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Koponen S, Nykänen I, Savela RM, Välimäki T, Suominen AL, Schwab U. Family caregivers' better nutritional status is associated with care recipients' better nutritional status. Clin Nutr ESPEN 2024; 62:199-205. [PMID: 38901942 DOI: 10.1016/j.clnesp.2024.05.016] [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: 09/21/2023] [Revised: 05/14/2024] [Accepted: 05/21/2024] [Indexed: 06/22/2024]
Abstract
BACKGROUND AND AIMS A high proportion of older care recipients (CRs) face malnutrition and risk of malnutrition, affecting their functional abilities and posing challenges for caregiving. The aim of this study was to assess the risk for malnutrition among older CRs and the associated characteristics of both CRs and family caregivers (FCs) with nutritional status of CRs. METHODS A cross-sectional study consisted of 120 CRs (≥65 years) and their 118 FCs (≥60 years). Nutritional status was assessed with the Mini Nutritional Assessment (MNA). RESULTS The majority (63%) of the CRs had a risk of malnutrition (MNA score 17-23.5), and 7% had malnutrition (MNA score <17). The CRs had significantly lower MNA scores compared to their FCs (p < 0.001). The multivariate linear regression analysis showed that CRs' higher number of comorbidities (B = -0.37, p = 0.013) and higher P-hs-CRP (B = -0.10, p = 0.047) were associated with their decreased MNA scores. There was a positive association between CRs' hand grip strength (B = 0.11, p = 0.004) and FCs' MNA scores (B = 0.41, p = 0.004) with MNA scores of the CRs. CONCLUSION Malnutrition and risk of malnutrition are common concerns in older CRs, especially those with a higher number of comorbidities and low-grade inflammation. Regular assessment of the nutritional status of both older CRs and FCs is justified, as FCs' better nutritional status is associated with better nutritional status of CR. CLINICAL TRIAL REGISTRATION NUMBER ClinicalTrials.gov NCT04003493.
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Affiliation(s)
- Sohvi Koponen
- Institute of Public Health and Clinical Nutrition, School of Medicine, University of Eastern Finland, P.O. Box 1627, FI-70211 Kuopio, Finland.
| | - Irma Nykänen
- Institute of Public Health and Clinical Nutrition, School of Medicine, University of Eastern Finland, P.O. Box 1627, FI-70211 Kuopio, Finland
| | - Roosa-Maria Savela
- Department of Nursing Science, University of Eastern Finland, P.O. Box 1627, FI-70211 Kuopio, Finland; INVEST Research Flagship Centre, University of Turku, Turku, Finland
| | - Tarja Välimäki
- Department of Nursing Science, University of Eastern Finland, P.O. Box 1627, FI-70211 Kuopio, Finland
| | - Anna Liisa Suominen
- Institute of Dentistry, School of Medicine, University of Eastern Finland, P.O. Box 1627, FI-70211 Kuopio, Finland; Oral and Maxillofacial Diseases Teaching Unit, Kuopio University Hospital, P.O. Box 1711, FI-70211 Kuopio, Finland
| | - Ursula Schwab
- Institute of Public Health and Clinical Nutrition, School of Medicine, University of Eastern Finland, P.O. Box 1627, FI-70211 Kuopio, Finland; Department of Medicine, Endocrinology and Clinical Nutrition, Kuopio University Hospital, P.O. Box 100, FI-70029 KYS, Finland
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Cao Y, Zhu X, Shang J, Zheng J, Tian X, Han Q, Shen J. Correlation between lipoprotein-associated phospholipase A2 and poststroke mild cognitive impairment. Expert Rev Mol Diagn 2024:1-7. [PMID: 38958430 DOI: 10.1080/14737159.2024.2370410] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Accepted: 04/24/2024] [Indexed: 07/04/2024]
Abstract
OBJECTIVES This study aimed to investigate the correlation between serum lipoprotein-associated phospholipase A2 (Lp-PLA2) and poststroke mild cognitive impairment (PSMCI). METHODS The patients included in the study were divided into PSMCI (68 cases) and cognitively normal (CN) (218 cases) groups and followed up for six months. Demographic and clinical data were collected. A logistic regression analysis was performed to determine whether Lp-PLA2 is an independent risk factor for PSMCI. Spearman's correlation analysis was used to examine the correlation between Lp-PLA2 levels and Montreal Cognitive Assessment (MoCA) scores. A receiver operating characteristic (ROC) curve analysis was performed to determine the diagnostic threshold value of Lp-PLA2 for PSMCI. RESULTS Serum Lp-PLA2 levels were significantly higher in the PSMCI group than in the CN group. The logistic regression analysis showed that Lp-PLA2 was an independent risk factor for PSMCI (OR = 1.05, 95% CI = 1.03-1.07). Spearman's correlation analysis revealed a significant correlation between the Lp-PLA2 levels and MoCA scores (R = -0.49). The area under the ROC curve for Lp-PLA2 was 0.849, and the threshold value for PSMCI occurrence was 236.8 ng/ml. CONCLUSIONS Elevated serum Lp-PLA2 is an independent risk factor for PSMCI and may serve as a potential biomarker for PSMCI.
