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Wang YZ, Zhao W, Moorjani P, Gross AL, Zhou X, Dey AB, Lee J, Smith JA, Kardia SLR. Effect of apolipoprotein E ε4 and its modification by sociodemographic characteristics on cognitive measures in South Asians from LASI-DAD. Alzheimers Dement 2024; 20:4854-4867. [PMID: 38889280 PMCID: PMC11247697 DOI: 10.1002/alz.14052] [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: 11/16/2023] [Revised: 05/13/2024] [Accepted: 05/15/2024] [Indexed: 06/20/2024]
Abstract
BACKGROUND We investigated the effects of apolipoprotein E (APOE) ε4 and its interactions with sociodemographic characteristics on cognitive measures in South Asians from the Diagnostic Assessment of Dementia for the Longitudinal Aging Study of India (LASI-DAD). METHODS Linear regression was used to assess the association between APOE ε4 and global- and domain-specific cognitive function in 2563 participants (mean age 69.6 ± 7.3 years; 53% female). Effect modification by age, sex, and education were explored using interaction terms and subgroup analyses. RESULTS APOE ε4 was inversely associated with most cognitive measures (p < 0.05). This association was stronger with advancing age for the Hindi Mental State Examination (HMSE) score (βε4×age = -0.44, p = 0.03), orientation (βε4×age = -0.07, p = 0.01), and language/fluency (βε4×age = -0.07, p = 0.01), as well as in females for memory (βε4×male = 0.17, p = 0.02) and language/fluency (βε4×male = 0.12, p = 0.03). DISCUSSION APOE ε4 is associated with lower cognitive function in South Asians from India, with a more pronounced impact observed in females and older individuals. HIGHLIGHTS APOE ε4 carriers had lower global and domain-specific cognitive performance. Females and older individuals may be more susceptible to ε4 effects. For most cognitive measures, there was no interaction between ε4 and education.
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Affiliation(s)
- Yi Zhe Wang
- Department of EpidemiologySchool of Public HealthUniversity of MichiganAnn ArborMichiganUSA
| | - Wei Zhao
- Department of EpidemiologySchool of Public HealthUniversity of MichiganAnn ArborMichiganUSA
- Survey Research CenterInstitute for Social ResearchUniversity of MichiganAnn ArborMichiganUSA
| | - Priya Moorjani
- Department of Molecular and Cell BiologyUniversity of CaliforniaBerkeleyCaliforniaUSA
- Center for Computational BiologyUniversity of CaliforniaBerkeleyCaliforniaUSA
| | - Alden L. Gross
- Department of EpidemiologyJohns Hopkins Bloomberg School of Public HealthBaltimoreMarylandUSA
| | - Xiang Zhou
- Department of BiostatisticsSchool of Public HealthUniversity of MichiganAnn ArborMichiganUSA
| | - Aparajit B. Dey
- Department of Geriatric MedicineAll India Institute of Medical Sciences, Ansari NagarNew DelhiIndia
| | - Jinkook Lee
- Department of Economics and Center for Social ResearchUniversity of Southern CaliforniaLos AngelesCaliforniaUSA
| | - Jennifer A. Smith
- Department of EpidemiologySchool of Public HealthUniversity of MichiganAnn ArborMichiganUSA
- Survey Research CenterInstitute for Social ResearchUniversity of MichiganAnn ArborMichiganUSA
| | - Sharon L. R. Kardia
- Department of EpidemiologySchool of Public HealthUniversity of MichiganAnn ArborMichiganUSA
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Ibrahim AM, Singh DKA, Ludin AFM, Sakian NIM, Rivan NFM, Shahar S. Cardiovascular risk factors among older persons with cognitive frailty in middle income country. World J Clin Cases 2024; 12:3076-3085. [PMID: 38898873 PMCID: PMC11185391 DOI: 10.12998/wjcc.v12.i17.3076] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2024] [Revised: 02/11/2024] [Accepted: 04/15/2024] [Indexed: 06/04/2024] Open
Abstract
BACKGROUND Cognitive frailty, characterized by the coexistence of cognitive impairment and physical frailty, represents a multifaceted challenge in the aging population. The role of cardiovascular risk factors in this complex interplay is not yet fully understood. AIM To investigate the relationships between cardiovascular risk factors and older persons with cognitive frailty by pooling data from two cohorts of studies in Malaysia. METHODS A comprehensive approach was employed, with a total of 512 community-dwelling older persons aged 60 years and above, involving two cohorts of older persons from previous studies. Datasets related to cardiovascular risks, namely sociodemographic factors, and cardiovascular risk factors, including hypertension, diabetes, hypercholesterolemia, anthropometric characteristics and biochemical profiles, were pooled for analysis. Cognitive frailty was defined based on the Clinical Dementia Rating scale and Fried frailty score. Cardiovascular risk was determined using Framingham risk score. Statistical analyses were conducted using SPSS version 21. RESULTS Of the study participants, 46.3% exhibited cognitive frailty. Cardiovascular risk factors including hypertension (OR:1.60; 95%CI: 1.12-2.30), low fat-free mass (OR:0.96; 95%CI: 0.94-0.98), high percentage body fat (OR:1.04; 95%CI: 1.02-1.06), high waist circumference (OR:1.02; 95%CI: 1.01-1.04), high fasting blood glucose (OR:1.64; 95%CI: 1.11-2.43), high Framingham risk score (OR:1.65; 95%CI: 1.17-2.31), together with sociodemographic factors, i.e., being single (OR 3.38; 95%CI: 2.26-5.05) and low household income (OR 2.18; 95%CI: 1.44-3.30) were found to be associated with cognitive frailty. CONCLUSION Cardiovascular-risk specific risk factors and sociodemographic factors were associated with risk of cognitive frailty, a prodromal stage of dementia. Early identification and management of cardiovascular risk factors, particularly among specific group of the population might mitigate the risk of cognitive frailty, hence preventing dementia.
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Affiliation(s)
- Azianah Mohamad Ibrahim
- Centre for Healthy Ageing and Wellness, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Wilayah Persekutuan Kuala Lumpur 50300, Malaysia
| | - Devinder Kaur Ajit Singh
- Centre for Healthy Ageing and Wellness, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Wilayah Persekutuan Kuala Lumpur 50300, Malaysia
| | - Arimi Fitri Mat Ludin
- Centre for Healthy Ageing and Wellness, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Wilayah Persekutuan Kuala Lumpur 50300, Malaysia
| | | | - Nurul Fatin Malek Rivan
- Centre for Healthy Ageing and Wellness, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Wilayah Persekutuan Kuala Lumpur 50300, Malaysia
| | - Suzana Shahar
- Centre for Healthy Ageing and Wellness, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Wilayah Persekutuan Kuala Lumpur 50300, Malaysia
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Cha CH, Lin TK, Wu CN, Yang CH, Huang YW, Hwang CF. Relationship of Hearing Loss to Parkinson's Disease, Dementia, and APOE Genotype in Adults. MEDICINA (KAUNAS, LITHUANIA) 2024; 60:703. [PMID: 38792885 PMCID: PMC11122976 DOI: 10.3390/medicina60050703] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/14/2024] [Revised: 04/13/2024] [Accepted: 04/16/2024] [Indexed: 05/26/2024]
Abstract
Background: Hearing loss has been recognized as a risk factor for dementia and non-motor features of Parkinson's disease (PD). The apolipoprotein E (APOE) protein contributes to maintenance and repair of neuronal cell membranes, causing age-related disorders. This study aimed to analyze the impact of hearing loss on cognitive impairment, PD severity, and APOE gene expression in these patients. Methods: A total of 72 out-patients diagnosed with either PD or hearing loss were enrolled in this study. The hearing assessment included pure-tone audiometry, speech reception thresholds, and speech discrimination ability. Dementia was assessed by filling out the Clinical Dementia Rating and Mini-Mental State Examination questionnaires. The severity of PD was assessed using the Modified Hoehn and Yahr scale. Blood samples were tested for the gene expression of APOE. Results: Out of the 72 cases, there were 44 males and 28 females, with an average age of 64.4 ± 9.1 years. A total of 41 out of 72 cases had dementia and had a worse hearing threshold than those without dementia (47.1 ± 24.4 vs. 31.7 ± 22.1 dB, p = 0.006). A total of 58 patients were diagnosed with PD, with 14 of them classified as having severe symptoms (Modified Hoehn and Yahr scale > 2). Patients with severe PD were found to have a worse hearing threshold (49.6 ± 28.3 vs. 30.3 ± 17.8 dB, p = 0.028) and higher prevalence of dementia (12/14 vs. 18/44, p = 0.006). Among 10 individuals with the APOE ε4 gene, the prevalence of dementia was higher than those without the ε4 allele (9/10 vs. 32/62, p = 0.036). Conclusions: Hearing loss is common in severe PD and in dementia patients. Severe PD has a negative impact on the hearing threshold and cognitive dysfunction. Patients with APOE ε4 have a higher prevalence of dementia.
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Affiliation(s)
- Chih-Hung Cha
- Department of Otolaryngology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, No. 123, Dapi Rd., Kaohsiung 83301, Taiwan; (C.-H.C.)
| | - Tsu-Kung Lin
- Department of Neurology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung 83301, Taiwan
- Center of Parkinson’s Disease, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung 83301, Taiwan
| | - Ching-Nung Wu
- Department of Otolaryngology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, No. 123, Dapi Rd., Kaohsiung 83301, Taiwan; (C.-H.C.)
| | - Chao-Hui Yang
- Department of Otolaryngology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, No. 123, Dapi Rd., Kaohsiung 83301, Taiwan; (C.-H.C.)
| | - Yi-Wen Huang
- Department of Neurology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Kaohsiung 83301, Taiwan
| | - Chung-Feng Hwang
- Department of Otolaryngology, Kaohsiung Chang Gung Memorial Hospital, Chang Gung University College of Medicine, No. 123, Dapi Rd., Kaohsiung 83301, Taiwan; (C.-H.C.)
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Ogonowski NS, García-Marín LM, Fernando AS, Flores-Ocampo V, Rentería ME. Impact of genetic predisposition to late-onset neurodegenerative diseases on early life outcomes and brain structure. Transl Psychiatry 2024; 14:185. [PMID: 38605018 PMCID: PMC11009228 DOI: 10.1038/s41398-024-02898-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2023] [Revised: 03/27/2024] [Accepted: 04/03/2024] [Indexed: 04/13/2024] Open
Abstract
Most patients with late-onset neurodegenerative diseases such as Alzheimer's and Parkinson's have a complex aetiology resulting from numerous genetic risk variants of small effects located across the genome, environmental factors, and the interaction between genes and environment. Over the last decade, genome-wide association studies (GWAS) and post-GWAS analyses have shed light on the polygenic architecture of these diseases, enabling polygenic risk scores (PRS) to estimate an individual's relative genetic liability for presenting with the disease. PRS can screen and stratify individuals based on their genetic risk, potentially years or even decades before the onset of clinical symptoms. An emerging body of evidence from various research studies suggests that genetic susceptibility to late-onset neurodegenerative diseases might impact early life outcomes, including cognitive function, brain structure and function, and behaviour. This article summarises recent findings exploring the potential impact of genetic susceptibility to neurodegenerative diseases on early life outcomes. A better understanding of the impact of genetic susceptibility to neurodegenerative diseases early in life could be valuable in disease screening, detection, and prevention and in informing treatment strategies before significant neural damage has occurred. However, ongoing studies have limitations. Overall, our review found several studies focused on APOE haplotypes and Alzheimer's risk, but a limited number of studies leveraging polygenic risk scores or focused on genetic susceptibility to other late-onset conditions.
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Affiliation(s)
- Natalia S Ogonowski
- Mental Health & Neuroscience Program, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia
- School of Biomedical Sciences, Faculty of Medicine, The University of Queensland, Brisbane, QLD, Australia
| | - Luis M García-Marín
- Mental Health & Neuroscience Program, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia
- School of Biomedical Sciences, Faculty of Medicine, The University of Queensland, Brisbane, QLD, Australia
| | - Amali S Fernando
- Mental Health & Neuroscience Program, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia
| | - Victor Flores-Ocampo
- Mental Health & Neuroscience Program, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia
- School of Biomedical Sciences, Faculty of Medicine, The University of Queensland, Brisbane, QLD, Australia
| | - Miguel E Rentería
- Mental Health & Neuroscience Program, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia.
- School of Biomedical Sciences, Faculty of Medicine, The University of Queensland, Brisbane, QLD, Australia.
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Kim J, Kim S, Um YH, Wang SM, Kim REY, Choe YS, Lee J, Kim D, Lim HK, Lee CU, Kang DW. Associations between Education Years and Resting-state Functional Connectivity Modulated by APOE ε4 Carrier Status in Cognitively Normal Older Adults. CLINICAL PSYCHOPHARMACOLOGY AND NEUROSCIENCE : THE OFFICIAL SCIENTIFIC JOURNAL OF THE KOREAN COLLEGE OF NEUROPSYCHOPHARMACOLOGY 2024; 22:169-181. [PMID: 38247423 PMCID: PMC10811405 DOI: 10.9758/cpn.23.1113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Revised: 09/13/2023] [Accepted: 09/26/2023] [Indexed: 01/23/2024]
Abstract
Objective : Cognitive reserve has emerged as a concept to explain the variable expression of clinical symptoms in the pathology of Alzheimer's disease (AD). The association between years of education, a proxy of cognitive reserve, and resting-state functional connectivity (rFC), a representative intermediate phenotype, has not been explored in the preclinical phase, considering risk factors for AD. We aimed to evaluate whether the relationship between years of education and rFC in cognitively preserved older adults differs depending on amyloid-beta deposition and APOE ε4 carrier status as effect modifiers. Methods : A total of 121 participants underwent functional magnetic resonance imaging, [18F] flutemetamol positron emission tomography-computed tomography, APOE genotyping, and a neuropsychological battery. Potential interactions between years of education and AD risk factors for rFC of AD-vulnerable neural networks were assessed with whole-brain voxel-wise analysis. Results : We found a significant education years-by-APOE ε4 carrier status interaction for the rFC from the seed region of the central executive (CEN) and dorsal attention networks. Moreover, there was a significant interaction of rFC between right superior occipital gyrus and the CEN seed region by APOE ε4 carrier status for memory performances and overall cognitive function. Conclusion : In preclinical APOE ε4 carriers, higher years of education were associated with higher rFC of the AD vulnerable network, but this contributed to lower cognitive function. These results contribute to a deeper understanding of the impact of cognitive reserve on sensitive functional intermediate phenotypic markers in the preclinical phase of AD.
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Affiliation(s)
- Jiwon Kim
- Department of Psychiatry, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Sunghwan Kim
- Department of Psychiatry, Yeouido St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Yoo Hyun Um
- Department of Psychiatry, St. Vincent’s Hospital, College of Medicine, The Catholic University of Korea, Suwon, Korea
| | - Sheng-Min Wang
- Department of Psychiatry, Yeouido St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | | | | | - Jiyeon Lee
- Research Institute, NEUROPHET Inc., Seoul, Korea
| | | | - Hyun Kook Lim
- Department of Psychiatry, Yeouido St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
- Research Institute, NEUROPHET Inc., Seoul, Korea
| | - Chang Uk Lee
- Department of Psychiatry, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Dong Woo Kang
- Department of Psychiatry, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
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Perneczky R. Alzheimer's Disease Prevention and Treatment Based on Population-Based Approaches. Methods Mol Biol 2024; 2785:15-33. [PMID: 38427185 DOI: 10.1007/978-1-0716-3774-6_2] [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] [Indexed: 03/02/2024]
Abstract
The development of effective prevention and treatment strategies for Alzheimer's disease (AD) and dementia is hindered by limited knowledge of the underlying biological and environmental causes. While certain genetic factors have been associated with AD, and various lifestyle and environmental factors have been linked to dementia risk, the interactions between genes and the environment are not yet fully understood. To identify new avenues for dementia prevention, coordinated global efforts are needed to utilize existing cohorts and resources effectively and efficiently. This chapter provides an overview of current research on risk and protective factors for AD and dementia and discusses the opportunities and challenges associated with population-based approaches.
