1
|
Paul O, Appiah-Brempong E, Singh A, Qanungo S, Donkor P, Mock C. Prevalence and risk factors for Alzheimer's disease and related dementias in Ghana: Evidence from a cross-sectional population-based study. COGENT PUBLIC HEALTH 2024; 11:2354393. [PMID: 39049873 PMCID: PMC11263803 DOI: 10.1080/27707571.2024.2354393] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/23/2023] [Accepted: 05/08/2024] [Indexed: 07/27/2024]
Abstract
Alzheimer's disease and Related Dementia (ADRD) is a growing concern for low- and middle-income countries. Yet, studies on the prevalence and risk factors for dementia in sub-Saharan Africa are limited. This study estimated the prevalence and identified the risk factors for ADRD in Ghana. A cross-sectional design involving 384 participants aged 60 years or more completed the Brief Community Screening Instrument for Dementia (CSID) with an additional set of questions on risk factors. The prevalence of dementia was 16% (62/384). Age (AOR = 1.031 (95% CI 1.002-1.061, p=0.035), education (AOR = 0.689 (95% CI 0.517-0.919, p=0.011), and employment (AOR = 0.320 (95% CI 0.149-0.685, p=0.004) were associated with dementia. Also, "experience of stressful life event from age 16-64" (AOR = 1.325 (95% CI 1.034-1.698, p=0.024), "experience of stressful life event from age 65+" (AOR = 1.258 (95% CI 1.024-1.546, p=0.042), and "activities of daily living" (AOR = 0.925 (95% CI 0.868-0.986, p=0.037) identified as risk factors of dementia. The burden of ADRD was high. Urgent actions are needed to address this problem. There is a possibility that the burden of dementia may have been overestimated because of the study instrument. Findings should be interpreted in light of this limitation.
Collapse
Affiliation(s)
- Okyere Paul
- Department of Health Promotion and Disability Studies, School of Public Health, Kwame Nkrumah University of Science and Technology, Kumasi-Ghana
| | - Emmanuel Appiah-Brempong
- Department of Health Promotion and Disability Studies, School of Public Health, Kwame Nkrumah University of Science and Technology, Kumasi-Ghana
| | - Arti Singh
- Department of Epidemiology and Biostatistics, Kwame Nkrumah University of Science and Technology, Kumasi-Ghana
| | - Suparna Qanungo
- Department of Nursing, Medical University of South Carolina, United States
| | - Peter Donkor
- Department of Surgery, Komfo Anokye Teaching Hospital, Kumasi -Ghana
| | - Charles Mock
- Harborview Injury Prevention and Research Center, University of Washington, Seattle – United States
| |
Collapse
|
2
|
Wang Z, Zhang L, Yang J, Zeng Y, Su C, Yao M, Zhang H, Hu W, Liu Y, Lai Y, Wang X, Zeng J, Liu R. Chronic stress induces Alzheimer's disease-like pathologies through DNA damage-Chk1-CIP2A signaling. Aging (Albany NY) 2024; 16:9168-9187. [PMID: 38819231 PMCID: PMC11164505 DOI: 10.18632/aging.205862] [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: 12/19/2023] [Accepted: 03/19/2024] [Indexed: 06/01/2024]
Abstract
Stress is an important initiating factor in promoting Alzheimer's disease (AD) pathogenesis. However, the mechanism by which stress induces AD-like cognitive impairment remains to be clarified. Here, we demonstrate that DNA damage is increased in stress hormone Corticotropin-releasing factor (CRF)-treated cells and in brains of mice exposed to chronic restraint stress. Accumulation of DNA damage drives activation of cell cycle checkpoint protein kinase 1 (Chk1), upregulation of cancerous inhibitor of PP2A (CIP2A), tau hyperphosphorylation, and Aβ overproduction, eventually resulting in synaptic impairment and cognitive deficits. Pharmacological intervention targeting Chk1 by specific inhibitor and DNA damage by vitamin C, suppress DNA damage-Chk1-CIP2A signaling pathway in chronic stress animal model, which in turn attenuate AD-like pathologies, synaptic impairments and cognitive deficits. Our study uncovers a novel molecular mechanism of stress-induced AD-like pathologies and provides effective preventive and therapeutic strategies targeting this signaling pathway.
Collapse
Affiliation(s)
- Zhuoqun Wang
- Department of Pathophysiology, Key Laboratory of Ministry of Education/Hubei Province for Neurological Disorders, School of Basic Medicine, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Lun Zhang
- Department of Pathophysiology, Key Laboratory of Ministry of Education/Hubei Province for Neurological Disorders, School of Basic Medicine, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Department of Clinical Laboratory, Wuhan Fourth Hospital, Wuhan, China
| | - Jiayu Yang
- Department of Pathophysiology, Key Laboratory of Ministry of Education/Hubei Province for Neurological Disorders, School of Basic Medicine, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yi Zeng
- Department of Pathophysiology, Key Laboratory of Ministry of Education/Hubei Province for Neurological Disorders, School of Basic Medicine, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Chengke Su
- Department of Pathophysiology, Key Laboratory of Ministry of Education/Hubei Province for Neurological Disorders, School of Basic Medicine, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Mengdong Yao
- Department of Pathophysiology, Key Laboratory of Ministry of Education/Hubei Province for Neurological Disorders, School of Basic Medicine, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Huiliang Zhang
- Department of Pathophysiology, Key Laboratory of Ministry of Education/Hubei Province for Neurological Disorders, School of Basic Medicine, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Wenting Hu
- Department of Pathophysiology, Key Laboratory of Ministry of Education/Hubei Province for Neurological Disorders, School of Basic Medicine, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Department of Pathology, Peking University Shenzhen Hospital, Shenzhen, China
| | - Yi Liu
- Department of Pathophysiology, Key Laboratory of Ministry of Education/Hubei Province for Neurological Disorders, School of Basic Medicine, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yiwen Lai
- Department of Pathophysiology, Key Laboratory of Ministry of Education/Hubei Province for Neurological Disorders, School of Basic Medicine, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Xiaochuan Wang
- Department of Pathophysiology, Key Laboratory of Ministry of Education/Hubei Province for Neurological Disorders, School of Basic Medicine, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Shenzhen Huazhong University of Science and Technology Research Institute, Shenzhen, China
| | - Ji Zeng
- Department of Clinical Laboratory, Wuhan Fourth Hospital, Wuhan, China
| | - Rong Liu
- Department of Pathophysiology, Key Laboratory of Ministry of Education/Hubei Province for Neurological Disorders, School of Basic Medicine, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Shenzhen Huazhong University of Science and Technology Research Institute, Shenzhen, China
- Department of Pediatrics, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
- Institute for Brain Research, Wuhan Center of Brain Science, Huazhong University of Science and Technology, Wuhan, China
| |
Collapse
|
3
|
Teräs T, Myllyntausta S, Salminen M, Viikari L, Pahkala K, Muranen O, Hutri-Kähönen N, Raitakari O, Rovio S, Stenholm S. The association of previous night's sleep duration with cognitive function among older adults: a pooled analysis of three Finnish cohorts. Eur J Ageing 2023; 20:32. [PMID: 37535149 PMCID: PMC10400735 DOI: 10.1007/s10433-023-00779-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/11/2023] [Indexed: 08/04/2023] Open
Abstract
STUDY OBJECTIVES Sleep duration has been shown to associate with cognitive function, but little is known about the short-term effect of sleep duration on the previous night. This study examines how usual sleep duration and previous night's sleep duration are associated with cognitive function in older adults. METHODS The study population consisted of 2949 adults aged 59-92 years (mean 72.6, SD 5.7) derived from three Finnish cohorts. Participants' self-reported usual sleep duration was categorized into short (< 7 h, 19%), mid-range (7- < 9 h, 64%), and long (≥ 9 h, 17%). Self-reported sleep duration on the night prior to cognitive testing was categorized into shorter (59%), same (35%), and longer (5.9%) than usual sleep duration. Computerized Cambridge Neuropsychological Test Automated Battery (CANTAB®) was used to assess: (1) learning and memory, (2) working memory, (3) information processing, and (4) reaction time. RESULTS Participants with self-reported long, but not short, usual sleep duration had poorer learning and memory (p = .004), information processing (p = .003), and reaction time (p = .006) when compared to those with mid-range sleep duration. Those who slept more than usually the night prior to cognitive testing had poorer information processing (p = .019) than those sleeping the same as usually, while sleeping less than usually was not associated with cognitive function. CONCLUSIONS This study suggests that while long sleep duration was associated with worse cognitive function, sleeping more than usually the night prior to cognitive testing was only associated with information processing, and sleeping less than usually is not associated with cognitive function.
Collapse
Affiliation(s)
- Tea Teräs
- Department of Public Health, University of Turku and Turku University Hospital, Turku, Finland.
- Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland.
| | - Saana Myllyntausta
- Department of Psychology and Speech-Language Pathology, University of Turku, Turku, Finland
| | - Marika Salminen
- Welfare Division, City of Turku, Turku, Finland
- Department of General Practice, Faculty of Medicine, University of Turku and Turku University Hospital, Turku, Finland
| | - Laura Viikari
- Department of Geriatric Medicine, Faculty of Medicine, University of Turku, Turku City Hospital, Turku, Finland
| | - Katja Pahkala
- Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland
- Research Center of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland
- Paavo Nurmi Centre & Unit for Health and Physical Activity, University of Turku, Turku, Finland
| | - Olli Muranen
- Department of Psychology and Speech-Language Pathology, University of Turku, Turku, Finland
| | - Nina Hutri-Kähönen
- Department of Pediatrics, Tampere University Hospital and Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | - Olli Raitakari
- Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland
- Research Center of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland
- Department of Clinical Physiology and Nuclear Medicine, Turku University Hospital, Turku, Finland
| | - Suvi Rovio
- Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland
- Research Center of Applied and Preventive Cardiovascular Medicine, University of Turku, Turku, Finland
| | - Sari Stenholm
- Department of Public Health, University of Turku and Turku University Hospital, Turku, Finland
- Centre for Population Health Research, University of Turku and Turku University Hospital, Turku, Finland
- Research Services, Turku University Hospital and University of Turku, Turku, Finland
| |
Collapse
|
4
|
Luo J, Beam CR, Gatz M. Is Stress an Overlooked Risk Factor for Dementia? A Systematic Review from a Lifespan Developmental Perspective. PREVENTION SCIENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR PREVENTION RESEARCH 2023; 24:936-949. [PMID: 35622193 DOI: 10.1007/s11121-022-01385-1] [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] [Accepted: 05/16/2022] [Indexed: 11/26/2022]
Abstract
Stress exposure and stress reactivity may be potent factors associated with increased risk of dementia. The 2017 Lancet Commission on Dementia and its 2020 update reviewed modifiable risk factors associated with dementia, but stress was not addressed directly. The present study provides a focused review of the association between stress and dementia across the lifespan, with measures of stress including stress exposure, psychological stress, posttraumatic stress disorder (PTSD), and biological markers of stress. Published research articles were identified in the American Psychological Association PsycINFO database (1887-2021), Web of Science database, and Google Scholar. A total of 53 samples from 40 studies published from 1985 to 2020 met inclusion criteria. Results suggest that stressful life events that occur earlier in the lifespan, such as loss of a parent, psychological stress experienced in midlife, and extreme stress responses, i.e., PTSD, correlate with higher risk of dementia. Although results generally are mixed, a consistent theme is that stress experienced earlier in the lifespan and chronic stress portend the greatest risk of dementia. Reducing stress exposure and improving stress management when stress exposure cannot be changed are thus relevant strategies in dementia risk reduction.
Collapse
Affiliation(s)
- Jing Luo
- Department of Medical Social Sciences, Feinberg School of Medicine, Northwestern University, 625 N. Michigan Avenue, Chicago, IL, 60611, USA.
| | - Christopher R Beam
- Department of Psychology, University of Southern California, Los Angeles, CA, 90089-1061, USA
- Leonard Davis School of Gerontology, University of Southern California, Los Angeles, CA, 90089-0191, USA
| | - Margaret Gatz
- Department of Psychology, University of Southern California, Los Angeles, CA, 90089-1061, USA
- Center for Economic and Social Research, University of Southern California, Los Angeles, CA, 90089-3332, USA
| |
Collapse
|
5
|
Ayenigbara IO. Preventive Measures against the Development of Dementia in Old Age. Korean J Fam Med 2022; 43:157-167. [PMID: 35610962 PMCID: PMC9136504 DOI: 10.4082/kjfm.21.0030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Accepted: 05/07/2022] [Indexed: 11/03/2022] Open
Abstract
Dementia is a neurological condition characterized by numerous types of central nervous system diseases, which gradually deteriorates an individual’s reasoning, rational thinking, and judgment abilities. As a serious public health concern that currently affects more than 50 million older adults, dementia is one of the most significant causes of incapacity, disability, and dependency among older adults. As new cases are expected to increase exponentially in the next three decades, dementia, which is not a normal feature of healthy aging despite the fact that it generally affects older adults disproportionately, requires enormous management and care efforts due to its associated socioeconomic, psychological, and physical burdens that involve the patient, their caregivers, guardians, family members, and society at large. Presently, there is no cure for dementia; however, this condition could be prevented. This narrative review aimed to provide a broad overview of studies detailing the alternative lifestyle modification-centered preventive measures against dementia. A comprehensive search of key databases to find articles related to this topic revealed that participating in regular physical activities, healthy eating and dieting, avoiding all forms of smoking, avoiding air pollutants, halting or reducing alcohol consumption, exercising the mind and being socially dynamic, getting enough rest and establishing good sleeping habits, infection prevention, stress prevention, avoidance of injuries, preventing the effects of social isolation and lockdowns, continuing education, and depression prevention are protective measures against the development of dementia.
Collapse
Affiliation(s)
- Israel Oluwasegun Ayenigbara
- School and Community Health Education Unit, Department of Health Education, University of Ibadan, Ibadan, Nigeria
- *Corresponding Author: Israel Oluwasegun Ayenigbara Tel: +234-8139177538, Fax: +234-809-810-3043, E-mail:
| |
Collapse
|
6
|
Zagnoli F, Filippini T, Jimenez MP, Wise LA, Hatch EE, Vinceti M. Is Greenness Associated with Dementia? A Systematic Review and Dose-Response Meta-analysis. Curr Environ Health Rep 2022; 9:574-590. [PMID: 35857243 PMCID: PMC9729322 DOI: 10.1007/s40572-022-00365-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/16/2022] [Indexed: 01/31/2023]
Abstract
PURPOSE OF REVIEW We assessed the relation between environmental greenness and risk of dementia and cognitive impairment, based on a systematic review and meta-analysis up to March 30, 2022, characterizing whenever possible the shape of the association using dose-response meta-analysis. RECENT FINDINGS Twelve studies were included in this review, either using normalized difference vegetation index (NDVI) or land use/cover (LU/LC) methodology to assess greenness. Comparing the highest versus lowest exposure categories of greenness assessed using the NDVI (6 studies) or LU/LC (6 studies), we found no association with dementia. Dose-response meta-analysis of the association between greenness measured by LU/LC and dementia, based on only 3 studies, indicated a U-shaped association, but estimates were imprecise. Our systematic review and meta-analysis provided some evidence of a slight inverse association between greenness and dementia at intermediate exposure levels, but not at high levels. Potential methodological limitations, such as exposure misclassification and unmeasured confounding, may have affected the results.
Collapse
Affiliation(s)
- Federico Zagnoli
- Environmental, Genetic and Nutritional Epidemiology Research Center (CREAGEN), Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia Medical School, 287 Via Campi, 41125 Modena, Italy
| | - Tommaso Filippini
- Environmental, Genetic and Nutritional Epidemiology Research Center (CREAGEN), Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia Medical School, 287 Via Campi, 41125 Modena, Italy ,School of Public Health, University of California Berkeley, Berkeley, CA 94704 USA
| | - Marcia P. Jimenez
- Department of Epidemiology, Boston University School of Public Health, Boston, MA 02118 USA
| | - Lauren A. Wise
- Department of Epidemiology, Boston University School of Public Health, Boston, MA 02118 USA
| | - Elizabeth E. Hatch
- Department of Epidemiology, Boston University School of Public Health, Boston, MA 02118 USA
| | - Marco Vinceti
- Environmental, Genetic and Nutritional Epidemiology Research Center (CREAGEN), Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia Medical School, 287 Via Campi, 41125 Modena, Italy ,Department of Epidemiology, Boston University School of Public Health, Boston, MA 02118 USA
| |
Collapse
|
7
|
Fox M, Siddarth P, Oughli HA, Nguyen SA, Milillo MM, Aguilar Y, Ercoli L, Lavretsky H. Women who breastfeed exhibit cognitive benefits after age 50. EVOLUTION MEDICINE AND PUBLIC HEALTH 2021; 9:322-331. [PMID: 34754453 PMCID: PMC8573189 DOI: 10.1093/emph/eoab027] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/11/2021] [Accepted: 09/06/2021] [Indexed: 12/21/2022]
Abstract
Background and objectives Women who breastfeed may experience long-term benefits for their health in addition to the more widely appreciated effects on the breastfed child. Breastfeeding may induce long-term effects on biopsychosocial systems implicated in brain health. Also, due to diminished breastfeeding in the postindustrial era, it is important to understand the lifespan implications of breastfeeding for surmising maternal phenotypes in our species’ collective past. Here, we assess how women’s breastfeeding history relates to postmenopausal cognitive performance. Methodology A convenience sample of Southern California women age 50+ was recruited via two clinical trials, completed a comprehensive neuropsychological test battery and answered a questionnaire about reproductive life history. General linear models examined whether cognitive domain scores were associated with breastfeeding in depressed and non-depressed women, controlling for age, education and ethnicity. Results Women who breastfed exhibited superior performance in the domains of Learning, Delayed Recall, Executive Functioning and Processing Speed compared to women who did not breastfeed (P-values 0.0003–0.015). These four domains remained significant in analyses limited to non-depressed and parous subsets of the cohort. Among those depressed, only Executive Functioning and Processing Speed were positively associated with breastfeeding. Conclusions and implications We add to the growing list of lifespan health correlates of breastfeeding for women’s health, such as the lower risk of type-2 diabetes, cardiovascular disease and breast cancer. We surmise that women’s postmenopausal cognitive competence may have been greater in past environments in which breastfeeding was more prevalent, bolstering the possibility that postmenopausal longevity may have been adaptive across human evolutionary history. Lay Summary Breastfeeding may affect women’s cognitive performance. Breastfeeding’s biological effects and psychosocial effects, such as improved stress regulation, could exert long-term benefits for the mother’s brain. We found that women who breastfed performed better on a series of cognitive tests in later life compared to women who did not breastfeed.