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Affiliation(s)
- Yawei Cao
- Clinical Laboratory, Huai'an First People's Hospital, The Affiliated Huai'an No.1 People's Hospital of Nanjing Medical University, Huai'an, Jiangsu, China
| | - Xiaofeng Zhu
- Department of Neurology, Huai'an First People's Hospital, The Affiliated Huai'an No.1 People's Hospital of Nanjing Medical University, Huai'an, Jiangsu, China
| | - Jin Shang
- Department of Neurology, Huai'an First People's Hospital, The Affiliated Huai'an No.1 People's Hospital of Nanjing Medical University, Huai'an, Jiangsu, China
| | - Jinlong Zheng
- Department of Neurology, Huai'an First People's Hospital, The Affiliated Huai'an No.1 People's Hospital of Nanjing Medical University, Huai'an, Jiangsu, China
| | - Xiangyang Tian
- Department of Neurology, Huai'an First People's Hospital, The Affiliated Huai'an No.1 People's Hospital of Nanjing Medical University, Huai'an, Jiangsu, China
| | - Qiu Han
- Department of Neurology, Huai'an First People's Hospital, The Affiliated Huai'an No.1 People's Hospital of Nanjing Medical University, Huai'an, Jiangsu, China
| | - Jun Shen
- Department of Neurology, The Second People's Hospital of Huai'an, The Affiliated Huai'an Hospital of Xuzhou Medical University, Huai'an, Jiangsu, China
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Pan Y, Liang J, Zhang W, Gao D, Li C, Xie W, Zheng F. Association between Age at Diagnosis of Hyperlipidemia and Subsequent Risk of Dementia. J Am Med Dir Assoc 2024; 25:104960. [PMID: 38453136 DOI: 10.1016/j.jamda.2024.01.029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Revised: 01/30/2024] [Accepted: 01/30/2024] [Indexed: 03/09/2024]
Abstract
OBJECTIVES The relationship between age at diagnosis of hyperlipidemia and dementia remains unclear. We examined whether younger age at diagnosis of hyperlipidemia is associated with higher risk of subsequent dementia. DESIGN A longitudinal population-based study with a median follow-up of 12.8 years. SETTING AND PARTICIPANTS We analyzed data on a sample of 489,642 participants in the United Kingdom. METHODS This study was based on the UK Biobank. Information on hyperlipidemia and dementia diagnoses was collected at baseline (2006-2010) and follow-up [median = 12.8 years, interquartile range (IQR): 12.1-13.6 years]. Propensity score matching method and Cox proportional hazards models were used to assess the association between age at diagnosis of hyperlipidemia and dementia. RESULTS Among 489,642 participants (mean age: 56.9 ± 8.1 years; female: 54.7%), 114,112 (23.3%) were diagnosed with hyperlipidemia. Younger age at diagnosis of hyperlipidemia (per 10-year decrease) was significantly associated with higher risks of all-cause dementia [hazard ratio (HR), 1.12; 95% CI, 1.07-1.18; P < .001], Alzheimer's disease (AD) (HR, 1.22; 95% CI, 1.14-1.31; P < .001), and vascular dementia (VD) (HR, 1.16; 95% CI, 1.05-1.27; P < .001). After propensity score matching, patients with hyperlipidemia diagnosed before 50 years had the highest HR for all-cause dementia (HR, 1.46; 95% CI, 1.15-1.86; P = .002), followed by patients diagnosed between 50 and 69 years (HR, 1.21; 95% CI, 1.12-1.31; P < .001) and then patients diagnosed aged 70 years and older (HR, 0.94; 95% CI, 0.84-1.06; P = .302). Similar results were observed for AD and VD. CONCLUSIONS AND IMPLICATIONS A dose-response relationship between age at hyperlipidemia diagnosis and risk of dementia was found in the longitudinal cohort study, with younger age at diagnosis of hyperlipidemia being associated with higher subsequent risk.
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Affiliation(s)
- Yang Pan
- School of Nursing, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Jie Liang
- School of Nursing, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Wenya Zhang
- School of Nursing, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Darui Gao
- Peking University Clinical Research Institute, Peking University First Hospital, Beijing, China
| | - Chenglong Li
- Peking University Clinical Research Institute, Peking University First Hospital, Beijing, China
| | - Wuxiang Xie
- Peking University Clinical Research Institute, Peking University First Hospital, Beijing, China; Key Laboratory of Epidemiology of Major Diseases (Peking University), Ministry of Education, Beijing, China.
| | - Fanfan Zheng
- School of Nursing, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
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Mutlay F, Cam Mahser A, Soylemez BA, Ates Bulut E, Petek K, Ontan MS, Kaya D, Guney S, Isik AT. Validity and reliability of the Turkish version of the Australian National University-Alzheimer's Disease Risk Index (ANU-ADRI). APPLIED NEUROPSYCHOLOGY. ADULT 2024:1-6. [PMID: 38917223 DOI: 10.1080/23279095.2024.2369657] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/27/2024]
Abstract
INTRODUCTION There is still a requirement for concise, practical scales that can be readily incorporated into everyday schedules and predict the likelihood of dementia onset in individuals without dementia. This study aimed to assess the reliability of the ANU-ADRI (Australian National University Alzheimer's Disease Risk Index)-Short Form in Turkish geriatric patients. METHODS This methodological study involved 339 elderly patients attending the geriatric outpatient clinic for various reasons. The known-group validity and divergent validity were assessed. The ANU-ADRI was administered during the baseline test and again within one week for retest purposes. Alongside the ANU-ADRI, all participants underwent a comprehensive geriatric assessment, including Activities of Daily Living (ADL), mobility assessment (Performance-Oriented Mobility Assessment (POMA) and Timed Up and Go Test), nutritional assessment (Mini Nutritional Assessment (MNA)), and global cognition evaluation (Mini-Mental State Examination (MMSE)). RESULTS The scale demonstrated satisfactory linguistic validity. A correlation was observed between the mean scores of the ANU-ADRI test and retest (r = 0.997, p < 0.001). Additionally, there existed a moderate negative linear association between the ANU-ADRI and MMSE scores (r = -0.310, p < 0.001), POMA (r = -0.406, p < 0.001), Basic ADL (r = -0.359, p < 0.001), and Instrumental ADL (r = -0.294, p < 0.001). Moreover, a moderate positive linear association was found between the ANU-ADRI and the Timed Up and Go Test duration (r = 0.538, p < 0.001). CONCLUSION The ANU-ADRI-Short Form was proved as a valuable tool for clinical practice, facilitating the assessment of Alzheimer's disease risk within the Turkish geriatric population.
