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Lopez S, Hampel H, Chiesa PA, Del Percio C, Noce G, Lizio R, Teipel SJ, Dyrba M, González-Escamilla G, Bakardjian H, Cavedo E, Lista S, Vergallo A, Lemercier P, Spinelli G, Grothe MJ, Potier MC, Stocchi F, Ferri R, Habert MO, Dubois B, Babiloni C. The association between posterior resting-state EEG alpha rhythms and functional MRI connectivity in older adults with subjective memory complaint. Neurobiol Aging 2024; 137:62-77. [PMID: 38431999 DOI: 10.1016/j.neurobiolaging.2024.02.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2020] [Revised: 02/09/2024] [Accepted: 02/19/2024] [Indexed: 03/05/2024]
Abstract
Resting-state eyes-closed electroencephalographic (rsEEG) alpha rhythms are dominant in posterior cortical areas in healthy adults and are abnormal in subjective memory complaint (SMC) persons with Alzheimer's disease amyloidosis. This exploratory study in 161 SMC participants tested the relationships between those rhythms and seed-based resting-state functional magnetic resonance imaging (rs-fMRI) connectivity between thalamus and visual cortical networks as a function of brain amyloid burden, revealed by positron emission tomography and cognitive reserve, measured by educational attainment. The SMC participants were divided into 4 groups according to 2 factors: Education (Edu+ and Edu-) and Amyloid burden (Amy+ and Amy-). There was a statistical interaction (p < 0.05) between the two factors, and the subgroup analysis using estimated marginal means showed a positive association between the mentioned rs-fMRI connectivity and the posterior rsEEG alpha rhythms in the SMC participants with low brain amyloidosis and high CR (Amy-/Edu+). These results suggest that in SMC persons, early Alzheimer's disease amyloidosis may contrast the beneficial effects of cognitive reserve on neurophysiological oscillatory mechanisms at alpha frequencies and connectivity between the thalamus and visual cortical networks.
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Affiliation(s)
- Susanna Lopez
- Department of Physiology and Pharmacology "Erspamer", Sapienza University of Rome, Rome, Italy
| | - Harald Hampel
- Sorbonne University, GRC n° 21, Alzheimer Precision Medicine (APM), AP-HP, Pitié-Salpêtrière Hospital, Boulevard de l'hôpital, Paris F-75013, France
| | - Patrizia Andrea Chiesa
- Sorbonne University, GRC n° 21, Alzheimer Precision Medicine (APM), AP-HP, Pitié-Salpêtrière Hospital, Boulevard de l'hôpital, Paris F-75013, France; Institute of Memory and Alzheimer's Disease (IM2A), Department of Neurology, Pitié-Salpêtrière Hospital, AP-HP, Boulevard de l'hôpital, Paris F-75013, France; Institut du Cerveau et de la Moelle épinière, ICM, INSERM U1127, CNRS UMR 7225, Sorbonne Université, Paris F- 75013, France
| | - Claudio Del Percio
- Department of Physiology and Pharmacology "Erspamer", Sapienza University of Rome, Rome, Italy
| | | | - Roberta Lizio
- Department of Physiology and Pharmacology "Erspamer", Sapienza University of Rome, Rome, Italy
| | - Stefan J Teipel
- Department of Psychosomatic Medicine, University of Rostock, Rostock, Germany; German Center for Neurodegenerative Diseases (DZNE), Greifswald, Rostock, Germany
| | - Martin Dyrba
- Department of Psychosomatic Medicine, University of Rostock, Rostock, Germany
| | - Gabriel González-Escamilla
- Department of Neurology, Focus Program Translational Neuroscience (FTN), Rhine-Main Neuroscience Network (rmn2), University Medical Center of the Johannes Gutenberg University Mainz, Mainz, Germany
| | - Hovagim Bakardjian
- Institute of Memory and Alzheimer's Disease (IM2A), Department of Neurology, Pitié-Salpêtrière Hospital, AP-HP, Boulevard de l'hôpital, Paris F-75013, France; Centre pour l'Acquisition et le Traitement des Images, (CATI platform), France; Laboratoire d'Imagerie Biomédicale, CNRS, INSERM, Sorbonne University, LIB, Paris F-75006, France
| | - Enrica Cavedo
- Sorbonne University, GRC n° 21, Alzheimer Precision Medicine (APM), AP-HP, Pitié-Salpêtrière Hospital, Boulevard de l'hôpital, Paris F-75013, France
| | - Simone Lista
- Sorbonne University, GRC n° 21, Alzheimer Precision Medicine (APM), AP-HP, Pitié-Salpêtrière Hospital, Boulevard de l'hôpital, Paris F-75013, France
| | - Andrea Vergallo
- Sorbonne University, GRC n° 21, Alzheimer Precision Medicine (APM), AP-HP, Pitié-Salpêtrière Hospital, Boulevard de l'hôpital, Paris F-75013, France
| | - Pablo Lemercier
- Sorbonne University, GRC n° 21, Alzheimer Precision Medicine (APM), AP-HP, Pitié-Salpêtrière Hospital, Boulevard de l'hôpital, Paris F-75013, France; Centre pour l'Acquisition et le Traitement des Images, (CATI platform), France; Laboratoire d'Imagerie Biomédicale, CNRS, INSERM, Sorbonne University, LIB, Paris F-75006, France
| | - Giuseppe Spinelli
- Centre pour l'Acquisition et le Traitement des Images, (CATI platform), France; Laboratoire d'Imagerie Biomédicale, CNRS, INSERM, Sorbonne University, LIB, Paris F-75006, France
| | - Michel J Grothe
- German Center for Neurodegenerative Diseases (DZNE), Greifswald, Rostock, Germany
| | - Marie-Claude Potier
- Institut du Cerveau et de la Moelle épinière, ICM, INSERM U1127, CNRS UMR 7225, Sorbonne Université, Paris F- 75013, France
| | - Fabrizio Stocchi
- IRCCS San Raffaele, Rome, Italy; Telematic University, San Raffaele, Rome, Italy
| | | | - Marie-Odile Habert
- Centre pour l'Acquisition et le Traitement des Images, (CATI platform), France; Laboratoire d'Imagerie Biomédicale, CNRS, INSERM, Sorbonne University, LIB, Paris F-75006, France; AP-HP, Pitié-Salpêtrière Hospital, Department of Nuclear Medicine, Paris F-75013, France
| | - Bruno Dubois
- Institute of Memory and Alzheimer's Disease (IM2A), Department of Neurology, Pitié-Salpêtrière Hospital, AP-HP, Boulevard de l'hôpital, Paris F-75013, France; Institut du Cerveau et de la Moelle épinière, ICM, INSERM U1127, CNRS UMR 7225, Sorbonne Université, Paris F- 75013, France
| | - Claudio Babiloni
- Department of Physiology and Pharmacology "Erspamer", Sapienza University of Rome, Rome, Italy; San Raffaele Cassino, Cassino, FR, Italy.
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2
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Huang WQ, Lin Q, Tzeng CM. Leukoaraiosis: Epidemiology, Imaging, Risk Factors, and Management of Age-Related Cerebral White Matter Hyperintensities. J Stroke 2024; 26:131-163. [PMID: 38836265 PMCID: PMC11164597 DOI: 10.5853/jos.2023.02719] [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: 08/18/2023] [Accepted: 01/15/2024] [Indexed: 06/06/2024] Open
Abstract
Leukoaraiosis (LA) manifests as cerebral white matter hyperintensities on T2-weighted magnetic resonance imaging scans and corresponds to white matter lesions or abnormalities in brain tissue. Clinically, it is generally detected in the early 40s and is highly prevalent globally in individuals aged >60 years. From the imaging perspective, LA can present as several heterogeneous forms, including punctate and patchy lesions in deep or subcortical white matter; lesions with periventricular caps, a pencil-thin lining, and smooth halo; as well as irregular lesions, which are not always benign. Given its potential of having deleterious effects on normal brain function and the resulting increase in public health burden, considerable effort has been focused on investigating the associations between various risk factors and LA risk, and developing its associated clinical interventions. However, study results have been inconsistent, most likely due to potential differences in study designs, neuroimaging methods, and sample sizes as well as the inherent neuroimaging heterogeneity and multi-factorial nature of LA. In this article, we provided an overview of LA and summarized the current knowledge regarding its epidemiology, neuroimaging classification, pathological characteristics, risk factors, and potential intervention strategies.
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Affiliation(s)
- Wen-Qing Huang
- Department of Central Laboratory, Shanghai Children's Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Qing Lin
- Department of Neurology, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, Fujian, China
- Xiamen Clinical Research Center for Neurological Diseases, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, Fujian, China
- Fujian Provincial Clinical Research Center for Brain Diseases, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, Fujian, China
- The Third Clinical College, Fujian Medical University, Fuzhou, Fujian, China
| | - Chi-Meng Tzeng
- Translational Medicine Research Center, School of Pharmaceutical Sciences, Xiamen University, Xiamen, Fujian, China
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3
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Schrempft S, Trofimova O, Künzi M, Ramponi C, Lutti A, Kherif F, Latypova A, Vollenweider P, Marques-Vidal P, Preisig M, Kliegel M, Stringhini S, Draganski B. The Neurobiology of Life Course Socioeconomic Conditions and Associated Cognitive Performance in Middle to Late Adulthood. J Neurosci 2024; 44:e1231232024. [PMID: 38499361 PMCID: PMC11044112 DOI: 10.1523/jneurosci.1231-23.2024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Revised: 01/18/2024] [Accepted: 01/23/2024] [Indexed: 03/20/2024] Open
Abstract
Despite major advances, our understanding of the neurobiology of life course socioeconomic conditions is still scarce. This study aimed to provide insight into the pathways linking socioeconomic exposures-household income, last known occupational position, and life course socioeconomic trajectories-with brain microstructure and cognitive performance in middle to late adulthood. We assessed socioeconomic conditions alongside quantitative relaxometry and diffusion-weighted magnetic resonance imaging indicators of brain tissue microstructure and cognitive performance in a sample of community-dwelling men and women (N = 751, aged 50-91 years). We adjusted the applied regression analyses and structural equation models for the linear and nonlinear effects of age, sex, education, cardiovascular risk factors, and the presence of depression, anxiety, and substance use disorders. Individuals from lower-income households showed signs of advanced brain white matter (WM) aging with greater mean diffusivity (MD), lower neurite density, lower myelination, and lower iron content. The association between household income and MD was mediated by neurite density (B = 0.084, p = 0.003) and myelination (B = 0.019, p = 0.009); MD partially mediated the association between household income and cognitive performance (B = 0.017, p < 0.05). Household income moderated the relation between WM microstructure and cognitive performance, such that greater MD, lower myelination, or lower neurite density was only associated with poorer cognitive performance among individuals from lower-income households. Individuals from higher-income households showed preserved cognitive performance even with greater MD, lower myelination, or lower neurite density. These findings provide novel mechanistic insights into the associations between socioeconomic conditions, brain anatomy, and cognitive performance in middle to late adulthood.
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Affiliation(s)
- Stephanie Schrempft
- Unit of Population Epidemiology, Division of Primary Care, Geneva University Hospitals, Geneva CH-1205, Switzerland
| | - Olga Trofimova
- Laboratory for Research in Neuroimaging (LREN), Department of Clinical Neurosciences, Lausanne University Hospital and University of Lausanne, Lausanne CH-1011, Switzerland
- Department of Computational Biology, University of Lausanne, Lausanne CH-1015, Switzerland
- Swiss Institute of Bioinformatics, Lausanne CH-1015, Switzerland
| | - Morgane Künzi
- Swiss National Centre of Competences in Research, "LIVES - Overcoming Vulnerability: Life Course Perspectives," University of Lausanne and University of Geneva, Lausanne CH-1015 and Carouge CH-1227, Switzerland
- Department of Psychology, University of Geneva, Geneva CH-1205, Switzerland
- Center for the Interdisciplinary Study of Gerontology and Vulnerability, University of Geneva, Carouge CH-1227, Switzerland
| | - Cristina Ramponi
- Laboratory for Research in Neuroimaging (LREN), Department of Clinical Neurosciences, Lausanne University Hospital and University of Lausanne, Lausanne CH-1011, Switzerland
| | - Antoine Lutti
- Laboratory for Research in Neuroimaging (LREN), Department of Clinical Neurosciences, Lausanne University Hospital and University of Lausanne, Lausanne CH-1011, Switzerland
| | - Ferath Kherif
- Laboratory for Research in Neuroimaging (LREN), Department of Clinical Neurosciences, Lausanne University Hospital and University of Lausanne, Lausanne CH-1011, Switzerland
| | - Adeliya Latypova
- Laboratory for Research in Neuroimaging (LREN), Department of Clinical Neurosciences, Lausanne University Hospital and University of Lausanne, Lausanne CH-1011, Switzerland
| | - Peter Vollenweider
- Department of Medicine, Internal Medicine, Lausanne University Hospital and University of Lausanne, Lausanne CH-1011, Switzerland
| | - Pedro Marques-Vidal
- Department of Medicine, Internal Medicine, Lausanne University Hospital and University of Lausanne, Lausanne CH-1011, Switzerland
| | - Martin Preisig
- Department of Psychiatry, Lausanne University Hospital and University of Lausanne, Lausanne CH-1008, Switzerland
| | - Matthias Kliegel
- Swiss National Centre of Competences in Research, "LIVES - Overcoming Vulnerability: Life Course Perspectives," University of Lausanne and University of Geneva, Lausanne CH-1015 and Carouge CH-1227, Switzerland
- Department of Psychology, University of Geneva, Geneva CH-1205, Switzerland
- Center for the Interdisciplinary Study of Gerontology and Vulnerability, University of Geneva, Carouge CH-1227, Switzerland
| | - Silvia Stringhini
- Unit of Population Epidemiology, Division of Primary Care, Geneva University Hospitals, Geneva CH-1205, Switzerland
- Department of Health and Community Medicine, Faculty of Medicine, University of Geneva, Geneva CH-1211, Switzerland
- University Centre for General Medicine and Public Health, University of Lausanne, Lausanne CH-1005, Switzerland
| | - Bogdan Draganski
- Laboratory for Research in Neuroimaging (LREN), Department of Clinical Neurosciences, Lausanne University Hospital and University of Lausanne, Lausanne CH-1011, Switzerland
- Neurology Department, Max-Planck-Institute for Human Cognitive and Brain Sciences, D-04303 Leipzig, Germany
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4
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Viher PV, Seitz-Holland J, Schulz MS, Kensinger EA, Karmacharya S, Swisher T, Lyall AE, Makris N, Bouix S, Shenton ME, Kubicki M, Waldinger RJ. More organized white matter is associated with positivity bias in older adults. Brain Imaging Behav 2024:10.1007/s11682-024-00850-5. [PMID: 38270836 DOI: 10.1007/s11682-024-00850-5] [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] [Accepted: 01/05/2024] [Indexed: 01/26/2024]
Abstract
On average, healthy older adults prefer positive over neutral or negative stimuli. This positivity bias is related to memory and attention processes and is linked to the function and structure of several interconnected brain areas. However, the relationship between the positivity bias and white matter integrity remains elusive. The present study examines how white matter organization relates to the degree of the positivity bias among older adults. We collected imaging and behavioral data from 25 individuals (12 females, 13 males, and a mean age of 77.32). Based on a functional memory task, we calculated a Pos-Neg score, reflecting the memory for positively valenced information over negative information, and a Pos-Neu score, reflecting the memory for positively valenced information over neutral information. Diffusion-weighted magnetic resonance imaging data were processed using Tract-Based Spatial Statistics. We performed two non-parametric permutation tests to correlate whole brain white matter integrity and the Pos-Neg and Pos-Neu scores while controlling for age, sex, and years of education. We observed a statistically significant positive association between the Pos-Neu score and white matter integrity in multiple brain connections, mostly frontal. The results did not remain significant when including verbal episodic memory as an additional covariate. Our study indicates that the positivity bias in memory in older adults is associated with more organized white matter in the connections of the frontal brain. While these frontal areas are critical for memory and executive processes and have been related to pathological aging, more extensive studies are needed to fully understand their role in the positivity bias and the potential for therapeutic interventions.
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Affiliation(s)
- Petra V Viher
- Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Johanna Seitz-Holland
- Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, USA
| | - Marc S Schulz
- Department of Psychology, Bryn Mawr College, Bryn Mawr, PA, USA
| | | | - Sarina Karmacharya
- Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Talis Swisher
- Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Amanda E Lyall
- Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, USA
| | - Nikos Makris
- Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, USA
| | - Sylvain Bouix
- Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Martha E Shenton
- Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, USA
- Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Marek Kubicki
- Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, USA.
- Department of Radiology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
| | - Robert J Waldinger
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA, USA
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5
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Du S, Ma X, Wang J, Mi Y, Zhang J, Du C, Li X, Tan H, Liang C, Yang T, Shi W, Zhang G, Tian Y. Spatiotemporal gait parameter fluctuations in older adults affected by mild cognitive impairment: comparisons among three cognitive dual-task tests. BMC Geriatr 2023; 23:603. [PMID: 37759185 PMCID: PMC10523758 DOI: 10.1186/s12877-023-04281-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Accepted: 09/05/2023] [Indexed: 09/29/2023] Open
Abstract
BACKGROUNDS Gait disorder is associated with cognitive functional impairment, and this disturbance is more pronouncedly when performing additional cognitive tasks. Our study aimed to characterize gait disorders in mild cognitive impairment (MCI) under three dual tasks and determine the association between gait performance and cognitive function. METHODS A total of 260 participants were enrolled in this cross-sectional study and divided into MCI and cognitively normal control. Spatiotemporal and kinematic gait parameters (31 items) in single task and three dual tasks (serial 100-7, naming animals and words recall) were measured using a wearable sensor. Baseline characteristics of the two groups were balanced using propensity score matching. Important gait features were filtered using random forest method and LASSO regression and further described using logistic analysis. RESULTS After matching, 106 participants with MCI and 106 normal controls were recruited. Top 5 gait features in random forest and 4 ~ 6 important features in LASSO regression were selected. Robust variables associating with cognitive function were temporal gait parameters. Participants with MCI exhibited decreased swing time and terminal swing, increased mid stance and variability of stride length compared with normal control. Subjects walked slower when performing an extra dual cognitive task. In the three dual tasks, words recall test exhibited more pronounced impact on gait regularity, velocity, and dual task cost than the other two cognitive tests. CONCLUSION Gait assessment under dual task conditions, particularly in words recall test, using portable sensors could be useful as a complementary strategy for early detection of MCI.
