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Shin S, Nam HY, Kim K, Kim J, Lee MJ, Pak K. Clinical assessment and striatal dopaminergic activity in healthy controls and patients with Parkinson's disease: a Bayesian approach. Ann Nucl Med 2024:10.1007/s12149-024-01972-y. [PMID: 39190111 DOI: 10.1007/s12149-024-01972-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2024] [Accepted: 08/20/2024] [Indexed: 08/28/2024]
Abstract
OBJECTIVES We aimed to evaluate correlations between striatal dopamine transporter (DAT) uptake and clinical assessments in both patients with Parkinson's disease (PD) and healthy controls. METHODS This study enrolled 193 healthy controls, and 581 patients with PD. They underwent various clinical assessments and 123I-FP-CIT SPECT scans. After reconstruction, attenuation correction, and normalization of SPECT images, counts were measured from the bilateral caudate and putamen, and the occipital cortex for reference. Count densities for each region were extracted and used to calculate striatal binding ratios (SBRs) for each striatal region. SBR is calculated as (target region/reference region)-1. After logarithmic transformation of striatal SBRs, we analyzed the effects of clinical assessments on striatal SBRs using Bayesian hierarchical modeling. RESULTS MDS-UPDRS total score, part I, part II, part III, Epworth Sleepiness Scale, REM sleep behavior disorder screening questionnaire, SCOPA-AUT total score were negatively associated with striatal SBR in patients with PD. Also, HVLT recognition discrimination was positively associated with striatal SBR in both healthy controls and patients with PD. In healthy control, MDS-UPDRS part II, MOCA, SCOPA-AUT total score were positively associated with striatal SBR. CONCLUSION We demonstrated that motor symptom, sleep disturbance, autonomic symptom, and cognition of patients with PD were associated with striatal dopaminergic activity. In healthy controls, motor symptoms, autonomic symptom, and cognition were associated with striatal dopaminergic activity, some of which showing the opposite direction with patients with PD. This result might provide new insight to underlying mechanism of dopamine system with motor and non-motor assessments.
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Affiliation(s)
- Seunghyeon Shin
- Department of Nuclear Medicine, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, 179 Gudeok-Ro, Seo-Gu, Busan, 49241, Republic of Korea
| | - Hyun-Yeol Nam
- Department of Nuclear Medicine, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, 179 Gudeok-Ro, Seo-Gu, Busan, 49241, Republic of Korea
| | - Keunyoung Kim
- Department of Nuclear Medicine and Biomedical Research Institute, Pusan National University Hospital, Busan, Republic of Korea
- School of Medicine, Pusan National University, Busan, Republic of Korea
| | - Jihyun Kim
- Department of Nuclear Medicine and Biomedical Research Institute, Pusan National University Hospital, Busan, Republic of Korea
| | - Myung Jun Lee
- School of Medicine, Pusan National University, Busan, Republic of Korea
- Department of Neurology and Biomedical Research Institute, Pusan National University Hospital, Busan, Republic of Korea
| | - Kyoungjune Pak
- Department of Nuclear Medicine and Biomedical Research Institute, Pusan National University Hospital, Busan, Republic of Korea.
- School of Medicine, Pusan National University, Busan, Republic of Korea.
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Kasputytė G, Kumpaitienė B, Švagždienė M, Andrejaitienė J, Gailiušas M, Širvinskas E, Gelmanas A, Hamarat Y, Chaleckas E, Putnynaitė V, Bartušis L, Žakelis R, Petkus V, Ragauskas A, Lenkutis T. The Association of Cerebral Autoregulation Dysfunction and Postoperative Memory Impairment in Cardiac Surgery Patients. MEDICINA (KAUNAS, LITHUANIA) 2024; 60:1337. [PMID: 39202618 PMCID: PMC11356179 DOI: 10.3390/medicina60081337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/29/2024] [Revised: 07/24/2024] [Accepted: 08/08/2024] [Indexed: 09/03/2024]
Abstract
Background and Objectives: Cardiac surgery is associated with various durations of cerebral autoregulation (CA) impairment and can significantly impact cognitive function. Cognitive functions such as memory, psychomotor speed, and attention are significantly impacted after cardiac surgery, necessitating prioritization of these areas in cognitive function tests. There is a lack of research connecting cerebral autoregulation impairment to specific cognitive function domains after cardiac surgery. This study aimed to determine if impaired cerebral autoregulation is associated with postoperative memory impairment and to test the hypothesis that the duration of this impairment affects the development of postoperative memory issues. Materials and Methods: A prospective study was conducted in 2021-2023. After approval of the Ethics Committee and with patient's written consent, 83 adult patients undergoing elective on-pump coronary artery bypass graft (CABG) surgery were enrolled. All patients were assessed for cognitive function 1 day before surgery using the Mini-Mental state examination (MMSE-2) test as a screening tool and the Hopkins Verbal Learning Test-Revised (HVLT-R) to assess memory specifically. To diagnose possible memory impairment (IM), all patients underwent a repeat assessment of cognitive function on the 7th-10th postoperative day. Cerebral autoregulation monitoring using transcranial Doppler was performed. Cerebral autoregulation status index (Mx) was recorded using Intensive Care Brain Monitoring System software, 9.1.5.23 (Cambridge, UK). Results: According to our research, the incidence of postoperative memory impairment is 30.1%. Temporary cerebral autoregulation impairment occurs in all patients undergoing elective in-pump CABG surgery. The duration of the single longest CA impairment event in seconds (LCAI) and the LCAI dose were higher in patients with postoperative memory impairment, p = 0.006 and p < 0.007, respectively. Conclusions: Cerebral autoregulation impairment is important in developing memory loss after cardiac surgery. The duration and dose of the LCAI event are predictive of postoperative memory impairment.
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Affiliation(s)
- Greta Kasputytė
- Institute of Cardiology, Medical Academy, Lithuanian University of Health Sciences, 50162 Kaunas, Lithuania
| | - Birutė Kumpaitienė
- Department of Disaster Medicine, Medical Academy, Lithuanian University of Health Sciences, 44307 Kaunas, Lithuania
| | - Milda Švagždienė
- Institute of Cardiology, Medical Academy, Lithuanian University of Health Sciences, 50162 Kaunas, Lithuania
| | - Judita Andrejaitienė
- Institute of Cardiology, Medical Academy, Lithuanian University of Health Sciences, 50162 Kaunas, Lithuania
| | - Mindaugas Gailiušas
- Department of Cardiac, Thoracic and Vascular Surgery, Lithuanian University of Health Sciences, 50161 Kaunas, Lithuania
| | - Edmundas Širvinskas
- Department of Cardiac, Thoracic and Vascular Surgery, Lithuanian University of Health Sciences, 50161 Kaunas, Lithuania
| | - Arūnas Gelmanas
- Department of Anesthesiology, Medical Academy, Lithuanian University of Health Sciences, 44307 Kaunas, Lithuania
| | - Yasin Hamarat
- Health Telematics Science Institute, Kaunas University of Technology, 51423 Kaunas, Lithuania (L.B.)
| | - Edvinas Chaleckas
- Health Telematics Science Institute, Kaunas University of Technology, 51423 Kaunas, Lithuania (L.B.)
| | - Vilma Putnynaitė
- Health Telematics Science Institute, Kaunas University of Technology, 51423 Kaunas, Lithuania (L.B.)
| | - Laimonas Bartušis
- Health Telematics Science Institute, Kaunas University of Technology, 51423 Kaunas, Lithuania (L.B.)
| | - Rolandas Žakelis
- Health Telematics Science Institute, Kaunas University of Technology, 51423 Kaunas, Lithuania (L.B.)
| | - Vytautas Petkus
- Health Telematics Science Institute, Kaunas University of Technology, 51423 Kaunas, Lithuania (L.B.)
| | - Arminas Ragauskas
- Health Telematics Science Institute, Kaunas University of Technology, 51423 Kaunas, Lithuania (L.B.)
| | - Tadas Lenkutis
- Department of Anesthesiology, Medical Academy, Lithuanian University of Health Sciences, 44307 Kaunas, Lithuania
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Tappen R, Newman D, Rosselli M, Conniff J, Sepe CP, Newman M. Fit2Drive: Screening Older Drivers with Cognitive Concerns. J Am Med Dir Assoc 2024; 25:105054. [PMID: 38843871 DOI: 10.1016/j.jamda.2024.105054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Revised: 04/22/2024] [Accepted: 04/23/2024] [Indexed: 06/20/2024]
Abstract
OBJECTIVES The purpose of this study was to identify the most parsimonious combination of cognitive tests that accurately predicts the likelihood of passing an on-road driving evaluation in order to develop a screening measure that can be administered as an in-office test. DESIGN This was a psychometric study of the new test's diagnostic accuracy. SETTINGS AND PARTICIPANTS The study was conducted at the Florida Atlantic University's Memory Center and Clinical Research Unit, both easily accessible to older drivers. Participants were older drivers who received a driving evaluation at the Memory Center and agreed to have their results included in the Driving Repository and community-based older drivers who volunteered to participate. METHODS Mini-Mental State Exam (MMSE), Trail Making Tests A and B, Clock Test, Hopkins Verbal Learning Test, and Driving Health Inventory results were compared with an on-road driving evaluation to identify those tests that best predict the ability to pass the on-road evaluation. RESULTS Altogether, 412 older drivers, 179 men and 233 women, were included in the analysis. Fifty-four percent of Driving Repository participants failed the on-road evaluation compared with 8% of the community sample. The highest correlation to the on-road evaluation was Trails B time in seconds r = -0.713 (P < .001). Variables with high multicollinearity and/or low correlation with the on-road evaluation were eliminated and sets of receiver operating characteristics curves were generated to assess the predictive accuracy of the remaining tests. A linear combination of Trails B in seconds and MMSE using the highest of the Serial 7s or WORLD spelled backward scores accounted for the highest area under the curve of 0.915. Finally, an algorithm was created to rapidly generate the prediction for an individual patient. CONCLUSIONS AND IMPLICATIONS The Fit2Drive algorithm demonstrated a strong 91.5% predictive accuracy. Usefulness in office-based patient consultations is promising but remains to be rigorously tested.
