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Yu Y, Martins LM. Mitochondrial One-Carbon Metabolism and Alzheimer's Disease. Int J Mol Sci 2024; 25:6302. [PMID: 38928008 PMCID: PMC11203557 DOI: 10.3390/ijms25126302] [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: 03/12/2024] [Revised: 05/13/2024] [Accepted: 05/15/2024] [Indexed: 06/28/2024] Open
Abstract
Mitochondrial one-carbon metabolism provides carbon units to several pathways, including nucleic acid synthesis, mitochondrial metabolism, amino acid metabolism, and methylation reactions. Late-onset Alzheimer's disease is the most common age-related neurodegenerative disease, characterised by impaired energy metabolism, and is potentially linked to mitochondrial bioenergetics. Here, we discuss the intersection between the molecular pathways linked to both mitochondrial one-carbon metabolism and Alzheimer's disease. We propose that enhancing one-carbon metabolism could promote the metabolic processes that help brain cells cope with Alzheimer's disease-related injuries. We also highlight potential therapeutic avenues to leverage one-carbon metabolism to delay Alzheimer's disease pathology.
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Affiliation(s)
- Yizhou Yu
- MRC Toxicology Unit, University of Cambridge, Gleeson Building, Tennis Court Road, Cambridge CB2 1QR, UK
| | - L. Miguel Martins
- MRC Toxicology Unit, University of Cambridge, Gleeson Building, Tennis Court Road, Cambridge CB2 1QR, UK
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Nguyen HD, Kim MS. The role of mixed B vitamin intakes on cognitive performance: Modeling, genes and miRNAs involved. J Psychiatr Res 2022; 152:38-56. [PMID: 35714552 DOI: 10.1016/j.jpsychires.2022.06.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2022] [Revised: 05/29/2022] [Accepted: 06/06/2022] [Indexed: 12/30/2022]
Abstract
OBJECTIVE To assess the relationships between mixed B vitamin intakes (B1, B2, B3, B6, B9, B12) and cognitive performance, as well as their molecular mechanisms. METHODS The associations of mixed B vitamin intakes with cognitive function were assessed using multivariate regression models, weighted quantile sum (WQS), quantile g-computation (qgcomp), and Bayesian kernel machine regression (BKMR). GeneMANIA, Comparative Toxicogenomics Database, MIENTURNET, miRNAsong were employed as the main data-mining methods. RESULTS Overall effects of the B vitamin intake mixture were significantly associated with global cognition in the WQS, qgcomp, and BKMR models. A mixture of B vitamins (B1, B2, B3, B9) interacted with the five genes (IL1B, BCL2, CASP3, BAX, PTGS2) and was associated with better cognitive function, especially CASP3 and BAX. Physical interactions (77.6%) were observed to be the most important interactions in gene networks. The IL-18 signaling pathway, apoptosis, and Alzheimer's disease were annotated as the key molecular mechanisms involved in mixed B vitamins' improving cognitive function. NFKB1, ATF3, and NR3C1 were the key significant transcription factors associated with cognitive function targeted by a mixture of B vitamins. The strong interaction and expression of hsa-miR-34a-5p, hsa-miR-128-3p, hsa-miR-181a-5p, and hsa-miR-204-5p are involved in mixed B vitamins' better cognitive performance. We also created and evaluated miRNA sponge sequences for these miRNAs, which might be used to alleviate cognitive decline. The cutoff thresholds for B vitamin intake levels that are associated with cognition performance were reported. CONCLUSIONS Given the increased incidence of dementia across the world, increasing daily mixed B vitamin intake via regular meals may contribute to minimizing dementia risk. Further studies are warranted to identify these links in well-characterized cohorts of diverse populations, either independently or together.
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Affiliation(s)
- Hai Duc Nguyen
- Department of Pharmacy, College of Pharmacy and Research Institute of Life and Pharmaceutical Sciences, Sunchon National University, Suncheon, 57922, Republic of Korea.
| | - Min-Sun Kim
- Department of Pharmacy, College of Pharmacy and Research Institute of Life and Pharmaceutical Sciences, Sunchon National University, Suncheon, 57922, Republic of Korea.
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Zhou J, Sun Y, Ji M, Li X, Wang Z. Association of Vitamin B Status with Risk of Dementia in Cohort Studies: A Systematic Review and Meta-Analysis. J Am Med Dir Assoc 2022; 23:1826.e21-1826.e35. [PMID: 35779574 DOI: 10.1016/j.jamda.2022.05.022] [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: 03/11/2022] [Revised: 05/23/2022] [Accepted: 05/24/2022] [Indexed: 10/17/2022]
Abstract
OBJECTIVE To examine the association between B vitamins status and the risk of dementia in older adults through a systematic review and meta-analysis of cohort studies. DESIGN Systematic review and meta-analysis. SETTING AND PARTICIPANTS Older adults aged ≥60 years from community, nursing home, institution, or hospital. METHODS PubMed, Cochrane Library, EMBASE, Web of Science, CINAHL, ClinicalTrials, WHO-ICTRP, NHS Trusts, and ACTR were searched from the date of their inception up to November 28, 2021. We included cohort studies that assessed the association between serum B vitamins or B vitamins intake and the risk of dementia among older adults aged ≥60 years. The quality of all studies was assessed by the modified Newcastle-Ottawa Scale (NOS). The hazard ratios (HRs) and 95% CIs were calculated by the random effects model. The Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) approach was used to rate the certainty of evidence. RESULTS Eleven cohort studies with sample sizes ranging from 233 to 3634 were included in the meta-analysis. Levels of serum folate showed statistically significant association with the risk of dementia (≥10 nmol/L: HR 1.57, 95% CI 1.01-2.46, low certainty; <10 nmol/L: HR 0.93, 95% CI 0.88-0.99, very low certainty). However, levels of vitamin B6 intake showed no statistically significant effects on risk of dementia; levels of serum vitamin B12 and vitamin B12 intake also showed no statistically significant effects on risk of dementia in older adults. CONCLUSIONS AND IMPLICATIONS The results from our meta-analysis suggest that vitamin B6, B12, and folate may not be modifiable risk factors for dementia among older adults. Current evidence on the relationship between vitamin B status and dementia is not sufficient for development of vitamin B recommendations. More high-quality cohort studies are needed to confirm the relationship between the two in the future.
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Affiliation(s)
- Jia Zhou
- School of Nursing, Peking university, Beijing, China
| | - Yue Sun
- School of Nursing, Peking university, Beijing, China
| | - Mengmeng Ji
- School of Nursing, Peking university, Beijing, China
| | - Xinrui Li
- School of Nursing, Peking university, Beijing, China
| | - Zhiwen Wang
- School of Nursing, Peking university, Beijing, China.
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Blood-Based Biomarkers for Alzheimer's Disease Diagnosis and Progression: An Overview. Cells 2022; 11:cells11081367. [PMID: 35456047 PMCID: PMC9044750 DOI: 10.3390/cells11081367] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Revised: 04/12/2022] [Accepted: 04/15/2022] [Indexed: 01/10/2023] Open
Abstract
Alzheimer’s Disease (AD) is a progressive neurodegenerative disease characterized by amyloid-β (Aβ) plaque deposition and neurofibrillary tangle accumulation in the brain. Although several studies have been conducted to unravel the complex and interconnected pathophysiology of AD, clinical trial failure rates have been high, and no disease-modifying therapies are presently available. Fluid biomarker discovery for AD is a rapidly expanding field of research aimed at anticipating disease diagnosis and following disease progression over time. Currently, Aβ1–42, phosphorylated tau, and total tau levels in the cerebrospinal fluid are the best-studied fluid biomarkers for AD, but the need for novel, cheap, less-invasive, easily detectable, and more-accessible markers has recently led to the search for new blood-based molecules. However, despite considerable research activity, a comprehensive and up-to-date overview of the main blood-based biomarker candidates is still lacking. In this narrative review, we discuss the role of proteins, lipids, metabolites, oxidative-stress-related molecules, and cytokines as possible disease biomarkers. Furthermore, we highlight the potential of the emerging miRNAs and long non-coding RNAs (lncRNAs) as diagnostic tools, and we briefly present the role of vitamins and gut-microbiome-related molecules as novel candidates for AD detection and monitoring, thus offering new insights into the diagnosis and progression of this devastating disease.
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Zhang C, Luo J, Yuan C, Ding D. Vitamin B12, B6, or Folate and Cognitive Function in Community-Dwelling Older Adults: A Systematic Review and Meta-Analysis. J Alzheimers Dis 2021; 77:781-794. [PMID: 32773392 DOI: 10.3233/jad-200534] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
BACKGROUND Previous studies have indicated that B vitamin deficiencies are an essential cause of neurological pathology. There is a need to provide evidence of the benefit of B vitamins for the prevention of cognitive decline in community-dwelling older adults. OBJECTIVE To examine the association between intake and plasma levels of vitamins B12, B6, and folate and cognitive function in older populations through a systematic review and meta-analysis. METHODS Medline (PubMed), EMBASE, and Cochrane databases were used to search the literature though August 8, 2019. We included observational population-based studies evaluating the association between concentrations or intake levels of vitamins B6, B12, or folate and cognition in older adults aged ≥45 years. The quality of all studies was assessed by the modified Newcastle-Ottawa Scale. Odds ratios (ORs) and hazard ratios (HRs) were analyzed by the random-effects model. Sensitivity analyses were conducted by excluding the studies with significant heterogeneity. RESULTS Twenty-one observational studies with sample sizes ranging from 155-7030 were included in the meta-analysis. Higher levels of vitamin B12 (OR = 0.77, 95% CI = 0.61-0.97) and folate concentration (OR = 0.68, 95% CI = 0.51-0.90) were associated with better cognition in cross-sectional studies, but not in sensitivity analyses or prospective studies. High vitamin B6 concentrations showed no significant benefit on cognition and dementia risk. Prospective studies did not provide substantial evidence for the relationship. CONCLUSION The results from our meta-analysis suggest that vitamins B12, B6, and folate may not be modifiable risk factors for slowing cognitive decline among community-dwelling older individuals.