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Affiliation(s)
- Robert Perneczky
- Department of Psychiatry and Psychotherapy, LMU Hospital, Ludwig-Maximilians-Universität München, Munich, Germany.
- German Center for Neurodegenerative Diseases (DZNE), Munich, Germany.
- Munich Cluster for Systems Neurology (SyNergy), Munich, Germany.
- Sheffield Institute for Translational Neuroscience (SITraN), University of Sheffield, Sheffield, UK.
- Ageing Epidemiology (AGE) Research Unit, School of Public Health, Imperial College London, London, UK.
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Kezios KL, Hayes-Larson E. Sufficient component cause simulations: an underutilized epidemiologic teaching tool. FRONTIERS IN EPIDEMIOLOGY 2023; 3:1282809. [PMID: 38435670 PMCID: PMC10906966 DOI: 10.3389/fepid.2023.1282809] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Accepted: 10/19/2023] [Indexed: 03/05/2024]
Abstract
Simulation studies are a powerful and important tool in epidemiologic teaching, especially for understanding causal inference. Simulations using the sufficient component cause framework can provide students key insights about causal mechanisms and sources of bias, but are not commonly used. To make them more accessible, we aim to provide an introduction and tutorial on developing and using these simulations, including an overview of translation from directed acyclic graphs and potential outcomes to sufficient component causal models, and a summary of the simulation approach. Using the applied question of the impact of educational attainment on dementia, we offer simple simulation examples and accompanying code to illustrate sufficient component cause-based simulations for four common causal structures (causation, confounding, selection bias, and effect modification) often introduced early in epidemiologic training. We show how sufficient component cause-based simulations illuminate both the causal processes and the mechanisms through which bias occurs, which can help enhance student understanding of these causal structures and the distinctions between them. We conclude with a discussion of considerations for using sufficient component cause-based simulations as a teaching tool.
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Affiliation(s)
- Katrina L. Kezios
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, United States
| | - Eleanor Hayes-Larson
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, CA, United States
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de Paula França Resende E, Lara VP, Santiago ALC, Friedlaender CV, Rosen HJ, Brown JA, Cobigo Y, Silva LLG, de Souza LC, Rincon L, Grinberg LT, Maciel FIP, Caramelli P. Literacy, but not memory, is associated with hippocampal connectivity in illiterate adults. RESEARCH SQUARE 2023:rs.3.rs-3053775. [PMID: 37398238 PMCID: PMC10312990 DOI: 10.21203/rs.3.rs-3053775/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/04/2023]
Abstract
Background The influence of hippocampal connectivity on memory performance is well established in individuals with high educational attainment. However, the role of hippocampal connectivity in illiterate populations remains poorly understood. Methods Thirty-five illiterate adults were administered a literacy assessment (Test of Functional Health Literacy in Adults - TOFHLA), structural and resting state functional MRI and an episodic memory test (Free and Cued Selective Reminding Test). Illiteracy was defined as a TOFHLA score below 53. We evaluated the correlation between hippocampal connectivity at rest and both free recall and literacy scores. Results Participants were mostly female (57.1%) and Black (84.8%), with a median age of 50 years. The median TOFHLA literacy score was 28.0 [21.0;42.5] out of 100 points and the median free recall score was 30.0 [26.2;35] out of 48 points. The median gray matter volume of both the left and right hippocampi was 2.3 [2.1; 2.4] cm3. We observed a significant connectivity between both hippocampi and the precuneus and the ventral medial prefrontal cortex. Interestingly, the right hippocampal connectivity positively correlated with the literacy scores (β = 0.58, p = 0.008). There was no significant association between episodic memory and hippocampal connectivity. Neither memory nor literacy scores correlated with hippocampal gray matter volume. Conclusions Low literacy levels correlate with hippocampal connectivity in illiterate adults. The lack of association with memory scores might be associated with low brain reserve in illiterate adults.
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Fingelkurts AA, Fingelkurts AA. Turning Back the Clock: A Retrospective Single-Blind Study on Brain Age Change in Response to Nutraceuticals Supplementation vs. Lifestyle Modifications. Brain Sci 2023; 13:brainsci13030520. [PMID: 36979330 PMCID: PMC10046544 DOI: 10.3390/brainsci13030520] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Revised: 03/17/2023] [Accepted: 03/19/2023] [Indexed: 03/30/2023] Open
Abstract
BACKGROUND There is a growing consensus that chronological age (CA) is not an accurate indicator of the aging process and that biological age (BA) instead is a better measure of an individual's risk of age-related outcomes and a more accurate predictor of mortality than actual CA. In this context, BA measures the "true" age, which is an integrated result of an individual's level of damage accumulation across all levels of biological organization, along with preserved resources. The BA is plastic and depends upon epigenetics. Brain state is an important factor contributing to health- and lifespan. METHODS AND OBJECTIVE Quantitative electroencephalography (qEEG)-derived brain BA (BBA) is a suitable and promising measure of brain aging. In the present study, we aimed to show that BBA can be decelerated or even reversed in humans (N = 89) by using customized programs of nutraceutical compounds or lifestyle changes (mean duration = 13 months). RESULTS We observed that BBA was younger than CA in both groups at the end of the intervention. Furthermore, the BBA of the participants in the nutraceuticals group was 2.83 years younger at the endpoint of the intervention compared with their BBA score at the beginning of the intervention, while the BBA of the participants in the lifestyle group was only 0.02 years younger at the end of the intervention. These results were accompanied by improvements in mental-physical health comorbidities in both groups. The pre-intervention BBA score and the sex of the participants were considered confounding factors and analyzed separately. CONCLUSIONS Overall, the obtained results support the feasibility of the goal of this study and also provide the first robust evidence that halting and reversal of brain aging are possible in humans within a reasonable (practical) timeframe of approximately one year.
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Iso-Markku P, Kaprio J, Lindgrén N, Rinne JO, Vuoksimaa E. Education as a moderator of middle-age cardiovascular risk factor-old-age cognition relationships: testing cognitive reserve hypothesis in epidemiological study. Age Ageing 2022; 51:6520517. [PMID: 35134847 PMCID: PMC8824709 DOI: 10.1093/ageing/afab228] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Revised: 09/14/2021] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND higher educational attainment and less midlife cardiovascular risk factors are related to better old-age cognition. Whether education moderates the association between cardiovascular risk factors and late-life cognition is not known. We studied if higher education provides resilience against the deteriorative effects of higher middle-age body mass index (BMI) and a combination of midlife cardiovascular risk factors on old-age cognition. METHODS the study population is the older Finnish Twin Cohort (n = 4,051, mean age [standard deviation, SD] = 45.5 years [6.5]). Cardiovascular risk factors and education were studied at baseline with questionnaires in 1975, 1981 and/or 1990 (participation rates of 89, 84 and 77%, respectively). Cognition was evaluated with telephone interviews (participation rate 67%, mean age [SD] =73.4 [2.9] years, mean follow-up [SD] = 27.8 [6.0] years) in 1999-2017. We studied the main and interactive effects of education and BMI/dementia risk score on late-life cognition with linear regression analysis. The study design was formulated before the pre-defined analyses. RESULTS years of education moderated the association between BMI with old-age cognition (among less educated persons, BMI-cognition association was stronger [B = -0.24 points per BMI unit, 95% CI -0.31, -0.18] than among more educated persons [B = -0.06 points per BMI unit, 95% CI -0.16, 0.03], Pinteraction < 0.01). There was a similar moderating effect of education on dementia risk score consisting of cardiovascular risk factors (P < 0.001). CONCLUSIONS our results support the cognitive reserve hypothesis. Those with higher education may tolerate the deteriorative effects of midlife cardiovascular risk factors on old-age cognition better than those with lower education.
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Affiliation(s)
- Paula Iso-Markku
- Institute for Molecular Medicine Finland (FIMM), Helsinki Institute of Life Science (HiLIFE), University of Helsinki, Helsinki, Finland
- HUS Diagnostic Center, Clinical Physiology and Nuclear Medicine, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Jaakko Kaprio
- Institute for Molecular Medicine Finland (FIMM), Helsinki Institute of Life Science (HiLIFE), University of Helsinki, Helsinki, Finland
- Clinicum, Department of Public Health, University of Helsinki, Helsinki, Finland
| | | | - Juha O Rinne
- Turku PET Centre, University of Turku and Turku University Hospital, Turku, Finland
| | - Eero Vuoksimaa
- Institute for Molecular Medicine Finland (FIMM), Helsinki Institute of Life Science (HiLIFE), University of Helsinki, Helsinki, Finland
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Berkes M, Bialystok E. Bilingualism as a Contributor to Cognitive Reserve: What it Can do and What it Cannot do. Am J Alzheimers Dis Other Demen 2022; 37:15333175221091417. [PMID: 35470704 PMCID: PMC10581104 DOI: 10.1177/15333175221091417] [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] [Indexed: 11/15/2022]
Abstract
In the absence of effective pharmacological interventions for the prevention of dementia, attention has turned to lifestyle factors that contribute to cognitive reserve. Although cognitive reserve cannot prevent the occurrence of disease, the trajectory is different for high reserve and low reserve patients, giving more time for independent living to high reserve individuals. We argue that lifelong bilingual experience meets the criteria for an experience that confers cognitive reserve, although neural reserve, a related concept, is more difficult to validate. Bilingual patients show symptoms at a later stage of disease and decline more rapidly than comparable monolingual patients. These patterns are considered in terms of evidence from behavioural, imaging and epidemiological studies. Finally, the role of bilingualism in protecting against symptoms of some forms of dementia are discussed in the context of other protective factors and the limits of this reserve approach in dealing with the consequences of dementia.
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Hyun J, Hall CB, Katz MJ, Derby CA, Lipnicki DM, Crawford JD, Guaita A, Vaccaro R, Davin A, Kim KW, Han JW, Bae JB, Röhr S, Riedel-Heller S, Ganguli M, Jacobsen E, Hughes TF, Brodaty H, Kochan NA, Trollor J, Lobo A, Santabarbara J, Lopez-Anton R, Sachdev PS, Lipton RB. Education, Occupational Complexity, and Incident Dementia: A COSMIC Collaborative Cohort Study. J Alzheimers Dis 2022; 85:179-196. [PMID: 34776437 PMCID: PMC8748312 DOI: 10.3233/jad-210627] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
BACKGROUND Education and occupational complexity are main sources of mental engagement during early life and adulthood respectively, but research findings are not conclusive regarding protective effects of these factors against late-life dementia. OBJECTIVE This project aimed to examine the unique contributions of education and occupational complexity to incident dementia, and to assess the mediating effects of occupational complexity on the association between education and dementia across diverse cohorts. METHOD We used data from 10,195 participants (median baseline age = 74.1, range = 58∼103), representing 9 international datasets from 6 countries over 4 continents. Using a coordinated analysis approach, the accelerated failure time model was applied to each dataset, followed by meta-analysis. In addition, causal mediation analyses were performed. RESULT The meta-analytic results indicated that both education and occupational complexity were independently associated with increased dementia-free survival time, with 28%of the effect of education mediated by occupational complexity. There was evidence of threshold effects for education, with increased dementia-free survival time associated with 'high school completion' or 'above high school' compared to 'middle school completion or below'. CONCLUSION Using datasets from a wide range of geographical regions, we found that both early life education and adulthood occupational complexity were independently predictive of dementia. Education and occupational experiences occur during early life and adulthood respectively, and dementia prevention efforts could thus be made at different stages of the life course.
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Affiliation(s)
- Jinshil Hyun
- Saul R. Korey Department of Neurology, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Charles B. Hall
- Saul R. Korey Department of Neurology, Albert Einstein College of Medicine, Bronx, NY, USA
- Department of Epidemiology & Population Health, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Mindy J. Katz
- Saul R. Korey Department of Neurology, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Carol A. Derby
- Saul R. Korey Department of Neurology, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Darren M. Lipnicki
- Centre for Healthy Brain Ageing, University of New South Wales, Sydney, New South Wales, Australia
| | - John D. Crawford
- Centre for Healthy Brain Ageing, University of New South Wales, Sydney, New South Wales, Australia
| | | | | | | | - Ki Woong Kim
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, South Korea
| | - Ji Won Han
- Department of Psychiatry, College of Medicine, Seoul National University, Seoul, South Korea
| | - Jong Bin Bae
- Department of Brain & Cognitive Sciences, Seoul National University, Seoul, South Korea
| | - Susanne Röhr
- Institute of Social Medicine, Occupational Health and Public Health (ISAP), University of Leipzig, Leipzig, Germany
- Global Brain Health Institute (GBHI), Trinity College Dublin, Dublin, Ireland
| | - Steffi Riedel-Heller
- Institute of Social Medicine, Occupational Health and Public Health (ISAP), University of Leipzig, Leipzig, Germany
| | | | | | | | - Henry Brodaty
- Centre for Healthy Brain Ageing, University of New South Wales, Sydney, New South Wales, Australia
- Dementia Collaborative Research Centre, University of New South Wales, Sydney, New South Wales, Australia
| | - Nicole A. Kochan
- Centre for Healthy Brain Ageing, University of New South Wales, Sydney, New South Wales, Australia
| | - Julian Trollor
- Centre for Healthy Brain Ageing, University of New South Wales, Sydney, New South Wales, Australia
- Department of Developmental Disability Neuropsychiatry, School of Psychiatry, University of New South Wales, Sydney, New South Wales, Australia
| | - Antonio Lobo
- Instituto de Investigación Sanitaria Aragón, Zaragoza, Spain
- Centro de Investigación Biomédica en Red de Salud Mental, Ministry of Science and Innovation, Spain
- Department of Medicine and Psychiatry, Universidad de Zaragoza, Zaragoza, Spain
| | - Javier Santabarbara
- Instituto de Investigación Sanitaria Aragón, Zaragoza, Spain
- Centro de Investigación Biomédica en Red de Salud Mental, Ministry of Science and Innovation, Spain
- Department of Preventive Medicine and Public Health, University of Zaragoza, Zaragoza, Spain
| | - Raul Lopez-Anton
- Instituto de Investigación Sanitaria Aragón, Zaragoza, Spain
- Centro de Investigación Biomédica en Red de Salud Mental, Ministry of Science and Innovation, Spain
- Department of Psychology and Sociology, Universidad de Zaragoza, Teruel, Spain
| | - Perminder S. Sachdev
- Centre for Healthy Brain Ageing, University of New South Wales, Sydney, New South Wales, Australia
- Dementia Collaborative Research Centre, University of New South Wales, Sydney, New South Wales, Australia
| | - Richard B. Lipton
- Saul R. Korey Department of Neurology, Albert Einstein College of Medicine, Bronx, NY, USA
- Department of Epidemiology & Population Health, Albert Einstein College of Medicine, Bronx, NY, USA
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13
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Lee M, Hughes TM, George KM, Griswold ME, Sedaghat S, Simino J, Lutsey PL. Education and Cardiovascular Health as Effect Modifiers of APOE ε4 on Dementia: The Atherosclerosis Risk in Communities (ARIC) Study. J Gerontol A Biol Sci Med Sci 2021; 77:1199-1207. [PMID: 34614170 PMCID: PMC9159668 DOI: 10.1093/gerona/glab299] [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: 05/24/2021] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Both education and cardiovascular risk factors are strongly associated with dementia risk. However, it is not clear whether these associations persist or vary among individuals with high genetic risk for Alzheimer's Disease. We examined the interactive relationship between lifestyle and genetic dementia risk factors in a prospective cohort study. METHODS Our data came from the Atherosclerosis Risk in Communities study participants (n=13,715; baseline age 45-64; 25% Black; 55% female), who were followed for incident dementia from 1987 through 2017. We used Cox proportional hazard models to estimate the risk of dementia (ascertained through in-person examination, telephone cognitive screeners, and/or hospital and death records) associated with baseline education and cardiovascular risk factors (measured using the American Heart Association's "Life Simple 7") among ε4 carriers and non-carriers separately. We also examined differences by race and sex. RESULTS 2,226 incident dementia cases occurred over a median 25 years of follow-up. Lower educational attainment and poorer cardiovascular health were associated with greater risk of incident dementia. There was an education by APOE status interaction (p=0.005) whereby the association of education and dementia was weaker for ε4 carriers (HR college graduates vs. less than high school: 0.71 (0.59-0.84) than non-carriers (0.54 (0.47-0.63)). There was no interaction between APOE status and cardiovascular health on dementia risk. These relationships did not vary significantly by race or sex. CONCLUSIONS Education and cardiovascular health were associated with lower dementia risk regardless of APOE genotype, though the protective effects of education were somewhat diminished among ε4 carriers.
