1
|
Liu Y, Ge X, Wang Y, Qiao S, Cai Y. How race and socioeconomic status moderate the association between moderate-to-vigorous physical activity and depressive symptoms: a cross-sectional study with compositional data. Br J Sports Med 2024:bjsports-2024-108290. [PMID: 38925888 DOI: 10.1136/bjsports-2024-108290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/11/2024] [Indexed: 06/28/2024]
Abstract
OBJECTIVES This study explored how race and socioeconomic status (SES) moderated the association between moderate-to-vigorous physical activity (MVPA) and depressive symptoms with compositional data. METHODS Participants were 2803 US adults from the 2005-2006 cycle of the National Health and Nutrition Examination Survey. Accelerometers were used to measure MVPA, light-intensity physical activity (LPA) and sedentary behaviours (SB). Participants self-reported sleep duration and depressive symptoms. SES was derived by latent class analysis using household income level, education attainment and occupation. The association between the relative time of MVPA and depressive symptoms and the moderating effects of race and SES were investigated through compositional data analysis. Isotemporal substitution analysis was employed to estimate the association of time reallocation from other movement behaviours to MVPA with depressive symptoms. RESULTS Increased time spent in MVPA relative to time spent in LPA, SB and sleep was inversely associated with depressive symptoms (OR (95% CI)=0.679 (0.538-0.855)). The relative time of MVPA significantly interacted with race and SES for depressive symptoms (P for interaction <0.05). Reallocating 10-30 min from sleep, SB or LPA to MVPA was associated with lower odds of depressive symptoms solely among non-Hispanic white individuals and those with higher SES. CONCLUSION This study used compositional data to reveal a reverse association between MVPA and depressive symptoms among white individuals and those with higher SES. Our results provide evidence of how race and SES moderate the relationship between MVPA and depressive symptoms. Future research is needed to further explore these racial and socioeconomic differences.
Collapse
Affiliation(s)
- Yujie Liu
- Public Health Department, Hongqiao International Institute of Medicine, Tongren Hospital, Shanghai Jiao Tong University School of Medicine Shanghai, Shanghai, China
- School of Public Health, Shanghai Jiao Tong University, Shanghai, China
| | - Xin Ge
- Public Health Department, Hongqiao International Institute of Medicine, Tongren Hospital, Shanghai Jiao Tong University School of Medicine Shanghai, Shanghai, China
- School of Public Health, Shanghai Jiao Tong University, Shanghai, China
| | - Ying Wang
- Public Health Department, Hongqiao International Institute of Medicine, Tongren Hospital, Shanghai Jiao Tong University School of Medicine Shanghai, Shanghai, China
| | - Shan Qiao
- Department of Health Promotion, Education and Behavior, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, USA
| | - Yong Cai
- Public Health Department, Hongqiao International Institute of Medicine, Tongren Hospital, Shanghai Jiao Tong University School of Medicine Shanghai, Shanghai, China
- School of Public Health, Shanghai Jiao Tong University, Shanghai, China
| |
Collapse
|
2
|
Jackson RJ, Hyman BT, Serrano-Pozo A. Multifaceted roles of APOE in Alzheimer disease. Nat Rev Neurol 2024:10.1038/s41582-024-00988-2. [PMID: 38906999 DOI: 10.1038/s41582-024-00988-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/24/2024] [Indexed: 06/23/2024]
Abstract
For the past three decades, apolipoprotein E (APOE) has been known as the single greatest genetic modulator of sporadic Alzheimer disease (AD) risk, influencing both the average age of onset and the lifetime risk of developing AD. The APOEε4 allele significantly increases AD risk, whereas the ε2 allele is protective relative to the most common ε3 allele. However, large differences in effect size exist across ethnoracial groups that are likely to depend on both global genetic ancestry and local genetic ancestry, as well as gene-environment interactions. Although early studies linked APOE to amyloid-β - one of the two culprit aggregation-prone proteins that define AD - in the past decade, mounting work has associated APOE with other neurodegenerative proteinopathies and broader ageing-related brain changes, such as neuroinflammation, energy metabolism failure, loss of myelin integrity and increased blood-brain barrier permeability, with potential implications for longevity and resilience to pathological protein aggregates. Novel mouse models and other technological advances have also enabled a number of therapeutic approaches aimed at either attenuating the APOEε4-linked increased AD risk or enhancing the APOEε2-linked AD protection. This Review summarizes this progress and highlights areas for future research towards the development of APOE-directed therapeutics.
Collapse
Affiliation(s)
- Rosemary J Jackson
- Department of Neurology, Massachusetts General Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Bradley T Hyman
- Department of Neurology, Massachusetts General Hospital, Boston, MA, USA.
