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Chandrashekar DV, Roules GC, Jagadeesan N, Panchal UR, Oyegbesan A, Imiruaye OE, Zhang H, Garcia J, Kaur K, Win S, Than TA, Kaplowitz N, Roosan MR, Han D, Sumbria RK. Hepatic LRP-1 plays an important role in amyloidosis in Alzheimer's disease mice: Potential role in chronic heavy alcohol feeding. Neurobiol Dis 2024; 199:106570. [PMID: 38885850 DOI: 10.1016/j.nbd.2024.106570] [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: 04/08/2024] [Revised: 06/13/2024] [Accepted: 06/14/2024] [Indexed: 06/20/2024] Open
Abstract
BACKGROUND Hepatic lipoprotein receptor-related protein 1 (LRP-1) plays a central role in peripheral amyloid beta (Aβ) clearance, but its importance in Alzheimer's disease (AD) pathology is understudied. Our previous work showed that intragastric alcohol feeding to C57BL/6 J mice reduced hepatic LRP-1 expression which correlated with significant AD-relevant brain changes. Herein, we examined the role of hepatic LRP-1 in AD pathogenesis in APP/PS1 AD mice using two approaches to modulate hepatic LRP-1, intragastric alcohol feeding to model chronic heavy drinking shown by us to reduce hepatic LRP-1, and hepato-specific LRP-1 silencing. METHODS Eight-month-old male APP/PS1 mice were fed ethanol or control diet intragastrically for 5 weeks (n = 7-11/group). Brain and liver Aβ were assessed using immunoassays. Three important mechanisms of brain amyloidosis were investigated: hepatic LRP-1 (major peripheral Aβ regulator), blood-brain barrier (BBB) function (vascular Aβ regulator), and microglia (major brain Aβ regulator) using immunoassays. Spatial LRP-1 gene expression in the periportal versus pericentral hepatic regions was confirmed using NanoString GeoMx Digital Spatial Profiler. Further, hepatic LRP-1 was silenced by injecting LRP-1 microRNA delivered by the adeno-associated virus 8 (AAV8) and the hepato-specific thyroxine-binding globulin (TBG) promoter to 4-month-old male APP/PS1 mice (n = 6). Control male APP/PS1 mice received control AAV8 (n = 6). Spatial memory and locomotion were assessed 12 weeks after LRP-1 silencing using Y-maze and open-field test, respectively, and brain and liver Aβ were measured. RESULTS Alcohol feeding reduced plaque-associated microglia in APP/PS1 mice brains and increased aggregated Aβ (p < 0.05) by ELISA and 6E10-positive Aβ load by immunostaining (p < 0.05). Increased brain Aβ corresponded with a significant downregulation of hepatic LRP-1 (p < 0.01) at the protein and transcript level, primarily in pericentral hepatocytes (zone 3) where alcohol-induced injury occurs. Hepato-specific LRP-1 silencing significantly increased brain Aβ and locomotion hyperactivity (p < 0.05) in APP/PS1 mice. CONCLUSION Chronic heavy alcohol intake reduced hepatic LRP-1 expression and increased brain Aβ. The hepato-specific LRP-1 silencing similarly increased brain Aβ which was associated with behavioral deficits in APP/PS1 mice. Collectively, our results suggest that hepatic LRP-1 is a key regulator of brain amyloidosis in alcohol-dependent AD.
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Affiliation(s)
- Devaraj V Chandrashekar
- Department of Biomedical and Pharmaceutical Sciences, School of Pharmacy, Chapman University, Irvine, CA, United States
| | - G Chuli Roules
- Department of Biomedical and Pharmaceutical Sciences, School of Pharmacy, Chapman University, Irvine, CA, United States
| | - Nataraj Jagadeesan
- Department of Biomedical and Pharmaceutical Sciences, School of Pharmacy, Chapman University, Irvine, CA, United States
| | - Urvashi R Panchal
- Department of Biomedical and Pharmaceutical Sciences, School of Pharmacy, Chapman University, Irvine, CA, United States
| | - Adenike Oyegbesan
- Department of Biomedical and Pharmaceutical Sciences, School of Pharmacy, Chapman University, Irvine, CA, United States
| | - Oghenetega E Imiruaye
- School of Pharmacy and Health Sciences, Keck Graduate Institute, Claremont, CA, United States
| | - Hai Zhang
- Department of Anatomy and Neurobiology, School of Medicine, University of California, Irvine, CA, United States
| | - Jerome Garcia
- Department of Biology, University of La Verne, La Verne, CA, United States
| | - Kamaljit Kaur
- Department of Biomedical and Pharmaceutical Sciences, School of Pharmacy, Chapman University, Irvine, CA, United States
| | - Sanda Win
- Department of Medicine, Division of Gastroenterology and Liver Diseases, Keck School of Medicine, University of Southern California, Los Angeles, CA, United States
| | - Tin A Than
- Department of Medicine, Division of Gastroenterology and Liver Diseases, Keck School of Medicine, University of Southern California, Los Angeles, CA, United States
| | - Neil Kaplowitz
- Department of Medicine, Division of Gastroenterology and Liver Diseases, Keck School of Medicine, University of Southern California, Los Angeles, CA, United States
| | - Moom R Roosan
- Pharmacy Practice, School of Pharmacy, Chapman University, Irvine, CA, United States
| | - Derick Han
- School of Pharmacy and Health Sciences, Keck Graduate Institute, Claremont, CA, United States.
| | - Rachita K Sumbria
- Department of Biomedical and Pharmaceutical Sciences, School of Pharmacy, Chapman University, Irvine, CA, United States; Department of Neurology, University of California, Irvine, CA, United States.
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Stevenson-Hoare J, Stocker H, Trares K, Holleczek B, Brenner H. Subjective hearing and memory problems are associated with dementia and cognition in later life. ALZHEIMER'S & DEMENTIA (AMSTERDAM, NETHERLANDS) 2024; 16:e12624. [PMID: 39011236 PMCID: PMC11247363 DOI: 10.1002/dad2.12624] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/09/2024] [Revised: 05/06/2024] [Accepted: 06/25/2024] [Indexed: 07/17/2024]
Abstract
INTRODUCTION Subjective hearing and memory problems are detectable earlier than objective measures of sensory loss and cognitive decline, which are known to be related to an increased risk of dementia in later life. METHODS Using a population-representative cohort of 6006 individuals (aged 50-75) we examined whether participants who self-reported hearing and short-term memory issues showed greater rates of dementia within 17 years of follow-up. A sub-cohort was tested for audiometric threshold and cognition after 14 years. RESULTS Hearing and memory problems were associated with a greater risk of dementia (hazard ratios [HRs] = 1.42 [95% confidence interval: 1.11-1.81], 1.57 [1.30-1.90]), and poorer cognition 14 years later. The risk was greatest in those reporting both problems (HR = 1.99 [1.42-2.80]). At follow-up, the level of hearing loss was associated with lower cognitive scores. DISCUSSION Self-reports of hearing and short-term memory problems are associated with poorer cognitive performance and a greater risk of dementia. Subjective assessments may have predictive power over more than a decade. Highlights In a sample of older adults subjective hearing and memory problems were associated with dementia risk.Cross-sectionally, the audiometric screening threshold was associated with cognitive test scores.Subjective sensory and memory loss questions are easy to implement and show good predictive power.
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Affiliation(s)
- Joshua Stevenson-Hoare
- Division of Clinical Epidemiology and Aging Research German Cancer Research Center Heidelberg Germany
| | - Hannah Stocker
- Network Aging Research Heidelberg University Heidelberg Germany
| | - Kira Trares
- Division of Clinical Epidemiology and Aging Research German Cancer Research Center Heidelberg Germany
| | | | - Hermann Brenner
- Division of Clinical Epidemiology and Aging Research German Cancer Research Center Heidelberg Germany
- Network Aging Research Heidelberg University Heidelberg Germany
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2024 Alzheimer's disease facts and figures. Alzheimers Dement 2024; 20:3708-3821. [PMID: 38689398 PMCID: PMC11095490 DOI: 10.1002/alz.13809] [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] [Indexed: 05/02/2024]
Abstract
This article describes the public health impact of Alzheimer's disease (AD), including prevalence and incidence, mortality and morbidity, use and costs of care and the ramifications of AD for family caregivers, the dementia workforce and society. The Special Report discusses the larger health care system for older adults with cognitive issues, focusing on the role of caregivers and non-physician health care professionals. An estimated 6.9 million Americans age 65 and older are living with Alzheimer's dementia today. This number could grow to 13.8 million by 2060, barring the development of medical breakthroughs to prevent or cure AD. Official AD death certificates recorded 119,399 deaths from AD in 2021. In 2020 and 2021, when COVID-19 entered the ranks of the top ten causes of death, Alzheimer's was the seventh-leading cause of death in the United States. Official counts for more recent years are still being compiled. Alzheimer's remains the fifth-leading cause of death among Americans age 65 and older. Between 2000 and 2021, deaths from stroke, heart disease and HIV decreased, whereas reported deaths from AD increased more than 140%. More than 11 million family members and other unpaid caregivers provided an estimated 18.4 billion hours of care to people with Alzheimer's or other dementias in 2023. These figures reflect a decline in the number of caregivers compared with a decade earlier, as well as an increase in the amount of care provided by each remaining caregiver. Unpaid dementia caregiving was valued at $346.6 billion in 2023. Its costs, however, extend to unpaid caregivers' increased risk for emotional distress and negative mental and physical health outcomes. Members of the paid health care and broader community-based workforce are involved in diagnosing, treating and caring for people with dementia. However, the United States faces growing shortages across different segments of the dementia care workforce due to a combination of factors, including the absolute increase in the number of people living with dementia. Therefore, targeted programs and care delivery models will be needed to attract, better train and effectively deploy health care and community-based workers to provide dementia care. Average per-person Medicare payments for services to beneficiaries age 65 and older with AD or other dementias are almost three times as great as payments for beneficiaries without these conditions, and Medicaid payments are more than 22 times as great. Total payments in 2024 for health care, long-term care and hospice services for people age 65 and older with dementia are estimated to be $360 billion. The Special Report investigates how caregivers of older adults with cognitive issues interact with the health care system and examines the role non-physician health care professionals play in facilitating clinical care and access to community-based services and supports. It includes surveys of caregivers and health care workers, focusing on their experiences, challenges, awareness and perceptions of dementia care navigation.
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de Melo Queiroz E, Marques Couto C, da Cruz Mecone CA, Souza Lima Macedo W, Caramelli P. Clinical profile and survival analysis of Alzheimer's disease patients in a Brazilian cohort. Neurol Sci 2024; 45:129-137. [PMID: 37540343 DOI: 10.1007/s10072-023-06937-z] [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: 02/21/2023] [Accepted: 06/30/2023] [Indexed: 08/05/2023]
Abstract
OBJECTIVE To investigate the clinical and epidemiological characteristics of a large sample of patients with dementia due to Alzheimer's disease (AD) who were followed up at a cognitive neurology outpatient clinic. METHODS Retrospective, longitudinal, and descriptive design. We collected data from patients with dementia due to AD who visited the outpatient clinic of the SARAH Network of Rehabilitation Hospitals in Rio de Janeiro, Brazil, between May 2009 and June 2019. The evaluated characteristics included age of onset, sex, education, family history, comorbidities, time until diagnosis, and survival rates. RESULTS Overall, 1434 patients were evaluated, 74% of whom were women, with a mean age at symptom onset of 72.7 years and 75.8 at diagnosis. A positive family history was reported in 602 patients, with a first-degree relative in 86.3% of them. Hypertension was the most prevalent comorbidity, affecting 61.2% of the sample, and 16.2% were classified as having early-onset AD. The mean survival rate for the sample population was 112.8 months (9.4 years). The sample population was positively affected by dyslipidaemia. CONCLUSIONS This study presents a clinical and epidemiological analysis of a large and diverse group of patients with AD. The study confirms previous observations such as a higher prevalence of AD in women, low education among sufferers, and the presence of a family history. The study also found that comorbidities significantly affected patient survival and provides new data on the survival rates of patients with early and late AD in the Brazilian population.
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Affiliation(s)
- Elisa de Melo Queiroz
- SARAH Network of Rehabilitation Hospitals, Avenida Abelardo Bueno, 1500, Jacarepaguá, Rio de Janeiro, RJ, 22775-040, Brazil.
| | - Christian Marques Couto
- SARAH Network of Rehabilitation Hospitals, Avenida Abelardo Bueno, 1500, Jacarepaguá, Rio de Janeiro, RJ, 22775-040, Brazil
| | - Cláudio Antônio da Cruz Mecone
- SARAH Network of Rehabilitation Hospitals, Avenida Abelardo Bueno, 1500, Jacarepaguá, Rio de Janeiro, RJ, 22775-040, Brazil
| | - Waneska Souza Lima Macedo
- SARAH Network of Rehabilitation Hospitals, Avenida Abelardo Bueno, 1500, Jacarepaguá, Rio de Janeiro, RJ, 22775-040, Brazil
| | - Paulo Caramelli
- Behavioral and Cognitive Neurology Research Group, Faculdade de Medicina, Universidade Federal de Minas Gerais, Avenida Professor Alfredo Balena, 190 - Santa Efigênia, Belo Horizonte, 30130-100, Brazil
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Bidzan L, Jurek P, Olech M, Bidzan-Wiącek M, Bidzan-Bluma I, Bidzan M. Somatic comorbidity and the progression of cognitive impairment. Front Aging Neurosci 2023; 15:1219449. [PMID: 38046465 PMCID: PMC10691469 DOI: 10.3389/fnagi.2023.1219449] [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: 05/09/2023] [Accepted: 11/02/2023] [Indexed: 12/05/2023] Open
Abstract
Background There are usually multiple factors underlying dementia in old age. Somatic comorbidity is one important element that influences the progression of cognitive impairment. Objective The goal of this study was to assess the relationship between the progression of cognitive impairment and the presence and severity of comorbidities based on a four-year observation. Material Out of 128 patients from the Clinic for Outpatients in Gdansk, who were recruited into the study based on the criteria of the Working Group on Mild Cognitive Impairment, a total of 93 participants completed the four-year observation. Only the data from participants who completed the full period of observations were analysed. The mean age of the group was M = 75.93 (SD = 9.43). The level of progression of cognitive impairment was measured using the Clinical Dementia Rating Scale - Sum of Boxes, the severity of comorbidities was measured using the modified Cumulative Illness Rating Scale, and, additionally, at the time of inclusion in the study, participants were assessed using the MMSE scale and the Activity Scale, and sociodemographic data were collected. The Generalized Estimating Equations method was employed to fit a marginal model for analyzing the data collected in a repeated measures design. The tested model elucidated the role of the overall severity of comorbidities in explaining the progression of cognitive impairment, while controlling for everyday activity and basic demographic variables. Results During the four-year observation, a significant decline in cognitive function (B = 1.86, p < 0.01) was observed in the examined sample. The statistical analysis revealed that individuals with higher overall severity of comorbidities exhibited significantly more pronounced progression of cognitive impairment over time. Regarding particular comorbidities, metabolic diseases were found to be associated with a poorer prognosis (rho = 0.41, p < 0.05). Furthermore, a time physical activity interaction was identified as predicting cognitive impairment, indicating that individuals who were more physically active at the beginning of the study exhibited significantly less pronounced progression of cognitive impairment over the course of the 4 years. Conclusion This study suggests the important roles of comorbidities and physical activity for the prognosis of mild cognitive impairment.
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Affiliation(s)
- Leszek Bidzan
- Faculty of Medicine, Medical University of Gdańsk, Gdańsk, Poland
- Department of Health Sciences, Pomeranian University in Słupsk, Słupsk, Poland
| | - Paweł Jurek
- Institute of Psychology, University of Gdańsk, Gdańsk, Poland
| | - Michał Olech
- Faculty of Health Sciences, Medical University of Gdańsk, Gdańsk, Poland
| | | | - Ilona Bidzan-Bluma
- Institute of Psychology, University of Gdańsk, Gdańsk, Poland
- Institute of Pedagogy and Languages, University of Applied Sciences in Elbląg, Elbląg, Poland
| | - Mariola Bidzan
- Institute of Psychology, University of Gdańsk, Gdańsk, Poland
- Institute of Pedagogy and Languages, University of Applied Sciences in Elbląg, Elbląg, Poland
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de Sousa AA, Rigby Dames BA, Graff EC, Mohamedelhassan R, Vassilopoulos T, Charvet CJ. Going beyond established model systems of Alzheimer's disease: companion animals provide novel insights into the neurobiology of aging. Commun Biol 2023; 6:655. [PMID: 37344566 PMCID: PMC10284893 DOI: 10.1038/s42003-023-05034-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Accepted: 06/12/2023] [Indexed: 06/23/2023] Open
Abstract
Alzheimer's disease (AD) is characterized by brain plaques, tangles, and cognitive impairment. AD is one of the most common age-related dementias in humans. Progress in characterizing AD and other age-related disorders is hindered by a perceived dearth of animal models that naturally reproduce diseases observed in humans. Mice and nonhuman primates are model systems used to understand human diseases. Still, these model systems lack many of the biological characteristics of Alzheimer-like diseases (e.g., plaques, tangles) as they grow older. In contrast, companion animal models (cats and dogs) age in ways that resemble humans. Both companion animal models and humans show evidence of brain atrophy, plaques, and tangles, as well as cognitive decline with age. We embrace a One Health perspective, which recognizes that the health of humans is connected to those of animals, and we illustrate how such a perspective can work synergistically to enhance human and animal health. A comparative biology perspective is ideally suited to integrate insights across veterinary and human medical disciplines and solve long-standing problems in aging.
