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Jibril AT, Ganjeh BJ, Mirrafiei A, Firouzi M, Norouziasl R, Ghaemi S, Bafkar N, Jayedi A, Djafarian K, Shab-Bidar S. Dose-response association of obesity and risk of mental health among tehranian residents: result of a cross-sectional study. BMC Public Health 2024; 24:1444. [PMID: 38811944 PMCID: PMC11138087 DOI: 10.1186/s12889-024-18670-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Accepted: 04/19/2024] [Indexed: 05/31/2024] Open
Abstract
BACKGROUND Obesity and mental health issues are two of the most prevalent global public health issues for a significant portion of people. The purpose of this study was to investigate the relationship between obesity indicators and mental health in Tehran-dwelling Iranian adults. METHODS We conducted a cross-sectional study on healthy Iranian adults using a convenience sampling technique. The short form of the Depression Anxiety and Stress Scale (DASS-21) was used to measure the outcome, and independent variables included body mass index (BMI), waist-to-hip ratio (WHR), waist-to-height ratio (WHtR), body adiposity index (BAI), and a body shape index (ABSI). The relationship between obesity and mental health was investigated using a multivariate logistic regression model. The non-linear dose-response relationships were evaluated using restricted cubic splines (RCS) with three knots. The Benjamini-Hochberg procedure was used to adjust for multiple testing. RESULTS In our study of 434 participants, females made up 52% of the participants, with a mean age of 38.57 years. In all, 54.6%, 53.9%, and 56.6% were classified as having anxiety, depression, and stress respectively. Logistic regression analysis showed that the odds of mental health components including anxiety, depression, or stress was not significantly different across the tertiles of the obesity indicators. We observed a significant dose-response relationship between BAI and ABSI and the risk of anxiety (PBenjamini-Hochberg 0.028 > Pdose-response 0.023) and stress (PBenjamini-Hochberg 0.028 > Pdose-response 0.003) but not depression (PBenjamini-Hochberg 0.014 < Pdose-response 0.018). The lowest risk for anxiety was observed in people with a BAI of 28% and ABSI equal to 0.079. The risk of stress seemed to increase beyond an ABSI of 0.086. CONCLUSION Our findings showed no direct linear association between obesity indices and anxiety. However, a dose-response relationship was observed between BAI and ABSI and the risk of anxiety and stress, indicating the need for further investigation.
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Affiliation(s)
- Aliyu Tijani Jibril
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Bahareh Jabbarzadeh Ganjeh
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Amin Mirrafiei
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Mahsa Firouzi
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Reyhane Norouziasl
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Shadi Ghaemi
- Social Determinants of Health Research Center, Semnan University of Medical Sciences, Semnan, Iran
| | - Negar Bafkar
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
| | - Ahmad Jayedi
- Social Determinants of Health Research Center, Semnan University of Medical Sciences, Semnan, Iran
| | - Kurosh Djafarian
- Department of Clinical Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran
- Sports Medicine Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Sakineh Shab-Bidar
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran.
- Sports Medicine Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran.
- Sports Medicine Research Center, Neuroscience Institute, Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, Tehran, Iran.
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Booranasuksakul U, Macdonald IA, Stephan BCM, Siervo M. Body Composition, Sarcopenic Obesity, and Cognitive Function in Older Adults: Findings From the National Health and Nutrition Examination Survey (NHANES) 1999-2002 and 2011-2014. JOURNAL OF THE AMERICAN NUTRITION ASSOCIATION 2024:1-14. [PMID: 38564377 DOI: 10.1080/27697061.2024.2333310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Accepted: 03/17/2024] [Indexed: 04/04/2024]
Abstract
OBJECTIVE Sarcopenic-obesity (SO) is characterized by the concomitant presence of low muscle mass and high adiposity. This study explores the association of body composition and SO phenotypes with cognitive function in older adults. METHODS Cross-sectional data in older adults (≥60 years) from NHANES 1999-2002 and 2011-2014 were used. In the 1999-2002 cohort, phenotypes were derived from body mass index (BMI) and dual-X-ray-absorptiometry, and cognition was assessed the by Digit-Symbol-Substitution-Test (DSST). In the 2011-2014 cohort, phenotypes were derived from BMI, waist-circumference (WC), and hand-grip-strength (HGS). Cognition was assessed using four tests: DSST, Animal Fluency, the Consortium-to-Establish-a-Registry-for-Alzheimer's-Disease-Delayed-Recall, and Word Learning. Mediation analysis was conducted to evaluate the contribution of inflammation (C-reactive-protein, CRP) and insulin resistance (Homeostatic-Model-Assessment-for-Insulin-Resistance, HOMA-IR) to the association between body composition and cognitive outcomes. RESULTS The SO phenotype had the lowest DSST mean scores (p < 0.05) and was associated with a significant risk of cognitive impairment [Odds Ratio (OR) = 1.9; 95%CI 1.0-3.7, p = 0.027] in the 1999-2002 cohort. A higher ratio of fat mass and fat free mass (FM/FFM) also showed a greater risk of cognitive impairment (OR = 2.0; 95%CI 1.3-3.1, p = 0.004). In the 2011-2014 cohort, the high WC-Low HGS group showed significantly lower scores on all four cognitive tests (p < 0.05) and a higher risk of cognitive impairment. CRP and HOMA-IR were significant partial mediators of the association between FM/FFM and DSST in the 1999-2002 cohort. CONCLUSIONS The SO phenotype was associated with a higher risk of cognitive impairment in older adults. Insulin resistance and inflammation may represent key mechanisms linking SO to the development of cognitive impairment.
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Affiliation(s)
- Uraiporn Booranasuksakul
- School of Life Sciences, The University of Nottingham Medical School, Queen's Medical Centre, Nottingham, UK
| | - Ian A Macdonald
- School of Life Sciences, The University of Nottingham Medical School, Queen's Medical Centre, Nottingham, UK
| | - Blossom C M Stephan
- Institute of Mental Health, The University of Nottingham Medical School, Nottingham, UK
- Faculty of Health Sciences, Curtin enAble Institute, Curtin University, Perth, Australia
| | - Mario Siervo
- School of Life Sciences, The University of Nottingham Medical School, Queen's Medical Centre, Nottingham, UK
- Faculty of Health Sciences, Curtin enAble Institute, Curtin University, Perth, Australia
- School of Population Health, Curtin University, Perth, Australia
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Uchida K, Sugimoto T, Tange C, Nishita Y, Shimokata H, Saji N, Kuroda Y, Matsumoto N, Kishino Y, Ono R, Akisue T, Otsuka R, Sakurai T. Association between abdominal adiposity and cognitive decline in older adults: a 10-year community-based study. J Nutr Health Aging 2024; 28:100175. [PMID: 38308924 DOI: 10.1016/j.jnha.2024.100175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Revised: 01/22/2024] [Accepted: 01/23/2024] [Indexed: 02/05/2024]
Abstract
OBJECTIVES This study aimed to investigate the association between abdominal adiposity and change in cognitive function in community-dwelling older adults. DESIGN, SETTING, AND PARTICIPANTS This longitudinal study included older adults aged ≥60 years without cognitive impairment who participated in the National Institute for Longevity Sciences - Longitudinal Study of Aging. MEASUREMENTS Cognitive function was evaluated biennially using the Mini-Mental State Examination (MMSE) over 10 years. Waist circumference (WC) was measured at the naval level, and subcutaneous fat area (SFA) and visceral fat area (VFA) were assessed using baseline computed tomography scans. WC, SFA, and VFA areas were stratified into sex-adjusted tertiles. A linear mixed model was applied separately for men and women. RESULTS This study included 873 older adults. In men, the groups with the highest levels of WC, SFA, and VFA exhibited a greater decline in MMSE score than the groups with the lowest levels (β [95% confidence interval]: WC, -0.12 [-0.23 to -0.01]; SFA, -0.13 [-0.24 to -0.02]; VFA, -0.11 [-0.22 to -0.01]). In women, the group with the highest level of WC and SFA showed a greater decline in MMSE score than the group with the lowest level (WC, -0.12 [-0.25 to -0.01]; SFA, -0.18 [-0.30 to -0.06]), but VFA was not associated with cognitive decline. CONCLUSION Higher WC, SFA, and VFA in men and higher WC and SFA in women were identified as risk factors for cognitive decline in later life, suggesting that abdominal adiposity involved in cognitive decline may differ according to sex.
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Affiliation(s)
- Kazuaki Uchida
- Department of Prevention and Care Science, Research Institute, National Center for Geriatrics and Gerontology, Obu, Aichi 474-8511, Japan; Department of Rehabilitation Science, Graduate School of Health Sciences, Kobe University, Kobe, Hyogo 654-0142, Japan
| | - Taiki Sugimoto
- Department of Prevention and Care Science, Research Institute, National Center for Geriatrics and Gerontology, Obu, Aichi 474-8511, Japan; Center for Comprehensive Care and Research on Memory Disorders, Hospital, National Center for Geriatrics and Gerontology, Obu, Aichi 474-8511, Japan
| | - Chikako Tange
- Department of Epidemiology of Aging, Research Institute, National Center for Geriatrics and Gerontology, Obu, Aichi 474-8511, Japan
| | - Yukiko Nishita
- Department of Epidemiology of Aging, Research Institute, National Center for Geriatrics and Gerontology, Obu, Aichi 474-8511, Japan
| | - Hiroshi Shimokata
- Department of Epidemiology of Aging, Research Institute, National Center for Geriatrics and Gerontology, Obu, Aichi 474-8511, Japan; Graduate School of Nutritional Sciences, Nagoya University of Arts and Sciences, Nisshin, Aichi 470-0196, Japan
| | - Naoki Saji
- Center for Comprehensive Care and Research on Memory Disorders, Hospital, National Center for Geriatrics and Gerontology, Obu, Aichi 474-8511, Japan
| | - Yujiro Kuroda
- Department of Prevention and Care Science, Research Institute, National Center for Geriatrics and Gerontology, Obu, Aichi 474-8511, Japan
| | - Nanae Matsumoto
- Department of Prevention and Care Science, Research Institute, National Center for Geriatrics and Gerontology, Obu, Aichi 474-8511, Japan
| | - Yoshinobu Kishino
- Department of Prevention and Care Science, Research Institute, National Center for Geriatrics and Gerontology, Obu, Aichi 474-8511, Japan; Department of Cognitive and Behavioral Science, Graduate School of Medicine, Nagoya University, Nagoya, Aichi 466-855, Japan
| | - Rei Ono
- Department of Physical Activity Research, National Institutes of Biomedical Innovation, Health and Nutrition, Settsu, Osaka 566-0002, Japan; Department of Public Health, Graduate School of Health Sciences, Kobe University, Kobe, Hyogo 654-0142, Japan
| | - Toshihiro Akisue
- Department of Rehabilitation Science, Graduate School of Health Sciences, Kobe University, Kobe, Hyogo 654-0142, Japan
| | - Rei Otsuka
- Department of Epidemiology of Aging, Research Institute, National Center for Geriatrics and Gerontology, Obu, Aichi 474-8511, Japan
| | - Takashi Sakurai
- Department of Prevention and Care Science, Research Institute, National Center for Geriatrics and Gerontology, Obu, Aichi 474-8511, Japan; Department of Cognitive and Behavioral Science, Graduate School of Medicine, Nagoya University, Nagoya, Aichi 466-855, Japan; Research Institute, National Center for Geriatrics and Gerontology, Obu, Aichi 474-8511, Japan.
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Zeng Z, Huang K, Cen Y, Jin W, Shen Y, Xiong L, Mao F, Hong G, Luo Y, Luo X. Elevated visceral adiposity index linked to improved cognitive function in middle-aged and elderly Chinese: evidence from the China health and retirement longitudinal study. Front Aging Neurosci 2023; 15:1270239. [PMID: 37927334 PMCID: PMC10623008 DOI: 10.3389/fnagi.2023.1270239] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Accepted: 10/10/2023] [Indexed: 11/07/2023] Open
Abstract
Object Cognitive decline and obesity are major global public health issues, and their association has been widely acknowledged. The link between the visceral adiposity index (VAI) and cognitive function in the Chinese population remains uncertain. This study aims to investigate the effects of VAI levels on cognitive function in the Chinese middle-aged and elderly population. Methods We analyzed longitudinal data from the China Health and Retirement Longitudinal Study (CHARLS) collected in 2011, 2013, 2015, and 2018. VAI levels were divided into three tertiles. Generalized estimating equation (GEE) models were used to explore the relationships between VAI levels and cognitive function, including overall cognitive scores, episodic memory, and mental status. Adjustments were made for potential confounders. Results The study consisted of 2,677 participants. Contrary to expectations, higher VAI levels were associated with higher overall cognitive scores and improved episodic memory scores, while no significant effect was observed on mental status. The GEE models consistently indicated that higher VAI levels were associated with higher overall cognitive scores, primarily due to their association with episodic memory. Stratified analyses revealed that the VAI was associated with better cognitive function primarily in males, individuals under 60 years old, those with lower education levels, rural residents, and married individuals, mainly in relation to episodic memory. No significant interactions were observed between VAI and demographic factors. Conclusion Our findings suggest that higher visceral adiposity is associated with slower cognitive decline in the Chinese middle-aged and elderly population, especially in its association with episodic memory. These results underline the need to further investigate the potential protective role of visceral fat in cognitive function, potentially offering new insights for interventions to enhance cognitive function and prevent dementia in this population.
