Correlates of plasma fibrinogen (FG) levels in a random sample of community-dwelling elderly

Risk and protective factors of neurocognitive disorders in older adults in Central and Eastern Europe: A systematic review of population-based studies

BACKGROUND

A wide range of potentially modifiable risk factors, indicating that the onset of neurocognitive disorders can be delayed or prevented, have been identified. The region of Central and Eastern Europe has cultural, political and economic specifics that may influence the occurrence of risk factors and their link to the cognitive health of the population.

OBJECTIVE

We aimed to systematically review population-based studies from Central and Eastern Europe to gather evidence on risk and protective factors for neurocognitive disorders.

METHODS

We searched the electronic databases PubMed, Cochrane Database of Systematic Reviews, PsycINFO, Web of Science, and Embase. The search was performed on 26th of February 2020 and repeated at the end of the review process on 20th May 2021.

RESULTS

We included 25 papers in a narrative synthesis of the evidence describing cardiovascular risk factors (n = 7), social factors (n = 5), oxidative stress (n = 2), vitamins (n = 2), genetic factors (n = 2) and other areas (n = 7). We found that there was a good body of evidence on the association between neurocognitive disorders and the history of cardiovascular disease while there were gaps in research of genetic and social risk factors.

CONCLUSION

We conclude that the epidemiological evidence from this region is insufficient and population-based prospectively followed cohorts should be established to allow the development of preventive strategies at national levels.

Association between circulating hemostatic measures and dementia or cognitive impairment: systematic review and meta-analyzes

BACKGROUND AND OBJECTIVES

Hemostasis and thrombosis may be important contributors to cognitive decline and dementia. Certain blood markers may assist in diagnosis or management.

OBJECTIVES

To collate evidence for the association of circulating hemostatic variables and dementia or cognitive impairment.

METHODS

A systematic review of studies describing blood markers of hemostatic function and cognition/dementia. Abstracts were reviewed by two independent assessors and studies selected based on pre-specified criteria. We described methodological quality and performed meta-analyzes where data allowed.

RESULTS

From 7103 titles, 485 abstracts and included 21 studies (n = 32,773) were assessed. In two longitudinal studies, the incident of vascular dementia risk was greater for higher D-dimer [hazard ratio (HR): 1.50, 95% confidence interval (CI): 1.15-1.96]. For case-control data, we calculated standardized mean differences (SMD) and 95% CI. Higher levels of: factor (F)VII (SMD: 0.93; 95% CI: 0.60-1.26), fibrinogen (SMD: 1.53; 95% CI: 1.17-1.87), prothrombin fragment 1 and 2 (SMD: 0.64; 95% CI: 0.32-0.96), plasminogen activator inhibitor (SMD: 0.68; 95% CI: 0.26-1.10), D-dimer (SMD: 2.00; 95% CI: 1.59-2.40) and von Willebrand factor (VWF) (SMD: 1.68; 95% CI: 1.30-2.06) showed modest but significant associations with vascular dementia. For patients with any dementia diagnosis, associations were with higher D-dimer (SMD: 0.36; 95% CI: 0.15-0.56) and VWF (SMD: 0.31; 95% CI: 0.11-0.51). For specific cognitive domains, significant (P < 0.001) positive correlations were fibrinogen and speed of processing (0.76; 95% CI: 0.67-0.84), verbal memory (0.69; 95% CI: 0.59-0.79) and non-verbal reasoning (0.57; 95% CI: 0.49-0.65).

CONCLUSIONS

The present results suggest a modest association between hemostasis and vascular dementia including increased levels of thrombin generation markers (D-dimer and prothrombin fragment 1 + 2) and endothelial dysfunction (VWF and plasminogen activator inhibitor). Associations are weaker for specific cognitive tests and when all dementias are combined.

Reverse causation in the association between C-reactive protein and fibrinogen levels and cognitive abilities in an aging sample

OBJECTIVE

To test the hypothesis that increased levels of inflammatory and hemostatic markers are associated with poorer cognitive performance and to assess the influence of childhood intelligence quotient (IQ) and current cardiovascular disease (CVD) risk factors on this relationship. Blood inflammatory markers have been shown to predict late-life cognition, although the mechanism through which this occurs is unknown.

METHODS

Levels of the biomarkers C-reactive protein and fibrinogen were measured in 1053 Scottish participants (50.2% female) from the Lothian Birth Cohort 1936 ranging in age from 67 to 71 years. Biomarker levels were tested for their association with diverse cognitive abilities.

RESULTS

Significant cross-sectional associations were found between the biomarkers and various cognitive abilities: their effect size was around 1% of the variance and was in the direction of higher marker levels conferring poorer cognitive performance. With the exception of the reaction time measures (and fibrinogen), these associations could be explained by childhood IQ, CVD risk factors, or both. Importantly, both the inflammatory markers at age 70 years were associated (p < .001) with childhood IQ.

CONCLUSIONS

Whereas inflammatory marker levels predict contemporaneous general cognitive ability, the results support a model of reverse causation because childhood IQ predicts late-life inflammation. This might be through its association with later life CVD risk factors or because it is a measure of system integrity. Unlike general cognitive ability, the association between inflammatory markers (particularly fibrinogen) and processing speed was maintained in the presence of childhood IQ and/or CVD risk factor adjustments. This might also reflect variation in physiological integrity.

Cardiovascular diseases (CVD) risk factors, physical activity (PA) and plasma plasminogen (Plg) in a random sample of community-dwelling elderly

The aim of this study was to evaluate the association between plasma Plg levels and coexisting CVD risk factors, comorbidities, PA, functional status and cognitive function in a random sample of 298 (179 women and 119 men) community-dwelling elderly aged 65-79 years. The average plasma Plg level was 91.4+/-19.7% and was lower in men (86.6+/-20.7%) than in women (94.6+/-18.5%). In women, Plg levels were higher in individuals with diagnosed ischemic heart disease (IHD) and increased with triglycerides (TG) and glucose level. In men, Plg levels decreased with advancing age, were higher in current smokers, decreased with the percentage of body fat, increased with total cholesterol (T-CH), low density lipoprotein cholesterol (LDL-CH) and high density lipoprotein cholesterol (HDL-CH) levels, and were directly correlated with two different PA indices. Multivariate analysis revealed that gender, current smoking, IHD, T-CH and the Seven Day Recall PA Questionnaire Hard score independently predict plasma Plg levels in the whole group of elderly people. In conclusion, Plg seems to be directly related to CVD and metabolic risk profile as well as PA level but not to functional status or cognitive function of older individuals.