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Affiliation(s)
- Chenbo Zhang
- Department of Biostatistics, School of Public Health, Fudan University, Shanghai, China.,NHC Key Laboratory of Health Technology Assessment (Fudan University), Shanghai, China.,Key Laboratory of Public Health Safety of Ministry of Education (Fudan University), Shanghai, China
| | - Jianfeng Luo
- Department of Biostatistics, School of Public Health, Fudan University, Shanghai, China.,NHC Key Laboratory of Health Technology Assessment (Fudan University), Shanghai, China.,Key Laboratory of Public Health Safety of Ministry of Education (Fudan University), Shanghai, China
| | - Changzheng Yuan
- School of Public Health, Zhejiang University, Hangzhou, China
| | - Ding Ding
- Institute of Neurology, Huashan Hospital, Fudan University, Shanghai, China.,National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai, China
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Wang Z, Zhu W, Xing Y, Jia J, Tang Y. B vitamins and prevention of cognitive decline and incident dementia: a systematic review and meta-analysis. Nutr Rev 2021; 80:931-949. [PMID: 34432056 DOI: 10.1093/nutrit/nuab057] [Citation(s) in RCA: 37] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
CONTEXT Elevation of homocysteine (Hcy) levels is well-established as a risk factor for dementia, yet controversy exists regarding whether B-vitamin-mediated reduction of homocysteine levels can benefit cognitive function. OBJECTIVE To investigate whether B vitamin supplementation can reduce the risk of cognitive decline and incident dementia. DATA SOURCES The PubMed, EMBASE, Cochrane Library, and Web of Science were systematically searched for articles published from the inception dates to March 1, 2020. Randomized controlled trials (RCT) were included if B vitamins were supplied to investigate their effect on the rate of cognitive decline. Cohort studies investigating dietary intake of B vitamins and the risk of incident dementia were eligible. Cross-sectional studies comparing differences in levels of B vitamins and Hcy were included. DATA EXTRACTION Two reviewers independently performed data extraction and assessed the study quality. DATA ANALYSIS Random-effect or fixed-effect models, depending on the degree of heterogeneity, were performed to calculate mean differences (MDs), hazard ratios (HRs), and odds ratios (ORs). RESULTS A total of 95 studies with 46175 participants (25 RCTs, 20 cohort studies, and 50 cross-sectional studies) were included in this meta-analysis. This meta-analysis supports that B vitamins can benefit cognitive function as measured by Mini-Mental State Examination score changes (6155 participants; MD, 0.14, 95%CI 0.04 to 0.23), and this result was also significant in studies where placebo groups developed cognitive decline (4211 participants; MD, 0.16, 95%CI 0.05 to 0.26), suggesting that B vitamins slow cognitive decline. For the > 12 months interventional period stratum, B vitamin supplementation decreased cognitive decline (3814 participants; MD, 0.15, 95%CI 0.05 to 0.26) compared to placebo; no such outcome was detected for the shorter interventional stratum (806 participants; MD, 0.18, 95%CI -0.25 to 0.61). In the non-dementia population, B vitamin supplementation slowed cognitive decline (3431 participants; MD, 0.15, 95%CI 0.04 to 0.25) compared to placebo; this outcome was not found for the dementia population (642 participants; MD, 0.20, 95%CI -0.35 to 0.75). Lower folate levels (but not B12 or B6 deficiency) and higher Hcy levels were significantly associated with higher risks of dementia (folate: 6654 participants; OR, 1.76, 95%CI 1.24 to 2.50; Hcy: 12665 participants; OR, 2.09, 95%CI 1.60 to 2.74) and cognitive decline (folate: 4336 participants; OR, 1.26, 95%CI 1.02 to 1.55; Hcy: 6149 participants; OR, 1.19, 95%CI 1.05 to 1.34). Among the population without dementia aged 50 years and above, the risk of incident dementia was significantly decreased among individuals with higher intake of folate (13529 participants; HR, 0.61, 95%CI 0.47 to 0.78), whereas higher intake of B12 or B6 was not associated with lower dementia risk. CONCLUSIONS This meta-analysis suggests that B vitamin supplementation is associated with slowing of cognitive decline, especially in populations who received early intervention and intervention of long duration; the study also indicates that higher intake of dietary folate, but not B12 or B6, is associated with a reduced risk of incident dementia in non-dementia aged population. Given the prevalence of dementia cases in many countries with aging populations, public health policies should be introduced to ensure that subgroups of the population at risk have an adequate B vitamin status.
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Affiliation(s)
- Zhibin Wang
- Zhibin Wang, Wei Zhu, Yi Xing, Jianping Jia, and Yi Tang are with the Innovation Center for Neurological Disorders, Department of Neurology, Xuanwu Hospital, Capital Medical University, National Center for Neurological Disorders, Beijing, China. Jianping Jia is with the Beijing Key Laboratory of Geriatric Cognitive Disorders, Beijing, China. Jianping Jia is with the Clinical Center for Neurodegenerative Disease and Memory Impairment, Capital Medical University, Beijing, China. Jianping Jia is with the Center of Alzheimer's Disease, Beijing Institute for Brain Disorders, Beijing, China. Yi Tang is with the Neurodegenerative Laboratory of Ministry of Education of the Peoples Republic of China, Beijing, China
| | - Wei Zhu
- Zhibin Wang, Wei Zhu, Yi Xing, Jianping Jia, and Yi Tang are with the Innovation Center for Neurological Disorders, Department of Neurology, Xuanwu Hospital, Capital Medical University, National Center for Neurological Disorders, Beijing, China. Jianping Jia is with the Beijing Key Laboratory of Geriatric Cognitive Disorders, Beijing, China. Jianping Jia is with the Clinical Center for Neurodegenerative Disease and Memory Impairment, Capital Medical University, Beijing, China. Jianping Jia is with the Center of Alzheimer's Disease, Beijing Institute for Brain Disorders, Beijing, China. Yi Tang is with the Neurodegenerative Laboratory of Ministry of Education of the Peoples Republic of China, Beijing, China
| | - Yi Xing
- Zhibin Wang, Wei Zhu, Yi Xing, Jianping Jia, and Yi Tang are with the Innovation Center for Neurological Disorders, Department of Neurology, Xuanwu Hospital, Capital Medical University, National Center for Neurological Disorders, Beijing, China. Jianping Jia is with the Beijing Key Laboratory of Geriatric Cognitive Disorders, Beijing, China. Jianping Jia is with the Clinical Center for Neurodegenerative Disease and Memory Impairment, Capital Medical University, Beijing, China. Jianping Jia is with the Center of Alzheimer's Disease, Beijing Institute for Brain Disorders, Beijing, China. Yi Tang is with the Neurodegenerative Laboratory of Ministry of Education of the Peoples Republic of China, Beijing, China
| | - Jianping Jia
- Zhibin Wang, Wei Zhu, Yi Xing, Jianping Jia, and Yi Tang are with the Innovation Center for Neurological Disorders, Department of Neurology, Xuanwu Hospital, Capital Medical University, National Center for Neurological Disorders, Beijing, China. Jianping Jia is with the Beijing Key Laboratory of Geriatric Cognitive Disorders, Beijing, China. Jianping Jia is with the Clinical Center for Neurodegenerative Disease and Memory Impairment, Capital Medical University, Beijing, China. Jianping Jia is with the Center of Alzheimer's Disease, Beijing Institute for Brain Disorders, Beijing, China. Yi Tang is with the Neurodegenerative Laboratory of Ministry of Education of the Peoples Republic of China, Beijing, China
| | - Yi Tang
- Zhibin Wang, Wei Zhu, Yi Xing, Jianping Jia, and Yi Tang are with the Innovation Center for Neurological Disorders, Department of Neurology, Xuanwu Hospital, Capital Medical University, National Center for Neurological Disorders, Beijing, China. Jianping Jia is with the Beijing Key Laboratory of Geriatric Cognitive Disorders, Beijing, China. Jianping Jia is with the Clinical Center for Neurodegenerative Disease and Memory Impairment, Capital Medical University, Beijing, China. Jianping Jia is with the Center of Alzheimer's Disease, Beijing Institute for Brain Disorders, Beijing, China. Yi Tang is with the Neurodegenerative Laboratory of Ministry of Education of the Peoples Republic of China, Beijing, China
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Zhang X, Bao G, Liu D, Yang Y, Li X, Cai G, Liu Y, Wu Y. The Association Between Folate and Alzheimer's Disease: A Systematic Review and Meta-Analysis. Front Neurosci 2021; 15:661198. [PMID: 33935641 PMCID: PMC8079632 DOI: 10.3389/fnins.2021.661198] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2021] [Accepted: 03/17/2021] [Indexed: 12/20/2022] Open
Abstract
Alzheimer's disease (AD) is the most common type of neurodegenerative disease leading to dementia in the elderly. Increasing evidence indicates that folate plays an important role in the pathogenesis of AD. To investigate the role of folate deficiency/possible deficiency in the risk of AD and the benefical effect of sufficient folate intake on the prevention of AD, a systematic review and meta-analysis were performed. The Web of Science, PubMed, CENTRAL, EBSCO, CNKI, CQVIP, and Wanfang databases were searched. The analysis of cross-sectional studies showed that the standardized mean difference (SMD) was −0.60 (95% confidence interval (CI): −0.65, −0.55), indicating that plasma/serum folate level is lower in AD patients than that in controls. Moreover, the combined odds ratio (OR) of case-control studies was 0.96 (95% CI: 0.93, 0.99), while the combined ORs were 0.86 (95% CI: 0.46, 1.26) and 1.94 (95% CI: 1.02, 2.86) in populations with normal levels of folate (≥13.5 nmol/L) and folate deficiency/possible deficiency (<13.5 nmol/L), respectively. In addition, the risk ratio (RR) of the cohort studies was 1.88 (95% CI: 1.20, 2.57) in populations with folate deficiency/possible deficiency. Furthermore, when the intake of folate was equal to or higher than the recommended daily allowance, the combined RR and hazard ratio (HR) were 0.44 (95% CI: 0.18, 0.71) and 0.76 (95% CI: 0.52, 0.99), respectively. These results indicate that folate deficiency/possible deficiency increases the risk for AD, while sufficient intake of folate is a protective factor against AD.
