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He Q, Wu KCH, Bennett AN, Zhang JY, Chan KHK. Nutritional Interventions for the Prevention of Cognitive Decline in Patients With Mild Cognitive Impairment and Alzheimer Disease: Protocol for a Network Meta-Analysis of Randomized Controlled Trials. JMIR Res Protoc 2024; 13:e47196. [PMID: 38416536 PMCID: PMC10938226 DOI: 10.2196/47196] [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: 03/11/2023] [Revised: 10/18/2023] [Accepted: 11/23/2023] [Indexed: 02/29/2024] Open
Abstract
BACKGROUND Mild cognitive impairment (MCI) is the stage between cognitive decline due to physiological aging and the severity of decline seen in neurodegenerative disorders like Alzheimer disease (AD), which is among the most prevalent neurodegenerative disorders characterized by cognitive impairment. People with MCI are at increased risk of developing AD. Although MCI and AD are incurable, nutritional interventions can potentially delay or prevent their onset. Consequently, effective interventions used to decelerate or alleviate the progress of cognitive impairment in older people are a significant focus in geriatric care. Given the synergistic effects of nutrition on health, assessing the effectiveness of nutritional supplements or dietary composition in preventing MCI or AD is essential for developing interventional strategies. OBJECTIVE Our study aims to assess the effectiveness of various nutritional interventions, including special dietary types, dietary patterns, specific foods, nutritional intake, and nutritional supplements, in preventing cognitive decline among patients diagnosed with MCI or AD. To achieve this, we will use a comprehensive approach, including network meta-analysis, pairwise meta-analysis, and systematic review of randomized controlled trials (RCTs). METHODS The review will follow the Population, Intervention, Comparison, Outcome (PICO) model and the PRISMA-P (Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols) guidelines. Two investigators will independently search PubMed electronically. Data extraction will follow the inclusion criteria, and data will be assessed for risk of bias using a revised tool. Additionally, evidence quality will be evaluated using the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) framework. The outcomes of interest are assessing the cognitive outcomes in patients with MCI or AD. A systematic literature search will be conducted, identifying randomized controlled trials that investigate the impact of these nutritional interventions on cognitive function decline in individuals with MCI and AD. Network meta-analyses (random-effects model) and pairwise meta-analyses will then estimate the relative effectiveness of different nutritional interventions. RESULTS We included 51 studies, published between 1999 and 2023 (27 studies for AD and 24 studies for MCI) and involving 8420 participants. We completed data extraction for all 51 studies by December 2023. Currently, we are actively engaged in data analysis and manuscript preparation. We plan to finalize the manuscript and publish the comprehensive results by the end of 2024. CONCLUSIONS Our study holds significant clinical relevance given the rising prevalence of AD and the potential influence of nutritional interventions on cognitive function in individuals with MCI and AD. By investigating this relationship, our research aims to inform evidence-based decision-making in the development of prevention strategies for MCI and AD. The outcomes are expected to contribute to the establishment of reliable recommendations for MCI or AD management, providing substantial support in the field. TRIAL REGISTRATION PROSPERO CRD42022331173; http://tinyurl.com/3snjp7a4. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) PRR1-10.2196/47196.
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Affiliation(s)
- Qian He
- Department of Biomedical Sciences, City University of Hong Kong, Hong Kong, China
| | - Kevin Chun Hei Wu
- Department of Biomedical Sciences, City University of Hong Kong, Hong Kong, China
| | - Adam N Bennett
- Department of Biomedical Sciences, City University of Hong Kong, Hong Kong, China
| | - Jia Yue Zhang
- Department of Biomedical Sciences, City University of Hong Kong, Hong Kong, China
| | - Kei Hang Katie Chan
- Department of Biomedical Sciences, City University of Hong Kong, Hong Kong, China
- Department of Electrical Engineering, City University of Hong Kong, Hong Kong, China
- Department of Epidemiology, Centre for Global Cardiometabolic Health, Brown University, Providence, RI, United States
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Singh S, Mahajan M, Kumar D, Singh K, Chowdhary M, Amit. An inclusive study of recent advancements in Alzheimer's disease: A comprehensive review. Neuropeptides 2023; 102:102369. [PMID: 37611472 DOI: 10.1016/j.npep.2023.102369] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2023] [Revised: 08/08/2023] [Accepted: 08/11/2023] [Indexed: 08/25/2023]
Abstract
Alzheimer's disease (AD) has remained elusive in revealing its pathophysiology and mechanism of development. In this review paper, we attempt to highlight several theories that abound about the exact pathway of AD development. The number of cases worldwide has prompted a constant flow of research to detect high-risk patients, slow the progression of the disease and discover improved methods of treatment that may prove effective. We shall focus on the two main classes of drugs that are currently in use; and emerging ones with novel mechanisms that are under development. As of late there has also been increased attention towards factors that were previously thought to be unrelated to AD, such as the gut microbiome, lifestyle habits, and diet. Studies have now shown that all these factors make an impact on AD progression, thus bringing to our attention more areas that could hold the key to combating this disease. This paper covers all the aforementioned factors concisely. We also briefly explore the relationship between mental health and AD, both before and after the diagnosis of the disease.