Collapse
Affiliation(s)
- Molly Fox
- Department of Anthropology, University of California, Los Angeles, 341 Haines Hall, 375 Portola Plaza, Los Angeles, CA 90095, USA.,Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, 760 Westwood Plaza, Los Angeles, CA 90095-1759, USA
| | - Prabha Siddarth
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, 760 Westwood Plaza, Los Angeles, CA 90095-1759, USA
| | - Hanadi Ajam Oughli
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, 760 Westwood Plaza, Los Angeles, CA 90095-1759, USA
| | - Sarah A Nguyen
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, 760 Westwood Plaza, Los Angeles, CA 90095-1759, USA
| | - Michaela M Milillo
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, 760 Westwood Plaza, Los Angeles, CA 90095-1759, USA
| | - Yesenia Aguilar
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, 760 Westwood Plaza, Los Angeles, CA 90095-1759, USA
| | - Linda Ercoli
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, 760 Westwood Plaza, Los Angeles, CA 90095-1759, USA
| | - Helen Lavretsky
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, 760 Westwood Plaza, Los Angeles, CA 90095-1759, USA
| |
Collapse
|
8
|
Arifi D, Bitterlich N, von Wolff M, Poethig D, Stute P. Impact of chronic stress exposure on cognitive performance incorporating the active and healthy aging (AHA) concept within the cross-sectional Bern Cohort Study 2014 (BeCS-14). Arch Gynecol Obstet 2021; 305:1021-1032. [PMID: 34741667 PMCID: PMC8967732 DOI: 10.1007/s00404-021-06289-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2021] [Accepted: 10/13/2021] [Indexed: 11/25/2022]
Abstract
Purpose This study aims to verify that the mental-cognitive domain of the validated generic bio-functional status (BFS)/bio-functional age (BFA) assessment tool, incorporating the concept of Active and Healthy Ageing (AHA), reflects cognitive performance. In addition, the effects of chronic stress exposure on the mental-cognitive BFS/BFA should be investigated. Methods The study was carried out as a monocenter, cross-sectional, observational, non-interventional trial (Bern Cohort Study 2014, BeCS-14) with the participation of 147 non-pediatric, non-geriatric subjects. All participants followed a standardized battery of biopsychosocial assessments consisting of BFS/BFA, a validated cognitive performance test battery (Inventar zur Gedächtnisdiagnostik; IGD) and a validated questionnaire for the assessment of chronic stress (Trier Inventory for the assessment of Chronic Stress; TICS), respectively. Results Mean cognitive performance was average and higher in younger or better educated individuals. The BFA of the participants was 7.8 ± 7.8 year-equivalents below their chronological age. The mental-cognitive BFS/BFA assessment correlated well with the validated questionnaire for cognition assessment, the IGD. Further, three TICS subdomains (work overload (r = − 0.246, p = 0.003), work discontent (r = − 0.299, p = 0.006) and pressure to succeed (r = − 0.274, p < 0.001)), reflecting mainly work-related stress, showed a significant negative correlation with the mental-cognitive BFS/BFA. Conclusions Our study shows that the BFS/BFA assessment tool follows European Innovation Partnership on Active and Healthy Ageing (EIP-AHA) requirements. Further, we could demonstrate that higher levels of chronic work-related stress may be associated with poorer mental-cognitive performance and a pro-aging state indicating that cognitive impairments can be reduced by stress management interventions. Supplementary Information The online version contains supplementary material available at 10.1007/s00404-021-06289-z.
Collapse
|
9
|
Hovbrandt P, Östergren PO, Canivet C, Albin M, Carlsson G, Nilsson K, Håkansson C. Psychosocial Working Conditions and Social Participation. A 10-Year Follow-Up of Senior Workers. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:9154. [PMID: 34501744 PMCID: PMC8430885 DOI: 10.3390/ijerph18179154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/14/2021] [Revised: 08/18/2021] [Accepted: 08/27/2021] [Indexed: 11/30/2022]
Abstract
Social participation is important for health, and it is well known that high strain jobs impact negatively on mental and physical health. However, knowledge about the impact of psychosocial working conditions on social participation from a long-term perspective is lacking. The purpose of this study was to investigate the associations between different job types and social participation from a long-term perspective. A comprehensive public health questionnaire "The Scania Public Health Survey", was used, and psychosocial working conditions were measured with a Swedish translation of the Job Content Questionnaire. Based on data from 1098 working respondents aged 55 at baseline and a 10-year follow-up when the respondents were not working, the analyses revealed that social participation varied by job type. Jobs with high decision latitude, as in active and relaxed jobs, seem to predict high social participation, even after cessation of employment. Besides that, the result suggests that high social participation during working life is a predictor of high social participation from a long-term perspective which promotes healthy aging. Incentives for working longer are strongly related to good working conditions. A supportive work environment with possibilities for employees to participate in decision making, i.e., high control, is vital for a sustainable working life. This may contribute to an extended working life and may also support social participation prior to retirement as well as after retirement and thus to healthy aging.
Collapse
Affiliation(s)
- Pia Hovbrandt
- Division of Occupational and Environmental Medicine, Department of Laboratory Medicine, Lund University, 22363 Lund, Sweden; (M.A.); (K.N.); (C.H.)
- Occupational Therapy and Occupational Science Research Group, Department of Health Sciences, Lund University, 22100 Lund, Sweden
| | - Per-Olof Östergren
- Division of Social Medicine and Global Health, Department of Clinical Sciences in Malmö, Lund University, 22213 Malmö, Sweden; (P.-O.Ö.); (C.C.)
| | - Catarina Canivet
- Division of Social Medicine and Global Health, Department of Clinical Sciences in Malmö, Lund University, 22213 Malmö, Sweden; (P.-O.Ö.); (C.C.)
| | - Maria Albin
- Division of Occupational and Environmental Medicine, Department of Laboratory Medicine, Lund University, 22363 Lund, Sweden; (M.A.); (K.N.); (C.H.)
- Unit of Occupational Medicine, Institute for Environmental Medicine, Karolinska Institute, 17177 Stockholm, Sweden
| | - Gunilla Carlsson
- Active and Healthy Ageing Research Group, Department of Health Sciences, Lund University, 22100 Lund, Sweden;
| | - Kerstin Nilsson
- Division of Occupational and Environmental Medicine, Department of Laboratory Medicine, Lund University, 22363 Lund, Sweden; (M.A.); (K.N.); (C.H.)
| | - Carita Håkansson
- Division of Occupational and Environmental Medicine, Department of Laboratory Medicine, Lund University, 22363 Lund, Sweden; (M.A.); (K.N.); (C.H.)
| |
Collapse
|
10
|
Sindi S, Kåreholt I, Ngandu T, Rosenberg A, Kulmala J, Johansson L, Wetterberg H, Skoog J, Sjöberg L, Wang H, Fratiglioni L, Skoog I, Kivipelto M. Sex differences in dementia and response to a lifestyle intervention: Evidence from Nordic population-based studies and a prevention trial. Alzheimers Dement 2021; 17:1166-1178. [PMID: 34255432 PMCID: PMC8361986 DOI: 10.1002/alz.12279] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Revised: 11/23/2020] [Accepted: 11/24/2020] [Indexed: 01/18/2023]
Abstract
INTRODUCTION Evidence on sex differences in the risk for dementia has been mixed. The goal was to assess sex differences in the development of dementia, and in the effects of a lifestyle intervention. METHODS Two strategies were adopted, one using combined data from three large Nordic population-based cohort studies (n = 2289), adopting dementia as outcome, and 2-year multidomain lifestyle intervention (n = 1260), adopting cognitive change as outcome. RESULTS There was higher risk for dementia after age 80 years in women. The positive effects of the lifestyle intervention on cognition did not significantly differ between men and women. Sex-specific analyses suggested that different vascular, lifestyle, and psychosocial risk factors are important for women and men in mid- and late-life. CONCLUSION Women had higher risk for dementia among the oldest individuals. Lifestyle interventions may be effectively implemented among older men and women.
