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Aravena JM, Lee J, Schwartz AE, Nyhan K, Wang SY, Levy BR. Beneficial Effect of Societal Factors on APOE-ε2 and ε4 Carriers' Brain Health: A Systematic Review. J Gerontol A Biol Sci Med Sci 2024; 79:glad237. [PMID: 37792627 PMCID: PMC10803122 DOI: 10.1093/gerona/glad237] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Indexed: 10/06/2023] Open
Abstract
BACKGROUND Apolipoprotein-E (APOE) ε4 and ε2 are the most prevalent risk-increasing and risk-reducing genetic predictors of Alzheimer's disease, respectively. However, the extent to which societal factors can reduce the harmful impact of APOE-ε4 and enhance the beneficial impact of APOE-ε2 on brain health has not yet been examined systematically. METHODS To fill this gap, we conducted a systematic review searching for studies in MEDLINE, Embase, PsycINFO, and Scopus until June 2023, that included: (a) 1 of 5 social determinants of health (SDH) identified by Healthy People 2030, (b) APOE-ε2 or APOE-ε4 allele carriers, (c) cognitive or brain-biomarker outcomes, and (d) studies with an analysis of how APOE-ε2 and/ or APOE-ε4 carriers differ on outcomes when exposed to SDH. RESULTS From 14 076 articles retrieved, 124 met the inclusion criteria. In most of the studies, exposure to favorable SDH reduced APOE-ε4's detrimental effect and enhanced APOE-ε2's beneficial effect on cognitive and brain-biomarker outcomes (cognition: 70.5%, n: 74/105; brain-biomarkers: 71.4%, n: 20/28). A similar pattern of results emerged in each of the 5 Healthy People 2030 SDH categories, where finishing high school, having resources to satisfy basic needs, less air pollution, less negative external stimuli that can generate stress (eg, negative age stereotypes), and exposure to multiple favorable SDH were associated with better cognitive and brain health among APOE-ε4 and APOE-ε2 carriers. CONCLUSIONS Societal factors can reduce the harmful impact of APOE-ε4 and enhance the beneficial impact of APOE-ε2 on cognitive outcomes. This suggests that plans to reduce dementia should include community-level policies promoting favorable SDH.
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Affiliation(s)
- José M Aravena
- Department of Social & Behavioral Sciences, School of Public Health, Yale University, New Haven, Connecticut, USA
| | - Jakyung Lee
- Institute for Community Care and Health Equity, Chung-Ang University, Seoul, Republic of South Korea
| | - Anna E Schwartz
- Department of Social & Behavioral Sciences, School of Public Health, Yale University, New Haven, Connecticut, USA
| | - Kate Nyhan
- Cushing/Whitney Medical Library, Department of Environmental Health Sciences, School of Public Health, Yale University, New Haven, Connecticut, USA
| | - Shi-Yi Wang
- Department of Chronic Disease Epidemiology, School of Public Health, Yale University, New Haven, Connecticut, USA
| | - Becca R Levy
- Department of Social & Behavioral Sciences, School of Public Health, Yale University, New Haven, Connecticut, USA
- Department of Psychology, Yale University, New Haven, Connecticut, USA
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Allen JO, Sikora N. Aging Stigma and the Health of US Adults Over 65: What Do We Know? Clin Interv Aging 2023; 18:2093-2116. [PMID: 38116457 PMCID: PMC10729833 DOI: 10.2147/cia.s396833] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2023] [Accepted: 12/01/2023] [Indexed: 12/21/2023] Open
Abstract
This narrative review assessed the current state of research on aging stigma and health relevant to US adults ages 65 and older. We adopted a stigma framework to highlight aging stigma as a meaningful social construct and the complex ways in which it may be harmful for health. We identified 29 studies of various types (experimental, intervention, cross-sectional quantitative, longitudinal quantitative, and qualitative) published between 2010 and 2023 that investigated relationships between concepts related to aging stigma and health. Aging stigma was associated with poor short- and long-term health outcomes spanning cognition, psychological wellbeing, physical health, and hospitalizations. The premise that aging stigma is harmful to health was moderately well supported, while evidence that health influenced aging stigma was weak. Collectively, studies provided insight into several mechanisms through which aging stigma may affect the health of older US adults, while also highlighting areas for future research. Potential strategies for addressing aging stigma as a public health hazard were discussed.