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Affiliation(s)
- Shan Du
- Department of Neurology, the Affiliated Hospital of Northwest University, Xi'an No.3 Hospital, Shaanxi, Xi'an, 710018, China
- Xi'an Key Laboratory of Cardiovascular and Cerebrovascular Diseases, the Affiliated Hospital of Northwest University, Xi'an No.3 Hospital, Shaanxi, Xi'an, 710018, China
| | - Xiaojuan Ma
- Clinical Medical Research Center, the Affiliated Hospital of Northwest University, Xi'an No.3 Hospital, Shaanxi, Xi'an, 710018, China
- Xi'an Key Laboratory of Cardiovascular and Cerebrovascular Diseases, the Affiliated Hospital of Northwest University, Xi'an No.3 Hospital, Shaanxi, Xi'an, 710018, China
| | - Jiachen Wang
- Department of Neurology, the Affiliated Hospital of Northwest University, Xi'an No.3 Hospital, Shaanxi, Xi'an, 710018, China
- Xi'an Key Laboratory of Cardiovascular and Cerebrovascular Diseases, the Affiliated Hospital of Northwest University, Xi'an No.3 Hospital, Shaanxi, Xi'an, 710018, China
| | - Yan Mi
- Department of Neurology, the Affiliated Hospital of Northwest University, Xi'an No.3 Hospital, Shaanxi, Xi'an, 710018, China
- Xi'an Key Laboratory of Cardiovascular and Cerebrovascular Diseases, the Affiliated Hospital of Northwest University, Xi'an No.3 Hospital, Shaanxi, Xi'an, 710018, China
| | - Jie Zhang
- Department of Neurology, the Affiliated Hospital of Northwest University, Xi'an No.3 Hospital, Shaanxi, Xi'an, 710018, China
- Xi'an Key Laboratory of Cardiovascular and Cerebrovascular Diseases, the Affiliated Hospital of Northwest University, Xi'an No.3 Hospital, Shaanxi, Xi'an, 710018, China
| | - Chengxue Du
- Department of Neurology, the Affiliated Hospital of Northwest University, Xi'an No.3 Hospital, Shaanxi, Xi'an, 710018, China
- Xi'an Key Laboratory of Cardiovascular and Cerebrovascular Diseases, the Affiliated Hospital of Northwest University, Xi'an No.3 Hospital, Shaanxi, Xi'an, 710018, China
| | - Xiaobo Li
- Department of Neurology, the Affiliated Hospital of Northwest University, Xi'an No.3 Hospital, Shaanxi, Xi'an, 710018, China
- Xi'an Key Laboratory of Cardiovascular and Cerebrovascular Diseases, the Affiliated Hospital of Northwest University, Xi'an No.3 Hospital, Shaanxi, Xi'an, 710018, China
| | - Huihui Tan
- Department of Neurology, the Affiliated Hospital of Northwest University, Xi'an No.3 Hospital, Shaanxi, Xi'an, 710018, China
- Xi'an Key Laboratory of Cardiovascular and Cerebrovascular Diseases, the Affiliated Hospital of Northwest University, Xi'an No.3 Hospital, Shaanxi, Xi'an, 710018, China
| | - Chen Liang
- Clinical Medical Research Center, the Affiliated Hospital of Northwest University, Xi'an No.3 Hospital, Shaanxi, Xi'an, 710018, China
- Xi'an Key Laboratory of Cardiovascular and Cerebrovascular Diseases, the Affiliated Hospital of Northwest University, Xi'an No.3 Hospital, Shaanxi, Xi'an, 710018, China
| | - Tian Yang
- Clinical Medical Research Center, the Affiliated Hospital of Northwest University, Xi'an No.3 Hospital, Shaanxi, Xi'an, 710018, China
- Xi'an Key Laboratory of Cardiovascular and Cerebrovascular Diseases, the Affiliated Hospital of Northwest University, Xi'an No.3 Hospital, Shaanxi, Xi'an, 710018, China
| | - Wenzhen Shi
- Clinical Medical Research Center, the Affiliated Hospital of Northwest University, Xi'an No.3 Hospital, Shaanxi, Xi'an, 710018, China.
- Xi'an Key Laboratory of Cardiovascular and Cerebrovascular Diseases, the Affiliated Hospital of Northwest University, Xi'an No.3 Hospital, Shaanxi, Xi'an, 710018, China.
| | - Gejuan Zhang
- Department of Neurology, the Affiliated Hospital of Northwest University, Xi'an No.3 Hospital, Shaanxi, Xi'an, 710018, China.
- Xi'an Key Laboratory of Cardiovascular and Cerebrovascular Diseases, the Affiliated Hospital of Northwest University, Xi'an No.3 Hospital, Shaanxi, Xi'an, 710018, China.
| | - Ye Tian
- Department of Neurology, the Affiliated Hospital of Northwest University, Xi'an No.3 Hospital, Shaanxi, Xi'an, 710018, China.
- Xi'an Key Laboratory of Cardiovascular and Cerebrovascular Diseases, the Affiliated Hospital of Northwest University, Xi'an No.3 Hospital, Shaanxi, Xi'an, 710018, China.
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6
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Gyllenhammar M, Rennie A, Padilla DF, Wallert J, Rydström A, Wahlund LO, Eriksdotter M, Westman E, Ekman U. The Association Between Temporal Atrophy and Episodic Memory Is Moderated by Education in a Multi-Center Memory Clinic Sample. J Alzheimers Dis 2023; 92:605-614. [PMID: 36776050 PMCID: PMC10041436 DOI: 10.3233/jad-220741] [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: 02/12/2023]
Abstract
BACKGROUND Cognitive reserve (CR) is hypothesized to partially explain the discrepancy between Alzheimer's disease related brain pathology and cognitive performance. Educational attainment is often used as a proxy for CR. OBJECTIVE To examine the association of years of education and the relationship between atrophy in the medial temporal lobe and episodic memory, in a cross-sectional ecological multi-center memory clinic cohort. METHODS Included patients (n = 702) had undergone memory clinic examination and were diagnosed with subjective cognitive impairment (n = 99), mild cognitive impairment (n = 471), or dementia (n = 132). Total years of education were used as a moderating variable and neuropathology was operationalized as visual ratings of medial temporal lobe atrophy (MTA) on magnetic resonance imaging and computer tomography images. Weighted least squares regression and multiple regression were used to analyze moderation and the effect of education separately by diagnostic group. A composite score of two episodic memory tests constituted the dependent variable. RESULTS After controlling for age and gender the interaction term between MTA and years of education was significant indicating moderation. In particular, the regression model showed that at low levels of MTA, high education individuals had better episodic memory performance. However, at higher MTA levels, high education individuals had the lowest episodic memory performance. Education had a significant positive effect on episodic memory in SCI and MCI, but not dementia. CONCLUSION These results extend the findings of education moderating the effect of MTA on cognition to a naturalistic memory clinic setting. Implications of the findings for theories on CR are discussed.
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Affiliation(s)
- Måns Gyllenhammar
- Women's Health and Allied Health Professionals Theme, Karolinska University Hospital, Stockholm, Sweden
| | - Anna Rennie
- Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | - Daniel Ferreira Padilla
- Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | - John Wallert
- Center for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Anders Rydström
- Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.,Aging Research Center, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden
| | - Lars-Olof Wahlund
- Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | - Maria Eriksdotter
- Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.,Theme Inflammation and Aging, Karolinska University Hospital, Stockholm, Sweden
| | - Eric Westman
- Women's Health and Allied Health Professionals Theme, Karolinska University Hospital, Stockholm, Sweden.,Department of Neuroimaging, Center for Neuroimaging Sciences, Institute of Psychiatry, Psychology and Neuroscience: King's College London, London, UK
| | - Urban Ekman
- Women's Health and Allied Health Professionals Theme, Karolinska University Hospital, Stockholm, Sweden.,Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
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7
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Amofa-Ho PA, Stickel AM, Chen R, Kobayashi LC, Glymour MM, Eng CW. The Mediating Roles of Neurobiomarkers in the Relationship Between Education and Late-Life Cognition. J Alzheimers Dis 2023; 95:1405-1416. [PMID: 37694365 PMCID: PMC10578223 DOI: 10.3233/jad-230244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/24/2023] [Indexed: 09/12/2023]
Abstract
BACKGROUND The mediating roles of neuropathologies and neurovascular damage in the relationship between early-life education and later-life cognitive function are unknown. OBJECTIVE To examine whether Alzheimer's and neurovascular biomarkers mediate the relationships between education and cognitive functions. METHODS Data were from 537 adults aged 55-94 in the Alzheimer's Disease Neuroimaging Initiative 3. We tested whether the relationships between education (continuous, years) and cognitive function (memory, executive functioning, and language composites) were mediated by neuroimaging biomarkers (hippocampal volumes, cortical gray matter volumes, meta-temporal tau PET standard uptake value ratio, and white matter hyperintensity volumes). Models were adjusted for age, race, sex/gender, cardiovascular history, body mass index, depression, and Apolipoprotein E-ɛ4 status. RESULTS Hippocampal volumes and white matter hyperintensities partially mediated the relationships between education and cognitive function across all domains (6.43% to 15.72% mediated). The direct effects of education on each cognitive domain were strong and statistically significant. CONCLUSIONS Commonly measured neurobiomarkers only partially mediate the relationships between education and multi-domain cognitive function.
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Affiliation(s)
- Priscilla A. Amofa-Ho
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, USA
| | - Ariana M. Stickel
- Department of Psychology, San Diego State University, San Diego, CA, USA
| | - Ruijia Chen
- Department of Epidemiology and Biostatistics, University of California, San Francisco, CA, USA
| | - Lindsay C. Kobayashi
- Center for Social Epidemiology and Population Health, Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI, USA
| | - M. Maria Glymour
- Department of Epidemiology and Biostatistics, University of California, San Francisco, CA, USA
| | - Chloe W. Eng
- Department of Epidemiology and Biostatistics, University of California, San Francisco, CA, USA
- Department of Epidemiology, Stanford University, Palo Alto, CA, USA
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8
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Cherkos K, Jember G, Mihret T, Fentanew M. Prevalence and Associated Factors of Cognitive Impairment Among Stroke Survivors at Comprehensive Specialized Hospitals in Northwest Ethiopia: Multi-Centered Cross-Sectional Study. Vasc Health Risk Manag 2023; 19:265-277. [PMID: 37138791 PMCID: PMC10150733 DOI: 10.2147/vhrm.s405357] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2023] [Accepted: 04/22/2023] [Indexed: 05/05/2023] Open
Abstract
Background Deficit in cognitive impairment is the most serious of the stroke sequelae. Post-stroke cognitive impairment is associated with impaired daily living activities and decreased capacity for independent living and functional performance. As a result, the purpose of this study was to determine the prevalence and associated factors of cognitive impairment among stroke survivors at comprehensive specialized hospitals in Ethiopia's Amhara region by 2022. Methods A multi-centered cross-sectional study was designed at an institution. During the study period. Data was gathered by conducting structured questionnaire interviews with participants and reviewing medical charts with trained data collectors. The participants were chosen using a systematic random sampling technique. The Montreal cognitive assessment basic was used to assess cognitive impairment. Descriptive statistics, binary and multivariate logistic regression methods were used to analyze the data. The Hosmer-Lemeshow goodness-of-fit test was used to assess the fitness of the model. The AOR with a P value of 0.05 at 95% CI was reported, and variables were considered statistically significant. Results This study enrolled 422 stroke survivors. Overall, 58.3% of stroke survivors had cognitive impairment (95% CI 53.4-63.0%). The study participants' age with AOR; 7.12 (4.40-11.45), being hypertensive with AOR; 7.52 (3.46-16.35), arriving at the hospital after 24 hours with AOR; 4.33 (1.49-12.05), less than three months after stroke with AOR; 4.83 (3.95-12.19), dominant hemisphere lesion with AOR; 4.83 (3.95-12.19) and being illiterate with AOR; 5.26 (4.43-18.64) were found significant factors. Conclusion Cognitive impairment was discovered to be relatively common among stroke survivors in this study. More than half of stroke survivors who attended comprehensive specialized hospitals during the study period were found to have cognitive impairment. Age, hypertension, arriving at the hospital after 24 hours, less than three months after stroke, dominant hemisphere lesion, and illiterate educational status were all significant factors in cognitive impairment.
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Affiliation(s)
- Kassahun Cherkos
- Department of Physiotherapy, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Gashaw Jember
- Department of Physiotherapy, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Tewodros Mihret
- Department of Physiotherapy, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
| | - Molla Fentanew
- Department of Physiotherapy, School of Medicine, College of Medicine and Health Sciences, University of Gondar, Gondar, Ethiopia
- Correspondence: Molla Fentanew, University of Gondar, P.O. Box. 196, Gondar, Ethiopia, Tel +251935686860, Email
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9
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Arakaki X, Hung SM, Rochart R, Fonteh AN, Harrington MG. Alpha desynchronization during Stroop test unmasks cognitively healthy individuals with abnormal CSF Amyloid/Tau. Neurobiol Aging 2022; 112:87-101. [PMID: 35066324 PMCID: PMC8976735 DOI: 10.1016/j.neurobiolaging.2021.11.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Revised: 11/27/2021] [Accepted: 11/30/2021] [Indexed: 01/15/2023]
Abstract
Synaptic dysfunctions precede cognitive decline in Alzheimer's disease by decades, affect executive functions, and can be detected by quantitative electroencephalography (qEEG). We used quantitative electroencephalography combined with Stroop testing to identify changes of inhibitory controls in cognitively healthy individuals with an abnormal versus normal ratio of cerebrospinal fluid (CSF) amyloid/total-tau. We studied two groups of participants (60-94 years) with either normal (CH-NAT or controls, n = 20) or abnormal (CH-PAT, n = 21) CSF amyloid/tau ratio. We compared: alpha event-related desynchronization (ERD), alpha spectral entropy (SE), and their relationships with estimated cognitive reserve. CH-PATs had more negative occipital alpha ERD, and higher frontal and occipital alpha SE during low load congruent trials, indicating hyperactivity. CH-PATs demonstrated fewer frontal SE changes with higher load, incongruent Stroop testing. Correlations of alpha ERD with estimated cognitive reserve were significant in CH-PATs but not in CH-NATs. These results suggested compensatory hyperactivity in CH-PATs compared to CH-NATs. We did not find differences in alpha ERD comparisons with individual CSF amyloid(A), p-tau(T), total-tau(N) biomarkers.
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10
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Beach PA, Humbel A, Dietrich MS, Bruehl S, Cowan RL, Moss KO, Monroe TB. A Cross-Sectional Study of Pain Sensitivity and Unpleasantness in People with Vascular Dementia. PAIN MEDICINE 2021; 23:1231-1238. [PMID: 34791388 DOI: 10.1093/pm/pnab327] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Revised: 10/26/2021] [Accepted: 11/04/2021] [Indexed: 11/12/2022]
Abstract
OBJECTIVE Advanced age holds higher risk of both pain and dementia, with many studies finding dementia often heightens sensitivity to pain. VaD is the second most common type of dementia. Only a few observational or retrospective studies have examined pain responsiveness in VaD, suggesting it may increase pain unpleasantness (i.e., pain affect). This study compared thermal pain psychophysics between a cohort of vascular dementia (VaD) patients and healthy control (HC) subjects. DESIGN Single center, cross-sectional, between-subjects design. SUBJECTS Verbally communicative, probable VaD patients (N = 23) and age- and sex-matched HC (N = 23). METHODS A thermal psychophysics protocol assessed "mild pain" and "moderate pain" thresholds (oC temperature) and associated unpleasantness ratings (0-20 scale) in both VaD and HC groups. Psychophysics were compared between groups by way of a mixed-effects analysis, controlling for depressive symptoms. RESULTS There were no significant differences between groups for pain thresholds (main effect p = 0.086, Cohen's d: mild = 0.55, moderate = 0.27). However, unpleasantness ratings were higher in the VaD group compared to HC (main effect p = 0.003; mild pain p = 0.022, Cohen's d = 0.79; moderate pain p = 0.057, Cohen's d = 0.6). CONCLUSIONS These results are consistent with prior observational findings suggesting VaD may make patients more susceptible to pain, particularly its affective component.
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Affiliation(s)
- Paul A Beach
- Bachelors of Science in Nursing Program, The Ohio State University College of Nursing, Columbus, OH
| | - Angela Humbel
- Bachelors of Science in Nursing Program, The Ohio State University College of Nursing, Columbus, OH
| | - Mary S Dietrich
- Department of Biostatistics, Vanderbilt University School of Medicine and School of Nursing, Nashville, TN
| | - Stephen Bruehl
- Department of Anesthesiology, Vanderbilt University Medical Center, Nashville, TN
| | - Ronald L Cowan
- Departments of Psychiatry and Anatomy and Neurobiology, Center for Addiction Science; College of Medicine; The University of Tennessee Health Science Center, Memphis, TN
| | - Karen O Moss
- Center for Health Outcomes in Medicine, The Ohio State University College of Medicine, Columbus, OH.,Center for Healthy Aging, The Ohio State University College of Nursing, Columbus, OH
| | - Todd B Monroe
- Center for Healthy Aging, The Ohio State University College of Nursing, Columbus, OH
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11
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Xu S, Sun Q, Li M, Luo J, Cai G, Chen R, Zhang L, Liu J. Hippocampal resting-state functional connectivity with the mPFC and DLPFC moderates and mediates the association between education level and memory function in subjective cognitive decline. BRAIN SCIENCE ADVANCES 2021. [DOI: 10.26599/bsa.2021.9050013] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
Objective: This study aims to determine the relationship between education level, memory function, and hippocampus functional and structural alterations in subjective cognitive decline (SCD). Methods: Seventy-five participants with SCD were divided into high education (HE) and low education (LE) level groups. A Wechsler Memory Scale–Chinese Revision test and functional and structural MRI were performed within 1 week after participant recruitment. The bilateral hippocampus resting-state functional connectivity (rsFC), gray matter volume (GMV) of brain regions identified by rsFC analysis, and moderating and mediating effects were assessed. Results: Compared with the LE group, HE individuals showed 1) higher memory quotient (MQ) and Digit Span subscore, 2) decreased hippocampal rsFC with the right medial prefrontal cortex (mPFC) and dorsolateral prefrontal cortex (DLPFC), and 3) increased GMV in the right mPFC and DLPFC. The bilateral hippocampus–right DLPFC rsFC significantly associated with the MQ and the bilateral hippocampus–right mPFCrsFC with the Digit Span subscore in each group. The bilateral hippocampus–right DLPFC rsFC moderated the relationship between the education level and MQ. The bilateral hippocampus–right mPFC rsFC mediated the relationship between the education level and Digit Span subscore in all subjects. Conclusion: The hippocampal rsFC with the right mPFC and DLPFC contributes to the education level effect on memory function in SCD.
