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Liu Y, Zang B, Shao J, Ning N, He L, Ma Y. Predictor of cognitive impairment: metabolic syndrome or circadian syndrome. BMC Geriatr 2023; 23:408. [PMID: 37403015 DOI: 10.1186/s12877-023-03996-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Accepted: 04/24/2023] [Indexed: 07/06/2023] Open
Abstract
BACKGROUND It was reported that metabolic syndrome increases the risk for cognitive impairment and circadian rhythm may influence cognition behavior. Identifying the potential risk factors is essential to screen individuals with neuronal dysfunction, neuronal loss, and cognitive decline and prevent cognitive impairment and dementia development. METHODS We clarified participants by the presence of metabolic syndrome (MetS) and circadian syndrome (CircS) and employed three multivariable Generalized Estimating Equation (GEE) models to control the potential confounding factors and estimate the β values for cognitive function using as referents those had neither MetS nor CircS at baseline. The cognitive function consists of episodic memory and executive function was estimated via the modified Telephone Interview for Cognitive Status (TICS) every two years until 2015. RESULTS The mean age of the participants was 58.80 (8.93) years and 49.92% (male). The prevalence of MetS and CircS was 42.98% and 36.43%, respectively. 1,075 (11.00%) and 435 (4.45%) participants had either MetS or CircS alone and 3,124 (31.98%) had both CircS and MetS. Participants with both MetS and CircS compared with normal had a significantly decreased cognitive function score during the 4-years cohort (β = -0.32, 95% CI: -0.63, -0.01) with the complete model, as well as among participants who suffered from CircS alone (β = -0.82, 95% CI: -1.47, -0.16), while not among participants with MetS alone (β = 0.13, 95% CI: -0.27, 0.53). Specifically, compared with the normal population a significantly lower score was discovered in the episodic memory (β = -0.51, 95% CI: -0.95, -0.07), while slightly lower in executive function (β = -0.33, 95% CI: -0.68, -0.01) among individuals with CircS alone. CONCLUSIONS Individuals with CircS alone or both MetS and CircS have a high risk of cognitive impairment. The association was even stronger in participants with CircS alone than those with both MetS and CircS, suggesting CircS probably have a stronger association with cognitive functioning than MetS and could be a better predictor for cognitive impairment.
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Affiliation(s)
- Yang Liu
- Department of Biostatistics and Epidemiology, School of Public Health, China Medical University, No.77 Puhe Road, Shenyang North New Area, Shenyang, 110122, Liaoning Province, China
| | - Boying Zang
- Department of Preventive Medicine, School of Public Heath, North China University of Science and Technology, Tangshan, Hebei, China
| | - Jinang Shao
- Department of Biostatistics and Epidemiology, School of Public Health, China Medical University, No.77 Puhe Road, Shenyang North New Area, Shenyang, 110122, Liaoning Province, China
| | - Ning Ning
- Department of Biostatistics and Epidemiology, School of Public Health, China Medical University, No.77 Puhe Road, Shenyang North New Area, Shenyang, 110122, Liaoning Province, China
| | - Lixia He
- Division of Molecular and Cellular Oncology, Brigham and Women's Hospital, Dana-Farber Cancer Institute, Harvard Medical School, Boston, 02215, USA.
| | - Yanan Ma
- Department of Biostatistics and Epidemiology, School of Public Health, China Medical University, No.77 Puhe Road, Shenyang North New Area, Shenyang, 110122, Liaoning Province, China.
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Alsuwaidi HN, Ahmed AI, Alkorbi HA, Ali SM, Altarawneh LN, Uddin SI, Roueentan SR, Alhitmi AA, Djouhri L, Chivese T. Association Between Metabolic Syndrome and Decline in Cognitive Function: A Cross-Sectional Study. Diabetes Metab Syndr Obes 2023; 16:849-859. [PMID: 36974329 PMCID: PMC10039709 DOI: 10.2147/dmso.s393282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2022] [Accepted: 03/04/2023] [Indexed: 03/29/2023] Open
Abstract
AIM We investigated whether metabolic syndrome (MetS) is associated with a decline in cognitive function in a cohort of middle-aged and elderly individuals without known cognitive dysfunction diseases in Qatar. METHODS We conducted a cross-sectional study on randomly selected participants aged 40-80 years from the Qatar Biobank, with data on cognitive tests and MetS components. Participants with a history of dementia, stroke, or mental disorders were excluded. MetS was diagnosed using the NCEP-ATP III criteria and cognitive performance was assessed using the Cambridge Neuropsychological Test Automated Battery (CANTAB). Two cognitive function domains were assessed. These are speed of reaction, measured using the Reaction Time (RT), and short-term visual memory, measured using the Paired Associate Learning (PAL) test. Multivariable logistic regression models were used to determine associations between MetS and poor speed of reaction and poor memory performance. RESULTS The mean age of the participants included was 49.8 years (SD 6.7). Of these, 51.9% were females and 88.0% were of Qatari nationality. Most of the 1000 participants had MetS (n=302) or 1-2 MetS components (n=523), whereas only 170 had no MetS components. There was a strong association between MetS and poor memory performance (OR 1.76, 95% CI 1.04-2.96, P=0.034), but a weaker association with poor speed of reaction (OR 1.5, 95% CI 0.89-2.50, P=0.125). CONCLUSION In middle-aged and elderly individuals, MetS was strongly associated with diminished short-term visual memory, psychomotor coordination and motor speed.
