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Nader MM, Cosarderelioglu C, Miao E, Whitson H, Xue QL, Grodstein F, Oh E, Ferrucci L, Bennett DA, Walston JD, George C, Abadir PM. Navigating and diagnosing cognitive frailty in research and clinical domains. NATURE AGING 2023; 3:1325-1333. [PMID: 37845509 DOI: 10.1038/s43587-023-00504-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Accepted: 09/13/2023] [Indexed: 10/18/2023]
Abstract
While physical frailty has been recognized as a clinical entity for some time, the concept of cognitive frailty (CF) is now gaining increasing attention in the geriatrics research community. CF refers to the co-occurrence of physical frailty and cognitive impairment in older adults, which has been suggested as a potential precursor to both dementia and adverse physical outcomes. However, this condition represents a challenge for researchers and clinicians, as there remains a lack of consensus regarding the definition and diagnostic criteria for CF, which has limited its utility. Here, using insights from both the physical frailty literature and cognitive science research, we describe emerging research on CF. We highlight areas of agreement as well as areas of confusion and remaining knowledge gaps, and provide our perspective on fine-tuning the current construct, aiming to stimulate further discussion in this developing field.
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Affiliation(s)
- Monica M Nader
- Johns Hopkins University School of Medicine, Division of Geriatric Medicine and Gerontology, Baltimore, MD, USA
| | - Caglar Cosarderelioglu
- Johns Hopkins University School of Medicine, Division of Geriatric Medicine and Gerontology, Baltimore, MD, USA
- Ankara University School of Medicine, Department of Internal Medicine, Division of Geriatrics, Ankara, Turkey
| | - Emily Miao
- Albert Einstein College of Medicine/Montefiore Medical Center, Department of Medicine, Division of Geriatrics, New York, NY, USA
| | - Heather Whitson
- Duke University School of Medicine, Center for the Study of Aging, Durham, NC, USA
| | - Qian-Li Xue
- Johns Hopkins University School of Medicine, Division of Geriatric Medicine and Gerontology, Baltimore, MD, USA
- Johns Hopkins University Center on Aging and Health, Baltimore, MD, USA
| | - Francine Grodstein
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, USA
| | - Esther Oh
- Johns Hopkins University School of Medicine, Division of Geriatric Medicine and Gerontology, Baltimore, MD, USA
| | | | - David A Bennett
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, USA
| | - Jeremy D Walston
- Johns Hopkins University School of Medicine, Division of Geriatric Medicine and Gerontology, Baltimore, MD, USA
| | - Claudene George
- Albert Einstein College of Medicine/Montefiore Medical Center, Department of Medicine, Division of Geriatrics, New York, NY, USA
| | - Peter M Abadir
- Johns Hopkins University School of Medicine, Division of Geriatric Medicine and Gerontology, Baltimore, MD, USA.
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2
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Denfeld QE, Purnell JQ, Lee CS, Orwoll ES, Camacho SA, Hiatt SO, Davis MR, Winters-Stone K, Woodward WR, Habecker BA. Candidate biomarkers of physical frailty in heart failure: an exploratory cross-sectional study. Eur J Cardiovasc Nurs 2023; 22:149-157. [PMID: 35727092 PMCID: PMC10243450 DOI: 10.1093/eurjcn/zvac054] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2022] [Revised: 05/31/2022] [Accepted: 06/01/2022] [Indexed: 02/05/2023]
Abstract
AIMS Physical frailty is highly prevalent and predictive of worse outcomes in heart failure (HF). Candidate biomarker analysis may help in understanding the mechanisms underlying physical frailty in HF. We aimed to identify candidate biomarkers associated with physical frailty in HF using a multimarker strategy of distinct pathophysiological processes. METHODS AND RESULTS We collected data and plasma samples from 113 adults with New York Heart Association Functional Class I-IV HF. Physical frailty was measured with the Frailty Phenotype Criteria. Plasma biomarkers included: N-terminal pro-B-type natriuretic peptide, norepinephrine, dihydroxyphenylglycol, soluble tumour necrosis factor alpha receptor-1, adiponectin, insulin, glucose, insulin-like growth factor-1 (IGF-1), and myostatin. Comparative statistics and multivariate linear regression were used to test group differences and associations. The average age was 63.5 ± 15.7 years, half were women (48%), and most had a non-ischaemic aetiology of HF (73%). Physical frailty was identified in 42% and associated with female sex, higher body mass index and percent body fat, more comorbidities, and HF with preserved ejection fraction. Adjusting for Seattle HF Model projected survival score, comorbidities, body composition, and sex, physical frailty was associated with significantly lower plasma adiponectin [β ± standard error (SE) -0.28 ± 0.14, P = 0.047], IGF-1 (β ± SE -0.21 ± 0.10, P = 0.032), and myostatin (β ± SE -0.22 ± 0.09, P = 0.011). In sex-stratified analyses, IGF-1 and myostatin were significantly associated with physical frailty in men but not women. CONCLUSION We identified biomarkers involved in adipose tissue and skeletal muscle development, maintenance, and function that were associated with physical frailty in HF.