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Affiliation(s)
- Ruth Tappen
- Christine E. Lynn College of Nursing, Florida Atlantic University, Boca Raton, FL, USA.
| | - David Newman
- Christine E. Lynn College of Nursing, Florida Atlantic University, Boca Raton, FL, USA
| | - Monica Rosselli
- Department of Psychology, Florida Atlantic University, Davie, FL, USA
| | - Joshua Conniff
- Neuropsychology Lab, Florida Atlantic University, Boca Raton, FL, USA
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Zhang J, Bandyopadhyay S, Kimmet F, Wittmayer J, Khezeli K, Libon DJ, Price CC, Rashidi P. Developing a fair and interpretable representation of the clock drawing test for mitigating low education and racial bias. Sci Rep 2024; 14:17444. [PMID: 39075127 PMCID: PMC11286895 DOI: 10.1038/s41598-024-68481-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Accepted: 07/24/2024] [Indexed: 07/31/2024] Open
Abstract
The clock drawing test (CDT) is a neuropsychological assessment tool to screen an individual's cognitive ability. In this study, we developed a Fair and Interpretable Representation of Clock drawing test (FaIRClocks) to evaluate and mitigate classification bias against people with less than 8 years of education, while screening their cognitive function using an array of neuropsychological measures. In this study, we represented clock drawings by a priorly published 10-dimensional deep learning feature set trained on publicly available data from the National Health and Aging Trends Study (NHATS). These embeddings were further fine-tuned with clocks from a preoperative cognitive screening program at the University of Florida to predict three cognitive scores: the Mini-Mental State Examination (MMSE) total score, an attention composite z-score (ATT-C), and a memory composite z-score (MEM-C). ATT-C and MEM-C scores were developed by averaging z-scores based on normative references. The cognitive screening classifiers were initially tested to see their relative performance in patients with low years of education (< = 8 years) versus patients with higher education (> 8 years) and race. Results indicated that the initial unweighted classifiers confounded lower education with cognitive compromise resulting in a 100% type I error rate for this group. Thereby, the samples were re-weighted using multiple fairness metrics to achieve sensitivity/specificity and positive/negative predictive value (PPV/NPV) balance across groups. In summary, we report the FaIRClocks model, with promise to help identify and mitigate bias against people with less than 8 years of education during preoperative cognitive screening.
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Affiliation(s)
- Jiaqing Zhang
- Department of Electrical and Computer Engineering, University of Florida, Gainesville, USA
- Intelligent Critical Care Center (IC3), University of Florida, Gainesville, USA
- Perioperative Cognitive Anesthesia Network(SM), University of Florida, Gainesville, USA
| | | | - Faith Kimmet
- Perioperative Cognitive Anesthesia Network(SM), University of Florida, Gainesville, USA
- Department of Anesthesiology, College of Medicine, University of Florida, Gainesville, USA
| | - Jack Wittmayer
- Intelligent Critical Care Center (IC3), University of Florida, Gainesville, USA
| | - Kia Khezeli
- Intelligent Critical Care Center (IC3), University of Florida, Gainesville, USA
| | - David J Libon
- Department of Geriatrics and Gerontology, Department of Psychology, School of Osteopathic Medicine, New Jersey Institute for Successful Aging, Rowan University, Glassboro, USA
| | - Catherine C Price
- Perioperative Cognitive Anesthesia Network(SM), University of Florida, Gainesville, USA.
- Department of Anesthesiology, College of Medicine, University of Florida, Gainesville, USA.
- Department of Clinical and Health Psychology, College of Public Health and Health Professions, University of Florida, Gainesville, USA.
| | - Parisa Rashidi
- Intelligent Critical Care Center (IC3), University of Florida, Gainesville, USA.
- J. Crayton Pruitt Family Department of Biomedical Engineering, University of Florida, Gainesville, USA.
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Lucero J, Gurnani A, Weinberg J, Shih LC. Neutrophil-to-lymphocyte ratio and longitudinal cognitive performance in Parkinson's disease. Ann Clin Transl Neurol 2024. [PMID: 39031909 DOI: 10.1002/acn3.52144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2024] [Revised: 06/18/2024] [Accepted: 06/21/2024] [Indexed: 07/22/2024] Open
Abstract
OBJECTIVE Previous studies have suggested a link between peripheral inflammation and cognitive outcomes in the general population and individuals with Parkinson's disease (PD). We sought to test the association between peripheral inflammation, measured by the neutrophil-to-lymphocyte ratio (NLR), cognitive performance, and mild cognitive impairment (MCI) status in individuals with PD. METHODS A retrospective, longitudinal analysis was carried out using data from the Parkinson's Progression Markers Initiative (PPMI), including 422 participants with PD followed over 5 years. Cognitive performance was assessed using a neuropsychological battery including the Montreal Cognitive Assessment (MoCA) and tests of verbal learning, visuospatial function, processing speed, and executive function. Mixed-effect regression models were used to analyze the association between NLR, cognitive performance, and MCI status, controlling for age, sex, education, APOE genotype, and motor severity. RESULTS There was a negative association between NLR and MoCA, even after adjusting for covariates (b = -0.12, p = 0.033). MoCA scores for individuals in the high NLR category exhibited a more rapid decline over time compared to the low NLR group (b = -0.16, p = 0.012). Increased NLR was associated with decreased performance across all cognitive domains. However, NLR was not associated with MCI status over 5 years of follow-up. INTERPRETATION This study demonstrates a link between elevated NLR and cognitive performance in PD, but not with MCI status over 5 years. This suggests that NLR is more strongly associated with day-to-day cognitive performance than with incident MCI, but this requires further study in more heterogeneous cohorts.
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Affiliation(s)
- Jenniffer Lucero
- Department of Neurology, Boston University Chobanian and Avedisian School of Medicine, Boston, Massachusetts, 02118, USA
- Department of Neurology, Boston Medical Center, Boston, Massachusetts, 02118, USA
| | - Ashita Gurnani
- Department of Neurology, Boston University Chobanian and Avedisian School of Medicine, Boston, Massachusetts, 02118, USA
| | - Janice Weinberg
- Department of Biostatistics, Boston University School of Public Health, Boston, 02118, Massachusetts, USA
| | - Ludy C Shih
- Department of Neurology, Boston University Chobanian and Avedisian School of Medicine, Boston, Massachusetts, 02118, USA
- Department of Neurology, Boston Medical Center, Boston, Massachusetts, 02118, USA
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Phyo AZZ, Wu Z, Espinoza SE, Murray AM, Fransquet PD, Wrigglesworth J, Woods RL, Ryan J. Epigenetic age acceleration and cognitive performance over time in older adults. ALZHEIMER'S & DEMENTIA (AMSTERDAM, NETHERLANDS) 2024; 16:e70010. [PMID: 39279995 PMCID: PMC11399883 DOI: 10.1002/dad2.70010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/13/2024] [Revised: 08/04/2024] [Accepted: 08/21/2024] [Indexed: 09/18/2024]
Abstract
INTRODUCTION This study investigated whether epigenetic age acceleration (AA) is associated with the change in cognitive function and the risk of incident dementia over 9 years, separately in males and females. METHODS Six epigenetic AA measures, including GrimAge, were estimated in baseline blood samples from 560 Australians aged ≥70 years (50.7% female). Cognitive assessments included global function, episodic memory, executive function, and psychomotor speed. Composite cognitive scores were also generated. Dementia (Diagnostic and Statistical Manual for Mental Disorders - IV [DSM-IV] criteria) was adjudicated by international experts. RESULTS Associations between epigenetic AA and cognitive performance over-time varied by sex. In females only, GrimAA/Grim2AA was associated with worse delayed recall, composite cognition, and composite memory (adjusted-beta ranged from -0.1372 to -0.2034). In males only, GrimAA/Grim2AA was associated with slower processing speed (adjusted-beta, -0.3049) and increased dementia risk (adjusted hazard ratios [HRs], 1.78 and 2.00, respectively). DISCUSSION Epigenetic AA is associated with cognitive deterioration in later life but with evidence of sex-specific associations. Highlights Epigenetic age acceleration was associated with cognitive deterioration over time.However, these associations differed by sex.In females, accelerated GrimAge appeared to be a better marker of decline in memory.In males, accelerated GrimAge was associated with slower processing speed over time.Association between accelerated GrimAge and dementia risk was found only in males.
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Affiliation(s)
- Aung Zaw Zaw Phyo
- Biological Neuropsychiatry & Dementia Unit School of Public Health and Preventive Medicine Monash University Melbourne Victoria Australia
| | - Zimu Wu
- Biological Neuropsychiatry & Dementia Unit School of Public Health and Preventive Medicine Monash University Melbourne Victoria Australia
| | - Sara E Espinoza
- Department of Medicine Center for Translational Geroscience Cedars-Sinai Medical Center Los Angeles California USA
| | - Anne M Murray
- Berman Center for Outcomes and Clinical Research Hennepin HealthCare Research Institute Minneapolis Minnesota USA
- Department of Medicine Division of Geriatrics Hennepin HealthCare and University of Minnesota Minneapolis Minnesota USA
| | - Peter D Fransquet
- School of Psychology Deakin University Burwood Victoria Australia
- School of Public Health and Preventive Medicine Monash University Melbourne Victoria Australia
| | - Jo Wrigglesworth
- Biological Neuropsychiatry & Dementia Unit School of Public Health and Preventive Medicine Monash University Melbourne Victoria Australia
| | - Robyn L Woods
- School of Public Health and Preventive Medicine Monash University Melbourne Victoria Australia
| | - Joanne Ryan
- Biological Neuropsychiatry & Dementia Unit School of Public Health and Preventive Medicine Monash University Melbourne Victoria Australia
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Sun J, Dong Y, Wang D, Yang Y, Zhou Z, Zhu M, Wang T, Teng L. The association between inflammation-related biomarkers and the subtypes of cancer-related cognitive impairment in colorectal cancer patients: A latent profile analysis. Eur J Oncol Nurs 2024; 68:102493. [PMID: 38134496 DOI: 10.1016/j.ejon.2023.102493] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2023] [Revised: 12/06/2023] [Accepted: 12/10/2023] [Indexed: 12/24/2023]
Abstract
PURPOSE Cancer-related cognitive impairment (CRCI) has garnered considerable attention, yet limited research has delved into nuanced distinctions among varying degrees of CRCI in colorectal cancer survivors. This study aimed to identify distinct subgroups based on the patterns of CRCI, assess the heterogeneity among different subgroups, and investigate the potential correlations between the subgroups of CRCI and inflammation-related biomarkers. METHODS 268 colorectal cancer patients were enrolled in this cross-sectional study, followed by the Functional Assessment of Cancer Therapy-Cognitive Function. The determination of CRCI subgroups was accomplished by the latent profile analysis (LPA). The effects of inflammation-related biomarkers on CRCI were examined using the binary logistic regression analysis. The receiver operating characteristic (ROC) curves assessed the diagnostic efficacy of inflammation-related biomarkers. RESULTS Two latent profiles were identified: CRCI (n = 64, 23.88%) and non-CRCI (n = 204, 76.12%). Independent factors for CRCI in colorectal cancer patients were SIRI (OR = 3.248, 95%CI [1.197-8.807], P = 0.021) and ALI (OR = 0.962, 95%CI [0.937-0.989], P = 0.005). The areas under the curve (AUCs) for SIRI and ALI in predicting CRCI were 0.781 and 0.774, with the optimal cut-off values being 0.70 and 37.04, respectively. CONCLUSIONS Colorectal cancer patients exhibited divergent cognitive performance profiles, categorized into two subgroups based on LPA. SIRI and ALI were identified as independent factors for CRCI, demonstrating strong diagnostic accuracy. These two inflammation-related biomarkers may potentially be novel indicators to identify and manage the development of CRCI among colorectal cancer patients.