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Affiliation(s)
- Zhaohao Zeng
- Department of Neurology, Shenzhen People’s Hospital (The Second Clinical Medical College, Jinan University; The First Affiliated Hospital, Southern University of Science and Technology), Shenzhen, Guangdong, China
- The First Clinical Medical College of Jinan University, Guangzhou, Guangdong, China
- Guangdong Provincial Clinical Research Center for Geriatrics, Shenzhen Clinical Research Center for Geriatrics, Shenzhen People's Hospital (The Second Clinical Medical College, Jinan University; The First Affiliated Hospital, Southern University of Science and Technology), Shenzhen, China
| | - Kunyu Huang
- Department of Pharmacy, Shenshan Medical Center, Memorial Hospital of Sun Yat-sen University, Shanwei, Guangdong, China
| | - Yanmei Cen
- The First Clinical Medical College of Jinan University, Guangzhou, Guangdong, China
| | - Wen Jin
- Department of Neurology, Shenzhen People’s Hospital (The Second Clinical Medical College, Jinan University; The First Affiliated Hospital, Southern University of Science and Technology), Shenzhen, Guangdong, China
| | - Yingao Shen
- Department of Neurology, Shenzhen People’s Hospital (The Second Clinical Medical College, Jinan University; The First Affiliated Hospital, Southern University of Science and Technology), Shenzhen, Guangdong, China
| | - Lijiao Xiong
- The First Clinical Medical College of Jinan University, Guangzhou, Guangdong, China
- Guangdong Provincial Clinical Research Center for Geriatrics, Shenzhen Clinical Research Center for Geriatrics, Shenzhen People's Hospital (The Second Clinical Medical College, Jinan University; The First Affiliated Hospital, Southern University of Science and Technology), Shenzhen, China
- Department of Geriatrics, Shenzhen People’s Hospital (The Second Clinical Medical College, Jinan University; The First Affiliated Hospital, Southern University of Science and Technology), Shenzhen, Guangdong, China
| | - Fengju Mao
- Department of Neurology, Shenzhen People’s Hospital (The Second Clinical Medical College, Jinan University; The First Affiliated Hospital, Southern University of Science and Technology), Shenzhen, Guangdong, China
- Guangdong Provincial Clinical Research Center for Geriatrics, Shenzhen Clinical Research Center for Geriatrics, Shenzhen People's Hospital (The Second Clinical Medical College, Jinan University; The First Affiliated Hospital, Southern University of Science and Technology), Shenzhen, China
| | - Guo Hong
- Department of Neurology, Shenzhen People’s Hospital (The Second Clinical Medical College, Jinan University; The First Affiliated Hospital, Southern University of Science and Technology), Shenzhen, Guangdong, China
- The First Clinical Medical College of Jinan University, Guangzhou, Guangdong, China
- Guangdong Provincial Clinical Research Center for Geriatrics, Shenzhen Clinical Research Center for Geriatrics, Shenzhen People's Hospital (The Second Clinical Medical College, Jinan University; The First Affiliated Hospital, Southern University of Science and Technology), Shenzhen, China
| | - Yu Luo
- Department of Neurology, Shenzhen People’s Hospital (The Second Clinical Medical College, Jinan University; The First Affiliated Hospital, Southern University of Science and Technology), Shenzhen, Guangdong, China
- The First Clinical Medical College of Jinan University, Guangzhou, Guangdong, China
- Guangdong Provincial Clinical Research Center for Geriatrics, Shenzhen Clinical Research Center for Geriatrics, Shenzhen People's Hospital (The Second Clinical Medical College, Jinan University; The First Affiliated Hospital, Southern University of Science and Technology), Shenzhen, China
| | - Xiaoguang Luo
- Department of Neurology, Shenzhen People’s Hospital (The Second Clinical Medical College, Jinan University; The First Affiliated Hospital, Southern University of Science and Technology), Shenzhen, Guangdong, China
- Guangdong Provincial Clinical Research Center for Geriatrics, Shenzhen Clinical Research Center for Geriatrics, Shenzhen People's Hospital (The Second Clinical Medical College, Jinan University; The First Affiliated Hospital, Southern University of Science and Technology), Shenzhen, China
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Liang F, Fu J, Moore JB, Zhang X, Xu Y, Qiu N, Wang Y, Li R. Body Mass Index, Waist Circumference, and Cognitive Decline Among Chinese Older Adults: A Nationwide Retrospective Cohort Study. Front Aging Neurosci 2022; 14:737532. [PMID: 35330705 PMCID: PMC8940526 DOI: 10.3389/fnagi.2022.737532] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Accepted: 01/14/2022] [Indexed: 01/10/2023] Open
Abstract
Background The reported associations between body mass index (BMI), waist circumference (WC), and cognitive decline are not consistent, especially in older adults. Objective This study aims to investigate the longitudinal associations of BMI, WC, and their change values with cognitive decline among Chinese adults aged 60 years and older and to examine the potential moderating effect of sex on these relationships. Methods The participants in this study were from waves one to four (2011–2018) of the China Health and Retirement Longitudinal Study (CHARLS). Cognition function, BMI, and WC were measured at four examinations over 7 years. The interview-based cognitive assessments of memory, orientation and attention, and visuospatial ability were recorded. Standardized global cognitive scores were generated. BMI and WC were objectively measured. Mixed-effects models were performed to evaluate the associations. Results A final sample of 3,035 Chinese older adults [mean (SD) age, 66.94 (5.43) years; 40.16% (n = 1,219) women] were included. Higher BMI (estimate = 0.0107; SE = 0.0024; p < 0.0001) and WC (estimate = 0.0019; SE = 0.0006; p = 0.0037) were associated with slower cognition score decline over a 7-year follow-up, while greater BMI variability (estimate = −0.0365; SE = 0.0116; p = 0.0017) was related to faster cognition score decline. The results were not modified by sex. BMI-defined overweight (estimate = 0.0094; SE = 0.0043; p = 0.0298) was associated with a slower cognition score decline, and both large weight gain (estimate = −0.0266; SE = 0.0074; p = 0.0003) and large WC loss (estimate = −0.0668; SE = 0.0329; p = 0.0426) were associated with faster cognition score decline. Conclusion Among Chinese older adults, higher BMI, higher WC, and overweight are related to slower cognitive decline, while greater BMI variability, large weight gain, and large WC loss are associated with faster cognitive decline.
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Affiliation(s)
- Fang Liang
- School of Public Health, Wuhan University, Wuhan, China
| | - Jialin Fu
- School of Public Health, Wuhan University, Wuhan, China
| | - Justin B. Moore
- Department of Implementation Science, Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, NC, United States
| | - Xinge Zhang
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong, Hong Kong SAR, China
| | - Yijia Xu
- School of Public Health, Wuhan University, Wuhan, China
| | - Nan Qiu
- School of Public Health, Wuhan University, Wuhan, China
| | - Yechuang Wang
- School of Public Health, Wuhan University, Wuhan, China
| | - Rui Li
- School of Public Health, Wuhan University, Wuhan, China
- School of Nursing, Wuhan University, Wuhan, China
- *Correspondence: Rui Li
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Kang SJ, Kim BH, Lee H, Wang J. Association among cognitive function, physical fitness, and health status in older women. J Exerc Rehabil 2022; 18:34-42. [PMID: 35356139 PMCID: PMC8934614 DOI: 10.12965/jer.2142716.358] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Accepted: 01/16/2022] [Indexed: 11/22/2022] Open
Abstract
This study examined the association among cognitive function, physical fitness, and health status in healthy older women. Ninety-four females aged from 62 to 86 years (72.66±5.38 years) from community healthcare centers and an exercise club in Seoul, South Korea. Cognitive function was assessed using the Seoul Neuropsychological Screening Battery. Physical performance comprised cardiorespiratory endurance, lower extremity strength, active balance ability, and walking speed. Health status included blood pressure and waist circumference. Multiple linear regression analyses were performed to determine the relationship among cognitive function, fitness components, and health status, with age and educational attainment as covariates. In the unadjusted model, attention was significantly associated with cardiovascular endurance (B=0.19, P<0.05). Memory was significantly associated with lower limb strength (B=0.77, P<0.05) and active balance ability (B=2.35, P<0.05). In the adjusted model, attention was significantly associated with cardiovascular endurance (B=0.15, P<0.05). Memory was significantly associated with lower limb strength (B=0.87, P<0.05). In both models, cognitive function was not significantly associated with any health status variable. Though limited by a relatively small sample of female participants, who were healthy registrants of a community exercise program with normal cognitive function, the current study demonstrates that cognitive function is significantly associated with physical fitness, but not with health status, in healthy older women.
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Affiliation(s)
- Suh-Jung Kang
- Department of Sports and Health Care, College of Art and Culture, Sangmyung University, Seoul,
Korea
- Corresponding author: Suh-Jung Kang, Department of Sports and Health Care, College of Art and Culture, Sangmyung University, 20 Hongjimun 2-gil, Jongno-gu, Seoul 03016, Korea,
| | - Byung-Hoon Kim
- Sports Science Research Center, Sangmyung University, Seoul,
Korea
| | - Hyo Lee
- Department of Sports and Health Care, College of Art and Culture, Sangmyung University, Seoul,
Korea
| | - Jinsung Wang
- University of Wisconsin-Milwaukee, Milwaukee, WI,
USA
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Bae EM, Park SM. Association between Variations in Body Mass Index and Cognitive Function in Older Korean Adults. J Obes Metab Syndr 2021; 30:271-278. [PMID: 34504046 PMCID: PMC8526292 DOI: 10.7570/jomes21044] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Revised: 05/11/2021] [Accepted: 05/22/2021] [Indexed: 11/26/2022] Open
Abstract
Background Although several studies have assessed obesity and cognitive impairment, most of these studies focus on body mass index (BMI) and cognitive impairment. Therefore to better understand the importance of weight maintenance with aging, this study investigated the relationship between variations in weight and cognitive impairment using the Korean version of the Mini-Mental State Examination (K-MMSE) in individuals aged 45 years or older in Korea. Methods Data on 3,477 adults with normal cognitive function (K-MMSE ≥24) at baseline were acquired from the Korean Longitudinal Study of Aging (KLoSA) 2006-2016. The association between weight variability and risk of cognitive impairment was assessed using multiple logistic regression models. We also assessed weight variability and change in cognitive function over the 6-year follow-up using multiple linear regression. Results Overall, higher variations in BMI were associated with cognitive impairment. Patients in the quintile with the highest variation (Q5) in BMI (mean of BMI changes, 2.69) showed the greatest degree of cognitive impairments (adjusted odds ratio, 1.52; 95% confidence interval [CI], 1.08-2.14; P for trend=0.016). Furthermore, a higher frequency in the number of times (3 times) the patient’s body weight changed was associated with a lower cognitive function (adjusted odds ratio, 3.42; 95% CI, 1.67-7.03; P for trend<0.001). Conclusion In this nationally representative study, weight variability was associated with a higher risk of cognitive decline during mid- and late-life stages.
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Affiliation(s)
- Eun Mi Bae
- Department of Family Medicine, National Police Hospital, Seoul, Korea
| | - Sang Min Park
- Department of Family Medicine, Seoul National University Hospital, Seoul, Korea.,Department of Biomedical Sciences, Seoul National University Graduate School, Seoul, Korea
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Seo YK, Won CW, Soh Y. Associations between body composition and cognitive function in an elderly Korean population: A cohort-based cross-sectional study. Medicine (Baltimore) 2021; 100:e25027. [PMID: 33655975 PMCID: PMC7939175 DOI: 10.1097/md.0000000000025027] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Accepted: 02/08/2021] [Indexed: 01/04/2023] Open
Abstract
The prevalence of obesity as well as cognitive impairment increases with age. Previous studies showed that obesity is associated with an increased risk of cognitive impairment and dementia. Body composition changes occur as part of the aging process; therefore, the assessment of obesity in elderly populations should include body composition as well as body weight. This study investigated the relationship between body mass index (BMI), body composition, and cognitive function in a community-dwelling elderly Korean population.This cohort-based cross-sectional analysis included 2386 elderly participants aged between 70 and 84 years from the Korean Frailty and Aging Cohort Study for 2016 to 2017. To investigate the relationship between body composition and cognitive function in community-dwelling individuals, BMI and body composition, including total and trunk fat mass and fat-free mass, were measured by dual-energy X-ray absorptiometry. Fat mass index (FMI), trunk fat mass index (TFMI), and fat-free mass index (FFMI) were used to represent the body composition. A short form of the Korean version of the Consortium to Establish a Registry for Alzheimer disease was used to assess cognitive function. To evaluate the relationship between variables, simple and fully adjusted multivariable analyses were performed using generalized linear regression models.The mean ages were 76.8 years for males and 76.1 years for females. The BMI of male participants was significantly lower than that of females (23.9 ± 2.89 vs 24.7 ± 3.02 kg/m2, P < .001). Among body composition parameters, the differences in FMI (6.44 ± 1.97 vs 9.29 ± 2.3 kg/m2), TFMI (3.68 ± 1.33 vs 5.03 ± 1.43 kg/m2), and FFMI (17.4 ± 1.64 vs 15.3 ± 1.39 kg/m2) were statistically significant. In linear regression analyses, BMI, FMI, and TFMI showed significant positive correlations with mini-mental state examination in the Korean version of the CERAD assessment packet; wordlist memory, recall, and recognition; and frontal assessment battery only in males. The significant positive correlations persisted even after fully adjusting for age, education periods, location of residence, depression, marriage, annual income, presence of diabetes mellitus, dyslipidemia, and hypertension. However, no significant correlations in either sex were observed between FFMI and cognitive functions in the fully adjusted models.In this study, BMI, and fat mass-related indexes including FMI and TFMI showed a positive linear correlation with cognitive functions but not FFMI. Moreover, the findings were significant only in men. Besides the difference between sexes, the results of this study showed a more apparent correlation in fat mass than in fat-free mass that comprises body weight.
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Affiliation(s)
- Yun Kyung Seo
- Department of Physical Medicine & Rehabilitation Medicine
| | - Chang Won Won
- Department of Family Medicine, Kyung Hee University Medical Center, Seoul, Republic of Korea
| | - Yunsoo Soh
- Department of Physical Medicine & Rehabilitation Medicine
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Sawada M, Kubota N, Sekine R, Yakabe M, Kojima T, Umeda-Kameyama Y, Usami S, Akishita M, Ogawa S. Sex-related differences in the effects of nutritional status and body composition on functional disability in the elderly. PLoS One 2021; 16:e0246276. [PMID: 33529213 PMCID: PMC7853464 DOI: 10.1371/journal.pone.0246276] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Accepted: 01/17/2021] [Indexed: 12/25/2022] Open
Abstract
Background The aim of our study was to evaluate the influence of changes of nutritional status and body composition on the results of comprehensive geriatric assessment (CGA) in inpatients of a geriatric ward. Sex differences in these relationships were also investigated. Methods A total of 212 elderly patients (>65 years old) admitted to the geriatric ward at the University of Tokyo hospital between 2012 and 2019 were enrolled in this study. CGA (ADL, IADL, MMSE, GDS, Vitality Index) was performed, along with assessment of body compositions (appendicular muscle mass, abdominal muscle mass, body fat mass) and blood malnutrition biomarkers (serum albumin, pre-albumin, 25-hydroxy vitamin D, zinc, hemoglobin concentrations). Results Multiple linear regression analysis showed that upper, lower limbs and abdominal muscle masses were significantly associated with the score on ADL in men. On the other hand, abdominal muscle mass was negatively associated with the scores on GDS. Body fat mass was also negatively associated with the score on IADL. In contrast, in women, multiple linear regression analysis failed to show any significant associations between body composition parameters and scores on any domains of CGA. Unlike in men, however, blood malnutrition biomarkers were significantly associated with ADL, IADL, MMSE, and Vitality Index in women. Conclusions Our study findings revealed that the association of the nutritional status and body composition with the functional status in the elderly differs by sex. These results suggest that intensification of exercise in men and improvement of the nutritional status in women are particularly useful to maintain the functional status.