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Affiliation(s)
- Shurui Xu
- National-Local Joint Engineering Research Center of Rehabilitation Medicine Technology, Fujian University of Traditional Chinese Medicine, Fuzhou 350122, Fujian, China
- These authors contributed equally to this work
| | - Qianqian Sun
- National-Local Joint Engineering Research Center of Rehabilitation Medicine Technology, Fujian University of Traditional Chinese Medicine, Fuzhou 350122, Fujian, China
- These authors contributed equally to this work
| | - Ming Li
- Affiliated Rehabilitation Hospital, Fujian University of Traditional Chinese Medicine, Fuzhou 350122, Fujian, China
- These authors contributed equally to this work
| | - Jia Luo
- College of Rehabilitation Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou 350122, Fujian, China
| | - Guiyan Cai
- National-Local Joint Engineering Research Center of Rehabilitation Medicine Technology, Fujian University of Traditional Chinese Medicine, Fuzhou 350122, Fujian, China
| | - Ruilin Chen
- National-Local Joint Engineering Research Center of Rehabilitation Medicine Technology, Fujian University of Traditional Chinese Medicine, Fuzhou 350122, Fujian, China
| | - Lin Zhang
- Institute for Stroke and Dementia Research (ISD), Klinikum der UniversitätMünchen, Ludwig-Maximilians-Universität (LMU) München, Munich 81377, Germany
| | - Jiao Liu
- National-Local Joint Engineering Research Center of Rehabilitation Medicine Technology, Fujian University of Traditional Chinese Medicine, Fuzhou 350122, Fujian, China
- Fujian Key Laboratory of Rehabilitation Technology, Fuzhou 350122, Fujian, China
- Traditional Chinese Medicine Rehabilitation Research Center of State Administration of Traditional Chinese Medicine, Fujian University of Traditional Chinese Medicine, Fuzhou 350122, Fujian, China
- Key Laboratory of Orthopedics & Traumatology of Traditional Chinese Medicine and Rehabilitation, Ministry of Education, Fujian University of Traditional Chinese Medicine, Fuzhou 350122, Fujian, China
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12
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Jiménez-Sánchez L, Hamilton OKL, Clancy U, Backhouse EV, Stewart CR, Stringer MS, Doubal FN, Wardlaw JM. Sex Differences in Cerebral Small Vessel Disease: A Systematic Review and Meta-Analysis. Front Neurol 2021; 12:756887. [PMID: 34777227 PMCID: PMC8581736 DOI: 10.3389/fneur.2021.756887] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Accepted: 10/04/2021] [Indexed: 01/12/2023] Open
Abstract
Background: Cerebral small vessel disease (SVD) is a common cause of stroke, mild cognitive impairment, dementia and physical impairments. Differences in SVD incidence or severity between males and females are unknown. We assessed sex differences in SVD by assessing the male-to-female ratio (M:F) of recruited participants and incidence of SVD, risk factor presence, distribution, and severity of SVD features. Methods: We assessed four recent systematic reviews on SVD and performed a supplementary search of MEDLINE to identify studies reporting M:F ratio in covert, stroke, or cognitive SVD presentations (registered protocol: CRD42020193995). We meta-analyzed differences in sex ratios across time, countries, SVD severity and presentations, age and risk factors for SVD. Results: Amongst 123 relevant studies (n = 36,910 participants) including 53 community-based, 67 hospital-based and three mixed studies published between 1989 and 2020, more males were recruited in hospital-based than in community-based studies [M:F = 1.16 (0.70) vs. M:F = 0.79 (0.35), respectively; p < 0.001]. More males had moderate to severe SVD [M:F = 1.08 (0.81) vs. M:F = 0.82 (0.47) in healthy to mild SVD; p < 0.001], and stroke presentations where M:F was 1.67 (0.53). M:F did not differ for recent (2015-2020) vs. pre-2015 publications, by geographical region, or age. There were insufficient sex-stratified data to explore M:F and risk factors for SVD. Conclusions: Our results highlight differences in male-to-female ratios in SVD severity and amongst those presenting with stroke that have important clinical and translational implications. Future SVD research should report participant demographics, risk factors and outcomes separately for males and females. Systematic Review Registration: [PROSPERO], identifier [CRD42020193995].
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Affiliation(s)
- Lorena Jiménez-Sánchez
- Translational Neuroscience PhD Programme, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, United Kingdom
| | - Olivia K. L. Hamilton
- Translational Neuroscience PhD Programme, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, United Kingdom
- Edinburgh Dementia Research Centre in the UK Dementia Research Institute, Edinburgh, United Kingdom
| | - Una Clancy
- Edinburgh Dementia Research Centre in the UK Dementia Research Institute, Edinburgh, United Kingdom
- Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, United Kingdom
| | - Ellen V. Backhouse
- Edinburgh Dementia Research Centre in the UK Dementia Research Institute, Edinburgh, United Kingdom
- Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, United Kingdom
| | - Catriona R. Stewart
- Edinburgh Dementia Research Centre in the UK Dementia Research Institute, Edinburgh, United Kingdom
- Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, United Kingdom
| | - Michael S. Stringer
- Edinburgh Dementia Research Centre in the UK Dementia Research Institute, Edinburgh, United Kingdom
- Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, United Kingdom
| | - Fergus N. Doubal
- Edinburgh Dementia Research Centre in the UK Dementia Research Institute, Edinburgh, United Kingdom
- Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, United Kingdom
| | - Joanna M. Wardlaw
- Edinburgh Dementia Research Centre in the UK Dementia Research Institute, Edinburgh, United Kingdom
- Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, United Kingdom
- Lothian Birth Cohorts, University of Edinburgh, Edinburgh, United Kingdom
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13
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Jansen MG, Geerligs L, Claassen JAHR, Overdorp EJ, Brazil IA, Kessels RPC, Oosterman JM. Positive Effects of Education on Cognitive Functioning Depend on Clinical Status and Neuropathological Severity. Front Hum Neurosci 2021; 15:723728. [PMID: 34566608 PMCID: PMC8459869 DOI: 10.3389/fnhum.2021.723728] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Accepted: 08/06/2021] [Indexed: 11/24/2022] Open
Abstract
Background: Variability in cognitive functions in healthy and pathological aging is often explained by educational attainment. However, it remains unclear to which extent different disease states alter protective effects of education. We aimed to investigate whether protective effects of education on cognition depend on (1) clinical diagnosis severity, and (2) the neuropathological burden within a diagnosis in a memory clinic setting. Methods: In this cross-sectional study, we included 108 patients with subjective cognitive decline [SCD, median age 71, IQR (66-78), 43% men], 190 with mild cognitive impairment [MCI, median age 78, IQR (73-82), 44% men], and 245 with Alzheimer's disease dementia (AD) [median age 80, IQR (76-84), 35% men]. We combined visual ratings of hippocampal atrophy, global atrophy, and white matter hyperintensities on MRI into a single neuropathology score. To investigate whether the contribution of education to cognitive performance differed across SCD, MCI, and AD, we employed several multiple linear regression models, stratified by diagnosis and adjusted for age, sex, and neurodegeneration. We re-ran each model with an additional interaction term to investigate whether these effects were influenced by neuropathological burden for each diagnostic group separately. False discovery rate (FDR) corrections for multiple comparisons were applied. Results: We observed significant positive associations between education and performance for global cognition and executive functions (all adjusted p-values < 0.05). As diagnosis became more severe, however, the strength of these associations decreased (all adjusted p-values < 0.05). Education related to episodic memory only at relatively lower levels of neuropathology in SCD (β = -0.23, uncorrected p = 0.02), whereas education related to episodic memory in those with higher levels of neuropathology in MCI (β = 0.15, uncorrected p = 0.04). However, these interaction effects did not survive FDR-corrections. Conclusions: Altogether, our results demonstrated that positive effects of education on cognitive functioning reduce with diagnosis severity, but the role of neuropathological burden within a particular diagnosis was small and warrants further investigation. Future studies may further unravel the extent to which different dimensions of an individual's disease severity contribute to the waxing and waning of protective effects in cognitive aging.
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Affiliation(s)
- Michelle G. Jansen
- Donders Institute for Brain, Cognition and Behavior, Radboud University Nijmegen, Nijmegen, Netherlands
| | - Linda Geerligs
- Donders Institute for Brain, Cognition and Behavior, Radboud University Nijmegen, Nijmegen, Netherlands
| | - Jurgen A. H. R. Claassen
- Donders Institute for Brain, Cognition and Behavior, Radboud University Nijmegen, Nijmegen, Netherlands
- Department of Geriatric Medicine, Radboudumc Alzheimer Center, Radboud University Medical Center, Nijmegen, Netherlands
| | | | - Inti A. Brazil
- Donders Institute for Brain, Cognition and Behavior, Radboud University Nijmegen, Nijmegen, Netherlands
| | - Roy P. C. Kessels
- Donders Institute for Brain, Cognition and Behavior, Radboud University Nijmegen, Nijmegen, Netherlands
- Department of Medical Psychology, Radboudumc Alzheimer Center, Radboud University Medical Center, Nijmegen, Netherlands
- Vincent van Gogh Institute for Psychiatry, Venray, Netherlands
| | - Joukje M. Oosterman
- Donders Institute for Brain, Cognition and Behavior, Radboud University Nijmegen, Nijmegen, Netherlands
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14
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Babiloni C, Ferri R, Noce G, Lizio R, Lopez S, Lorenzo I, Tucci F, Soricelli A, Nobili F, Arnaldi D, Famà F, Orzi F, Buttinelli C, Giubilei F, Cipollini V, Marizzoni M, Güntekin B, Aktürk T, Hanoğlu L, Yener G, Özbek Y, Stocchi F, Vacca L, Frisoni GB, Del Percio C. Resting State Alpha Electroencephalographic Rhythms Are Differently Related to Aging in Cognitively Unimpaired Seniors and Patients with Alzheimer's Disease and Amnesic Mild Cognitive Impairment. J Alzheimers Dis 2021; 82:1085-1114. [PMID: 34151788 DOI: 10.3233/jad-201271] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
BACKGROUND In relaxed adults, staying in quiet wakefulness at eyes closed is related to the so-called resting state electroencephalographic (rsEEG) rhythms, showing the highest amplitude in posterior areas at alpha frequencies (8-13 Hz). OBJECTIVE Here we tested the hypothesis that age may affect rsEEG alpha (8-12 Hz) rhythms recorded in normal elderly (Nold) seniors and patients with mild cognitive impairment due to Alzheimer's disease (ADMCI). METHODS Clinical and rsEEG datasets in 63 ADMCI and 60 Nold individuals (matched for demography, education, and gender) were taken from an international archive. The rsEEG rhythms were investigated at individual delta, theta, and alpha frequency bands, as well as fixed beta (14-30 Hz) and gamma (30-40 Hz) bands. Each group was stratified into three subgroups based on age ranges (i.e., tertiles). RESULTS As compared to the younger Nold subgroups, the older one showed greater reductions in the rsEEG alpha rhythms with major topographical effects in posterior regions. On the contrary, in relation to the younger ADMCI subgroups, the older one displayed a lesser reduction in those rhythms. Notably, the ADMCI subgroups pointed to similar cerebrospinal fluid AD diagnostic biomarkers, gray and white matter brain lesions revealed by neuroimaging, and clinical and neuropsychological scores. CONCLUSION The present results suggest that age may represent a deranging factor for dominant rsEEG alpha rhythms in Nold seniors, while rsEEG alpha rhythms in ADMCI patients may be more affected by the disease variants related to earlier versus later onset of the AD.
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Affiliation(s)
- Claudio Babiloni
- Department of Physiology and Pharmacology "Vittorio Erspamer", Sapienza University of Rome, Rome, Italy.,San Raffaele of Cassino, Cassino (FR), Italy
| | | | | | | | - Susanna Lopez
- Department of Physiology and Pharmacology "Vittorio Erspamer", Sapienza University of Rome, Rome, Italy
| | | | - Federico Tucci
- Department of Physiology and Pharmacology "Vittorio Erspamer", Sapienza University of Rome, Rome, Italy
| | - Andrea Soricelli
- IRCCS SDN, Napoli, Italy.,Department of Motor Sciences and Healthiness, University of Naples Parthenope, Naples, Italy
| | - Flavio Nobili
- Clinica Neurologica, IRCCS Ospedale Policlinico San Martino, Genova, Italy.,Dipartimento di Neuroscienze, Oftalmologia, Genetica, Riabilitazione e Scienze Materno-infantili (DiNOGMI), Università di Genova, Genova, Italy
| | - Dario Arnaldi
- Clinica Neurologica, IRCCS Ospedale Policlinico San Martino, Genova, Italy.,Dipartimento di Neuroscienze, Oftalmologia, Genetica, Riabilitazione e Scienze Materno-infantili (DiNOGMI), Università di Genova, Genova, Italy
| | - Francesco Famà
- Clinica Neurologica, IRCCS Ospedale Policlinico San Martino, Genova, Italy
| | - Francesco Orzi
- Department of Neuroscience, Mental Health and Sensory Organs, Sapienza University of Rome, Rome, Italy
| | - Carla Buttinelli
- Department of Neuroscience, Mental Health and Sensory Organs, Sapienza University of Rome, Rome, Italy
| | - Franco Giubilei
- Department of Neuroscience, Mental Health and Sensory Organs, Sapienza University of Rome, Rome, Italy
| | - Virginia Cipollini
- Department of Neuroscience, Mental Health and Sensory Organs, Sapienza University of Rome, Rome, Italy
| | - Moira Marizzoni
- Laboratory of Alzheimer's Neuroimaging and Epidemiology, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Bahar Güntekin
- Department of Biophysics, School of Medicine, Istanbul Medipol University, Istanbul, Turkey.,REMER, Clinical Electrophysiology, Neuroimaging and Neuromodulation Laboratory, Istanbul Medipol University, Istanbul, Turkey
| | - Tuba Aktürk
- REMER, Clinical Electrophysiology, Neuroimaging and Neuromodulation Laboratory, Istanbul Medipol University, Istanbul, Turkey
| | - Lutfu Hanoğlu
- Department of Neurology, School of Medicine, Istanbul Medipol University, Istanbul, Turkey
| | - Görsev Yener
- Izmir Biomedicine and Genome Center, Dokuz Eylul University Health Campus, Izmir, Turkey.,Department of Neurosciences, Institute of Health Sciences, Dokuz Eylul University, Izmir, Turkey
| | - Yağmur Özbek
- Department of Neurosciences, Institute of Health Sciences, Dokuz Eylul University, Izmir, Turkey
| | - Fabrizio Stocchi
- Institute for Research and Medical Care, IRCCS San Raffaele Pisana, Rome, Italy
| | - Laura Vacca
- Institute for Research and Medical Care, IRCCS San Raffaele Pisana, Rome, Italy
| | - Giovanni B Frisoni
- Laboratory of Alzheimer's Neuroimaging and Epidemiology, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy.,Memory Clinic and LANVIE - Laboratory of Neuroimaging of Aging, University Hospitals and University of Geneva, Geneva, Switzerland
| | - Claudio Del Percio
- Department of Physiology and Pharmacology "Vittorio Erspamer", Sapienza University of Rome, Rome, Italy
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15
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Babiloni C, Ferri R, Noce G, Lizio R, Lopez S, Lorenzo I, Panzavolta A, Soricelli A, Nobili F, Arnaldi D, Famà F, Orzi F, Buttinelli C, Giubilei F, Cipollini V, Marizzoni M, Güntekin B, Aktürk T, Hanoğlu L, Yener G, Özbek Y, Stocchi F, Vacca L, Frisoni GB, Del Percio C. Abnormalities of Cortical Sources of Resting State Alpha Electroencephalographic Rhythms are Related to Education Attainment in Cognitively Unimpaired Seniors and Patients with Alzheimer's Disease and Amnesic Mild Cognitive Impairment. Cereb Cortex 2021; 31:2220-2237. [PMID: 33251540 DOI: 10.1093/cercor/bhaa356] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2020] [Revised: 10/23/2020] [Accepted: 10/26/2020] [Indexed: 12/21/2022] Open
Abstract
In normal old (Nold) and Alzheimer's disease (AD) persons, a high cognitive reserve (CR) makes them more resistant and resilient to brain neuropathology and neurodegeneration. Here, we tested whether these effects may affect neurophysiological oscillatory mechanisms generating dominant resting state electroencephalographic (rsEEG) alpha rhythms in Nold and patients with mild cognitive impairment (MCI) due to AD (ADMCI). Data in 60 Nold and 70 ADMCI participants, stratified in higher (Edu+) and lower (Edu-) educational attainment subgroups, were available in an Italian-Turkish archive. The subgroups were matched for age, gender, and education. RsEEG cortical sources were estimated by eLORETA freeware. As compared to the Nold-Edu- subgroup, the Nold-Edu+ subgroup showed greater alpha source activations topographically widespread. On the contrary, in relation to the ADMCI-Edu- subgroup, the ADMCI-Edu+ subgroup displayed lower alpha source activations topographically widespread. Furthermore, the 2 ADMCI subgroups had matched cerebrospinal AD diagnostic biomarkers, brain gray-white matter measures, and neuropsychological scores. The current findings suggest that a high CR may be related to changes in rsEEG alpha rhythms in Nold and ADMCI persons. These changes may underlie neuroprotective effects in Nold seniors and subtend functional compensatory mechanisms unrelated to brain structure alterations in ADMCI patients.
