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Wang J, Ackley S, Woodworth DC, Sajjadi SA, Decarli CS, Fletcher EF, Glymour MM, Jiang L, Kawas C, Corrada MM. Associations of Amyloid Burden, White Matter Hyperintensities, and Hippocampal Volume With Cognitive Trajectories in the 90+ Study. Neurology 2024; 103:e209665. [PMID: 39008782 PMCID: PMC11249511 DOI: 10.1212/wnl.0000000000209665] [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: 02/16/2024] [Accepted: 05/10/2024] [Indexed: 07/17/2024] Open
Abstract
BACKGROUND AND OBJECTIVES Amyloid pathology, vascular disease pathology, and pathologies affecting the medial temporal lobe are associated with cognitive trajectories in older adults. However, only limited evidence exists on how these pathologies influence cognition in the oldest old. We evaluated whether amyloid burden, white matter hyperintensity (WMH) volume, and hippocampal volume (HV) are associated with cognitive level and decline in the oldest old. METHODS This was a longitudinal, observational community-based cohort study. We included participants with 18F-florbetapir PET and MRI data from the 90+ Study. Amyloid load was measured using the standardized uptake value ratio in the precuneus/posterior cingulate with eroded white matter mask as reference. WMH volume was log-transformed. All imaging measures were standardized using sample means and SDs. HV and log-WMH volume were normalized by total intracranial volume using the residual approach. Global cognitive performance was measured by the Mini-Mental State Examination (MMSE) and modified MMSE (3MS) tests, repeated every 6 months. We used linear mixed-effects models with random intercepts; random slopes; and interaction between time, time squared, and imaging variables to estimate the associations of imaging variables with cognitive level and cognitive decline. Models were adjusted for demographics, APOE genotype, and health behaviors. RESULTS The sample included 192 participants. The mean age was 92.9 years, 125 (65.1%) were female, 71 (37.0%) achieved a degree beyond college, and the median follow-up time was 3.0 years. A higher amyloid load was associated with a lower cognitive level (βMMSE = -0.82, 95% CI -1.17 to -0.46; β3MS = -2.77, 95% CI -3.69 to -1.84). A 1-SD decrease in HV was associated with a 0.70-point decrease in the MMSE score (95% CI -1.14 to -0.27) and a 2.27-point decrease in the 3MS score (95% CI -3.40 to -1.14). Clear nonlinear cognitive trajectories were detected. A higher amyloid burden and smaller HV were associated with faster cognitive decline. WMH volume was not significantly associated with cognitive level or decline. DISCUSSION Amyloid burden and hippocampal atrophy are associated with both cognitive level and cognitive decline in the oldest old. Our findings shed light on how different pathologies contributed to driving cognitive function in the oldest old.
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Affiliation(s)
- Jingxuan Wang
- From the Department of Epidemiology and Biostatistics (J.W.), University of California, San Francisco; Department of Epidemiology (J.W., S.A., M.M.G.), Boston University, MA; Department of Neurology (D.C.W., S.A.S., C.K., M.M.C.), University of California, Irvine; Imaging of Dementia and Aging Laboratory (C.S.D., E.F.F.), Department of Neurology, University of California, Davis; and Department of Epidemiology and Biostatistics (L.J., M.M.C.), and Department of Neurobiology and Behavior (C.K.), University of California, Irvine
| | - Sarah Ackley
- From the Department of Epidemiology and Biostatistics (J.W.), University of California, San Francisco; Department of Epidemiology (J.W., S.A., M.M.G.), Boston University, MA; Department of Neurology (D.C.W., S.A.S., C.K., M.M.C.), University of California, Irvine; Imaging of Dementia and Aging Laboratory (C.S.D., E.F.F.), Department of Neurology, University of California, Davis; and Department of Epidemiology and Biostatistics (L.J., M.M.C.), and Department of Neurobiology and Behavior (C.K.), University of California, Irvine
| | - Davis C Woodworth
- From the Department of Epidemiology and Biostatistics (J.W.), University of California, San Francisco; Department of Epidemiology (J.W., S.A., M.M.G.), Boston University, MA; Department of Neurology (D.C.W., S.A.S., C.K., M.M.C.), University of California, Irvine; Imaging of Dementia and Aging Laboratory (C.S.D., E.F.F.), Department of Neurology, University of California, Davis; and Department of Epidemiology and Biostatistics (L.J., M.M.C.), and Department of Neurobiology and Behavior (C.K.), University of California, Irvine
| | - Seyed Ahmad Sajjadi
- From the Department of Epidemiology and Biostatistics (J.W.), University of California, San Francisco; Department of Epidemiology (J.W., S.A., M.M.G.), Boston University, MA; Department of Neurology (D.C.W., S.A.S., C.K., M.M.C.), University of California, Irvine; Imaging of Dementia and Aging Laboratory (C.S.D., E.F.F.), Department of Neurology, University of California, Davis; and Department of Epidemiology and Biostatistics (L.J., M.M.C.), and Department of Neurobiology and Behavior (C.K.), University of California, Irvine
| | - Charles S Decarli
- From the Department of Epidemiology and Biostatistics (J.W.), University of California, San Francisco; Department of Epidemiology (J.W., S.A., M.M.G.), Boston University, MA; Department of Neurology (D.C.W., S.A.S., C.K., M.M.C.), University of California, Irvine; Imaging of Dementia and Aging Laboratory (C.S.D., E.F.F.), Department of Neurology, University of California, Davis; and Department of Epidemiology and Biostatistics (L.J., M.M.C.), and Department of Neurobiology and Behavior (C.K.), University of California, Irvine
| | - Evan F Fletcher
- From the Department of Epidemiology and Biostatistics (J.W.), University of California, San Francisco; Department of Epidemiology (J.W., S.A., M.M.G.), Boston University, MA; Department of Neurology (D.C.W., S.A.S., C.K., M.M.C.), University of California, Irvine; Imaging of Dementia and Aging Laboratory (C.S.D., E.F.F.), Department of Neurology, University of California, Davis; and Department of Epidemiology and Biostatistics (L.J., M.M.C.), and Department of Neurobiology and Behavior (C.K.), University of California, Irvine
| | - M Maria Glymour
- From the Department of Epidemiology and Biostatistics (J.W.), University of California, San Francisco; Department of Epidemiology (J.W., S.A., M.M.G.), Boston University, MA; Department of Neurology (D.C.W., S.A.S., C.K., M.M.C.), University of California, Irvine; Imaging of Dementia and Aging Laboratory (C.S.D., E.F.F.), Department of Neurology, University of California, Davis; and Department of Epidemiology and Biostatistics (L.J., M.M.C.), and Department of Neurobiology and Behavior (C.K.), University of California, Irvine
| | - Luohua Jiang
- From the Department of Epidemiology and Biostatistics (J.W.), University of California, San Francisco; Department of Epidemiology (J.W., S.A., M.M.G.), Boston University, MA; Department of Neurology (D.C.W., S.A.S., C.K., M.M.C.), University of California, Irvine; Imaging of Dementia and Aging Laboratory (C.S.D., E.F.F.), Department of Neurology, University of California, Davis; and Department of Epidemiology and Biostatistics (L.J., M.M.C.), and Department of Neurobiology and Behavior (C.K.), University of California, Irvine
| | - Claudia Kawas
- From the Department of Epidemiology and Biostatistics (J.W.), University of California, San Francisco; Department of Epidemiology (J.W., S.A., M.M.G.), Boston University, MA; Department of Neurology (D.C.W., S.A.S., C.K., M.M.C.), University of California, Irvine; Imaging of Dementia and Aging Laboratory (C.S.D., E.F.F.), Department of Neurology, University of California, Davis; and Department of Epidemiology and Biostatistics (L.J., M.M.C.), and Department of Neurobiology and Behavior (C.K.), University of California, Irvine
| | - Maria M Corrada
- From the Department of Epidemiology and Biostatistics (J.W.), University of California, San Francisco; Department of Epidemiology (J.W., S.A., M.M.G.), Boston University, MA; Department of Neurology (D.C.W., S.A.S., C.K., M.M.C.), University of California, Irvine; Imaging of Dementia and Aging Laboratory (C.S.D., E.F.F.), Department of Neurology, University of California, Davis; and Department of Epidemiology and Biostatistics (L.J., M.M.C.), and Department of Neurobiology and Behavior (C.K.), University of California, Irvine
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Wertman E. Essential New Complexity-Based Themes for Patient-Centered Diagnosis and Treatment of Dementia and Predementia in Older People: Multimorbidity and Multilevel Phenomenology. J Clin Med 2024; 13:4202. [PMID: 39064242 PMCID: PMC11277671 DOI: 10.3390/jcm13144202] [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: 06/10/2024] [Revised: 07/12/2024] [Accepted: 07/13/2024] [Indexed: 07/28/2024] Open
Abstract
Dementia is a highly prevalent condition with devastating clinical and socioeconomic sequela. It is expected to triple in prevalence by 2050. No treatment is currently known to be effective. Symptomatic late-onset dementia and predementia (SLODP) affects 95% of patients with the syndrome. In contrast to trials of pharmacological prevention, no treatment is suggested to remediate or cure these symptomatic patients. SLODP but not young onset dementia is intensely associated with multimorbidity (MUM), including brain-perturbating conditions (BPCs). Recent studies showed that MUM/BPCs have a major role in the pathogenesis of SLODP. Fortunately, most MUM/BPCs are medically treatable, and thus, their treatment may modify and improve SLODP, relieving suffering and reducing its clinical and socioeconomic threats. Regrettably, the complex system features of SLODP impede the diagnosis and treatment of the potentially remediable conditions (PRCs) associated with them, mainly due to failure of pattern recognition and a flawed diagnostic workup. We suggest incorporating two SLODP-specific conceptual themes into the diagnostic workup: MUM/BPC and multilevel phenomenological themes. By doing so, we were able to improve the diagnostic accuracy of SLODP components and optimize detecting and favorably treating PRCs. These revolutionary concepts and their implications for remediability and other parameters are discussed in the paper.
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Affiliation(s)
- Eli Wertman
- Department of Neurology, Hadassah University Hospital, The Hebrew University, Jerusalem 9190500, Israel;
- Section of Neuropsychology, Department of Psychology, The Hebrew University, Jerusalem 9190500, Israel
- Or’ad: Organization for Cognitive and Behavioral Changes in the Elderly, Jerusalem 9458118, Israel
- Merhav Neuropsychogeriatric Clinics, Nehalim 4995000, Israel
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Dong H, Wang S, Hu C, Wang M, Zhou T, Zhou Y. Neuroprotective Effects of Intermittent Fasting in the Aging Brain. ANNALS OF NUTRITION & METABOLISM 2024; 80:175-185. [PMID: 38631305 DOI: 10.1159/000538782] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/23/2023] [Accepted: 04/06/2024] [Indexed: 04/19/2024]
Abstract
BACKGROUND A major risk factor for neurodegenerative disorders is old age. Nutritional interventions that delay aging, such as calorie restriction (CR) and intermittent fasting (IF), as well as pharmaceuticals that affect the pathways linking nutrition and aging processes, have been developed in recent decades and have been shown to alleviate the effects of aging on the brain. SUMMARY CR is accomplished by alternating periods of ad libitum feeding and fasting. In animal models, IF has been shown to increase lifespan and slow the progression and severity of age-related pathologies such as cardiovascular and neurodegenerative diseases and cancer. According to recent research, dietary changes can help older people with dementia retain brain function. However, the mechanisms underlying the neuroprotective effect of IF on the aging brain and related questions in this area of study (i.e., the potential of IF to treat neurodegenerative disorders) remain to be examined. KEY MESSAGES This review addresses the hypothesis that IF may have translational potential in protecting the aged brain while summarizing the research supporting the putative neuroprotective mechanisms of IF in animal models. Additionally, given the emerging understanding of the connection between aging and dementia, our investigations may offer a fresh perspective on the use of dietary interventions for enhancing brain function and preventing dementia in elderly individuals. Finally, the absence of guidelines regarding the application of IF in patients hampers its broad utilization in clinical practice, and further studies are needed to improve our knowledge of the long-term effects of IF on dementia before it can be widely prescribed. In conclusion, IF may be an ancillary intervention for preserving memory and cognition in elderly individuals.
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Affiliation(s)
- Hao Dong
- Department of Pharmacy, West China Hospital, Sichuan University, Chengdu, China
| | - Shiyan Wang
- Department of Pharmacy, West China Hospital, Sichuan University, Chengdu, China
| | - Chenji Hu
- Department of Pharmacy, West China Hospital, Sichuan University, Chengdu, China
| | - Mao Wang
- Department of Pharmacy, West China Hospital, Sichuan University, Chengdu, China
| | - Tao Zhou
- Department of Pharmaceutical and Medical Equipment, Ba Yi Orthopedic Hospital, Chengdu, China
| | - Yue Zhou
- Department of Pharmacy, Xindu District People's Hospital of Chengdu, Chengdu, China
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Ye Y, Tong HYK, Chong WH, Li Z, Tam PKH, Baptista-Hon DT, Monteiro O. A systematic review and meta-analysis of the effects of long-term antibiotic use on cognitive outcomes. Sci Rep 2024; 14:4026. [PMID: 38369574 PMCID: PMC10874946 DOI: 10.1038/s41598-024-54553-4] [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: 11/10/2023] [Accepted: 02/14/2024] [Indexed: 02/20/2024] Open
Abstract
Antibiotics are indispensable to infection management. However, use of antibiotics can cause gut microbiota dysbiosis, which has been linked to cognitive impairment by disrupting communication between the gut microbiota and the brain. We conducted a systematic review and meta-analysis on the effects of long-term antibiotic use on cognitive outcomes. We have searched PubMed, Web of Science, Embase, Cochrane Library and Scopus for English publications before March 2023 following the PRISMA guidelines. Screening, data extraction, and quality assessment were performed in duplicate. 960 articles were screened and 16 studies which evaluated the effect of any antibiotic compared to no antibiotics or placebo were included. Case-reports, in vitro and animal studies were excluded. We found that antibiotic use was associated with worse cognitive outcomes with a pooled effect estimate of - 0.11 (95% CI - 0.15, - 0.07, Z = 5.45; P < 0.00001). Subgroup analyses performed on adult vs pediatric patients showed a similar association of antibiotic on cognition in both subgroups. Antibiotic treatment was not associated with worse cognition on subjects with existing cognitive impairment. On the other hand, antibiotic treatment on subjects with no prior cognitive impairment was associated with worse cognitive performance later in life. This calls for future well-designed and well-powered studies to investigate the impact of antibiotics on cognitive performance.
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Affiliation(s)
- Yongqin Ye
- Faculty of Medicine, Medical Sciences Division, Macau University of Science and Technology, Avenida da Harmonia, Praia Park, Coloane, 999078, Macao SAR, China
| | | | - Wai Hong Chong
- Faculty of Medicine, Medical Sciences Division, Macau University of Science and Technology, Avenida da Harmonia, Praia Park, Coloane, 999078, Macao SAR, China
| | - Zhiqian Li
- Faculty of Medicine, Medical Sciences Division, Macau University of Science and Technology, Avenida da Harmonia, Praia Park, Coloane, 999078, Macao SAR, China
| | - Paul Kwong Hang Tam
- Faculty of Medicine, Medical Sciences Division, Macau University of Science and Technology, Avenida da Harmonia, Praia Park, Coloane, 999078, Macao SAR, China
| | - Daniel T Baptista-Hon
- Faculty of Medicine, Medical Sciences Division, Macau University of Science and Technology, Avenida da Harmonia, Praia Park, Coloane, 999078, Macao SAR, China
- Division of Systems Medicine, School of Medicine, University of Dundee, Dundee, UK
| | - Olivia Monteiro
- Faculty of Medicine, Medical Sciences Division, Macau University of Science and Technology, Avenida da Harmonia, Praia Park, Coloane, 999078, Macao SAR, China.
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Perneczky R. Alzheimer's Disease Prevention and Treatment Based on Population-Based Approaches. Methods Mol Biol 2024; 2785:15-33. [PMID: 38427185 DOI: 10.1007/978-1-0716-3774-6_2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/02/2024]
Abstract
The development of effective prevention and treatment strategies for Alzheimer's disease (AD) and dementia is hindered by limited knowledge of the underlying biological and environmental causes. While certain genetic factors have been associated with AD, and various lifestyle and environmental factors have been linked to dementia risk, the interactions between genes and the environment are not yet fully understood. To identify new avenues for dementia prevention, coordinated global efforts are needed to utilize existing cohorts and resources effectively and efficiently. This chapter provides an overview of current research on risk and protective factors for AD and dementia and discusses the opportunities and challenges associated with population-based approaches.
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Affiliation(s)
- Robert Perneczky
- Department of Psychiatry and Psychotherapy, LMU Hospital, Ludwig-Maximilians-Universität München, Munich, Germany.
- German Center for Neurodegenerative Diseases (DZNE), Munich, Germany.
- Munich Cluster for Systems Neurology (SyNergy), Munich, Germany.
- Sheffield Institute for Translational Neuroscience (SITraN), University of Sheffield, Sheffield, UK.
- Ageing Epidemiology (AGE) Research Unit, School of Public Health, Imperial College London, London, UK.
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Stevenson-Hoare J, Schalkamp AK, Sandor C, Hardy J, Escott-Price V. New cases of dementia are rising in elderly populations in Wales, UK. J Neurol Sci 2023; 451:120715. [PMID: 37385025 PMCID: PMC7615574 DOI: 10.1016/j.jns.2023.120715] [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: 04/09/2023] [Revised: 06/02/2023] [Accepted: 06/15/2023] [Indexed: 07/01/2023]
Abstract
Dementia is one of the most common diseases in elderly populations, and older populations are one of the fastest growing groups globally. Consequently, the number of people developing and living with dementia is likely to grow. Using longitudinal medical records from Wales, UK between 1999 and 2018, diagnoses of overall dementia and common subtypes were combined with demographic data to assess numbers of new and existing cases per year. Data extraction resulted in 161,186 diagnoses from 116,645 individuals. Mean age at diagnosis of dementia increased over this period, resulting in fewer younger people with the disease. New cases of dementia have risen, as has the number of people living with dementia. Individuals with dementia are also living longer, even accounting for their older age. This may present a challenge for healthcare systems as the number of elderly people living with dementia is expected to continue to grow.