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Affiliation(s)
- Mika Sawada
- Department of Clinical Nutrition Therapy, The University of Tokyo, Tokyo, Japan
| | - Naoto Kubota
- Department of Clinical Nutrition Therapy, The University of Tokyo, Tokyo, Japan
- Department of Diabetes and Metabolic Diseases, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Rie Sekine
- Department of Clinical Nutrition Therapy, The University of Tokyo, Tokyo, Japan
| | - Mitsutaka Yakabe
- Department of Geriatric Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Taro Kojima
- Department of Geriatric Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Yumi Umeda-Kameyama
- Department of Geriatric Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Satoshi Usami
- Graduate School of Education, The University of Tokyo, Tokyo, Japan
| | - Masahiro Akishita
- Department of Geriatric Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Sumito Ogawa
- Department of Geriatric Medicine, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
- * E-mail:
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10
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Balasubramanian P, Kiss T, Tarantini S, Nyúl-Tóth Á, Ahire C, Yabluchanskiy A, Csipo T, Lipecz A, Tabak A, Institoris A, Csiszar A, Ungvari Z. Obesity-induced cognitive impairment in older adults: a microvascular perspective. Am J Physiol Heart Circ Physiol 2021; 320:H740-H761. [PMID: 33337961 PMCID: PMC8091942 DOI: 10.1152/ajpheart.00736.2020] [Citation(s) in RCA: 53] [Impact Index Per Article: 17.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Over two-thirds of individuals aged 65 and older are obese or overweight in the United States. Epidemiological data show an association between the degree of adiposity and cognitive dysfunction in the elderly. In this review, the pathophysiological roles of microvascular mechanisms, including impaired endothelial function and neurovascular coupling responses, microvascular rarefaction, and blood-brain barrier disruption in the genesis of cognitive impairment in geriatric obesity are considered. The potential contribution of adipose-derived factors and fundamental cellular and molecular mechanisms of senescence to exacerbated obesity-induced cerebromicrovascular impairment and cognitive decline in aging are discussed.
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Affiliation(s)
- Priya Balasubramanian
- 1Vascular Cognitive Impairment and Neurodegeneration Program, Department of Biochemistry and Molecular Biology, Center for Geroscience and Healthy Brain Aging/Reynolds Oklahoma Center on Aging, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma
| | - Tamas Kiss
- 1Vascular Cognitive Impairment and Neurodegeneration Program, Department of Biochemistry and Molecular Biology, Center for Geroscience and Healthy Brain Aging/Reynolds Oklahoma Center on Aging, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma,2International Training Program in Geroscience, Theoretical Medicine Doctoral School, Departments of Medical Physics and Informatics & Cell Biology and Molecular Medicine, University of Szeged, Szeged, Hungary
| | - Stefano Tarantini
- 1Vascular Cognitive Impairment and Neurodegeneration Program, Department of Biochemistry and Molecular Biology, Center for Geroscience and Healthy Brain Aging/Reynolds Oklahoma Center on Aging, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma,3International Training Program in Geroscience, Doctoral School of Basic and Translational Medicine, Department of Public Health, Semmelweis University, Budapest, Hungary,4Department of Health Promotion Sciences, the Hudson College of Public Health, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma
| | - Ádám Nyúl-Tóth
- 1Vascular Cognitive Impairment and Neurodegeneration Program, Department of Biochemistry and Molecular Biology, Center for Geroscience and Healthy Brain Aging/Reynolds Oklahoma Center on Aging, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma,5International Training Program in Geroscience, Institute of Biophysics, Biological Research Centre, Szeged, Hungary
| | - Chetan Ahire
- 1Vascular Cognitive Impairment and Neurodegeneration Program, Department of Biochemistry and Molecular Biology, Center for Geroscience and Healthy Brain Aging/Reynolds Oklahoma Center on Aging, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma
| | - Andriy Yabluchanskiy
- 1Vascular Cognitive Impairment and Neurodegeneration Program, Department of Biochemistry and Molecular Biology, Center for Geroscience and Healthy Brain Aging/Reynolds Oklahoma Center on Aging, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma
| | - Tamas Csipo
- 1Vascular Cognitive Impairment and Neurodegeneration Program, Department of Biochemistry and Molecular Biology, Center for Geroscience and Healthy Brain Aging/Reynolds Oklahoma Center on Aging, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma,3International Training Program in Geroscience, Doctoral School of Basic and Translational Medicine, Department of Public Health, Semmelweis University, Budapest, Hungary,6International Training Program in Geroscience, Division of Clinical Physiology, Department of Cardiology, Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Agnes Lipecz
- 1Vascular Cognitive Impairment and Neurodegeneration Program, Department of Biochemistry and Molecular Biology, Center for Geroscience and Healthy Brain Aging/Reynolds Oklahoma Center on Aging, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma,3International Training Program in Geroscience, Doctoral School of Basic and Translational Medicine, Department of Public Health, Semmelweis University, Budapest, Hungary
| | - Adam Tabak
- 3International Training Program in Geroscience, Doctoral School of Basic and Translational Medicine, Department of Public Health, Semmelweis University, Budapest, Hungary,7Department of Internal Medicine and Oncology, Faculty of Medicine, Semmelweis University, Budapest, Hungary,8Department of Epidemiology and Public Health, University College London, London, United Kingdom
| | - Adam Institoris
- 9Hotchkiss Brain Institute, Department of Physiology and Pharmacology, Cumming School of Medicine, University of Calgary, Calgary, Alberta, Canada
| | - Anna Csiszar
- 1Vascular Cognitive Impairment and Neurodegeneration Program, Department of Biochemistry and Molecular Biology, Center for Geroscience and Healthy Brain Aging/Reynolds Oklahoma Center on Aging, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma,2International Training Program in Geroscience, Theoretical Medicine Doctoral School, Departments of Medical Physics and Informatics & Cell Biology and Molecular Medicine, University of Szeged, Szeged, Hungary
| | - Zoltan Ungvari
- 1Vascular Cognitive Impairment and Neurodegeneration Program, Department of Biochemistry and Molecular Biology, Center for Geroscience and Healthy Brain Aging/Reynolds Oklahoma Center on Aging, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma,2International Training Program in Geroscience, Theoretical Medicine Doctoral School, Departments of Medical Physics and Informatics & Cell Biology and Molecular Medicine, University of Szeged, Szeged, Hungary,3International Training Program in Geroscience, Doctoral School of Basic and Translational Medicine, Department of Public Health, Semmelweis University, Budapest, Hungary,4Department of Health Promotion Sciences, the Hudson College of Public Health, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma
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11
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Han K, Jia W, Wang S, Cao W, Song Y, Wang J, Liu M, Yang S, He Y. Synergistic Impact of Body Mass Index and Cognitive Function on All-Cause Mortality in Older Adults: A Nationwide Longitudinal Study. Front Endocrinol (Lausanne) 2021; 12:620261. [PMID: 34267724 PMCID: PMC8276260 DOI: 10.3389/fendo.2021.620261] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Accepted: 04/07/2021] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Body mass index (BMI) and cognitive function are independent predictors of mortality risk. However, little is known about the combined impact of BMI and cognitive function on the risk of all-cause mortality in older adults. In this study, we aimed to examine the associations between BMI, cognitive function, and all-cause mortality, including between-factor interactions, in the general population of older adults in China. METHODS We used the data between 2011 and 2018 from the Chinese Longitudinal Healthy Longevity Survey that included adults aged ≥65 years residing in the 23 provinces of China. The association between BMI and cognitive function on all-cause mortality was examined with the Cox proportional hazards regression model. RESULTS The study included 8,293 Chinese older adults. Low BMI (underweight) and cognitive impairment were associated with the highest risk of death after adjustments [hazard ratio (HR) = 2.18; 95% confidence interval (CI), 1.96-2.41]; this combined effect was more prominent among adults aged <100 years and women. In addition, there was an interaction effect of BMI and cognitive impairment on all-cause mortality (P <0.001). Concurrently, among older adults with normal cognition, the risk of mortality related to underweight was higher than among their cognitively impaired counterparts [55% (normal cognition) vs. 38% (cognitive impairment)]. CONCLUSIONS Low BMI (underweight) and cognitive impairment were independently and jointly associated with increased risk of all-cause mortality among Chinese older adults, and females showed a stronger effect in this association. The association between BMI and mortality was more pronounced in the participants with normal cognition than in their cognitively impaired counterparts.
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Affiliation(s)
- Ke Han
- Medical School of Chinese PLA, Beijing, China
- Institute of Geriatrics, Beijing Key Laboratory of Aging and Geriatrics, National Clinical Research Center for Geriatrics Diseases, State Key Laboratory of Kidney Disease, The 2nd Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Wangping Jia
- Medical School of Chinese PLA, Beijing, China
- Institute of Geriatrics, Beijing Key Laboratory of Aging and Geriatrics, National Clinical Research Center for Geriatrics Diseases, State Key Laboratory of Kidney Disease, The 2nd Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Shengshu Wang
- Institute of Geriatrics, Beijing Key Laboratory of Aging and Geriatrics, National Clinical Research Center for Geriatrics Diseases, State Key Laboratory of Kidney Disease, The 2nd Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Wenzhe Cao
- Medical School of Chinese PLA, Beijing, China
- Institute of Geriatrics, Beijing Key Laboratory of Aging and Geriatrics, National Clinical Research Center for Geriatrics Diseases, State Key Laboratory of Kidney Disease, The 2nd Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Yang Song
- Medical School of Chinese PLA, Beijing, China
- Institute of Geriatrics, Beijing Key Laboratory of Aging and Geriatrics, National Clinical Research Center for Geriatrics Diseases, State Key Laboratory of Kidney Disease, The 2nd Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Jianwei Wang
- Medical School of Chinese PLA, Beijing, China
- Institute of Geriatrics, Beijing Key Laboratory of Aging and Geriatrics, National Clinical Research Center for Geriatrics Diseases, State Key Laboratory of Kidney Disease, The 2nd Medical Center of Chinese PLA General Hospital, Beijing, China
| | - Miao Liu
- Department of Statistics and Epidemiology, Medical School of Chinese PLA, Beijing, China
| | - Shanshan Yang
- Department of Disease Prevention and Control, The 1st Medical Center, Chinese PLA General Hospital, Beijing, China
- *Correspondence: Yao He, ; Shanshan Yang,
| | - Yao He
- Institute of Geriatrics, Beijing Key Laboratory of Aging and Geriatrics, National Clinical Research Center for Geriatrics Diseases, State Key Laboratory of Kidney Disease, The 2nd Medical Center of Chinese PLA General Hospital, Beijing, China
- *Correspondence: Yao He, ; Shanshan Yang,
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12
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Tai P, Yang S, Liu W, Wang S, Chen K, Jia W, Han K, Liu M, He Y. Association of anthropometric and nutrition status indicators with cognitive functions in centenarians. Clin Nutr 2020; 40:2252-2258. [PMID: 33087249 DOI: 10.1016/j.clnu.2020.10.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2020] [Revised: 09/23/2020] [Accepted: 10/02/2020] [Indexed: 10/23/2022]
Abstract
BACKGROUND & AIMS How anthropometric and nutrition status indicators relate to cognitive function in the oldest old adults is an issue that needs to be explored. This study aimed to analyze the association of parameters and nutrition status indicators (waist circumference, BMI, calf circumference, and waist-calf circumference ratio [WCR]) with cognitive functions in centenarians. METHODS A cross-sectional observational study was conducted with the full sample of 1002 centenarians from Hainan. The mini-mental state examination (MMSE) was used to identify cognitive impairment. Multiple logistic regression analysis was used to examine the strength of association between each anthropometric index and the risk of cognitive impairment or severe cognitive impairment identified by MMSE. Locally Weighted Scatterplot Smoothing (LOWESS) curve was used to visualize the linear or non-linear relationship of each pair. RESULTS The risk of cognitive impairment identified by MMSE for centenarians was reduced by 12% for every 1 cm thickening of the calf circumference (OR = 0.88, 95% CI: 0.81-0.95) and the increase in each unit of WCR increased cognitive impairment the risk by 1.60 times (OR = 2.60, 95% CI: 1.31-5.13) after adjusting for demographic characteristics (i.e., gender, age, ethnicity, marital status, education level, and type of residence) and lifestyle (i.e., smoking, drinking, and exercise) related variables. CONCLUSIONS Results suggest that calf circumference is negatively associated with the risk of cognitive impairment identified by MMSE in centenarians. Older adults with lower calf circumference should pay attention to their cognitive function.
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Affiliation(s)
- Penggang Tai
- Institute of Geriatrics, State Key Laboratory of Kidney Disease, Beijing Key Laboratory of Aging and Geriatrics, The 2nd Clinical Center, Chinese PLA General Hospital, 28 Fuxing Road, Beijing, 100853, China
| | - Shanshan Yang
- Institute of Geriatrics, State Key Laboratory of Kidney Disease, Beijing Key Laboratory of Aging and Geriatrics, The 2nd Clinical Center, Chinese PLA General Hospital, 28 Fuxing Road, Beijing, 100853, China; Department of Disease Prevention and Control, The 1st Medical Center, Chinese PLA General Hospital, 28 Fuxing Road, Beijing, 100853, China
| | - Weiguo Liu
- Emergency Department, Henan Province Corps Hospital of CAPF, Zhengzhou, Henan, China
| | - Shengshu Wang
- Institute of Geriatrics, State Key Laboratory of Kidney Disease, Beijing Key Laboratory of Aging and Geriatrics, The 2nd Clinical Center, Chinese PLA General Hospital, 28 Fuxing Road, Beijing, 100853, China
| | - Kai Chen
- University of Texas Health Center at Houston, United States
| | - Wangping Jia
- Institute of Geriatrics, State Key Laboratory of Kidney Disease, Beijing Key Laboratory of Aging and Geriatrics, The 2nd Clinical Center, Chinese PLA General Hospital, 28 Fuxing Road, Beijing, 100853, China
| | - Ke Han
- Institute of Geriatrics, State Key Laboratory of Kidney Disease, Beijing Key Laboratory of Aging and Geriatrics, The 2nd Clinical Center, Chinese PLA General Hospital, 28 Fuxing Road, Beijing, 100853, China
| | - Miao Liu
- Institute of Geriatrics, State Key Laboratory of Kidney Disease, Beijing Key Laboratory of Aging and Geriatrics, The 2nd Clinical Center, Chinese PLA General Hospital, 28 Fuxing Road, Beijing, 100853, China.
| | - Yao He
- Institute of Geriatrics, State Key Laboratory of Kidney Disease, Beijing Key Laboratory of Aging and Geriatrics, The 2nd Clinical Center, Chinese PLA General Hospital, 28 Fuxing Road, Beijing, 100853, China.