- Harvard Medical School, Boston, MA, USA.
- Massachusetts Alzheimer's Disease Research Center, Charlestown, MA, USA.
| | - Alberto Serrano-Pozo
- Department of Neurology, Massachusetts General Hospital, Boston, MA, USA.
- Harvard Medical School, Boston, MA, USA.
- Massachusetts Alzheimer's Disease Research Center, Charlestown, MA, USA.
| |
Collapse
|
3
|
Barrett E, Ivey G, Cunningham A, Coffman G, Pemberton T, Lee C, Patra P, Day JB, Lee PHU, Shim JW. Reduced GLP-1R availability in the caudate nucleus with Alzheimer's disease. Front Aging Neurosci 2024; 16:1350239. [PMID: 38915346 PMCID: PMC11194438 DOI: 10.3389/fnagi.2024.1350239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Accepted: 05/15/2024] [Indexed: 06/26/2024] Open
Abstract
The glucagon-like peptide-1 receptor (GLP-1R) agonists reduce glycated hemoglobin in patients with type 2 diabetes. Mounting evidence indicates that the potential of GLP-1R agonists, mimicking a 30 amino acid ligand, GLP-1, extends to the treatment of neurodegenerative conditions, with a particular focus on Alzheimer's disease (AD). However, the mechanism that underlies regulation of GLP-1R availability in the brain with AD remains poorly understood. Here, using whole transcriptome RNA-Seq of the human postmortem caudate nucleus with AD and chronic hydrocephalus (CH) in the elderly, we found that GLP-1R and select mRNAs expressed in glucose dysmetabolism and dyslipidemia were significantly altered. Furthermore, we detected human RNA indicating a deficiency in doublecortin (DCX) levels and the presence of ferroptosis in the caudate nucleus impacted by AD. Using the genome data viewer, we assessed mutability of GLP-1R and 39 other genes by two factors associated with high mutation rates in chromosomes of four species. Surprisingly, we identified that nucleotide sizes of GLP-1R transcript exceptionally differed in all four species of humans, chimpanzees, rats, and mice by up to 6-fold. Taken together, the protein network database analysis suggests that reduced GLP-1R in the aged human brain is associated with glucose dysmetabolism, ferroptosis, and reduced DCX+ neurons, that may contribute to AD.
Collapse
Affiliation(s)
- Emma Barrett
- Department of Biomedical Engineering, Marshall University, Huntington, WV, United States
| | - Gabrielle Ivey
- Department of Biomedical Engineering, Marshall University, Huntington, WV, United States
| | - Adam Cunningham
- Department of Biomedical Engineering, Marshall University, Huntington, WV, United States
| | - Gary Coffman
- Department of Biomedical Engineering, Marshall University, Huntington, WV, United States
| | - Tyera Pemberton
- Department of Biomedical Engineering, Marshall University, Huntington, WV, United States
| | - Chan Lee
- Department of Anesthesia, Indiana University Health Arnett Hospital, Lafayette, IN, United States
| | - Prabir Patra
- Department of Biomedical Engineering, Marshall University, Huntington, WV, United States
| | - James B. Day
- Department of Orthopedic Surgery, Cabell Huntington Hospital and Marshall University School of Medicine, Huntington, WV, United States
| | - Peter H. U. Lee
- Department of Cardiothoracic Surgery, Southcoast Health, Fall River, MA, United States
- Department of Pathology and Laboratory Medicine, Brown University, Providence, RI, United States
| | - Joon W. Shim
- Department of Biomedical Engineering, Marshall University, Huntington, WV, United States
| |
Collapse
|
4
|
Park SY, Setiawan VW, Crimmins EM, White LR, Wu AH, Cheng I, Darst BF, Haiman CA, Wilkens LR, Le Marchand L, Lim U. Racial and Ethnic Differences in the Population-Attributable Fractions of Alzheimer Disease and Related Dementias. Neurology 2024; 102:e208116. [PMID: 38232335 PMCID: PMC11097758 DOI: 10.1212/wnl.0000000000208116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Accepted: 11/22/2023] [Indexed: 01/19/2024] Open
Abstract