Collapse
Affiliation(s)
- Shireen Sindi
- Division of Clinical GeriatricsCenter for Alzheimer ResearchKarolinska Institutet and Karolinska University HospitalStockholmSweden
- Ageing Epidemiology (AGE) Research UnitSchool of Public HealthImperial College LondonLondonUK
| | - Ingemar Kåreholt
- Aging Research CenterKarolinska Institutet and Stockholm UniversityStockholmSweden
- Institute of GerontologySchool of Health and WelfareAging Research Network – Jönköping (ARN‐J)Jönköping UniversityJönköpingSweden
| | - Tiia Ngandu
- Public Health Promotion UnitNational Institute for Health and WelfareHelsinkiFinland
| | - Anna Rosenberg
- Institute of Public Health and Clinical Nutrition and Institute of Clinical MedicineNeurologyUniversity of Eastern FinlandKuopioFinland
| | - Jenni Kulmala
- Division of Clinical GeriatricsCenter for Alzheimer ResearchKarolinska Institutet and Karolinska University HospitalStockholmSweden
- Public Health Promotion UnitNational Institute for Health and WelfareHelsinkiFinland
| | - Lena Johansson
- Institute of Neuroscience and PhysiologyCenter for Health and Ageing AGECAPSahlgrenska AcademyUniversity of GothenburgGothenburgSweden
| | - Hanna Wetterberg
- Institute of Neuroscience and PhysiologyCenter for Health and Ageing AGECAPSahlgrenska AcademyUniversity of GothenburgGothenburgSweden
| | - Johan Skoog
- Department of PsychologyCenter for Health and Ageing (AGECAP)University of GothenburgGothenburgSweden
| | - Linnea Sjöberg
- Aging Research CenterKarolinska Institutet and Stockholm UniversityStockholmSweden
| | - Hui‐Xin Wang
- Aging Research CenterKarolinska Institutet and Stockholm UniversityStockholmSweden
- Stress Research InstituteStockholom UniversityStockholmSweden
| | - Laura Fratiglioni
- Aging Research CenterKarolinska Institutet and Stockholm UniversityStockholmSweden
- Stockholm Gerontology Research CenterStockholmSweden
| | - Ingmar Skoog
- Institute of Neuroscience and PhysiologyCenter for Health and Ageing AGECAPSahlgrenska AcademyUniversity of GothenburgGothenburgSweden
| | - Miia Kivipelto
- Division of Clinical GeriatricsCenter for Alzheimer ResearchKarolinska Institutet and Karolinska University HospitalStockholmSweden
- Ageing Epidemiology (AGE) Research UnitSchool of Public HealthImperial College LondonLondonUK
- Institute of Public Health and Clinical Nutrition and Institute of Clinical MedicineNeurologyUniversity of Eastern FinlandKuopioFinland
- Theme AgingKarolinska University HospitalStockholmSweden
| |
Collapse
|
11
|
Lisko I, Kulmala J, Annetorp M, Ngandu T, Mangialasche F, Kivipelto M. How can dementia and disability be prevented in older adults: where are we today and where are we going? J Intern Med 2021; 289:807-830. [PMID: 33314384 PMCID: PMC8248434 DOI: 10.1111/joim.13227] [Citation(s) in RCA: 70] [Impact Index Per Article: 23.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Ageing of the population, together with population growth, has brought along an ample increase in the number of older individuals living with dementia and disabilities. Dementia is the main cause of disability in old age, and promoting healthy brain ageing is considered as a key element in diminishing the burden of age-related disabilities. The World Health Organization recently launched the first risk reduction guidelines for cognitive impairment and dementia. According to recent estimates, approximately 40% of dementia cases worldwide could be attributable to 12 modifiable risk factors: low education; midlife hypertension and obesity; diabetes, smoking, excessive alcohol use, physical inactivity, depression, low social contact, hearing loss, traumatic brain injury and air pollution indicating clear prevention potential. Dementia and physical disability are closely linked with shared risk factors and possible shared underlying mechanisms supporting the possibility of integrated preventive interventions. FINGER trial was the first large randomized controlled trial indicating that multidomain lifestyle-based intervention can prevent cognitive and functional decline amongst at-risk older adults from the general population. Within the World-Wide FINGERS network, the multidomain FINGER concept is now tested and adapted worldwide proving evidence and tools for effective and easily implementable preventive strategies. Close collaboration between researchers, policymakers and healthcare practitioners, involvement of older adults and utilization of new technologies to support self-management is needed to facilitate the implementation of the research findings. In this scoping review, we present the current scientific evidence in the field of dementia and disability prevention and discuss future directions in the field.
Collapse
Affiliation(s)
- I. Lisko
- From theDivision of Clinical GeriatricsCenter for Alzheimer ResearchDepartment of Neurobiology, Care Sciences and SocietyKarolinska InstitutetStockholmSweden
- Faculty of Sport and Health Sciences and Gerontology Research CenterUniversity of JyväskyläJyväskyläFinland
| | - J. Kulmala
- From theDivision of Clinical GeriatricsCenter for Alzheimer ResearchDepartment of Neurobiology, Care Sciences and SocietyKarolinska InstitutetStockholmSweden
- Public Health Promotion UnitFinnish Institute for Health and WelfareHelsinkiFinland
- School of Health Care and Social WorkSeinäjoki University of Applied SciencesSeinäjokiFinland
| | - M. Annetorp
- Karolinska University Hospital, Theme AgingStockholmSweden
| | - T. Ngandu
- From theDivision of Clinical GeriatricsCenter for Alzheimer ResearchDepartment of Neurobiology, Care Sciences and SocietyKarolinska InstitutetStockholmSweden
- Public Health Promotion UnitFinnish Institute for Health and WelfareHelsinkiFinland
| | - F. Mangialasche
- From theDivision of Clinical GeriatricsCenter for Alzheimer ResearchDepartment of Neurobiology, Care Sciences and SocietyKarolinska InstitutetStockholmSweden
- Aging Research CenterDepartment of Neurobiology, Care Sciences and SocietyKarolinska Institutet and Stockholm UniversityStockholmSweden
| | - M. Kivipelto
- From theDivision of Clinical GeriatricsCenter for Alzheimer ResearchDepartment of Neurobiology, Care Sciences and SocietyKarolinska InstitutetStockholmSweden
- Karolinska University Hospital, Theme AgingStockholmSweden
- Institute of Public Health and Clinical NutritionUniversity of Eastern FinlandHelsinkiFinland
- Ageing and Epidemiology (AGE) Research UnitSchool of Public HealthImperial College LondonLondonUK
| |
Collapse
|
12
|
Rosenberg A, Mangialasche F, Ngandu T, Solomon A, Kivipelto M. Multidomain Interventions to Prevent Cognitive Impairment, Alzheimer's Disease, and Dementia: From FINGER to World-Wide FINGERS. JPAD-JOURNAL OF PREVENTION OF ALZHEIMERS DISEASE 2021; 7:29-36. [PMID: 32010923 PMCID: PMC7222931 DOI: 10.14283/jpad.2019.41] [Citation(s) in RCA: 74] [Impact Index Per Article: 24.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Alzheimer’s disease (AD) and dementia are a global public health priority, and prevention has been highlighted as a pivotal component in managing the dementia epidemic. Modifiable risk factors of dementia and AD include lifestyle-related factors, vascular and metabolic disorders, and psychosocial factors. Randomized controlled clinical trials (RCTs) are needed to clarify whether modifying such factors can prevent or postpone cognitive impairment and dementia in older adults. Given the complex, multifactorial, and heterogeneous nature of late-onset AD and dementia, interventions targeting several risk factors and mechanisms simultaneously may be required for optimal preventive effects. The Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability (FINGER) is the first large, long-term RCT to demonstrate that a multidomain lifestyle-based intervention ameliorating vascular and lifestyle-related risk factors can preserve cognitive functioning and reduce the risk of cognitive decline among older adults at increased risk of dementia. To investigate the multidomain intervention in other populations and diverse cultural and geographical settings, the World-Wide FINGERS (WW-FINGERS) network was recently launched (https://alz.org/wwfingers). Within this network, new FINGER-type trials with shared core methodology, but local culture and context-specific adaptations, will be conducted in several countries. The WW-FINGERS initiative facilitates international collaborations, provides a platform for testing multidomain strategies to prevent cognitive impairment and dementia, and aims at generating high-quality scientific evidence to support public health and clinical decision-making. Furthermore, the WW-FINGERS network can support the implementation of preventive strategies and translation of research findings into practice.
Collapse
Affiliation(s)
- A Rosenberg
- Miia Kivipelto, Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Karolinska Universitetssjukhuset, Karolinska Vägen 37 A, QA32, 171 64 Solna, Sweden, Phone: +46 (0)73 99 40 922,
| | | | | | | | | |
Collapse
|
13
|
Design and overview of the Origins of Alzheimer's Disease Across the Life course (ORACLE) study. Eur J Epidemiol 2020; 36:117-127. [PMID: 33324997 PMCID: PMC7847463 DOI: 10.1007/s10654-020-00696-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Accepted: 11/07/2020] [Indexed: 12/15/2022]
Abstract
Brain development and deterioration across the lifespan are integral to the etiology of late-life neurodegenerative disease. Factors that influence the health of the adult brain remain to be elucidated and include risk factors, protective factors, and factors related to cognitive and brain reserve.
To address this knowledge gap we designed a life-course study on brain health, which received funding through the EU ERC Programme under the name Origins of Alzheimer’s Disease Across the Life course (ORACLE) Study. The ORACLE Study is embedded within Generation R, a prospective population-based cohort study of children and their parents, and links this with the Rotterdam Study, a population-based study in middle-aged and elderly persons. The studies are based in Rotterdam, the Netherlands. Generation R focuses on child health from fetal life until adolescence with repeated in-person examinations, but has also included data collection on the children’s parents. The ORACLE Study aims to extend the parental data collection in nearly 2000 parents with extensive measures on brain health, including neuroimaging, cognitive testing and motor testing. Additionally, questionnaires on migraine, depressive symptoms, sleep, and neurological family history were completed. These data allow for the investigation of longitudinal influences on adult brain health as well as intergenerational designs involving children and parents. As a secondary focus, the sampling is enriched by mothers (n = 356) that suffered from hypertensive disorders during pregnancy in order to study brain health in this high-risk population. This article provides an overview of the rationale and the design of the ORACLE Study.
Collapse
|
14
|
Hasselgren C, Ekbrand H, Halleröd B, Mellqvist Fässberg M, Zettergren A, Johansson L, Skoog I, Dellve L. Sex differences in dementia: on the potentially mediating effects of educational attainment and experiences of psychological distress. BMC Psychiatry 2020; 20:434. [PMID: 32887574 PMCID: PMC7487622 DOI: 10.1186/s12888-020-02820-9] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2019] [Accepted: 08/13/2020] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND Old-age dementias are known to disproportionally affect women as well as individuals with low educational attainment. The higher lifetime risk of dementia among women is usually attributed to their longer life expectancy. However, the impact of sex, and subsequent gender inequity, is likely to be more multifaceted than this explanation implies. Not least because of historical inequities in access to education between the sexes and the gender and socio-economic gradients in risk factors such as stress, depression and social isolation. Consequently, the present study sought to test whether differences in educational attainment and experiences of general psychological distress mediate the association between female sex and dementia. METHODS The study utilizes data obtained through the Gothenburg H70 Birth Cohort Study and the Prospective Populations Study on Women (n = 892). Data were analysed using Confirmatory Factor Analysis (CFA) and Structural Equation Modelling (SEM) with Weighted Least Squares Means and Variance adjusted (WLSMV) estimation. General psychological distress was indicated by a latent variable and constructed from five manifest items (previous depression, stress, self-esteem, chronic loneliness and satisfaction with social situation) that were all measured at baseline. RESULTS While the results could not corroborate that education directly mediates the effect of sex on dementia, level of distress was predicted by both female sex (0.607, p < .001) and education (- 0.166, p < .01) and, in turn, shown to be significantly associated with dementia (0.167, p < .05), also after controlling for confounders. When time from baseline to diagnosis was increased through sequential exclusion of dementia cases, the effect of distress on dementia was no longer significant. CONCLUSION The overall findings suggest that social (dis) advantage predicts general psychological distress, which thereby constitutes a potential, and rarely acknowledged, pathway between female sex, education, and dementia. They further underline the importance of attending to both education and distress as 'gendered' phenomena when considering the nature of their associations with dementia. However, the possibility of reverse causality bias must be acknowledged and the need for longitudinal studies with longer follow-up stressed.