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Affiliation(s)
- Claudio Babiloni
- Department of Physiology and Pharmacology "Vittorio Erspamer", Sapienza University of Rome, Rome, Italy.,San Raffaele of Cassino, Cassino, Italy
| | | | | | | | - Susanna Lopez
- Nephrology, Dialysis and Transplantation Unit, Department of Emergency and Organ Transplantation, Aldo Moro University of Bari, Bari, Italy
| | | | - Andrea Panzavolta
- Department of Physiology and Pharmacology "Vittorio Erspamer", Sapienza University of Rome, Rome, Italy
| | - Andrea Soricelli
- IRCCS SDN, Napoli, Italy.,Department of Motor Sciences and Healthiness, University of Naples Parthenope, Naples, Italy
| | - Flavio Nobili
- Clinica Neurologica, IRCCS Ospedale Policlinico San Martino, Genova, Italy.,Dipartimento di Neuroscienze, Oftalmologia, Genetica, Riabilitazione e Scienze Materno-infantili (DiNOGMI), Università di Genova, Italy
| | - Dario Arnaldi
- Clinica Neurologica, IRCCS Ospedale Policlinico San Martino, Genova, Italy.,Dipartimento di Neuroscienze, Oftalmologia, Genetica, Riabilitazione e Scienze Materno-infantili (DiNOGMI), Università di Genova, Italy
| | - Francesco Famà
- Dipartimento di Neuroscienze, Oftalmologia, Genetica, Riabilitazione e Scienze Materno-infantili (DiNOGMI), Università di Genova, Italy
| | - Francesco Orzi
- Department of Neuroscience, Mental Health and Sensory Organs, Sapienza University of Rome, Rome, Italy
| | - Carla Buttinelli
- Department of Neuroscience, Mental Health and Sensory Organs, Sapienza University of Rome, Rome, Italy
| | - Franco Giubilei
- Department of Neuroscience, Mental Health and Sensory Organs, Sapienza University of Rome, Rome, Italy
| | - Virginia Cipollini
- Department of Neuroscience, Mental Health and Sensory Organs, Sapienza University of Rome, Rome, Italy
| | - Moira Marizzoni
- Laboratory of Alzheimer's Neuroimaging and Epidemiology, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Bahar Güntekin
- Department of Biophysics, School of Medicine, Istanbul Medipol University, Istanbul, Turkey.,REMER, Clinical Electrophysiology, Neuroimaging and Neuromodulation Lab., Istanbul Medipol University, Istanbul, Turkey
| | - Tuba Aktürk
- REMER, Clinical Electrophysiology, Neuroimaging and Neuromodulation Lab., Istanbul Medipol University, Istanbul, Turkey
| | - Lutfu Hanoğlu
- Department of Neurology, School of Medicine, Istanbul Medipol University, Istanbul, Turkey
| | - Görsev Yener
- Izmir Biomedicine and Genome Center, Dokuz Eylul University Health Campus, Izmir, Turkey.,Department of Neurosciences, Institute of Health Sciences, Dokuz Eylul University, Izmir, Turkey
| | - Yağmur Özbek
- Department of Neurosciences, Institute of Health Sciences, Dokuz Eylul University, Izmir, Turkey
| | - Fabrizio Stocchi
- Institute for Research and Medical Care, IRCCS San Raffaele Pisana, Rome, Italy
| | - Laura Vacca
- Institute for Research and Medical Care, IRCCS San Raffaele Pisana, Rome, Italy
| | - Giovanni B Frisoni
- Laboratory of Alzheimer's Neuroimaging and Epidemiology, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy.,Memory Clinic and LANVIE-Laboratory of Neuroimaging of Aging, University Hospitals and University of Geneva, Geneva, Switzerland
| | - Claudio Del Percio
- Department of Physiology and Pharmacology "Vittorio Erspamer", Sapienza University of Rome, Rome, Italy
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16
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Sanderson-Cimino M, Panizzon MS, Elman JA, Tu X, Gustavson DE, Puckett O, Cross K, Notestine R, Hatton SN, Eyler LT, McEvoy LK, Hagler DJ, Neale MC, Gillespie NA, Lyons MJ, Franz CE, Fennema-Notestine C, Kremen WS. Periventricular and deep abnormal white matter differ in associations with cognitive performance at midlife. Neuropsychology 2021; 35:252-264. [PMID: 33970659 PMCID: PMC8500190 DOI: 10.1037/neu0000718] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
Objective: Abnormal white matter (AWM) on magnetic resonance imaging is associated with cognitive performance in older adults. We explored cognitive associations with AWM during late-midlife. Method: Participants were community-dwelling men (n = 242; M = 61.90 years; range = 56-66). Linear-mixed effects regression models examined associations of total, periventricular, and deep AWM with cognitive performance, controlling for multiple comparisons. Models considering specific cognitive domains controlled for current general cognitive ability (GCA). We hypothesized that total AWM would be associated with worse processing speed, executive function, and current GCA; deep AWM would correlate with GCA and periventricular AWM would relate to specific cognitive abilities. We also assessed the potential influence of cognitive reserve by examining a moderation effect of early life (mean age of 20) cognition. Results: Greater total and deep AWM were associated with poorer current GCA. Periventricular AWM was associated with worse executive function, working memory, and episodic memory. When periventricular and deep AWM were modeled simultaneously, both retained their respective significant associations with cognitive performance. Cognitive reserve did not moderate associations. Conclusions: Our findings suggest that AWM contributes to poorer cognitive function in late-midlife. Examining only total AWM may obscure the potential differential impact of regional AWM. Separating total AWM into subtypes while controlling for current GCA revealed a dissociation in relationships with cognitive performance; deep AWM was associated with nonspecific cognitive ability whereas periventricular AWM was associated with specific frontal-related abilities and memory. Management of vascular or other risk factors that may increase the risk of AWM should begin during or before early late-midlife. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
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Affiliation(s)
- Mark Sanderson-Cimino
- Joint Doctoral Program in Clinical Psychology, San Diego State/University of California
- Center for Behavior Genetics of Aging, University of California
| | - Matthew S. Panizzon
- Center for Behavior Genetics of Aging, University of California
- Department of Psychiatry University of California
| | - Jeremy A. Elman
- Center for Behavior Genetics of Aging, University of California
- Department of Psychiatry University of California
| | - Xin Tu
- Family Medicine and Public Health, University of California
| | - Daniel E. Gustavson
- Center for Behavior Genetics of Aging, University of California
- Department of Psychiatry University of California
- Department of Medicine, Vanderbilt University Medical Center
| | - Olivia Puckett
- Center for Behavior Genetics of Aging, University of California
- Department of Psychiatry University of California
| | | | - Randy Notestine
- Department of Psychiatry University of California
- Computational and Applied Statistics Laboratory (CASL) at the San Diego Supercomputer Center
| | - Sean N Hatton
- Center for Behavior Genetics of Aging, University of California
- Department of Psychiatry University of California
- Department of Neurosciences, University of California
| | - Lisa T. Eyler
- Department of Psychiatry University of California
- Mental Illness Research, Education, And Clinical Center, Veterans Affairs San Diego Healthcare System
| | - Linda K. McEvoy
- Department of Radiology, University of California, San Diego
| | | | - Michael C. Neale
- Virginia Institute for Psychiatric and Behavior Genetics, Virginia Commonwealth University
| | - Nathan A. Gillespie
- Virginia Institute for Psychiatric and Behavior Genetics, Virginia Commonwealth University
| | - Michael J. Lyons
- Department of Psychological and Brain Sciences, Boston University
| | - Carol E. Franz
- Center for Behavior Genetics of Aging, University of California
- Department of Psychiatry University of California
| | - Christine Fennema-Notestine
- Center for Behavior Genetics of Aging, University of California
- Department of Psychiatry University of California
- Department of Radiology, University of California, San Diego
| | - William S. Kremen
- Center for Behavior Genetics of Aging, University of California
- Department of Psychiatry University of California
- Center of Excellence for Stress and Mental Health, Veterans Affairs San Diego Healthcare System
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17
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White matter hyperintensities and risks of cognitive impairment and dementia: A systematic review and meta-analysis of 36 prospective studies. Neurosci Biobehav Rev 2020; 120:16-27. [PMID: 33188821 DOI: 10.1016/j.neubiorev.2020.11.007] [Citation(s) in RCA: 113] [Impact Index Per Article: 28.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Revised: 10/20/2020] [Accepted: 11/06/2020] [Indexed: 12/16/2022]
Abstract
BACKGROUND White matter hyperintensities of presumed vascular origin (WMH) are one of the imaging features of cerebral small vessel disease. Controversies persist about the effects of WMH on cognitive dysfunction. This meta-analysis aimed to identify the associations of WMH with risks of cognitive impairment and dementia. METHODS We searched PubMed, EMBASE and Cochrane Library for prospective studies. Primary analyses of cognitive dysfunction and sub-analyses of specific outcomes and study characteristics were conducted using random-effect models. RESULTS Thirty-six prospective studies with 19,040 participants were included. WMH at baseline conferred a 14 % elevated risk of cognitive impairment and all-cause dementia (ACD). WMH also conferred 25 % elevated risk of Alzheimer's disease and 73 % elevated risk of vascular dementia. Risk effects of high-grade WMH and continually increasing WMH (in volume or severity) on ACD were revealed. Periventricular WMH conferred a 1.51-fold excess risk for dementia. CONCLUSIONS WMH were associated with increased risk of cognitive dysfunction and could become a neuroimaging indicator of dementia.
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18
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Soldan A, Pettigrew C, Zhu Y, Wang M, Gottesman RF, DeCarli C, Albert M. Cognitive reserve and midlife vascular risk: Cognitive and clinical outcomes. Ann Clin Transl Neurol 2020; 7:1307-1317. [PMID: 32856790 PMCID: PMC7448143 DOI: 10.1002/acn3.51120] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2020] [Revised: 05/18/2020] [Accepted: 06/05/2020] [Indexed: 12/19/2022] Open
Abstract
OBJECTIVE Examine whether cognitive reserve moderates the association of 1) vascular risk factors and 2) white matter hyperintensity burden with risk of clinical progression and longitudinal cognitive decline. METHODS BIOCARD Study participants were cognitively normal and primarily middle-aged (M = 57 years) at baseline and have been followed with annual cognitive and clinical assessments (M = 13 years). Baseline cognitive reserve was indexed with a composite score combining education with reading and vocabulary scores. Baseline vascular risk (N = 229) was assessed with a composite risk score reflecting five vascular risk factors. Baseline white matter hyperintensity load (N = 271) was measured with FLAIR magnetic resonance imaging. Cox regression models assessed risk of progression from normal cognition to onset of clinical symptoms of Mild Cognitive Impairment. Longitudinal mixed effects models measured the relationship of these variables to cognitive decline, using a global composite score, and executive function and episodic memory sub-scores. RESULTS Both vascular risk and white matter hyperintensities were associated with cognitive decline, particularly in executive function. Higher vascular risk, but not white matter hyperintensity burden, was associated with an increased risk of progression to Mild Cognitive Impairment. Higher cognitive reserve was associated with a reduced risk of symptom onset and higher levels of baseline cognition but did not modify the associations between the vascular risk score and white matter hyperintensities with clinical progression or cognitive decline. INTERPRETATION Although cognitive reserve has protective effects on clinical and cognitive outcomes, it does not mitigate the negative impact of vascular risk and small vessel cerebrovascular disease on these same outcomes.
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Affiliation(s)
- Anja Soldan
- Department of NeurologyThe Johns Hopkins University School of MedicineBaltimoreMD21205
| | - Corinne Pettigrew
- Department of NeurologyThe Johns Hopkins University School of MedicineBaltimoreMD21205
| | - Yuxin Zhu
- Department of BiostatisticsJohns Hopkins Bloomberg School of Public HealthBaltimoreMD21287
| | - Mei‐Cheng Wang
- Department of BiostatisticsJohns Hopkins Bloomberg School of Public HealthBaltimoreMD21287
| | - Rebecca F. Gottesman
- Department of NeurologyThe Johns Hopkins University School of MedicineBaltimoreMD21205
| | - Charles DeCarli
- Department of NeurologyUniversity of California, Davis, School of MedicineDavisCA95616
| | - Marilyn Albert
- Department of NeurologyThe Johns Hopkins University School of MedicineBaltimoreMD21205
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19
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Babiloni C, Lopez S, Del Percio C, Noce G, Pascarelli MT, Lizio R, Teipel SJ, González-Escamilla G, Bakardjian H, George N, Cavedo E, Lista S, Chiesa PA, Vergallo A, Lemercier P, Spinelli G, Grothe MJ, Potier MC, Stocchi F, Ferri R, Habert MO, Fraga FJ, Dubois B, Hampel H. Resting-state posterior alpha rhythms are abnormal in subjective memory complaint seniors with preclinical Alzheimer's neuropathology and high education level: the INSIGHT-preAD study. Neurobiol Aging 2020; 90:43-59. [DOI: 10.1016/j.neurobiolaging.2020.01.012] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2019] [Revised: 01/24/2020] [Accepted: 01/26/2020] [Indexed: 01/05/2023]
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20
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Balestrini CS, Al-Khazraji BK, Suskin N, Shoemaker JK. Does vascular stiffness predict white matter hyperintensity burden in ischemic heart disease with preserved ejection fraction? Am J Physiol Heart Circ Physiol 2020; 318:H1401-H1409. [PMID: 32357114 DOI: 10.1152/ajpheart.00057.2020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
The survival rate of patients with ischemic heart disease (IHD) is increasing. However, survivors experience increased risk for neurological complications. The mechanisms for this increased risk are unknown. We tested the hypothesis that patients with IHD have greater carotid and cerebrovascular stiffness, and these indexes predict white matter small vessel disease. Fifty participants (age, 40-78 yr), 30 with IHD with preserved ejection fraction and 20 healthy age-matched controls, were studied using ultrasound imaging of the common carotid artery (CCA) and middle cerebral artery (MCA), as well as magnetic resonance imaging (T1, T2-FLAIR), to measure white matter lesion volume (WMLv). Carotid β-stiffness provided the primary measure of peripheral vascular stiffness. Carotid-cerebral pulse wave transit time (ccPWTT) provided a marker of cerebrovascular stiffness. Pulsatility index (PI) and resistive index (RI) of the MCA were calculated as measures of downstream cerebrovascular resistance. When compared with controls, patients with IHD exhibited greater β-stiffness [8.5 ± 3.3 vs. 6.8 ± 2.2 arbitrary units (AU); P = 0.04], MCA PI (1.1 ± 0.20 vs. 0.98 ± 0.18 AU; P = 0.02), and MCA RI (0.66 ± 0.06 vs. 0.62 ± 0.07 AU; P = 0.04). There was no difference in WMLv between IHD and control groups (0.95 ± 1.2 vs. 0.86 ± 1.4 mL; P = 0.81). In pooled patient data, WMLv correlated with both β-stiffness (R = 0.34, P = 0.02) and cerebrovascular ccPWTT (R = -0.43, P = 0.02); however, β-stiffness and ccPWTT were not associated (P = 0.13). In multivariate analysis, WMLv remained independently associated with ccPWTT (P = 0.02) and carotid β-stiffness (P = 0.04). Patients with IHD expressed greater β-stiffness and cerebral microvascular resistance. However, IHD did not increase risk of WMLv or cerebrovascular stiffness. Nonetheless, pooled data indicate that both carotid and cerebrovascular stiffness are independently associated with WMLv.NEW & NOTEWORTHY This study found that patients with ischemic heart disease (IHD) with preserved ejection fraction and normal blood pressures exhibit greater carotid β-stiffness, as well as middle cerebral artery pulsatility and resistive indexes, than controls. White matter lesion volume (WMLv) was not different between vascular pathology groups. Cerebrovascular pulse wave transit time (ccPWTT) and carotid β-stiffness independently associate with WMLv in pooled participant data, suggesting that regardless of heart disease history, ccPWTT and β-stiffness are associated with structural white matter damage.
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Affiliation(s)
| | | | - Neville Suskin
- Cardiac Rehabilitation and Secondary Prevention Program of Saint Joseph's Health Care London, London, Ontario, Canada.,Division of Cardiology, Department of Medicine, and Program of Experimental Medicine, Western University, London, Ontario, Canada
| | - J Kevin Shoemaker
- School of Kinesiology, Western University, London, Ontario, Canada.,Department of Physiology and Pharmacology, Western University, London, Ontario, Canada
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21
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Kokubun K, Nemoto K, Yamakawa Y. Fish Intake May Affect Brain Structure and Improve Cognitive Ability in Healthy People. Front Aging Neurosci 2020; 12:76. [PMID: 32265686 PMCID: PMC7103640 DOI: 10.3389/fnagi.2020.00076] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2019] [Accepted: 03/02/2020] [Indexed: 01/09/2023] Open
Abstract
As the population ages worldwide, the prevalence of cognitive disorders including mild cognitive impairment (MCI) is increasing. MCI appears in 10–20% of adults aged 65 years and older and is generally referred to as an intermediate stage between normal cognitive aging and dementia. To develop timely prevention and early treatment strategies by identifying biological factors, we investigated the relationship between dietary consumption of fish, brain structure, and MCI in cognitively normal subjects. The brain structure was assessed using neuroimaging-derived measures including the “gray-matter brain healthcare quotient (GM-BHQ)” and “fractional-anisotropy brain healthcare quotient (FA-BHQ),” which are approved as the international standard (H.861.1) by the International Telecommunication Union Telecommunication Standardization Sector. Dietary consumption of fish was calculated using the brief self-administered diet history questionnaire (BDHQ), and MCI was assessed using the Memory Performance Index (MPI) of MCI screening method (MCI Screen). This study showed that fish intake was positively associated with both FA-BHQ and MPI, and FA-BHQ was more strongly associated with MPI than fish intake. Our findings are in line with those in previous studies, but our study further indicates that the condition of the whole brain integrity measured by the FA-BHQ may mediate the relationship between fish intake and MCI prevention in healthy people. In other words, FA-BHQ may be used to identify people at high risk of MCI to provide the appropriate intervention.
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Affiliation(s)
| | - Kiyotaka Nemoto
- Division of Clinical Medicine, Department of Neuropsychiatry, Faculty of Medicine, University of Tsukuba, Tsukuba, Japan
| | - Yoshinori Yamakawa
- Open Innovation Institute, Kyoto University, Kyoto, Japan.,ImPACT Program of Council for Science, Technology and Innovation (Cabinet Office, Government of Japan), Chiyoda, Tokyo, Japan.,Institute of Innovative Research, Tokyo Institute of Technology, Meguro, Tokyo, Japan.,Office for Academic and Industrial Innovation, Kobe University, Kobe, Japan.,NTT Data Institute of Management Consulting, Inc., Chiyoda, Tokyo, Japan
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22
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Chen Y, Qi D, Qin T, Chen K, Ai M, Li X, Li H, Zhang J, Mao H, Yang Y, Zhang Z. Brain Network Connectivity Mediates Education-related Cognitive Performance in Healthy Elderly Adults. Curr Alzheimer Res 2020; 16:19-28. [PMID: 30345918 DOI: 10.2174/1567205015666181022094158] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2018] [Revised: 09/18/2018] [Accepted: 10/15/2018] [Indexed: 12/16/2022]
Abstract
BACKGROUND Among the protective factors for cognitive decline related to aging and Alzheimer's disease, education level is one of the most prominent. However, the mechanisms underlying the protective effects of education on cognition remain to be elucidated. In this study, we aimed to systematically assess the role of Functional Connectivity (FC) of resting-state brain networks playing in the cognition-protection effect of education. METHODS Data from a battery of neuropsychological tests and functional magnetic resonance imaging in resting-state were acquired in 77 cognitively normal elderly participants from local communities in Beijing, China. Six resting-state networks related to primary function or complex cognition were extracted through independent component analysis. We then explored the relationships between education level, cognition, and FC of these networks. RESULTS We found that education level was positively associated with a wide range of complex cognitive domains including general mental status, episodic memory, language, attention, executive function and visuospatial processing, and it showed significantly negative correlations with FC of multiple areas in the Default Mode Network (DMN) and Left Frontal-parietal Network (LFP) which are related to complex cognition. And regional connectivity of DMN was significantly negatively correlated with episodic memory performance. Further mediation analysis suggested that higher education level was associated with higher episodic memory performance through lower regional connectivity of DMN. CONCLUSION Our findings indicate that inhibitory modulation in the resting-state brain networks related to complex cognition is one of the main routes through which education exerts its protective effects on cognition in normal aging.