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13
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Yassine HN, Anderson A, Brinton R, Carmichael O, Espeland MA, Hoscheidt S, Hugenschmidt CE, Keller JN, Peters A, Pi-Sunyer X. Do menopausal status and APOE4 genotype alter the long-term effects of intensive lifestyle intervention on cognitive function in women with type 2 diabetes mellitus? Neurobiol Aging 2020; 92:61-72. [PMID: 32388179 PMCID: PMC7269875 DOI: 10.1016/j.neurobiolaging.2020.03.020] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2019] [Revised: 02/07/2020] [Accepted: 03/29/2020] [Indexed: 01/13/2023]
Abstract
In the Look AHEAD trial, randomization to Intensive Lifestyle Intervention (ILI) or Diabetes Support and Education (DSE) did not result in differences in cognitive outcomes. However, menopause and APOE genotype are factors that affect the response to this intervention. The effect of this intervention on a single cognitive assessment was examined in 3 groups of women: premenopausal or <5 years postmenopausal (N = 594), within 5-10 years (n = 388), and ≥10 years postmenopausal (n = 963), and as a function of continuous years since menopause. The late postmenopausal group in the ILI had worse composite z-scores compared to those in the DSE, whereas the younger premenopausal or early postmenopausal women in the ILI had better composite z-scores than the DSE. A significant interaction between years since menopause and intervention arm, but not baseline age, was observed on executive function domains. ILI appeared only to benefit cognitive function among non-APOE4 carriers during premenopause or early postmenopause. These findings emphasize the importance of assessing menopause and APOE status to understand how weight loss impacts cognition.
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Affiliation(s)
- Hussein N Yassine
- Department of Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.
| | - Andrea Anderson
- Department of Biostatistics and Data Science, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Roberta Brinton
- Departments of Pharmacology and Neurology, College of Medicine, University of Arizona, Tucson, AZ, USA
| | | | - Mark A Espeland
- Department of Biostatistics and Data Science, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Siobhan Hoscheidt
- Department of Internal Medicine, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | | | | | - Anne Peters
- Department of Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
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14
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Associations of truncal body composition with cognitive status in patients with dementia. Neurol Sci 2020; 42:209-214. [DOI: 10.1007/s10072-020-04503-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2020] [Accepted: 05/30/2020] [Indexed: 01/01/2023]
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15
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Waki T, Tanaka-Mizuno S, Takashima N, Takechi H, Hayakawa T, Miura K, Ueshima H, Kita Y, Dodge HH. Waist Circumference and Domain-Specific Cognitive Function Among Non-Demented Japanese Older Adults Stratified by Sex: Results from the Takashima Cognition Study. J Alzheimers Dis 2020; 73:887-896. [DOI: 10.3233/jad-190395] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Takashi Waki
- Department of Medical Statistics, Shiga University of Medical Science, Otsu, Japan
| | - Sachiko Tanaka-Mizuno
- Department of Medical Statistics, Shiga University of Medical Science, Otsu, Japan
- The Center for Data Science Education and Research, Shiga University, Hikone, Japan
| | - Naoyuki Takashima
- Department of Public Health, Shiga University of Medical Science, Otsu, Japan
- Department of Public Health, Kindai University Faculty of Medicine, Osaka-Sayama, Japan
| | - Hajime Takechi
- Department of Geriatrics and Cognitive Disorders, Fujita Health University School of Medicine, Toyoake, Japan
| | - Takehito Hayakawa
- Department of Public Health, Shiga University of Medical Science, Otsu, Japan
- Research Center for Social Studies of Health and Community, Ritsumeikan University, Kyoto, Japan
| | - Katsuyuki Miura
- Department of Public Health, Shiga University of Medical Science, Otsu, Japan
- Center for Epidemiologic Research in Asia, Shiga University of Medical Science, Otsu, Japan
| | - Hirotsugu Ueshima
- Department of Public Health, Shiga University of Medical Science, Otsu, Japan
- Center for Epidemiologic Research in Asia, Shiga University of Medical Science, Otsu, Japan
| | - Yoshikuni Kita
- Department of Public Health, Shiga University of Medical Science, Otsu, Japan
- Faculty of Nursing Science, Tsuruga Nursing University, Tsuruga, Japan
| | - Hiroko H. Dodge
- Department of Public Health, Shiga University of Medical Science, Otsu, Japan
- Department of Neurology, Layton Aging and Alzheimer’s Disease Center, Oregon Health & Science University, Portland, OR, USA
- Department of Neurology, Michigan Alzheimer’s Disease Center, University of Michigan, Ann Arbor, MI, USA
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16
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Chiba I, Lee S, Bae S, Makino K, Shinkai Y, Shimada H. Visceral Fat Accumulation Is Associated with Mild Cognitive Impairment in Community-Dwelling Older Japanese Women. J Nutr Health Aging 2020; 24:352-357. [PMID: 32115619 DOI: 10.1007/s12603-020-1330-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
OBJECTIVES Visceral fat accumulation is detrimental for brain health and is associated with cognitive impairment in older adults. The objectives of the present study were to examine the association between visceral fat accumulation and prevalence of mild cognitive impairment and its subtypes. DESIGN a cross-sectional study. PARTICIPANTS This study enrolled 6,109 community-dwelling older adults, including 3,434 women (mean age: 74.4 years) and 2,675 men (mean age: 74.3 years). Individuals with dementia, Parkinson's disease, stroke, Mini-Mental State Examination scores ≤23, and who could not perform basic activities of daily living independently were excluded. MEASUREMENTS Participants underwent neurocognitive assessments to assess mild cognitive impairment (MCI) and its subtypes. Visceral fat area (VFA) was measured using abdominal bioelectrical impedance analysis. Participants were divided into quartile groups by VFA. RESULTS There were 731 (21.3%) women and 562 (21.0%) men with MCI, and the median VFA values were 63.3 cm2 and 96.3 cm2, respectively. Women participants in the second (adjusted odds ratios [aOR], 0.71; 95% confidence interval [95% CI], 0.54-0.94), third (aOR, 0.66; 95% CI, 0.47-0.92), and fourth quartiles of VFA (aOR, 0.62; 95% CI, 0.41-0.93) had a significantly lower risk of MCI than those in the first quartile. Higher VFA quartiles in women were associated with lower risk of non-amnestic MCI. There were no significant differences in men between quartiles. CONCLUSIONS Visceral fat accumulation was associated with MCI, especially non-amnestic MCI, in community-dwelling older Japanese women. These results suggest that visceral fat accumulation is partially protective against cognitive impairment.
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Affiliation(s)
- I Chiba
- Ippei Chiba, 7-430, Morioka-cho, Obu, City, Aichi 474-8511, Japan; E-mail: ; Tel/FAX: +81-562-44-5651; ORCID: https://orcid.org/0000-0003-1966-3595
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17
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Correlation between Executive Network Integrity and Sarcopenia in Patients with Parkinson's Disease. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16244884. [PMID: 31817127 PMCID: PMC6950743 DOI: 10.3390/ijerph16244884] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/03/2019] [Revised: 12/02/2019] [Accepted: 12/03/2019] [Indexed: 01/18/2023]
Abstract
Background: Sarcopenia is critically associated with morbidity and mortality in the progression of Parkinson's disease (PD). However, analyses of clinical severity and brain changes, such as white matter (WM) alterations in PD patients with sarcopenia are limited. Further understanding of the factors associated with sarcopenia may provide a focused screen and potential for early intervention in PD patients. Methods: 52 PD patients and 19 healthy participants accepted dual-energy X-ray absorptiometry to measure the body composition. Using diffusion tensor imaging, the difference of WM integrity was measured between PD patients with sarcopenia (PDSa) and without sarcopenia (PDNSa). Multivariate analysis was performed to explore the relationships between clinical factors, WM integrity, and sarcopenia in PD patients. Results: 21 PD patients (40.4%) had sarcopenia. PDSa had a higher Unified Parkinson's Disease Rating Scale (UPDRS III) score, lower body mass index (BMI) and lower fat weight compared with the PDNSa. Additionally, PDSa patients exhibited lower fractional anisotropy accompanied by higher radial diffusivity and/or higher mean diffusivity in the fronto-striato-thalamic circuits, including bilateral cingulum, left superior longitudinal fasciculus, left genu of corpus callosum, and right anterior thalamic radiation, which participate in the executive function. In addition, decreased muscle mass was associated with worse WM integrity in these regions. Multiple linear regression analysis revealed that WM integrity in the left cingulum, right anterior thalamic radiation, together with gender (male) significantly predicted muscle mass in PD patients. Conclusions: WM alterations in the executive network, such as the fronto-striato-thalamic circuits, may indicate a risk factor for ongoing sarcopenia in PD patients. The effectiveness of using executive function to serve as a prodromal marker of sarcopenia in PD patients should be evaluated in future studies.
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Neergaard JS, Dragsbæk K, Kehlet SN, Hansen HB, Hansen G, Byrjalsen I, Alexandersen P, Lindgren LM, Bihlet AR, Riis BJ, Andersen JR, Qvist P, Karsdal MA, Christiansen C. Cohort Profile: The Prospective Epidemiological Risk Factor (PERF) study. Int J Epidemiol 2018; 46:1104-1104i. [PMID: 27789666 DOI: 10.1093/ije/dyw251] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/08/2016] [Indexed: 01/09/2023] Open
Affiliation(s)
| | | | | | | | - G Hansen
- Nordic Bioscience A/S, Herlev, Denmark
| | | | | | - L M Lindgren
- Center for Clinical and Basic Research, Ballerup, Denmark
| | | | - B J Riis
- Nordic Bioscience A/S, Herlev, Denmark
| | | | - P Qvist
- Nordic Bioscience A/S, Herlev, Denmark
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19
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Alonso R, Pisa D, Fernández-Fernández AM, Carrasco L. Infection of Fungi and Bacteria in Brain Tissue From Elderly Persons and Patients With Alzheimer's Disease. Front Aging Neurosci 2018; 10:159. [PMID: 29881346 PMCID: PMC5976758 DOI: 10.3389/fnagi.2018.00159] [Citation(s) in RCA: 97] [Impact Index Per Article: 16.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2018] [Accepted: 05/08/2018] [Indexed: 12/17/2022] Open
Abstract
Alzheimer's disease (AD) is the leading cause of dementia in elderly people. The etiology of this disease remains a matter of intensive research in many laboratories. We have advanced the idea that disseminated fungal infection contributes to the etiology of AD. Thus, we have demonstrated that fungal proteins and DNA are present in nervous tissue from AD patients. More recently, we have reported that bacterial infections can accompany these mycoses, suggesting that polymicrobial infections exist in AD brains. In the present study, we have examined fungal and bacterial infection in brain tissue from AD patients and control subjects by immunohistochemistry. In addition, we have documented the fungal and bacterial species in brain regions from AD patients and control subjects by next-generation sequencing (NGS). Our results from the analysis of ten AD patients reveal a variety of fungal and bacterial species, although some were more prominent than others. The fungal genera more prevalent in AD patients were Alternaria, Botrytis, Candida, and Malassezia. We also compared these genera with those found in elderly and younger subjects. One of the most prominent genera in control subjects was Fusarium. Principal component analysis clearly indicated that fungi from frontal cortex samples of AD brains clustered together and differed from those of equivalent control subjects. Regarding bacterial infection, the phylum Proteobacteria was the most prominent in both AD patients and controls, followed by Firmicutes, Actinobacteria, and Bacteroides. At the family level, Burkholderiaceae and Staphylococcaceae exhibited higher percentages in AD brains than in control brains. These findings could be of interest to guide targeted antimicrobial therapy for AD patients. Moreover, the variety of microbial species in each patient may constitute a basis for a better understanding of the evolution and severity of clinical symptoms in each patient.
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Affiliation(s)
| | | | | | - Luis Carrasco
- Centro de Biología Molecular “Severo Ochoa”, Consejo Superior de Investigaciones Científicas y Universidad Autónoma de Madrid, Madrid, Spain
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Kitamura K, Watanabe Y, Nakamura K, Takahashi A, Takachi R, Oshiki R, Kobayashi R, Saito T, Tsugane S, Sasaki A. Weight loss from 20 years of age is associated with cognitive impairment in middle-aged and elderly individuals. PLoS One 2017; 12:e0185960. [PMID: 28982190 PMCID: PMC5628924 DOI: 10.1371/journal.pone.0185960] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2017] [Accepted: 09/24/2017] [Indexed: 12/21/2022] Open
Abstract
Background Few empirical studies have been conducted to identify modifiable factors that may affect cognitive impairment in Japanese individuals. The present study aimed to clarify whether body mass and lifestyle are associated with cognitive impairment in Japanese middle-aged and elderly individuals. Methods Subjects were 1814 community-dwelling individuals aged 44–79 years, all of whom were participants of the Murakami Cohort Study baseline survey conducted in 2011–2013. Cognitive function was assessed using the Mini-Mental State Examination (MMSE) in 2014–2016, and cognitive impairment, the outcome measure, was defined as an MMSE score <24. Predictor variables were body mass index (BMI), long-term weight changes from 20 years of age, and lifestyle factors, such as smoking, drinking, and physical activity levels, which were obtained from a self-administered questionnaire in the baseline survey. Covariates were sex, age, education level, and histories of stroke and diabetes. Multiple logistic regression analysis was used to calculate the adjusted odds ratios (ORs). Results The prevalence of overall cognitive impairment was 6.2%. The adjusted ORs of cognitive impairment in the lowest (<[-4]kg) (OR = 2.70, 95%CI, 1.18–6.20) and second ([-4]-[0]kg) (OR = 2.37, 95%CI, 1.04–5.37) quintiles for long-term weight change were significantly higher than the reference 4th quintile ([+4]-[+7]kg). The adjusted OR in the highest quintile (≥[+8]kg) was 2.24 (95%CI, 0.99–5.04). Current BMI was not associated with cognitive impairment. Conclusions Long-term weight loss is associated with cognitive impairment in Japanese middle-aged and elderly individuals. Because the present study was retrospective in nature, prospective studies should also be conducted for further characterization of this association.
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Affiliation(s)
- Kaori Kitamura
- Division of Preventive Medicine, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Yumi Watanabe
- Division of Preventive Medicine, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
| | - Kazutoshi Nakamura
- Division of Preventive Medicine, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
- * E-mail:
| | - Akemi Takahashi
- Department of Physical Therapy, Niigata University of Rehabilitation, Murakami, Niigata, Japan
| | - Ribeka Takachi
- Division of Preventive Medicine, Niigata University Graduate School of Medical and Dental Sciences, Niigata, Japan
- Department of Food Science and Nutrition, Nara Women’s University Graduate School of Humanities and Sciences, Nara, Japan
| | - Rieko Oshiki
- Department of Physical Therapy, Niigata University of Rehabilitation, Murakami, Niigata, Japan
| | - Ryosaku Kobayashi
- Department of Physical Therapy, Niigata University of Health and Welfare, Niigata, Japan
| | - Toshiko Saito
- Department of Health and Nutrition, Niigata University of Health and Welfare, Niigata, Japan
| | - Shoichiro Tsugane
- Center for Public Health Sciences, National Cancer Center, Tokyo, Japan
| | - Ayako Sasaki
- Murakami Public Health Center, Murakami, Niigata, Japan
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Gibby JT, Njeru DK, Cvetko ST, Heiny EL, Creer AR, Gibby WA. Whole-Body Computed Tomography-Based Body Mass and Body Fat Quantification: A Comparison to Hydrostatic Weighing and Air Displacement Plethysmography. J Comput Assist Tomogr 2017; 41:302-308. [PMID: 27753722 DOI: 10.1097/rct.0000000000000516] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
OBJECTIVE We correlate and evaluate the accuracy of accepted anthropometric methods of percent body fat (%BF) quantification, namely, hydrostatic weighing (HW) and air displacement plethysmography (ADP), to 2 automatic adipose tissue quantification methods using computed tomography (CT). METHODS Twenty volunteer subjects (14 men, 6 women) received head-to-toe CT scans. Hydrostatic weighing and ADP were obtained from 17 and 12 subjects, respectively. The CT data underwent conversion using 2 separate algorithms, namely, the Schneider method and the Beam method, to convert Hounsfield units to their respective tissue densities. The overall mass and %BF of both methods were compared with HW and ADP. RESULTS When comparing ADP to CT data using the Schneider method and Beam method, correlations were r = 0.9806 and 0.9804, respectively. Paired t tests indicated there were no statistically significant biases. Additionally, observed average differences in %BF between ADP and the Schneider method and the Beam method were 0.38% and 0.77%, respectively. The %BF measured from ADP, the Schneider method, and the Beam method all had significantly higher mean differences when compared with HW (3.05%, 2.32%, and 1.94%, respectively). CONCLUSIONS We have shown that total body mass correlates remarkably well with both the Schneider method and Beam method of mass quantification. Furthermore, %BF calculated with the Schneider method and Beam method CT algorithms correlates remarkably well with ADP. The application of these CT algorithms have utility in further research to accurately stratify risk factors with periorgan, visceral, and subcutaneous types of adipose tissue, and has the potential for significant clinical application.
