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Rice PE, Thumuluri D, Barnstaple R, Fanning J, Laurita-Spanglet J, Soriano CT, Hugenschmidt CE. Moving Towards a Medicine of Dance: A Scoping Review of Characteristics of Dance Interventions Targeting Older Adults and a Theoretical Framework. J Alzheimers Dis 2024:JAD230741. [PMID: 39031353 DOI: 10.3233/jad-230741] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/22/2024]
Abstract
Background Dance combines cultural and aesthetic elements with behaviors important for brain health, including physical activity, social engagement, and cognitive challenge. Therefore, dance could positively impact public health given the rapidly aging population, increasing incidence of Alzheimer's disease and related dementias, and lack of uptake of exercise in many older adults. Despite a high volume of literature, existing literature does not support evidence-based guidelines for dance to support healthy aging. Objective To conduct a scoping review of the dance intervention literature in older adults and provide information to facilitate a more consistent approach among scientists in designing dance interventions for older adults that stimulate physical and neurocognitive health adaptations. Methods Study characteristics (sample size, population, study design, outcomes, intervention details) were ascertained from 112 separate studies of dance reported in 127 papers that reported outcomes important for brain health (cardiorespiratory fitness, balance and mobility, cognition, mood, and quality of life). Results High heterogeneity across studies was evident. Class frequency ranged from < 1 to 5 classes per week, class length from 30-120 minutes, and intervention duration from 2 weeks to 18 months. Studies often did not randomize participants, had small (< 30) sample sizes, and used varied comparator conditions. Over 50 tests of cognition, 40 dance forms, and 30 tests of mobility were identified. Conclusions Based on these results, important future directions are establishing common data elements, developing intervention mapping and mechanistic modeling, and testing dosing parameters to strengthen and focus trial design of future studies and generate evidence-based guidelines for dance.
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Affiliation(s)
- Paige E Rice
- Department of Health and Exercise Science, Wake Forest University, Winston-Salem, NC, USA
| | - Deepthi Thumuluri
- Department of Internal Medicine, Section on Gerontology and Geriatric Medicine, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | | | - Jason Fanning
- Department of Health and Exercise Science, Wake Forest University, Winston-Salem, NC, USA
- Department of Internal Medicine, Section on Gerontology and Geriatric Medicine, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | | | - Christina T Soriano
- Department of Theatre and Dance, Wake Forest University, Winston-Salem, NC, USA
| | - Christina E Hugenschmidt
- Department of Internal Medicine, Section on Gerontology and Geriatric Medicine, Wake Forest School of Medicine, Winston-Salem, NC, USA
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Xu X, Catts VS, Harris K, Wang N, Numbers K, Trollor J, Brodaty H, Sachdev PS, Schutte AE. The contribution of cumulative blood pressure load to dementia, cognitive function and mortality in older adults. J Hypertens 2024:00004872-990000000-00505. [PMID: 38989713 DOI: 10.1097/hjh.0000000000003808] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/12/2024]
Abstract
BACKGROUND Few studies evaluated the contribution of long-term elevated blood pressure (BP) towards dementia and deaths. We examined the association between cumulative BP (cBP) load and dementia, cognitive decline, all-cause and cardiovascular deaths in older Australians. We also explored whether seated versus standing BP were associated with these outcomes. METHODS The Sydney Memory and Aging Study included 1037 community-dwelling individuals aged 70-90 years, recruited from Sydney, Australia. Baseline data was collected in 2005-2007 and the cohort was followed for seven waves until 2021. cSBP load was calculated as the area under the curve (AUC) for SBP ≥140 mmHg divided by the AUC for all SBP values. Cumulative diastolic BP (cDBP) and pulse pressure (cPP) load were calculated using thresholds of 90 mmHg and 60 mmHg. Cox and mixed linear models were used to assess associations. RESULTS Of 527 participants with both seated and standing BP data (47.7% men, median age 77), 152 (28.8%) developed dementia over a mean follow-up of 10.5 years. Higher cPP load was associated with a higher risk of all-cause deaths, and cSBP load was associated with a higher risk of cardiovascular deaths in multivariate models (P for trend < 0.05). Associations between cPP load, dementia and cognitive decline lost statistical significance after adjustment for age. Differences between sitting and standing BP load were not associated with the outcomes. CONCLUSION Long-term cPP load was associated with a higher risk of all-cause deaths and cSBP load associated with a higher risk of cardiovascular deaths in older Australians.
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Affiliation(s)
- Xiaoyue Xu
- School of Population Health, Faculty of Medicine and Health
- The George Institute for Global Health
| | - Vibeke S Catts
- Centre for Healthy Brain Ageing (CHeBA), Discipline of Psychiatry and Mental Health, School of Clinical Medicine
| | | | | | - Katya Numbers
- Centre for Healthy Brain Ageing (CHeBA), Discipline of Psychiatry and Mental Health, School of Clinical Medicine
| | - Julian Trollor
- Centre for Healthy Brain Ageing (CHeBA), Discipline of Psychiatry and Mental Health, School of Clinical Medicine
- Department of Developmental Disability Neuropsychiatry, Discipline of Psychiatry and Mental Health, School of Clinical Medicine, University of New South Wales, Sydney, Australia
| | - Henry Brodaty
- Centre for Healthy Brain Ageing (CHeBA), Discipline of Psychiatry and Mental Health, School of Clinical Medicine
| | - Perminder S Sachdev
- Centre for Healthy Brain Ageing (CHeBA), Discipline of Psychiatry and Mental Health, School of Clinical Medicine
| | - Aletta E Schutte
- School of Population Health, Faculty of Medicine and Health
- The George Institute for Global Health
- Hypertension in Africa Research Team; Medical Research Council Unit for Hypertension and Cardiovascular Disease, North-West University, Potchefstroom 2520, South Africa
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Yang Z, Lange F, Xia Y, Chertavian C, Cabolis K, Sajic M, Werring DJ, Tachtsidis I, Smith KJ. Nimodipine Protects Vascular and Cognitive Function in an Animal Model of Cerebral Small Vessel Disease. Stroke 2024; 55:1914-1922. [PMID: 38860370 PMCID: PMC11251505 DOI: 10.1161/strokeaha.124.047154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2023] [Revised: 04/22/2024] [Accepted: 04/26/2024] [Indexed: 06/12/2024]
Abstract
BACKGROUND Cerebral small vessel disease is a common cause of vascular cognitive impairment and dementia. There is an urgent need for preventative treatments for vascular cognitive impairment and dementia, and reducing vascular dysfunction may provide a therapeutic route. Here, we investigate whether the chronic administration of nimodipine, a central nervous system-selective dihydropyridine calcium channel blocking agent, protects vascular, metabolic, and cognitive function in an animal model of cerebral small vessel disease, the spontaneously hypertensive stroke-prone rat. METHODS Male spontaneously hypertensive stroke-prone rats were randomly allocated to receive either a placebo (n=24) or nimodipine (n=24) diet between 3 and 6 months of age. Animals were examined daily for any neurological deficits, and vascular function was assessed in terms of neurovascular and neurometabolic coupling at 3 and 6 months of age, and cerebrovascular reactivity at 6 months of age. Cognitive function was evaluated using the novel object recognition test at 6 months of age. RESULTS Six untreated control animals were terminated prematurely due to strokes, including one due to seizure, but no treated animals experienced strokes and so had a higher survival (P=0.0088). Vascular function was significantly impaired with disease progression, but nimodipine treatment partially preserved neurovascular coupling and neurometabolic coupling, indicated by larger (P<0.001) and more prompt responses (P<0.01), and less habituation upon repeated stimulation (P<0.01). Also, animals treated with nimodipine showed greater cerebrovascular reactivity, indicated by larger dilation of arterioles (P=0.015) and an increase in blood flow velocity (P=0.001). This protection of vascular and metabolic function achieved by nimodipine treatment was associated with better cognitive function (P<0.001) in the treated animals. CONCLUSIONS Chronic treatment with nimodipine protects from strokes, and vascular and cognitive deficits in spontaneously hypertensive stroke-prone rat. Nimodipine may provide an effective preventive treatment for stroke and cognitive decline in cerebral small vessel disease.
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Affiliation(s)
- Zhiyuan Yang
- Department of Neuroinflammation, UCL Queen Square Institute of Neurology (Z.Y., Y.X., C.C., K.C., M.S., K.J.S.), University College London, United Kingdom
| | - Frédéric Lange
- Department of Medical Physics and Biomedical Engineering (F.L., I.T.), University College London, United Kingdom
| | - Yiqing Xia
- Department of Neuroinflammation, UCL Queen Square Institute of Neurology (Z.Y., Y.X., C.C., K.C., M.S., K.J.S.), University College London, United Kingdom
| | - Casey Chertavian
- Department of Neuroinflammation, UCL Queen Square Institute of Neurology (Z.Y., Y.X., C.C., K.C., M.S., K.J.S.), University College London, United Kingdom
| | - Katerina Cabolis
- Department of Neuroinflammation, UCL Queen Square Institute of Neurology (Z.Y., Y.X., C.C., K.C., M.S., K.J.S.), University College London, United Kingdom
| | - Marija Sajic
- Department of Neuroinflammation, UCL Queen Square Institute of Neurology (Z.Y., Y.X., C.C., K.C., M.S., K.J.S.), University College London, United Kingdom
| | - David J. Werring
- Stroke Research Centre, Department of Brain Repair and Rehabilitation, UCL Queen Square Institute of Neurology (D.J.W.), University College London, United Kingdom
| | - Ilias Tachtsidis
- Department of Medical Physics and Biomedical Engineering (F.L., I.T.), University College London, United Kingdom
| | - Kenneth J. Smith
- Department of Neuroinflammation, UCL Queen Square Institute of Neurology (Z.Y., Y.X., C.C., K.C., M.S., K.J.S.), University College London, United Kingdom
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Cheng Y, Lin L, Huang P, Zhang J, Wang Y, Pan X. Hypotension with neurovascular changes and cognitive dysfunction: An epidemiological, pathobiological, and treatment review. Chin Med J (Engl) 2024:00029330-990000000-01080. [PMID: 38785189 DOI: 10.1097/cm9.0000000000003103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2023] [Indexed: 05/25/2024] Open
Abstract
ABSTRACT Hypotension is a leading cause of age-related cognitive impairment. The available literature evidences that vascular factors are associated with dementia and that hypotension alters cerebral perfusion flow and can aggravate the neurodegeneration of Alzheimer's disease (AD). Despite the discovery of biomarkers and the recent progress made in neurovascular biology, epidemiology, and brain imaging, some key issues remain largely unresolved: the potential mechanisms underlying the neural deterioration observed in AD, the effect of cerebrovascular alterations on cognitive deficits, and the positive effects of hypotension treatment on cognition. Therefore, further well-designed studies are needed to unravel the potential association between hypotension and cognitive dysfunction and reveal the potential benefits of hypotension treatment for AD patients. Here, we review the current epidemiological, pathobiological, and treatment-related literature on neurovascular changes and hypotension-related cognitive dysfunction and highlight the unsettled but imminent issues that warrant future research endeavors.
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Affiliation(s)
- Yingzhe Cheng
- Department of Neurology, Center for Cognitive Neurology, Fujian Medical University Union Hospital, Fuzhou, Fujian 350001, China
- Fujian Institute of Geriatrics, Fujian Medical University Union Hospital, Fuzhou, Fujian 350001, China
- Institute of Clinical Neurology, Fujian Medical University, Fuzhou, Fujian 350001, China
- Fujian Key Laboratory of Molecular Neurology, Fujian Medical University, Fuzhou, Fujian 350001, China
| | - Lin Lin
- Department of Neurology, Center for Cognitive Neurology, Fujian Medical University Union Hospital, Fuzhou, Fujian 350001, China
- Fujian Institute of Geriatrics, Fujian Medical University Union Hospital, Fuzhou, Fujian 350001, China
- Institute of Clinical Neurology, Fujian Medical University, Fuzhou, Fujian 350001, China
- Fujian Key Laboratory of Molecular Neurology, Fujian Medical University, Fuzhou, Fujian 350001, China
| | - Peilin Huang
- Department of Neurology, Center for Cognitive Neurology, Fujian Medical University Union Hospital, Fuzhou, Fujian 350001, China
- Fujian Institute of Geriatrics, Fujian Medical University Union Hospital, Fuzhou, Fujian 350001, China
- Institute of Clinical Neurology, Fujian Medical University, Fuzhou, Fujian 350001, China
- Fujian Key Laboratory of Molecular Neurology, Fujian Medical University, Fuzhou, Fujian 350001, China
| | - Jiejun Zhang
- Department of Neurology, Center for Cognitive Neurology, Fujian Medical University Union Hospital, Fuzhou, Fujian 350001, China
- Fujian Institute of Geriatrics, Fujian Medical University Union Hospital, Fuzhou, Fujian 350001, China
- Institute of Clinical Neurology, Fujian Medical University, Fuzhou, Fujian 350001, China
- Fujian Key Laboratory of Molecular Neurology, Fujian Medical University, Fuzhou, Fujian 350001, China
- Center for Geriatrics, Hainan General Hospital, Haikou, Hainan 570311, China
| | - Yanping Wang
- Department of Endocrinology, Fujian Medical University Union Hospital, Fuzhou, Fujian 350001, China
| | - Xiaodong Pan
- Department of Neurology, Center for Cognitive Neurology, Fujian Medical University Union Hospital, Fuzhou, Fujian 350001, China
- Fujian Institute of Geriatrics, Fujian Medical University Union Hospital, Fuzhou, Fujian 350001, China
- Institute of Clinical Neurology, Fujian Medical University, Fuzhou, Fujian 350001, China
- Fujian Key Laboratory of Molecular Neurology, Fujian Medical University, Fuzhou, Fujian 350001, China
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Bothe TL, Kreutz R, Glos M, Patzak A, Pilz N. Simultaneous 24-h ambulatory blood pressure measurement on both arms: a consideration for improving hypertension management. J Hypertens 2024; 42:828-840. [PMID: 38088417 DOI: 10.1097/hjh.0000000000003632] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/05/2024]
Abstract
OBJECTIVE Arterial hypertension is one of the common treatment goals in today's medicine. 24-h ambulatory blood pressure measurement (ABPM) performed by oscillometric cuff-based devices is considered as the gold standard in hypertension diagnostics. This study aims at examining the measurement accuracy of a widely used, ABPM device. METHODS Fifty-two young and healthy participants underwent simultaneous 24-h ABPM on the left and the right upper arm using two Boso/A&D TM-2430 oscillometric cuff-based devices. Pressure curves of the cuffs, as well as hydrostatic pressure difference between the cuffs were recorded. RESULTS The mean differences between both simultaneous measurements were 1.16 mmHg with limits of agreement of 36.23 mmHg for SBP and 1.32 mmHg with limits of agreement of 32.65 mmHg for DBP. Excluding measurements where the pressure curves were disturbed and correcting for hydrostatic pressure difference between the cuffs, reduced the measurement error. However, limits of agreement remained around 20 mmHg. There were large differences in hypertension grading and dipping pattern classification between simultaneous measurements on the left and right arm. CONCLUSION The cuff-based ABPM device reveals notable measurement uncertainties, influencing hypertension grading, dipping pattern classification and blood pressure variability. These effects are attributed in part to disturbances during cuff deflation and hydrostatic influences. Nonetheless, ABPM has shown its clinical values in several studies, while this study underscores its still unlocked potential to improve hypertension management.
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Affiliation(s)
- Tomas L Bothe
- Charité - Universitätsmedizin Berlin, Institute of Physiology, Center for Space Medicine and Extreme Environments Berlin
| | - Reinhold Kreutz
- Charité - Universitätsmedizin Berlin, Institute of Clinical Pharmacology and Toxicology
| | - Martin Glos
- Charité - Universitätsmedizin Berlin, Interdisciplinary Center of Sleep Medicine
| | - Andreas Patzak
- Charité - Universitätsmedizin Berlin, Institute of Translational Physiology, Berlin, Germany
| | - Niklas Pilz
- Charité - Universitätsmedizin Berlin, Institute of Translational Physiology, Berlin, Germany
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6
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Popiołek AK, Niznikiewicz MA, Borkowska A, Bieliński MK. Evaluation of Event-Related Potentials in Somatic Diseases - Systematic Review. Appl Psychophysiol Biofeedback 2024:10.1007/s10484-024-09642-5. [PMID: 38564137 DOI: 10.1007/s10484-024-09642-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/04/2024]
Abstract
Many somatic illnesses (e.g. hypertension, diabetes, pulmonary and cardiac diseases, hepatitis C, kidney and heart failure, HIV infection, Sjogren's disease) may impact central nervous system functions resulting in emotional, sensory, cognitive or even personality impairments. Event-related potential (ERP) methodology allows for monitoring neurocognitive processes and thus can provide a valuable window into these cognitive processes that are influenced, or brought about, by somatic disorders. The current review aims to present published studies on the relationships between somatic illness and brain function as assessed with ERP methodology, with the goal to discuss where this field of study is right now and suggest future directions.
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Affiliation(s)
- Alicja K Popiołek
- Department of Clinical Neuropsychology, Nicolaus Copernicus University in Toruń, Collegium Medicum in Bydgoszcz, Curie Sklodowskiej 9, 85-094, Bydgoszcz, Poland.
| | - Margaret A Niznikiewicz
- Medical Center, Harvard Medical School and Boston VA Healthcare System, Psychiatry 116a C/O R. McCarly 940 Belmont St, Brockton, MA, 02301, USA
| | - Alina Borkowska
- Department of Clinical Neuropsychology, Nicolaus Copernicus University in Toruń, Collegium Medicum in Bydgoszcz, Curie Sklodowskiej 9, 85-094, Bydgoszcz, Poland
| | - Maciej K Bieliński
- Department of Clinical Neuropsychology, Nicolaus Copernicus University in Toruń, Collegium Medicum in Bydgoszcz, Curie Sklodowskiej 9, 85-094, Bydgoszcz, Poland
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7
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Richey LN, Abad Coronel MX, Bryant BR, Esagoff AI, White J, Cranston CC, Peters ME. A systematic review of cognition in idiopathic intracranial hypertension. Clin Neuropsychol 2024; 38:612-643. [PMID: 37614079 DOI: 10.1080/13854046.2023.2249176] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2022] [Accepted: 08/12/2023] [Indexed: 08/25/2023]
Abstract
Background: Cognitive disturbance is not pathognomonic of idiopathic intracranial hypertension (IIH), and therefore is not routinely assessed unless it presents as a major complaint. Consequently, cognition has been slow to gain substantial traction in IIH-related research, despite its notable impact on a subset of patients. We completed a systematic review of the literature examining the neurocognitive profile of patients with IIH. Methods: A PRISMA compliant literature search was conducted in Ovid Medline, PubMed, PsycInfo, Embase, Web of Science, Cochrane, Cinahl, and Scopus databases. The initial query yielded 1376 unique articles. These articles were narrowed to those including empirical analyses of cognitive assessment in adult patients with IIH. Results: A final cohort of nine articles resulted, comprising the findings from 309 patients with IIH and 153 healthy control subjects. Although there was considerable variability in methodology particularly with respect to cognitive assessment, fairly consistent deficits were observed across studies in the domains of processing speed, working memory, sustained and complex attention, set-shifting, and confrontation naming. Body mass index and body weight were not associated with cognitive performance. Pertinent limitations of the literature were identified, most notably failure to report trial-level cognitive testing data, the need for more comprehensive testing batteries with less reliance on screening tools, and not controlling for variables that may impact cognition. Conclusions: A more complete understanding of the cognitive profile in patients with idiopathic intracranial hypertension could lead to the increased -relevance of cognitive screening in disease management, and therefore more appropriate neuropsychological referral, earlier identification of functional limitations, and targeted neurorehabilitation.
