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Tang C, Ma Y, Lei X, Ding Y, Yang S, He D. Hypertension linked to Alzheimer's disease via stroke: Mendelian randomization. Sci Rep 2023; 13:21606. [PMID: 38062190 PMCID: PMC10703897 DOI: 10.1038/s41598-023-49087-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Accepted: 12/04/2023] [Indexed: 12/18/2023] Open
Abstract
This study aimed to investigate the relationship between hypertension and Alzheimer's disease (AD) and demonstrate the key role of stroke in this relationship using mediating Mendelian randomization. AD, a neurodegenerative disease characterized by memory loss, cognitive impairment, and behavioral abnormalities, severely affects the quality of life of patients. Hypertension is an important risk factor for AD. However, the precise mechanism underlying this relationship is unclear. To investigate the relationship between hypertension and AD, we used a mediated Mendelian randomization method and screened for mediating variables between hypertension and AD by setting instrumental variables. The results of the mediated analysis showed that stroke, as a mediating variable, plays an important role in the causal relationship between hypertension and AD. Specifically, the mediated indirect effect value for stroke obtained using multivariate mediated MR analysis was 54.9%. This implies that approximately 55% of the risk of AD owing to hypertension can be attributed to stroke. The results suggest that the increased risk of AD owing to hypertension is mediated through stroke. The finding not only sheds light on the relationship between hypertension and AD but also indicates novel methods for the prevention and treatment of AD. By identifying the critical role of stroke in the link between hypertension and AD, this study provides insights into potential interventions that could mitigate the impact of hypertension on AD. This could help develop personalized treatments and help improve the quality of life of patients with AD who suffer from hypertension.
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Affiliation(s)
- Chao Tang
- Department of Neurology, Affiliated Hospital of Guizhou Medical University, No. 28, Guiyi Street, Yunyan District, Guiyang, 550004, Guizhou Province, China
| | - Yayu Ma
- Department of Neurology, Affiliated Hospital of Guizhou Medical University, No. 28, Guiyi Street, Yunyan District, Guiyang, 550004, Guizhou Province, China
| | - Xiaoyang Lei
- Department of Neurology, Affiliated Hospital of Guizhou Medical University, No. 28, Guiyi Street, Yunyan District, Guiyang, 550004, Guizhou Province, China
| | - Yaqi Ding
- Department of Neurology, Affiliated Hospital of Guizhou Medical University, No. 28, Guiyi Street, Yunyan District, Guiyang, 550004, Guizhou Province, China
| | - Sushuang Yang
- Department of Neurology, Affiliated Hospital of Guizhou Medical University, No. 28, Guiyi Street, Yunyan District, Guiyang, 550004, Guizhou Province, China
| | - Dian He
- Department of Neurology, Affiliated Hospital of Guizhou Medical University, No. 28, Guiyi Street, Yunyan District, Guiyang, 550004, Guizhou Province, China.
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Oliveira-Kumakura ARDS, Batista LMOS, Spagnol GS, Valler L. Functionality and quality of life in Brazilian patients 6 months post-stroke. Front Neurol 2023; 14:1020587. [PMID: 37153670 PMCID: PMC10157197 DOI: 10.3389/fneur.2023.1020587] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Accepted: 03/14/2023] [Indexed: 05/10/2023] Open
Abstract
Background Surviving a stroke poses a social and economic impact that requires the care system to be reformulated and the patient to be addressed in a comprehensive approach. Purpose This study aims to investigate if there is a relationship between functional activities performed before the stroke, patients' clinical and hospitalization data, and functionality and quality of life measures in the first 6 months after the stroke. Methods This study used a prospective cohort of 92 patients. We investigated sociodemographic and clinical data, the modified Rankin Scale (mRS), and the Frenchay Activities Index (FAI) during hospitalization. The Barthel Index (BI) and EuroQol-5D (EQ-5D) were applied at the following time points: 30 days (T1), 90 days (T2), and 180 days (T3) following postictal state. Statistical analysis was conducted using Spearman's coefficient, Friedman's non-parametric test, and multiple linear regression models. Results No correlation was found between FAI, BI, and EQ-5D average scores. Severe patients, patients with comorbidities, and patients with extended hospital stays showed lower BI and EQ-5D scores □in the follow-up. BI and EQ-5D scores increased. Conclusion This research found no relationship between activities performed before the stroke and functionalities and quality of life after the stroke, but comorbidities and extended hospital stay were associated with worse outcomes.