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Affiliation(s)
- Jacob T Gibby
- From the *Department of Physiology and Developmental Biology, Brigham Young University, Provo UT; †Department Health Sciences, George Washington University, Washington, DC; ‡Department of Computer Science, Utah Valley University, Orem, UT; §Novarad, American Fork, UT; ∥Department of Mathematics, Utah Valley University, Orem, UT; ¶Exercise Science/Outdoor Recreation, Utah Valley University, Orem, UT; and #Department of Radiology, University of California San Diego, San Diego, CA
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LeBlanc ES, Rizzo JH, Pedula KL, Yaffe K, Ensrud KE, Cauley J, Cawthon PM, Cummings S, Hillier TA. Weight Trajectory over 20 Years and Likelihood of Mild Cognitive Impairment or Dementia Among Older Women. J Am Geriatr Soc 2017; 65:511-519. [PMID: 27991654 PMCID: PMC5685172 DOI: 10.1111/jgs.14552] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVES The association between weight change and cognition is controversial. We examined the association between 20-year weight change and cognitive function in late life. DESIGN Cohort study. SETTING Study of Osteoporotic Fractures (SOF). PARTICIPANTS One thousand two hundred eighty-nine older, community-dwelling women (mean baseline age 68 (65-81) and 88 (82-102) at cognitive testing). MEASUREMENTS Study of Osteoporotic Fractures participants had body weight measured repeatedly over 20 years (mean 8 weights). Adjudicated cognitive status was classified as normal (n = 775) or mild cognitive impairment (MCI)/dementia (n = 514) at Year 20. Logistic models were used to evaluate whether absolute weight change, rate of weight loss per year, presence of abrupt, unrecovered weight loss, and weight variability were associated with MCI or dementia. RESULTS Women with greater rate of weight loss over 20 years had increased chance of developing MCI or dementia. In age/education/clinic-adjusted "base" models, each 0.5 kg/yr decrease resulted in 30% increased odds of MCI/dementia (OR = 1.30 [95% CI: 1.14, 1.49]). After adjustment for age, education, clinic, depression, and walking speed, there was 17% (OR = 1.17 [95% CI: 1.02, 1.35]) increased odds of MCI/dementia for each 0.5 kg/yr decrease in weight. In base models, variability in weight was significant. Each 1% average deviation from each woman's predicted weight curve was associated with 11% increased odds of MCI/dementia (OR = 1.11 [95% CI: 1.04, 1.18]). The estimate was attenuated after full adjustment (OR = 1.06 [95% CI: 0.99, 1.14]). The presence of an abrupt weight decline was not associated with MCI/dementia. CONCLUSIONS Rate of weight loss over 20 years was associated with development of MCI or dementia in women surviving past 80 years, suggesting that nutritional status, social-environmental factors, and/or adipose tissue function and structure may affect cognitive function with aging.
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Affiliation(s)
- Erin S. LeBlanc
- Center for Health Research, Kaiser Permanente Northwest, Portland, OR, USA
| | - Joanne H. Rizzo
- Center for Health Research, Kaiser Permanente Northwest, Portland, OR, USA
| | - Kathryn L. Pedula
- Center for Health Research, Kaiser Permanente Northwest, Portland, OR, USA
| | - Kristine Yaffe
- Departments of Psychiatry, Neurology, and Epidemiology and Biostatistics, University of California San Francisco School of Medicine and San Francisco VA Medical Center, San Francisco, CA, USA
| | - Kristine E. Ensrud
- Department of Medicine, University of Minnesota; University of Epidemiology & Community Health, University of Minnesota; Center for Chronic Disease Outcomes Research, VA Health Care System, Minneapolis, MN University of Minnesota, USA
| | - Jane Cauley
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA
| | - Peggy M. Cawthon
- Research Institute, California Pacific Medical Center, San Francisco, CA, USA
| | - Steven Cummings
- Research Institute, California Pacific Medical Center, San Francisco, CA, USA
| | - Teresa A. Hillier
- Center for Health Research, Kaiser Permanente Northwest, Portland, OR, USA
- Center for Health Research, Kaiser Permanente Hawaii, Honolulu, HI, USA
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Spauwen PJJ, Murphy RA, Jónsson PV, Sigurdsson S, Garcia ME, Eiriksdottir G, van Boxtel MPJ, Lopez OL, Gudnason V, Harris TB, Launer LJ. Associations of fat and muscle tissue with cognitive status in older adults: the AGES-Reykjavik Study. Age Ageing 2017; 46:250-257. [PMID: 28399220 DOI: 10.1093/ageing/afw219] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2016] [Indexed: 11/14/2022] Open
Abstract
Background/Objective studies on the association of dementia with specific body composition (BC) components are scarce. Our aim was to investigate associations of BC measures with different levels of cognitive function in late-life. Methods we studied 5,169 participants (mean age 76 years, 42.9% men) in the AGES-Reykjavik Study of whom 485 (9.4%) were diagnosed with mild cognitive impairment (MCI) and 307 (5.9%) with dementia. Visceral fat, abdominal and thigh subcutaneous fat, and thigh muscle were assessed by computed tomography. MCI and dementia were based on clinical assessment and a consensus meeting; those without MCI or dementia were categorised as normal. Multinomial regression models assessed the associations stratified by sex and in additional analyses by midlife body mass index (BMI). Results among women, there was a decreased likelihood of dementia per SD increase in abdominal subcutaneous fat (OR 0.72; 95% CI: 0.59-0.88), thigh subcutaneous fat (0.81; 0.67-0.98) and thigh muscle (0.63; 0.52-0.76), but not visceral fat, adjusting for demographics, vascular risk factors, stroke and depression. Inverse associations of fat with dementia were attenuated by weight change from midlife and were strongest in women with midlife BMI <25. In men, one SD increase in thigh muscle was associated with a decreased likelihood of dementia (0.75; 0.61-0.92). BC was not associated with MCI in men or women. Conclusion a higher amount of abdominal and thigh subcutaneous fat were associated with a lower likelihood of dementia in women only, while more thigh muscle was associated with a lower likelihood of dementia in men and women.
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Affiliation(s)
- Peggy J J Spauwen
- Department of Psychiatry and Neuropsychology, Maastricht University Medical Center and School for Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands
| | - Rachel A Murphy
- Laboratory of Epidemiology and Population Sciences, National Institute on Aging, Bethesda, MD, USA
| | - Pálmi V Jónsson
- Department of Geriatrics, Landspitali National University Hospital and Faculty of Medicine, University of Iceland, Reykjavik, Iceland
| | | | - Melissa E Garcia
- Laboratory of Epidemiology and Population Sciences, National Institute on Aging, Bethesda, MD, USA
| | | | - Martin P J van Boxtel
- Department of Psychiatry and Neuropsychology, Maastricht University Medical Center and School for Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands
| | - Oscar L Lopez
- Department of Neurology, School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA
| | | | - Tamara B Harris
- Laboratory of Epidemiology and Population Sciences, National Institute on Aging, Bethesda, MD, USA
| | - Lenore J Launer
- Laboratory of Epidemiology and Population Sciences, National Institute on Aging, Bethesda, MD, USA
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Rodríguez-Fernández JM, Danies E, Martínez-Ortega J, Chen WC. Cognitive Decline, Body Mass Index, and Waist Circumference in Community-Dwelling Elderly Participants. J Geriatr Psychiatry Neurol 2017; 30:67-76. [PMID: 28077009 DOI: 10.1177/0891988716686832] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
OBJECTIVE The aim of this study was to explore the association of body mass index (BMI), waist circumference (WC), and BMI and WC changes over time with cognitive decline in a nationally representative sample. METHODS A total of 5239 participants (≥65 years) were followed for 3 years as part of the National Health and Aging Trends Study. Cox proportional hazard regression was applied to model the risk of cognitive decline. RESULTS BMI, after adjusting for WC and main confounders, was associated with reduced risk of cognitive decline (hazard ratio [HR] 0.97 for each unit BMI increase, 0.95-0.99). After stratifying by gender and age, this effect remained significant among females and young elders ≤80 years. A BMI decrease and WC increase >10% over the study period were associated with increased risk of cognitive decline (HR 1.98, 1.16-3.38; HR 1.30, 1.04-1.62, respectively). CONCLUSION In the elderly individuals, lean mass, as measured by BMI adjusted for WC, was associated with reduced risk of cognitive decline. Loss of lean mass and gain of fat mass, as measured by WC adjusted for BMI, were associated with elevated risk of cognitive decline.
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Affiliation(s)
| | - Emily Danies
- 1 Department of Psychiatry, New York State Psychiatric Institute, Columbia University, New York, NY, USA
| | - José Martínez-Ortega
- 1 Department of Psychiatry, New York State Psychiatric Institute, Columbia University, New York, NY, USA
| | - William C Chen
- 2 Department of Neurosurgery, University of California, San Francisco, CA, USA
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Forte R, Pesce C, De Vito G, Boreham CAG. The Body Fat-Cognition Relationship in Healthy Older Individuals: Does Gynoid vs Android Distribution Matter? J Nutr Health Aging 2017; 21:284-291. [PMID: 28244568 DOI: 10.1007/s12603-016-0783-1] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
OBJECTIVE To examine the relationship between regional and whole body fat accumulation and core cognitive executive functions. DESIGN Cross-sectional study. SETTINGS AND PARTICIPANTS 78 healthy men and women aged between 65 and 75 years recruited through consumer's database. MEASUREMENTS DXA measured percentage total body fat, android, gynoid distribution and android/gynoid ratio; inhibition and working memory updating through Random Number Generation test and cognitive flexibility by Trail Making test. First-order partial correlations between regional body fat and cognitive executive function were computed partialling out the effects of whole body fat. Moderation analysis was performed to verify the effect of gender on the body fat-cognition relationship. RESULTS Results showed a differentiated pattern of fat-cognition relationship depending on fat localization and type of cognitive function. Statistically significant relationships were observed between working memory updating and: android fat (r = -0.232; p = 0.042), gynoid fat (r = 0.333; p = 0.003) and android/gynoid ratio (r = -0.272; p = 0.017). Separating genders, the only significant relationship was observed in females between working memory updating and gynoid fat (r = 0.280; p = 0.045). In spite of gender differences in both working memory updating and gynoid body fat levels, moderation analysis did not show an effect of gender on the relationship between gynoid fat and working memory updating. CONCLUSIONS Results suggest a protective effect of gynoid body fat and a deleterious effect of android body fat. Although excessive body fat increases the risk of developing CDV, metabolic and cognitive problems, maintaining a certain proportion of gynoid fat may help prevent cognitive decline, particularly in older women. Guidelines for optimal body composition maintenance for the elderly should not target indiscriminate weight loss, but weight maintenance through body fat/lean mass control based on non-pharmacological tools such as physical exercise, known to have protective effects against CVD risk factors and age-related cognitive deterioration.
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Affiliation(s)
- R Forte
- Roberta Forte Department of Human Health and Movement Sciences, University of Rome «Foro Italico», Roma 00135, Italy telephone +39 6 36733367 fax +39 6 36733362 e-mail:
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Neergaard JS, Dragsbæk K, Hansen HB, Henriksen K, Christiansen C, Karsdal MA. Late-Life Risk Factors for All-Cause Dementia and Differential Dementia Diagnoses in Women: A Prospective Cohort Study. Medicine (Baltimore) 2016; 95:e3112. [PMID: 26986157 PMCID: PMC4839938 DOI: 10.1097/md.0000000000003112] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
Since the first evidence of a decline in dementia incidence was reported in 2011, the focus on modifiable risk factors has increased. The possibility of risk factor intervention as a prevention strategy has been widely discussed; however, further evidence in relation to risk factors is still needed. The Prospective Epidemiologic Risk Factor (PERF I) study was an observational prospective study of postmenopausal Danish women who were initially examined between 1999 and 2001 (n = 5855). Follow-up data on diagnosis and survival as of December 31, 2014 was retrieved from the National Danish Patient Registry and the National Danish Causes of Death Registry. Cox proportional hazards regression model was applied to calculate adjusted hazard ratios (HR) for selected risk factors for dementia. Of 5512 eligible subjects, 592 developed dementia within the follow-up period of maximum 15 years. The independent factors associated with increased risk of all-cause dementia were depression (HR = 1.75 [95% CI 1.32-2.34]) and impaired fasting glucose levels. A dose-response relationship was observed between fasting glucose level and risk of dementia with HRs of 1.25 [1.05-1.49] and 1.45 [1.03-2.06] for impaired (5.6-6.9 mmol/L) and hyperglycemic (≥7.0 mmol/L) glucose levels, respectively. The factors associated with a decreased risk of dementia were overweight in late-life (HR = 0.75 [0. 62-0.89]) and physical activity at least once weekly (HR = 0.77 [0.61-0.96]). The identified risk factors for dementia in women in late-life are all considered modifiable. This supports the notion that prevention strategies may improve the poor future prospects for dementias in the ageing population.
