical stages. CONCLUSIONS Our current study demonstrated functional and structural alterations of DAN in SCD and aMCI, especially in the MTG, IPL, and SPL. Furthermore, cognitive performance was closely related to these significant alterations. Our study further suggested that the combined multiple indicators of DAN could be acted as the latent neuroimaging markers of preclinical and early-stage AD for their high diagnostic value.
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Affiliation(s)
- Huimin Wu
- Department of Neurology, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Yu Song
- Department of Neurology, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Xinyi Yang
- Department of Neurology, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Shanshan Chen
- Department of Neurology, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Honglin Ge
- Institute of Neuropsychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
- Institute of Brain Functional Imaging, Nanjing Medical University, Nanjing, China
| | - Zheng Yan
- Institute of Neuropsychiatry, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
- Institute of Brain Functional Imaging, Nanjing Medical University, Nanjing, China
| | - Wenzhang Qi
- Department of Radiology, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Qianqian Yuan
- Department of Radiology, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Xuhong Liang
- Department of Radiology, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Xingjian Lin
- Department of Neurology, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Jiu Chen
- Department of Radiology, Affiliated Drum Tower Hospital, Medical School of Nanjing University, Nanjing, China
- Institute of Medical Imaging and Artificial Intelligence, Nanjing University, Nanjing, China
- Medical Imaging Center, Affiliated Drum Tower Hospital, Medical School of Nanjing University, Nanjing, China
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293
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Fleming B, Edison P, Kenny L. Cognitive impairment after cancer treatment: mechanisms, clinical characterization, and management. BMJ 2023; 380:e071726. [PMID: 36921926 DOI: 10.1136/bmj-2022-071726] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/18/2023]
Abstract
Cognitive impairment is a debilitating side effect experienced by patients with cancer treated with systemically administered anticancer therapies. With around 19.3 million new cases of cancer worldwide in 2020 and the five year survival rate growing from 50% in 1970 to 67% in 2013, an urgent need exists to understand enduring side effects with severe implications for quality of life. Whereas cognitive impairment associated with chemotherapy is recognized in patients with breast cancer, researchers have started to identify cognitive impairment associated with other treatments such as immune, endocrine, and targeted therapies only recently. The underlying mechanisms are diverse and therapy specific, so further evaluation is needed to develop effective therapeutic interventions. Drug and non-drug management strategies are emerging that target mechanistic pathways or the cognitive deficits themselves, but they need to be rigorously evaluated. Clinically, consistent use of objective diagnostic tools is necessary for accurate diagnosis and clinical characterization of cognitive impairment in patients treated with anticancer therapies. This should be supplemented with clinical guidelines that could be implemented in daily practice. This review summarizes the recent advances in the mechanisms, clinical characterization, and novel management strategies of cognitive impairment associated with treatment of non-central nervous system cancers.
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Affiliation(s)
- Ben Fleming
- Department of Brain Sciences, Faculty of Medicine, Imperial College London, London, UK
| | - Paul Edison
- Department of Brain Sciences, Faculty of Medicine, Imperial College London, London, UK
- College of Biomedical and Life Sciences, Cardiff University, Cardiff, UK
| | - Laura Kenny
- Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, London, UK
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294
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Tsai CL, Chang WP, Lin YK, Ho SC, Lin YH. Physical frailty related to cognitive impairment and COPD exacerbation: A cross-sectional study. Respir Med 2023; 208:107129. [PMID: 36709919 DOI: 10.1016/j.rmed.2023.107129] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2022] [Revised: 01/14/2023] [Accepted: 01/20/2023] [Indexed: 01/27/2023]
Affiliation(s)
- Chen-Liang Tsai
- Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.
| | - Wen Pei Chang
- Department of Nursing, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan; School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan.
| | - Yen-Kuang Lin
- Graduate Institute of Athletics and Coaching Science, National Taiwan Sport University, Taoyuan, Taiwan.
| | - Shu-Chuan Ho
- School of Respiratory Therapy, College of Medicine, Taipei Medical University, Taipei City, Taiwan; Division of Pulmonary Medicine, Department of Internal Medicine, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan.
| | - Yu-Huei Lin
- Post-Baccalaureate Program in Nursing, College of Nursing, Taipei Medical University, Taipei City, Taiwan; Research Center in Nursing Clinical Practice, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan; Department of Nursing, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan.