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Affiliation(s)
- Joshua Stevenson-Hoare
- Department of Psychological Medicine and Clinical Neuroscience, Cardiff University, United Kingdom; MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, United Kingdom
| | - Ann-Kathrin Schalkamp
- Department of Psychological Medicine and Clinical Neuroscience, Cardiff University, United Kingdom; UK Dementia Research Institute at Cardiff University, United Kingdom
| | - Cynthia Sandor
- Department of Psychological Medicine and Clinical Neuroscience, Cardiff University, United Kingdom; UK Dementia Research Institute at Cardiff University, United Kingdom
| | - John Hardy
- Department of Neurodegenerative Disease, UCL Institute of Neurology, United Kingdom; UK Dementia Research Institute at UCL, London, United Kingdom
| | - Valentina Escott-Price
- Department of Psychological Medicine and Clinical Neuroscience, Cardiff University, United Kingdom; MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, United Kingdom.
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Leung Y, Barzilai N, Batko-Szwaczka A, Beker N, Boerner K, Brayne C, Brodaty H, Cheung KSL, Corrada MM, Crawford JD, Galbussera AA, Gondo Y, Holstege H, Hulsman M, Ishioka YL, Jopp D, Kawas CH, Kaye J, Kochan NA, Lau BHP, Lipnicki DM, Lo JW, Lucca U, Makkar SR, Marcon G, Martin P, Meguro K, Milman S, Poon LW, Recchia A, Ribeiro O, Riva E, Rott C, Sikkes SA, Skoog I, Stephan B, Szewieczek J, Teixeira L, Tettamanti M, Wilczyński K, Sachdev P. Cognition, function, and prevalent dementia in centenarians and near-centenarians: An individual participant data (IPD) meta-analysis of 18 studies. Alzheimers Dement 2023; 19:2265-2275. [PMID: 36453627 DOI: 10.1002/alz.12828] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Revised: 05/08/2022] [Accepted: 05/18/2022] [Indexed: 12/03/2022]
Abstract
INTRODUCTION There are limited data on prevalence of dementia in centenarians and near-centenarians (C/NC), its determinants, and whether the risk of dementia continues to rise beyond 100. METHODS Participant-level data were obtained from 18 community-based studies (N = 4427) in 11 countries that included individuals ≥95 years. A harmonization protocol was applied to cognitive and functional impairments, and a meta-analysis was performed. RESULTS The mean age was 98.3 years (SD = 2.67); 79% were women. After adjusting for age, sex, and education, dementia prevalence was 53.2% in women and 45.5% in men, with risk continuing to increase with age. Education (OR 0.95;0.92-0.98) was protective, as was hypertension (odds ratio [OR] 0.51;0.35-0.74) in five studies. Dementia was not associated with diabetes, vision and hearing impairments, smoking, and body mass index (BMI). DISCUSSION Among the exceptional old, dementia prevalence remains higher in the older participants. Education was protective against dementia, but other factors for dementia-free survival in C/NC remain to be understood.
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Affiliation(s)
- Yvonne Leung
- Centre for Healthy Brain Ageing (CHeBA), School of Psychiatry, University of New South Wales (UNSW), Sydney, Australia
| | - Nir Barzilai
- Albert Einstein College of Medicine, New York, USA
| | - Agnieszka Batko-Szwaczka
- Department of Geriatrics, School of Health Sciences in Katowice, Medical University of Silesia, Katowice, Poland
| | - Nina Beker
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands
| | - Kathrin Boerner
- Department of Gerontology, McCormack Graduate School, University of Massachusetts Boston, Boston, USA
| | - Carol Brayne
- University of Cambridge, Cambridge, United Kingdom
| | - Henry Brodaty
- Centre for Healthy Brain Ageing (CHeBA), School of Psychiatry, University of New South Wales (UNSW), Sydney, Australia
| | | | | | - John D Crawford
- Centre for Healthy Brain Ageing (CHeBA), School of Psychiatry, University of New South Wales (UNSW), Sydney, Australia
| | - Alessia A Galbussera
- Laboratory of Geriatric Neuropsychiatry, Department of Neuroscience, Istituto di Ricerche Farmacologiche "Mario Negri" IRCCS, Milano, Italy
| | - Yasuyuki Gondo
- Osaka University Graduate School of Human Sciences School of Human Sciences: Osaka, Osaka, Japan
| | - Henne Holstege
- Genomics of Neurodegenerative Diseases and Aging, Human Genetics, Vrije Universiteit Amsterdam, Amsterdam UMC location VUmc, Amsterdam, The Netherlands
| | - Marc Hulsman
- Genomics of Neurodegenerative Diseases and Aging, Human Genetics, Vrije Universiteit Amsterdam, Amsterdam UMC location VUmc, Amsterdam, The Netherlands
| | | | | | | | - Jeff Kaye
- NIA - sLayton Aging & Alzheimer's Disease Research Center, Oregon Health & Science University, Portland, USA
| | - Nicole A Kochan
- Centre for Healthy Brain Ageing (CHeBA), School of Psychiatry, University of New South Wales (UNSW), Sydney, Australia
| | - Bobo Hi-Po Lau
- Hong Kong Shue Yan University (HKSYU), Hong Kong SAR, Hong Kong
| | - Darren M Lipnicki
- Centre for Healthy Brain Ageing (CHeBA), School of Psychiatry, University of New South Wales (UNSW), Sydney, Australia
| | - Jessica W Lo
- Centre for Healthy Brain Ageing (CHeBA), School of Psychiatry, University of New South Wales (UNSW), Sydney, Australia
| | - Ugo Lucca
- Laboratory of Geriatric Neuropsychiatry, Department of Neuroscience, Istituto di Ricerche Farmacologiche "Mario Negri" IRCCS, Milano, Italy
| | - Steve R Makkar
- Centre for Healthy Brain Ageing (CHeBA), School of Psychiatry, University of New South Wales (UNSW), Sydney, Australia
| | - Gabriella Marcon
- University of Trieste, Trieste, Italy
- University of Udine, Udine, Italy
| | | | - Kenichi Meguro
- Geriatric Behavioral Neurology, Tohoku University, Sendai, Japan
| | | | | | - Angela Recchia
- Laboratory of Geriatric Neuropsychiatry, Department of Neuroscience, Istituto di Ricerche Farmacologiche "Mario Negri" IRCCS, Milano, Italy
| | - Oscar Ribeiro
- Center for Health Technology and Services Research (CINTESIS), University of Aveiro and ICBAS-University of Porto, Porto, Portugal
| | - Emma Riva
- Laboratory of Geriatric Neuropsychiatry, Department of Neuroscience, Istituto di Ricerche Farmacologiche "Mario Negri" IRCCS, Milano, Italy
| | - Christoph Rott
- Institute of Gerontology, Heidelberg University, Heidelberg, Germany
| | - Sietske Am Sikkes
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands
- Section Clinical, Neuro- and Developmental Psychology, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | | | - Blossom Stephan
- Institute for Ageing and Institute for Health & Society, Newcastle University, Newcastle, UK
| | - Jan Szewieczek
- Department of Geriatrics, School of Health Sciences in Katowice, Medical University of Silesia, Katowice, Poland
| | - Laetitia Teixeira
- Center for Health Technology and Services Research (CINTESIS), University of Aveiro and ICBAS-University of Porto, Porto, Portugal
| | - Mauro Tettamanti
- Mario Negri Institute for Pharmacological Research, Milan, Italy
| | - Krzysztof Wilczyński
- Department of Geriatrics, School of Health Sciences in Katowice, Medical University of Silesia, Katowice, Poland
| | - Perminder Sachdev
- Centre for Healthy Brain Ageing (CHeBA), School of Psychiatry, University of New South Wales (UNSW), Sydney, Australia
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Hajek A, Kretzler B, Riedel-Heller SG, König HH. Frequency and correlates of mild cognitive impairment and dementia among the oldest old - Evidence from the representative "Survey on quality of life and subjective well-being of the very old in North Rhine-Westphalia (NRW80+)". Arch Gerontol Geriatr 2023; 104:104804. [PMID: 36084607 DOI: 10.1016/j.archger.2022.104804] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Revised: 08/24/2022] [Accepted: 08/31/2022] [Indexed: 02/07/2023]
Abstract
OBJECTIVES Since there is limited knowledge with regard to the frequency and correlates of mild cognitive impairment and dementia among the oldest old based on large representative data (including institutionalized individuals), our objective was to fill this research gap. METHODS For our study, data came from the representative "Survey on quality of life and subjective well-being of the very old in North Rhine-Westphalia (NRW80+)". This study included community-dwelling and institutionalized individuals aged 80 years and over (n = 1,173, mean age: 86 years) residing in the most populous state of Germany (North Rhine-Westphalia). The DemTect was used to quantify cognitive impairment (i.e., probable mild cognitive impairment and probable dementia). RESULTS Overall, 73.1% of the individuals were not cognitively impaired, 17.0% of the individuals had probable mild cognitive impairment and 9.9% of the individuals had probable dementia. Compared to individuals without cognitive impairment, individuals with probable mild cognitive impairment were more likely to be male, live in an institutionalized setting, have a lower educational level, have a smaller network size, and have lower functional abilities. Moreover, compared to individuals without cognitive impairment, individuals with probable dementia were more likely to be older, live in an institutionalized setting, have a lower educational level, have a smaller network size, not be multimorbid, and have lower functional abilities. CONCLUSIONS Our study identified several sociodemographic and health-related factors which are associated with probable mild cognitive impairment and probable dementia among the oldest old. This knowledge may help to address individuals at risk for mild cognitive impairment and dementia.
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Affiliation(s)
- André Hajek
- Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, Hamburg Center for Health Economics, Hamburg, Germany.
| | - Benedikt Kretzler
- Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, Hamburg Center for Health Economics, Hamburg, Germany
| | - Steffi G Riedel-Heller
- Institute of Social Medicine, Occupational Health and Public Health, University of Leipzig, Leipzig, Germany
| | - Hans-Helmut König
- Department of Health Economics and Health Services Research, University Medical Center Hamburg-Eppendorf, Hamburg Center for Health Economics, Hamburg, Germany
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9
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Merenstein JL, Bennett IJ. Bridging patterns of neurocognitive aging across the older adult lifespan. Neurosci Biobehav Rev 2022; 135:104594. [PMID: 35227712 PMCID: PMC9888009 DOI: 10.1016/j.neubiorev.2022.104594] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Revised: 01/27/2022] [Accepted: 02/23/2022] [Indexed: 02/02/2023]
Abstract
Magnetic resonance imaging (MRI) studies of brain and neurocognitive aging rarely include oldest-old adults (ages 80 +). But predictions of neurocognitive aging theories derived from MRI findings in younger-old adults (ages ~55-80) may not generalize into advanced age, particularly given the increased prevalence of cognitive impairment/dementia in the oldest-old. Here, we reviewed the MRI literature in oldest-old adults and interpreted findings within the context of regional variation, compensation, brain maintenance, and reserve theories. Structural MRI studies revealed regional variation in brain aging as larger age effects on medial temporal and posterior regions for oldest-old than younger-old adults. They also revealed that brain maintenance explained preserved cognitive functioning into the tenth decade of life. Very few functional MRI studies examined compensatory activity in oldest-old adults who perform as well as younger groups, although there was evidence that higher brain reserve in oldest-old adults may mediate effects of brain aging on cognition. Despite some continuity, different cognitive and neural profiles across the older adult lifespan should be addressed in modern neurocognitive aging theories.
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10
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Hirano S, Sakakibara R, Komatsu N, Shimizu K, Ishikawa M, Hosoi N, Asahi T, Shuno T, Sugihara H, Kanai S, Miura N, Mochida H, Ozawa Y, Iyo M, Kuwabara S. Characteristics of Early-Onset Dementia in Chiba Prefecture, Japan: A Multicenter Survey. Dement Geriatr Cogn Disord 2021; 50:283-288. [PMID: 34515090 DOI: 10.1159/000518294] [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: 05/24/2021] [Accepted: 07/04/2021] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION Early-onset dementia (EOD), defined as dementia onset before the age of 65 years, is relatively rare, but its social impacts are significant. This study aimed to characterize the diagnosis and clinical and social status of EOD subjects in the 11 dementia centers in Chiba Prefecture, Japan. METHODS A retrospective 1-year survey was conducted. Collected data included clinical diagnosis, age at onset, age at survey, neuropsychological test, family history, employment, and living status. RESULTS We identified 208 EOD subjects, including 123 (59.4%), 24 (11.6%), 21 (10.1%), 17 (8.2%), and 10 (4.8%) with Alzheimer's disease (AD), vascular dementia, frontotemporal lobar degeneration (FTLD), dementia with Lewy bodies/Parkinson's disease dementia, and alcohol-related dementia, respectively. The Mini-Mental State Examination (MMSE) score <24 was observed in 50-75% of patients and was not correlated with disease duration. Twenty-four (16.4%) subjects had positive family history of EOD. EOD subjects were at risk of early retirement, and 133 subjects lived with their family, in whom 64 (30.8%) lived with their child. CONCLUSION In dementia centers, AD, FTLD, and Lewy body dementia had relatively large proportion. Employment, economy, and social supports are urgently needed for EOD subjects and their family.
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Affiliation(s)
- Shigeki Hirano
- Department of Neurology, Graduate School of Medicine, Chiba University, Chiba, Japan.,Chiba Medical Center for Dementia, Chiba University Hospital, Chiba, Japan
| | - Ryuji Sakakibara
- Department of Neurology, Toho University, Sakura Medical Center, Chiba, Japan
| | - Naoya Komatsu
- Department of Psychiatry, Douwakai Chiba Hospital, Chiba, Japan
| | - Keisuke Shimizu
- Chiba Medical Center for Dementia, Chiba University Hospital, Chiba, Japan
| | - Moeno Ishikawa
- Chiba Medical Center for Dementia, Chiba University Hospital, Chiba, Japan
| | - Naohito Hosoi
- Department of Psychiatry, Sodegaura Satsukidai Hospital, Chiba, Japan
| | - Toshiomi Asahi
- Department of Neurology, Asahi Neurology Hospital, Chiba, Japan
| | | | - Hiroshi Sugihara
- Department of Neurology, Kitakashiwa Rehabilitation General Hospital, Chiba, Japan
| | - Shigeto Kanai
- Department of Psychiatry, Tohjo Mental Hospital, Chiba, Japan
| | | | | | - Yoshinori Ozawa
- Department of Neurosurgery, Chiba Rosai Hospital, Chiba, Japan
| | - Masaomi Iyo
- Chiba Medical Center for Dementia, Chiba University Hospital, Chiba, Japan.,Department of Psychiatry, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - Satoshi Kuwabara
- Department of Neurology, Graduate School of Medicine, Chiba University, Chiba, Japan.,Chiba Medical Center for Dementia, Chiba University Hospital, Chiba, Japan
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11
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Griffa A, Legdeur N, Badissi M, van den Heuvel MP, Stam CJ, Visser PJ, Hillebrand A. Magnetoencephalography Brain Signatures Relate to Cognition and Cognitive Reserve in the Oldest-Old: The EMIF-AD 90 + Study. Front Aging Neurosci 2021; 13:746373. [PMID: 34899269 PMCID: PMC8656941 DOI: 10.3389/fnagi.2021.746373] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Accepted: 11/01/2021] [Indexed: 11/25/2022] Open
Abstract
The oldest-old subjects represent the fastest growing segment of society and are at high risk for dementia with a prevalence of up to 40%. Lifestyle factors, such as lifelong participation in cognitive and leisure activities, may contribute to individual cognitive reserve and reduce the risk for cognitive impairments. However, the neural bases underlying cognitive functioning and cognitive reserve in this age range are still poorly understood. Here, we investigate spectral and functional connectivity features obtained from resting-state MEG recordings in a cohort of 35 cognitively normal (92.2 ± 1.8 years old, 19 women) and 11 cognitively impaired (90.9 ± 1.9 years old, 1 woman) oldest-old participants, in relation to cognitive traits and cognitive reserve. The latter was approximated with a self-reported scale on lifelong engagement in cognitively demanding activities. Cognitively impaired oldest-old participants had slower cortical rhythms in frontal, parietal and default mode network regions compared to the cognitively normal subjects. These alterations mainly concerned the theta and beta band and partially explained inter-subject variability of episodic memory scores. Moreover, a distinct spectral pattern characterized by higher relative power in the alpha band was specifically associated with higher cognitive reserve while taking into account the effect of age and education level. Finally, stronger functional connectivity in the alpha and beta band were weakly associated with better cognitive performances in the whole group of subjects, although functional connectivity effects were less prominent than the spectral ones. Our results shed new light on the neural underpinnings of cognitive functioning in the oldest-old population and indicate that cognitive performance and cognitive reserve may have distinct spectral electrophysiological substrates.