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Gibby JT, Njeru DK, Cvetko ST, Merrill RM, Bikman BT, Gibby WA. Volumetric analysis of central body fat accurately predicts incidence of diabetes and hypertension in adults. BMC OBESITY 2015; 2:10. [PMID: 26217525 PMCID: PMC4511444 DOI: 10.1186/s40608-015-0039-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/16/2014] [Accepted: 02/05/2015] [Indexed: 12/28/2022]
Abstract
BACKGROUND Central adipose tissue is appreciated as a risk factor for cardiometabolic disorders. The purpose of this study was to determine the efficacy of a volumetric 3D analysis of central adipose tissue in predicting disease. Full body computerized tomography (CT) scans were obtained from 1225 female (518) and male (707) subjects, aged 18-88. Percent central body fat (%cBF) was determined by quantifying the adipose tissue volume from the dome of the liver to the pubic symphysis. Calcium score was determined from the calcium content of coronary arteries. Relationships between %cBF, BMI, and several cardiometabolic disorders were assessed controlling for age, sex, and race. RESULTS Higher %cBF was significantly greater for those with type 2 diabetes and hypertension, but not stroke or hypercholesterolemia. Simple anthropometric determination of BMI equally correlated with diabetes and hypertension as central body fat. Calcium scoring significantly correlated with all measurements of cardiovascular health, including hypertension, hypercholesterolemia, and heart disease. CONCLUSIONS Central body fat and BMI equally and highly predict incidence of hypertension and type 2 diabetes.
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Affiliation(s)
- Jacob T Gibby
- />Departments of Physiology and Developmental Biology, Provo, UT USA
| | | | | | - Ray M Merrill
- />Health Science, Brigham Young University, Provo, UT USA
| | - Benjamin T Bikman
- />Departments of Physiology and Developmental Biology, Provo, UT USA
| | - Wendell A Gibby
- />Accuscan Health Imaging Center, Salt Lake City, UT 84101 USA
- />Novarad, American Fork, UT 84003 USA
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Sohrabi HR, Bates KA, Weinborn M, Bucks RS, Rainey-Smith SR, Rodrigues MA, Bird SM, Brown BM, Beilby J, Howard M, Criddle A, Wraith M, Taddei K, Martins G, Paton A, Shah T, Dhaliwal SS, Mehta PD, Foster JK, Martins IJ, Lautenschlager NT, Mastaglia F, Laws SM, Martins RN. Bone mineral density, adiposity, and cognitive functions. Front Aging Neurosci 2015; 7:16. [PMID: 25741279 PMCID: PMC4332358 DOI: 10.3389/fnagi.2015.00016] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2014] [Accepted: 02/03/2015] [Indexed: 12/12/2022] Open
Abstract
Cognitive decline and dementia due to Alzheimer's disease (AD) have been associated with genetic, lifestyle, and environmental factors. A number of potentially modifiable risk factors should be taken into account when preventive or ameliorative interventions targeting dementia and its preclinical stages are investigated. Bone mineral density (BMD) and body composition are two such potentially modifiable risk factors, and their association with cognitive decline was investigated in this study. 164 participants, aged 34–87 years old (62.78 ± 9.27), were recruited for this longitudinal study and underwent cognitive and clinical examinations at baseline and after 3 years. Blood samples were collected for apolipoprotein E (APOE) genotyping and dual energy x-ray absorptiometry (DXA) was conducted at the same day as cognitive assessment. Using hierarchical regression analysis, we found that BMD and lean body mass, as measured using DXA were significant predictors of episodic memory. Age, gender, APOE status, and premorbid IQ were controlled for. Specifically, the List A learning from California Verbal Learning Test was significantly associated with BMD and lean mass both at baseline and at follow up assessment. Our findings indicate that there is a significant association between BMD and lean body mass and episodic verbal learning. While the involvement of modifiable lifestyle factors in human cognitive function has been examined in different studies, there is a need for further research to understand the potential underlying mechanisms.
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Affiliation(s)
- Hamid R Sohrabi
- School of Medical Sciences, Edith Cowan University Joondalup, WA, Australia ; The McCusker Alzheimer's Research Foundation Nedlands, WA, Australia ; School of Psychiatry and Clinical Neurosciences, University of Western Australia Crawley, Australia
| | - Kristyn A Bates
- The McCusker Alzheimer's Research Foundation Nedlands, WA, Australia ; The School of Animal Biology, University of Western Australia Crawley, WA, Australia
| | - Michael Weinborn
- The McCusker Alzheimer's Research Foundation Nedlands, WA, Australia ; School of Psychology, University of Western Australia Crawley, WA, Australia
| | - Romola S Bucks
- School of Psychology, University of Western Australia Crawley, WA, Australia
| | - Stephanie R Rainey-Smith
- School of Medical Sciences, Edith Cowan University Joondalup, WA, Australia ; The McCusker Alzheimer's Research Foundation Nedlands, WA, Australia
| | - Mark A Rodrigues
- School of Medical Sciences, Edith Cowan University Joondalup, WA, Australia ; The McCusker Alzheimer's Research Foundation Nedlands, WA, Australia
| | - Sabine M Bird
- The McCusker Alzheimer's Research Foundation Nedlands, WA, Australia ; School of Psychiatry and Clinical Neurosciences, University of Western Australia Crawley, Australia
| | - Belinda M Brown
- School of Medical Sciences, Edith Cowan University Joondalup, WA, Australia ; The McCusker Alzheimer's Research Foundation Nedlands, WA, Australia
| | - John Beilby
- School of Pathology and Laboratory Medicine, University of Western Australia Nedlands, WA, Australia ; PathWest Laboratory Medicine of WA Nedlands, WA, Australia
| | - Matthew Howard
- The McCusker Alzheimer's Research Foundation Nedlands, WA, Australia
| | - Arthur Criddle
- Western Medicine, Hollywood Specialist Centre Nedlands, WA, Australia
| | - Megan Wraith
- Western Medicine, Hollywood Specialist Centre Nedlands, WA, Australia
| | - Kevin Taddei
- School of Medical Sciences, Edith Cowan University Joondalup, WA, Australia ; The McCusker Alzheimer's Research Foundation Nedlands, WA, Australia
| | - Georgia Martins
- School of Medical Sciences, Edith Cowan University Joondalup, WA, Australia ; The McCusker Alzheimer's Research Foundation Nedlands, WA, Australia
| | - Athena Paton
- School of Medical Sciences, Edith Cowan University Joondalup, WA, Australia ; The McCusker Alzheimer's Research Foundation Nedlands, WA, Australia
| | - Tejal Shah
- School of Medical Sciences, Edith Cowan University Joondalup, WA, Australia ; The McCusker Alzheimer's Research Foundation Nedlands, WA, Australia
| | | | - Pankaj D Mehta
- Division of Immunology, Department of Developmental Neurobiolog,Institute for Basic Research in Developmental Disabilities Staten Island, NY, USA
| | - Jonathan K Foster
- Neurosciences Unit, Health Department of WA, School of Psychology and Speech Pathology, Curtin University of Technology Perth, WA, Australia
| | - Ian J Martins
- School of Medical Sciences, Edith Cowan University Joondalup, WA, Australia ; The McCusker Alzheimer's Research Foundation Nedlands, WA, Australia
| | - Nicola T Lautenschlager
- School of Psychiatry and Clinical Neurosciences, University of Western Australia Crawley, Australia ; Academic Unit for Psychiatry of Old Age, St. Vincent's Health, Department of Psychiatry, University of Melbourne Parkville, VIC, Australia ; The WA Centre for Health and Ageing, University of Western Australia Crawley, Australia
| | - Francis Mastaglia
- Institute for Immunology and Infectious Diseases, Murdoch University WA, Australia
| | - Simon M Laws
- School of Medical Sciences, Edith Cowan University Joondalup, WA, Australia ; The McCusker Alzheimer's Research Foundation Nedlands, WA, Australia
| | - Ralph N Martins
- School of Medical Sciences, Edith Cowan University Joondalup, WA, Australia ; The McCusker Alzheimer's Research Foundation Nedlands, WA, Australia ; School of Psychiatry and Clinical Neurosciences, University of Western Australia Crawley, Australia
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Aslan AKD, Starr JM, Pattie A, Deary I. Cognitive consequences of overweight and obesity in the ninth decade of life? Age Ageing 2015; 44:59-65. [PMID: 25249169 DOI: 10.1093/ageing/afu108] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND/OBJECTIVES the association between late-life obesity and late-life cognitive abilities is poorly understood. We studied the association between body mass index (BMI) and cognitive change in longitudinal population-based study spanning over the ninth decade of life. SUBJECTS/METHODS in total, 475 participants free of dementia at baseline from the Lothian Birth Cohort 1921 (mean age: 79.1 years, SD: 0.6) were included. Height and weight were assessed at baseline. BMI was calculated as kg/m(2). Cognitive abilities were assessed at age ∼11 years and at age ∼79, ∼83, ∼87 and ∼90 years. RESULTS latent growth models showed that men being overweight and obese had a 0.65 (SD: 0.3) and 1.10 (SD: 0.5) points less steep decline in general cognitive ability (as measured by the Moray House Test) for each year than people of normal weight. These associations were to some extent confounded by childhood intelligence. No other association between BMI and cognition was significant, either for men or women. People who were obese in old age had significantly lower childhood intelligence (m = 43.6, SD: 1.3) than people who were normal in weight (m = 47.0, SD: 0.8) and persons being overweight (m = 47.5, SD: 0.8), F (472, 3) = 3.2, P = 0.043. CONCLUSIONS the current study shows weak or no evidence for an association between BMI in old age and cognitive function, especially not when childhood intelligence is controlled for. Lower intelligence at the age of 11 years predicted obesity at the age of 79 years.
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Affiliation(s)
- Anna K Dahl Aslan
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm 17177, Sweden Institute of Gerontology, School of Health Sciences, Box 1026, Jönköping 551 11, Sweden
| | - John M Starr
- Geriatric Medicine, University of Edinburgh, Royal Victoria Hospital, Craigleith Road, Edinburgh EH4 2DN, UK Centre for Cognitive Ageing and Cognitive Epidemiology, Department of Psychology, University of Edinburgh, Edinburgh, UK
| | - Alison Pattie
- Centre for Cognitive Ageing and Cognitive Epidemiology, Department of Psychology, University of Edinburgh, Edinburgh, UK
| | - Ian Deary
- Centre for Cognitive Ageing and Cognitive Epidemiology, Department of Psychology, University of Edinburgh, Edinburgh, UK
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Lemini C, Jaimez R, Figueroa A, Martinez-Mota L, Avila ME, Medina M. Ovariectomy differential influence on some hemostatic markers of mice and rats. Exp Anim 2014; 64:81-9. [PMID: 25312504 PMCID: PMC4329519 DOI: 10.1538/expanim.14-0052] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Rodent ovariectomy is an experimental method to eliminate the main source of sexual
steroids. This work explored for the first time the ovariectomy temporal changes induced
in the hemostatic coagulation markers: prothrombin time (PT), activated partial
thromboplastin time (aPTT), thrombin time (TT), and fibrinogen concentration (FIB) along
with uterine weight on adult female CD1 mice and Wistar rats. Uterine weight (Uw) was
assessed before ovariectomy (control), and 1, 3, 5, 7, 9, 16, and 21 days after surgery.
PT, aPTT, TT and FIB were estimated the same days, using reported standard techniques.
Ovariectomy decreased Uw, since day 1; and from day 10 to 21 reached the lowest values for
both species. After day 1, mice hemostatic parameters changed (PT +10%,
P<0.05; aPTT +53%, P<0.05; TT −24%,
P<0.05; FIB +67%, P<0.05). Rats showed
significant changes only in TT and FIB (TT −13%, P<0.001; FIB +65%,
P<0.001). Neither mice PT, aPTT and TT, recovered control values
after 21 days. In the rats from day 5 to 16 aPTT diminished (18–23%,
P<0.05) recovering to control values on day 21, TT after 9 days and PT
on day 16. In both species, FIB returned to its control values after 9 days. Ovariectomy
differentially altered the PT hemostatic parameter of mice and rats indicating a
non-equivalence among both species behaviour for experimental studies of blood
coagulation.
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Affiliation(s)
- Cristina Lemini
- Facultad de Medicina, Departamento de Farmacología, Universidad Nacional Autónoma de México, Av. Universidad 3000, Ciudad Universitaria, CP 04510, México D.F., México
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A systematic review of the evidence that brain structure is related to muscle structure and their relationship to brain and muscle function in humans over the lifecourse. BMC Geriatr 2014; 14:85. [PMID: 25011478 PMCID: PMC4105796 DOI: 10.1186/1471-2318-14-85] [Citation(s) in RCA: 66] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2013] [Accepted: 07/01/2014] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND An association between cognition and physical function has been shown to exist but the roles of muscle and brain structure in this relationship are not fully understood. A greater understanding of these relationships may lead to identification of the underlying mechanisms in this important area of research. This systematic review examines the evidence for whether: a) brain structure is related to muscle structure; b) brain structure is related to muscle function; and c) brain function is related to muscle structure in healthy children and adults. METHODS Medline, Embase, CINAHL and PsycINFO were searched on March 6th 2014. A grey literature search was performed using Google and Google Scholar. Hand searching through citations and references of relevant articles was also undertaken. RESULTS 53 articles were included in the review; mean age of the subjects ranged from 8.8 to 85.5 years old. There is evidence of a positive association between both whole brain volume and white matter (WM) volume and muscle size. Total grey matter (GM) volume was not associated with muscle size but some areas of regional GM volume were associated with muscle size (right temporal pole and bilateral ventromedial prefrontal cortex). No evidence was found of a relationship between grip strength and whole brain volume however there was some evidence of a positive association with WM volume. Conversely, there is evidence that gait speed is positively associated with whole brain volume; this relationship may be driven by total WM volume or regional GM volumes, specifically the hippocampus. Markers of brain ageing, that is brain atrophy and greater accumulation of white matter hyperintensities (WMH), were associated with grip strength and gait speed. The location of WMH is important for gait speed; periventricular hyperintensities and brainstem WMH are associated with gait speed but subcortical WMH play less of a role. Cognitive function does not appear to be associated with muscle size. CONCLUSION There is evidence that brain structure is associated with muscle structure and function. Future studies need to follow these interactions longitudinally to understand potential causal relationships.
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Santos NC, Costa PS, Cunha P, Portugal-Nunes C, Amorim L, Cotter J, Cerqueira JJ, Palha JA, Sousa N. Clinical, physical and lifestyle variables and relationship with cognition and mood in aging: a cross-sectional analysis of distinct educational groups. Front Aging Neurosci 2014; 6:21. [PMID: 24605100 PMCID: PMC3932406 DOI: 10.3389/fnagi.2014.00021] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2013] [Accepted: 02/04/2014] [Indexed: 12/01/2022] Open
Abstract
It is relevant to unravel the factors that may mediate the cognitive decline observed during aging. Previous reports indicate that education has a positive influence on cognitive performance, while age, female gender and, especially, depressed mood were associated with poorer performances across multiple cognitive dimensions (memory and general executive function). Herein, the present study aimed to characterize the cognitive performance of community-dwelling individuals within distinct educational groups categorized by the number of completed formal school years: “less than 4,” “4, completed primary education,” and “more than 4.” Participants (n = 1051) were randomly selected from local health registries and representative of the Portuguese population for age and gender. Neurocognitive and clinical assessments were conducted in local health care centers. Structural equation modeling was used to derive a cognitive score, and hierarchical linear regressions were conducted for each educational group. Education, age and depressed mood were significant variables in directly explaining the obtained cognitive score, while gender was found to be an indirect variable. In all educational groups, mood was the most significant factor with effect on cognitive performance. Specifically, a depressed mood led to lower cognitive performance. The clinical disease indices cardiac and stroke associated with a more negative mood, while moderate increases in BMI, alcohol consumption and physical activity associated positively with improved mood and thus benefitted cognitive performance. Results warrant further research on the cause-effect (longitudinal) relationship between clinical indices of disease and risk factors and mood and cognition throughout aging.