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Affiliation(s)
- Yaojing Chen
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing 100875, China.,BABRI Centre, Beijing Normal University, Beijing 100875, China
| | - Di Qi
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing 100875, China.,BABRI Centre, Beijing Normal University, Beijing 100875, China.,Laboratory of Neuropsychology, The University of Hong Kong, Pokfulam, Hong Kong
| | - Ting Qin
- BABRI Centre, Beijing Normal University, Beijing 100875, China
| | - Kewei Chen
- Banner Alzheimer's Institute, Phoenix, AZ 85006, United States
| | - Meishan Ai
- Faculty of Psychology, Beijing Normal University, Beijing 100875, China
| | - Xin Li
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing 100875, China.,BABRI Centre, Beijing Normal University, Beijing 100875, China
| | - He Li
- BABRI Centre, Beijing Normal University, Beijing 100875, China.,Institute of Basic Research in Clinical Medicine, China Academy of Chinese Medical Sciences, Beijing 100700, China
| | - Junying Zhang
- BABRI Centre, Beijing Normal University, Beijing 100875, China.,Institute of Basic Research in Clinical Medicine, China Academy of Chinese Medical Sciences, Beijing 100700, China
| | - Haohao Mao
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing 100875, China.,BABRI Centre, Beijing Normal University, Beijing 100875, China
| | - Yiru Yang
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing 100875, China.,BABRI Centre, Beijing Normal University, Beijing 100875, China
| | - Zhanjun Zhang
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing 100875, China.,BABRI Centre, Beijing Normal University, Beijing 100875, China.,Institute of Basic Research in Clinical Medicine, China Academy of Chinese Medical Sciences, Beijing 100700, China
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23
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Kwak S, Shin M, Kim H, Cho B, Ha JH, Han G, Kim H, Koo Y, Kwon S, Lee C, Lee HJ, Park KS, Chey J. Moderating effect of cognitive reserve on the association between grey matter atrophy and memory varies with age in older adults. Psychogeriatrics 2020; 20:87-95. [PMID: 31069884 PMCID: PMC7003838 DOI: 10.1111/psyg.12460] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/23/2018] [Revised: 02/24/2019] [Accepted: 04/01/2019] [Indexed: 12/16/2022]
Abstract
BACKGROUND Educational attainment and verbal intelligence, which indirectly reflect an individual's cognitive reserve (CR), is suggested to buffer the effect of late-life brain degradation on cognitive performance outcome. We aimed to explore how the relationship between whole grey matter volume (GMV) and episodic memory function is altered by CR proxy as well as age in healthy older adults. METHODS Elderly Verbal Learning Test (EVLT) and structural magnetic resonance imaging were administered to 110 community-residing older adults. Moderated moderation model tested whether the association between whole GMV and episodic memory was moderated by both CR and chronological age. RESULTS The results showed that the moderating effect of CR on Immediate Recall, Short-delay Recall, and Recognition scores of EVLT differed across age groups. The elderly with higher CR showed steeper GMV effect on EVLT at the Age-Younger condition, while such moderating effect was reversed in the Age-Older condition, suggesting an alleviated brain atrophy effect in higher CR elderly. CONCLUSION These findings suggest that although higher CR elderly may exhibit earlier GMV-related memory decline, the buffering effect of CR on the cognitive decline due to brain atrophy would become more evident in old-old elderly people who are likely to have accumulated more neuropathological changes. This study underscores chronological age as an important moderating factor in examining the moderating role of CR in late-life memory function.
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Affiliation(s)
- Seyul Kwak
- Department of Psychology, Seoul National University, Seoul, Republic of Korea
| | - Minyoung Shin
- Department of Psychology, Seoul National University, Seoul, Republic of Korea.,Yongmoon Graduate School of Counseling Psychology, Seoul, Republic of Korea
| | - Hoyoung Kim
- Department of Psychology, Chonbuk National University, Jeonju, Republic of Korea
| | - Belong Cho
- Department of Family Medicine, Center for Health Promotion and Optimal Aging, Seoul National University, Seoul, Republic of Korea.,Institute of Aging, Seoul National University College of Medicine, and Hospital, Seoul, Republic of Korea
| | - Jung-Hwa Ha
- Department of Social Welfare, Seoul National University, Seoul, Republic of Korea
| | - Gyounghae Han
- Research Institute of Human Ecology, Department of Child Development and Family Studies, Seoul National University, Seoul, Republic of Korea
| | - Hongsoo Kim
- Graduate School of Public Health Department of Public Health Sciences, Institute of Aging, Institute of Health and Environment at Seoul National University, Seoul, Republic of Korea
| | - Yangmi Koo
- Department of Geography, Seoul National University, Seoul, Republic of Korea
| | - Soonman Kwon
- Graduate School of Public Health Department of Public Health Sciences, Seoul National University, Seoul, Republic of Korea
| | - Chulhee Lee
- Department of Economics, Seoul National University, Seoul, Republic of Korea
| | - Hyeon Jung Lee
- Department of Anthropology, Seoul National University, Seoul, Republic of Korea
| | - Keong-Suk Park
- Department of Sociology, Seoul National University, Seoul, Republic of Korea
| | - Jeanyung Chey
- Department of Psychology, Seoul National University, Seoul, Republic of Korea
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24
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DuBose LE, Moser DJ, Harlynn E, Fiedorowicz JG, Pierce GL. Education moderates the effects of large central artery aging on cognitive performance in middle-aged and older adults. Physiol Rep 2019; 7:e14291. [PMID: 31833225 PMCID: PMC6908737 DOI: 10.14814/phy2.14291] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Central artery aging, including elevated aortic stiffness, central blood pressure (BP), and pulse pressure (PP), is a novel risk factor for the development of age-associated cognitive dysfunction. Individuals with higher educational attainment may develop greater brain pathology prior to the onset of cognitive decline. However, whether education moderates relations between central artery aging and cognitive performance is unknown. We hypothesized that years of formal education would moderate the relation between central artery aging and cognitive performance in middle-aged/older (MA/O) adults (n = 113, age 67.3 ± 0.7 years). Significant interactions between education*central systolic BP (β = .21, p = .02) and education*central PP (β = .22, p = .01) demonstrated weaker associations between central BP and PP with processing speed performance in those with higher education. Similarly, education moderated the relation between aortic stiffness (carotid-femoral pulse wave velocity, cfPWV) and executive function performance (β = .21, p = .02). To test if the relation between central arterial aging and cognitive performance was captured by a predetermined education threshold, MA/O adults were secondarily categorized as ≤high school (HS) (i.e., ≤12 years, n = 36) or >HS (≥13 years, n = 77). Higher central systolic BP was associated with slower processing speed (≤HS: r = -.59, p < .001 vs. >HS: r = -.25, p = .03) and weaker executive function (r = -.39, p = .03 vs. r = -.32, p = .006). Higher cfPWV was selectively correlated with weaker executive function performance (r = -.39, p = .03) in ≤HS only and this association significantly differed between education groups. Educational attainment appears to moderate the adverse effects of central artery aging on cognitive performance among MA/O adults.
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Affiliation(s)
- Lyndsey E. DuBose
- Department of Health and Human PhysiologyUniversity of IowaIowa CityIowa
| | | | - Emily Harlynn
- Department of PsychiatryUniversity of IowaIowa CityIowa
| | - Jess G. Fiedorowicz
- Department of PsychiatryUniversity of IowaIowa CityIowa
- Department of EpidemiologyUniversity of IowaIowa CityIowa
- Department of Internal MedicineUniversity of IowaIowa CityIowa
| | - Gary L. Pierce
- Department of Health and Human PhysiologyUniversity of IowaIowa CityIowa
- Abboud Cardiovascular Research CenterUniversity of IowaIowa CityIowa
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25
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Menardi A, Pascual-Leone A, Fried PJ, Santarnecchi E. The Role of Cognitive Reserve in Alzheimer's Disease and Aging: A Multi-Modal Imaging Review. J Alzheimers Dis 2019; 66:1341-1362. [PMID: 30507572 DOI: 10.3233/jad-180549] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Comforts in modern society have generally been associated with longer survival rates, enabling individuals to reach advanced age as never before in history. With the increase in longevity, however, the incidence of neurodegenerative diseases, especially Alzheimer's disease, has also doubled. Nevertheless, most of the observed variance, in terms of time of clinical diagnosis and progression, often remains striking. Only recently, differences in the social, educational and occupational background of the individual, as proxies of cognitive reserve (CR), have been hypothesized to play a role in accounting for such discrepancies. CR is a well-established concept in literature; lots of studies have been conducted in trying to better understand its underlying neural substrates and associated biomarkers, resulting in an incredible amount of data being produced. Here, we aimed to summarize recent relevant published work addressing the issue, gathering evidence for the existence of a common path across research efforts that might ease future investigations by providing a general perspective on the actual state of the arts. An innovative model is hereby proposed, addressing the role of CR across structural and functional evidences, as well as the potential implementation of non-invasive brain stimulation techniques in the causal validation of such theoretical frame.
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Affiliation(s)
- Arianna Menardi
- Brain Investigation and Neuromodulation Lab, Department of Medicine, Surgery and Neuroscience, Neurology and Clinical Neurophysiology Section, University of Siena, Italy.,Berenson-Allen Center for Noninvasive Brain Stimulation, Division of Cognitive Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Alvaro Pascual-Leone
- Berenson-Allen Center for Noninvasive Brain Stimulation, Division of Cognitive Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Peter J Fried
- Berenson-Allen Center for Noninvasive Brain Stimulation, Division of Cognitive Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
| | - Emiliano Santarnecchi
- Brain Investigation and Neuromodulation Lab, Department of Medicine, Surgery and Neuroscience, Neurology and Clinical Neurophysiology Section, University of Siena, Italy.,Berenson-Allen Center for Noninvasive Brain Stimulation, Division of Cognitive Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
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Zahodne LB, Mayeda ER, Hohman TJ, Fletcher E, Racine AM, Gavett B, Manly JJ, Schupf N, Mayeux R, Brickman AM, Mungas D. The role of education in a vascular pathway to episodic memory: brain maintenance or cognitive reserve? Neurobiol Aging 2019; 84:109-118. [PMID: 31539647 DOI: 10.1016/j.neurobiolaging.2019.08.009] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2019] [Revised: 08/02/2019] [Accepted: 08/09/2019] [Indexed: 01/05/2023]
Abstract
Educational attainment is associated with cognition among older adults, but this association is complex and not well understood. While associated with better cognition among healthy adults, more education predicts faster decline in older adults with cognitive impairment. Education may influence cognitive functioning through mechanisms involving brain maintenance (BM: reduced age-related pathology) or cognitive reserve (CR: altered pathology-cognition association). We examined evidence for each mechanism by quantifying main and interaction effects of education within a well-studied pathway involving systolic blood pressure, white matter hyperintensities (WMH), and episodic memory in 2 samples without dementia at the baseline (total N = 1136). There were no effects of education on systolic blood pressure or WMH, suggesting a lack of evidence for BM. In the sample less likely to progress to dementia, education attenuated the effect of WMH on memory at the baseline. In the sample more likely to progress to dementia, education exacerbated this effect at the baseline. These moderations provide evidence for a CR mechanism and are consistent with previous findings of faster decline once CR is depleted.
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Affiliation(s)
- Laura B Zahodne
- Department of Psychology, University of Michigan, Ann Arbor, MI, USA.
| | - Elizabeth Rose Mayeda
- Department of Epidemiology, University of California, Los Angeles, Los Angeles, CA, USA
| | - Timothy J Hohman
- Department of Neurology, Vanderbilt University, Nashville, TN, USA
| | - Evan Fletcher
- Department of Neurology, University of California, Davis, Sacramento, CA, USA
| | | | - Brandon Gavett
- School of Psychological Science, The University of Western Australia, Perth, Australia
| | - Jennifer J Manly
- Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Gertrude H. Sergievsky Center, Department of Neurology, Columbia University Medical Center, New York, NY, USA
| | - Nicole Schupf
- Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Gertrude H. Sergievsky Center, Department of Neurology, Columbia University Medical Center, New York, NY, USA; Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Gertrude H. Sergievsky Center, Departments of Epidemiology and Psychiatry, New York, NY, USA
| | - Richard Mayeux
- Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Gertrude H. Sergievsky Center, Departments of Neurology, Epidemiology, and Psychiatry, New York, NY, USA
| | - Adam M Brickman
- Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Gertrude H. Sergievsky Center, Department of Neurology, Columbia University Medical Center, New York, NY, USA
| | - Dan Mungas
- Department of Neurology, University of California, Davis, Sacramento, CA, USA
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Fan R, Zhao L, Ding BJ, Xiao R, Ma WW. The association of blood non-esterified fatty acid, saturated fatty acids, and polyunsaturated fatty acids levels with mild cognitive impairment in Chinese population aged 35-64 years: a cross-sectional study. Nutr Neurosci 2019; 24:148-160. [PMID: 31079572 DOI: 10.1080/1028415x.2019.1610606] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
OBJECTIVES The aim of this study was to explore the correlation between blood profiles and cognitive functions or mild cognitive impairment (MCI) in the Chinese population aged 35-64 years old. METHODS A cross-sectional study was performed, which recruited 675 Chinese adults aged 35-64 years old from Beijing, China. Their cognitive performance was assessed with Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA), the serum lipids levels were measured by hexokinase method and colorimetric assay, and the plasma fatty acids profiles were analyzed by fast gas chromatography. RESULTS Among the 675 participants, 84 (12.4%) had MCI. Age, years of education, saturated fatty acids (SFAs) and monounsaturated fatty acids (MUFAs) were associated with MMSE scores (all P < 0.05). Age, years of education, smoking, drinking, non-esterified fatty acids (NEFAs), SFAs, MUFAs, n-3 polyunsaturated fatty acids (n-3 PUFAs) and n-6/n-3 PUFAs were associated with MoCA scores (all P < 0.05). Increased age (P = 0.002) and smoking (P = 0.028) were positively associated with the prevalence of MCI, while educational level (P = 0.005) and alcohol drinking (P = 0.003) both were negatively correlated to the prevalence of MCI. Elevated serum NEFAs (P = 0.032), high plasma SFAs (P = 0.023), and excessive polyunsaturated fatty acids (PUFAs) levels (P = 0.033) were significantly associated with increased frequency of MCI. CONCLUSION In the Chinese population aged 35-64 years, advanced age and cigarette smoking were risk factors of MCI, whereas higher educational level and alcohol drinking were protective factors for MCI. Excessive serum or plasma levels of NEFAs, SFAs and PUFAs were associated with an increased risk of MCI.
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Affiliation(s)
- Rong Fan
- School of Public Health, Beijing Key Laboratory of Environmental Toxicology, Capital Medical University, Beijing, People's Republic of China
| | - Lei Zhao
- Department of Molecular Physiology and Biophysics, Holden Comprehensive Cancer Center, University of Iowa Carver College of Medicine, Iowa City, IA, USA
| | - Bing-Jie Ding
- Department of Clinical Nutrition, Beijing Friendship Hospital, Capital Medical University, Beijing, People's Republic of China
| | - Rong Xiao
- School of Public Health, Beijing Key Laboratory of Environmental Toxicology, Capital Medical University, Beijing, People's Republic of China
| | - Wei-Wei Ma
- School of Public Health, Beijing Key Laboratory of Environmental Toxicology, Capital Medical University, Beijing, People's Republic of China
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Abstract
PURPOSE OF REVIEW The aim of this review is to summarize current conceptual models of cognitive reserve (CR) and related concepts and to discuss evidence for these concepts within the context of aging and Alzheimer's disease. RECENT FINDINGS Evidence to date supports the notion that higher levels of CR, as measured by proxy variables reflective of lifetime experiences, are associated with better cognitive performance, and with a reduced risk of incident mild cognitive impairment/dementia. However, the impact of CR on longitudinal cognitive trajectories is unclear and may be influenced by a number of factors. Although there is promising evidence that some proxy measures of CR may influence structural brain measures, more research is needed. The protective effects of CR may provide an important mechanism for preserving cognitive function and cognitive well-being with age, in part because it can be enhanced throughout the lifespan. However, more research on the mechanisms by which CR is protective is needed.
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Affiliation(s)
- Corinne Pettigrew
- Department of Neurology, Johns Hopkins University School of Medicine, 1620 McElderry St., Reed Hall 1-West, Baltimore, MD, 21205, USA
| | - Anja Soldan
- Department of Neurology, Johns Hopkins University School of Medicine, 1620 McElderry St., Reed Hall 1-West, Baltimore, MD, 21205, USA.
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Guo J, Nunley KA, Costacou T, Miller RG, Rosano C, Edmundowicz D, Orchard TJ. Greater progression of coronary artery calcification is associated with clinically relevant cognitive impairment in type 1 diabetes. Atherosclerosis 2019; 280:58-65. [PMID: 30471556 PMCID: PMC6584032 DOI: 10.1016/j.atherosclerosis.2018.11.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2018] [Revised: 10/16/2018] [Accepted: 11/07/2018] [Indexed: 01/10/2023]
Abstract
BACKGROUND AND AIMS We assessed the predictive role of coronary artery calcification (CAC) in clinically relevant cognitive impairment in 148 middle-aged individuals with childhood-onset type 1 diabetes (T1D) from the Pittsburgh Epidemiology of Diabetes Complications (EDC) Study. METHODS Baseline CAC was measured in 1996-98 and repeated 4-8 years later. Per extensive neuropsychological testing in 2010-15, 28% (41/148) of participants met the study definition of clinically relevant cognitive impairment (two or more of 7 select test scores ≥1.5SD worse than demographically appropriate published norms). Logistic regression models with backward selection were constructed for statistical analysis. RESULTS Mean age and T1D duration at first CAC measure were 37 and 29 years, respectively. A greater burden of initial CAC was associated with cognitive impairment determined 14 years later. Compared to Agatston score = 0, odds ratio (OR) and 95% confidence intervals (CI) of 0<-100, 100<-300 and >300 were 1.4 (0.6, 3.6), 2.3 (0.6, 9.7), and 7.9 (1.6, 38.5), respectively. With both initial and progression of CAC in the multivariable model, backward selection retained only CAC progression, showing it was significantly associated with cognitive impairment (OR [95% CI]: 1.7 [1.1, 2.9]). In those with an initial CAC>0, CAC density was marginally, inversely, associated with cognitive impairment when controlling for CAC volume (OR [95%CI]: 0.3 (0.1, 1.2), p value = 0.078). CONCLUSIONS Greater CAC burden was associated with clinically relevant cognitive impairment in middle-aged adults with childhood-onset T1D. CAC progression appears to be a more powerful predictor than initial calcification.
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Affiliation(s)
- Jingchuan Guo
- Department of Epidemiology, University of Pittsburgh, Pittsburgh, PA, USA
| | - Karen A Nunley
- Department of Epidemiology, University of Pittsburgh, Pittsburgh, PA, USA
| | - Tina Costacou
- Department of Epidemiology, University of Pittsburgh, Pittsburgh, PA, USA
| | - Rachel G Miller
- Department of Epidemiology, University of Pittsburgh, Pittsburgh, PA, USA
| | - Caterina Rosano
- Department of Epidemiology, University of Pittsburgh, Pittsburgh, PA, USA
| | - Daniel Edmundowicz
- Section of Cardiology, Temple University Hospital, Philadelphia, PA, USA
| | - Trevor J Orchard
- Department of Epidemiology, University of Pittsburgh, Pittsburgh, PA, USA.