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Affiliation(s)
- Lisa N Richey
- Division of Geriatric Psychiatry and Neuropsychiatry, Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Marcelo X Abad Coronel
- Division of Geriatric Psychiatry and Neuropsychiatry, Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Barry R Bryant
- Division of Geriatric Psychiatry and Neuropsychiatry, Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Aaron I Esagoff
- Division of Geriatric Psychiatry and Neuropsychiatry, Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Jacob White
- Welch Medical Library, Johns Hopkins University, Baltimore, MD, USA
| | - Christopher C Cranston
- Division of Geriatric Psychiatry and Neuropsychiatry, Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Matthew E Peters
- Division of Geriatric Psychiatry and Neuropsychiatry, Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
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Norling AM, Gerstenecker A, Bolding MS, Hoef LV, Buford T, Walden R, An H, Ying C, Myers T, Jones BS, Del Bene V, Lazar RM. Effects of a brief HIIT intervention on cognitive performance in older women. GeroScience 2024; 46:1371-1384. [PMID: 37581755 PMCID: PMC10828265 DOI: 10.1007/s11357-023-00893-4] [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: 06/19/2023] [Accepted: 07/25/2023] [Indexed: 08/16/2023] Open
Abstract
Cardiorespiratory fitness (CRF) mitigates age-related decline in cognition and brain volume. Little is known, however, about the effects of high-intensity interval training (HIIT) on cognitive aging and the relationship between HIIT, cognition, hippocampal subfield volumes, and cerebral oxygen extraction fraction (OEF). Older sedentary women participated in an 8-week HIIT intervention. We conducted cognitive assessments, fitness assessments (VO2max), MRI scans: asymmetric spin echo oxygen extraction fraction (ASE-OEF), high-resolution multiple image co-registration and averaging (HR-MICRA) imaging, and transcranial Doppler ultrasonography before and after the intervention. VO2max increased from baseline (M = 19.36, SD = 2.84) to follow-up (M = 23.25, SD = 3.61), Z = - 2.93, p < .001, r = 0.63. Composite cognitive (Z = - 2.05, p = 0.041), language (Z = - 2.19, p = 0.028), and visuospatial memory (Z = - 2.22, p = 0.026), z-scores increased significantly. Hippocampal subfield volumes CA1 and CA3 dentate gyrus and subiculum decreased non-significantly (all p > 0.05); whereas a significant decrease in CA2 (Z = - 2.045, p = 0.041, r = 0.436) from baseline (M = 29.51; SD = 24.50) to follow-up (M = 24.50; SD = 13.38) was observed. Right hemisphere gray matter was correlated with language z-scores (p = 0.025; r = 0.679). The subiculum was correlated with attention (p = 0.047; r = 0.618) and verbal memory (p = 0.020; r = 0.700). The OEF and CBF were unchanged at follow-up (all p > .05). Although we observed cognitive improvements following 8 weeks of our HIIT intervention, they were not explained by hippocampal, OEF, or CBF changes.
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Affiliation(s)
- Amani M Norling
- Department of Neurology, University of Alabama at Birmingham, 650 Sparks Center, 1720 7Th Avenue South, Birmingham, AL, 35294, USA.
- Department of Psychology, University of Alabama at Birmingham, Birmingham, AL, USA.
- Evelyn F. McKnight Brain Institute, University of Alabama at Birmingham, Birmingham, AL, USA.
| | - Adam Gerstenecker
- Department of Neurology, University of Alabama at Birmingham, 650 Sparks Center, 1720 7Th Avenue South, Birmingham, AL, 35294, USA
- Evelyn F. McKnight Brain Institute, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Mark S Bolding
- Evelyn F. McKnight Brain Institute, University of Alabama at Birmingham, Birmingham, AL, USA
- Department of Radiology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Lawrence Ver Hoef
- Department of Neurology, University of Alabama at Birmingham, 650 Sparks Center, 1720 7Th Avenue South, Birmingham, AL, 35294, USA
| | - Thomas Buford
- Center for Exercise Medicine, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Randall Walden
- School of Engineering, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Hongyu An
- Mallinckrodt Institute of Radiology, Washington University of Medicine in St. Louis, St. Louis, MO, USA
| | - Chunwei Ying
- Mallinckrodt Institute of Radiology, Washington University of Medicine in St. Louis, St. Louis, MO, USA
| | - Terina Myers
- Department of Neurology, University of Alabama at Birmingham, 650 Sparks Center, 1720 7Th Avenue South, Birmingham, AL, 35294, USA
- Evelyn F. McKnight Brain Institute, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Benjamin S Jones
- Department of Neurology, University of Alabama at Birmingham, 650 Sparks Center, 1720 7Th Avenue South, Birmingham, AL, 35294, USA
| | - Victor Del Bene
- Department of Neurology, University of Alabama at Birmingham, 650 Sparks Center, 1720 7Th Avenue South, Birmingham, AL, 35294, USA
- Evelyn F. McKnight Brain Institute, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Ronald M Lazar
- Department of Neurology, University of Alabama at Birmingham, 650 Sparks Center, 1720 7Th Avenue South, Birmingham, AL, 35294, USA
- Evelyn F. McKnight Brain Institute, University of Alabama at Birmingham, Birmingham, AL, USA
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Cao Y, Zhu G, Feng C, Chen J, Gan W, Ma Y, Hu Y, Dhana K, Voortman T, Shen J, Li T, Zheng Y, Yuan C, Zong G. Cardiovascular risk burden, dementia risk and brain structural imaging markers: a study from UK Biobank. Gen Psychiatr 2024; 37:e101209. [PMID: 38292861 PMCID: PMC10826560 DOI: 10.1136/gpsych-2023-101209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Accepted: 12/11/2023] [Indexed: 02/01/2024] Open
Abstract
Background Cardiovascular risk burden is associated with dementia risk and neurodegeneration-related brain structure, while the role of genetics and incident cardiovascular disease (CVD) remains unclear. Aims To examine the association of overall cardiovascular risk burden with the risk of major dementia subtypes and volumes of related brain regions in a large sample, and to explore the role of genetics and CVD onset. Methods A prospective study among 354 654 participants free of CVD and dementia (2006-2010, mean age 56.4 years) was conducted within the UK Biobank, with brain magnetic resonance imaging (MRI) measurement available for 15 104 participants since 2014. CVD risk burden was evaluated by the Framingham General Cardiovascular Risk Score (FGCRS). Dementia diagnosis was ascertained from inpatient and death register data. Results Over a median 12.0-year follow-up, 3998 all-cause dementia cases were identified. Higher FGCRS was associated with increased all-cause dementia risk after adjusting for demographic, major lifestyle, clinical factors and the polygenic risk score (PRS) of Alzheimer's disease. Comparing the high versus low tertile of FGCRS, the odds ratios (ORs) and 95% confidence intervals (CIs) were 1.26 (1.12 to 1.41) for all-cause dementia, 1.67 (1.33 to 2.09) for Alzheimer's disease and 1.53 (1.07 to 2.16) for vascular dementia (all ptrend<0.05). Incident stroke and coronary heart disease accounted for 14% (95% CI: 9% to 21%) of the association between FGCRS and all-cause dementia. Interactions were not detected for FGCRS and PRS on the risk of any dementia subtype. We observed an 83% (95% CI: 47% to 128%) higher all-cause dementia risk comparing the high-high versus low-low FGCRS-PRS category. For brain volumes, higher FGCRS was associated with greater log-transformed white matter hyperintensities, smaller cortical volume and smaller grey matter volume. Conclusions Our findings suggest that the positive association of cardiovascular risk burden with dementia risk also applies to major dementia subtypes. The association of cardiovascular risk burden with all-cause dementia is largely independent of CVD onset and genetic predisposition to dementia.
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Affiliation(s)
- Yaying Cao
- Department of Food Nutrition and Health, School of Medicine and Health, Harbin Institute of Technology, Harbin, Heilongjiang, China
- CAS Key Laboratory of Nutrition, Metabolism and Food Safety, Shanghai Institute of Nutrition and Health, Chinese Academy of Sciences, Shanghai, China
| | - Gaohong Zhu
- Department of Nuclear Medicine, First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, China
| | - Chengwu Feng
- CAS Key Laboratory of Nutrition, Metabolism and Food Safety, Shanghai Institute of Nutrition and Health, Chinese Academy of Sciences, Shanghai, China
| | - Jing Chen
- Neurology Department, Zhongshan Hospital Affiliated with Fudan University, Shanghai, China
| | - Wei Gan
- Medical Research Council Population Health Research Unit, University of Oxford, Oxford, UK
- Department of Genetics, Novo Nordisk Research Centre Oxford, Oxford, UK
| | - Yuan Ma
- Harvard University T H Chan School of Public Health, Boston, Massachusetts, USA
| | - Yonghua Hu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
| | - Klodian Dhana
- Department of Internal Medicine, Rush University Medical Center, Chicago, Illinois, USA
| | - Trudy Voortman
- Department of Epidemiology, Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
- Division of Human Nutrition and Health, Wageningen University & Research, Wageningen, The Netherlands
| | - Jie Shen
- School of Public Health, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Ting Li
- First Affiliated Hospital of Kunming Medical University, Kunming, Yunnan, China
| | - Yan Zheng
- State Key Laboratory of Genetic Engineering, School of Life Sciences, Fudan University, Shanghai, China
- Ministry of Education Key Laboratory of Public Health Safety, School of Public Health, Fudan University, Shanghai, China
| | - Changzheng Yuan
- School of Public Health, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
- The Key Laboratory of Intelligent Preventive Medicine of Zhejiang Province, Hangzhou, Zhejiang, China
| | - Geng Zong
- CAS Key Laboratory of Nutrition, Metabolism and Food Safety, Shanghai Institute of Nutrition and Health, Chinese Academy of Sciences, Shanghai, China
- Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Shanghai, China
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10
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Howie EK, Lamm C, Shreve MD, Caldwell AR, Ganio MS. Beyond weight: associations between 24-hour movement behaviors, cardiometabolic and cognitive health in adolescents with and without obesity. CHILD AND ADOLESCENT OBESITY 2023. [DOI: 10.1080/2574254x.2023.2189875] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/19/2023] Open
Affiliation(s)
- Erin K Howie
- Department of Health, Human Performance and Recreation, University of Arkansas, Fayetteville, AR, USA
| | - Connie Lamm
- Department of Health, Human Performance and Recreation, University of Arkansas, Fayetteville, AR, USA
| | - Marilou D. Shreve
- Department of Health, Human Performance and Recreation, University of Arkansas, Fayetteville, AR, USA
| | - Aaron R. Caldwell
- Department of Health, Human Performance and Recreation, University of Arkansas, Fayetteville, AR, USA
| | - Matthew S. Ganio
- Department of Health, Human Performance and Recreation, University of Arkansas, Fayetteville, AR, USA
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11
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Zhao C, Habtewold TD, Naderi E, Liemburg EJ, Bruggeman R, Alizadeh BZ. Association of clinical symptoms and cardiometabolic dysregulations in patients with schizophrenia spectrum disorders. Eur Psychiatry 2023; 67:e7. [PMID: 38088065 DOI: 10.1192/j.eurpsy.2023.2477] [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] [Indexed: 01/23/2024] Open
Abstract
BACKGROUND Patients with schizophrenia spectrum disorders (SSD) have a shortened life expectancy related to cardiovascular diseases. We investigated the association of cognitive, positive, and negative symptoms with cardiometabolic dysregulations in SSD patients. METHODS Overall, 1,119 patients from the Genetic Risk and Outcome in Psychosis (GROUP) study were included. Cognitive function, positive and negative symptoms were assessed at baseline, 3-year, and 6-year. Cardiometabolic biomarkers were measured at 3-year follow-up. We used linear and multinomial logistic regression models to test the association between cardiometabolic biomarkers and clinical trajectories and performed mediation analyzes, while adjusting for clinical and demographic confounders. RESULTS Cognitive performance was inversely associated with increased body mass index (mean difference [β], βhigh = -1.24, 95% CI = -2.28 to 0.20, P = 0.02) and systolic blood pressure (βmild = 2.74, 95% CI = 0.11 to 5.37, P = 0.04). The severity of positive symptoms was associated with increased glycated hemoglobin (HbA1c) levels (βlow = -2.01, 95% CI = -3.21 to -0.82, P = 0.001). Increased diastolic blood pressure (ORhigh-decreased = 1.04, 95% CI = 1.01 to 1.08, P = 0.02; ORhigh-increased = 1.04, 95% CI = 1.00 to 1.08, P = 0.048) and decreased high-density lipoprotein (OR high-increased = 6.25, 95% CI = 1.81 to 21.59, P = 0.004) were associated with more severe negative symptoms. Increased HbA1c (ORmoderate = 1.05, 95% CI = 1.01 to 1.10, P = 0.024; ORhigh = 1.08, 95% CI = 1.02 to 1.14, P = 0.006) was associated with more severe positive symptoms. These associations were not mediated by antipsychotics. CONCLUSIONS We showed an association between cardiometabolic dysregulations and clinical and cognitive symptoms in SSD patients. The observed associations underscore the need for early identification of patients at risk of cardiometabolic outcomes.
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Affiliation(s)
- Chenxu Zhao
- Department of Epidemiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Tesfa Dejenie Habtewold
- Department of Epidemiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Elnaz Naderi
- Department of Epidemiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Edith J Liemburg
- Department of Psychiatry, Rob Giel Research Center, University Center for Psychiatry, Groningen, The Netherlands
| | - Richard Bruggeman
- Department of Psychiatry, Rob Giel Research Center, University Center for Psychiatry, Groningen, The Netherlands
| | - Behrooz Z Alizadeh
- Department of Epidemiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
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12
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Wang H, Yu M, Ren J, Zhong X, Xu D, Gao L, Xu H. Neuroanatomical correlates of cognitive impairment following basal ganglia-thalamic post-hemorrhagic stroke: Uncovering network-wide alterations in hemispheric gray matter asymmetry. Brain Res 2023; 1820:148559. [PMID: 37652090 DOI: 10.1016/j.brainres.2023.148559] [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: 04/12/2023] [Revised: 08/16/2023] [Accepted: 08/26/2023] [Indexed: 09/02/2023]
Abstract
Cognitive impairment and recovery are central issues in hemorrhagic stroke. This study aimed to investigate whether post-hemorrhagic stroke cognitive impairment (PhSCI) is associated with cortical gray matter (GM) loss and hemispheric asymmetry changes and whether these changes could predict improvements in cognitive function during the recovery. Nineteen patients with PhSCI, comprising 10 with basal ganglia hemorrhage and 9 with thalamic hemorrhage, were recruited. Among them, 9 completed a course of repetitive transcranial magnetic stimulation (rTMS). Additionally, 19 demographically and comorbidity-matched healthy controls were also included. Structural brain MRI and cognitive assessments were performed. Voxel-wise GM volume and hemispheric asymmetry were analyzed. The PhSCI patients exhibited bilateral, yet asymmetric, GM losses in the hippocampus, fusiform, lateral temporal, prefrontal, somatomotor, and inferior parietal regions. The analysis of GM asymmetry revealed that patients showed rightward GM in the lateral temporal, somatomotor, and inferior parietal regions. Among the 9 PhSCI patients who completed rTMS, there was a marginal trend of regional GM increase and leftward GM, and these changes were in parallel with the improvements in cognitive tests. Further lesion connectivity and metanalytic mapping identified two interconnected systems linked to the lesions, which were anchored in the default mode, somatomotor, and salience/cognitive control networks and in the cognitive domains of memory, language, decision-making, and executive function. In conclusion, PhSCI patients exhibited network-wide cortical GM losses, distal to subcortical hemorrhagic lesions, and hemisphere asymmetry changes. These changes appear to predict rTMS-related cognitive improvements, suggesting that even subcortical focal lesions can lead to alterations in distal cortical neuroanatomical architecture. Our preliminary findings provide new insights into the neuroanatomical basis of PhSCI.
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Affiliation(s)
- Huan Wang
- Department of Radiology, Zhongnan Hospital of Wuhan University, Wuchang District, Wuhan City 430071, Hubei Province, China
| | - Minhua Yu
- Department of Radiology, Zhongnan Hospital of Wuhan University, Wuchang District, Wuhan City 430071, Hubei Province, China
| | - Jinxia Ren
- Department of Radiology, Zhongnan Hospital of Wuhan University, Wuchang District, Wuhan City 430071, Hubei Province, China
| | - Xiaoli Zhong
- Department of Radiology, Zhongnan Hospital of Wuhan University, Wuchang District, Wuhan City 430071, Hubei Province, China
| | - Dan Xu
- Department of Nuclear Medicine, Zhongnan Hospital of Wuhan University, Wuchang District, Wuhan City 430071, Hubei Province, China
| | - Lei Gao
- Department of Radiology, Zhongnan Hospital of Wuhan University, Wuchang District, Wuhan City 430071, Hubei Province, China.
| | - Haibo Xu
- Department of Radiology, Zhongnan Hospital of Wuhan University, Wuchang District, Wuhan City 430071, Hubei Province, China.
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13
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Beishon L, Haunton VJ, Panerai RB. Antihypertensives in dementia: Good or bad for the brain? J Cereb Blood Flow Metab 2023; 43:1800-1802. [PMID: 36284494 PMCID: PMC10581243 DOI: 10.1177/0271678x221133473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Revised: 07/19/2022] [Accepted: 07/29/2022] [Indexed: 11/15/2022]
Abstract
Hypertension is associated with both ageing and dementia. Despite this, optimal blood pressure targets in dementia remain unclear. Both high and low blood pressure are associated with poorer cognition. Changes in vascular physiology in dementia may increase the vulnerability of the brain to hypoperfusion associated with antihypertensives. We discuss the potential risks of antihypertensives in the context of altered cerebral haemodynamics, and evidence from antihypertensive trials in dementia. We suggest that individualised blood pressure targets should be the focus for antihypertensive therapy in dementia, rather than strict control to uniform targets extrapolated from trials in cognitively healthy individuals.