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Affiliation(s)
- Quin E. Denfeld
- Oregon Health & Science University, School of Nursing, Portland, OR, USA
- Oregon Health & Science University, Knight Cardiovascular Institute, Portland, OR, USA
| | - Jonathan Q. Purnell
- Oregon Health & Science University, Knight Cardiovascular Institute, Portland, OR, USA
| | - Christopher S. Lee
- Boston College, William F. Connell School of Nursing, Chestnut Hill, MA, USA
- Australian Catholic University, Melbourne, Australia
| | - Eric S. Orwoll
- Oregon Health & Science University, School of Medicine, Portland, OR, USA
| | - S. Albert Camacho
- Oregon Health & Science University, Knight Cardiovascular Institute, Portland, OR, USA
| | - Shirin O. Hiatt
- Oregon Health & Science University, School of Nursing, Portland, OR, USA
| | - Mary Roberts Davis
- Oregon Health & Science University, School of Nursing, Portland, OR, USA
| | - Kerri Winters-Stone
- Oregon Health & Science University, School of Nursing, Portland, OR, USA
- Oregon Health & Science University, Knight Cancer Institute, Portland, OR, USA
| | - William R. Woodward
- Oregon Health & Science University, Department of Chemical Physiology & Biochemistry, Portland, OR, USA
| | - Beth A. Habecker
- Oregon Health & Science University, Knight Cardiovascular Institute, Portland, OR, USA
- Oregon Health & Science University, Department of Chemical Physiology & Biochemistry, Portland, OR, USA
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3
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The effects of dynamic and static stretching exercises performed to elite wrestlers after high intensity exercise on heart rate variability. Sci Sports 2022. [DOI: 10.1016/j.scispo.2022.03.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Walpot J, van Herck P, Collas V, Bossaerts L, Van de Heyning CM, Vandendriessche T, Heidbuchel H, Rodrigus I, De Block C, Small GR, Bosmans J. Adiponectin serum level is an independent and incremental predictor of all-cause mortality after transcatheter aortic valve replacement. Clin Cardiol 2022; 45:1060-1069. [PMID: 35932173 PMCID: PMC9574742 DOI: 10.1002/clc.23892] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Revised: 06/20/2022] [Accepted: 07/12/2022] [Indexed: 11/22/2022] Open
Abstract
Background Quantifiable biomarkers may be useful for a better risk and frailty assessment of patients referred for transcatheter aortic valve implantation (TAVI). Hypothesis To determine if adiponectin serum concentration predicts all‐cause mortality in patients undergoing TAVI. Methods 77 consecutive patients, undergoing TAVI, were analyzed. The CT axial slices at the level of the fourth lumbar vertebra were used to measure the psoas muscle area, and its low‐density muscle fraction (LDM (%)). To assess the operative risk, the STS (Society of Thoracic Surgeons Predicted Risk of Mortality) score, Log. Euroscore, and Euroscore II were determined. A clinical frailty assessment was performed. ELISA kits were used to measure adiponectin serum levels. We searched for a correlation between serum adiponectin concentration and all‐cause mortality after TAVI. Results The mean age was 80.8 ± 7.4 years. All‐cause mortality occurred in 22 patients. The mean follow‐up was 1779 days (range: 1572–1825 days). Compared with patients with the lowest adiponectin level, patients in the third tertile had a hazards ratio of all‐cause mortality after TAVI of 4.155 (95% CI: 1.364–12.655) (p = .004). In the multivariable model, including STS score, vascular access of TAVI procedure, LDM (%), and adiponectin serum concentration, serum adiponectin level, and LDM(%) were independent predictors of all‐cause mortality after TAVI (p = .178, .303, .042, and .017, respectively). Adiponectin level was a predictor of all‐cause mortality in females and males (p = .012 and 0.024, respectively). Conclusion Adiponectin serum level is an independent and incremental predictor of all‐cause mortality in patients undergoing TAVI.