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Affiliation(s)
- Jun Sun
- Wuxi School of Medicine, Jiangnan University, Wuxi 214122, Jiangsu, China
| | - Yajun Dong
- Wuxi School of Medicine, Jiangnan University, Wuxi 214122, Jiangsu, China
| | - Danhui Wang
- Wuxi School of Medicine, Jiangnan University, Wuxi 214122, Jiangsu, China
| | - Yiting Yang
- Wuxi School of Medicine, Jiangnan University, Wuxi 214122, Jiangsu, China
| | - Zhou Zhou
- Wuxi School of Medicine, Jiangnan University, Wuxi 214122, Jiangsu, China
| | - Min Zhu
- Wuxi School of Medicine, Jiangnan University, Wuxi 214122, Jiangsu, China
| | - Teng Wang
- Department of Oncology, Affiliated Hospital of Jiangnan University, Wuxi 214122, Jiangsu, China
| | - Liping Teng
- Wuxi School of Medicine, Jiangnan University, Wuxi 214122, Jiangsu, China.
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Yu C, Ryan J, Orchard SG, Robb C, Woods RL, Wolfe R, Renton AE, Goate AM, Brodtmann A, Shah RC, Chong TTJ, Sheets K, Kyndt C, Sood A, Storey E, Murray AM, McNeil JJ, Lacaze P. Validation of newly derived polygenic risk scores for dementia in a prospective study of older individuals. Alzheimers Dement 2023; 19:5333-5342. [PMID: 37177856 PMCID: PMC10640662 DOI: 10.1002/alz.13113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2022] [Revised: 03/27/2023] [Accepted: 04/03/2023] [Indexed: 05/15/2023]
Abstract
INTRODUCTION Recent genome-wide association studies identified new dementia-associated variants. We assessed the performance of updated polygenic risk scores (PRSs) using these variants in an independent cohort. METHODS We used Cox models and area under the curve (AUC) to validate new PRSs (PRS-83SNP, PRS-SBayesR, and PRS-CS) compared with an older PRS-23SNP in 12,031 initially-healthy participants ≥70 years of age. Dementia was rigorously adjudicated according to Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) criteria. RESULTS PRS-83SNP, PRS-SBayesR, and PRS-CS were associated with incident dementia, with fully adjusted (including apolipoprotein E [APOE] ε4) hazard ratios per standard deviation (SD) of 1.35 (1.23-1.47), 1.37 (1.25-1.50), and 1.42 (1.30-1.56), respectively. The AUC of a model containing conventional/non-genetic factors and APOE was 74.7%. This was improved to 75.7% (p = 0.007), 76% (p = 0.004), and 76.1% (p = 0.003) with addition of PRS-83SNP, PRS-SBayesR, and PRS-CS, respectively. The PRS-23SNP did not improve AUC (74.7%, p = 0.95). CONCLUSION New PRSs for dementia significantly improve risk-prediction performance, but still account for less risk than APOE genotype overall.
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Affiliation(s)
- Chenglong Yu
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Joanne Ryan
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Suzanne G. Orchard
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Catherine Robb
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Robyn L. Woods
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Rory Wolfe
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Alan E. Renton
- Department Genetics and Genomic Sciences and Ronald M. Loeb Center for Alzheimer’s Disease, Icahn School of Medicine at Mount Sinai, New York, New York, USA
- Departments of Neurology and Neuroscience, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Alison M. Goate
- Department Genetics and Genomic Sciences and Ronald M. Loeb Center for Alzheimer’s Disease, Icahn School of Medicine at Mount Sinai, New York, New York, USA
- Departments of Neurology and Neuroscience, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Amy Brodtmann
- Cognitive Health Initiative, Central Clinical School, Monash University, Melbourne, Victoria, Australia
- Florey Institute of Neuroscience and Mental Health, Melbourne, Victoria, Australia
| | - Raj C. Shah
- Department of Family & Preventive Medicine and the Rush Alzheimer’s Disease Center, Chicago, Illinois, USA
| | - Trevor T.-J. Chong
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Clayton, Victoria, Australia
- Department of Neurology, Alfred Health, Melbourne, Victoria, Australia
- Department of Clinical Neurosciences, St. Vincent’s Hospital, Melbourne, Victoria, Australia
| | - Kerry Sheets
- Department of Medicine, University of Minnesota, Minneapolis, Minnesota, USA
- Division of Geriatrics, Hennepin Healthcare, Minneapolis, Minnesota, USA
| | - Christopher Kyndt
- Department of Neurology, Melbourne Health, Parkville, Victoria, Australia
- Department of Neuroscience, Eastern Health, Box Hill, Victoria, Australia
| | - Ajay Sood
- Department of Neurology and the Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, Illinois, USA
| | - Elsdon Storey
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Anne M. Murray
- Department of Medicine, University of Minnesota, Minneapolis, Minnesota, USA
- Division of Geriatrics, Hennepin Healthcare, Minneapolis, Minnesota, USA
- Berman Center for Outcomes and Clinical Research, Hennepin Healthcare Research Institute, Hennepin Healthcare, and University of Minnesota, Minneapolis, Minnesota, USA
| | - John J. McNeil
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Paul Lacaze
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
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Waner JL, Hausman HK, Kraft JN, Hardcastle C, Evangelista ND, O'Shea A, Albizu A, Boutzoukas EM, Van Etten EJ, Bharadwaj PK, Song H, Smith SG, DeKosky ST, Hishaw GA, Wu SS, Marsiske M, Cohen R, Alexander GE, Porges EC, Woods AJ. Connecting memory and functional brain networks in older adults: a resting-state fMRI study. GeroScience 2023; 45:3079-3093. [PMID: 37814198 PMCID: PMC10643735 DOI: 10.1007/s11357-023-00967-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Accepted: 09/29/2023] [Indexed: 10/11/2023] Open
Abstract
Limited research exists on the association between resting-state functional network connectivity in the brain and learning and memory processes in advanced age. This study examined within-network connectivity of cingulo-opercular (CON), frontoparietal control (FPCN), and default mode (DMN) networks, and verbal and visuospatial learning and memory in older adults. Across domains, we hypothesized that greater CON and FPCN connectivity would associate with better learning, and greater DMN connectivity would associate with better memory. A total of 330 healthy older adults (age range = 65-89) underwent resting-state fMRI and completed the Hopkins Verbal Learning Test-Revised (HVLT-R) and Brief Visuospatial Memory Test-Revised (BVMT-R) in a randomized clinical trial. Total and delayed recall scores were assessed from baseline data, and a learning ratio calculation was applied to participants' scores. Average CON, FPCN, and DMN connectivity values were obtained with CONN Toolbox. Hierarchical regressions controlled for sex, race, ethnicity, years of education, and scanner site, as this was a multi-site study. Greater within-network CON connectivity was associated with better verbal learning (HVLT-R Total Recall, Learning Ratio), visuospatial learning (BVMT-R Total Recall), and visuospatial memory (BVMT-R Delayed Recall). Greater FPCN connectivity was associated with better visuospatial learning (BVMT-R Learning Ratio) but did not survive multiple comparison correction. DMN connectivity was not associated with these measures of learning and memory. CON may make small but unique contributions to learning and memory across domains, making it a valuable target in future longitudinal studies and interventions to attenuate memory decline. Further research is necessary to understand the role of FPCN in learning and memory.
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Affiliation(s)
- Jori L Waner
- Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, PO Box 100196, 1249 Center Drive, Gainesville, FL, 32610-0165, USA
- Department of Clinical and Health Psychology, College of Public Health and Health Professions, University of Florida, Gainesville, FL, USA
| | - Hanna K Hausman
- Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, PO Box 100196, 1249 Center Drive, Gainesville, FL, 32610-0165, USA
- Department of Clinical and Health Psychology, College of Public Health and Health Professions, University of Florida, Gainesville, FL, USA
| | - Jessica N Kraft
- Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, PO Box 100196, 1249 Center Drive, Gainesville, FL, 32610-0165, USA
- Department of Neuroscience, College of Medicine, University of Florida, Gainesville, FL, USA
| | - Cheshire Hardcastle
- Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, PO Box 100196, 1249 Center Drive, Gainesville, FL, 32610-0165, USA
- Department of Clinical and Health Psychology, College of Public Health and Health Professions, University of Florida, Gainesville, FL, USA
| | - Nicole D Evangelista
- Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, PO Box 100196, 1249 Center Drive, Gainesville, FL, 32610-0165, USA
- Department of Clinical and Health Psychology, College of Public Health and Health Professions, University of Florida, Gainesville, FL, USA
| | - Andrew O'Shea
- Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, PO Box 100196, 1249 Center Drive, Gainesville, FL, 32610-0165, USA
| | - Alejandro Albizu
- Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, PO Box 100196, 1249 Center Drive, Gainesville, FL, 32610-0165, USA
- Department of Neuroscience, College of Medicine, University of Florida, Gainesville, FL, USA
| | - Emanuel M Boutzoukas
- Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, PO Box 100196, 1249 Center Drive, Gainesville, FL, 32610-0165, USA
- Department of Clinical and Health Psychology, College of Public Health and Health Professions, University of Florida, Gainesville, FL, USA
| | - Emily J Van Etten
- Department of Psychology and Evelyn F. McKnight Brain Institute, University of Arizona, Tucson, AZ, USA
| | - Pradyumna K Bharadwaj
- Department of Psychology and Evelyn F. McKnight Brain Institute, University of Arizona, Tucson, AZ, USA
| | - Hyun Song
- Department of Psychology and Evelyn F. McKnight Brain Institute, University of Arizona, Tucson, AZ, USA
| | - Samantha G Smith
- Department of Psychology and Evelyn F. McKnight Brain Institute, University of Arizona, Tucson, AZ, USA
| | - Steven T DeKosky
- Department of Neurology and McKnight Brain Institute, University of Florida, Gainesville, FL, USA
| | - Georg A Hishaw
- Department of Psychiatry, College of Medicine, University of Arizona, Tucson, AZ, USA
- Department of Neurology, College of Medicine, University of Arizona, Tucson, AZ, USA
| | - Samuel S Wu
- Department of Biostatistics, College of Public Health and Health Professions, College of Medicine, University of Florida, Gainesville, FL, USA
| | - Michael Marsiske
- Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, PO Box 100196, 1249 Center Drive, Gainesville, FL, 32610-0165, USA
- Department of Clinical and Health Psychology, College of Public Health and Health Professions, University of Florida, Gainesville, FL, USA
| | - Ronald Cohen
- Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, PO Box 100196, 1249 Center Drive, Gainesville, FL, 32610-0165, USA
- Department of Clinical and Health Psychology, College of Public Health and Health Professions, University of Florida, Gainesville, FL, USA
| | - Gene E Alexander
- Department of Psychology and Evelyn F. McKnight Brain Institute, University of Arizona, Tucson, AZ, USA
- Department of Psychiatry, Neuroscience and Physiological Sciences Graduate Interdisciplinary Programs, and BIO5 Institute, University of Arizona and Arizona Alzheimer's Disease Consortium, Tucson, AZ, USA
| | - Eric C Porges
- Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, PO Box 100196, 1249 Center Drive, Gainesville, FL, 32610-0165, USA
- Department of Clinical and Health Psychology, College of Public Health and Health Professions, University of Florida, Gainesville, FL, USA
| | - Adam J Woods
- Center for Cognitive Aging and Memory, McKnight Brain Institute, University of Florida, Gainesville, PO Box 100196, 1249 Center Drive, Gainesville, FL, 32610-0165, USA.