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Kaup AR, Xia F, Launer LJ, Sidney S, Nasrallah I, Erus G, Allen N, Yaffe K. Occupational cognitive complexity in earlier adulthood is associated with brain structure and cognitive health in midlife: The CARDIA study. Neuropsychology 2018; 32:895-905. [PMID: 29985017 PMCID: PMC6234051 DOI: 10.1037/neu0000474] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
OBJECTIVE In line with cognitive reserve theory, higher occupational cognitive complexity is associated with reduced cognitive decline in older adulthood. How and when occupational cognitive complexity first exerts protective effects during the life span remains unclear. We investigated associations between occupational cognitive complexity during early to midadulthood and brain structure and cognition in midlife. METHOD Participants were 669 adults from the Coronary Artery Risk Development in Young Adults study (aged 18-30 years at baseline, 52% female, 38% Black). We calculated scores reflecting occupational cognitive complexity using Census Occupation Codes (years 10 and 15) and Occupational Information Network (O*NET) data. At year 25, participants had structural brain magnetic resonance imaging, diffusion tensor imaging, and cognitive testing (Rey Auditory Verbal Learning Test, Digit Symbol Substitution Test, Stroop). In adjusted mixed models, we examined associations between occupational cognitive complexity during early to midadulthood and midlife brain structure, specifically gray matter volume and white matter fractional anisotropy, and cognition in midlife (all outcomes converted to z-scores). RESULTS Higher occupational cognitive complexity was associated with greater white matter fractional anisotropy (estimate = 0.10, p = .01) but not gray matter volume. Higher occupational cognitive complexity was associated with better Digit Symbol Substitution Test (estimate = 0.13, p < .001) and Stroop (estimate = 0.09, p = .01) performance but not Rey Auditory Verbal Learning Test performance. CONCLUSIONS Occupational cognitive complexity earlier in adulthood is associated with better white matter integrity, processing speed, and executive function in midlife. These associations may capture how occupational cognitive complexity contributes to cognitive reserve. (PsycINFO Database Record (c) 2018 APA, all rights reserved).
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Affiliation(s)
- Allison R. Kaup
- Research Service, San Francisco VA Health Care System and Department of Psychiatry, Weill Institute for Neurosciences, University of California San Francisco, San Francisco, CA, USA
| | - Feng Xia
- Northern California Institute for Research and Education, San Francisco, CA, USA
| | | | - Stephen Sidney
- Kaiser Permanente Division of Research, Oakland, CA, USA
| | - Ilya Nasrallah
- Department of Radiology, University of Pennsylvania, Philadelphia, PA, USA
| | - Guray Erus
- Department of Radiology, University of Pennsylvania, Philadelphia, PA, USA
| | - Norrina Allen
- Department of Preventive Medicine-Epidemiology, Feinberg School of Medicine, Northwestern University, Chicago, IL, USA
| | - Kristine Yaffe
- Departments of Psychiatry, Neurology, and Epidemiology and Biostatistics, University of California San Francisco and San Francisco VA Healthcare System, San Francisco, CA, USA
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A longitudinal study of cognitive decline in rural Tanzania: rates and potentially modifiable risk factors. Int Psychogeriatr 2018; 30:1333-1343. [PMID: 29559014 DOI: 10.1017/s1041610217002861] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
UNLABELLED ABSTRACTBackground:The number of people living with dementia in sub-Saharan Africa (SSA) is expected to increase rapidly in the coming decades. However, our understanding of how best to reduce dementia risk in the population is very limited. As a first step in developing intervention strategies to manage dementia risk in this setting, we investigated rates of cognitive decline in a rural population in Tanzania and attempted to identify associated factors. METHODS The study was conducted in the rural Hai district of northern Tanzania. In 2014, community-dwelling people aged 65 years and over living in six villages were invited to take part in a cognitive screening program. All participants from four of the six villages were followed-up at two years and cognitive function re-tested. At baseline and follow-up, participants were assessed for functional disability, hypertension, and grip strength (as a measure of frailty). At follow-up, additional assessments of visual acuity, hearing impairment, tobacco and alcohol consumption, and clinical assessment for stroke were completed. RESULTS Baseline and follow-up data were available for 327 people. Fifty people had significant cognitive decline at two-year follow-up. Having no formal education, low grip strength at baseline, being female and having depression at follow-up were independently associated with cognitive decline. CONCLUSIONS This is one of the first studies of cognitive decline conducted in SSA. Rates of decline at two years were relatively high. Future work should focus on identification of specific modifiable risk factors for cognitive decline with a view to developing culturally appropriate interventions.
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Rajtar-Zembaty A, Sałakowski A, Rajtar-Zembaty J, Starowicz-Filip A, Skalska A. Slow gait as a motor marker of mild cognitive impairment? the relationships between functional mobility and mild cognitive impairment. AGING NEUROPSYCHOLOGY AND COGNITION 2018; 26:521-530. [PMID: 29985737 DOI: 10.1080/13825585.2018.1495690] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
The purpose of this study was to evaluate the association between functional mobility and mild cognitive impairment in older adults. A total of 800 older adults were recruited (653 controls and 147 subjects with MCI [88 subjects with aMCI and 59 subjects with naMCI]). Motor performance was measured with the Timed Up and Go test (TUG). The demographic factors associated with MCI were: age (OR = 1.05; 95% CI: 1.01-1.09) and the level of education (OR = 0.73; 95% CI: 0.68-0.79). An independent clinical factor associated with MCI was the TUG (OR = 1.14; 95% CI: 1.03-1.27). In the aMCI group, the relation between the TUG and cognitive status occurred (OR = 1.15; 95% CI: 1.02-1.31), whereas in the naMCI group this relationship was not observed. There is an association between cognitive dysfunction and impaired motor performance in older adults with MCI.
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Affiliation(s)
- Anna Rajtar-Zembaty
- a The Department of Psychiatry , Jagiellonian University Medical College , Krakow , Poland
| | - Andrzej Sałakowski
- b Nowa Rehabilitacja - Medical-Rehabilitation Center Kraków-Południe , Kraków , Poland
| | - Jakub Rajtar-Zembaty
- c The Department of Internal Medicine and Gerontology , Jagiellonian University Medical College , Krakow , Poland
| | - Anna Starowicz-Filip
- a The Department of Psychiatry , Jagiellonian University Medical College , Krakow , Poland
| | - Anna Skalska
- c The Department of Internal Medicine and Gerontology , Jagiellonian University Medical College , Krakow , Poland
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Oliveira CR, Lopes Filho BJP, Esteves CS, Rossi T, Nunes DS, Lima MMBMP, Irigaray TQ, Argimon IIL. Neuropsychological Assessment of Older Adults With Virtual Reality: Association of Age, Schooling, and General Cognitive Status. Front Psychol 2018; 9:1085. [PMID: 30008689 PMCID: PMC6034167 DOI: 10.3389/fpsyg.2018.01085] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2018] [Accepted: 06/07/2018] [Indexed: 11/13/2022] Open
Abstract
The development of neuropsychological assessment methods using virtual reality (VR) is a valid and promising option for the detection of cognitive impairment in the older people, focusing on activities composed of tasks of multiple demands. This study verified the association of age, schooling, and general cognitive status on the performance of neurologically healthy older adults in ECO-VR, a VR task of multiple demands for neuropsychological assessment. A total of 111 older adults answered a sociodemographic questionnaire, the Mini Mental State Examination, the Vocabulary subtest of the Wechsler Intelligence Scale for Adults (third edition), and the ECO-VR. Correlation analyses, multiple linear regression, and comparisons between groups (effects by age and schooling groups) were used to evaluate the results. The ECO-VR total score was significantly associated with age, years of education, MMSE, and Vocabulary subtest. The linear regression models identified that age was the main predictor for total score and rule breaking of ECO-VR. According to the univariate analysis, it was identified the main effect of age group and schooling group in the total ECO-VR score, but there was no interaction effect. The results are discussed in order to understand the role of sociodemographic characteristics in the performance of older adults in a VR task of multiple demands. It was also verified the possibility use of VR for neuropsychological assessment of older adults.
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Affiliation(s)
- Camila R. Oliveira
- Postgraduate Program in Psychology, Faculdade Meridional IMED, Passo Fundo, Brazil
| | - Brandel J. P. Lopes Filho
- Postgraduate Program in Biomedical Gerontology, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, Brazil
| | - Cristiane S. Esteves
- Postgraduate Program in Biomedical Gerontology, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, Brazil
| | - Tainá Rossi
- Postgraduate Program in Psychology, Faculdade Meridional IMED, Passo Fundo, Brazil
| | - Daniela S. Nunes
- Postgraduate Program in Psychology, Faculdade Meridional IMED, Passo Fundo, Brazil
| | | | - Tatiana Q. Irigaray
- Postgraduate Program in Psychology, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, Brazil
| | - Irani I. L. Argimon
- Postgraduate Program in Biomedical Gerontology, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, Brazil
- Postgraduate Program in Psychology, Pontifícia Universidade Católica do Rio Grande do Sul, Porto Alegre, Brazil
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Bos D, Wolters FJ, Darweesh SKL, Vernooij MW, de Wolf F, Ikram MA, Hofman A. Cerebral small vessel disease and the risk of dementia: A systematic review and meta-analysis of population-based evidence. Alzheimers Dement 2018; 14:1482-1492. [PMID: 29792871 DOI: 10.1016/j.jalz.2018.04.007] [Citation(s) in RCA: 103] [Impact Index Per Article: 17.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2017] [Revised: 04/04/2018] [Accepted: 04/09/2018] [Indexed: 01/28/2023]
Abstract
INTRODUCTION Cerebral small vessel disease is increasingly linked to dementia. METHODS We systematically searched Medline, Embase, and Cochrane databases for prospective population-based studies addressing associations of white matter hyperintensities, covert brain infarcts (i.e., clinically silent infarcts), and cerebral microbleeds with risk of all-dementia or Alzheimer's disease and performed meta-analyses. RESULTS We identified 11 studies on white matter hyperintensities, covert brain infarcts, or cerebral microbleeds with risk of all-dementia or Alzheimer's disease. Pooled analyses showed an association of white matter hyperintensity volume and a borderline association of covert brain infarcts with risk of all-dementia (hazard ratio: 1.39 [95% confidence interval: 1.00; 1.94], N = 3913, and 1.47 [95% confidence interval: 0.97; 2.22], N = 8296). Microbleeds were not statistically significantly associated with an increased risk of all-dementia (hazard ratio: 1.25 [95% confidence interval: 0.66; 2.38], N = 8739). DISCUSSION White matter hyperintensities are associated with an increased risk of all-dementia and Alzheimer's disease in the general population. However, studies are warranted to further determine the role of markers of cerebral small vessel disease in dementia.
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Affiliation(s)
- Daniel Bos
- Department of Radiology and Nuclear Medicine, Erasmus MC - University Medical Center Rotterdam, Rotterdam, The Netherlands; Department of Epidemiology, Erasmus MC - University Medical Center Rotterdam, Rotterdam, The Netherlands; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Frank J Wolters
- Department of Epidemiology, Erasmus MC - University Medical Center Rotterdam, Rotterdam, The Netherlands; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Sirwan K L Darweesh
- Department of Epidemiology, Erasmus MC - University Medical Center Rotterdam, Rotterdam, The Netherlands; Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Meike W Vernooij
- Department of Radiology and Nuclear Medicine, Erasmus MC - University Medical Center Rotterdam, Rotterdam, The Netherlands; Department of Epidemiology, Erasmus MC - University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Frank de Wolf
- Janssen Prevention Center, Leiden, The Netherlands; Faculty of Medicine, School of Public Health, Imperial College London, London, UK
| | - M Arfan Ikram
- Department of Radiology and Nuclear Medicine, Erasmus MC - University Medical Center Rotterdam, Rotterdam, The Netherlands; Department of Epidemiology, Erasmus MC - University Medical Center Rotterdam, Rotterdam, The Netherlands; Department of Neurology, Erasmus MC - University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Albert Hofman
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
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Ishibashi M, Kimura N, Aso Y, Matsubara E. Effects of white matter lesions on brain perfusion in patients with mild cognitive impairment. Clin Neurol Neurosurg 2018; 168:7-11. [PMID: 29499394 DOI: 10.1016/j.clineuro.2018.02.030] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2017] [Revised: 02/07/2018] [Accepted: 02/19/2018] [Indexed: 11/15/2022]
Abstract
OBJECTIVE To evaluate the effects of white matter lesions on regional cerebral blood flow in subjects with amnestic mild cognitive impairment. PATIENTS AND METHODS Seventy-five subjects with mild cognitive impairment (36 men and 39 women; mean age, 78.1 years) were included in the study. We used the Mini-Mental State Examination to assess cognitive function. All subjects underwent brain magnetic resonance imaging and 99mTc ethylcysteinate dimer single photon emission computed tomography. Subjects were stratified based on the presence or absence of white matter lesions on magnetic resonance imaging. Statistical parametric mapping of differences in regional cerebral blood flow between the two groups were assessed by voxel-by-voxel group analysis using SPM8. RESULTS Of all 75 subjects with mild cognitive impairment, 46 (61.3%) had mild to moderate white matter lesions. The prevalence of hypertension tended to be higher in subjects with white matter lesions than in those without white matter lesions. Mini-Mental State Examination scores were significantly lower in subjects with white matter lesions than in those without white matter lesions. Subjects with white matter lesions had decreased regional cerebral blood flow mainly in the frontal, parietal, and medial temporal lobes, as well as the putamen, compared to those without white matter lesions. CONCLUSION In subjects with mild cognitive impairment, white matter lesions were associated with cognitive impairment and mainly frontal lobe brain function.
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Affiliation(s)
- Masato Ishibashi
- Department of Neurology, Oita University, Faculty of Medicine, Japan
| | - Noriyuki Kimura
- Department of Neurology, Oita University, Faculty of Medicine, Japan.
| | - Yasuhiro Aso
- Department of Neurology, Oita University, Faculty of Medicine, Japan
| | - Etsuro Matsubara
- Department of Neurology, Oita University, Faculty of Medicine, Japan
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Podcasy JL, Epperson CN. Considering sex and gender in Alzheimer disease and other dementias. DIALOGUES IN CLINICAL NEUROSCIENCE 2017. [PMID: 28179815 PMCID: PMC5286729 DOI: 10.31887/dcns.2016.18.4/cepperson] [Citation(s) in RCA: 361] [Impact Index Per Article: 51.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Suffering related to dementia is multifaceted because cognitive and physical functioning slowly deteriorates. Advanced age and sex, two of the most prominent risk factors for dementia, are not modifiable. Lifestyle factors such as smoking, excessive alcohol use, and poor diet modulate susceptibility to dementia in both males and females. The degree to which the resulting health conditions (eg, obesity, type 2 diabetes, and cardiovascular disease) impact dementia risk varies by sex. Depending on the subtype of dementia, the ratio of male to female prevalence differs. For example, females are at greater risk of developing Alzheimer disease dementia, whereas males are at greater risk of developing vascular dementia. This review examines sex and gender differences in the development of dementia with the goal of highlighting factors that require further investigation. Considering sex as a biological variable in dementia research promises to advance our understanding of the pathophysiology and treatment of these conditions.
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Affiliation(s)
- Jessica L Podcasy
- Penn PROMOTES Research on Sex and Gender in Health, University of Pennsylvania; Department of Psychiatry, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - C Neill Epperson
- Penn PROMOTES Research on Sex and Gender in Health, University of Pennsylvania; Department of Psychiatry and Department of Obstetrics and Gynecology, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, Pennsylvania, USA
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Phillips C. Lifestyle Modulators of Neuroplasticity: How Physical Activity, Mental Engagement, and Diet Promote Cognitive Health during Aging. Neural Plast 2017; 2017:3589271. [PMID: 28695017 PMCID: PMC5485368 DOI: 10.1155/2017/3589271] [Citation(s) in RCA: 125] [Impact Index Per Article: 17.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2017] [Revised: 05/01/2017] [Accepted: 05/28/2017] [Indexed: 12/24/2022] Open
Abstract
The number of the elderly across the globe will approximate 2.1 billion by 2050. Juxtaposed against this burgeoning segment of the population is evidence that nonpathological aging is associated with an increased risk for cognitive decline in a variety of domains, changes that can cause mild disability even before the onset of dementia. Given that pharmacological treatments that mitigate dementia are still outstanding, alternative therapeutic options are being investigated increasingly. The results from translational studies have shown that modifiable lifestyle factors-including physical activity, cognitive engagement, and diet-are a key strategy for maintaining brain health during aging. Indeed, a multiplicity of studies has demonstrated relationships between lifestyle factors, brain structure and function, and cognitive function in aging adults. For example, physical activity and diet modulate common neuroplasticity substrates (neurotrophic signaling, neurogenesis, inflammation, stress response, and antioxidant defense) in the brain whereas cognitive engagement enhances brain and cognitive reserve. The aims of this review are to evaluate the relationship between modifiable lifestyle factors, neuroplasticity, and optimal brain health during aging; to identify putative mechanisms that contribute positive brain aging; and to highlight future directions for scientists and clinicians. Undoubtedly, the translation of cutting-edge knowledge derived from the field of cognitive neuroscience will advance our understanding and enhance clinical treatment interventions as we endeavor to promote brain health during aging.
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Vanoh D, Shahar S, Din NC, Omar A, Vyrn CA, Razali R, Ibrahim R, Hamid TA. Predictors of poor cognitive status among older Malaysian adults: baseline findings from the LRGS TUA cohort study. Aging Clin Exp Res 2017; 29:173-182. [PMID: 26980453 DOI: 10.1007/s40520-016-0553-2] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2015] [Accepted: 02/22/2016] [Indexed: 10/22/2022]
Abstract
BACKGROUND Concepts of successful aging (SA), usual aging (UA), and mild cognitive impairment (MCI) have been developed to identify older adults at high risk of Alzheimer's diseases (AD), however, the predictors have rarely been investigated in a single study. Thus, this study aims to explore the risk factors of MCI as compared to UA and SA among older adults, in a large community based cohort study in Malaysia. METHOD 1993 subjects from four states in Malaysia were recruited. A comprehensive interview-based questionnaire was administered to determine socio-demographic information, followed by assessments to evaluate cognitive function, functional status, dietary intake, lifestyle and psychosocial status. Risk factors of cognitive impairment were assessed using the ordinal logistic regression (OLR). RESULT The prevalence of SA, UA and MCI in this study was 11, 73 and 16 % respectively. OLR indicated that higher fasting blood sugar, hyperlipidemia, disability, lower education level, not regularly involved in technical based activities, limited use of modern technologies, lower intake of fruits and fresh fruit juices and not practicing calorie restriction were among the risk factors of poor cognitive performance in this study. CONCLUSION This study will be a stepping stone for future researchers to develop intervention strategies to prevent cognitive decline.