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Affiliation(s)
- Ana Railka de Souza Oliveira-Kumakura
- School of Nursing, University of Campinas, Campinas, Brazil
- Nursing Sciences Research Chair, Laboratory Education and Health Promotion, Université Sorbonne Paris Nord, Bobigny, France
| | | | - Gabriela Salim Spagnol
- Nursing School, Anhanguera University, Sumaré, Brazil
- Knowledge Management and Education Solutions, Cogna Education, Valinhos, Brazil
| | - Lenise Valler
- Clinical Hospital, University of Campinas, Campinas, Brazil
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Yao H, Zhang J, Wang Y, Wang Q, Zhao F, Zhang P. Stroke risk and its association with quality of life: a cross-sectional study among Chinese urban adults. Health Qual Life Outcomes 2021; 19:236. [PMID: 34627278 PMCID: PMC8501711 DOI: 10.1186/s12955-021-01868-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Accepted: 09/20/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Stroke is a leading cause of mortality and disability worldwide. Most stroke risk studies focused on more established biological and pathophysiological risk factors such as hypertension and smoking, psychosocial factors such as quality of life are often under-investigated and thus less reported. The current study aims to estimate stroke risk and explore the impact of quality of life on stroke risk among a community sample of urban residents in Shanghai. METHODS This cross-sectional study was conducted in Fengxian District of Shanghai City from December 2018 to April 2019. 4030 representative participants were recruited through a multistage, stratified, probability proportional to size sampling method and completed the study. Stroke risk was assessed using the Rapid Stroke Risk Screening Chart that included 8 risk factors for stroke. Quality of life was measured using the World Health Organization Quality of Life-brief version (WHOQOL-BREF). RESULTS One-third of residents were at risk for stroke, including 14.39% at high risk, and 18.68% at middle risk. The top three most commonly reported risk factors were physical inactivity (37.30%), hypertension (25.38%), and smoking (17.32%). Quality of life and its four domains were all independently and significantly associated with stroke risk. Multinominal logistic regressions showed that a one-unit increase in the quality of life was associated with a decreased relative risk for middle-risk relative to low-risk of stroke by a factor of 0.988 (95% CI:0.979, 0.997, P = 0.007), and a decreased relative risk for high-risk relative to low-risk of stroke by a factor of 0.975 (95% CI:0.966, 0.984, P < 0.001). CONCLUSIONS Our findings showed an alarmingly high prevalence of stroke risk among the sample, which may require future intervention programs to focus on improving both biological and behavioral risk factors such as increasing physical activity, early diagnosis and treatment of hypertension, and smoking cessation, as well as improving psychosocial factors such as quality of life.
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Affiliation(s)
- Huiqing Yao
- Clinical Trial Center, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Science, Beijing Key Laboratory of Drug Clinical Risk and Personalized Medication Evaluation, Beijing, 100730, People's Republic of China
| | - Juhua Zhang
- Fudan University, Shanghai, 200433, People's Republic of China.,Shanghai Pudong Health Development Research Institute, Shanghai, 200129, People's Republic of China.,Shanghai University of Medicine and Health Sciences Affiliated Zhoupu Hospital, Shanghai, 201318, People's Republic of China
| | - Yanmei Wang
- Department of Nursing, Shanghai Gongli Hospital, Second Military Medical University, Shanghai, 200135, People's Republic of China
| | - Qingqing Wang
- Clinical Trial Center, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Science, Beijing Key Laboratory of Drug Clinical Risk and Personalized Medication Evaluation, Beijing, 100730, People's Republic of China
| | - Fei Zhao
- Clinical Trial Center, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Science, Beijing Key Laboratory of Drug Clinical Risk and Personalized Medication Evaluation, Beijing, 100730, People's Republic of China.