- Department of Clinical and Health Psychology, College of Public Health and Health Professions, University of Florida, Gainesville, FL, USA.
- Department of Neuroscience, College of Medicine, University of Florida, Gainesville, FL, USA.
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10
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Nilaweera D, Gurvich C, Freak-Poli R, Woods R, Owen A, Murray A, Orchard SG, Britt C, Wu Z, McNeil J, Ryan J. Adverse events in older adults and the risk of dementia and cognitive decline. JOURNAL OF AFFECTIVE DISORDERS REPORTS 2023; 13:100592. [PMID: 37475782 PMCID: PMC10357969 DOI: 10.1016/j.jadr.2023.100592] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/22/2023] Open
Abstract
Background Increasing evidence suggests that stress could be a risk factor for dementia but this might vary by gender. This study investigated whether adverse life events were associated with cognitive decline and dementia in later-life, separately in men and women. Methods Participants were 12,789 community-dwelling Australians aged ≥ 70 years. Ten common adverse events in later-life were self-reported. Cognitive decline was defined as a 1.5 SD decline from participants' baseline score in tests of global cognition, psychomotor speed, episodic memory, and executive functioning, which were assessed regularly over a maximum of 10.3 years. Dementia was diagnosed according to DSM-IV criteria. Results An increased risk of dementia was observed in participants who experienced the death of a spouse/partner (HR: 1.72, 95% CI: 1.17 - 2.52) and for individuals who experienced major financial problems (HR: 1.53, 95% CI: 1.05 - 2.23). The latter also increased the risk of cognitive decline in men specifically (HR: 1.43, 95% CI: 1.10 - 1.86). In contrast, some events for women were associated with a reduced risk of dementia (e.g. close family or friends lost their job/retired (HR: 0.62, 95% CI: 0.40-0.95)). Limitations Events including major money problems may result from prodromal dementia symptoms, thus reverse causation needs to be considered. Conclusions Adverse life events may influence dementia risk in older adults, but associations vary depending on the nature of the event, and across genders. These findings support the need for early interventions in older people who have experienced adversities, particularly for the death of a loved one.
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Affiliation(s)
- Dinuli Nilaweera
- School of Public Health and Preventive Medicine, Monash University, Level 4, 553St Kilda Road, Melbourne, Victoria 3004, Australia
| | - Caroline Gurvich
- Central Clinical School, Monash University, Melbourne, Victoria, Australia
| | - Rosanne Freak-Poli
- School of Public Health and Preventive Medicine, Monash University, Level 4, 553St Kilda Road, Melbourne, Victoria 3004, Australia
| | - Robyn Woods
- School of Public Health and Preventive Medicine, Monash University, Level 4, 553St Kilda Road, Melbourne, Victoria 3004, Australia
| | - Alice Owen
- School of Public Health and Preventive Medicine, Monash University, Level 4, 553St Kilda Road, Melbourne, Victoria 3004, Australia
| | - Anne Murray
- Berman Centre for Outcomes and Clinical Research, Hennepin Healthcare Research Institute, Minneapolis, USA
| | - Suzanne G. Orchard
- School of Public Health and Preventive Medicine, Monash University, Level 4, 553St Kilda Road, Melbourne, Victoria 3004, Australia
| | - Carlene Britt
- School of Public Health and Preventive Medicine, Monash University, Level 4, 553St Kilda Road, Melbourne, Victoria 3004, Australia
| | - Zimu Wu
- School of Public Health and Preventive Medicine, Monash University, Level 4, 553St Kilda Road, Melbourne, Victoria 3004, Australia
| | - John McNeil
- School of Public Health and Preventive Medicine, Monash University, Level 4, 553St Kilda Road, Melbourne, Victoria 3004, Australia
| | - Joanne Ryan
- School of Public Health and Preventive Medicine, Monash University, Level 4, 553St Kilda Road, Melbourne, Victoria 3004, Australia
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11
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Jiang L, Xu M, Xia S, Zhu J, Zhou Q, Xu L, Shi C, Wu D. Reliability and validity of the electronic version of the Hopkins verbal learning test-revised in middle-aged and elderly Chinese people. Front Aging Neurosci 2023; 15:1124731. [PMID: 37377673 PMCID: PMC10292015 DOI: 10.3389/fnagi.2023.1124731] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2023] [Accepted: 05/16/2023] [Indexed: 06/29/2023] Open
Abstract
Background The aging population is increasing, making it essential to have a standardized, convenient, and valid electronic memory test that can be accessed online for older people and caregivers. The electronic version of the Hopkins Verbal Learning Test-Revised (HVLT-R) as a test with these advantages and its reliability and validity has not yet been tested. Thus, this study examined the reliability and validity of the electronic version of the HVLT-R in middle-aged and elderly Chinese people to provide a scientific basis for its future dissemination and use. Methods We included 1,925 healthy participants aged over 40, among whom 38 were retested after 3-6 months. In addition, 65 participants completed both the pad and paper-and-pencil versions of the HVLT-R (PAP-HVLT-R). We also recruited 42 Alzheimer's disease (AD) patients, and 45 amnestic mild cognitive impairment (aMCI) patients. All participants completed the Pad-HVLT-R, the Hong Kong Brief Cognitive Test (HKBC), the Brief Visual Memory Test-Revised (BVMT-R), and the Logical Memory Test (LM). Results (1) Reliability: the Cronbach's α value was 0.94, the split-half reliability was 0.96. The test-retest correlation coefficients were moderate, ranging from 0.38 to 0.65 for direct variables and 0.16 to 0.52 for derived variables; (2) Concurrent validity: the Pad-HVLT-R showed a moderate correlation with the HKBC and BVMT-R, with correlation coefficients between total recall of 0.41 and 0.54, and between long-delayed recall of 0.42 and 0.59, respectively. It also showed a high correlation with the LM, with correlation coefficients of 0.72 for total recall and 0.62 for long-delayed recall; (3) Convergent validity: the Pad-HVLT-R was moderately correlated with the PAP version, with correlation coefficients ranging from 0.29 to 0.53 for direct variables and 0.15 to 0.43 for derived variables; (4) Discriminant capacity: the Pad-HVLT-R was effective in differentiating AD patients, as demonstrated by the ROC analysis with AUC values of 0.834 and 0.934 for total recall and long-delayed recall, respectively. Conclusion (1) The electronic version of HVLT-R has good reliability and validity in middle-aged and elderly Chinese people; (2) The electronic version of HVLT-R can be used as an effective tool to distinguish AD patients from healthy people.
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Affiliation(s)
- Lichen Jiang
- Medical Psychological Center, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Ming Xu
- Medical Psychological Center, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China
| | - Shunyao Xia
- Institute of Mental Health, Peking University Sixth Hospital, Peking University, Beijing, China
- NHC Key Laboratory for Mental Health, National Clinical Research Center for Mental Disorders, Peking University Sixth Hospital, Peking University, Beijing, China
| | - Jiahui Zhu
- Institute of Mental Health, Peking University Sixth Hospital, Peking University, Beijing, China
- NHC Key Laboratory for Mental Health, National Clinical Research Center for Mental Disorders, Peking University Sixth Hospital, Peking University, Beijing, China
| | - Qi Zhou
- Institute of Mental Health, Peking University Sixth Hospital, Peking University, Beijing, China
- NHC Key Laboratory for Mental Health, National Clinical Research Center for Mental Disorders, Peking University Sixth Hospital, Peking University, Beijing, China
| | - Luoyi Xu
- Department of Psychiatry, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Chuan Shi
- Institute of Mental Health, Peking University Sixth Hospital, Peking University, Beijing, China
- NHC Key Laboratory for Mental Health, National Clinical Research Center for Mental Disorders, Peking University Sixth Hospital, Peking University, Beijing, China
| | - Daxing Wu
- Medical Psychological Center, The Second Xiangya Hospital, Central South University, Changsha, Hunan, China
- Medical Psychological Institute, Central South University, Changsha, Hunan, China
- National Clinical Research Center for Mental Disorders, Changsha, Hunan, China
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12
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Wu Z, Woods RL, Chong TT, Orchard SG, Shah RC, Wolfe R, Storey E, Sheets KM, Murray AM, McNeil JJ, Ryan J. Grip strength, gait speed, and trajectories of cognitive function in community-dwelling older adults: A prospective study. ALZHEIMER'S & DEMENTIA (AMSTERDAM, NETHERLANDS) 2023; 15:e12388. [PMID: 36815873 PMCID: PMC9927855 DOI: 10.1002/dad2.12388] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Revised: 10/08/2022] [Accepted: 11/22/2022] [Indexed: 02/16/2023]
Abstract
Introduction This study investigated whether grip strength and gait speed predict cognitive aging trajectories and examined potential sex-specific associations. Methods Community-dwelling older adults (n = 19,114) were followed for up to 7 years, with regular assessment of global function, episodic memory, psychomotor speed, and executive function. Group-based multi-trajectory modeling identified joint cognitive trajectories. Multinomial logistic regression examined the association of grip strength and gait speed at baseline with cognitive trajectories. Results High performers (14.3%, n = 2298) and low performers (4.0%, n = 642) were compared to the average performers (21.8%, n = 3492). Grip strength and gait speed were positively associated with high performance and negatively with low performance (P-values < 0.01). The association between grip strength and high performance was stronger in women (interaction P < 0.001), while gait speed was a stronger predictor of low performance in men (interaction P < 0.05). Discussion Grip strength and gait speed are associated with cognitive trajectories in older age, but with sex differences. Highlights There is inter-individual variability in late-life cognitive trajectories.Grip strength and gait speed predicted cognitive trajectories in older age.However, sex-specific associations were identified.In women, grip strength strongly predicted high, compared to average, trajectory.In men, gait speed was a stronger predictor of low cognitive performance trajectory.
