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Ambroselli D, Masciulli F, Romano E, Catanzaro G, Besharat ZM, Massari MC, Ferretti E, Migliaccio S, Izzo L, Ritieni A, Grosso M, Formichi C, Dotta F, Frigerio F, Barbiera E, Giusti AM, Ingallina C, Mannina L. New Advances in Metabolic Syndrome, from Prevention to Treatment: The Role of Diet and Food. Nutrients 2023; 15:640. [PMID: 36771347 PMCID: PMC9921449 DOI: 10.3390/nu15030640] [Citation(s) in RCA: 22] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2022] [Revised: 01/19/2023] [Accepted: 01/23/2023] [Indexed: 01/28/2023] Open
Abstract
The definition of metabolic syndrome (MetS) has undergone several changes over the years due to the difficulty in establishing universal criteria for it. Underlying the disorders related to MetS is almost invariably a pro-inflammatory state related to altered glucose metabolism, which could lead to elevated cardiovascular risk. Indeed, the complications closely related to MetS are cardiovascular diseases (CVDs) and type 2 diabetes (T2D). It has been observed that the predisposition to metabolic syndrome is modulated by complex interactions between human microbiota, genetic factors, and diet. This review provides a summary of the last decade of literature related to three principal aspects of MetS: (i) the syndrome's definition and classification, pathophysiology, and treatment approaches; (ii) prediction and diagnosis underlying the biomarkers identified by means of advanced methodologies (NMR, LC/GC-MS, and LC, LC-MS); and (iii) the role of foods and food components in prevention and/or treatment of MetS, demonstrating a possible role of specific foods intake in the development of MetS.
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Affiliation(s)
- Donatella Ambroselli
- Laboratory of Food Chemistry, Department of Chemistry and Technologies of Drugs, Sapienza University of Rome, 00185 Rome, Italy
| | - Fabrizio Masciulli
- Laboratory of Food Chemistry, Department of Chemistry and Technologies of Drugs, Sapienza University of Rome, 00185 Rome, Italy
| | - Enrico Romano
- Laboratory of Food Chemistry, Department of Chemistry and Technologies of Drugs, Sapienza University of Rome, 00185 Rome, Italy
| | - Giuseppina Catanzaro
- Department of Experimental Medicine, Sapienza University of Rome, 00161 Rome, Italy
| | | | - Maria Chiara Massari
- Department of Experimental Medicine, Sapienza University of Rome, 00161 Rome, Italy
| | - Elisabetta Ferretti
- Department of Experimental Medicine, Sapienza University of Rome, 00161 Rome, Italy
| | - Silvia Migliaccio
- Department of Movement, Human and Health Sciences, Health Sciences Section, University “Foro Italico”, 00135 Rome, Italy
| | - Luana Izzo
- Department of Pharmacy, University of Naples Federico II, 80131 Naples, Italy
| | - Alberto Ritieni
- Department of Pharmacy, University of Naples Federico II, 80131 Naples, Italy
- UNESCO, Health Education and Sustainable Development, University of Naples Federico II, 80131 Naples, Italy
| | - Michela Grosso
- Department of Molecular Medicine and Medical Biotechnology, University of Naples Federico II, 80131 Naples, Italy
| | - Caterina Formichi
- Diabetes Unit, Department of Medicine, Surgery and Neurosciences, University of Siena, 53100 Siena, Italy
| | - Francesco Dotta
- Diabetes Unit, Department of Medicine, Surgery and Neurosciences, University of Siena, 53100 Siena, Italy
| | - Francesco Frigerio
- Department of Experimental Medicine, Sapienza University of Rome, 00161 Rome, Italy
| | - Eleonora Barbiera
- Department of Experimental Medicine, Sapienza University of Rome, 00161 Rome, Italy
| | - Anna Maria Giusti
- Department of Experimental Medicine, Sapienza University of Rome, 00161 Rome, Italy
| | - Cinzia Ingallina
- Laboratory of Food Chemistry, Department of Chemistry and Technologies of Drugs, Sapienza University of Rome, 00185 Rome, Italy
| | - Luisa Mannina
- Laboratory of Food Chemistry, Department of Chemistry and Technologies of Drugs, Sapienza University of Rome, 00185 Rome, Italy
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2
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Flintoff J, Kesby JP, Siskind D, Burne TH. Treating cognitive impairment in schizophrenia with GLP-1RAs: an overview of their therapeutic potential. Expert Opin Investig Drugs 2021; 30:877-891. [PMID: 34213981 DOI: 10.1080/13543784.2021.1951702] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
INTRODUCTION Schizophrenia is a neuropsychiatric disorder that affects approximately 1% of individuals worldwide. There are no available medications to treat cognitive impairment in this patient population currently. Preclinical evidence suggests that glucagon-like peptide-1 receptor agonists (GLP-1 RAs) improve cognitive function. There is a need to evaluate how GLP-1 RAs alter specific domains of cognition and whether they will be of therapeutic benefit in individuals with schizophrenia. AREAS COVERED This paper summarizes the effects of GLP-1 RAs on metabolic processes in the brain and how these mechanisms relate to improved cognitive function. We provide an overview of preclinical studies that demonstrate GLP-1 RAs improve cognition and comment on their potential therapeutic benefit in individuals with schizophrenia. EXPERT OPINION To understand the benefits of GLP-1 RAs in individuals with schizophrenia, further preclinical research with rodent models relevant to schizophrenia symptomology are needed. Moreover, preclinical studies must focus on using a wider range of behavioral assays to understand whether important aspects of cognition such as executive function, attention, and goal-directed behavior are improved using GLP-1 RAs. Further research into the specific mechanisms of how GLP-1 RAs affect cognitive function and their interactions with antipsychotic medication commonly prescribed is necessary.
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Affiliation(s)
- Jonathan Flintoff
- Queensland Brain Institute, the University of Queensland, St Lucia, QLD, Australia
| | - James P Kesby
- Queensland Brain Institute, the University of Queensland, St Lucia, QLD, Australia.,QIMR Berghofer Medical Research Institute, Herston, QLD, Australia
| | - Dan Siskind
- Queensland Centre for Mental Health Research, Wacol, QLD, Australia.,Metro South Addiction and Mental Health Service, Woolloongabba, QLD, Australia
| | - Thomas Hj Burne
- Queensland Brain Institute, the University of Queensland, St Lucia, QLD, Australia.,Queensland Centre for Mental Health Research, Wacol, QLD, Australia
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3
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Haase Alasantro L, Hicks TH, Green-Krogmann E, Murphy C. Metabolic syndrome and cognitive performance across the adult lifespan. PLoS One 2021; 16:e0249348. [PMID: 33956820 PMCID: PMC8101918 DOI: 10.1371/journal.pone.0249348] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Accepted: 03/16/2021] [Indexed: 12/24/2022] Open
Abstract
Metabolic Syndrome (MetS) is associated with increased rates of mortality and increased risk for developing dementia. Changes in brain structure and cognitive functioning have been reported within the literature. However, research examining cognitive performance in individuals with MetS is limited, inconclusive, and focuses primarily on older cohorts. As such, the effect of MetS on cognitive functioning earlier in the lifespan is unclear. This study aimed to investigate cognitive performance in young, middle-aged, and older adults with multiple metabolic and vascular risk factors in a sample of community dwelling participants (N = 128). Participants were administered a comprehensive neuropsychological battery and self-report measures. As expected, older adults performed more poorly than young and middle-aged adults across most assessments. Relative to controls, individuals with MetS reported greater hunger and disinhibited eating. MetS participants performed more poorly on Color-Word Interference: Inhibition. Additionally, when weight was accounted for, there was a significant relationship between MetS and select executive functioning tasks in middle-aged adults. These findings suggest that aspects of executive functioning may be impaired in MetS and could be further impacted by excess weight in middle-age. Future studies aimed at investigating potential causal relationships between metabolic and vascular risk factors, disinhibited eating, and executive dysfunction may provide insight into effective intervention targets to prevent MetS.
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Affiliation(s)
- Lori Haase Alasantro
- San Diego Joint Doctoral Program in Clinical Psychology, San Diego State University/University of California, San Diego, California, United States of America
- Department of Psychiatry, University of California, San Diego, La Jolla, California, United States of America
| | - Tracey H. Hicks
- Department of Psychology, San Diego State University, San Diego, California, United States of America
| | - Erin Green-Krogmann
- San Diego Joint Doctoral Program in Clinical Psychology, San Diego State University/University of California, San Diego, California, United States of America
| | - Claire Murphy
- San Diego Joint Doctoral Program in Clinical Psychology, San Diego State University/University of California, San Diego, California, United States of America
- Department of Psychiatry, University of California, San Diego, La Jolla, California, United States of America
- Department of Psychology, San Diego State University, San Diego, California, United States of America
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4
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Medrano M, Castro-Tejada G, Lantigua R, Silvestre G, Diaz S, Mota P, Diaz-Garelli F. Vascular mild cognitive impairment and its relationship to hemoglobin A1c levels and apolipoprotein E genotypes in the Dominican Republic. Dement Neuropsychol 2021; 15:69-78. [PMID: 33907599 PMCID: PMC8049571 DOI: 10.1590/1980-57642021dn15-010007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Dementia and vascular mild cognitive impairment (VaMCI) currently impose a
tremendous human and economic burden on patients from aging populations and
their families worldwide. Understanding the interplay of cardiometabolic risk
factors and apolipoprotein E (APOE) may direct us to a more personalized
medicine and preventative care in MCI and dementia.