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Affiliation(s)
- Mark Lee
- Department of Sociology, University of Minnesota, Minneapolis, MN, USA
| | - Timothy M Hughes
- Department of Internal Medicine, Wake Forest School of Medicine, Winston-Salem, NC, USA.,Alzheimer's Disease Research Center, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Kristen M George
- Department of Public Health Sciences, University of California - Davis, Davis, CA, USA
| | - Michael E Griswold
- School of Medicine, University of Mississippi Medical Center, Jackson, MS, USA
| | - Sanaz Sedaghat
- Division of Epidemiology and Community Health, University of Minnesota School of Public Health, Minneapolis, MN USA
| | - Jeannette Simino
- Department of Data Science, School of Population Health, University of Mississippi Medical Center, Jackson, MS, USA.,MIND Center, University of Mississippi Medical Center, Jackson, MS, USA
| | - Pamela L Lutsey
- Division of Epidemiology and Community Health, University of Minnesota School of Public Health, Minneapolis, MN USA
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14
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Frank M, Hensel J, Baak L, Schramm S, Dragano N, Weimar C, Hoffmann P, Nöthen MM, Erbel R, Jöckel KH, Jokisch M, Schmidt B. Interaction of Alzheimer's Disease-Associated Genetic Risk with Indicators of Socioeconomic Position on Mild Cognitive Impairment in the Heinz Nixdorf Recall Study. J Alzheimers Dis 2021; 82:1715-1725. [PMID: 34219719 PMCID: PMC8461721 DOI: 10.3233/jad-210244] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND The apolipoprotein E (APOE) ɛ4 allele is reported to be a strong genetic risk factor for mild cognitive impairment (MCI) and Alzheimer's disease (AD). Additional genetic loci have been detected that influence the risk for late-onset AD. As socioeconomic position (SEP) is also strongly related to cognitive decline, SEP has been suggested to be a possible modifier of the genetic effect on MCI. OBJECTIVE To investigate whether APOEɛ4 and a genetic sum score of AD-associated risk alleles (GRSAD) interact with SEP indicators to affect MCI in a population-based cohort. METHODS Using data of 3,834 participants of the Heinz Nixdorf Recall Study, APOEɛ4 and GRSAD by SEP interactions were assessed using logistic regression models, as well as SEP-stratified genetic association analysis. Interaction on additive scale was calculated using the relative excess risk due to interaction (RERI). All analysis were additionally stratified by sex. RESULTS Indication for interaction on the additive scale was found between APOEɛ4 and low education on MCI (RERI: 0.52 [95% confidence interval (CI): 0.01; 1.03]). The strongest genetic effects of the APOEɛ4 genotype on MCI were observed in groups of low education (Odds ratio (OR): 1.46 [95% CI: 0.79; 2.63] for≤10 years of education versus OR: 1.00 [95% CI: 0.43; 2.14] for≥18 years of education). Sex stratified results showed stronger effects in women. No indication for interaction between the GRSAD and SEP indicators on MCI was observed. CONCLUSION Results indicate that low education may have an impact on APOEɛ4 expression on MCI, especially among women.
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Affiliation(s)
- Mirjam Frank
- Institute for Medical Informatics, Biometry and Epidemiology, University of Duisburg-Essen, Essen, Germany
| | - Jonas Hensel
- Institute for Medical Informatics, Biometry and Epidemiology, University of Duisburg-Essen, Essen, Germany
| | - Lisa Baak
- Institute for Medical Informatics, Biometry and Epidemiology, University of Duisburg-Essen, Essen, Germany
| | - Sara Schramm
- Institute for Medical Informatics, Biometry and Epidemiology, University of Duisburg-Essen, Essen, Germany
| | - Nico Dragano
- Institute of Medical Sociology, Centre for Health and Society, Medical Faculty, University of Düsseldorf, Düsseldorf, Germany
| | - Christian Weimar
- Institute for Medical Informatics, Biometry and Epidemiology, University of Duisburg-Essen, Essen, Germany.,BDH-clinic Elzach, Elzach, Germany
| | - Per Hoffmann
- Institute of Human Genetics, University of Bonn, School of Medicine & University Hospital Bonn, Bonn, Germany
| | - Markus M Nöthen
- Institute of Human Genetics, University of Bonn, School of Medicine & University Hospital Bonn, Bonn, Germany
| | - Raimund Erbel
- Institute for Medical Informatics, Biometry and Epidemiology, University of Duisburg-Essen, Essen, Germany
| | - Karl-Heinz Jöckel
- Institute for Medical Informatics, Biometry and Epidemiology, University of Duisburg-Essen, Essen, Germany
| | - Martha Jokisch
- Department of Neurology, University Hospital of Essen, University of Duisburg-Essen, Essen, Germany
| | - Börge Schmidt
- Institute for Medical Informatics, Biometry and Epidemiology, University of Duisburg-Essen, Essen, Germany
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15
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Angelopoulou E, Paudel YN, Papageorgiou SG, Piperi C. APOE Genotype and Alzheimer's Disease: The Influence of Lifestyle and Environmental Factors. ACS Chem Neurosci 2021; 12:2749-2764. [PMID: 34275270 DOI: 10.1021/acschemneuro.1c00295] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
Alzheimer's disease (AD) is the most common neurodegenerative disorder with obscure pathogenesis and no disease-modifying therapy to date. AD is multifactorial disease that develops from the complex interplay of genetic factors and environmental exposures. The E4 allele of the gene encoding apolipoprotein E (APOE) is the most common genetic risk factor for AD, whereas the E2 allele acts in a protective manner. A growing amount of epidemiological evidence suggests that several lifestyle habits and environmental factors may interact with APOE alleles to synergistically affect the risk of AD development. Among them, physical exercise, dietary habits including fat intake and ketogenic diet, higher education, traumatic brain injury, cigarette smoking, coffee consumption, alcohol intake, and exposure to pesticides and sunlight have gained increasing attention. Although the current evidence is inconsistent, it seems that younger APOE4 carriers in preclinical stages may benefit mostly from preventive lifestyle interventions, whereas older APOE4 noncarriers with dementia may show the most pronounced effects. The large discrepancies between the epidemiological studies may be attributed to differences in the sample sizes, the demographic characteristics of the participants, including age and sex, the methodological design, and potential related exposures and comorbidities as possible cofounding factors. In this Review, we aim to discuss available evidence of the prominent APOE genotype-environment interactions in regard to cognitive decline with a focus on AD, providing an overview of the current landscape in this field and suggesting future directions.
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Affiliation(s)
- Efthalia Angelopoulou
- Department of Biological Chemistry, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
- Department of Neurology, Eginition University Hospital, Medical School, National and Kapodistrian University of Athens, 11528 Athens, Greece
| | - Yam Nath Paudel
- Neuropharmacology Research Laboratory, Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Bandar Sunway, 47500 Selangor, Malaysia
| | - Sokratis G. Papageorgiou
- Department of Biological Chemistry, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
| | - Christina Piperi
- Department of Biological Chemistry, Medical School, National and Kapodistrian University of Athens, 11527 Athens, Greece
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16
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Chang YL, Zhuo YY, Luo DH. Education Moderates the Negative Effect of Apolipoprotein E ɛ4 on Response Inhibition in Older Adults. J Alzheimers Dis 2021; 82:1147-1157. [PMID: 34151797 DOI: 10.3233/jad-210183] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Studies have reported that apolipoprotein E epsilon 4 (APOE ɛ4) has adverse effects on executive functions (EFs) in late adulthood. However, the results have been inconsistent. Insufficient measurements of executive functioning, uncontrolled clinical and demographic confounders, and moderation effects from other environmental factors are suspected to account for the inconsistency. OBJECTIVE This study used aggregate measures to examine the effects of APOE ɛ4 on four components of EFs, namely switching, working memory, inhibition, and reasoning. We further investigated whether high educational attainment, a proxy measure for cognitive reserve, moderates the adverse effects of ɛ4 on EFs. METHODS Cognitively unimpaired older participants were divided into groups based on APOE genotype and into subgroups based on educational attainment level. The demographic and clinical variables were matched between the groups. Four core components of the EFs were measured using a relatively comprehensive battery. RESULTS The results revealed that although no main effect of the APOE genotype was observed across the four EF components, the potentially adverse effects of ɛ4 on inhibition were alleviated by high educational attainment. A main effect of education on the reasoning component was also observed. The moderation analysis revealed that for older adults with 12 years of education or fewer, the relationship between the APOE ɛ4 genotype and inhibition performance became increasingly negative. CONCLUSION This study highlights the distinctive role of response inhibition in the gene-environment interaction and underlines the importance of considering factors of both nature and nurture to understand the complex process of cognitive aging.
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Affiliation(s)
- Yu-Ling Chang
- Department of Psychology, College of Science, National Taiwan University, Taipei, Taiwan.,Neurobiology and Cognitive Science Center, National Taiwan University, Taipei, Taiwan.,Department of Neurology, National Taiwan University Hospital, College of Medicine, National Taiwan University, Taipei, Taiwan.,Center for Artificial Intelligence and Advanced Robotics, National Taiwan University, Taipei, Taiwan
| | - Yi-Yuan Zhuo
- Department of Psychology, College of Science, National Taiwan University, Taipei, Taiwan
| | - Di-Hua Luo
- Department of Psychology, College of Science, National Taiwan University, Taipei, Taiwan
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17
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Boyle R, Knight SP, De Looze C, Carey D, Scarlett S, Stern Y, Robertson IH, Kenny RA, Whelan R. Verbal intelligence is a more robust cross-sectional measure of cognitive reserve than level of education in healthy older adults. Alzheimers Res Ther 2021; 13:128. [PMID: 34253231 PMCID: PMC8276413 DOI: 10.1186/s13195-021-00870-z] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Accepted: 06/28/2021] [Indexed: 01/02/2023]
Abstract
BACKGROUND Cognitive reserve is most commonly measured using socio-behavioural proxy variables. These variables are easy to collect, have a straightforward interpretation, and are widely associated with reduced risk of dementia and cognitive decline in epidemiological studies. However, the specific proxies vary across studies and have rarely been assessed in complete models of cognitive reserve (i.e. alongside both a measure of cognitive outcome and a measure of brain structure). Complete models can test independent associations between proxies and cognitive function in addition to the moderation effect of proxies on the brain-cognition relationship. Consequently, there is insufficient empirical evidence guiding the choice of proxy measures of cognitive reserve and poor comparability across studies. METHOD In a cross-sectional study, we assessed the validity of 5 common proxies (education, occupational complexity, verbal intelligence, leisure activities, and exercise) and all possible combinations of these proxies in 2 separate community-dwelling older adult cohorts: The Irish Longitudinal Study on Ageing (TILDA; N = 313, mean age = 68.9 years, range = 54-88) and the Cognitive Reserve/Reference Ability Neural Network Study (CR/RANN; N = 234, mean age = 64.49 years, range = 50-80). Fifteen models were created with 3 brain structure variables (grey matter volume, hippocampal volume, and mean cortical thickness) and 5 cognitive variables (verbal fluency, processing speed, executive function, episodic memory, and global cognition). RESULTS No moderation effects were observed. There were robust positive associations with cognitive function, independent of brain structure, for 2 individual proxies (verbal intelligence and education) and 16 composites (i.e. combinations of proxies). Verbal intelligence was statistically significant in all models. Education was significant only in models with executive function as the cognitive outcome variable. Three robust composites were observed in more than two-thirds of brain-cognition models: the composites of (1) occupational complexity and verbal intelligence, (2) education and verbal intelligence, and (3) education, occupational complexity, and verbal intelligence. However, no composite had larger average effects nor was more robust than verbal intelligence alone. CONCLUSION These results support the use of verbal intelligence as a proxy measure of CR in cross-sectional studies of cognitively healthy older adults.
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Affiliation(s)
- R Boyle
- Trinity College Institute of Neuroscience, Trinity College Dublin, Dublin, Ireland
| | - S P Knight
- The Irish Longitudinal Study on Ageing, Trinity College Dublin, Dublin, Ireland
| | - C De Looze
- The Irish Longitudinal Study on Ageing, Trinity College Dublin, Dublin, Ireland
| | - D Carey
- The Irish Longitudinal Study on Ageing, Trinity College Dublin, Dublin, Ireland
| | - S Scarlett
- The Irish Longitudinal Study on Ageing, Trinity College Dublin, Dublin, Ireland
| | - Y Stern
- Cognitive Neuroscience Division, Department of Neurology, Columbia University, New York City, USA
| | - I H Robertson
- Trinity College Institute of Neuroscience, Trinity College Dublin, Dublin, Ireland
- Global Brain Health Institute, Trinity College Dublin, Dublin, Ireland
| | - R A Kenny
- The Irish Longitudinal Study on Ageing, Trinity College Dublin, Dublin, Ireland
- Mercer's Institute for Successful Ageing, St. James's Hospital, Dublin, Ireland
| | - R Whelan
- Trinity College Institute of Neuroscience, Trinity College Dublin, Dublin, Ireland.
- Global Brain Health Institute, Trinity College Dublin, Dublin, Ireland.
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18
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Zia A, Pourbagher-Shahri AM, Farkhondeh T, Samarghandian S. Molecular and cellular pathways contributing to brain aging. BEHAVIORAL AND BRAIN FUNCTIONS : BBF 2021; 17:6. [PMID: 34118939 PMCID: PMC8199306 DOI: 10.1186/s12993-021-00179-9] [Citation(s) in RCA: 59] [Impact Index Per Article: 19.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Accepted: 05/27/2021] [Indexed: 12/12/2022]
Abstract
Aging is the leading risk factor for several age-associated diseases such as neurodegenerative diseases. Understanding the biology of aging mechanisms is essential to the pursuit of brain health. In this regard, brain aging is defined by a gradual decrease in neurophysiological functions, impaired adaptive neuroplasticity, dysregulation of neuronal Ca2+ homeostasis, neuroinflammation, and oxidatively modified molecules and organelles. Numerous pathways lead to brain aging, including increased oxidative stress, inflammation, disturbances in energy metabolism such as deregulated autophagy, mitochondrial dysfunction, and IGF-1, mTOR, ROS, AMPK, SIRTs, and p53 as central modulators of the metabolic control, connecting aging to the pathways, which lead to neurodegenerative disorders. Also, calorie restriction (CR), physical exercise, and mental activities can extend lifespan and increase nervous system resistance to age-associated neurodegenerative diseases. The neuroprotective effect of CR involves increased protection against ROS generation, maintenance of cellular Ca2+ homeostasis, and inhibition of apoptosis. The recent evidence about the modem molecular and cellular methods in neurobiology to brain aging is exhibiting a significant potential in brain cells for adaptation to aging and resistance to neurodegenerative disorders.