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295
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Godefroy V, Sezer I, Bouzigues A, Montembeault M, Koban L, Plassmann H, Migliaccio R. Altered delay discounting in neurodegeneration: insight into the underlying mechanisms and perspectives for clinical applications. Neurosci Biobehav Rev 2023; 146:105048. [PMID: 36669749 DOI: 10.1016/j.neubiorev.2023.105048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Revised: 12/12/2022] [Accepted: 01/14/2023] [Indexed: 01/19/2023]
Abstract
Steeper delay discounting (i.e., the extent to which future rewards are perceived as less valuable than immediate ones) has been proposed as a transdiagnostic process across different health conditions, in particular psychiatric disorders. Impulsive decision-making is a hallmark of different neurodegenerative conditions but little is known about delay discounting in the domain of neurodegenerative conditions. We reviewed studies on delay discounting in patients with Parkinson's disease (PD) and in patients with dementia (Alzheimer's disease / AD or frontotemporal dementia / FTD). We proposed that delay discounting could be an early marker of the neurodegenerative process. We developed the idea that altered delay discounting is associated with overlapping but distinct neurocognitive mechanisms across neurodegenerative diseases: dopaminergic-related disorders of reward processing in PD, memory/projection deficits due to medial temporal atrophy in AD, modified reward processing due to orbitofrontal atrophy in FTD. Neurodegeneration could provide a framework to decipher the neuropsychological mechanisms of value-based decision-making. Further, delay discounting could become a marker of interest in clinical practice, in particular for differential diagnosis.
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Affiliation(s)
- Valérie Godefroy
- FrontLab, INSERM U1127, Institut du cerveau, Hôpital Pitié-Salpêtrière, Paris, France; Marketing Area, INSEAD, Fontainebleau, France; Control-Interoception-Attention Team, Paris Brain Institute (ICM), INSERM U 1127, CNRS UMR 7225, Sorbonne University, Paris, France.
| | - Idil Sezer
- FrontLab, INSERM U1127, Institut du cerveau, Hôpital Pitié-Salpêtrière, Paris, France
| | - Arabella Bouzigues
- FrontLab, INSERM U1127, Institut du cerveau, Hôpital Pitié-Salpêtrière, Paris, France
| | - Maxime Montembeault
- Douglas Research Centre, Montréal, Canada; Department of Psychiatry, McGill University, Montréal, Canada
| | - Leonie Koban
- Université Claude Bernard Lyon 1, CNRS, INSERM, Centre de Recherche en Neurosciences de Lyon CRNL U1028 UMR5292, Bron, France
| | - Hilke Plassmann
- Marketing Area, INSEAD, Fontainebleau, France; Control-Interoception-Attention Team, Paris Brain Institute (ICM), INSERM U 1127, CNRS UMR 7225, Sorbonne University, Paris, France
| | - Raffaella Migliaccio
- FrontLab, INSERM U1127, Institut du cerveau, Hôpital Pitié-Salpêtrière, Paris, France; Centre de Référence des Démences Rares ou Précoces, Hôpital Pitié-Salpêtrière, Assistance Publique-Hôpitaux de Paris, Paris, France; Institute of Memory and Alzheimer's Disease, Centre of Excellence of Neurodegenerative Disease, Department of Neurology, Hôpital Pitié-Salpêtrière, Assistance Publique-Hôpitaux de Paris, Paris, France.