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Affiliation(s)
- Lucy Beishon
- Department of Cardiovascular Sciences, University of Leicester, Leicester, UK
- NIHR Leicester Biomedical Research Centre, British Heart Foundation Cardiovascular Research Centre, Glenfield Hospital, Leicester, UK
| | | | - Ronney B Panerai
- Department of Cardiovascular Sciences, University of Leicester, Leicester, UK
- NIHR Leicester Biomedical Research Centre, British Heart Foundation Cardiovascular Research Centre, Glenfield Hospital, Leicester, UK
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14
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Zhu X, Luo Z, Tian G, Hu Z, Li S, Wang QM, Luo X, Chen L. Hypotension and cognitive impairment among the elderly: Evidence from the CLHLS. PLoS One 2023; 18:e0291775. [PMID: 37725634 PMCID: PMC10508618 DOI: 10.1371/journal.pone.0291775] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Accepted: 08/25/2023] [Indexed: 09/21/2023] Open
Abstract
BACKGROUND While high blood pressure has been linked to cognitive impairment, the relationship between low blood pressure, especially hypotension, and cognitive impairment has not been well studied. Therefore, this study aimed to assess the prevalence of hypotension and cognitive impairment in the seniors of China, and the association between hypotension and cognitive function impairment. METHODS The data was derived from the 2018 wave of the Chinese Longitudinal Healthy Longevity Survey (CLHLS). Systolic blood pressures (SBP) and diastolic blood pressures (DBP) were measured by objective examination. The Chinese version of the Mini-Mental State Examination (CMMSE) was used to evaluate the cognitive impairment of the elderly. Generalized linear models were conducted to evaluate the association of hypotension with cognitive impairment. RESULTS The prevalence of hypotension and cognitive impairment in the Chinese elderly were 0.76% and 22.06%, respectively. Participants with hypotension, lower SBP, and lower DBP, had odds ratios of 1.62, 1.38, and 1.48 for cognitive impairment, respectively. Besides, the CMMSE scores decreased by 2.08, 0.86, and 1.08 in the elderly with hypotension, lower SBP, and DBP, compared with those with non-hypotension, higher SBP, and DBP, respectively. Subgroup analyses showed that the association of cognitive impairment with hypotension was stronger in Chinese elderly who had decreased activity of daily living. Moreover, there was statistical evidence of a nonlinear dose-response relationship of SBP and DBP with cognitive impairment (Pnonlinear < 0.05). CONCLUSION Hypotension was a potential risk factor for cognitive impairment of the Chinese elderly, especially for those having decreased activity of daily living. Blood pressure management should be conducted to prevent them from cognitive impairment.
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Affiliation(s)
- Xidi Zhu
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, China
- Stroke Biological Recovery Laboratory, Spaulding Rehabilitation Hospital, the Teaching Affiliate of Harvard Medical School, Boston, Massachusetts, United States of America
| | - Zhicheng Luo
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, China
| | - Gang Tian
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, China
| | - Zhao Hu
- Department of Social Medicine and Health Management, Xiangya School of Public Health, Central South University, Changsha, China
| | - Shaojie Li
- School of Public Health, Peking University, Beijing, China
| | - Qing Mei Wang
- Stroke Biological Recovery Laboratory, Spaulding Rehabilitation Hospital, the Teaching Affiliate of Harvard Medical School, Boston, Massachusetts, United States of America
| | - Xun Luo
- Kerry Rehabilitation Medicine Research Institute, Shenzhen, China
- School of Medicine, Shenzhen University, Shenzhen, China
| | - Lizhang Chen
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, China
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15
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Sible IJ, Nation DA. Blood Pressure Variability and Cerebral Perfusion Decline: A Post Hoc Analysis of the SPRINT MIND Trial. J Am Heart Assoc 2023; 12:e029797. [PMID: 37301768 PMCID: PMC10356024 DOI: 10.1161/jaha.123.029797] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Accepted: 05/17/2023] [Indexed: 06/12/2023]
Abstract
Background Blood pressure variability (BPV) is predictive of cerebrovascular disease and dementia, possibly though cerebral hypoperfusion. Higher BPV is associated with cerebral blood flow (CBF) decline in observational cohorts, but relationships in samples with strictly controlled blood pressure remain understudied. We investigated whether BPV relates to change in CBF in the context of intensive versus standard antihypertensive treatment. Methods and Results In this post hoc analysis of the SPRINT MIND (Systolic Blood Pressure Intervention Trial-Memory and Cognition in Decreased Hypertension) trial, 289 participants (mean, 67.6 [7.6 SD] years, 38.8% women) underwent 4 blood pressure measurements over a 9-month period after treatment randomization (intensive versus standard) and pseudo-continuous arterial spin labeling magnetic resonance imaging at baseline and ≈4-year follow-up. BPV was calculated as tertiles of variability independent of mean. CBF was determined for whole brain, gray matter, white matter, hippocampus, parahippocampal gyrus, and entorhinal cortex. Linear mixed models examined relationships between BPV and change in CBF under intensive versus standard antihypertensive treatment. Higher BPV in the standard treatment group was associated with CBF decline in all regions (ß comparing the first versus third tertiles of BPV in whole brain: -0.09 [95% CI, -0.17 to -0.01]; P=0.03), especially in medial temporal regions. In the intensive treatment group, elevated BPV was related to CBF decline only in the hippocampus (ß, -0.10 [95% CI, -0.18, -0.01]; P=0.03). Conclusions Elevated BPV is associated with CBF decline, especially under standard blood pressure-lowering strategies. Relationships were particularly robust in medial temporal regions, consistent with prior work using observational cohorts. Findings highlight the possibility that BPV remains a risk for CBF decline even in individuals with strictly controlled mean blood pressure levels. Registration URL: http://clinicaltrials.gov. Identifier: NCT01206062.
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Affiliation(s)
- Isabel J. Sible
- Department of PsychologyUniversity of Southern CaliforniaLos AngelesCA
| | - Daniel A. Nation
- Institute for Memory Impairments and Neurological DisordersUniversity of California IrvineIrvineCA
- Department of Psychological ScienceUniversity of California IrvineIrvineCA
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Sachs BC, Gaussoin SA, Brenes GA, Casanova R, Chlebowski RT, Chen JC, Luo J, Rapp SR, Shadyab AH, Shumaker S, Wactawski-Wende J, Wells GL, Hayden KM. The relationship between optimism, MCI, and dementia among postmenopausal women. Aging Ment Health 2023; 27:1208-1216. [PMID: 35694859 PMCID: PMC9741664 DOI: 10.1080/13607863.2022.2084710] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Accepted: 05/27/2022] [Indexed: 12/14/2022]
Abstract
OBJECTIVES The relationship between optimism and cognitive functioning is not fully understood. We examined the association of optimism with risk of mild cognitive impairment (MCI) and dementia in the Women's Health Initiative Memory Study (WHIMS). METHODS Optimism was measured by the Life Orientation Test-Revised (LOT-R) total score, and optimism and pessimism subscales. A panel of experts adjudicated cognitive endpoints based on annual cognitive assessments. We used cox proportional hazard regression models to examine the association of LOT-R total score and optimism and pessimism sub-scores with MCI/dementia. We also examined the relationship between vascular disease, LOT-R total score, optimism and pessimism, and cognition. RESULTS Mean age was 70.5 (SD = 3.9) years. The sample (N = 7249) was 87% white, and 29.8% of participants had < 12 years of education. Total LOT-R score (HR = 0.96, 95% CI: 0.94, 0.98, p < 0.001) was associated with lower risk of combined MCI or dementia. More pessimism (HR = 1.08, 95% CI: 1.05, 1.11, p < 0.0001) was associated with higher risk of MCI or dementia after adjustment for ethnicity, education, vascular disease, and depression. No significant relationships emerged from the optimism subscale. CONCLUSION These data suggest that less pessimism, but not more optimism, was associated with a lower risk of MCI and dementia.
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Affiliation(s)
- Bonnie C Sachs
- Department of Neurology, Wake Forest School of Medicine, Winston-Salem, NC USA
- Department of Internal Medicine, Section on Gerontology and Geriatric Medicine, Wake Forest School of Medicine, Winston-Salem,NC USA
| | - Sarah A Gaussoin
- Department of Biostatistics and Data Science, Division of Public Health Sciences, Wake Forest School of Medicine Winston-Salem, NC USA
| | - Gretchen A Brenes
- Department of Internal Medicine, Section on Gerontology and Geriatric Medicine, Wake Forest School of Medicine, Winston-Salem,NC USA
| | - Ramon Casanova
- Department of Biostatistics and Data Science, Division of Public Health Sciences, Wake Forest School of Medicine Winston-Salem, NC USA
| | - Rowan T Chlebowski
- Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center, Torrance, CA USA
| | - Jiu-Chiuan Chen
- Departments of Population & Public Health Sciences and Neurology, University of Southern California, Los Angeles, CA, USA
| | - Juhua Luo
- Department of Epidemiology and Biostatistics, School of Public Health, Indiana University, Bloomington, IN USA
| | - Stephen R Rapp
- Department of Psychiatry & Behavioral Medicine, Wake Forest School of Medicine, Winston-Salem, NC USA
- Department of Social Sciences and Health Policy, Wake Forest School of Medicine, Winston-Salem, NC USA
| | - Aladdin H Shadyab
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California, San Diego, La Jolla, CA
| | - Sally Shumaker
- Department of Social Sciences and Health Policy, Wake Forest School of Medicine, Winston-Salem, NC USA
| | - Jean Wactawski-Wende
- Department of Epidemiology and Environmental Health, University at Buffalo, Buffalo, NY USA
| | - Gretchen L Wells
- Gill Heart and Vascular Institute, University of Kentucky School of Medicine, Lexington, KY USA
| | - Kathleen M Hayden
- Department of Social Sciences and Health Policy, Wake Forest School of Medicine, Winston-Salem, NC USA
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17
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Sible IJ, Nation DA. Blood Pressure Variability and Cognitive Decline: A Post Hoc Analysis of the SPRINT MIND Trial. Am J Hypertens 2023; 36:168-175. [PMID: 36448621 PMCID: PMC10208742 DOI: 10.1093/ajh/hpac128] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Revised: 11/06/2022] [Accepted: 11/29/2022] [Indexed: 12/05/2022] Open
Abstract
BACKGROUND Blood pressure (BP) variability (BPV) is an emerging risk factor for cognitive impairment and dementia, but relationships with cognition in the context of antihypertensive strategies remain unclear. We examined whether visit-to-visit BPV relates to cognitive change based on antihypertensive treatment type. METHODS In this post hoc analysis of the SPRINT MIND trial, 2,348 participants underwent 4 BP measurements over a 9-month period after treatment randomization (standard vs. intensive BP lowering) and ≥ 1 neuropsychological evaluation thereafter. BPV was calculated as tertiles of BP SD. Participants underwent cognitive testing at baseline and every 2 years during the planned 4-year follow-up. Cognitive composite scores were calculated for global cognition, memory, language, executive function, and processing speed. Linear mixed models investigated relationships between BPV, antihypertensive treatment group, and time on cognitive composite scores. RESULTS Elevated BPV was associated with the fastest decline in processing speed (ß = -.07 [95% CI -.12, -.01]; P = 0.02) and executive function (ß = -.08 [95% CI -.16, -.006]; P = 0.03) in the standard treatment group only. BPV was not related to cognitive change in the intensive treatment group. Mean/minimum/maximum BP was not associated with cognitive composite scores over time in either antihypertensive treatment group. CONCLUSIONS Elevated BPV remains a risk for cognitive decline despite strictly controlled BP levels, in the standard treatment group. Specific declines were observed in processing speed and executive function, domains often impacted by cerebrovascular disease and may underpin risk for dementia and cerebrovascular disease associated with BPV. Clinical trial information: ClinicalTrials.gov; NCT01206062.
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Affiliation(s)
- Isabel J Sible
- Department of Psychology, University of Southern California, Los Angeles, California 90007, USA
| | - Daniel A Nation
- Institute for Memory Impairments and Neurological Disorders, University of California Irvine, Irvine, California 92697, USA
- Department of Psychological Science, University of California Irvine, Irvine, California 92697, USA
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18
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Fungwe TV, Ngwa JS, Johnson SP, Turner JV, Ramirez Ruiz MI, Ogunlana OO, Bedada FB, Nadarajah S, Ntekim OE, Obisesan TO. Systolic Blood Pressure Is Associated with Increased Brain Amyloid Load in Mild Cognitively Impaired Participants: Alzheimer's Disease Neuroimaging Initiatives Study. Dement Geriatr Cogn Disord 2023; 52:39-46. [PMID: 36808103 PMCID: PMC10219843 DOI: 10.1159/000528117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Accepted: 11/13/2022] [Indexed: 02/22/2023] Open
Abstract
BACKGROUND Cardiovascular disease (CVD), including elevated blood pressure (BP), is known to promote Alzheimer's disease (AD) risk. Although brain amyloid load is a recognized hallmark of pre-symptomatic AD, its relationship to increased BP is less known. The objective of this study was to examine the relationship of BP to brain estimates of amyloid-β (Aβ) and standard uptake ratio (SUVr). We hypothesized that increased BP is associated with increased SUVr. METHODS Using data from the Alzheimer's Disease Neuroimaging Initiative (ADNI), we stratified BP according to the Seventh Joint National Committee (JNC) on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure Classification (JNC VII). Florbetapir (AV-45) SUVr was derived from the averaged frontal, anterior cingulate, precuneus, and parietal cortex relative to the cerebellum. A linear mixed-effects model enabled the elucidation of amyloid SUVr relationships to BP. The model discounted the effects of demographics, biologics, and diagnosis at baseline within APOE genotype groups. The least squares means procedure was used to estimate the fixed-effect means. All analyses were performed using the Statistical Analysis System (SAS). RESULTS In non-ɛ4 carrier MCI subjects, escalating JNC categories of BP was associated with increasing mean SUVr using JNC-4 as a reference point (low-normal (JNC1) p = 0.018; normal (JNC-1) p = 0.039; JNC-2 p = 0.018 and JNC-3 p = 0.04). A significantly higher brain SUVr was associated with increasing BP despite adjustment for demographics and biological variables in non-ɛ4 carriers but not in ɛ4-carriers. This observation supports the view that CVD risk may promote increased brain amyloid load, and potentially, amyloid-mediated cognitive decline. CONCLUSION Increasing levels of JNC classification of BP is dynamically associated with significant changes in brain amyloid burden in non-ɛ4 carriers but not in ɛ4-carrier MCI subjects. Though not statistically significant, amyloid burden tended to decrease with increasing BP in ɛ4 homozygote, perhaps motivated by increased vascular resistance and the need for higher brain perfusion pressure.
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Affiliation(s)
- Thomas V. Fungwe
- Department of Nutritional Sciences, College of Nursing and Allied Health Sciences, Howard University
| | - Julius S. Ngwa
- Division of Cardiology, Department of Medicine, Howard University
| | - Steven P. Johnson
- Division of Geriatrics, Department of Internal Medicine, Howard University Hospital
| | - Jilian V. Turner
- Division of Geriatrics, Department of Internal Medicine, Howard University Hospital
| | - Mara I. Ramirez Ruiz
- Division of Geriatrics, Department of Internal Medicine, Howard University Hospital
| | | | - Fikru B Bedada
- Department of Clinical Laboratory Sciences, College of Nursing and Allied Health Sciences, Howard University
| | - Sheeba Nadarajah
- Department of Nursing, College of Nursing and Allied Health Sciences, Howard University
| | - Oyonumo E. Ntekim
- Department of Nutritional Sciences, College of Nursing and Allied Health Sciences, Howard University
| | - Thomas O. Obisesan
- Division of Geriatrics, Department of Internal Medicine, Howard University Hospital
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Jung MH, Kim KI, Lee JH, Sung KC. Relative importance of potential risk factors for dementia in patients with hypertension. PLoS One 2023; 18:e0281532. [PMID: 36920888 PMCID: PMC10016665 DOI: 10.1371/journal.pone.0281532] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2022] [Accepted: 01/25/2023] [Indexed: 03/16/2023] Open
Abstract
Patients with hypertension are at higher risk for dementia than the general population. We sought to understand the relative importance of various risk factors in the development of dementia among patients with hypertension. This population-based cohort study used data from the Korean National Insurance Service database. Using the Cox proportional hazard model, R2 values for each potential risk factor were calculated to test the relative importance of risk factors for the development of dementia. Eligible individuals were adults 40 to 79 years of age with hypertension and without a history of stroke and dementia between 2007 and 2009. A total of 650,476 individuals (mean age, 60 ± 11 years) with hypertension were included in the analyses. During a mean follow-up of 9.5 years (±2.8 years), 57,112 cases of dementia were observed. The three strongest predictors of dementia were age, comorbidity burden (assessed using the Charlson Comorbidity Index), and female sex (R2 values, 0.0504, 0.0023, and 0.0022, respectively). The next strongest risk factors were physical inactivity, smoking, alcohol consumption, and obesity (R2 values, 0.00070, 0.00024, 0.00021, and 0.00020, respectively). Across all age groups, physical inactivity was an important risk factor for dementia occurrence. In summary, controlling and preventing comorbidities are of utmost importance to prevent dementia in patients with hypertension. More efforts should be taken to encourage physical activity among patients with hypertension across all age groups. Furthermore, smoking cessation, avoiding and limiting alcohol consumption, and maintaining an appropriate body weight are urged to prevent dementia.
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Affiliation(s)
- Mi-Hyang Jung
- Department of Internal Medicine, Division of Cardiology, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
- Catholic Research Institute for Intractable Cardiovascular Disease, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
- * E-mail: (M-HJ); (K-CS)
| | - Kwang-Il Kim
- Department of Internal Medicine, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, Republic of Korea
| | - Jun Hyeok Lee
- Department of Biostatistics, Wonju College of Medicine, Yonsei University, Wonju, Republic of Korea
| | - Ki-Chul Sung
- Department of Internal Medicine, Division of Cardiology, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
- * E-mail: (M-HJ); (K-CS)
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Feng L, Wu D, Ping P, Lin J, Zhao Y, Yao Y, Zhang P, Fu S. Age Related Cognitive Function Was Positively Associated with Diastolic Pressure and Negatively Associated with Antibody Expression in Chinese Oldest-Old and Centenarian Adults. J Inflamm Res 2022; 15:6675-6682. [DOI: 10.2147/jir.s344105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Accepted: 05/16/2022] [Indexed: 12/14/2022] Open
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21
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Malone JE, Elkasaby MI, Lerner AJ. Effects of Hypertension on Alzheimer's Disease and Related Disorders. Curr Hypertens Rep 2022; 24:615-625. [PMID: 36125695 DOI: 10.1007/s11906-022-01221-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/26/2022] [Indexed: 01/31/2023]
Abstract
PURPOSE OF REVIEW To review the pathophysiology of hypertension in Alzheimer's disease and related dementias and explore the current landscape of clinical trials involving treatment of hypertension to improve cognition. RECENT FINDINGS Hypertension is increasingly recognized as a contributor to cognitive impairment. Clinical trials that explore blood pressure reductions with cognitive outcomes have been promising. Various antihypertensives have been evaluated in clinical trials, with growing interest in those agents that impact the renin-angiotensin-aldosterone system due to its own association with cognitive impairment. No antihypertensive agent has been found to be superior to others in reducing cognitive impairment risk or conferring neuroprotective benefits. In this review, the pathophysiology of and clinical trial data involving hypertension and dementia will be explored. Hypertension is a significant risk factor for the development of neurodegenerative dementias, and clinical trials have been overall favorable in improving cognition by reductions in blood pressure using antihypertensive agents.
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Affiliation(s)
- Joseph E Malone
- Department of Neurology, University Hospitals Cleveland Medical Center, Cleveland, OH, USA
| | - Mohamed I Elkasaby
- Department of Neurology, University Hospitals Cleveland Medical Center, Cleveland, OH, USA
| | - Alan J Lerner
- Department of Neurology, University Hospitals Cleveland Medical Center, Cleveland, OH, USA.
- Case Western Reserve University School of Medicine, Cleveland, OH, USA.