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Affiliation(s)
- Sukanya Singh
- Department of Zoology, Hansraj College, University of Delhi, New Delhi, Delhi 110007, India
| | - Mitali Mahajan
- Department of Zoology, Hansraj College, University of Delhi, New Delhi, Delhi 110007, India
| | - Dhawal Kumar
- Department of Zoology, Hansraj College, University of Delhi, New Delhi, Delhi 110007, India
| | - Kunika Singh
- Department of Zoology, Hansraj College, University of Delhi, New Delhi, Delhi 110007, India
| | - Mehvish Chowdhary
- Department of Zoology, Hansraj College, University of Delhi, New Delhi, Delhi 110007, India
| | - Amit
- Department of Zoology, Hansraj College, University of Delhi, New Delhi, Delhi 110007, India.
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Zhang JJ, Wu ZX, Tan W, Liu D, Cheng GR, Xu L, Hu FF, Zeng Y. Associations among multidomain lifestyles, chronic diseases, and dementia in older adults: a cross-sectional analysis of a cohort study. Front Aging Neurosci 2023; 15:1200671. [PMID: 37600519 PMCID: PMC10438989 DOI: 10.3389/fnagi.2023.1200671] [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: 04/05/2023] [Accepted: 07/10/2023] [Indexed: 08/22/2023] Open
Abstract
Background Unhealthy lifestyles and chronic diseases are commonly seen and treatable factors in older adults and are both associated with dementia. However, the synergistic effect of the interaction of lifestyles and chronic diseases on dementia is unknown. Methods We determined independent associations of multidomain lifestyles and chronic diseases (cerebrovascular disease, diabetes, and hypertension) with dementia and examined their synergistic impact on dementia among older adults. The data were drawn from the Hubei Memory and Aging Cohort Study. We created a summary score of six factors for multidomain lifestyles. Dementia was diagnosed according to the Diagnostic and Statistical Manual of Mental Disorders IV. Logistic regression and multiple correspondence analyses were used to explore the relationships among multidomain lifestyles, chronic diseases, and dementia. A sensitivity analysis was performed to minimize the interference of reverse causality and potential confounders. Results Independent associations with dementia were found in unhealthy (OR = 1.90, 95% CI: 1.38-2.61) and intermediate healthy lifestyles (OR, 3.29, 2.32-4.68), hypertension (OR, 1.21, 1.01-1.46), diabetes (OR, 1.30, 1.04-1.63), and cerebrovascular disease (OR, 1.39, 1.12-1.72). Interactions of diabetes (p = 0.004), hypertension (p = 0.004), and lifestyles were significant, suggesting a combined impact on dementia. Sensitivity analysis supported the strong association among multidomain lifestyles, chronic diseases, and dementia prevalence. Conclusion An unhealthy lifestyle was associated with a higher prevalence of dementia, regardless of whether the participants had chronic diseases; however, this association was stronger in individuals with chronic diseases. Multidomain lifestyles and chronic diseases may have an enhanced impact on dementia.
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Affiliation(s)
- Jing-jing Zhang
- Geriatric Hospital Affiliated to Wuhan University of Science and Technology, Wuhan, China
- Brain Science and Advanced Technology Institute, Wuhan University of Science and Technology, Wuhan, China
- School of Public Health, Wuhan University of Science and Technology, Wuhan, China
| | - Zhao-xia Wu
- Wuchang Hospital Affiliated to Wuhan University of Science and Technology, Wuhan, China
| | - Wei Tan
- Geriatric Hospital Affiliated to Wuhan University of Science and Technology, Wuhan, China
| | - Dan Liu
- Geriatric Hospital Affiliated to Wuhan University of Science and Technology, Wuhan, China
- Brain Science and Advanced Technology Institute, Wuhan University of Science and Technology, Wuhan, China
- School of Public Health, Wuhan University of Science and Technology, Wuhan, China
| | - Gui-rong Cheng
- Geriatric Hospital Affiliated to Wuhan University of Science and Technology, Wuhan, China
- Brain Science and Advanced Technology Institute, Wuhan University of Science and Technology, Wuhan, China
- School of Public Health, Wuhan University of Science and Technology, Wuhan, China
| | - Lang Xu
- Geriatric Hospital Affiliated to Wuhan University of Science and Technology, Wuhan, China
- Brain Science and Advanced Technology Institute, Wuhan University of Science and Technology, Wuhan, China
- School of Public Health, Wuhan University of Science and Technology, Wuhan, China
| | - Fei-fei Hu
- Geriatric Hospital Affiliated to Wuhan University of Science and Technology, Wuhan, China
- Brain Science and Advanced Technology Institute, Wuhan University of Science and Technology, Wuhan, China
- School of Public Health, Wuhan University of Science and Technology, Wuhan, China
| | - Yan Zeng
- Geriatric Hospital Affiliated to Wuhan University of Science and Technology, Wuhan, China
- Brain Science and Advanced Technology Institute, Wuhan University of Science and Technology, Wuhan, China
- School of Public Health, Wuhan University of Science and Technology, Wuhan, China
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Tanprasertsuk J, Scott TM, Barbey AK, Barger K, Wang XD, Johnson MA, Poon LW, Vishwanathan R, Matthan NR, Lichtenstein AH, Ferland G, Johnson EJ. Carotenoid-Rich Brain Nutrient Pattern Is Positively Correlated With Higher Cognition and Lower Depression in the Oldest Old With No Dementia. Front Nutr 2021; 8:704691. [PMID: 34268331 PMCID: PMC8275828 DOI: 10.3389/fnut.2021.704691] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Accepted: 05/31/2021] [Indexed: 12/17/2022] Open