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Affiliation(s)
- Xiaohong Zhang
- College of Marine Life Sciences, Ocean University of China, Qingdao, China.,Shandong Key Laboratory of Behavioral Medicine, School of Mental Health, Jining Medical University, Jining, China.,Shandong Collaborative Innovation Center for Diagnosis, Treatment & Behavioral Interventions of Mental Disorders, Institute of Mental Health, Jining Medical University, Jining, China
| | - Guangyi Bao
- Shandong Key Laboratory of Behavioral Medicine, School of Mental Health, Jining Medical University, Jining, China.,Shandong Collaborative Innovation Center for Diagnosis, Treatment & Behavioral Interventions of Mental Disorders, Institute of Mental Health, Jining Medical University, Jining, China
| | - Debiao Liu
- Shandong Key Laboratory of Behavioral Medicine, School of Mental Health, Jining Medical University, Jining, China.,Shandong Collaborative Innovation Center for Diagnosis, Treatment & Behavioral Interventions of Mental Disorders, Institute of Mental Health, Jining Medical University, Jining, China
| | - Yu Yang
- Shandong Key Laboratory of Behavioral Medicine, School of Mental Health, Jining Medical University, Jining, China.,Shandong Collaborative Innovation Center for Diagnosis, Treatment & Behavioral Interventions of Mental Disorders, Institute of Mental Health, Jining Medical University, Jining, China.,Center of Evidence-Based Medicine, Jining Medical University, Jining, China
| | - Xuezhi Li
- Shandong Key Laboratory of Behavioral Medicine, School of Mental Health, Jining Medical University, Jining, China.,Shandong Collaborative Innovation Center for Diagnosis, Treatment & Behavioral Interventions of Mental Disorders, Institute of Mental Health, Jining Medical University, Jining, China.,Center of Evidence-Based Medicine, Jining Medical University, Jining, China
| | - Gaomei Cai
- Department of Neurology, Affiliated Hospital of Jining Medical University, Jining Medical University, Jining, China
| | - Yan Liu
- Shandong Key Laboratory of Behavioral Medicine, School of Mental Health, Jining Medical University, Jining, China.,Shandong Collaborative Innovation Center for Diagnosis, Treatment & Behavioral Interventions of Mental Disorders, Institute of Mental Health, Jining Medical University, Jining, China.,Center of Evidence-Based Medicine, Jining Medical University, Jining, China
| | - Yili Wu
- Shandong Key Laboratory of Behavioral Medicine, School of Mental Health, Jining Medical University, Jining, China.,Shandong Collaborative Innovation Center for Diagnosis, Treatment & Behavioral Interventions of Mental Disorders, Institute of Mental Health, Jining Medical University, Jining, China.,Center of Evidence-Based Medicine, Jining Medical University, Jining, China
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Behl T, Kaur G, Sehgal A, Singh S, Bhatia S, Al-Harrasi A, Zengin G, Bungau SG, Munteanu MA, Brisc MC, Andronie-Cioara FL, Brisc C. Elucidating the Multi-Targeted Role of Nutraceuticals: A Complementary Therapy to Starve Neurodegenerative Diseases. Int J Mol Sci 2021; 22:4045. [PMID: 33919895 PMCID: PMC8070907 DOI: 10.3390/ijms22084045] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Revised: 04/09/2021] [Accepted: 04/13/2021] [Indexed: 12/13/2022] Open
Abstract
The mechanisms underlying multifactorial diseases are always complex and challenging. Neurodegenerative disorders (NDs) are common around the globe, posing a critical healthcare issue and financial burden to the country. However, integrative evidence implies some common shared mechanisms and pathways in NDs, which include mitochondrial dysfunction, neuroinflammation, oxidative stress, intracellular calcium overload, protein aggregates, oxidative stress (OS), and neuronal destruction in specific regions of the brain, owing to multifaceted pathologies. The co-existence of these multiple pathways often limits the advantages of available therapies. The nutraceutical-based approach has opened the doors to target these common multifaceted pathways in a slow and more physiological manner to starve the NDs. Peer-reviewed articles were searched via MEDLINE and PubMed published to date for in-depth research and database collection. Considered to be complementary therapy with current clinical management and common drug therapy, the intake of nutraceuticals is considered safe to target multiple mechanisms of action in NDs. The current review summarizes the popular nutraceuticals showing different effects (anti-inflammatory, antioxidant, neuro-protectant, mitochondrial homeostasis, neurogenesis promotion, and autophagy regulation) on vital molecular mechanisms involved in NDs, which can be considered as complementary therapy to first-line treatment. Moreover, owing to its natural source, lower toxicity, therapeutic interventions, biocompatibility, potential nutritional effects, and presence of various anti-oxidative and neuroprotective constituents, the nutraceuticals serve as an attractive option to tackle NDs.
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Affiliation(s)
- Tapan Behl
- Department of Pharmacology, Chitkara College of Pharmacy, Chitkara University, Chandigarh 160009, India; (T.B.); (G.K.); (A.S.); (S.S.)
| | - Gagandeep Kaur
- Department of Pharmacology, Chitkara College of Pharmacy, Chitkara University, Chandigarh 160009, India; (T.B.); (G.K.); (A.S.); (S.S.)
| | - Aayush Sehgal
- Department of Pharmacology, Chitkara College of Pharmacy, Chitkara University, Chandigarh 160009, India; (T.B.); (G.K.); (A.S.); (S.S.)
| | - Sukhbir Singh
- Department of Pharmacology, Chitkara College of Pharmacy, Chitkara University, Chandigarh 160009, India; (T.B.); (G.K.); (A.S.); (S.S.)
| | - Saurabh Bhatia
- Natural and Medical Sciences Research Center, University of Nizwa, 616 Birkat Al Mauz, P.O. Box 33, Nizwa, Oman; (S.B.); (A.A.-H.)
| | - Ahmed Al-Harrasi
- Natural and Medical Sciences Research Center, University of Nizwa, 616 Birkat Al Mauz, P.O. Box 33, Nizwa, Oman; (S.B.); (A.A.-H.)
| | - Gokhan Zengin
- Department of Biology, Faculty of Science, Selcuk University Campus, Konya 42130, Turkey;
| | - Simona Gabriela Bungau
- Department of Pharmacy, Faculty of Medicine and Pharmacy, University of Oradea, 410028 Oradea, Romania
| | - Mihai Alexandru Munteanu
- Department of Medical Disciplines, Faculty of Medicine and Pharmacy, University of Oradea, 410073 Oradea, Romania; (M.A.M.); (M.C.B.); (C.B.)
| | - Mihaela Cristina Brisc
- Department of Medical Disciplines, Faculty of Medicine and Pharmacy, University of Oradea, 410073 Oradea, Romania; (M.A.M.); (M.C.B.); (C.B.)
| | - Felicia Liana Andronie-Cioara
- Department of Psycho-Neuroscience and Recovery, Faculty of Medicine and Pharmacy, University of Oradea, 410073 Oradea, Romania;
| | - Ciprian Brisc
- Department of Medical Disciplines, Faculty of Medicine and Pharmacy, University of Oradea, 410073 Oradea, Romania; (M.A.M.); (M.C.B.); (C.B.)
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Sheng LT, Jiang YW, Pan XF, Feng L, Yuan JM, Pan A, Koh WP. Association Between Dietary Intakes of B Vitamins in Midlife and Cognitive Impairment in Late-Life: The Singapore Chinese Health Study. J Gerontol A Biol Sci Med Sci 2020; 75:1222-1227. [PMID: 31094422 PMCID: PMC7243584 DOI: 10.1093/gerona/glz125] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2019] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Dietary intakes of B vitamins (eg, folate) are related to cognitive function according to epidemiological studies in western countries. But prospective studies in Asian populations are scarce. This study evaluated the relationships of dietary intakes of six B vitamins in midlife with cognitive impairment in old age in a Chinese population living in Singapore. METHODS This study included 16,948 participants from the Singapore Chinese Health Study, a population-based prospective cohort. Baseline dietary intakes of B vitamins were assessed using a validated 165-item food frequency questionnaire when the participants were aged 45-74 years (1993-1998). After an average follow-up of 20 years, cognitive function was examined using a Singapore-modified version of Mini-Mental State Examination scale in 2014-2016, and cognitive impairment was defined using education-specific cutoffs. Logistic regression models were applied to estimate the association between B vitamins and cognitive impairment. All the six B vitamins were mutually adjusted in the final model. RESULTS In the 2014-2016 interview, 2,443 participants were defined as cognitive impairment. Riboflavin and folate were significantly and independently associated with cognitive impairment in a dose-dependent manner: the odds ratio (95% confidence interval) comparing the highest with the lowest quartile was 0.82 (0.69, 0.97) for riboflavin and 0.83 (0.70, 0.98) for folate (both p-trend <.05). Dietary intakes of thiamine, niacin, vitamin B-6, and B-12 were not significantly associated with risk of cognitive impairment. CONCLUSIONS Higher dietary intakes of riboflavin and folate in midlife were associated with a lower risk of cognitive impairment in late-life in the Chinese population.