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Affiliation(s)
- Julie Ober Allen
- Department of Health and Exercise Science, University of Oklahoma, Norman, OK, USA
- Research Center for Group Dynamics, Institute for Social Research, University of Michigan, Ann Arbor, MI, USA
| | - Nadine Sikora
- Department of Health and Exercise Science, University of Oklahoma, Norman, OK, USA
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Fernández-Ballbé Ó, Martin-Moratinos M, Saiz J, Gallardo-Peralta L, Barrón López de Roda A. The Relationship between Subjective Aging and Cognition in Elderly People: A Systematic Review. Healthcare (Basel) 2023; 11:3115. [PMID: 38132005 PMCID: PMC10743019 DOI: 10.3390/healthcare11243115] [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: 11/03/2023] [Revised: 12/01/2023] [Accepted: 12/04/2023] [Indexed: 12/23/2023] Open
Abstract
There is a growing body of evidence on the effects of subjective aging on health, well-being and quality of life. This review aims to synthesize findings about the link between subjective aging and cognition and cognitive decline. Furthermore, it provides an examination of variation sources such as subjective aging construct, cognitive domains, measures employed, age and moderator variables. A systematic search was performed in PubMed, PsychInfo and Web of Science, as well as grey literature searches in Google Scholar, OpenGrey, WorldCat and NDLTD, which resulted in 59 reports being included. Subjective aging is a relevant construct in the explanation and prediction of cognitive aging and cognitive decline in elderly adults. More positive views about own aging and self-perceptions of aging, as well as a younger subjective age, were consistently related to better cognition and lower risk of cognitive decline. However, there were differences due to subjective aging subdimensions and cognitive domains, as well as an effect of age. Additionally, there were concerns about the content validity of some measures employed, such as the Philadelphia Geriatric Center Morale Scale for subjective aging and the Mini Mental State Examination for global cognition. Further studies should employ longitudinal designs with a process-based approach to cognition and precise subjective aging measures.
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Affiliation(s)
- Óscar Fernández-Ballbé
- Faculty of Psychology, Complutense University of Madrid, 28223 Madrid, Spain; (J.S.); (L.G.-P.); (A.B.L.d.R.)
| | | | - Jesus Saiz
- Faculty of Psychology, Complutense University of Madrid, 28223 Madrid, Spain; (J.S.); (L.G.-P.); (A.B.L.d.R.)
| | - Lorena Gallardo-Peralta
- Faculty of Psychology, Complutense University of Madrid, 28223 Madrid, Spain; (J.S.); (L.G.-P.); (A.B.L.d.R.)
| | - Ana Barrón López de Roda
- Faculty of Psychology, Complutense University of Madrid, 28223 Madrid, Spain; (J.S.); (L.G.-P.); (A.B.L.d.R.)
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Valsdóttir V, Magnúsdóttir BB, Chang M, Sigurdsson S, Gudnason V, Launer LJ, Jónsdóttir MK. Cognition and brain health among older adults in Iceland: the AGES-Reykjavik study. GeroScience 2022; 44:2785-2800. [PMID: 35978066 PMCID: PMC9768066 DOI: 10.1007/s11357-022-00642-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Accepted: 08/05/2022] [Indexed: 01/07/2023] Open
Abstract
The paper aimed to compare how factors previously identified as predictive factors for cognitive decline and dementia related to cognitive performance on the one hand and brain health on the other. To that aim, multiple linear regression was applied to the AGES-Reykjavik study epidemiological data. Additionally, a regression analysis was performed for change in cognition over 5 years, using the same exposure factors. The study ran from 2002 to 2011, and the sample analyzed included 1707 participants between the ages of 66 and 90. The data contains MR imaging, cognitive testing, background data, and physiological measurements. Overall, we conclude that risk factors linked to dementia relate differently to cognition and brain health. Mobility, physical strength, alcohol consumption, coronary artery disease, and hypertension were associated with cognition and brain volume. Smoking, depression, diabetes, and body fat percentage were only associated with brain volume, not cognitive performance. Modifiable factors previously linked to cognitive reserve, such as educational attainment, participation in leisure activities, multilingualism and good self-reported health, were associated with cognitive function but did not relate to brain volume. These findings show that, within the same participant pool, cognitive reserve proxy variables have a relationship with cognitive performance but have no association with relative brain volume measured simultaneously.