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Affiliation(s)
- Aliabbas Zia
- Department of Biochemistry, Institute of Biochemistry and Biophysics (IBB), University of Tehran, Tehran, Iran
| | - Ali Mohammad Pourbagher-Shahri
- Medical Toxicology and Drug Abuse Research Center (MTDRC), Birjand University of Medical Sciences (BUMS), 9717853577 Birjand, Iran
| | - Tahereh Farkhondeh
- Cardiovascular Diseases Research Center, Birjand University of Medical Sciences, Birjand, Iran
- Faculty of Pharmacy, Birjand University of Medical Sciences, Birjand, Iran
| | - Saeed Samarghandian
- Noncommunicable Diseases Research Center, Neyshabur University of Medical Sciences, Neyshabur, Iran
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19
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Rodriguez FS. Life-Course Pathways to Cognitive Aging: The Significance of Intellectual Stimulation in the Form of Education and Occupation for Public Policy and Prevention Plans. Front Psychiatry 2021; 12:719609. [PMID: 34366944 PMCID: PMC8339265 DOI: 10.3389/fpsyt.2021.719609] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2021] [Accepted: 06/29/2021] [Indexed: 11/30/2022] Open
Affiliation(s)
- Francisca S Rodriguez
- German Center for Neurodegenerative Diseases (DZNE), RG Psychosocial Epidemiology and Public Health, Greifswald, Germany.,Center for Cognitive Science, University of Kaiserslautern, Kaiserslautern, Germany.,Institute of Social Medicine, Occupational Medicine and Public Health, University of Leipzig, Leipzig, Germany
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20
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Association of Late Life Depression, (Non-) Modifiable Risk and Protective Factors with Dementia and Alzheimer's Disease: Literature Review on Current Evidences, Preventive Interventions and Possible Future Trends in Prevention and Treatment of Dementia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17207475. [PMID: 33066592 PMCID: PMC7602449 DOI: 10.3390/ijerph17207475] [Citation(s) in RCA: 36] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Revised: 10/04/2020] [Accepted: 10/06/2020] [Indexed: 02/07/2023]
Abstract
The number of people living with dementia and Alzheimer’s disease is growing rapidly, making dementia one of the biggest challenges for this century. Many studies have indicated that depression plays an important role in development of dementia, including Alzheimer’s disease; depression, especially, during the late life may either increase the risk of dementia or even being its prodromal stage. Despite a notably large number of carried observational studies and/or clinical trials, the association between the late life depression and dementia remains, due to the complexity of their relationship, still unclear. Moreover, during past two decades multiple other (non-)modifiable risk and possibly protective factors such as the hypertension, social engagement, obesity, level of education or physical (in)activity have been identified and their relationship with the risk for development of dementia and Alzheimer’s disease has been extensively studied. It has been proposed that to understand mechanisms of dementia and Alzheimer’s disease pathogeneses require their multifactorial nature represented by these multiple factors to be considered. In this review, we first summarize the recent literature findings on roles of the late life depression and the other known (non-)modifiable risk and possibly protective factors in development of dementia and Alzheimer’s disease. Then, we provide evidences supporting hypotheses that (i) depressive syndromes in late life may indicate the prodromal stage of dementia (Alzheimer’s disease) and, (ii) the interplay among the multiple (non-)modifiable risk and protective factors should be considered to gain a better understanding of dementia and Alzheimer’s disease pathogeneses. We also discuss the evidences of recently established interventions considered to prevent or delay the prodromes of dementia and provide the prospective future directions in prevention and treatment of dementia and Alzheimer’s disease using both the single-domain and multidomain interventions.
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21
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Hasselgren C, Ekbrand H, Halleröd B, Mellqvist Fässberg M, Zettergren A, Johansson L, Skoog I, Dellve L. Sex differences in dementia: on the potentially mediating effects of educational attainment and experiences of psychological distress. BMC Psychiatry 2020; 20:434. [PMID: 32887574 PMCID: PMC7487622 DOI: 10.1186/s12888-020-02820-9] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2019] [Accepted: 08/13/2020] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND Old-age dementias are known to disproportionally affect women as well as individuals with low educational attainment. The higher lifetime risk of dementia among women is usually attributed to their longer life expectancy. However, the impact of sex, and subsequent gender inequity, is likely to be more multifaceted than this explanation implies. Not least because of historical inequities in access to education between the sexes and the gender and socio-economic gradients in risk factors such as stress, depression and social isolation. Consequently, the present study sought to test whether differences in educational attainment and experiences of general psychological distress mediate the association between female sex and dementia. METHODS The study utilizes data obtained through the Gothenburg H70 Birth Cohort Study and the Prospective Populations Study on Women (n = 892). Data were analysed using Confirmatory Factor Analysis (CFA) and Structural Equation Modelling (SEM) with Weighted Least Squares Means and Variance adjusted (WLSMV) estimation. General psychological distress was indicated by a latent variable and constructed from five manifest items (previous depression, stress, self-esteem, chronic loneliness and satisfaction with social situation) that were all measured at baseline. RESULTS While the results could not corroborate that education directly mediates the effect of sex on dementia, level of distress was predicted by both female sex (0.607, p < .001) and education (- 0.166, p < .01) and, in turn, shown to be significantly associated with dementia (0.167, p < .05), also after controlling for confounders. When time from baseline to diagnosis was increased through sequential exclusion of dementia cases, the effect of distress on dementia was no longer significant. CONCLUSION The overall findings suggest that social (dis) advantage predicts general psychological distress, which thereby constitutes a potential, and rarely acknowledged, pathway between female sex, education, and dementia. They further underline the importance of attending to both education and distress as 'gendered' phenomena when considering the nature of their associations with dementia. However, the possibility of reverse causality bias must be acknowledged and the need for longitudinal studies with longer follow-up stressed.
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Affiliation(s)
- Caroline Hasselgren
- Department of Sociology and Work Science, University of Gothenburg, Box 720, 405 30, Gothenburg, Sweden.
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, Centre for Ageing and Health - AgeCap, University of Gothenburg, Mölndal, Sweden.
| | - Hans Ekbrand
- Department of Sociology and Work Science, University of Gothenburg, Box 720, 405 30, Gothenburg, Sweden
| | - Björn Halleröd
- Department of Sociology and Work Science, University of Gothenburg, Box 720, 405 30, Gothenburg, Sweden
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, Centre for Ageing and Health - AgeCap, University of Gothenburg, Mölndal, Sweden
| | - Madeleine Mellqvist Fässberg
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, Centre for Ageing and Health - AgeCap, University of Gothenburg, Mölndal, Sweden
| | - Anna Zettergren
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, Centre for Ageing and Health - AgeCap, University of Gothenburg, Mölndal, Sweden
| | - Lena Johansson
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, Centre for Ageing and Health - AgeCap, University of Gothenburg, Mölndal, Sweden
| | - Ingmar Skoog
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, Centre for Ageing and Health - AgeCap, University of Gothenburg, Mölndal, Sweden
| | - Lotta Dellve
- Department of Sociology and Work Science, University of Gothenburg, Box 720, 405 30, Gothenburg, Sweden
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, Centre for Ageing and Health - AgeCap, University of Gothenburg, Mölndal, Sweden
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22
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Chen Y, Lv C, Li X, Zhang J, Chen K, Liu Z, Li H, Fan J, Qin T, Luo L, Zhang Z. The positive impacts of early-life education on cognition, leisure activity, and brain structure in healthy aging. Aging (Albany NY) 2020; 11:4923-4942. [PMID: 31315089 PMCID: PMC6682517 DOI: 10.18632/aging.102088] [Citation(s) in RCA: 43] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2019] [Accepted: 07/04/2019] [Indexed: 12/17/2022]
Abstract
Education in people's early lives are positively related to their cognitive function, but its modulating effects on detailed cognition domains, its interaction with leisure activities and the associated brain changes have yet to be investigated. This report used data from 659 cognitively normal community dwelling elderly who completed neuropsychological tests, leisure activities measurement, and 78 of them underwent structural and diffusion MRI scans. We found that: (i) the highly educated elderly had a better cognitive functioning in multi-domains, higher frequencies of participation in knowledge-related leisure activities, and slower age-related reductions of executive function; (ii) the intellectual and social types of leisure activities mediated the association between education and multiple cognitive domains, including memory, language, attention and executive function; (iii) there was a significant age by education interaction on the gray matter volume of the anterior brain regions and white matter integrity; and (iv) the interaction between age and education affected cognition indirectly through white matter integrity analyzed using structural equation model. Overall, our results revealed that high education in early life served as a protective factor in aging that may help to postpone cognitive and brain reserve decline in cognitively normal aging.
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Affiliation(s)
- Yaojing Chen
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing, P. R. China.,BABRI Centre, Beijing Normal University, Beijing, P. R. China
| | - Chenlong Lv
- Teaching and Research Section, Graduate School, Academy of Military Sciences, Beijing, P. R. China
| | - Xin Li
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing, P. R. China.,BABRI Centre, Beijing Normal University, Beijing, P. R. China
| | - Junying Zhang
- BABRI Centre, Beijing Normal University, Beijing, P. R. China.,Institute of Basic Research in Clinical Medicine, China Academy of Chinese Medical Sciences, Beijing, P. R. China
| | - Kewei Chen
- Banner Alzheimer's Institute, Phoenix, AZ 85006, USA
| | - Zhongwan Liu
- Department of Psychology, The University of Hong Kong, Hong Kong, China
| | - He Li
- BABRI Centre, Beijing Normal University, Beijing, P. R. China.,Institute of Basic Research in Clinical Medicine, China Academy of Chinese Medical Sciences, Beijing, P. R. China
| | - Jialing Fan
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing, P. R. China.,BABRI Centre, Beijing Normal University, Beijing, P. R. China
| | - Ting Qin
- BABRI Centre, Beijing Normal University, Beijing, P. R. China
| | - Liang Luo
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing, P. R. China
| | - Zhanjun Zhang
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing, P. R. China.,BABRI Centre, Beijing Normal University, Beijing, P. R. China
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23
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Lövdén M, Fratiglioni L, Glymour MM, Lindenberger U, Tucker-Drob EM. Education and Cognitive Functioning Across the Life Span. Psychol Sci Public Interest 2020; 21:6-41. [PMID: 32772803 PMCID: PMC7425377 DOI: 10.1177/1529100620920576] [Citation(s) in RCA: 370] [Impact Index Per Article: 92.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Cognitive abilities are important predictors of educational and occupational performance, socioeconomic attainment, health, and longevity. Declines in cognitive abilities are linked to impairments in older adults' everyday functions, but people differ from one another in their rates of cognitive decline over the course of adulthood and old age. Hence, identifying factors that protect against compromised late-life cognition is of great societal interest. The number of years of formal education completed by individuals is positively correlated with their cognitive function throughout adulthood and predicts lower risk of dementia late in life. These observations have led to the propositions that prolonging education might (a) affect cognitive ability and (b) attenuate aging-associated declines in cognition. We evaluate these propositions by reviewing the literature on educational attainment and cognitive aging, including recent analyses of data harmonized across multiple longitudinal cohort studies and related meta-analyses. In line with the first proposition, the evidence indicates that educational attainment has positive effects on cognitive function. We also find evidence that cognitive abilities are associated with selection into longer durations of education and that there are common factors (e.g., parental socioeconomic resources) that affect both educational attainment and cognitive development. There is likely reciprocal interplay among these factors, and among cognitive abilities, during development. Education-cognitive ability associations are apparent across the entire adult life span and across the full range of education levels, including (to some degree) tertiary education. However, contrary to the second proposition, we find that associations between education and aging-associated cognitive declines are negligible and that a threshold model of dementia can account for the association between educational attainment and late-life dementia risk. We conclude that educational attainment exerts its influences on late-life cognitive function primarily by contributing to individual differences in cognitive skills that emerge in early adulthood but persist into older age. We also note that the widespread absence of educational influences on rates of cognitive decline puts constraints on theoretical notions of cognitive aging, such as the concepts of cognitive reserve and brain maintenance. Improving the conditions that shape development during the first decades of life carries great potential for improving cognitive ability in early adulthood and for reducing public-health burdens related to cognitive aging and dementia.
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Affiliation(s)
- Martin Lövdén
- Aging Research Center, Department of Neurobiology, Care Sciences, and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden
- Department of Psychology, University of Gothenburg, Gothenburg, Sweden
| | - Laura Fratiglioni
- Aging Research Center, Department of Neurobiology, Care Sciences, and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden
- Stockholm Gerontology Research Center, Stockholm, Sweden
| | - M. Maria Glymour
- Department of Epidemiology and Biostatistics, University of California, San Francisco
| | - Ulman Lindenberger
- Center for Lifespan Psychology, Max Planck Institute for Human Development, Berlin, Germany
- Max Planck UCL Centre for Computational Psychiatry and Ageing Research, Berlin, Germany, and London, United Kingdom
| | - Elliot M. Tucker-Drob
- Department of Psychology and Population Research Center, University of Texas at Austin
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24
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Arenaza-Urquijo EM, Przybelski SA, Machulda MM, Knopman DS, Lowe VJ, Mielke MM, Reddy AL, Geda YE, Jack CR, Petersen RC, Vemuri P. Better stress coping associated with lower tau in amyloid-positive cognitively unimpaired older adults. Neurology 2020; 94:e1571-e1579. [PMID: 31964689 PMCID: PMC7251516 DOI: 10.1212/wnl.0000000000008979] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2019] [Accepted: 10/16/2019] [Indexed: 12/17/2022] Open
Abstract
OBJECTIVE Research in animals has shown that chronic stress exacerbates tau pathology. In humans, psychological stress has been associated with higher risk of Alzheimer disease clinical syndrome. The objective of this cross-sectional study was to assess the hypothesis that stress coping ability (assessed via the Brief Resilience Scale [BRS]) is associated with tau burden and to evaluate whether these associations differed by sex and amyloid status (A+/A-) in cognitively unimpaired (CU) older adults. METHODS We included 225 CU participants (mean age 70.4 ± 10.2 years, 48% female) enrolled in the population-based Mayo Clinic Study of Aging who completed the BRS and underwent amyloid-PET (Pittsburgh compound B-PET) and tau-PET (AV1451-PET). We fitted multiple regression and analysis of covariance models to assess the associations between BRS and tau-PET and the interaction with amyloid status and sex. We focused on entorhinal cortex (ERC) tau burden and also performed voxel-wise analyses. Age, sex, education, depression, and anxiety were considered as covariates. RESULTS Higher stress coping ability was associated with lower tau burden in the medial temporal lobe (including ERC) and occipito-temporal and cuneal/precuneal cortices. The association was present in both A+ and A- but weaker in A- CU older adults. There was an interaction between amyloid status and stress coping ability that was restricted to the medial temporal lobe tau such that A+ CU older adults with lower stress coping abilities showed higher tau. There were no significant interactions between stress coping and sex. CONCLUSIONS A faster termination of the stress response (higher coping ability) may limit the negative effects of stress on tau deposition. Conversely, lower stress coping ability may be an early sign of accumulating tau pathology. Longitudinal studies are warranted to clarify whether stress mechanisms act to exacerbate tau pathology or tau influences stress-related brain mechanisms and lowers the ability to cope with stress.