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Affiliation(s)
- Zimu Wu
- School of Public Health and Preventive MedicineMonash UniversityMelbourneVictoriaAustralia
| | - Robyn L. Woods
- School of Public Health and Preventive MedicineMonash UniversityMelbourneVictoriaAustralia
| | - Trevor T.‐J. Chong
- Turner Institute for Brain and Mental HealthMonash UniversityMelbourneVictoriaAustralia
- Department of NeurologyAlfred HealthMelbourneVictoriaAustralia
- Department of Clinical NeurosciencesSt Vincent's HospitalMelbourneVictoriaAustralia
| | - Suzanne G. Orchard
- School of Public Health and Preventive MedicineMonash UniversityMelbourneVictoriaAustralia
| | - Raj C. Shah
- Department of Family Medicine and Rush Alzheimer's Disease CenterRush University Medical CenterChicagoIllinoisUSA
| | - Rory Wolfe
- School of Public Health and Preventive MedicineMonash UniversityMelbourneVictoriaAustralia
| | - Elsdon Storey
- School of Public Health and Preventive MedicineMonash UniversityMelbourneVictoriaAustralia
| | - Kerry M. Sheets
- Department of MedicineDivision of Geriatric and Palliative MedicineHennepin HealthcareMinneapolisMinnesotaUSA
| | - Anne M. Murray
- Berman Center for Outcomes and Clinical ResearchMinneapolisMinnesotaUSA
| | - John J. McNeil
- School of Public Health and Preventive MedicineMonash UniversityMelbourneVictoriaAustralia
| | - Joanne Ryan
- School of Public Health and Preventive MedicineMonash UniversityMelbourneVictoriaAustralia
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13
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Mascarenhas Fonseca L, Sage Chaytor N, Olufadi Y, Buchwald D, Galvin JE, Schmitter-Edgecombe M, Suchy-Dicey A. Intraindividual Cognitive Variability and Magnetic Resonance Imaging in Aging American Indians: Data from the Strong Heart Study. J Alzheimers Dis 2023; 91:1395-1407. [PMID: 36641671 PMCID: PMC9974814 DOI: 10.3233/jad-220825] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
BACKGROUND American Indians have high prevalence of risk factors for Alzheimer's disease and related dementias (ADRD) compared to the general population, yet dementia onset and frequency in this population are understudied. Intraindividual cognitive variability (IICV), a measure of variability in neuropsychological test performance within a person at a single timepoint, may be a novel, noninvasive biomarker of neurodegeneration and early dementia. OBJECTIVE To characterize the cross-sectional associations between IICV and hippocampal, total brain volume, and white matter disease measured by magnetic resonance imaging (MRI) among older American Indians. METHODS IICV measures for memory, executive function, and processing speed, and multidomain cognition were calculated for 746 American Indians (aged 64-95) who underwent MRI. Regression models were used to examine the associations of IICV score with hippocampal volume, total brain volume, and graded white matter disease, adjusting for age, sex, education, body mass index, intracranial volume, diabetes, stroke, hypertension, hypercholesterolemia, alcohol use, and smoking. RESULTS Higher memory IICV measure was associated with lower hippocampal volume (Beta = -0.076; 95% CI -0.499, -0.023; p = 0.031). After adjustment for Bonferroni or IICV mean scores in the same tests, the associations were no longer significant. No IICV measures were associated with white matter disease or total brain volume. CONCLUSION These findings suggest that the IICV measures used in this research cannot be robustly associated with cross-sectional neuroimaging features; nonetheless, the results encourage future studies investigating the associations between IICV and other brain regions, as well as its utility in the prediction of neurodegeneration and dementia in American Indians.
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Affiliation(s)
- Luciana Mascarenhas Fonseca
- Elson S Floyd College of Medicine, Washington State University, United States
- Programa Terceira Idade (PROTER, Old Age Research Group), Department and Institute of Psychiatry, University of São Paulo School of Medicine, São Paulo, Brazil
| | - Naomi Sage Chaytor
- Elson S Floyd College of Medicine, Washington State University, United States
| | - Yunusa Olufadi
- Elson S Floyd College of Medicine, Washington State University, United States
| | - Dedra Buchwald
- Elson S Floyd College of Medicine, Washington State University, United States
- Institute for Research and Education to Advance Community Health, Washington State University, United States
| | - James E. Galvin
- Comprehensive Center for Brain Health, Department of Neurology, University of Miami Miller School of Medicine, United States
| | | | - Astrid Suchy-Dicey
- Elson S Floyd College of Medicine, Washington State University, United States
- Institute for Research and Education to Advance Community Health, Washington State University, United States
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14
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Bahrani AA, Abner EL, DeCarli CS, Barber JM, Sutton AC, Maillard P, Sandoval F, Arfanakis K, Yang YC, Evia AM, Schneider JA, Habes M, Franklin CG, Seshadri S, Satizabal CL, Caprihan A, Thompson JF, Rosenberg GA, Wang DJ, Jann K, Zhao C, Lu H, Rosenberg PB, Albert MS, Ali DG, Singh H, Schwab K, Greenberg SM, Helmer KG, Powel DK, Gold BT, Goldstein LB, Wilcock DM, Jicha GA. Multi-Site Cross-Site Inter-Rater and Test-Retest Reliability and Construct Validity of the MarkVCID White Matter Hyperintensity Growth and Regression Protocol. J Alzheimers Dis 2023; 96:683-693. [PMID: 37840499 PMCID: PMC11009792 DOI: 10.3233/jad-230629] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2023]
Abstract
BACKGROUND White matter hyperintensities (WMH) that occur in the setting of vascular cognitive impairment and dementia (VCID) may be dynamic increasing or decreasing volumes or stable over time. Quantifying such changes may prove useful as a biomarker for clinical trials designed to address vascular cognitive-impairment and dementia and Alzheimer's Disease. OBJECTIVE Conducting multi-site cross-site inter-rater and test-retest reliability of the MarkVCID white matter hyperintensity growth and regression protocol. METHODS The NINDS-supported MarkVCID Consortium evaluated a neuroimaging biomarker developed to track WMH change. Test-retest and cross-site inter-rater reliability of the protocol were assessed. Cognitive test scores were analyzed in relation to WMH changes to explore its construct validity. RESULTS ICC values for test-retest reliability of WMH growth and regression were 0.969 and 0.937 respectively, while for cross-site inter-rater ICC values for WMH growth and regression were 0.995 and 0.990 respectively. Word list long-delay free-recall was negatively associated with WMH growth (p < 0.028) but was not associated with WMH regression. CONCLUSIONS The present data demonstrate robust ICC validity of a WMH growth/regression protocol over a one-year period as measured by cross-site inter-rater and test-retest reliability. These data suggest that this approach may serve an important role in clinical trials of disease-modifying agents for VCID that may preferentially affect WMH growth, stability, or regression.
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Affiliation(s)
- Ahmed A. Bahrani
- Department of Neurology, University of Kentucky, College of Medicine, Lexington, KY, USA
- Sanders-Brown Center on Aging, University of Kentucky, College of Medicine, Lexington, KY, USA
| | - Erin L. Abner
- Sanders-Brown Center on Aging, University of Kentucky, College of Medicine, Lexington, KY, USA
- Department of Epidemiology & Environmental Health, University of Kentucky, College of Public Health, Lexington, KY, USA
| | | | - Justin M. Barber
- Sanders-Brown Center on Aging, University of Kentucky, College of Medicine, Lexington, KY, USA
| | - Abigail C. Sutton
- Sanders-Brown Center on Aging, University of Kentucky, College of Medicine, Lexington, KY, USA
| | - Pauline Maillard
- Department of Neurology, University of California, Davis, CA, USA
| | | | - Konstantinos Arfanakis
- Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, IL, USA
- Department of Biomedical Engineering, Illinois Institute of Technology, Chicago, IL, USA
| | - Yung-Chuan Yang
- Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, IL, USA
| | - Arnold M. Evia
- Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, IL, USA
| | - Julie A. Schneider
- Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, IL, USA
- Department of Neurological Sciences, Rush University Medical Center, Chicago, IL, USA
| | - Mohamad Habes
- Research Imaging Institute, University of Texas Health San Antonio, San Antonio, TX, USA
- Glenn Biggs Institute for Alzheimer’s & Neurodegenerative Diseases, University of Texas Health San Antonio, San Antonio, TX, USA
| | - Crystal G. Franklin
- Research Imaging Institute, University of Texas Health San Antonio, San Antonio, TX, USA
| | - Sudha Seshadri
- Glenn Biggs Institute for Alzheimer’s & Neurodegenerative Diseases, University of Texas Health San Antonio, San Antonio, TX, USA
| | - Claudia L. Satizabal
- Glenn Biggs Institute for Alzheimer’s & Neurodegenerative Diseases, University of Texas Health San Antonio, San Antonio, TX, USA
| | | | | | - Gary A. Rosenberg
- Center for Memory and Aging, University of New Mexico, Health Sciences Center, Albuquerque, NM, USA
| | - Danny J.J. Wang
- Departments of Neurology and Radiology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Kay Jann
- Departments of Neurology and Radiology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Chenyang Zhao
- Departments of Neurology and Radiology, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Hanzhang Lu
- Department of Radiology and Radiological Science, Johns Hopkins University, School of Medicine, Baltimore, MD, USA
| | - Paul B. Rosenberg
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, School of Medicine, Baltimore, MD, USA
| | - Marilyn S. Albert
- Department of Neurology, Johns Hopkins University, School of Medicine, Baltimore, MD, USA
| | - Doaa G. Ali
- Sanders-Brown Center on Aging, University of Kentucky, College of Medicine, Lexington, KY, USA
| | - Herpreet Singh
- Department of Neurology, Massachusetts General Hospital, Boston, MA, USA
| | - Kristin Schwab
- Department of Neurology, Massachusetts General Hospital, Boston, MA, USA
| | | | - Karl G. Helmer
- Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - David K. Powel
- Department of Neuroscience, University of Kentucky, College of Medicine, Lexington, KY, USA
- Magnetic Resonance Imaging and Spectroscopy Center, University of Kentucky, Lexington, KY, USA
| | - Brian T. Gold
- Sanders-Brown Center on Aging, University of Kentucky, College of Medicine, Lexington, KY, USA
- Department of Neuroscience, University of Kentucky, College of Medicine, Lexington, KY, USA
- Magnetic Resonance Imaging and Spectroscopy Center, University of Kentucky, Lexington, KY, USA
| | - Larry B. Goldstein
- Department of Neurology, University of Kentucky, College of Medicine, Lexington, KY, USA
| | - Donna M. Wilcock
- Sanders-Brown Center on Aging, University of Kentucky, College of Medicine, Lexington, KY, USA
- Department of Physiology, University of Kentucky, College of Medicine, Lexington, KY, USA
| | - Gregory A. Jicha
- Department of Neurology, University of Kentucky, College of Medicine, Lexington, KY, USA
- Sanders-Brown Center on Aging, University of Kentucky, College of Medicine, Lexington, KY, USA
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15
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Wu Z, Woods RL, Chong TTJ, Orchard SG, McNeil JJ, Shah RC, Wolfe R, Murray AM, Storey E, Ryan J. Potential modifiable factors associated with late-life cognitive trajectories. Front Neurol 2022; 13:950644. [PMID: 35989918 PMCID: PMC9381981 DOI: 10.3389/fneur.2022.950644] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Accepted: 07/11/2022] [Indexed: 11/19/2022] Open
Abstract
Objective There is variability across individuals in cognitive aging. To investigate the associations of several modifiable factors with high and low cognitive performance. Methods Data came from 17,724 community-dwelling individuals aged 65-98 years. Global cognition, verbal fluency, episodic memory, and psychomotor speed were assessed over up to seven years. Group-based multi-trajectory modeling identified distinct cognitive trajectories. Structural equation modeling examined the direct/indirect associations of social/behavioral factors and several chronic conditions with cognitive trajectories. Results Seven trajectory subgroups were identified. In the structural equation modeling we compared two subgroups-participants with the highest (14.2%) and lowest (4.1%) cognitive performance with the average subgroup. Lower education, never alcohol intake, and frailty directly predicted increased risk of low performance, and decreased likelihood of high performance. Hypertension (RR: 0.69, 95%CI: 0.60-0.80), obesity (RR: 0.84, 95%CI: 0.73-0.97), diabetes (RR: 0.69, 95%CI: 0.56-0.86) and depression (RR: 0.68, 95%CI: 0.54-0.85) only predicted lower likelihood of high cognitive performance, while dyslipidemia was only associated with low performance (RR: 1.30, 95%CI: 1.07-1.57). Living alone predicted increased risk of low cognitive performance and several comorbidities. Smoking did not predict cognitive trajectories but was associated with increased risk of diabetes, obesity and frailty. Findings were similar when examining the direct associations between modifiable risk factors and all seven cognitive subgroups. Conclusions Although several modifiable factors were associated with high performance, and reversely with low performance, this was not observed for obesity, hypertension and dyslipidemia. Further, health behaviors may affect cognitive function indirectly, via geriatric conditions. This indicates that strategies to promote healthy cognitive aging, may be distinct from those targeting dementia prevention.