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Affiliation(s)
- Feyza Mutlay
- Department of Geriatric Medicine, Van Research and Training Hospital, Van, Turkey
| | - Alev Cam Mahser
- Unit for Aging Brain and Dementia, Department of Geriatric Medicine, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey
| | - Burcu Akpinar Soylemez
- Department of Internal Medicine Nursing, Faculty of Nursing, Dokuz Eylul University, Izmir, Turkey
| | - Esra Ates Bulut
- Department of Geriatric Medicine, Adana City Research and Training Hospital, Adana, Turkey
| | - Kadriye Petek
- Unit for Aging Brain and Dementia, Department of Geriatric Medicine, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey
| | - Mehmet Selman Ontan
- Unit for Aging Brain and Dementia, Department of Geriatric Medicine, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey
| | - Derya Kaya
- Unit for Aging Brain and Dementia, Department of Geriatric Medicine, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey
| | - Seda Guney
- Faculty of Nursing, Koç University, Health Sciences Campus, Istanbul, Turkey
| | - Ahmet Turan Isik
- Unit for Aging Brain and Dementia, Department of Geriatric Medicine, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey
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Usefi F, Rustamzadeh A, Ghobadi Z, Sadigh N, Mohebi N, Ariaei A, Moradi F. Rosuvastatin attenuates total-tau serum levels and increases expression of miR-124-3p in dyslipidemic Alzheimer's patients: a historic cohort study. Metab Brain Dis 2024:10.1007/s11011-024-01371-2. [PMID: 38896205 DOI: 10.1007/s11011-024-01371-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Accepted: 06/10/2024] [Indexed: 06/21/2024]
Abstract
microRNAs are candidate diagnostic biomarkers for Alzheimer's disease. This study aimed to compare Silymarin with Rosuvastatin and placebo on total-Tau protein level and expression levels of microRNAs and TGF-β and COX-2 in Alzheimer's patients with secondary dyslipidemia. 36 mild AD patients with dyslipidemia were divided into three groups of 12. The first group received silymarin (140mg), the second group received placebo (140mg), and the third group recieved Rosuvastatin (10mg). Tablets were administered three times a day for Six months. The blood samples of the patients were collected before and after the intervention and the serum was separated. Using the RT-qPCR method, the expression levels of miR-124-3p and miR-125b-5p were assessed, and the serum levels of total-Tau, TGF-β, and COX-2 enzyme were measured using the ELISA method. Data were analyzed with SPSS software. In this study, the level of Δtotal-Tau was significantly lower in the Rosuvastatin group compared to the placebo (P = 0.038). Also, a significant reduction in the level of ΔTGF-β was observed in the Silymarin to Rosuvastatin group (p = 0.046) and ΔmiR-124-3p was significantly increased in the Rosuvastatin compared to the placebo group (p = 0.044). Rosuvastatin outperformed silymarin in decreasing Δtotal-Tau serum levels and enhancing expression of ΔmiR-124-3p, attributed to Rosuvastatin's capacity to lower cholesterol levels and inflammation concurrently. Conversely, silymarin was more effective than Rosuvastatin in reducing levels of ΔTGF-β. Serum miR-124-3p could serve as a promising diagnostic biomarker and a new therapeutic focus in AD.
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Affiliation(s)
- Farnoosh Usefi
- Department of Anatomy, School of Medicine, Iran University of Medical Sciences, Tehran, 1449614535, Iran
| | - Auob Rustamzadeh
- Cellular and Molecular Research Center, Research Institute for Non-communicable Diseases, Qazvin University of Medical Sciences, Qazvin, Iran
- Department of Anatomical Sciences, Faculty of Medicine, Qazvin University of Medical Sciences, Qazvin, Iran
| | - Zahra Ghobadi
- Advanced Medical Imaging Ward, Pars Darman Medical Imaging Center, Karaj, Iran
| | - Nader Sadigh
- Department of Emergency Medicine, School of Medicine, Trauma and Injury Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Nafiseh Mohebi
- Department of Neurology, Rasool Akram Hospital, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Armin Ariaei
- Student Research Committee, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Fatemeh Moradi
- Department of Anatomy, School of Medicine, Iran University of Medical Sciences, Tehran, 1449614535, Iran.