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Affiliation(s)
- Eider M Arenaza-Urquijo
- From the Departments of Radiology (E.M.A.-U., V.J.L., A.L.R., C.R.J., P.V.), Health Sciences Research (S.A.P., M.M.M.), Psychiatry and Psychology (M.M. Machulda), and Neurology (D.S.K., M.M. Mielke, R.C.P.), Mayo Clinic, Rochester, MN; and Department of Neurology (Y.E.G.), Mayo Clinic, Scottsdale, AZ
| | - Scott A Przybelski
- From the Departments of Radiology (E.M.A.-U., V.J.L., A.L.R., C.R.J., P.V.), Health Sciences Research (S.A.P., M.M.M.), Psychiatry and Psychology (M.M. Machulda), and Neurology (D.S.K., M.M. Mielke, R.C.P.), Mayo Clinic, Rochester, MN; and Department of Neurology (Y.E.G.), Mayo Clinic, Scottsdale, AZ
| | - Mary M Machulda
- From the Departments of Radiology (E.M.A.-U., V.J.L., A.L.R., C.R.J., P.V.), Health Sciences Research (S.A.P., M.M.M.), Psychiatry and Psychology (M.M. Machulda), and Neurology (D.S.K., M.M. Mielke, R.C.P.), Mayo Clinic, Rochester, MN; and Department of Neurology (Y.E.G.), Mayo Clinic, Scottsdale, AZ
| | - David S Knopman
- From the Departments of Radiology (E.M.A.-U., V.J.L., A.L.R., C.R.J., P.V.), Health Sciences Research (S.A.P., M.M.M.), Psychiatry and Psychology (M.M. Machulda), and Neurology (D.S.K., M.M. Mielke, R.C.P.), Mayo Clinic, Rochester, MN; and Department of Neurology (Y.E.G.), Mayo Clinic, Scottsdale, AZ
| | - Val J Lowe
- From the Departments of Radiology (E.M.A.-U., V.J.L., A.L.R., C.R.J., P.V.), Health Sciences Research (S.A.P., M.M.M.), Psychiatry and Psychology (M.M. Machulda), and Neurology (D.S.K., M.M. Mielke, R.C.P.), Mayo Clinic, Rochester, MN; and Department of Neurology (Y.E.G.), Mayo Clinic, Scottsdale, AZ
| | - Michelle M Mielke
- From the Departments of Radiology (E.M.A.-U., V.J.L., A.L.R., C.R.J., P.V.), Health Sciences Research (S.A.P., M.M.M.), Psychiatry and Psychology (M.M. Machulda), and Neurology (D.S.K., M.M. Mielke, R.C.P.), Mayo Clinic, Rochester, MN; and Department of Neurology (Y.E.G.), Mayo Clinic, Scottsdale, AZ
| | - Ashritha L Reddy
- From the Departments of Radiology (E.M.A.-U., V.J.L., A.L.R., C.R.J., P.V.), Health Sciences Research (S.A.P., M.M.M.), Psychiatry and Psychology (M.M. Machulda), and Neurology (D.S.K., M.M. Mielke, R.C.P.), Mayo Clinic, Rochester, MN; and Department of Neurology (Y.E.G.), Mayo Clinic, Scottsdale, AZ
| | - Yonas E Geda
- From the Departments of Radiology (E.M.A.-U., V.J.L., A.L.R., C.R.J., P.V.), Health Sciences Research (S.A.P., M.M.M.), Psychiatry and Psychology (M.M. Machulda), and Neurology (D.S.K., M.M. Mielke, R.C.P.), Mayo Clinic, Rochester, MN; and Department of Neurology (Y.E.G.), Mayo Clinic, Scottsdale, AZ
| | - Clifford R Jack
- From the Departments of Radiology (E.M.A.-U., V.J.L., A.L.R., C.R.J., P.V.), Health Sciences Research (S.A.P., M.M.M.), Psychiatry and Psychology (M.M. Machulda), and Neurology (D.S.K., M.M. Mielke, R.C.P.), Mayo Clinic, Rochester, MN; and Department of Neurology (Y.E.G.), Mayo Clinic, Scottsdale, AZ
| | - Ronald C Petersen
- From the Departments of Radiology (E.M.A.-U., V.J.L., A.L.R., C.R.J., P.V.), Health Sciences Research (S.A.P., M.M.M.), Psychiatry and Psychology (M.M. Machulda), and Neurology (D.S.K., M.M. Mielke, R.C.P.), Mayo Clinic, Rochester, MN; and Department of Neurology (Y.E.G.), Mayo Clinic, Scottsdale, AZ
| | - Prashanthi Vemuri
- From the Departments of Radiology (E.M.A.-U., V.J.L., A.L.R., C.R.J., P.V.), Health Sciences Research (S.A.P., M.M.M.), Psychiatry and Psychology (M.M. Machulda), and Neurology (D.S.K., M.M. Mielke, R.C.P.), Mayo Clinic, Rochester, MN; and Department of Neurology (Y.E.G.), Mayo Clinic, Scottsdale, AZ.
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25
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Wu J, Hasselgren C, Zettergren A, Zetterberg H, Blennow K, Skoog I, Halleröd B. The impact of social networks and APOE ε4 on dementia among older adults: tests of possible interactions. Aging Ment Health 2020; 24:395-404. [PMID: 30587010 DOI: 10.1080/13607863.2018.1531368] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Objectives: Emerging evidence suggests that social networks may protect against the development of dementia among older adults. In this study we analysed the association between social networks, the apolipoprotein E (APOE) ε4 allele, and dementia. We also investigated whether there were gender-specific patterns in this respect.Method: The analyses used population-based longitudinal data from Gothenburg, Sweden: the H70 Birth Cohort Study and the Prospective Population Study on Women (PPSW). A total of 580 individuals born in 1930 underwent semi-structured neuropsychiatric examinations in 2000-2001. Follow-up examinations were carried out in 2005-2006 and 2009-2010. The timing of dementia onset was analysed using Cox proportional hazards regression.Results: The presence of the APOE ε4 allele affected the risk of developing dementia in both genders. Among women, distant social networks had a protective effect on dementia, while among men the significant associations between close social networks and dementia did not remain after controlling for covariates. Significant interactions between social networks and the APOE ε4 allele were not found.Conclusion: Strong social networks do not seem to moderate the increased risk of dementia implied by the APOE ε4 allele. Nevertheless, our results underline the importance of strong social networks in postponing dementia onset and indicate that their impact may differ among men and women.
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Affiliation(s)
- Jing Wu
- Department of Sociology and Work Science, University of Gothenburg, Gothenburg, Sweden.,Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, Centre for Ageing and Health - AgeCap, University of Gothenburg, Mölndal, Sweden
| | - Caroline Hasselgren
- Department of Sociology and Work Science, University of Gothenburg, Gothenburg, Sweden.,Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, Centre for Ageing and Health - AgeCap, University of Gothenburg, Mölndal, Sweden
| | - Anna Zettergren
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, Centre for Ageing and Health - AgeCap, University of Gothenburg, Mölndal, Sweden
| | - Henrik Zetterberg
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, Centre for Ageing and Health - AgeCap, University of Gothenburg, Mölndal, Sweden.,Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden.,Department of Molecular Neuroscience, UCL Institute of Neurology, London, UK.,UK Dementia Research Institute, London, UK
| | - Kaj Blennow
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, Centre for Ageing and Health - AgeCap, University of Gothenburg, Mölndal, Sweden.,Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden
| | - Ingmar Skoog
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, Centre for Ageing and Health - AgeCap, University of Gothenburg, Mölndal, Sweden
| | - Björn Halleröd
- Department of Sociology and Work Science, University of Gothenburg, Gothenburg, Sweden.,Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, Centre for Ageing and Health - AgeCap, University of Gothenburg, Mölndal, Sweden
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26
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Walhovd KB, Fjell AM, Westerhausen R, Nyberg L, Ebmeier KP, Lindenberger U, Bartrés-Faz D, Baaré WF, Siebner HR, Henson R, Drevon CA, Strømstad Knudsen GP, Ljøsne IB, Penninx BW, Ghisletta P, Rogeberg O, Tyler L, Bertram L. Healthy minds 0–100 years: Optimising the use of European brain imaging cohorts (“Lifebrain”). Eur Psychiatry 2020; 50:47-56. [DOI: 10.1016/j.eurpsy.2017.12.006] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2017] [Revised: 10/04/2017] [Accepted: 10/05/2017] [Indexed: 12/26/2022] Open
Abstract
AbstractThe main objective of “Lifebrain” is to identify the determinants of brain, cognitive and mental (BCM) health at different stages of life. By integrating, harmonising and enriching major European neuroimaging studies across the life span, we will merge fine-grained BCM health measures of more than 5000 individuals. Longitudinal brain imaging, genetic and health data are available for a major part, as well as cognitive and mental health measures for the broader cohorts, exceeding 27,000 examinations in total. By linking these data to other databases and biobanks, including birth registries, national and regional archives, and by enriching them with a new online data collection and novel measures, we will address the risk factors and protective factors of BCM health. We will identify pathways through which risk and protective factors work and their moderators. Exploiting existing European infrastructures and initiatives, we hope to make major conceptual, methodological and analytical contributions towards large integrative cohorts and their efficient exploitation. We will thus provide novel information on BCM health maintenance, as well as the onset and course of BCM disorders. This will lay a foundation for earlier diagnosis of brain disorders, aberrant development and decline of BCM health, and translate into future preventive and therapeutic strategies. Aiming to improve clinical practice and public health we will work with stakeholders and health authorities, and thus provide the evidence base for prevention and intervention.
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27
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Talboom JS, Håberg A, De Both MD, Naymik MA, Schrauwen I, Lewis CR, Bertinelli SF, Hammersland C, Fritz MA, Myers AJ, Hay M, Barnes CA, Glisky E, Ryan L, Huentelman MJ. Family history of Alzheimer's disease alters cognition and is modified by medical and genetic factors. eLife 2019; 8:46179. [PMID: 31210642 PMCID: PMC6615857 DOI: 10.7554/elife.46179] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2019] [Accepted: 06/13/2019] [Indexed: 01/02/2023] Open
Abstract
In humans, a first-degree family history of dementia (FH) is a well-documented risk factor for Alzheimer’s disease (AD); however, the influence of FH on cognition across the lifespan is poorly understood. To address this issue, we developed an internet-based paired-associates learning (PAL) task and tested 59,571 participants between the ages of 18–85. FH was associated with lower PAL performance in both sexes under 65 years old. Modifiers of this effect of FH on PAL performance included age, sex, education, and diabetes. The Apolipoprotein E ε4 allele was also associated with lower PAL scores in FH positive individuals. Here we show, FH is associated with reduced PAL performance four decades before the typical onset of AD; additionally, several heritable and non-heritable modifiers of this effect were identified.
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Affiliation(s)
- Joshua S Talboom
- The Translational Genomics Research Institute, Phoenix, United States.,Arizona Alzheimer's Consortium, Phoenix, United States
| | - Asta Håberg
- Norwegian University of Science and Technology, Trondheim, Norway
| | - Matthew D De Both
- The Translational Genomics Research Institute, Phoenix, United States.,Arizona Alzheimer's Consortium, Phoenix, United States
| | - Marcus A Naymik
- The Translational Genomics Research Institute, Phoenix, United States.,Arizona Alzheimer's Consortium, Phoenix, United States
| | - Isabelle Schrauwen
- The Translational Genomics Research Institute, Phoenix, United States.,Arizona Alzheimer's Consortium, Phoenix, United States
| | - Candace R Lewis
- The Translational Genomics Research Institute, Phoenix, United States.,Arizona Alzheimer's Consortium, Phoenix, United States
| | | | | | - Mason A Fritz
- The Translational Genomics Research Institute, Phoenix, United States
| | | | - Meredith Hay
- Arizona Alzheimer's Consortium, Phoenix, United States.,University of Arizona, Tucson, United States
| | - Carol A Barnes
- Arizona Alzheimer's Consortium, Phoenix, United States.,University of Arizona, Tucson, United States
| | - Elizabeth Glisky
- Arizona Alzheimer's Consortium, Phoenix, United States.,University of Arizona, Tucson, United States
| | - Lee Ryan
- Arizona Alzheimer's Consortium, Phoenix, United States.,University of Arizona, Tucson, United States
| | - Matthew J Huentelman
- The Translational Genomics Research Institute, Phoenix, United States.,Arizona Alzheimer's Consortium, Phoenix, United States
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28
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Dekhtyar S, Marseglia A, Xu W, Darin-Mattsson A, Wang HX, Fratiglioni L. Genetic risk of dementia mitigated by cognitive reserve: A cohort study. Ann Neurol 2019; 86:68-78. [PMID: 31066941 PMCID: PMC6618249 DOI: 10.1002/ana.25501] [Citation(s) in RCA: 57] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2018] [Revised: 04/14/2019] [Accepted: 05/05/2019] [Indexed: 01/27/2023]
Abstract
OBJECTIVE We investigated whether cognitive reserve modifies the risk of dementia attributable to apolipoprotein ε4 (APOE-ε4), a well-known genetic risk factor for dementia. METHODS We followed 2,556 cognitively intact participants aged ≥60 years from the ongoing prospective community-based Swedish National Study on Aging and Care in Kungsholmen (SNAC-K). Dementia was ascertained through clinical and neuropsychological assessments and diagnosed according to Diagnostic and Statistical Manual of Mental Disorders, 4th edition criteria. Structural equation modeling was used to generate a cognitive reserve indicator from 4 previously validated contributors: early life education, midlife substantive work complexity, late life leisure activities, and late life social networks. Cox proportional hazard models estimated dementia risk in relation to cognitive reserve indicator. The interaction between the cognitive reserve indicator and APOE-ε4 was assessed on multiplicative and additive scales. RESULTS After an average of 6.3 years (range = 2.1-10.7) of follow-up, 232 dementia cases were ascertained. Relative to individuals in the lowest tertile of cognitive reserve indicator, those with moderate and high reserve were at a reduced risk of dementia. There was no multiplicative interaction between APOE-ε4 status and cognitive reserve indicator (p = 0.113). Additive interaction was statistically significant. Relative to APOE-ε4 carriers with low cognitive reserve, ε4 carriers with high reserve had a reduced risk of dementia (hazard ratio [HR] = 0.28, 95% confidence interval [CI] = 0.13-0.59). The magnitude of risk reduction was similar in ε4 noncarriers with a high cognitive reserve indicator (HR = 0.24, 95% CI = 0.15-0.40). INTERPRETATION Lifelong engagement in reserve-enhancing activities attenuates the risk of dementia attributable to APOE-ε4. Promoting cognitive reserve might be especially effective in subpopulations with high genetic risk of dementia. ANN NEUROL 2019.
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Affiliation(s)
- Serhiy Dekhtyar
- Aging Research Center, Department of Neurobiology, Care Sciences, and Society, Karolinska Institute and Stockholm University, Stockholm, Sweden
| | - Anna Marseglia
- Aging Research Center, Department of Neurobiology, Care Sciences, and Society, Karolinska Institute and Stockholm University, Stockholm, Sweden
| | - Weili Xu
- Aging Research Center, Department of Neurobiology, Care Sciences, and Society, Karolinska Institute and Stockholm University, Stockholm, Sweden
| | - Alexander Darin-Mattsson
- Aging Research Center, Department of Neurobiology, Care Sciences, and Society, Karolinska Institute and Stockholm University, Stockholm, Sweden
| | - Hui-Xin Wang
- Stress Research Institute, Stockholm University, Stockholm, Sweden
| | - Laura Fratiglioni
- Aging Research Center, Department of Neurobiology, Care Sciences, and Society, Karolinska Institute and Stockholm University, Stockholm, Sweden.,Stockholm Gerontology Research Center, Stockholm, Sweden
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29
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Zhu QB, Bao AM, Swaab D. Activation of the Brain to Postpone Dementia: A Concept Originating from Postmortem Human Brain Studies. Neurosci Bull 2019; 35:253-266. [PMID: 30721394 PMCID: PMC6426905 DOI: 10.1007/s12264-019-00340-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2018] [Accepted: 10/29/2018] [Indexed: 01/27/2023] Open
Abstract
Alzheimer's disease (AD) is characterized by decreased neuronal activity and atrophy, while hyperactivity of neurons seems to make them resistant to aging and neurodegeneration, a phenomenon which we have paraphrased as 'use it or lose it'. Our hypothesis proposes that (1) during their functioning, neurons are damaged; (2) accumulation of damage that is not repaired is the basis of aging; (3) the vulnerability to AD is determined by the genetic background and the balance between the amount of damage and the efficiency of repair, and (4) by stimulating the brain, repair mechanisms are stimulated and cognitive reserve is increased, resulting in a decreased rate of aging and risk for AD. Environmental stimulating factors such as bilingualism/multilingualism, education, occupation, musical experience, physical exercise, and leisure activities have been reported to reduce the risk of dementia and decrease the rate of cognitive decline, although methodological problems are present.