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Affiliation(s)
- Jeroen Walpot
- Department of Cardiology, University Hospital Antwerp, Edegem, Antwerp, Belgium.,Department of Cardiology, ZorgSaam Hospital, Terneuzen, The Netherlands
| | - Paul van Herck
- Department of Cardiology, University Hospital Antwerp, Edegem, Antwerp, Belgium
| | - Valerie Collas
- Faculty of Health Sciences and Medicine, University of Antwerp, Wilrijk, Belgium
| | - Liene Bossaerts
- Faculty of Biomedical Sciences, University of Antwerp, Wilrijk, Belgium
| | - Caroline M Van de Heyning
- Department of Cardiology, University Hospital Antwerp, Edegem, Antwerp, Belgium.,Faculty of Health Sciences and Medicine, University of Antwerp, Wilrijk, Belgium
| | - Tom Vandendriessche
- Department of Cardiology, University Hospital Antwerp, Edegem, Antwerp, Belgium
| | - Hein Heidbuchel
- Department of Cardiology, University Hospital Antwerp, Edegem, Antwerp, Belgium.,Faculty of Health Sciences and Medicine, University of Antwerp, Wilrijk, Belgium
| | - Inez Rodrigus
- Department of Cardiac Surgery, University Hospital Antwerp, Antwerp, Edegem, Belgium
| | - Christophe De Block
- Department of Endocrinology-Diabetology and Metabolism, Antwerp University Hospital, Edegem, Antwerp, Belgium
| | - Gary R Small
- Division of Cardiology, University of Ottawa Heart Institute, Ottawa, Ontario, Canada
| | - Johan Bosmans
- Department of Cardiology, University Hospital Antwerp, Edegem, Antwerp, Belgium.,Faculty of Biomedical Sciences, University of Antwerp, Wilrijk, Belgium
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Han Y, Quan X, Chuang Y, Liang Q, Li Y, Yuan Z, Bian Y, Wei L, Wang J, Zhao Y. A multi-omics analysis for the prediction of neurocognitive disorders risk among the elderly in Macao. Clin Transl Med 2022; 12:e909. [PMID: 35696554 PMCID: PMC9191869 DOI: 10.1002/ctm2.909] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2022] [Revised: 05/13/2022] [Accepted: 05/17/2022] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND Due to the increasing ageing population, neurocognitive disorders (NCDs) have been a global public health issue, and its prevention and early diagnosis are crucial. Our previous study demonstrated that there is a significant correlation between specific populations and NCDs, but the biological characteristics of the vulnerable group predispose to NCDs are unclear. The purpose of this study is to investigate the predictors for the vulnerable group by a multi-omics analysis. METHODS Multi-omics approaches, including metagenomics, metabolomic and proteomic, were used to detect gut microbiota, faecal metabolites and urine exosome of 8 normal controls and 13 vulnerable elders after a rigorous screening of 400 elders in Macao. The multi-omics data were analysed using R and Bioconductor. The two-sided Wilcoxon's rank-sum test, Kruskal-Wallis rank sum test and the linear discriminant analysis effective size were applied to investigate characterized features. Moreover, a 2-year follow-up was conducted to evaluate cognitive function change of the elderly. RESULTS Compared with the control elders, the metagenomics of gut microbiota showed that Ruminococcus gnavus, Lachnospira eligens, Escherichia coli and Desulfovibrio piger were increased significantly in the vulnerable group. Carboxylates, like alpha-ketoglutaric acid and d-saccharic acid, and levels of vitamins had obvious differences in the faecal metabolites. There was a distinct decrease in the expression of eukaryotic translation initiation factor 2 subunit 1 (eIF2α) and amine oxidase A (MAO-A) according to the proteomic results of the urine exosomes. Moreover, the compound annual growth rate of neurocognitive scores was notably decreased in vulnerable elders. CONCLUSIONS The multi-omics characteristics of disturbed glyoxylate and dicarboxylate metabolism (bacteria), vitamin digestion and absorption and tricarboxylic acid cycle in vulnerable elders can serve as predictors of NCDs risk among the elderly of Macao. Intervention with them may be effective therapeutic approaches for NCDs, and the underlying mechanisms merit further exploration.