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Chang HT, Chan PC, Chiu PY. Non-linear relationship between serum cholesterol levels and cognitive change among older people in the preclinical and prodromal stages of dementia: a retrospective longitudinal study in Taiwan. BMC Geriatr 2024; 24:474. [PMID: 38816835 PMCID: PMC11138028 DOI: 10.1186/s12877-024-05030-0] [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: 01/31/2024] [Accepted: 04/30/2024] [Indexed: 06/01/2024] Open
Abstract
BACKGROUND Adverse effects of rigorously lowering low-density lipoprotein cholesterol on cognition have been reported; therefore, we aimed to study the contribution of serum cholesterol in cognitive decline in older people with or without dementia. METHODS Cognitive function was assessed by the Cognitive Abilities Screening Instrument (CASI). We investigated associations between serum cholesterol with cognitive decline using multiple regressions controlling for the effects of demographics, vascular risk factors, and treatments. RESULTS Most associations between cholesterol and CASI scores could be explained by non-linear and inverted U-shaped relationships (R2 = 0.003-0.006, p < 0.016, Šidákcorrection). The relationships were most evident between changes in cholesterol and CASI scores in older people at the preclinical or prodromal stages of dementia (R2 = 0.02-0.064, p values < 0.016). There were no differences in level of changes in CASI scores between individuals in 1st decile and 10th decile groups of changes in cholesterol (p = 0.266-0.972). However, individuals in the 1st decile of triglyceride changes and with stable and normal cognitive functions showed significant improvement in CASI scores compared to those in the 10th decile (t(202) = 2.275, p values < 0.05). CONCLUSION These findings could implicate that rigorously lowering cholesterol may not be suitable for the prevention of cognitive decline among older people, especially among individuals in preclinical or prodromal stages of dementia.
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Affiliation(s)
- Hsin-Te Chang
- Department of Psychology, College of Science, Chung Yuan Christian University, Taoyuan, Taiwan
- Research Assistant Center, Show Chwan Memorial Hospital, Changhua City, Changhua, Taiwan
| | - Po-Chi Chan
- Department of Neurology, Show Chwan Memorial Hospital, Changhua City, Changhua, Taiwan
| | - Pai-Yi Chiu
- Department of Neurology, Show Chwan Memorial Hospital, Changhua City, Changhua, Taiwan.
- Department of Applied Mathematics, College of Science, Tunghai University, Taichung, Taiwan.
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Mei Y, Christensen GM, Li Z, Waller LA, Ebelt S, Marcus M, Lah JJ, Wingo AP, Wingo TS, Hüls A. Joint effects of air pollution and neighborhood socioeconomic status on cognitive decline - Mediation by depression, high cholesterol levels, and high blood pressure. THE SCIENCE OF THE TOTAL ENVIRONMENT 2024; 923:171535. [PMID: 38453069 DOI: 10.1016/j.scitotenv.2024.171535] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Revised: 12/21/2023] [Accepted: 03/04/2024] [Indexed: 03/09/2024]
Abstract
Air pollution and neighborhood socioeconomic status (N-SES) are associated with adverse cardiovascular health and neuropsychiatric functioning in older adults. This study examines the degree to which the joint effects of air pollution and N-SES on the cognitive decline are mediated by high cholesterol levels, high blood pressure (HBP), and depression. In the Emory Healthy Aging Study, 14,390 participants aged 50+ years from Metro Atlanta, GA, were assessed for subjective cognitive decline using the cognitive function instrument (CFI). Information on the prior diagnosis of high cholesterol, HBP, and depression was collected through the Health History Questionnaire. Participants' census tracts were assigned 3-year average concentrations of 12 air pollutants and 16 N-SES characteristics. We used the unsupervised clustering algorithm Self-Organizing Maps (SOM) to create 6 exposure clusters based on the joint distribution of air pollution and N-SES in each census tract. Linear regression analysis was used to estimate the effects of the SOM cluster indicator on CFI, adjusting for age, race/ethnicity, education, and neighborhood residential stability. The proportion of the association mediated by high cholesterol levels, HBP, and depression was calculated by comparing the total and direct effects of SOM clusters on CFI. Depression mediated up to 87 % of the association between SOM clusters and CFI. For example, participants living in the high N-SES and high air pollution cluster had CFI scores 0.05 (95 %-CI:0.01,0.09) points higher on average compared to those from the high N-SES and low air pollution cluster; after adjusting for depression, this association was attenuated to 0.01 (95 %-CI:-0.04,0.05). HBP mediated up to 8 % of the association between SOM clusters and CFI and high cholesterol up to 5 %. Air pollution and N-SES associated cognitive decline was partially mediated by depression. Only a small portion (<10 %) of the association was mediated by HBP and high cholesterol.
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Affiliation(s)
- Yiyang Mei
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Grace M Christensen
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Zhenjiang Li
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Lance A Waller
- Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA; Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Stefanie Ebelt
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA; Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Michele Marcus
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA; Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - James J Lah
- Department of Neurology, School of Medicine, Emory University, Atlanta, GA, USA
| | - Aliza P Wingo
- Division of Mental Health, Atlanta VA Medical Center, Decatur, GA, USA; Department of Psychiatry, Emory University School of Medicine, Atlanta, GA, USA
| | - Thomas S Wingo
- Department of Neurology, School of Medicine, Emory University, Atlanta, GA, USA; Department of Human Genetics, Emory University, Atlanta, GA, USA
| | - Anke Hüls
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA; Gangarosa Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, GA, USA.
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Sperling JD, Frikke-Schmidt R, Scheike T, Kessing LV, Miskowiak K, Vinberg M. APOE Genotype, ApoE Plasma Levels, Lipid Metabolism, and Cognition in Monozygotic Twins with, at Risk of, and without Affective Disorders. J Clin Med 2024; 13:2361. [PMID: 38673634 PMCID: PMC11051543 DOI: 10.3390/jcm13082361] [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] [Received: 02/13/2024] [Revised: 04/01/2024] [Accepted: 04/11/2024] [Indexed: 04/28/2024] Open
Abstract
Background: Lipids influence brain function and mental health. Understanding the role of apolipoproteins in affective disorders could provide valuable insights and potentially pave the way for novel therapeutic approaches. Methods: We examined the apolipoprotein E genotype and ApoE-levels, lipid profiles, and the correlation with cognition in 204 monozygotic (MZ) twins with unipolar or bipolar disorder in remission or partial remission (affected, AT), their unaffected co-twins (high-risk, HR), and twins with no personal or family history of affective disorder (low-risk, LR). Results: The APOE genotype was not associated with affective disorders. No significant group differences in ApoE levels were found between the three risk groups. Post hoc analysis group-wise comparisons showed higher ApoE levels in the AT than HR twins and in the concordant AT twin pairs relative to the discordant twin pairs. Within the discordant twin pairs, higher ApoE levels were observed in the affected twins (AT = 39.4 mg/L vs. HR = 36.8 mg/L, p = 0.037). Limitations: The present study could benefit from a larger sample size. We did not assess dietary habits. Conclusions: The results did not support our main hypothesis. However, exploratory post hoc analysis suggests a role for plasma ApoE and triglycerides in affective disorders. Future research is needed.