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296
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Adedeji DO, Holleman J, Juster RP, Udeh-Momoh CT, Kåreholt I, Hagman G, Aspö M, Adagunodo S, Håkansson K, Kivipelto M, Solomon A, Sindi S. Longitudinal study of Alzheimer's disease biomarkers, allostatic load, and cognition among memory clinic patients. Brain Behav Immun Health 2023; 28:100592. [PMID: 36820052 PMCID: PMC9937889 DOI: 10.1016/j.bbih.2023.100592] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Revised: 01/11/2023] [Accepted: 01/16/2023] [Indexed: 02/04/2023] Open
Abstract
Background Allostatic load (AL) is defined as the cumulative dysregulation of neuroendocrine, immunological, metabolic, and cardiovascular systems that increases the susceptibility to stress-related health problems. Several dementia and Alzheimer's disease (AD) risk factors have been identified, yet little is known about the role of AL and its associations with AD biomarkers (e.g., beta-amyloid (Aβ) or tau) and cognitive function among memory clinic patients. Hence, this study aims to assess the association between AL and AD biomarkers, cognitive performance, and cognitive decline after 3-years of follow-up. Methods Data from 188 memory clinic patients were derived from the Cortisol and Stress in AD (Co-STAR) study in Sweden. Participants underwent baseline assessments including blood tests for AL measures (including cortisol, thyroid stimulating hormone, cobalamin, homocysteine, leukocytes, glycated hemoglobin, albumin, high-density and low-density lipoprotein cholesterol, triglycerides, and creatinine), cerebrospinal fluid (CSF) sampling for AD biomarkers and neuropsychological tests including five cognitive domains. Linear regressions were conducted, adjusting for age, sex, and education. Results Higher AL was associated with lower CSF Aβ1-42 levels (β = -0.175, p = 0.025), reflecting higher brain levels of Aβ1-42. Stratified analyses suggested a significant association among women but not men, although the AL-sex interaction was not statistically significant. AL was not significantly associated with T-tau level (β = -0.030, p = 0.682) and P-tau level (β = 0.091, p = 0.980). There were no significant associations between AL and cognition or cognitive decline after 3 years. Conclusion This study showed that higher AL was associated with increased brain amyloid accumulation. This suggests that AL may play a role in AD/dementia pathophysiology. Potential sex-related differences should be assessed in further larger studies.
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Affiliation(s)
- Dickson O. Adedeji
- Psychiatric Clinic, Vrinnevi Hospital, Norrköping, Sweden
- Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences, and Society, Karolinska Institutet, Stockholm, Sweden
| | - Jasper Holleman
- Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences, and Society, Karolinska Institutet, Stockholm, Sweden
| | | | - Chinedu T. Udeh-Momoh
- Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences, and Society, Karolinska Institutet, Stockholm, Sweden
- Ageing Epidemiology Research Unit (AGE), School of Public Health, Faculty of Medicine, Imperial College London, UK
| | - Ingemar Kåreholt
- Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences, and Society, Karolinska Institutet, Stockholm, Sweden
- Institute of Gerontology, School of Health and Welfare, Aging Research Network – Jönköping (ARN-J), Jönköping University, Jönköping, Sweden
- Aging Research Center, Karolinska Institutet and Stockholm University, Stockholm, Sweden