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Affiliation(s)
- Alessandra Griffa
- Division of Neurology, Department of Clinical Neurosciences, Geneva University Hospitals and Faculty of Medicine, University of Geneva, Geneva, Switzerland.,Center of Neuroprosthetics, Institute of Bioengineering, École Polytechnique Fédérale De Lausanne (EPFL), Geneva, Switzerland.,Department of Clinical Neurophysiology and MEG Center, Amsterdam Neuroscience, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Nienke Legdeur
- Department of Neurology, Amsterdam Neuroscience, Alzheimer Center Amsterdam, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, Netherlands
| | - Maryam Badissi
- Department of Neurology, Amsterdam Neuroscience, Alzheimer Center Amsterdam, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, Netherlands
| | - Martijn P van den Heuvel
- Dutch Connectome Lab, Department of Complex Trait Genetics, Center for Neuroscience and Cognitive Research, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, Netherlands
| | - Cornelis J Stam
- Department of Clinical Neurophysiology and MEG Center, Amsterdam Neuroscience, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Pieter Jelle Visser
- Department of Neurology, Amsterdam Neuroscience, Alzheimer Center Amsterdam, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, Netherlands.,Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University, Maastricht, Netherlands
| | - Arjan Hillebrand
- Department of Clinical Neurophysiology and MEG Center, Amsterdam Neuroscience, Amsterdam UMC, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
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12
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Merenstein JL, Corrada MM, Kawas CH, Bennett IJ. Age affects white matter microstructure and episodic memory across the older adult lifespan. Neurobiol Aging 2021; 106:282-291. [PMID: 34332220 DOI: 10.1016/j.neurobiolaging.2021.06.021] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Revised: 06/25/2021] [Accepted: 06/28/2021] [Indexed: 02/07/2023]
Abstract
Diffusion imaging studies have observed age-related degradation of white matter that contributes to cognitive deficits separately in younger-old (ages 65-89) and oldest-old (ages 90+) adults. But it remains unclear whether these age effects are magnified in advanced age groups, which may reflect disease-related pathology. Here, we tested whether age-related differences in white matter microstructure followed linear or nonlinear patterns across the entire older adult lifespan (65-98 years), these patterns were influenced by oldest-old adults at increased risk of dementia (cognitive impairment no dementia, CIND), and they explained age effects on episodic memory. Results revealed nonlinear microstructure declines across fiber classes (medial temporal, callosal, association, projection and/or thalamic) that were largest for medial temporal fibers. These patterns remained after excluding oldest-old participants with CIND, indicating that aging of white matter microstructure cannot solely be explained by pathology associated with early cognitive impairment. Moreover, finding that the effect of age on episodic memory was mediated by medial temporal fiber microstructure suggests it is essential for facilitating memory-related neural signals across the older adult lifespan.
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Affiliation(s)
| | - María M Corrada
- Institute for Memory Impairments and Neurological Disorders, University of California, Irvine, CA, USA; Department of Neurology, University of California, Irvine, CA, USA; Department of Epidemiology, University of California, Irvine, CA, USA
| | - Claudia H Kawas
- Institute for Memory Impairments and Neurological Disorders, University of California, Irvine, CA, USA; Department of Neurology, University of California, Irvine, CA, USA; Department of Neurobiology and Behavior, University of California, Irvine, CA, USA
| | - Ilana J Bennett
- Department of Psychology, University of California, Riverside, CA, USA
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13
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Lisko I, Kulmala J, Annetorp M, Ngandu T, Mangialasche F, Kivipelto M. How can dementia and disability be prevented in older adults: where are we today and where are we going? J Intern Med 2021; 289:807-830. [PMID: 33314384 PMCID: PMC8248434 DOI: 10.1111/joim.13227] [Citation(s) in RCA: 77] [Impact Index Per Article: 25.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Ageing of the population, together with population growth, has brought along an ample increase in the number of older individuals living with dementia and disabilities. Dementia is the main cause of disability in old age, and promoting healthy brain ageing is considered as a key element in diminishing the burden of age-related disabilities. The World Health Organization recently launched the first risk reduction guidelines for cognitive impairment and dementia. According to recent estimates, approximately 40% of dementia cases worldwide could be attributable to 12 modifiable risk factors: low education; midlife hypertension and obesity; diabetes, smoking, excessive alcohol use, physical inactivity, depression, low social contact, hearing loss, traumatic brain injury and air pollution indicating clear prevention potential. Dementia and physical disability are closely linked with shared risk factors and possible shared underlying mechanisms supporting the possibility of integrated preventive interventions. FINGER trial was the first large randomized controlled trial indicating that multidomain lifestyle-based intervention can prevent cognitive and functional decline amongst at-risk older adults from the general population. Within the World-Wide FINGERS network, the multidomain FINGER concept is now tested and adapted worldwide proving evidence and tools for effective and easily implementable preventive strategies. Close collaboration between researchers, policymakers and healthcare practitioners, involvement of older adults and utilization of new technologies to support self-management is needed to facilitate the implementation of the research findings. In this scoping review, we present the current scientific evidence in the field of dementia and disability prevention and discuss future directions in the field.
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Affiliation(s)
- I. Lisko
- From theDivision of Clinical GeriatricsCenter for Alzheimer ResearchDepartment of Neurobiology, Care Sciences and SocietyKarolinska InstitutetStockholmSweden
- Faculty of Sport and Health Sciences and Gerontology Research CenterUniversity of JyväskyläJyväskyläFinland
| | - J. Kulmala
- From theDivision of Clinical GeriatricsCenter for Alzheimer ResearchDepartment of Neurobiology, Care Sciences and SocietyKarolinska InstitutetStockholmSweden
- Public Health Promotion UnitFinnish Institute for Health and WelfareHelsinkiFinland
- School of Health Care and Social WorkSeinäjoki University of Applied SciencesSeinäjokiFinland
| | - M. Annetorp
- Karolinska University Hospital, Theme AgingStockholmSweden
| | - T. Ngandu
- From theDivision of Clinical GeriatricsCenter for Alzheimer ResearchDepartment of Neurobiology, Care Sciences and SocietyKarolinska InstitutetStockholmSweden
- Public Health Promotion UnitFinnish Institute for Health and WelfareHelsinkiFinland
| | - F. Mangialasche
- From theDivision of Clinical GeriatricsCenter for Alzheimer ResearchDepartment of Neurobiology, Care Sciences and SocietyKarolinska InstitutetStockholmSweden
- Aging Research CenterDepartment of Neurobiology, Care Sciences and SocietyKarolinska Institutet and Stockholm UniversityStockholmSweden
| | - M. Kivipelto
- From theDivision of Clinical GeriatricsCenter for Alzheimer ResearchDepartment of Neurobiology, Care Sciences and SocietyKarolinska InstitutetStockholmSweden
- Karolinska University Hospital, Theme AgingStockholmSweden
- Institute of Public Health and Clinical NutritionUniversity of Eastern FinlandHelsinkiFinland
- Ageing and Epidemiology (AGE) Research UnitSchool of Public HealthImperial College LondonLondonUK
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14
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Aschwanden D, Aichele S, Ghisletta P, Terracciano A, Kliegel M, Sutin AR, Brown J, Allemand M. Predicting Cognitive Impairment and Dementia: A Machine Learning Approach. J Alzheimers Dis 2021; 75:717-728. [PMID: 32333585 DOI: 10.3233/jad-190967] [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: 12/15/2022]
Abstract
BACKGROUND Efforts to identify important risk factors for cognitive impairment and dementia have to date mostly relied on meta-analytic strategies. A comprehensive empirical evaluation of these risk factors within a single study is currently lacking. OBJECTIVE We used a combined methodology of machine learning and semi-parametric survival analysis to estimate the relative importance of 52 predictors in forecasting cognitive impairment and dementia in a large, population-representative sample of older adults. METHODS Participants from the Health and Retirement Study (N = 9,979; aged 50-98 years) were followed for up to 10 years (M = 6.85 for cognitive impairment; M = 7.67 for dementia). Using a split-sample methodology, we first estimated the relative importance of predictors using machine learning (random forest survival analysis), and we then used semi-parametric survival analysis (Cox proportional hazards) to estimate effect sizes for the most important variables. RESULTS African Americans and individuals who scored high on emotional distress were at relatively highest risk for developing cognitive impairment and dementia. Sociodemographic (lower education, Hispanic ethnicity) and health variables (worse subjective health, increasing BMI) were comparatively strong predictors for cognitive impairment. Cardiovascular factors (e.g., smoking, physical inactivity) and polygenic scores (with and without APOEɛ4) appeared less important than expected. Post-hoc sensitivity analyses underscored the robustness of these results. CONCLUSIONS Higher-order factors (e.g., emotional distress, subjective health), which reflect complex interactions between various aspects of an individual, were more important than narrowly defined factors (e.g., clinical and behavioral indicators) when evaluated concurrently to predict cognitive impairment and dementia.
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Affiliation(s)
| | - Stephen Aichele
- Faculty of Psychology and Educational Sciences, University of Geneva, Switzerland.,Colorado State University, Fort Collins, CO, USA
| | - Paolo Ghisletta
- Faculty of Psychology and Educational Sciences, University of Geneva, Switzerland.,Swiss Distance University Institute, Switzerland.,Swiss National Centre of Competence in Research LIVES - Overcoming Vulnerability: Life Course Perspectives, Universities of Lausanne and of Geneva, Switzerland
| | | | - Matthias Kliegel
- Faculty of Psychology and Educational Sciences, University of Geneva, Switzerland.,Swiss National Centre of Competence in Research LIVES - Overcoming Vulnerability: Life Course Perspectives, Universities of Lausanne and of Geneva, Switzerland
| | | | | | - Mathias Allemand
- University of Zurich, Zurich, Switzerland.,University Research Priority Program Dynamics of Healthy Aging, University of Zurich, Switzerland
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15
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Beach TG, Malek-Ahmadi M. Alzheimer's Disease Neuropathological Comorbidities are Common in the Younger-Old. J Alzheimers Dis 2021; 79:389-400. [PMID: 33285640 PMCID: PMC8034496 DOI: 10.3233/jad-201213] [Citation(s) in RCA: 46] [Impact Index Per Article: 15.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
BACKGROUND Clinicopathological studies have demonstrated that Alzheimer's disease dementia (ADD) is often accompanied by clinically undetectable comorbid neurodegenerative and cerebrovascular disease that alter the rate of cognitive decline. Aside from causing increased variability in clinical response, it is possible that the major ADD comorbidities may not respond to ADD-specific molecular therapeutics. OBJECTIVE As most reports have focused on comorbidity in the oldest-old, its extent in younger age groups that are more likely to be involved in clinical trials is largely unknown; our objective is to provide this information. METHODS We conducted a survey of neuropathological comorbidities in sporadic ADD using data from the US National Alzheimer's Coordinating Center. Subject data was restricted to those with dementia and meeting National Institute on Aging-Alzheimer's Association intermediate or high AD Neuropathological Change levels, excluding those with known autosomal dominant AD-related mutations. RESULTS Highly prevalent ADD comorbidities are not restricted to the oldest-old but are common even in early-onset ADD. The percentage of cases with ADD as the sole major neuropathological diagnosis is highest in the under-60 group, where "pure" ADD cases are still in the minority at 44%. After this AD as a sole major pathology in ADD declines to roughly 20%in the 70s and beyond. Lewy body disease is the most common comorbidity at younger ages but actually is less common at later ages, while for most others, their prevalence increases with age. CONCLUSION Alzheimer's disease neuropathological comorbidities are highly prevalent even in the younger-old.
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16
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Wu JJ, Weng SC, Liang CK, Lin CS, Lan TH, Lin SY, Lin YT. Effects of kidney function, serum albumin and hemoglobin on dementia severity in the oldest old people with newly diagnosed Alzheimer's disease in a residential aged care facility: a cross-sectional study. BMC Geriatr 2020; 20:391. [PMID: 33028210 PMCID: PMC7541276 DOI: 10.1186/s12877-020-01789-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2020] [Accepted: 09/24/2020] [Indexed: 01/09/2023] Open
Abstract
Background Chronic kidney disease (CKD), low serum albumin, and anemia are known risk factors for cognitive decline in older people. We investigated the association between kidney function and cognitive impairment severity in oldest-old people with a diagnosis of Alzheimer’s disease (AD). Methods A cross-sectional study of patients aged 80 years and older was conducted at a veterans’ home in Taiwan between 2012 and 2016. Their estimated glomerular filtration rate (eGFR) was determined using the Modification of Diet in Renal Diseases (MDRD) equation. Cognitive function was evaluated with the Mini-Mental State Examination (MMSE) and Clinical Dementia Rating (CDR). Results A total of 84 patients (age mean ± SD, 86.6 ± 3.9 years) had MMSE scores of 10.1 ± 6.7, and CDR scores of 1.6 ± 0.7. The average eGFR was 61.7 ± 21.5 mL/min/1.73m2. The mean hemoglobin concentration was 12.7 ± 1.7 g/dl, and the mean albumin concentration was 4.5 ± 4.8 g/dl. Multivariate regression analyses showed that scores of CDR were significantly correlated with eGFR after adjustment for potential confounders. The scores of MMSE were significantly correlated with serum albumin and hemoglobin after adjustment for potential confounders. Conclusions We found dementia severity was significantly associated with kidney function, serum albumin, and hemoglobin in the oldest-old with AD. We recommend that oldest-old people with a diagnosis of AD be evaluated to determine kidney function, as well as nutritional and hematological status. Further study is needed to establish whether prevention of CKD deterioration, and correction of malnutrition and anemia may help to slow cognitive decline in oldest-old people with dementia.
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Affiliation(s)
- Jia-Jyun Wu
- Center for Geriatrics and Gerontology, Taichung Veterans General Hospital, Taichung, Taiwan.,Department of Family Medicine, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Shuo-Chun Weng
- Center for Geriatrics and Gerontology, Taichung Veterans General Hospital, Taichung, Taiwan.,Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan.,Division of Nephrology, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Chih-Kuang Liang
- Center for Geriatrics and Gerontology, Division of Neurology, Department of Medicine, Kaohsiung Veterans General Hospital, No.386, Dazhong 1st Rd., Zuoying Dist, Kaohsiung, Taiwan
| | - Chu-Sheng Lin
- Center for Geriatrics and Gerontology, Taichung Veterans General Hospital, Taichung, Taiwan.,Department of Family Medicine, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Tsuo-Hung Lan
- Tsaotun Psychiatric Center, Ministry of Health and Welfare, Nantou, Taiwan.,Department of Psychiatry, School of Medicine, National Yang-Ming University, Taipei, Taiwan.,Center for Neuropsychiatric Research, National Health Research Institutes, Miaoli, Taiwan
| | - Shih-Yi Lin
- Center for Geriatrics and Gerontology, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Yu-Te Lin
- Center for Geriatrics and Gerontology, Division of Neurology, Department of Medicine, Kaohsiung Veterans General Hospital, No.386, Dazhong 1st Rd., Zuoying Dist, Kaohsiung, Taiwan.
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17
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Gao W, Wang W, Dong X, Sun Y. Nitrogen-Doped Carbonized Polymer Dots: A Potent Scavenger and Detector Targeting Alzheimer's β-Amyloid Plaques. SMALL (WEINHEIM AN DER BERGSTRASSE, GERMANY) 2020; 16:e2002804. [PMID: 33006250 DOI: 10.1002/smll.202002804] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Revised: 08/05/2020] [Indexed: 05/16/2023]
Abstract
The fibrillization and deposition of β-amyloid protein (Aβ) are recognized to be the pathological hallmarks of Alzheimer's disease (AD), which signify the need for the effective detection and inhibition of Aβ accumulation. Development of multifunctional agents that can inhibit Aβ aggregation, rapidly disaggregate fibrils, and image aggregates is one of the effective strategies to treat and diagnose AD. Herein, the multifunctionality of nitrogen-doped carbonized polymer dots (CPDs) targeting Aβ aggregation is reported. CPDs inhibit the fibrillization of Aβ monomers and rapidly disintegrate Aβ fibrils by electrostatic interactions, hydrogen-bonding and hydrophobic interactions with Aβ in a time scale of seconds to minutes. Moreover, the interactions make CPDs label Aβ fibrils and emit enhanced red fluorescence by the binding, so CPDs can be used for in vivo imaging of the amyloids in transgenic Caenorhabditis elegans CL2006 as an AD model. Importantly, CPDs are demonstrated to scavenge the in vivo amyloid plaques and to promote the lifespan extension of CL2006 strain by alleviating the Aβ-triggered toxicity. Taken together, the multifunctional CPDs show an exciting prospect for further investigations in Aβ-targeted AD treatment and diagnosis, and this study provides new insight into the development of carbon materials in AD theranostics.
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Affiliation(s)
- Weiqun Gao
- Department of Biochemical Engineering, School of Chemical Engineering and Technology, Tianjin University, Tianjin, 300350, China
| | - Wenjuan Wang
- Department of Biochemical Engineering, School of Chemical Engineering and Technology, Tianjin University, Tianjin, 300350, China
| | - Xiaoyan Dong
- Department of Biochemical Engineering, School of Chemical Engineering and Technology, Tianjin University, Tianjin, 300350, China
- Key Laboratory of Systems Bioengineering and Frontiers Science Center for Synthetic Biology (Ministry of Education), Tianjin University, Tianjin, 300350, China
| | - Yan Sun
- Department of Biochemical Engineering, School of Chemical Engineering and Technology, Tianjin University, Tianjin, 300350, China
- Key Laboratory of Systems Bioengineering and Frontiers Science Center for Synthetic Biology (Ministry of Education), Tianjin University, Tianjin, 300350, China
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18
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Association of mild cognitive impairment and metabolic syndrome in patients with hypertension. Asian J Psychiatr 2020; 53:102185. [PMID: 32540752 DOI: 10.1016/j.ajp.2020.102185] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2020] [Revised: 05/22/2020] [Accepted: 05/26/2020] [Indexed: 12/27/2022]
Abstract
AIM The aim of this study was to evaluate the prevalence of mild cognitive impairment (MCI) in patients with hypertension and to evaluate the association of MCI with metabolic syndrome (MetS). METHODOLOGY 186 subjects with hypertension were evaluated on Montreal Cognitive Assessment (MoCA) and Patient Health Questionnaire (PHQ-9) for cognitive decline and depression, respectively and MetS was diagnosed as per the Consensus definition. RESULTS The prevalence of MCI was 65.6 % and that of MetS was 45.7 %. Compared to those without MetS, those with MetS had significantly poorer cognitive functioning on the all cognitive domain of the MoCA, even after controlling for age, education, severity of the depression and duration of illness. Low High-Density Lipoprotein (HDL) was found to have a positive correlation with MoCA. Higher age, lower education, higher duration of illness and use of higher numbers of medications were associated with significantly lower score on MoCA. CONCLUSION Presence of MetS among persons with hypertension is associated with cognitive decline. Hence, there is a need to monitor and manage other parameters of MetS among patients with hypertension, to reduce the risk of cognitive decline and future dementia.