Collapse
Affiliation(s)
- Caroline Hasselgren
- Department of Sociology and Work Science, University of Gothenburg, Box 720, 405 30, Gothenburg, Sweden.
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, Centre for Ageing and Health - AgeCap, University of Gothenburg, Mölndal, Sweden.
| | - Hans Ekbrand
- Department of Sociology and Work Science, University of Gothenburg, Box 720, 405 30, Gothenburg, Sweden
| | - Björn Halleröd
- Department of Sociology and Work Science, University of Gothenburg, Box 720, 405 30, Gothenburg, Sweden
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, Centre for Ageing and Health - AgeCap, University of Gothenburg, Mölndal, Sweden
| | - Madeleine Mellqvist Fässberg
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, Centre for Ageing and Health - AgeCap, University of Gothenburg, Mölndal, Sweden
| | - Anna Zettergren
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, Centre for Ageing and Health - AgeCap, University of Gothenburg, Mölndal, Sweden
| | - Lena Johansson
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, Centre for Ageing and Health - AgeCap, University of Gothenburg, Mölndal, Sweden
| | - Ingmar Skoog
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, Centre for Ageing and Health - AgeCap, University of Gothenburg, Mölndal, Sweden
| | - Lotta Dellve
- Department of Sociology and Work Science, University of Gothenburg, Box 720, 405 30, Gothenburg, Sweden
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, Centre for Ageing and Health - AgeCap, University of Gothenburg, Mölndal, Sweden
| |
Collapse
|
15
|
Abstract
BACKGROUND Posttraumatic stress disorder is associated with increased dementia risk but less is known about stress because of everyday problems in diverse populations. METHODS A total of 9605 health care plan members who provided information regarding midlife stressors in 1972 to 1973 (ages, 40 to 55 y) were followed for dementia diagnosis between 1996 and 2017. Cox proportional hazard models evaluated associations between midlife stressors and dementia adjusting for demographics and lifecourse health indicators. RESULTS Reporting at least 1 midlife stressor was associated with 17% greater dementia risk [hazard ratio (HR), 1.17; 95% confidence interval (CI),1.07-1.27] versus 0 midlife stressors and 26% increased risk among those with less than equal to high school education (HR, 1.26; 95% CI,1.09-1.44) adjusting for demographics. Compared with whites without stressors, whites with ≥1 stressor had 13% greater dementia risk (HR, 1.13; 95% CI, 1.02-1.24), blacks without stressors 19% greater risk (HR, 1.19; 95% CI,1.08-1.32), and blacks with ≥1 stressors 47% greater risk (HR, 1.47; 95% CI,1.27-1.69) in fully adjusted models. Resource problems were associated with 20% greater risk (HR, 1.20; 95% CI, 1.01-1.42) than interpersonal problems. CONCLUSION Reporting ≥1 serious midlife stressor was associated with elevated dementia risk, especially stressors related to resources problems and for those with less than equal to high school education. Everyday stressors can impact brain health over the long term and may contribute to racial inequities in dementia rates, though education can be a mitigating factor.
Collapse
|
16
|
Pan KY, Xu W, Mangialasche F, Grande G, Fratiglioni L, Wang HX. The role of Apolipoprotein E epsilon4 in the association between psychosocial working conditions and dementia. Aging (Albany NY) 2020; 12:3730-3746. [PMID: 32081835 PMCID: PMC7066897 DOI: 10.18632/aging.102843] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2019] [Accepted: 02/04/2020] [Indexed: 12/02/2022]
Abstract
In this population-based prospective study, we examined the association of job demand-control combinations with dementia, and explored the roles of Apolipoprotein E epsilon4 (APOE ɛ4) and work duration in this association. A total of 2,579 dementia-free individuals aged 60+ years from Sweden were followed over 12 years. Dementia diagnosis was made by physicians. Lifelong occupational experience was collected, and job demands and control were assessed using a psychosocial job-exposure matrix. Data were analyzed using multivariate Cox proportional hazard models. During the follow-up, 282 people developed dementia. Passive jobs (low control/low demands) were related to a higher risk of dementia compared with active jobs (high control/high demands) among the younger-old (aged ≤72 years), but not among the older-old (aged ≥78 years). Among the younger-old, compared to those with no passive job experience, those with 11+ years in passive jobs had a higher dementia risk. The joint-effect analyses showed that APOE ɛ4 carriers with passive jobs had an even higher risk of dementia compared to APOE ɛ4 non-carriers with active jobs. These findings suggest that passive jobs are related to a higher dementia risk among the younger-old. APOE ɛ4 and long work duration may amplify the impact of passive jobs on dementia.
Collapse
Affiliation(s)
- Kuan-Yu Pan
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm 171 65, Sweden
| | - Weili Xu
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm 171 65, Sweden
| | - Francesca Mangialasche
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm 171 65, Sweden.,Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Solna 171 64, Sweden
| | - Giulia Grande
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm 171 65, Sweden
| | - Laura Fratiglioni
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm 171 65, Sweden.,Stockholm Gerontology Research Center, Stockholm 113 30, Sweden
| | - Hui-Xin Wang
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm 171 65, Sweden.,Stress Research Institute, Stockholm University, Stockholm 114 19, Sweden
| |
Collapse
|
17
|
Giorgi G, Lecca LI, Leon-Perez JM, Pignata S, Topa G, Mucci N. Emerging Issues in Occupational Disease: Mental Health in the Aging Working Population and Cognitive Impairment-A Narrative Review. BIOMED RESEARCH INTERNATIONAL 2020; 2020:1742123. [PMID: 32083124 PMCID: PMC7011340 DOI: 10.1155/2020/1742123] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/18/2019] [Accepted: 01/07/2020] [Indexed: 12/29/2022]
Abstract
Cognitive impairment has often been reported in scientific literature as a concern derived from chronic exposure to work-related stress. Organizational factors can contribute to the onset of this concern especially in a susceptible population such as elderly workers. The aim of our study was to review the last five years of scientific literature, focusing on experimental and epidemiological studies, possible mechanisms implicated in the onset of cognitive decline due to work-related stress, and the recent organizational strategies to prevent detrimental effects of stress on cognitive processes. A literature search was performed in scientific platforms Medline and Web of Science, by means of specific string search terms, restricting the search to the years of publication 2014-2019. Thirty-three articles were identified and qualitatively evaluated, reporting narratively the main point of interest. At this stage, six articles were excluded because they did not meet the inclusion criteria. Only a few articles considered the population of the elderly workers, often with a short follow-up period. Strategies to manage stress with organizational procedures are scarce. Mechanisms implicated in the development of cognitive impairment due to stress are not fully explained and seem to include a chronical decrease in the inhibitory process of neurological pathways. Further research that focused on strategies to manage stress in elderly workers, with the aim of preventing cognitive impairment processes, is warranted.
Collapse
Affiliation(s)
- Gabriele Giorgi
- Department of Human Sciences, European University of Rome, Via Degli Aldobrandeschi, 190, 00163 Rome, Italy
| | - Luigi I. Lecca
- Department of Experimental and Clinical Medicine, University of Florence, Largo Piero Palagi 1, 50139 Florence, Italy
| | - Jose M. Leon-Perez
- Department of Social Psychology, University of Seville, Camilo Jose Cela s/n, 41018 Sevilla, Spain
| | - Silvia Pignata
- Aviation Faculty School of Engineering, University of South Australia, Adelaide, SA, Australia
| | - Gabriela Topa
- Department of Social and Organizational Psychology, National Distance Education University (UNED), Madrid 28040, Spain
| | - Nicola Mucci
- Department of Experimental and Clinical Medicine, University of Florence, Largo Piero Palagi 1, 50139 Florence, Italy
| |
Collapse
|
18
|
GABA-A receptor modulating steroids in acute and chronic stress; relevance for cognition and dementia? Neurobiol Stress 2019; 12:100206. [PMID: 31921942 PMCID: PMC6948369 DOI: 10.1016/j.ynstr.2019.100206] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2019] [Revised: 11/13/2019] [Accepted: 12/18/2019] [Indexed: 01/10/2023] Open
Abstract
Cognitive dysfunction, dementia and Alzheimer's disease (AD) are increasing as the population worldwide ages. Therapeutics for these conditions is an unmet need. This review focuses on the role of the positive GABA-A receptor modulating steroid allopregnanolone (APα), it's role in underlying mechanisms for impaired cognition and of AD, and to determine options for therapy of AD. On one hand, APα given intermittently promotes neurogenesis, decreases AD-related pathology and improves cognition. On the other, continuous exposure of APα impairs cognition and deteriorates AD pathology. The disparity between these two outcomes led our groups to analyze the mechanisms underlying the difference. We conclude that the effects of APα depend on administration pattern and that chronic slightly increased APα exposure is harmful to cognitive function and worsens AD pathology whereas single administrations with longer intervals improve cognition and decrease AD pathology. These collaborative assessments provide insights for the therapeutic development of APα and APα antagonists for AD and provide a model for cross laboratory collaborations aimed at generating translatable data for human clinical trials.