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Affiliation(s)
- Martin Medrano
- School of Medicine, Pontificia Universidad Católica Madre y Maestra - Santiago, Dominican Republic
| | - Gelanys Castro-Tejada
- School of Medicine, Pontificia Universidad Católica Madre y Maestra - Santiago, Dominican Republic.,Biomedical and Clinical Research Center, Hospital Universitario José Maria Cabral y Baez - Santiago, Dominican Republic
| | - Rafael Lantigua
- The Taub Institute for Research on Alzheimer's Disease and the Aging Brain - New York, NY, USA.,Department of Medicine, Columbia University, The New York Presbyterian Hospital - New York, NY, USA
| | - Gretel Silvestre
- Neuroscience and Behavior Research Program, Pontificia Universidad Católica Madre y Maestra - Santiago, Dominican Republic.,School of Psychology, Pontificia Universidad Católica Madre y Maestra - Santiago, Dominican Republic
| | - Sergio Diaz
- School of Medicine, Pontificia Universidad Católica Madre y Maestra - Santiago, Dominican Republic.,Internal Medicine Service at Hospital Universitario Jose Maria Cabral y Baez - Santiago, Dominican Republic.,Department of Preventive Medicine, Hospital Metropolitano de Santiago - Santiago, Dominican Republic
| | - Patricia Mota
- School of Psychology, Pontificia Universidad Católica Madre y Maestra - Santiago, Dominican Republic
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Szabo-Reed AN, Donnelly JE. Cognitive Training: Associations and Implications for Weight Management and Translational Research. TRANSLATIONAL JOURNAL OF THE AMERICAN COLLEGE OF SPORTS MEDICINE 2021; 6. [PMID: 34017915 DOI: 10.1249/tjx.0000000000000151] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Behavioral weight loss programs combining energy restriction and increased physical activity (PA) are generally successful in producing clinically significant weight loss (≥5%) over 3-6 mos. However, weight maintenance (≥ 2 yrs.) continues to be problematic, due in part to an inability of individuals to continue adherence to diet and PA recommendations. It is hypothesized that neurocognitive processes, specifically executive functions (EFs, i.e., inhibition, working memory, mental flexibility), underlie self-regulation, self-efficacy, and are essential for the adoption and maintenance of health behaviors. Behavioral weight loss programs generally attempt to improve self-regulation; however, these skills are difficult to implement long-term. Strengthening EFs through cognitive training may improve weight maintenance by improving self-efficacy and self-regulation, resulting in improved program attendance and improved adherence to dietary and PA recommendations. Although randomized trials have not been conducted to specifically evaluate this hypothesis, results from the available literature suggest the potential for cognitive training to improve weight maintenance.
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Affiliation(s)
- Amanda N Szabo-Reed
- Department of Weight Management, Division of Internal Medicine, The University of Kansas Medical Center, 3901 Rainbow Boulevard, Kansas City, KS, 66160 USA
| | - Joseph E Donnelly
- Department of Weight Management, Division of Internal Medicine, The University of Kansas Medical Center, 3901 Rainbow Boulevard, Kansas City, KS, 66160 USA
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Yulug B, Saatci O, Işıklar A, Hanoglu L, Kilic U, Ozansoy M, Cankaya S, Cankaya B, Kilic E. The Association between HbA1c Levels, Olfactory Memory and Cognition in Normal, Pre-Diabetic and Diabetic Persons. Endocr Metab Immune Disord Drug Targets 2020; 20:198-212. [PMID: 31203811 DOI: 10.2174/1871530319666190614121738] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2019] [Revised: 03/26/2019] [Accepted: 05/10/2019] [Indexed: 12/11/2022]
Abstract
BACKGROUND AND AIM Recent data have shown that olfactory dysfunction is strongly related to Alzheimer's Disease (AD) that is often preceded by olfactory deficits suggesting that olfactory dysfunction might represent an early indicator of future cognitive in prediabetes. METHODS We have applied to a group of normal (n=15), prediabetic (n=16) and type 2 diabetic outpatients (n=15) olfactory testing, 1.5-T MRI scanner and detailed cognitive evaluation including the standard Mini-Mental State Examination (MMSE) form, Short Blessed Test (SBT), Letter Fluency Test (LFT) and the category fluency test with animal, Fruit and Vegetable Naming (CFT). RESULTS We have shown that Odour Threshold (OT), Discrimination (OD), and Identification (OI) scores and most cognitive test results were significantly different in the prediabetes and diabetes group compared to those in the control group. OD and OT were significantly different between the prediabetes and diabetes group, although the cognitive test results were only significantly different in the prediabetes and diabetes group compared to those in the control group. In evaluating the association between OI, OT, OD scores and specific cognitive tests, we have found, that impaired olfactory identification was the only parameter that correlated significantly with the SBT both in the pre-diabetes and diabetes group. Although spot glucose values were only correlated with OT, HbA1c levels were correlated with OT, OD, and OI, as well as results of the letter fluency test suggesting that HbA1c levels rather than the spot glucose values play a critical role in specific cognitive dysfunction. CONCLUSION To the best of our knowledge, this is the first prospective study to demonstrate a strong association between olfactory dysfunction and specific memory impairment in a population with prediabetes and diabetes suggesting that impaired olfactory identification might play an important role as a specific predictor of memory decline.
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Affiliation(s)
- Burak Yulug
- Department of Neurology, Alanya AlaaddinKeykubat University, Antalya/Alanya, Turkey.,Istanbul Medipol University, Restorative and Regenerative Medicine Center, Istanbul, Turkey
| | - Ozlem Saatci
- Department of Otorhinolaryngology, Istanbul Sancaktepe, Education and Research Hospital, Istanbul, Turkey
| | - Aysun Işıklar
- Department of Internal Medicine, Istanbul Sancaktepe, Education and Research Hospital, Istanbul, Turkey
| | - Lutfu Hanoglu
- Department of Neurology, Istanbul Medipol University, Istanbul, Turkey
| | - Ulkan Kilic
- Department of Medical Biology, University of Health Sciences, Faculty of Medicine, Istanbul, Turkey
| | - Mehmet Ozansoy
- Istanbul Medipol University, Restorative and Regenerative Medicine Center, Istanbul, Turkey
| | - Seyda Cankaya
- Department of Neurology, Alanya AlaaddinKeykubat University, Antalya/Alanya, Turkey
| | - Baris Cankaya
- Department of Anesthesiology and Reanimation, Marmara University Pendik Education and Research Hospital, Istanbul, Turkey
| | - Ertugrul Kilic
- Istanbul Medipol University, Restorative and Regenerative Medicine Center, Istanbul, Turkey.,Department of Physiology, Istanbul Medipol University, International School of Medicine, Istanbul, Turkey
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7
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Bangen KJ, Armstrong NM, Au R, Gross AL. Metabolic Syndrome and Cognitive Trajectories in the Framingham Offspring Study. J Alzheimers Dis 2020; 71:931-943. [PMID: 31450495 DOI: 10.3233/jad-190261] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Metabolic syndrome (MetS) has been linked to increased risk of developing cognitive impairment and dementia including Alzheimer's disease. It remains unclear whether and at what stage in the adult lifespan MetS and its components begin to alter the trajectory of cognitive performance. In the present study, 2,892 Framingham Offspring participants completed health assessments every four years since 1971 and underwent repeat neuropsychological testing from 1999 to 2014. We estimated the associations of levels and changes in cognitive trajectories with hazard of MetS using a joint growth/survival model. All models were adjusted for baseline age, sex, education, and smoking status. Findings showed that both mid-life and late-life MetS were associated with lower level of cognitive functioning but not cognitive trajectories. Associations were strongest among those who were nondemented and apolipoprotein (APOE) ɛ4 noncarriers. In addition, individuals with the most rapid cognitive decline were more likely to have MetS. The pattern of results showed that associations between MetS and cognition varied, depending upon whether the sample was stratified by genetic and cognitive status and whether we considered cognitive performance as a continuous variable or examined categorical groupings. Given that mid-life MetS was associated with poorer cognition at age 55, cognitive changes may occur early during the MetS process. Our findings suggest that those with MetS are at greater risk of dementia given their lower level of cognitive functioning and also suggest that MetS may be a risk factor for decline in the absence of known risk factors including the APOEɛ4 allele.
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Affiliation(s)
- Katherine J Bangen
- VA San Diego Healthcare System, San Diego, CA, USA.,Department of Psychiatry, University of California, La Jolla, CA, USA
| | - Nicole M Armstrong
- Laboratory of Behavioral Neuroscience, National Institute on Aging, Baltimore, MD, USA
| | - Rhoda Au
- Department of Anatomy & Neurobiology and Neurology, Framingham Heart Study, Boston University School of Medicine, Boston, MA.,Department of Epidemiology, Boston University School of Public Health, Boston, MA
| | - Alden L Gross
- Department of Epidemiology, Baltimore, MD, USA.,Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.,Johns Hopkins Center on Aging and Health, Baltimore, MD, USA
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8
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Zhao X, Han Q, Gang X, Wang G. Altered brain metabolites in patients with diabetes mellitus and related complications - evidence from 1H MRS study. Biosci Rep 2018; 38:BSR20180660. [PMID: 30104398 PMCID: PMC6127672 DOI: 10.1042/bsr20180660] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2018] [Revised: 07/23/2018] [Accepted: 08/09/2018] [Indexed: 12/24/2022] Open
Abstract
In recent years, diabetes mellitus (DM) has been acknowledged as an important factor for brain disorders. Significant alterations in brain metabolism have been demonstrated during the development of DM and its complications. Magnetic resonance spectroscopy (MRS), a cutting-edge technique used in biochemical analyses, non-invasively provides insights into altered brain metabolite levels in vivo This review aims to discuss current MRS data describing brain metabolite levels in DM patients with or without complications. Cerebral metabolites including N-acetylaspartate (NAA), creatine (Cr), choline (Cho), myo-inositol (mI), glutamate, and glutamine were significantly altered in DM patients, suggesting that energy metabolism, neurotransmission, and lipid membrane metabolism might be disturbed during the progression of DM. Changes in brain metabolites may be non-invasive biomarkers for DM and DM-related complications. Different brain regions presented distinct metabolic signatures, indicating region-specific diabetic brain damages. In addition to serving as biomarkers, MRS data on brain metabolites can also shed light on diabetic treatment monitoring. For example, exercise may restore altered brain metabolite levels and has beneficial effects on cognition in DM patients. Future studies should validate the above findings in larger populations and uncover the mechanisms of DM-induced brain damages.