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22
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Louras P, Brown LM, Gomez R, Warren SL, Fairchild JK. BDNF Val66Met Moderates the Effects of Hypertension on Executive Functioning in Older Adults Diagnosed With aMCI. Am J Geriatr Psychiatry 2022; 30:1223-1233. [PMID: 35779988 DOI: 10.1016/j.jagp.2022.05.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Revised: 05/16/2022] [Accepted: 05/25/2022] [Indexed: 01/25/2023]
Abstract
OBJECTIVE To investigate whether the BDNF Val66Met polymorphism influences the associations of hypertension, executive functioning and processing speed in older adults diagnosed with amnestic Mild Cognitive Impairment (aMCI). DESIGN Secondary data analysis using moderation modeling. SETTING Veterans Affairs Hospital, Palo Alto, CA. PARTICIPANTS Sample included 108 community-dwelling volunteers (mean age 71.3 ± 9.2 years) diagnosed with aMCI. MEASUREMENTS Cognitive performance was evaluated from multiple baseline assessments (Trail Making Test; Stroop Color-Word Test; Symbol Digit Modality Test) and grouped into standardized composite scores representing executive function and processing speed domains. BDNF genotypes were determined from whole blood samples. Hypertension was assessed from resting blood pressures or by self-report. RESULTS Controlling for age, BDNF Val66Met moderated the effects of hypertension on executive functioning, but added no significant variance to processing speed scores. Specifically, hypertensive carriers of the BDNF Met allele performed significantly below the sample mean on tasks of executive functioning, and evidenced significantly lower scores when compared to Val-Val homozygotes and normotensive participants. CONCLUSIONS Results posit that the executive functioning of non-demented older adults may be susceptible to interactions between BDNF genotype and hypertension, and Val-Val homozygotes and normotensive older adults may be more resilient to these effects of cognitive change. Further research is needed to understand the underlying processes and to implement strategies that target modifiable risk factors and promote cognitive resilience.
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Affiliation(s)
- Peter Louras
- Sierra Pacific Mental Illness Research (PL, JKF), Education, and Clinical Center (MIRECC) at VA Palo Alto Health Care System, Palo Alto, CA; Department of Psychiatry and Behavioral Sciences (PL, LMB, JKF), Stanford University School of Medicine, Stanford, CA
| | - Lisa M Brown
- Department of Psychiatry and Behavioral Sciences (PL, LMB, JKF), Stanford University School of Medicine, Stanford, CA; Department of Psychology (LMB, RG, SLW), Palo Alto University, Palo Alto, CA
| | - Rowena Gomez
- Department of Psychology (LMB, RG, SLW), Palo Alto University, Palo Alto, CA
| | - Stacie L Warren
- Department of Psychology (LMB, RG, SLW), Palo Alto University, Palo Alto, CA
| | - Jennifer Kaci Fairchild
- Sierra Pacific Mental Illness Research (PL, JKF), Education, and Clinical Center (MIRECC) at VA Palo Alto Health Care System, Palo Alto, CA; Department of Psychiatry and Behavioral Sciences (PL, LMB, JKF), Stanford University School of Medicine, Stanford, CA.
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23
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Stefaniak O, Dobrzyńska M, Drzymała-Czyż S, Przysławski J. Diet in the Prevention of Alzheimer's Disease: Current Knowledge and Future Research Requirements. Nutrients 2022; 14:4564. [PMID: 36364826 PMCID: PMC9656789 DOI: 10.3390/nu14214564] [Citation(s) in RCA: 29] [Impact Index Per Article: 14.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Revised: 09/23/2022] [Accepted: 10/25/2022] [Indexed: 08/13/2023] Open
Abstract
Alzheimer's disease is a progressive brain disease that is becoming a major health problem in today's world due to the aging population. Despite it being widely known that diet has a significant impact on the prevention and progression of Alzheimer's disease, the literature data are still scarce and controversial. The application of the principles of rational nutrition for the elderly is suggested for Alzheimer's disease. The diet should be rich in neuroprotective nutrients, i.e., antioxidants, B vitamins, and polyunsaturated fatty acids. Some studies suggest that diets such as the Mediterranean diet, the DASH (Dietary Approaches to Stop Hypertension) diet, and the MIND (Mediterranean-DASH Intervention for Neurodegenerative Delay) diet have a beneficial effect on the risk of developing Alzheimer's disease.
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Affiliation(s)
| | - Małgorzata Dobrzyńska
- Department of Bromatology, Poznan University of Medical Science, Rokietnicka 3 Street, 60-806 Poznan, Poland
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24
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Zhu Y, He S, Herold F, Sun F, Li C, Tao S, Gao TY. Effect of isometric handgrip exercise on cognitive function: Current evidence, methodology, and safety considerations. Front Physiol 2022; 13:1012836. [PMID: 36267588 PMCID: PMC9576950 DOI: 10.3389/fphys.2022.1012836] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2022] [Accepted: 09/15/2022] [Indexed: 11/13/2022] Open
Abstract
Cognitive function is essential for most behaviors of daily living and is a critical component in assessing the quality of life. Mounting prospective evidence supports the use of isometric handgrip exercise (IHE) as a small muscle mass practice to promote health-related outcomes in clinical and healthy populations. The aim of the present review was to systematically investigate whether IHE is effective in improving the cognitive function of adults (aged ≥18 years). Studies were identified by searching five databases (CINAHL, MEDLINE, SPORTDiscus, PsychINFO, and Web of Science). Eight out of 767 studies met the inclusion criteria, including three types of studies: 1) acute effect for IHE with various intensity protocols (n = 4); 2) acute effect for IHE with one set exhaustion protocol (n = 2); and 3) chronic effect of IHE on cognitive function (n = 2). To assess the methodological quality of studies, the PEDro scale was used (mean score = 6.75). The evidence on whether IHE exerts acute positive effects on cognitive performance is currently rather inconclusive. However, a trend was discernible that implementing IHE can generate a beneficial chronic effect on cognitive function, although the results should be interpreted with caution. The clinical relevance of IHE as a time-efficient type of physical exercise to improve cognitive function warrants further investigation. Methodology and safety considerations were discussed.Systematic Review Registration: (https://osf.io/gbzp9).
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Affiliation(s)
- Yuxin Zhu
- School of Physical Education, Guangzhou Sport University, Guangzhou, China
- Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong SAR, China
- *Correspondence: Yuxin Zhu,
| | - Shan He
- School of Physical Education, Guangzhou Sport University, Guangzhou, China
| | - Fabian Herold
- Research Group Degenerative and Chronic Disease, Movement, Faculty of Health Sciences Brandenburg, University of Potsdam, Potsdam, Germany
| | - Fenghua Sun
- Department of Health and Physical Education, The Education University of Hong Kong, Hong Kong SAR, China
| | - Chunxiao Li
- School of Physical Education and Sports Science, South China Normal University, Guangzhou, China
| | - Sisi Tao
- Faculty of Education, The University of Hong Kong, Hong Kong SAR, China
| | - Tian-Yu Gao
- School of Physical Education, Jinan University, Guangzhou, China
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25
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Nguyen BT, Shin EJ, Jeong JH, Sharma N, Nah SY, Ko SK, Byun JK, Lee Y, Lei XG, Kim DJ, Nabeshima T, Kim HC. Ginsenoside Re attenuates memory impairments in aged Klotho deficient mice via interactive modulations of angiotensin II AT1 receptor, Nrf2 and GPx-1 gene. Free Radic Biol Med 2022; 189:2-19. [PMID: 35840016 DOI: 10.1016/j.freeradbiomed.2022.07.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Revised: 06/28/2022] [Accepted: 07/08/2022] [Indexed: 12/14/2022]
Abstract
Ginseng is known to possess anti-aging potential. Klotho mutant mice exhibit phenotypes that resemble the phenotype of the human aging process. Similar to Klotho deficient mice, patients with chronic kidney disease (CKD) suffer vascular damage and cognitive impairment, which might upregulate the angiotensin II AT1 receptor. Since AT1 receptor expression was more pronounced than endothelin ET-1 expression in the hippocampus of aged Klotho deficient (±) mice, we focused on the AT1 receptor in this study. Ginsenoside Re (GRe), but not ginsenoside Rb1 (GRb1), significantly attenuated the increase in AT1 receptor expression in aged Klotho deficient mice. Both GRe and the AT1 receptor antagonist losartan failed to attenuate the decrease in phosphorylation of JAK2/STAT3 in aged Klotho deficient (±) mice but significantly activated nuclear factor erythroid 2-related factor 2 (Nrf2)-mediated signaling. Both GRe and losartan attenuated the increased NADPH oxidase (NOX) activity and reactive oxygen species (ROS) in aged Klotho deficient mice. Furthermore, of all the antioxidant enzymes, GRe significantly increased glutathione peroxidase (GPx) activity. GRe significantly attenuated the reduced phosphorylation of ERK and CREB in GPx-1 knockout mice; however, genetic overexpression of GPx-1 did not significantly affect them in aged mice. Klotho-, Nrf2-, and GPx-1-immunoreactivities were co-localized in the same cells of the hippocampus in aged Klotho wild-type mice. Both the GPx inhibitor mercaptosuccinate and Nrf2 inhibitor brusatol counteracted the effects of GRe on all neurobehavioral impairments in aged Klotho deficient (±) mice. Our results suggest that GRe attenuates all alterations, such as AT1 receptor expression, NOX-, ROS-, and GPx-levels, and cognitive dysfunction in aged Klotho deficient (±) mice via upregulation of Nrf2/GPx-1/ERK/CREB signaling.
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Affiliation(s)
- Bao Trong Nguyen
- Neuropsychopharmacology and Toxicology Program, BK21 PLUS Project, College of Pharmacy, Kangwon National University, Chunchon, 24341, Republic of Korea
| | - Eun-Joo Shin
- Neuropsychopharmacology and Toxicology Program, BK21 PLUS Project, College of Pharmacy, Kangwon National University, Chunchon, 24341, Republic of Korea
| | - Ji Hoon Jeong
- Department of Global Innovative Drugs, Graduate School of Chung-Ang University, College of Medicine, Chung-Ang University, Seoul, 06974, Republic of Korea.
| | - Naveen Sharma
- Neuropsychopharmacology and Toxicology Program, BK21 PLUS Project, College of Pharmacy, Kangwon National University, Chunchon, 24341, Republic of Korea; Department of Global Innovative Drugs, Graduate School of Chung-Ang University, College of Medicine, Chung-Ang University, Seoul, 06974, Republic of Korea
| | - Seung Yeol Nah
- Ginsentology Research Laboratory and Department of Physiology, College of Veterinary Medicine and Bio/Molecular Informatics Center, Konkuk University, Seoul, 05029, Republic of Korea
| | - Sung Kwon Ko
- Department of Oriental Medical Food & Nutrition, Semyung University, Jecheon, 27136, Republic of Korea
| | - Jae Kyung Byun
- Korea Society of Forest Environmental Research, Namyanju, 12106, Republic of Korea
| | - Yi Lee
- Department of Industrial Plant Science & Technology, Chungbuk National University, Chungju, 28644, Republic of Korea
| | - Xin Gen Lei
- Department of Animal Science, Cornell University, Ithaca, NY, 14853, USA
| | - Dae-Joong Kim
- Department of Anatomy and Cell Biology, Medical School, Kangwon National University, Chunchon, 24341, Republic of Korea
| | - Toshitaka Nabeshima
- Advanced Diagnostic System Research Laboratory, Fujita Health University Graduate School of Health Science, Toyoake, 470-1192, Japan
| | - Hyoung-Chun Kim
- Neuropsychopharmacology and Toxicology Program, BK21 PLUS Project, College of Pharmacy, Kangwon National University, Chunchon, 24341, Republic of Korea.
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26
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De Amicis R, Mambrini SP, Pellizzari M, Foppiani A, Bertoli S, Battezzati A, Leone A. Systematic Review on the Potential Effect of Berry Intake in the Cognitive Functions of Healthy People. Nutrients 2022; 14:nu14142977. [PMID: 35889934 PMCID: PMC9321916 DOI: 10.3390/nu14142977] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Revised: 07/15/2022] [Accepted: 07/17/2022] [Indexed: 02/06/2023] Open
Abstract
The increase in life expectancy poses health challenges, such as increasing the impairment of cognitive functions. Berries show a neuroprotective effect thanks to flavonoids, able to reduce neuroinflammatory and to increase neuronal connections. The aim of this systematic review is to explore the impact of berries supplementation on cognitive function in healthy adults and the elderly. Twelve studies were included for a total of 399 participants, aged 18–81 years (mean age: 41.8 ± 4.7 years). Six studies involved young adults (23.9 ± 3.7 years), and four studies involved the elderly (60.6 ± 6.4 years). Most studies investigated effects of a single berry product, but one used a mixture of 4 berries. Non-significant differences were detected across cognition domains and methodologies, but significant and positive effects were found for all cognitive domains (attention and concentration, executive functioning, memory, motor skills and construction, and processing speed), and in most cases they were present in more than one study and detected using different methodologies. Although some limitations should be taken into account to explain these results, the positive findings across studies and methodologies elicit further studies on this topic, to endorse the consumption of berries in healthy populations to prevent cognitive decline.
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Affiliation(s)
- Ramona De Amicis
- International Center for the Assessment of Nutritional Status (ICANS), Department of Food, Environmental and Nutritional Sciences (DeFENS), University of Milan, 20133 Milan, Italy; (S.P.M.); (M.P.); (A.F.); (S.B.); (A.B.); (A.L.)
- Laboratory of Nutrition and Obesity Research, Department of Endocrine and Metabolic Diseases, IRCCS, Istituto Auxologico Italiano, 20145 Milan, Italy
- Correspondence:
| | - Sara Paola Mambrini
- International Center for the Assessment of Nutritional Status (ICANS), Department of Food, Environmental and Nutritional Sciences (DeFENS), University of Milan, 20133 Milan, Italy; (S.P.M.); (M.P.); (A.F.); (S.B.); (A.B.); (A.L.)
- Laboratory of Metabolic Research, S. Giuseppe Hospital, IRCCS, Istituto Auxologico Italiano, 28824 Piancavallo, Italy
| | - Marta Pellizzari
- International Center for the Assessment of Nutritional Status (ICANS), Department of Food, Environmental and Nutritional Sciences (DeFENS), University of Milan, 20133 Milan, Italy; (S.P.M.); (M.P.); (A.F.); (S.B.); (A.B.); (A.L.)
| | - Andrea Foppiani
- International Center for the Assessment of Nutritional Status (ICANS), Department of Food, Environmental and Nutritional Sciences (DeFENS), University of Milan, 20133 Milan, Italy; (S.P.M.); (M.P.); (A.F.); (S.B.); (A.B.); (A.L.)
| | - Simona Bertoli
- International Center for the Assessment of Nutritional Status (ICANS), Department of Food, Environmental and Nutritional Sciences (DeFENS), University of Milan, 20133 Milan, Italy; (S.P.M.); (M.P.); (A.F.); (S.B.); (A.B.); (A.L.)
- Laboratory of Nutrition and Obesity Research, Department of Endocrine and Metabolic Diseases, IRCCS, Istituto Auxologico Italiano, 20145 Milan, Italy
| | - Alberto Battezzati
- International Center for the Assessment of Nutritional Status (ICANS), Department of Food, Environmental and Nutritional Sciences (DeFENS), University of Milan, 20133 Milan, Italy; (S.P.M.); (M.P.); (A.F.); (S.B.); (A.B.); (A.L.)
| | - Alessandro Leone
- International Center for the Assessment of Nutritional Status (ICANS), Department of Food, Environmental and Nutritional Sciences (DeFENS), University of Milan, 20133 Milan, Italy; (S.P.M.); (M.P.); (A.F.); (S.B.); (A.B.); (A.L.)
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27
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Agrawal S, Schneider JA. Vascular pathology and pathogenesis of cognitive impairment and dementia in older adults. CEREBRAL CIRCULATION - COGNITION AND BEHAVIOR 2022; 3:100148. [PMID: 36324408 PMCID: PMC9616381 DOI: 10.1016/j.cccb.2022.100148] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/29/2022] [Revised: 05/25/2022] [Accepted: 06/23/2022] [Indexed: 12/24/2022]
Abstract
It is well recognized that brains of older people often harbor cerebrovascular disease pathology including vessel disease and vascular-related tissue injuries and that this is associated with vascular cognitive impairment and contributes to dementia. Here we review vascular pathologies, cognitive impairment, and dementia. We highlight the importance of mixed co-morbid AD/non-AD neurodegenerative and vascular pathology that has been collected in multiple clinical pathologic studies, especially in community-based studies. We also provide an update of vascular pathologies from the Rush Memory and Aging Project and Religious Orders Study cohorts with special emphasis on the differences across age in persons with and without dementia. Finally, we discuss neuropathological perspectives on the interpretation of clinical-pathological studies and emerging data in community-based studies.
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Affiliation(s)
- Sonal Agrawal
- Rush Alzheimer's Disease Center, Rush University Medical Center, Jelke Building, 1750 W. Harrison Street, Chicago 60612, IL, USA
- Department of Pathology, Rush University Medical Center, Chicago, IL, USA
| | - Julie A. Schneider
- Rush Alzheimer's Disease Center, Rush University Medical Center, Jelke Building, 1750 W. Harrison Street, Chicago 60612, IL, USA
- Department of Pathology, Rush University Medical Center, Chicago, IL, USA
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28
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Effects of Diastolic Blood Pressure on Brain Structures and Cognitive Functions in Middle and Old Ages: Longitudinal Analyses. Nutrients 2022; 14:nu14122464. [PMID: 35745194 PMCID: PMC9229545 DOI: 10.3390/nu14122464] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Revised: 06/07/2022] [Accepted: 06/08/2022] [Indexed: 01/21/2023] Open
Abstract
Hypertension is a pervasive public health concern due to strong associations with cardiovascular diseases and stroke. Alternatively, the associations between hypertension and the risk of Alzheimer's disease are complex and recent large sample studies reported positive associations. In this paper, we examine the associations between diastolic blood pressure (BP) and subsequent changes in brain structure and cognitive function over several years by multiple regression analyses (with adjustment for a wide range of potential confounding variables) among a large cohort from the UK Biobank. Higher baseline diastolic BP was associated with a slightly smaller relative increase (relative improvements) in reaction time and a slightly greater reduction in depression scores. Higher baseline diastolic BP was also associated with a greater total gray matter volume (GMV) retention, while aging alone was associated with GMV reduction. White matter microstructural analyses revealed that a greater diastolic BP was associated with reduced longitudinal mean and regional fractional anisotropy, greater increases in mean and regional mean diffusivity, radial diffusivity, and axial diffusivity, a greater decline in mean intracellular volume fraction, and greater increases in mean and regional isotropic volume fraction. These white matter microstructural changes were consistent with those seen in the aging process. Additional analyses revealed a greater cheese intake level at baseline, which is associated with a subsequent decline in diastolic BP and a relative subsequent increase in depressive tendency together with a relative increase in fluid intelligence and visuospatial memory performance. These results are congruent with the view that a higher BP in the aging brain has a complex role.