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Affiliation(s)
- Zimu Wu
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Robyn L. Woods
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Trevor T. -J. Chong
- Turner Institute for Brain and Mental Health, Monash University, Melbourne, VIC, Australia,Department of Neurology, Alfred Health, Melbourne, VIC, Australia,Department of Clinical Neurosciences, St Vincent's Hospital, Melbourne, VIC, Australia
| | - Suzanne G. Orchard
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - John J. McNeil
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Raj C. Shah
- Department of Family Medicine and Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, United States
| | - Rory Wolfe
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Anne M. Murray
- Berman Center for Outcomes and Clinical Research, Hennepin Healthcare Research Institute, Minneapolis, MN, United States
| | - Elsdon Storey
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Joanne Ryan
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia,*Correspondence: Joanne Ryan
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16
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Wu Z, Woods RL, Chong TTJ, Orchard SG, Shah RC, Wolfe R, Storey E, Sheets KM, Murray AM, McNeil JJ, Ryan J. Cognitive Trajectories in Community-Dwelling Older Adults and Incident Dementia, Disability and Death: A 10-Year Longitudinal Study. Front Med (Lausanne) 2022; 9:917254. [PMID: 35833102 PMCID: PMC9271785 DOI: 10.3389/fmed.2022.917254] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2022] [Accepted: 05/30/2022] [Indexed: 11/13/2022] Open
Abstract
ObjectiveThe inter-individual variability in cognitive changes may be early indicators of major health events. We aimed to determine whether late-life cognitive trajectories were associated with incident dementia, persistent physical disability and all-cause mortality.MethodsData came from a cohort of older community-dwelling individuals aged 70 years or above in Australia and the United States. Global cognition, verbal fluency, episodic memory and psychomotor speed were assessed regularly at up to seven waves between 2010 and 2017. Dementia, disability in activities of daily living, and death were adjudicated between 2017 and 2020. Latent classes of cognitive trajectories over seven years were determined using group-based trajectory modeling. Multivariable logistic regression was used for the prospective associations between cognitive trajectories and these outcomes.ResultsCognitive trajectories were defined for 16,174 participants (mean age: 78.9 years; 56.7% female) who were alive and without incident dementia or disability by 2017, among which 14,655 participants were included in the association analysis. Between three and five trajectory classes were identified depending on the cognitive test. Cognitive trajectories were strongly associated with the risk of dementia. For example, compared to those in the highest-functioning trajectory, the worst performers of episodic memory had a 37-fold increased risk of dementia (95% CI: 17.23–82.64). The lowest trajectories of both global cognition and episodic memory also predicted increased mortality risk (OR: 1.80, 95% CI: 1.28–2.52; OR: 1.61, 95% CI: 1.09–2.36, respectively), while only slow psychomotor speed was marginally associated with physical disability (OR: 2.39, 95% CI: 0.99–5.77).ConclusionsIn older individuals, cognitive trajectories appear to be early indicators of clinically relevant health outcomes. Systematic cognitive assessments as part of routine geriatric evaluation may facilitate early identification and interventions for those individuals at highest risk.
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Affiliation(s)
- Zimu Wu
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Robyn L. Woods
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Trevor T. J. Chong
- Turner Institute for Brain and Mental Health, Monash University, Melbourne, VIC, Australia
- Department of Neurology, Alfred Health, Melbourne, VIC, Australia
- Department of Clinical Neurosciences, St Vincent's Hospital, Melbourne, VIC, Australia
| | - Suzanne G. Orchard
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Raj C. Shah
- Department of Family Medicine and Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, United States
| | - Rory Wolfe
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Elsdon Storey
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Kerry M. Sheets
- Division of Geriatrics and Palliative Medicine, Department of Medicine, Hennepin Healthcare, Minneapolis, MN, United States
| | - Anne M. Murray
- Berman Center for Outcomes and Clinical Research, Hennepin Healthcare Research Institute, Minneapolis, MN, United States
| | - John J. McNeil
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Joanne Ryan
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
- *Correspondence: Joanne Ryan
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17
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Prenatal earthquake stress exposure in different gestational trimesters is associated with methylation changes in the glucocorticoid receptor gene (NR3C1) and long-term working memory in adulthood. Transl Psychiatry 2022; 12:176. [PMID: 35487912 PMCID: PMC9054818 DOI: 10.1038/s41398-022-01945-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Accepted: 04/21/2022] [Indexed: 11/08/2022] Open
Abstract
Prenatal stress exposure is thought to affect the long-term development of the foetal brain via the HPA axis and to change health outcomes in adulthood, including working memory (WM). The potential mechanism is that there is a critical period of brain development of the foetus, which is a result of selective adaptation to the external environment. The human glucocorticoid gene (NR3C1) is associated with memory and cognition. This study investigates the association between earthquake stress during pregnancy and CpG methylation of the NR3C1 exon 1F promoter and its influence on working memory in adulthood. DNA methylation analysis using bisulfite sequencing PCR was quantified in 176 subjects who were exposed or not exposed to intrauterine earthquake and were divided into three groups based on the pregnancy trimester. The Hopkins Verbal Learning Test-Revised (HVLT-R) and Brief Visuospatial Memory Test-Revised (BVMT-R) were used to assess working memory performance. The methylated NR3C1 exon 1F promoter of the prenatal earthquake exposure (PEE) group was significantly higher than that of the control group (CN). Analysis of subgroups indicated that the subjects in the second trimester of PEE group showed significantly higher methylation than those in the third trimester. Significantly low BVMT-R scores were detected in those who experienced prenatal earthquake in the second trimester of PEE group. Methylated CpG site 1 may play a critical role in contributing to lower BVMT-R scores in the second trimester in the PEE group, and may offer a potential epigenetic mechanism that links prenatal stress and long-term effects on working memory.
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18
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Li J, Hao W, Fu C, Zhou C, Zhu D. Sex Differences in Memory: Do Female Reproductive Factors Explain the Differences? Front Endocrinol (Lausanne) 2022; 13:837852. [PMID: 35527998 PMCID: PMC9073013 DOI: 10.3389/fendo.2022.837852] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Accepted: 03/17/2022] [Indexed: 11/25/2022] Open
Abstract
Background The sex differences in memory impairment were inconclusive, and the effect of female reproductive factors (age at menarche, age at menopause, and reproductive period) on the differences was not clear. We aimed to examine the sex differences in objective and subjective memory impairment in postmenopausal women and age- and education-matched men and explore whether the differences were differed by female reproductive factors. Methods Data were obtained from the China Health and Retirement Longitudinal Study. Using the case-control matching method, 3,218 paired postmenopausal women and men matched for age and education were selected. Memory was assessed using the three-word recall task and a self-rated question. Poisson regression models with a robust error variance were used. Results The relative risk was 1.22 (95% confidence interval 1.08-1.38) for objective memory impairment in women compared with men (23.87% vs. 27.36%), and 1.51 (1.36-1.67) for subjective memory impairment (39.34% vs. 28.25%) after adjusting the confounders. The higher risk of objective memory impairment in women was different among groups of age at menarche in a linear pattern, with younger age at menarche associated with higher risks of objective memory impairment (p < 0.001 for trend). It was also different among groups of menopausal age and reproductive period in an approximate U-shaped pattern, with a similar risk of objective memory with men in women menopause at 52-53 years and having a reproductive period of 31-33 years and higher risks in women with earlier or later menopause (RRs raging form 1.17 to1.41) and a shorter or longer period of reproduction (RR, 1.23-1.29). The higher risks of subjective memory impairment in women were not different among different groups of reproductive factors. Conclusions Postmenopausal women were at an increased risk of objective and subjective memory impairment than men. The higher risks in objective memory, but not subjective memory, were varied by age at menarche, age at menopause, and reproductive periods, which may help understand the underlying mechanisms of sex differences in cognitive ageing and guide precise intervention to preventing dementia among older women and men.