Abstract
Background: Healthy dietary patterns are related to better cognitive health in aging populations. While levels of individual nutrients in neural tissues are individually associated with cognitive function, the investigation of nutrient patterns in human brain tissue has not been conducted. Methods: Brain tissues were acquired from frontal and temporal cortices of 47 centenarians from the Georgia Centenarian Study. Fat-soluble nutrients (carotenoids, vitamins A, E, K, and fatty acids [FA]) were measured and averaged from the two brain regions. Nutrient patterns were constructed using principal component analysis. Cognitive composite scores were constructed from cognitive assessment from the time point closest to death. Dementia status was rated by Global Deterioration Scale (GDS). Pearson's correlation coefficients between NP scores and cognitive composite scores were calculated controlling for sex, education, hypertension, diabetes, and APOE ε4 allele. Result: Among non-demented subjects (GDS = 1-3, n = 23), a nutrient pattern higher in carotenoids was consistently associated with better performance on global cognition (r = 0.38, p = 0.070), memory (r = 0.38, p = 0.073), language (r = 0.42, p = 0.046), and lower depression (r = -0.40, p = 0.090). The findings were confirmed with univariate analysis. Conclusion: Both multivariate and univariate analyses demonstrate that brain nutrient pattern explained mainly by carotenoid concentrations is correlated with cognitive function among subjects who had no dementia. Investigation of their synergistic roles on the prevention of age-related cognitive impairment remains to be performed.
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Affiliation(s)
- Jirayu Tanprasertsuk
- Gerald J. and Dorothy R. Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, United States
| | - Tammy M. Scott
- Gerald J. and Dorothy R. Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, United States
| | - Aron K. Barbey
- Department of Psychology, Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign, Urbana, IL, United States
| | - Kathryn Barger
- Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, Boston, MA, United States
| | - Xiang-Dong Wang
- Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, Boston, MA, United States
| | - Mary Ann Johnson
- Department of Nutrition and Health Sciences, University of Nebraska Lincoln, Lincoln, NE, United States
| | - Leonard W. Poon
- Institute of Gerontology, College of Public Health, University of Georgia, Athens, GA, United States
| | - Rohini Vishwanathan
- Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, Boston, MA, United States
| | - Nirupa R. Matthan
- Gerald J. and Dorothy R. Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, United States
- Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, Boston, MA, United States
| | - Alice H. Lichtenstein
- Gerald J. and Dorothy R. Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, United States
- Jean Mayer USDA Human Nutrition Research Center on Aging at Tufts University, Boston, MA, United States
| | - Guylaine Ferland
- Département de Nutrition, Université de Montréal, Montréal, QC, Canada
| | - Elizabeth J. Johnson
- Gerald J. and Dorothy R. Friedman School of Nutrition Science and Policy, Tufts University, Boston, MA, United States
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5
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Hepsomali P, Groeger JA. Diet and general cognitive ability in the UK Biobank dataset. Sci Rep 2021; 11:11786. [PMID: 34083695 PMCID: PMC8175590 DOI: 10.1038/s41598-021-91259-3] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2021] [Accepted: 05/25/2021] [Indexed: 12/03/2022] Open
Abstract
Accumulating evidence suggests that dietary interventions might have potential to be used as a strategy to protect against age-related cognitive decline and neurodegeneration, as there are associations between some nutrients, food groups, dietary patterns, and some domains of cognition. In this study, we aimed to conduct the largest investigation of diet and cognition to date, through systematically examining the UK Biobank (UKB) data to find out whether dietary quality and food groups play a role on general cognitive ability. This cross-sectional population-based study involved 48,749 participants. UKB data on food frequency questionnaire and cognitive function were used. Also, healthy diet, partial fibre intake, and milk intake scores were calculated. Adjusted models included age, sex, and BMI. We observed associations between better general cognitive ability and higher intakes of fish, and unprocessed red meat; and moderate intakes of fibre, and milk. Surprisingly, we found that diet quality, vegetable intake, high and low fibre and milk intake were inversely associated with general cognitive ability. Our results suggest that fish and unprocessed red meat and/or nutrients that are found in fish and unprocessed red meat might be beneficial for general cognitive ability. However, results should be interpreted in caution as the same food groups may affect other domains of cognition or mental health differently. These discrepancies in the current state of evidence invites further research to examine domain-specific effects of dietary patterns/food groups on a wide range of cognitive and affective outcomes with a special focus on potential covariates that may have an impact on diet and cognition relationship.