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19
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Barbera M, Kulmala J, Lisko I, Pietilä E, Rosenberg A, Hallikainen I, Hallikainen M, Laatikainen T, Lehtisalo J, Neuvonen E, Rusanen M, Soininen H, Tuomilehto J, Ngandu T, Solomon A, Kivipelto M. Third follow-up of the Cardiovascular Risk Factors, Aging and Dementia (CAIDE) cohort investigating determinants of cognitive, physical, and psychosocial wellbeing among the oldest old: the CAIDE85+ study protocol. BMC Geriatr 2020; 20:238. [PMID: 32650731 PMCID: PMC7350760 DOI: 10.1186/s12877-020-01617-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2020] [Accepted: 06/15/2020] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND The oldest old is the fastest growing age group worldwide and the most prone to severe disability, especially in relation to loss of cognitive function. Improving our understanding of the predictors of cognitive, physical and psychosocial wellbeing among the oldest old can result in substantial benefits for the individuals and for the society as a whole. The Cardiovascular Risk Factors, Aging and Dementia (CAIDE) study investigated risk factors and determinants of cognitive impairment in a population-based longitudinal cohort, which was first examined between 1972 and 1992, when individuals were in their midlife, and re-assessed in 1998 and 2005-2009. Most of the study participants are currently aged 85 years or older. We aim to re-examine the cohort's survivors and gain further insights on the mechanisms underlying both cognitive and overall healthy ageing at old age. METHODS CAIDE85+ is the third follow-up of the CAIDE study participants. All individuals still alive and living in the Kuopio and Joensuu areas of Eastern Finland, from the original CAIDE cohort (two random samples, N = 2000 + ~ 900), will be invited to a re-examination. The assessment includes self-reported data related to basic demographics and lifestyle, as well as psychosocial and physical health status. Cognitive and physical evaluations are also conducted. Blood biomarkers relevant for dementia and ageing are assessed. Primary outcomes are the measurements related to cognition and daily life functioning (CERAD, Trail Making Test-A, Letter-Digit Substitution Test, Clinical Dementia Rating and Activities of Daily Living). Secondary endpoints of the study are outcomes related to physical health status, psychosocial wellbeing, as well as age-related health indicators. DISCUSSION Through a follow-up of more than 40 years, CAIDE85+ will provide invaluable information on the risk and protective factors that contribute to cognitive and physical health, as well as ageing and longevity. STUDY REGISTRATION The present study protocol has been registered at https://clinicaltrials.gov/ (registration nr NCT03938727 , date 03.05.2019).
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Affiliation(s)
- Mariagnese Barbera
- Institute of Clinical Medicine, Department of Neurology, University of Eastern Finland, P.O. Box 1627, 70211, Kuopio, Finland.
| | - Jenni Kulmala
- Public Health Promotion Unit, Finnish Institute for Health and Welfare, P.O. Box 30, 00271, Helsinki, Finland.,School of Health Care and Social Work, Seinäjoki University of Applied Sciences, Seinäjoki, Finland.,Division of Clinical Geriatrics, Center for Alzheimer Research, Care Sciences and Society (NVS), Karolinska Institutet, Karolinska Universitetssjukhuset, Karolinska Vägen 37 A, QA32, Stockholm, Sweden
| | - Inna Lisko
- Division of Clinical Geriatrics, Center for Alzheimer Research, Care Sciences and Society (NVS), Karolinska Institutet, Karolinska Universitetssjukhuset, Karolinska Vägen 37 A, QA32, Stockholm, Sweden
| | - Eija Pietilä
- Institute of Clinical Medicine, Department of Neurology, University of Eastern Finland, P.O. Box 1627, 70211, Kuopio, Finland
| | - Anna Rosenberg
- Institute of Clinical Medicine, Department of Neurology, University of Eastern Finland, P.O. Box 1627, 70211, Kuopio, Finland
| | - Ilona Hallikainen
- Institute of Clinical Medicine, Department of Neurology, University of Eastern Finland, P.O. Box 1627, 70211, Kuopio, Finland
| | - Merja Hallikainen
- Institute of Clinical Medicine, Department of Neurology, University of Eastern Finland, P.O. Box 1627, 70211, Kuopio, Finland
| | - Tiina Laatikainen
- Public Health Promotion Unit, Finnish Institute for Health and Welfare, P.O. Box 30, 00271, Helsinki, Finland.,Institute of Public Health and Clinical Nutrition, University of Eastern Finland, P.O. Box 1627, 70211, Kuopio, Finland.,Joint Municipal Authority for North Karelia Social and Health Services (Siun Sote), Central Hospital, Tikkamäentie 16, 80210, Joensuu, Finland
| | - Jenni Lehtisalo
- Institute of Clinical Medicine, Department of Neurology, University of Eastern Finland, P.O. Box 1627, 70211, Kuopio, Finland.,Public Health Promotion Unit, Finnish Institute for Health and Welfare, P.O. Box 30, 00271, Helsinki, Finland
| | - Elisa Neuvonen
- Institute of Clinical Medicine, Department of Neurology, University of Eastern Finland, P.O. Box 1627, 70211, Kuopio, Finland
| | - Minna Rusanen
- Institute of Clinical Medicine, Department of Neurology, University of Eastern Finland, P.O. Box 1627, 70211, Kuopio, Finland.,Public Health Promotion Unit, Finnish Institute for Health and Welfare, P.O. Box 30, 00271, Helsinki, Finland.,Neurocenter Finland, Department of Neurology, Kuopio University Hospital, Puijonlaaksontie 2, 70210, Kuopio, Finland
| | - Hilkka Soininen
- Institute of Clinical Medicine, Department of Neurology, University of Eastern Finland, P.O. Box 1627, 70211, Kuopio, Finland.,Neurocenter Finland, Department of Neurology, Kuopio University Hospital, Puijonlaaksontie 2, 70210, Kuopio, Finland
| | - Jaakko Tuomilehto
- Public Health Promotion Unit, Finnish Institute for Health and Welfare, P.O. Box 30, 00271, Helsinki, Finland.,Department of Public Health, University of Helsinki, PO BOX 20, 00014, Helsinki, Finland.,Diabetes Research Group, King Abdulaziz University, Jeddah, 21589, Saudi Arabia
| | - Tiia Ngandu
- Public Health Promotion Unit, Finnish Institute for Health and Welfare, P.O. Box 30, 00271, Helsinki, Finland.,Division of Clinical Geriatrics, Center for Alzheimer Research, Care Sciences and Society (NVS), Karolinska Institutet, Karolinska Universitetssjukhuset, Karolinska Vägen 37 A, QA32, Stockholm, Sweden
| | - Alina Solomon
- Institute of Clinical Medicine, Department of Neurology, University of Eastern Finland, P.O. Box 1627, 70211, Kuopio, Finland.,Division of Clinical Geriatrics, Center for Alzheimer Research, Care Sciences and Society (NVS), Karolinska Institutet, Karolinska Universitetssjukhuset, Karolinska Vägen 37 A, QA32, Stockholm, Sweden
| | - Miia Kivipelto
- Institute of Clinical Medicine, Department of Neurology, University of Eastern Finland, P.O. Box 1627, 70211, Kuopio, Finland.,Division of Clinical Geriatrics, Center for Alzheimer Research, Care Sciences and Society (NVS), Karolinska Institutet, Karolinska Universitetssjukhuset, Karolinska Vägen 37 A, QA32, Stockholm, Sweden.,Institute of Public Health and Clinical Nutrition, University of Eastern Finland, P.O. Box 1627, 70211, Kuopio, Finland.,Ageing Epidemiology Research Unit, School of Public Health, Imperial College London, Charing Cross Hospital, St Dunstan's Road, London, W6 8RP, UK
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20
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Jiang J, Liu T, Crawford JD, Kochan NA, Brodaty H, Sachdev PS, Wen W. Stronger bilateral functional connectivity of the frontoparietal control network in near-centenarians and centenarians without dementia. Neuroimage 2020; 215:116855. [DOI: 10.1016/j.neuroimage.2020.116855] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2020] [Revised: 03/10/2020] [Accepted: 04/10/2020] [Indexed: 01/14/2023] Open
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Determinants of incident dementia in different old age groups: results of the prospective AgeCoDe/AgeQualiDe study. Int Psychogeriatr 2020; 32:645-659. [PMID: 31865929 DOI: 10.1017/s1041610219001935] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
OBJECTIVES To examine the impact of determinants of incident dementia in three different old age groups (75-79, 80-84, 85+years) in Germany. DESIGN Multicenter prospective AgeCoDe/AgeQualiDe cohort study with baseline and nine follow-up assessments at 1.5-year intervals. SETTING Primary care medical record registry sample. PARTICIPANTS General practitioners' (GPs) patients aged 75+years at baseline. MEASUREMENTS Conduction of standardized interviews including neuropsychological assessment and collection of GP information at each assessment wave. We used age-stratified competing risk regression models (accounting for the competing event of mortality) to assess determinants of incident dementia and age-stratified ordinary least square regressions to quantify the impact of identified determinants on the age at dementia onset. RESULTS Among 3027 dementia-free GP patients, n = 704 (23.3%) developed dementia during the 13-year study period. Worse cognitive performance and subjective memory decline with related worries at baseline, and the APOE ε4 allele were associated independently with increased dementia risk in all three old age groups. Worse cognitive performance at baseline was also associated with younger age at dementia onset in all three age groups. Other well-known determinants were associated with dementia risk and age at dementia onset only in some or in none of the three old age groups. CONCLUSIONS This study provides further evidence for the age-specific importance of determinants of incident dementia in old age. Such specifics have to be considered more strongly particularly with regard to potential approaches of early detection and prevention of dementia.
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van de Kreeke JA, Legdeur N, Badissi M, Nguyen HT, Konijnenberg E, Tomassen J, Ten Kate M, den Braber A, Maier AB, Tan HS, Verbraak FD, Visser PJ. Ocular biomarkers for cognitive impairment in nonagenarians; a prospective cross-sectional study. BMC Geriatr 2020; 20:155. [PMID: 32345233 PMCID: PMC7189586 DOI: 10.1186/s12877-020-01556-1] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2019] [Accepted: 04/13/2020] [Indexed: 12/03/2022] Open
Abstract
Background Ocular imaging receives much attention as a source of potential biomarkers for dementia. In the present study, we analyze these ocular biomarkers in cognitively impaired and healthy participants in a population aged over 90 years (= nonagenarian), and elucidate the effects of age on these biomarkers. Methods For this prospective cross-sectional study, we included individuals from the EMIF-AD 90+ study, consisting of a cognitively healthy (N = 67) and cognitively impaired group (N = 33), and the EMIF-AD PreclinAD study, consisting of cognitively healthy controls aged ≥60 (N = 198). Participants underwent Optical Coherence Tomography (OCT) and fundus photography of both eyes. OCT was used to asses total and individual inner retinal layer thickness in the macular region (Early Treatment Diabetic Retinopathy Study circles) as well as peripapillary retinal nerve fiber layer thickness, fundus images were analyzed with Singapore I Vessel Assessment to obtain 7 retinal vascular parameters. Values for both eyes were averaged. Differences in ocular biomarkers between the 2 nonagenarian groups were analyzed using linear regression, differences between the individual nonagenarian groups and controls were analyzed using generalized estimating equations. Results Ocular biomarkers did not differ between the healthy and cognitively impaired nonagenarian groups. 19 out of 22 ocular biomarkers assessed in this study differed between either nonagenarian group and the younger controls. Conclusion The ocular biomarkers assessed in this study were not associated with cognitive impairment in nonagenarians, making their use as a screening tool for dementing disorders in this group limited. However, ocular biomarkers were significantly associated with chronological age, which were very similar to those ascribed to occur in Alzheimer’s Disease.
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Affiliation(s)
- Jacoba A van de Kreeke
- Ophthalmology Department, Amsterdam UMC, location VUmc, De Boelelaan 1117, 1081HV, Amsterdam, The Netherlands.
| | - Nienke Legdeur
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands
| | - Maryam Badissi
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands
| | - H Ton Nguyen
- Ophthalmology Department, Amsterdam UMC, location VUmc, De Boelelaan 1117, 1081HV, Amsterdam, The Netherlands
| | - Elles Konijnenberg
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands
| | - Jori Tomassen
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands
| | - Mara Ten Kate
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands
| | - Anouk den Braber
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands.,Department of Biological Psychology, VU University Amsterdam, Amsterdam, The Netherlands
| | - Andrea B Maier
- Department of Medicine and Aged Care, @AgeMelbourne, Royal Melbourne Hospital, University of Melbourne, Melbourne, Australia.,Department of Human Movement Sciences, @AgeAmsterdam, Amsterdam Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - H Stevie Tan
- Ophthalmology Department, Amsterdam UMC, location VUmc, De Boelelaan 1117, 1081HV, Amsterdam, The Netherlands
| | - Frank D Verbraak
- Ophthalmology Department, Amsterdam UMC, location VUmc, De Boelelaan 1117, 1081HV, Amsterdam, The Netherlands
| | - Pieter Jelle Visser
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands
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Lisko I, Törmäkangas T, Jylhä M. Structure of self-rated health among the oldest old: Analyses in the total population and those living with dementia. SSM Popul Health 2020; 11:100567. [PMID: 32258355 PMCID: PMC7110410 DOI: 10.1016/j.ssmph.2020.100567] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2019] [Revised: 02/08/2020] [Accepted: 03/12/2020] [Indexed: 01/04/2023] Open
Abstract
No previous study has explored the structure of self-rated health (SRH), a measure holding strong predictive value for future health events, in the oldest old or in individuals with dementia. The aim was to construct a structural equation model of SRH for oldest old in general and for oldest old with dementia, and to explore direct and indirect associations between health-related factors and SRH. Cross-sectional data from the Vitality 90+, a population-based study in the city of Tampere, Finland, was used. Data were gathered by a mailed questionnaire in 2014. Altogether 1299 nonagenarians, of which 408 had self-reported dementia or cognitive decline, were included. Structural equation models were constructed for all participants and separately for participants with dementia. Diseases (heart disease, stroke, diabetes, arthritis, hip fracture, cancer and dementia for the model for all), dizziness, hearing, vision, mobility, activities of daily living, fatigue, depression and SRH were included in the models. Among all participants, fatigue, depression, problems in mobility, dizziness, deficits in vision and heart disease were directly associated with poor SRH. Among participants with dementia, only fatigue, dizziness and deficits in vision were directly associated with poor SRH. Among all participants, dementia and arthritis were indirectly associated with poor SRH through problems in mobility, depression and fatigue. Among the oldest old, the effects of diseases on SRH were mainly manifested through the consequences of diseases, namely fatigue, dizziness, deficits in vision and problems in mobility. Depression has an important direct and indirect role, and dementia and arthritis an important indirect role in the structure of SRH. Dementia weakens many of the direct and indirect associations for SRH. First study to explore structure of self-rated health in oldest old and persons with dementia. Fatigue, depression, mobility, dizziness, vision and heart disease directly affect health-rating in oldest old. Dementia, depression and arthritis affect health rating indirectly through various routes in oldest old. Dementia weakens many of the associations between objective indicators of health with self-rated health.
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Affiliation(s)
- Inna Lisko
- Tampere University, Faculty of Social Sciences (Health Sciences), P.O. Box 100, FI-33014, Finland.,Gerontology Research Center, Tampere University and University of Jyväskylä, Finland.,University of Jyväskylä, Faculty of Sport and Health Sciences, P.O. Box 35, FI-40014, Finland.,Karolinska Institutet, Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Stockholm, Karolinska Vägen 37 A, QA32, SE-171 64, Solna, Sweden
| | - Timo Törmäkangas
- Gerontology Research Center, Tampere University and University of Jyväskylä, Finland.,University of Jyväskylä, Faculty of Sport and Health Sciences, P.O. Box 35, FI-40014, Finland
| | - Marja Jylhä
- Tampere University, Faculty of Social Sciences (Health Sciences), P.O. Box 100, FI-33014, Finland.,Gerontology Research Center, Tampere University and University of Jyväskylä, Finland.,Science Center, Tampere University Hospital, Finland
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24
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Xu W, Chen T, Shan Q, Hu B, Zhao M, Deng X, Zuo J, Hu Y, Fan L. Sarcopenia Is Associated with Cognitive Decline and Falls but Not Hospitalization in Community-Dwelling Oldest Old in China: A Cross-Sectional Study. Med Sci Monit 2020; 26:e919894. [PMID: 31980594 PMCID: PMC6998786 DOI: 10.12659/msm.919894] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Background The aim of this study was to investigate the association between sarcopenia and cognitive decline, falls, and hospitalization in a Chinese elderly population. Material/Methods This cross-sectional survey was conducted between November 2018 and May 2019, and enrolled only older adults aged 80 years or over (oldest old). We diagnosed sarcopenia using the Asian Working Group for Sarcopenia criteria. Demographic characteristics, disease history, smoking status, drinking status, cognitive function, falls, and hospitalization events in the previous 12 months were acquired by face-to-face interview. Cognitive status was evaluated by the Montreal Cognitive Assessment. Falls was ascertained by the question “Have you fallen down in the last 12 months?” Hospitalization was ascertained by the question “Have you received inpatient care in the past year?” Results A total of 582 participants (aged 80–99 years and 42.3% male) were included. The prevalence of sarcopenia was 21.7% (95% confidence interval [CI]: 17.3–26.2%) and 33.3% (95% CI: 27.4–39.3%) for females and males, respectively. Among the study population, the prevalence of cognitive decline was 60.8%; the proportions of the oldest old who had falls or hospitalization in the past 12 months were 18.1% and 34.3%, respectively. Multivariate analyses showed that sarcopenia was significantly and independently associated with cognitive decline [odds ratio (OR)=1.96, 95% CI: 1.17–3.27] and falls (OR=2.00, 95% CI: 1.17–3.43) but not associated with hospitalization (OR=1.32, 95% CI: 0.83–2.08). Conclusions Our results showed that sarcopenia was significantly and independently associated with cognitive decline and falls, but not associated with hospitalization, in the community-dwelling oldest old.