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Affiliation(s)
- Jon Dyg Sperling
- The Early Multimodular Prevention and Intervention Research Institution (EMPIRI), Mental Health Centre, Northern Zealand, Copenhagen University Hospital—Mental Health Services CPH, 3400 North Zealand, Denmark;
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, 2200 Copenhagen, Denmark (L.V.K.)
| | - Ruth Frikke-Schmidt
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, 2200 Copenhagen, Denmark (L.V.K.)
- Department of Clinical Biochemistry Rigshospitalet, Copenhagen University Hospital, 2100 Copenhagen, Denmark
| | - Thomas Scheike
- Department of Biostatistics, University of Copenhagen, 1353 Copenhagen, Denmark
| | - Lars Vedel Kessing
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, 2200 Copenhagen, Denmark (L.V.K.)
- Copenhagen Affective Disorders Research Centre (CADIC), Psychiatric Center Copenhagen, 2000 Frederiksberg, Denmark
| | - Kamilla Miskowiak
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, 2200 Copenhagen, Denmark (L.V.K.)
- Copenhagen Affective Disorders Research Centre (CADIC), Psychiatric Center Copenhagen, 2000 Frederiksberg, Denmark
- Neurocognition and Emotion in Affective Disorders (NEAD) Centre, Department of Psychology, University of Copenhagen, and Mental Health Services, Capital Region of Denmark, 2000 Frederiksberg, Denmark
| | - Maj Vinberg
- The Early Multimodular Prevention and Intervention Research Institution (EMPIRI), Mental Health Centre, Northern Zealand, Copenhagen University Hospital—Mental Health Services CPH, 3400 North Zealand, Denmark;
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, 2200 Copenhagen, Denmark (L.V.K.)
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Jeong SH, Chung SJ, Yoo HS, Jung JH, Baik JS, Sohn YH, Lee PH. Differential effects of cholesterol levels on cognition according to body mass index in Parkinson's disease. Alzheimers Res Ther 2024; 16:24. [PMID: 38297344 PMCID: PMC10829366 DOI: 10.1186/s13195-023-01326-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2023] [Accepted: 10/05/2023] [Indexed: 02/02/2024]
Abstract
BACKGROUND Cholesterol is an essential component of the neuronal cell membrane and is crucial for neuronal function; however, the role of cholesterol levels in Parkinson's disease (PD) is debatable. This study investigated the complex relationship between total cholesterol (TC) levels, body mass index (BMI), and cognition in patients with PD. METHODS This study included 321 drug-naïve patients with PD who underwent dopamine transporter (DAT) imaging and baseline neuropsychological tests. Multivariate linear regression and Cox regression models were used to investigate the effect of TC levels on the composite score of each cognitive domain and dementia conversion after adjusting for covariates, respectively. Interaction analyses were performed to examine the interaction effect between TC levels and BMI on baseline cognition and dementia conversion. RESULTS TC levels and cognition showed no significant relationship after adjusting for potential confounders. A significant interaction effect between TC levels and BMI was observed in frontal/executive function and dementia conversion. Further analyses showed that TC levels were positively associated with frontal/executive function in the under-/normal weight group (β = 0.205, p = 0.013), whereas a negative relationship existed between TC levels and frontal/executive function in the obese group (β = - 0.213, p = 0.017). Cox regression analyses also showed the differential effects of TC levels on dementia conversion according to BMI (under-/normal weight group: hazard ratio [HR] = 0.550, p = 0.013; obese group: HR = 2.085, p = 0.014). CONCLUSIONS This study suggests a cross-over interaction between TC levels and BMI on cognitive symptoms in PD.
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Affiliation(s)
- Seong Ho Jeong
- Department of Neurology, Inje University Sanggye Paik Hospital, Seoul, South Korea
- Department of Neurology, Yonsei University College of Medicine, 50 Yonsei-Ro, Seodaemun-Gu, Seoul, 03722, South Korea
| | - Seok Jong Chung
- Department of Neurology, Yongin Severance Hospital, Yonsei University Health System, Yongin, South Korea
| | - Han Soo Yoo
- Department of Neurology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea
| | - Jin Ho Jung
- Department of Neurology, Inje Universitiy Busan Paik Hospital, Seoul, South Korea
| | - Jong Sam Baik
- Department of Neurology, Inje University Sanggye Paik Hospital, Seoul, South Korea
| | - Young H Sohn
- Department of Neurology, Yonsei University College of Medicine, 50 Yonsei-Ro, Seodaemun-Gu, Seoul, 03722, South Korea
| | - Phil Hyu Lee
- Department of Neurology, Yonsei University College of Medicine, 50 Yonsei-Ro, Seodaemun-Gu, Seoul, 03722, South Korea.
- Severance Biomedical Science Institute, Yonsei University College of Medicine, Seoul, South Korea.