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Affiliation(s)
- Li-Ting Sheng
- Department of Epidemiology and Biostatistics, Ministry of Education Key Laboratory of Environment and Health and State Key Laboratory of Environmental Health (incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, China
| | - Yi-Wen Jiang
- Department of Epidemiology and Biostatistics, Ministry of Education Key Laboratory of Environment and Health and State Key Laboratory of Environmental Health (incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, China
| | - Xiong-Fei Pan
- Department of Epidemiology and Biostatistics, Ministry of Education Key Laboratory of Environment and Health and State Key Laboratory of Environmental Health (incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, China
| | - Lei Feng
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Jian-Min Yuan
- UPMC Hillman Cancer Center, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pennsylvania
| | - An Pan
- Department of Epidemiology and Biostatistics, Ministry of Education Key Laboratory of Environment and Health and State Key Laboratory of Environmental Health (incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, China
| | - Woon-Puay Koh
- Health Services and Systems Research, Duke-NUS Medical School Singapore
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore
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10
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Moretti R, Peinkhofer C. B Vitamins and Fatty Acids: What Do They Share with Small Vessel Disease-Related Dementia? Int J Mol Sci 2019; 20:E5797. [PMID: 31752183 PMCID: PMC6888477 DOI: 10.3390/ijms20225797] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2019] [Revised: 10/21/2019] [Accepted: 11/12/2019] [Indexed: 12/12/2022] Open
Abstract
Many studies have been written on vitamin supplementation, fatty acid, and dementia, but results are still under debate, and no definite conclusion has yet been drawn. Nevertheless, a significant amount of lab evidence confirms that vitamins of the B group are tightly related to gene control for endothelium protection, act as antioxidants, play a co-enzymatic role in the most critical biochemical reactions inside the brain, and cooperate with many other elements, such as choline, for the synthesis of polyunsaturated phosphatidylcholine, through S-adenosyl-methionine (SAM) methyl donation. B-vitamins have anti-inflammatory properties and act in protective roles against neurodegenerative mechanisms, for example, through modulation of the glutamate currents and a reduction of the calcium currents. In addition, they also have extraordinary antioxidant properties. However, laboratory data are far from clinical practice. Many studies have tried to apply these results in everyday clinical activity, but results have been discouraging and far from a possible resolution of the associated mysteries, like those represented by Alzheimer's disease (AD) or small vessel disease dementia. Above all, two significant problems emerge from the research: No consensus exists on general diagnostic criteria-MCI or AD? Which diagnostic criteria should be applied for small vessel disease-related dementia? In addition, no general schema exists for determining a possible correct time of implementation to have effective results. Here we present an up-to-date review of the literature on such topics, shedding some light on the possible interaction of vitamins and phosphatidylcholine, and their role in brain metabolism and catabolism. Further studies should take into account all of these questions, with well-designed and world-homogeneous trials.
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Affiliation(s)
- Rita Moretti
- Neurology Clinic, Department of Medical, Surgical and Health Sciences, University of Trieste, 34149 Trieste, Italy;
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11
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An Y, Feng L, Zhang X, Wang Y, Wang Y, Tao L, Qin Z, Xiao R. Dietary intakes and biomarker patterns of folate, vitamin B 6, and vitamin B 12 can be associated with cognitive impairment by hypermethylation of redox-related genes NUDT15 and TXNRD1. Clin Epigenetics 2019; 11:139. [PMID: 31601260 PMCID: PMC6787977 DOI: 10.1186/s13148-019-0741-y] [Citation(s) in RCA: 56] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2019] [Accepted: 09/08/2019] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND B vitamins in the one-carbon metabolism pathway (folate, vitamin B6, and vitamin B12) have been implicated in DNA methylation, and their deficiency may contribute to cognitive decline through increased homocysteine (Hcy) levels and subsequent oxidative damage. The aim of this study was to investigate whether B vitamin deficiency and increased Hcy could interact with DNA methylation of oxidative-related genes and exacerbate cognitive impairment. METHODS Participants were selected from a large cohort study entitled the Effects and Mechanism Investigation of Cholesterol and Oxysterol on Alzheimer's disease (EMCOA) study. We included 2533 participants who completed a selection of comprehensive cognitive tests and a semiquantitative food frequency questionnaire (FFQ) and were followed for an average of 2.3 years. The longitudinal effects of B vitamin intake on cognitive decline were examined using linear mixed-effect models. Seven mild cognitive impairment (MCI) patients, in the predementia stage of Alzheimer's disease (AD), and fivev healthy controls were selected for the discovery of genome-wide differentially methylated CpG sites. Candidate oxidative stress-related genes significantly correlated with serum levels of B vitamins were selected for validation in 102 MCI patients and 68 controls. The correlations between DNA methylation levels and serum concentrations of B vitamins and oxidative biomarkers were analyzed with Spearman's correlation. The interactive effects of DNA methylation and B vitamins on cognitive performance were further evaluated by multiple linear regression. RESULTS In the prospective analysis, inadequate dietary intake of vitamin B12 was significantly associated with accelerated cognitive decline, whereas adequate folate, vitamin B6, and vitamin B12 intakes were significantly associated with better cognitive reserve. In the case-control analysis, the DNA methylation levels of NUDT15 and TXNRD1 were examined, and significantly hypermethylated sites were identified in MCI patients. Significant correlations of hypermethylated sites with serum levels of folate, homocysteine (Hcy), and oxidative biomarkers were observed, and interactive effects of B vitamins and hypermethylated sites were significantly associated with cognitive performance. CONCLUSION Adequate dietary folate at baseline predicted a better cognitive reserve, while decreased serum levels of B vitamins may contribute to cognitive impairment by affecting methylation levels of specific redox-related genes. TRIAL REGISTRATION EMCOA, ChiCTR-OOC-17011882, Registered 5th, July 2017-Retrospectively registered, http://www.medresman.org/uc/project/projectedit.aspx?proj=2610.
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Affiliation(s)
- Yu An
- School of Public Health, Capital Medical University, No.10 Xitoutiao, You An Men Wai, Beijing, 100069, China
| | - Lingli Feng
- School of Public Health, Capital Medical University, No.10 Xitoutiao, You An Men Wai, Beijing, 100069, China.,Peking University First Hospital, Beijing, China
| | - Xiaona Zhang
- School of Public Health, Capital Medical University, No.10 Xitoutiao, You An Men Wai, Beijing, 100069, China
| | - Ying Wang
- School of Public Health, Capital Medical University, No.10 Xitoutiao, You An Men Wai, Beijing, 100069, China
| | - Yushan Wang
- School of Public Health, Capital Medical University, No.10 Xitoutiao, You An Men Wai, Beijing, 100069, China
| | - Lingwei Tao
- School of Public Health, Capital Medical University, No.10 Xitoutiao, You An Men Wai, Beijing, 100069, China
| | | | - Rong Xiao
- School of Public Health, Capital Medical University, No.10 Xitoutiao, You An Men Wai, Beijing, 100069, China.
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12
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Choi YJ, Shin DW, Jang W, Lee DH, Jeong SM, Park S, Han KD, Park YG. Risk of Dementia in Gastric Cancer Survivors Who Underwent Gastrectomy: A Nationwide Study in Korea. Ann Surg Oncol 2019; 26:4229-4237. [DOI: 10.1245/s10434-019-07913-8] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2019] [Indexed: 12/16/2022]
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13
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McCarty MF, O'Keefe JH, DiNicolantonio JJ. A diet rich in taurine, cysteine, folate, B 12 and betaine may lessen risk for Alzheimer's disease by boosting brain synthesis of hydrogen sulfide. Med Hypotheses 2019; 132:109356. [PMID: 31450076 DOI: 10.1016/j.mehy.2019.109356] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2019] [Revised: 08/06/2019] [Accepted: 08/09/2019] [Indexed: 02/08/2023]
Abstract
The gaseous physiological modulator hydrogen sulfide (H2S) has recently been shown to exert a variety of neuroprotective effects. In particular, the treatment of transgenic mouse models of Alzheimer's disease (AD) with agents that release H2S aids preservation of cognitive function, suppresses brain production of amyloid beta, and decreases tau phosphorylation. The possible physiological relevance of these findings is suggested by the finding that brain and plasma levels of H2S are markedly lower in AD patients than matched controls. Hence, nutraceutical strategies which boost brain synthesis or levels of H2S may have potential for prevention of AD. The chief enzyme which synthesizes H2S in brain parenchyma, cystathionine beta-synthase (CBS), employs cysteine as its rate-limiting substrate, and is allosterically activated by S-adenosylmethionine (SAM). Supplemental taurine has been shown to boost expression of this enzyme, as well as that of another H2S source, cystathionine gamma-lyase, in vascular tissue, and to enhance plasma H2S levels; in rats subjected to hemorrhagic stroke, co-administration of taurine has been shown to blunt a marked reduction in brain CBS expression. Brain levels of SAM are about half as high in AD patients as in controls, and this is thought to explain the reduction of brain H2S in these patients. These considerations suggest that supplementation with cysteine, taurine, and agents which promote methyl group availability - such as SAM, folate, vitamin B12, and betaine - may have potential for boosting brain synthesis of H2S and thereby aiding AD prevention. Indeed, most of these agents have already demonstrated utility in mouse AD models - albeit the extent to which increased H2S synthesis contributes to this protection remains unclear. Moreover, prospective epidemiology has associated low dietary or plasma levels of folate, B12, and taurine with increased dementia risk. Rodent studies suggest that effective nutraceutical strategies for boosting brain H2S synthesis may in fact have broad neuroprotective utility, possibly aiding prevention and/or control not only of AD but also Parkinson's disease and glaucoma, while diminishing the neuronal damage associated with brain trauma or stroke.
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Affiliation(s)
| | - James H O'Keefe
- Saint Luke's Mid America Heart Institute, Kansas City, MO, United States
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14
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Craenen K, Verslegers M, Baatout S, Abderrafi Benotmane M. An appraisal of folates as key factors in cognition and ageing-related diseases. Crit Rev Food Sci Nutr 2019; 60:722-739. [PMID: 30729795 DOI: 10.1080/10408398.2018.1549017] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Folic acid (FA) is often consumed as a food supplement and can be found in fortified staple foods in various western countries. Even though FA supplementation during pregnancy is known to prevent severe congenital anomalies in the developing child (e.g., neural tube defects), much less is known about its influence on cognition and neurological functioning. In this review, we address the advances in this field and situate how folate intake during pregnancy, postnatal life, adulthood and in the elderly affects cognition. In addition, an association between folate status and ageing, dementia and other neurodegenerative disorders such as Alzheimer's disease, Parkinson's disease and amyotrophic lateral sclerosis is discussed. While its role in the incidence and severity of these diseases is becoming apparent, the underlying action of folates and related metabolites remains elusive. Finally, the potential of FA as a nutraceutical has been proposed, although the efficacy will highly depend on the interplay with other micronutrients, the disease stage and the duration of supplementation. Hence, the lack of consistent data urges for more animal studies and (pre)clinical trials in humans to ascertain a potential beneficial role for folates in the treatment or amelioration of cognitive decline and ageing-related disorders.