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Affiliation(s)
- Weihao Xu
- Department of Geriatric Cardiology, The Second Medical Center and National Clinical Research Center for Geriatric Diseases, Chinese People's Liberation Army (PLA) General Hospital, Beijing, China (mainland)
| | - Tao Chen
- Department of Cardiology, The First Medical Center, Chinese People's Liberation Army (PLA) General Hospital, Beijing, China (mainland)
| | - Qing Shan
- Department of Pharmacy, The Second Medical Center and National Clinical Research Center for Geriatric Diseases, Chinese People's Liberation Army (PLA) General Hospital, Beijing, China (mainland)
| | - Bo Hu
- Department of Pharmacy, The Second Medical Center and National Clinical Research Center for Geriatric Diseases, Chinese People's Liberation Army (PLA) General Hospital, Beijing, China (mainland)
| | - Ming Zhao
- Outpatient Department, Haidian 37th Ex-Cadre Rest and Recuperation Center, Beijing, China (mainland)
| | - Xinli Deng
- Laboratory Department, The Second Medical Center and National Clinical Research Center for Geriatric Diseases, Chinese People's Liberation Army (PLA) General Hospital, Beijing, China (mainland)
| | - Jing Zuo
- Department of Geriatric Health Care, The Second Medical Center and National Clinical Research Center for Geriatric Diseases, Chinese People's Liberation Army (PLA) General Hospital, Beijing, China (mainland)
| | - Yixin Hu
- Department of Geriatric Health Care, The Second Medical Center and National Clinical Research Center for Geriatric Diseases, Chinese People's Liberation Army (PLA) General Hospital, Beijing, China (mainland)
| | - Li Fan
- Department of Geriatric Cardiology, The Second Medical Center and National Clinical Research Center for Geriatric Diseases, Chinese People's Liberation Army (PLA) General Hospital, Beijing, China (mainland)
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Marcon G, Manganotti P, Tettamanti M. Is Parkinson’s Disease a Very Rare Pathology in Centenarians? A Clinical Study in a Cohort of Subjects. J Alzheimers Dis 2020; 73:73-76. [DOI: 10.3233/jad-190717] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Affiliation(s)
- Gabriella Marcon
- Department of Medical Surgical and Health Sciences, University of Trieste, Trieste, Italy
- DAME, University of Udine, Udine, Italy
- ASUITS (Azienda Sanitaria Universitaria Integrata di Trieste), Trieste, Italy
| | - Paolo Manganotti
- Department of Medical Surgical and Health Sciences, University of Trieste, Trieste, Italy
- ASUITS (Azienda Sanitaria Universitaria Integrata di Trieste), Trieste, Italy
| | - Mauro Tettamanti
- Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milano, Italy
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26
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Lucca U, Tettamanti M, Tiraboschi P, Logroscino G, Landi C, Sacco L, Garrì M, Ammesso S, Biotti A, Gargantini E, Piedicorcia A, Mandelli S, Riva E, Galbussera AA, Recchia A. Incidence of dementia in the oldest-old and its relationship with age: The Monzino 80-plus population-based study. Alzheimers Dement 2020; 16:472-481. [PMID: 31786127 DOI: 10.1016/j.jalz.2019.09.083] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
INTRODUCTION Relationship between age and dementia at extreme old ages is still an open question, yet population-based studies in this high-risk age segment are rare. METHODS The Monzino 80-plus is a population-based study among residents 80 years and older in the Varese province, Italy. Of 1371 eligible individuals, 1294 (94.4%), of whom 64 are centenarians, were included in the incidence study. RESULTS Since 2002, 584 new cases of all-cause dementia were identified over 15 years. The overall incidence rate was 7.9 per 100 person-years. Dementia risk rose with age (IRR: 1.06), with the cubic model providing the best fit (R2 = 0.91-0.96). Cumulative incidences of dementia unadjusted and adjusted for competing mortality risk progressively diverged with age. CONCLUSION Dementia incidence also keeps rising in nonagenarians and centenarians. Slowing down in growing risk of developing dementia with age is mainly attributable to increasing competing risk of death and resulting selective survival of individuals at lower risk of dementia.
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Affiliation(s)
- Ugo Lucca
- Laboratory of Geriatric Neuropsychiatry, Department of Neuroscience, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milano, Italy
| | - Mauro Tettamanti
- Laboratory of Geriatric Neuropsychiatry, Department of Neuroscience, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milano, Italy
| | - Pietro Tiraboschi
- Division of Neurology V and Neuropathology, Fondazione IRCCS Istituto Neurologico "Carlo Besta", Milano, Italy
| | | | - Cristina Landi
- European Foundation of Biomedical Research (FERB), Division of Neurological Rehabilitation, Cernusco s/N (Milano), Italy
| | - Leonardo Sacco
- Neurocenter of Southern Switzerland, Ospedale Civico, Lugano, Switzerland
| | - Mariateresa Garrì
- Laboratory of Geriatric Neuropsychiatry, Department of Neuroscience, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milano, Italy
| | - Sonia Ammesso
- Laboratory of Geriatric Neuropsychiatry, Department of Neuroscience, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milano, Italy
| | - Anna Biotti
- Laboratory of Geriatric Neuropsychiatry, Department of Neuroscience, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milano, Italy
| | - Elena Gargantini
- Laboratory of Geriatric Neuropsychiatry, Department of Neuroscience, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milano, Italy
| | - Alessandro Piedicorcia
- Laboratory of Geriatric Neuropsychiatry, Department of Neuroscience, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milano, Italy
| | - Sara Mandelli
- Laboratory of Geriatric Neuropsychiatry, Department of Neuroscience, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milano, Italy
| | - Emma Riva
- Laboratory of Geriatric Neuropsychiatry, Department of Neuroscience, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milano, Italy
| | - Alessia A Galbussera
- Laboratory of Geriatric Neuropsychiatry, Department of Neuroscience, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milano, Italy
| | - Angela Recchia
- Laboratory of Geriatric Neuropsychiatry, Department of Neuroscience, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milano, Italy
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27
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The puzzle of preserved cognition in the oldest old. Neurol Sci 2019; 41:441-447. [PMID: 31713754 DOI: 10.1007/s10072-019-04111-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2019] [Accepted: 10/15/2019] [Indexed: 02/07/2023]
Abstract
Although epidemiological studies predict an exponential increase in the prevalence of dementia with age, recent studies have demonstrated that the oldest old are actually less frequently affected by dementia than the younger elderly. To explain this, I suggest a parallel between brain ageing and Alzheimer's disease (AD) and assume that theories concerning the brain's vulnerability to AD and its individual variability may also explain why some of the oldest old remain cognitively efficient. Some theories argue that AD is due to the continuing presence of the immature neurones vulnerable to amyloid beta protein (Aß) that are normally involved in brain development and then removed as a result of cell selection by the proteins associated with both brain development and AD. If a dysfunction in cell selection allows these immature neurones to survive, they degenerate early as a result of the neurotoxic action of Aß accumulation, which their mature counterparts can withstand. Consequently, age at the time of onset of AD and its clinical presentations depend on the number and location of such immature cells. I speculate that the same mechanism is responsible for the variability of normal brain ageing: the oldest old with well-preserved cognitive function are people genetically programmed for extreme ageing who have benefited from better cell selection during prenatal and neonatal life and therefore have fewer surviving neurones vulnerable to amyloid-promoted degeneration, whereas the process of early life cell selection was less successful in the oldest old who develop dementia.
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Zamboni G, Griffanti L, Mazzucco S, Pendlebury ST, Rothwell PM. Age-dependent association of white matter abnormality with cognition after TIA or minor stroke. Neurology 2019; 93:e272-e282. [PMID: 31201296 PMCID: PMC6656647 DOI: 10.1212/wnl.0000000000007772] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2017] [Accepted: 03/04/2019] [Indexed: 01/06/2023] Open
Abstract
OBJECTIVE To investigate if the association between MRI-detectable white matter hyperintensity (WMH) and cognitive status reported in previous studies persists at older ages (>80 years), when some white matter abnormality is almost universally reported in clinical practice. METHODS Consecutive eligible patients from a population-based cohort of all TIA/nondisabling stroke (Oxford Vascular Study) underwent multimodal MRI, including fluid-attenuated inversion recovery and diffusion-weighted imaging, allowing automated measurement of WMH volume, mean diffusivity (MD), and fractional anisotropy (FA) in normal-appearing white matter using FSL tools. These measures were related to cognitive status (Montreal Cognitive Assessment) at age ≤80 vs >80 years. RESULTS Of 566 patients (mean [range] age 66.7 [20-102] years), 107 were aged >80 years. WMH volumes and MD/FA were strongly associated with cognitive status in patients aged ≤80 years (all p < 0.001 for WMH, MD, and FA) but not in patients aged >80 years (not significant for WMH, MD, and FA), with age interactions for WMH volume (p interaction = 0.016) and MD (p interaction = 0.037). Voxel-wise analyses also showed that lower Montreal Cognitive Assessment scores were associated with frontal WMH in patients ≤80 years, but not >80 years. CONCLUSION MRI markers of white matter damage are strongly related to cognition in patients with TIA/minor stroke at younger ages, but not at age >80 years. Clinicians and patients should not overinterpret the significance of these abnormalities at older ages.
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Affiliation(s)
- Giovanna Zamboni
- From the Centre for Prevention of Stroke and Dementia (G.Z., L.G., S.M., S.T.P., P.M.R.) and Wellcome Centre for Integrative Neuroimaging, FMRIB (G.Z., L.G.), Nuffield Department of Clinical Neurosciences, John Radcliffe Hospital, University of Oxford; and Department of Biomedical, Metabolic and Neural Sciences and Centre for Neurosciences and Neurotechnology (G.Z.), University of Modena and Reggio Emilia, Italy.
| | - Ludovica Griffanti
- From the Centre for Prevention of Stroke and Dementia (G.Z., L.G., S.M., S.T.P., P.M.R.) and Wellcome Centre for Integrative Neuroimaging, FMRIB (G.Z., L.G.), Nuffield Department of Clinical Neurosciences, John Radcliffe Hospital, University of Oxford; and Department of Biomedical, Metabolic and Neural Sciences and Centre for Neurosciences and Neurotechnology (G.Z.), University of Modena and Reggio Emilia, Italy
| | - Sara Mazzucco
- From the Centre for Prevention of Stroke and Dementia (G.Z., L.G., S.M., S.T.P., P.M.R.) and Wellcome Centre for Integrative Neuroimaging, FMRIB (G.Z., L.G.), Nuffield Department of Clinical Neurosciences, John Radcliffe Hospital, University of Oxford; and Department of Biomedical, Metabolic and Neural Sciences and Centre for Neurosciences and Neurotechnology (G.Z.), University of Modena and Reggio Emilia, Italy
| | - Sarah T Pendlebury
- From the Centre for Prevention of Stroke and Dementia (G.Z., L.G., S.M., S.T.P., P.M.R.) and Wellcome Centre for Integrative Neuroimaging, FMRIB (G.Z., L.G.), Nuffield Department of Clinical Neurosciences, John Radcliffe Hospital, University of Oxford; and Department of Biomedical, Metabolic and Neural Sciences and Centre for Neurosciences and Neurotechnology (G.Z.), University of Modena and Reggio Emilia, Italy
| | - Peter M Rothwell
- From the Centre for Prevention of Stroke and Dementia (G.Z., L.G., S.M., S.T.P., P.M.R.) and Wellcome Centre for Integrative Neuroimaging, FMRIB (G.Z., L.G.), Nuffield Department of Clinical Neurosciences, John Radcliffe Hospital, University of Oxford; and Department of Biomedical, Metabolic and Neural Sciences and Centre for Neurosciences and Neurotechnology (G.Z.), University of Modena and Reggio Emilia, Italy
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29
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Qiu C, Fratiglioni L. Aging without Dementia is Achievable: Current Evidence from Epidemiological Research. J Alzheimers Dis 2019; 62:933-942. [PMID: 29562544 PMCID: PMC5870011 DOI: 10.3233/jad-171037] [Citation(s) in RCA: 69] [Impact Index Per Article: 13.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Both the incidence and the prevalence of dementia increase exponentially with increasing age. This raises the question of whether dementia is an inevitable consequence of aging or whether aging without dementia is achievable. In this review article, we sought to summarize the current evidence from epidemiological and neuropathological studies that investigated this topic. Epidemiological studies have shown that dementia could be avoided even at extreme old ages (e.g., centenarians or supercentenarians). Furthermore, clinico-neuropathological studies found that nearly half of centenarians with dementia did not have sufficient brain pathology to explain their cognitive symptoms, while intermediate-to-high Alzheimer pathology was present in around one-third of very old people without dementia or cognitive impairment. This suggests that certain compensatory mechanisms (e.g., cognitive reserve or resilience) may play a role in helping people in extreme old ages escape dementia syndrome. Finally, evidence has been accumulating in recent years indicating that the incidence of dementia has declined in Europe and North America, which supports the view that the risk of dementia in late life is modifiable. Evidence has emerged that intervention strategies that promote general health, maintain vascular health, and increase cognitive reserve are likely to help preserve cognitive function till late life, thus achieving the goal of aging without dementia.
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Affiliation(s)
- Chengxuan Qiu
- Department of Neurology, Shandong Provincial Hospital Affiliated to Shandong University, Jinan, Shandong, China.,Department of Neurobiology, Care Sciences and Society, Aging Research Center, Karolinska Institutet-Stockholm University, Stockholm, Sweden
| | - Laura Fratiglioni
- Department of Neurobiology, Care Sciences and Society, Aging Research Center, Karolinska Institutet-Stockholm University, Stockholm, Sweden.,Stockholm Gerontology Research Center, Stockholm, Sweden
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Peters R, Booth A, Rockwood K, Peters J, D’Este C, Anstey KJ. Combining modifiable risk factors and risk of dementia: a systematic review and meta-analysis. BMJ Open 2019; 9:e022846. [PMID: 30782689 PMCID: PMC6352772 DOI: 10.1136/bmjopen-2018-022846] [Citation(s) in RCA: 128] [Impact Index Per Article: 25.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
OBJECTIVE To systematically review the literature relating to the impact of multiple co-occurring modifiable risk factors for cognitive decline and dementia. DESIGN A systematic review and meta-analysis of the literature relating to the impact of co-occurring key risk factors for incident cognitive decline and dementia. All abstracts and full text were screened independently by two reviewers and each article assessed for bias using a standard checklist. A fixed effects meta-analysis was undertaken. DATA SOURCES Databases Medline, Embase and PsycINFO were searched from 1999 to 2017. ELIGIBILITY CRITERIA For inclusion articles were required to report longitudinal data from participants free of cognitive decline at baseline, with formal assessment of cognitive function or dementia during follow-up, and an aim to examine the impact of additive or clustered comorbid risk factor burden in with two or more core modifiable risk factors. RESULTS Seventy-nine full-text articles were examined. Twenty-two articles (18 studies) were included reporting data on >40 000 participants. Included studies consistently reported an increased risk associated with greater numbers of intraindividual risk factors or unhealthy behaviours and the opposite for healthy or protective behaviours. A meta-analysis of studies with dementia outcomes resulted in a pooled relative risk for dementia of 1.20 (95% CI 1.04 to 1.39) for one risk factor, 1.65 (95% CI 1.40 to 1.94) for two and 2.21 (95% CI 1.78 to 2.73) for three or more, relative to no risk factors. Limitations include dependence on published results and variations in study outcome, cognitive assessment, length of follow-up and definition of risk factor exposure. CONCLUSIONS The strength of the reported associations, the consistency across studies and the suggestion of a dose response supports a need to keep modifiable risk factor exposure to a minimum and to avoid exposure to additional modifiable risks. Further research is needed to establish whether particular combinations of risk factors confer greater risk than others. PROSPERO REGISTRATION NUMBER 42016052914.