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Affiliation(s)
- Yan Han
- State Key Laboratory of Quality Research in Chinese MedicineInstitute of Chinese Medical SciencesUniversity of MacauTaipaMacao SARChina
| | - Xingping Quan
- State Key Laboratory of Quality Research in Chinese MedicineInstitute of Chinese Medical SciencesUniversity of MacauTaipaMacao SARChina
| | | | - Qiaoxing Liang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic CenterSun Yat‐sen UniversityGuangzhouChina
| | - Yang Li
- Department of Gastrointestinal SurgerySecond Clinical Medical College of Jinan University, Shenzhen People's HospitalShenzhenChina
| | - Zhen Yuan
- Centre for Cognitive and Brain SciencesUniversity of MacauTaipaMacao SARChina
| | - Ying Bian
- State Key Laboratory of Quality Research in Chinese MedicineInstitute of Chinese Medical SciencesUniversity of MacauTaipaMacao SARChina
| | - Lai Wei
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic CenterSun Yat‐sen UniversityGuangzhouChina
| | - Ji Wang
- School of Traditional Chinese MedicineBeijing University of Chinese MedicineBeijingChina
| | - Yonghua Zhao
- State Key Laboratory of Quality Research in Chinese MedicineInstitute of Chinese Medical SciencesUniversity of MacauTaipaMacao SARChina
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Arrieta H, Rezola-Pardo C, Sanz B, Virgala J, Lacunza-Zumeta M, Rodriguez-Larrad A, Irazusta J. Improving the Identification of Frailty in Long-Term Care Residents: A Cross-Sectional Study. Biol Res Nurs 2022; 24:530-540. [PMID: 35574636 DOI: 10.1177/10998004221100797] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
PURPOSE To compare the capacity of blood myostatin concentration and physical, cognitive, and affective function tests to predict frailty among long-term care (LTC) residents. METHODS This cross-sectional analysis used baseline data from three randomized controlled trials involving 260 older adults in 14 LTC centers. Serum myostatin levels were analyzed by enzyme-linked immunosorbent assay. Frailty, physical fitness, cognitive and affective functions were assessed using validated tests and scales. RESULTS The Timed Up and Go, gait speed, 6-minute walk, and Berg Balance Scale had excellent capabilities in identifying frail individuals in accordance with Fried's Frailty Phenotype (FFP). The best tests for identifying frailty in accordance with the Clinical Frailty Scale (CFS) were Timed Up and Go and Berg Balance Scale. For the Tilburg Frailty Indicator (TFI), the best tests were Quality of Life in Alzheimer's Disease (QoL-AD) and Goldberg Anxiety. Myostatin, along with physical, cognitive, and affective function tests, improved the capability of the hand grip, arm-curl, Montreal Cognitive Assessment, Goldberg Anxiety, Goldberg Depression, and QoL-AD to identify frailty according to FFP, while myostatin improved CFS-defined frailty identification by the hand grip, arm-curl, 6-minute walk test, Berg Balance Scale, 30-second chair-stand, gait speed, Montreal Cognitive Assessment, Goldberg Anxiety, and De Jong-Gierveld Loneliness Scale. CONCLUSION Among LTC residents, serum myostatin was associated with being frail according to FFP and CFS. However, this measure was less discriminating of frailty than physical fitness tests (for FFP and CFS) and affective function parameters (for TFI). However, evaluated concurrently with physical, cognitive, and affective parameters, myostatin improved the capabilities of these measures to predict CFS-defined frailty.