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Backhouse EV, McHutchison CA, Cvoro V, Shenkin SD, Wardlaw JM. Early life risk factors for cerebrovascular disease: A systematic review and meta-analysis. Neurology 2017; 88:976-984. [PMID: 28188307 DOI: 10.1212/wnl.0000000000003687] [Citation(s) in RCA: 51] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2016] [Accepted: 12/14/2016] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE Cerebrovascular disease (CVD) causes subclinical brain vascular lesions detected using neuroimaging and childhood factors may increase later CVD risk. METHODS We searched MEDLINE, PsycINFO, and EMBASE, and meta-analyzed all available evidence on childhood (premorbid) IQ, socioeconomic status (SES), education, and subclinical CVD in later life. Overall odds ratios (OR), mean difference or correlation, and 95% confidence intervals (CIs) were calculated using random effects methods. RESULTS We identified 30 relevant studies (n = 22,890). Lower childhood IQ and lower childhood SES were associated with more white matter hyperintensities (WMH) (IQ: n = 1,512, r = -0.07, 95% CI -0.12 to -0.02, p = 0.007; SES: n = 243, deep WMH r = -0.18, periventricular WMH r = -0.146). Fewer years of education were associated with several CVD markers (n = 15,439, OR = 1.17, 95% CI 1.05 to 1.31, p = 0.003). No studies assessed early life factors combined. CONCLUSIONS Childhood IQ, SES, and education are associated with increased risk of CVD on neuroimaging in later life. Further studies are required to provide further evidence and thereby inform policy.
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Affiliation(s)
- Ellen V Backhouse
- From the Centre for Clinical Brain Sciences (E.V.B., C.A.M., V.C., J.M.W.), Centre for Cognitive Ageing and Cognitive Epidemiology (C.A.M., V.C., S.D.S., J.M.W.), and Geriatric Medicine, Department of Clinical and Surgical Sciences (S.D.S.), University of Edinburgh; and Scottish Imaging Network (V.C., S.D.S., J.M.W.), A Platform for Scientific Excellence (SINAPSE), UK
| | - Caroline A McHutchison
- From the Centre for Clinical Brain Sciences (E.V.B., C.A.M., V.C., J.M.W.), Centre for Cognitive Ageing and Cognitive Epidemiology (C.A.M., V.C., S.D.S., J.M.W.), and Geriatric Medicine, Department of Clinical and Surgical Sciences (S.D.S.), University of Edinburgh; and Scottish Imaging Network (V.C., S.D.S., J.M.W.), A Platform for Scientific Excellence (SINAPSE), UK
| | - Vera Cvoro
- From the Centre for Clinical Brain Sciences (E.V.B., C.A.M., V.C., J.M.W.), Centre for Cognitive Ageing and Cognitive Epidemiology (C.A.M., V.C., S.D.S., J.M.W.), and Geriatric Medicine, Department of Clinical and Surgical Sciences (S.D.S.), University of Edinburgh; and Scottish Imaging Network (V.C., S.D.S., J.M.W.), A Platform for Scientific Excellence (SINAPSE), UK
| | - Susan D Shenkin
- From the Centre for Clinical Brain Sciences (E.V.B., C.A.M., V.C., J.M.W.), Centre for Cognitive Ageing and Cognitive Epidemiology (C.A.M., V.C., S.D.S., J.M.W.), and Geriatric Medicine, Department of Clinical and Surgical Sciences (S.D.S.), University of Edinburgh; and Scottish Imaging Network (V.C., S.D.S., J.M.W.), A Platform for Scientific Excellence (SINAPSE), UK
| | - Joanna M Wardlaw
- From the Centre for Clinical Brain Sciences (E.V.B., C.A.M., V.C., J.M.W.), Centre for Cognitive Ageing and Cognitive Epidemiology (C.A.M., V.C., S.D.S., J.M.W.), and Geriatric Medicine, Department of Clinical and Surgical Sciences (S.D.S.), University of Edinburgh; and Scottish Imaging Network (V.C., S.D.S., J.M.W.), A Platform for Scientific Excellence (SINAPSE), UK.
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Watson C, Busovaca E, Foley JM, Allen IE, Schwarz CG, Jahanshad N, Nir TM, Esmaeili-Firidouni P, Milanini B, Rosen H, Carmichael OT, Thompson PM, Valcour VG. White matter hyperintensities correlate to cognition and fiber tract integrity in older adults with HIV. J Neurovirol 2017; 23:422-429. [PMID: 28101804 DOI: 10.1007/s13365-016-0509-5] [Citation(s) in RCA: 46] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2016] [Revised: 12/20/2016] [Accepted: 12/26/2016] [Indexed: 12/24/2022]
Abstract
Our aim was to examine the clinical relevance of white matter hyperintensities (WMH) in HIV. We used an automated approach to quantify WMH volume in HIV seropositive (HIV+; n = 65) and HIV seronegative (HIV-; n = 29) adults over age 60. We compared WMH volumes between HIV+ and HIV- groups in cross-sectional and multiple time-point analyses. We also assessed correlations between WMH volumes and cardiovascular, HIV severity, cognitive scores, and diffusion tensor imaging variables. Serostatus groups did not differ in WMH volume, but HIV+ participants had less cerebral white matter (mean: 470.95 [43.24] vs. 497.63 [49.42] mL, p = 0.010). The distribution of WMH volume was skewed in HIV+ with a high proportion (23%) falling above the 95th percentile of WMH volume defined by the HIV- group. Serostatus groups had similar amount of WMH volume growth over time. Total WMH volume directly correlated with measures of hypertension and inversely correlated with measures of global cognition, particularly in executive functioning, and psychomotor speed. Greater WMH volume was associated with poorer brain integrity measured from diffusion tensor imaging (DTI) in the corpus callosum and sagittal stratum. In this group of HIV+ individuals over 60, WMH burden was associated with cardiovascular risk and both worse diffusion MRI and cognition. The median total burden did not differ by serostatus; however, a subset of HIV+ individuals had high WMH burden.
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Affiliation(s)
- Christa Watson
- Memory and Aging Center, Department of Neurology, University of California, 675 Nelson Rising Lane, Suite 190, MC: 1207, San Francisco, CA, 94158, USA.
| | - Edgar Busovaca
- Memory and Aging Center, Department of Neurology, University of California, 675 Nelson Rising Lane, Suite 190, MC: 1207, San Francisco, CA, 94158, USA.,Department of Medicine, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Jessica M Foley
- Memory and Aging Center, Department of Neurology, University of California, 675 Nelson Rising Lane, Suite 190, MC: 1207, San Francisco, CA, 94158, USA
| | - I Elaine Allen
- Department of Biostatistics and Epidemiology, University of California, San Francisco, San Francisco, CA, USA
| | - Christopher G Schwarz
- Department of Radiology, Mayo Clinic, Rochester, MN, USA.,Center for Neuroscience, Department of Neurology, University of California, Davis, Davis, CA, USA
| | - Neda Jahanshad
- Imaging Genetics Center, Stevens Neuroimaging and Informatics Institute, Keck School of Medicine, University of Southern California, Marina del Rey, Los Angeles, CA, USA
| | - Talia M Nir
- Imaging Genetics Center, Stevens Neuroimaging and Informatics Institute, Keck School of Medicine, University of Southern California, Marina del Rey, Los Angeles, CA, USA
| | - Pardis Esmaeili-Firidouni
- Memory and Aging Center, Department of Neurology, University of California, 675 Nelson Rising Lane, Suite 190, MC: 1207, San Francisco, CA, 94158, USA
| | - Benedetta Milanini
- Memory and Aging Center, Department of Neurology, University of California, 675 Nelson Rising Lane, Suite 190, MC: 1207, San Francisco, CA, 94158, USA
| | - Howard Rosen
- Memory and Aging Center, Department of Neurology, University of California, 675 Nelson Rising Lane, Suite 190, MC: 1207, San Francisco, CA, 94158, USA
| | - Owen T Carmichael
- Biomedical Imaging Center, Pennington Biomedical Research Center, Louisiana State University, Baton Rouge, LA, USA
| | - Paul M Thompson
- Imaging Genetics Center, Stevens Neuroimaging and Informatics Institute, Keck School of Medicine, University of Southern California, Marina del Rey, Los Angeles, CA, USA
| | - Victor G Valcour
- Memory and Aging Center, Department of Neurology, University of California, 675 Nelson Rising Lane, Suite 190, MC: 1207, San Francisco, CA, 94158, USA
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Gray WK, Paddick SM, Collingwood C, Kisoli A, Mbowe G, Mkenda S, Lissu C, Rogathi J, Kissima J, Walker RW, Mushi D, Chaote P, Ogunniyi A, Dotchin CL. Community validation of the IDEA study cognitive screen in rural Tanzania. Int J Geriatr Psychiatry 2016; 31:1199-1207. [PMID: 26833889 DOI: 10.1002/gps.4415] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2015] [Revised: 11/26/2015] [Accepted: 12/03/2015] [Indexed: 11/11/2022]
Abstract
OBJECTIVES The dementia diagnosis gap in sub-Saharan Africa (SSA) is large, partly because of difficulties in screening for cognitive impairment in the community. As part of the Identification and Intervention for Dementia in Elderly Africans (IDEA) study, we aimed to validate the IDEA cognitive screen in a community-based sample in rural Tanzania METHODS: Study participants were recruited from people who attended screening days held in villages within the rural Hai district of Tanzania. Criterion validity was assessed against the gold standard clinical dementia diagnosis using DSM-IV criteria. Construct validity was assessed against, age, education, sex and grip strength and instrumental activities of daily living (IADLs). Internal consistency and floor and ceiling effects were also examined. RESULTS During community screening, the IDEA cognitive screen had high criterion validity, with an area under the receiver operating characteristic curve of 0.855 (95% CI 0.794 to 0.915). Higher scores on the screen were significantly correlated with lower age, male sex, having attended school, better grip strength and improved performance in activities of daily living. Factor analysis revealed a single factor with an eigenvalue greater than one, although internal consistency was only moderate (Cronbach's alpha = 0.534). CONCLUSIONS The IDEA cognitive screen had high criterion and construct validity and is suitable for use as a cognitive screening instrument in a community setting in SSA. Only moderate internal consistency may partly reflect the multi-domain nature of dementia as diagnosed clinically. Copyright © 2016 John Wiley & Sons, Ltd.
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Affiliation(s)
- William K Gray
- Northumbria Healthcare NHS Foundation Trust, North Tyneside General Hospital, North Shields, Tyne and Wear, UK.
| | - Stella Maria Paddick
- Northumbria Healthcare NHS Foundation Trust, North Tyneside General Hospital, North Shields, Tyne and Wear, UK.,Institute of Neuroscience, Newcastle University, Newcastle Upon Tyne, UK
| | | | - Aloyce Kisoli
- Hai District Medical Office, Boma'ngombe, Kilimanjaro, Tanzania
| | - Godfrey Mbowe
- Kilimanjaro Christian Medical University College, Moshi, Tanzania
| | - Sarah Mkenda
- Kilimanjaro Christian Medical University College, Moshi, Tanzania
| | - Carolyn Lissu
- Kilimanjaro Christian Medical University College, Moshi, Tanzania
| | - Jane Rogathi
- Kilimanjaro Christian Medical Centre, Moshi, Tanzania
| | - John Kissima
- Hai District Medical Office, Boma'ngombe, Kilimanjaro, Tanzania
| | - Richard W Walker
- Northumbria Healthcare NHS Foundation Trust, North Tyneside General Hospital, North Shields, Tyne and Wear, UK.,Institute of Health and Society, Newcastle University, UK
| | - Declare Mushi
- Kilimanjaro Christian Medical University College, Moshi, Tanzania
| | - Paul Chaote
- Hai District Medical Office, Boma'ngombe, Kilimanjaro, Tanzania
| | | | - Catherine L Dotchin
- Northumbria Healthcare NHS Foundation Trust, North Tyneside General Hospital, North Shields, Tyne and Wear, UK.,Institute of Ageing, Newcastle University, Newcastle upon Tyne, UK
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Kats D, Patel MD, Palta P, Meyer ML, Gross AL, Whitsel EA, Knopman D, Alonso A, Mosley TH, Heiss G. Social support and cognition in a community-based cohort: the Atherosclerosis Risk in Communities (ARIC) study. Age Ageing 2016; 45:475-80. [PMID: 27107128 DOI: 10.1093/ageing/afw060] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2015] [Accepted: 01/20/2016] [Indexed: 12/29/2022] Open
Abstract
OBJECTIVE social support has demonstrated cross-sectional associations with greater cognitive function and a protective effect against cognitive decline in older adults, but exploration of its temporal role in cognitive ageing from mid-life to older adulthood has been limited. We aimed to quantify the associations of social support, assessed at mid-life, with cognitive function in mid-life and with cognitive decline into late life among African Americans and Caucasians. METHODS data from the community-based, prospective Atherosclerosis Risk in Communities (ARIC) cohort of 15,792 biracial participants were examined for baseline and longitudinal associations of mid-life social support with global cognition at mid-life and with 20-year change in global cognition, respectively, stratified by race. Interactions with sociodemographic and cardiometabolic covariates were additionally explored within each race group. Social support was ascertained using two metrics: interpersonal support and social network. RESULTS interpersonal support was directly associated with greater global cognition at baseline in both race groups. Social network was directly associated with greater global cognition at baseline among Caucasians and African American females, but it was not significantly associated with global cognition in African American males. Neither mid-life social support measure was associated with 20-year change in global cognition. CONCLUSIONS higher levels of social support were moderately associated with greater multi-dimensional cognitive function at mid-life, but mid-life social support was not associated with temporal change in global cognitive function over 20 years into late life. Prospective studies with time-dependent measures of social support and cognition are needed to better understand the role of social engagement in ageing-related cognitive functioning.
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Affiliation(s)
- Dmitry Kats
- Department of Epidemiology, University of North Carolina at Chapel Hill, Gillings School of Global Public Health, Chapel Hill, NC, USA
| | - Mehul D Patel
- Center for Observational and Real World Evidence, Merck & Co., Inc., North Wales, PA, USA
| | - Priya Palta
- Department of Epidemiology, University of North Carolina at Chapel Hill, Gillings School of Global Public Health, Chapel Hill, NC, USA
| | - Michelle L Meyer
- Department of Epidemiology, University of North Carolina at Chapel Hill, Gillings School of Global Public Health, Chapel Hill, NC, USA
| | - Alden L Gross
- Department of Epidemiology, Johns Hopkins University, Bloomberg School of Public Health, Baltimore, MD, USA
| | - Eric A Whitsel
- Department of Epidemiology, University of North Carolina at Chapel Hill, Gillings School of Global Public Health, Chapel Hill, NC, USA Department of Medicine, University of North Carolina at Chapel Hill, School of Medicine, Chapel Hill, NC, USA
| | - David Knopman
- Department of Neurology, Mayo Clinic, Rochester, MN, USA
| | - Alvaro Alonso
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, USA
| | - Thomas H Mosley
- Department of Medicine, University of Mississippi Medical Center, Jackson, MS, USA
| | - Gerardo Heiss
- Department of Epidemiology, University of North Carolina at Chapel Hill, Gillings School of Global Public Health, Chapel Hill, NC, USA
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Wayde EN, Black SR, Gilpin A. Decision-making quality of younger and older adults in familiar and unfamiliar domains. AGING NEUROPSYCHOLOGY AND COGNITION 2016; 24:135-157. [PMID: 27123545 DOI: 10.1080/13825585.2016.1176110] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Age-related differences in purchasing decisions were examined as a function of age and familiarity. On each trial, participants received purchasing options which varied in quality but ultimately cost the same amount of money. On half the trials, participants made decisions about items familiar to younger adults and on the other half of the trials, participants made decisions about products familiar to older adults. The participants' task was to choose the option that provided the best value for the money. We were particularly interested in participants' performance when inferencing was required to select the optimal option from the two choices. Younger adults outperformed older adults in unfamiliar but not familiar domains. It appeared that both younger and older adults used inferencing and elaborative processing to make the best decision in familiar domains but that only younger adults used inferencing and elaborative processing in unfamiliar domains.
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Affiliation(s)
- Ernest N Wayde
- a Psychology Department , University of Alabama , Tuscaloosa , AL , USA
| | - Sheila R Black
- a Psychology Department , University of Alabama , Tuscaloosa , AL , USA
| | - Ansley Gilpin
- a Psychology Department , University of Alabama , Tuscaloosa , AL , USA
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Watts A, Honea RA, Billinger SA, Rhyner KT, Hutfles L, Vidoni ED, Burns JM. A combined measure of vascular risk for white matter lesions. J Alzheimers Dis 2016; 45:187-93. [PMID: 25690663 DOI: 10.3233/jad-142085] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
BACKGROUND Though hypertension is a commonly studied risk factor for white matter lesions (WMLs), measures of blood pressure may fluctuate depending on external conditions resulting in measurement error. Indicators of arterial stiffening and reduced elasticity may be more sensitive indicators of risk for WMLs in aging; however the interdependent nature of vascular indicators creates statistical complications. OBJECTIVE The purpose of the study was to determine whether a factor score comprised of multiple vascular indicators would be a stronger predictor of WMLs than traditional measures of blood pressure. METHODS In a sample of well-characterized nondemented older adults, we used a factor analytic approach to account for variance common across multiple vascular measures while reducing measurement error. The result was a single factor score reflecting arterial stiffness and reduced elasticity. We used this factor score to predict white matter lesion volumes acquired via fluid attenuated inversion recovery (FLAIR) magnetic resonance imaging. RESULTS The combined vascular factor score was a stronger predictor of deep WML (β = 0.42, p < 0.001) and periventricular WML volumes (β = 0.49, p < 0.001). After accounting for the vascular factor, systolic and diastolic blood pressure measurements were not significant predictors. CONCLUSIONS This suggests that a combined measure of arterial elasticity and stiffening may be a stronger predictor of WMLs than systolic and diastolic blood pressure accounting for the multicollinearity associated with a variety of interrelated vascular measures.