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Affiliation(s)
- Qiong-Bin Zhu
- Department of Neurology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, 310020, China
- Department of Neurobiology, Key Laboratory of Medical Neurobiology of the Ministry of Health of China, Zhejiang Province Key Laboratory of Neurobiology, Zhejiang University School of Medicine, Hangzhou, 310058, China
| | - Ai-Min Bao
- Department of Neurobiology, Key Laboratory of Medical Neurobiology of the Ministry of Health of China, Zhejiang Province Key Laboratory of Neurobiology, Zhejiang University School of Medicine, Hangzhou, 310058, China.
| | - Dick Swaab
- Department of Neurobiology, Key Laboratory of Medical Neurobiology of the Ministry of Health of China, Zhejiang Province Key Laboratory of Neurobiology, Zhejiang University School of Medicine, Hangzhou, 310058, China
- Netherlands Institute for Neuroscience, Institute of the Royal Netherlands Academy of Arts and Sciences, Meibergdreef 47, 1105 BA, Amsterdam, The Netherlands
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30
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Reas ET, Laughlin GA, Bergstrom J, Kritz-Silverstein D, Barrett-Connor E, McEvoy LK. Effects of APOE on cognitive aging in community-dwelling older adults. Neuropsychology 2019; 33:406-416. [PMID: 30730162 DOI: 10.1037/neu0000501] [Citation(s) in RCA: 44] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
OBJECTIVE The apolipoprotein E (APOE) gene is an established risk factor for sporadic Alzheimer's disease, with elevated risk for ε4-carriers and reduced risk for ε2-carriers. However, it is unclear whether APOE modifies risk for cognitive decline in normal aging. The objective of this study was to determine whether ε2 and ε4 are associated with rates of normal cognitive aging, and whether associations of ε4 with cognitive decline are modified by sex, education or health behaviors (exercise, alcohol consumption, smoking). METHOD A community-based sample of 1,393 older adults were genotyped for APOE and underwent cognitive assessment up to seven times over a maximum of period of 27 years. RESULTS ε2-carriers showed slower executive function decline with age relative to ε3 homozygotes or ε4-carriers, whereas ε4-carriers demonstrated more rapid executive function and verbal fluency decline. Accelerated executive function decline was particularly pronounced in ε4-carriers with lower education. After excluding individuals with cognitive impairment, faster executive function decline was still apparent in ε4-carriers, and the effect of ε4 on episodic memory interacted with alcohol consumption, such that only ε4-carriers who did not drink showed more rapid memory decline than ε4 noncarriers. The influence of ε4 on cognitive aging did not differ by sex, nor was it modified by smoking or exercise. CONCLUSIONS These findings indicate that the ε2 and ε4 alleles have differential effects on cognitive aging, and that negative effects of ε4 may be partly mitigated by behavioral choices. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
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Medeiros ADM, Silva RH. Sex Differences in Alzheimer’s Disease: Where Do We Stand? J Alzheimers Dis 2019; 67:35-60. [DOI: 10.3233/jad-180213] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Affiliation(s)
- André de Macêdo Medeiros
- Behavioral Neuroscience Laboratory, Department of Pharmacology, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, Brazil
- Center of Health and Biological Sciences, Universidade Federal Rural do Semiárido, Mossoró, Brazil
| | - Regina Helena Silva
- Behavioral Neuroscience Laboratory, Department of Pharmacology, Escola Paulista de Medicina, Universidade Federal de São Paulo, São Paulo, Brazil
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The dual role of cognitive reserve in subjective cognitive decline and mild cognitive impairment: a 7-year follow-up study. J Neurol 2019; 266:487-497. [PMID: 30604054 DOI: 10.1007/s00415-018-9164-5] [Citation(s) in RCA: 44] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2018] [Revised: 11/26/2018] [Accepted: 12/17/2018] [Indexed: 12/18/2022]
Abstract
The aim of this study was to evaluate the effect of cognitive reserve (CR), in progression from subjective cognitive decline (SCD) to mild cognitive impairment (MCI) and Alzheimer's disease (AD). For this purpose, we followed up 263 patients (154 SCD; 109 MCI) for a mean time of 7 years. CR was assessed by the Test di Intelligenza Breve (TIB), functionally equivalent to the National Adult Reading Test. High CR resulted as a protective factor for progression from SCD to MCI. Age at conversion to MCI was delayed 9 years on average in SCD with high CR with respect to SCD with low CR. On the contrary, high CR resulted as a risk factor for progression from MCI to AD dementia only in APOE ε4 carriers. Conversion time from MCI to AD dementia was 3 years shorter in ε4 carriers with high CR than subjects with low CR and ε4 non-carriers with high CR. Consistent with the CR hypothesis, our results showed that higher levels of CR protect against the earliest clinical manifestations of AD. In line with the previous researches, we found an interaction between CR and APOE in progression from MCI to AD dementia.
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Abstract
Cognitive reserve is a latent construct theorized to account for the discrepancy between observed brain deterioration and ultimate clinical outcomes. This review outlines the theoretical development of the reserve concept and presents major trends within epidemiological and neuroimaging research literatures in support of such a construct. Particular focus is placed on the implications for cognitive aging and dementia.
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Affiliation(s)
- Yaakov Stern
- Departments of Neurology, Psychiatry and Taub Institute, Columbia University College of Physicians and Surgeons, New York, NY, United States.
| | - Daniel Barulli
- Department of Psychology, Columbia University, New York, NY, United States
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Genetic effects and gene-by-education interactions on episodic memory performance and decline in an aging population. Soc Sci Med 2018; 271:112039. [PMID: 30449520 DOI: 10.1016/j.socscimed.2018.11.019] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2018] [Revised: 10/19/2018] [Accepted: 11/08/2018] [Indexed: 01/13/2023]
Abstract
Both social and genetic factors contribute to cognitive impairment and decline, yet genetic factors identified through genome-wide association studies (GWAS) explain only a small portion of trait variability. This "missing heritability" may be due to rare, potentially functional, genetic variants not assessed by GWAS, as well as gene-by-social factor interactions not explicitly modeled. Gene-by-social factor interactions may also operate differently across race/ethnic groups. We selected 39 genes that had significant, replicated associations with cognition, dementia, and related traits in published GWAS. Using gene-based analysis (SKAT/iSKAT), we tested whether common and/or rare variants were associated with episodic memory performance and decline either alone or through interaction with education in >10,000 European ancestry (EA) and >2200 African ancestry (AA) respondents from the Health and Retirement Study (HRS). Nine genes in EA and five genes in AA were associated with memory performance or decline (p < 0.05), and these effects did not attenuate after adjusting for education. Interaction between education and CLPTM1 on memory performance was significant in AA (p = 0.003; FDR-adjusted p = 0.038) and nominally significant in EA (p = 0.026). In both ethnicities, low memory performance was associated with CLPTM1 genotype (rs10416261) only for those with less than high school education, and effects persisted after adjusting for APOE ε4. For over 70% of gene-by-education interactions across the genome that were at least nominally significant in either ethnic group (p < 0.05), genetic effects were only observed for those with less than high school education. These results suggest that genetic effects on memory identified in this study are not mediated by education, but there may be important gene-by-education interactions across the genome, including in the broader APOE genomic region, which operate independently of APOE ε4. This work illustrates the importance of developing theoretical frameworks and methodological approaches for integrating social and genomic data to study cognition across ethnic groups.
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Hasselgren C, Dellve L, Ekbrand H, Zettergren A, Zetterberg H, Blennow K, Skoog I, Halleröd B. Socioeconomic status, gender and dementia: The influence of work environment exposures and their interactions with APOE ɛ4. SSM Popul Health 2018; 5:171-179. [PMID: 30014031 PMCID: PMC6043817 DOI: 10.1016/j.ssmph.2018.06.009] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2018] [Revised: 06/08/2018] [Accepted: 06/21/2018] [Indexed: 01/07/2023] Open
Abstract
It is a well-established fact that unfavourable social and economic conditions have a negative impact on health and longevity. Recent findings suggest that this is also true of age-related dementias. Yet most common indicators of socioeconomic status (SES) say very little about the actual mechanisms at play in disease development. The present paper explores five work exposure characteristics, all of which have a clear social gradient, that could potentially shed further light on the relationship between SES and dementia. Specifically, it investigates whether these exposures could moderate the impact of a well-known genetic risk factor: the APOE ɛ4 allele. The empirical analyses are based on data from a Swedish population study (n = 1019). Main occupation was linked to The Job Exposure Matrix to estimate the individuals’ exposure to the following work environment factors: work control, support, psychological demands, physical demands and job hazards. All analyses were conducted using binary logistic regression and focused specifically on gene-work exposure interactions. A significant main effect of work control on dementia risk was detected for males (OR = 0.68; p< 0.05), but not for females. However, control was found to significantly moderate the effect of APOE ɛ4 in both genders, albeit in different ways. These findings do not only underscore the importance of considering interactions between social and genetic risk factors to better understanding multifactorial diseases such as dementia. They also propose that gender- and class-based inequities interact, and hence must be considered simultaneously, also in relation to this particular disease. There are steep social gradients in exposure to various work environment conditions. Work control alters the effect of APOE ɛ4 in both genders, albeit in different ways. High work control protects male, but not female, APOE ɛ4-carriers. ‘Male’ high control jobs differ greatly from ‘female’ high control jobs. Gender- and class-based inequities interact also in the development of dementia.
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Affiliation(s)
- Caroline Hasselgren
- Department of Sociology and Work Science, University of Gothenburg, Box 720, 405 30 Gothenburg, Sweden.,Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, Centre for Ageing and Health - AgeCap, University of Gothenburg, Mölndal, Sweden
| | - Lotta Dellve
- Department of Sociology and Work Science, University of Gothenburg, Box 720, 405 30 Gothenburg, Sweden.,Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, Centre for Ageing and Health - AgeCap, University of Gothenburg, Mölndal, Sweden
| | - Hans Ekbrand
- Department of Sociology and Work Science, University of Gothenburg, Box 720, 405 30 Gothenburg, Sweden
| | - Anna Zettergren
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, Centre for Ageing and Health - AgeCap, University of Gothenburg, Mölndal, Sweden
| | - Henrik Zetterberg
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, Centre for Ageing and Health - AgeCap, University of Gothenburg, Mölndal, Sweden.,Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden.,Department of Molecular Neuroscience, UCL Institute of Neurology, Queen Square, London, United Kingdom.,UK Dementia Research Institute at UCL, London, United Kingdom
| | - Kaj Blennow
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, Centre for Ageing and Health - AgeCap, University of Gothenburg, Mölndal, Sweden.,Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden
| | - Ingmar Skoog
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, Centre for Ageing and Health - AgeCap, University of Gothenburg, Mölndal, Sweden
| | - Björn Halleröd
- Department of Sociology and Work Science, University of Gothenburg, Box 720, 405 30 Gothenburg, Sweden.,Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, Centre for Ageing and Health - AgeCap, University of Gothenburg, Mölndal, Sweden
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APOEε4 and the long arm of social inequity: estimated effects of socio-economic status and sex on the timing of dementia onset. AGEING & SOCIETY 2018. [DOI: 10.1017/s0144686x18000351] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
ABSTRACTIt is well established that carriers of the apolipoprotein E (APOE) ε4 allele run a greater risk of developing Alzheimer's disease, the most common form of dementia and a strongly age-related condition known to disproportionally affect women. Low educational attainment also stands out as a prominent risk factor, and it has been suggested that occupational class plays a similar role in disease susceptibility. Not yet fully explored, however, is the question of whether socio-economic status (SES) could moderate the effect ofAPOEε4. In the present paper, we address this issue. As substantial inequities in workforce participation and educational opportunities have existed between men and women in previous generations, we further examine whether SES-related moderations of the relationship between dementia andAPOEε4 are sex-specific. Our analyses are based on a sample of 580 individuals from the H70 Birth Cohort Study and the Prospective Population Study on Women in Gothenburg, Sweden. Data were analysed using Cox proportional hazards regression, and the results suggest that while high SES postpones dementia onset among maleAPOEε4 carriers, this is not the case for women. These findings underscore the long-term impact of social inequity on health as well as the importance of considering potential interactions between social and genetic risk factors if we are to understand better the complex aetiology of dementia.
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The Influence of Education and Apolipoprotein ε4 on Mortality in Community-Dwelling Elderly Men and Women. J Aging Res 2018; 2018:6037058. [PMID: 29770230 PMCID: PMC5889858 DOI: 10.1155/2018/6037058] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2017] [Accepted: 02/07/2018] [Indexed: 12/15/2022] Open
Abstract
We investigated the risk of death in relation to the apolipoprotein ε4 allele and evaluated how it interacts with education in 504 elderly adults (mean age 73 years, 65.3% women) who were enrolled in 1993 into the New Mexico Aging Process Study. During 9 years of follow-up, apolipoprotein ε2 appeared to be associated with a lower risk for all-cause mortality (hazard ratio (HR) = 0.73, 95% confidence interval (CI): 0.30-1.71) compared to apolipoprotein ε3 carriers in models adjusted for age, sociodemographic variables, medical conditions, adiposity, and lifestyle factors. The apolipoprotein ε4 allele conferred almost a threefold elevated risk of mortality (HR = 2.76, CI: 1.42-5.37). An interaction between education and apolipoprotein e4 (p=0.027) was observed with the HR of mortality among e4 carriers compared to noncarriers being 1.59 (0.64-3.96) for those with ≥college education; 6.66 (1.90-23.4) for those with some college or trade; and 14.1 (3.03-65.6) for participants with ≤high school education. No significant interaction was identified between apolipoprotein E genotype and cognitive function for mortality risk. These findings suggest that genetic (apolipoprotein ε4) and environmental (education) factors act interactively to influences survival in the elderly with higher education attenuating the adverse effect of apolipoprotein ε4 on mortality.