BACKGROUND AND OBJECTIVES Previous studies estimated that modifiable risk factors explain up to 40% of the dementia cases in the United States and that this population-attributable fraction (PAF) differs by race and ethnicity-estimates of future impact based on the risk factor prevalence in contemporary surveys. The aim of this study was to determine the race-specific and ethnicity-specific PAF of late-onset Alzheimer disease and related dementias (ADRDs) based on the risk factor prevalence and associations observed on the same individuals within a prospective cohort. METHODS Data were from Multiethnic Cohort Study participants (African American, Japanese American, Latino, Native Hawaiian, and White) enrolled in Medicare Fee-for-Service. We estimated the PAF based on the prevalence of risk factors at cohort baseline and their mutually adjusted association with subsequent ADRD incidence. Risk factors included low educational attainment and midlife exposures to low neighborhood socioeconomic status, unmarried status, history of hypertension, stroke, diabetes or heart disease, smoking, physical inactivity, short or long sleep duration, obesity, and low-quality diet, as well as APOE ε4 for a subset. RESULTS Among 91,881 participants (mean age 59.3 at baseline, 55.0% female participants), 16,507 incident ADRD cases were identified from Medicare claims (1999-2016, mean follow-up 9.3 years). The PAF for nongenetic factors combined was similar in men (24.0% [95% CI 21.3-26.6]) and women (22.8% [20.3-25.2]) but varied across Japanese American (14.2% [11.1-17.2]), White (21.9% [19.0-24.7]), African American (27.8% [22.3-33.0]), Native Hawaiian (29.3% [21.0-36.7]), and Latino (33.3% [27.5-38.5]) groups. The combined PAF was attenuated when accounting for competing risk of death, in both men (10.4%) and women (13.9%) and across racial and ethnic groups (4.7%-25.5%). The combined PAF was also different by age at diagnosis and ADRD subtypes, higher for younger (65-74 years: 43.2%) than older (75-84 years: 32.4%; ≥85 years: 11.3%) diagnoses and higher for vascular or unspecified ADRD than for AD or Lewy body dementia. An additional PAF of 11.8% (9.9-13.6) was associated with APOE ε4, which together with nongenetic risk factors accounted for 30.6% (25.8-35.1) of ADRD. DISCUSSION Known risk factors explained about a third of the ADRD cases but with unequal distributions across racial and ethnic groups.
Collapse
Affiliation(s)
- Song-Yi Park
- From the Population Sciences in the Pacific Program (S.-Y.P., L.R. Wilkens, L.L.M., U.L.), University of Hawaii Cancer Center, University of Hawaii at Manoa, Honolulu; Department of Population and Public Health Sciences (V.W.S., A.H.W., C.A.H.), Keck School of Medicine and Norris Comprehensive Cancer Center, and Leonard Davis School of Gerontology (E.M.C.), Andrus Gerontology Center, University of Southern California, Los Angeles; Pacific Health Research and Education Institute (L.R. White), Honolulu, HI; Department of Epidemiology and Biostatistics (I.C.), University of California, San Francisco; and Public Health Sciences Division (B.F.D.), Fred Hutchinson Cancer Center, Seattle, WA
| | - Veronica Wendy Setiawan
- From the Population Sciences in the Pacific Program (S.-Y.P., L.R. Wilkens, L.L.M., U.L.), University of Hawaii Cancer Center, University of Hawaii at Manoa, Honolulu; Department of Population and Public Health Sciences (V.W.S., A.H.W., C.A.H.), Keck School of Medicine and Norris Comprehensive Cancer Center, and Leonard Davis School of Gerontology (E.M.C.), Andrus Gerontology Center, University of Southern California, Los Angeles; Pacific Health Research and Education Institute (L.R. White), Honolulu, HI; Department of Epidemiology and Biostatistics (I.C.), University of California, San Francisco; and Public Health Sciences Division (B.F.D.), Fred Hutchinson Cancer Center, Seattle, WA
| | - Eileen M Crimmins
- From the Population Sciences in the Pacific Program (S.-Y.P., L.R. Wilkens, L.L.M., U.L.), University of Hawaii Cancer Center, University of Hawaii at Manoa, Honolulu; Department of Population and Public Health Sciences (V.W.S., A.H.W., C.A.H.), Keck School of Medicine and Norris Comprehensive Cancer Center, and Leonard Davis School of Gerontology (E.M.C.), Andrus Gerontology Center, University of Southern California, Los Angeles; Pacific Health Research and Education Institute (L.R. White), Honolulu, HI; Department of Epidemiology and Biostatistics (I.C.), University of California, San Francisco; and Public Health Sciences Division (B.F.D.), Fred Hutchinson Cancer Center, Seattle, WA
| | - Lon R White