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Affiliation(s)
| | - Ashraf I Ahmed
- College of Medicine, QU Health, Qatar University, Doha, Qatar
| | - Hamad A Alkorbi
- College of Medicine, QU Health, Qatar University, Doha, Qatar
| | - Sara M Ali
- College of Medicine, QU Health, Qatar University, Doha, Qatar
| | | | - Shooq I Uddin
- College of Medicine, QU Health, Qatar University, Doha, Qatar
| | | | - Asmaa A Alhitmi
- College of Medicine, QU Health, Qatar University, Doha, Qatar
| | - Laiche Djouhri
- College of Medicine, QU Health, Qatar University, Doha, Qatar
| | - Tawanda Chivese
- College of Medicine, QU Health, Qatar University, Doha, Qatar
- Correspondence: Tawanda Chivese, College of Medicine, Qatar University, PO BOX, Doha, 2713, Qatar, Email
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Verbal Fluency in Metabolic Syndrome. Brain Sci 2022; 12:brainsci12020255. [PMID: 35204018 PMCID: PMC8870615 DOI: 10.3390/brainsci12020255] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Revised: 02/06/2022] [Accepted: 02/07/2022] [Indexed: 02/05/2023] Open
Abstract
Metabolic syndrome (MetS) or otherwise insulin resistance (IR) is described as a cluster of several commonly occurring disorders, including abdominal obesity; lipids disorders, such as hypertriglyceridemia; and low levels of high-density-lipoprotein cholesterol (HDL-C), hypertension (≥130/85 mmHg), and carbohydrates disorders, such as impaired fasting glucose or diabetes mellitus type 2. Type 2 diabetes (T2DM) constitutes insulin resistance, which is a strong risk factor for strokes. Patients with MetS are often prone to cognitive decline. Metabolic risk factors, hypertension, and diabetes, amongst them, have been hypothesized to play a great role in the pathogenesis of Alzheimer’s disease (AD) and the development of vascular dementia. For neuropsychological diagnostic and theoretical purposes verbal fluency is defined as a cognitive function that facilitates information retrieval from memory. It engages executive control and other cognitive processes, such as selective attention, selective inhibition, mental set shifting, internal response generation, and self-monitoring, as well as imagination and psychomotor skills. A total of 90 subjects, divided into 2 groups, patients with MetS (45) and healthy controls (45), were assessed. A significant difference in performance was found between the patients and controls, both in the phonetic (p < 0.01) and semantic fluency trials (p < 0.001). The MetS patients produced less words in the letter K and animal categories. The analysis of descriptive statistics shows that the group of patients with metabolic syndrome generated fewer words in both the phonetic and semantic categories. Our study shows that there is an association between metabolic factors and the verbal fluency performance of MetS patients. This is true, especially for phonetic verbal fluency, which is traditionally connected with the frontal cortex. Lower switching signifies possible executive dysfunctions amongst people with MetS. Subjects with this condition generated more diverse words and created less standard associations. This further implies the existence of dysexecutive syndrome and the need for diagnosing patients in this direction and involving this group of people in therapy. The proper correction of MetS components may improve cognitive function.
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Kaustov L, Fleet A, Brenna CT, Orser BA, Choi S. Perioperative Neurocognitive Screening Tools for At-Risk Surgical Patients. Neurol Clin Pract 2022; 12:76-84. [PMID: 36157624 PMCID: PMC9491510 DOI: 10.1212/cpj.0000000000001132] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2021] [Accepted: 07/23/2021] [Indexed: 02/03/2023]
Abstract
Purpose of Review Perioperative neurocognitive disorders are common after surgery and have serious socioeconomic impacts. Despite this, these disorders remain under-recognized and underdiagnosed. To facilitate detection and direct patients toward appropriate preventative interventions, assessment of cognition during the perioperative period is of critical importance. However, there are considerable barriers to the widespread clinical implementation of cognitive assessments, including a lack of consensus regarding the optimal tool for use in specific clinical scenarios. Recent Findings We provide an overview of the most widely used and validated cognitive assessment tools, including those that permit telemedicine-enabled patient encounters. Summary No single tool is optimal for all contexts. This narrative review can help clinicians to identify the appropriate cognitive screening tool for their needs by describing the advantages and disadvantages of several available tools, thereby enabling the identification of patients at risk of cognitive decline and facilitating optimization of patient-focused perioperative care.