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Affiliation(s)
- Haritz Arrieta
- Department of Nursing II, Faculty of Medicine and Nursing, 83067University of the Basque Country (UPV/EHU), Donostia-San Sebastián, Gipuzkoa, Spain
| | - Chloe Rezola-Pardo
- Department of Physiology, Faculty of Medicine and Nursing, 83067University of the Basque Country (UPV/EHU), Leioa, Spain
| | - Begoña Sanz
- Department of Physiology, Faculty of Medicine and Nursing, 83067University of the Basque Country (UPV/EHU), Leioa, Spain
| | - Janire Virgala
- Department of Physiology, Faculty of Medicine and Nursing, 83067University of the Basque Country (UPV/EHU), Leioa, Spain
| | | | - Ana Rodriguez-Larrad
- Department of Physiology, Faculty of Medicine and Nursing, 83067University of the Basque Country (UPV/EHU), Leioa, Spain
| | - Jon Irazusta
- Department of Physiology, Faculty of Medicine and Nursing, 83067University of the Basque Country (UPV/EHU), Leioa, Spain
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7
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de Souza LF, Fontanela LC, Leopoldino AAO, Mendonça VA, Danielewicz AL, Lacerda ACR, de Avelar NCP. Are sociodemographic and anthropometric variables effective in screening probable and confirmed sarcopenia in community-dwelling older adults? A cross-sectional study. SAO PAULO MED J 2022; 141:e2022141. [PMID: 36417659 PMCID: PMC10065114 DOI: 10.1590/1516-3180.2022.0141.r1.17082022] [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: 03/12/2022] [Accepted: 08/17/2022] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Screening for probable and confirmed sarcopenia using sociodemographic and anthropometric indicators can be a practical, cheap, and effective strategy to identify and treat older people susceptible to this condition. OBJECTIVES To identify cutoff points for sociodemographic and anthropometric variables in screening probable and confirmed sarcopenia in community-dwelling older adults. DESIGN AND SETTING This was a cross-sectional study of community-dwelling older adults in Araranguá, Santa Catarina, Brazil. METHODS Sociodemographic (age, education) and anthropometric (weight, height, body mass index [BMI], waist circumference [WC], and dominant calf circumference [DCC]) factors were considered as predictors. The outcomes were probable sarcopenia (reduction in muscle strength assessed by time ≥ 15 s in the five-time sit-to-stand test) and confirmed sarcopenia (reduction in strength and muscle mass). Receiver operating characteristic curve analysis was used to analyze the ability to track sociodemographic and anthropometric variables for sarcopenia. RESULTS In 308 older adults, WC > 91 cm in women and age > 69 years in men were useful in screening for probable sarcopenia. The variables age, weight, BMI, WC, and DCC can be used to screen for sarcopenia in older women and men. CONCLUSION Sociodemographic and anthropometric variables are simple and accessible tools for sarcopenia screening in older adults.
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Affiliation(s)
- Larissa Franciny de Souza
- PT. Physical Therapist, Department of Health Sciences,
Universidade Federal de Santa Catarina (UFSC), Araranguá (SC), Brazil
| | - Laís Coan Fontanela
- PT. Physical Therapist, Department of Health Sciences,
Universidade Federal de Santa Catarina (UFSC), Araranguá (SC), Brazil
| | | | - Vanessa Amaral Mendonça
- PT, MSc, PhD. Associate Professor, Universidade Federal dos
Vales do Jequitinhonha e Mucuri (UFVJM), Diamantina (MG), Brazil
| | - Ana Lúcia Danielewicz
- PT, MSc, PhD. Adjunct Professor, Department of Health Sciences,
Universidade Federal de Santa Catarina (UFSC), Araranguá (SC), Brazil
| | - Ana Cristina Rodrigues Lacerda
- PT, MSc, PhD. Associate Professor, Universidade Federal dos
Vales do Jequitinhonha e Mucuri (UFVJM), Diamantina (MG), Brazil
| | - Núbia Carelli Pereira de Avelar
- PT, MSc, PhD. Adjunct Professor, Department of Health
Sciences, Universidade Federal de Santa Catarina (UFSC), Araranguá (SC),
Brazil
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Lopez-Vilaret KM, Cantero JL, Fernandez-Alvarez M, Calero M, Calero O, Lindín M, Zurrón M, Díaz F, Atienza M. Impaired glucose metabolism reduces the neuroprotective action of adipocytokines in cognitively normal older adults with insulin resistance. Aging (Albany NY) 2021; 13:23936-23952. [PMID: 34731089 PMCID: PMC8610113 DOI: 10.18632/aging.203668] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Accepted: 10/26/2021] [Indexed: 12/26/2022]
Abstract
Evidence suggests that aging-related dysfunctions of adipose tissue and metabolic disturbances increase the risk of diabetes and metabolic syndrome (MtbS), eventually leading to cognitive impairment and dementia. However, the neuroprotective role of adipocytokines in this process has not been specifically investigated. The present study aims to identify metabolic alterations that may prevent adipocytokines from exerting their neuroprotective action in normal ageing. We hypothesize that neuroprotection may occur under insulin resistance (IR) conditions as long as there are no other metabolic alterations that indirectly impair the action of adipocytokines, such as hyperglycemia. This hypothesis was tested in 239 cognitively normal older adults (149 females) aged 52 to 87 years (67.4 ± 5.9 yr). We assessed whether the homeostasis model assessment-estimated insulin resistance (HOMA-IR) and the presence of different components of MtbS moderated the association of plasma adipocytokines (i.e., adiponectin, leptin and the adiponectin to leptin [Ad/L] ratio) with cognitive functioning and cortical thickness. The results showed that HOMA-IR, circulating triglyceride and glucose levels moderated the neuroprotective effect of adipocytokines. In particular, elevated triglyceride levels reduced the beneficial effect of Ad/L ratio on cognitive functioning in insulin-sensitive individuals; whereas under high IR conditions, it was elevated glucose levels that weakened the association of the Ad/L ratio with cognitive functioning and with cortical thickness of prefrontal regions. Taken together, these findings suggest that the neuroprotective action of adipocytokines is conditioned not only by whether cognitively normal older adults are insulin-sensitive or not, but also by the circulating levels of triglycerides and glucose, respectively.