Collapse
|
19
|
Nilsen C, Andel R, Darin-Mattsson A, Kåreholt I. Psychosocial working conditions across working life may predict late-life physical function: a follow-up cohort study. BMC Public Health 2019; 19:1125. [PMID: 31419956 PMCID: PMC6698007 DOI: 10.1186/s12889-019-7473-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2019] [Accepted: 08/12/2019] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Increasing life expectancy has made understanding the mechanisms underlying late-life health and function more important. We set out to investigate whether trajectories of change in psychosocial working conditions are associated with late-life physical function. METHODS Two Swedish surveys, linked at the individual level, were used (n = 803). A psychosocial job exposure matrix was used to measure psychosocial working conditions during people's first occupation, as well as their occupation every five years thereafter until baseline in 1991. Physical function was measured in 2014. Random effects growth curve models were used to calculate intraindividual trajectories of working conditions. Predictors of physical function were assessed with ordered logistic regression. RESULTS A more active job at baseline was associated with increased odds of late-life physical function (OR 1.15, CI 1.01-1.32). Higher baseline job strain was associated with decreased odds of late-life physical function (OR 0.75, CI 0.59-0.96). A high initial level followed by an upward trajectory of job strain throughout working life was associated with decreased odds of late-life physical function (OR 0.32, CI 0.17-0.58). CONCLUSIONS Promoting a healthier workplace by reducing chronic stress and inducing intellectual stimulation, control, and personal growth may contribute to better late-life physical function.
Collapse
Affiliation(s)
- Charlotta Nilsen
- Aging Research Center (ARC), Karolinska Institutet/Stockholm University, Tomtebodavägen 18A, SE-171 65, Stockholm, Sweden.
| | - Ross Andel
- School of Aging Studies, University of South Florida, 13301 Bruce B. Downs Blvd, MHC 1323, Tampa, Florida, 33612, USA.,The International Clinical Research Center, St. Anne's University Hospital, Brno, Czech Republic.,Department of Neurology, 2nd Faculty of Medicine, Charles University and Motol University Hospital, Prague, Czech Republic
| | - Alexander Darin-Mattsson
- Aging Research Center (ARC), Karolinska Institutet/Stockholm University, Tomtebodavägen 18A, SE-171 65, Stockholm, Sweden
| | - Ingemar Kåreholt
- Aging Research Center (ARC), Karolinska Institutet/Stockholm University, Tomtebodavägen 18A, SE-171 65, Stockholm, Sweden.,Institute of Gerontology, School of Health and Welfare, Aging Research Network - Jönköping (ARN-J), Jönköping University, Box 1026, 55111, Jönköping, Sweden
| |
Collapse
|
20
|
Matos TM, Souza-Talarico JND. How stress mediators can cumulatively contribute to Alzheimer's disease An allostatic load approach. Dement Neuropsychol 2019; 13:11-21. [PMID: 31073376 PMCID: PMC6497016 DOI: 10.1590/1980-57642018dn13-010002] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2018] [Accepted: 12/17/2018] [Indexed: 11/22/2022] Open
Abstract
Allostatic load is defined as the frequent activation of the neuroendocrine, immunological, metabolic and cardiovascular systems, which makes individuals more susceptible to stress-related health problems. According to this model, physiological dysregulations start to emerge decades before diseases manifest. Consequently, stress research has shifted its attention to anticipating the degree of this dysregulation to better understand the impact of stress hormones and other biomarkers on disease progression. In view of the growing number of studies that demonstrate the influence of modifiable risk factors on cognitive decline, in addition to the effects of chronic stress mediators, the objective of the present review was to present an overview of the development of cognitive changes based on studies on stress and its mediators.
Collapse
Affiliation(s)
- Tatiane Martins Matos
- Nurse, Master of Science from the School of Nursing, University of
São Paulo (EE-USP), SP, Brazil
| | - Juliana Nery De Souza-Talarico
- Professor at the Department of Medical-Surgical Nursing, School of
Nursing, University of São Paulo (EE-USP), SP, Brazil. PhD In the Area of
Neurobiology of Stress and Cognition
| |
Collapse
|
21
|
Hasselgren C, Dellve L, Ekbrand H, Zettergren A, Zetterberg H, Blennow K, Skoog I, Halleröd B. Socioeconomic status, gender and dementia: The influence of work environment exposures and their interactions with APOE ɛ4. SSM Popul Health 2018; 5:171-179. [PMID: 30014031 PMCID: PMC6043817 DOI: 10.1016/j.ssmph.2018.06.009] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2018] [Revised: 06/08/2018] [Accepted: 06/21/2018] [Indexed: 01/07/2023] Open
Abstract
It is a well-established fact that unfavourable social and economic conditions have a negative impact on health and longevity. Recent findings suggest that this is also true of age-related dementias. Yet most common indicators of socioeconomic status (SES) say very little about the actual mechanisms at play in disease development. The present paper explores five work exposure characteristics, all of which have a clear social gradient, that could potentially shed further light on the relationship between SES and dementia. Specifically, it investigates whether these exposures could moderate the impact of a well-known genetic risk factor: the APOE ɛ4 allele. The empirical analyses are based on data from a Swedish population study (n = 1019). Main occupation was linked to The Job Exposure Matrix to estimate the individuals’ exposure to the following work environment factors: work control, support, psychological demands, physical demands and job hazards. All analyses were conducted using binary logistic regression and focused specifically on gene-work exposure interactions. A significant main effect of work control on dementia risk was detected for males (OR = 0.68; p< 0.05), but not for females. However, control was found to significantly moderate the effect of APOE ɛ4 in both genders, albeit in different ways. These findings do not only underscore the importance of considering interactions between social and genetic risk factors to better understanding multifactorial diseases such as dementia. They also propose that gender- and class-based inequities interact, and hence must be considered simultaneously, also in relation to this particular disease. There are steep social gradients in exposure to various work environment conditions. Work control alters the effect of APOE ɛ4 in both genders, albeit in different ways. High work control protects male, but not female, APOE ɛ4-carriers. ‘Male’ high control jobs differ greatly from ‘female’ high control jobs. Gender- and class-based inequities interact also in the development of dementia.
Collapse
Affiliation(s)
- Caroline Hasselgren
- Department of Sociology and Work Science, University of Gothenburg, Box 720, 405 30 Gothenburg, Sweden.,Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, Centre for Ageing and Health - AgeCap, University of Gothenburg, Mölndal, Sweden
| | - Lotta Dellve
- Department of Sociology and Work Science, University of Gothenburg, Box 720, 405 30 Gothenburg, Sweden.,Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, Centre for Ageing and Health - AgeCap, University of Gothenburg, Mölndal, Sweden
| | - Hans Ekbrand
- Department of Sociology and Work Science, University of Gothenburg, Box 720, 405 30 Gothenburg, Sweden
| | - Anna Zettergren
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, Centre for Ageing and Health - AgeCap, University of Gothenburg, Mölndal, Sweden
| | - Henrik Zetterberg
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, Centre for Ageing and Health - AgeCap, University of Gothenburg, Mölndal, Sweden.,Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden.,Department of Molecular Neuroscience, UCL Institute of Neurology, Queen Square, London, United Kingdom.,UK Dementia Research Institute at UCL, London, United Kingdom
| | - Kaj Blennow
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, Centre for Ageing and Health - AgeCap, University of Gothenburg, Mölndal, Sweden.,Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden
| | - Ingmar Skoog
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, Centre for Ageing and Health - AgeCap, University of Gothenburg, Mölndal, Sweden
| | - Björn Halleröd
- Department of Sociology and Work Science, University of Gothenburg, Box 720, 405 30 Gothenburg, Sweden.,Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, Centre for Ageing and Health - AgeCap, University of Gothenburg, Mölndal, Sweden
| |
Collapse
|
22
|
Hoeijmakers L, Amelianchik A, Verhaag F, Kotah J, Lucassen PJ, Korosi A. Early-Life Stress Does Not Aggravate Spatial Memory or the Process of Hippocampal Neurogenesis in Adult and Middle-Aged APP/PS1 Mice. Front Aging Neurosci 2018; 10:61. [PMID: 29563870 PMCID: PMC5845884 DOI: 10.3389/fnagi.2018.00061] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2017] [Accepted: 02/20/2018] [Indexed: 01/13/2023] Open
Abstract
Life-time experiences are thought to influence the risk to develop the neurodegenerative disorder Alzheimer’s disease (AD). In particular, early-life stress (ES) may modulate the onset and progression of AD. There is recent evidence by our group and others that AD-related neuropathological progression and the associated neuroimmune responses are modulated by ES in the classic APPswe/PS1dE9 mouse model for AD. We here extend our previous study on ES mediated modulation of neuropathology and neuroinflammation and address in the same cohort of mice whether ES accelerates and/or aggravates AD-induced cognitive decline and alterations in the process of adult hippocampal neurogenesis (AHN), a form of brain plasticity. Chronic ES was induced by limiting bedding and nesting material during the first postnatal week and is known to induce cognitive deficits by 4 months in wild type (WT) mice. The onset of cognitive decline in APP/PS1 mice generally starts around 6 months of age. We here tested mice at ages 2–4 months to study acceleration and at ages 8–10 months for aggravation of the APP/PS1 phenotype. ES-exposed WT and APP/PS1 mice were able to perform the object recognition (ORT) and location tasks (OLT) at 2 months of age. Interestingly, at 3 months, ES induced impairments in the performance of the OLT in WT, but not in APP/PS1 mice. APP/PS1 mice exhibited alterations in hippocampal cell proliferation and differentiation, but ES exposure did not further change this. At 9 months, APP/PS1 mice exhibited impaired performance in the Morris Water Maze (MWM) task, as well as reductions in markers of the AHN process, which were not further modulated by ES exposure. In addition, we observed a so far unreported hyperactivity in ES-exposed mice at 8 months of age, which hampered assessment of cognitive functions in the ORT and OLT. In conclusion, while ES has been reported to modulate AD neuropathology and neuroinflammation before, it failed to accelerate or aggravate the decline in cognition or the process of AHN in APP/PS1 mice at ages 2–4 and 8–10 months. Future studies are needed to unravel how ES might affect the vulnerability to develop AD.