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Affiliation(s)
- Piril Hepsomali
- Department of Psychology, University of Roehampton, London, UK.
- Unilever R&D, Colworth Science Park, Bedford, UK.
| | - John A Groeger
- Department of Psychology, Nottingham Trent University, School of Social Sciences, Nottingham, UK
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6
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Rosenberg A, Mangialasche F, Ngandu T, Solomon A, Kivipelto M. Multidomain Interventions to Prevent Cognitive Impairment, Alzheimer's Disease, and Dementia: From FINGER to World-Wide FINGERS. JPAD-JOURNAL OF PREVENTION OF ALZHEIMERS DISEASE 2021; 7:29-36. [PMID: 32010923 PMCID: PMC7222931 DOI: 10.14283/jpad.2019.41] [Citation(s) in RCA: 74] [Impact Index Per Article: 24.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Alzheimer’s disease (AD) and dementia are a global public health priority, and prevention has been highlighted as a pivotal component in managing the dementia epidemic. Modifiable risk factors of dementia and AD include lifestyle-related factors, vascular and metabolic disorders, and psychosocial factors. Randomized controlled clinical trials (RCTs) are needed to clarify whether modifying such factors can prevent or postpone cognitive impairment and dementia in older adults. Given the complex, multifactorial, and heterogeneous nature of late-onset AD and dementia, interventions targeting several risk factors and mechanisms simultaneously may be required for optimal preventive effects. The Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability (FINGER) is the first large, long-term RCT to demonstrate that a multidomain lifestyle-based intervention ameliorating vascular and lifestyle-related risk factors can preserve cognitive functioning and reduce the risk of cognitive decline among older adults at increased risk of dementia. To investigate the multidomain intervention in other populations and diverse cultural and geographical settings, the World-Wide FINGERS (WW-FINGERS) network was recently launched (https://alz.org/wwfingers). Within this network, new FINGER-type trials with shared core methodology, but local culture and context-specific adaptations, will be conducted in several countries. The WW-FINGERS initiative facilitates international collaborations, provides a platform for testing multidomain strategies to prevent cognitive impairment and dementia, and aims at generating high-quality scientific evidence to support public health and clinical decision-making. Furthermore, the WW-FINGERS network can support the implementation of preventive strategies and translation of research findings into practice.
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Affiliation(s)
- A Rosenberg
- Miia Kivipelto, Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Karolinska Universitetssjukhuset, Karolinska Vägen 37 A, QA32, 171 64 Solna, Sweden, Phone: +46 (0)73 99 40 922,
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Chen L, Xu X, Cao H, Li H. Comparison of effects of different dietary interventions on cognitive function in Alzheimer's disease: protocol for systematic review and network meta-analysis. BMJ Open 2021; 11:e042997. [PMID: 33452198 PMCID: PMC7813288 DOI: 10.1136/bmjopen-2020-042997] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
INTRODUCTION Alzheimer's disease (AD) is the most common neurodegenerative disease and is characterised by cognitive impairment. Non-pharmacological treatments such as diet therapy have been widely investigated in studies on AD. Given the synergistic effects of nutrients present in foods, considering overall dietary composition rather than focusing on a single nutrient may be more useful for evaluating the relationship between diet and AD cognition. The present study aimed to assess the efficacy of different dietary interventions (eg, ketogenic and Mediterranean diets) on cognitive function in patients with AD in a systematic review and pairwise and network meta-analyses of randomised controlled trials or clinical trials. METHODS AND ANALYSIS Two reviewers will independently conduct searches of PubMed, Cochrane Central Register of Controlled Trials, Embase, CINAHL, PsycINFO and China National Knowledge Infrastructure databases. Data will be extracted from selected studies and risk of bias will be assessed using the revised Cochrane risk-of-bias tool, and evidence quality will be assessed according to the Grading of Recommendations, Assessment, Development and Evaluation framework. The primary outcome of interest is cognitive function in patients with AD; secondary outcomes include biochemical biomarkers of AD and oxidative stress and/or inflammatory biomarkers in cerebrospinal fluid or plasma. For each outcome, random-effects pairwise and network meta-analyses will be carried out to determine the pooled relative effect of each intervention relative to every other intervention. ETHICS AND DISSEMINATION As this study is based solely on published literature, no ethics approval is required. The research will be published in a peer-reviewed journal.