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39
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Upadhyay A, Mishra A. Amyloids of multiple species: are they helpful in survival? Biol Rev Camb Philos Soc 2018; 93:1363-1386. [DOI: 10.1111/brv.12399] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2017] [Revised: 01/13/2018] [Accepted: 01/18/2018] [Indexed: 12/12/2022]
Affiliation(s)
- Arun Upadhyay
- Cellular and Molecular Neurobiology Unit; Indian Institute of Technology Jodhpur; Rajasthan 342011 India
| | - Amit Mishra
- Cellular and Molecular Neurobiology Unit; Indian Institute of Technology Jodhpur; Rajasthan 342011 India
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Tangwongchai S, Supasitthumrong T, Hemrunroj S, Tunvirachaisakul C, Chuchuen P, Houngngam N, Snabboon T, Tawankanjanachot I, Likitchareon Y, Phanthumchindad K, Maes M. In Thai Nationals, the ApoE4 Allele Affects Multiple Domains of Neuropsychological, Biobehavioral, and Social Functioning Thereby Contributing to Alzheimer's Disorder, while the ApoE3 Allele Protects Against Neuropsychiatric Symptoms and Psychosocial Deficits. Mol Neurobiol 2018; 55:6449-6462. [PMID: 29307083 DOI: 10.1007/s12035-017-0848-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2017] [Accepted: 12/19/2017] [Indexed: 01/01/2023]
Abstract
The apolipoprotein E epsilon 4 (ApoE4) allele is the strongest genetic risk factor for Alzheimer's disorder (AD) and is associated with semantic and episodic memory deficits. The aim of this study was to examine the associations between ApoE alleles (E2, E3, E4) and genotypes and neuropsychological tests, behavioral functions, and dementia symptoms as assessed using Consortium to Establish a Registry for Alzheimer's Disease (CERAD). This study included 60 patients with Alzheimer's disorder (AD), 60 with mild cognitive disorder (MCI), and 62 normal volunteers. ApoE4 carriers and individuals with E3/E4 and E4/E4 genotypes show an increased incidence of AD, but not MCI. ApoE4 carriers and especially E4/E4 homozygotes show a worse outcome on the CERAD total score, Blessed Dementia Scale, and Short Blessed Test and lower scores on the Verbal Fluency Test, Boston Naming Test, Constructional Praxis Recall, and Word List Memory, Recall, and Recognition. ApoE4 carriers and E4/E3 heterozygotes show higher scores on the Clock Drawing Test. ApoE4 carriers show a worse outcome on the CERAD clinical history scores of memory, language, personality, ADL, orientation, and social skills, while allele AopE3 carriers show better scores on activities of daily living (ADL) and social skills. ApoE3 carriers show lower total weighted, irritability/aggression, and behavioral dysregulation scores on the Behavior Rating Scale for Dementia. The results show that in Thai individuals, the presence of ApoE4 allele is accompanied by a multifarious decline in neurocognitive functions and behavioral features and that ApoE3 may convey protection against neuropsychiatric symptoms and a decline in social skills. ApoE4 and especially the E4/E4 genotype may affect multiple domains of cognitive, biobehavioral, and social functioning thereby contributing to AD phenomenology.
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Affiliation(s)
| | | | - Solaphat Hemrunroj
- Department of Psychiatry, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | | | - Phenphichcha Chuchuen
- Department of Psychiatry, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Natnicha Houngngam
- Excellence Center of Diabetes, Hormones and Metabolism, King Chulalongkorn Memorial Hospital, Bangkok, Thailand.,Division of Neurology, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, 10330, Thailand
| | - Thiti Snabboon
- Division of Neurology, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, 10330, Thailand
| | | | - Yuthachai Likitchareon
- Division of Neurology, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, 10330, Thailand
| | - Kamman Phanthumchindad
- Division of Neurology, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, 10330, Thailand
| | - Michael Maes
- Department of Psychiatry, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand. .,Department of Psychiatry, Medical University Plovdiv, Plovdiv, Bulgaria. .,IMPACT Strategic Research Center, Barwon Health, Deakin University, Geelong, VIC, Australia.
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Abstract
Progress in prevention and treatment of Alzheimer's disease (AD) and dementia is hampered by the restricted understanding of the biological and environmental causes underlying pathophysiology. It is widely accepted that certain genetic factors are associated with AD and a number of lifestyle and other environmental characteristics have also been linked to dementia risk. However, interactions between genes and the environment are not yet well understood, and coordinated global action is required to utilize existing cohorts and other resources effectively and efficiently to identify new avenues for dementia prevention. This chapter provides a brief summary of current research on risk and protective factors and opportunities and challenges in relation to population-based approaches are discussed.
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Affiliation(s)
- Robert Perneczky
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilians-Universität München, Munich, Germany. .,German Center for Neurodegenerative Diseases (DZNE) Munich, Munich, Germany. .,Neuroepidemiology and Ageing Research Unit, School of Public Health, The Imperial College of Science, Technology and Medicine, London, UK. .,West London Mental Health NHS Trust, London, UK.
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42
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Walhovd KB, Fjell AM, Westerhausen R, Nyberg L, Ebmeier KP, Lindenberger U, Bartrés-Faz D, Baaré WFC, Siebner HR, Henson R, Drevon CA, Knudsen GP, Budin-Ljøsne I, Penninx BWJH, Ghisletta P, Rogeberg O, Tyler L, Bertram L. Healthy minds from 0-100 years: Optimising the use of European brain imaging cohorts ("Lifebrain"). Eur Psychiatry 2017; 47:76-87. [PMID: 29127911 DOI: 10.1016/j.eurpsy.2017.10.005] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2017] [Revised: 10/04/2017] [Accepted: 10/05/2017] [Indexed: 11/17/2022] Open
Abstract
The main objective of "Lifebrain" is to identify the determinants of brain, cognitive and mental (BCM) health at different stages of life. By integrating, harmonising and enriching major European neuroimaging studies across the life span, we will merge fine-grained BCM health measures of more than 5,000 individuals. Longitudinal brain imaging, genetic and health data are available for a major part, as well as cognitive and mental health measures for the broader cohorts, exceeding 27,000 examinations in total. By linking these data to other databases and biobanks, including birth registries, national and regional archives, and by enriching them with a new online data collection and novel measures, we will address the risk factors and protective factors of BCM health. We will identify pathways through which risk and protective factors work and their moderators. Exploiting existing European infrastructures and initiatives, we hope to make major conceptual, methodological and analytical contributions towards large integrative cohorts and their efficient exploitation. We will thus provide novel information on BCM health maintenance, as well as the onset and course of BCM disorders. This will lay a foundation for earlier diagnosis of brain disorders, aberrant development and decline of BCM health, and translate into future preventive and therapeutic strategies. Aiming to improve clinical practice and public health we will work with stakeholders and health authorities, and thus provide the evidence base for prevention and intervention.
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Affiliation(s)
- K B Walhovd
- Department of Psychology, University of Oslo Centre for Lifespan Changes in Brain and Cognition (UiO), Harald Schelderups Hus, Forskningsveien 3A, N-0373 Oslo, Norway.
| | - A M Fjell
- Department of Psychology, University of Oslo Centre for Lifespan Changes in Brain and Cognition (UiO), Harald Schelderups Hus, Forskningsveien 3A, N-0373 Oslo, Norway
| | - R Westerhausen
- Department of Psychology, University of Oslo Centre for Lifespan Changes in Brain and Cognition (UiO), Harald Schelderups Hus, Forskningsveien 3A, N-0373 Oslo, Norway
| | - L Nyberg
- Centre for Functional Brain Imaging (Umeå), Umeå Universitet, SE-90187 Umeå, Sweden.
| | - K P Ebmeier
- Department of Psychiatry (UOXF), University of Oxford Wellcome Centre for Integrative Neuroimaging, Warneford Hospital, University of Oxford, OX37JX Oxford, UK.
| | - U Lindenberger
- Centre for Lifespan Psychology (MPIB), Max-Planck Institute for Human Development, Lentzeallee 94, D-14195 Berlin, Germany.
| | - D Bartrés-Faz
- Facultat de Medicina, Campus Clínic, C/. Casanova, University of Barcelona Brain Stimulation Lab (UB), 143, Ala Nord, 5a planta, S-08036 Barcelona, Spain.
| | - W F C Baaré
- Region Hovedstaden (RegionH), Danish Research Centre for Magnetic Resonance, Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital Hvidovre, Section 714, Kettegard Allé 30, DK-2650 Hvidovre, Denmark.
| | - H R Siebner
- Region Hovedstaden (RegionH), Danish Research Centre for Magnetic Resonance, Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital Hvidovre, Section 714, Kettegard Allé 30, DK-2650 Hvidovre, Denmark
| | - R Henson
- Medical Research Council Cognition and Brain Science Unit (MRC), University of Cambridge, 15, Chaucer Road, CB2 7EF Cambridge, UK.
| | - C A Drevon
- Vitas AS (Analytical Services), Gaustadalléen 21, N-0349 Oslo, Norway.
| | - G P Knudsen
- Norwegian Institute of Public Health Oslo (NIPH), PO Box 4404 Nydalen, N-0403 Oslo, Norway.
| | - I Budin-Ljøsne
- Norwegian Institute of Public Health Oslo (NIPH), PO Box 4404 Nydalen, N-0403 Oslo, Norway
| | - B W J H Penninx
- VU University Medical Centre (VUmc), PO Box 7057, NL-1007 Amsterdam, MB, USA.
| | - P Ghisletta
- Research Group: Methodology and Data Analysis, Faculty of Psychology and Educational Sciences, University of Geneva (UNIGE), Sandrine Amstutz, Uni Mail, 4(e) étage, boulevard du Pont-d'Arve 40, 1205 Geneva, Switzerland; Swiss Distance Learning University, Überlandstrasse 12, Postfach 689 CH-3900 Brig, Switzerland.
| | - O Rogeberg
- Ragnar Frisch Centre for Economic Research (Frisch), Gaustadalleen 21, N-0349 Oslo, Norway.
| | - L Tyler
- University of Cambridge Department of Psychology (UCAM), Downing Street, CB2 3EB Cambridge, UK.
| | - L Bertram
- University of Lübeck Interdisciplinary Platform for Genome Analytics (LIGA-UzL), University of Lübeck, Maria-Goeppert-Str. 1 (MFC1), 23562 D-Lübeck, Germany.
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Custodio N, Wheelock A, Thumala D, Slachevsky A. Dementia in Latin America: Epidemiological Evidence and Implications for Public Policy. Front Aging Neurosci 2017; 9:221. [PMID: 28751861 PMCID: PMC5508025 DOI: 10.3389/fnagi.2017.00221] [Citation(s) in RCA: 82] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2016] [Accepted: 06/23/2017] [Indexed: 01/20/2023] Open
Abstract
Population aging is among the most important global transformations. Today, 12% of the world population is of age 60 and over and by the middle of this century this segment will represent 21.5%. The increase in population of those aged 80 and over, also referred to as the "oldest old" or the "very elderly", will be even more pronounced, going from 1.7% of the population to 4.5% within the same period. Compared to European and North American countries, Latin America (LA) is experiencing this unprecedented demographic change at a significantly faster rate. Due to demographic and health transitions, the number of people with dementia will rise from 7.8 million in 2013 to over 27 million by 2050. Nowadays, the global prevalence of dementia in LA has reached 7.1%, with Alzheimer's Disease (AD) being the most frequent type. This level is similar to those found in developed countries; however, the dementia rate is twice as high as that of the 65-69 years age group in developed countries. In addition, the prevalence and incidence of dementia is higher among illiterate people. Mortality rates due to dementia have risen considerably. The burden and costs of the disease are high and must be covered by patients' families. The prevention of dementia and the development of long-term care policies and plans for people with dementia in LA, which take into account regional differences and similarities, should be urgent priorities.
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Affiliation(s)
- Nilton Custodio
- Unidad de diagnóstico de deterioro cognitivo y prevención de demencia, Departamento de Neurología, Instituto Peruano de NeurocienciasLima, Peru
| | - Ana Wheelock
- Gerosciences Center for Brain Health and Metabolism (GERO)Santiago, Chile.,Department of Surgery and Cancer, National Institute for Health Research Imperial Patient Safety Translational Research Centre, Imperial College LondonLondon, United Kingdom
| | - Daniela Thumala
- Gerosciences Center for Brain Health and Metabolism (GERO)Santiago, Chile.,Psychology Department, Faculty of Social Sciences, Universidad de ChileSantiago, Chile
| | - Andrea Slachevsky
- Gerosciences Center for Brain Health and Metabolism (GERO)Santiago, Chile.,Physiopathology Department, ICBM, and East Neuroscience Department, Faculty of Medicine, Universidad de ChileSantiago, Chile.,Cognitive Neurology and Dementia Unit, Neurology Department, Hospital del SalvadorSantiago, Chile.,Center for Advanced Research in Education (CIAE), Universidad de ChileSantiago, Chile.,Servicio de Neurología, Departamento de Medicina, Clínica Alemana-Universidad del DesarrolloSantiago, Chile
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44
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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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Ishioka YL, Gondo Y, Fuku N, Inagaki H, Masui Y, Takayama M, Abe Y, Arai Y, Hirose N. Effects of the APOE ε4 allele and education on cognitive function in Japanese centenarians. AGE (DORDRECHT, NETHERLANDS) 2016; 38:495-503. [PMID: 27558117 PMCID: PMC5266218 DOI: 10.1007/s11357-016-9944-8] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/25/2015] [Accepted: 08/09/2016] [Indexed: 06/06/2023]
Abstract
Apolipoprotein E (APOE) ε4 allele and education have been reported to affect the cognitive function in young-old adults. However, the effects and interactions of the ε4 allele and education on cognitive function in very old age, particularly in centenarians, are not well known. We studied 542 Japanese centenarians. Using the data in total of 452 participants (74 men and 378 women, mean age 103.6 ± 3.2 years) who were genotyped and assessed cognitive function with the Mini-Mental States Examination (MMSE), we examined the effects and interactions of the ε4 allele and education on the MMSE score. First, we coded education as three levels: low, middle, and high based on the formal educational levels (analysis 1). Second, to clarify the modifying effect of education, we adopted a new coding for education into two levels, considering a periodical background (around 1900) of gender differences in educational attainments (analysis 2). In analysis 1, the main effects of the ε4 allele and education on the MMSE score were significant after adjusting for age. Further, there was a significant three-way interaction effect between the ε4 allele, education, and gender on the MMSE. Analysis 2 showed that the modifying effect of the ε4 allele by education was observed only in women with the ε4 allele. These findings suggest that both the APOE ε4 allele and education appear to be associated with cognitive function even in centenarians, but the interaction between the ε4 allele and education might depend on gender in this cohort.
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Affiliation(s)
- Yoshiko Lily Ishioka
- Tokyo Metropolitan Institute of Gerontology, 35-2 Sakaemachi, Itabashi-ku, Tokyo, 173-0015, Japan.
| | - Yasuyuki Gondo
- Graduate School of Human Sciences, Osaka University, 1-2 Yamadaoka, Suita, Osaka, 565-0871, Japan
| | - Noriyuki Fuku
- Graduate School of Health and Sports Science, Juntendo University, 1-1 Hiraka-gakuendai, Inzai-shi, Chiba, 270-1695, Japan
| | - Hiroki Inagaki
- Tokyo Metropolitan Institute of Gerontology, 35-2 Sakaemachi, Itabashi-ku, Tokyo, 173-0015, Japan
| | - Yukie Masui
- Tokyo Metropolitan Institute of Gerontology, 35-2 Sakaemachi, Itabashi-ku, Tokyo, 173-0015, Japan
| | - Michiyo Takayama
- Center for Supercentenarian Medical Research, School of Medicine, Keio University, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Yukiko Abe
- Center for Supercentenarian Medical Research, School of Medicine, Keio University, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Yasumichi Arai
- Center for Supercentenarian Medical Research, School of Medicine, Keio University, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Nobuyoshi Hirose
- Center for Supercentenarian Medical Research, School of Medicine, Keio University, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
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Baumgaertel J, Haussmann R, Gruschwitz A, Werner A, Osterrath A, Lange J, Donix KL, Linn J, Donix M. Education and Genetic Risk Modulate Hippocampal Structure in Alzheimer's Disease. Aging Dis 2016; 7:553-560. [PMID: 27699079 PMCID: PMC5036951 DOI: 10.14336/ad.2016.0305] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2015] [Accepted: 03/05/2016] [Indexed: 02/02/2023] Open
Abstract
Genetic and environmental protective factors and risks modulate brain structure and function in neurodegenerative diseases and their preclinical stages. We wanted to investigate whether the years of formal education, a proxy measure for cognitive reserve, would influence hippocampal structure in Alzheimer’s disease patients, and whether apolipoprotein Eε4 (APOE4) carrier status and a first-degree family history of the disease would change a possible association. Fifty-eight Alzheimer’s disease patients underwent 3T magnetic resonance imaging. We applied a cortical unfolding approach to investigate individual subregions of the medial temporal lobe. Among patients homozygous for the APOE4 genotype or carrying both APOE4 and family history risks, lower education was associated with a thinner cortex in multiple medial temporal regions, including the hippocampus. Our data suggest that the years of formal education and genetic risks interact in their influence on hippocampal structure in Alzheimer’s disease patients.