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Zhang X, Yu Y, Shi ZS, Xu K, Feng JH, Li ZY, Zhang XN, Shen SN, Yang Y, Yan LF, Zhang J, Sun Q, Hu B, Cui GB, Wang W. Increased resting state functional irregularity of T2DM brains with high HbA1c: sign for impaired verbal memory function? Brain Imaging Behav 2021; 15:772-781. [PMID: 32712796 DOI: 10.1007/s11682-020-00285-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
Glycosylated hemoglobin A1c (HbA1c) has been considered as a key contributor to impaired cognition in type 2 diabetes mellitus (T2DM) brains. However, how does it affect the brain and whether the glucose controlling can slow down the process are still unknown. In the current study, T2DM patients with high glycosylated hemoglobin level (HGL) and controls with normal glycosylated hemoglobin level (NGL) were enrolled to investigate the relationships between HbA1c, brain imaging characteristics and cognitive function. First, a series of cognitive tests including California Verbal Learning Test (CVLT) were conducted. Then, the functional irregularity based on resting state functional magnetic resonance imaging data was evaluated via a new data-driven brain entropy (BEN) mapping analysis method. We found that the HGLs exhibited significantly increased BEN in the right precentral gyrus (PreCG.R), the right middle frontal gyrus (MFG.R), the triangular and opercular parts of the right inferior frontal gyrus (IFGtriang.R and IFGoperc.R). The strengths of the functional connections of PreCG.R with the brainstem/cerebellum were decreased. Partial correlation analysis showed that HbA1c had a strong positive correlation to regional BEN and negatively correlated with some CVLT scores. Negative correlations also existed between the BEN of PreCG.R/IFGoperc.R and some CVLT scores, suggesting the correspondence between higher HbA1c, increased BEN and decreased verbal memory function. This study demonstrated the potential of BEN in exploring the functional alterations affected by HbA1c and interpreting the verbal memory function decline. It will help understanding the neurophysiological mechanism of T2DM-induced cognitive decline and taking effective prevention or treatment measures.
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Affiliation(s)
- Xin Zhang
- Functional and Molecular Imaging Key Lab of Shaanxi Province, Department of Radiology, Tangdu Hospital, Fourth Military Medical University, Xi'an, 710038, Shaanxi, China
- Institute of Medical Research, Northwestern Polytechnical University, Xi'an, 710072, Shaanxi, China
| | - Ying Yu
- Functional and Molecular Imaging Key Lab of Shaanxi Province, Department of Radiology, Tangdu Hospital, Fourth Military Medical University, Xi'an, 710038, Shaanxi, China
| | - Zhe-Sheng Shi
- Student Brigade, Fourth Military Medical University, 169 Changle Road, Xi'an, 710032, Shaanxi, China
| | - Ke Xu
- Student Brigade, Fourth Military Medical University, 169 Changle Road, Xi'an, 710032, Shaanxi, China
| | - Jia-Hao Feng
- Student Brigade, Fourth Military Medical University, 169 Changle Road, Xi'an, 710032, Shaanxi, China
| | - Ze-Yang Li
- Student Brigade, Fourth Military Medical University, 169 Changle Road, Xi'an, 710032, Shaanxi, China
| | - Xiang-Nan Zhang
- Department of Science and Technology Affairs, Tangdu Hospital, Fourth Military Medical University, Xi'an, 710038, Shaanxi, China
| | - Shu-Ning Shen
- Department of Stomatology, PLA 984 Hospital, Beijing, 100094, China
| | - Yang Yang
- Functional and Molecular Imaging Key Lab of Shaanxi Province, Department of Radiology, Tangdu Hospital, Fourth Military Medical University, Xi'an, 710038, Shaanxi, China
| | - Lin-Feng Yan
- Functional and Molecular Imaging Key Lab of Shaanxi Province, Department of Radiology, Tangdu Hospital, Fourth Military Medical University, Xi'an, 710038, Shaanxi, China
| | - Jin Zhang
- Functional and Molecular Imaging Key Lab of Shaanxi Province, Department of Radiology, Tangdu Hospital, Fourth Military Medical University, Xi'an, 710038, Shaanxi, China
| | - Qian Sun
- Functional and Molecular Imaging Key Lab of Shaanxi Province, Department of Radiology, Tangdu Hospital, Fourth Military Medical University, Xi'an, 710038, Shaanxi, China
| | - Bo Hu
- Functional and Molecular Imaging Key Lab of Shaanxi Province, Department of Radiology, Tangdu Hospital, Fourth Military Medical University, Xi'an, 710038, Shaanxi, China
| | - Guang-Bin Cui
- Functional and Molecular Imaging Key Lab of Shaanxi Province, Department of Radiology, Tangdu Hospital, Fourth Military Medical University, Xi'an, 710038, Shaanxi, China.
| | - Wen Wang
- Functional and Molecular Imaging Key Lab of Shaanxi Province, Department of Radiology, Tangdu Hospital, Fourth Military Medical University, Xi'an, 710038, Shaanxi, China.