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10
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Wen J, Hao X, Jia Y, Wang B, Pang J, Liang F. Sex Differences in the Association Between LDL/HDL with Cognitive Decline in Older Adults: National Health and Nutrition Examination Survey. J Alzheimers Dis 2024; 98:1493-1502. [PMID: 38578891 DOI: 10.3233/jad-231195] [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] [Indexed: 04/07/2024]
Abstract
Background Lipids have a significant impact on the development and functioning of the nervous system, but the sex differences between the association of LDL/HDL, which reflects lipid metabolic status, and cognitive impairment remains unclear. Objective We aimed to determine if there were sex differences between the association of LDL/HDL and cognitive function in US older adults. Methods This population-based cross-sectional study used data from the National Health and Nutrition Examination Survey (NHANES) 2011-2012 and 2013-2014 cycles. The main outcome was poor cognitive performance defined by the Digit Symbol Substitution Test (DSST) < 34 based on published literature. Results A total of 1,225 participants were included in the study, with a cognitive impairment incidence of 25.6% (314/1,225). Multivariate regression models demonstrated a significant association between cognitive decline and each 1-unit increase in LDL/HDL, after adjusting for all covariates (adjusted odds ratio [OR] = 1.36, 95% confidence interval [CI]: 1.11-1.67). Furthermore, subgroup analysis revealed an interaction between LDL/HDL and cognitive impairment in sex subgroups. Conclusions LDL/HDL was associated with cognitive impairment in the US older adult population in adjusted models, although the significance of this association was not observed in females.
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Affiliation(s)
- Jiaqi Wen
- Department of Neurology, Baotou Central Hospital, Baotou, China
- Inner Mongolia Autonomous Region Clinical Medical Research Center for Neurological Diseases, Baotou, China
| | - Xiwa Hao
- Department of Neurology, Baotou Central Hospital, Baotou, China
- Inner Mongolia Autonomous Region Clinical Medical Research Center for Neurological Diseases, Baotou, China
| | - Yanhong Jia
- Department of Neurology, Baotou Central Hospital, Baotou, China
| | - Baojun Wang
- Department of Neurology, Baotou Central Hospital, Baotou, China
- Inner Mongolia Autonomous Region Clinical Medical Research Center for Neurological Diseases, Baotou, China
| | - Jiangxia Pang
- Department of Neurology, Baotou Central Hospital, Baotou, China
- Inner Mongolia Autonomous Region Clinical Medical Research Center for Neurological Diseases, Baotou, China
| | - Furu Liang
- Department of Neurology, Baotou Central Hospital, Baotou, China
- Inner Mongolia Autonomous Region Clinical Medical Research Center for Neurological Diseases, Baotou, China
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11
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Lee KJ, Bae HJ. What have clinical trials taught us about brain health? CEREBRAL CIRCULATION - COGNITION AND BEHAVIOR 2023; 6:100199. [PMID: 38235315 PMCID: PMC10792690 DOI: 10.1016/j.cccb.2023.100199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/19/2023] [Revised: 12/26/2023] [Accepted: 12/27/2023] [Indexed: 01/19/2024]
Abstract
The Global Burden of Disease Study projects an almost tripling of dementia cases worldwide in the next 30 years making it important to recognize and understand modifiable risks and preventatives for cognitive impairment. Recent studies suggest that prevention or treatment of cardiovascular risks may be an important strategy to prevent or slow the progression of cognitive impairment. In 2017, the American Heart Association and American Stroke Association introduced metrics for "optimal brain health". These metrics defined brain health in terms of ideal health behaviors and factors. Since then and leading up to 2017, a number of clinical trials have been conducted to investigate the potential of modification of cardiovascular risks on prevention of dementia or cognitive impairment and thus, enhancement of brain health. This discussion is a review of findings from clinical trials focusing on interventions, including antihypertensive agents, glycemic control and lipid-lowering therapies, multidomain approaches, and antithrombotic medications. Notably, the results highlight the promise of intensive blood pressure lowering strategies and multidomain approaches, as evidenced by the FINGER trial. The review also discusses the potential of treatment or prevention of cerebral small vessel disease (cSVD) and the application of Mendelian randomization as a strategy to preserve brain structure and function.
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Affiliation(s)
- Keon-Joo Lee
- Department of Neurology, Korea University Guro Hospital, Seoul, South Korea
| | - Hee-Joon Bae
- Department of Neurology and Cerebrovascular Center, Seoul National University College of Medicine, Seoul National University Bundang Hospital, Seongnam, South Korea
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12
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Hassen CB, Machado‐Fragua MD, Landré B, Fayosse A, Dumurgier J, Kivimaki M, Sabia S, Singh‐Manoux A. Change in lipids before onset of dementia, coronary heart disease, and mortality: A 28-year follow-up Whitehall II prospective cohort study. Alzheimers Dement 2023; 19:5518-5530. [PMID: 37243914 PMCID: PMC10679471 DOI: 10.1002/alz.13140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Accepted: 04/07/2023] [Indexed: 05/29/2023]
Abstract
INTRODUCTION The association of lipids with dementia remains a subject of debate. Using data from 7,672 participants of the Whitehall II prospective cohort study, we examined whether timing of exposure, length of follow-up, or sex modifies this association. METHODS Twelve markers of lipid levels were measured from fasting blood and eight among them a further five times. We performed time-to-event as well as trajectory analyses. RESULTS No associations were observed in men; in women most lipids were associated with the risk of dementia, but only for events occurring after the first 20 years of follow-up. Differences in lipid trajectories in men emerged only in the years immediately before diagnosis whereas in women total cholesterol (TC), LDL-cholesterol (LDL-C), non-HDL-cholesterol (non-HDL-C), TC/HDL-C, and LDL-C/HDL-C were higher in midlife among dementia cases before declining progressively. DISCUSSION Abnormal lipid levels in midlife seem to be associated with a higher risk of dementia in women.