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Affiliation(s)
- Alexandra A de Sousa
- Centre for Health and Cognition, Bath Spa University, Bath, UK
- Department of Psychology, University of Bath, Bath, UK
| | - Brier A Rigby Dames
- Department of Psychology, University of Bath, Bath, UK
- Department of Computer Science, University of Bath, Bath, UK
- Department of Biology and Biochemistry, Milner Centre for Evolution, University of Bath, Bath, UK
| | - Emily C Graff
- Department of Pathobiology, College of Veterinary Medicine, Auburn University, Auburn, AL, USA
| | - Rania Mohamedelhassan
- Department of Anatomy, Physiology and Pharmacology, College of Veterinary Medicine, Auburn University, Auburn, AL, USA
| | - Tatianna Vassilopoulos
- Department of Anatomy, Physiology and Pharmacology, College of Veterinary Medicine, Auburn University, Auburn, AL, USA
| | - Christine J Charvet
- Department of Anatomy, Physiology and Pharmacology, College of Veterinary Medicine, Auburn University, Auburn, AL, USA.
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Tripathi SJ, Chakraborty S, Miller E, Pieper AA, Paul BD. Hydrogen sulfide signalling in neurodegenerative diseases. Br J Pharmacol 2023:10.1111/bph.16170. [PMID: 37338307 PMCID: PMC10730776 DOI: 10.1111/bph.16170] [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: 05/17/2023] [Revised: 06/05/2023] [Accepted: 06/09/2023] [Indexed: 06/21/2023] Open
Abstract
The gaseous neurotransmitter hydrogen sulfide (H2 S) exerts neuroprotective efficacy in the brain via post-translational modification of cysteine residues by sulfhydration, also known as persulfidation. This process is comparable in biological impact to phosphorylation and mediates a variety of signalling events. Unlike conventional neurotransmitters, H2 S cannot be stored in vesicles due to its gaseous nature. Instead, it is either locally synthesized or released from endogenous stores. Sulfhydration affords both specific and general neuroprotective effects and is critically diminished in several neurodegenerative disorders. Conversely, some forms of neurodegenerative disease are linked to excessive cellular H2 S. Here, we review the signalling roles of H2 S across the spectrum of neurodegenerative diseases, including Huntington's disease, Parkinson's disease, Alzheimer's disease, Down syndrome, traumatic brain injury, the ataxias, and amyotrophic lateral sclerosis, as well as neurodegeneration generally associated with ageing.
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Affiliation(s)
- Sunil Jamuna Tripathi
- Department of Pharmacology and Molecular Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Suwarna Chakraborty
- Department of Pharmacology and Molecular Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Emiko Miller
- Brain Health Medicines Center, Harrington Discovery Institute, University Hospitals Cleveland Medical Center, Cleveland, Ohio, USA
| | - Andrew A Pieper
- Brain Health Medicines Center, Harrington Discovery Institute, University Hospitals Cleveland Medical Center, Cleveland, Ohio, USA
- Department of Psychiatry, Case Western Reserve University, Cleveland, Ohio, USA
- Geriatric Psychiatry, GRECC, Louis Stokes Cleveland VA Medical Center; Cleveland, Ohio, USA
- School of Medicine, Institute for Transformative Molecular Medicine, Case Western Reserve University, Cleveland, Ohio, USA
- Department of Pathology, School of Medicine, Case Western Reserve University, Cleveland, Ohio, USA
- Department of Neuroscience, School of Medicine, Case Western Reserve University, Cleveland, Ohio, USA
- Translational Therapeutics Core, Cleveland Alzheimer's Disease Research Center, Cleveland, Ohio, USA
| | - Bindu D Paul
- Department of Pharmacology and Molecular Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
- The Solomon H. Snyder Department of Neuroscience, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
- Lieber Institute for Brain Development, Baltimore, Maryland, USA
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Wang G, Li DY, Vance DE, Li W. Alcohol Use Disorder as a Risk Factor for Cognitive Impairment. J Alzheimers Dis 2023:JAD230181. [PMID: 37355899 DOI: 10.3233/jad-230181] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/26/2023]
Abstract
BACKGROUND Alcohol use disorder (AUD) is a worldwide problem. The AUD can take the form of hazardous drinking, binge drinking, or alcohol dependence. The effects of alcohol on cognition can be diverse and complex. OBJECTIVE Our study aimed to assess AUD as a risk factor for cognitive impairment. METHODS A literature search was conducted using major electronic databases of PubMed, EMBASE, and Web of Science. Abstracts were screened independently to include data from original research reports. The following keywords were used: alcohol abuse, cognitive impairment, Alzheimer's disease, and dementia. In total, 767 abstracts were retrieved. After removing the duplicates, 76 articles met the criteria for full-text review, of which 41 were included in this report. RESULTS People with AUD are seen from different geographical areas and cultures. AUD is associated with an increased risk of cognitive impairments, Alzheimer's disease, and dementia, especially vascular dementia. In addition, AUD interacts with comorbidities increasing the risk of cognitive impairment. CONCLUSION AUD is associated with an increased risk of cognitive impairments, which may have more than one underlying mechanism.
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Affiliation(s)
- Ge Wang
- Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Daniel Y Li
- The College, University of California at Los Angeles, Los Angeles, CA, USA
| | - David E Vance
- School of Nursing, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Wei Li
- School of Health Professions, University of Alabama at Birmingham, Birmingham, AL, USA
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Logue MW, Miller MW, Sherva R, Zhang R, Harrington KM, Fonda JR, Merritt VC, Panizzon MS, Hauger RL, Wolf EJ, Neale Z, Gaziano JM. Alzheimer's disease and related dementias among aging veterans: Examining gene-by-environment interactions with post-traumatic stress disorder and traumatic brain injury. Alzheimers Dement 2023; 19:2549-2559. [PMID: 36546606 PMCID: PMC10271966 DOI: 10.1002/alz.12870] [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: 05/24/2022] [Revised: 10/03/2022] [Accepted: 10/17/2022] [Indexed: 12/24/2022]
Abstract
INTRODUCTION Post-traumatic stress disorder (PTSD) and traumatic brain injury (TBI) confer risk for Alzheimer's disease and related dementias (ADRD). METHODS This study from the Million Veteran Program (MVP) evaluated the impact of apolipoprotein E (APOE) ε4, PTSD, and TBI on ADRD prevalence in veteran cohorts of European ancestry (EA; n = 11,112 ADRD cases, 170,361 controls) and African ancestry (AA; n = 1443 ADRD cases, 16,191 controls). Additive-scale interactions were estimated using the relative excess risk due to interaction (RERI) statistic. RESULTS PTSD, TBI, and APOE ε4 showed strong main-effect associations with ADRD. RERI analysis revealed significant additive APOE ε4 interactions with PTSD and TBI in the EA cohort and TBI in the AA cohort. These additive interactions indicate that ADRD prevalence associated with PTSD and TBI increased with the number of inherited APOE ε4 alleles. DISCUSSION PTSD and TBI history will be an important part of interpreting the results of ADRD genetic testing and doing accurate ADRD risk assessment.
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Affiliation(s)
- Mark W Logue
- National Center for PTSD, Behavioral Sciences Division, VA Boston Healthcare System, Boston, Massachusetts, USA
- Department of Psychiatry, Boston University Chobanian & Avedisian School of Medicine, Boston, Massachusetts, USA
- Boston University Chobanian & Avedisian School of Medicine, Biomedical Genetics, Boston, Massachusetts, USA
- Department of Biostatistics, Boston University School of Public Health, Boston, Massachusetts, USA
| | - Mark W Miller
- National Center for PTSD, Behavioral Sciences Division, VA Boston Healthcare System, Boston, Massachusetts, USA
- Department of Psychiatry, Boston University Chobanian & Avedisian School of Medicine, Boston, Massachusetts, USA
| | - Richard Sherva
- Boston University Chobanian & Avedisian School of Medicine, Biomedical Genetics, Boston, Massachusetts, USA
| | - Rui Zhang
- National Center for PTSD, Behavioral Sciences Division, VA Boston Healthcare System, Boston, Massachusetts, USA
| | - Kelly M Harrington
- Department of Psychiatry, Boston University Chobanian & Avedisian School of Medicine, Boston, Massachusetts, USA
- Massachusetts Veterans Epidemiology Research and Information Center (MAVERIC), VA Boston Healthcare System, Boston, Massachusetts, USA
| | - Jennifer R Fonda
- Department of Psychiatry, Boston University Chobanian & Avedisian School of Medicine, Boston, Massachusetts, USA
- Translational Research Center for TBI and Stress Disorders (TRACTS) and Geriatric Research, Educational and Clinical Center (GRECC), VA Boston Healthcare System, Boston, Massachusetts, USA
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts, USA
| | - Victoria C Merritt
- Center of Excellence for Stress and Mental Health, VA San Diego Healthcare System, San Diego, California, USA
- Department of Psychiatry, University of California San Diego, La Jolla, California, USA
| | - Matthew S Panizzon
- Department of Psychiatry, University of California San Diego, La Jolla, California, USA
- Center for Behavior Genetics of Aging, University of California, San Diego, California, USA
- Division of Aging, Harvard Medical School, Brigham & Women's Hospital, Boston, Massachusetts, USA
| | - Richard L Hauger
- Center of Excellence for Stress and Mental Health, VA San Diego Healthcare System, San Diego, California, USA
- Department of Psychiatry, University of California San Diego, La Jolla, California, USA
- Center for Behavior Genetics of Aging, University of California, San Diego, California, USA
| | - Erika J Wolf
- National Center for PTSD, Behavioral Sciences Division, VA Boston Healthcare System, Boston, Massachusetts, USA
- Department of Psychiatry, Boston University Chobanian & Avedisian School of Medicine, Boston, Massachusetts, USA
| | - Zoe Neale
- National Center for PTSD, Behavioral Sciences Division, VA Boston Healthcare System, Boston, Massachusetts, USA
- Department of Psychiatry, Boston University Chobanian & Avedisian School of Medicine, Boston, Massachusetts, USA
| | - J Michael Gaziano
- Massachusetts Veterans Epidemiology Research and Information Center (MAVERIC), VA Boston Healthcare System, Boston, Massachusetts, USA
- Division of Aging, Harvard Medical School, Brigham & Women's Hospital, Boston, Massachusetts, USA
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Wiegersma AM, Boots A, Langendam MW, Limpens J, Shenkin SD, Korosi A, Roseboom TJ, de Rooij SR. Do prenatal factors shape the risk for dementia?: A systematic review of the epidemiological evidence for the prenatal origins of dementia. Soc Psychiatry Psychiatr Epidemiol 2023:10.1007/s00127-023-02471-7. [PMID: 37029828 DOI: 10.1007/s00127-023-02471-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Accepted: 03/30/2023] [Indexed: 04/09/2023]
Abstract
PURPOSE Prenatal factors such as maternal stress, infection and nutrition affect fetal brain development and may also influence later risk for dementia. The purpose of this systematic review was to provide an overview of all studies which investigated the association between prenatal factors and later risk for dementia. METHODS We systematically searched MEDLINE and Embase for original human studies reporting on associations between prenatal factors and dementia from inception to 23 November 2022. Prenatal factors could be any factor assessed during pregnancy, at birth or postnatally, provided they were indicative of a prenatal exposure. Risk of bias was assessed using the Newcastle Ottawa Scale. We followed PRISMA guidelines for reporting. RESULTS A total of 68 studies met eligibility criteria (including millions of individuals), assessing maternal age (N = 30), paternal age (N = 22), birth order (N = 15), season of birth (N = 16), place of birth (N = 13), prenatal influenza pandemic (N = 1) or Chinese famine exposure (N = 1), birth characteristics (N = 3) and prenatal hormone exposure (N = 4). We observed consistent results for birth in a generally less optimal environment (e.g. high infant mortality area) being associated with higher dementia risk. Lower and higher birth weight and prenatal famine exposure were associated with higher dementia risk. The studies on season of birth, digit ratio, prenatal influenza pandemic exposure, parental age and birth order showed inconsistent results and were hampered by relatively high risk of bias. CONCLUSION Our findings suggest that some prenatal factors, especially those related to a suboptimal prenatal environment, are associated with an increased dementia risk. As these associations may be confounded by factors such as parental socioeconomic status, more research is needed to examine the potential causal role of the prenatal environment in dementia.
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Affiliation(s)
- Aline Marileen Wiegersma
- Epidemiology and Data Science, Amsterdam UMC Location University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands.
- Amsterdam Public Health Research Institute, Aging & Later Life, Health Behaviors & Chronic Diseases, Amsterdam, The Netherlands.
- Amsterdam Reproduction and Development, Amsterdam, The Netherlands.
| | - Amber Boots
- Epidemiology and Data Science, Amsterdam UMC Location University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands
- Amsterdam Public Health Research Institute, Aging & Later Life, Health Behaviors & Chronic Diseases, Amsterdam, The Netherlands
- Amsterdam Reproduction and Development, Amsterdam, The Netherlands
| | - Miranda W Langendam
- Epidemiology and Data Science, Amsterdam UMC Location University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands
- Amsterdam Public Health Research Institute, Methodology, Amsterdam, The Netherlands
| | - Jacqueline Limpens
- Medical Library, Amsterdam UMC Location University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands
| | - Susan D Shenkin
- Geriatric Medicine, Usher Institute, University of Edinburgh, Edinburgh, Scotland, UK
| | - Aniko Korosi
- Swammerdam Institute for Life Sciences, University of Amsterdam, Amsterdam, The Netherlands
| | - Tessa J Roseboom
- Epidemiology and Data Science, Amsterdam UMC Location University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands
- Obstetrics and Gynaecology, Amsterdam UMC Location University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands
- Amsterdam Public Health Research Institute, Aging & Later Life, Health Behaviors & Chronic Diseases, Amsterdam, The Netherlands
- Amsterdam Reproduction and Development, Amsterdam, The Netherlands
| | - Susanne R de Rooij
- Epidemiology and Data Science, Amsterdam UMC Location University of Amsterdam, Meibergdreef 9, Amsterdam, The Netherlands
- Amsterdam Public Health Research Institute, Aging & Later Life, Health Behaviors & Chronic Diseases, Amsterdam, The Netherlands
- Amsterdam Reproduction and Development, Amsterdam, The Netherlands
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11
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Nikolac Perkovic M, Borovecki F, Filipcic I, Vuic B, Milos T, Nedic Erjavec G, Konjevod M, Tudor L, Mimica N, Uzun S, Kozumplik O, Svob Strac D, Pivac N. Relationship between Brain-Derived Neurotrophic Factor and Cognitive Decline in Patients with Mild Cognitive Impairment and Dementia. Biomolecules 2023; 13:biom13030570. [PMID: 36979505 PMCID: PMC10046678 DOI: 10.3390/biom13030570] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Revised: 03/10/2023] [Accepted: 03/17/2023] [Indexed: 03/30/2023] Open
Abstract
In the last decade, increasing evidence has emerged linking alterations in the brain-derived neurotrophic factor (BDNF) expression with the development of Alzheimer's disease (AD). Because of the important role of BDNF in cognition and its association with AD pathogenesis, the aim of this study was to evaluate the potential difference in plasma BDNF concentrations between subjects with mild cognitive impairment (MCI; N = 209) and AD patients (N = 295) and to determine the possible association between BDNF plasma levels and the degree of cognitive decline in these individuals. The results showed a significantly higher (p < 0.001) concentration of plasma BDNF in subjects with AD (1.16; 0.13-21.34) compared with individuals with MCI (0.68; 0.02-19.14). The results of the present study additionally indicated a negative correlation between cognitive functions and BDNF plasma concentrations, suggesting higher BDNF levels in subjects with more pronounced cognitive decline. The correlation analysis revealed a significant negative correlation between BDNF plasma levels and both Mini-Mental State Examination (p < 0.001) and Clock Drawing test (p < 0.001) scores. In conclusion, the results of our study point towards elevated plasma BDNF levels in AD patients compared with MCI subjects, which may be due to the body's attempt to counteract the early and middle stages of neurodegeneration.