| | - Peng Zhang
- Department of Neurology, Jiading District Central Hospital Affiliated Shanghai University of Medicine and Health Sciences, Shanghai, 201800, People's Republic of China. .,School of Clinical Medicine, Shanghai University of Medicine & Health Sciences, Shanghai, 201318, People's Republic of China.
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Wang T, Ni QB, Wang K, Han Z, Sun BL. Stroke and Alzheimer’s Disease: A Mendelian Randomization Study. Front Genet 2020; 11:581. [PMID: 32760421 PMCID: PMC7371994 DOI: 10.3389/fgene.2020.00581] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2020] [Accepted: 05/12/2020] [Indexed: 12/17/2022] Open
Affiliation(s)
- Tao Wang
- Academy for Advanced Interdisciplinary Studies, Peking University, Beijing, China
| | - Qing-bin Ni
- Postdoctoral Workstation, Taian City Central Hospital, Taian, China
| | - Kun Wang
- Postdoctoral Workstation, Taian City Central Hospital, Taian, China
| | - Zhifa Han
- School of Pharmaceutical Sciences, Tsinghua University, Beijing, China
- *Correspondence: Zhifa Han,
| | - Bao-liang Sun
- Department of Neurology, The Second Affiliated Hospital, Shandong First Medical University & Shandong Academy of Medical Sciences, Taian, China
- Key Laboratory of Cerebral Microcirculation in Universities of Shandong, Shandong First Medical University & Shandong Academy of Medical Sciences, Taian, China
- Bao-liang Sun,
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Ramos-Lima MJM, Brasileiro IDC, de Lima TL, Braga-Neto P. Quality of life after stroke: impact of clinical and sociodemographic factors. Clinics (Sao Paulo) 2018; 73:e418. [PMID: 30304300 PMCID: PMC6152181 DOI: 10.6061/clinics/2017/e418] [Citation(s) in RCA: 101] [Impact Index Per Article: 16.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2017] [Accepted: 03/23/2018] [Indexed: 12/05/2022] Open
Abstract
OBJECTIVES The aim of the study was to analyze the impact of ischemic stroke on health-related quality of life (QoL) and associate this event with individuals' clinical and sociodemographic characteristics. METHODS We investigated the clinical and demographic aspects of stroke patients. The Modified Rankin Scale, National Institutes of Health Stroke Scale (NIHSS) and the Stroke Specific Quality of Life Scale (SS-QoL) were used for correlation analysis. RESULTS Among 131 patients with ischemic stroke, 53.4% of patients presented with moderate to severe disability on the Rankin Scale. According to the SS-QoL, several QoL domains were compromised. QoL was significantly negatively correlated with the values of the Rankin and NIHSS scales, indicating lower QoL among people with worse functional status and greater clinical severity of stroke (p<0.001). The use of orthosis and total anterior circulation infarct subtype of stroke led to a more marked reduction in QoL. CONCLUSION The present study described an inversely proportional relationship between the severity of stroke, disability and QoL. The use of orthosis also had a negative impact on QoL. Early identification of these factors could promote better interventions for individuals with ischemic stroke, minimizing disabilities and improving QoL.
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Affiliation(s)
| | | | | | - Pedro Braga-Neto
- Centro de Ciencias da Saude, Universidade Estadual do Ceara, Fortaleza, CE, BR
- Divisao de Neurologia, Departamento de Medicina Clinica, Universidade Federal do Ceara, Fortaleza, CE, BR
- *Corresponding author. E-mail:
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