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Affiliation(s)
- Lili Chen
- Sheng Li Clinical Medical College of Fujian Medical University, Fujian Provincial Hospital, Fuzhou, Fujian, China
- School of Nursing, Fujian Medical University, Fuzhou, Fujian, China
| | - Xinhua Xu
- School of Nursing, Fujian Medical University, Fuzhou, Fujian, China
| | - Huizhen Cao
- School of Nursing, Fujian Medical University, Fuzhou, Fujian, China
| | - Hong Li
- Sheng Li Clinical Medical College of Fujian Medical University, Fujian Provincial Hospital, Fuzhou, Fujian, China
- School of Nursing, Fujian Medical University, Fuzhou, Fujian, China
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Rendón-Torres L, Sierra-Rojas I, Benavides-Guerrero C, Botello-Moreno Y, Guajardo-Balderas V, García-Perales L. Predictive factors of cognitive impairment in people over 60. ENFERMERIA CLINICA 2020; 31:91-98. [PMID: 33334685 DOI: 10.1016/j.enfcli.2020.10.026] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2018] [Revised: 09/03/2020] [Accepted: 10/14/2020] [Indexed: 11/19/2022]
Abstract
OBJECTIVE To determine the relationship of depressive symptoms, sleep hygiene, nutritional status and gait speed with cognitive impairment in people over 60 years. METHOD Cross-sectional, correlational design with a non-probability convenience sampling. The population was made up of people over 60 years of age belonging to recreational stays in an urban area of Tamaulipas, Mexico. Criterion measures included three neuropsychological tests (Stroop Test, Trail Making Test and Digit Span Subtest) the Geriatric Depression Scale, Pittsburgh Sleep Quality Index, Mini Nutritional Assessment and the Short Physical Performance Battery. RESULTS The final sample was of 108 participants. Regarding the influence of risk factors to predict cognitive impairment a significant model was observed (F=12.914, gl=4, P≥.001), showing a variance explained of 33.4%, where depressive symptoms (β=.205, P=.048), sleep (β=-.322, P=.001), nutritional status (β=-.336, P=.001) and gait speed (β=.244, P=.004) were associated with cognitive impairment. CONCLUSIONS High levels of depressive symptoms, prolonged sleep duration, a malnutrition status and a slow gait speed predict cognitive impairment of the people over 60 years, this provides knowledge for the implementation of interventions aimed at preventing the risk factors that predict cognitive decline in order to delay its appearance.
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Kivipelto M, Mangialasche F, Ngandu T. Lifestyle interventions to prevent cognitive impairment, dementia and Alzheimer disease. Nat Rev Neurol 2019; 14:653-666. [PMID: 30291317 DOI: 10.1038/s41582-018-0070-3] [Citation(s) in RCA: 606] [Impact Index Per Article: 121.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Research into dementia prevention is of paramount importance if the dementia epidemic is to be halted. Observational studies have identified several potentially modifiable risk factors for dementia, including hypertension, dyslipidaemia and obesity at midlife, diabetes mellitus, smoking, physical inactivity, depression and low levels of education. Randomized clinical trials are needed that investigate whether interventions targeting these risk factors can reduce the risk of cognitive decline and dementia in elderly adults, but such trials are methodologically challenging. To date, most preventive interventions have been tested in small groups, have focused on a single lifestyle factor and have yielded negative or modest results. Given the multifactorial aetiology of dementia and late-onset Alzheimer disease, multidomain interventions that target several risk factors and mechanisms simultaneously might be necessary for an optimal preventive effect. In the past few years, three large multidomain trials (FINGER, MAPT and PreDIVA) have been completed. The FINGER trial showed that a multidomain lifestyle intervention can benefit cognition in elderly people with an elevated risk of dementia. The primary results from the other trials did not show a statistically significant benefit of preventive interventions, but additional analyses among participants at risk of dementia showed beneficial effects of intervention. Overall, results from these three trials suggest that targeting of preventive interventions to at-risk individuals is an effective strategy. This Review discusses the current knowledge of lifestyle-related risk factors and results from novel trials aiming to prevent cognitive decline and dementia. Global initiatives are presented, including the World Wide FINGERS network, which aims to harmonize studies on dementia prevention, generate high-quality scientific evidence and promote its implementation.
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Affiliation(s)
- Miia Kivipelto
- Public Health Promotion Unit, National Institute for Health and Welfare (THL), Helsinki, Finland. .,Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden. .,Institute of Clinical Medicine, Neurology, University of Eastern Finland, Kuopio, Finland. .,Neuroepidemiology and Ageing Unit, School of Public Health, Imperial College London, London, UK.