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Naguib R, Soliman ES, Neimatallah FM, AlKhudhairy NS, ALGhamdi AM, Almosa RS, Aldashash KA, Alkhalifah BY, Elmorshedy H. Cognitive impairment among patients with diabetes in Saudi Arabia: a cross-sectional study. MIDDLE EAST CURRENT PSYCHIATRY 2020. [DOI: 10.1186/s43045-020-00058-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
The incidence of cognitive impairment (CI) is higher in patients with diabetes mellitus (DM). The association between DM and CI and the risk factors for CI need to be addressed to estimate the prevalence of cognitive impairment in patients with DM and to identify the potential risk factors. The study is a cross-sectional study using a convenient sample of 269 subjects. Sociodemographic diabetes-related variables including biochemical markers were collected. CI and diabetes-related distress (DRD) were assessed using the Arabic version of Montreal Cognitive Assessment scale (MoCA) and the Diabetes Distress Screening Scale respectively.
Results
Overall, 80.3% had cognitive impairment while 33.8% had severe impairment. Older age, female gender, low level of education, and low income were associated with CI; duration of diabetes and DRD were associated with CI while ophthalmic complications were associated with severe CI. Duration of diabetes was inversely associated with CI. Level of HbA1c was significantly higher in patients with severe CI, and the probability of CI increased as the level of HbA1c increased. Low level of education was associated with severe CI, and CI was two times more likely among patients with DRD.
Conclusion
CI was higher than worldwide figures. Elderly females with low educational level, long duration of DM, and low socioeconomic status are at more risk. The probability of severe CI increased with increased level of HbA1c. Screening for CI in patients with diabetes along with intervention programs while considering the DRD and the level of HbA1c is crucial.
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Yulug B, Saatci O, Işıklar A, Hanoglu L, Kilic U, Ozansoy M, Cankaya S, Cankaya B, Kilic E. The Association between HbA1c Levels, Olfactory Memory and Cognition in Normal, Pre-Diabetic and Diabetic Persons. Endocr Metab Immune Disord Drug Targets 2020; 20:198-212. [PMID: 31203811 DOI: 10.2174/1871530319666190614121738] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2019] [Revised: 03/26/2019] [Accepted: 05/10/2019] [Indexed: 12/11/2022]
Abstract
BACKGROUND AND AIM Recent data have shown that olfactory dysfunction is strongly related to Alzheimer's Disease (AD) that is often preceded by olfactory deficits suggesting that olfactory dysfunction might represent an early indicator of future cognitive in prediabetes. METHODS We have applied to a group of normal (n=15), prediabetic (n=16) and type 2 diabetic outpatients (n=15) olfactory testing, 1.5-T MRI scanner and detailed cognitive evaluation including the standard Mini-Mental State Examination (MMSE) form, Short Blessed Test (SBT), Letter Fluency Test (LFT) and the category fluency test with animal, Fruit and Vegetable Naming (CFT). RESULTS We have shown that Odour Threshold (OT), Discrimination (OD), and Identification (OI) scores and most cognitive test results were significantly different in the prediabetes and diabetes group compared to those in the control group. OD and OT were significantly different between the prediabetes and diabetes group, although the cognitive test results were only significantly different in the prediabetes and diabetes group compared to those in the control group. In evaluating the association between OI, OT, OD scores and specific cognitive tests, we have found, that impaired olfactory identification was the only parameter that correlated significantly with the SBT both in the pre-diabetes and diabetes group. Although spot glucose values were only correlated with OT, HbA1c levels were correlated with OT, OD, and OI, as well as results of the letter fluency test suggesting that HbA1c levels rather than the spot glucose values play a critical role in specific cognitive dysfunction. CONCLUSION To the best of our knowledge, this is the first prospective study to demonstrate a strong association between olfactory dysfunction and specific memory impairment in a population with prediabetes and diabetes suggesting that impaired olfactory identification might play an important role as a specific predictor of memory decline.
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Affiliation(s)
- Burak Yulug
- Department of Neurology, Alanya AlaaddinKeykubat University, Antalya/Alanya, Turkey.,Istanbul Medipol University, Restorative and Regenerative Medicine Center, Istanbul, Turkey
| | - Ozlem Saatci
- Department of Otorhinolaryngology, Istanbul Sancaktepe, Education and Research Hospital, Istanbul, Turkey
| | - Aysun Işıklar
- Department of Internal Medicine, Istanbul Sancaktepe, Education and Research Hospital, Istanbul, Turkey
| | - Lutfu Hanoglu
- Department of Neurology, Istanbul Medipol University, Istanbul, Turkey
| | - Ulkan Kilic
- Department of Medical Biology, University of Health Sciences, Faculty of Medicine, Istanbul, Turkey
| | - Mehmet Ozansoy
- Istanbul Medipol University, Restorative and Regenerative Medicine Center, Istanbul, Turkey
| | - Seyda Cankaya
- Department of Neurology, Alanya AlaaddinKeykubat University, Antalya/Alanya, Turkey
| | - Baris Cankaya
- Department of Anesthesiology and Reanimation, Marmara University Pendik Education and Research Hospital, Istanbul, Turkey
| | - Ertugrul Kilic
- Istanbul Medipol University, Restorative and Regenerative Medicine Center, Istanbul, Turkey.,Department of Physiology, Istanbul Medipol University, International School of Medicine, Istanbul, Turkey
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Berlanga-Acosta J, Guillén-Nieto G, Rodríguez-Rodríguez N, Bringas-Vega ML, García-del-Barco-Herrera D, Berlanga-Saez JO, García-Ojalvo A, Valdés-Sosa MJ, Valdés-Sosa PA. Insulin Resistance at the Crossroad of Alzheimer Disease Pathology: A Review. Front Endocrinol (Lausanne) 2020; 11:560375. [PMID: 33224105 PMCID: PMC7674493 DOI: 10.3389/fendo.2020.560375] [Citation(s) in RCA: 31] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/08/2020] [Accepted: 08/13/2020] [Indexed: 12/16/2022] Open