Collapse
Affiliation(s)
- Lianne Hoeijmakers
- Brain Plasticity Group, Center for Neuroscience, Swammerdam Institute for Life Sciences, University of Amsterdam, Amsterdam, Netherlands
| | - Anna Amelianchik
- Brain Plasticity Group, Center for Neuroscience, Swammerdam Institute for Life Sciences, University of Amsterdam, Amsterdam, Netherlands
| | - Fleur Verhaag
- Brain Plasticity Group, Center for Neuroscience, Swammerdam Institute for Life Sciences, University of Amsterdam, Amsterdam, Netherlands
| | - Janssen Kotah
- Brain Plasticity Group, Center for Neuroscience, Swammerdam Institute for Life Sciences, University of Amsterdam, Amsterdam, Netherlands
| | - Paul J Lucassen
- Brain Plasticity Group, Center for Neuroscience, Swammerdam Institute for Life Sciences, University of Amsterdam, Amsterdam, Netherlands
| | - A Korosi
- Brain Plasticity Group, Center for Neuroscience, Swammerdam Institute for Life Sciences, University of Amsterdam, Amsterdam, Netherlands
| |
Collapse
|
23
|
Hoeijmakers L, Lesuis SL, Krugers H, Lucassen PJ, Korosi A. A preclinical perspective on the enhanced vulnerability to Alzheimer's disease after early-life stress. Neurobiol Stress 2018; 8:172-185. [PMID: 29888312 PMCID: PMC5991337 DOI: 10.1016/j.ynstr.2018.02.003] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2017] [Revised: 02/17/2018] [Accepted: 02/20/2018] [Indexed: 12/13/2022] Open
Abstract
Stress experienced early in life (ES), in the form of childhood maltreatment, maternal neglect or trauma, enhances the risk for cognitive decline in later life. Several epidemiological studies have now shown that environmental and adult life style factors influence AD incidence or age-of-onset and early-life environmental conditions have attracted attention in this respect. There is now emerging interest in understanding whether ES impacts the risk to develop age-related neurodegenerative disorders, and their severity, such as in Alzheimer's disease (AD), which is characterized by cognitive decline and extensive (hippocampal) neuropathology. While this might be relevant for the identification of individuals at risk and preventive strategies, this topic and its possible underlying mechanisms have been poorly studied to date. In this review, we discuss the role of ES in modulating AD risk and progression, primarily from a preclinical perspective. We focus on the possible involvement of stress-related, neuro-inflammatory and metabolic factors in mediating ES-induced effects on later neuropathology and the associated impairments in neuroplasticity. The available studies suggest that the age of onset and progression of AD-related neuropathology and cognitive decline can be affected by ES, and may aggravate the progression of AD neuropathology. These relevant changes in AD pathology after ES exposure in animal models call for future clinical studies to elucidate whether stress exposure during the early-life period in humans modulates later vulnerability for AD.
Collapse
Affiliation(s)
| | | | | | | | - Aniko Korosi
- Brain Plasticity Group, Center for Neuroscience, Swammerdam Institute for Life Sciences, University of Amsterdam, Science Park 904, Amsterdam, The Netherlands
| |
Collapse
|
24
|
Sindi S, Kåreholt I, Spulber G, Soininen H, Kivipelto M, Solomon A. Midlife Work-Related Stress is Associated with Late-Life Gray Matter Volume Atrophy. J Alzheimers Dis Rep 2017; 1:219-227. [PMID: 30480239 PMCID: PMC6159714 DOI: 10.3233/adr-170035] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Background: Work-related stress has been associated with an increased dementia risk. However, less is known about the mechanisms that underlie these associations. Objective: The goal is to examine associations between midlife work-related stress and late-life structural brain alterations. Methods: The Cardiovascular Risk Factors, Aging, and Dementia (CAIDE) study participants were randomly selected from independent population-based surveys (mean age 50) in Finland. MRI measurements included gray matter (GM) volume, white matter lesions (WML) and medial temporal atrophy (MTA) (1st re-examination, n = 102); and GM volume, hippocampal volume, WML volume, cortical thickness, and MTA (2nd re-examination, n = 64). Work-related stress comprised a score from two questions administered in midlife. Results: Higher levels of midlife work-related stress were associated with lower GM volume (β= –0.077, p = 0.033) at the first re-examination, even after adjusting for several confounders. No significant associations were found with MTA, WML, or MRI measurements at the second re-examination. Conclusion: Previously shown associations of midlife work-related stress with dementia risk may be at least partly explained by associations with lower GM volume in late-life. The lack of associations at the second re-examination may indicate a critical time window for the effects of midlife work-related stress, and/or selective survival/participation.
Collapse
Affiliation(s)
- Shireen Sindi
- Aging Research Center, Karolinska Institutet and Stockholm University, Stockholm, Sweden.,Karolinska Institutet Center for Alzheimer Research, Stockholm, Sweden.,Neuroepidemiology and Ageing Research Unit, School of Public Health, Imperial College London, London, UK
| | - Ingemar Kåreholt
- Aging Research Center, Karolinska Institutet and Stockholm University, Stockholm, Sweden.,Institute of Gerontology, School of Health and Welfare, Jönköping University, Jönköping, Sweden
| | - Gabriela Spulber
- Karolinska Institutet Center for Alzheimer Research, Stockholm, Sweden
| | - Hilkka Soininen
- Department of Neurology, Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland.,Department of Neurology, University of Eastern Finland, and Kuopio University Hospital, Kuopio, Finland
| | - Miia Kivipelto
- Karolinska Institutet Center for Alzheimer Research, Stockholm, Sweden.,Neuroepidemiology and Ageing Research Unit, School of Public Health, Imperial College London, London, UK.,Department of Neurology, Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland.,Department of Chronic Disease Prevention, National Institute for Health and Welfare, Helsinki, Finland.,Department of Geriatrics, Karolinska University Hospital, Stockholm, Sweden
| | - Alina Solomon
- Aging Research Center, Karolinska Institutet and Stockholm University, Stockholm, Sweden.,Karolinska Institutet Center for Alzheimer Research, Stockholm, Sweden.,Department of Neurology, Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland.,Department of Geriatrics, Karolinska University Hospital, Stockholm, Sweden
| |
Collapse
|
25
|
Midlife work-related stress is associated with late-life cognition. J Neurol 2017; 264:1996-2002. [PMID: 28821958 PMCID: PMC5587634 DOI: 10.1007/s00415-017-8571-3] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2017] [Revised: 07/11/2017] [Accepted: 07/11/2017] [Indexed: 10/25/2022]
Abstract
To investigate the associations between midlife work-related stress and late-life cognition in individuals without dementia from the general population. The Cardiovascular Risk Factors, Aging and Dementia (CAIDE) study population (n = 2000) was randomly selected from independent Finnish population-based surveys (baseline mean age 50 years). Participants underwent two re-examinations in late life (mean age 71 and 78 years, respectively). 1511 subjects participated in at least one re-examination (mean total follow-up 25 years). Work-related stress was measured using two questions on work demands administered in midlife. Multiple cognitive domains were assessed. Analyses were adjusted for several potential confounders. Higher levels of midlife work-related stress were associated with poorer performance on global cognition [β-coefficient, -0.02; 95% confidence interval (CI), -0.05 to -0.00], and processing speed [β -0.03, CI -0.05 to -0.01]. Results remained significant after adjusting for potential confounders. Work-related stress was not significantly associated with episodic memory, executive functioning, verbal fluency or manual dexterity. This study shows that global cognition and processing speed may be particularly susceptible to the effects of midlife work-related stress.
Collapse
|
26
|
Abstract
Alzheimer's disease (AD) affects more than 5 million Americans, with substantial consequences for individuals with AD, families, and society in terms of morbidity, mortality, and healthcare costs. With disease-modifying treatment trials unsuccessful at the present time and only medications to treat symptoms available, an emerging approach is prevention. Advances in diagnostic criteria, biomarker development, and greater understanding of the biophysiological basis of AD make these initiatives feasible. Ongoing pharmacological trials using anti-amyloid therapies are underway in sporadic and genetic forms of AD, although a large number of modifiable risk factors for AD have been identified in observational studies, many of which do not appear to exert effects through amyloid or tau. This suggests that prevention studies focusing on risk reduction and lifestyle modification may offer additional benefits. Rather than relying solely on large-sample, long-duration, randomized clinical trial designs, a precision medicine approach using N-of-1 trials may provide more-rapid information on whether personalized prevention plans can improve person-centered outcomes. Because there appear to be multiple pathways to developing AD, there may also be multiple ways to prevent or delay the onset of AD. Even if these precision approaches alone are not successful in preventing AD, they may greatly improve the likelihood of amyloid- or tau-specific therapies to reach their endpoints by reducing comorbidities. Keeping this in mind, dementia may be a disorder that develops over a lifetime, with individualized ways to build a better brain as we age.