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Affiliation(s)
- Johanna Baumgaertel
- 1Department of Psychiatry, University Hospital Carl Gustav Carus, Technische Universität Dresden, 01307 Dresden, Germany
| | - Robert Haussmann
- 1Department of Psychiatry, University Hospital Carl Gustav Carus, Technische Universität Dresden, 01307 Dresden, Germany
| | - Antonia Gruschwitz
- 1Department of Psychiatry, University Hospital Carl Gustav Carus, Technische Universität Dresden, 01307 Dresden, Germany
| | - Annett Werner
- 3Department of Neuroradiology, University Hospital Carl Gustav Carus, Technische Universität Dresden, 01307 Dresden, Germany
| | - Antje Osterrath
- 1Department of Psychiatry, University Hospital Carl Gustav Carus, Technische Universität Dresden, 01307 Dresden, Germany; 2DZNE, German Center for Neurodegenerative Diseases, Dresden, Germany
| | - Jan Lange
- 1Department of Psychiatry, University Hospital Carl Gustav Carus, Technische Universität Dresden, 01307 Dresden, Germany
| | - Katharina L Donix
- 1Department of Psychiatry, University Hospital Carl Gustav Carus, Technische Universität Dresden, 01307 Dresden, Germany
| | - Jennifer Linn
- 3Department of Neuroradiology, University Hospital Carl Gustav Carus, Technische Universität Dresden, 01307 Dresden, Germany
| | - Markus Donix
- 1Department of Psychiatry, University Hospital Carl Gustav Carus, Technische Universität Dresden, 01307 Dresden, Germany; 2DZNE, German Center for Neurodegenerative Diseases, Dresden, Germany
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Abstract
This chapter will focus on the descriptive, analytic, and intervention-oriented epidemiology of dementia and its most frequent etiologic type due to Alzheimer's disease. The chapter opens with a brief presentation of the concept of dementia, followed by the presentation of dementia of the Alzheimer type (DAT), including natural history, clinical manifestation, neuropathology, medical prognosis, and management. Further, the chapter presents the prevalence and incidence of dementia, with special consideration of secular trends in prevalence and incidence of DAT, and prognosis of the socioeconomic impact of dementia. Thereafter the main risk factors for DAT are covered. The chapter also addresses the results of ongoing therapeutic and preventive intervention trials for DAT. Finally, the future challenges of the epidemiology of dementia with a focus on the impact of the new diagnostic criteria for neurocognitive disorders, as well as the development of biomarkers for DAT and other types of dementia, will be briefly discussed.
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Affiliation(s)
- S F Sacuiu
- Department of Neuropsychiatry, Sahlgrenska University Hospital and Department of Psychiatry and Neurochemistry, University of Gothenburg Institute of Neuroscience and Physiology, Gothenburg, Sweden.
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Arenaza-Urquijo EM, Gonneaud J, Fouquet M, Perrotin A, Mézenge F, Landeau B, Egret S, De la Sayette V, Desgranges B, Chételat G. Interaction between years of education and APOE ε4 status on frontal and temporal metabolism. Neurology 2015; 85:1392-9. [PMID: 26408498 PMCID: PMC4626241 DOI: 10.1212/wnl.0000000000002034] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2015] [Accepted: 06/23/2015] [Indexed: 11/15/2022] Open
Abstract
Objective: To examine interactions between years of education and APOE ε4 status on gray matter volume and metabolism in cognitively healthy participants. Methods: Seventy-two healthy participants (28 APOE ε4 carriers and 44 noncarriers; from 23 to 84 years of age) with FDG-PET and structural MRI were included. A subgroup also underwent florbetapir-PET. We tested the interaction effect between years of education and APOE ε4 status (carrier vs noncarrier) on FDG-PET and structural MRI within the whole brain (voxel-wise) adjusting for age and sex. Computed florbetapir standardized uptake value ratios were used for complementary analyses. Results: We found an interaction between years of education and APOE ε4 status on frontotemporal FDG-PET metabolism, such that higher education was positively related to frontotemporal metabolism only in APOE ε4 carriers. Complementary analyses revealed that (1) this interaction was independent from amyloid load; (2) increased metabolism in APOE ε4 carriers in this region correlated with episodic memory performances; (3) lower educated APOE ε4 carriers showed decreased metabolism relative to noncarriers in medial temporal and prefrontal areas, while higher educated carriers were comparable to noncarriers in these areas and showed increased metabolism in the middle temporal lobe. Conclusions: Our results showed that education may counteract the effects of APOE ε4 on metabolism independently of amyloid deposition. Higher metabolism in higher (compared to lower) educated APOE ε4 carriers was found in regions that sustain episodic memory. Overall, our results point to education as a protective factor that may help to postpone cognitive changes in APOE ε4 carriers.
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Affiliation(s)
- Eider M Arenaza-Urquijo
- From INSERM U1077 (E.M.A.-U., J.G., M.F., A.P., F.M., B.L., S.E., V.D.l.S., B.D., G.C.); Université de Caen Basse-Normandie (E.M.A.-U., J.G., M.F., A.P., F.M., B.L., V.D.l.S., B.D., G.C.) and Ecole Pratique des Hautes Etudes (E.M.A.-U., J.G., M.F., A.P., F.M., B.L., V.D.l.S., B.D., G.C.), UMR-S1077; CHU de Caen, U1077 (E.M.A.-U., J.G., M.F., A.P., F.M., B.L., S.E., B.D., G.C.); and CHU de Caen (S.E., V.D.l.S.), Service de Neurologie, Caen, France
| | - Julie Gonneaud
- From INSERM U1077 (E.M.A.-U., J.G., M.F., A.P., F.M., B.L., S.E., V.D.l.S., B.D., G.C.); Université de Caen Basse-Normandie (E.M.A.-U., J.G., M.F., A.P., F.M., B.L., V.D.l.S., B.D., G.C.) and Ecole Pratique des Hautes Etudes (E.M.A.-U., J.G., M.F., A.P., F.M., B.L., V.D.l.S., B.D., G.C.), UMR-S1077; CHU de Caen, U1077 (E.M.A.-U., J.G., M.F., A.P., F.M., B.L., S.E., B.D., G.C.); and CHU de Caen (S.E., V.D.l.S.), Service de Neurologie, Caen, France
| | - Marine Fouquet
- From INSERM U1077 (E.M.A.-U., J.G., M.F., A.P., F.M., B.L., S.E., V.D.l.S., B.D., G.C.); Université de Caen Basse-Normandie (E.M.A.-U., J.G., M.F., A.P., F.M., B.L., V.D.l.S., B.D., G.C.) and Ecole Pratique des Hautes Etudes (E.M.A.-U., J.G., M.F., A.P., F.M., B.L., V.D.l.S., B.D., G.C.), UMR-S1077; CHU de Caen, U1077 (E.M.A.-U., J.G., M.F., A.P., F.M., B.L., S.E., B.D., G.C.); and CHU de Caen (S.E., V.D.l.S.), Service de Neurologie, Caen, France
| | - Audrey Perrotin
- From INSERM U1077 (E.M.A.-U., J.G., M.F., A.P., F.M., B.L., S.E., V.D.l.S., B.D., G.C.); Université de Caen Basse-Normandie (E.M.A.-U., J.G., M.F., A.P., F.M., B.L., V.D.l.S., B.D., G.C.) and Ecole Pratique des Hautes Etudes (E.M.A.-U., J.G., M.F., A.P., F.M., B.L., V.D.l.S., B.D., G.C.), UMR-S1077; CHU de Caen, U1077 (E.M.A.-U., J.G., M.F., A.P., F.M., B.L., S.E., B.D., G.C.); and CHU de Caen (S.E., V.D.l.S.), Service de Neurologie, Caen, France
| | - Florence Mézenge
- From INSERM U1077 (E.M.A.-U., J.G., M.F., A.P., F.M., B.L., S.E., V.D.l.S., B.D., G.C.); Université de Caen Basse-Normandie (E.M.A.-U., J.G., M.F., A.P., F.M., B.L., V.D.l.S., B.D., G.C.) and Ecole Pratique des Hautes Etudes (E.M.A.-U., J.G., M.F., A.P., F.M., B.L., V.D.l.S., B.D., G.C.), UMR-S1077; CHU de Caen, U1077 (E.M.A.-U., J.G., M.F., A.P., F.M., B.L., S.E., B.D., G.C.); and CHU de Caen (S.E., V.D.l.S.), Service de Neurologie, Caen, France
| | - Brigitte Landeau
- From INSERM U1077 (E.M.A.-U., J.G., M.F., A.P., F.M., B.L., S.E., V.D.l.S., B.D., G.C.); Université de Caen Basse-Normandie (E.M.A.-U., J.G., M.F., A.P., F.M., B.L., V.D.l.S., B.D., G.C.) and Ecole Pratique des Hautes Etudes (E.M.A.-U., J.G., M.F., A.P., F.M., B.L., V.D.l.S., B.D., G.C.), UMR-S1077; CHU de Caen, U1077 (E.M.A.-U., J.G., M.F., A.P., F.M., B.L., S.E., B.D., G.C.); and CHU de Caen (S.E., V.D.l.S.), Service de Neurologie, Caen, France
| | - Stéphanie Egret
- From INSERM U1077 (E.M.A.-U., J.G., M.F., A.P., F.M., B.L., S.E., V.D.l.S., B.D., G.C.); Université de Caen Basse-Normandie (E.M.A.-U., J.G., M.F., A.P., F.M., B.L., V.D.l.S., B.D., G.C.) and Ecole Pratique des Hautes Etudes (E.M.A.-U., J.G., M.F., A.P., F.M., B.L., V.D.l.S., B.D., G.C.), UMR-S1077; CHU de Caen, U1077 (E.M.A.-U., J.G., M.F., A.P., F.M., B.L., S.E., B.D., G.C.); and CHU de Caen (S.E., V.D.l.S.), Service de Neurologie, Caen, France
| | - Vincent De la Sayette
- From INSERM U1077 (E.M.A.-U., J.G., M.F., A.P., F.M., B.L., S.E., V.D.l.S., B.D., G.C.); Université de Caen Basse-Normandie (E.M.A.-U., J.G., M.F., A.P., F.M., B.L., V.D.l.S., B.D., G.C.) and Ecole Pratique des Hautes Etudes (E.M.A.-U., J.G., M.F., A.P., F.M., B.L., V.D.l.S., B.D., G.C.), UMR-S1077; CHU de Caen, U1077 (E.M.A.-U., J.G., M.F., A.P., F.M., B.L., S.E., B.D., G.C.); and CHU de Caen (S.E., V.D.l.S.), Service de Neurologie, Caen, France
| | - Béatrice Desgranges
- From INSERM U1077 (E.M.A.-U., J.G., M.F., A.P., F.M., B.L., S.E., V.D.l.S., B.D., G.C.); Université de Caen Basse-Normandie (E.M.A.-U., J.G., M.F., A.P., F.M., B.L., V.D.l.S., B.D., G.C.) and Ecole Pratique des Hautes Etudes (E.M.A.-U., J.G., M.F., A.P., F.M., B.L., V.D.l.S., B.D., G.C.), UMR-S1077; CHU de Caen, U1077 (E.M.A.-U., J.G., M.F., A.P., F.M., B.L., S.E., B.D., G.C.); and CHU de Caen (S.E., V.D.l.S.), Service de Neurologie, Caen, France
| | - Gaël Chételat
- From INSERM U1077 (E.M.A.-U., J.G., M.F., A.P., F.M., B.L., S.E., V.D.l.S., B.D., G.C.); Université de Caen Basse-Normandie (E.M.A.-U., J.G., M.F., A.P., F.M., B.L., V.D.l.S., B.D., G.C.) and Ecole Pratique des Hautes Etudes (E.M.A.-U., J.G., M.F., A.P., F.M., B.L., V.D.l.S., B.D., G.C.), UMR-S1077; CHU de Caen, U1077 (E.M.A.-U., J.G., M.F., A.P., F.M., B.L., S.E., B.D., G.C.); and CHU de Caen (S.E., V.D.l.S.), Service de Neurologie, Caen, France.
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Dekhtyar S, Wang HX, Scott K, Goodman A, Koupil I, Herlitz A. A Life-Course Study of Cognitive Reserve in Dementia--From Childhood to Old Age. Am J Geriatr Psychiatry 2015; 23:885-96. [PMID: 25746486 DOI: 10.1016/j.jagp.2015.02.002] [Citation(s) in RCA: 92] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2014] [Revised: 01/19/2015] [Accepted: 02/03/2015] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To test a life-course model of cognitive reserve in dementia and examine if school grades around age 10 years, formal educational attainment, and lifetime occupational complexity affect the risk of dementia in old age. METHODS 7,574 men and women from the Uppsala Birth Cohort Multigenerational Study were followed for 21 years. Information on school performance, formal education, and occupational attainment was collected prospectively from elementary school archives and population censuses. Dementia diagnosis was extracted from the two Swedish registers. Discrete-time Cox proportional hazard models were estimated. RESULTS Dementia was diagnosed in 950 individuals (12.5%). Dementia risk was lower among individuals with higher childhood school grades (hazard ratio [HR]: 0.79; 95% confidence interval [CI]: 0.68 to 0.93) and was lower among individuals in data-complex occupations (HR: 0.77; 95% CI: 0.64 to 0.92). Professional/university education predicted lower risk of dementia in minimally adjusted models (HR: 0.74; 95% CI: 0.60 to 0.91), although the effect faded with adjustment for occupational complexity. Lowest risk was found in the group with both higher childhood school performance and high occupational complexity with data (HR: 0.61; 95% CI: 0.50 to 0.75). Importantly, high occupational complexity could not compensate for the effect of low childhood grades. In contrast, dementia risk was reduced in those with higher school grades, irrespective of occupational complexity. CONCLUSION Higher childhood school performance is protective of dementia risk, particularly when preserved through complex work environments in adulthood, although it will remain protective even in the absence of later-life educational or occupational stimulation.
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Affiliation(s)
- Serhiy Dekhtyar
- Department of Clinical Neuroscience, Section of Psychology, Karolinska Institutet and Stockholm University, Stockholm, Sweden.
| | - Hui-Xin Wang
- Aging Research Center, Department of Neurobiology, Care Sciences, and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden
| | - Kirk Scott
- Centre for Economic Demography and Department of Economic History, Lund, Sweden
| | - Anna Goodman
- Faculty of Epidemiology and Population Health, London School of Hygiene and Tropical Medicine, London, UK
| | - Ilona Koupil
- Centre for Health and Equity Studies, Karolinska Institutet and Stockholm University, Stockholm, Sweden
| | - Agneta Herlitz
- Department of Clinical Neuroscience, Section of Psychology, Karolinska Institutet and Stockholm University, Stockholm, Sweden
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Caselli RJ, Coon EA, Johansson L. Midlife personality and risk of Alzheimer disease and distress: A 38-year follow-upAuthor Response. Neurology 2015. [DOI: 10.1212/wnl.0000000000001777] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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