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Affiliation(s)
- Vaka Valsdóttir
- Department of Psychology, Reykjavik University, Menntavegur 1, 102 Reykjavik, Iceland
- RHLÖ – Icelandic Gerontological Research Center, Landspitali University Hospital, Reykjavik, Iceland
| | - Brynja Björk Magnúsdóttir
- Department of Psychology, Reykjavik University, Menntavegur 1, 102 Reykjavik, Iceland
- Mental Health Services, Landspitali University Hospital, Reykjavik, Iceland
| | - Milan Chang
- RHLÖ – Icelandic Gerontological Research Center, Landspitali University Hospital, Reykjavik, Iceland
| | | | - Vilmundur Gudnason
- The Icelandic Heart Association, Kopavogur, Iceland
- Faculty of Medicine, University of Iceland, Reykjavik, Iceland
| | - Lenore J. Launer
- Laboratory of Epidemiology and Population Sciences, National Institute On Aging, National Institutes of Health (NIH), Bethesda, MD USA
| | - María K. Jónsdóttir
- Department of Psychology, Reykjavik University, Menntavegur 1, 102 Reykjavik, Iceland
- Mental Health Services, Landspitali University Hospital, Reykjavik, Iceland
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Savignac C, Villeneuve S, Badhwar A, Saltoun K, Shafighi K, Zajner C, Sharma V, Gagliano Taliun SA, Farhan S, Poirier J, Bzdok D. APOE alleles are associated with sex-specific structural differences in brain regions affected in Alzheimer's disease and related dementia. PLoS Biol 2022; 20:e3001863. [PMID: 36512526 PMCID: PMC9747055 DOI: 10.1371/journal.pbio.3001863] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Accepted: 09/30/2022] [Indexed: 12/15/2022] Open
Abstract
Alzheimer's disease is marked by intracellular tau aggregates in the medial temporal lobe (MTL) and extracellular amyloid aggregates in the default network (DN). Here, we examined codependent structural variations between the MTL's most vulnerable structure, the hippocampus (HC), and the DN at subregion resolution in individuals with Alzheimer's disease and related dementia (ADRD). By leveraging the power of the approximately 40,000 participants of the UK Biobank cohort, we assessed impacts from the protective APOE ɛ2 and the deleterious APOE ɛ4 Alzheimer's disease alleles on these structural relationships. We demonstrate ɛ2 and ɛ4 genotype effects on the inter-individual expression of HC-DN co-variation structural patterns at the population level. Across these HC-DN signatures, recurrent deviations in the CA1, CA2/3, molecular layer, fornix's fimbria, and their cortical partners related to ADRD risk. Analyses of the rich phenotypic profiles in the UK Biobank cohort further revealed male-specific HC-DN associations with air pollution and female-specific associations with cardiovascular traits. We also showed that APOE ɛ2/2 interacts preferentially with HC-DN co-variation patterns in estimating social lifestyle in males and physical activity in females. Our structural, genetic, and phenotypic analyses in this large epidemiological cohort reinvigorate the often-neglected interplay between APOE ɛ2 dosage and sex and link APOE alleles to inter-individual brain structural differences indicative of ADRD familial risk.
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Affiliation(s)
- Chloé Savignac
- Department of Biomedical Engineering, Faculty of Medicine, McGill University, Montreal, Quebec, Canada
| | - Sylvia Villeneuve
- Department of Neurology and Neurosurgery, Montreal Neurological Institute (MNI), Faculty of Medicine, McGill University, Montreal, Quebec, Canada
- McConnell Brain Imaging Centre (BIC), MNI, Faculty of Medicine, McGill University, Montreal, Quebec, Canada
- Department of Psychiatry, Faculty of Medicine, McGill University, Montreal, Quebec, Canada
- Centre for Studies in the Prevention of Alzheimer’s Disease, Douglas Mental Health Institute, McGill University, Montreal, Quebec, Canada
| | - AmanPreet Badhwar
- Department of Pharmacology and Physiology, Faculty of Medicine, Université de Montréal, Montreal, Quebec, Canada
- Centre de recherche de l’Institut universitaire de gériatrie de Montréal (CRIUGM), Montreal, Quebec, Canada
| | - Karin Saltoun
- Department of Biomedical Engineering, Faculty of Medicine, McGill University, Montreal, Quebec, Canada
| | - Kimia Shafighi
- Department of Biomedical Engineering, Faculty of Medicine, McGill University, Montreal, Quebec, Canada
| | - Chris Zajner
- Department of Biomedical Engineering, Faculty of Medicine, McGill University, Montreal, Quebec, Canada
| | - Vaibhav Sharma
- Department of Biomedical Engineering, Faculty of Medicine, McGill University, Montreal, Quebec, Canada
| | - Sarah A. Gagliano Taliun
- Department of Neurosciences & Department of Medicine, Faculty of Medicine, Université de Montréal, Montreal, Quebec, Canada
- Montreal Heart Institute, Montréal, Quebec, Canada
| | - Sali Farhan
- Department of Neurology and Neurosurgery, Montreal Neurological Institute (MNI), Faculty of Medicine, McGill University, Montreal, Quebec, Canada
- Department of Human Genetics, Faculty of Medicine, McGill University, Montreal, Quebec, Canada
| | - Judes Poirier
- Department of Neurology and Neurosurgery, Montreal Neurological Institute (MNI), Faculty of Medicine, McGill University, Montreal, Quebec, Canada
- Department of Psychiatry, Faculty of Medicine, McGill University, Montreal, Quebec, Canada
- Centre for Studies in the Prevention of Alzheimer’s Disease, Douglas Mental Health Institute, McGill University, Montreal, Quebec, Canada
| | - Danilo Bzdok
- Department of Biomedical Engineering, Faculty of Medicine, McGill University, Montreal, Quebec, Canada
- McConnell Brain Imaging Centre (BIC), MNI, Faculty of Medicine, McGill University, Montreal, Quebec, Canada
- School of Computer Science, McGill University, Montreal, Quebec, Canada
- Mila—Quebec Artificial Intelligence Institute, Montreal, Quebec, Canada
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