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Affiliation(s)
- Xue Zhao
- Department of Endocrinology and Metabolism, The First Hospital of Jilin University, Changchun 130021, Jilin Province, China
| | - Qing Han
- Department of Orthopedics, The Second Hospital of Jilin University, Changchun 130021, Jilin Province, China
| | - Xiaokun Gang
- Department of Endocrinology and Metabolism, The First Hospital of Jilin University, Changchun 130021, Jilin Province, China
| | - Guixia Wang
- Department of Endocrinology and Metabolism, The First Hospital of Jilin University, Changchun 130021, Jilin Province, China
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9
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Kurita K, Henderson VW, Gatz M, St John J, Hodis HN, Karim R, Mack WJ. Association of bilateral oophorectomy with cognitive function in healthy, postmenopausal women. Fertil Steril 2016; 106:749-756.e2. [PMID: 27183047 DOI: 10.1016/j.fertnstert.2016.04.033] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2016] [Revised: 04/06/2016] [Accepted: 04/21/2016] [Indexed: 01/24/2023]
Abstract
OBJECTIVE To investigate the association between bilateral oophorectomy and cognitive performance in healthy, older women. DESIGN Retrospective analysis of clinical trial data. SETTING Academic research institution. PATIENT(S) Healthy postmenopausal women without signs or symptoms of cardiovascular disease or diabetes (n = 926). INTERVENTION(S) Randomized interventions (not the focus of this analysis) in analyzed trials included B-vitamins, soy isoflavones, oral estradiol, and matching placebos. MAIN OUTCOME MEASURE(S) Measures in five cognitive domains (executive functions, semantic memory, logical memory, visual memory, and verbal learning) and global cognitive function. RESULT(S) Using data from three clinical trials conducted under uniform conditions, bilateral oophorectomy and its timing were analyzed cross-sectionally and longitudinally in relation to cognitive function in linear regression models. Covariates included age, education, race/ethnicity, body mass index, trial, and randomized treatment (in longitudinal models). Duration of menopausal hormone use was considered as a possible mediator and effect modifier. Median age of oophorectomy was 45 years. When evaluating baseline cognition, we found that surgical menopause after 45 years of age was associated with lower performance in verbal learning compared with natural menopause. Evaluating the change in cognition over approximately 2.7 years, surgical menopause was associated with performance declines in visual memory for those who had an oophorectomy after 45 years of age and in semantic memory for those who had oophorectomy before 45 years of age compared with natural menopause. Oophorectomy after natural menopause was not associated with cognitive performance. Adjustment for duration of hormone use did not alter these associations. CONCLUSION(S) Cognitive associations with ovarian removal vary by timing of surgery relative to both menopause and age.
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Affiliation(s)
- Keiko Kurita
- Department of Population Health, School of Medicine, New York University, New York, New York
| | - Victor W Henderson
- Department of Health Research and Policy (Epidemiology) and Department of Neurology and Neurological Sciences, School of Medicine, Stanford University, Stanford, California
| | - Margaret Gatz
- Department of Psychology, University of Southern California, Los Angeles, California; Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California
| | - Jan St John
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California; Atherosclerosis Research Unit, Keck School of Medicine, University of Southern California, Los Angeles, California
| | - Howard N Hodis
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California; Atherosclerosis Research Unit, Keck School of Medicine, University of Southern California, Los Angeles, California; Department of Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California; Department of Molecular Pharmacology and Toxicology, School of Pharmacy, University of Southern California, Los Angeles, California
| | - Roksana Karim
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California; Atherosclerosis Research Unit, Keck School of Medicine, University of Southern California, Los Angeles, California
| | - Wendy J Mack
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California; Atherosclerosis Research Unit, Keck School of Medicine, University of Southern California, Los Angeles, California.
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10
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Wang Y, Xu XY, Feng CH, Li YL, Ge X, Zong GL, Wang YB, Feng B, Zhang P. Patients with type 2 diabetes exhibit cognitive impairment with changes of metabolite concentration in the left hippocampus. Metab Brain Dis 2015; 30:1027-34. [PMID: 25875132 PMCID: PMC4491369 DOI: 10.1007/s11011-015-9670-4] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2014] [Accepted: 04/07/2015] [Indexed: 11/26/2022]
Abstract
Type 2 diabetes mellitus (T2DM) is associated with cognitive dysfunction. Previous studies have reported the relationship between cerebral metabolite changes and glucose levels. However, the specific aspects of cognition that are affected by metabolic changes in T2DM- related cognitive impairment remain undetermined. In this study, 188 T2DM patients and 266 controls were recruited. Proton magnetic resonance spectra with a single voxel stimulated echo acquisition mode (STEAM) were acquired from the left hippocampus and the frontal lobe. Presence of T2DM negatively affected the scores of Mini-Mental State Examination (MMSE), sub-tests (i.e., attention and language) of MMSE, Montreal Cognitive Assessment (MoCA) according to the Beijing version, and sub-tests (i.e., visuospatial/executive reasoning, attention, and language) of MoCA, rather than the Wechsler Memory Scale - Revised in China (WMS-RC), and all memory sub-tests contained with the MMSE and MoCA frameworks. T2DM positively affected creatine and myoinositol peak areas from the left hippocampus, rather than metabolites in the left frontal lobe. Negative correlations were shown between the left hippocampal myoinositol levels and language scores, and between the left hippocampal creatine levels and visuospatial/executive scores in T2DM. These findings suggest that T2DM may be an independent risk factor for cognitive impairment. Further, the cognitive domains of visuospatial /executive reasoning, attention and language may be predominantly impaired in the early phases of T2DM-related cognitive impairment. In addition, left hippocampal myoinositol and creatine concentrations were associated with cognitive impairment in patients with T2DM.
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Affiliation(s)
- Yue Wang
- />Department of Neurology, East Hospital, Tongji University, Shanghai, China
| | - Xiao-yun Xu
- />Department of Neurology, Pudong New Area Zhoupu Hospital, Shanghai, China
| | - Chun-hua Feng
- />Department of Neurology, East Hospital, Tongji University, Shanghai, China
| | - Yuan-ling Li
- />Department of Neurology, East Hospital, Tongji University, Shanghai, China
| | - Xia Ge
- />Department of Neurology, East Hospital, Tongji University, Shanghai, China
| | - Gen-lin Zong
- />Department of Radiology, East Hospital, Tongji University, Shanghai, China
| | - Yi-bin Wang
- />Department of Radiology, East Hospital, Tongji University, Shanghai, China
| | - Bo Feng
- />Department of Endocrinology, East Hospital, Tongji University, Shanghai, China
| | - Peng Zhang
- />Shanghai Pudong New Area Center for Disease Control & Prevention, Shanghai, China
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11
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Pistollato F, Battino M. Role of plant-based diets in the prevention and regression of metabolic syndrome and neurodegenerative diseases. Trends Food Sci Technol 2014. [DOI: 10.1016/j.tifs.2014.07.012] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
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12
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Tully PJ, Baker RA. Current readings: neurocognitive impairment and clinical implications after cardiac surgery. Semin Thorac Cardiovasc Surg 2014; 25:237-44. [PMID: 24331146 DOI: 10.1053/j.semtcvs.2013.09.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/09/2013] [Indexed: 11/11/2022]
Abstract
The earliest reports of cardiac surgery literatures reported evidence of neurocognitive decline, highlighted in the 1995 statement of Consensus on assessment of neurobehavioral outcomes after cardiac surgery. Until now, the magnitude and clinical importance of neurocognitive outcomes continues to fluctuate and lack clarity. The aim of this review is to evaluate the contemporary status of neurocognitive outcomes in relation to pre-existing impairment, revascularization strategy, broader cardiovascular pathophysiological processes, and any longer-term clinical implications. Five studies published between 2009 and 2013 were reviewed. A meta-analysis did not find differences between on- and off-pump procedures. In other studies, there was evidence for extensive preoperative neurocognitive impairments. Additional 2 studies showed that longer-term neurocognitive impairment, including dementia, was not dissimilar to nonsurgical patients with cardiovascular disease. Currently, there is no convincing evidence to suggest that cardiac surgery, and cardiopulmonary bypass in particular, has a causal role in progression to dementia, or long-term deficit, independent of pre-existing neurocognitive impairments and cardiovascular disease.
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Affiliation(s)
- Phillip J Tully
- Cardiac Surgery Research and Perfusion, Cardiac and Thoracic Surgery Unit, Flinders Medical Centre and Flinders University, Adelaide, South Australia, Australia.; Discipline of Medicine, School of Medicine, The University of Adelaide, Adelaide, South Australia, Australia
| | - Robert A Baker
- Cardiac Surgery Research and Perfusion, Cardiac and Thoracic Surgery Unit, Flinders Medical Centre and Flinders University, Adelaide, South Australia, Australia..