Abstract
Insulin plays a major neuroprotective and trophic function for cerebral cell population, thus countering apoptosis, beta-amyloid toxicity, and oxidative stress; favoring neuronal survival; and enhancing memory and learning processes. Insulin resistance and impaired cerebral glucose metabolism are invariantly reported in Alzheimer's disease (AD) and other neurodegenerative processes. AD is a fatal neurodegenerative disorder in which progressive glucose hypometabolism parallels to cognitive impairment. Although AD may appear and progress in virtue of multifactorial nosogenic ingredients, multiple interperpetuative and interconnected vicious circles appear to drive disease pathophysiology. The disease is primarily a metabolic/energetic disorder in which amyloid accumulation may appear as a by-product of more proximal events, especially in the late-onset form. As a bridge between AD and type 2 diabetes, activation of c-Jun N-terminal kinase (JNK) pathway with the ensued serine phosphorylation of the insulin response substrate (IRS)-1/2 may be at the crossroads of insulin resistance and its subsequent dysmetabolic consequences. Central insulin axis bankruptcy translates in neuronal vulnerability and demise. As a link in the chain of pathogenic vicious circles, mitochondrial dysfunction, oxidative stress, and peripheral/central immune-inflammation are increasingly advocated as major pathology drivers. Pharmacological interventions addressed to preserve insulin axis physiology, mitochondrial biogenesis-integral functionality, and mitophagy of diseased organelles may attenuate the adjacent spillover of free radicals that further perpetuate mitochondrial damages and catalyze inflammation. Central and/or peripheral inflammation may account for a local flood of proinflammatory cytokines that along with astrogliosis amplify insulin resistance, mitochondrial dysfunction, and oxidative stress. All these elements are endogenous stressor, pro-senescent factors that contribute to JNK activation. Taken together, these evidences incite to identify novel multi-mechanistic approaches to succeed in ameliorating this pandemic affliction.
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Affiliation(s)
- Jorge Berlanga-Acosta
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Lab for Neuroinformation, University of Electronic Science and Technology of China, Chengdu, China
- Tissue Repair and Cytoprotection Research Group, Center for Genetic Engineering and Biotechnology, Havana, Cuba
| | - Gerardo Guillén-Nieto
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Lab for Neuroinformation, University of Electronic Science and Technology of China, Chengdu, China
- Tissue Repair and Cytoprotection Research Group, Center for Genetic Engineering and Biotechnology, Havana, Cuba
| | - Nadia Rodríguez-Rodríguez
- Tissue Repair and Cytoprotection Research Group, Center for Genetic Engineering and Biotechnology, Havana, Cuba
| | - Maria Luisa Bringas-Vega
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Lab for Neuroinformation, University of Electronic Science and Technology of China, Chengdu, China
- Cuban Neurosciences Center, Cubanacan, Havana, Cuba
| | | | - Jorge O. Berlanga-Saez
- Applied Mathematics Department, Institute of Mathematics, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Ariana García-Ojalvo
- Tissue Repair and Cytoprotection Research Group, Center for Genetic Engineering and Biotechnology, Havana, Cuba
| | - Mitchell Joseph Valdés-Sosa
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Lab for Neuroinformation, University of Electronic Science and Technology of China, Chengdu, China
- Cuban Neurosciences Center, Cubanacan, Havana, Cuba
| | - Pedro A. Valdés-Sosa
- The Clinical Hospital of Chengdu Brain Science Institute, MOE Key Lab for Neuroinformation, University of Electronic Science and Technology of China, Chengdu, China
- Cuban Neurosciences Center, Cubanacan, Havana, Cuba
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Association between diabetes and cognitive function at baseline in the Brazilian Longitudinal Study of Adult Health (ELSA- Brasil). Sci Rep 2020; 10:1596. [PMID: 32005901 PMCID: PMC6994611 DOI: 10.1038/s41598-020-58332-9] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2019] [Accepted: 01/06/2020] [Indexed: 01/21/2023] Open
Abstract
Diabetes has been associated with cognitive changes and an increased risk of vascular dementia and Alzheimer’s disease, but it is unclear whether there are associations between diabetes and early alterations in cognitive performance. The present study consisted of a cross-section analysis of 14,444 participants aged 35–74 years and from a developing country at baseline in the Brazilian Longitudinal Study of Adult Health (ELSA–Brasil); these participants were recruited between 2008 and 2010. We investigated whether there was an association between diabetes and early changes in the cognitive performance of this Brazilian population. To assess cognitive domains, we used the word-list learning, word-list delayed recall and word recognition tests along. Phonemic verbal fluency tests included semantic phonemic test (animals) and a phonemic test (words beginning with the letter F). Executive functions associated with attention, concentration and psychomotor speed were evaluated using the Trail Making Test B. The exposure variable in the study was defined as diabetes. Multiple linear regression was used to estimate the association between diabetes and cognitive performance. The results were adjusted for age, sex, education, hypertension, coronary disease, depression, physical activity, smoking, alcohol consumption, and the cholesterol/HDL-C ratio. We found a significant association between diabetes and decreased memory, language and executive function (attention, concentration and psychomotor speed) performance in this population from a country with a distinct epidemiological profile, even after adjusting for the main intervening variables.