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Affiliation(s)
- Ruth Peters
- Neuroscience Research Australia, Sydney, New South Wales, Australia
- School of Public Health, Imperial College London, London, UK
- University of New South Wales, Sydney, New South Wales, Australia
| | - Andrew Booth
- School of Health and Related Research (ScHARR), University of Sheffield, Sheffield, UK
| | | | - Jean Peters
- School of Health and Related Research (ScHARR), University of Sheffield, Sheffield, UK
| | - Catherine D’Este
- Australian National University (ANU), Canberra, Australian Capital Territory, Australia
- University of Newcastle, Callaghan, New South Wales, Australia
| | - Kaarin J Anstey
- Neuroscience Research Australia, Sydney, New South Wales, Australia
- University of New South Wales, Sydney, New South Wales, Australia
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Beker N, Sikkes SAM, Hulsman M, Schmand B, Scheltens P, Holstege H. Neuropsychological Test Performance of Cognitively Healthy Centenarians: Normative Data From the Dutch 100-Plus Study. J Am Geriatr Soc 2018; 67:759-767. [PMID: 30592018 PMCID: PMC7379661 DOI: 10.1111/jgs.15729] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2018] [Revised: 11/05/2018] [Accepted: 11/13/2018] [Indexed: 12/01/2022]
Abstract
OBJECTIVES The fraction of the population that reaches the age of 100 years is growing. At this age, dementia incidence is high and cognitive functioning is highly variable across individuals. Normative data for neuropsychological tests are lacking in centenarians, which hampers the ability to evaluate their cognitive functioning for both research and clinical practice. Here, we generated norms for neuropsychological tests in a sample of cognitively healthy centenarians while taking sensory impairments into account. DESIGN Cross-sectional cohort study. SETTING Centenarians who participate in the prospective 100-plus Study. PARTICIPANTS A total of 235 centenarians (71.5% female), who self-reported to be cognitively healthy, which was confirmed by an informant and a trained researcher. MEASUREMENTS We generated normative data for 15 cognitive tests, measuring global cognition (Mini-Mental State Examination [MMSE]), premorbid intelligence, attention, language, memory, executive function, and visuospatial function by multiple linear regressions and/or by reporting percentiles. RESULTS Normative data for global cognition resulted in a mean MMSE score of 25.6 ± 3.1 (range = 17-30; interquartile range = 24-28). Vision problems and fatigue often complicated the ability to complete tests, and these problems explained 41% and 22% of the missing test scores, respectively. In contrast, hearing problems (4%) and task incomprehension (6%) rarely complicated test performance. While educational level was associated with performance on the majority of the tests, sex and age were only weakly associated with test performance. CONCLUSIONS We generated normative data for 15 common neuropsychological tests in a large sample of cognitively healthy centenarians, while taking age-related sensory impairments into consideration. These normative data allow the detection of deficits across a wide range of cognitive domains. Our results suggest that, next to education level, vision ability and the level of fatigue should be taken into account when evaluating cognitive functioning in centenarians. J Am Geriatr Soc 67:759-767, 2019.
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Affiliation(s)
- Nina Beker
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands
| | - Sietske A M Sikkes
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands.,Department of Neurology, Massachusetts General Hospital Boston, Boston, Massachusetts
| | - Marc Hulsman
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands.,Department of Clinical Genetics, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands
| | - Ben Schmand
- Department of Psychology, University of Amsterdam, Amsterdam, The Netherlands
| | - Philip Scheltens
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands
| | - Henne Holstege
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands.,Department of Clinical Genetics, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands
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The 100-plus Study of cognitively healthy centenarians: rationale, design and cohort description. Eur J Epidemiol 2018; 33:1229-1249. [PMID: 30362018 PMCID: PMC6290855 DOI: 10.1007/s10654-018-0451-3] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2018] [Accepted: 10/03/2018] [Indexed: 12/24/2022]
Abstract
Although the incidence of dementia increases exponentially with age, some individuals reach more than 100 years with fully retained cognitive abilities. To identify the characteristics associated with the escape or delay of cognitive decline, we initiated the 100-plus Study (www.100plus.nl). The 100-plus Study is an on-going prospective cohort study of Dutch centenarians who self-reported to be cognitively healthy, their first-degree family members and their respective partners. We collect demographics, life history, medical history, genealogy, neuropsychological data and blood samples. Centenarians are followed annually until death. PET–MRI scans and feces donation are optional. Almost 30% of the centenarians agreed to post-mortem brain donation. To date (September 2018), 332 centenarians were included in the study. We analyzed demographic statistics of the first 300 centenarians (25% males) included in the cohort. Centenarians came from higher socio-economic classes and had higher levels of education compared to their birth cohort; alcohol consumption of centenarians was similar, and most males smoked during their lifetime. At baseline, the centenarians had a median MMSE score of 25 points (IQR 22.0–27.5); most centenarians lived independently, retained hearing and vision abilities and were independently mobile. Mortality was associated with cognitive functioning: centenarians with a baseline MMSE score ≥ 26 points had a mortality percentage of 17% per annual year in the second year after baseline, while centenarians with a baseline MMSE score < 26 points had a mortality of 42% per annual year (p = 0.003). The cohort was 2.1-fold enriched with the neuroprotective APOE-ε2 allele relative to 60–80 year-old population controls (p = 4.8 × 10−7), APOE-ε3 was unchanged and the APOE-ε4 allele was 2.3-fold depleted (p = 6.3 × 10−7). Comprehensive characterization of the 100-plus cohort of cognitively healthy centenarians might reveal protective factors that explain the physiology of long-term preserved cognitive health.
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Paolacci L, Giannandrea D, Mecocci P, Parnetti L. Biomarkers for Early Diagnosis of Alzheimer's Disease in the Oldest Old: Yes or No? J Alzheimers Dis 2018; 58:323-335. [PMID: 28436390 DOI: 10.3233/jad-161127] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
In recent years, many efforts have been spent to identify sensitive biomarkers able to improve the accuracy of Alzheimer's disease (AD) diagnosis. Two different workgroups (NIA-AA and IWG) included cerebrospinal fluid (CSF) and neuroimaging findings in their sets of criteria in order to improve diagnostic accuracy as well as early diagnosis. The number of subjects with cognitive impairment increases with aging but the oldest old (≥85 years of age), the fastest growing age group, is still the most unknown from a biological point of view. For this reason, the aim of our narrative mini-review is to evaluate the pertinence of the new criteria for AD diagnosis in the oldest old. Moreover, since different subgroups of oldest old have been described in scientific literature (escapers, delayers, survivors), we want to outline the clinical profile of the oldest old who could really benefit from the use of biomarkers for early diagnosis. Reviewing the literature on biomarkers included in the diagnostic criteria, we did not find a high degree of evidence for their use in the oldest old, although CSF biomarkers seem to be still the most useful for excluding AD diagnosis in the "fit" subgroup of oldest old subjects, due to the high negative predictive value maintained in this age group.
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Affiliation(s)
- Lucia Paolacci
- Department of Medicine, Section of Gerontologyand Geriatrics, University of Perugia, Perugia, Italy
| | - David Giannandrea
- Department of Medicine, Section of Neurology, Center for Memory Disturbances-Lab of Clinical Neurochemistry, University of Perugia, Perugia, Italy.,Neurology Unit, Presidio Ospedaliero Alto Chiascio, USL 1 Umbria, Italy
| | - Patrizia Mecocci
- Department of Medicine, Section of Gerontologyand Geriatrics, University of Perugia, Perugia, Italy
| | - Lucilla Parnetti
- Department of Medicine, Section of Neurology, Center for Memory Disturbances-Lab of Clinical Neurochemistry, University of Perugia, Perugia, Italy
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Tettamanti M, Marcon G. Cohort profile: 'Centenari a Trieste' (CaT), a study of the health status of centenarians in a small defined area of Italy. BMJ Open 2018; 8:e019250. [PMID: 29439076 PMCID: PMC5829861 DOI: 10.1136/bmjopen-2017-019250] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
PURPOSE Centenarians, a segment of the population which some 50 years ago comprised only a few individuals, now count thousands in many countries, and demographic projections forecast that this growth will continue. The study of this new population will give us new information on extreme longevity and help prepare for their health and social needs. The aim of the Centenari a Trieste study is to describe the health and health service use by centenarians, with specific focus on cognitive status. PARTICIPANTS This is a population-based study of centenarians living in the province of Trieste (Italy), a small area with a high prevalence of centenarians and a close network of health and social services, which makes it possible to conduct a study. Consenting individuals were visited by a clinician, tested by neuropsychologists and also gave a sample of their blood. Administrative data were retrieved as well. FINDINGS TO DATE Of the 163 centenarians, 70 could be contacted and participated in the study. The main reasons for non-participation were impossibility to contact the subject (70) and death (20). Centenarians were mostly women (90%), tended to live in a nursing home (60%) and were generally severely functionally impaired (Barthel Index <50: 61%). Data from the administrative database showed that about one out of five needed hospitalisation in the preceding year and more than three out of four had at least one drug prescription. FUTURE PLANS In 2017, we started a new wave of the study enrolling people who had just become centenarian and reassessing subjects already seen; we hope to extend this recruitment in the next years. Subjects are now examined also by cardiologists and dental specialists. We are collecting further different biological specimens to investigate new hypotheses on the cognitive function of the centenarians.
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Affiliation(s)
- Mauro Tettamanti
- Laboratory of Geriatric Neuropsychiatry, Department of Neuroscience, IRCCS - Istituto di Ricerche Farmacologiche Mario Negri, Milan, Italy
| | - Gabriella Marcon
- ASUITS - Dipartimento di Scienze Mediche Chirurgiche e della Salute (DSMCS), University of Trieste, Trieste, Italy
- Dipartimento di Area Medica (DAME), University of Udine, Udine, Italy
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Abstract
Progress in prevention and treatment of Alzheimer's disease (AD) and dementia is hampered by the restricted understanding of the biological and environmental causes underlying pathophysiology. It is widely accepted that certain genetic factors are associated with AD and a number of lifestyle and other environmental characteristics have also been linked to dementia risk. However, interactions between genes and the environment are not yet well understood, and coordinated global action is required to utilize existing cohorts and other resources effectively and efficiently to identify new avenues for dementia prevention. This chapter provides a brief summary of current research on risk and protective factors and opportunities and challenges in relation to population-based approaches are discussed.
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Affiliation(s)
- Robert Perneczky
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilians-Universität München, Munich, Germany. .,German Center for Neurodegenerative Diseases (DZNE) Munich, Munich, Germany. .,Neuroepidemiology and Ageing Research Unit, School of Public Health, The Imperial College of Science, Technology and Medicine, London, UK. .,West London Mental Health NHS Trust, London, UK.
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36
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Rajasekhar K, Narayanaswamy N, Murugan NA, Viccaro K, Lee HG, Shah K, Govindaraju T. Aβ plaque-selective NIR fluorescence probe to differentiate Alzheimer's disease from tauopathies. Biosens Bioelectron 2017; 98:54-61. [PMID: 28649025 PMCID: PMC6370041 DOI: 10.1016/j.bios.2017.06.030] [Citation(s) in RCA: 63] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2017] [Revised: 06/01/2017] [Accepted: 06/15/2017] [Indexed: 10/19/2022]
Abstract
Selective detection and staining of toxic amyloid plaques, a potential biomarker present in the Alzheimer's disease (AD) brain is crucial for both clinical diagnosis and monitoring AD disease progression. Herein, we report a coumarin-quinoline (CQ) conjugate-based turn-on near-infrared (NIR) fluorescence probe for specific detection of β-amyloid (Aβ) aggregates. CQ probe is highly sensitive and exhibits ~100-fold fluorescence enhancement in vitro upon binding Aβ aggregates with enhanced quantum yield. Furthermore, the probe has ~10-fold higher binding affinity towards Aβ aggregates (86nM) compared to commonly used Thioflavin T. Most importantly, CQ probe displays unambiguous selectivity towards Aβ aggregates compared to other toxic protein aggregates such as tau, α-synuclein (α-Syn) and islet amyloid polypeptide (IAPP). In addition, CQ is nontoxic to neuronal cells and shows significant blood brain barrier permeability. Remarkably, CQ stains Aβ plaques in human brain tissue over co-existing tau aggregates and neurofibrillary tangles (NFTs), which are associated in AD and tauopathies. This is a highly desirable attribute to distinguish AD from tau pathology and mixed dementia.
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Affiliation(s)
- K Rajasekhar
- Bioorganic Chemistry Laboratory, New Chemistry Unit, Jawaharlal Nehru Centre for Advanced Scientific Research, Jakkur P.O., Bengaluru 560064, Karnataka, India
| | - Nagarjun Narayanaswamy
- Bioorganic Chemistry Laboratory, New Chemistry Unit, Jawaharlal Nehru Centre for Advanced Scientific Research, Jakkur P.O., Bengaluru 560064, Karnataka, India
| | - N Arul Murugan
- Division of Theoretical Chemistry and Biology, School of Biotechnology, KTH Royal Institute of Technology, S-106 91 Stockholm, Sweden
| | - Keith Viccaro
- Department of Chemistry, Purdue University Center for Cancer Research, 560 Oval Drive, West Lafayette, IN 47907, USA
| | - Hyoung-Gon Lee
- Department of Biology, The University of Texas at San Antonio, One UTSA Circle, San Antonio, TX 78249, USA
| | - Kavita Shah
- Department of Chemistry, Purdue University Center for Cancer Research, 560 Oval Drive, West Lafayette, IN 47907, USA
| | - Thimmaiah Govindaraju
- Bioorganic Chemistry Laboratory, New Chemistry Unit, Jawaharlal Nehru Centre for Advanced Scientific Research, Jakkur P.O., Bengaluru 560064, Karnataka, India.
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Of Energy and Entropy: The Ineluctable Impact of Aging in Old Age Dementia. Int J Mol Sci 2017; 18:ijms18122672. [PMID: 29232829 PMCID: PMC5751274 DOI: 10.3390/ijms18122672] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2017] [Revised: 12/04/2017] [Accepted: 12/07/2017] [Indexed: 01/20/2023] Open
Abstract
Alzheimer’s disease (AD) represents the most common form of dementia among older age subjects, and despite decades of studies, the underlying mechanisms remain unresolved. The definition of AD has changed over the past 100 years, and while early-onset AD is commonly related to genetic mutations, late-onset AD is more likely due to a gradual accumulation of age-related modifications. “Normal brain aging” and AD may represent different pathways of successful or failed capability to adapt brain structures and cerebral functions. Cellular senescence and age-related changes (ARCs) affecting the brain may be considered as biologic manifestations of increasing entropy, a measure of disorder. Late-onset AD may be regarded as the final effect of a reduced energy production, due to exhausted mitochondria, and an increased entropy in the brain. This unique trajectory enables a bioenergetics-centered strategy targeting disease-stage specific profile of brain metabolism for disease prevention and treatment.
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Bennett IJ, Greenia DE, Maillard P, Sajjadi SA, DeCarli C, Corrada MM, Kawas CH. Age-related white matter integrity differences in oldest-old without dementia. Neurobiol Aging 2017; 56:108-114. [PMID: 28527525 PMCID: PMC5647141 DOI: 10.1016/j.neurobiolaging.2017.04.013] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2016] [Revised: 04/07/2017] [Accepted: 04/15/2017] [Indexed: 12/30/2022]
Abstract
Aging is known to have deleterious effects on cerebral white matter, yet little is known about these white matter alterations in advanced age. In this study, 94 oldest-old adults without dementia (90-103 years) underwent diffusion tensor imaging to assess relationships between chronological age and multiple measures of integrity in 18 white matter regions across the brain. Results revealed significant age-related declines in integrity in regions previously identified as being sensitive to aging in younger-old adults (corpus callosum, fornix, cingulum, external capsule). For the corpus callosum, the effect of age on genu fractional anisotropy was significantly weaker than the relationship between age and splenium fractional anisotropy. Importantly, age-related declines in white matter integrity did not differ in cognitively normal and cognitively impaired not demented oldest-old, suggesting that they were not solely driven by cognitive dysfunction or preclinical dementia in this advanced age group. Instead, white matter in these regions appears to remain vulnerable to normal aging processes through the 10th decade of life.
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Affiliation(s)
- Ilana J Bennett
- Department of Psychology, University of California, Riverside, CA, USA.
| | - Dana E Greenia
- Institute for Memory Impairments and Neurological Disorders, University of California, Irvine, CA, USA
| | - Pauline Maillard
- Department of Neurology, University of California, Davis, CA, USA
| | - S Ahmad Sajjadi
- Department of Neurology, University of California, Irvine, CA, USA
| | - Charles DeCarli
- Department of Neurology, University of California, Davis, CA, USA; Alzheimer's Disease Center, University of California, Davis, CA, USA
| | - Maria M Corrada
- Institute for Memory Impairments and Neurological Disorders, University of California, Irvine, CA, USA; Department of Neurology, University of California, Irvine, CA, USA; Department of Epidemiology, University of California, Irvine, CA, USA
| | - Claudia H Kawas
- Institute for Memory Impairments and Neurological Disorders, University of California, Irvine, CA, USA; Department of Neurology, University of California, Irvine, CA, USA; Department of Epidemiology, University of California, Irvine, CA, USA; Department of Neurobiology and Behavior, University of California, Irvine, CA, USA
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Nosraty L, Pulkki J, Raitanen J, Enroth L, Jylhä M. Successful Aging as a Predictor of Long-Term Care Among Oldest Old: The Vitality 90+ Study. J Appl Gerontol 2017; 38:553-571. [PMID: 28671023 DOI: 10.1177/0733464817716968] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
AIM The aim of the study was to investigate whether successful aging (SA) predicts entering long-term care (LTC) among nonagenarians. METHODS Data originated from the linkage of the Vitality 90+ Study surveys with register data from Finnish Population Register and Care Registers. Altogether 1,966 community-dwelling individuals were followed for 2 years and 1,354 individuals for 5 years. Four models of SA were constructed by varying combinations of physical, psychological, and social components. Competing risk regression analysis was used. FINDINGS The incidence rate for entering LTC was lower for successful agers. Three models of SA presented a significantly decreased risk for entering LTC in the whole group and in women. The impact of SA was attenuated when living alone, needing help, and the year of participation were adjusted for, but was still significant for Model 3. CONCLUSION Nonagenarians who meet the multidimensional criteria of SA are less likely to enter LTC than those aging less successfully.