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Affiliation(s)
- Kai Craenen
- Radiobiology Unit, Belgian Nuclear Research Centre SCK•CEN, Mol, Belgium.,Biology Department, Research Group Neural Circuit Development and Regeneration, KU Leuven, Leuven, Belgium
| | - Mieke Verslegers
- Radiobiology Unit, Belgian Nuclear Research Centre SCK•CEN, Mol, Belgium
| | - Sarah Baatout
- Radiobiology Unit, Belgian Nuclear Research Centre SCK•CEN, Mol, Belgium
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15
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Abstract
AbstractIn recent decades, clinical trials in Alzheimer’s disease (AD) have failed at an unprecedented rate. The etiology of AD has since come under renewed scrutiny, both to elucidate the underlying pathologies and to identify novel therapeutic strategies. Here, diet has emerged as a potential causative/protective agent. A variety of nutrients, including lipids, minerals, vitamins, antioxidants and sugars as well as broader dietary patterns and microbiotal interactions have demonstrated associations with AD. Although clinical trials have yet to definitively implicate any singular dietary element as therapeutic or causative, it is apparent that dietary preferences, likely in complex synergies, may influence the risk, onset and course of AD. This review catalogs the impact of major dietary elements on AD. It further examines an unexplored reciprocal association where AD may modulate diet, as well as how potential therapeutics may complicate these interactions. In doing so, we observe diet may have profound effects on the outcome of a clinical trial, either as a confounder of a drug/disease interaction or as a generally disruptive covariate. We therefore conclude that future clinical trials in AD should endeavor to control for diet, either in study design or subsequent analyses.
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16
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Hunter S, Smailagic N, Brayne C. Dementia Research: Populations, Progress, Problems, and Predictions. J Alzheimers Dis 2018; 64:S119-S143. [DOI: 10.3233/jad-179927] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Affiliation(s)
- Sally Hunter
- Institute of Public Health, University of Cambridge, Cambridge, UK
| | - Nadja Smailagic
- Institute of Public Health, University of Cambridge, Cambridge, UK
| | - Carol Brayne
- Institute of Public Health, University of Cambridge, Cambridge, UK
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17
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Robinson N, Grabowski P, Rehman I. Alzheimer's disease pathogenesis: Is there a role for folate? Mech Ageing Dev 2017; 174:86-94. [PMID: 29037490 DOI: 10.1016/j.mad.2017.10.001] [Citation(s) in RCA: 42] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2017] [Revised: 10/04/2017] [Accepted: 10/05/2017] [Indexed: 12/22/2022]
Abstract
Epigenetic modifications, including changes in DNA methylation, have been implicated in a wide range of diseases including neurological diseases such as Alzheimer's. The role of dietary folate in providing methyl groups required for maintenance and modulation of DNA methylation makes it a nutrient of interest in Alzheimer's. Late onset Alzheimer's disease is the most common form of dementia and at present its aetiology is largely undetermined. From epidemiological studies, the interactions between folate, B-vitamins and homocysteine as well as the long latency period has led to difficulties in interpretation of the data, thus current evidence exploring the role of dietary folate in Alzheimer's is contradictory and unresolved. Therefore, examining the effects at a molecular level and exploring potential epigenetic mechanisms could increase our understanding of the disease and aetiology. The aim of this review is to examine the role that folate could play in Alzheimer's disease neuropathology and will focus on the effects of folate on DNA methylation which link to disease pathology, initiation and progression.
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Affiliation(s)
- Natassia Robinson
- Institute of Health & Society, University of Newcastle upon Tyne, United Kingdom.
| | - Peter Grabowski
- Human Nutrition Unit, Department of Oncology & Metabolism, University of Sheffield, United Kingdom
| | - Ishtiaq Rehman
- Academic Urology Unit, Department of Oncology and Metabolism, University of Sheffield, United Kingdom
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18
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Ford K, Whiting SJ. Vitamin and Mineral Supplement Use by Community-Dwelling Adults Living in Canada and the United States: A Scoping Review. J Diet Suppl 2017; 15:419-430. [DOI: 10.1080/19390211.2017.1350247] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Affiliation(s)
- Katherine Ford
- College of Pharmacy and Nutrition, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Susan J. Whiting
- College of Pharmacy and Nutrition, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
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20
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B-Vitamin Intake and Biomarker Status in Relation to Cognitive Decline in Healthy Older Adults in a 4-Year Follow-Up Study. Nutrients 2017; 9:nu9010053. [PMID: 28075382 PMCID: PMC5295097 DOI: 10.3390/nu9010053] [Citation(s) in RCA: 46] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2016] [Revised: 12/23/2016] [Accepted: 01/04/2017] [Indexed: 11/16/2022] Open
Abstract
Advancing age can be associated with an increase in cognitive dysfunction, a spectrum of disability that ranges in severity from mild cognitive impairment to dementia. Folate and the other B-vitamins involved in one-carbon metabolism are associated with cognition in ageing but the evidence is not entirely clear. The hypothesis addressed in this study was that lower dietary intake or biomarker status of folate and/or the metabolically related B-vitamins would be associated with a greater than expected rate of cognitive decline over a 4-year follow-up period in healthy older adults. Participants (aged 60-88 years; n = 155) who had been previously screened for cognitive function were reassessed four years after initial investigation using the Mini-Mental State Examination (MMSE). At the 4-year follow-up assessment when participants were aged 73.4 ± 7.1 years, mean cognitive MMSE scores had declined from 29.1 ± 1.3 at baseline to 27.5 ± 2.4 (p < 0.001), but some 27% of participants showed a greater than expected rate of cognitive decline (i.e., decrease in MMSE > 0.56 points per year). Lower vitamin B6 status, as measured using pyridoxal-5-phosphate (PLP; <43 nmol/L) was associated with a 3.5 times higher risk of accelerated cognitive decline, after adjustment for age and baseline MMSE score (OR, 3.48; 95% CI, 1.58 to 7.63; p < 0.05). Correspondingly, lower dietary intake (0.9-1.4 mg/day) of vitamin B6 was also associated with a greater rate of cognitive decline (OR, 4.22; 95% CI, 1.28-13.90; p < 0.05). No significant relationships of dietary intake or biomarker status with cognitive decline were observed for the other B-vitamins. In conclusion, lower dietary and biomarker status of vitamin B6 at baseline predicted a greater than expected rate of cognitive decline over a 4-year period in healthy older adults. Vitamin B6 may be an important protective factor in helping maintain cognitive health in ageing.
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Lefèvre-Arbogast S, Féart C, Dartigues JF, Helmer C, Letenneur L, Samieri C. Dietary B Vitamins and a 10-Year Risk of Dementia in Older Persons. Nutrients 2016; 8:nu8120761. [PMID: 27898035 PMCID: PMC5188416 DOI: 10.3390/nu8120761] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2016] [Revised: 11/21/2016] [Accepted: 11/21/2016] [Indexed: 12/15/2022] Open
Abstract
B vitamins may lower the risk of dementia, yet epidemiological findings, mostly from countries with folic acid fortification, have remained inconsistent. We evaluated in a large French cohort of older persons the associations between dietary B vitamins and long-term incident dementia. We included 1321 participants from the Three-City Study who completed a 24 h dietary recall, were free of dementia at the time of diet assessment, and were followed for an average of 7.4 years. In Cox proportional hazards models adjusted for multiple potential confounders, including overall diet quality, higher intake of folate was inversely associated with the risk of dementia (p for trend = 0.02), with an approximately 50% lower risk for individuals in the highest compared to the lowest quintile of folate (HR = 0.47; 95% CI 0.28; 0.81). No association was found for vitamins B6 and B12. In conclusion, in a large French cohort with a relatively low baseline folate status (average intake = 278 µg/day), higher folate intakes were associated with a decreased risk of dementia.
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Affiliation(s)
- Sophie Lefèvre-Arbogast
- University Bordeaux, Institut de Santé Publique d'Epidémiologie et de Développement (ISPED), Centre INSERM U1219-Bordeaux Population Health, Bordeaux 33076, France.
- Institut National de la Santé et de la Recherche Médicale (INSERM), Institut de Santé Publique d'Epidémiologie et de Développement (ISPED), Centre INSERM U1219-Bordeaux Population Health, Bordeaux 33076, France.
| | - Catherine Féart
- University Bordeaux, Institut de Santé Publique d'Epidémiologie et de Développement (ISPED), Centre INSERM U1219-Bordeaux Population Health, Bordeaux 33076, France.
- Institut National de la Santé et de la Recherche Médicale (INSERM), Institut de Santé Publique d'Epidémiologie et de Développement (ISPED), Centre INSERM U1219-Bordeaux Population Health, Bordeaux 33076, France.
| | - Jean-François Dartigues
- University Bordeaux, Institut de Santé Publique d'Epidémiologie et de Développement (ISPED), Centre INSERM U1219-Bordeaux Population Health, Bordeaux 33076, France.
- Institut National de la Santé et de la Recherche Médicale (INSERM), Institut de Santé Publique d'Epidémiologie et de Développement (ISPED), Centre INSERM U1219-Bordeaux Population Health, Bordeaux 33076, France.
| | - Catherine Helmer
- University Bordeaux, Institut de Santé Publique d'Epidémiologie et de Développement (ISPED), Centre INSERM U1219-Bordeaux Population Health, Bordeaux 33076, France.
- Institut National de la Santé et de la Recherche Médicale (INSERM), Institut de Santé Publique d'Epidémiologie et de Développement (ISPED), Centre INSERM U1219-Bordeaux Population Health, Bordeaux 33076, France.
| | - Luc Letenneur
- University Bordeaux, Institut de Santé Publique d'Epidémiologie et de Développement (ISPED), Centre INSERM U1219-Bordeaux Population Health, Bordeaux 33076, France.