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13
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Falkowski J, Atchison T, Debutte-Smith M, Weiner MF, O'Bryant S. Executive functioning and the metabolic syndrome: a project FRONTIER study. Arch Clin Neuropsychol 2013; 29:47-53. [PMID: 24152591 DOI: 10.1093/arclin/act078] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Abstract
Decrements in cognitive functioning have been linked to the metabolic syndrome (MetS), a risk factor for cardiovascular disease defined by the presence of three of the following: elevated blood pressure, increased waist circumference, elevated blood glucose, elevated triglycerides, and low high-density lipoprotein cholesterol. We examined the relationship between four measures of executive functioning (EF) and MetS as diagnosed by National Heart, Lung, and Blood Institute-American Heart Association criteria. MetS was examined in a rural population of 395 persons with a mean age of 61.3 years, 71.4% women, 37.0% Hispanic, 53.7% White non-Hispanic. There was a 61.0% prevalence of MetS. We derived a factor score from the four executive function measures which was used to compare those with and without the syndrome, as well as any additive effects of components of the syndrome. Those with MetS exhibited significantly poorer performance than those without the syndrome. However, there was no additive effect, having more components of the syndrome was not related to lower performance. The presence of MetS was associated with poorer EF in this rural cohort of community dwelling volunteers.
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Affiliation(s)
- Jed Falkowski
- Department of Psychiatry, Division of Psychology, University of Texas Southwestern Medical Center, Dallas, TX, USA
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14
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Gatto NM, Henderson VW, Hodis HN, St John JA, Lurmann F, Chen JC, Mack WJ. Components of air pollution and cognitive function in middle-aged and older adults in Los Angeles. Neurotoxicology 2013; 40:1-7. [PMID: 24148924 DOI: 10.1016/j.neuro.2013.09.004] [Citation(s) in RCA: 175] [Impact Index Per Article: 15.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2013] [Revised: 09/09/2013] [Accepted: 09/19/2013] [Indexed: 12/17/2022]
Abstract
While experiments in animals demonstrate neurotoxic effects of particulate matter (PM) and ozone (O3), epidemiologic evidence is sparse regarding the relationship between different constituencies of air pollution mixtures and cognitive function in adults. We examined cross-sectional associations between various ambient air pollutants [O3, PM2.5 and nitrogen dioxide (NO2)] and six measures of cognitive function and global cognition among healthy, cognitively intact individuals (n=1496, mean age 60.5 years) residing in the Los Angeles Basin. Air pollution exposures were assigned to each residential address in 2000-06 using a geographic information system that included monitoring data. A neuropsychological battery was used to assess cognitive function; a principal components analysis defined six domain-specific functions and a measure of global cognitive function was created. Regression models estimated effects of air pollutants on cognitive function, adjusting for age, gender, race, education, income, study and mood. Increasing exposure to PM2.5 was associated with lower verbal learning (β=-0.32 per 10 μg/m(3) PM2.5, 95% CI=-0.63, 0.00; p=0.05). Ambient exposure to NO2 >20 ppb tended to be associated with lower logical memory. Compared to the lowest level of exposure to ambient O3, exposure above 49 ppb was associated with lower executive function. Including carotid artery intima-media thickness, a measure of subclinical atherosclerosis, in models as a possible mediator did not attenuate effect estimates. This study provides support for cross-sectional associations between increasing levels of ambient O3, PM2.5 and NO2 and measures of domain-specific cognitive abilities.
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Affiliation(s)
- Nicole M Gatto
- Department of Epidemiology, Biostatistics & Population Medicine, School of Public Health, Loma Linda University, Loma Linda, CA, USA.
| | - Victor W Henderson
- Department of Health Research & Policy (Epidemiology), Stanford University, Stanford, CA, USA; Department of Neurology & Neurological Sciences, Stanford University, Stanford, CA, USA
| | - Howard N Hodis
- Department of Preventive Medicine, Keck School of Medicine, USC, Los Angeles, CA, USA; Atherosclerosis Research Unit, Department of Medicine, Keck School of Medicine, USC, Los Angeles, CA, USA
| | - Jan A St John
- Department of Preventive Medicine, Keck School of Medicine, USC, Los Angeles, CA, USA; Atherosclerosis Research Unit, Department of Medicine, Keck School of Medicine, USC, Los Angeles, CA, USA
| | | | - Jiu-Chiuan Chen
- Department of Preventive Medicine, Keck School of Medicine, USC, Los Angeles, CA, USA
| | - Wendy J Mack
- Department of Preventive Medicine, Keck School of Medicine, USC, Los Angeles, CA, USA; Atherosclerosis Research Unit, Department of Medicine, Keck School of Medicine, USC, Los Angeles, CA, USA
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15
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Watts AS, Loskutova N, Burns JM, Johnson DK. Metabolic syndrome and cognitive decline in early Alzheimer's disease and healthy older adults. J Alzheimers Dis 2013; 35:253-65. [PMID: 23388170 DOI: 10.3233/jad-121168] [Citation(s) in RCA: 50] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Metabolic syndrome (MetS) is a cluster of risk factors (i.e., abdominal obesity, hypertension, dyslipidemia, glucose and insulin dysregulation) that is associated with cardiovascular disease, diabetes, and dementia. Recent studies addressing the association of MetS with cognitive performance and risk for dementia report mixed results. An important step in clarifying these conflicting results is determining whether cognition is influenced by the effects of individual MetS components versus the additive effects of multiple components. We assessed the effect of MetS on cognitive performance and decline over two years in 75 cases of early Alzheimer's disease (AD) and 73 healthy older adult controls in the Brain Aging Project. Using factor analytic techniques, we compared the effect of a combined MetS factor to the effect of individual MetS components on change in attention, verbal memory, and mental status. In healthy controls, a combined MetS factor did not significantly predict cognitive performance, though higher insulin predicted poorer cognitive performance outcomes. In the AD group, higher scores on a combined MetS factor predicted better cognitive outcomes. Our findings suggest that MetS does not have the same association with cognitive decline in healthy older adults and those with early AD. We suggest that individual MetS components should not be evaluated in isolation and that careful methodological approaches are needed to understand the timing and non-linear relationships among these components over time.
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Affiliation(s)
- Amber S Watts
- Department of Psychology, University of Kansas, Lawrence, KS, USA Gerontology Center, Lifespan Institute, University of Kansas, Lawrence, KS, USA.
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16
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Skogen JC, Øverland S, Smith AD, Mykletun A, Stewart R. The impact of early life factors on cognitive function in old age: The Hordaland Health Study (HUSK). BMC Psychol 2013; 1:16. [PMID: 25566368 PMCID: PMC4270022 DOI: 10.1186/2050-7283-1-16] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2013] [Accepted: 09/12/2013] [Indexed: 01/01/2023] Open
Abstract
Background Previous studies have shown that adverse conditions during fetal and early life are associated with lower performance on neurocognitive tests in childhood, adolescence and adult life. There is, however, a paucity in studies investigating these associations into old age. The aim was to investigate the impact of early life factors on cognitive function in old age by taking advantage of the potential for a linkage between a community survey and historical birth records. Methods A historical cohort study employing a linkage between a community survey of people aged 72–74 years with the participants’ birth records (n=346). Early life factors included anthropometric measures taken at birth, birth complications, parental socioeconomic status, and maternal health status. The main outcome was a z-scored composite cognitive score, based on test scores from Kendrick Object Learning Test, Trail Making Test A, a modified version of the Digit Symbol Test, Block Design, a modified version of Mini-Mental State Examination and an abridged version of the Controlled Oral Word Association Test (COWAT). The separate cognitive tests were also individually analysed in relation to measures identified at birth. Results Higher parental socioeconomic status (SES; based on father’s occupation) was associated with a higher value on the composite cognitive score (by 0.25 SD, p=0.0146) and higher Digit Symbol and Trail Making Test A performance. Higher head circumference at birth was associated with higher COWAT and Trail Making Test A performance. Both higher parental SES and head circumference at birth predicted cognitive function in old age independently of each other. There were no other consistent associations. Conclusions In general we found little evidence for a substantial role of early life factors on late-life cognitive function. However, there was some evidence for an association with parental SES status and head circumference on certain cognitive domains.
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Affiliation(s)
- Jens Christoffer Skogen
- Faculty of Psychology, Department of Health Promotion and Development, University of Bergen, Bergen, Norway ; Division of Mental Health, Department of Public Mental Health, Norwegian Institute of Public Health, Bergen, Norway
| | - Simon Øverland
- Faculty of Psychology, Department of Health Promotion and Development, University of Bergen, Bergen, Norway ; Division of Mental Health, Department of Public Mental Health, Norwegian Institute of Public Health, Bergen, Norway
| | - A David Smith
- Department of Pharmacology, University of Oxford, Oxford, UK
| | - Arnstein Mykletun
- Faculty of Psychology, Department of Health Promotion and Development, University of Bergen, Bergen, Norway ; Division of Mental Health, Department of Public Mental Health, Norwegian Institute of Public Health, Bergen, Norway
| | - Robert Stewart
- King's College London (Institute of Psychiatry), London, UK
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Beck B, Pourié G. Ghrelin, neuropeptide Y, and other feeding-regulatory peptides active in the hippocampus: role in learning and memory. Nutr Rev 2013; 71:541-61. [PMID: 23865799 DOI: 10.1111/nure.12045] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Abstract
The hippocampus is a brain region of primary importance for neurogenesis, which occurs during early developmental states as well as during adulthood. Increases in neuronal proliferation and in neuronal death with age have been associated with drastic changes in memory and learning. Numerous neurotransmitters are involved in these processes, and some neuropeptides that mediate neurogenesis also modulate feeding behavior. Concomitantly, feeding peptides, which act primarily in the hypothalamus, are also present in the hippocampus. This review aims to ascertain the role of several important feeding peptides in cognitive functions, either through their local synthesis in the hippocampus or through their actions via specific receptors in the hippocampus. A link between neurogenesis and the orexigenic or anorexigenic properties of feeding peptides is discussed.