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Affiliation(s)
- Nadine C Santos
- Life and Health Sciences Research Institute (ICVS), School of Health Sciences, University of Minho Braga, Portugal ; ICVS/3B's, PT Government Associate Laboratory Braga/Guimarães, Portugal ; Clinical Academic Center - Braga Braga, Portugal
| | - Patrício S Costa
- Life and Health Sciences Research Institute (ICVS), School of Health Sciences, University of Minho Braga, Portugal ; ICVS/3B's, PT Government Associate Laboratory Braga/Guimarães, Portugal ; Clinical Academic Center - Braga Braga, Portugal
| | - Pedro Cunha
- Life and Health Sciences Research Institute (ICVS), School of Health Sciences, University of Minho Braga, Portugal ; ICVS/3B's, PT Government Associate Laboratory Braga/Guimarães, Portugal ; Centro Hospitalar do Alto Ave - EPE Guimarães, Portugal
| | - Carlos Portugal-Nunes
- Life and Health Sciences Research Institute (ICVS), School of Health Sciences, University of Minho Braga, Portugal ; ICVS/3B's, PT Government Associate Laboratory Braga/Guimarães, Portugal ; Clinical Academic Center - Braga Braga, Portugal
| | - Liliana Amorim
- Life and Health Sciences Research Institute (ICVS), School of Health Sciences, University of Minho Braga, Portugal ; ICVS/3B's, PT Government Associate Laboratory Braga/Guimarães, Portugal ; Clinical Academic Center - Braga Braga, Portugal
| | - Jorge Cotter
- Life and Health Sciences Research Institute (ICVS), School of Health Sciences, University of Minho Braga, Portugal ; ICVS/3B's, PT Government Associate Laboratory Braga/Guimarães, Portugal ; Centro Hospitalar do Alto Ave - EPE Guimarães, Portugal
| | - João J Cerqueira
- Life and Health Sciences Research Institute (ICVS), School of Health Sciences, University of Minho Braga, Portugal ; ICVS/3B's, PT Government Associate Laboratory Braga/Guimarães, Portugal ; Clinical Academic Center - Braga Braga, Portugal
| | - Joana A Palha
- Life and Health Sciences Research Institute (ICVS), School of Health Sciences, University of Minho Braga, Portugal ; ICVS/3B's, PT Government Associate Laboratory Braga/Guimarães, Portugal ; Clinical Academic Center - Braga Braga, Portugal
| | - Nuno Sousa
- Life and Health Sciences Research Institute (ICVS), School of Health Sciences, University of Minho Braga, Portugal ; ICVS/3B's, PT Government Associate Laboratory Braga/Guimarães, Portugal ; Clinical Academic Center - Braga Braga, Portugal
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Alonso R, Pisa D, Rábano A, Carrasco L. Alzheimer's disease and disseminated mycoses. Eur J Clin Microbiol Infect Dis 2014; 33:1125-32. [PMID: 24452965 DOI: 10.1007/s10096-013-2045-z] [Citation(s) in RCA: 46] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2013] [Accepted: 12/29/2013] [Indexed: 12/31/2022]
Abstract
Alzheimer's disease (AD) is characterized by the presence in the brain of amyloid plaques and neurofibrillary tangles that provoke neuronal cell death, vascular dysfunction and inflammatory processes. In the present work, we have analyzed the existence of fungal infection in AD patients. A number of tests have been carried out in blood serum, including the detection of antibodies against several yeast species and fungal proteins, and also the presence of fungal (1,3)-β-glucan. Results from this analysis indicate that there is disseminated fungal infection in the majority of AD patients tested. Of interest, several AD patients contain high levels of fungal polysaccharides in peripheral blood, reflecting that disseminated fungal infection occurs in these patients. Together, these results suggest the presence of disseminated mycoses in blood serum from AD patients. To our knowledge these findings represent the first evidence that fungal infection is detectable in blood samples in AD patients. The possibility that this may represent a risk factor or may contribute to the etiological cause of AD is discussed.
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Affiliation(s)
- R Alonso
- Centro de Biología Molecular Severo Ochoa CSIC-UAM, Universidad Autónoma de Madrid, C / Nicolás Cabrera, 1, Cantoblanco, 28049, Madrid, Spain
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McIntyre RS, Cha DS, Jerrell JM, Soczynska JK, Woldeyohannes HO, Taylor V, Kaidanovich-Beilin O, Alsuwaidan M, Ahmed AT. Obesity and mental illness: implications for cognitive functioning. Adv Ther 2013; 30:577-88. [PMID: 23839214 DOI: 10.1007/s12325-013-0040-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2013] [Indexed: 02/07/2023]
Abstract
A priority research and clinical agenda is to identify determinants of cognitive impairment in individuals with neuropsychiatric disorders (NPD). The bidirectional association between NPD and cognitive performance has been reported to be mediated and/or moderated by obesity in a subset of individuals. Obesity can be conceptualized as a neurotoxic phenotype among individuals with NPD as evidenced by alterations in the structure and function of neural circuits and disseminated networks, diminished cognitive performance, and adverse effects on illness trajectory. The neurotoxic effect of obesity provides a rationale for screening, treating, and preventing obesity in neuropsychiatric populations. Research endeavors that aim to refine mediators and moderators of this association as well as novel strategies to reverse the injurious process of obesity on cognition are warranted.
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Affiliation(s)
- Roger S McIntyre
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada.
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35
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Dahl AK, Hassing LB, Fransson EI, Gatz M, Reynolds CA, Pedersen NL. Body mass index across midlife and cognitive change in late life. Int J Obes (Lond) 2013; 37:296-302. [PMID: 22450854 PMCID: PMC3387354 DOI: 10.1038/ijo.2012.37] [Citation(s) in RCA: 72] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND High midlife body mass index (BMI) has been linked to a greater risk of dementia in late life, but few have studied the effect of BMI across midlife on cognitive abilities and cognitive change in a dementia-free sample. METHODS We investigated the association between BMI, measured twice across midlife (mean age 40 and 61 years, respectively), and cognitive change in four domains across two decades in the Swedish Adoption/Twin Study of Aging. RESULTS Latent growth curve models fitted to data from 657 non-demented participants showed that persons who were overweight/obese in early midlife had significantly lower cognitive performance across domains in late life and significantly steeper decline in perceptual speed, adjusting for cardio-metabolic factors. Both underweight and overweight/obesity in late midlife were associated with lower cognitive abilities in late life. However, the association between underweight and low cognitive abilities did not remain significant when weight decline between early and late midlife was controlled for. CONCLUSION There is a negative effect on cognitive abilities later in life related to being overweight/obese across midlife. Moreover, weight decline across midlife rather than low weight in late midlife per se was associated with low cognitive abilities. Weight patterns across midlife may be prodromal markers of late life cognitive health.
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Affiliation(s)
- A K Dahl
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
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36
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Dao E, Davis JC, Sharma D, Chan A, Nagamatsu LS, Liu-Ambrose T. Change in body fat mass is independently associated with executive functions in older women: a secondary analysis of a 12-month randomized controlled trial. PLoS One 2013; 8:e52831. [PMID: 23308123 PMCID: PMC3538688 DOI: 10.1371/journal.pone.0052831] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2012] [Accepted: 11/22/2012] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVES To investigate the independent contribution of change in sub-total body fat and lean mass to cognitive performance, specifically the executive processes of selective attention and conflict resolution, in community-dwelling older women. METHODS This secondary analysis included 114 women aged 65 to 75 years old. Participants were randomly allocated to once-weekly resistance training, twice-weekly resistance training, or twice-weekly balance and tone training. The primary outcome measure was the executive processes of selective attention and conflict resolution as assessed by the Stroop Test. Sub-total body fat and lean mass were measured by dual-energy x-ray absorptiometry (DXA) to determine the independent association of change in both sub-total body fat and sub-total body lean mass with Stroop Test performance at trial completion. RESULTS A multiple linear regression model showed reductions in sub-total body fat mass to be independently associated with better performance on the Stroop Test at trial completion after accounting for baseline Stroop performance, age, baseline global cognitive state, baseline number of comorbidities, baseline depression, and experimental group. The total variance explained was 39.5%; change in sub-total body fat mass explained 3.9% of the variance. Change in sub-total body lean mass was not independently associated with Stroop Test performance (P>0.05). CONCLUSION Our findings suggest that reductions in sub-total body fat mass - not sub-total lean mass - is associated with better performance of selective attention and conflict resolution.
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Affiliation(s)
- Elizabeth Dao
- Department of Physical Therapy, University of British Columbia, Vancouver, British Columbia, Canada
| | - Jennifer C. Davis
- Department of Physical Therapy, University of British Columbia, Vancouver, British Columbia, Canada
- Collaboration for Outcomes Research and Evaluation, Vancouver, British Columbia, Canada
| | - Devika Sharma
- Department of Physical Therapy, University of British Columbia, Vancouver, British Columbia, Canada
| | - Alison Chan
- Department of Physical Therapy, University of British Columbia, Vancouver, British Columbia, Canada
| | - Lindsay S. Nagamatsu
- Department of Physical Therapy, University of British Columbia, Vancouver, British Columbia, Canada
- Department of Psychology, University of British Columbia, Vancouver, British Columbia, Canada
- Brain Research Centre, University of British Columbia, Vancouver, British Columbia, Canada
| | - Teresa Liu-Ambrose
- Department of Physical Therapy, University of British Columbia, Vancouver, British Columbia, Canada
- Brain Research Centre, University of British Columbia, Vancouver, British Columbia, Canada
- * E-mail:
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Mayeux R, Stern Y. Epidemiology of Alzheimer disease. Cold Spring Harb Perspect Med 2012; 2:cshperspect.a006239. [PMID: 22908189 DOI: 10.1101/cshperspect.a006239] [Citation(s) in RCA: 563] [Impact Index Per Article: 46.9] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
The global prevalence of dementia has been estimated to be as high as 24 million, and is predicted to double every 20 years until at least 2040. As the population worldwide continues to age, the number of individuals at risk will also increase, particularly among the very old. Alzheimer disease is the leading cause of dementia beginning with impaired memory. The neuropathological hallmarks of Alzheimer disease include diffuse and neuritic extracellular amyloid plaques in brain that are frequently surrounded by dystrophic neurites and intraneuronal neurofibrillary tangles. The etiology of Alzheimer disease remains unclear, but it is likely to be the result of both genetic and environmental factors. In this review we discuss the prevalence and incidence rates, the established environmental risk factors, and the protective factors, and briefly review genetic variants predisposing to disease.
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Affiliation(s)
- Richard Mayeux
- Gertrude H. Sergievsky Center, Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Columbia University Medical Center, New York, NY 10032, USA
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Zueva IB, Vanaeva KI, Sanez EL, Piotrovskaya VR, Genikhovich EL, Kirillova VI, Shlyakhto EV. Association of cognitive function with cardiovascular risk factors in middle age individuals. ACTA ACUST UNITED AC 2011. [DOI: 10.18705/1607-419x-2011-17-5-432-440] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022]
Abstract
Objective. To find the association between cognitive function and cardiovascular risk factors and to develop statistic model. Results. Our study demonstrated that cognitive dysfunction is more profound in middle-aged patients with metabolic syndrome (MS) compared to the individuals with single risk factors without MS. Multiple regression analysis defined glucose (β = 0,0114) and systolic blood pressure (SBP) (β = -0,212) to be factors related with MMSE-test results. When glucose level was excluded from the model, the following factors were shown to be significant: SBP (β = -0,202), age (β = -0,093), operative memory (β = -0,169), total cholesterol level (β = -0,065), therapy by calcium antagonist (β = 0,082), obesity (β = 0,06), R = 92 %.
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Affiliation(s)
- I. B. Zueva
- Almazov Federal Heart, Blood, and Endocrinology Centre
| | - K. I. Vanaeva
- Almazov Federal Heart, Blood, and Endocrinology Centre
| | - E. L. Sanez
- Almazov Federal Heart, Blood, and Endocrinology Centre
| | - V. R. Piotrovskaya
- Pavlov St Petersburg State Medical University, the Department of Psychiatry and Narcology with the Course of Medical Psychology and Psychosomatic Medicine
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Smith E, Hay P, Campbell L, Trollor JN. A review of the association between obesity and cognitive function across the lifespan: implications for novel approaches to prevention and treatment. Obes Rev 2011; 12:740-55. [PMID: 21991597 DOI: 10.1111/j.1467-789x.2011.00920.x] [Citation(s) in RCA: 479] [Impact Index Per Article: 36.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Affiliation(s)
- E Smith
- Brain and Ageing Research Program, School of Psychiatry, University of New South Wales, Sydney, Australia.
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Driscoll I, Espeland MA, Wassertheil-Smoller S, Gaussoin SA, Ding J, Granek I, Ockene JK, Phillips LS, Yaffe K, Resnick SM. Weight change and cognitive function: findings from the Women's Health Initiative Study of Cognitive Aging. Obesity (Silver Spring) 2011; 19:1595-600. [PMID: 21394095 PMCID: PMC3175491 DOI: 10.1038/oby.2011.23] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Although studies exploring relationships between obesity and cognitive impairment in the elderly are conflicting, literature suggests that overweight and obesity may be protective against cognitive impairment and dementia in older women. We examine the associations between changes in weight and waist circumference (WC) with global and domain-specific cognitive function in a large, well-defined cohort of 2,283 older, postmenopausal women (aged 65-79) prospectively followed through the Women's Health Initiative (WHI) Study of Cognitive Aging (WHISCA). We assessed the associations between changes in weight and WC collected up to 5 years before WHISCA enrollment and mean levels of global and domain-specific cognitive performance across an average of 5.4 years of subsequent follow-up. There was a lack of associations between weight and cognition in women who remained stable or gained weight. The only significant relationships observed were in association with weight loss (P ≤ 0.05), most likely signaling incipient disease. Moreover, cognition was not related to changes in WC. Relationships were largely independent of initial BMI, self-reported caloric intake or dieting. The lack of associations between weight gain and cognition in women is consistent with the existing literature.