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29
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Bao J, Liu J, Li Z, Zhang Z, Su X, Sun J, Tu J, Wang J, Li J, Song Y, Ning X. Relationship Between Hypertension and Cognitive Function in an Elderly Population: A Population-Based Study in Rural Northern China. Front Neurol 2022; 13:885598. [PMID: 35651343 PMCID: PMC9150797 DOI: 10.3389/fneur.2022.885598] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Accepted: 04/21/2022] [Indexed: 11/13/2022] Open
Abstract
The burden of cognitive impairment and dementia is particularly severe in low- and middle-income countries. Although hypertension is an important risk factor for cognitive impairment, the influence of different hypertension classification on cognitive impairment remains controversial. To explore the impact of hypertension and hypertension classification on cognitive function, this study was based on a low-income population aged over 60 years in northern China. This population-based, cross-sectional study was conducted from April 2014 to January 2015 in rural areas of Tianjin, China. A total of 1,171 participants aged ≥ 60 years were included. Participants were interviewed by professional researchers face-to-face, using the pre-designed questionnaire. Cognitive function was assessed using the Mini-mental State Examination (MMSE). Multivariate regression analysis was used to calculate the odds ratio (OR) value. There was a significant association between hypertension and cognitive impairment (OR, 1.415; 95% CI: 1.005–1.992; P = 0.047) and a significant positive association between stage 3 hypertension (OR, 1.734; 95% CI: 1.131–2.656; P = 0.012) and the prevalence of cognitive impairment. To prevent dementia, clinicians should consider the cognitive function and blood pressure control of low-income individuals aged over 60 years with hypertension in northern China, especially those with stage 3 hypertension. In addition, the inconsistent effects of blood pressure on different cognitive functions should also be considered; special attention should be paid to orientation and concentration.
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Affiliation(s)
- Jie Bao
- Department of Rehabilitation Medicine, Tianjin Medical University General Hospital, Tianjin, China
| | - Jie Liu
- Department of Neurology, Tianjin Medical University General Hospital, Tianjin, China
- Laboratory of Epidemiology, Tianjin Neurological Institute, Tianjin, China
- Key Laboratory of Post-Neuroinjury Neuro-Repair and Regeneration in Central Nervous System, Tianjin Neurological Institute, Ministry of Education and Tianjin City, Tianjin, China
- Center of Clinical Epidemiology and Evidence-Based Medicine, Tianjin Jizhou People's Hospital, Tianjin, China
| | - Zhiying Li
- Department of Acupuncture, First Teaching Hospital of Tianjin University of Traditional Chinese Medicine & National Clinical Research Center for Chinese Medicine Acupuncture and Moxibustion, Tianjin, China
| | - Zhen Zhang
- Department of Cardiology, Tianjin Medical University General Hospital, Tianjin, China
| | - Xiao Su
- Department of Neurology, Tianjin Medical University General Hospital, Tianjin, China
| | - Jiayi Sun
- Department of Neurology, Tianjin Medical University General Hospital, Tianjin, China
| | - Jun Tu
- Department of Neurology, Tianjin Medical University General Hospital, Tianjin, China
- Laboratory of Epidemiology, Tianjin Neurological Institute, Tianjin, China
- Key Laboratory of Post-Neuroinjury Neuro-Repair and Regeneration in Central Nervous System, Tianjin Neurological Institute, Ministry of Education and Tianjin City, Tianjin, China
- Center of Clinical Epidemiology and Evidence-Based Medicine, Tianjin Jizhou People's Hospital, Tianjin, China
| | - Jinghua Wang
- Department of Neurology, Tianjin Medical University General Hospital, Tianjin, China
- Laboratory of Epidemiology, Tianjin Neurological Institute, Tianjin, China
- Key Laboratory of Post-Neuroinjury Neuro-Repair and Regeneration in Central Nervous System, Tianjin Neurological Institute, Ministry of Education and Tianjin City, Tianjin, China
- Center of Clinical Epidemiology and Evidence-Based Medicine, Tianjin Jizhou People's Hospital, Tianjin, China
| | - Jidong Li
- Center of Clinical Epidemiology and Evidence-Based Medicine, Tianjin Jizhou People's Hospital, Tianjin, China
- Department of Neurosurgery, Tianjin Jizhou People's Hospital, Tianjin, China
- Jidong Li
| | - Yijun Song
- Department of General Medicine, Tianjin Medical University General Hospital, Tianjin, China
- Yijun Song
| | - Xianjia Ning
- Department of Neurology, Tianjin Medical University General Hospital, Tianjin, China
- Laboratory of Epidemiology, Tianjin Neurological Institute, Tianjin, China
- Key Laboratory of Post-Neuroinjury Neuro-Repair and Regeneration in Central Nervous System, Tianjin Neurological Institute, Ministry of Education and Tianjin City, Tianjin, China
- Center of Clinical Epidemiology and Evidence-Based Medicine, Tianjin Jizhou People's Hospital, Tianjin, China
- *Correspondence: Xianjia Ning
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30
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Custodero C, Ciavarella A, Panza F, Gnocchi D, Lenato GM, Lee J, Mazzocca A, Sabbà C, Solfrizzi V. Role of inflammatory markers in the diagnosis of vascular contributions to cognitive impairment and dementia: a systematic review and meta-analysis. GeroScience 2022; 44:1373-1392. [PMID: 35486344 PMCID: PMC9213626 DOI: 10.1007/s11357-022-00556-w] [Citation(s) in RCA: 35] [Impact Index Per Article: 17.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2021] [Accepted: 03/23/2022] [Indexed: 12/29/2022] Open
Abstract
Vascular contribution to cognitive impairment and dementia (VCID) is a clinical label encompassing a wide range of cognitive disorders progressing from mild to major vascular cognitive impairment (VCI), which is also defined as vascular dementia (VaD). VaD diagnosis is mainly based on clinical and imaging findings. Earlier biomarkers are needed to identify subjects at risk to develop mild VCI and VaD. In the present meta-analysis, we comprehensively evaluated the role of inflammatory biomarkers in differential diagnosis between VaD and Alzheimer’s disease (AD), and assessed their prognostic value on predicting VaD incidence. We collected literature until January 31, 2021, assessing three inflammatory markers [interleukin(IL)-6, C-reactive protein (CRP), tumor necrosis factor (TNF)-α] from blood or cerebrospinal fluid (CSF) samples. Thirteen cross-sectional and seven prospective studies were included. Blood IL-6 levels were cross-sectionally significantly higher in people with VaD compared to AD patients (SMD: 0.40, 95% CI: 0.18 to 0.62) with low heterogeneity (I2: 41%, p = 0.13). Higher IL-6 levels were also associated to higher risk of incident VaD (relative risk: 1.28, 95% CI: 1.03 to 1.59, I2: 0%). IL-6 in CSF was significantly higher in people with VaD compared to healthy subjects (SMD: 0.77, 95% CI: 0.17 to 1.37, I2: 70%), and not compared to AD patients, but due to limited evidence and high inconsistency across studies, we could not draw definite conclusion. Higher blood IL-6 levels might represent a useful biomarker able to differentiate people with VaD from those with AD and might be correlated with higher risk of future VaD.
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Affiliation(s)
- Carlo Custodero
- Dipartimento Interdisciplinare di Medicina, Clinica Medica e Geriatria "Cesare Frugoni", University of Bari Aldo Moro, Bari, Italy
| | - Alessandro Ciavarella
- Dipartimento Interdisciplinare di Medicina, Clinica Medica e Geriatria "Cesare Frugoni", University of Bari Aldo Moro, Bari, Italy.,Fondazione IRCCS Ca' Granda-Ospedale Maggiore Policlinico, A. Bianchi Bonomi Hemophilia and Thrombosis Center, Milan, Italy
| | - Francesco Panza
- Population Health Unit-"Salus In Apulia Study", National Institute of Gastroenterology "Saverio de Bellis", Research Hospital, Castellana Grotte, Bari, Italy
| | - Davide Gnocchi
- Dipartimento Interdisciplinare di Medicina, Clinica Medica e Geriatria "Cesare Frugoni", University of Bari Aldo Moro, Bari, Italy
| | - Gennaro M Lenato
- Dipartimento Interdisciplinare di Medicina, Clinica Medica e Geriatria "Cesare Frugoni", University of Bari Aldo Moro, Bari, Italy
| | - Juhan Lee
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - Antonio Mazzocca
- Dipartimento Interdisciplinare di Medicina, Clinica Medica e Geriatria "Cesare Frugoni", University of Bari Aldo Moro, Bari, Italy
| | - Carlo Sabbà
- Dipartimento Interdisciplinare di Medicina, Clinica Medica e Geriatria "Cesare Frugoni", University of Bari Aldo Moro, Bari, Italy
| | - Vincenzo Solfrizzi
- Dipartimento Interdisciplinare di Medicina, Clinica Medica e Geriatria "Cesare Frugoni", University of Bari Aldo Moro, Bari, Italy.
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Intensity distribution segmentation in ultrafast Doppler combined with scanning laser confocal microscopy for assessing vascular changes associated with ageing in murine hippocampi. Sci Rep 2022; 12:6784. [PMID: 35473942 PMCID: PMC9042937 DOI: 10.1038/s41598-022-10457-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Accepted: 04/06/2022] [Indexed: 11/21/2022] Open
Abstract
The hippocampus plays an important role in learning and memory, requiring high-neuronal oxygenation. Understanding the relationship between blood flow and vascular structure—and how it changes with ageing—is physiologically and anatomically relevant. Ultrafast Doppler (\documentclass[12pt]{minimal}
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\begin{document}$$\mu$$\end{document}μDoppler) and scanning laser confocal microscopy (SLCM) are powerful imaging modalities that can measure in vivo cerebral blood volume (CBV) and post mortem vascular structure, respectively. Here, we apply both imaging modalities to a cross-sectional and longitudinal study of hippocampi vasculature in wild-type mice brains. We introduce a segmentation of CBV distribution obtained from \documentclass[12pt]{minimal}
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\begin{document}$$\mu$$\end{document}μDoppler and show that this mice-independent and mesoscopic measurement is correlated with vessel volume fraction (VVF) distribution obtained from SLCM—e.g., high CBV relates to specific vessel locations with large VVF. Moreover, we find significant changes in CBV distribution and vasculature due to ageing (5 vs. 21 month-old mice), highlighting the sensitivity of our approach. Overall, we are able to associate CBV with vascular structure—and track its longitudinal changes—at the artery-vein, venules, arteriole, and capillary levels. We believe that this combined approach can be a powerful tool for studying other acute (e.g., brain injuries), progressive (e.g., neurodegeneration) or induced pathological changes.
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Raisi-Estabragh Z, M'Charrak A, McCracken C, Biasiolli L, Ardissino M, Curtis EM, Aung N, Suemoto CK, Mackay C, Suri S, Nichols TE, Harvey NC, Petersen SE, Neubauer S. Associations of cognitive performance with cardiovascular magnetic resonance phenotypes in the UK Biobank. Eur Heart J Cardiovasc Imaging 2022; 23:663-672. [PMID: 33987659 PMCID: PMC9016359 DOI: 10.1093/ehjci/jeab075] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Accepted: 04/07/2021] [Indexed: 01/22/2023] Open
Abstract
AIMS Existing evidence suggests links between brain and cardiovascular health. We investigated associations between cognitive performance and cardiovascular magnetic resonance (CMR) phenotypes in the UK Biobank, considering a range of potential confounders. METHODS AND RESULTS We studied 29 763 participants with CMR and cognitive testing, specifically, fluid intelligence (FI, 13 verbal-numeric reasoning questions), and reaction time (RT, a timed pairs matching exercise); both were considered continuous variables for modelling. We included the following CMR metrics: left and right ventricular (LV and RV) volumes in end-diastole and end-systole, LV/RV ejection fractions, LV/RV stroke volumes, LV mass, and aortic distensibility. Multivariable linear regression models were used to estimate the association of each CMR measure with FI and RT, adjusting for age, sex, smoking, education, deprivation, diabetes, hypertension, high cholesterol, prior myocardial infarction, alcohol intake, and exercise level. We report standardized beta-coefficients, 95% confidence intervals, and P-values adjusted for multiple testing. In this predominantly healthy cohort (average age 63.0 ± 7.5 years), better cognitive performance (higher FI, lower RT) was associated with larger LV/RV volumes, higher LV/RV stroke volumes, greater LV mass, and greater aortic distensibility in fully adjusted models. There was some evidence of non-linearity in the relationship between FI and LV end-systolic volume, with reversal of the direction of association at very high volumes. Associations were consistent for men and women and in different ages. CONCLUSION Better cognitive performance is associated with CMR measures likely representing a healthier cardiovascular phenotype. These relationships remained significant after adjustment for a range of cardiometabolic, lifestyle, and demographic factors, suggesting possible involvement of alternative disease mechanisms.
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Affiliation(s)
- Zahra Raisi-Estabragh
- Centre for Advanced Cardiovascular Imaging, William Harvey Research Institute, NIHR Barts Biomedical Research Centre, Queen Mary University of London, Charterhouse Square, London EC1M 6BQ, UK
- Barts Heart Centre, St Bartholomew’s Hospital, Barts Health NHS Trust, London EC1A 7BE, UK
| | - Amine M'Charrak
- Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, National Institute for Health Research Oxford Biomedical Research Centre, Oxford University Hospitals NHS Foundation Trust, Oxford, OX3 9DU, UK
| | - Celeste McCracken
- Centre for Advanced Cardiovascular Imaging, William Harvey Research Institute, NIHR Barts Biomedical Research Centre, Queen Mary University of London, Charterhouse Square, London EC1M 6BQ, UK
- Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, National Institute for Health Research Oxford Biomedical Research Centre, Oxford University Hospitals NHS Foundation Trust, Oxford, OX3 9DU, UK
| | - Luca Biasiolli
- Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, National Institute for Health Research Oxford Biomedical Research Centre, Oxford University Hospitals NHS Foundation Trust, Oxford, OX3 9DU, UK
| | | | - Elizabeth M Curtis
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
| | - Nay Aung
- Centre for Advanced Cardiovascular Imaging, William Harvey Research Institute, NIHR Barts Biomedical Research Centre, Queen Mary University of London, Charterhouse Square, London EC1M 6BQ, UK
- Barts Heart Centre, St Bartholomew’s Hospital, Barts Health NHS Trust, London EC1A 7BE, UK
| | - Claudia K Suemoto
- Division of Geriatrics, Department of Internal Medicine, University of Sao Paulo Medical School, Sao Paulo, Brazil
| | - Clare Mackay
- Department of Psychiatry, University of Oxford, Oxford, UK
| | - Sana Suri
- Department of Psychiatry, University of Oxford, Oxford, UK
| | - Thomas E Nichols
- Nuffield Department of Population Health, Oxford Big Data Institute, Li Ka Shing Centre for Health Information and Discovery, University of Oxford, Oxford OX3 7LF, UK
- Nuffield Department of Clinical Neurosciences, Wellcome Centre for Integrative Neuroimaging, FMRIB, University of Oxford, Oxford OX3 9DU, UK
| | - Nicholas C Harvey
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
- NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Steffen E Petersen
- Centre for Advanced Cardiovascular Imaging, William Harvey Research Institute, NIHR Barts Biomedical Research Centre, Queen Mary University of London, Charterhouse Square, London EC1M 6BQ, UK
- Barts Heart Centre, St Bartholomew’s Hospital, Barts Health NHS Trust, London EC1A 7BE, UK
| | - Stefan Neubauer
- Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, National Institute for Health Research Oxford Biomedical Research Centre, Oxford University Hospitals NHS Foundation Trust, Oxford, OX3 9DU, UK
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Al-Kawaz M, Cho SM, Gottesman RF, Suarez JI, Rivera-Lara L. Impact of Cerebral Autoregulation Monitoring in Cerebrovascular Disease: A Systematic Review. Neurocrit Care 2022; 36:1053-1070. [PMID: 35378665 DOI: 10.1007/s12028-022-01484-5] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2021] [Accepted: 03/01/2022] [Indexed: 12/16/2022]
Abstract
Cerebral autoregulation (CA) prevents brain injury by maintaining a relatively constant cerebral blood flow despite fluctuations in cerebral perfusion pressure. This process is disrupted consequent to various neurologic pathologic processes, which may result in worsening neurologic outcomes. Herein, we aim to highlight evidence describing CA changes and the impact of CA monitoring in patients with cerebrovascular disease, including ischemic stroke, intracerebral hemorrhage (ICH), and aneurysmal subarachnoid hemorrhage (aSAH). The study was preformed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines. English language publications were identified through a systematic literature conducted in Ovid Medline, PubMed, and Embase databases. The search spanned the dates of each database's inception through January 2021. We selected case-control studies, cohort observational studies, and randomized clinical trials for adult patients (≥ 18 years) who were monitored with continuous metrics using transcranial Doppler, near-infrared spectroscopy, and intracranial pressure monitors. Of 2799 records screened, 48 studies met the inclusion criteria. There were 23 studies on ischemic stroke, 18 studies on aSAH, 5 studies on ICH, and 2 studies on systemic hypertension. CA impairment was reported after ischemic stroke but generally improved after tissue plasminogen activator administration and successful mechanical thrombectomy. Persistent impairment in CA was associated with hemorrhagic transformation, malignant cerebral edema, and need for hemicraniectomy. Studies that investigated large ICHs described bilateral CA impairment up to 12 days from the ictus, especially in the presence of small vessel disease. In aSAH, impairment of CA was associated with angiographic vasospasm, delayed cerebral ischemia, and poor functional outcomes at 6 months. This systematic review highlights the available evidence for CA disruption during cerebrovascular diseases and its possible association with long-term neurological outcome. CA may be disrupted even before acute stroke in patients with untreated chronic hypertension. Monitoring CA may help in establishing individualized management targets in patients with cerebrovascular disease.
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Affiliation(s)
- Mais Al-Kawaz
- Department of Neurosurgery, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
- Department of Neurology, The Johns Hopkins University School of Medicine, Baltimore, MD, USA.
| | - Sung-Min Cho
- Department of Neurology, The Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Department of Anesthesiology and Critical Care Medicine, The Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Rebecca F Gottesman
- Stroke Branch, National Institute of Neurological Disorders and Stroke Intramural Program, National Institutes of Health, Bethesda, MD, USA
| | - Jose I Suarez
- Department of Neurology, The Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Department of Anesthesiology and Critical Care Medicine, The Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Department of Neurosurgery, The Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Lucia Rivera-Lara
- Division of Stroke and Neurocritical Care, Stanford University, Palo Alto, CA, USA
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Cataloging the potential SNPs (single nucleotide polymorphisms) associated with quantitative traits, viz. BMI (body mass index), IQ (intelligence quotient) and BP (blood pressure): an updated review. EGYPTIAN JOURNAL OF MEDICAL HUMAN GENETICS 2022. [DOI: 10.1186/s43042-022-00266-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Single nucleotide polymorphism (SNP) variants are abundant, persistent and widely distributed across the genome and are frequently linked to the development of genetic diseases. Identifying SNPs that underpin complex diseases can aid scientists in the discovery of disease-related genes by allowing for early detection, effective medication and eventually disease prevention.
Main body
Various SNP or polymorphism-based studies were used to categorize different SNPs potentially related to three quantitative traits: body mass index (BMI), intelligence quotient (IQ) and blood pressure, and then uncovered common SNPs for these three traits. We employed SNPedia, RefSNP Report, GWAS Catalog, Gene Cards (Data Bases), PubMed and Google Scholar search engines to find relevant material on SNPs associated with three quantitative traits. As a result, we detected three common SNPs for all three quantitative traits in global populations: SNP rs6265 of the BDNF gene on chromosome 11p14.1, SNP rs131070325 of the SL39A8 gene on chromosome 4p24 and SNP rs4680 of the COMT gene on chromosome 22q11.21.