| | - Francesca Mangialasche
- Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.,Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden
| | - Tiia Ngandu
- Public Health Promotion Unit, National Institute for Health and Welfare (THL), Helsinki, Finland.,Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
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10
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Key MN, Zwilling CE, Talukdar T, Barbey AK. Essential Amino Acids, Vitamins, and Minerals Moderate the Relationship between the Right Frontal Pole and Measures of Memory. Mol Nutr Food Res 2019; 63:e1801048. [PMID: 31245921 DOI: 10.1002/mnfr.201801048] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2018] [Revised: 04/23/2019] [Indexed: 02/02/2023]
Abstract
SCOPE Nutrition has increasingly been recognized for its ability to help prevent and protect against disease, inspiring new programs of research that translate findings from nutritional science into innovative assessment tools, technologies, and therapies to advance the practice of modern medicine. A central aim in this effort is to discover specific dietary patterns that promote healthy brain aging and moderate the engagement of neural systems known to facilitate cognitive performance in later life. METHODS AND RESULTS The present study therefore investigates estimates of nutrient intake derived from food frequency questionnaires, structural measures of brain volume via high-resolution magnetic resonance imaging, and standardized neuropsychological measures of memory performance in nondemented elders (n = 111) using a moderation analysis. The results reveal that the essential amino acids, vitamins, and minerals nutrient pattern moderates the positive relationship between the volume of the right frontal pole and measures of both delayed and auditory memory. CONCLUSIONS Our findings demonstrate that a nutrient pattern including macro- and micronutrients moderate the effect of brain structure on cognitive function in old age and support the efficacy of interdisciplinary methods in nutritional cognitive neuroscience for the study of healthy brain aging.
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Affiliation(s)
- Mickeal N Key
- Decision Neuroscience Laboratory, University of Illinois, Urbana, IL, 61801, USA.,Neuroscience Program, University of Illinois, Urbana, IL, 61801, USA.,Beckman Institute for Advanced Science and Technology, University of Illinois, Urbana, IL, 61801, USA
| | - Christopher E Zwilling
- Decision Neuroscience Laboratory, University of Illinois, Urbana, IL, 61801, USA.,Beckman Institute for Advanced Science and Technology, University of Illinois, Urbana, IL, 61801, USA
| | - Tanveer Talukdar
- Decision Neuroscience Laboratory, University of Illinois, Urbana, IL, 61801, USA.,Beckman Institute for Advanced Science and Technology, University of Illinois, Urbana, IL, 61801, USA
| | - Aron K Barbey
- Decision Neuroscience Laboratory, University of Illinois, Urbana, IL, 61801, USA.,Neuroscience Program, University of Illinois, Urbana, IL, 61801, USA.,Beckman Institute for Advanced Science and Technology, University of Illinois, Urbana, IL, 61801, USA.,Carl R. Woese Institute for Genomic Biology, University of Illinois, Urbana, IL, 61801, USA.,Center for Brain Plasticity, University of Illinois, Urbana, IL, 61801, USA.,Department of Psychology, University of Illinois, Champaign, IL, 61820, USA.,Department of Bioengineering, University of Illinois, Urbana, IL, 61801, USA.,Division of Nutritional Sciences, University of Illinois, Urbana, IL, 61801, USA
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11
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Price JS, Larsen SE, Miller LA, Smith HM, Apps JA, Weis JM. Clinical Biopsychosocial Reflection on Coping With Chronic Illness and Reliance Upon Nutrition Support: An Integrated Healthcare Approach. Nutr Clin Pract 2019; 34:220-225. [DOI: 10.1002/ncp.10263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Affiliation(s)
| | | | | | | | | | - Jo M. Weis
- Medical College of Wisconsin; Milwaukee Wisconsin USA
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12
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Löhr JM, Panic N, Vujasinovic M, Verbeke CS. The ageing pancreas: a systematic review of the evidence and analysis of the consequences. J Intern Med 2018; 283:446-460. [PMID: 29474746 DOI: 10.1111/joim.12745] [Citation(s) in RCA: 56] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Senior people constitute the fastest growing segment of the population. The elderly are at risk for malnutrition, thought to be caused by reduced food intake or involution of the physiological capacity of the GI tract. Age-related changes are well known in other secretory organs such as liver, kidney and intestine. The pancreas, representing a metabolically active organ with uptake and breakdown of essential nutritional components, changes its morphology and function with age. During childhood, the volume of the pancreas increases, reaching a plateau between 20 and 60 years, and declines thereafter. This decline involves the pancreatic parenchyma and is associated with decreased perfusion, fibrosis and atrophy. As a consequence of these changes, pancreatic exocrine function is impaired in healthy older individuals without any gastrointestinal disease. Five per cent of people older than 70 years and ten per cent older than 80 years have pancreatic exocrine insufficiency (PEI) with a faecal elastase-1 below 200 μg g-1 stool, and 5% have severe PEI with faecal elastase-1 below 100 μg g-1 stool. This may lead to maldigestion and malnutrition. Patients may have few symptoms, for example steatorrhoea, diarrhoea, abdominal pain and weight loss. Malnutrition consists of deficits of fat-soluble vitamins and is affecting both patients with PEI and the elderly. Secondary consequences may include decreased bone mineral density and results from impaired absorption of fat-soluble vitamin D due to impaired pancreatic exocrine function. The unanswered question is whether this age-related decrease in pancreatic function warrants therapy. Therapeutic intervention, which may consist of supplementation of pancreatic enzymes and/or vitamins in aged individuals with proven exocrine pancreas insufficiency, could contribute to healthy ageing.