- From the Population Sciences in the Pacific Program (S.-Y.P., L.R. Wilkens, L.L.M., U.L.), University of Hawaii Cancer Center, University of Hawaii at Manoa, Honolulu; Department of Population and Public Health Sciences (V.W.S., A.H.W., C.A.H.), Keck School of Medicine and Norris Comprehensive Cancer Center, and Leonard Davis School of Gerontology (E.M.C.), Andrus Gerontology Center, University of Southern California, Los Angeles; Pacific Health Research and Education Institute (L.R. White), Honolulu, HI; Department of Epidemiology and Biostatistics (I.C.), University of California, San Francisco; and Public Health Sciences Division (B.F.D.), Fred Hutchinson Cancer Center, Seattle, WA
| | - Anna H Wu
- From the Population Sciences in the Pacific Program (S.-Y.P., L.R. Wilkens, L.L.M., U.L.), University of Hawaii Cancer Center, University of Hawaii at Manoa, Honolulu; Department of Population and Public Health Sciences (V.W.S., A.H.W., C.A.H.), Keck School of Medicine and Norris Comprehensive Cancer Center, and Leonard Davis School of Gerontology (E.M.C.), Andrus Gerontology Center, University of Southern California, Los Angeles; Pacific Health Research and Education Institute (L.R. White), Honolulu, HI; Department of Epidemiology and Biostatistics (I.C.), University of California, San Francisco; and Public Health Sciences Division (B.F.D.), Fred Hutchinson Cancer Center, Seattle, WA
| | - Iona Cheng
- From the Population Sciences in the Pacific Program (S.-Y.P., L.R. Wilkens, L.L.M., U.L.), University of Hawaii Cancer Center, University of Hawaii at Manoa, Honolulu; Department of Population and Public Health Sciences (V.W.S., A.H.W., C.A.H.), Keck School of Medicine and Norris Comprehensive Cancer Center, and Leonard Davis School of Gerontology (E.M.C.), Andrus Gerontology Center, University of Southern California, Los Angeles; Pacific Health Research and Education Institute (L.R. White), Honolulu, HI; Department of Epidemiology and Biostatistics (I.C.), University of California, San Francisco; and Public Health Sciences Division (B.F.D.), Fred Hutchinson Cancer Center, Seattle, WA
| | - Burcu F Darst
- From the Population Sciences in the Pacific Program (S.-Y.P., L.R. Wilkens, L.L.M., U.L.), University of Hawaii Cancer Center, University of Hawaii at Manoa, Honolulu; Department of Population and Public Health Sciences (V.W.S., A.H.W., C.A.H.), Keck School of Medicine and Norris Comprehensive Cancer Center, and Leonard Davis School of Gerontology (E.M.C.), Andrus Gerontology Center, University of Southern California, Los Angeles; Pacific Health Research and Education Institute (L.R. White), Honolulu, HI; Department of Epidemiology and Biostatistics (I.C.), University of California, San Francisco; and Public Health Sciences Division (B.F.D.), Fred Hutchinson Cancer Center, Seattle, WA
| | - Christopher A Haiman
- From the Population Sciences in the Pacific Program (S.-Y.P., L.R. Wilkens, L.L.M., U.L.), University of Hawaii Cancer Center, University of Hawaii at Manoa, Honolulu; Department of Population and Public Health Sciences (V.W.S., A.H.W., C.A.H.), Keck School of Medicine and Norris Comprehensive Cancer Center, and Leonard Davis School of Gerontology (E.M.C.), Andrus Gerontology Center, University of Southern California, Los Angeles; Pacific Health Research and Education Institute (L.R. White), Honolulu, HI; Department of Epidemiology and Biostatistics (I.C.), University of California, San Francisco; and Public Health Sciences Division (B.F.D.), Fred Hutchinson Cancer Center, Seattle, WA
| | - Lynne R Wilkens
- From the Population Sciences in the Pacific Program (S.-Y.P., L.R. Wilkens, L.L.M., U.L.), University of Hawaii Cancer Center, University of Hawaii at Manoa, Honolulu; Department of Population and Public Health Sciences (V.W.S., A.H.W., C.A.H.), Keck School of Medicine and Norris Comprehensive Cancer Center, and Leonard Davis School of Gerontology (E.M.C.), Andrus Gerontology Center, University of Southern California, Los Angeles; Pacific Health Research and Education Institute (L.R. White), Honolulu, HI; Department of Epidemiology and Biostatistics (I.C.), University of California, San Francisco; and Public Health Sciences Division (B.F.D.), Fred Hutchinson Cancer Center, Seattle, WA
| | - Loїc Le Marchand