Collapse
Affiliation(s)
- James E Galvin
- Comprehensive Center for Brain Health, Department of Integrated Medical Sciences, Charles E. Schmidt College of Medicine, Florida Atlantic University, Boca Raton, Florida
| |
Collapse
|
27
|
Effect of high fat diet on phenotype, brain transcriptome and lipidome in Alzheimer's model mice. Sci Rep 2017; 7:4307. [PMID: 28655926 PMCID: PMC5487356 DOI: 10.1038/s41598-017-04412-2] [Citation(s) in RCA: 61] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2017] [Accepted: 05/15/2017] [Indexed: 02/01/2023] Open
Abstract
We examined the effect of chronic high fat diet (HFD) on amyloid deposition and cognition of 12-months old APP23 mice, and correlated the phenotype to brain transcriptome and lipidome. HFD significantly increased amyloid plaques and worsened cognitive performance compared to mice on normal diet (ND). RNA-seq results revealed that in HFD mice there was an increased expression of genes related to immune response, such as Trem2 and Tyrobp. We found a significant increase of TREM2 immunoreactivity in the cortex in response to HFD, most pronounced in female mice that correlated to the amyloid pathology. Down-regulated by HFD were genes related to neuron projections and synaptic transmission in agreement to the significantly deteriorated neurite morphology and cognition in these mice. To examine the effect of the diet on the brain lipidome, we performed Shotgun Lipidomics. While there was no difference in the total amounts of phospholipids of each class, we revealed that the levels of 24 lipid sub-species in the brain were significantly modulated by HFD. Network visualization of correlated lipids demonstrated overall imbalance with most prominent effect on cardiolipin molecular sub-species. This integrative approach demonstrates that HFD elicits a complex response at molecular, cellular and system levels in the CNS.
Collapse
|
28
|
Pan KY, Xu W, Mangialasche F, Fratiglioni L, Wang HX. Work-related psychosocial stress and the risk of type 2 diabetes in later life. J Intern Med 2017; 281:601-610. [PMID: 28439925 DOI: 10.1111/joim.12615] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVES Although work-related psychosocial stress and type 2 diabetes mellitus (T2DM) have been investigated, the association between lifelong work stress and T2DM in later life remains unclear. This study examined whether high work stress increased the risk of T2DM risk in later life, accounting also for other sources of stress outside work, such as burden from household chores. METHODS From the population-based prospective study SNAC-K, 2719 diabetes-free participants aged ≥60 years were identified and followed up for 6 years. T2DM was ascertained by glycated haemoglobin level, self-report, hypoglycaemic medication use and clinical records. Levels of job control and demands over the whole working life were assessed by a validated matrix. Household chores load was assessed by hours spent on such chores. Multivariate logistic regression models were used to estimate the association between job strain and T2DM. RESULTS During the 6-year follow-up, 154 incident cases of T2DM were identified. High job strain was associated with T2DM occurrence amongst the 60-year-old cohort (OR = 3.14, 95% CI: 1.27-7.77), and only amongst women (OR = 6.18, 95% CI: 1.22-31.26), but not in men. When taking into account household chores load, a more pronounced risk of T2DM was associated with high job strain in combination with heavy household chores load in women aged 60 years at baseline (OR = 9.45, 95% CI: 1.17-76.53). CONCLUSION Work-related psychosocial stress may increase the risk of T2DM only amongst women in their early 60s. The risk can be amplified by high household chores load.
Collapse
Affiliation(s)
- K-Y Pan
- Aging Research Center, Department of Neurobiology, Care Sciences and Society (NVS), Karolinska Institutet, Stockholm University, Stockholm, Sweden
| | - W Xu
- Aging Research Center, Department of Neurobiology, Care Sciences and Society (NVS), Karolinska Institutet, Stockholm University, Stockholm, Sweden
| | - F Mangialasche
- Aging Research Center, Department of Neurobiology, Care Sciences and Society (NVS), Karolinska Institutet, Stockholm University, Stockholm, Sweden
| | - L Fratiglioni
- Aging Research Center, Department of Neurobiology, Care Sciences and Society (NVS), Karolinska Institutet, Stockholm University, Stockholm, Sweden.,Stockholm Gerontology Research Center, Stockholm, Sweden
| | - H-X Wang
- Aging Research Center, Department of Neurobiology, Care Sciences and Society (NVS), Karolinska Institutet, Stockholm University, Stockholm, Sweden.,Stress Research Institute, Stockholm University, Stockholm, Sweden
| |
Collapse
|
29
|
Wilson RS, Bennett DA. How Does Psychosocial Behavior Contribute to Cognitive Health in Old Age? Brain Sci 2017; 7:brainsci7060056. [PMID: 28545247 PMCID: PMC5483629 DOI: 10.3390/brainsci7060056] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2017] [Revised: 05/18/2017] [Accepted: 05/22/2017] [Indexed: 11/16/2022] Open
Abstract
With the aging of the U.S. population, the number of cognitively disabled persons is expected to substantially increase in coming decades, underscoring the urgent need for effective interventions. Here, we review the current evidence linking psychosocial factors to late-life cognitive loss and consider the study design needed to illuminate the biologic bases of the associations. We then examine an ongoing study that includes several of the key design elements, the Rush Memory and Aging Project. In this longitudinal clinical-pathological cohort study, indicators of personality, social connectedness, and psychological well-being were shown to predict late-life cognitive outcomes. Participants who died underwent a uniform neuropathologic examination to quantify common dementia-related pathologies. Some psychosocial indicators were associated with cerebral infarction; some indicators modified the association of neurodegenerative pathologies with cognitive loss; and the association of some indicators with cognitive outcomes appears to be independent of the pathologies traditionally associated with late-life dementia. These findings suggest that psychosocial behavior influences late-life cognitive health through multiple neurobiologic mechanisms. A better understanding of these mechanisms may lead to novel strategies for preserving cognitive health in old age.
Collapse
Affiliation(s)
- Robert S Wilson
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL 60612, USA.
- Department of Neurological Sciences, Rush University Medical Center, Chicago, IL 60612, USA.
- Department of Behavioral Sciences, Rush University Medical Center, Chicago, IL 60612, USA.
| | - David A Bennett
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL 60612, USA.
| |
Collapse
|
30
|
Stenfors CUD, Hanson LM, Theorell T, Osika WS. Executive Cognitive Functioning and Cardiovascular Autonomic Regulation in a Population-Based Sample of Working Adults. Front Psychol 2016; 7:1536. [PMID: 27761124 PMCID: PMC5050226 DOI: 10.3389/fpsyg.2016.01536] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2016] [Accepted: 09/21/2016] [Indexed: 01/06/2023] Open
Abstract
Objective: Executive cognitive functioning is essential in private and working life and is sensitive to stress and aging. Cardiovascular (CV) health factors are related to cognitive decline and dementia, but there is relatively few studies of the role of CV autonomic regulation, a key component in stress responses and risk factor for cardiovascular disease (CVD), and executive processes. An emerging pattern of results from previous studies suggest that different executive processes may be differentially associated with CV autonomic regulation. The aim was thus to study the associations between multiple measures of CV autonomic regulation and measures of different executive cognitive processes. Method: Participants were 119 healthy working adults (79% women), from the Swedish Longitudinal Occupational Survey of Health. Electrocardiogram was sampled for analysis of heart rate variability (HRV) measures, including the Standard Deviation of NN, here heart beats (SDNN), root of the mean squares of successive differences (RMSSD), high frequency (HF) power band from spectral analyses, and QT variability index (QTVI), a measure of myocardial repolarization patterns. Executive cognitive functioning was measured by seven neuropsychological tests. The relationships between CV autonomic regulation measures and executive cognitive measures were tested with bivariate and partial correlational analyses, controlling for demographic variables, and mental health symptoms. Results: Higher SDNN and RMSSD and lower QTVI were significantly associated with better performance on cognitive tests tapping inhibition, updating, shifting, and psychomotor speed. After adjustments for demographic factors however (age being the greatest confounder), only QTVI was clearly associated with these executive tests. No such associations were seen for working memory capacity. Conclusion: Poorer CV autonomic regulation in terms of lower SDNN and RMSSD and higher QTVI was associated with poorer executive cognitive functioning in terms of inhibition, shifting, updating, and speed in healthy working adults. Age could largely explain the associations between the executive measures and SDNN and RMSSD, while associations with QTVI remained. QTVI may be a useful measure of autonomic regulation and promising as an early indicator of risk among otherwise healthy adults, compared to traditional HRV measures, as associations between QTVI and executive functioning was not affected by age.
Collapse
Affiliation(s)
- Cecilia U D Stenfors
- Aging Research Center, Department of Neurobiology, Care Science and Society, Karolinska InstituteStockholm, Sweden; Environmental Neuroscience Lab, Department of Psychology, University of ChicagoChicago, IL, USA
| | - Linda M Hanson
- Stress Research Institute, Stockholm University Stockholm, Sweden
| | - Töres Theorell
- Stress Research Institute, Stockholm University Stockholm, Sweden
| | - Walter S Osika
- Department of Neurobiology, Care Science and Society, Center for Social Sustainability, Karolinska InstituteStockholm, Sweden; Department of Clinical Neuroscience, Karolinska InstituteStockholm, Sweden
| |
Collapse
|