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Affiliation(s)
- Matea Nikolac Perkovic
- Laboratory for Molecular Neuropsychiatry, Division of Molecular Medicine, Ruder Boskovic Institute, 10000 Zagreb, Croatia
| | - Fran Borovecki
- Department of Neurology, University Hospital Centre Zagreb, 10000 Zagreb, Croatia
- School of Medicine, University of Zagreb, 10000 Zagreb, Croatia
| | - Igor Filipcic
- Psychiatric Hospital "Sveti Ivan", 10090 Zagreb, Croatia
| | - Barbara Vuic
- Laboratory for Molecular Neuropsychiatry, Division of Molecular Medicine, Ruder Boskovic Institute, 10000 Zagreb, Croatia
| | - Tina Milos
- Laboratory for Molecular Neuropsychiatry, Division of Molecular Medicine, Ruder Boskovic Institute, 10000 Zagreb, Croatia
| | - Gordana Nedic Erjavec
- Laboratory for Molecular Neuropsychiatry, Division of Molecular Medicine, Ruder Boskovic Institute, 10000 Zagreb, Croatia
| | - Marcela Konjevod
- Laboratory for Molecular Neuropsychiatry, Division of Molecular Medicine, Ruder Boskovic Institute, 10000 Zagreb, Croatia
| | - Lucija Tudor
- Laboratory for Molecular Neuropsychiatry, Division of Molecular Medicine, Ruder Boskovic Institute, 10000 Zagreb, Croatia
| | - Ninoslav Mimica
- School of Medicine, University of Zagreb, 10000 Zagreb, Croatia
- Department for Biological Psychiatry and Psychogeriatrics, University Psychiatric Hospital Vrapče, 10090 Zagreb, Croatia
| | - Suzana Uzun
- School of Medicine, University of Zagreb, 10000 Zagreb, Croatia
- Department for Biological Psychiatry and Psychogeriatrics, University Psychiatric Hospital Vrapče, 10090 Zagreb, Croatia
| | - Oliver Kozumplik
- Department for Biological Psychiatry and Psychogeriatrics, University Psychiatric Hospital Vrapče, 10090 Zagreb, Croatia
| | - Dubravka Svob Strac
- Laboratory for Molecular Neuropsychiatry, Division of Molecular Medicine, Ruder Boskovic Institute, 10000 Zagreb, Croatia
| | - Nela Pivac
- Laboratory for Molecular Neuropsychiatry, Division of Molecular Medicine, Ruder Boskovic Institute, 10000 Zagreb, Croatia
- University of Applied Sciences Hrvatsko Zagorje Krapina, 49000 Krapina, Croatia
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12
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Abstract
This article describes the public health impact of Alzheimer's disease, including prevalence and incidence, mortality and morbidity, use and costs of care, and the overall impact on family caregivers, the dementia workforce and society. The Special Report examines the patient journey from awareness of cognitive changes to potential treatment with drugs that change the underlying biology of Alzheimer's. An estimated 6.7 million Americans age 65 and older are living with Alzheimer's dementia today. This number could grow to 13.8 million by 2060 barring the development of medical breakthroughs to prevent, slow or cure AD. Official death certificates recorded 121,499 deaths from AD in 2019, and Alzheimer's disease was officially listed as the sixth-leading cause of death in the United States. In 2020 and 2021, when COVID-19 entered the ranks of the top ten causes of death, Alzheimer's was the seventh-leading cause of death. Alzheimer's remains the fifth-leading cause of death among Americans age 65 and older. Between 2000 and 2019, deaths from stroke, heart disease and HIV decreased, whereas reported deaths from AD increased more than 145%. This trajectory of deaths from AD was likely exacerbated by the COVID-19 pandemic in 2020 and 2021. More than 11 million family members and other unpaid caregivers provided an estimated 18 billion hours of care to people with Alzheimer's or other dementias in 2022. These figures reflect a decline in the number of caregivers compared with a decade earlier, as well as an increase in the amount of care provided by each remaining caregiver. Unpaid dementia caregiving was valued at $339.5 billion in 2022. Its costs, however, extend to family caregivers' increased risk for emotional distress and negative mental and physical health outcomes - costs that have been aggravated by COVID-19. Members of the paid health care workforce are involved in diagnosing, treating and caring for people with dementia. In recent years, however, a shortage of such workers has developed in the United States. This shortage - brought about, in part, by COVID-19 - has occurred at a time when more members of the dementia care workforce are needed. Therefore, programs will be needed to attract workers and better train health care teams. Average per-person Medicare payments for services to beneficiaries age 65 and older with AD or other dementias are almost three times as great as payments for beneficiaries without these conditions, and Medicaid payments are more than 22 times as great. Total payments in 2023 for health care, long-term care and hospice services for people age 65 and older with dementia are estimated to be $345 billion. The Special Report examines whether there will be sufficient numbers of physician specialists to provide Alzheimer's care and treatment now that two drugs are available that change the underlying biology of Alzheimer's disease.
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13
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Fernandez-Alvarez M, Atienza M, Cantero JL. Effects of non-modifiable risk factors of Alzheimer's disease on intracortical myelin content. Alzheimers Res Ther 2022; 14:202. [PMID: 36587227 PMCID: PMC9805254 DOI: 10.1186/s13195-022-01152-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Accepted: 12/25/2022] [Indexed: 01/01/2023]
Abstract
BACKGROUND Non-modifiable risk factors of Alzheimer's disease (AD) have lifelong effects on cortical integrity that could be mitigated if identified at early stages. However, it remains unknown whether cortical microstructure is affected in older individuals with non-modifiable AD risk factors and whether altered cortical tissue integrity produces abnormalities in brain functional networks in this AD-risk population. METHODS Using relative T1w/T2w (rT1w/T2w) ratio maps, we have compared tissue integrity of normal-appearing cortical GM between controls and cognitively normal older adults with either APOE4 (N = 50), with a first-degree family history (FH) of AD (N = 52), or with the co-occurrence of both AD risk factors (APOE4+FH) (N = 35). Additionally, individuals with only one risk factor (APOE4 or FH) were combined into one group (N = 102) and compared with controls. The same number of controls matched in age, sex, and years of education was employed for each of these comparisons. Group differences in resting state functional connectivity (rs-FC) patterns were also investigated, using as FC seeds those cortical regions showing significant changes in rT1w/T2w ratios. RESULTS Overall, individuals with non-modifiable AD risk factors exhibited significant variations in rT1w/T2w ratios compared to controls, being APOE4 and APOE4+FH at opposite ends of a continuum. The co-occurrence of APOE4 and FH was further accompanied by altered patterns of rs-FC. CONCLUSIONS These findings may have practical implications for early detection of cortical abnormalities in older populations with APOE4 and/or FH of AD and open new avenues to monitor changes in cortical tissue integrity associated with non-modifiable AD risk factors.
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Affiliation(s)
- Marina Fernandez-Alvarez
- grid.15449.3d0000 0001 2200 2355Laboratory of Functional Neuroscience, Pablo de Olavide University, Ctra. de Utrera Km 1, 41013 Seville, Spain ,grid.418264.d0000 0004 1762 4012CIBERNED, Network Center for Biomedical Research in Neurodegenerative Diseases, Madrid, Spain
| | - Mercedes Atienza
- grid.15449.3d0000 0001 2200 2355Laboratory of Functional Neuroscience, Pablo de Olavide University, Ctra. de Utrera Km 1, 41013 Seville, Spain ,grid.418264.d0000 0004 1762 4012CIBERNED, Network Center for Biomedical Research in Neurodegenerative Diseases, Madrid, Spain
| | - Jose L. Cantero
- grid.15449.3d0000 0001 2200 2355Laboratory of Functional Neuroscience, Pablo de Olavide University, Ctra. de Utrera Km 1, 41013 Seville, Spain ,grid.418264.d0000 0004 1762 4012CIBERNED, Network Center for Biomedical Research in Neurodegenerative Diseases, Madrid, Spain
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14
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Brenowitz WD, Yaffe K. Observational studies in Alzheimer disease: bridging preclinical studies and clinical trials. Nat Rev Neurol 2022; 18:747-757. [PMID: 36316487 PMCID: PMC9894623 DOI: 10.1038/s41582-022-00733-7] [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] [Accepted: 09/28/2022] [Indexed: 11/29/2022]
Abstract
Recent high-profile failures of Alzheimer disease treatments at the clinical trial stage have led to renewed efforts to identify and test novel interventions for Alzheimer disease and related dementias (ADRD). In this Perspective, we highlight the importance of including well-designed observational studies as part of these efforts. Observational research is an important cornerstone for gathering evidence on risk factors and causes of ADRD; this evidence can then be combined with data from preclinical studies and randomized controlled trials to inform the development of effective interventions. Observational study designs can be particularly beneficial for hypothesis generation, posing questions that are unethical or impractical for a trial setting, studying life-course associations, research in populations typically not included in trials, and public health surveillance. Here, we discuss each of these situations in the specific context of ADRD research. We also highlight novel approaches to enhance causal inference and provide a timely discussion on how observational epidemiological studies help provide a bridge between preclinical studies and successful interventions for ADRD.
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Affiliation(s)
- Willa D Brenowitz
- Departments of Psychiatry and Behavioral Sciences, Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA, USA
| | - Kristine Yaffe
- Departments of Psychiatry and Behavioral Sciences, Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA, USA.
- Department of Neurology, University of California San Francisco, San Francisco, CA, USA.
- San Francisco VA Medical Center, San Francisco, CA, USA.
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15
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Liang WS, Goetz LH, Schork NJ. Assessing brain and biological aging trajectories associated with Alzheimer's disease. Front Neurosci 2022; 16:1036102. [PMID: 36389222 PMCID: PMC9650396 DOI: 10.3389/fnins.2022.1036102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2022] [Accepted: 10/07/2022] [Indexed: 11/24/2022] Open
Abstract
The development of effective treatments to prevent and slow Alzheimer's disease (AD) pathogenesis is needed in order to tackle the steady increase in the global prevalence of AD. This challenge is complicated by the need to identify key health shifts that precede the onset of AD and cognitive decline as these represent windows of opportunity for intervening and preventing disease. Such shifts may be captured through the measurement of biomarkers that reflect the health of the individual, in particular those that reflect brain age and biological age. Brain age biomarkers provide a composite view of the health of the brain based on neuroanatomical analyses, while biological age biomarkers, which encompass the epigenetic clock, provide a measurement of the overall health state of an individual based on DNA methylation analysis. Acceleration of brain and biological ages is associated with changes in cognitive function, as well as neuropathological markers of AD. In this mini-review, we discuss brain age and biological age research in the context of cognitive decline and AD. While more research is needed, studies show that brain and biological aging trajectories are variable across individuals and that such trajectories are non-linear at older ages. Longitudinal monitoring of these biomarkers may be valuable for enabling earlier identification of divergent pathological trajectories toward AD and providing insight into points for intervention.
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Affiliation(s)
- Winnie S. Liang
- NetBio, Inc., Los Angeles, CA, United States
- Translational Genomics Research Institute, Phoenix, AZ, United States
| | - Laura H. Goetz
- NetBio, Inc., Los Angeles, CA, United States
- Translational Genomics Research Institute, Phoenix, AZ, United States
| | - Nicholas J. Schork
- NetBio, Inc., Los Angeles, CA, United States
- Translational Genomics Research Institute, Phoenix, AZ, United States
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16
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BozbeyMerde İ, Önel GT, Türkmenoğlu B, Gürsoy Ş, Dilek E. (
p
‐Chlorophenyl)‐3(2
H
)pyridazinone Derivatives: Synthesis,
in Silico
, and AChE/BChE Inhibitory Activity. ChemistrySelect 2022. [DOI: 10.1002/slct.202202446] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- İrem BozbeyMerde
- Department of Pharmaceutical Chemistry Faculty of Pharmacy Erzincan Binali Yıldırım University Yalnızbağ 24002 Erzincan Turkey
| | - Gülce Taşkor Önel
- Department of Analytical Chemistry Faculty of Pharmacy Erzincan Binali Yıldırım University Yalnızbağ 24002 Erzincan Turkey
| | - Burçin Türkmenoğlu
- Department of Analytical Chemistry Faculty of Pharmacy Erzincan Binali Yıldırım University Yalnızbağ 24002 Erzincan Turkey
| | - Şule Gürsoy
- Department of Biochemistry Faculty of Pharmacy Erzincan Binali Yıldırım University Yalnızbağ 24002 Erzincan Turkey
| | - Esra Dilek
- Department of Biochemistry Faculty of Pharmacy Erzincan Binali Yıldırım University Yalnızbağ 24002 Erzincan Turkey
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17
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Garcia J, Chang R, Steinberg RA, Arce A, Yang J, Van Der Eb P, Abdullah T, Chandrashekar DV, Eck SM, Meza P, Liu ZX, Cadenas E, Cribbs DH, Kaplowitz N, Sumbria RK, Han D. Modulation of hepatic amyloid precursor protein and lipoprotein receptor-related protein 1 by chronic alcohol intake: Potential link between liver steatosis and amyloid-β. Front Physiol 2022; 13:930402. [PMID: 36187787 PMCID: PMC9520570 DOI: 10.3389/fphys.2022.930402] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Accepted: 08/09/2022] [Indexed: 11/13/2022] Open
Abstract
Heavy alcohol consumption is a known risk factor for various forms of dementia and the development of Alzheimer’s disease (AD). In this work, we investigated how intragastric alcohol feeding may alter the liver-to-brain axis to induce and/or promote AD pathology. Four weeks of intragastric alcohol feeding to mice, which causes significant fatty liver (steatosis) and liver injury, caused no changes in AD pathology markers in the brain [amyloid precursor protein (APP), presenilin], except for a decrease in microglial cell number in the cortex of the brain. Interestingly, the decline in microglial numbers correlated with serum alanine transaminase (ALT) levels, suggesting a potential link between liver injury and microglial loss in the brain. Intragastric alcohol feeding significantly affected two hepatic proteins important in amyloid-beta (Aβ) processing by the liver: 1) alcohol feeding downregulated lipoprotein receptor-related protein 1 (LRP1, ∼46%), the major receptor in the liver that removes Aβ from blood and peripheral organs, and 2) alcohol significantly upregulated APP (∼2-fold), a potentially important source of Aβ in the periphery and brain. The decrease in hepatic LRP1 and increase in hepatic APP likely switches the liver from being a remover or low producer of Aβ to an important source of Aβ in the periphery, which can impact the brain. The downregulation of LRP1 and upregulation of APP in the liver was observed in the first week of intragastric alcohol feeding, and also occurred in other alcohol feeding models (NIAAA binge alcohol model and intragastric alcohol feeding to rats). Modulation of hepatic LRP1 and APP does not seem alcohol-specific, as ob/ob mice with significant steatosis also had declines in LRP1 and increases in APP expression in the liver. These findings suggest that liver steatosis rather than alcohol-induced liver injury is likely responsible for regulation of hepatic LRP1 and APP. Both obesity and alcohol intake have been linked to AD and our data suggests that liver steatosis associated with these two conditions modulates hepatic LRP1 and APP to disrupt Aβ processing by the liver to promote AD.
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Affiliation(s)
- Jerome Garcia
- Department of Biology, University of La Verne, Verne, CA, United States
| | - Rudy Chang
- Department of Biomedical and Pharmaceutical Sciences, School of Pharmacy, Chapman University, Irvine, CA, United States
| | - Ross A. Steinberg
- School of Pharmacy and Health Sciences, Keck Graduate Institute, Claremont, CA, United States
| | - Aldo Arce
- School of Pharmacy and Health Sciences, Keck Graduate Institute, Claremont, CA, United States
| | - Joshua Yang
- Department of Biomedical and Pharmaceutical Sciences, School of Pharmacy, Chapman University, Irvine, CA, United States
| | - Peter Van Der Eb
- School of Pharmacy and Health Sciences, Keck Graduate Institute, Claremont, CA, United States
| | - Tamara Abdullah
- Department of Biomedical and Pharmaceutical Sciences, School of Pharmacy, Chapman University, Irvine, CA, United States
| | - Devaraj V. Chandrashekar
- Department of Biomedical and Pharmaceutical Sciences, School of Pharmacy, Chapman University, Irvine, CA, United States
| | - Sydney M. Eck
- School of Pharmacy and Health Sciences, Keck Graduate Institute, Claremont, CA, United States
| | - Pablo Meza
- School of Pharmacy and Health Sciences, Keck Graduate Institute, Claremont, CA, United States
| | - Zhang-Xu Liu
- Department of Molecular Microbiology and Immunology, USC/Norris Comprehensive Cancer Center, Keck School of Medicine, University of Southern California, Los Angeles, CA, United States
| | - Enrique Cadenas
- Department of Pharmacology and Pharmaceutical Sciences, School of Pharmacy, University of Southern California, Los Angeles, CA, United States
| | - David H. Cribbs
- Institute for Memory Impairments and Neurological Disorders, University of California, Irvine, Irvine, CA, United States
| | - Neil Kaplowitz
- University of Southern California Research Center for Liver Diseases and Southern California Research Center for ALPD, Keck School of Medicine, University of Southern California, Los Angeles, CA, United States
| | - Rachita K. Sumbria
- Department of Biomedical and Pharmaceutical Sciences, School of Pharmacy, Chapman University, Irvine, CA, United States
- Department of Neurology, University of California, Irvine, Irvine, CA, United States
| | - Derick Han
- School of Pharmacy and Health Sciences, Keck Graduate Institute, Claremont, CA, United States
- *Correspondence: Derick Han,
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18
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Mander BA, Dave A, Lui KK, Sprecher KE, Berisha D, Chappel-Farley MG, Chen IY, Riedner BA, Heston M, Suridjan I, Kollmorgen G, Zetterberg H, Blennow K, Carlsson CM, Okonkwo OC, Asthana S, Johnson SC, Bendlin BB, Benca RM. Inflammation, tau pathology, and synaptic integrity associated with sleep spindles and memory prior to β-amyloid positivity. Sleep 2022; 45:zsac135. [PMID: 35670275 PMCID: PMC9758508 DOI: 10.1093/sleep/zsac135] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2021] [Revised: 05/17/2022] [Indexed: 01/25/2023] Open
Abstract
STUDY OBJECTIVES Fast frequency sleep spindles are reduced in aging and Alzheimer's disease (AD), but the mechanisms and functional relevance of these deficits remain unclear. The study objective was to identify AD biomarkers associated with fast sleep spindle deficits in cognitively unimpaired older adults at risk for AD. METHODS Fifty-eight cognitively unimpaired, β-amyloid-negative, older adults (mean ± SD; 61.4 ± 6.3 years, 38 female) enriched with parental history of AD (77.6%) and apolipoprotein E (APOE) ε4 positivity (25.9%) completed the study. Cerebrospinal fluid (CSF) biomarkers of central nervous system inflammation, β-amyloid and tau proteins, and neurodegeneration were combined with polysomnography (PSG) using high-density electroencephalography and assessment of overnight memory retention. Parallelized serial mediation models were used to assess indirect effects of age on fast frequency (13 to <16Hz) sleep spindle measures through these AD biomarkers. RESULTS Glial activation was associated with prefrontal fast frequency sleep spindle expression deficits. While adjusting for sex, APOE ε4 genotype, apnea-hypopnea index, and time between CSF sampling and sleep study, serial mediation models detected indirect effects of age on fast sleep spindle expression through microglial activation markers and then tau phosphorylation and synaptic degeneration markers. Sleep spindle expression at these electrodes was also associated with overnight memory retention in multiple regression models adjusting for covariates. CONCLUSIONS These findings point toward microglia dysfunction as associated with tau phosphorylation, synaptic loss, sleep spindle deficits, and memory impairment even prior to β-amyloid positivity, thus offering a promising candidate therapeutic target to arrest cognitive decline associated with aging and AD.