- Institut National de la Santé et de la Recherche Médicale (INSERM), Institut de Santé Publique d'Epidémiologie et de Développement (ISPED), Centre INSERM U1219-Bordeaux Population Health, Bordeaux 33076, France.
| | - Cécilia Samieri
- University Bordeaux, Institut de Santé Publique d'Epidémiologie et de Développement (ISPED), Centre INSERM U1219-Bordeaux Population Health, Bordeaux 33076, France.
- Institut National de la Santé et de la Recherche Médicale (INSERM), Institut de Santé Publique d'Epidémiologie et de Développement (ISPED), Centre INSERM U1219-Bordeaux Population Health, Bordeaux 33076, France.
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Lee HK, Kim SY, Sok SR. Effects of Multivitamin Supplements on Cognitive Function, Serum Homocysteine Level, and Depression of Korean Older Adults With Mild Cognitive Impairment in Care Facilities. J Nurs Scholarsh 2016; 48:223-31. [DOI: 10.1111/jnu.12201] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/16/2016] [Indexed: 11/28/2022]
Affiliation(s)
- Hye Kyung Lee
- Assistant Professor, Department of Nursing; Suwon Women's University; GyungGi-do Republic of Korea
| | - So Young Kim
- Doctoral Student, Department of Nursing, Graduate School; Kyung Hee University; Seoul Republic of Korea
| | - Sohyune R. Sok
- Associate Professor, College of Nursing Science; Kyung Hee University; Seoul Republic of Korea
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Dietary Patterns and Risk of Dementia: a Systematic Review and Meta-Analysis of Cohort Studies. Mol Neurobiol 2015; 53:6144-6154. [PMID: 26553347 DOI: 10.1007/s12035-015-9516-4] [Citation(s) in RCA: 123] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2015] [Accepted: 10/27/2015] [Indexed: 01/19/2023]
Abstract
Dietary patterns and some dietary components have been linked with dementia. We therefore performed a meta-analysis of available studies to determine whether there is an association between diet and risk of dementia. We included eligible articles and estimated risk ratio (RR) with 95 % confidence intervals (95 % CIs). Finally, there were 43 trials that met the inclusion standard. Some food intake was related with decrease of dementia, such as unsaturated fatty acids (RR: 0.84, 95 % CI: [0.74-0.95], P = 0.006), antioxidants (RR: 0.87, 95 % CI: [0.77-0.98], P = 0.026), vitamin B (RR: 0.72, 95 % CI: [0.54-0.96], P = 0.026), and the Mediterranean diet (MeDi) (RR: 0.69, 95 % CI: [0.57-0.84], P < 0.001). Some material intakes were related with increase of dementia, such as aluminum (RR: 2.24, 95 % CI: [1.49-3.37], P < 0.001), smoking (RR: 1.43, 95 % CI: [1.15-1.77], P = 0.001), and low levels of vitamin D (RR: 1.52, 95 % CI: [1.17-1.98], P = 0.002). The effect of some materials needs further investigation, such as fish (RR: 0.79, 95 % CI: [0.59-1.06], P = 0.113), vegetables and fruits (RR: 0.46, 95 % CI: [0.16-1.32], P = 0.149), and alcohol (RR: 0.74, 95 % CI: [0.55- 1.01], P = 0.056). Thus, the MeDi and higher consumption of unsaturated fatty acids, antioxidants, and B vitamins decrease the risk of dementia while smoking and higher consumption of aluminum increase the risk of dementia. Low levels of vitamin D were associated with cognitive decline. The effect of fish, vegetables, fruits, and alcohol needs further investigation. The findings will be of great significance to guide people to prevent dementia.
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Ter Borg S, Verlaan S, Mijnarends DM, Schols JMGA, de Groot LCPGM, Luiking YC. Macronutrient Intake and Inadequacies of Community-Dwelling Older Adults, a Systematic Review. ANNALS OF NUTRITION & METABOLISM 2015; 66:242-255. [PMID: 26183836 DOI: 10.1159/000435862] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/09/2015] [Accepted: 06/03/2015] [Indexed: 11/19/2022]
Abstract
BACKGROUND Anorexia of ageing may predispose older adults to under-nutrition and protein energy malnutrition. Studies, however, report a large variation in nutrient inadequacies among community-dwelling older adults. SUMMARY This systematic review provides a comprehensive overview of the energy and macronutrient intakes and possible inadequacies in community-dwelling older adults. PubMed and EMBASE were screened up to December 2013; data from national nutrition surveys were added. Forty-six studies were included, following the PRISMA guideline. KEY MESSAGES Mean daily energy intake was 8.9 MJ in men and 7.3 MJ in women. Mean daily carbohydrate and protein intakes were 46 and 15 En% in men and 47 and 16 En% in women, respectively. Mean daily total fat, saturated fatty acid (SFA), mono-unsaturated fatty acid (MUFA) and poly-unsaturated fatty acid intakes were respectively 34, 13, 13 and 5-6 En%. The carbohydrates and MUFA intakes are below the acceptable macronutrient distribution ranges (AMDR). Fat intake is relatively high, and SFA intake exceeds the upper-AMDR. Based on the estimated average requirement (EAR) cut-point method, 10-12% of older adults do not meet the EAR for protein. To interpret a possible energy imbalance additional information is needed on physical activity, energy expenditure and body weight changes. This systematic review indicates a suboptimal dietary macronutrient distribution and a large variation in nutrient intakes among community-dwelling older adults.
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ter Borg S, Verlaan S, Hemsworth J, Mijnarends DM, Schols JMGA, Luiking YC, de Groot LCPGM. Micronutrient intakes and potential inadequacies of community-dwelling older adults: a systematic review. Br J Nutr 2015; 113:1195-206. [PMID: 25822905 PMCID: PMC4531469 DOI: 10.1017/s0007114515000203] [Citation(s) in RCA: 134] [Impact Index Per Article: 14.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2014] [Revised: 12/17/2014] [Accepted: 01/08/2015] [Indexed: 02/05/2023]
Abstract
Micronutrient deficiencies and low dietary intakes among community-dwelling older adults are associated with functional decline, frailty and difficulties with independent living. As such, studies that seek to understand the types and magnitude of potential dietary inadequacies might be beneficial for guiding future interventions. We carried out a systematic review following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses statement. Observational cohort and longitudinal studies presenting the habitual dietary intakes of older adults (≥65 years) were included. Sex-specific mean (and standard deviation) habitual micronutrient intakes were extracted from each article to calculate the percentage of older people who were at risk for inadequate micronutrient intakes using the estimated average requirement (EAR) cut-point method. The percentage at risk for inadequate micronutrient intakes from habitual dietary intakes was calculated for twenty micronutrients. A total of thirty-seven articles were included in the pooled systematic analysis. Of the twenty nutrients analysed, six were considered a possible public health concern: vitamin D, thiamin, riboflavin, Ca, Mg and Se. The extent to which these apparent inadequacies are relevant depends on dynamic factors, including absorption and utilisation, vitamin and mineral supplement use, dietary assessment methods and the selection of the reference value. In light of these considerations, the present review provides insight into the type and magnitude of vitamin and mineral inadequacies.
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Affiliation(s)
- Sovianne ter Borg
- Nutricia Research, Nutricia Advanced Medical Nutrition,
Uppsalalaan 12, PO Box 80141, 3508TC, Utrecht, The
Netherlands
| | - Sjors Verlaan
- Nutricia Research, Nutricia Advanced Medical Nutrition,
Uppsalalaan 12, PO Box 80141, 3508TC, Utrecht, The
Netherlands
| | - Jaimie Hemsworth
- Nutricia Research, Nutricia Advanced Medical Nutrition,
Uppsalalaan 12, PO Box 80141, 3508TC, Utrecht, The
Netherlands
| | - Donja M. Mijnarends
- Department of Health Services Research, School CAPHRI,
Maastricht University, Maastricht, The
Netherlands
| | - Jos M. G. A. Schols
- Department of Health Services Research, School CAPHRI,
Maastricht University, Maastricht, The
Netherlands
- Department of Family Medicine, School CAPHRI, Maastricht
University, Maastricht, The
Netherlands
| | - Yvette C. Luiking
- Nutricia Research, Nutricia Advanced Medical Nutrition,
Uppsalalaan 12, PO Box 80141, 3508TC, Utrecht, The
Netherlands
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Ashby-Mitchell K, Peeters A, Anstey KJ. Role of dietary pattern analysis in determining cognitive status in elderly Australian adults. Nutrients 2015; 7:1052-67. [PMID: 25658241 PMCID: PMC4344574 DOI: 10.3390/nu7021052] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2014] [Revised: 12/19/2014] [Accepted: 01/20/2015] [Indexed: 11/16/2022] Open
Abstract
Principal Component Analysis (PCA) was used to determine the association between dietary patterns and cognitive function and to examine how classification systems based on food groups and food items affect levels of association between diet and cognitive function. The present study focuses on the older segment of the Australian Diabetes, Obesity and Lifestyle Study (AusDiab) sample (age 60+) that completed the food frequency questionnaire at Wave 1 (1999/2000) and the mini-mental state examination and tests of memory, verbal ability and processing speed at Wave 3 (2012). Three methods were used in order to classify these foods before applying PCA. In the first instance, the 101 individual food items asked about in the questionnaire were used (no categorisation). In the second and third instances, foods were combined and reduced to 32 and 20 food groups, respectively, based on nutrient content and culinary usage—a method employed in several other published studies for PCA. Logistic regression analysis and generalized linear modelling was used to analyse the relationship between PCA-derived dietary patterns and cognitive outcome. Broader food group classifications resulted in a greater proportion of food use variance in the sample being explained (use of 101 individual foods explained 23.22% of total food use, while use of 32 and 20 food groups explained 29.74% and 30.74% of total variance in food use in the sample, respectively). Three dietary patterns were found to be associated with decreased odds of cognitive impairment (CI). Dietary patterns derived from 101 individual food items showed that for every one unit increase in ((Fruit and Vegetable Pattern: p = 0.030, OR 1.061, confidence interval: 1.006–1.118); (Fish, Legumes and Vegetable Pattern: p = 0.040, OR 1.032, confidence interval: 1.001–1.064); (Dairy, Cereal and Eggs Pattern: p = 0.003, OR 1.020, confidence interval: 1.007–1.033)), the odds of cognitive impairment decreased. Different results were observed when the effect of dietary patterns on memory, processing speed and vocabulary were examined. Complex patterns of associations between dietary factors and cognition were evident, with the most consistent finding being the protective effects of high vegetable and plant-based food item consumption and negative effects of ‘Western’ patterns on cognition. Further long-term studies and investigation of the best methods for dietary measurement are needed to better understand diet-disease relationships in this age group.