- From the Population Sciences in the Pacific Program (S.-Y.P., L.R. Wilkens, L.L.M., U.L.), University of Hawaii Cancer Center, University of Hawaii at Manoa, Honolulu; Department of Population and Public Health Sciences (V.W.S., A.H.W., C.A.H.), Keck School of Medicine and Norris Comprehensive Cancer Center, and Leonard Davis School of Gerontology (E.M.C.), Andrus Gerontology Center, University of Southern California, Los Angeles; Pacific Health Research and Education Institute (L.R. White), Honolulu, HI; Department of Epidemiology and Biostatistics (I.C.), University of California, San Francisco; and Public Health Sciences Division (B.F.D.), Fred Hutchinson Cancer Center, Seattle, WA
| | - Unhee Lim
- From the Population Sciences in the Pacific Program (S.-Y.P., L.R. Wilkens, L.L.M., U.L.), University of Hawaii Cancer Center, University of Hawaii at Manoa, Honolulu; Department of Population and Public Health Sciences (V.W.S., A.H.W., C.A.H.), Keck School of Medicine and Norris Comprehensive Cancer Center, and Leonard Davis School of Gerontology (E.M.C.), Andrus Gerontology Center, University of Southern California, Los Angeles; Pacific Health Research and Education Institute (L.R. White), Honolulu, HI; Department of Epidemiology and Biostatistics (I.C.), University of California, San Francisco; and Public Health Sciences Division (B.F.D.), Fred Hutchinson Cancer Center, Seattle, WA
| |
Collapse
|
5
|
Zhang X, Li Q, Cong W, Mu S, Zhan R, Zhong S, Zhao M, Zhao C, Kang K, Zhou Z. Effect of physical activity on risk of Alzheimer's disease: A systematic review and meta-analysis of twenty-nine prospective cohort studies. Ageing Res Rev 2023; 92:102127. [PMID: 37979700 DOI: 10.1016/j.arr.2023.102127] [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: 09/30/2023] [Revised: 11/05/2023] [Accepted: 11/12/2023] [Indexed: 11/20/2023]
Abstract
OBJECTIVE Physical activity (PA) is beneficial in reductions of all-cause mortality and dementia. However, whether Alzheimer's disease (AD) risk is modified by PA remains disputable. This meta-analysis aims to disclose the underlying relationship between PA and incident AD. METHODS Pubmed, Embase, Cochrane Library, and Web of Science were retrieved from inception to June 2023. Random-effects models were employed to derive the effect size, represented by hazard ratio (HR) and 95% confidence interval (CI). RESULTS Twenty-nine prospective cohort studies involving 2068,519 participants were included. The pooled estimate showed a favorable effect of PA on AD risk decline (HR 0.72, 95% CI 0.65-0.80). This association remained robust after adjusting for maximum confounders (HR 0.85, 95% CI 0.79-0.91). Subgroup analysis of PA intensity demonstrated an inverse dose-response relationship between PA and AD, effect sizes of which were significant in moderate (HR 0.85, 95% CI 0.80-0.93) and high PA (HR 0.56, 95% CI 0.45-0.68), but not in low PA (HR 0.94, 95% CI 0.77-1.15). Regardless of all participants or the mid-life cohort, the protection of PA against AD appeared to be valid in shorter follow-up (<15 years) rather than longer follow-up (≥15 years). In addition to follow-up, the robustness of the estimates persisted in supplementary meta-analyses, meta-regression analyses, and sensitivity analyses. CONCLUSION PA intervention reduces the incidence of AD, but merely in moderate to vigorous PA with follow-up of less than 15 years, thus conditionally recommending the popularization of PA as a modifiable lifestyle factor to prevent AD.
Collapse
Affiliation(s)
- Xiaoqian Zhang
- Department of Neurology, The First Hospital of China Medical University, Shenyang 110001, Liaoning, PR China
| | - Qu Li
- Department of Neurology, The First Hospital of China Medical University, Shenyang 110001, Liaoning, PR China
| | - Wenqiang Cong
- Department of Geriatrics, The First Hospital of China Medical University, Shenyang 110001, Liaoning, PR China
| | - Siyu Mu
- Department of Neurology, The First Hospital of China Medical University, Shenyang 110001, Liaoning, PR China
| | - Rui Zhan
- Department of Geriatrics, The First Hospital of China Medical University, Shenyang 110001, Liaoning, PR China
| | - Shanshan Zhong
- Department of Neurology, The First Hospital of China Medical University, Shenyang 110001, Liaoning, PR China
| | - Mei Zhao
- Department of Cardiology, The Shengjing Affiliated Hospital of China Medical University, Shenyang 110004, Liaoning, PR China
| | - Chuansheng Zhao
- Department of Neurology, The First Hospital of China Medical University, Shenyang 110001, Liaoning, PR China
| | - Kexin Kang
- Department of Geriatrics, The First Hospital of China Medical University, Shenyang 110001, Liaoning, PR China.