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Affiliation(s)
- Bryce A Mander
- Department of Psychiatry and Human Behavior, University of California, Irvine, CA, USA
- Center for the Neurobiology of Learning and Memory, University of California, Irvine, CA, USA
- Department of Cognitive Sciences, University of California, Irvine, CA, USA
| | - Abhishek Dave
- Department of Psychiatry and Human Behavior, University of California, Irvine, CA, USA
- Department of Cognitive Sciences, University of California, Irvine, CA, USA
| | - Kitty K Lui
- Department of Psychiatry and Human Behavior, University of California, Irvine, CA, USA
- San Diego State University/University of California San Diego, Joint Doctoral Program in Clinical Psychology, San Diego, CA, USA
| | - Katherine E Sprecher
- Neuroscience Training Program, University of Wisconsin-Madison, Madison, WI, USA
- Department of Medicine, University of Wisconsin-Madison, Madison, WI, USA
- Wisconsin Alzheimer’s Disease Research Center, University of Wisconsin-Madison, Madison, WI, USA
| | - Destiny Berisha
- Department of Neurobiology and Behavior, University of California, Irvine, CA, USA
| | - Miranda G Chappel-Farley
- Center for the Neurobiology of Learning and Memory, University of California, Irvine, CA, USA
- Department of Neurobiology and Behavior, University of California, Irvine, CA, USA
| | - Ivy Y Chen
- Department of Psychiatry and Human Behavior, University of California, Irvine, CA, USA
| | - Brady A Riedner
- Department of Psychiatry, University of Wisconsin-Madison, Madison, WI, USA
| | - Margo Heston
- Department of Medicine, University of Wisconsin-Madison, Madison, WI, USA
- Wisconsin Alzheimer’s Disease Research Center, University of Wisconsin-Madison, Madison, WI, USA
| | | | | | - Henrik Zetterberg
- Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden
- Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital
, Mölndal, Sweden
- Department of Neurodegenerative Disease, UCL Institute of Neurology, Queen Square, London, UK
- UK Dementia Research Institute at UCL, London, UK
| | - Kaj Blennow
- Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden
- Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital
, Mölndal, Sweden
| | - Cynthia M Carlsson
- Wisconsin Alzheimer’s Disease Research Center, University of Wisconsin-Madison, Madison, WI, USA
- Wisconsin Alzheimer’s Institute, Madison, WI, USA
- Geriatric Research Education and Clinical Center, Wm. S. Middleton Veterans Hospital, Madison, WI, USA
| | - Ozioma C Okonkwo
- Wisconsin Alzheimer’s Disease Research Center, University of Wisconsin-Madison, Madison, WI, USA
- Wisconsin Alzheimer’s Institute, Madison, WI, USA
- Geriatric Research Education and Clinical Center, Wm. S. Middleton Veterans Hospital, Madison, WI, USA
| | - Sanjay Asthana
- Wisconsin Alzheimer’s Disease Research Center, University of Wisconsin-Madison, Madison, WI, USA
- Wisconsin Alzheimer’s Institute, Madison, WI, USA
- Geriatric Research Education and Clinical Center, Wm. S. Middleton Veterans Hospital, Madison, WI, USA
| | - Sterling C Johnson
- Wisconsin Alzheimer’s Disease Research Center, University of Wisconsin-Madison, Madison, WI, USA
- Wisconsin Alzheimer’s Institute, Madison, WI, USA
- Geriatric Research Education and Clinical Center, Wm. S. Middleton Veterans Hospital, Madison, WI, USA
| | - Barbara B Bendlin
- Wisconsin Alzheimer’s Disease Research Center, University of Wisconsin-Madison, Madison, WI, USA
- Wisconsin Alzheimer’s Institute, Madison, WI, USA
- Geriatric Research Education and Clinical Center, Wm. S. Middleton Veterans Hospital, Madison, WI, USA
| | - Ruth M Benca
- Department of Psychiatry and Human Behavior, University of California, Irvine, CA, USA
- Center for the Neurobiology of Learning and Memory, University of California, Irvine, CA, USA
- Neuroscience Training Program, University of Wisconsin-Madison, Madison, WI, USA
- Department of Neurobiology and Behavior, University of California, Irvine, CA, USA
- Department of Psychiatry, University of Wisconsin-Madison, Madison, WI, USA
- Department of Psychiatry and Behavioral Medicine, Wake Forest University, Winston-Salem, NC, USA
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19
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López-Cuenca I, Salobrar-García E, Sánchez-Puebla L, Espejel E, García del Arco L, Rojas P, Elvira-Hurtado L, Fernández-Albarral JA, Ramírez-Toraño F, Barabash A, Salazar JJ, Ramírez JM, de Hoz R, Ramírez AI. Retinal Vascular Study Using OCTA in Subjects at High Genetic Risk of Developing Alzheimer's Disease and Cardiovascular Risk Factors. J Clin Med 2022; 11:3248. [PMID: 35683633 PMCID: PMC9181641 DOI: 10.3390/jcm11113248] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Revised: 06/02/2022] [Accepted: 06/05/2022] [Indexed: 02/01/2023] Open
Abstract
In 103 subjects with a high genetic risk of developing Alzheimer's disease (AD), family history (FH) of AD and ApoE ɛ4 characterization (ApoE ɛ4) were analyzed for changes in the retinal vascular network by OCTA (optical coherence tomography angiography), and AngioTool and Erlangen-Angio-Tool (EA-Tool) as imaging analysis software. Retinal vascularization was analyzed by measuring hypercholesterolemia (HCL) and high blood pressure (HBP). Angio-Tool showed a statistically significant higher percentage of area occupied by vessels in the FH+ ApoE ɛ4- group vs. in the FH+ ApoE ɛ4+ group, and EA-Tool showed statistically significant higher vascular densities in the C3 ring in the FH+ ApoE ɛ4+ group when compared with: i)FH- ApoE ɛ4- in sectors H3, H4, H10 and H11; and ii) FH+ ApoE ɛ4- in sectors H4 and H12. In participants with HCL and HBP, statistically significant changes were found, in particular using EA-Tool, both in the macular area, mainly in the deep plexus, and in the peripapillary area. In conclusion, OCTA in subjects with genetic risk factors for the development of AD showed an apparent increase in vascular density in some sectors of the retina, which was one of the first vascular changes detectable. These changes constitute a promising biomarker for monitoring the progression of pathological neuronal degeneration.
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Affiliation(s)
- Inés López-Cuenca
- Ramon Castroviejo Institute of Ophthalmologic Research, Group UCM 920105, Health Research Institute of the Hospital Clínico San Carlos (IdISSC), Complutense University of Madrid, 28040 Madrid, Spain; (I.L.-C.); (E.S.-G.); (L.S.-P.); (E.E.); (L.G.d.A.); (P.R.); (L.E.-H.); (J.A.F.-A.); (J.J.S.); (J.M.R.)
| | - Elena Salobrar-García
- Ramon Castroviejo Institute of Ophthalmologic Research, Group UCM 920105, Health Research Institute of the Hospital Clínico San Carlos (IdISSC), Complutense University of Madrid, 28040 Madrid, Spain; (I.L.-C.); (E.S.-G.); (L.S.-P.); (E.E.); (L.G.d.A.); (P.R.); (L.E.-H.); (J.A.F.-A.); (J.J.S.); (J.M.R.)
- Department of Immunology, Ophthalmology and ENT, Faculty of Optics and Optometry, Complutense University of Madrid, 28037 Madrid, Spain
| | - Lidia Sánchez-Puebla
- Ramon Castroviejo Institute of Ophthalmologic Research, Group UCM 920105, Health Research Institute of the Hospital Clínico San Carlos (IdISSC), Complutense University of Madrid, 28040 Madrid, Spain; (I.L.-C.); (E.S.-G.); (L.S.-P.); (E.E.); (L.G.d.A.); (P.R.); (L.E.-H.); (J.A.F.-A.); (J.J.S.); (J.M.R.)
| | - Eva Espejel
- Ramon Castroviejo Institute of Ophthalmologic Research, Group UCM 920105, Health Research Institute of the Hospital Clínico San Carlos (IdISSC), Complutense University of Madrid, 28040 Madrid, Spain; (I.L.-C.); (E.S.-G.); (L.S.-P.); (E.E.); (L.G.d.A.); (P.R.); (L.E.-H.); (J.A.F.-A.); (J.J.S.); (J.M.R.)
| | - Lucía García del Arco
- Ramon Castroviejo Institute of Ophthalmologic Research, Group UCM 920105, Health Research Institute of the Hospital Clínico San Carlos (IdISSC), Complutense University of Madrid, 28040 Madrid, Spain; (I.L.-C.); (E.S.-G.); (L.S.-P.); (E.E.); (L.G.d.A.); (P.R.); (L.E.-H.); (J.A.F.-A.); (J.J.S.); (J.M.R.)
| | - Pilar Rojas
- Ramon Castroviejo Institute of Ophthalmologic Research, Group UCM 920105, Health Research Institute of the Hospital Clínico San Carlos (IdISSC), Complutense University of Madrid, 28040 Madrid, Spain; (I.L.-C.); (E.S.-G.); (L.S.-P.); (E.E.); (L.G.d.A.); (P.R.); (L.E.-H.); (J.A.F.-A.); (J.J.S.); (J.M.R.)
- Madrid Eye Institute, Gregorio Marañón General University Hospital, 28007 Madrid, Spain
| | - Lorena Elvira-Hurtado
- Ramon Castroviejo Institute of Ophthalmologic Research, Group UCM 920105, Health Research Institute of the Hospital Clínico San Carlos (IdISSC), Complutense University of Madrid, 28040 Madrid, Spain; (I.L.-C.); (E.S.-G.); (L.S.-P.); (E.E.); (L.G.d.A.); (P.R.); (L.E.-H.); (J.A.F.-A.); (J.J.S.); (J.M.R.)
| | - José A. Fernández-Albarral
- Ramon Castroviejo Institute of Ophthalmologic Research, Group UCM 920105, Health Research Institute of the Hospital Clínico San Carlos (IdISSC), Complutense University of Madrid, 28040 Madrid, Spain; (I.L.-C.); (E.S.-G.); (L.S.-P.); (E.E.); (L.G.d.A.); (P.R.); (L.E.-H.); (J.A.F.-A.); (J.J.S.); (J.M.R.)
| | - Federico Ramírez-Toraño
- Laboratory of Cognitive and Computational Neuroscience, Center for Biomedical Technology, Technical University of Madrid, 28233 Madrid, Spain;
- Department of Experimental Psychology, Complutense University of Madrid, 28223 Madrid, Spain
| | - Ana Barabash
- Department of Endocrinology and Nutrition, Health Research Institute of the Hospital Clínico San Carlos (IdISSC), 28040 Madrid, Spain;
- Diabetes and Associated Metabolic Diseases Networking Biomedical Research Centre, Carlos III Health Institute, 28029 Madrid, Spain
- Department of Medicine II, School of Medicine, Complutense University of Madrid, 28040 Madrid, Spain
| | - Juan J. Salazar
- Ramon Castroviejo Institute of Ophthalmologic Research, Group UCM 920105, Health Research Institute of the Hospital Clínico San Carlos (IdISSC), Complutense University of Madrid, 28040 Madrid, Spain; (I.L.-C.); (E.S.-G.); (L.S.-P.); (E.E.); (L.G.d.A.); (P.R.); (L.E.-H.); (J.A.F.-A.); (J.J.S.); (J.M.R.)
- Department of Immunology, Ophthalmology and ENT, Faculty of Optics and Optometry, Complutense University of Madrid, 28037 Madrid, Spain
| | - José M. Ramírez
- Ramon Castroviejo Institute of Ophthalmologic Research, Group UCM 920105, Health Research Institute of the Hospital Clínico San Carlos (IdISSC), Complutense University of Madrid, 28040 Madrid, Spain; (I.L.-C.); (E.S.-G.); (L.S.-P.); (E.E.); (L.G.d.A.); (P.R.); (L.E.-H.); (J.A.F.-A.); (J.J.S.); (J.M.R.)
- Department of Immunology, Ophthalmology and ENT, School of Medicine, Complutense University of Madrid, 28040 Madrid, Spain
| | - Rosa de Hoz
- Ramon Castroviejo Institute of Ophthalmologic Research, Group UCM 920105, Health Research Institute of the Hospital Clínico San Carlos (IdISSC), Complutense University of Madrid, 28040 Madrid, Spain; (I.L.-C.); (E.S.-G.); (L.S.-P.); (E.E.); (L.G.d.A.); (P.R.); (L.E.-H.); (J.A.F.-A.); (J.J.S.); (J.M.R.)
- Department of Immunology, Ophthalmology and ENT, Faculty of Optics and Optometry, Complutense University of Madrid, 28037 Madrid, Spain
| | - Ana I. Ramírez
- Ramon Castroviejo Institute of Ophthalmologic Research, Group UCM 920105, Health Research Institute of the Hospital Clínico San Carlos (IdISSC), Complutense University of Madrid, 28040 Madrid, Spain; (I.L.-C.); (E.S.-G.); (L.S.-P.); (E.E.); (L.G.d.A.); (P.R.); (L.E.-H.); (J.A.F.-A.); (J.J.S.); (J.M.R.)
- Department of Immunology, Ophthalmology and ENT, Faculty of Optics and Optometry, Complutense University of Madrid, 28037 Madrid, Spain
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20
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Characterization of Retinal Drusen in Subjects at High Genetic Risk of Developing Sporadic Alzheimer’s Disease: An Exploratory Analysis. J Pers Med 2022; 12:jpm12050847. [PMID: 35629270 PMCID: PMC9145327 DOI: 10.3390/jpm12050847] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Revised: 05/17/2022] [Accepted: 05/19/2022] [Indexed: 11/16/2022] Open
Abstract
Having a family history (FH+) of Alzheimer’s disease (AD) and being a carrier of at least one ɛ4 allele of the ApoE gene are two of the main risk factors for the development of AD. AD and age-related macular degeneration (AMD) share one of the main risk factors, such as age, and characteristics including the presence of deposits (Aβ plaques in AD and drusen in AMD); however, the role of apolipoprotein E isoforms in both pathologies is controversial. We analyzed and characterized retinal drusen by optical coherence tomography (OCT) in subjects, classifying them by their AD FH (FH- or FH+) and their allelic characterization of ApoE ɛ4 (ApoE ɛ4- or ApoE ɛ4+) and considering cardiovascular risk factors (hypercholesterolemia, hypertension, and diabetes mellitus). In addition, we analyzed the choroidal thickness by OCT and the area of the foveal avascular zone with OCTA. We did not find a relationship between a family history of AD or any of the ApoE isoforms and the presence or absence of drusen. Subjects with drusen show choroidal thinning compared to patients without drusen, and thinning could trigger changes in choroidal perfusion that may give rise to the deposits that generate drusen.
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Abstract
This article describes the public health impact of Alzheimer's disease (AD), including incidence and prevalence, mortality and morbidity, use and costs of care, and the overall impact on family caregivers, the dementia workforce and society. The Special Report discusses consumers' and primary care physicians' perspectives on awareness, diagnosis and treatment of mild cognitive impairment (MCI), including MCI due to Alzheimer's disease. An estimated 6.5 million Americans age 65 and older are living with Alzheimer's dementia today. This number could grow to 13.8 million by 2060 barring the development of medical breakthroughs to prevent, slow or cure AD. Official death certificates recorded 121,499 deaths from AD in 2019, the latest year for which data are available. Alzheimer's disease was officially listed as the sixth-leading cause of death in the United States in 2019 and the seventh-leading cause of death in 2020 and 2021, when COVID-19 entered the ranks of the top ten causes of death. Alzheimer's remains the fifth-leading cause of death among Americans age 65 and older. Between 2000 and 2019, deaths from stroke, heart disease and HIV decreased, whereas reported deaths from AD increased more than 145%. More than 11 million family members and other unpaid caregivers provided an estimated 16 billion hours of care to people with Alzheimer's or other dementias in 2021. These figures reflect a decline in the number of caregivers compared with a decade earlier, as well as an increase in the amount of care provided by each remaining caregiver. Unpaid dementia caregiving was valued at $271.6 billion in 2021. Its costs, however, extend to family caregivers' increased risk for emotional distress and negative mental and physical health outcomes - costs that have been aggravated by COVID-19. Members of the dementia care workforce have also been affected by COVID-19. As essential care workers, some have opted to change jobs to protect their own health and the health of their families. However, this occurs at a time when more members of the dementia care workforce are needed. Average per-person Medicare payments for services to beneficiaries age 65 and older with AD or other dementias are almost three times as great as payments for beneficiaries without these conditions, and Medicaid payments are more than 22 times as great. Total payments in 2022 for health care, long-term care and hospice services for people age 65 and older with dementia are estimated to be $321 billion. A recent survey commissioned by the Alzheimer's Association revealed several barriers to consumers' understanding of MCI. The survey showed low awareness of MCI among Americans, a reluctance among Americans to see their doctor after noticing MCI symptoms, and persistent challenges for primary care physicians in diagnosing MCI. Survey results indicate the need to improve MCI awareness and diagnosis, especially in underserved communities, and to encourage greater participation in MCI-related clinical trials.