Conclusion
In our review, we focused on the prevalent SNPs and gene expression activities that influence these three quantitative traits. These SNPs have been used to detect and map complex, common illnesses in communities for homogeneity testing and pharmacogenetic studies. High blood pressure, diabetes and heart disease, as well as BMI, schizophrenia and IQ, can all be predicted using common SNPs. Finally, the results of our work can be used to find common SNPs and genes that regulate these three quantitative features across the genome.
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Liu L, Hayden KM, May NS, Haring B, Liu Z, Henderson VW, Chen JC, Gracely EJ, Wassertheil-Smoller S, Rapp SR. Association between blood pressure levels and cognitive impairment in older women: a prospective analysis of the Women's Health Initiative Memory Study. THE LANCET. HEALTHY LONGEVITY 2022; 3:e42-e53. [PMID: 35112096 PMCID: PMC8804967 DOI: 10.1016/s2666-7568(21)00283-x] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Whether blood pressure (BP), and at what level of controlled BP, reduces risk of cognitive impairment remains uncertain. We investigated the association of BP and hypertension treatment status with mild cognitive impairment and dementia in older women. METHODS We prospectively analysed a sample of 7207 community-dwelling women aged 65-79 years participating in the Women's Health Initiative Memory Study (WHIMS). Participants were recruited between May 28, 1996, and Dec 13, 1999, at 39 US clinical centres, and they were followed up until Dec 31, 2019. Cognitive function was assessed annually. Mild cognitive impairment and probable dementia were defined through a centralised adjudication process. BP was measured by trained and certified staff at baseline. Pulse pressure (PP) was calculated as systolic BP (SBP) minus diastolic BP. Hypertension was defined using the American Heart Association 2017 Guideline for High BP in Adults. Outcomes were (1) mild cognitive impairment, (2) probable dementia, and (3) cognitive loss (the combined endpoint of either mild cognitive impairment or probable dementia, or both). We estimated hazard ratios (HRs) to assess the association between hypertension, SBP, and PP with the risk of study outcomes using Cox proportional hazards regression models, with adjustment for key covariates. FINDINGS During a median follow-up of 9 years (IQR 6-15), 1132 (15·7%) participants were classified as mild cognitive impairment, 739 (10·3%) as probable dementia, and 1533 (21·3%) as cognitive loss. The incidence rates per 1000 person-years were 15·3 cases (95% CI 14·4-16·2) for mild cognitive impairment, 9·7 cases (9·0-10·4) for probable dementia, and 20·3 (19·3-21·3) for cognitive loss. Elevated SBP and PP were significantly associated with increased risk of mild cognitive impairment and cognitive loss (test for trends across SBP and PP strata, p<0·01). Individuals with hypertension, but with controlled SBP of less than 120 mm Hg did not have a significantly increased risk of mild cognitive impairment (HR 1·33, 95% CI 0·98-1·82, p=0·071), and of cognitive loss (1·09, 0·82-1·44, p=0·57) compared with normotension. Individuals on anti-hypertensive treatment with PP of less than 50 mm Hg did not have a significantly higher risk of mild cognitive impairment (1·26, 0·98-1·62, p=0·07) and of cognitive loss (1·17, 0·94-1·46, p=0·16). There were no significant associations between hypertension, SBP, or PP and probable dementia. INTERPRETATION Results of our study show significant associations of hypertension and elevated SBP and PP levels with risk of mild cognitive impairment and the combined endpoint of either mild cognitive impairment or probable dementia, suggesting that intensive control of hypertension, SBP, and PP can preserve cognitive health in older women. FUNDING National Heart, Lung, and Blood Institute, National Institutes of Health, and US Department of Health and Human Services.
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Affiliation(s)
- Longjian Liu
- Department of Epidemiology and Biostatistics, Drexel University Dornsife School of Public Health, Philadelphia, PA, USA (L Liu MD, E J Gracely PhD); Department of Social Sciences and Health Policy (K M Hayden PhD) and Department of Psychiatry and Behavioral Medicine (Prof S R Rapp PhD), Wake Forest School of Medicine, Winston-Salem, NC, USA; Department of Medicine, Drexel University College of Medicine, Philadelphia, PA, USA (N S May MD); Department of Cardiology, University Heart Center Graz, Medical University of Graz, Graz, Austria (B Haring MD); Department of Medicine, University of Wuerzburg, Wuerzburg, Germany (B Haring); Neurology, California Pacific Medical Center, Sutter Health, San Francisco, CA, USA (Z Liu MD); Department of Epidemiology and Population Health and Department of Neurology and Neurological Sciences, Stanford University, Stanford, CA, USA (Prof V W Henderson MD); Departments of Population & Public Health Sciences and Neurology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA (J-C Chen MD); Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York, NY, USA (Prof S Wassertheil-Smoller PhD)
| | - Kathleen M Hayden
- Department of Epidemiology and Biostatistics, Drexel University Dornsife School of Public Health, Philadelphia, PA, USA (L Liu MD, E J Gracely PhD); Department of Social Sciences and Health Policy (K M Hayden PhD) and Department of Psychiatry and Behavioral Medicine (Prof S R Rapp PhD), Wake Forest School of Medicine, Winston-Salem, NC, USA; Department of Medicine, Drexel University College of Medicine, Philadelphia, PA, USA (N S May MD); Department of Cardiology, University Heart Center Graz, Medical University of Graz, Graz, Austria (B Haring MD); Department of Medicine, University of Wuerzburg, Wuerzburg, Germany (B Haring); Neurology, California Pacific Medical Center, Sutter Health, San Francisco, CA, USA (Z Liu MD); Department of Epidemiology and Population Health and Department of Neurology and Neurological Sciences, Stanford University, Stanford, CA, USA (Prof V W Henderson MD); Departments of Population & Public Health Sciences and Neurology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA (J-C Chen MD); Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York, NY, USA (Prof S Wassertheil-Smoller PhD)
| | - Nathalie S May
- Department of Epidemiology and Biostatistics, Drexel University Dornsife School of Public Health, Philadelphia, PA, USA (L Liu MD, E J Gracely PhD); Department of Social Sciences and Health Policy (K M Hayden PhD) and Department of Psychiatry and Behavioral Medicine (Prof S R Rapp PhD), Wake Forest School of Medicine, Winston-Salem, NC, USA; Department of Medicine, Drexel University College of Medicine, Philadelphia, PA, USA (N S May MD); Department of Cardiology, University Heart Center Graz, Medical University of Graz, Graz, Austria (B Haring MD); Department of Medicine, University of Wuerzburg, Wuerzburg, Germany (B Haring); Neurology, California Pacific Medical Center, Sutter Health, San Francisco, CA, USA (Z Liu MD); Department of Epidemiology and Population Health and Department of Neurology and Neurological Sciences, Stanford University, Stanford, CA, USA (Prof V W Henderson MD); Departments of Population & Public Health Sciences and Neurology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA (J-C Chen MD); Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York, NY, USA (Prof S Wassertheil-Smoller PhD)
| | - Bernhard Haring
- Department of Epidemiology and Biostatistics, Drexel University Dornsife School of Public Health, Philadelphia, PA, USA (L Liu MD, E J Gracely PhD); Department of Social Sciences and Health Policy (K M Hayden PhD) and Department of Psychiatry and Behavioral Medicine (Prof S R Rapp PhD), Wake Forest School of Medicine, Winston-Salem, NC, USA; Department of Medicine, Drexel University College of Medicine, Philadelphia, PA, USA (N S May MD); Department of Cardiology, University Heart Center Graz, Medical University of Graz, Graz, Austria (B Haring MD); Department of Medicine, University of Wuerzburg, Wuerzburg, Germany (B Haring); Neurology, California Pacific Medical Center, Sutter Health, San Francisco, CA, USA (Z Liu MD); Department of Epidemiology and Population Health and Department of Neurology and Neurological Sciences, Stanford University, Stanford, CA, USA (Prof V W Henderson MD); Departments of Population & Public Health Sciences and Neurology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA (J-C Chen MD); Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York, NY, USA (Prof S Wassertheil-Smoller PhD)
| | - Zuolu Liu
- Department of Epidemiology and Biostatistics, Drexel University Dornsife School of Public Health, Philadelphia, PA, USA (L Liu MD, E J Gracely PhD); Department of Social Sciences and Health Policy (K M Hayden PhD) and Department of Psychiatry and Behavioral Medicine (Prof S R Rapp PhD), Wake Forest School of Medicine, Winston-Salem, NC, USA; Department of Medicine, Drexel University College of Medicine, Philadelphia, PA, USA (N S May MD); Department of Cardiology, University Heart Center Graz, Medical University of Graz, Graz, Austria (B Haring MD); Department of Medicine, University of Wuerzburg, Wuerzburg, Germany (B Haring); Neurology, California Pacific Medical Center, Sutter Health, San Francisco, CA, USA (Z Liu MD); Department of Epidemiology and Population Health and Department of Neurology and Neurological Sciences, Stanford University, Stanford, CA, USA (Prof V W Henderson MD); Departments of Population & Public Health Sciences and Neurology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA (J-C Chen MD); Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York, NY, USA (Prof S Wassertheil-Smoller PhD)
| | - Victor W Henderson
- Department of Epidemiology and Biostatistics, Drexel University Dornsife School of Public Health, Philadelphia, PA, USA (L Liu MD, E J Gracely PhD); Department of Social Sciences and Health Policy (K M Hayden PhD) and Department of Psychiatry and Behavioral Medicine (Prof S R Rapp PhD), Wake Forest School of Medicine, Winston-Salem, NC, USA; Department of Medicine, Drexel University College of Medicine, Philadelphia, PA, USA (N S May MD); Department of Cardiology, University Heart Center Graz, Medical University of Graz, Graz, Austria (B Haring MD); Department of Medicine, University of Wuerzburg, Wuerzburg, Germany (B Haring); Neurology, California Pacific Medical Center, Sutter Health, San Francisco, CA, USA (Z Liu MD); Department of Epidemiology and Population Health and Department of Neurology and Neurological Sciences, Stanford University, Stanford, CA, USA (Prof V W Henderson MD); Departments of Population & Public Health Sciences and Neurology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA (J-C Chen MD); Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York, NY, USA (Prof S Wassertheil-Smoller PhD)
| | - Jiu-Chiuan Chen
- Department of Epidemiology and Biostatistics, Drexel University Dornsife School of Public Health, Philadelphia, PA, USA (L Liu MD, E J Gracely PhD); Department of Social Sciences and Health Policy (K M Hayden PhD) and Department of Psychiatry and Behavioral Medicine (Prof S R Rapp PhD), Wake Forest School of Medicine, Winston-Salem, NC, USA; Department of Medicine, Drexel University College of Medicine, Philadelphia, PA, USA (N S May MD); Department of Cardiology, University Heart Center Graz, Medical University of Graz, Graz, Austria (B Haring MD); Department of Medicine, University of Wuerzburg, Wuerzburg, Germany (B Haring); Neurology, California Pacific Medical Center, Sutter Health, San Francisco, CA, USA (Z Liu MD); Department of Epidemiology and Population Health and Department of Neurology and Neurological Sciences, Stanford University, Stanford, CA, USA (Prof V W Henderson MD); Departments of Population & Public Health Sciences and Neurology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA (J-C Chen MD); Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York, NY, USA (Prof S Wassertheil-Smoller PhD)
| | - Edward J Gracely
- Department of Epidemiology and Biostatistics, Drexel University Dornsife School of Public Health, Philadelphia, PA, USA (L Liu MD, E J Gracely PhD); Department of Social Sciences and Health Policy (K M Hayden PhD) and Department of Psychiatry and Behavioral Medicine (Prof S R Rapp PhD), Wake Forest School of Medicine, Winston-Salem, NC, USA; Department of Medicine, Drexel University College of Medicine, Philadelphia, PA, USA (N S May MD); Department of Cardiology, University Heart Center Graz, Medical University of Graz, Graz, Austria (B Haring MD); Department of Medicine, University of Wuerzburg, Wuerzburg, Germany (B Haring); Neurology, California Pacific Medical Center, Sutter Health, San Francisco, CA, USA (Z Liu MD); Department of Epidemiology and Population Health and Department of Neurology and Neurological Sciences, Stanford University, Stanford, CA, USA (Prof V W Henderson MD); Departments of Population & Public Health Sciences and Neurology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA (J-C Chen MD); Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York, NY, USA (Prof S Wassertheil-Smoller PhD)
| | - Sylvia Wassertheil-Smoller
- Department of Epidemiology and Biostatistics, Drexel University Dornsife School of Public Health, Philadelphia, PA, USA (L Liu MD, E J Gracely PhD); Department of Social Sciences and Health Policy (K M Hayden PhD) and Department of Psychiatry and Behavioral Medicine (Prof S R Rapp PhD), Wake Forest School of Medicine, Winston-Salem, NC, USA; Department of Medicine, Drexel University College of Medicine, Philadelphia, PA, USA (N S May MD); Department of Cardiology, University Heart Center Graz, Medical University of Graz, Graz, Austria (B Haring MD); Department of Medicine, University of Wuerzburg, Wuerzburg, Germany (B Haring); Neurology, California Pacific Medical Center, Sutter Health, San Francisco, CA, USA (Z Liu MD); Department of Epidemiology and Population Health and Department of Neurology and Neurological Sciences, Stanford University, Stanford, CA, USA (Prof V W Henderson MD); Departments of Population & Public Health Sciences and Neurology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA (J-C Chen MD); Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York, NY, USA (Prof S Wassertheil-Smoller PhD)
| | - Stephen R Rapp
- Department of Epidemiology and Biostatistics, Drexel University Dornsife School of Public Health, Philadelphia, PA, USA (L Liu MD, E J Gracely PhD); Department of Social Sciences and Health Policy (K M Hayden PhD) and Department of Psychiatry and Behavioral Medicine (Prof S R Rapp PhD), Wake Forest School of Medicine, Winston-Salem, NC, USA; Department of Medicine, Drexel University College of Medicine, Philadelphia, PA, USA (N S May MD); Department of Cardiology, University Heart Center Graz, Medical University of Graz, Graz, Austria (B Haring MD); Department of Medicine, University of Wuerzburg, Wuerzburg, Germany (B Haring); Neurology, California Pacific Medical Center, Sutter Health, San Francisco, CA, USA (Z Liu MD); Department of Epidemiology and Population Health and Department of Neurology and Neurological Sciences, Stanford University, Stanford, CA, USA (Prof V W Henderson MD); Departments of Population & Public Health Sciences and Neurology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA (J-C Chen MD); Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York, NY, USA (Prof S Wassertheil-Smoller PhD)
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Badji A, Cohen-Adad J, Girouard H. Relationship Between Arterial Stiffness Index, Pulse Pressure, and Magnetic Resonance Imaging Markers of White Matter Integrity: A UK Biobank Study. Front Aging Neurosci 2022; 14:856782. [PMID: 35800980 PMCID: PMC9252854 DOI: 10.3389/fnagi.2022.856782] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Accepted: 05/09/2022] [Indexed: 12/29/2022] Open
Abstract
Background Alzheimer's disease and dementia in general constitute one of the major public health problems of the 21st century. Research in arterial stiffness and pulse pressure (PP) play an important role in the quest to reduce the risk of developing dementia through controlling modifiable risk factors. Objective The aim of the study is to investigate the association between peripheral PP, arterial stiffness index (ASI) and brain integrity, and to discover if ASI is a better predictor of white matter integrity than peripheral PP. Materials and Methods 17,984 participants 63.09 ± 7.31 from the UK Biobank were used for this study. ASI was estimated using infrared light (photoplethysmography) and peripheral PP was calculated by subtracting the diastolic from the systolic brachial blood pressure value. Measure of fractional anisotropy (FA) was obtained from diffusion imaging to estimate white matter microstructural integrity. White matter hyperintensities were segmented from the combined T1 and T2-weighted FLAIR images as a measure of irreversible white matter damage. Results An important finding is that peripheral PP better predicts white matter integrity when compared to ASI. This finding is consistent until 75 years old. Interestingly, no significant relationship is found between either peripheral PP or ASI and white matter integrity after 75 years old. Conclusion These results suggest that ASI from plethysmography should not be used to estimate cerebrovascular integrity in older adults and further question the relationship between arterial stiffness, blood pressure, and white matter damage after the age of 75 years old.
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Affiliation(s)
- Atef Badji
- NeuroPoly Lab, Institute of Biomedical Engineering, Polytechnique Montréal, Montréal, QC, Canada.,Functional Neuroimaging Unit, Centre de Recherche de l'Institut Universitaire de Gériatrie de Montréal, Université de Montréal, Montréal, QC, Canada.,Department of Neurosciences, Faculty of Medicine, Université de Montréal, Montréal, QC, Canada
| | - Julien Cohen-Adad
- NeuroPoly Lab, Institute of Biomedical Engineering, Polytechnique Montréal, Montréal, QC, Canada.,Functional Neuroimaging Unit, Centre de Recherche de l'Institut Universitaire de Gériatrie de Montréal, Université de Montréal, Montréal, QC, Canada.,Mila - Quebec AI Institute, Montréal, QC, Canada
| | - Hélène Girouard
- Functional Neuroimaging Unit, Centre de Recherche de l'Institut Universitaire de Gériatrie de Montréal, Université de Montréal, Montréal, QC, Canada.,Department of Pharmacology and Physiology, Faculty of Medicine, Université de Montréal, Montréal, QC, Canada.,Groupe de Recherche sur le Système Nerveux Central, Montréal, QC, Canada.,Centre Interdisciplinaire de Recherche sur le Cerveau et l'Apprentissage, Montréal, QC, Canada.,Groupe de Recherche Universitaire Sur le Médicament (GRUM), Montréal, QC, Canada
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Gabay A, London S, Yates KF, Convit A. Does obesity-associated insulin resistance affect brain structure and function of adolescents differentially by sex? Psychiatry Res Neuroimaging 2022; 319:111417. [PMID: 34875560 PMCID: PMC8809005 DOI: 10.1016/j.pscychresns.2021.111417] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2021] [Revised: 11/17/2021] [Accepted: 11/22/2021] [Indexed: 01/03/2023]
Abstract
Metabolic abnormalities affect the adolescent brain. For equivalent abnormalities in metabolism young people exhibit deficits in more cognitive domains than adults. We examine sex differences performance for adolescents with obesity/insulin resistance (IR) and evaluated how sex and IR effected frontal lobe structures and executive functioning. 125 adolescents underwent medical, cognitive, and brain-imaging assessments. Participants were categorized as insulin sensitive (IS) (QUICKI ≥ 0.350) or IR (QUICKI < 0.350). Degree of IR may affect brain and cognition differentially by sex. Females had positive associations between QUICKI and anterior cingulate cortex (ACC) volume, medial orbito-frontal cortex (OFC) thickness, and scores on the Stroop and Digit Symbol Substitution (DSST) tests. Females with IR tended to have thinner insular cortices. No such associations were found in males. In female adolescents, IR may negatively affect brain structure and function. No such effects were found for males. Although needing more development, hormonal effects and inflammation are potential contributors.
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Affiliation(s)
- Andrea Gabay
- Department of Psychiatry, New York University School of Medicine, New York, NY, United States of America
| | - Stephanie London
- Department of Psychiatry, New York University School of Medicine, New York, NY, United States of America; Resident in Psychiatry, Massachusetts General Hospital, Boston, MA, United States of America
| | - Kathy F Yates
- Department of Psychiatry, New York University School of Medicine, New York, NY, United States of America; Nathan Kline Institute for Psychiatric Research, New York, Orangeburg, United States of America
| | - Antonio Convit
- Department of Psychiatry, New York University School of Medicine, New York, NY, United States of America; Department of Medicine, New York University School of Medicine, New York, NY, United States of America; Department of Radiology, New York University School of Medicine, New York, NY, United States of America; Nathan Kline Institute for Psychiatric Research, New York, Orangeburg, United States of America.