| | - Zhike Zhou
- Department of Geriatrics, The First Hospital of China Medical University, Shenyang 110001, Liaoning, PR China.
| |
Collapse
|
6
|
Andrade-Guerrero J, Rodríguez-Arellano P, Barron-Leon N, Orta-Salazar E, Ledesma-Alonso C, Díaz-Cintra S, Soto-Rojas LO. Advancing Alzheimer's Therapeutics: Exploring the Impact of Physical Exercise in Animal Models and Patients. Cells 2023; 12:2531. [PMID: 37947609 PMCID: PMC10648553 DOI: 10.3390/cells12212531] [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: 09/26/2023] [Revised: 10/18/2023] [Accepted: 10/25/2023] [Indexed: 11/12/2023] Open
Abstract
Alzheimer's disease (AD) is the main neurodegenerative disorder characterized by several pathophysiological features, including the misfolding of the tau protein and the amyloid beta (Aβ) peptide, neuroinflammation, oxidative stress, synaptic dysfunction, metabolic alterations, and cognitive impairment. These mechanisms collectively contribute to neurodegeneration, necessitating the exploration of therapeutic approaches with multiple targets. Physical exercise has emerged as a promising non-pharmacological intervention for AD, with demonstrated effects on promoting neurogenesis, activating neurotrophic factors, reducing Aβ aggregates, minimizing the formation of neurofibrillary tangles (NFTs), dampening inflammatory processes, mitigating oxidative stress, and improving the functionality of the neurovascular unit (NVU). Overall, the neuroprotective effects of exercise are not singular, but are multi-targets. Numerous studies have investigated physical exercise's potential in both AD patients and animal models, employing various exercise protocols to elucidate the underlying neurobiological mechanisms and effects. The objective of this review is to analyze the neurological therapeutic effects of these exercise protocols in animal models and compare them with studies conducted in AD patients. By translating findings from different approaches, this review aims to identify opportune, specific, and personalized therapeutic windows, thus advancing research on the use of physical exercise with AD patients.
Collapse
Affiliation(s)
- Jesús Andrade-Guerrero
- Laboratorio de Patogénesis Molecular, Laboratorio 4, Edificio A4, Carrera Médico Cirujano, Facultad de Estudios Superiores Iztacala, Universidad Nacional Autónoma de México, Tlalnepantla 54090, Mexico;
- Departamento de Neurobiología del Desarrollo y Neurofisiología, Instituto de Neurobiología, Universidad Nacional Autónoma de México, Queretaro 76230, Mexico; (P.R.-A.); (N.B.-L.); (E.O.-S.); (C.L.-A.)
| | - Paola Rodríguez-Arellano
- Departamento de Neurobiología del Desarrollo y Neurofisiología, Instituto de Neurobiología, Universidad Nacional Autónoma de México, Queretaro 76230, Mexico; (P.R.-A.); (N.B.-L.); (E.O.-S.); (C.L.-A.)
| | - Nayeli Barron-Leon
- Departamento de Neurobiología del Desarrollo y Neurofisiología, Instituto de Neurobiología, Universidad Nacional Autónoma de México, Queretaro 76230, Mexico; (P.R.-A.); (N.B.-L.); (E.O.-S.); (C.L.-A.)
| | - Erika Orta-Salazar
- Departamento de Neurobiología del Desarrollo y Neurofisiología, Instituto de Neurobiología, Universidad Nacional Autónoma de México, Queretaro 76230, Mexico; (P.R.-A.); (N.B.-L.); (E.O.-S.); (C.L.-A.)
| | - Carlos Ledesma-Alonso
- Departamento de Neurobiología del Desarrollo y Neurofisiología, Instituto de Neurobiología, Universidad Nacional Autónoma de México, Queretaro 76230, Mexico; (P.R.-A.); (N.B.-L.); (E.O.-S.); (C.L.-A.)
| | - Sofía Díaz-Cintra
- Departamento de Neurobiología del Desarrollo y Neurofisiología, Instituto de Neurobiología, Universidad Nacional Autónoma de México, Queretaro 76230, Mexico; (P.R.-A.); (N.B.-L.); (E.O.-S.); (C.L.-A.)