| | - Göran Hagman
- Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences, and Society, Karolinska Institutet, Stockholm, Sweden
- Theme Inflammation and Aging, Karolinska University Hospital, Stockholm, Sweden
| | - Malin Aspö
- Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences, and Society, Karolinska Institutet, Stockholm, Sweden
- Theme Inflammation and Aging, Karolinska University Hospital, Stockholm, Sweden
| | - Sofia Adagunodo
- Memory Clinic Zentralschweiz, Luzerner Psychiatrie, Lucerne, Switzerland
| | - Krister Håkansson
- Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences, and Society, Karolinska Institutet, Stockholm, Sweden
| | - Miia Kivipelto
- Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences, and Society, Karolinska Institutet, Stockholm, Sweden
- Ageing Epidemiology Research Unit (AGE), School of Public Health, Faculty of Medicine, Imperial College London, UK
- Theme Inflammation and Aging, Karolinska University Hospital, Stockholm, Sweden
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
| | - Alina Solomon
- Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences, and Society, Karolinska Institutet, Stockholm, Sweden
- Ageing Epidemiology Research Unit (AGE), School of Public Health, Faculty of Medicine, Imperial College London, UK
- Theme Inflammation and Aging, Karolinska University Hospital, Stockholm, Sweden
- Institute of Clinical Medicine, Neurology, University of Eastern Finland, Kuopio, Finland
| | - Shireen Sindi
- Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences, and Society, Karolinska Institutet, Stockholm, Sweden
- Ageing Epidemiology Research Unit (AGE), School of Public Health, Faculty of Medicine, Imperial College London, UK
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297
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Mathioudakis L, Dimovasili C, Bourbouli M, Latsoudis H, Kokosali E, Gouna G, Vogiatzi E, Basta M, Kapetanaki S, Panagiotakis S, Kanterakis A, Boumpas D, Lionis C, Plaitakis A, Simos P, Vgontzas A, Kafetzopoulos D, Zaganas I. Study of Alzheimer's disease- and frontotemporal dementia-associated genes in the Cretan Aging Cohort. Neurobiol Aging 2023; 123:111-128. [PMID: 36117051 DOI: 10.1016/j.neurobiolaging.2022.07.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Revised: 07/03/2022] [Accepted: 07/04/2022] [Indexed: 02/02/2023]
Abstract
Using exome sequencing, we analyzed 196 participants of the Cretan Aging Cohort (CAC; 95 with Alzheimer's disease [AD], 20 with mild cognitive impairment [MCI], and 81 cognitively normal controls). The APOE ε4 allele was more common in AD patients (23.2%) than in controls (7.4%; p < 0.01) and the PSEN2 p.Arg29His and p.Cys391Arg variants were found in 3 AD and 1 MCI patient, respectively. Also, we found the frontotemporal dementia (FTD)-associated TARDBP gene p.Ile383Val variant in 2 elderly patients diagnosed with AD and in 2 patients, non CAC members, with the amyotrophic lateral sclerosis/FTD phenotype. Furthermore, the p.Ser498Ala variant in the positively selected GLUD2 gene was less frequent in AD patients (2.11%) than in controls (16%; p < 0.01), suggesting a possible protective effect. While the same trend was found in another local replication cohort (n = 406) and in section of the ADNI cohort (n = 808), this finding did not reach statistical significance and therefore it should be considered preliminary. Our results attest to the value of genetic testing to study aged adults with AD phenotype.