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Affiliation(s)
- Céline Ben Hassen
- Université Paris Cité, Inserm U1153, Epidemiology of Ageing and Neurodegenerative diseasesParisFrance
| | - Marcos D Machado‐Fragua
- Université Paris Cité, Inserm U1153, Epidemiology of Ageing and Neurodegenerative diseasesParisFrance
| | - Benjamin Landré
- Université Paris Cité, Inserm U1153, Epidemiology of Ageing and Neurodegenerative diseasesParisFrance
| | - Aurore Fayosse
- Université Paris Cité, Inserm U1153, Epidemiology of Ageing and Neurodegenerative diseasesParisFrance
| | - Julien Dumurgier
- Université Paris Cité, Inserm U1153, Epidemiology of Ageing and Neurodegenerative diseasesParisFrance
- Cognitive Neurology Center, Lariboisière – Fernand Widal Hospital, AP‐HPUniversité Paris CitéParisFrance
| | - Mika Kivimaki
- Department of Mental Health of Older People, Faculty of Brain SciencesUniversity College LondonLondonUK
| | - Séverine Sabia
- Université Paris Cité, Inserm U1153, Epidemiology of Ageing and Neurodegenerative diseasesParisFrance
- Department of Mental Health of Older People, Faculty of Brain SciencesUniversity College LondonLondonUK
| | - Archana Singh‐Manoux
- Université Paris Cité, Inserm U1153, Epidemiology of Ageing and Neurodegenerative diseasesParisFrance
- Department of Mental Health of Older People, Faculty of Brain SciencesUniversity College LondonLondonUK
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13
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Xu H, Fu J, Mohammed Nazar RB, Yang J, Chen S, Huang Y, Bao T, Chen X. Investigation of the Relationship between Apolipoprotein E Alleles and Serum Lipids in Alzheimer's Disease: A Meta-Analysis. Brain Sci 2023; 13:1554. [PMID: 38002514 PMCID: PMC10670160 DOI: 10.3390/brainsci13111554] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2023] [Revised: 10/30/2023] [Accepted: 11/02/2023] [Indexed: 11/26/2023] Open
Abstract
Prior studies have yielded mixed findings concerning the association between apolipoprotein E(APOE)-ε4 and serum lipids in patients with Alzheimer's disease (AD) and healthy individuals. Some studies suggested a relationship between APOEε4 and serum lipids in patients with AD and healthy individuals, whereas others proposed that the APOEε4 allele affects lipids only in patients with AD. Our study aimed to investigate whether APOE alleles have a distinct impact on lipids in AD. We conducted a comprehensive search of the PubMed and Embase databases for all related studies that investigate APOE and serum lipids of AD from the inception to 30 May 2022. Elevated total cholesterol (TC) and low-density lipoprotein (LDL) levels were found in APOEε4 allele carriers compared with non-carriers. No significant differences were found for high-density lipoprotein (HDL) and triglyceride (TG) levels in APOEε4 allele carriers compared to non-carriers. Notably, elevated TC and LDL levels showed considerable heterogeneity between patients with AD and healthy controls. A network meta-analysis did not find a distinct effect of carrying one or two APOEε4 alleles on lipid profiles. Higher TC and LDL levels were found in APOEε4 allele carriers compared with non-carriers, and the difference was more significant in patients with AD than in healthy controls.
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Affiliation(s)
- Huaxue Xu
- Department of Neurology, West China Hospital, Sichuan University, Chengdu 610041, China; (H.X.); (J.F.); (R.B.M.N.); (J.Y.); (S.C.)
| | - Jiajia Fu
- Department of Neurology, West China Hospital, Sichuan University, Chengdu 610041, China; (H.X.); (J.F.); (R.B.M.N.); (J.Y.); (S.C.)
| | - Risna Begam Mohammed Nazar
- Department of Neurology, West China Hospital, Sichuan University, Chengdu 610041, China; (H.X.); (J.F.); (R.B.M.N.); (J.Y.); (S.C.)
| | - Jing Yang
- Department of Neurology, West China Hospital, Sichuan University, Chengdu 610041, China; (H.X.); (J.F.); (R.B.M.N.); (J.Y.); (S.C.)
| | - Sihui Chen
- Department of Neurology, West China Hospital, Sichuan University, Chengdu 610041, China; (H.X.); (J.F.); (R.B.M.N.); (J.Y.); (S.C.)
| | - Yan Huang
- Management Center, West China Hospital, Sichuan University, Chengdu 610041, China; (Y.H.); (T.B.)
| | - Ting Bao
- Management Center, West China Hospital, Sichuan University, Chengdu 610041, China; (Y.H.); (T.B.)
| | - Xueping Chen
- Department of Neurology, West China Hospital, Sichuan University, Chengdu 610041, China; (H.X.); (J.F.); (R.B.M.N.); (J.Y.); (S.C.)