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Affiliation(s)
| | - Jose L Cantero
- Laboratory of Functional Neuroscience, Universidad Pablo de Olavide, Seville, Spain.,CIBERNED, Network Center for Biomedical Research in Neurodegenerative Diseases, Madrid, Spain
| | - Marina Fernandez-Alvarez
- Laboratory of Functional Neuroscience, Universidad Pablo de Olavide, Seville, Spain.,CIBERNED, Network Center for Biomedical Research in Neurodegenerative Diseases, Madrid, Spain
| | - Miguel Calero
- CIBERNED, Network Center for Biomedical Research in Neurodegenerative Diseases, Madrid, Spain.,Chronic Disease Programme, Instituto de Salud Carlos III, Madrid, Spain
| | - Olga Calero
- CIBERNED, Network Center for Biomedical Research in Neurodegenerative Diseases, Madrid, Spain.,Chronic Disease Programme, Instituto de Salud Carlos III, Madrid, Spain
| | - Mónica Lindín
- Cognitive Neuroscience Laboratory, Universidade de Santiago de Compostela, Santiago de Compostela, Spain
| | - Montserrat Zurrón
- Cognitive Neuroscience Laboratory, Universidade de Santiago de Compostela, Santiago de Compostela, Spain
| | - Fernando Díaz
- Cognitive Neuroscience Laboratory, Universidade de Santiago de Compostela, Santiago de Compostela, Spain
| | - Mercedes Atienza
- Laboratory of Functional Neuroscience, Universidad Pablo de Olavide, Seville, Spain.,CIBERNED, Network Center for Biomedical Research in Neurodegenerative Diseases, Madrid, Spain
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9
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Effects of In-Hospital Exercise on Frailty in Patients with Hepatocellular Carcinoma. Cancers (Basel) 2021; 13:cancers13020194. [PMID: 33430438 PMCID: PMC7826707 DOI: 10.3390/cancers13020194] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2020] [Revised: 12/22/2020] [Accepted: 01/04/2021] [Indexed: 02/07/2023] Open
Abstract
Frailty including physical inactivity is associated with the survival of patients with hepatocellular carcinoma (HCC). We aimed to investigate the effects of in-hospital exercise on frailty in patients with HCC. This was a multi-center observational study. Patients with HCC were classified into exercise (n = 114) and non-exercise (n = 67) groups. The exercise group was treated with a mixture of aerobic and resistance exercises (20-40 min/day, median four days). Frailty was assessed using the liver frailty index (LFI). Factors for changes in LFI were examined by multivariate and decision-tree analyses. The factors were also examined after propensity score matching. During hospitalization, LFI was significantly improved in the exercise group compared to the non-exercise group (ΔLFI -0.17 vs. -0.02, p = 0.0119). In multivariate analysis, exercise (odds ratio (OR) 2.38, 95% confidence interval (CI) 1.240-4.570, p = 0.0091) and females (OR 2.09; 95%CI, 1.062-4.109; p = 0.0328) were identified as independent factors for the improvement of LFI. In the decision-tree analysis, exercise was identified as an initial classifier associated with the improvement of LFI. Similar findings were also seen in the propensity score matching analyses. We demonstrated that in-hospital exercise improved frailty in patients with HCC. Thus, in-hospital exercise may be beneficial for improving physical function in patients with HCC.