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38
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Goenarjo R, Dupuy O, Fraser S, Berryman N, Perrochon A, Bosquet L. Cardiorespiratory fitness and prefrontal cortex oxygenation during Stroop task in older males. Physiol Behav 2021; 242:113621. [PMID: 34648819 DOI: 10.1016/j.physbeh.2021.113621] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Revised: 09/23/2021] [Accepted: 10/09/2021] [Indexed: 11/17/2022]
Abstract
AIM The aim of the current study was to assess whether executive function and prefrontal oxygenation are dependent on fitness level and age in older adults. METHODS Twenty-four healthy males aged between 55 and 69 years old were recruited for this study. They were stratified by age, leading to the creation of two groups: 55-60 years old and 61-69 years old. A median split based on CRF created higher- and lower-fit categories of participants. Cerebral oxygenation was assessed using functional near-infrared spectroscopy (fNIRS) during a computerized Stroop task. Accuracy (% of correct responses) and reaction times (ms) were used as behavioural indicators of cognitive performances. Changes in oxygenated (∆[HbO2]) and deoxygenated (∆[HHb]) hemoglobin were measured to capture neural changes. Repeated measures ANOVAs (CRF × Age × Stroop conditions) were performed to test the null hypothesis of an absence of interaction between CRF, Age and executive performance. RESULTS We also found an interaction between CRF and age on reaction times (p = .001), in which higher fitness levels were related to faster reaction times in the 61-69 year olds but not in the 55-60 year olds. Regarding ΔHHb, the ANOVA revealed a main effect of CRF in the right PFC (p = .04), in which higher-fit participants had a greater Δ[HHb] than the lower-fit (d = 1.5). We also found fitness by age interaction for Δ[HHb] in the right PFC (p = .04). CONCLUSION Our results support the positive association of CRF on cerebral oxygenation and Stroop performance in healthy older males. They indicated that high-fit individuals performed better in the 61-69 year olds group, but not in the 55-60 years old group. We also observed a greater PFC oxygenation change (as measured by Δ[HHb]) in the high-fit individuals.
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Affiliation(s)
- Roman Goenarjo
- Laboratoire MOVE (EA 6314), Faculté des Sciences du Sport, Université de Poitiers, Poitiers, France; Department of Medical Physiology, Faculty of Medicine, Universitas Indonesia, Depok, Indonesia
| | - Olivier Dupuy
- Laboratoire MOVE (EA 6314), Faculté des Sciences du Sport, Université de Poitiers, Poitiers, France; Ecole de Kinésiologie et des Sciences de l'Activité Physique (EKSAP), Faculté de Médecine, Université de Montreal, Montreal, Canada.
| | - Sarah Fraser
- Interdisciplinary School of Health Sciences, Faculty of Health Sciences, University of Ottawa, Ottawa (Ontario), Canada
| | - Nicolas Berryman
- Centre de Recherche de l'Institut Universitaire de Gériatrie de Montréal, Montréal, Canada; Département des Sciences de l'activité physique, Université du Québec à Montréal (UQAM), Montréal, Canada
| | - Anaïck Perrochon
- Laboratoire HAVAE (EA 6310), Université de Limoges, Limoges, France
| | - Laurent Bosquet
- Laboratoire MOVE (EA 6314), Faculté des Sciences du Sport, Université de Poitiers, Poitiers, France; Centre de Recherche de l'Institut Universitaire de Gériatrie de Montréal, Montréal, Canada; Ecole de Kinésiologie et des Sciences de l'Activité Physique (EKSAP), Faculté de Médecine, Université de Montreal, Montreal, Canada
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Guzman VA, Cham H, Gutierrez J, Byrd D, Morris EP, Tureson K, Morgello S, Mindt MR. The Longitudinal Effects of Blood Pressure and Hypertension on Neurocognitive Performance in People Living With HIV. J Acquir Immune Defic Syndr 2021; 88:197-205. [PMID: 34081663 PMCID: PMC8434985 DOI: 10.1097/qai.0000000000002740] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Accepted: 05/24/2021] [Indexed: 11/25/2022]
Abstract
BACKGROUND Hypertension (HTN) and HIV are salient risk factors for cerebral small vessel disease and neurocognitive (NC) impairment, yet the effects of HTN on NC performance in persons living with HIV remain poorly understood. This is the first study to examine the longitudinal associations between blood pressure (BP), HTN, and pulse pressure (PP) with NC performance in persons living with HIV. SETTING New York City. METHODS Analysis of medical, NC, and virologic data from 485 HIV+ participants was collected by the Manhattan HIV Brain Bank, a prospective, observational, longitudinal study of neuroHIV. A series of multilevel linear growth curve models with random intercepts and slopes were estimated for BP, HTN status, and PP to predict the change in NC performance. RESULTS The baseline prevalence of HTN was 23%. Longitudinal changes in diastolic and systolic pressure were associated with a 10.5-second and 4-second increase in the Grooved Pegboard Test nondominant hand performance, respectively. A longitudinal change in diastolic BP was also associated with a 0.3-point decline in correct categories and 3-point increase in perseverative responses and total errors on the Wisconsin Card Sorting Test. Increasing odds of prevalent and/or incident HTN were associated with a 0.1-point decrease in correct categories and a 0.8-point increase in total errors on the Wisconsin Card Sorting Test. There was no association between PP and NC performance. CONCLUSIONS The results indicate linear longitudinal relations for BP and HTN with poorer NC test performance, particularly in psychomotor and executive functions in persons with HIV.
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Affiliation(s)
- Vanessa A. Guzman
- Department of Neurology, Columbia University Irving Medical Center, New York, NY, USA
- Department of Neurology, The Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Psychology, Fordham University, New York, NY, USA
| | - Heining Cham
- Department of Psychology, Fordham University, New York, NY, USA
| | - Jose Gutierrez
- Department of Neurology, Columbia University Irving Medical Center, New York, NY, USA
| | - Desiree Byrd
- Department of Neurology, The Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Psychology, Queens College and The Graduate Center, CUNY, Queens, New York, USA
| | - Emily P. Morris
- Department of Psychology, Fordham University, New York, NY, USA
- Department of Psychology, University of Michigan, Ann Arbor, Michigan, USA
| | - Kayla Tureson
- Department of Psychology, Fordham University, New York, NY, USA
- Department of Psychology, University of Southern California, Los Angeles, USA
| | - Susan Morgello
- Department of Neurology, The Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Departments of Pathology and Neuroscience, The Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Monica Rivera Mindt
- Department of Neurology, The Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Psychology, Fordham University, New York, NY, USA
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Adherence to Mediterranean Diet and Cognitive Abilities in the Greek Cohort of Epirus Health Study. Nutrients 2021; 13:nu13103363. [PMID: 34684367 PMCID: PMC8541267 DOI: 10.3390/nu13103363] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2021] [Revised: 09/20/2021] [Accepted: 09/22/2021] [Indexed: 01/27/2023] Open
Abstract
The Mediterranean diet is commonly proposed as a major modifiable protective factor that may delay cognitive impairment in the elderly. The aim of the study was to investigate the cross-sectional association of adherence to the Mediterranean diet with cognitive abilities in a younger Greek population. A total of 1201 healthy adults aged 21-77 years (mean: 47.8) from the Epirus Health Study cohort were included in the analysis. Adherence to the Mediterranean diet was measured using the 14-point Mediterranean Diet Adherence Screener (MEDAS) and cognition was measured using the Trail Making Test, the Verbal Fluency test and the Logical Memory test. Statistical analysis was performed using multiple linear regression models adjusted for age, sex, education, body mass index, smoking status, alcohol consumption and physical activity. Overall, no association was found between the MEDAS score and cognitive tests, which could be explained by the young mean age and high level of education of the participants. Future studies should target young and middle-aged individuals to gain further understanding of the association between Mediterranean diet and cognition in this age group.
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41
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Sible IJ, Bangen KJ, Blanken AE, Ho JK, Nation DA. Antemortem Visit-To-Visit Blood Pressure Variability Predicts Cerebrovascular Lesion Burden in Autopsy-Confirmed Alzheimer's Disease. J Alzheimers Dis 2021; 83:65-75. [PMID: 34250941 DOI: 10.3233/jad-210435] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Blood pressure variability is linked to Alzheimer's disease (AD) risk and MRI-based markers of cerebrovascular disease. Less is known about the role of blood pressure variability in postmortem evaluation of cerebrovascular disease and AD. OBJECTIVE To determine whether antemortem blood pressure variability predicts cerebrovascular and AD pathology and follow-up cognitive change in autopsy-confirmed AD. METHODS National Alzheimer's Coordinating Center participants (n = 513) underwent 3-4 approximately annual blood pressure measurements and were confirmed to have AD at postmortem evaluation. A subset (n = 493) underwent neuropsychological evaluation at follow-up. Regression models examined relationships between blood pressure variability and cerebrovascular and AD pathological features and follow-up cognitive change. RESULTS Elevated blood pressure variability predicted increased postmortem cerebrovascular lesion burden (ß = 0.26 [0.10, 0.42]; p = 0.001; R2 = 0.12). Increased blood pressure variability predicted specific cerebrovascular lesion severity, including atherosclerosis in the Circle of Willis (OR = 1.22 [1.03, 1.44]; p = 0.02) and cerebral arteriolosclerosis (OR = 1.32 [1.04, 1.69]; p = 0.03). No significant relationships were observed between blood pressure variability and AD pathological findings, including Braak & Braak stage, neuritic plaques or diffuse plaques, or cerebral amyloid angiopathy, or follow-up cognitive decline. CONCLUSION Findings suggest that elevated blood pressure variability is related to postmortem cerebrovascular lesion burden in autopsy-confirmed AD, independent of average blood pressure and AD neuropathology. Blood pressure fluctuation may selectively promote atherosclerotic and arteriolosclerotic brain lesions with potential implications for cognitive impairment and dementia.
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Affiliation(s)
- Isabel J Sible
- Department of Psychology, University of Southern California, Los Angeles, CA, USA
| | - Katherine J Bangen
- Research Service, Veteran Affairs San Diego Health Care System, San Diego, CA, USA.,Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA
| | - Anna E Blanken
- Department of Psychology, University of Southern California, Los Angeles, CA, USA
| | - Jean K Ho
- Institute for Memory Impairments and Neurological Disorders, University of California, Irvine, Irvine, CA, USA
| | - Daniel A Nation
- Institute for Memory Impairments and Neurological Disorders, University of California, Irvine, Irvine, CA, USA.,Department of Psychological Science, University of California, Irvine, Irvine, CA, USA
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Empana JP, Boutouyrie P, Lemogne C, Jouven X, van Sloten TT. Microvascular Contribution to Late-Onset Depression: Mechanisms, Current Evidence, Association With Other Brain Diseases, and Therapeutic Perspectives. Biol Psychiatry 2021; 90:214-225. [PMID: 34325805 DOI: 10.1016/j.biopsych.2021.04.012] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Revised: 04/20/2021] [Accepted: 04/21/2021] [Indexed: 12/16/2022]
Abstract
Depression is common in older individuals and is associated with high disability and mortality. A major problem is treatment resistance: >50% of older patients do not respond to current antidepressants. Therefore, new effective interventions for prevention and treatment of depression in older individuals need to be developed, which requires a better understanding of the mechanisms underlying depression. The pathophysiology of depression is multifactorial and complex. Microvascular dysfunction may be an early and targetable mechanism in the development of depression, notably depression that initiates in late life (late-onset depression). Late-onset depression commonly co-occurs with other diseases or syndromes that may share a microvascular origin, including apathy, cognitive impairment, dementia, and stroke. Together, these disabilities may all be part of one large phenotype resulting from global cerebral microvascular dysfunction. In this review, we discuss the pathophysiology of microvascular dysfunction-related late-onset depression, summarize recent epidemiological evidence on the association between cerebral microvascular dysfunction and depression, and indicate potential drivers of cerebral microvascular dysfunction. We also propose the hypothesis that depression may be a manifestation of a larger phenotype of cerebral microvascular dysfunction, highlight potential therapeutic targets and interventions, and give directions for future research.
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Affiliation(s)
- Jean-Philippe Empana
- Université de Paris, INSERM, U970, Paris Cardiovascular Research Center, Paris, France
| | - Pierre Boutouyrie
- Université de Paris, INSERM, U970, Paris Cardiovascular Research Center, Paris, France
| | - Cédric Lemogne
- Université de Paris, AP-HP, Hôpital Hôtel-Dieu, DMU Psychiatrie et Addictologie, Service de Psychiatrie de l'adulte, INSERM, Institut de Psychiatrie et Neurosciences de Paris, UMR_S1266, Paris, France
| | - Xavier Jouven
- Université de Paris, INSERM, U970, Paris Cardiovascular Research Center, Paris, France
| | - Thomas T van Sloten
- Université de Paris, INSERM, U970, Paris Cardiovascular Research Center, Paris, France; School for Cardiovascular Diseases Maastricht and Department of Internal Medicine, Maastricht University Medical Centre, Maastricht, the Netherlands.
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43
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Lu S, Herold F, Zhang Y, Lei Y, Kramer AF, Jiao C, Yu Q, Doig S, Li J, Yan Z, Kuang J, Wang T, Zou L. Higher Handgrip Strength Is Linked to Better Cognitive Performance in Chinese Adults with Hypertension. Brain Sci 2021; 11:brainsci11080985. [PMID: 34439604 PMCID: PMC8391417 DOI: 10.3390/brainsci11080985] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Revised: 07/16/2021] [Accepted: 07/19/2021] [Indexed: 01/03/2023] Open
Abstract
Objective: There is growing evidence that in adults, higher levels of handgrip strength (HGS) are linked to better cognitive performance. However, the relationship between HGS and cognitive performance has not been sufficiently investigated in special cohorts, such as individuals with hypertension who have an intrinsically higher risk of cognitive decline. Thus, the purpose of this study was to examine the relationship between HGS and cognitive performance in adults with hypertension using data from the Global Ageing and Adult Health Survey (SAGE). Methods: A total of 4486 Chinese adults with hypertension from the SAGE were included in this study. Absolute handgrip strength (aHGS in kilograms) was measured using a handheld electronic dynamometer, and cognitive performance was assessed in the domains of short-term memory, delayed memory, and language ability. Multiple linear regression models were fitted to examine the association between relative handgrip strength (rHGS; aHGS divided by body mass index) and measures of cognitive performance. Results: Overall, higher levels of rHGS were associated with higher scores in short-term memory (β = 0.20) and language (β = 0.63) compared with the lowest tertiles of rHGS. In male participants, higher HGS was associated with higher scores in short-term memory (β = 0.31), language (β = 0.64), and delayed memory (β = 0.22). There were no associations between rHGS and cognitive performance measures in females. Conclusion: We observed that a higher level of rHGS was associated with better cognitive performance among hypertensive male individuals. Further studies are needed to investigate the neurobiological mechanisms, including sex-specific differences driving the relationship between measures of HGS and cognitive performance in individuals with hypertension.
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Affiliation(s)
- Shenghua Lu
- Hunan Academy of Education Sciences, Changsha 225002, China;
- College of Sports Science, Jishou University, Jishou 416000, China
| | - Fabian Herold
- Research Group Neuroprotection, German Center for Neurodegenerative Diseases (DZNE), Leipziger Str. 44, 39120 Magdeburg, Germany;
- Department of Neurology, Medical Faculty, Otto von Guericke University, Leipziger Str. 44, 39120 Magdeburg, Germany
| | - Yanjie Zhang
- Health and Exercise Science Laboratory, Institute of Sports Science, Seoul National University, Seoul 08826, Korea
- Physical Education Unit, School of Humanities and Social Science, The Chinese University of Hong Kong-Shenzhen, Shenzhen 518172, China
- Correspondence: (Y.Z.); (Y.L.)
| | - Yuruo Lei
- Institute of Urban Governance, Shenzhen University, Shenzhen 518060, China
- Correspondence: (Y.Z.); (Y.L.)
| | - Arthur F. Kramer
- Center for Cognitive and Brain Health, Northeastern University, Boston, MA 02115, USA;
- Beckman Institute, University of Illinois at Urbana-Champaign, Champaign, IL 61801, USA
| | - Can Jiao
- Institute of KEEP Collaborative Innovation, Shenzhen University, Shenzhen 518060, China; (C.J.); (Q.Y.); (J.L.); (Z.Y.); (J.K.); (T.W.); (L.Z.)
- Exercise Psychophysiology Laboratory, School of Psychology, Shenzhen University, Shenzhen 518060, China
| | - Qian Yu
- Institute of KEEP Collaborative Innovation, Shenzhen University, Shenzhen 518060, China; (C.J.); (Q.Y.); (J.L.); (Z.Y.); (J.K.); (T.W.); (L.Z.)
- Exercise Psychophysiology Laboratory, School of Psychology, Shenzhen University, Shenzhen 518060, China
| | - Scott Doig
- Department of Physical Education, Limestone University, Gaffney, SC 29340, USA;
| | - Jinming Li
- Institute of KEEP Collaborative Innovation, Shenzhen University, Shenzhen 518060, China; (C.J.); (Q.Y.); (J.L.); (Z.Y.); (J.K.); (T.W.); (L.Z.)
- Exercise Psychophysiology Laboratory, School of Psychology, Shenzhen University, Shenzhen 518060, China
| | - Zhe Yan
- Institute of KEEP Collaborative Innovation, Shenzhen University, Shenzhen 518060, China; (C.J.); (Q.Y.); (J.L.); (Z.Y.); (J.K.); (T.W.); (L.Z.)
- Exercise Psychophysiology Laboratory, School of Psychology, Shenzhen University, Shenzhen 518060, China
| | - Jin Kuang
- Institute of KEEP Collaborative Innovation, Shenzhen University, Shenzhen 518060, China; (C.J.); (Q.Y.); (J.L.); (Z.Y.); (J.K.); (T.W.); (L.Z.)
- Exercise Psychophysiology Laboratory, School of Psychology, Shenzhen University, Shenzhen 518060, China
| | - Ting Wang
- Institute of KEEP Collaborative Innovation, Shenzhen University, Shenzhen 518060, China; (C.J.); (Q.Y.); (J.L.); (Z.Y.); (J.K.); (T.W.); (L.Z.)
- Exercise Psychophysiology Laboratory, School of Psychology, Shenzhen University, Shenzhen 518060, China
| | - Liye Zou
- Institute of KEEP Collaborative Innovation, Shenzhen University, Shenzhen 518060, China; (C.J.); (Q.Y.); (J.L.); (Z.Y.); (J.K.); (T.W.); (L.Z.)