| | - Luis O. Soto-Rojas
- Laboratorio de Patogénesis Molecular, Laboratorio 4, Edificio A4, Carrera Médico Cirujano, Facultad de Estudios Superiores Iztacala, Universidad Nacional Autónoma de México, Tlalnepantla 54090, Mexico;
- Red MEDICI, Carrera Médico Cirujano, Facultad de Estudios Superiores Iztacala, Universidad Nacional Autónoma de México, Tlalnepantla 54090, Mexico
| |
Collapse
|
7
|
Feng J, Wang Q, Zhang Y. Ideal vitamin D and handgrip strength counteracts the risk effect of APOE genotype on dementia: a population-based longitudinal study. J Transl Med 2023; 21:355. [PMID: 37246226 DOI: 10.1186/s12967-023-04195-3] [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: 01/27/2023] [Accepted: 05/14/2023] [Indexed: 05/30/2023] Open
Abstract
BACKGROUND Higher vitamin D concentrations and grip strength contribute to lower individual-level risk of dementia, while apolipoprotein 4 (APOE e4) genotype carries increases dementia risk, but whether combination of ideal vitamin D and grip strength counteracts the risk effect of dementia related to APOE e4 genotype remains unclear. We aimed to investigate the interactions between vitamin D/grip strength and APOE e4 genotype and their association with dementia. METHODS The UK Biobank cohort comprised 165,688 dementia-free participants (aged at least 60 years) for the dementia analysis. Dementia was ascertained using hospital inpatient, mortality, and self-reported data until 2021. Vitamin D and grip strength were collected at baseline and divided into tertiles. APOE genotype was coded as APOE e4 non-carries and APOE e4 carries. Data were analyzed using Cox proportional hazard models and restricted cubic regression splines, with adjusted for known confounders. RESULTS Over the follow-up (median: 12.0 years), 3917 participants developed dementia. In women and men, respectively, compared with to the lowest tertile of vitamin D, the HRs (95% CIs) of dementia were lower in the middle [0.86 (0.76-0.97)/0.80 (0.72-0.90)] and the highest tertile [0.81 (0.72-0.90)/0.73 (0.66-0.81)]. Tertiles of grip strength showed similar patterns. In women and men, respectively, participants who had both highest tertile of vitamin D and grip strength was associated with a lower risk of dementia compared to those with both lowest tertile of these two exposures among APOE e4 genotype carries (HR = 0.56, 95% CI 0.42-0.76, and HR = 0.48, 95% CI 0.36-0.64) and APOE e4 genotype non-carries (HR = 0.56, 95% CI 0.38-0.81, and HR = 0.34, 95% CI 0.24-0.47). There were significant additive interactions between lower vitamin D/grip strength and APOE e4 genotype on dementia among women and men. CONCLUSIONS Higher vitamin D and grip strength were associated with a lower risk of dementia, and seemed to halve the adverse effects of APOE e4 genotype on dementia. Our findings suggested that vitamin D and grip strength may be imperative for estimating the risks of dementia, especially among APOE e4 genotype carries.
Collapse
Affiliation(s)
- Jiangtao Feng
- Department of Orthopedics, Tianjin NanKai Hospital, Changjiang Road 6, Tianjin, 300100, China
- Department of Orthopedics, Integrated Chinese and Western Medicine Hospital, Tianjin University, Changjiang Road 6, Tianjin, 300100, China
| | - Qi Wang
- Department of Orthopedics, Tianjin NanKai Hospital, Changjiang Road 6, Tianjin, 300100, China
- Department of Orthopedics, Integrated Chinese and Western Medicine Hospital, Tianjin University, Changjiang Road 6, Tianjin, 300100, China
| | - Yuan Zhang
- Department of Orthopedics, Tianjin NanKai Hospital, Changjiang Road 6, Tianjin, 300100, China.
- Raymond G. Perelman Center for Cellular and Molecular Therapeutics, Children's Hospital of Philadelphia, Philadelphia, PA, 19104, USA.
- School of Public Health, Tianjin Medical University, Tianjin, 300070, China.