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Affiliation(s)
- Jie Li
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
- NHC Key Laboratory of Health Economics and Policy Research (Shandong University), Jinan, China
| | - Wenting Hao
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
- NHC Key Laboratory of Health Economics and Policy Research (Shandong University), Jinan, China
| | - Chunying Fu
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
- NHC Key Laboratory of Health Economics and Policy Research (Shandong University), Jinan, China
| | - Chengchao Zhou
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
- NHC Key Laboratory of Health Economics and Policy Research (Shandong University), Jinan, China
| | - Dongshan Zhu
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
- NHC Key Laboratory of Health Economics and Policy Research (Shandong University), Jinan, China
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan, China
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19
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Hilsabeck RC, Marquine MJ. Editorial from the TCN department of culture and gender in neuropsychology: moving the field toward broader representation in neuropsychological studies. Clin Neuropsychol 2022; 36:779-789. [PMID: 35435148 DOI: 10.1080/13854046.2022.2056924] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Affiliation(s)
- Robin C Hilsabeck
- Department of Neurology, The University of Texas at Austin Dell Medical School, Austin, TX, USA.,Comprehensive Memory Center, Mulva Clinic for the Neurosciences, Austin, TX, USA
| | - María J Marquine
- Departments of Medicine and Psychiatry, University of California San Diego, San Diego, CA, USA
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20
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Webb KL, Ryan J, Wolfe R, Woods RL, Shah RC, Murray AM, Orchard SG, Storey E. Test-Retest Reliability and Minimal Detectable Change of Four Cognitive Tests in Community-Dwelling Older Adults. J Alzheimers Dis 2022; 87:1683-1693. [PMID: 35491779 PMCID: PMC9588392 DOI: 10.3233/jad-215564] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
BACKGROUND Cognitive test-retest reliability measures can be used to evaluate meaningful changes in scores. OBJECTIVE This analysis aimed to develop a comprehensive set of test-retest reliability values and minimal detectable change (MDC) values for a cognitive battery for community-dwelling older individuals in Australia and the U.S., for use in clinical practice. METHODS Cognitive scores collected at baseline and year 1, in the ASPirin in Reducing Events in the Elderly clinical trial were used to calculate intraclass correlation coefficients (ICC) for four tests: Modified Mini-Mental State examination (3MS), Hopkins Verbal Learning Test-Revised (HVLT-R), single-letter Controlled Oral Word Association Test (COWAT-F), and Symbol Digit Modalities Test (SDMT). 16,956 participants aged 70 years and over (65 years and over for U.S. minorities) were included. ICCs were used to calculate MDC values for eight education and ethno-racial subgroups. RESULTS All four cognitive tests had moderate (ICC > 0.5) to good (ICC > 0.7) test-retest reliability. ICCs ranged from 0.53 to 0.63 (3MS), 0.68 to 0.77 (SDMT), 0.56 to 0.64 (COWAT-F), 0.57 to 0.69 (HVLT-R total recall), and 0.57 to 0.70 (HVLT-R delayed recall) across the subgroups. MDC values ranged from 6.60 to 9.95 (3MS), 12.42 to 15.61 (SDMT), 6.34 to 8.34 (COWAT-F), 8.13 to 10.85 (HVLT-R total recall), and 4.00 to 5.62 (HVLT-R delayed recall). CONCLUSION This large cohort of older individuals provides test-retest reliability and MDC values for four widely employed tests of cognitive function. These results can aid interpretation of cognitive scores and decline instead of relying on cross-sectional normative data alone.
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Affiliation(s)
- Katherine L. Webb
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia,Correspondence to: Katherine L. Webb Monash University, School of Public Health and Preventive Medicine, Address: 553 St Kilda Rd, Melbourne VIC 3004, Australia. Tel.: +61 03 9903 0555;
| | - Joanne Ryan
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Rory Wolfe
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Robyn L. Woods
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Raj C. Shah
- Department of Family Medicine and Rush Alzheimer’s Disease Center; Rush University Medical Center, Chicago, IL, USA
| | - Anne M. Murray
- Berman Center for Outcomes and Clinical Research, Minneapolis Medical Research Foundation, Hennepin Healthcare Research Institute, Minneapolis, MN, USA,Department of Medicine, Division of Geriatrics, Hennepin County Medical Center and University of Minnesota, Minneapolis, MN, USA
| | - Suzanne G. Orchard
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
| | - Elsdon Storey
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia
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21
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Fransquet PD, Lacaze P, Saffery R, Shah RC, Vryer R, Murray A, Woods RL, Ryan J. Accelerated Epigenetic Aging in Peripheral Blood does not Predict Dementia Risk. Curr Alzheimer Res 2021; 18:443-451. [PMID: 34429046 DOI: 10.2174/1567205018666210823100721] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Revised: 04/08/2021] [Accepted: 06/15/2021] [Indexed: 11/22/2022]
Abstract
BACKGROUND There is strong evidence that epigenetic age acceleration is associated with increased risk of later-life diseases and all-cause mortality. However, there is currently limited evidence that suggests accelerated epigenetic age is associated with dementia risk. OBJECTIVE This study aims to clarify whether epigenetic biomarkers of accelerated aging can predict dementia risk, which is an important consideration as aging is the greatest risk factor for the disease. METHODS DNA methylation was measured in peripheral blood samples provided by 160 participants from the ASPirin in Reducing Events in the Elderly study, including 73 pre-symptomatic dementia cases and 87 controls matched for age, sex, and smoking and education status. Epigenetic age was calculated using Horvath, Hannum, GrimAge and PhenoAge DNA methylation clocks, and age acceleration (the disparity between chronological age and epigenetic age) was determined. RESULTS There was no difference in age acceleration between dementia cases and controls. In males, only Hannum's intrinsic epigenetic age acceleration was increased in pre-symptomatic dementia cases compared to controls (Δ +1.8 years, p = 0.03). CONCLUSION These findings provide no strong evidence that accelerated epigenetic aging measured in peripheral blood can predict dementia risk.
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Affiliation(s)
- P D Fransquet
- School of Public Health and Preventive Medicine, Monash University, Melbourne, 3004, Victoria, Australia
| | - P Lacaze
- School of Public Health and Preventive Medicine, Monash University, Melbourne, 3004, Victoria, Australia
| | - R Saffery
- Murdoch Children's Research Institute, Department of Paediatrics, The University of Melbourne, Parkville, 3052 Victoria, Australia
| | - R C Shah
- Department of Family Medicine and Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL 60612, United States
| | - R Vryer
- Murdoch Children's Research Institute, Department of Paediatrics, The University of Melbourne, Parkville, 3052 Victoria, Australia
| | - A Murray
- Berman Center for Outcomes and Clinical Research, Hennepin Healthcare Research Institute, Hennepin Healthcare, Division of Geriatrics, Department of Medicine, University of Minnesota, Minneapolis, MN 55455, United States
| | - R L Woods
- School of Public Health and Preventive Medicine, Monash University, Melbourne, 3004, Victoria, Australia
| | - J Ryan
- School of Public Health and Preventive Medicine, Monash University, Melbourne, 3004, Victoria, Australia
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22
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Vicente SG, Ramos-Usuga D, Barbosa F, Gaspar N, Dores AR, Rivera D, Arango-Lasprilla JC. Regression-Based Norms for the Hopkins Verbal Learning Test-Revised and the Rey-Osterrieth Complex Figure in a Portuguese Adult Population. Arch Clin Neuropsychol 2021; 36:587-596. [PMID: 33067608 DOI: 10.1093/arclin/acaa087] [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] [Received: 02/24/2020] [Revised: 06/16/2020] [Accepted: 09/16/2020] [Indexed: 11/14/2022] Open
Abstract
OBJECTIVE The principal goal of this study was to produce adjusted normative data for European Portuguese native speakers from Portugal on 2 neuropsychological tests widely used to assess learning and memory: the Hopkins Verbal Learning Test-Revised (HVLT-R) and the Rey-Osterrieth Complex Figure Test (ROCF). METHOD The study included 300 individuals aged 18-92 years (M = 50.4, SD = 21.2), who had educational backgrounds ranging from 3 to 25 years (M = 10.4, SD = 5.2). RESULTS Age, education, and sex were significantly associated with HVLT-R and ROCF performance. These demographic variables accounted for 61% of the variance in HVLT-R total recall, 54% in HVLT-R delayed recall, 18% in HVLT-R recognition, 55% in ROCF copy, and 39% in ROCF immediate recall. CONCLUSIONS The normative data are presented as regression-based algorithms to adjust direct and derived test scores for age, education, and sex. This study provides a calculator of normative data derived from the results of the regression models.
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Affiliation(s)
- Selene G Vicente
- Centre for Psychology, Faculty of Psychology and Education Sciences, University of Porto, Porto 4099-002, Portugal
| | - Daniela Ramos-Usuga
- Biocruces Bizkaia Health Research Institute, Barakaldo 48903, Spain.,Biomedical Research Doctorate Program, University of the Basque Country (UPV/EHU), Leioa 48940, Spain
| | - Fernando Barbosa
- Laboratory of Neuropsychophysiology, Faculty of Psychology and Education Sciences, University of Porto, Porto 4099-002, Portugal
| | - Nuno Gaspar
- Centre for Psychology, Faculty of Psychology and Education Sciences, University of Porto, Porto 4099-002, Portugal
| | - Artemisa R Dores
- School of Health, Polytechnic of Porto, Porto 4200-072, Portugal
| | - Diego Rivera
- Departamento de Ciencias de la Salud, Universidad Pública de Navarra, Navarra 31006, España
| | - Juan Carlos Arango-Lasprilla
- Biocruces Bizkaia Health Research Institute, Barakaldo 48903, Spain.,IKERBASQUE. Basque Foundation for Science, Bilbao 48013, Spain.,Department of Cell Biology and Histology, University of the Basque Country (UPV/EHU), Leioa 48940, Spain
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23
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Wu Z, Woods RL, Wolfe R, Storey E, Chong TTJ, Shah RC, Orchard SG, McNeil JJ, Murray AM, Ryan J. Trajectories of cognitive function in community-dwelling older adults: A longitudinal study of population heterogeneity. ALZHEIMER'S & DEMENTIA (AMSTERDAM, NETHERLANDS) 2021; 13:e12180. [PMID: 33969173 PMCID: PMC8088593 DOI: 10.1002/dad2.12180] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/25/2021] [Accepted: 03/01/2021] [Indexed: 11/20/2022]
Abstract
INTRODUCTION This study aimed to investigate cognitive aging trajectories, the associated sociodemographic characteristics, and the association of these trajectories with dementia. METHODS Generally healthy older adults (n = 19,114) were followed for up to 7 years, with regular cognitive assessments. Group-based trajectory modeling identified distinct cognitive trajectories. RESULTS Four to seven trajectories were identified per cognitive domain. Stable trajectories were observed across domains. Improvement in verbal fluency and minor psychomotor slowing were common. Substantial decline in global cognition and episodic memory were observed in a small proportion of individuals. Older, less educated participants and men were more common in lower-functioning trajectories (p < .001). The highest proportions of dementia cases were in trajectories with major decline in global cognition (56.9%) and memory (33.2%). DISCUSSION Inter-individual variability in cognitive trajectories was observed across all domains. Some individuals appear resilient to cognitive decline even with advancing age. Further research into factors promoting cognitive resilience is needed.