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Affiliation(s)
- Kimberly Ashby-Mitchell
- Centre for Research on Ageing, Health & Wellbeing, The Australian National University, Florey, Building 54, Mills Road, Acton, ACT 2601, Australia.
| | - Anna Peeters
- Baker IDI Heart and Diabetes Institute, 75 Commercial Rd, Melbourne VIC 3004, Australia.
| | - Kaarin J Anstey
- Centre for Research on Ageing, Health & Wellbeing, The Australian National University, Florey, Building 54, Mills Road, Acton, ACT 2601, Australia.
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Inadequate supply of vitamins and DHA in the elderly: Implications for brain aging and Alzheimer-type dementia. Nutrition 2015; 31:261-75. [DOI: 10.1016/j.nut.2014.06.016] [Citation(s) in RCA: 73] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2014] [Revised: 05/27/2014] [Accepted: 06/04/2014] [Indexed: 12/28/2022]
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Kumar A, Singh A, Ekavali. A review on Alzheimer's disease pathophysiology and its management: an update. Pharmacol Rep 2014; 67:195-203. [PMID: 25712639 DOI: 10.1016/j.pharep.2014.09.004] [Citation(s) in RCA: 945] [Impact Index Per Article: 94.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2014] [Revised: 08/26/2014] [Accepted: 09/08/2014] [Indexed: 12/15/2022]
Abstract
Alzheimer's disease acknowledged as progressive multifarious neurodegenerative disorder, is the leading cause of dementia in late adult life. Pathologically it is characterized by intracellular neurofibrillary tangles and extracellular amyloidal protein deposits contributing to senile plaques. Over the last two decades, advances in the field of pathogenesis have inspired the researchers for the investigation of novel pharmacological therapeutics centered more towards the pathophysiological events of the disease. Currently available treatments i.e. acetylcholinesterase inhibitors (rivastigmine, galantamine, donepezil) and N-methyl d-aspartate receptor antagonist (memantine) contribute minimal impact on the disease and target late aspects of the disease. These drugs decelerate the progression of the disease, provide symptomatic relief but fail to achieve a definite cure. While the neuropathological features of Alzheimer's disease are recognized but the intricacies of the mechanism have not been clearly defined. This lack of understanding regarding the pathogenic process may be the likely reason for the non-availability of effective treatment which can prevent onset and progression of the disease. Owing to the important progress in the field of pathophysiology in the last couple of years, new therapeutic targets are available that should render the underlying disease process to be tackled directly. In this review, authors will discusses the different aspects of pathophysiological mechanisms behind Alzheimer's disease and its management through conventional drug therapy, including modern investigational therapeutic strategies, recently completed and ongoing.
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Affiliation(s)
- Anil Kumar
- Pharmacology Division, University Institute of Pharmaceutical Sciences, UGC Centre of Advanced Study, Panjab University, Chandigarh 160014, India.
| | - Arti Singh
- Pharmacology Division, University Institute of Pharmaceutical Sciences, UGC Centre of Advanced Study, Panjab University, Chandigarh 160014, India
| | - Ekavali
- Pharmacology Division, University Institute of Pharmaceutical Sciences, UGC Centre of Advanced Study, Panjab University, Chandigarh 160014, India
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Caracciolo B, Xu W, Collins S, Fratiglioni L. Cognitive decline, dietary factors and gut–brain interactions. Mech Ageing Dev 2014; 136-137:59-69. [DOI: 10.1016/j.mad.2013.11.011] [Citation(s) in RCA: 99] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2013] [Revised: 11/16/2013] [Accepted: 11/28/2013] [Indexed: 02/08/2023]
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Tschanz JT, Norton MC, Zandi PP, Lyketsos CG. The Cache County Study on Memory in Aging: factors affecting risk of Alzheimer's disease and its progression after onset. Int Rev Psychiatry 2013; 25:673-85. [PMID: 24423221 PMCID: PMC4089882 DOI: 10.3109/09540261.2013.849663] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
The Cache County Study on Memory in Aging is a longitudinal, population-based study of Alzheimer's disease (AD) and other dementias. Initiated in 1995 and extending to 2013, the study has followed over 5,000 elderly residents of Cache County, Utah (USA) for over twelve years. Achieving a 90% participation rate at enrolment, and spawning two ancillary projects, the study has contributed to the literature on genetic, psychosocial and environmental risk factors for AD, late-life cognitive decline, and the clinical progression of dementia after its onset. This paper describes the major study contributions to the literature on AD and dementia.
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Affiliation(s)
- JoAnn T. Tschanz
- Department of Psychology, Utah State University,Center for Epidemiologic Studies, Utah State University
| | - Maria C. Norton
- Center for Epidemiologic Studies, Utah State University,Department of Family, Consumer & Human Development, Utah State University
| | - Peter P. Zandi
- Bloomberg School of Public Health, Johns Hopkins University
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Otaegui-Arrazola A, Amiano P, Elbusto A, Urdaneta E, Martínez-Lage P. Diet, cognition, and Alzheimer's disease: food for thought. Eur J Nutr 2013; 53:1-23. [PMID: 23892520 DOI: 10.1007/s00394-013-0561-3] [Citation(s) in RCA: 134] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2013] [Accepted: 07/11/2013] [Indexed: 02/07/2023]
Abstract
INTRODUCTION The prevention of Alzheimer's disease (AD) has become a real challenge due to its rising prevalence and the lack of an effective cure. Diet and nutrients have gained significant interest as potentially modifiable protective factors. PURPOSE The aim of this review is to provide an updated summary of evidence related to the effect of diet and nutritional factors on the risk of AD and cognitive aging, and discuss the potential mechanisms and confounding factors involved. METHODS A search was conducted in Medline and Web of Knowledge for epidemiological and clinical studies in the international literature from January 2000 to February 2013 using combinations of the following keywords: "Alzheimer's disease", "mild cognitive impairment", "cognitive function", "dietary factors", "omega-3", "antioxidants", "B vitamins", "dietary patterns", and "Mediterranean diet". RESULTS AND CONCLUSION Data from observational studies point to a protective role for certain nutrients, such as omega-3 fatty acids, antioxidants or B vitamins, and dietary patterns (Mediterranean diet). However, data from randomized controlled trials do not show a consistent effect. Whether confounding factors such as age, disease stage, other dietary components, cooking processes, and other methodological issues explain the divergent results remains to be established. Moreover, if certain nutrients protect against dementia, it is as yet unknown whether they may have a general effect on brain vascular health or directly interfere with the etiopathogenesis of AD.
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Affiliation(s)
- Ane Otaegui-Arrazola
- Department of Neurology, Fundación CITA-alzhéimer Fundazioa, Paseo Mikeletegi 71, Planta 1, 20009, San Sebastián, Guipúzcoa, Spain,
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Anand R, Gill KD, Mahdi AA. Therapeutics of Alzheimer's disease: Past, present and future. Neuropharmacology 2013; 76 Pt A:27-50. [PMID: 23891641 DOI: 10.1016/j.neuropharm.2013.07.004] [Citation(s) in RCA: 500] [Impact Index Per Article: 45.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2012] [Revised: 06/26/2013] [Accepted: 07/02/2013] [Indexed: 12/15/2022]
Abstract
Alzheimer's disease (AD) is the most common cause of dementia worldwide. The etiology is multifactorial, and pathophysiology of the disease is complex. Data indicate an exponential rise in the number of cases of AD, emphasizing the need for developing an effective treatment. AD also imposes tremendous emotional and financial burden to the patient's family and community. The disease has been studied over a century, but acetylcholinesterase inhibitors and memantine are the only drugs currently approved for its management. These drugs provide symptomatic improvement alone but do less to modify the disease process. The extensive insight into the molecular and cellular pathomechanism in AD over the past few decades has provided us significant progress in the understanding of the disease. A number of novel strategies that seek to modify the disease process have been developed. The major developments in this direction are the amyloid and tau based therapeutics, which could hold the key to treatment of AD in the near future. Several putative drugs have been thoroughly investigated in preclinical studies, but many of them have failed to produce results in the clinical scenario; therefore it is only prudent that lessons be learnt from the past mistakes. The current rationales and targets evaluated for therapeutic benefit in AD are reviewed in this article. This article is part of the Special Issue entitled 'The Synaptic Basis of Neurodegenerative Disorders'.
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Affiliation(s)
- R Anand
- Department of Biochemistry, Christian Medical College, Vellore 632002, Tamilnadu, India.