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Affiliation(s)
- Bernard Beck
- INSERM U954, Nutrition, Génétique et Expositions aux Risques Environnementaux, Faculté de Médecine, Vandœuvre, France.
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Haley AP, Gonzales MM, Tarumi T, Tanaka H. Subclinical vascular disease and cerebral glutamate elevation in metabolic syndrome. Metab Brain Dis 2012; 27:513-20. [PMID: 22552897 PMCID: PMC3614081 DOI: 10.1007/s11011-012-9306-x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2012] [Accepted: 04/12/2012] [Indexed: 01/22/2023]
Abstract
Metabolic syndrome (MetS), the co-occurrence of obesity, hypertension, hyperglycemia and dyslipidema, is an important risk factor for diabetes, cardiovascular disease and end-organ damage in the brain. Our goal was to determine if metabolic syndrome (MetS) differentially affects cerebral metabolism in middle-aged adults with varying degrees of subclinical vascular disease. Sixty-five neurologically healthy adults aged 40 to 60 years (19 with MetS and 46 controls) underwent ultrasound examination of carotid artery intima-media thickness (IMT), a measure of peripheral vascular disease, a full neuropsychological evaluation, and a proton magnetic resonance spectroscopy ((1)H MRS) scan of occipitoparietal grey matter. The Johnson-Neyman technique and pick-a-point approach were used to test if MetS-related neurochemical changes were moderated by IMT. The MetS and control groups were comparable in age, education, gender distribution, average IMT, and cognitive performance. MetS individuals with low IMT values (1 SD below sample mean) demonstrated comparable neurochemical concentrations to the healthy controls (t = -0.21, p = 0.84, 95 % CI -0.106 to 0.086), while MetS individuals with high IMT values (1 SD above sample mean) exhibited significantly elevated glutamate concentrations (t = 2.84, p = 0.006, 95 % CI 0.038 to 0.220). We found that the level of peripheral atherosclerosis moderated the level of elevation of cerebral glutamate concentrations in patients with MetS. These results suggest that peripheral metabolic dysfunction in midlife likely acts in conjunction with subclinical vascular disease to foster pro-neurotoxic conditions in the central nervous system creating early brain vulnerability.
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Affiliation(s)
- Andreana P Haley
- Department of Psychology, The University of Texas at Austin, 1 University Station, A8000, Austin, TX, 78712, USA.
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19
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Tamosiunas A, Baceviciene M, Reklaitiene R, Radisauskas R, Jureniene K, Azaraviciene A, Luksiene D, Malinauskiene V, Daugeliene E, Sapranaviciute-Zabazlajeva L. Cardiovascular risk factors and cognitive function in middle aged and elderly Lithuanian urban population: results from the HAPIEE study. BMC Neurol 2012. [PMID: 23199035 PMCID: PMC3517768 DOI: 10.1186/1471-2377-12-149] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Background The purpose of this study was to examine associations between cardiovascular risk factors and cognitive ability in middle aged and elderly Lithuanian urban population. Methods Data from the survey performed in the framework of the HAPIEE (Health, Alcohol, Psychosocial Factors in Eastern Europe) study were presented. A random sample of 7,087 individuals aged 45–72 years was screened in 2006–2008. Results The scores of immediate recall and delayed verbal recall, cognitive speed and attention were significantly lower in men than in women; yet numerical ability scores were higher in men. Significant associations between lowered cognitive functions and previous stroke (in male OR = 2.52; 95% CI = 1.75-3.64; in female OR = 2.45; 95% CI = 1.75, 3.64) as well as ischemic heart disease history (among male OR = 1.28; 95% CI = 1.03-1.60) have been determined. Higher level of physical activity in leisure time (among female OR = 1.32; 95% CI = 1.03-1.69), poor self-rated health (among male OR = 1.57; 95% CI = 1.15-2.14) and poor quality of life (in male OR = 1.67; 95% CI = 1.07-2.61; in female OR = 2.81; 95% CI = 1.92-4.11) were related to lowered cognitive function. Conclusions The findings of the study suggest that associations between cardiovascular risk factors and lowered cognitive function among healthy middle-aged and elderly adults strongly depend on gender.
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Affiliation(s)
- Abdonas Tamosiunas
- Lithuanian University of Health Sciences, Academy of Medicine, Institute of Cardiology, Sukileliu 17, 50009, Kaunas, Lithuania.
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20
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Yau PL, Castro, BS MG, Tagani A, Tsui WH, Convit A. Obesity and metabolic syndrome and functional and structural brain impairments in adolescence. Pediatrics 2012; 130:e856-64. [PMID: 22945407 PMCID: PMC3457620 DOI: 10.1542/peds.2012-0324] [Citation(s) in RCA: 169] [Impact Index Per Article: 14.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND The prevalence of metabolic syndrome (MetS) parallels the rise in childhood obesity. MetS is associated with neurocognitive impairments in adults, but this is thought to be a long-term effect of poor metabolism. It would be important to ascertain whether these brain complications are also present among adolescents with MetS, a group without clinically manifest vascular disease and relatively short duration of poor metabolism. METHODS Forty-nine adolescents with and 62 without MetS, matched on age, socioeconomic status, school grade, gender, and ethnicity, received endocrine, MRI, and neuropsychological evaluations. RESULTS Adolescents with MetS showed significantly lower arithmetic, spelling, attention, and mental flexibility and a trend for lower overall intelligence. They also had, in a MetS-dose-related fashion, smaller hippocampal volumes, increased brain cerebrospinal fluid, and reductions of microstructural integrity in major white matter tracts. CONCLUSIONS We document lower cognitive performance and reductions in brain structural integrity among adolescents with MetS, thus suggesting that even relatively short-term impairments in metabolism, in the absence of clinically manifest vascular disease, may give rise to brain complications. In view of these alarming results, it is plausible that obesity-associated metabolic disease, short of type 2 diabetes mellitus, may be mechanistically linked to lower the academic and professional potential of adolescents. Although obesity may not be enough to stir clinicians or even parents into action, these results in adolescents strongly argue for an early and comprehensive intervention. We propose that brain function be introduced among the parameters that need to be evaluated when considering early treatment of childhood obesity.
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Affiliation(s)
| | | | | | | | - Antonio Convit
- Departments of Psychiatry and,Medicine, New York University School of Medicine, New York, New York; and,Nathan Kline Institute for Psychiatric Research, Orangeburg, New York
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22
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Yates KF, Sweat V, Yau PL, Turchiano MM, Convit A. Impact of metabolic syndrome on cognition and brain: a selected review of the literature. Arterioscler Thromb Vasc Biol 2012; 32:2060-7. [PMID: 22895667 PMCID: PMC3442257 DOI: 10.1161/atvbaha.112.252759] [Citation(s) in RCA: 293] [Impact Index Per Article: 24.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Metabolic syndrome (MetS), a clustering of risk factors for type 2 diabetes mellitus and cardiovascular disease, has been associated with cognitive dysfunction and brain abnormalities. This review describes the literature on the impact of MetS on brain and cognition and suggests directions for future research. A literature search for reports of MetS and cognition and brain imaging was conducted for both nonelderly adults and adolescents. No studies were found describing MetS and brain or cognition among adolescents; therefore, we also included studies investigating individual components of MetS in this age group. Most studies found associations between MetS and cognitive dysfunction. Multiple cognitive domains were affected by MetS in adults. In adolescents, the majority of findings were in executive functioning. Brain imaging literature in adults implicated MetS in ischemic stroke, white matter alterations, and altered brain metabolism. For adolescents, individual MetS factors were linked to volume losses in the hippocampus and frontal lobes. MetS negatively impacts cognitive performance and brain structure. Potential explanatory models include impaired vascular reactivity, neuroinflammation, oxidative stress, and abnormal brain lipid metabolism. We posit that insulin resistance-associated impairment in cerebrovascular reactivity is an important mechanism underlying brain deficits seen in MetS.
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Affiliation(s)
- Kathy F. Yates
- Department of Psychiatry, New York University School of Medicine, 550 First Avenue, New York, NY 10016 USA
- Nathan Kline Institute for Psychiatric Research, 140 Old Orangeburg Rd., Orangeburg, NY 10962 USA
| | - Victoria Sweat
- Department of Psychiatry, New York University School of Medicine, 550 First Avenue, New York, NY 10016 USA
| | - Po Lai Yau
- Department of Psychiatry, New York University School of Medicine, 550 First Avenue, New York, NY 10016 USA
| | - Michael M. Turchiano
- Department of Psychiatry, New York University School of Medicine, 550 First Avenue, New York, NY 10016 USA
| | - Antonio Convit
- Department of Psychiatry, New York University School of Medicine, 550 First Avenue, New York, NY 10016 USA
- Department of Medicine, New York University School of Medicine, 550 First Avenue, New York, NY 10016 USA
- Nathan Kline Institute for Psychiatric Research, 140 Old Orangeburg Rd., Orangeburg, NY 10962 USA
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23
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Sartorius T, Ketterer C, Kullmann S, Balzer M, Rotermund C, Binder S, Hallschmid M, Machann J, Schick F, Somoza V, Preissl H, Fritsche A, Häring HU, Hennige AM. Monounsaturated fatty acids prevent the aversive effects of obesity on locomotion, brain activity, and sleep behavior. Diabetes 2012; 61:1669-79. [PMID: 22492529 PMCID: PMC3379681 DOI: 10.2337/db11-1521] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Fat and physical inactivity are the most evident factors in the pathogenesis of obesity, and fat quality seems to play a crucial role for measures of glucose homeostasis. However, the impact of dietary fat quality on brain function, behavior, and sleep is basically unknown. In this study, mice were fed a diet supplemented with either monounsaturated fatty acids (MUFAs) or saturated fatty acids (SFAs) and their impact on glucose homeostasis, locomotion, brain activity, and sleep behavior was evaluated. MUFAs and SFAs led to a significant increase in fat mass but only feeding of SFAs was accompanied by glucose intolerance in mice. Radiotelemetry revealed a significant decrease in cortical activity in SFA-mice whereas MUFAs even improved activity. SFAs decreased wakefulness and increased non-rapid eye movement sleep. An intracerebroventricular application of insulin promoted locomotor activity in MUFA-fed mice, whereas SFA-mice were resistant. In humans, SFA-enriched diet led to a decrease in hippocampal and cortical activity determined by functional magnetic resonance imaging techniques. Together, dietary intake of MUFAs promoted insulin action in the brain with its beneficial effects for cortical activity, locomotion, and sleep, whereas a comparable intake of SFAs acted as a negative modulator of brain activity in mice and humans.