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Affiliation(s)
- Zimu Wu
- School of Public Health and Preventive MedicineMonash UniversityMelbourneAustralia
| | - Robyn L. Woods
- School of Public Health and Preventive MedicineMonash UniversityMelbourneAustralia
| | - Rory Wolfe
- School of Public Health and Preventive MedicineMonash UniversityMelbourneAustralia
| | - Elsdon Storey
- School of Public Health and Preventive MedicineMonash UniversityMelbourneAustralia
| | - Trevor T. J. Chong
- Turner Institute for Brain and Mental HealthMonash UniversityMelbourneAustralia
- Department of NeurologyAlfred HealthMelbourneAustralia
- Department of Clinical NeurosciencesSt. Vincent's HospitalMelbourneAustralia
| | - Raj C. Shah
- Department of Family Medicine and Rush Alzheimer's Disease CenterRush University Medical CenterChicagoIllinoisUSA
| | - Suzanne G. Orchard
- School of Public Health and Preventive MedicineMonash UniversityMelbourneAustralia
| | - John J. McNeil
- School of Public Health and Preventive MedicineMonash UniversityMelbourneAustralia
| | - Anne M. Murray
- Berman Center for Outcomes and Clinical ResearchMinneapolisMinnesotaUSA
| | - Joanne Ryan
- School of Public Health and Preventive MedicineMonash UniversityMelbourneAustralia
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24
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Fransquet PD, Lacaze P, Saffery R, Phung J, Parker E, Shah RC, Murray A, Woods RL, Ryan J. DNA methylation analysis of candidate genes associated with dementia in peripheral blood. Epigenomics 2020; 12:2109-2123. [PMID: 33300824 DOI: 10.2217/epi-2020-0236] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
Aim: To investigate whether genes implicated in dementia pathogenesis are differently methylated in peripheral blood. Materials & methods: Participants included 160 cognitively healthy individuals aged 70+ years: 73 who were subsequently diagnosed with dementia and 87 controls matched on age, gender, education, smoking and baseline cognition. A total of 49 participants also provided blood samples at diagnosis. Blood DNA methylation of APOE, APP, BDNF, PIN1, SNCA and TOMM40 was examined. Results: A total of 56 of 299 probes were differentially methylated in dementia compared with controls and 39 probes prior to diagnosis. The greatest effect size was in APP (cg19423170, Δ-8.32%, adjusted p = 0.009 at diagnosis; cg19933173, Δ-4.18%, adjusted p < 0.0001 prediagnosis). Conclusion: Genes implicated in dementia pathogenesis show differential blood methylation in dementia, even prior to diagnosis.
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Affiliation(s)
- Peter D Fransquet
- School of Public Health & Preventive Medicine, Monash University, Melbourne, 3004 Victoria, Australia
| | - Paul Lacaze
- School of Public Health & Preventive Medicine, Monash University, Melbourne, 3004 Victoria, Australia
| | - Richard Saffery
- Murdoch Children's Research Institute & Department of Paediatrics, The University of Melbourne, Parkville, 3052 Victoria, Australia
| | - James Phung
- School of Public Health & Preventive Medicine, Monash University, Melbourne, 3004 Victoria, Australia
| | - Emily Parker
- School of Public Health & Preventive Medicine, Monash University, Melbourne, 3004 Victoria, Australia
| | - Raj C Shah
- Department of Family Medicine & Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, USA
| | - Anne Murray
- Berman Center for Outcomes & Clinical Research, Hennepin Healthcare Research Institute, Hennepin Healthcare; Division of Geriatrics, Department of Medicine, University of Minnesota, Minneapolis, MN, USA
| | - Robyn L Woods
- School of Public Health & Preventive Medicine, Monash University, Melbourne, 3004 Victoria, Australia
| | - Joanne Ryan
- School of Public Health & Preventive Medicine, Monash University, Melbourne, 3004 Victoria, Australia.,PSNREC, University of Montpellier, INSERM, Montpellier, France
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25
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Ryan J, Woods RL, Britt CJ, Murray AM, Shah RC, Reid CM, Wolfe R, Nelson MR, Orchard SG, Lockery JE, Trevaks RE, Storey E. Normative Data for the Symbol Digit Modalities Test in Older White Australians and Americans, African-Americans, and Hispanic/Latinos. J Alzheimers Dis Rep 2020; 4:313-323. [PMID: 33024939 PMCID: PMC7504980 DOI: 10.3233/adr-200194] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Background Processing speed, which can be assessed using the Symbol Digit Modalities Test (SDMT), is central to many brain functions. Processing speed declines with advanced age but substantial impairments are indicative of brain injury or disease. Objective The purpose of this study was to provide SDMT normative data for older community-dwelling individuals in the U.S. and Australia. Methods The ASPREE trial recruited 19,114 relatively healthy older men and women in Australia and the U.S. from the general community. All participants were without a diagnosis of dementia and with a Modified Mini-Mental State examination score of 78 or more at enrolment. The SDMT was administered at baseline as part of a neuropsychological test battery. Results The median age of participants was 74 years (range 65-99), and 56% were women. The median years of education was 12. Ethno-racial differences in SDMT performance were observed and normative data were thus presented separately for 16,289 white Australians, 1,082 white Americans, 891 African-Americans, and 316 Hispanic/Latinos. There were consistent positive associations found between SDMT and education level, and negative associations between SDMT and age. Mean scores for women were consistently higher than men with the exception of Hispanic/Latinos aged ≥70 years. Conclusion This study provides comprehensive SDMT normative data for whites (Australian and U.S.), Hispanic/Latinos, and African-Americans, according to gender, age, and education level. These norms can be used clinically as reference standards to screen for cognitive impairments in older individuals.
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Affiliation(s)
- Joanne Ryan
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Robyn L Woods
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Carlene J Britt
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Anne M Murray
- Berman Center for Outcomes and Clinical Research, Hennepin Health Research Institute and Division of Geriatrics, Department of Medicine, Hennepin HealthCare and University of Minnesota, MN, USA
| | - Raj C Shah
- Department of Family Medicine and Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, USA
| | - Christopher M Reid
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.,School of Public Health, Curtin University, Perth, Western Australia, Australia
| | - Rory Wolfe
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Mark R Nelson
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.,Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia
| | - Suzanne G Orchard
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Jessica E Lockery
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Ruth E Trevaks
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Elsdon Storey
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
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Fransquet PD, Lacaze P, Saffery R, Phung J, Parker E, Shah R, Murray A, Woods RL, Ryan J. Blood DNA methylation signatures to detect dementia prior to overt clinical symptoms. ALZHEIMER'S & DEMENTIA (AMSTERDAM, NETHERLANDS) 2020; 12:e12056. [PMID: 32671182 PMCID: PMC7346866 DOI: 10.1002/dad2.12056] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Revised: 05/27/2020] [Accepted: 05/27/2020] [Indexed: 12/13/2022]
Abstract
INTRODUCTION This study determined whether blood DNA methylation (DNAm) patterns differentiate individuals with presymptomatic dementia compared to controls. METHODS DNAm was measured in 73 individuals prior to dementia diagnosis and 87 cognitively healthy controls matched for age, sex, smoking, education, and baseline cognition. DNAm was also measured at 3 years follow-up in 25 dementia cases, and 24 controls. RESULTS Cases and controls differed in DNAm (unadjusted P < .01) at the time of diagnosis (n = 28,787 probes), and pre-diagnosis (n = 15,111 probes), with cg01404610 (General transcription factor IIA subunit 1 gene) significant after correction for multiple testing. Overall, 1150 probes overlapped between analyses (methylation differences from -10.6% to +11.0%), and effect sizes increased from pre-diagnosis to diagnosis. DISCUSSION Discernible blood DNAm signatures are in dementia cases before the appearance of overt clinical symptoms. Blood-based methylation may serve as a potential biomarker of dementia, but further investigation is needed to determine their true clinical utility.
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Affiliation(s)
- Peter Daniel Fransquet
- School of Public Health and Preventive MedicineMonash UniversityMelbourneVictoriaAustralia
| | - Paul Lacaze
- School of Public Health and Preventive MedicineMonash UniversityMelbourneVictoriaAustralia
| | - Richard Saffery
- Department of PaediatricsMurdoch Children's Research InstituteThe University of MelbourneParkvilleVictoriaAustralia
| | - James Phung
- School of Public Health and Preventive MedicineMonash UniversityMelbourneVictoriaAustralia
| | - Emily Parker
- School of Public Health and Preventive MedicineMonash UniversityMelbourneVictoriaAustralia
| | - Raj Shah
- Department of Family Medicine and Rush Alzheimer's Disease CenterRush University Medical CenterChicagoIllinoisUSA
| | - Anne Murray
- Berman Center for Outcomes and Clinical ResearchHennepin Healthcare, Division of GeriatricsDepartment of MedicineHennepin Healthcare Research InstituteUniversity of MinnesotaMinneapolisMinnesotaUSA
| | - Robyn L. Woods
- School of Public Health and Preventive MedicineMonash UniversityMelbourneVictoriaAustralia
| | - Joanne Ryan
- School of Public Health and Preventive MedicineMonash UniversityMelbourneVictoriaAustralia
- PSNRECUniversité de MontpellierINSERMMontpellierFrance
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Rodríguez-Lorenzana A, Núñez-Fernández S, Adana-Díaz L, Mascialino G, Ponce TY, Rivera D, Arango-Lasprilla JC. Normative data for test of learning and memory in an ecuadorian adult population. Clin Neuropsychol 2020; 34:54-69. [PMID: 32544370 DOI: 10.1080/13854046.2020.1775892] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
OBJECTIVE The objective of this study was to develop norms for two neuropsychological tests of learning and memory in an Ecuadorian adult population. METHOD 322 healthy individuals, ages between 18 and 84, were enrolled in the Metropolitan District of Quito. Participants were administered a comprehensive neuropsychological evaluation that included tests of learning and memory (Rey-Osterrieth Complex Figure Test [ROCF] and Hopkins Verbal Learning Test-Revised [HVLT-R]). Backward stepwise multiple linear regression analyses were used to examine the influence of demographic variables age, education, and gender on test performance. Normative data were developed adjusting for demographic variables found to be significant in the final regression models. RESULTS The final multiple linear models revealed performance on tests of learning and memory worsened with age and improved as a function of education. A user-friendly Excel-based calculator is presented to calculate the z score and percentile automatically based on raw score and sociodemographic information. CONCLUSION This is the first study that presents normative data for tests of learning and memory for an adult population in Ecuador. It is expected that these norms will help to improve the clinical practice of neuropsychology in Ecuador by limiting erroneous raw score interpretation and incrementing diagnostic accuracy.
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Affiliation(s)
| | | | - Lila Adana-Díaz
- Escuela de psicología, Universidad de Las Américas, Quito, Ecuador
| | - Guido Mascialino
- Escuela de psicología, Universidad de Las Américas, Quito, Ecuador
| | | | - Diego Rivera
- Departamento de Ciencias de la Salud, Universidad Pública de Navarra, Pamplona, España
| | - Juan Carlos Arango-Lasprilla
- Biocruces Bizkaia Health Research Institute, Barakaldo, Spain.,IKERBASQUE, Basque Foundation for Science, Bilbao, Spain.,Department of Cell Biology and Histology, University of the Basque Country, (UPV/EHU), Leioa, Spain
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