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Shah R. The Role of Nutrition and Diet in Alzheimer Disease: A Systematic Review. J Am Med Dir Assoc 2013; 14:398-402. [DOI: 10.1016/j.jamda.2013.01.014] [Citation(s) in RCA: 70] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2013] [Accepted: 01/22/2013] [Indexed: 01/16/2023]
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Doets EL, van Wijngaarden JP, Szczecińska A, Dullemeijer C, Souverein OW, Dhonukshe-Rutten RAM, Cavelaars AEJM, van 't Veer P, Brzozowska A, de Groot LCPGM. Vitamin B12 Intake and Status and Cognitive Function in Elderly People. Epidemiol Rev 2012; 35:2-21. [DOI: 10.1093/epirev/mxs003] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/06/2012] [Indexed: 11/13/2022] Open
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35
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Folate and Alzheimer: when time matters. J Neural Transm (Vienna) 2012; 120:211-24. [DOI: 10.1007/s00702-012-0822-y] [Citation(s) in RCA: 50] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2012] [Accepted: 05/06/2012] [Indexed: 12/14/2022]
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Viveky N, Toffelmire L, Thorpe L, Billinsky J, Alcorn J, Hadjistavropoulos T, Whiting SJ. Use of vitamin and mineral supplements in long-term care home residents. Appl Physiol Nutr Metab 2012; 37:100-5. [DOI: 10.1139/h11-141] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Vitamin–mineral supplementation may offer older adults health and cognition-related benefits but overuse may contribute to polypharmacy. We examined the prevalence of supplement usage in long-term care facility (LTC) residents (≥65 years of age). As cognition may be affected by nutrition, we also examined use in those with diagnosis of dementia and those with no dementia diagnosis. The prevalence of supplement usage and overall “pill count” from pharmaceutical use was assessed in 189 LTC residents and a subsample of 56 older adults with dementia diagnosis, respectively. Participants were residing in an LTC facility of a mid-size metropolitan area during 2009. The average use of supplements was 1.0 per day for all residents, with 35% taking vitamin D supplements, 20% multivitamins, and 26% calcium. Supplement use was similar (p ≥ 0.05) for those with dementia diagnosis (53%, average 2.0 per day) and for those without such diagnosis (45%, average 2.2 per day). Usage ranged between 1–6 supplements per day. In both of these groups, ∼73% of users were taking vitamin D. The number of prescribed medications ranged from 4 to 24 (average 10.2) in a subsample of residents whose supplement intake was 0 to 6 (average 2). These findings suggest an overall low rate of supplement use, with no significant differences (p ≥ 0.05) in use between residents with and without dementia diagnosis. However, some residents were at risk for supplement overuse.
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Affiliation(s)
- Navita Viveky
- College of Pharmacy and Nutrition, University of Saskatchewan, Saskatoon, SK S7N 5C9, Canada
| | - Lynda Toffelmire
- College of Pharmacy and Nutrition, University of Saskatchewan, Saskatoon, SK S7N 5C9, Canada
| | - Lilian Thorpe
- College of Medicine, University of Saskatchewan, Saskatoon, SK S7N 5E5, Canada
| | - Jennifer Billinsky
- College of Pharmacy and Nutrition, University of Saskatchewan, Saskatoon, SK S7N 5C9, Canada
| | - Jane Alcorn
- College of Pharmacy and Nutrition, University of Saskatchewan, Saskatoon, SK S7N 5C9, Canada
| | | | - Susan J. Whiting
- College of Pharmacy and Nutrition, University of Saskatchewan, Saskatoon, SK S7N 5C9, Canada
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Sittig LJ, Herzing LBK, Xie H, Batra KK, Shukla PK, Redei EE. Excess folate during adolescence suppresses thyroid function with permanent deficits in motivation and spatial memory. GENES BRAIN AND BEHAVIOR 2011; 11:193-200. [PMID: 22050771 DOI: 10.1111/j.1601-183x.2011.00749.x] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Cognitive and memory deficits can be caused or exacerbated by dietary folate deficiency, which has been combatted by the addition of folate to grains and dietary supplements. The recommended dose of the B9 vitamin folate is 400 µg/day for adolescents and non-pregnant adults, and consumption above the recommended daily allowance is not considered to be detrimental. However, the effects of excess folate have not been tested in adolescence when neuro and endocrine development suggest possible vulnerability to long-term cognitive effects. We administered folate-supplemented (8.0 mg folic acid/kg diet) or control lab chow (2.7 mg folic acid/kg diet) to rats ad libitum from 30 to 60 days of age, and subsequently tested their motivation and learning and memory in the Morris water maze. We found that folate-supplemented animals had deficits in motivation and spatial memory, but they showed no changes of the learning- and memory-related molecules growth-associated protein-43 or Gs-α subunit protein in the hippocampus. They had decreased levels of thyroxine (T4) and triiodothyronine (T3) in the periphery and decreased protein levels of thyroid receptor-α1 and -α2 (TRα1 and TRα2) in the hippocampus. The latter may have been due to an observed increase of cytosine-phosphate-guanosine island methylation within the putative thyroid hormone receptor-α promoter, which we have mapped for the first time in the rat. Overall, folate supplementation in adolescence led to motivational and spatial memory deficits that may have been mediated by suppressed thyroid hormone function in the periphery and hippocampus.
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Affiliation(s)
- L J Sittig
- Department of Psychiatry and Behavioral Sciences, The Asher Center, Feinberg School of Medicine, Northwestern University, Chicago, IL 60611, USA
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Abstract
The objective of this review is to provide an overview of nutritional factors involved in cognitive aging and dementia with a focus on nutrients that are also important in neurocognitive development. Several dietary components were targeted, including antioxidant nutrients, dietary fats and B-vitamins. A critical review of the literature on each nutrient group is presented, beginning with laboratory and animal studies of the underlying biological mechanisms, followed by prospective epidemiological studies and randomised clinical trials. The evidence to date is fairly strong for protective associations of vitamin E from food sources, the n-3 fatty acid, DHA, found in fish, a high ratio of polyunsaturated to saturated fats, and vitamin B12 and folate. Attention to the level of nutrient intake is crucial for interpreting the literature and the inconsistencies across studies. Most of the epidemiological studies that observe associations have sufficient numbers of individuals who have both low and adequate nutrient status. Few of the randomised clinical trials are designed to target participants who have low baseline status before randomising to vitamin supplement treatments, and this may have resulted in negative findings. Post-hoc analyses by some of the trials reveal vitamin effects in individuals with low baseline intakes. The field of diet and dementia is a relatively young area of study. Much further work needs to be done to understand dietary determinants of cognitive aging and diseases. Further, these studies must be particularly focused on the levels of nutrient intake or status that confer optimum or suboptimal brain functioning.
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Anstey KJ, Cherbuin N, Budge M, Young J. Body mass index in midlife and late-life as a risk factor for dementia: a meta-analysis of prospective studies. Obes Rev 2011; 12:e426-37. [PMID: 21348917 DOI: 10.1111/j.1467-789x.2010.00825.x] [Citation(s) in RCA: 543] [Impact Index Per Article: 41.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
The relationship between body mass index (BMI) (in midlife and late-life) and dementia was investigated in meta-analyses of 16 articles reporting on 15 prospective studies. Follow-ups ranged from 3.2 to 36.0 years. Meta-analyses were conducted on samples including 25 624 participants evaluated for Alzheimer's disease (AD), 15 435 participants evaluated for vascular dementia (VaD) and 30 470 followed for any type of dementia (Any Dementia). Low BMI in midlife was associated with 1.96 [95% confidence interval (CI): 1.32, 2.92] times the risk of developing AD. The pooled relative risks for AD, VaD and Any Dementia for overweight BMI in midlife compared with normal BMI were 1.35 (95% CI:1.19, 1.54), 1.33 (95% CI: 1.02, 1.75) and 1.26 (95% CI: 1.10, 1.44), respectively. The pooled relative risks of AD and Any Dementia for obese BMI in midlife compared to normal BMI were 2.04 (95% CI: 1.59, 2.62) and 1.64 (95% CI: 1.34, 2.00), respectively. Continuous BMI in late-life was not associated with dementia. Small numbers of studies included in pooled analyses reduce generalizability of findings, and emphasize the need for publication of additional findings. We conclude that underweight, overweight and obesity in midlife increase dementia risk. Further research evaluating late-life BMI and dementia is required.
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Affiliation(s)
- K J Anstey
- Ageing Research Unit, Centre for Mental Health Research Medical School, Australian National University, Canberra, ACT, Australia.
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Kim HJ, Kim H, Kim KN, Kim G, Son JI, Kim SY, Chang N. Relationship among Plasma Homocysteine, Folate, Vitamin B12and Nutrient Intake and Neurocognitive Function in the Elderly. ACTA ACUST UNITED AC 2011. [DOI: 10.4163/kjn.2011.44.6.498] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Affiliation(s)
- Hee Jung Kim
- Department of Nutritional Science and Food Management, Ewha Womans University, Seoul 120-750, Korea
| | - Hyesook Kim
- Department of Nutritional Science and Food Management, Ewha Womans University, Seoul 120-750, Korea
| | - Ki Nam Kim
- Department of Nutritional Science and Food Management, Ewha Womans University, Seoul 120-750, Korea
| | - Ggotpin Kim
- Department of Nutritional Science and Food Management, Ewha Womans University, Seoul 120-750, Korea
| | - Jung In Son
- Department of Psychiatry, Seoul Asan Medical Center, Seoul 138-736, Korea
| | - Seong Yoon Kim
- Department of Psychiatry, Seoul Asan Medical Center, Seoul 138-736, Korea
| | - Namsoo Chang
- Department of Nutritional Science and Food Management, Ewha Womans University, Seoul 120-750, Korea
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Galan C, Jardín I, Dionisio N, Salido G, Rosado JA. Role of oxidant scavengers in the prevention of Ca²+ homeostasis disorders. Molecules 2010; 15:7167-87. [PMID: 20953160 PMCID: PMC6259185 DOI: 10.3390/molecules15107167] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2010] [Revised: 09/09/2010] [Accepted: 10/14/2010] [Indexed: 02/07/2023] Open
Abstract
A number of disorders, such as Alzheimer disease and diabetes mellitus, have in common the alteration of the redox balance, resulting in an increase in reactive oxygen species (ROS) generation that might lead to the development of apoptosis and cell death. It has long been known that ROS can significantly alter Ca²+ mobilization, an intracellular signal that is involved in the regulation of a wide variety of cellular functions. Cells have a limited capability to counteract the effects of oxidative stress, but evidence has been provided supporting the beneficial effects of exogenous ROS scavengers. Here, we review the effects of oxidative stress on intracellular Ca²+ homeostasis and the role of antioxidants in the prevention and treatment of disorders associated to abnormal Ca²+ mobilization induced by ROS.
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Affiliation(s)
| | | | | | | | - Juan A. Rosado
- Author to whom correspondence should be addressed; E-Mail: ; Tel.: +34 927257139; Fax: +34 927257110
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