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Affiliation(s)
- Tina Sartorius
- Department of Internal Medicine, Division of Endocrinology, Diabetology, and Vascular Disease, University of Tuebingen, Tuebingen, Germany
| | - Caroline Ketterer
- Department of Internal Medicine, Division of Endocrinology, Diabetology, and Vascular Disease, University of Tuebingen, Tuebingen, Germany
| | | | - Michelle Balzer
- German Research Center for Food Chemistry, Freising, Germany
| | - Carola Rotermund
- Department of Internal Medicine, Division of Endocrinology, Diabetology, and Vascular Disease, University of Tuebingen, Tuebingen, Germany
| | - Sonja Binder
- Department of Neuroendocrinology, University of Luebeck, Luebeck, Germany
| | - Manfred Hallschmid
- Department of Neuroendocrinology, University of Luebeck, Luebeck, Germany
| | - Jürgen Machann
- Section on Experimental Radiology, Department of Diagnostic and Interventional Radiology, University of Tuebingen, Tuebingen, Germany
| | - Fritz Schick
- Section on Experimental Radiology, Department of Diagnostic and Interventional Radiology, University of Tuebingen, Tuebingen, Germany
| | - Veronika Somoza
- Department of Nutritional and Physiological Chemistry, University of Vienna, Vienna, Austria
| | - Hubert Preissl
- MEG Center, University of Tuebingen, Tuebingen, Germany
- Department of Obstetrics and Gynecology, University of Arkansas for Medical Sciences, Little Rock, Arkansas
| | - Andreas Fritsche
- Department of Internal Medicine, Division of Clinical Chemistry, University of Tuebingen, Tuebingen, Germany
| | - Hans-Ulrich Häring
- Department of Internal Medicine, Division of Endocrinology, Diabetology, and Vascular Disease, University of Tuebingen, Tuebingen, Germany
- Corresponding author: Hans-Ulrich Häring,
| | - Anita M. Hennige
- Department of Internal Medicine, Division of Endocrinology, Diabetology, and Vascular Disease, University of Tuebingen, Tuebingen, Germany
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Valcour V, Maki P, Bacchetti P, Anastos K, Crystal H, Young M, Mack WJ, Cohen M, Golub ET, Tien PC. Insulin resistance and cognition among HIV-infected and HIV-uninfected adult women: the Women's Interagency HIV Study. AIDS Res Hum Retroviruses 2012; 28:447-53. [PMID: 21878059 DOI: 10.1089/aid.2011.0159] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Cognitive impairment remains prevalent in the era of combination antiretroviral therapy (cART) and may be partially due to comorbidities. We postulated that insulin resistance (IR) is negatively associated with cognitive performance. We completed a cross-sectional analysis among 1547 (1201 HIV(+)) women enrolled in the Women's Interagency HIV Study (WIHS). We evaluated the association of IR with cognitive measures among all WIHS women with concurrent fasting bloods and cognitive testing [Trails A, Trails B, and Symbol Digit Modalities Test (SDMT)] using multiple linear regression models. A smaller subgroup also completed the Stroop test (n=1036). IR was estimated using the Homeostasis Model Assessment (HOMA). Higher HOMA was associated with poorer performance on the SDMT, Stroop Color-Naming (SCN) trial, and Stroop interference trial, but remained statistically significant only for the SCN in models adjusting for important factors [β=3.78 s (95% CI: 0.48-7.08), p=0.025, for highest vs. lowest quartile of HOMA]. HIV status did not appear to substantially impact the relationship of HOMA with SCN. There was a small but statistically significant association of HOMA and reduced neuropsychological performance on the SCN test in this cohort of women.
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Affiliation(s)
- Victor Valcour
- Memory and Aging Center, Department of Neurology and Division of Geriatric Medicine, Department of Medicine, University of California at San Francisco, San Francisco, California
| | - Pauline Maki
- Departments of Psychiatry and Psychology, University of Illinois at Chicago, Chicago, Illinois
| | - Peter Bacchetti
- Department of Epidemiology and Biostatistics, University of California at San Francisco, San Francisco, California
| | - Kathryn Anastos
- Department of Medicine, Montefiore Medical Center and Albert Einstein College of Medicine, Bronx, New York
| | | | - Mary Young
- Georgetown University Medical Center, Washington, District of Columbia
| | - Wendy J. Mack
- Department of Preventive Medicine, University of Southern California, Los Angeles, California
| | - Mardge Cohen
- Department of Medicine, Stroger Hospital and Rush University, Chicago, Illinois
| | - Elizabeth T. Golub
- Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland
| | - Phyllis C. Tien
- Department Medicine, University of California at San Francisco and Veterans Affairs Medical Center, San Francisco, California
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25
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Vieira JR, Elkind MSV, Moon YP, Rundek T, Boden-Albala B, Paik MC, Sacco RL, Wright CB. The metabolic syndrome and cognitive performance: the Northern Manhattan Study. Neuroepidemiology 2011; 37:153-9. [PMID: 22005335 DOI: 10.1159/000332208] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2011] [Accepted: 08/25/2011] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND The metabolic syndrome (MetS) is a risk factor for diabetes, stroke, myocardial infarction, and increased mortality, and has been associated with cognition in some populations. We hypothesized that MetS would be associated with lower Mini-Mental State Examination (MMSE) scores in a multi-ethnic population, and that MetS is a better predictor of cognition than its individual components or diabetes. METHODS We conducted a cross-sectional analysis among 3,150 stroke-free participants. MetS was defined by the modified National Cholesterol Education Program guidelines-Adult Treatment Panel III (NCEP-ATPIII) criteria. Linear regression and polytomous logistic regression estimated the association between MMSE score and MetS, its individual components, diabetes, and inflammatory biomarkers. RESULTS MetS was inversely associated with MMSE score (unadjusted β = -0.67; 95% CI -0.92, -0.41). Adjusting for potential confounders, MetS was associated with lower MMSE score (adjusted β = -0.24; 95% CI -0.47, -0.01), but its individual components and diabetes were not. Those with MetS were more likely to have an MMSE score of <18 than a score of ≥ 24 (adjusted OR = 1.94; 95% CI 1.26, 3.01). There was an interaction between MetS and race-ethnicity, such that MetS was associated with lower MMSE score among non-Hispanic whites and Hispanics but not non-Hispanic blacks. CONCLUSIONS MetS was associated with lower cognition in a multi-ethnic population. Further studies of the effect of MetS on cognition are warranted, and should account for demographic differences.
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Affiliation(s)
- Julio R Vieira
- Department of Neurology, College of Physicians and Surgeons, Columbia University, New York, NY, USA
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26
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Gonzales MM, Tarumi T, Eagan DE, Tanaka H, Biney FO, Haley AP. Current serum lipoprotein levels and FMRI response to working memory in midlife. Dement Geriatr Cogn Disord 2011; 31:259-67. [PMID: 21494033 PMCID: PMC3085033 DOI: 10.1159/000324713] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 01/30/2011] [Indexed: 11/19/2022] Open
Abstract
AIMS Given that high cholesterol levels at midlife are a risk factor for future cognitive decline, the goal of the current study was to determine if cholesterol-related alterations in the cerebrovascular response to cognition could be detected at midlife. METHODS Forty adults, aged 40-60 years, performed a 2-Back working memory task during fMRI. The associations between serum total cholesterol, HDL-cholesterol, and total cholesterol/HDL-cholesterol concentrations to task-related activation intensity were modeled using multivariate multiple regression (two-tailed p < 0.02). RESULTS Higher levels of total cholesterol/HDL-cholesterol related to reduced working memory-related activation intensity in the left inferior parietal lobe, right superior frontal gyrus, and right middle frontal gyrus. CONCLUSION These data provide preliminary support for a deleterious effect of elevated total cholesterol/HDL-cholesterol ratio on cerebrovascular support for cognition in midlife.