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22
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Xie C, Feng Y. Alcohol consumption and risk of Alzheimer's disease: A dose-response meta-analysis. Geriatr Gerontol Int 2022; 22:278-285. [PMID: 35171516 DOI: 10.1111/ggi.14357] [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: 07/28/2021] [Revised: 11/10/2021] [Accepted: 12/29/2021] [Indexed: 11/29/2022]
Abstract
AIM This study aimed to investigate the association between alcohol consumption and the risk of Alzheimer's disease (AD). METHODS PubMed and Web of Science databases were systematically searched as of 1 September 2019. Relative risk and 95% CI were used to evaluate the association between alcohol consumption and AD risk. Subgroup analyses based on the type of alcohol, ethnicity, study design and sex were carried out. An alcohol dose-response meta-analysis was carried out. RESULTS A total of 13 studies were included in the quantitative synthesis, and six were used in the dose-response meta-analysis. Compared with non-drinkers, individuals who drank had a lower risk of AD (relative risk 0.68, 95% CI 0.53-0.87; I2 = 87.9%, P < 0.001). In subgroup analyses, drinking wine was found to reduce the occurrence of AD (relative risk 0.71, 95% CI 0.51-0.96). When stratified by ethnicity, sex and study design, no association was seen between AD risk and alcohol use. There was an overall non-linear, but not significant, association between alcohol intake dose and AD risk. A significant non-linear association was observed between excess AD risk and alcohol intake dose in men (overall P = 0.023; P for non-linearity = 0.025) starting from 14.8 drinks per week. Women's alcohol intake dose <16.9 drinks per week showed a significant non-linear association with decreased AD risk (overall P = 0.002; P for non-linearity = 0.019). CONCLUSIONS Drinking alcohol could reduce the risk of AD. Alcohol dose had a non-linear, but non-significant, relationship with the development of AD. The amount of alcohol consumption showed significant sex-specific effects on AD. Geriatr Gerontol Int 2022; ••: ••-••.
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Affiliation(s)
- Chunxiang Xie
- Department of Neurology, Affiliated Hospital of Jilin Medical University, Jilin City, China
| | - Yuhua Feng
- Department of Medical Insurance, Affiliated Hospital of Jilin Medical University, Jilin City, China
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23
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Zhao YL, Qu Y, Ou YN, Zhang YR, Tan L, Yu JT. Environmental factors and risks of cognitive impairment and dementia: A systematic review and meta-analysis. Ageing Res Rev 2021; 72:101504. [PMID: 34755643 DOI: 10.1016/j.arr.2021.101504] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Revised: 10/22/2021] [Accepted: 10/26/2021] [Indexed: 01/10/2023]
Abstract
BACKGROUND Dementia is a challenging neurodegenerative disease. This systematic review aimed to summarize natural, physical, and social environmental factors that are associated with age-related cognitive impairment and dementia. METHODS We systematically searched PubMed, EMBASE, Web of Science, and PsychINFO till January 11, 2021 for observational studies. The hazard ratio (HR), relative risk (RR), and odds ratio (OR) with 95% confidence interval (CI) were aggregated using random-effects methods. The quality of evidence for each association was evaluated. RESULTS Of the 48,399 publications identified, there were 185 suitable for review across 44 environmental factors. Meta-analyses were performed for 22 factors. With high-to-moderate quality of evidence, risks were suggested in exposure to PM2.5 (HR=1.24, 95%CI: 1.17-1.31), NO2 (HR=1.07, 95%CI: 1.02-1.12), aluminum (OR=1.35, 95%CI: 1.14-1.59), solvents (OR=1.14, 95%CI: 1.07-1.22), road proximity (OR=1.08, 95%CI: 1.04-1.12) and other air pollutions, yet more frequent social contact (HR=0.82, 95%CI: 0.76-0.90) and more greenness (OR=0.97, 95%CI: 0.95-0.995) were protective. With low-to-very low quality, electromagnetic fields, pesticides, SO2, neighborhood socioeconomic status, and rural living were suggested risks, but more community cultural engagement might be protective. No significant associations were observed in exposure to PM10, NOx, noise, silicon, community group, and temperature. For the remaining 22 factors, only a descriptive analysis was undertaken as too few studies or lack of information. CONCLUSIONS This review highlights that air pollutions, especially PM2.5 and NO2 play important role in the risk for age-related cognitive impairment and dementia.
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24
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Shon C, Yoon H. Health-economic burden of dementia in South Korea. BMC Geriatr 2021; 21:549. [PMID: 34645415 PMCID: PMC8515696 DOI: 10.1186/s12877-021-02526-x] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Accepted: 10/07/2021] [Indexed: 11/17/2022] Open
Abstract
Background This population-based study estimated the health-economic costs of dementia from a societal perspective using nationally representative data from 2015 to 2019 and analysed recent trends in Korea. Methods The prevalence of and mortality due to dementia were calculated using the National Health Insurance claims data and population census. The health-economic burden due to dementia was estimated using a prevalence-based approach, including the number of dementia patients and the number of deaths resulting from dementia during 2015–2019. The health-economic burden was presented separately as the national burden and the burden per capita by summing the direct and indirect costs. Results Between 2015 and 2019, the prevalence of dementia among the elderly aged 65 years or older based on clinical diagnosis increased from 5.9 to 7.3%, with approximately 588000 elderly dementia patients in Korea. The total health-economic cost of dementia increased by about 1.5 times in the last 5 years and was estimated to be about USD 4218 million. Direct costs were 52.0% in 2019, and the proportion has been steadily increasing over the past 5 years; indirect costs accounted for 48.0% of the total burden, mainly from family members and caregivers. The health-economic cost per capita due to dementia was approximately USD 6957. Conclusions The burden of dementia in Korea is expected to considerably increase alongside the elderly population in the future. Health policies addressing the prevention and management of dementia should be prioritised.
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Affiliation(s)
- Changwoo Shon
- Department of Urban Society Research, The Seoul Institute, 57 Nambusunhwan-ro, 340-gil, Seocho-gu, Seoul, 06756, Korea
| | - Hyejung Yoon
- Department of Urban Society Research, The Seoul Institute, 57 Nambusunhwan-ro, 340-gil, Seocho-gu, Seoul, 06756, Korea.
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25
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Golzari-Sorkheh M, Brown CE, Weaver DF, Reed MA. The NLRP3 Inflammasome in the Pathogenesis and Treatment of Alzheimer's Disease. J Alzheimers Dis 2021; 84:579-598. [PMID: 34569958 DOI: 10.3233/jad-210660] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Alzheimer's disease (AD) is the most common form of dementia. Although AD is one of the most socioeconomically devastating diseases confronting humanity, no "curative" disease modifying drug has been identified. Recent decades have witnessed repeated failures of drug trials and have called into question the utility of the amyloid hypothesis approach to AD therapeutics design. Accordingly, new neurochemical processes are being evaluated and explored as sources of alternative druggable targets. Among these newly identified targets, neuroinflammation is emerging as a front-runner, and within the realm of neuroinflammation, the inflammasome, particularly the NLRP3 complex, is garnering focussed attention. This review summarizes current data and approaches to understanding the role of the NLRP3 inflammasome in neuroinflammation and AD, and systematically identifies and evaluates multiple targets within the NLRP3 inflammasome cascade as putative drug targets.
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Affiliation(s)
| | | | - Donald F Weaver
- Krembil Research Institute, Toronto, ON, Canada.,Department of Chemistry, University of Toronto, Toronto, ON, Canada.,Department of Pharmaceutical Sciences, University of Toronto, Toronto, ON, Canada
| | - Mark A Reed
- Department of Pharmacology and Toxicology, University of Toronto, Toronto, ON, Canada.,Krembil Research Institute, Toronto, ON, Canada
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26
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Gonneaud J, Baria AT, Pichet Binette A, Gordon BA, Chhatwal JP, Cruchaga C, Jucker M, Levin J, Salloway S, Farlow M, Gauthier S, Benzinger TLS, Morris JC, Bateman RJ, Breitner JCS, Poirier J, Vachon-Presseau E, Villeneuve S. Accelerated functional brain aging in pre-clinical familial Alzheimer's disease. Nat Commun 2021; 12:5346. [PMID: 34504080 PMCID: PMC8429427 DOI: 10.1038/s41467-021-25492-9] [Citation(s) in RCA: 41] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Accepted: 08/06/2021] [Indexed: 01/02/2023] Open
Abstract
Resting state functional connectivity (rs-fMRI) is impaired early in persons who subsequently develop Alzheimer's disease (AD) dementia. This impairment may be leveraged to aid investigation of the pre-clinical phase of AD. We developed a model that predicts brain age from resting state (rs)-fMRI data, and assessed whether genetic determinants of AD, as well as beta-amyloid (Aβ) pathology, can accelerate brain aging. Using data from 1340 cognitively unimpaired participants between 18-94 years of age from multiple sites, we showed that topological properties of graphs constructed from rs-fMRI can predict chronological age across the lifespan. Application of our predictive model to the context of pre-clinical AD revealed that the pre-symptomatic phase of autosomal dominant AD includes acceleration of functional brain aging. This association was stronger in individuals having significant Aβ pathology.
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Affiliation(s)
- Julie Gonneaud
- Douglas Mental Health University Institute, McGill University, Montreal, QC, Canada.
- McConnell Brain Imaging Center, Montreal Neurological Institute, McGill University, Montreal, QC, Canada.
| | - Alex T Baria
- Douglas Mental Health University Institute, McGill University, Montreal, QC, Canada
| | - Alexa Pichet Binette
- Douglas Mental Health University Institute, McGill University, Montreal, QC, Canada
- McConnell Brain Imaging Center, Montreal Neurological Institute, McGill University, Montreal, QC, Canada
| | - Brian A Gordon
- Knight Alzheimer Disease Research Center, Washington University School of Medicine, St. Louis, MO, USA
| | - Jasmeer P Chhatwal
- Brigham and Women's Hospital-Massachusetts General Hospital, Boston, MA, USA
| | - Carlos Cruchaga
- Knight Alzheimer Disease Research Center, Washington University School of Medicine, St. Louis, MO, USA
| | - Mathias Jucker
- Hertie-Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany
| | - Johannes Levin
- Ludwig-Maximilians-Universität München, German Center for Neurodegenerative Diseases and Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
| | | | - Martin Farlow
- Department of Neurology, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Serge Gauthier
- Douglas Mental Health University Institute, McGill University, Montreal, QC, Canada
| | - Tammie L S Benzinger
- Knight Alzheimer Disease Research Center, Washington University School of Medicine, St. Louis, MO, USA
| | - John C Morris
- Knight Alzheimer Disease Research Center, Washington University School of Medicine, St. Louis, MO, USA
| | - Randall J Bateman
- Knight Alzheimer Disease Research Center, Washington University School of Medicine, St. Louis, MO, USA
| | - John C S Breitner
- Douglas Mental Health University Institute, McGill University, Montreal, QC, Canada
| | - Judes Poirier
- Douglas Mental Health University Institute, McGill University, Montreal, QC, Canada
| | - Etienne Vachon-Presseau
- Department of Anesthesia, Faculty of Medicine, McGill University, Montreal, QC, Canada
- Faculty of Dentistry, McGill University, Montreal, QC, Canada
- Alan Edwards Centre for Research on Pain, McGill University, Montreal, QC, Canada
| | - Sylvia Villeneuve
- Douglas Mental Health University Institute, McGill University, Montreal, QC, Canada.
- McConnell Brain Imaging Center, Montreal Neurological Institute, McGill University, Montreal, QC, Canada.
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27
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Appel AM, Brønnum-Hansen H, Garde AH, Hansen ÅM, Ishtiak-Ahmed K, Islamoska S, Mortensen EL, Nabe-Nielsen K. Socioeconomic Position and Late-Onset Dementia: A Nationwide Register-Based Study. J Aging Health 2021; 34:184-195. [PMID: 34388948 DOI: 10.1177/08982643211037200] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
OBJECTIVES Previous research on the association between socioeconomic position (SEP) and dementia has not sufficiently accounted for the complex relationship between education and occupation. We investigated the independent and joint effects of educational attainment and occupation-based SEP on dementia. METHODS We used register-based information about educational attainment, occupation-based SEP, and dementia from 1,210,720 individuals. Information about cognitive ability at conscription was available for a subsample of men. RESULTS When mutually adjusted, lower educational attainment and occupation-based SEP were associated with higher dementia risk in a dose-response manner. Higher occupation-based SEP partly mitigated the higher dementia risk associated with lower educational attainment. After adjusting for cognitive ability in a subgroup of men, only unskilled work was associated with higher dementia risk. DISCUSSION Occupation-based SEP is independently associated with dementia and may mitigate the higher dementia risk associated with short education. Future research should elucidate the mechanisms underlying social inequality in dementia.
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Affiliation(s)
- Andreas M Appel
- Department of Public Health, 4321University of Copenhagen, Copenhagen, Denmark.,Danish Dementia Research Centre, 53146Rigshospitalet, Copenhagen, Denmark
| | | | - Anne H Garde
- Department of Public Health, 4321University of Copenhagen, Copenhagen, Denmark.,2686The National Research Centre for the Working Environment, Copenhagen, Denmark
| | - Åse Marie Hansen
- Department of Public Health, 4321University of Copenhagen, Copenhagen, Denmark.,2686The National Research Centre for the Working Environment, Copenhagen, Denmark
| | - Kazi Ishtiak-Ahmed
- Department of Depression and Anxiety, 1006Aarhus University Hospital Psychiatry, Aarhus, Denmark.,Department of Clinical Medicine, 1006Aarhus University, Aarhus, Denmark
| | - Sabrina Islamoska
- Department of Public Health, 4321University of Copenhagen, Copenhagen, Denmark
| | - Erik L Mortensen
- Department of Public Health, 4321University of Copenhagen, Copenhagen, Denmark
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28
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Mooldijk SS, Licher S, Vinke EJ, Vernooij MW, Ikram MK, Ikram MA. Season of birth and the risk of dementia in the population-based Rotterdam Study. Eur J Epidemiol 2021; 36:497-506. [PMID: 34002295 PMCID: PMC8159812 DOI: 10.1007/s10654-021-00755-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Accepted: 04/20/2021] [Indexed: 11/29/2022]
Abstract
Early-life environmental factors have been suggested in the pathophysiology of dementia. Season of birth has previously been used as a proxy for these external exposures. We investigated the link between season of birth and the risk of dementia and further explored underlying pathways by studying structural brain changes on MRI. From the Dutch, population-based Rotterdam Study, 12,964 participants born between 1887 and 1960 were followed between 1990 and 2018 for dementia. Cox regression was conducted to assess the association between season of birth and dementia. In addition, we distinguished between mild and cold winters. The association of season of birth with structural brain markers on MRI was examined in 5237 participants. The risk of dementia in participants born in winter and fall was higher than of those born in summer (hazard ratio (HR) 1.15 [95% confidence interval (CI) 1.01–1.31] for winter and HR 1.17 [95% CI 1.01–1.33] for fall), especially for Alzheimer’s disease (HR 1.23 [1.06–1.43] for winter and HR 1.15 [95% CI 0.99–1.35] for fall). The risk was particularly increased for participants born in a cold winter. Except for slightly lower hippocampus in fall born participants (β − 0.03; 95% CI − 0.06 to 0.00), we did not find associations with brain imaging markers. In conclusion, winter and fall births were associated with a higher incidence of dementia, especially of AD. We did not find evidence for structural brain changes as an underlying mechanism.
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Affiliation(s)
- Sanne S Mooldijk
- Department of Epidemiology, Erasmus MC University Medical Center, PO Box 2040, 3000 CA, Rotterdam, The Netherlands
| | - Silvan Licher
- Department of Epidemiology, Erasmus MC University Medical Center, PO Box 2040, 3000 CA, Rotterdam, The Netherlands
| | - Elisabeth J Vinke
- Department of Epidemiology, Erasmus MC University Medical Center, PO Box 2040, 3000 CA, Rotterdam, The Netherlands.,Department of Radiology and Nuclear Medicine, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - Meike W Vernooij
- Department of Epidemiology, Erasmus MC University Medical Center, PO Box 2040, 3000 CA, Rotterdam, The Netherlands.,Department of Radiology and Nuclear Medicine, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - Mohammad Kamran Ikram
- Department of Epidemiology, Erasmus MC University Medical Center, PO Box 2040, 3000 CA, Rotterdam, The Netherlands.,Department of Neurology, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - Mohammad Arfan Ikram
- Department of Epidemiology, Erasmus MC University Medical Center, PO Box 2040, 3000 CA, Rotterdam, The Netherlands.
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Bauer EE, Shoeman A, Buhr TJ, Daniels KM, Lyte M, Clark PJ. Voluntary binge-patterned alcohol drinking and sex-specific influences on monoamine-related neurochemical signatures in the mouse gut and brain. Alcohol Clin Exp Res 2021; 45:996-1012. [PMID: 33704774 DOI: 10.1111/acer.14592] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2020] [Revised: 01/30/2021] [Accepted: 03/01/2021] [Indexed: 12/13/2022]
Abstract
BACKGROUND Altered monoamine (i.e., serotonin, dopamine, and norepinephrine) activity following episodes of alcohol abuse plays key roles not only in the motivation to ingest ethanol, but also physiological dysfunction related to its misuse. Although monoamine activity is essential for physiological processes that require coordinated communication across the gut-brain axis (GBA), relatively little is known about how alcohol misuse may affect monoamine levels across the GBA. Therefore, we evaluated monoamine activity across the mouse gut and brain following episodes of binge-patterned ethanol drinking. METHODS Monoamine and select metabolite neurochemical concentrations were analyzed by ultra-high-performance liquid chromatography in gut and brain regions of female and male C57BL/6J mice following "Drinking in the Dark" (DID), a binge-patterned ethanol ingestion paradigm. RESULTS First, we found that alcohol access had an overall small effect on gut monoamine-related neurochemical concentrations, primarily influencing dopamine activity. Second, neurochemical patterns between the small intestine and the striatum were correlated, adding to recent evidence of modulatory activity between these areas. Third, although alcohol access robustly influenced activity in brain areas in the mesolimbic dopamine system, binge exposure also influenced monoaminergic activity in the hypothalamic region. Finally, sex differences were observed in the concentrations of neurochemicals within the gut, which was particularly pronounced in the small intestine. CONCLUSION Together, these data provide insights into the influence of alcohol abuse and biological sex on monoamine-related neurochemical changes across the GBA, which could have important implications for GBA function and dysfunction.