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Abstract
AIMS To determine the risk of dementia in patients with type 1 or type 2 diabetes and in individuals with glycosylated haemoglobin, type A1C (HbA1c) of ⩾48 mmol/mol, which is the diagnostic limit for diabetes. METHODS We included the following cohorts: all incident diabetes cases aged 15 or above registered in the National Diabetes Registry (NDR) from January 2000 through December 2012 (n = 148 036) and a reference population, adult participants from the Glostrup cohort (n = 16 801), the ADDITION Study (n = 26 586) and Copenhagen Aging and Midlife Biobank (CAMB) (n = 5408). Using these cohorts, we analysed if a diagnosis of type 1 or type 2 diabetes in the NDR or HbA1c level of ⩾ 6.5% (48 mmol/mol) in the cohorts increased risk of dementia in the Danish National Patient Registry or cognitive performance assessed by the Intelligenz-Struktur-Test 2000R (IST2000R). RESULTS A diagnosis of type 1 or type 2 diabetes in the NDR was associated with increased risk of dementia diagnosed both before or after age 65 as well as across different subtypes of dementia. Self-reported diabetes or high HbA1c levels were associated with lower cognitive performance (p = 0.004), while high HbA1c was associated with increased risk of dementia (HR 1.94 (1.10-3.44) in the Glostrup cohort but not in the ADDITION Study (HR 0.96 (0.57-1.61)). CONCLUSIONS Both type 1 and type 2 diabetes are associated with an increased risk of dementia, while the importance of screening-detected elevated HbA1c remains less clear.
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Factors associated with cognitive impairment in elderly versus nonelderly patients with metabolic syndrome: the different roles of FGF21. Sci Rep 2018; 8:5174. [PMID: 29581470 PMCID: PMC5980096 DOI: 10.1038/s41598-018-23550-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2017] [Accepted: 03/13/2018] [Indexed: 12/30/2022] Open
Abstract
Increased fibroblast growth factor 21 (FGF21) levels have been found in patients with metabolic syndrome (MetS). MetS is also associated with cognitive decline. However, the correlation between FGF21 and cognitive decline in elderly and nonelderly MetS patients has not been investigated. 116 non-elderly patients (age <65 years old) and 96 elderly patients (≥65 years old) with MetS were enrolled. Blood samples for FGF21 were collected from all participants after 12-hour fasting. Cognitive function was assessed using the Montreal cognitive assessment (MoCA) test. The MoCA score was negatively associated with age and was different among different levels of education in these MetS patients. In the non-elderly group, body mass index (BMI) showed positively correlated with MoCA score while, FGF21 level and HbA1C were negatively associated with the MoCA score in non-elderly MetS patients. BMI was the only factor which showed a negative correlation with the MoCA score in elderly MetS patients. This study demonstrated that FGF21 level was independently associated with cognitive impairment in non-elderly patients but not in elderly patients. The possible role of FGF21 level in cognitive impairment in non-elderly should be confirmed in a prospective study.
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Morelli NL, Cachioni M, Lopes A, Batistoni SST, Falcão DVDS, Neri AL, Yassuda MS. Verbal fluency in elderly with and without hypertension and diabetes from the FIBRA study in Ermelino Matarazzo. Dement Neuropsychol 2017; 11:413-418. [PMID: 29354222 PMCID: PMC5770000 DOI: 10.1590/1980-57642016dn11-040011] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2017] [Accepted: 11/06/2017] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND There are few studies on the qualitative variables derived from the animal category verbal fluency test (VF), especially with data originating from low-income samples of community-based studies. OBJECTIVE To compare elderly with and without hypertension (HTN) and diabetes mellitus (DM) regarding the total number of animals spoken, number of categories, groups and category switches on the VF test. METHODS We used the database of the FIBRA (Frailty in Brazilian Elderly) community-based study. The variables number of Categories, Groups and Category Switches were created for each participant. The total sample (n = 384) was divided into groups of elderly who reported having HTN, DM, both HTN and DM, or neither of these conditions. RESULTS There were no significant differences between the groups with and without these chronic diseases for VF total score or for the qualitative variables. CONCLUSION Among independent community-dwelling elderly, the qualitative variables derived from the VF animal category may not add information regarding the cognitive profile of elderly with chronic diseases. Total VF score and the qualitative variables Category, Group and Switching did not differentiate elderly with and without HTN and DM.