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Affiliation(s)
- Lambros Mathioudakis
- University of Crete, Medical School, Neurology/Neurogenetics Laboratory, Heraklion, Crete, Greece
| | - Christina Dimovasili
- University of Crete, Medical School, Neurology/Neurogenetics Laboratory, Heraklion, Crete, Greece
| | - Mara Bourbouli
- University of Crete, Medical School, Neurology/Neurogenetics Laboratory, Heraklion, Crete, Greece
| | - Helen Latsoudis
- Minotech Genomics Facility, Institute of Molecular Biology and Biotechnology (IMBB-FORTH), Heraklion, Crete, Greece
| | - Evgenia Kokosali
- University of Crete, Medical School, Neurology/Neurogenetics Laboratory, Heraklion, Crete, Greece
| | - Garyfallia Gouna
- University of Crete, Medical School, Neurology/Neurogenetics Laboratory, Heraklion, Crete, Greece
| | - Emmanouella Vogiatzi
- University of Crete, Medical School, Neurology/Neurogenetics Laboratory, Heraklion, Crete, Greece
| | - Maria Basta
- University of Crete, Medical School, Psychiatry Department, Heraklion, Crete, Greece
| | - Stefania Kapetanaki
- University of Crete, Medical School, Neurology/Neurogenetics Laboratory, Heraklion, Crete, Greece
| | - Simeon Panagiotakis
- University of Crete, Medical School, Internal Medicine Department, Heraklion, Crete, Greece
| | - Alexandros Kanterakis
- Computational BioMedicine Laboratory, Institute of Computer Science, Foundation for Research and Technology - Hellas (ICS-FORTH), Heraklion, Crete, Greece
| | - Dimitrios Boumpas
- University of Crete, Medical School, Internal Medicine Department, Heraklion, Crete, Greece
| | - Christos Lionis
- University of Crete, Medical School, Clinic of Social and Family Medicine, Heraklion, Crete, Greece
| | - Andreas Plaitakis
- University of Crete, Medical School, Neurology/Neurogenetics Laboratory, Heraklion, Crete, Greece
| | - Panagiotis Simos
- University of Crete, Medical School, Psychiatry Department, Heraklion, Crete, Greece
| | - Alexandros Vgontzas
- University of Crete, Medical School, Psychiatry Department, Heraklion, Crete, Greece
| | - Dimitrios Kafetzopoulos
- Minotech Genomics Facility, Institute of Molecular Biology and Biotechnology (IMBB-FORTH), Heraklion, Crete, Greece
| | - Ioannis Zaganas
- University of Crete, Medical School, Neurology/Neurogenetics Laboratory, Heraklion, Crete, Greece.
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298
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Gao F, Lv X, Dai L, Wang Q, Wang P, Cheng Z, Xie Q, Ni M, Wu Y, Chai X, Wang W, Li H, Yu F, Cao Y, Tang F, Pan B, Wang G, Deng K, Wang S, Tang Q, Shi J, Shen Y. A combination model of AD biomarkers revealed by machine learning precisely predicts Alzheimer's dementia: China Aging and Neurodegenerative Initiative (CANDI) study. Alzheimers Dement 2023; 19:749-760. [PMID: 35668045 DOI: 10.1002/alz.12700] [Citation(s) in RCA: 16] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Revised: 04/02/2022] [Accepted: 04/29/2022] [Indexed: 12/31/2022]
Abstract
INTRODUCTION To test the utility of the "A/T/N" system in the Chinese population, we study core Alzheimer's disease (AD) biomarkers in a newly established Chinese cohort. METHODS A total of 411 participants were selected, including 96 cognitively normal individuals, 94 patients with mild cognitive impairment (MCI) patients, 173 patients with AD, and 48 patients with non-AD dementia. Fluid biomarkers were measured with single molecule array. Amyloid beta (Aβ) deposition was determined by 18F-Flobetapir positron emission tomography (PET), and brain atrophy was quantified using magnetic resonance imaging (MRI). RESULTS Aβ42/Aβ40 was decreased, whereas levels of phosphorylated tau (p-tau) were increased in cerebrospinal fluid (CSF) and plasma from patients with AD. CSF Aβ42/Aβ40, CSF p-tau, and plasma p-tau showed a high concordance in discriminating between AD and non-AD dementia or elderly controls. A combination of plasma p-tau, apolipoprotein E (APOE) genotype, and MRI measures accurately predicted amyloid PET status. DISCUSSION These results revealed a universal applicability of the "A/T/N" framework in a Chinese population and established an optimal diagnostic model consisting of cost-effective and non-invasive approaches for diagnosing AD.