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Affiliation(s)
- Ella E Bauer
- Department of Food Science and Human Nutrition, Iowa State University, Ames, IA, USA
| | - Allyse Shoeman
- Department of Food Science and Human Nutrition, Iowa State University, Ames, IA, USA
| | - Trevor J Buhr
- Department of Food Science and Human Nutrition, Iowa State University, Ames, IA, USA
| | - Karrie M Daniels
- Department of Veterinary Microbiology and Preventative Medicine, Iowa State University, Ames, IA, USA
| | - Mark Lyte
- Department of Veterinary Microbiology and Preventative Medicine, Iowa State University, Ames, IA, USA
| | - Peter J Clark
- Department of Food Science and Human Nutrition, Iowa State University, Ames, IA, USA
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Szejko N, Macul Ferreira de Barros P, Avila-Quintero VJ, Lombroso A, Bloch MH. Parental Age and the Risk for Alzheimer's Disease in Offspring: Systematic Review and Meta-Analysis. Dement Geriatr Cogn Dis Extra 2021; 11:140-150. [PMID: 34178019 PMCID: PMC8216010 DOI: 10.1159/000515523] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Accepted: 02/20/2021] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Alzheimer's disease (AD) is the most common cause of dementia worldwide, accounting for 50-75% of all cases. While older maternal and paternal age at childbirth are established risk factors for Down syndrome which is associated with later AD, it is still not entirely clear whether parental age is a risk factor for AD. Previous studies have suggested contradictory findings. OBJECTIVES We conducted a systematic review and meta-analysis to examine whether parental (maternal and paternal) age at birth was associated with AD and whether individuals born to younger or older parents were at an increased risk for AD. METHODS Two reviewers searched the electronic database of PubMed for relevant studies. Eligibility for the meta-analysis was based on the following criteria: (1) studies involving patients with AD and an adequate control group, (2) case control or cohort studies, (3) studies investigating parental age. All statistical analyses were completed in STATA/IC version 16. RESULTS Eleven studies involving 4,371 participants were included in the systematic review and meta-analysis. Meta-analysis demonstrated no significant association between maternal (weighted mean difference [WMD] 0.49, 95% CI -0.52 to 1.49, p = 0.34) and paternal age and AD (WMD 1.00, 95% CI -0.55 to 2.56, p = 0.21). Similarly, individuals born to younger (<25 years) or older parents (>35 years) did not demonstrate a differential risk for AD. CONCLUSIONS Overall, this meta-analysis did not demonstrate an association between parental age and the risk of AD in offspring. These findings should be interpreted with caution given the limited power of the overall meta-analysis and the methodological limitations of the underlying studies as in many cases no adjustment for potential confounders was included.
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Affiliation(s)
- Natalia Szejko
- Department of Neurology, Medical University of Warsaw, Warsaw, Poland
- Department of Bioethics, Medical University of Warsaw, Warsaw, Poland
- Department of Neurology, Yale University School of Medicine, New Haven, Connecticut, USA
| | | | | | - Adam Lombroso
- Yale Child Study Center, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Michael Howard Bloch
- Yale Child Study Center, Yale University School of Medicine, New Haven, Connecticut, USA
- Yale Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut, USA
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31
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Somaa F. A Review of the Application of Hyperbaric Oxygen Therapy in Alzheimer's Disease. J Alzheimers Dis 2021; 81:1361-1367. [PMID: 33935095 DOI: 10.3233/jad-210157] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Alzheimer's disease (AD) is considered as the most common cause of dementia in elderly population. While the exact mechanism of AD has not been discovered, hyperbolic oxygen therapy (HBOT) has been proven to be effective in the treatment of this degenerative disease. The objectives of this article are to review the literature available on molecular and physiological mechanisms underlying HBOT and its efficacy in treating AD and to review the effectiveness of HBOT as an alternate treatment intervention in both human and animal models. 391 full text articles were included in the review after literature search between 1980-2021 from two online data base (ScienceDirect and PubMed). The following key words were used: 'hyperbaric oxygen therapy' and 'Alzheimer disease.' Based on the outcomes of clinical and experimental studies, this review advocates the use of HBOT for the treatment of AD. This review explores future directions and recommends further research into a treatment protocol that will maintain long-term cognitive health of AD patients.
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Affiliation(s)
- Fahad Somaa
- Occupational Therapy Department, Faculty of Medical Rehabilitation Sciences, King AbdulAziz University, Jeddah, Saudi Arabia
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32
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Abstract
This article describes the public health impact of Alzheimer's disease (AD), including incidence and prevalence, mortality and morbidity, use and costs of care, and the overall impact on caregivers and society. The Special Report discusses the challenges of providing equitable health care for people with dementia in the United States. An estimated 6.2 million Americans age 65 and older are living with Alzheimer's dementia today. This number could grow to 13.8 million by 2060 barring the development of medical breakthroughs to prevent, slow or cure AD. Official death certificates recorded 121,499 deaths from AD in 2019, the latest year for which data are available, making Alzheimer's the sixth-leading cause of death in the United States and the fifth-leading cause of death among Americans age 65 and older. Between 2000 and 2019, deaths from stroke, heart disease and HIV decreased, whereas reported deaths from AD increased more than 145%. This trajectory of deaths from AD was likely exacerbated in 2020 by the COVID-19 pandemic. More than 11 million family members and other unpaid caregivers provided an estimated 15.3 billion hours of care to people with Alzheimer's or other dementias in 2020. These figures reflect a decline in the number of caregivers compared with a decade earlier, as well as an increase in the amount of care provided by each remaining caregiver. Unpaid dementia caregiving was valued at $256.7 billion in 2020. Its costs, however, extend to family caregivers' increased risk for emotional distress and negative mental and physical health outcomes - costs that have been aggravated by COVID-19. Average per-person Medicare payments for services to beneficiaries age 65 and older with AD or other dementias are more than three times as great as payments for beneficiaries without these conditions, and Medicaid payments are more than 23 times as great. Total payments in 2021 for health care, long-term care and hospice services for people age 65 and older with dementia are estimated to be $355 billion. Despite years of efforts to make health care more equitable in the United States, racial and ethnic disparities remain - both in terms of health disparities, which involve differences in the burden of illness, and health care disparities, which involve differences in the ability to use health care services. Blacks, Hispanics, Asian Americans and Native Americans continue to have a higher burden of illness and lower access to health care compared with Whites. Such disparities, which have become more apparent during COVID-19, extend to dementia care. Surveys commissioned by the Alzheimer's Association recently shed new light on the role of discrimination in dementia care, the varying levels of trust between racial and ethnic groups in medical research, and the differences between groups in their levels of concern about and awareness of Alzheimer's disease. These findings emphasize the need to increase racial and ethnic diversity in both the dementia care workforce and in Alzheimer's clinical trials.
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Feng YS, Tan ZX, Wu LY, Dong F, Zhang F. The involvement of NLRP3 inflammasome in the treatment of Alzheimer's disease. Ageing Res Rev 2020; 64:101192. [PMID: 33059089 DOI: 10.1016/j.arr.2020.101192] [Citation(s) in RCA: 113] [Impact Index Per Article: 28.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2020] [Revised: 09/04/2020] [Accepted: 10/05/2020] [Indexed: 12/12/2022]
Abstract
Alzheimer's disease (AD) is one of the most common neurodegenerative diseases, and it is characterised by progressive deterioration in cognitive and memory abilities, which can severely influence the elderly population's daily living abilities. Although researchers have made great efforts in the field of AD, there are still no well-established strategies to prevent and treat this disease. Therefore, better clarification of the molecular mechanisms associated with the onset and progression of AD is critical to provide a theoretical basis for the establishment of novel preventive and therapeutic strategies. Currently, it is generally believed that neuroinflammation plays a key role in the pathogenesis of AD. Inflammasome, a multiprotein complex, is involved in the innate immune system, and it can mediate inflammatory responses and pyroptosis, which lead to neurodegeneration. Among the various types of inflammasomes, the NLRP3 inflammasome is the most characterised in neurodegenerative diseases, especially in AD. The activation of the NLRP3 inflammasome causes the generation of caspase-1-mediated interleukin (IL)-1β and IL-18 in microglia cells, where neuroinflammation is involved in the development and progression of AD. Thus, the NLRP3 inflammasome is likely to be a crucial therapeutic molecular target for AD via regulating neuroinflammation. In this review, we summarise the current knowledge on the role and regulatory mechanisms of the NLRP3 inflammasome in the pathogenic mechanisms of AD. We also focus on a series of potential therapeutic treatments targeting NLRP3 inflammasome for AD. Further clarification of the regulatory mechanisms of the NLRP3 inflammasome in AD may provide more useful clues to develop novel AD treatment strategies.
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Kamal H, Tan GC, Ibrahim SF, Shaikh MF, Mohamed IN, Mohamed RMP, Hamid AA, Ugusman A, Kumar J. Alcohol Use Disorder, Neurodegeneration, Alzheimer's and Parkinson's Disease: Interplay Between Oxidative Stress, Neuroimmune Response and Excitotoxicity. Front Cell Neurosci 2020; 14:282. [PMID: 33061892 PMCID: PMC7488355 DOI: 10.3389/fncel.2020.00282] [Citation(s) in RCA: 75] [Impact Index Per Article: 18.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Accepted: 08/10/2020] [Indexed: 12/12/2022] Open
Abstract
Alcohol use disorder (AUD) has been associated with neurodegenerative diseases such as Alzheimer's and Parkinson's disease. Prolonged excessive alcohol intake contributes to increased production of reactive oxygen species that triggers neuroimmune response and cellular apoptosis and necrosis via lipid peroxidation, mitochondrial, protein or DNA damage. Long term binge alcohol consumption also upregulates glutamate receptors, glucocorticoids and reduces reuptake of glutamate in the central nervous system, resulting in glutamate excitotoxicity, and eventually mitochondrial injury and cell death. In this review, we delineate the following principles in alcohol-induced neurodegeneration: (1) alcohol-induced oxidative stress, (2) neuroimmune response toward increased oxidants and lipopolysaccharide, (3) glutamate excitotoxicity and cell injury, and (4) interplay between oxidative stress, neuroimmune response and excitotoxicity leading to neurodegeneration and (5) potential chronic alcohol intake-induced development of neurodegenerative diseases, including Alzheimer's and Parkinson's disease.
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Affiliation(s)
- Haziq Kamal
- Department of Physiology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Geok Chin Tan
- Department of Pathology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Siti Fatimah Ibrahim
- Department of Physiology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Mohd. Farooq Shaikh
- Neuropharmacology Research Laboratory, Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Selangor, Malaysia
| | - Isa Naina Mohamed
- Department of Pharmacology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Rashidi M. Pakri Mohamed
- Department of Family Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Adila A. Hamid
- Department of Physiology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Azizah Ugusman
- Department of Physiology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Jaya Kumar
- Department of Physiology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
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35
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Alzheimer's disease; a review of the pathophysiological basis and therapeutic interventions. Life Sci 2020; 256:117996. [PMID: 32585249 DOI: 10.1016/j.lfs.2020.117996] [Citation(s) in RCA: 111] [Impact Index Per Article: 27.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Revised: 06/14/2020] [Accepted: 06/14/2020] [Indexed: 12/11/2022]
Abstract
Alzheimer's disease (AD) is a neurodegenerative disorder and is identified as the most common cause for dementia. Despite huge global economic burden and the impact on the close family of the patients, there is no definitive cure and thus, improved treatment methods are of need. While memory and cognition are severely affected in AD, exact etiology is yet unknown. The β-Amyloid plaque formation and aggregation hypothesis is among the well-known hypotheses used to explain disease pathogenesis. Currently there are five Food and Drug Administration (FDA) approved drugs as treatment options. All these drugs are used for symptomatic treatment of AD. Thus, disease modifying therapies which can directly address the pathological changes in AD, are needed. Such therapies could be designed based on inhibiting key steps of pathogenesis. Currently there are novel AD drug candidates with various therapeutic mechanisms, undergoing different stages of drug development. Extensive research is being done globally to broaden understanding of the exact mechanisms involved in AD and to develop therapeutic agents that can successfully hinder the occurrence and progression of the disease. In this review, a comprehensive approach to understanding AD and suggestions to be considered in the development of therapeutics for it are presented.
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36
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Echlin HV, Gorbet DJ, Sergio LE. Assessment of a Cognitive-Motor Training Program in Adults at Risk for Developing Dementia. Can Geriatr J 2020; 23:190-198. [PMID: 32494335 PMCID: PMC7259920 DOI: 10.5770/cgj.23.394] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023] Open
Abstract
Background With the prevalence of dementia increasing each year, pre-clinically implemented therapeutic interventions are needed. It has been suggested that cascading neural network failures may bring on behavioural deficits associated with Alzheimer’s disease. Methods Previously we have shown that cognitive-motor integration (CMI) training in adults with cognitive impairments generalized to improved global cognitive and activities of daily living scores. Here we employ a novel movement control–based training approach involving CMI rather than traditional cognition-only brain training. We hypothesized that such training would stimulate widespread neural networks and enhance rule-based visuomotor ability in at-risk individuals. Results We observed a significant improvement in bimanual coordination in the at-risk training group. We also observed significant decreases in movement variability for the most complex CMI condition in the at-risk and healthy training groups. Conclusions These data suggest that integrating cognition into action in a training intervention may be effective at strengthening vulnerable brain networks in asymptomatic adults at risk for developing dementia.
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Affiliation(s)
- Holly V Echlin
- School of Kinesiology and Health Science, Faculty of Health, York University, Toronto, ON, Canada
| | - Diana J Gorbet
- School of Kinesiology and Health Science, Faculty of Health, York University, Toronto, ON, Canada
| | - Lauren E Sergio
- School of Kinesiology and Health Science, Faculty of Health, York University, Toronto, ON, Canada
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Wilson B, Geetha KM. Neurotherapeutic applications of nanomedicine for treating Alzheimer's disease. J Control Release 2020; 325:25-37. [PMID: 32473177 DOI: 10.1016/j.jconrel.2020.05.044] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2020] [Revised: 05/25/2020] [Accepted: 05/26/2020] [Indexed: 01/30/2023]
Abstract
Alzheimer's disease (AD) is a progressive, irreversible, fatal brain disease which disturbs cognitive functions. It affects 35 million people worldwide and the number of people suffering may increase to 100 million by 2050 if no effective treatments are available. The present treatment improves cognitive functions and provide temporary symptomatic relief, but do not stop or delay the disease progression. Moreover, they are mainly available as conventional oral dosage forms and these conventional oral medications lack brain specificity and also produce side effects which leads to poor patient compliance. Brain drug targeting by nanomedicines is a promising approach to improve brain targeting specificity, brain bioavailability and patient compliance. The present review discuses about the currently available pharmacotherapy for AD and the neurotherapeutic applications as well as the advancements of nanomedicine for treating AD. It also highlights the recent advancements of various nanomedicines containing phytopharmaceuticals for treating AD. It is believed that nanomedicines containing approved drugs can be transformed into the clinics hence improve the life style of AD patients.
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Affiliation(s)
- Barnabas Wilson
- Department of Pharmaceutics, College of Pharmaceutical Sciences, Dayananda Sagar University, Kumaraswamy Layout, Bangalore, Karnataka 560078, India.
| | - Kannoth Mukundan Geetha
- Department of Pharmacology, College of Pharmaceutical Sciences, Dayananda Sagar University, Kumaraswamy Layout, Bangalore, Karnataka 560078, India
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Ptok U, Papassotiropoulos A, Maier W, Heun R. Seasonal distribution of births in patients with Alzheimer’s disease and elderly depressive patients. Eur Psychiatry 2020; 16:157-61. [PMID: 11353593 DOI: 10.1016/s0924-9338(01)00557-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Abstract
SummaryWinter births have been associated with a higher risk of Alzheimer’s disease (AD) and other psychiatric disorders. In the present investigation, this putative association was examined in a sample of gerontopsychiatric patients. An analysis of the quarterly birth rates of 83 patients with AD, 78 elderly depressive patients with an early onset and 74 patients with a late onset of the depressive disorder, 48 patients with both AD and depression (co-morbid patients) and 107 healthy control subjects, revealed no particular seasonal distribution for any of the diagnostic groups. In AD and co-morbid patients, controlling for the ApoE genotype did not change this finding. Logistic regression analysis revealed the expected findings that increasing age and the presence of the ApoE4 allele were associated with a higher risk of dementia. Younger age and female gender were identified as risk factors for a depressive disorder. A winter birth (birth in the first three months of the year) was not associated with any of the diagnostic subgroups.We concluded that in our sample a seasonal distribution of births was not found to increase the risk for AD or geriatric depression.
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Affiliation(s)
- U Ptok
- Department of Psychiatry, University of Bonn, Sigmund-Freud-St. 25 53105, Bonn, Germany.