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Affiliation(s)
| | | | - Jani Raitanen
- 1 University of Tampere, Finland.,2 UKK Institute, Tampere, Finland
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Skoog J, Backman K, Ribbe M, Falk H, Gudmundsson P, Thorvaldsson V, Borjesson-Hanson A, Ostling S, Johansson B, Skoog I. A Longitudinal Study of the Mini-Mental State Examination in Late Nonagenarians and Its Relationship with Dementia, Mortality, and Education. J Am Geriatr Soc 2017; 65:1296-1300. [PMID: 28323333 DOI: 10.1111/jgs.14871] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVES To examine level of and change in cognitive status using the Mini-Mental State Examination (MMSE) in relation to dementia, mortality, education, and sex in late nonagenarians. DESIGN Three-year longitudinal study with examinations at ages 97, 99, and 100. SETTING Trained psychiatric research nurses examined participants at their place of living. PARTICIPANTS A representative population-based sample of 97-year-old Swedes (N = 591; 107 men, 484 women) living in Gothenburg, Sweden. MEASUREMENTS A Swedish version of the MMSE was used to measure cognitive status. Geriatric psychiatrists diagnosed dementia according to the Diagnostic and Statistical Manual of Mental Disorders, Third Edition, Revised. Mixed models were fitted to the data to model the longitudinal relationship between MMSE score and explanatory variables. RESULTS Individuals with dementia between age 97 and 100 had lower mean MMSE scores than those without dementia. Those who died during the 3-year follow-up had lower MMSE scores than those who survived. MMSE scores at baseline did not differ between those without dementia and those who developed dementia during the 3-year follow-up. Participants with more education had higher MMSE scores, but there was no association between education and linear change. CONCLUSION MMSE score is associated with dementia and subsequent mortality even in very old individuals, although the preclinical phase of dementia may be short in older age. Level of education is positively associated with MMSE score but not rate of decline in individuals approaching age 100.
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Affiliation(s)
- Johan Skoog
- Neuropsychiatric Epidemiology Unit, Section of Psychiatry and Neurochemistry, Institution of Neuroscience and Physiology, Molndal, Sweden.,Department of Psychology, University of Gothenburg, Gothenburg, Sweden
| | - Kristoffer Backman
- Neuropsychiatric Epidemiology Unit, Section of Psychiatry and Neurochemistry, Institution of Neuroscience and Physiology, Molndal, Sweden
| | - Mats Ribbe
- Neuropsychiatric Epidemiology Unit, Section of Psychiatry and Neurochemistry, Institution of Neuroscience and Physiology, Molndal, Sweden
| | - Hanna Falk
- Neuropsychiatric Epidemiology Unit, Section of Psychiatry and Neurochemistry, Institution of Neuroscience and Physiology, Molndal, Sweden
| | - Pia Gudmundsson
- Neuropsychiatric Epidemiology Unit, Section of Psychiatry and Neurochemistry, Institution of Neuroscience and Physiology, Molndal, Sweden
| | | | - Anne Borjesson-Hanson
- Neuropsychiatric Epidemiology Unit, Section of Psychiatry and Neurochemistry, Institution of Neuroscience and Physiology, Molndal, Sweden
| | - Svante Ostling
- Neuropsychiatric Epidemiology Unit, Section of Psychiatry and Neurochemistry, Institution of Neuroscience and Physiology, Molndal, Sweden
| | - Boo Johansson
- Department of Psychology, University of Gothenburg, Gothenburg, Sweden
| | - Ingmar Skoog
- Neuropsychiatric Epidemiology Unit, Section of Psychiatry and Neurochemistry, Institution of Neuroscience and Physiology, Molndal, Sweden
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Abstract
In a Perspective, Aimee Pierce and Claudia Kawas discuss risk factors and pathologies of dementia in the oldest-old.
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42
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Muenchhoff J, Song F, Poljak A, Crawford JD, Mather KA, Kochan NA, Yang Z, Trollor JN, Reppermund S, Maston K, Theobald A, Kirchner-Adelhardt S, Kwok JB, Richmond RL, McEvoy M, Attia J, Schofield PW, Brodaty H, Sachdev PS. Plasma apolipoproteins and physical and cognitive health in very old individuals. Neurobiol Aging 2017; 55:49-60. [PMID: 28419892 DOI: 10.1016/j.neurobiolaging.2017.02.017] [Citation(s) in RCA: 36] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2016] [Revised: 02/13/2017] [Accepted: 02/22/2017] [Indexed: 11/28/2022]
Abstract
Apolipoproteins play a crucial role in lipid metabolism with implications in cardiovascular disease, obesity, diabetes, Alzheimer's disease, and longevity. We quantified 7 apolipoproteins in plasma in 1067 individuals aged 56-105 using immunoassays and explored relationships with APOE polymorphism ε2/3/4, vascular health, frailty, and cognition. ApoA1, ApoA2, ApoB, ApoC3, ApoE, ApoH, and ApoJ decreased from mid-life, although ApoE and ApoJ had U-shaped trends. Centenarians had the highest ApoE levels and the lowest frequency of APOE ε4 allele relative to younger groups. Apolipoprotein levels trended lower in APOE ε4 homozygotes and heterozygotes compared with noncarriers, with ApoE and ApoJ being significantly lower. Levels of all apolipoproteins except ApoH were higher in females. Sex- and age-related differences were apparent in the association of apolipoproteins with cognitive performance, as only women had significant negative associations of ApoB, ApoE, ApoH, and ApoJ in mid-life, whereas associations at older age were nonsignificant or positive. Our findings suggest levels of some apolipoproteins, especially ApoE, are associated with lifespan and cognitive function in exceptionally long-lived individuals.
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Affiliation(s)
- Julia Muenchhoff
- Centre for Healthy Brain Ageing, School of Psychiatry, University of New South Wales, Sydney, Australia
| | - Fei Song
- Centre for Healthy Brain Ageing, School of Psychiatry, University of New South Wales, Sydney, Australia
| | - Anne Poljak
- Centre for Healthy Brain Ageing, School of Psychiatry, University of New South Wales, Sydney, Australia; Bioanalytical Mass Spectrometry Facility, University of New South Wales, Sydney, Australia; School of Medical Sciences, University of New South Wales, Sydney, Australia
| | - John D Crawford
- Centre for Healthy Brain Ageing, School of Psychiatry, University of New South Wales, Sydney, Australia
| | - Karen A Mather
- Centre for Healthy Brain Ageing, School of Psychiatry, University of New South Wales, Sydney, Australia
| | - Nicole A Kochan
- Centre for Healthy Brain Ageing, School of Psychiatry, University of New South Wales, Sydney, Australia; Neuropsychiatric Institute, Prince of Wales Hospital, Sydney, Australia
| | - Zixuan Yang
- Centre for Healthy Brain Ageing, School of Psychiatry, University of New South Wales, Sydney, Australia
| | - Julian N Trollor
- Centre for Healthy Brain Ageing, School of Psychiatry, University of New South Wales, Sydney, Australia; Department of Developmental Disability Neuropsychiatry (3DN), School of Psychiatry, University of New South Wales, Sydney, Australia
| | - Simone Reppermund
- Centre for Healthy Brain Ageing, School of Psychiatry, University of New South Wales, Sydney, Australia; Department of Developmental Disability Neuropsychiatry (3DN), School of Psychiatry, University of New South Wales, Sydney, Australia
| | - Kate Maston
- Centre for Healthy Brain Ageing, School of Psychiatry, University of New South Wales, Sydney, Australia
| | - Adam Theobald
- Centre for Healthy Brain Ageing, School of Psychiatry, University of New South Wales, Sydney, Australia
| | | | - John B Kwok
- School of Medical Sciences, University of New South Wales, Sydney, Australia; Neuroscience Research Australia, Randwick, Australia
| | - Robyn L Richmond
- School of Public Health and Community Medicine, University of New South Wales, Sydney, Australia
| | - Mark McEvoy
- School of Medicine and Public Health, University of Newcastle, Newcastle, Australia
| | - John Attia
- School of Medicine and Public Health, University of Newcastle, Newcastle, Australia; Hunter Medical Research Institute, Newcastle, Australia
| | - Peter W Schofield
- School of Medicine and Public Health, University of Newcastle, Newcastle, Australia; School of Psychology, University of Newcastle, Newcastle, Australia
| | - Henry Brodaty
- Centre for Healthy Brain Ageing, School of Psychiatry, University of New South Wales, Sydney, Australia; Dementia Collaborative Research Centre, School of Psychiatry, University of New South Wales, Sydney, Australia
| | - Perminder S Sachdev
- Centre for Healthy Brain Ageing, School of Psychiatry, University of New South Wales, Sydney, Australia; Neuropsychiatric Institute, Prince of Wales Hospital, Sydney, Australia.
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Wahl D, Cogger VC, Solon-Biet SM, Waern RVR, Gokarn R, Pulpitel T, Cabo RD, Mattson MP, Raubenheimer D, Simpson SJ, Le Couteur DG. Nutritional strategies to optimise cognitive function in the aging brain. Ageing Res Rev 2016; 31:80-92. [PMID: 27355990 PMCID: PMC5035589 DOI: 10.1016/j.arr.2016.06.006] [Citation(s) in RCA: 65] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2016] [Revised: 06/17/2016] [Accepted: 06/23/2016] [Indexed: 12/15/2022]
Abstract
Old age is the greatest risk factor for most neurodegenerative diseases. During recent decades there have been major advances in understanding the biology of aging, and the development of nutritional interventions that delay aging including calorie restriction (CR) and intermittent fasting (IF), and chemicals that influence pathways linking nutrition and aging processes. CR influences brain aging in many animal models and recent findings suggest that dietary interventions can influence brain health and dementia in older humans. The role of individual macronutrients in brain aging also has been studied, with conflicting results about the effects of dietary protein and carbohydrates. A new approach known as the Geometric Framework (GF) has been used to unravel the complex interactions between macronutrients (protein, fat, and carbohydrate) and total energy on outcomes such as aging. These studies have shown that low-protein, high-carbohydrate (LPHC) diets are optimal for lifespan in ad libitum fed animals, while total calories have minimal effect once macronutrients are taken into account. One of the primary purposes of this review is to explore the notion that macronutrients may have a more translational potential than CR and IF in humans, and therefore there is a pressing need to use GF to study the impact of diet on brain aging. Furthermore, given the growing recognition of the role of aging biology in dementia, such studies might provide a new approach for dietary interventions for optimizing brain health and preventing dementia in older people.
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Affiliation(s)
- Devin Wahl
- Charles Perkins Centre, University of Sydney, Sydney 2006 Australia; Aging and Alzheimers Institute, ANZAC Research Institute, Concord Clinical School/Sydney Medical School, Concord, 2139 Australia
| | - Victoria C Cogger
- Charles Perkins Centre, University of Sydney, Sydney 2006 Australia; Aging and Alzheimers Institute, ANZAC Research Institute, Concord Clinical School/Sydney Medical School, Concord, 2139 Australia
| | - Samantha M Solon-Biet
- Charles Perkins Centre, University of Sydney, Sydney 2006 Australia; Aging and Alzheimers Institute, ANZAC Research Institute, Concord Clinical School/Sydney Medical School, Concord, 2139 Australia
| | - Rosilene V R Waern
- Charles Perkins Centre, University of Sydney, Sydney 2006 Australia; School of Life and Environmental Sciences, University of Sydney, Sydney 2006, Australia
| | - Rahul Gokarn
- Charles Perkins Centre, University of Sydney, Sydney 2006 Australia; Aging and Alzheimers Institute, ANZAC Research Institute, Concord Clinical School/Sydney Medical School, Concord, 2139 Australia
| | - Tamara Pulpitel
- Charles Perkins Centre, University of Sydney, Sydney 2006 Australia
| | - Rafael de Cabo
- Translational Gerontology Branch, National Institute on Aging, National Institutes of Health, Baltimore, MD 21224, USA
| | - Mark P Mattson
- Laboratory of Neurosciences, National Institute on Aging, National Institutes of Health, Baltimore, MD 21224, USA
| | - David Raubenheimer
- Charles Perkins Centre, University of Sydney, Sydney 2006 Australia; Faculty of Veterinary Science, University of Sydney, Sydney 2006, Australia; School of Life and Environmental Sciences, University of Sydney, Sydney 2006, Australia
| | - Stephen J Simpson
- Charles Perkins Centre, University of Sydney, Sydney 2006 Australia; School of Life and Environmental Sciences, University of Sydney, Sydney 2006, Australia
| | - David G Le Couteur
- Charles Perkins Centre, University of Sydney, Sydney 2006 Australia; Aging and Alzheimers Institute, ANZAC Research Institute, Concord Clinical School/Sydney Medical School, Concord, 2139 Australia.
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Takao M, Hirose N, Arai Y, Mihara B, Mimura M. Neuropathology of supercentenarians - four autopsy case studies. Acta Neuropathol Commun 2016; 4:97. [PMID: 27590044 PMCID: PMC5010697 DOI: 10.1186/s40478-016-0368-6] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2016] [Accepted: 08/17/2016] [Indexed: 12/12/2022] Open
Abstract
Supercentenarians (aged 110 years old or more) are extremely rare in the world population (the number of living supercentenarians is estimated as 47 in the world), and details about their neuropathological information are limited. Based on previous studies, centenarians (aged 100–109 years old) exhibit several types of neuropathological changes, such as Alzheimer’s disease and Lewy body disease pathology, primary age-related tauopathy, TDP-43 pathology, and hippocampal sclerosis. In the present study, we provide results from neuropathological analyses of four supercentenarian autopsy cases using conventional and immunohistochemical analysis for neurodegenerative disorders. In particular, we focused on the pathology of Alzheimer’s disease and Lewy body disease, as well as the status of hippocampal sclerosis, TDP-43 pathology, aging-related tau astrogliopathy, and cerebrovascular diseases. Three cases were characterized as an “intermediate” level of Alzheimer’s disease changes (NIA-AA guideline) and one was characterized as primary age-related tauopathy. TDP-43 deposits were present in the hippocampus in two cases. Neither Lewy body pathology nor hippocampal sclerosis was observed. Aging-related tau astrogliopathy was consistently observed, particularly in the basal forebrain. Small vessel diseases were also present, but they were relatively mild for cerebral amyloid-beta angiopathy and arteriolosclerosis. Although our study involved a small number of cases, the results provide a better understanding about human longevity. Neuropathological alterations associated with aging were mild to moderate in the supercentenarian brain, suggesting that these individuals might have some neuroprotective factors against aging. Future prospective studies and extensive molecular analyses are needed to determine the mechanisms of human longevity.
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Abstract
Two new sets of criteria for Alzheimer’s disease (AD) are now in play, including one set released in 2014, and a proposal for a “new lexicon” for how to describe the disease spectrum. A 2012 Canadian consensus conference said that to then, none of the new criteria or terminology would change primary care practice; that is still likely to be so. For dementia consultants, however, the new criteria pose challenges and offer opportunities. In general, the new criteria see an expanded role for bio-markers. Even so, the evidence base for this remains incomplete. Our understanding of the neuropathological criteria for dementia changed as the evidence base included more community cases. This is likely to inform the experience with biomarkers. At present, each of the criteria specifies an exclusive research role. Still, wider uptake is likely, especially in the United States. Geriatricians should be aware of the fundamental change in the terminology now being employed: AD diagnosis no longer obliges a diagnosis of dementia. Until more data emerge—something to which geriatricians can contribute—there is reason to be cautious in the adoption of the new criteria, as they are likely to be least applicable to older adults.
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Affiliation(s)
- Pierre Molin
- Department of Medicine, Divisions of Geriatric Medicine and of Neurology, Dalhousie University, Halifax, NS;; Département de médecine, Division de gériatrie, Université Laval, Québec, QC, Canada
| | - Kenneth Rockwood
- Department of Medicine, Divisions of Geriatric Medicine and of Neurology, Dalhousie University, Halifax, NS
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46
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Abstract
Deux nouvelles séries de critères pour le diagnostic de la maladie d’Alzheimer sont maintenant en vigueur, incluant une série publiée en 2014. Un « nouveau lexique » conceptualisant la maladie a également été proposé. En 2012, la Conférence consensuelle canadienne affirmait que, pour l’instant, ni les nouveaux critères ni la nouvelle terminologie ne modifiaient la pratique en première ligne. Néanmoins, pour les consultants spécialisés en démence, l’avènement de ces critères ouvre la porte à de nombreux défis et occasions. En général, les nouveaux critères accordent une place grandissante aux biomarqueurs. Toutefois, les évidences qui sous-tendent leur utilisation demeurent incomplètes. L’étude de sujets provenant de la communauté ayant raffiné notre compréhension des critères neuropathologiques des démences, il est probable que notre expérience avec les biomarqueurs en bénéficierait également. Pour l’instant, ces critères sont réservés à la recherche. Cependant, leur adoption à plus large échelle est pressentie, particulièrement aux États-Unis. Les gériatres canadiens doivent être conscients de la terminologie maintenant utilisée et du changement fondamental qui en découle : un diagnostic de maladie d’Alzheimer ne requiert plus un diagnostic de démence. Dans l’attente de nouvelles données – auxquelles les gériatres peuvent contribuer – il y a lieu de faire preuve de prudence dans l’adoption des nouveaux critères, car ils sont susceptibles de moins bien s’appliquer aux personnes âgées.