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Affiliation(s)
- Nathalia Lais Morelli
- Gerontologia, Escola de Artes, Ciências e Humanidades, Universidade de São Paulo, São Paulo, São Paulo, Brazil
| | - Meire Cachioni
- Gerontologia, Escola de Artes, Ciências e Humanidades, Universidade de São Paulo, São Paulo, São Paulo, Brazil
- Gerontologia, Faculdade de Ciências Médicas, UNICAMP, Campinas, São Paulo, Brazil
| | - Andrea Lopes
- Gerontologia, Escola de Artes, Ciências e Humanidades, Universidade de São Paulo, São Paulo, São Paulo, Brazil
| | - Samila Sathler Tavares Batistoni
- Gerontologia, Escola de Artes, Ciências e Humanidades, Universidade de São Paulo, São Paulo, São Paulo, Brazil
- Gerontologia, Faculdade de Ciências Médicas, UNICAMP, Campinas, São Paulo, Brazil
| | | | - Anita Liberalesso Neri
- Gerontologia, Escola de Artes, Ciências e Humanidades, Universidade de São Paulo, São Paulo, São Paulo, Brazil
- Gerontologia, Faculdade de Ciências Médicas, UNICAMP, Campinas, São Paulo, Brazil
| | - Monica Sanches Yassuda
- Gerontologia, Escola de Artes, Ciências e Humanidades, Universidade de São Paulo, São Paulo, São Paulo, Brazil
- Gerontologia, Faculdade de Ciências Médicas, UNICAMP, Campinas, São Paulo, Brazil
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Gayda M, Gremeaux V, Bherer L, Juneau M, Drigny J, Dupuy O, Lapierre G, Labelle V, Fortier A, Nigam A. Cognitive function in patients with stable coronary heart disease: Related cerebrovascular and cardiovascular responses. PLoS One 2017; 12:e0183791. [PMID: 28937981 PMCID: PMC5609740 DOI: 10.1371/journal.pone.0183791] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2017] [Accepted: 06/08/2017] [Indexed: 11/18/2022] Open
Abstract
Chronic exercise has been shown to prevent or slow age-related decline in cognitive functions in otherwise healthy, asymptomatic individuals. We sought to assess cognitive function in a stable coronary heart disease (CHD) sample and its relationship to cerebral oxygenation-perfusion, cardiac hemodynamic responses, and V˙O2 peak compared to age-matched and young healthy control subjects. Twenty-two young healthy controls (YHC), 20 age-matched old healthy controls (OHC) and 25 patients with stable CHD were recruited. Cognitive function assessment included short term—working memory, perceptual abilities, processing speed, cognitive inhibition and flexibility and long-term verbal memory. Maximal cardiopulmonary function (gas exchange analysis), cardiac hemodynamic (impedance cardiography) and left frontal cerebral oxygenation-perfusion (near-infra red spectroscopy) were measured during and after a maximal incremental ergocycle test. Compared to OHC and CHD, YHC had higher V˙O2 peak, maximal cardiac index (CI max), cerebral oxygenation-perfusion (ΔO2 Hb, ΔtHb: exercise and recovery) and cognitive function (for all items) (P<0.05). Compared to OHC, CHD patients had lower V˙O2 peak, CI max, cerebral oxygenation-perfusion (during recovery) and short term—working memory, processing speed, cognitive inhibition and flexibility and long-term verbal memory (P<0.05). V˙O2 peak and CI max were related to exercise cerebral oxygenation-perfusion and cognitive function (P<0.005). Cerebral oxygenation-perfusion (exercise) was related to cognitive function (P<0.005). Stable CHD patients have a worse cognitive function, a similar cerebral oxygenation/perfusion during exercise but reduced one during recovery vs. their aged-matched healthy counterparts. In the all sample, cognitive functions correlated with V˙O2 peak, CI max and cerebral oxygenation-perfusion.