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10
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Feinkohl I, Janke J, Slooter AJC, Winterer G, Spies C, Pischon T. Plasma leptin, but not adiponectin, is associated with cognitive impairment in older adults. Psychoneuroendocrinology 2020; 120:104783. [PMID: 32623019 DOI: 10.1016/j.psyneuen.2020.104783] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2019] [Revised: 04/28/2020] [Accepted: 06/19/2020] [Indexed: 01/24/2023]
Abstract
BACKGROUND Leptin and adiponectin are adipose-tissue derived hormones primarily involved in glucose, lipid, and energy metabolism, inflammation, and atherosclerosis. Both adipokines may cross the blood-brain barrier but evidence on their roles in cognitive impairment is limited and conflicting. Here, we determined associations of plasma adipokine concentration with cognitive impairment in older adults. METHODS Cross-sectional analysis of baseline data from 669 participants aged ≥65 years of the Biomarker Development for Postoperative Cognitive Impairment in the Elderly (BioCog) study were recruited 2014-2017 at study sites in Berlin, Germany and Utrecht, the Netherlands. Cognitive impairment was defined as the lowest tertile of a cognitive summary score derived from six neuropsychological tests. RESULTS After adjustment for age, sex, fasting, BMI, diabetes, hypertension, cerebrovascular disease, and coronary heart disease, higher leptin concentrations and a higher leptin/adiponectin ratio (LAR) were associated with a higher odds of cognitive impairment (OR per 1 SD higher leptin concentration, 1.33; 95 % CI 1.05, 1.69; p = 0.02; OR per 1 SD higher LAR, 1.26; 95 % CI 1.01, 1.57; p = 0.04). Sensitivity analyses determined that these findings were driven by the non-obese group (BMI < 30 kg/m2), whereas leptin and LAR were not associated with cognitive impairment in the obese group (BMI ≥ 30 kg/m2). Soluble leptin receptor, leptin/soluble leptin receptor ratio, total adiponectin and high-molecular weight adiponectin concentrations were each not associated with impairment. CONCLUSIONS With leptin as a known promoter of atherosclerosis and inflammation, our findings point to a pathogenic role of leptin in age-related cognitive impairment that may be limited to non-obese individuals and warrants further investigation.
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Affiliation(s)
- Insa Feinkohl
- Molecular Epidemiology Research Group, Max-Delbrueck-Center for Molecular Medicine in the Helmholtz Association (MDC), Robert-Rössle Str. 10, D-13092 Berlin, Germany.
| | - Jürgen Janke
- Molecular Epidemiology Research Group, Max-Delbrueck-Center for Molecular Medicine in the Helmholtz Association (MDC), Robert-Rössle Str. 10, D-13092 Berlin, Germany
| | - Arjen J C Slooter
- Department of Intensive Care Medicine, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht University, Universiteitsweg 98, 3584 CG Utrecht, the Netherlands
| | - Georg Winterer
- Charité - Universitaetsmedizin Berlin, Corporate Member of Freie Universitaet Berlin, Humboldt-Universitaet zu Berlin, and Berlin Institute of Health, Charitéplatz 1, D-10117 Berlin, Germany
| | - Claudia Spies
- Charité - Universitaetsmedizin Berlin, Corporate Member of Freie Universitaet Berlin, Humboldt-Universitaet zu Berlin, and Berlin Institute of Health, Charitéplatz 1, D-10117 Berlin, Germany
| | - Tobias Pischon
- Molecular Epidemiology Research Group, Max-Delbrueck-Center for Molecular Medicine in the Helmholtz Association (MDC), Robert-Rössle Str. 10, D-13092 Berlin, Germany; Charité - Universitaetsmedizin Berlin, Corporate Member of Freie Universitaet Berlin, Humboldt-Universitaet zu Berlin, and Berlin Institute of Health, Charitéplatz 1, D-10117 Berlin, Germany; MDC/BIH Biobank, Max-Delbrueck-Center for Molecular Medicine in the Helmholtz Association (MDC), and Berlin Institute of Health (BIH), Robert-Rössle Str. 10, D-13092 Berlin, Germany
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