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Disrupted functional connectivity of the locus coeruleus in healthy adults with parental history of Alzheimer's disease. J Psychiatr Res 2020; 123:81-88. [PMID: 32044590 DOI: 10.1016/j.jpsychires.2020.01.018] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2019] [Revised: 01/27/2020] [Accepted: 01/27/2020] [Indexed: 01/18/2023]
Abstract
Prevention and early treatment strategies for Alzheimer's disease (AD) are hampered by the lack of research biomarkers. Neuropathological changes in the Locus Coeruleus (LC) are detected early in AD, and noradrenaline plays a neuroprotective role in LC projecting areas. We assessed functional connectivity (FC) of the brainstem in asymptomatic individuals at familial risk for AD hypothesizing that FC of the LC will be decreased in relation to not-at-risk individuals. Thirty-one offspring of patients with late-onset AD (O-LOAD) (22 females; mean age ± SD = 50.36 ± 8.32) and 28 healthy controls (HC) (20 females; mean age ± SD = 53.90 ± 8.44) underwent a neurocognitive evaluation and a resting-state functional magnetic resonance imaging acquisition. In FC analyses we evaluated whole-brain global connectivity of the brainstem area, and subsequently assessed seed-to-voxel FC patterns from regions showing between-group differences. O-LOAD individuals scored worse in neurocognitive measures of memory and overall functioning (pFDR<0.05). In imaging analyses, we observed that O-LOAD individuals showed decreased global connectivity in a cluster encompassing the left LC (peak = -4, -34, -32, pTFCE<0.05). Seed-to-voxel analyses revealed that this finding was largely explained by decreased connectivity between the LC and the cerebellar cortex. Moreover, FC between the LC and the left cerebellum correlated positively with delayed recall scores. FC between the LC and the cerebellar cortex is decreased in the healthy offspring of patients with LOAD, such connectivity measurements being associated with delayed memory scores. The assessment of FC between the LC and the cerebellum may serve as a biomarker of AD vulnerability.
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40
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Yang HJ, Kang NR, Jung YE, Kim MD, Jeong HG, Lee TJ, Han JW, Kim KW, Park JH. "Choosing Wisely": Apolipoprotein E Genetic Testing for the Diagnosis of Alzheimer's Disease in Dementia Clinics. J Alzheimers Dis 2020; 74:1253-1260. [PMID: 32176640 DOI: 10.3233/jad-190983] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Apolipoprotein E (APOE) ɛ4 allele carriers have an increased risk of late-onset Alzheimer's disease (AD). However, in the "Choosing Wisely" campaign for avoiding unnecessary medical tests, treatments, and procedures, APOE genetic testing is not recommended as a predictive test for AD. OBJECTIVE The aim of this study was to investigate the potential value of APOE genetic testing in a specific clinical context. METHODS Subjects with poor performance in the Korean version of the Mini-Mental Status Examination for dementia screening (MMSE-DS) with a Z-score of less than -1.5 were recruited from the public health centers. All participants underwent APOE genetic testing. Family history of dementia (FHx) was confirmed if one or more first-degree relatives had dementia. RESULTS Among 349 subjects, 162 (46.4%) were diagnosed with AD. APOEɛ4 allele carriers had a much higher risk of AD in the group with FHx than in the group without FHx (OR = 15.81, 95% CI = 2.74-91.21 versus OR = 1.82, 95% CI = 1.00-3.27, z = 2.293, p = 0.011). The sensitivity, specificity, positive predictive value, and negative predictive value for the APOEɛ4 allele were 47.7%, 90.9%, 91.3%, and 46.5% in the group with FHx. CONCLUSION It would be a wise choice to perform the APOE genetic testing for the diagnosis of AD in subjects with poor performance in a screening test and a family history of dementia.
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Affiliation(s)
- Hyun Ju Yang
- Department of Neuropsychiatry, Jeju National University Hospital, Jeju, Korea
| | - Na Ri Kang
- Department of Neuropsychiatry, Jeju National University Hospital, Jeju, Korea.,Department of Neuropsychiatry, Jeju National University School of Medicine, Jeju, Korea
| | - Young Eun Jung
- Department of Neuropsychiatry, Jeju National University Hospital, Jeju, Korea.,Department of Neuropsychiatry, Jeju National University School of Medicine, Jeju, Korea
| | - Moon Doo Kim
- Department of Neuropsychiatry, Jeju National University Hospital, Jeju, Korea.,Department of Neuropsychiatry, Jeju National University School of Medicine, Jeju, Korea
| | - Hyun Ghang Jeong
- Department of Neuropsychiatry, Korea University College of Medicine, Seoul, Korea
| | - Tae Jin Lee
- Department of Public Health Science, Seoul National University, Seoul, Korea
| | - Ji Won Han
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Gyeonggido, Korea
| | - Ki Woong Kim
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Gyeonggido, Korea.,Department of Psychiatry, Seoul National University, College of Medicine, Seoul, Korea.,Department of Brain and Cognitive Sciences, Seoul National University, College of Natural Sciences, Seoul, Korea
| | - Joon Hyuk Park
- Department of Neuropsychiatry, Jeju National University Hospital, Jeju, Korea.,Department of Neuropsychiatry, Jeju National University School of Medicine, Jeju, Korea
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Abstract
This article describes the public health impact of Alzheimer's disease (AD), including incidence and prevalence, mortality and morbidity, use and costs of care, and the overall impact on caregivers and society. The Special Report discusses the future challenges of meeting care demands for the growing number of people living with Alzheimer's dementia in the United States with a particular emphasis on primary care. By mid-century, the number of Americans age 65 and older with Alzheimer's dementia may grow to 13.8 million. This represents a steep increase from the estimated 5.8 million Americans age 65 and older who have Alzheimer's dementia today. Official death certificates recorded 122,019 deaths from AD in 2018, the latest year for which data are available, making Alzheimer's the sixth leading cause of death in the United States and the fifth leading cause of death among Americans age 65 and older. Between 2000 and 2018, deaths resulting from stroke, HIV and heart disease decreased, whereas reported deaths from Alzheimer's increased 146.2%. In 2019, more than 16 million family members and other unpaid caregivers provided an estimated 18.6 billion hours of care to people with Alzheimer's or other dementias. This care is valued at nearly $244 billion, but its costs extend to family caregivers' increased risk for emotional distress and negative mental and physical health outcomes. Average per-person Medicare payments for services to beneficiaries age 65 and older with AD or other dementias are more than three times as great as payments for beneficiaries without these conditions, and Medicaid payments are more than 23 times as great. Total payments in 2020 for health care, long-term care and hospice services for people age 65 and older with dementia are estimated to be $305 billion. As the population of Americans living with Alzheimer's dementia increases, the burden of caring for that population also increases. These challenges are exacerbated by a shortage of dementia care specialists, which places an increasing burden on primary care physicians (PCPs) to provide care for people living with dementia. Many PCPs feel underprepared and inadequately trained to handle dementia care responsibilities effectively. This report includes recommendations for maximizing quality care in the face of the shortage of specialists and training challenges in primary care.
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Araya-Quintanilla F, Gutiérrez-Espinoza H, Sánchez-Montoya U, Muñoz-Yañez M, Baeza-Vergara A, Petersen-Yanjarí M, Fernández-Lecaros L. Effectiveness of omega-3 fatty acid supplementation in patients with Alzheimer disease: A systematic review and meta-analysis. NEUROLOGÍA (ENGLISH EDITION) 2020. [DOI: 10.1016/j.nrleng.2017.07.014] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
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Prolonged isolation stress accelerates the onset of Alzheimer’s disease-related pathology in 5xFAD mice despite running wheels and environmental enrichment. Behav Brain Res 2020; 379:112366. [DOI: 10.1016/j.bbr.2019.112366] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2019] [Revised: 11/14/2019] [Accepted: 11/14/2019] [Indexed: 02/06/2023]
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Co-occurrence of cognitive impairment and physical frailty, and incidence of dementia: Systematic review and meta-analysis. Neurosci Biobehav Rev 2019; 107:96-103. [DOI: 10.1016/j.neubiorev.2019.09.001] [Citation(s) in RCA: 45] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2018] [Revised: 08/16/2019] [Accepted: 09/01/2019] [Indexed: 12/11/2022]
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Meyer PF, McSweeney M, Gonneaud J, Villeneuve S. AD molecular: PET amyloid imaging across the Alzheimer's disease spectrum: From disease mechanisms to prevention. PROGRESS IN MOLECULAR BIOLOGY AND TRANSLATIONAL SCIENCE 2019; 165:63-106. [PMID: 31481172 DOI: 10.1016/bs.pmbts.2019.05.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
The advent of amyloid-beta (Aβ) positron emission tomography (PET) imaging has transformed the field of Alzheimer's disease (AD) by enabling the quantification of cortical Aβ accumulation and propagation in vivo. This revolutionary tool has made it possible to measure direct associations between Aβ and other AD biomarkers, to identify factors that influence Aβ accumulation and to redefine entry criteria into clinical trials as well as measure drug target engagement. This chapter summarizes the main findings on the associations of Aβ with other biomarkers of disease progression across the AD spectrum. It discusses investigations of the timing at which Aβ pathology starts to accumulate, demonstrates the clinical utility of Aβ PET imaging and discusses some ethical implications. Finally, it presents genetic and potentially modifiable lifestyle factors that might influence Aβ accumulation and therefore be targets for AD prevention.
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Affiliation(s)
- Pierre-François Meyer
- Centre for Studies on the Prevention of Alzheimer's Disease, Douglas Mental Health University Institute, Montréal, Canada; McGill University, Montréal, Canada
| | - Melissa McSweeney
- Centre for Studies on the Prevention of Alzheimer's Disease, Douglas Mental Health University Institute, Montréal, Canada; McGill University, Montréal, Canada
| | - Julie Gonneaud
- Centre for Studies on the Prevention of Alzheimer's Disease, Douglas Mental Health University Institute, Montréal, Canada; McGill University, Montréal, Canada
| | - Sylvia Villeneuve
- Centre for Studies on the Prevention of Alzheimer's Disease, Douglas Mental Health University Institute, Montréal, Canada; McGill University, Montréal, Canada.
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Liebsch F, Kulic L, Teunissen C, Shobo A, Ulku I, Engelschalt V, Hancock MA, van der Flier WM, Kunach P, Rosa-Neto P, Scheltens P, Poirier J, Saftig P, Bateman RJ, Breitner J, Hock C, Multhaup G. Aβ34 is a BACE1-derived degradation intermediate associated with amyloid clearance and Alzheimer's disease progression. Nat Commun 2019; 10:2240. [PMID: 31110178 PMCID: PMC6527709 DOI: 10.1038/s41467-019-10152-w] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2018] [Accepted: 04/17/2019] [Indexed: 12/13/2022] Open
Abstract
The beta-site APP cleaving enzyme 1 (BACE1) is known primarily for its initial cleavage of the amyloid precursor protein (APP), which ultimately leads to the generation of Aβ peptides. Here, we provide evidence that altered BACE1 levels and activity impact the degradation of Aβ40 and Aβ42 into a common Aβ34 intermediate. Using human cerebrospinal fluid (CSF) samples from the Amsterdam Dementia Cohort, we show that Aβ34 is elevated in individuals with mild cognitive impairment who later progressed to dementia. Furthermore, Aβ34 levels correlate with the overall Aβ clearance rates in amyloid positive individuals. Using CSF samples from the PREVENT-AD cohort (cognitively normal individuals at risk for Alzheimer’s disease), we further demonstrate that the Aβ34/Aβ42 ratio, representing Aβ degradation and cortical deposition, associates with pre-clinical markers of neurodegeneration. We propose that Aβ34 represents a marker of amyloid clearance and may be helpful for the characterization of Aβ turnover in clinical samples. Aβ34 is generated from degradation of Aβ40 and Aβ42 by β-secretase. Here, the authors show that Aβ34 is a marker for amyloid clearance and is elevated in the CSF of patients that go on to convert from mild cognitive impairment to Alzheimer’s disease, suggesting it may be a useful biomarker.
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Affiliation(s)
- Filip Liebsch
- Department of Pharmacology and Therapeutics and Integrated Program in Neuroscience, McGill University, Montreal, QC, H3G 1Y6, Canada
| | - Luka Kulic
- Institute for Regenerative Medicine, University of Zurich, CH-8952, Schlieren, Switzerland
| | - Charlotte Teunissen
- Department of Clinical Chemistry, Amsterdam Neuroscience, Amsterdam UMC, Vrije Universiteit Amsterdam, 1081HZ, Amsterdam, The Netherlands
| | - Adeola Shobo
- Department of Pharmacology and Therapeutics and Integrated Program in Neuroscience, McGill University, Montreal, QC, H3G 1Y6, Canada
| | - Irem Ulku
- Department of Pharmacology and Therapeutics and Integrated Program in Neuroscience, McGill University, Montreal, QC, H3G 1Y6, Canada
| | - Vivienne Engelschalt
- Institut für Chemie und Biochemie, Freie Universität Berlin, 14195, Berlin, Germany
| | - Mark A Hancock
- SPR-MS Facility, McGill University, Montreal, QC, H3G 1Y6, Canada
| | - Wiesje M van der Flier
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, 1081HZ, The Netherlands
| | - Peter Kunach
- Translational Neuroimaging Laboratory, The McGill University Research Centre for Studies in Aging, Alzheimer's Disease Research Unit, Douglas Research Institute, McGill University, Montreal, H4H 1R3, QC, Canada
| | - Pedro Rosa-Neto
- Translational Neuroimaging Laboratory, The McGill University Research Centre for Studies in Aging, Alzheimer's Disease Research Unit, Douglas Research Institute, McGill University, Montreal, H4H 1R3, QC, Canada
| | - Philip Scheltens
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, 1081HZ, The Netherlands
| | - Judes Poirier
- Department of Psychiatry, McGill University, Montreal, QC, H4H 1R3, Canada
| | - Paul Saftig
- Biochemisches Institut, Christian-Albrechts-Universität-Kiel, 24118, Kiel, Germany
| | - Randall J Bateman
- Department of Neurology, Washington University in St. Louis, St. Louis, MO, 63110, USA
| | - John Breitner
- Department of Psychiatry, McGill University, Montreal, QC, H4H 1R3, Canada
| | - Christoph Hock
- Institute for Regenerative Medicine, University of Zurich, CH-8952, Schlieren, Switzerland.,Neurimmune, CH-8952, Schlieren, Switzerland
| | - Gerhard Multhaup
- Department of Pharmacology and Therapeutics and Integrated Program in Neuroscience, McGill University, Montreal, QC, H3G 1Y6, Canada.
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Rochoy M, Gautier S, Béné J, Bordet R, Chazard E. Evolution of Dementia Related to the Use of Alcohol in the French Nationwide Discharge Summary Database Between 2007 and 2017. Am J Alzheimers Dis Other Demen 2019; 34:188-192. [PMID: 30595024 PMCID: PMC10852432 DOI: 10.1177/1533317518822043] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND The French nationwide exhaustive hospital discharge database (PMSI) is used for activity-based payment of hospital services. We hypothesized that the release of articles about alcohol and dementia could influence the identification of these diagnoses in PMSI. METHODS We analyzed temporal evolution of coding for dementia and other persistent or late-onset cognitive impairment (OPLOCI) due to alcohol and other psychoactive substances in the PMSI database from 2007 to 2017 (285 748 938 inpatient stays). These codings use the International Classification of Diseases, 10th revision (ICD-10). RESULTS The number of inpatient stays with dementia and OPLOCI due to alcohol increased from 34 to 1704 from 2007 to 2017. While the number of diagnosed dementias remained stable at around 400 from 2013, the number of OPLOCIs increased 10-fold from 2013 to 2017. This increase was not found with dementia or OPLOCI due to other psychoactive substances than alcohol. CONCLUSION Notoriety of a diagnosis in the literature seems to have an impact on the coding.
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Affiliation(s)
- Michaël Rochoy
- Univ. Lille, Lille, France
- INSERM, U1171-Degenerative and Vascular Cognitive Disorders, Lille, France
- EA2694, Public Health Department, Lille, France
| | - Sophie Gautier
- Univ. Lille, Lille, France
- INSERM, U1171-Degenerative and Vascular Cognitive Disorders, Lille, France
| | - Johana Béné
- Univ. Lille, Lille, France
- INSERM, U1171-Degenerative and Vascular Cognitive Disorders, Lille, France
| | - Régis Bordet
- Univ. Lille, Lille, France
- INSERM, U1171-Degenerative and Vascular Cognitive Disorders, Lille, France
| | - Emmanuel Chazard
- Univ. Lille, Lille, France
- EA2694, Public Health Department, Lille, France
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Meyer PF, Tremblay-Mercier J, Leoutsakos J, Madjar C, Lafaille-Magnan ME, Savard M, Rosa-Neto P, Poirier J, Etienne P, Breitner J. INTREPAD: A randomized trial of naproxen to slow progress of presymptomatic Alzheimer disease. Neurology 2019; 92:e2070-e2080. [PMID: 30952794 PMCID: PMC6512884 DOI: 10.1212/wnl.0000000000007232] [Citation(s) in RCA: 54] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2018] [Accepted: 01/07/2019] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To evaluate the safety and efficacy of low-dose naproxen for prevention of progression in presymptomatic Alzheimer disease (AD) among cognitively intact persons at risk. METHODS Investigation of Naproxen Treatment Effects in Pre-symptomatic Alzheimer's Disease (INTREPAD), a 2-year double-masked pharmaco-prevention trial, enrolled 195 AD family history-positive elderly (mean age 63 years) participants screened carefully to exclude cognitive disorder (NCT-02702817). These were randomized 1:1 to naproxen sodium 220 mg twice daily or placebo. Multimodal imaging, neurosensory, cognitive, and (in ∼50%) CSF biomarker evaluations were performed at baseline, 3, 12, and 24 months. A modified intent-to-treat analysis considered 160 participants who remained on-treatment through their first follow-up examination. The primary outcome was rate of change in a multimodal composite presymptomatic Alzheimer Progression Score (APS). RESULTS Naproxen-treated individuals showed a clear excess of adverse events. Among treatment groups combined, the APS increased by 0.102 points/year (SE 0.014; p < 10-12), but rate of change showed little difference by treatment assignment (0.019 points/year). The treatment-related rate ratio of 1.16 (95% confidence interval 0.64-1.96) suggested that naproxen does not reduce the rate of APS progression by more than 36%. Secondary analyses revealed no notable treatment effects on individual CSF, cognitive, or neurosensory biomarker indicators of progressive presymptomatic AD. CONCLUSIONS In cognitively intact individuals at risk, sustained treatment with naproxen sodium 220 mg twice daily increases frequency of adverse health effects but does not reduce apparent progression of presymptomatic AD. CLASSIFICATION OF EVIDENCE This study provides Class I evidence that, for people who are cognitively intact, low-dose naproxen does not significantly reduce progression of a composite indicator of presymptomatic AD.