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Affiliation(s)
- Amber Watts
- Department of Clinical Psychology, University of Kansas, Lawrence, KS, USA
| | - Robyn A Honea
- Alzheimer's Disease Center, University of Kansas, Fairway, KS, USA
| | - Sandra A Billinger
- Department of Physical Therapy & Rehabilitation Science, University of Kansas Medical Center, Kansas City, KS, USA
| | - Kathleen T Rhyner
- Department of Clinical Psychology, University of Kansas, Lawrence, KS, USA
| | - Lewis Hutfles
- Alzheimer's Disease Center, University of Kansas, Fairway, KS, USA
| | - Eric D Vidoni
- Alzheimer's Disease Center, University of Kansas, Fairway, KS, USA
| | - Jeffrey M Burns
- Alzheimer's Disease Center, University of Kansas, Fairway, KS, USA
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Zhai Y, Chao Q, Li H, Wang B, Xu R, Wang N, Han Y, He X, Jia X, Wang X. Application and Revision of Montreal Cognitive Assessment in China's Military Retirees with Mild Cognitive Impairment. PLoS One 2016; 11:e0145547. [PMID: 26727602 PMCID: PMC4699698 DOI: 10.1371/journal.pone.0145547] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2015] [Accepted: 12/04/2015] [Indexed: 11/18/2022] Open
Abstract
Objective In an effort to accommodate MOCA to better fit for the Chinese context, this study was designed to employ the MOCA criteria to screen mild cognitive impairment (MCI) and analyze associated risk factors in military retirees. Methods Three hundred and four retired military cadres were recruited using a random cluster sampling technique with information collected including personal, prevalence, MOCA scale, and related neuropsychiatry scale. Thirty retirees were randomly chosen to be further analyzed one month later using the revised MOCA scale. Results ①Our data indicated an incidence rate of 64.8% for mild cognitive impairment in retired military cadres. The incidence rate for MCI was significantly higher in those aged 80 or above compared with those 80 years of age or younger (P<0.05). The incidence rate of MCI was significantly higher in those with fewer than 6 years of education compared with those with over 7 years of education (P<0.05). The MCI incidence was higher for those with little exercise than those taking regular exercise (P<0.01). Moreover, the MCI incidence was higher in stroke patients than those who never had a stroke episode (P<0.05). ②There was a significant correlation between MOCA and MMSE scale scores (r = 0.81). MOCA scale scores were negatively correlated with ADL and CES-D scores (although not PSQI scores). ③ MOCA recension Cronbach’s alpha value was 0.862. The related coefficient of MOCA and MOCA recension was 0.878(P<0.01). When the Score of cut-off -point of the MOCA recension was 28, the area in ROC curve analyses was 0.859, as well as the largest area. Conclusion Retired cadres exhibited a greater incidence of MCI (than general population), which was closely associated with age, level of education and physical exercise and cerebral apoplexy. Revised MOCA scale displays a better validity and reaction degree of reliability and is more suitable for screening and diagnosis of MCI in the elderly in China.
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Affiliation(s)
- Yali Zhai
- Department of Geriatrics, Xijing Hospital, Fourth Military Medical University. Xi’an, Shaanxi, China
| | - Qiuling Chao
- Department of Geriatrics, Xijing Hospital, Fourth Military Medical University. Xi’an, Shaanxi, China
- Center for Ageing and Health Research, Xi’an Jiaotong University, Xi’an, Shaanxi, China
- * E-mail: (QLC); (XMW)
| | - Hong Li
- Department of Geriatrics, Xijing Hospital, Fourth Military Medical University. Xi’an, Shaanxi, China
| | - Bo Wang
- Department of Epidemic, Fourth Military Medical University, Xi’an, Shaanxi, China
| | - Rong Xu
- Department of Geriatrics, Xijing Hospital, Fourth Military Medical University. Xi’an, Shaanxi, China
| | - Ning Wang
- Department of Geriatrics, Xijing Hospital, Fourth Military Medical University. Xi’an, Shaanxi, China
| | - Yajun Han
- Department of Geriatrics, Xijing Hospital, Fourth Military Medical University. Xi’an, Shaanxi, China
| | - Xiaole He
- Department of Geriatrics, Xijing Hospital, Fourth Military Medical University. Xi’an, Shaanxi, China
| | - Xin Jia
- Department of Geriatrics, Xijing Hospital, Fourth Military Medical University. Xi’an, Shaanxi, China
| | - Xiaoming Wang
- Department of Geriatrics, Xijing Hospital, Fourth Military Medical University. Xi’an, Shaanxi, China
- * E-mail: (QLC); (XMW)
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Almeida RP, Schultz SA, Austin BP, Boots EA, Dowling NM, Gleason CE, Bendlin BB, Sager M, Hermann BP, Zetterberg H, Carlsson C, Johnson S, Asthana S, Okonkwo OC. Effect of Cognitive Reserve on Age-Related Changes in Cerebrospinal Fluid Biomarkers of Alzheimer Disease. JAMA Neurol 2015; 72:699-706. [PMID: 25893879 PMCID: PMC4639566 DOI: 10.1001/jamaneurol.2015.0098] [Citation(s) in RCA: 62] [Impact Index Per Article: 6.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
IMPORTANCE Although advancing age is the strongest risk factor for the development of symptomatic Alzheimer disease (AD), recent studies have shown that there are individual differences in susceptibility to age-related alterations in the biomarkers of AD pathophysiology. OBJECTIVE To investigate whether cognitive reserve (CR) modifies the adverse influence of age on key cerebrospinal fluid (CSF) biomarkers of AD. DESIGN, SETTING, AND PARTICIPANTS A cross-sectional cohort of 268 individuals (211 in a cognitively normal group and 57 in a cognitively impaired group) from the Wisconsin Registry for Alzheimer's Prevention and the Wisconsin Alzheimer's Disease Research Center participated in this study. They underwent lumbar puncture for collection of CSF samples, from which Aβ42, total tau (t-tau), and phosphorylated tau (p-tau) were immunoassayed. In addition, we computed t-tau/Aβ42 and p-tau/Aβ42 ratios. Cognitive reserve was indexed by years of education, with 16 or more years taken to confer high reserve. Covariate-adjusted regression analyses were used to test whether the effect of age on CSF biomarkers was modified by CR. The study dates were March 5, 2010, to February 13, 2013. MAIN OUTCOMES AND MEASURES Cerebrospinal fluid levels of Aβ42, t-tau, p-tau, t-tau/Aβ42, and p-tau/Aβ42. RESULTS There were significant age × CR interactions for CSF t-tau (β [SE] = -6.72 [2.84], P = .02), p-tau (β [SE] = -0.71 [0.27], P = .01), t-tau/Aβ42 (β [SE] = -0.02 [0.01], P = .02), and p-tau/Aβ42 (β [SE] = -0.002 [0.001], P = .004). With advancing age, individuals with high CR exhibited attenuated adverse alterations in these CSF biomarkers compared with individuals with low CR. This attenuation of age effects by CR tended to be more pronounced in the cognitively impaired group compared with the cognitively normal group. There was evidence of a dose-response relationship such that the effect of age on the biomarkers was progressively attenuated given additional years of schooling. CONCLUSIONS AND RELEVANCE In a sample composed of a cognitively normal group and a cognitively impaired group, higher CR was associated with a diminution of age-related alterations in CSF biomarkers of AD. This suggests one pathway through which CR might favorably alter lifetime risk for symptomatic AD.
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Affiliation(s)
- Rodrigo P. Almeida
- Fluminense Federal University, Niteroi, Brazil
- Geriatric Research Education and Clinical Center, William S. Middleton Memorial VA Hospital, Madison WI
- Wisconsin Alzheimer's Institute, University of Wisconsin School of Medicine and Public Health, Madison, WI
- Wisconsin Alzheimer's Disease Research Center, University of Wisconsin School of Medicine and Public Health, Madison, WI
| | - Stephanie A. Schultz
- Geriatric Research Education and Clinical Center, William S. Middleton Memorial VA Hospital, Madison WI
- Wisconsin Alzheimer's Institute, University of Wisconsin School of Medicine and Public Health, Madison, WI
- Wisconsin Alzheimer's Disease Research Center, University of Wisconsin School of Medicine and Public Health, Madison, WI
| | - Benjamin P. Austin
- Geriatric Research Education and Clinical Center, William S. Middleton Memorial VA Hospital, Madison WI
- Wisconsin Alzheimer's Disease Research Center, University of Wisconsin School of Medicine and Public Health, Madison, WI
| | - Elizabeth A. Boots
- Geriatric Research Education and Clinical Center, William S. Middleton Memorial VA Hospital, Madison WI
- Wisconsin Alzheimer's Institute, University of Wisconsin School of Medicine and Public Health, Madison, WI
- Wisconsin Alzheimer's Disease Research Center, University of Wisconsin School of Medicine and Public Health, Madison, WI
| | - N. Maritza Dowling
- Wisconsin Alzheimer's Disease Research Center, University of Wisconsin School of Medicine and Public Health, Madison, WI
- Department of Neurology, University of Wisconsin School of Medicine and Public Health, Madison, WI
| | - Carey E. Gleason
- Geriatric Research Education and Clinical Center, William S. Middleton Memorial VA Hospital, Madison WI
- Wisconsin Alzheimer's Disease Research Center, University of Wisconsin School of Medicine and Public Health, Madison, WI
| | - Barbara B. Bendlin
- Geriatric Research Education and Clinical Center, William S. Middleton Memorial VA Hospital, Madison WI
- Wisconsin Alzheimer's Institute, University of Wisconsin School of Medicine and Public Health, Madison, WI
- Wisconsin Alzheimer's Disease Research Center, University of Wisconsin School of Medicine and Public Health, Madison, WI
| | - Mark Sager
- Wisconsin Alzheimer's Institute, University of Wisconsin School of Medicine and Public Health, Madison, WI
- Wisconsin Alzheimer's Disease Research Center, University of Wisconsin School of Medicine and Public Health, Madison, WI
| | - Bruce P. Hermann
- Wisconsin Alzheimer's Institute, University of Wisconsin School of Medicine and Public Health, Madison, WI
- Wisconsin Alzheimer's Disease Research Center, University of Wisconsin School of Medicine and Public Health, Madison, WI
- Department of Neurology, University of Wisconsin School of Medicine and Public Health, Madison, WI
| | - Henrik Zetterberg
- Department of Psychiatry and Neurochemistry, the Sahlgrenska Academy at University of Gothenburg, Mölndal, Sweden
- University of London Institute of Neurology, Queen Square, London, United Kingdom
| | - Cindy Carlsson
- Geriatric Research Education and Clinical Center, William S. Middleton Memorial VA Hospital, Madison WI
- Wisconsin Alzheimer's Disease Research Center, University of Wisconsin School of Medicine and Public Health, Madison, WI
| | - Sterling Johnson
- Geriatric Research Education and Clinical Center, William S. Middleton Memorial VA Hospital, Madison WI
- Wisconsin Alzheimer's Institute, University of Wisconsin School of Medicine and Public Health, Madison, WI
- Wisconsin Alzheimer's Disease Research Center, University of Wisconsin School of Medicine and Public Health, Madison, WI
| | - Sanjay Asthana
- Geriatric Research Education and Clinical Center, William S. Middleton Memorial VA Hospital, Madison WI
- Wisconsin Alzheimer's Institute, University of Wisconsin School of Medicine and Public Health, Madison, WI
- Wisconsin Alzheimer's Disease Research Center, University of Wisconsin School of Medicine and Public Health, Madison, WI
| | - Ozioma C. Okonkwo
- Geriatric Research Education and Clinical Center, William S. Middleton Memorial VA Hospital, Madison WI
- Wisconsin Alzheimer's Institute, University of Wisconsin School of Medicine and Public Health, Madison, WI
- Wisconsin Alzheimer's Disease Research Center, University of Wisconsin School of Medicine and Public Health, Madison, WI
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Zhang N, Li YJ, Fu Y, Shao JH, Luo LL, Yang L, Shi FD, Liu Y. Cognitive impairment in Chinese neuromyelitis optica. Mult Scler 2015; 21:1839-46. [PMID: 25828756 DOI: 10.1177/1352458515576982] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2014] [Accepted: 02/12/2015] [Indexed: 01/08/2023]
Abstract
BACKGROUND Cognitive dysfunction is frequently seen in neuromyelitis optica (NMO). However, the features and influencing factors of cognitive impairment of Chinese NMO patients are unclear. OBJECTIVE To investigate the patterns of cognitive impairment in Chinese NMO patients, and correlate the neuropsychiatric scores with clinical and MRI parameters. METHODS Thirty-six Chinese NMO patients, and 30 sex and age-matched healthy controls were recruited with extensive neuropsychological assessments, using the modified Minimal Assessment of Cognitive Function in MS (MACFIMS). The demographic and clinical characteristics as well as MRI parameters were compared between cognitively impaired (CI) and cognitively preserved (CP) patients. RESULTS NMO patients were significantly impaired in the Paced Auditory Serial Addition Task (P<0.05), the Symbol Digit Modalities Test (P<0.001), the California Verbal Learning Test-Second Edition (P<0.05), the Brief Visuospatial Memory Test-Revised (P<0.05) and semantic fluency (P<0.001). Only lower education level was associated with cognitive dysfunction in NMO (odds ratio: 0.57, P<0.05). There were no significant differences of MRI parameters regarding white matter (WM) lesions, grey matter and WM brain volume between CI and CP patients. CONCLUSIONS Chinese NMO patients particularly demonstrated cognitive impairment in information processing speed, executive function and memory. Lower education level was the main factor contributing to cognitive impairment in NMO.
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Affiliation(s)
- N Zhang
- Department of Neurology, Key Laboratory of Post-traumatic Neuro-repair and Regeneration in the Central Nervous System, Tianjin Neurological Institute, Tianjin Medical University General Hospital, China
| | - Y J Li
- Department of Neurology, Key Laboratory of Post-traumatic Neuro-repair and Regeneration in the Central Nervous System, Tianjin Neurological Institute, Tianjin Medical University General Hospital, China
| | - Y Fu
- Department of Neurology, Key Laboratory of Post-traumatic Neuro-repair and Regeneration in the Central Nervous System, Tianjin Neurological Institute, Tianjin Medical University General Hospital, China
| | - J H Shao
- Department of Neurology, Key Laboratory of Post-traumatic Neuro-repair and Regeneration in the Central Nervous System, Tianjin Neurological Institute, Tianjin Medical University General Hospital, China
| | - L L Luo
- Department of Neurology, Key Laboratory of Post-traumatic Neuro-repair and Regeneration in the Central Nervous System, Tianjin Neurological Institute, Tianjin Medical University General Hospital, China
| | - L Yang
- Department of Neurology, Key Laboratory of Post-traumatic Neuro-repair and Regeneration in the Central Nervous System, Tianjin Neurological Institute, Tianjin Medical University General Hospital, China
| | - F D Shi
- Department of Neurology, Key Laboratory of Post-traumatic Neuro-repair and Regeneration in the Central Nervous System, Tianjin Neurological Institute, Tianjin Medical University General Hospital, China/Department of Neurology, Barrow Neurological Institute, St Joseph's Hospital and Medical Center, USA
| | - Y Liu
- Department of Neurology, Key Laboratory of Post-traumatic Neuro-repair and Regeneration in the Central Nervous System, Tianjin Neurological Institute, Tianjin Medical University General Hospital, China/Department of Radiology, Xuanwu Hospital, Capital Medical University, China/Department of Radiology and Nuclear Medicine, Neuroscience Campus Amsterdam, VU University Medical Center, The Netherlands
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Te M, Zhao E, Xingyue Z, Qinjian S, Chuanqiang Q. Leukoaraiosis with mild cognitive impairment. Neurol Res 2015; 37:410-4. [DOI: 10.1179/1743132815y.0000000028] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
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Ma L, Feng M, Qian Y, Yang W, Liu J, Han R, Zhu H, Li Y. Insulin resistance is an important risk factor for cognitive impairment in elderly patients with primary hypertension. Yonsei Med J 2015; 56:89-94. [PMID: 25510751 PMCID: PMC4276782 DOI: 10.3349/ymj.2015.56.1.89] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/21/2023] Open
Abstract
PURPOSE Insulin resistance plays a role in the development of dementia and hypertension. We investigated a possible relationship between cognitive impairment and insulin resistance in elderly Chinese patients with primary hypertension. MATERIALS AND METHODS One hundred and thirty-two hypertensive elderly patients (>60 years) were enrolled in this study, and assigned into either the cognitive impairment group (n=61) or the normal cognitive group (n=71). Gender, age, education, body mass index (BMI), waist hip ratio (WHR), total cholesterol (TC), triglyceride (TG), C-reactive protein (CRP), high density lipoprotein cholesterol (HDL-C), low density lipoprotein cholesterol (LDL-C), creatinine (Cr), fasting plasma glucose (FPG), fasting insulin (FINS), homeostasis model of assessment for insulin resistance index (HOMA-IR), systolic blood pressure, diastolic blood pressure, smoking history, atherosclerosis and the proportion of uncontrolled hypertension were compared between the two groups. Multi-factorial logistic regression analysis was performed. RESULTS No significant differences were found in gender, age, TC, CRP, HDL-C, LDL-C, Cr, BP, smoking history, atherosclerosis and the proportion of uncontrolled hypertension between the two groups. The cognitive impairment group had lower education levels, and higher BMI, WHR, TG, FPG, FINS, and HOMA-IR levels than the control group. Logistic regression analysis revealed the levels of education, BMI, WHR, and HOMA-IR as independent factors that predict cognitive impairment in patients. CONCLUSION Our study demonstrates that poor education and increased BMI, WHR, and HOMA-IR are independent risk factors for cognitive impairment in elderly patients with hypertension. Insulin resistance plays an important role in the development of cognitive impairment in primary elderly hypertensive patients.
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Affiliation(s)
- Lina Ma
- Department of Geriatrics, Xuan Wu Hospital, Capital Medical University, Beijing, China
| | - Ming Feng
- Department of Geriatrics, Xuan Wu Hospital, Capital Medical University, Beijing, China
| | - Yuying Qian
- Department of Geriatrics, Xuan Wu Hospital, Capital Medical University, Beijing, China
| | - Wei Yang
- Department of Geriatrics, Xuan Wu Hospital, Capital Medical University, Beijing, China
| | - Jia Liu
- Department of Geriatrics, Xuan Wu Hospital, Capital Medical University, Beijing, China
| | - Rui Han
- Department of Geriatrics, Xuan Wu Hospital, Capital Medical University, Beijing, China
| | - Hong Zhu
- Department of Geriatrics, Xuan Wu Hospital, Capital Medical University, Beijing, China
| | - Yun Li
- Department of Geriatrics, Xuan Wu Hospital, Capital Medical University, Beijing, China.
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50
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The impact of illiteracy on the assessment of cognition and dementia: a critical issue in the developing countries. Int Psychogeriatr 2014; 26:2051-60. [PMID: 25166718 DOI: 10.1017/s1041610214001707] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Dementia and Alzheimer's disease (AD) is considered a major public health challenge in this decade and in the future. Early detection of AD through appropriate screening tools would be valuable approach in facing the burden of disease specifically in developing societies with insufficient resources. Selecting a screening tool which is non-expensive, non-invasive and implementable by trained primary healthcare providers is the first and probably the most important step in detecting high risk individuals. The goal of this review is to address the key issues in assessment tools in developing countries with a high level of illiteracy. METHOD We set about a review on literature on the subject of cognitive function assessment among minorities, people with low or no education, and people who live in underdeveloped societies. We also reviewed the studies on validation of such tests in a new society. RESULTS The most popular assessment tools are more or less biased by the level of education; not all of them are useful for any type of dementia as they assess only some domains of cognitive function. CONCLUSION Even though people with lower level of education have a higher rate of developing dementia, cognitive function cannot be accurately assessed because of limitations of current available tools. It is strongly suggested that special attention be paid to assess them by functional scales and activity daily living scales. For a more efficient assessment, cognitive tests can also benefit from illustrative questions, proverbs, metaphors, traditions, religious rituals and historical events.
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