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Affiliation(s)
- J-M Löhr
- Center for Digestive Diseases, Karolinska University Hospital, Stockholm, Sweden.,CLINTEC, Karolinska Institutet, Stockholm, Sweden
| | - N Panic
- University Hospital Dr. Dragisa Misovic-Dedinje, Belgrade, Serbia
| | - M Vujasinovic
- Center for Digestive Diseases, Karolinska University Hospital, Stockholm, Sweden
| | - C S Verbeke
- Department of Pathology, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
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Sarubbo F, Esteban S, Miralles A, Moranta D. Effects of Resveratrol and other Polyphenols on Sirt1: Relevance to Brain Function During Aging. Curr Neuropharmacol 2018; 16:126-136. [PMID: 28676015 PMCID: PMC5883375 DOI: 10.2174/1570159x15666170703113212] [Citation(s) in RCA: 75] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2016] [Revised: 04/15/2017] [Accepted: 06/22/2017] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Classically the oxidative stress and more recently inflammatory processes have been identified as the major causes of brain aging. Oxidative stress and inflammation affect each other, but there is more information about the effects of oxidative stress on aging than regarding the contribution of inflammation on it. METHODS In the intense research for methods to delay or mitigate the effects of aging, are interesting polyphenols, natural molecules synthesized by plants (e.g. resveratrol). Their antioxidant and anti-inflammatory properties make them useful molecules in the prevention of aging. RESULTS The antiaging effects of polyphenols could be due to several related mechanisms, among which are the prevention of oxidative stress, SIRT1 activation and inflammaging modulation, via regulation of some signaling pathways, such as NF-κB. CONCLUSION In this review, we describe the positive effects of polyphenols on the prevention of the changes that occur during aging in the brain and their consequences on cognition, emphasizing the possible modulation of inflammaging by polyphenols through a SIRT1-mediated mechanism.
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Affiliation(s)
- F. Sarubbo
- Laboratorio de Neurofisiología, Departamento de Biología, Instituto Universitario de Investigación en Ciencias de la Salud, Universidad de las Islas Baleares (UIB), Mallorca, Spain
| | - S. Esteban
- Laboratorio de Neurofisiología, Departamento de Biología, Instituto Universitario de Investigación en Ciencias de la Salud, Universidad de las Islas Baleares (UIB), Mallorca, Spain
| | - A. Miralles
- Laboratorio de Neurofisiología, Departamento de Biología, Instituto Universitario de Investigación en Ciencias de la Salud, Universidad de las Islas Baleares (UIB), Mallorca, Spain
| | - D. Moranta
- Laboratorio de Neurofisiología, Departamento de Biología, Instituto Universitario de Investigación en Ciencias de la Salud, Universidad de las Islas Baleares (UIB), Mallorca, Spain
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Ng TP, Ling LHA, Feng L, Nyunt MSZ, Feng L, Niti M, Tan BY, Chan G, Khoo SA, Chan SM, Yap P, Yap KB. Cognitive Effects of Multi-Domain Interventions Among Pre-Frail and Frail Community-Living Older Persons: Randomized Controlled Trial. J Gerontol A Biol Sci Med Sci 2017; 73:806-812. [DOI: 10.1093/gerona/glx207] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2016] [Accepted: 10/20/2017] [Indexed: 11/13/2022] Open
Affiliation(s)
- Tze Pin Ng
- Gerontology Research Programme, Department of Psychological Medicine, National University of Singapore, Singapore
| | - Ling Hui Audrey Ling
- Gerontology Research Programme, Department of Psychological Medicine, National University of Singapore, Singapore
| | - Liang Feng
- Gerontology Research Programme, Department of Psychological Medicine, National University of Singapore, Singapore
| | - Ma Shwe Zin Nyunt
- Gerontology Research Programme, Department of Psychological Medicine, National University of Singapore, Singapore
| | - Lei Feng
- Gerontology Research Programme, Department of Psychological Medicine, National University of Singapore, Singapore
| | - Mathew Niti
- Performance and Technology Assessment Department, Ministry of Health, Singapore
| | - Boon Yeow Tan
- Medical Services Department, St Luke’s Hospital, Singapore
| | - Gribson Chan
- Rehabilitation Services Division, St Luke’s Hospital, Singapore
| | - Sue Anne Khoo
- Psychological Medicine Department, Khoo Teck Puat Hospital, Singapore
| | - Sue Mei Chan
- Nutrition and Dietetics Department, Khoo Teck Puat Hospital, Singapore
| | - Philip Yap
- Geriatric Medicine Department, Khoo Teck Puat Hospital, Singapore
| | - Keng Bee Yap
- Geriatric Medicine and Palliative Medicine Department, Ng Teng Fong General Hospital
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15
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Omar SH. Biophenols pharmacology against the amyloidogenic activity in Alzheimer’s disease. Biomed Pharmacother 2017; 89:396-413. [DOI: 10.1016/j.biopha.2017.02.051] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2016] [Revised: 02/15/2017] [Accepted: 02/15/2017] [Indexed: 02/01/2023] Open