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Affiliation(s)
- Pierre-François Meyer
- From the McGill Centre for Integrative Neuroscience, Montreal Neurological Institute (C.M.), and McGill University Research Centre for Studies in Aging (M.S., P.R.-N.), McGill University (P.-F.M., M.-E.L.-M., P.R.-N., J.P., P.E., J.B.); StoP-AD Centre (P.-F.M., J.T.-M., M.-E.L.-M., P.R.-N., J.P., P.E., J.B.), Douglas Mental Health University Institute Research Centre, Montréal, Canada; and John Hopkins University (J.L.), Baltimore, MD
| | - Jennifer Tremblay-Mercier
- From the McGill Centre for Integrative Neuroscience, Montreal Neurological Institute (C.M.), and McGill University Research Centre for Studies in Aging (M.S., P.R.-N.), McGill University (P.-F.M., M.-E.L.-M., P.R.-N., J.P., P.E., J.B.); StoP-AD Centre (P.-F.M., J.T.-M., M.-E.L.-M., P.R.-N., J.P., P.E., J.B.), Douglas Mental Health University Institute Research Centre, Montréal, Canada; and John Hopkins University (J.L.), Baltimore, MD
| | - Jeannie Leoutsakos
- From the McGill Centre for Integrative Neuroscience, Montreal Neurological Institute (C.M.), and McGill University Research Centre for Studies in Aging (M.S., P.R.-N.), McGill University (P.-F.M., M.-E.L.-M., P.R.-N., J.P., P.E., J.B.); StoP-AD Centre (P.-F.M., J.T.-M., M.-E.L.-M., P.R.-N., J.P., P.E., J.B.), Douglas Mental Health University Institute Research Centre, Montréal, Canada; and John Hopkins University (J.L.), Baltimore, MD
| | - Cécile Madjar
- From the McGill Centre for Integrative Neuroscience, Montreal Neurological Institute (C.M.), and McGill University Research Centre for Studies in Aging (M.S., P.R.-N.), McGill University (P.-F.M., M.-E.L.-M., P.R.-N., J.P., P.E., J.B.); StoP-AD Centre (P.-F.M., J.T.-M., M.-E.L.-M., P.R.-N., J.P., P.E., J.B.), Douglas Mental Health University Institute Research Centre, Montréal, Canada; and John Hopkins University (J.L.), Baltimore, MD
| | - Marie-Elyse Lafaille-Magnan
- From the McGill Centre for Integrative Neuroscience, Montreal Neurological Institute (C.M.), and McGill University Research Centre for Studies in Aging (M.S., P.R.-N.), McGill University (P.-F.M., M.-E.L.-M., P.R.-N., J.P., P.E., J.B.); StoP-AD Centre (P.-F.M., J.T.-M., M.-E.L.-M., P.R.-N., J.P., P.E., J.B.), Douglas Mental Health University Institute Research Centre, Montréal, Canada; and John Hopkins University (J.L.), Baltimore, MD
| | - Melissa Savard
- From the McGill Centre for Integrative Neuroscience, Montreal Neurological Institute (C.M.), and McGill University Research Centre for Studies in Aging (M.S., P.R.-N.), McGill University (P.-F.M., M.-E.L.-M., P.R.-N., J.P., P.E., J.B.); StoP-AD Centre (P.-F.M., J.T.-M., M.-E.L.-M., P.R.-N., J.P., P.E., J.B.), Douglas Mental Health University Institute Research Centre, Montréal, Canada; and John Hopkins University (J.L.), Baltimore, MD
| | - Pedro Rosa-Neto
- From the McGill Centre for Integrative Neuroscience, Montreal Neurological Institute (C.M.), and McGill University Research Centre for Studies in Aging (M.S., P.R.-N.), McGill University (P.-F.M., M.-E.L.-M., P.R.-N., J.P., P.E., J.B.); StoP-AD Centre (P.-F.M., J.T.-M., M.-E.L.-M., P.R.-N., J.P., P.E., J.B.), Douglas Mental Health University Institute Research Centre, Montréal, Canada; and John Hopkins University (J.L.), Baltimore, MD
| | - Judes Poirier
- From the McGill Centre for Integrative Neuroscience, Montreal Neurological Institute (C.M.), and McGill University Research Centre for Studies in Aging (M.S., P.R.-N.), McGill University (P.-F.M., M.-E.L.-M., P.R.-N., J.P., P.E., J.B.); StoP-AD Centre (P.-F.M., J.T.-M., M.-E.L.-M., P.R.-N., J.P., P.E., J.B.), Douglas Mental Health University Institute Research Centre, Montréal, Canada; and John Hopkins University (J.L.), Baltimore, MD
| | - Pierre Etienne
- From the McGill Centre for Integrative Neuroscience, Montreal Neurological Institute (C.M.), and McGill University Research Centre for Studies in Aging (M.S., P.R.-N.), McGill University (P.-F.M., M.-E.L.-M., P.R.-N., J.P., P.E., J.B.); StoP-AD Centre (P.-F.M., J.T.-M., M.-E.L.-M., P.R.-N., J.P., P.E., J.B.), Douglas Mental Health University Institute Research Centre, Montréal, Canada; and John Hopkins University (J.L.), Baltimore, MD
| | - John Breitner
- From the McGill Centre for Integrative Neuroscience, Montreal Neurological Institute (C.M.), and McGill University Research Centre for Studies in Aging (M.S., P.R.-N.), McGill University (P.-F.M., M.-E.L.-M., P.R.-N., J.P., P.E., J.B.); StoP-AD Centre (P.-F.M., J.T.-M., M.-E.L.-M., P.R.-N., J.P., P.E., J.B.), Douglas Mental Health University Institute Research Centre, Montréal, Canada; and John Hopkins University (J.L.), Baltimore, MD.
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Alsumari SR, AlNouri DM, El-Sayed MMA, El-Din MFS, Arzoo S. The sociodemographic characteristics and dietary and blood plasma fatty acid profiles of elderly Saudi women with Alzheimer disease. Lipids Health Dis 2019; 18:77. [PMID: 30927917 PMCID: PMC6441169 DOI: 10.1186/s12944-019-1029-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2018] [Accepted: 03/21/2019] [Indexed: 12/02/2022] Open
Abstract
Background Alzheimer’s disease (AD) is a progressive neurodegenerative disease, and due to various physiological and psychological factors the patients are at risk of nutritional insufficiencies. The purpose of this study was to assess the dietary fatty acid intake and its effect on plasma fatty acids in elderly Saudi women and to compare the differences in their food and plasma fatty acid profile on the basis of their residence. Methods A total of 76 elderly women (50–100 years) were recruited through a random sampling method. A structured proforma was designed to gather information related to their age, income, dietary habits, and presence of any disease and awareness of AD. A 24-h dietary recall method for 3 days and food frequency questionnaire, concentrating on fish consumption and consumption of foods rich in ω-3 fatty acids, which was planned by dietitians, was used for dietary assessment. The gathered data were then analyzed using food processor software. The blood samples were collected to determine plasma fatty acids. Results The mean age of women diagnosed with AD was more than 75 years, and the prevalence of illiteracy was higher among AD subjects. As compared to the AD group, the concentration of LA and total ω-6 was significantly (p ≤ 0.05) higher in the control group from both recruitment sites [National Guard Health Affairs, King Abdulaziz Medical City, Riyadh (NGH) and Social Welfare Homes for the Elderly (SWH)]. Similarly, the concentrations of EPA, DHA, and ω-3 were also slightly higher in the control group at both sites, but the difference between the control and AD subjects was only significant (p ≤ 0.05) in subjects from NGH. We found no significant difference in the ω-6/ ω-3 ratio between groups. Also, no significant difference was found in the mean level of the plasma fatty acid when comparing the control and AD groups. The concentration of DHA in controls only and AA, EPA and ω-6 in both control and AD were significant (although weakly) correlated with their respective dietary intakes. No correlations were found between the intake of 18 C precursors (LA and ALA) and plasma levels of their long chain derivatives (AA, EPA, and DHA). Education, income, overall health status and the concentration of various fatty acids from food was higher and better in subjects from SWH than NGH. The lower plasma level indicates lower impaired systemic availability of several nutrients. Conclusion We found that dietary intervention might play a role in the prevention of AD.
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Affiliation(s)
- Samar Rashed Alsumari
- Department of Food and Nutrition Sciences, College of Food and Agriculture Sciences, King Saud University, Riyadh-11495, P.O. 11495, Riyadh, Saudi Arabia
| | - Doha Mustafa AlNouri
- Department of Food and Nutrition Sciences, College of Food and Agriculture Sciences, King Saud University, Riyadh-11495, P.O. 11495, Riyadh, Saudi Arabia.
| | - Mervat Mohamed Ali El-Sayed
- Department of Food and Nutrition Sciences, College of Food and Agriculture Sciences, King Saud University, Riyadh-11495, P.O. 11495, Riyadh, Saudi Arabia
| | - Mohamed Fekry Serag El-Din
- Department of Food and Nutrition Sciences, College of Food and Agriculture Sciences, King Saud University, Riyadh-11495, P.O. 11495, Riyadh, Saudi Arabia.,Department of Nutrition and Food Science, Faculty of Home Economics, Menoufia University, Shebin El Kom, Egypt
| | - Shaista Arzoo
- Department of Food and Nutrition Sciences, College of Food and Agriculture Sciences, King Saud University, Riyadh-11495, P.O. 11495, Riyadh, Saudi Arabia
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Cannon-Albright LA, Foster NL, Schliep K, Farnham JM, Teerlink CC, Kaddas H, Tschanz J, Corcoran C, Kauwe JSK. Relative risk for Alzheimer disease based on complete family history. Neurology 2019; 92:e1745-e1753. [PMID: 30867271 PMCID: PMC6511086 DOI: 10.1212/wnl.0000000000007231] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2018] [Accepted: 12/06/2018] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVE The inherited component for Alzheimer disease (AD) risk has focused on close relatives; consideration of the full family history may improve accuracy and utility of risk estimates. METHODS A population resource including a genealogy of Utah pioneers from the 1800s linked to Utah death certificates was used to estimate relative risk for AD based on specific family history constellations, including from first- to third-degree relatives. RESULTS Any affected first-degree relatives (FDR) significantly increased risk of AD (≥1 FDRs: relative risk [RR] 1.73, 95% confidence interval [CI] [1.59-1.87]; ≥2 FDRs: RR 3.98 [3.26-4.82]; ≥3 FDRs: RR 2.48 [1.07-4.89]; ≥4 FDRs: RR 14.77 [5.42-32.15]). Affected second-degree relatives (SDR) increased risk even in the presence of affected FDRs (FDR = 1 with SDR = 2: RR 21.29 [5.80-54.52]). AD only in third-degree relatives (TDR) also increased risk (FDR = 0, SDR = 0, TDR ≥3: RR 1.43 [1.21-1.68]). Mixed evidence was observed for differences in risk based on maternal compared to paternal inheritance; higher risks for men than women with equivalent family history, and higher risk for individuals with at least one affected FDR regardless of the relative's age at death, were observed. CONCLUSIONS This population-based estimation of RRs for AD based on family history ascertained from extended genealogy data indicates that inherited genetic factors have a broad influence, extending beyond immediate relatives. Providers should consider the full constellation of family history when counseling patients and families about their risk of AD.
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Affiliation(s)
- Lisa A Cannon-Albright
- From the Genetic Epidemiology Program, Department of Internal Medicine (L.A.C.-A., J.M.F., C.C.T., H.K.), Center for Alzheimer's Care, Imaging and Research, Department of Neurology (N.L.F.), and Department of Family and Preventive Medicine (K.S.), University of Utah School of Medicine; Huntsman Cancer Institute (L.A.C.-A., H.K.); George E. Wahlen Department of Veterans Affairs Medical Center (L.A.C.-A.), Salt Lake City; Department of Psychology (J.T., C.C.), Utah State University, Logan; and Departments of Biology and Neuroscience (J.S.K.K.), Brigham Young University, Provo, UT.
| | - Norman L Foster
- From the Genetic Epidemiology Program, Department of Internal Medicine (L.A.C.-A., J.M.F., C.C.T., H.K.), Center for Alzheimer's Care, Imaging and Research, Department of Neurology (N.L.F.), and Department of Family and Preventive Medicine (K.S.), University of Utah School of Medicine; Huntsman Cancer Institute (L.A.C.-A., H.K.); George E. Wahlen Department of Veterans Affairs Medical Center (L.A.C.-A.), Salt Lake City; Department of Psychology (J.T., C.C.), Utah State University, Logan; and Departments of Biology and Neuroscience (J.S.K.K.), Brigham Young University, Provo, UT
| | - Karen Schliep
- From the Genetic Epidemiology Program, Department of Internal Medicine (L.A.C.-A., J.M.F., C.C.T., H.K.), Center for Alzheimer's Care, Imaging and Research, Department of Neurology (N.L.F.), and Department of Family and Preventive Medicine (K.S.), University of Utah School of Medicine; Huntsman Cancer Institute (L.A.C.-A., H.K.); George E. Wahlen Department of Veterans Affairs Medical Center (L.A.C.-A.), Salt Lake City; Department of Psychology (J.T., C.C.), Utah State University, Logan; and Departments of Biology and Neuroscience (J.S.K.K.), Brigham Young University, Provo, UT
| | - James M Farnham
- From the Genetic Epidemiology Program, Department of Internal Medicine (L.A.C.-A., J.M.F., C.C.T., H.K.), Center for Alzheimer's Care, Imaging and Research, Department of Neurology (N.L.F.), and Department of Family and Preventive Medicine (K.S.), University of Utah School of Medicine; Huntsman Cancer Institute (L.A.C.-A., H.K.); George E. Wahlen Department of Veterans Affairs Medical Center (L.A.C.-A.), Salt Lake City; Department of Psychology (J.T., C.C.), Utah State University, Logan; and Departments of Biology and Neuroscience (J.S.K.K.), Brigham Young University, Provo, UT
| | - Craig C Teerlink
- From the Genetic Epidemiology Program, Department of Internal Medicine (L.A.C.-A., J.M.F., C.C.T., H.K.), Center for Alzheimer's Care, Imaging and Research, Department of Neurology (N.L.F.), and Department of Family and Preventive Medicine (K.S.), University of Utah School of Medicine; Huntsman Cancer Institute (L.A.C.-A., H.K.); George E. Wahlen Department of Veterans Affairs Medical Center (L.A.C.-A.), Salt Lake City; Department of Psychology (J.T., C.C.), Utah State University, Logan; and Departments of Biology and Neuroscience (J.S.K.K.), Brigham Young University, Provo, UT
| | - Heydon Kaddas
- From the Genetic Epidemiology Program, Department of Internal Medicine (L.A.C.-A., J.M.F., C.C.T., H.K.), Center for Alzheimer's Care, Imaging and Research, Department of Neurology (N.L.F.), and Department of Family and Preventive Medicine (K.S.), University of Utah School of Medicine; Huntsman Cancer Institute (L.A.C.-A., H.K.); George E. Wahlen Department of Veterans Affairs Medical Center (L.A.C.-A.), Salt Lake City; Department of Psychology (J.T., C.C.), Utah State University, Logan; and Departments of Biology and Neuroscience (J.S.K.K.), Brigham Young University, Provo, UT
| | - Joann Tschanz
- From the Genetic Epidemiology Program, Department of Internal Medicine (L.A.C.-A., J.M.F., C.C.T., H.K.), Center for Alzheimer's Care, Imaging and Research, Department of Neurology (N.L.F.), and Department of Family and Preventive Medicine (K.S.), University of Utah School of Medicine; Huntsman Cancer Institute (L.A.C.-A., H.K.); George E. Wahlen Department of Veterans Affairs Medical Center (L.A.C.-A.), Salt Lake City; Department of Psychology (J.T., C.C.), Utah State University, Logan; and Departments of Biology and Neuroscience (J.S.K.K.), Brigham Young University, Provo, UT
| | - Chris Corcoran
- From the Genetic Epidemiology Program, Department of Internal Medicine (L.A.C.-A., J.M.F., C.C.T., H.K.), Center for Alzheimer's Care, Imaging and Research, Department of Neurology (N.L.F.), and Department of Family and Preventive Medicine (K.S.), University of Utah School of Medicine; Huntsman Cancer Institute (L.A.C.-A., H.K.); George E. Wahlen Department of Veterans Affairs Medical Center (L.A.C.-A.), Salt Lake City; Department of Psychology (J.T., C.C.), Utah State University, Logan; and Departments of Biology and Neuroscience (J.S.K.K.), Brigham Young University, Provo, UT
| | - John S K Kauwe
- From the Genetic Epidemiology Program, Department of Internal Medicine (L.A.C.-A., J.M.F., C.C.T., H.K.), Center for Alzheimer's Care, Imaging and Research, Department of Neurology (N.L.F.), and Department of Family and Preventive Medicine (K.S.), University of Utah School of Medicine; Huntsman Cancer Institute (L.A.C.-A., H.K.); George E. Wahlen Department of Veterans Affairs Medical Center (L.A.C.-A.), Salt Lake City; Department of Psychology (J.T., C.C.), Utah State University, Logan; and Departments of Biology and Neuroscience (J.S.K.K.), Brigham Young University, Provo, UT
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