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Affiliation(s)
- Feng Gao
- Department of Neurology, Institute on Aging and Brain Disorders, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, People's Republic of China
- Neurodegenerative Disorder Research Center, Anhui Province Key Laboratory of Biomedical Aging Research, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, People's Republic of China
| | - Xinyi Lv
- Department of Neurology, Institute on Aging and Brain Disorders, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, People's Republic of China
| | - Linbin Dai
- Department of Neurology, Institute on Aging and Brain Disorders, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, People's Republic of China
- Neurodegenerative Disorder Research Center, Anhui Province Key Laboratory of Biomedical Aging Research, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, People's Republic of China
| | - Qiong Wang
- Department of Neurology, Institute on Aging and Brain Disorders, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, People's Republic of China
- Neurodegenerative Disorder Research Center, Anhui Province Key Laboratory of Biomedical Aging Research, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, People's Republic of China
| | - Peng Wang
- Department of Radiology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, People's Republic of China
| | - Zhaozhao Cheng
- Department of Neurology, Institute on Aging and Brain Disorders, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, People's Republic of China
| | - Qiang Xie
- Department of Nuclear Medicine, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, People's Republic of China
| | - Ming Ni
- Department of Nuclear Medicine, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, People's Republic of China
| | - Yan Wu
- Department of Neurology, Institute on Aging and Brain Disorders, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, People's Republic of China
| | - Xianliang Chai
- Department of Neurology, Institute on Aging and Brain Disorders, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, People's Republic of China
| | - Wenjing Wang
- Department of Neurology, Institute on Aging and Brain Disorders, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, People's Republic of China
| | - Huaiyu Li
- Department of Neurology, Institute on Aging and Brain Disorders, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, People's Republic of China
| | - Feng Yu
- Department of Neurology, Institute on Aging and Brain Disorders, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, People's Republic of China
| | - Yuqin Cao
- Department of Neurology, Institute on Aging and Brain Disorders, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, People's Republic of China
| | - Fang Tang
- Department of Neurology, Institute on Aging and Brain Disorders, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, People's Republic of China
| | - Bo Pan
- Department of Nuclear Medicine, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, People's Republic of China
| | - Guoping Wang
- Department of Neurology, Institute on Aging and Brain Disorders, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, People's Republic of China
| | - Kexue Deng
- Department of Radiology, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, People's Republic of China
| | - Shicun Wang
- Department of Nuclear Medicine, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, People's Republic of China
| | - Qiqiang Tang
- Department of Neurology, Institute on Aging and Brain Disorders, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, People's Republic of China
| | - Jiong Shi
- China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, People's Republic of China
| | - Yong Shen
- Department of Neurology, Institute on Aging and Brain Disorders, The First Affiliated Hospital of USTC, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, People's Republic of China
- Neurodegenerative Disorder Research Center, Anhui Province Key Laboratory of Biomedical Aging Research, Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, People's Republic of China
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299
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Study of Diet Habits and Cognitive Function in the Chinese Middle-Aged and Elderly Population: The Association between Folic Acid, B Vitamins, Vitamin D, Coenzyme Q10 Supplementation and Cognitive Ability. Nutrients 2023; 15:nu15051243. [PMID: 36904242 PMCID: PMC10005055 DOI: 10.3390/nu15051243] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2023] [Revised: 02/19/2023] [Accepted: 02/28/2023] [Indexed: 03/05/2023] Open
Abstract
A growing body of evidence suggests that vitamin supplements play a role in the prevention of cognitive decline. The objective of the present cross-sectional study was to evaluate the relationship between cognitive ability and folic acid, B vitamins, vitamin D (VD) and Coenzyme Q10 (CoQ10) supplementation. The sample consisted of 892 adults aged above 50 who were assessed for their cognitive status in the Shanghai Sixth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine (China) from July 2019 to January 2022. According to the degree of cognitive impairment, the subjects were divided into a normal control (NC) group, subjective cognitive decline (SCD) group, mild cognitive impairment (MCI) group and Alzheimer's disease (AD) group. The results indicated a lower risk of AD in the daily VD-supplemented subjects with MCI compared to those who were not supplemented; a lower risk of cognitive impairment in those with normal cognitive who consumed VD, folic acid or CoQ10 on a daily basis compared those who did not; and a lower risk of cognitive impairment in subjects with normal cognitive performance who consumed B vitamin supplements, either daily or occasionally, compared to those who did not. The correlation was independent of other factors that potentially affect cognition, such as education level, age, etc. In conclusion, our findings confirmed a lower prevalence of cognitive impairment in those who took vitamins (folic acid, B vitamins, VD, CoQ10) daily. Therefore, we would recommend daily supplementation of vitamins (folic acid, B vitamins, VD, CoQ10), especially group B vitamins, as a potential preventive measure to slow cognitive decline and neurodegeneration in the elderly. However, for the elderly who have already suffered from cognitive impairment, VD supplementation may also be beneficial for their brains.