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Affiliation(s)
- Pierre Molin
- Department of Medicine, Divisions of Geriatric Medicine and of Neurology, Dalhousie University, Halifax, NS;; Département de médecine, Division de gériatrie, Université Laval, Québec, QC
| | - Kenneth Rockwood
- Department of Medicine, Divisions of Geriatric Medicine and of Neurology, Dalhousie University, Halifax, NS
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Brodaty H, Woolf C, Andersen S, Barzilai N, Brayne C, Cheung KSL, Corrada MM, Crawford JD, Daly C, Gondo Y, Hagberg B, Hirose N, Holstege H, Kawas C, Kaye J, Kochan NA, Lau BHP, Lucca U, Marcon G, Martin P, Poon LW, Richmond R, Robine JM, Skoog I, Slavin MJ, Szewieczek J, Tettamanti M, Viña J, Perls T, Sachdev PS. ICC-dementia (International Centenarian Consortium - dementia): an international consortium to determine the prevalence and incidence of dementia in centenarians across diverse ethnoracial and sociocultural groups. BMC Neurol 2016; 16:52. [PMID: 27098177 PMCID: PMC4839126 DOI: 10.1186/s12883-016-0569-4] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2015] [Accepted: 04/07/2016] [Indexed: 12/29/2022] Open
Abstract
Background Considerable variability exists in international prevalence and incidence estimates of dementia. The accuracy of estimates of dementia in the oldest-old and the controversial question of whether dementia incidence and prevalence decline at very old age will be crucial for better understanding the dynamics between survival to extreme old age and the occurrence and risk for various types of dementia and comorbidities. International Centenarian Consortium – Dementia (ICC-Dementia) seeks to harmonise centenarian and near-centenarian studies internationally to describe the cognitive and functional profiles of exceptionally old individuals, and ascertain the trajectories of decline and thereby the age-standardised prevalence and incidence of dementia in this population. The primary goal of the ICC-Dementia is to establish a large and thorough heterogeneous sample that has the power to answer epidemiological questions that small, separate studies cannot. A secondary aim is to examine cohort-specific effects and differential survivorship into very old age. We hope to lay the foundation for further investigation into risk and protective factors for dementia and healthy exceptional brain ageing in centenarians across diverse ethnoracial and sociocultural groups. Methods Studies focusing on individuals aged ≥95 years (approximately the oldest 1 percentile for men, oldest 5th percentile for women), with a minimum sample of 80 individuals, including assessment of cognition and functional status, are invited to participate. There are currently seventeen member or potential member studies from Asia, Europe, the Americas, and Oceania. Initial attempts at harmonising key variables are in progress. Discussion General challenges facing large, international consortia like ICC-Dementia include timely and effective communication among member studies, ethical and practical issues relating to human subject studies and data sharing, and the challenges related to data harmonisation. A specific challenge for ICC-Dementia relates to the concept and definition of’abnormal’ in this exceptional group of individuals who are rarely free of physical, sensory and/or cognitive impairments.
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Affiliation(s)
- Henry Brodaty
- Dementia Collaborative Research Centre - Assessment and Better Care, School of Psychiatry, UNSW Medicine, The University of New South Wales, Sydney, Australia.,Centre for Healthy Brain Ageing (CHeBA), School of Psychiatry, UNSW Medicine, The University of New South Wales, Sydney, Australia
| | - Claudia Woolf
- Dementia Collaborative Research Centre - Assessment and Better Care, School of Psychiatry, UNSW Medicine, The University of New South Wales, Sydney, Australia.,Centre for Healthy Brain Ageing (CHeBA), School of Psychiatry, UNSW Medicine, The University of New South Wales, Sydney, Australia.,Psychogeriatric Mental Health and Dementia Service, St Vincent's Hospital Sydney, Darlinghurst, Australia
| | - Stacy Andersen
- New England Centenarian Study, Geriatrics Section, Department of Medicine, Boston Medical Center, Boston University School of Medicine, Boston, Massachusetts, USA
| | - Nir Barzilai
- Department of Medicine, Albert Einstein College of Medicine, Bronx, USA.,Department of Genetics, Albert Einstein College of Medicine, Bronx, USA
| | - Carol Brayne
- Department of Public Health and Primary Care, Institute of Public Health, Cambridge University, Cambridge, UK
| | - Karen Siu-Lan Cheung
- Sau Po Centre on Ageing, The University of Hong Kong, Hong Kong, SAR, China.,Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong, SAR, China
| | - Maria M Corrada
- Department of Neurology, University of California Irvine, Irvine, USA.,Department of Epidemiology, University of California Irvine, Irvine, USA
| | - John D Crawford
- Centre for Healthy Brain Ageing (CHeBA), School of Psychiatry, UNSW Medicine, The University of New South Wales, Sydney, Australia
| | - Catriona Daly
- Dementia Collaborative Research Centre - Assessment and Better Care, School of Psychiatry, UNSW Medicine, The University of New South Wales, Sydney, Australia.,Centre for Healthy Brain Ageing (CHeBA), School of Psychiatry, UNSW Medicine, The University of New South Wales, Sydney, Australia
| | - Yasuyuki Gondo
- Graduate School of Human Sciences, Clinical Thanatology and Geriatric Behavioral Science, Osaka University, Suita, Japan
| | - Bo Hagberg
- Gerontology Research Centre, Lund, Sweden
| | - Nobuyoshi Hirose
- Centre for Supercentenarian Research, Keio University School of Medicine, Tokyo, Japan
| | - Henne Holstege
- Department of Clinical Genetics, VU University Medical Centre, Amsterdam, The Netherlands.,Alzheimer Centre, Department of Neurology, VU University Medical Centre, Neuroscience Campus Amsterdam, Amsterdam, The Netherlands
| | - Claudia Kawas
- Department of Neurology, University of California Irvine, Irvine, USA.,Department of Neurobiology and Behavior, University of California Irvine, Irvine, USA
| | - Jeffrey Kaye
- Department of Neurology and Biomedical Engineering, Oregon Health and Science University, Portland, USA
| | - Nicole A Kochan
- Centre for Healthy Brain Ageing (CHeBA), School of Psychiatry, UNSW Medicine, The University of New South Wales, Sydney, Australia.,Neuropsychiatric Institute, Prince of Wales Hospital, Randwick, Australia
| | - Bobo Hi-Po Lau
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong, SAR, China
| | - Ugo Lucca
- Laboratory of Geriatric Neuropsychiatry, Department of Neuroscience, IRCCS - Istituto di Ricerche Farmacologiche Mario Negri, Milan, Italy
| | - Gabriella Marcon
- Department of Medical and Biological Sciences, University of Udine, Udine, Italy.,AAS 1 Triestina, Trieste, Italy
| | - Peter Martin
- Department of Human Development and Family Studies, Iowa State University, Ames, USA
| | - Leonard W Poon
- Institute of Gerontology, University of Georgia, Athens, Georgia, USA
| | - Robyn Richmond
- School of Public Health and Community Medicine, UNSW Medicine, The University of New South Wales, Sydney, Australia
| | - Jean-Marie Robine
- National Institute on Health and Medical Research, INSERM, Paris, France
| | - Ingmar Skoog
- Department of Psychiatry, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Melissa J Slavin
- Dementia Collaborative Research Centre - Assessment and Better Care, School of Psychiatry, UNSW Medicine, The University of New South Wales, Sydney, Australia.,Centre for Healthy Brain Ageing (CHeBA), School of Psychiatry, UNSW Medicine, The University of New South Wales, Sydney, Australia
| | - Jan Szewieczek
- Department of Geriatrics, School of Health Sciences in Katowice, Medical University of Silesia, Katowice, Poland
| | - Mauro Tettamanti
- Laboratory of Geriatric Neuropsychiatry, Department of Neuroscience, IRCCS - Istituto di Ricerche Farmacologiche Mario Negri, Milan, Italy
| | - José Viña
- Department of Physiology, University of Valencia and INCLIVA, Valencia, Spain
| | - Thomas Perls
- New England Centenarian Study, Geriatrics Section, Department of Medicine, Boston Medical Center, Boston University School of Medicine, Boston, Massachusetts, USA
| | - Perminder S Sachdev
- Centre for Healthy Brain Ageing (CHeBA), School of Psychiatry, UNSW Medicine, The University of New South Wales, Sydney, Australia. .,Neuropsychiatric Institute, Prince of Wales Hospital, Randwick, Australia.
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Kawasaki M, Arai Y, Takayama M, Hirata T, Takayama M, Abe Y, Niimura H, Mimura M, Takebayashi T, Hirose N. Carotid atherosclerosis, cytomegalovirus infection, and cognitive decline in the very old: a community-based prospective cohort study. AGE (DORDRECHT, NETHERLANDS) 2016; 38:29. [PMID: 26886582 PMCID: PMC5005896 DOI: 10.1007/s11357-016-9890-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/28/2015] [Accepted: 02/03/2016] [Indexed: 06/05/2023]
Abstract
To investigate various risk factors of cognitive decline in the very old, we studied 494 subjects over 85 years old without diagnosis of dementia at baseline from the Tokyo Oldest Old Survey on Total Health, an ongoing, community-based cohort in Japan. Cognitive function was assessed at baseline and at 3-year follow-up using Mini-Mental State Examination (MMSE). Plasma samples were assayed for levels of cytomegalovirus (CMV) immunoglobulin G (IgG) antibodies, tumor necrosis factor-alpha, interleukin-6, and blood chemistry. Carotid artery plaques were measured using an ultrasonography. In the cross-sectional analyses using Tobit regression, individuals with high carotid artery plaque score (≥5.0) had MMSE scores that were 1.08 points lower compared to those with no plaque (95 % confidence interval (CI) -1.95 to -0.20; p = 0.016), adjusted for age, sex, and education. Individuals with CMV IgG titers in the highest quartile had MMSE scores that were 1.47 points lower compared to individuals in the lowest quartile (95 % CI -2.44 to -0.50; p = 0.003). CMV and carotid atherosclerosis showed evidence of an interaction, where the association between CMV and MMSE was present only in subjects with carotid artery plaque. In the longitudinal analyses using linear regression, carotid atherosclerosis, smoking, low grip strength, and poor activities of daily living (ADL) status were associated with faster cognitive decline, adjusted for age, sex, education, and baseline cognitive function. Our findings suggest that carotid atherosclerosis is consistently associated with low cognitive function in the very old and modifies the association between latent CMV infection and cognition.
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Affiliation(s)
- Midori Kawasaki
- Center for Supercentenarian Medical Research, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Yasumichi Arai
- Center for Supercentenarian Medical Research, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan.
| | - Michiyo Takayama
- Center for Preventive Medicine, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Takumi Hirata
- Center for Supercentenarian Medical Research, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Midori Takayama
- Faculty of Science and Technology, Keio University, 4-1-1 Hiyoshi, Kohoku-ku, Yokohama, Kanagawa, 252-8520, Japan
| | - Yukiko Abe
- Center for Supercentenarian Medical Research, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Hidehito Niimura
- Department of Neuropsychiatry, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Masaru Mimura
- Department of Neuropsychiatry, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Toru Takebayashi
- Department of Preventative Medicine and Public Health, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Nobuyoshi Hirose
- Center for Supercentenarian Medical Research, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
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49
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Yang Z, Wen W, Jiang J, Crawford JD, Reppermund S, Levitan C, Slavin MJ, Kochan NA, Richmond RL, Brodaty H, Trollor JN, Sachdev PS. Age-associated differences on structural brain MRI in nondemented individuals from 71 to 103 years. Neurobiol Aging 2016; 40:86-97. [PMID: 26973107 DOI: 10.1016/j.neurobiolaging.2016.01.006] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2015] [Revised: 12/15/2015] [Accepted: 01/13/2016] [Indexed: 12/11/2022]
Abstract
Successful brain aging in the oldest old (≥90 years) is underexplored. This study examined cross-sectional brain morphological differences from 8th to 11th decades of life in nondemented individuals by high-resolution magnetic resonance imaging. Two hundred seventy-seven nondemented community-dwelling participants (71-103 years) from Sydney Memory and Ageing Study and Sydney Centenarian Study comprised the sample, including a subsample of 160 cognitively high-functioning elders. Relationships between age and magnetic resonance imaging-derived measurements were studied using general linear models; and structural profiles of the ≥90 years were delineated. In full sample and the subsample, significant linear negative relationship of gray matter with age was found, with the greatest age effects in the medial temporal lobe and parietal and occipital cortices. This pattern was further confirmed by comparing directly the ≥90 years to the 71-89 years groups. Significant quadratic age effects on total white matter and white matter hyperintensities were observed. Our study demonstrated heterogeneous differences across brain regions between the oldest old and young old, with an emphasis on hippocampus, temporoposterior cortex, and white matter hyperintensities.
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Affiliation(s)
- Zixuan Yang
- Centre for Healthy Brain Ageing (CHeBA), School of Psychiatry, University of New South Wales (UNSW) Australia, Sydney, New South Wales, Australia
| | - Wei Wen
- Centre for Healthy Brain Ageing (CHeBA), School of Psychiatry, University of New South Wales (UNSW) Australia, Sydney, New South Wales, Australia; Neuropsychiatric Institute, Prince of Wales Hospital, Randwick, New South Wales, Australia
| | - Jiyang Jiang
- Centre for Healthy Brain Ageing (CHeBA), School of Psychiatry, University of New South Wales (UNSW) Australia, Sydney, New South Wales, Australia
| | - John D Crawford
- Centre for Healthy Brain Ageing (CHeBA), School of Psychiatry, University of New South Wales (UNSW) Australia, Sydney, New South Wales, Australia
| | - Simone Reppermund
- Centre for Healthy Brain Ageing (CHeBA), School of Psychiatry, University of New South Wales (UNSW) Australia, Sydney, New South Wales, Australia; Department of Developmental Disability Neuropsychiatry, School of Psychiatry, UNSW Australia, Sydney, New South Wales, Australia
| | - Charlene Levitan
- Centre for Healthy Brain Ageing (CHeBA), School of Psychiatry, University of New South Wales (UNSW) Australia, Sydney, New South Wales, Australia; Prince of Wales Clinical School, UNSW Australia, Sydney, New South Wales, Australia
| | - Melissa J Slavin
- Centre for Healthy Brain Ageing (CHeBA), School of Psychiatry, University of New South Wales (UNSW) Australia, Sydney, New South Wales, Australia
| | - Nicole A Kochan
- Centre for Healthy Brain Ageing (CHeBA), School of Psychiatry, University of New South Wales (UNSW) Australia, Sydney, New South Wales, Australia; Neuropsychiatric Institute, Prince of Wales Hospital, Randwick, New South Wales, Australia
| | - Robyn L Richmond
- School of Public Health and Community Medicine, UNSW Australia, Sydney, New South Wales, Australia
| | - Henry Brodaty
- Centre for Healthy Brain Ageing (CHeBA), School of Psychiatry, University of New South Wales (UNSW) Australia, Sydney, New South Wales, Australia; Dementia Collaborative Research Centre-Assessment and Better Care (DCRC-ABC), School of Psychiatry, UNSW Australia, Sydney, New South Wales, Australia; Academic Department for Old Age Psychiatry, Prince of Wales Hospital, Randwick, New South Wales, Australia
| | - Julian N Trollor
- Centre for Healthy Brain Ageing (CHeBA), School of Psychiatry, University of New South Wales (UNSW) Australia, Sydney, New South Wales, Australia; Department of Developmental Disability Neuropsychiatry, School of Psychiatry, UNSW Australia, Sydney, New South Wales, Australia
| | - Perminder S Sachdev
- Centre for Healthy Brain Ageing (CHeBA), School of Psychiatry, University of New South Wales (UNSW) Australia, Sydney, New South Wales, Australia; Neuropsychiatric Institute, Prince of Wales Hospital, Randwick, New South Wales, Australia.
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Burzynska AZ, Wong CN, Chaddock-Heyman L, Olson EA, Gothe NP, Knecht A, Voss MW, McAuley E, Kramer AF. White matter integrity, hippocampal volume, and cognitive performance of a world-famous nonagenarian track-and-field athlete. Neurocase 2016; 22:135-44. [PMID: 26237526 PMCID: PMC6029702 DOI: 10.1080/13554794.2015.1074709] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Physical activity (PA) and cardiorespiratory fitness (CRF) are associated with successful brain and cognitive aging. However, little is known about the effects of PA, CRF, and exercise on the brain in the oldest-old. Here we examined white matter (WM) integrity, measured as fractional anisotropy (FA) and WM hyperintensity (WMH) burden, and hippocampal (HIPP) volume of Olga Kotelko (1919-2014). Olga began training for competitions at age of 77 and as of June 2014 held over 30 world records in her age category in track-and-field. We found that Olga's WMH burden was larger and the HIPP was smaller than in the reference sample (58 healthy low-active women 60-78 years old), and her FA was consistently lower in the regions overlapping with WMH. Olga's FA in many normal-appearing WM regions, however, did not differ or was greater than in the reference sample. In particular, FA in her genu corpus callosum was higher than any FA value observed in the reference sample. We speculate that her relatively high FA may be related to both successful aging and the beneficial effects of exercise in old age. In addition, Olga had lower scores on memory, reasoning and speed tasks than the younger reference sample, but outperformed typical adults of age 90-95 on speed and memory. Together, our findings open the possibility of old-age benefits of increasing PA on WM microstructure and cognition despite age-related increase in WMH burden and HIPP shrinkage, and add to the still scarce neuroimaging data of the healthy oldest-old (>90 years) adults.
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Affiliation(s)
- A Z Burzynska
- a The Beckman Institute for Advanced Science and Technology at the University of Illinois , Urbana , IL 61801 , USA
| | - C N Wong
- a The Beckman Institute for Advanced Science and Technology at the University of Illinois , Urbana , IL 61801 , USA
| | - L Chaddock-Heyman
- a The Beckman Institute for Advanced Science and Technology at the University of Illinois , Urbana , IL 61801 , USA
| | - E A Olson
- b Department of Kinesiology and Community Health , University of Illinois , Urbana , IL 61801 , USA
| | - N P Gothe
- b Department of Kinesiology and Community Health , University of Illinois , Urbana , IL 61801 , USA
| | - A Knecht
- a The Beckman Institute for Advanced Science and Technology at the University of Illinois , Urbana , IL 61801 , USA
| | - M W Voss
- c Department of Psychological and Brain Sciences , University of Iowa , Iowa City , IA 52242-1407 , USA
| | - E McAuley
- a The Beckman Institute for Advanced Science and Technology at the University of Illinois , Urbana , IL 61801 , USA.,b Department of Kinesiology and Community Health , University of Illinois , Urbana , IL 61801 , USA
| | - A F Kramer
- a The Beckman Institute for Advanced Science and Technology at the University of Illinois , Urbana , IL 61801 , USA
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