| |
Collapse
|
8
|
Aguayo GA, Zhang L, Vaillant M, Ngari M, Perquin M, Moran V, Huiart L, Krüger R, Azuaje F, Ferdynus C, Fagherazzi G. Machine learning for predicting neurodegenerative diseases in the general older population: a cohort study. BMC Med Res Methodol 2023; 23:8. [PMID: 36631766 PMCID: PMC9832793 DOI: 10.1186/s12874-023-01837-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Accepted: 01/06/2023] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND In the older general population, neurodegenerative diseases (NDs) are associated with increased disability, decreased physical and cognitive function. Detecting risk factors can help implement prevention measures. Using deep neural networks (DNNs), a machine-learning algorithm could be an alternative to Cox regression in tabular datasets with many predictive features. We aimed to compare the performance of different types of DNNs with regularized Cox proportional hazards models to predict NDs in the older general population. METHODS We performed a longitudinal analysis with participants of the English Longitudinal Study of Ageing. We included men and women with no NDs at baseline, aged 60 years and older, assessed every 2 years from 2004 to 2005 (wave2) to 2016-2017 (wave 8). The features were a set of 91 epidemiological and clinical baseline variables. The outcome was new events of Parkinson's, Alzheimer or dementia. After applying multiple imputations, we trained three DNN algorithms: Feedforward, TabTransformer, and Dense Convolutional (Densenet). In addition, we trained two algorithms based on Cox models: Elastic Net regularization (CoxEn) and selected features (CoxSf). RESULTS 5433 participants were included in wave 2. During follow-up, 12.7% participants developed NDs. Although the five models predicted NDs events, the discriminative ability was superior using TabTransformer (Uno's C-statistic (coefficient (95% confidence intervals)) 0.757 (0.702, 0.805). TabTransformer showed superior time-dependent balanced accuracy (0.834 (0.779, 0.889)) and specificity (0.855 (0.0.773, 0.909)) than the other models. With the CoxSf (hazard ratio (95% confidence intervals)), age (10.0 (6.9, 14.7)), poor hearing (1.3 (1.1, 1.5)) and weight loss 1.3 (1.1, 1.6)) were associated with a higher DNN risk. In contrast, executive function (0.3 (0.2, 0.6)), memory (0, 0, 0.1)), increased gait speed (0.2, (0.1, 0.4)), vigorous physical activity (0.7, 0.6, 0.9)) and higher BMI (0.4 (0.2, 0.8)) were associated with a lower DNN risk. CONCLUSION TabTransformer is promising for prediction of NDs with heterogeneous tabular datasets with numerous features. Moreover, it can handle censored data. However, Cox models perform well and are easier to interpret than DNNs. Therefore, they are still a good choice for NDs.
Collapse
Affiliation(s)
- Gloria A. Aguayo
- grid.451012.30000 0004 0621 531XDeep Digital Phenotyping Research Unit, Department of Precision Health, Luxembourg Institute of Health, Strassen, Luxembourg
| | - Lu Zhang
- grid.451012.30000 0004 0621 531XBioinformatics Platform, Luxembourg Institute of Health, Strassen, Luxembourg
| | - Michel Vaillant
- grid.451012.30000 0004 0621 531XCompetence Center for Methodology and Statistics, Translational Medicine Operations Hub, Luxembourg Institute of Health, Strassen, Luxembourg
| | - Moses Ngari
- grid.451012.30000 0004 0621 531XCompetence Center for Methodology and Statistics, Translational Medicine Operations Hub, Luxembourg Institute of Health, Strassen, Luxembourg ,grid.33058.3d0000 0001 0155 5938KEMRI/Wellcome Trust Research Programme, Kilifi, Kenya
| | - Magali Perquin
- grid.451012.30000 0004 0621 531XDepartment of Precision Health, Luxembourg Institute of Health, Strassen, Luxembourg
| | - Valerie Moran
- grid.451012.30000 0004 0621 531XDepartment of Precision Health, Luxembourg Institute of Health, Strassen, Luxembourg ,grid.432900.c0000 0001 2215 8798Living Conditions Department, Luxembourg Institute of Socio-Economic Research, Esch-Sur-Alzette, Luxembourg
| | - Laetitia Huiart
- grid.451012.30000 0004 0621 531XDepartment of Precision Health, Luxembourg Institute of Health, Strassen, Luxembourg
| | - Rejko Krüger
- grid.16008.3f0000 0001 2295 9843LCSB, Luxembourg Centre for System Biomedicine, University of Luxembourg, Esch-Sur-Alzette, Luxembourg ,grid.418041.80000 0004 0578 0421Parkinson Research Clinic, Centre Hospitalier de Luxembourg, Luxembourg, Luxembourg ,grid.451012.30000 0004 0621 531XTransversal Translational Medicine, Luxembourg Institute of Health, Strassen, Luxembourg
| | - Francisco Azuaje
- grid.451012.30000 0004 0621 531XBioinformatics Platform, Luxembourg Institute of Health, Strassen, Luxembourg ,grid.498322.6Genomics England, London, UK
| | - Cyril Ferdynus
- Methodological Support Unit, Félix Guyon University Hospital Center, Saint-Denis, La Réunion France
| | - Guy Fagherazzi
- grid.451012.30000 0004 0621 531XDeep Digital Phenotyping Research Unit, Department of Precision Health, Luxembourg Institute of Health, Strassen, Luxembourg
| |
Collapse
|