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Affiliation(s)
- Ira Driscoll
- Laboratory of Personality and Cognition, Intramural Research Program, National Institute on Aging, NIH, Baltimore, MD 21224
| | - Mark A. Espeland
- Department of Biostatistical Sciences, Wake Forest University School of Medicine, Winston-Salem, NC, 27157
| | | | - Sarah A. Gaussoin
- Department of Biostatistical Sciences, Wake Forest University School of Medicine, Winston-Salem, NC, 27157
| | - Jingzhong Ding
- Department of Internal Medicine and, Wake Forest University School of Medicine, Winston-Salem, NC, 27157
| | - Iris Granek
- Department of Preventive Medicine, State University of New York at Stony Brook, Stony Brook, NY 11794
| | - Judith K. Ockene
- Division of Preventive and Behavioral Medicine, University of Massachusetts, Worcester, MA, 01680
| | - Lawrence S. Phillips
- Division of Endocrinology, Emory University School of Medicine, Atlanta, GA 30322
| | - Kristine Yaffe
- Departments of Psychiatry, Neurology, and Epidemiology and Biostatistics, University of California, San Francisco, CA 94143
| | - Susan M. Resnick
- Laboratory of Personality and Cognition, Intramural Research Program, National Institute on Aging, NIH, Baltimore, MD 21224
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Anstey KJ, Cherbuin N, Budge M, Young J. Body mass index in midlife and late-life as a risk factor for dementia: a meta-analysis of prospective studies. Obes Rev 2011; 12:e426-37. [PMID: 21348917 DOI: 10.1111/j.1467-789x.2010.00825.x] [Citation(s) in RCA: 543] [Impact Index Per Article: 41.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
The relationship between body mass index (BMI) (in midlife and late-life) and dementia was investigated in meta-analyses of 16 articles reporting on 15 prospective studies. Follow-ups ranged from 3.2 to 36.0 years. Meta-analyses were conducted on samples including 25 624 participants evaluated for Alzheimer's disease (AD), 15 435 participants evaluated for vascular dementia (VaD) and 30 470 followed for any type of dementia (Any Dementia). Low BMI in midlife was associated with 1.96 [95% confidence interval (CI): 1.32, 2.92] times the risk of developing AD. The pooled relative risks for AD, VaD and Any Dementia for overweight BMI in midlife compared with normal BMI were 1.35 (95% CI:1.19, 1.54), 1.33 (95% CI: 1.02, 1.75) and 1.26 (95% CI: 1.10, 1.44), respectively. The pooled relative risks of AD and Any Dementia for obese BMI in midlife compared to normal BMI were 2.04 (95% CI: 1.59, 2.62) and 1.64 (95% CI: 1.34, 2.00), respectively. Continuous BMI in late-life was not associated with dementia. Small numbers of studies included in pooled analyses reduce generalizability of findings, and emphasize the need for publication of additional findings. We conclude that underweight, overweight and obesity in midlife increase dementia risk. Further research evaluating late-life BMI and dementia is required.
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Affiliation(s)
- K J Anstey
- Ageing Research Unit, Centre for Mental Health Research Medical School, Australian National University, Canberra, ACT, Australia.
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43
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Kerwin DR, Gaussoin SA, Chlebowski RT, Kuller LH, Vitolins M, Coker LH, Kotchen JM, Nicklas BJ, Wassertheil-Smoller S, Hoffmann RG, Espeland MA. Interaction Between Body Mass Index and Central Adiposity and Risk of Incident Cognitive Impairment and Dementia: Results from the Women's Health Initiative Memory Study. J Am Geriatr Soc 2011; 59:107-12. [DOI: 10.1111/j.1532-5415.2010.03219.x] [Citation(s) in RCA: 68] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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Raji MA, Al Snih S, Ostir GV, Markides KS, Ottenbacher KJ. Cognitive status and future risk of frailty in older Mexican Americans. J Gerontol A Biol Sci Med Sci 2010; 65:1228-34. [PMID: 20622137 DOI: 10.1093/gerona/glq121] [Citation(s) in RCA: 120] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Because cognitive impairment and frailty share common risk factors (eg, high proinflammatory cytokines), we examined whether poor cognition predicts subsequent risk of frailty in initially nonfrail Mexican Americans aged 67 years and older. METHODS Frailty was defined as meeting one or more of the following components: (a) unintentional weight loss of >10 pounds, (b) weakness, (c) self-reported exhaustion, and (d) slow walking speed. Sociodemographic factors, Mini-Mental State Examination, medical conditions (stroke, heart attack, diabetes, arthritis, cancer, and hypertension), and depressive symptoms were obtained. Main outcome measure was risk of becoming frail over 10 years. RESULTS Out of 942 participants who were nonfrail at baseline (1995-1996), 57.8% were women and the mean age was 73.7 years (SD = 5.3). In general estimation equation models testing the relationship between Mini-Mental State Examination (<21 vs. ≥21) and the risk of becoming frail over a 10-year period, there was a significant association (odds ratio = 1.09, 95% confidence interval = 1.00-1.19; p = .0310)] between the cognition-by-time interaction and odds of becoming prefrail or frail over time. This association was independent of age, sex, marital status, education, time, and medical conditions, indicating that nonfrail participants with poor cognition had a 9% odds per year of becoming frail over time compared with those with good cognition. CONCLUSION Low Mini-Mental State Examination score was independently associated with increased risk of frailty over a 10-year period in older Mexican Americans. Low Mini-Mental State Examination score may be an early marker for future risk of frailty.
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Affiliation(s)
- Mukaila A Raji
- Division of Geriatrics, Department of Internal Medicine, University of Texas Medical Branch, Galveston, TX 77555-0460, USA.
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Kanaya AM, Lindquist K, Harris TB, Launer L, Rosano C, Satterfield S, Yaffe K. Total and regional adiposity and cognitive change in older adults: The Health, Aging and Body Composition (ABC) study. ACTA ACUST UNITED AC 2009; 66:329-35. [PMID: 19273751 DOI: 10.1001/archneurol.2008.570] [Citation(s) in RCA: 87] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
OBJECTIVES To investigate whether total and/or regional adiposity measured by anthropometry and radiographic studies influences cognitive decline in older adults and whether this association is explained by hormones and inflammatory factors known to be secreted by adipose tissue. DESIGN Prospective cohort study. SETTING Two clinical centers. PARTICIPANTS Three thousand fifty-four elderly individuals enrolled in the Health ABC Study. Adiposity measures included body mass index, waist circumference, sagittal diameter, total fat mass by dual-energy x-ray absorptiometry, and subcutaneous and visceral fat by abdominal computed tomography. We examined the association between baseline body fat measures and change in Modified Mini-Mental State Examination (3MS) score, sequentially adjusting for confounding and mediating variables, including comorbid diseases, adipocytokines, and sex hormones. Main Outcome Measure Scores from the 3MS, administered at the first, third, fifth, and eighth annual clinical examinations. RESULTS All baseline adiposity measures varied significantly by sex. In mixed-effects models, the association between total and regional adiposity and change in 3MS score varied significantly by sex, with the highest adiposity tertile being associated with greater cognitive declines in men (for each adiposity measure, P < .05) but not in women (for interaction, P < .05). Total fat mass was significantly associated with greater change in 3MS scores among men (lowest tertile, -1.6; middle tertile, -2.2; highest tertile, -2.7; P = .006), even after adjusting for mediators. CONCLUSIONS Higher levels of all adiposity measures were associated with worsening cognitive function in men after controlling for metabolic disorders, adipocytokines, and sex hormone levels. Conversely, there was no association between adiposity and cognitive change in women.
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Affiliation(s)
- Alka M Kanaya
- Department of Medicine, University of California-San Francisco, 94115, USA.
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Coker LH, Hogan PE, Bryan NR, Kuller LH, Margolis KL, Bettermann K, Wallace RB, Lao Z, Freeman R, Stefanick ML, Shumaker SA. Postmenopausal hormone therapy and subclinical cerebrovascular disease: the WHIMS-MRI Study. Neurology 2009; 72:125-34. [PMID: 19139363 DOI: 10.1212/01.wnl.0000339036.88842.9e] [Citation(s) in RCA: 71] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE The Women's Health Initiative Memory Study (WHIMS) hormone therapy (HT) trials reported that conjugated equine estrogen (CEE) with or without medroxyprogesterone acetate (MPA) increases risk for all-cause dementia and global cognitive decline. WHIMS MRI measured subclinical cerebrovascular disease as a possible mechanism to explain cognitive decline reported in WHIMS. METHODS We contacted 2,345 women at 14 WHIMS sites; scans were completed on 1,424 (61%) and 1,403 were accepted for analysis. The primary outcome measure was total ischemic lesion volume on brain MRI. Mean duration of on-trial HT or placebo was 4 (CEE+MPA) or 5.6 years (CEE-Alone) and scans were conducted an average of 3 (CEE+MPA) or 1.4 years (CEE-Alone) post-trial termination. Cross-sectional analysis of MRI lesions was conducted; general linear models were fitted to assess treatment group differences using analysis of covariance. A (two-tailed) critical value of alpha = 0.05 was used. RESULTS In women evenly matched within trials at baseline, increased lesion volumes were significantly related to age, smoking, history of cardiovascular disease, hypertension, lower post-trial global cognition scores, and increased incident cases of on- or post-trial mild cognitive impairment or probable dementia. Mean ischemic lesion volumes were slightly larger for the CEE+MPA group vs placebo, except for the basal ganglia, but the differences were not significant. Women assigned to CEE-Alone had similar mean ischemic lesion volumes compared to placebo. CONCLUSIONS Conjugated equine estrogen-based hormone therapy was not associated with a significant increase in ischemic brain lesion volume relative to placebo. This finding was consistent within each trial and in pooled analyses across trials.
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Affiliation(s)
- L H Coker
- Division of Public Health Sciences, Wake Forest University Health Sciences, Winston-Salem, NC 27157, USA.
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Sabia S, Kivimaki M, Shipley MJ, Marmot MG, Singh-Manoux A. Body mass index over the adult life course and cognition in late midlife: the Whitehall II Cohort Study. Am J Clin Nutr 2009; 89:601-7. [PMID: 19073790 PMCID: PMC2714395 DOI: 10.3945/ajcn.2008.26482] [Citation(s) in RCA: 183] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND The extent to which cognition in late midlife is influenced by lifetime obesity is unclear. OBJECTIVE We examined the association between body mass index (BMI) over the adult life course and cognition in late midlife and assessed the cumulative effects of obesity and underweight. DESIGN Data from the Whitehall II Study were examined. BMI at 25 y (early adulthood) was self-reported at phase 1 and was measured in early midlife (mean age = 44 y; phase 1) and in late midlife (mean age = 61 y; phase 7). Cognition (n = 5131) was assessed in late midlife (phase 7) by using the Mini-Mental State Examination and tests of memory and executive function, all of which were standardized to T scores (mean +/- SD: 50 +/- 10). RESULTS Both underweight and obesity were associated with lower cognition in late midlife and with early adulthood, early midlife, and late midlife measures of BMI. Being obese at 2 or 3 occasions was associated with lower Mini-Mental State Examination scores and scores of memory and executive function in analyses adjusted for age, sex, and education [difference (95% CI) in mean T scores compared with normal-weight group: -1.51 (-2.77, -0.25), -1.27 (-2.46, -0.07), and -1.35 (-2.45, -0.24), respectively]. Participants who were underweight at > or =2 occasions from early adulthood to late midlife had lower executive function [difference (95% CI) in mean T score: -4.57 (-6.94, -2.20)]. A large increase in BMI from early to late midlife was associated with lower executive function. CONCLUSIONS Long-term obesity and long-term underweight in adulthood are associated with lower cognitive scores in late midlife. Public health messages should promote a healthy weight at all ages.
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Affiliation(s)
- Séverine Sabia
- INSERM U687-IFR69, Hopital Paul Brousse, Villejuif, France.
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Kennedy RL, Malabu U, Kazi M, Shahsidhar V. Management of obesity in the elderly: too much and too late? J Nutr Health Aging 2008; 12:608-21. [PMID: 18953458 DOI: 10.1007/bf03008271] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- R L Kennedy
- James Cook University School of Medicine, Queensland, Australia.
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Matzel LD, Grossman H, Light K, Townsend D, Kolata S. Age-related declines in general cognitive abilities of Balb/C mice are associated with disparities in working memory, body weight, and general activity. Learn Mem 2008; 15:733-46. [PMID: 18832560 DOI: 10.1101/lm.954808] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
A defining characteristic of age-related cognitive decline is a deficit in general cognitive performance. Here we use a testing and analysis regimen that allows us to characterize the general learning abilities of young (3-5 mo old) and aged (19-21 mo old) male and female Balb/C mice. Animals' performance was assessed on a battery of seven diverse learning tasks. Aged animals exhibited deficits in five of the seven tasks and ranked significantly lower than their young counterparts in general learning abilities (aggregate performance across the battery of tasks). Aging added variability to common core performance (i.e., general learning ability), which translated into increased variability on the individual cognitive tasks. Relatedly, general learning abilities did not differ between the two ages among the best quartile of learners (i.e., cognitive abilities were spared in a subsample of the aged animals). Additionally, working memory capacity (resistance to interference) and duration (resistance to decay) accounted for significantly more of the variability in general learning abilities in aged relative to young animals. Tests of 15 noncognitive performance variables indicated that an increase in body weight (and an associated decrease in general activity) was characteristic of those aged animals which exhibited deficient general learning abilities. These results suggest the possibility that general cognitive deficits in aged animals reflect a failure of specific components of the working memory system, and may be related to variations in body weight and an associated decrease in activity.
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Affiliation(s)
- Louis D Matzel
- Department of Psychology, Program in Behavioral Neuroscience, Rutgers University, Piscataway, New Jersey 08854, USA.
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Abstract
There is an increasing interest in exercise and fitness in Alzheimer disease (AD) given evidence suggesting a role in the maintenance of cognitive health. There is, however, little data on the objective measure of cardiorespiratory fitness in individuals with AD. Thus, we assessed cardiorespiratory fitness in early AD and its relationship with physical activity levels, health markers, and cognitive performance in nondemented (Clinical Dementia Rating 0, n=31) and early-stage AD (Clinical Dementia Rating 0.5 and 1, n=31) participants. Cardiorespiratory fitness was assessed with maximal exercise testing to determine peak oxygen consumption (VOpeak2). Additionally, dual emission x-ray absorptiometry scanning for body composition and glucose tolerance tests were conducted. Despite reductions in physical performance and habitual physical activity levels in early AD, cardiorespiratory fitness (VOpeak2) was comparable in the 2 groups (19.8 in early AD vs. 21.2 mL/kg/min in nondemented, P=0.26). AD participants performed well on treadmill tests with similar levels of perceived exertion, maximal heart rate, and respiratory exchange ratio compared with nondemented individuals. After controlling for age and sex, VOpeak2 was associated with a beneficial glucoregulatory profile and inversely associated with percent body fat, body mass index, and triglycerides. A relationship between cognitive performance measures and VOpeak2 was not apparent. These results suggest that individuals in the early stages of AD have the capacity for maximal exercise testing and have comparable levels of cardiorespiratory fitness as nondemented individuals. Reduced physical activity associated with early AD underscores the need for further defining the role of exercise as a potential therapeutic intervention in the early stages of AD.
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