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300
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Hu S, Patten S, Charlton A, Fischer K, Fick G, Smith EE, Ismail Z. Validating the Mild Behavioral Impairment Checklist in a Cognitive Clinic: Comparisons With the Neuropsychiatric Inventory Questionnaire. J Geriatr Psychiatry Neurol 2023; 36:107-120. [PMID: 35430902 PMCID: PMC9941652 DOI: 10.1177/08919887221093353] [Citation(s) in RCA: 26] [Impact Index Per Article: 26.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
OBJECTIVE To compare the utility of the Mild Behavioral Impairment-Checklist (MBI-C) and Neuropsychiatric Inventory Questionnaire (NPI-Q) to capture NPS in subjective cognitive decline (SCD), mild cognitive impairment (MCI), and dementia. METHODS In this cross-sectional memory clinic study, linear regression models compared MBI-C (n = 474) and NPI-Q (n = 1040) scores in relation to Montreal Cognitive Assessment (MoCA) score. RESULTS MBI prevalence was 37% in subjective cognitive decline, 54% in mild cognitive impairment, and 62% in dementia. Worse diagnostic status was associated with higher MBI-C and NPI-Q score (P < .001), lower MoCA (P < .001), and greater age (P < .001). Higher MBI-C (β -.09; 95% CI -.13, -.05) and NPI-Q (β -.17; 95% CI -.23, -.10) scores were associated with lower MoCA scores, with psychosis most strongly associated (β -1.11; 95% CI -1.56, -.65 vs β -1.14; 95% CI -1.55, -.73). CONCLUSIONS The MBI-C captures global and domain-specific NPS across cognitive stages. Both the MBI-C and NPI-Q have utility in characterizing NPS.
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Affiliation(s)
- Sophie Hu
- Department of Community Health Sciences, University of Calgary, Calgary, AB, Canada
- Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada
| | - Scott Patten
- Department of Community Health Sciences, University of Calgary, Calgary, AB, Canada
- Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada
- Department of Psychiatry, University of Calgary, Calgary, AB, Canada
- O’Brien Institute for Public Health, University of Calgary, Calgary, AB, Canada
| | - Anna Charlton
- Department of Clinical Neurosciences, University of Calgary, Calgary, AB, Canada
| | - Karyn Fischer
- Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada
| | - Gordon Fick
- Department of Community Health Sciences, University of Calgary, Calgary, AB, Canada
- O’Brien Institute for Public Health, University of Calgary, Calgary, AB, Canada
| | - Eric E. Smith
- Department of Community Health Sciences, University of Calgary, Calgary, AB, Canada
- Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada
- Department of Clinical Neurosciences, University of Calgary, Calgary, AB, Canada
| | - Zahinoor Ismail
- Department of Community Health Sciences, University of Calgary, Calgary, AB, Canada
- Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada
- Department of Clinical Neurosciences, University of Calgary, Calgary, AB, Canada
- Department of Psychiatry, University of Calgary, Calgary, AB, Canada
- O’Brien Institute for Public Health, University of Calgary, Calgary, AB, Canada
- Zahinoor Ismail, MD, Hotchkiss Brain Institute, University of Calgary, 3280 Hospital Drive NW, TRW Building 1st Floor Calgary, AB T2N 4Z6, Canada.
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