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Affiliation(s)
- Mitzi M. Gonzales
- Department of Psychology, The University of Texas at Austin, Tex., USA
| | - Takashi Tarumi
- Department of Kinesiology and Health Education, The University of Texas at Austin, Tex., USA
| | - Danielle E. Eagan
- Department of Psychology, The University of Texas at Austin, Tex., USA
| | - Hirofumi Tanaka
- Department of Kinesiology and Health Education, The University of Texas at Austin, Tex., USA
| | - Fedora O. Biney
- Department of Psychology, The University of Texas at Austin, Tex., USA
| | - Andreana P. Haley
- Department of Psychology, The University of Texas at Austin, Tex., USA,University of Texas Imaging Research Center, Austin, Tex., USA,*Andreana P. Haley, PhD, Department of Psychology, The University of Texas at Austin, 108 E. Dean Keaton, SEA 4.110, Austin, TX 78712 (USA), Tel. +1 512 232 0863, E-Mail
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Ooi CP, Loke SC, Yassin Z, Hamid T. Carbohydrates for improving the cognitive performance of independent-living older adults with normal cognition or mild cognitive impairment. Cochrane Database Syst Rev 2011; 2011:CD007220. [PMID: 21491398 PMCID: PMC7388979 DOI: 10.1002/14651858.cd007220.pub2] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
BACKGROUND Mild cognitive impairment (MCI) is an intermediate state between normal cognition and dementia in which daily function is largely intact. This condition may present an opportunity for research into the prevention of dementia. Carbohydrate is an essential and easily accessible macronutrient which influences cognitive performance. A better understanding of carbohydrate-driven cognitive changes in normal cognition and mild cognitive impairment may suggest ways to prevent or reduce cognitive decline. OBJECTIVES To assess the effectiveness of carbohydrates in improving cognitive function in older adults. SEARCH STRATEGY We searched ALOIS, the Cochrane Dementia and Cognitive Improvement Group Specialized Register on 22 June 2010 using the terms: carbohydrates OR carbohydrate OR monosaccharides OR disaccharides OR oligosaccharides OR polysaccharides OR CARBS. ALOIS contains records from all major healthcare databases (The Cochrane Library, MEDLINE, EMBASE, PsycINFO, CINAHL, LILACS) as well as from many trial databases and grey literature sources. SELECTION CRITERIA All randomised controlled trials (RCT) that have examined the efficacy of any form of carbohydrates in normal cognition and MCI. DATA COLLECTION AND ANALYSIS One review author selected and retrieved relevant articles for further assessment. The remaining authors independently assessed whether any of the retrieved trials should be included. Disagreements were resolved by discussion. MAIN RESULTS There is no suitable RCT of any form of carbohydrates involving independent-living older adults with normal cognition or mild cognitive impairment. AUTHORS' CONCLUSIONS There are no suitable RCTs on which to base any recommendations about the use of any form of carbohydrate for enhancing cognitive performance in older adults with normal cognition or mild cognitive impairment. More studies of many different carbohydrates are needed to tease out complex nutritional issues and further evaluate memory improvement.
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Affiliation(s)
- Cheow Peng Ooi
- Faculty of Medicine and Health Sciences, Universiti Putra MalaysiaEndocrine Unit, Department of MedicineSerdangSelangor DEMalaysia43400
| | - Seng Cheong Loke
- Universiti Putra MalaysiaInstitute of GerontologySerdangSelangor DEMalaysia43400
| | - Zaitun Yassin
- University Putra MalaysiaDepartment of Nutrition and Dietetics, Faculty of Medicine & Health Sciences43400 UPM SerdangSelangorMalaysia
| | - Tengku‐Aizan Hamid
- Universiti Putra MalaysiaInstitute of GerontologySerdangSelangor DEMalaysia43400
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Hao Z, Wu B, Wang D, Liu M. Association between metabolic syndrome and cognitive decline: a systematic review of prospective population-based studies. Acta Neuropsychiatr 2011; 23:69-74. [PMID: 26952861 DOI: 10.1111/j.1601-5215.2011.00527.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
OBJECTIVE The association between metabolic syndrome (MS) and the risk of cognitive impairment or dementia remains unclear. In this article, we systematically review studies on the risk of cognitive disorders in patients with MS to determine the strength of the association between MS and cognitive decline. METHODS Electronic databases through December 2009 were searched to identify prospective population-based studies that examined the association between MS and risk of cognitive disorders. Two reviewers used a standardised form to collect data and assess eligibility. The quality of study was assessed by the Newcastle-Ottawa Scale. RESULTS We found nine eligible studies that involve 19 876 participants. All studies but two indicate that MS is associated with cognitive decline (from one-fold to more than two-fold increase in risk). It seems that MS may be associated with cognitive impairment (positive results in three of five) and vascular dementia (positive results in two of three), whereas three studies involving patients with Alzheimer's disease (AD) did not find the association between MS and AD. When examining the association of the individual risk factors of the MS and cognition in seven eligible studies, glucose (three studies) and hypertension (three studies) showed positive results associated with cognitive decline. CONCLUSION The MS may be associated with cognitive impairment and vascular dementia but not for AD, which need to be further investigated with high-quality studies.
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Affiliation(s)
- Zilong Hao
- Stroke Clinical Research Unit, Department of Neurology, State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Sichuan University, Chengdu, Sichuan Province, P. R. China
| | - Bo Wu
- Stroke Clinical Research Unit, Department of Neurology, State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Sichuan University, Chengdu, Sichuan Province, P. R. China
| | - Deren Wang
- Stroke Clinical Research Unit, Department of Neurology, State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Sichuan University, Chengdu, Sichuan Province, P. R. China
| | - Ming Liu
- Stroke Clinical Research Unit, Department of Neurology, State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Sichuan University, Chengdu, Sichuan Province, P. R. China
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Hoth KF, Gonzales MM, Tarumi T, Miles SC, Tanaka H, Haley AP. Functional MR imaging evidence of altered functional activation in metabolic syndrome. AJNR Am J Neuroradiol 2011; 32:541-7. [PMID: 21183618 PMCID: PMC8013105 DOI: 10.3174/ajnr.a2315] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2010] [Accepted: 08/11/2010] [Indexed: 12/13/2022]
Abstract
BACKGROUND AND PURPOSE MetS is a cluster of risk factors associated with significant cardiovascular morbidity and mortality and diminished cognitive function. Given that little is known about the early signs of brain vulnerability related to persistent metabolic dysfunction, we set out to determine whether cognitively healthy middle-aged individuals with MetS exhibit an altered cerebrovascular response to a cognitive challenge relative to those without MetS. MATERIALS AND METHODS Forty neurologically healthy adults aged 40-60 years (19 with MetS and 21 healthy controls) performed a 2-back verbal working memory task during fMRI. We compared BOLD responses between the 2 groups in 8 a priori regions of interest previously shown to be associated with the 2-back in patients with cardiovascular disease. RESULTS Age, education level, sex distribution, cognitive and emotional functioning, and task performance (accuracy and reaction time) were not different between the groups. Compared with healthy controls, individuals with MetS demonstrated a lower 2-back-related BOLD response in the right superior frontal gyrus, right superior parietal lobule, and left inferior parietal lobule. CONCLUSIONS This study provides preliminary evidence that cognitively intact middle-aged individuals with MetS exhibit significant alterations in cerebrovascular response to a cognitive challenge. Our results also demonstrate that fMRI may identify early brain changes associated with MetS.
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Affiliation(s)
- K F Hoth
- Department of Medicine, Division of Psychosocial Medicine, National Jewish Health, Denver, Colorado, USA
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Haley AP, Gonzales MM, Tarumi T, Miles SC, Goudarzi K, Tanaka H. Elevated cerebral glutamate and myo-inositol levels in cognitively normal middle-aged adults with metabolic syndrome. Metab Brain Dis 2010; 25:397-405. [PMID: 21063759 DOI: 10.1007/s11011-010-9221-y] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2010] [Accepted: 09/15/2010] [Indexed: 11/25/2022]
Abstract
Metabolic syndrome (MetS) is a cluster of risk factors associated with significant cardiovascular morbidity and mortality and diminished cognitive function. Given that the cerebral mechanisms mediating the relationship between peripheral metabolic dysfunction and cognitive impairment are unknown, we set out to examine the relationship between diagnosis of metabolic syndrome and cerebral metabolism. Thirteen participants with MetS (aged 48 ± 6 years) and 25 healthy adults (aged 51 ± 6 years) underwent neuropsychological assessment, health screen and proton magnetic resonance spectroscopy ((1)H MRS) examining N-acetyl-aspartate (NAA), myo-inositol (mI), creatine (Cr), choline (Cho), and glutamate (Glu) concentrations in occipitoparietal grey matter. Cerebral metabolite ratios (NAA/Cr, Cho/Cr, mI/Cr, and Glu/Cr) of participants with MetS, defined by the International Diabetes Federation criteria, were compared with controls matched for age, education, cognition, and emotional function. There were no significant differences in global cognitive function, memory, language, and psychomotor performance between the groups. Diagnosis of MetS was associated with significantly higher mI/Cr (F(1,36) = 5.02, p = 0.031) and Glu/Cr ratio (F(1,36) = 4.81, p = 0.035). Even in cognitively normal adults, MetS is related to cerebral metabolic disturbances, a possible indication of early brain vulnerability. Longitudinal studies that begin in mid-life can help validate the use of (1)H MRS markers as indicators of long-term cognitive outcomes.
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Affiliation(s)
- Andreana P Haley
- Department of Psychology, The University of Texas at Austin, 1 University Station, A8000, Austin, TX 78712, USA.