- Exercise Psychophysiology Laboratory, School of Psychology, Shenzhen University, Shenzhen 518060, China
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Bahchevanov KM, Dzhambov AM, Chompalov KA, Massaldjieva RI, Atanassova PA, Mitkov MD. Contribution of Components of Metabolic Syndrome to Cognitive Performance in Middle-Aged Adults. Arch Clin Neuropsychol 2021; 36:498-506. [PMID: 33067992 PMCID: PMC8138821 DOI: 10.1093/arclin/acaa081] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/09/2020] [Indexed: 11/16/2022] Open
Abstract
Introduction Metabolic syndrome (MetS) has been associated with impaired cognition in different cognitive domains. This study investigated the association between MetS and cognitive functioning in middle-aged Bulgarians across different definitions of MetS severity. Material and Methods Our cross-sectional sample included 112 participants (67 free of MetS and 45 with MetS) with a mean age of 50.04 ± 3.31 years. The following MetS variables were considered—presence of MetS, continuously measured MetS components, dichotomized MetS components, number of MetS components present, and Metabolic Syndrome Severity Score (MSSS). Participants’ cognitive performance was assessed using the Consortium to Establish a Registry for Alzheimer’s Disease Neuropsychological Battery (CERAD-NB). We employed multivariate regression models to investigate the associations between different measures of MetS severity and CERAD-NB total and subtest scores. Results Bivariate analyses showed that the CERAD-NB total score was significantly higher in women, participants with a university degree, those with normal blood pressure, normal waist circumference, and low triglyceride levels, compared with their counterparts. MetS participants had lower CERAD-NB total score (78.87 ± 6.89 vs. 84.97 ± 7.84) and specifically performed poorer on the subtest Word List Recall (7.16 ± 1.52 vs. 7.99 ± 1.52). These findings persisted after controlling for age, gender, and education. Next, generalized linear regression indicated that the CERAD-NB total score was lower in participants with MetS (β = −4.86; 95% confidence interval [CI]: −7.60, −2.11), those with more MetS components (β = −8.31; 95% CI: −14.13, −2.50 for fours vs. 0 components) and with an increase in MSSS (β = −3.19; 95% CI: −4.67, −1.71). Hypertension independently contributed to lower CERAD-NB total score (β = −4.00; 95% CI: −6.81, −1.19). Conclusions Across several definitions, MetS was associated with lower cognitive functioning, and MetS severity appeared to be a better predictor than most MetS components. Recognizing and reducing severity of MetS components might be helpful in supporting cognitive functioning. Further longitudinal research is needed to shed more light on the relationship between MetS and cognitive functioning across the life span.
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Affiliation(s)
- Karamfil M Bahchevanov
- Department of Neurology, Faculty of Medicine, Medical University of Plovdiv, Plovdiv, Bulgaria
| | - Angel M Dzhambov
- Department of Hygiene and Ecomedicine, Faculty of Public Health, Medical University of Plovdiv, Plovdiv, Bulgaria
| | - Kostadin A Chompalov
- Department of Neurology, Faculty of Medicine, Medical University of Plovdiv, Plovdiv, Bulgaria
| | - Radka I Massaldjieva
- Department of Healthcare Management, Faculty of Public Health, Medical University of Plovdiv, Plovdiv, Bulgaria
| | - Penka A Atanassova
- Department of Neurology, Faculty of Medicine, Medical University of Plovdiv, Plovdiv, Bulgaria
| | - Mitko D Mitkov
- Division of Endocrinology, Second Department of Internal Diseases, Faculty of Medicine, Medical University of Plovdiv, Plovdiv, Bulgaria
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Hosoki S, Tanaka T, Ihara M. Diagnostic and prognostic blood biomarkers in vascular dementia: From the viewpoint of ischemic stroke. Neurochem Int 2021; 146:105015. [PMID: 33781849 DOI: 10.1016/j.neuint.2021.105015] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Revised: 02/25/2021] [Accepted: 03/02/2021] [Indexed: 12/14/2022]
Abstract
Reliable quantitative blood biomarkers are important in vascular dementia (VaD) because early diagnosis and therapeutic intervention are effective in preventing progression of dementia. Although many blood biomarkers for acute ischemic stroke (AIS) or VaD have been reported, there are few reliable blood biomarkers. VaD and AIS have similar pathological conditions that are associated with small vessel disease (SVD) such as oxidative stress, inflammation, endothelial dysfunction, and neuronal injury. Therefore, it may be possible to find superior blood biomarkers of VaD among AIS blood biomarkers. Owing to recent developments, noncoding RNAs such as microRNA and long noncoding RNA, which can be analyzed using a single drop of blood, are also particularly reliable VaD markers because they stably reflect brain tissue damage. A multimarker combining several blood biomarkers or artificial intelligence technology may also be beneficial to compensate for insufficiencies of a single blood biomarker. This review describes the blood biomarkers of VaD and how they are related to blood biomarkers of AIS.
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Affiliation(s)
- Satoshi Hosoki
- Department of Neurology, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Tomotaka Tanaka
- Department of Neurology, National Cerebral and Cardiovascular Center, Suita, Japan
| | - Masafumi Ihara
- Department of Neurology, National Cerebral and Cardiovascular Center, Suita, Japan.
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Krishnamurthy V, Sprick JD, Krishnamurthy LC, Barter JD, Turabi A, Hajjar IM, Nocera JR. The Utility of Cerebrovascular Reactivity MRI in Brain Rehabilitation: A Mechanistic Perspective. Front Physiol 2021; 12:642850. [PMID: 33815146 PMCID: PMC8009989 DOI: 10.3389/fphys.2021.642850] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Accepted: 02/22/2021] [Indexed: 01/06/2023] Open
Abstract
Cerebrovascular control and its integration with other physiological systems play a key role in the effective maintenance of homeostasis in brain functioning. Maintenance, restoration, and promotion of such a balance are one of the paramount goals of brain rehabilitation and intervention programs. Cerebrovascular reactivity (CVR), an index of cerebrovascular reserve, plays an important role in chemo-regulation of cerebral blood flow. Improved vascular reactivity and cerebral blood flow are important factors in brain rehabilitation to facilitate desired cognitive and functional outcomes. It is widely accepted that CVR is impaired in aging, hypertension, and cerebrovascular diseases and possibly in neurodegenerative syndromes. However, a multitude of physiological factors influence CVR, and thus a comprehensive understanding of underlying mechanisms are needed. We are currently underinformed on which rehabilitation method will improve CVR, and how this information can inform on a patient's prognosis and diagnosis. Implementation of targeted rehabilitation regimes would be the first step to elucidate whether such regimes can modulate CVR and in the process may assist in improving our understanding for the underlying vascular pathophysiology. As such, the high spatial resolution along with whole brain coverage offered by MRI has opened the door to exciting recent developments in CVR MRI. Yet, several challenges currently preclude its potential as an effective diagnostic and prognostic tool in treatment planning and guidance. Understanding these knowledge gaps will ultimately facilitate a deeper understanding for cerebrovascular physiology and its role in brain function and rehabilitation. Based on the lessons learned from our group's past and ongoing neurorehabilitation studies, we present a systematic review of physiological mechanisms that lead to impaired CVR in aging and disease, and how CVR imaging and its further development in the context of brain rehabilitation can add value to the clinical settings.
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Affiliation(s)
- Venkatagiri Krishnamurthy
- Center for Visual and Neurocognitive Rehabilitation, Atlanta VAMC, Decatur, GA, United States
- Division of Geriatrics and Gerontology, Department of Medicine, Emory University, Atlanta, GA, United States
- Department of Neurology, Emory University, Atlanta, GA, United States
| | - Justin D. Sprick
- Division of Renal Medicine, Department of Medicine, Emory University, Atlanta, GA, United States
| | - Lisa C. Krishnamurthy
- Center for Visual and Neurocognitive Rehabilitation, Atlanta VAMC, Decatur, GA, United States
- Department of Physics & Astronomy, Georgia State University, Atlanta, GA, United States
| | - Jolie D. Barter
- Division of Geriatrics and Gerontology, Department of Medicine, Emory University, Atlanta, GA, United States
| | - Aaminah Turabi
- Center for Visual and Neurocognitive Rehabilitation, Atlanta VAMC, Decatur, GA, United States
- Department of Biology, Georgia State University, Atlanta, GA, United States
| | - Ihab M. Hajjar
- Department of Neurology, Emory University, Atlanta, GA, United States
| | - Joe R. Nocera
- Center for Visual and Neurocognitive Rehabilitation, Atlanta VAMC, Decatur, GA, United States
- Department of Neurology, Emory University, Atlanta, GA, United States
- Division of Physical Therapy, Department of Rehabilitation Medicine, Emory University, Atlanta, GA, United States
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47
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Suvila K, Lima JA, Yano Y, Tan ZS, Cheng S, Niiranen TJ. Early-but Not Late-Onset Hypertension Is Related to Midlife Cognitive Function. Hypertension 2021; 77:972-979. [PMID: 33461314 PMCID: PMC7878356 DOI: 10.1161/hypertensionaha.120.16556] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Accepted: 12/16/2020] [Indexed: 12/16/2022]
Abstract
Hypertension is related to increased risk of cognitive decline in a highly age-dependent manner. However, conflicting evidence exists on the relation between age of hypertension onset and cognition. Our goal was to investigate the association between early- versus late-onset hypertension and midlife cognitive performance in 2946 CARDIA study (Coronary Artery Risk Development in Young Adults) participants (mean age 55±4, 57% women). The participants underwent 9 repeat examinations, including blood pressure measurements, between 1985 to 1986 and 2015 to 2016. The participants underwent brain magnetic resonance imaging and completed Digit Symbol Substitution Test, Rey Auditory Verbal Learning Test, Stroop interference test, and the Montreal Cognitive Assessment to evaluate cognitive function at the year 30 exam. We assessed the relation between age of hypertension onset and cognitive function using linear regression models adjusted for cognitive decline risk factors, including systolic blood pressure. We observed that individuals with early-onset hypertension (onset at <35 years) had 0.24±0.09, 0.22±0.10, 0.27±0.09, and 0.19±0.07 lower standardized Z-scores in Digit Symbol Substitution Test, Stroop test, Montreal Cognitive Assessment, and a composite cognitive score than participants without hypertension (P<0.05 for all). In contrast, hypertension onset at ≥35 years was not associated with cognitive function (P >0.05 for all). In a subgroup of 559 participants, neither early- nor late-onset hypertension was related to macrostructural brain alterations (P >0.05 for all). Our results indicate that early-onset hypertension is a potent risk factor for midlife cognitive impairment. Thus, age of hypertension onset assessment in clinical practice could improve risk stratification of cognitive decline in patients with hypertension.
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Affiliation(s)
- Karri Suvila
- Division of Medicine, Turku University Hospital and University of Turku, Turku, Finland
| | - Joao A.C. Lima
- Division of Cardiology, Johns Hopkins University, Baltimore, Maryland, USA
| | - Yuichiro Yano
- Department of Family Medicine and Community Health, Duke University, Durham, USA
| | - Zaldy S. Tan
- Department of Neurology, Jona Goldrich Center for Alzheimer’s and Memory Disorders, Cedars-Sinai Medical Center, Los Angeles, USA
| | - Susan Cheng
- Division of Medicine, Department of Medicine, Brigham and Women’s Hospital, Boston, USA
- Smidt Heart Institute, Cedars-Sinai Medical Center, Los Angeles, USA
- Framingham Heart Study, Framingham, USA
| | - Teemu J. Niiranen
- Division of Medicine, Turku University Hospital and University of Turku, Turku, Finland
- Department of Public Health Solutions, Finnish Institute for Health and Welfare, Turku, Finland
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48
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Ribeiro VT, de Souza LC, Simões E Silva AC. Renin-Angiotensin System and Alzheimer's Disease Pathophysiology: From the Potential Interactions to Therapeutic Perspectives. Protein Pept Lett 2020; 27:484-511. [PMID: 31886744 DOI: 10.2174/0929866527666191230103739] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2019] [Revised: 08/27/2019] [Accepted: 11/16/2019] [Indexed: 12/21/2022]
Abstract
New roles of the Renin-Angiotensin System (RAS), apart from fluid homeostasis and Blood Pressure (BP) regulation, are being progressively unveiled, since the discoveries of RAS alternative axes and local RAS in different tissues, including the brain. Brain RAS is reported to interact with pathophysiological mechanisms of many neurological and psychiatric diseases, including Alzheimer's Disease (AD). Even though AD is the most common cause of dementia worldwide, its pathophysiology is far from elucidated. Currently, no treatment can halt the disease course. Successive failures of amyloid-targeting drugs have challenged the amyloid hypothesis and increased the interest in the inflammatory and vascular aspects of AD. RAS compounds, both centrally and peripherally, potentially interact with neuroinflammation and cerebrovascular regulation. This narrative review discusses the AD pathophysiology and its possible interaction with RAS, looking forward to potential therapeutic approaches. RAS molecules affect BP, cerebral blood flow, neuroinflammation, and oxidative stress. Angiotensin (Ang) II, via angiotensin type 1 receptors may promote brain tissue damage, while Ang-(1-7) seems to elicit neuroprotection. Several studies dosed RAS molecules in AD patients' biological material, with heterogeneous results. The link between AD and clinical conditions related to classical RAS axis overactivation (hypertension, heart failure, and chronic kidney disease) supports the hypothesized role of this system in AD. Additionally, RAStargeting drugs as Angiotensin Converting Enzyme inhibitors (ACEis) and Angiotensin Receptor Blockers (ARBs) seem to exert beneficial effects on AD. Results of randomized controlled trials testing ACEi or ARBs in AD are awaited to elucidate whether AD-RAS interaction has implications on AD therapeutics.
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Affiliation(s)
- Victor Teatini Ribeiro
- Interdisciplinary Laboratory of Medical Investigation, Faculty of Medicine, Federal University of Minas Gerais (UFMG), Belo Horizonte, Brazil
| | - Leonardo Cruz de Souza
- Interdisciplinary Laboratory of Medical Investigation, Faculty of Medicine, Federal University of Minas Gerais (UFMG), Belo Horizonte, Brazil.,Department of Internal Medicine, Service of Neurology, Faculty of Medicine, Federal University of Minas Gerais (UFMG), Belo Horizonte, Brazil
| | - Ana Cristina Simões E Silva
- Interdisciplinary Laboratory of Medical Investigation, Faculty of Medicine, Federal University of Minas Gerais (UFMG), Belo Horizonte, Brazil
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Carter SE, Draijer R, Maxwell JD, Morris AS, Pedersen SJ, Graves LEF, Thijssen DHJ, Hopkins ND. Using an e-Health Intervention to Reduce Prolonged Sitting in UK Office Workers: A Randomised Acceptability and Feasibility Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17238942. [PMID: 33271884 PMCID: PMC7729470 DOI: 10.3390/ijerph17238942] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Revised: 11/25/2020] [Accepted: 11/27/2020] [Indexed: 01/03/2023]
Abstract
Low-cost workplace interventions are required to reduce prolonged sitting in office workers as this may improve employees’ health and well-being. This study aimed to assess the acceptability and feasibility of an e-health intervention to reduce prolonged sitting among sedentary UK-based office workers. Secondary aims were to describe preliminary changes in employee health, mood and work productivity after using an e-health intervention. Healthy, university office workers (n = 14) completed this study. An 8 week randomised crossover design was used, consisting of two trials: Intervention (computer-based prompts) and Control. Eligibility and retention rates were recorded to assess the feasibility of the trial and interviews were conducted following the intervention to explore its acceptability. Sitting, standing and stepping were objectively assessed prior to and during week 8 of each trial. Before and after each trial, measurements of vascular function, cerebrovascular function, mood and work productivity were obtained. This study had eligibility and retention rates of 54.5% and 77.8%, respectively. Participants expressed a lack of autonomy and disruption to their workflow when using the e-health intervention, raising concerns over its acceptability and long-term implementation. Preliminary data indicate that the intervention may improve the patterning of activity accrued during work hours, with increases in the number of standing and stepping bouts completed, in addition to improving vascular function. This e-health intervention is feasible to deliver in a cohort of university office workers. However, adaptations to its implementation, such as personalised settings, are needed to increase acceptability before larger trials can be conducted.
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Affiliation(s)
- Sophie E. Carter
- Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool L3 3AF, UK; (J.D.M.); (L.E.F.G.); (D.H.J.T.); (N.D.H.)
- School of Science, Technology and Health, York St John University, York YO31 8TA, UK
- Correspondence: ; Tel.: +44-1904-876207
| | - Richard Draijer
- Unilever Foods Innovation Centre, Wageningen, The Netherlands;
| | - Joseph D. Maxwell
- Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool L3 3AF, UK; (J.D.M.); (L.E.F.G.); (D.H.J.T.); (N.D.H.)
| | - Abigail S. Morris
- Department of Health Research, Lancaster University, Lancaster LA1 4YW, UK;
| | - Scott J. Pedersen
- Active Work Laboratory, School of Education, University of Tasmania, Launceston 7250, Australia;
| | - Lee E. F. Graves
- Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool L3 3AF, UK; (J.D.M.); (L.E.F.G.); (D.H.J.T.); (N.D.H.)
| | - Dick H. J. Thijssen
- Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool L3 3AF, UK; (J.D.M.); (L.E.F.G.); (D.H.J.T.); (N.D.H.)
- Department of Physiology, Radboud Institute for Health Sciences, Radboud University Medical Center, PO Box 9101, 6500 HB Nijmegen, The Netherlands
| | - Nicola D. Hopkins
- Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool L3 3AF, UK; (J.D.M.); (L.E.F.G.); (D.H.J.T.); (N.D.H.)
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50
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Leong SL, Robertson IH, Lawlor B, Vanneste S. Associations between Hypertension, Treatment, and Cognitive Function in the Irish Longitudinal Study on Ageing. J Clin Med 2020; 9:jcm9113735. [PMID: 33233792 PMCID: PMC7699900 DOI: 10.3390/jcm9113735] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Revised: 11/16/2020] [Accepted: 11/17/2020] [Indexed: 11/18/2022] Open
Abstract
Epidemiological studies have produced conflicting results regarding the associations between the use of different hypertensive drugs and cognition. Data from the Irish Longitudinal Study on Ageing (TILDA), a nationwide prospective longitudinal study of adults aged 50 or more years, was used to explore the associations between hypertensive status, categories of antihypertensive and cognitive function controlling for age, education, and other demographic and lifestyle factors. The study sample included 8173 participants. ANCOVAs and multivariate regressions were used to assess the cross-sectional and longitudinal associations between cognitive function and hypertension status and the different categories of hypertensive medication. Hypertension was not associated with decline in global cognitive and executive functions and were fully explained by age and education. Different hypertensive medications were not associated with cognitive function. Consistent with previous studies, changes in cognition can largely be explained by age and education. The use of antihypertensive medications is neither harmful nor protective for cognition.
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Affiliation(s)
- Sook Ling Leong
- Global Brain Health Institute & Trinity Institute of Neuroscience, Trinity College Dublin, DO2 PN40 Dublin, Ireland; (S.L.L.); (I.H.R.); (B.L.)
- School of Psychology, Trinity College Dublin, DO2 PN40 Dublin, Ireland
| | - Ian H. Robertson
- Global Brain Health Institute & Trinity Institute of Neuroscience, Trinity College Dublin, DO2 PN40 Dublin, Ireland; (S.L.L.); (I.H.R.); (B.L.)
| | - Brian Lawlor
- Global Brain Health Institute & Trinity Institute of Neuroscience, Trinity College Dublin, DO2 PN40 Dublin, Ireland; (S.L.L.); (I.H.R.); (B.L.)
| | - Sven Vanneste
- Global Brain Health Institute & Trinity Institute of Neuroscience, Trinity College Dublin, DO2 PN40 Dublin, Ireland; (S.L.L.); (I.H.R.); (B.L.)
- School of Psychology, Trinity College Dublin, DO2 PN40 Dublin, Ireland
- Correspondence:
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