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Affiliation(s)
- Mathieu Gayda
- Cardiovascular Prevention and Rehabilitation Centre (ÉPIC), Montreal Heart Institute and University of Montreal, Montreal, Quebec, Canada
- Research Center, Montreal Heart Institute and University of Montreal, Montreal, Quebec, Canada
- Department of Medicine, Faculty of Medicine, University of Montreal, Montreal, Quebec, Canada
| | - Vincent Gremeaux
- INSERM - U1093 “Cognition, Action, et Plasticité Sensorimotrice”, Dijon, France
| | - Louis Bherer
- Cardiovascular Prevention and Rehabilitation Centre (ÉPIC), Montreal Heart Institute and University of Montreal, Montreal, Quebec, Canada
- Research Center, Montreal Heart Institute and University of Montreal, Montreal, Quebec, Canada
- Department of Medicine, Faculty of Medicine, University of Montreal, Montreal, Quebec, Canada
| | - Martin Juneau
- Cardiovascular Prevention and Rehabilitation Centre (ÉPIC), Montreal Heart Institute and University of Montreal, Montreal, Quebec, Canada
- Research Center, Montreal Heart Institute and University of Montreal, Montreal, Quebec, Canada
- Department of Medicine, Faculty of Medicine, University of Montreal, Montreal, Quebec, Canada
| | - Joffrey Drigny
- Cardiovascular Prevention and Rehabilitation Centre (ÉPIC), Montreal Heart Institute and University of Montreal, Montreal, Quebec, Canada
| | - Olivier Dupuy
- Cardiovascular Prevention and Rehabilitation Centre (ÉPIC), Montreal Heart Institute and University of Montreal, Montreal, Quebec, Canada
- PERFORM Centre, Department of Psychology, Concordia University, Montreal, Quebec, Canada
- Research Centre, Institut Universitaire de Gériatrie de Montreal, Montreal, Quebec, Canada
- Laboratory, MOVE (EA6314), Faculty of Sport Sciences, Université de Poitiers, Poitiers, France
| | - Gabriel Lapierre
- Cardiovascular Prevention and Rehabilitation Centre (ÉPIC), Montreal Heart Institute and University of Montreal, Montreal, Quebec, Canada
- Research Center, Montreal Heart Institute and University of Montreal, Montreal, Quebec, Canada
- Department of Medicine, Faculty of Medicine, University of Montreal, Montreal, Quebec, Canada
| | - Véronique Labelle
- Research Centre, Institut Universitaire de Gériatrie de Montreal, Montreal, Quebec, Canada
| | - Annik Fortier
- Montreal Health Innovations Coordinating Center, A Division of the Montreal Heart Institute, Montreal, Quebec, Canada
| | - Anil Nigam
- Cardiovascular Prevention and Rehabilitation Centre (ÉPIC), Montreal Heart Institute and University of Montreal, Montreal, Quebec, Canada
- Research Center, Montreal Heart Institute and University of Montreal, Montreal, Quebec, Canada
- Department of Medicine, Faculty of Medicine, University of Montreal, Montreal, Quebec, Canada
- * E-mail:
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Stewart MW, Traylor AC, Bratzke LC. Nutrition and Cognition in Older Adults With Heart Failure: A Systematic Review. J Gerontol Nurs 2017; 41:50-9. [PMID: 26505248 DOI: 10.3928/00989134-20151015-06] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2015] [Accepted: 09/02/2015] [Indexed: 11/20/2022]
Abstract
Cognitive impairment is commonly observed in older adults with heart failure; nutrition is a possible contributing factor. The purpose of the current systematic review is to examine the relationship between nutrition and cognition in older adults with heart failure. A literature review was performed through August 2015 that examined published, peer-reviewed studies from PubMed, PsycINFO, CINAHL, and Web of Science. Four articles were selected for inclusion. Findings revealed that poorer nutritional habits were associated with poorer attention, executive functioning, and memory in older adults with heart failure. Nutritional biomarkers, including anemia, hyponatremia, hypokalemia, hyperglycemia, and hypoalbuminemia, were also associated with cognitive impairment. More research is needed to explore the relationship between nutrition and cognition in this population. Descriptive studies will inform scientists as they design and test nutritional interventions to optimize cognitive function in older adults with heart failure.
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Angiographic evidence of proliferative retinopathy predicts neuropsychiatric morbidity in diabetic patients. Psychoneuroendocrinology 2016; 67:163-70. [PMID: 26907995 DOI: 10.1016/j.psyneuen.2016.02.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2016] [Revised: 02/09/2016] [Accepted: 02/11/2016] [Indexed: 01/21/2023]
Abstract
INTRODUCTION Diabetic retinopathy (DR) is a common vasculopathy categorized as either non-proliferative (NPDR) or proliferative (PDR),characterized by dysfunctional blood-retinal barrier (BRB) and diagnosed using fluorescein angiography (FA). Since the BRB is similar in structure and function to the blood-brain barrier (BBB) and BBB dysfunction plays a key role in the pathogenesis of brain disorders, we hypothesized that PDR, the severe form of DR, is likely to mirror BBB damage and to predict a worse neuropsychiatric outcome. METHODS A retrospective cohort study was conducted among subjects with diabetes (N=2982) with FA-confirmed NPDR (N=2606) or PDR (N=376). Incidence and probability to develop brain pathologies and mortality were investigated in a 10-year follow-up study. We used Kaplan-Meier, Cox and logistic regression analyses to examine association between DR severity and neuropsychiatric morbidity adjusting for confounders. RESULTS Patients with PDR had significantly higher rates of all-cause brain pathologies (P<0.001), specifically stroke (P=0.005), epilepsy (P=0.006) and psychosis (P=0.024), and a shorter time to develop any neuropsychiatric event (P<0.001) or death (P=0.014) compared to NPDR. Cox adjusted hazard ratio for developing all-cause brain impairments was higher for PDR (HR=1.37, 95% CI 1.16-1.61, P<0.001) which was an independent predictor for all-cause brain impairments (OR 1.30, 95% CI 1.04-1.64, P=0.022), epilepsy (OR 2.16, 95% CI 1.05-4.41, P=0.035) and mortality (HR=1.35, 95% CI 1.06-1.70, P=0.014). CONCLUSIONS This is the first study to confirm that angiography-proven microvasculopathy identifies patients at high risk for neuropsychiatric morbidity and mortality.
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