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Tournoy J, Lee DM, Pendleton N, O'Neill TW, O'Connor DB, Bartfai G, Casanueva FF, Finn JD, Forti G, Giwercman A, Han TS, Huhtaniemi IT, Kula K, Lean MEJ, Moseley CM, Punab M, Silman AJ, Vanderschueren D, Wu FCW, Boonen S. Association of cognitive performance with the metabolic syndrome and with glycaemia in middle-aged and older European men: the European Male Ageing Study. Diabetes Metab Res Rev 2010; 26:668-76. [PMID: 21043047 DOI: 10.1002/dmrr.1144] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
BACKGROUND AND AIMS Metabolic syndrome has been reported to have adverse effects on cognition although the results are conflicting. We investigated the association between metabolic syndrome and cognitive function in a population sample of middle-aged and older European men and whether any observed association could be explained by lifestyle or other confounding factors. METHODS A total of 3369 men in the 40- to 79-year age group were recruited from population registers in eight centres for participation in the European Male Ageing Study. The subjects completed a questionnaire instrument and several cognitive function tests including the Rey-Osterrieth Complex Figure test, the Camden Topographical Recognition Memory test and the Digit Symbol Substitution Test. Metabolic syndrome data were assessed at an invited visit and metabolic syndrome was defined by the National Cholesterol Education Program's Adult Treatment Panel-III criteria. Associations between cognitive performance and metabolic syndrome were explored using linear regression. RESULTS Complete cognitive and metabolic syndrome data from 3152 subjects were included in the analysis, of whom 1007 (32%) fulfilled criteria for metabolic syndrome. After adjustment for putative health and lifestyle confounders, no significant associations were found between any of the cognitive function scores and metabolic syndrome or between cognitive performance and high-sensitivity C-reactive protein. Analysis of the individual metabolic syndrome factors, however, revealed an inverse association between the level of glucose and cognitive performance. CONCLUSIONS Metabolic syndrome was not associated with cognitive impairment in this population. Of the individual components of the syndrome, diabetes was associated with poorer performances in memory, executive functions and processing speed, associations that warrant further investigation.
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Affiliation(s)
- Jos Tournoy
- Department of Experimental Medicine, Division of Gerontology and Geriatrics, Katholieke Universiteit Leuven, Herestraat 49, Leuven, Belgium.
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Zihl J, Schaaf L, Zillmer EA. The relationship between adult neuropsychological profiles and diabetic patients' glycemic control. ACTA ACUST UNITED AC 2010; 17:44-51. [PMID: 20146121 DOI: 10.1080/09084280903526133] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
The purpose of this study was to assess, in relation to metabolic control, the cognitive, depressive, and anxiety symptoms among 40 adult patients (age: 18-60 years) with either type 1 (n = 28) or type 2 (n = 12) diabetes mellitus (DM1, DM2). Nineteen healthy subjects matched for age, gender, and education served as the control group. For most cognitive domains, no significant performance differences were found between subjects from the diabetic groups and control subjects. However, diabetes patients demonstrated reduced information processing accuracy along with impaired visual and verbal working memory performance. In addition, psychopathology scores were significantly elevated but did not reach the clinical criteria for depression or anxiety. Overall, there were no significant differences between diabetic subgroups, and no significant correlation was found between cognitive performance, psychopathology scores, and HbA1c values for either subgroup. Thus, patients with DM1 or DM2 may show mild-to-moderate cognitive impairment as well as subtle psychopathological symptoms. While cognitive impairments may be understood in terms of diabetes-associated cognitive dysfunction, psychopathological symptoms may also result from unsuccessful coping with high task demands in everyday life activities. The outcome of the current study underscores the importance of early clinical neuropsychological standardized assessment as well as the diagnosis of cognitive and psychopathological symptoms in adult patients with diabetes.
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Affiliation(s)
- Josef Zihl
- Max Planck Institute of Psychiatry, 80404Munich, Germany.
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Brain glucose overexposure and lack of acute metabolic flexibility in obesity and type 2 diabetes: a PET-[18F]FDG study in Zucker and ZDF rats. J Cereb Blood Flow Metab 2010; 30:895-9. [PMID: 20179723 PMCID: PMC2949188 DOI: 10.1038/jcbfm.2010.27] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
Brain glucose exposure may complicate diabetes and obesity. We used positron emission tomography with (18)F-fluorodeoxyglucose in Zucker obese, diabetic, and control rats to determine the contributions of blood glucose mass action versus local mechanisms in regulating central glucose disposal in fasted and acutely glucose-stimulated states, and their adaptations in obesity and diabetes. Our study data indicate that brain glucose uptake is dependent on both local and mass action components, and is stimulated by acute glucose intake in healthy rats. In diseased animals, the organ was chronically overexposed to glucose, due to high fasting glucose uptake, almost abolishing the physiologic response to glucose loading.
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The effects of metabolic syndrome and apolipoprotein E4 on cognitive event-related potentials. Biol Psychol 2010; 83:56-61. [DOI: 10.1016/j.biopsycho.2009.10.004] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2009] [Revised: 09/05/2009] [Accepted: 10/18/2009] [Indexed: 11/22/2022]
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Akbaraly TN, Kivimaki M, Shipley MJ, Tabak AG, Jokela M, Virtanen M, Marmot MG, Ferrie JE, Singh-Manoux A. Metabolic syndrome over 10 years and cognitive functioning in late midlife: the Whitehall II study. Diabetes Care 2010; 33:84-9. [PMID: 19837794 PMCID: PMC2797991 DOI: 10.2337/dc09-1218] [Citation(s) in RCA: 58] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVE Evidence that the metabolic syndrome is a risk factor for poor cognition is mixed and is focused mainly on the elderly population; rarely is an adjustment made for socioeconomic factors. We examined this association in late midlife, with particular focus on cumulative effects and the role of socioeconomic circumstances. RESEARCH DESIGN AND METHODS Analyses were performed for 4,150 white participants from the Whitehall II study. Metabolic syndrome, using the National Cholesterol Education Program Adult Treatment Panel III criteria, was assessed three times over the 10-year follow-up (1991-2001). Cognitive function was assessed using a battery of six tests at the end of the follow-up. RESULTS After adjustment for demographic variables, health behaviors, and health status, participants with persistent metabolic syndrome (at least two of the three screenings) over the 10-year follow-up had lower cognitive performance than participants who never had metabolic syndrome. No significant differences in cognitive function were observed between participants with nonpersistent metabolic syndrome (one of the three screenings) and those who never had metabolic syndrome during the follow-up. Adjustment for adult occupational position attenuated this association by between 41 and 86%, depending on the measure of cognitive function. Adjustment for education had little effect. CONCLUSIONS Only persistent metabolic syndrome was associated with lower cognitive performance in late midlife. Adult occupational position but not education had a substantial impact on this association; these results highlight the importance of adult socioeconomic circumstances in identifying and targeting risk factors for cognitive aging.
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Affiliation(s)
- Tasnime N Akbaraly
- Department of Epidemiology and Public Health, University College London, London, UK.
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Tully PJ, Baker RA, Knight JL, Turnbull DA, Winefield HR. Neuropsychological function 5 years after cardiac surgery and the effect of psychological distress. Arch Clin Neuropsychol 2009; 24:741-51. [PMID: 19875394 DOI: 10.1093/arclin/acp082] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Research has shown conflicting results with regard to the influence of depression and anxiety on neuropsychological performance following coronary artery bypass graft (CABG) surgery. Notably, the independent effects of depression and anxiety have not been examined among CABG candidates in the longer term where it is has been suggested that these patients show marked cognitive deterioration. A neuropsychological test battery and measures of psychological distress were completed by 86 CABG patients and 50 nonsurgical control participants at baseline and 6 months, whereas 75 patients and 36 controls, respectively, completed a 5-year follow-up. In CABG patients, cognitive and affective depressive symptoms were independently associated with lower and worse performance on the Boston Naming Test, Purdue Peg Board, and Digit Symbol Coding 6 months after surgery, whereas at 5-year follow-up an effect for Digit Symbol persisted, and an association was also observed for the Trail Making Test (TMT). On average, CABG patients performed worse on TMT and Digit Symbol at 6 months, whereas at 5-year follow-up their performance was worse on short-term delayed verbal recall. The results among the CABG patients did not show a consistent pattern of association between psychological distress and those neuropsychological domains that were on average significantly lower than a nonsurgical control group. The results here also support the use of nonbiased statistical methodology to document dysfunction among heterogeneous cognitive domains after CABG surgery.
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Affiliation(s)
- Phillip J Tully
- Cardiothoracic Surgery Unit and Cardiac Surgery Research, Flinders Medical Centre and The Flinders University, Adelaide, South Australia, Australia
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Liu-Ambrose T, Katarynych LA, Ashe MC, Nagamatsu LS, Hsu CL. Dual-task gait performance among community-dwelling senior women: the role of balance confidence and executive functions. J Gerontol A Biol Sci Med Sci 2009; 64:975-82. [PMID: 19429702 DOI: 10.1093/gerona/glp063] [Citation(s) in RCA: 57] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Exploring factors that contribute to dual-task gait performance among seniors is of particular interest in falls prevention because dual-task-related gait changes are associated with increased falls risk. It is unclear currently which specific executive processes are most relevant to dual-task gait performance and whether "balance confidence" is independently associated with dual-task gait performance. METHODS A cross-sectional analysis of 140 senior women aged 65-75 years old. Balance confidence was assessed by the Activities-Specific Balance Confidence scale. Three key executive processes were assessed by standard neuropsychological tests: (i) set shifting, (ii) working memory, and (iii) response inhibition. Dual-task gait performance was assessed by the simple and complex versions of the walking while talking (WWT) test. Two linear regression models were constructed to determine the independent association of executive functions and balance confidence with: (i) simple WWT completion time and (ii) complex WWT completion time. RESULTS Balance confidence was independently associated with both simple and complex WWT completion times after accounting for age, time to walk 40 ft without talking, and global cognition. Set shifting was independently associated with complex WWT completion time; no executive processes were independently associated with simple WWT completion time. CONCLUSIONS This study highlights that balance confidence is independently associated with dual-task gait performance. Furthermore, executive functions do not play a significant role in dual-task gait performance when the concurrent cognitive load is low. Clinicians may need to consider balance confidence and executive functions in the assessment and rehabilitation of dual-task gait performance among community-dwelling seniors.
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Affiliation(s)
- Teresa Liu-Ambrose
- Centre for Hip Health and Mobility, Vancouver Coastal Health Research Institute, Vancouver, British Columbia, Canada V5Z 1M9.
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Abstracts. Metab Syndr Relat Disord 2008. [DOI: 10.1089/met.2008.abst2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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