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16
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Ng TP, Nyunt MSZ, Feng L, Feng L, Niti M, Tan BY, Chan G, Khoo SA, Chan SM, Yap P, Yap KB. Multi-Domains Lifestyle Interventions Reduces Depressive Symptoms among Frail and Pre-Frail Older Persons: Randomized Controlled Trial. J Nutr Health Aging 2017; 21:918-926. [PMID: 28972245 DOI: 10.1007/s12603-016-0867-y] [Citation(s) in RCA: 38] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
BACKGROUND We investigated the effect of multi-domain lifestyle (physical, nutritional, cognitive) interventions among frail and pre-frail community-living older persons on reducing depressive symptoms. METHOD Participants aged 65 and above were randomly allocated to 24 weeks duration interventions with nutritional supplementation (N=49), physical training (N=48), cognitive training (N=50), combination intervention (N=49) and usual care control (N=50). Depressive symptoms were assessed by the Geriatric Depression Scale (GDS-15) at baseline (0M), 3 month (3M), 6 month (6M) and 12 month (12M). RESULTS Mean GDS scores in the control group increased from 0.52 (0M) and 0.54 (3M) to 0.74 (6M), and 0.83 (12M). Compared to the control group, interventions showed significant differences (∆=change) at 6M for cognitive versus control (∆=-0.39, p=0.021, group*time interaction p=0.14); physical versus control (∆ =-0.37, p=0.026, group*time interaction p=0.13), and at 12M for nutrition versus control (∆ =-0.46, p=0.016, group*time interaction p=0.15). The effect for combination versus control was significant at 6M (∆ =-0.43, p=0.020) and 12M (∆ =-0.51, p=0.005, group*time interaction p=0.026). Estimated 12-month cumulative incidence of depressive symptoms (GDS≥2) relative to control were OR=0.38, p=0.037 (nutrition); OR=0.71, p=0.40 (cognitive); OR=0.39, p=0.042 (physical training) and OR=0.38, p=0.037 (combination). Changes in gait speed and energy level were significantly associated with changes in GDS scores over time. CONCLUSION Multi-domain interventions that reverse frailty among community-living older persons also reduce depressive symptomatology. Public health education and programmatic measures combining nutritional, physical and cognitive interventions for at-risk frail older people may likely benefit psychological wellbeing.
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Affiliation(s)
- T P Ng
- A/P Tze-Pin Ng, Gerontology Research Programme, National University of Singapore, Department of Psychological Medicine, NUHS Tower Block, 9th Floor, 1E Kent Ridge Road, Singapore 119228 Fax: 65-67772191, Tel: 65-67723478
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Yuan L, Zhen J, Ma W, Cai C, Huang X, Xiao R. The Erythrocyte Fatty Acid Profile and Cognitive Function in Old Chinese Adults. Nutrients 2016; 8:nu8070385. [PMID: 27347995 PMCID: PMC4963861 DOI: 10.3390/nu8070385] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2016] [Revised: 05/24/2016] [Accepted: 06/17/2016] [Indexed: 12/14/2022] Open
Abstract
Objective: To explore the relationship between the erythrocyte fatty acid profile and cognition in elderly Chinese adults. Methods: 60 mild cognitive impairment (MCI) subjects and 60 age- and gender-matched control adults (aged 55 years and above) were involved in this cross-sectional study. Cognitive function was measured by using the Montreal Cognitive Assessment (MoCA) test. Information regarding the demographic characteristics and lifestyle of the participants was collected with a questionnaire. A semi-quantified food frequency questionnaire (FFQ) method was used for dietary assessment. The erythrocytes fatty acid profile was measured. Results: The MCI subjects had a lower education level than the control subjects (p < 0.05). Compared with control subjects, MCI subjects had higher daily poultry intake and lower fish intake (p < 0.05). Erythrocyte fatty acid profile of the MCI subjects was characterized as lower erythrocyte proportions of 20:4 n-6, 20:5 n-3, and total n-3 fatty acids compared with control subjects (p < 0.05). An association of erythrocyte proportions of 18:0, 22:0, total SFA, 18:2 n-6, 24:4 n-6 fatty acids, docosahexaenoic acid (DHA), and total n-6 PUFAs with cognition in elderly Chinese adults was detected. Conclusion: The erythrocyte fatty acid profile was related to cognitionin the elderly. Lower erythrocyte unsaturated fatty acid and higher saturated fatty acid proportions might predict cognitive function decline in elderly Chinese adults.
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Affiliation(s)
- Linhong Yuan
- School of Public Health, Capital Medical University, Beijing 100069, China.
| | - Jie Zhen
- School of Public Health, Capital Medical University, Beijing 100069, China.
| | - Weiwei Ma
- School of Public Health, Capital Medical University, Beijing 100069, China.
| | - Can Cai
- School of Public Health, Capital Medical University, Beijing 100069, China.
| | - Xiaochen Huang
- School of Public Health, Capital Medical University, Beijing 100069, China.
| | - Rong Xiao
- School of Public Health, Capital Medical University, Beijing 100069, China.
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