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14
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Gentreau M, Rukh G, Miguet M, Clemensson LE, Alsehli AM, Titova OE, Schiöth HB. The Effects of Statins on Cognitive Performance Are Mediated by Low-Density Lipoprotein, C-Reactive Protein, and Blood Glucose Concentrations. J Gerontol A Biol Sci Med Sci 2023; 78:1964-1972. [PMID: 37431946 PMCID: PMC10613010 DOI: 10.1093/gerona/glad163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Indexed: 07/12/2023] Open
Abstract
Statins are widely used for cardiovascular disease prevention but their effects on cognition remain unclear. Statins reduce cholesterol concentration and have been suggested to provide both beneficial and detrimental effects. Our aim was to investigate the cross-sectional and longitudinal association between statin use and cognitive performance, and whether blood low-density lipoprotein, high-density lipoprotein, triglycerides, glucose, C-reactive protein, and vitamin D biomarkers mediated this association. We used participants from the UK biobank aged 40-69 without neurological and psychiatric disorders (n = 147 502 and n = 24 355, respectively). We performed linear regression to evaluate the association between statin use and cognitive performance and, mediation analysis to quantify the total, direct, indirect effects and the proportion meditated by blood biomarkers. Statin use was associated with lower cognitive performance at baseline (β = -0.40 [-0.53, -0.28], p = <.0001), and this association was mediated by low-density lipoprotein (proportion mediated = 51.4%, p = .002), C-reactive protein (proportion mediated = -11%, p = .006) and blood glucose (proportion mediated = 2.6%, p = .018) concentrations. However, statin use was not associated with cognitive performance, measured 8 years later (β = -0.003 [-0.11, 0.10], p = .96). Our findings suggest that statins are associated with lower short-term cognitive performance by lowering low-density lipoprotein and raising blood glucose concentrations, and better performance by lowering C-reactive protein concentrations. In contrast, statins have no effect on long-term cognition and remain beneficial in reducing cardiovascular risk factors.
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Affiliation(s)
- Mélissa Gentreau
- Functional Pharmacology and Neuroscience, Department of Surgical Sciences, University of Uppsala, Uppsala, Sweden
| | - Gull Rukh
- Functional Pharmacology and Neuroscience, Department of Surgical Sciences, University of Uppsala, Uppsala, Sweden
| | - Maud Miguet
- Functional Pharmacology and Neuroscience, Department of Surgical Sciences, University of Uppsala, Uppsala, Sweden
| | - Laura E Clemensson
- Functional Pharmacology and Neuroscience, Department of Surgical Sciences, University of Uppsala, Uppsala, Sweden
| | - Ahmed M Alsehli
- Department of Physiology, Faculty of Medicine, King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia
| | - Olga E Titova
- Medical Epidemiology, Department of Surgical Sciences, University of Uppsala, Uppsala, Sweden
| | - Helgi B Schiöth
- Functional Pharmacology and Neuroscience, Department of Surgical Sciences, University of Uppsala, Uppsala, Sweden
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15
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White KS, Walker JA, Wang J, Autissier P, Miller AD, Abuelezan NN, Burrack R, Li Q, Kim WK, Williams KC. Simian immunodeficiency virus-infected rhesus macaques with AIDS co-develop cardiovascular pathology and encephalitis. Front Immunol 2023; 14:1240946. [PMID: 37965349 PMCID: PMC10641955 DOI: 10.3389/fimmu.2023.1240946] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Accepted: 10/03/2023] [Indexed: 11/16/2023] Open
Abstract
Despite effective antiretroviral therapy, HIV co-morbidities remain where central nervous system (CNS) neurocognitive disorders and cardiovascular disease (CVD)-pathology that are linked with myeloid activation are most prevalent. Comorbidities such as neurocogntive dysfunction and cardiovascular disease (CVD) remain prevalent among people living with HIV. We sought to investigate if cardiac pathology (inflammation, fibrosis, cardiomyocyte damage) and CNS pathology (encephalitis) develop together during simian immunodeficiency virus (SIV) infection and if their co-development is linked with monocyte/macrophage activation. We used a cohort of SIV-infected rhesus macaques with rapid AIDS and demonstrated that SIV encephalitis (SIVE) and CVD pathology occur together more frequently than SIVE or CVD pathology alone. Their co-development correlated more strongly with activated myeloid cells, increased numbers of CD14+CD16+ monocytes, plasma CD163 and interleukin-18 (IL-18) than did SIVE or CVD pathology alone, or no pathology. Animals with both SIVE and CVD pathology had greater numbers of cardiac macrophages and increased collagen and monocyte/macrophage accumulation, which were better correlates of CVD-pathology than SIV-RNA. Animals with SIVE alone had higher levels of activated macrophage biomarkers and cardiac macrophage accumulation than SIVnoE animals. These observations were confirmed in HIV infected individuals with HIV encephalitis (HIVE) that had greater numbers of cardiac macrophages and fibrosis than HIV-infected controls without HIVE. These results underscore the notion that CNS and CVD pathologies frequently occur together in HIV and SIV infection, and demonstrate an unmet need for adjunctive therapies targeting macrophages.
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Affiliation(s)
- Kevin S. White
- Department of Biology, Boston College, Chestnut Hill, MA, United States
| | - Joshua A. Walker
- Department of Biology, Boston College, Chestnut Hill, MA, United States
| | - John Wang
- Department of Biology, Boston College, Chestnut Hill, MA, United States
| | - Patrick Autissier
- Department of Biology, Boston College, Chestnut Hill, MA, United States
| | - Andrew D. Miller
- Department of Biomedical Sciences, Section of Anatomic Physiology, Cornell University College of Veterinary Medicine, Ithaca, NY, United States
| | - Nadia N. Abuelezan
- Connel School of Nursing, Boston College, Chestnut Hill, MA, United States
| | - Rachel Burrack
- Nebraska Center for Virology, School of Biological Sciences, University of Nebraska-Lincoln, Lincoln, NE, United States
| | - Qingsheng Li
- Nebraska Center for Virology, School of Biological Sciences, University of Nebraska-Lincoln, Lincoln, NE, United States
| | - Woong-Ki Kim
- Division of Microbiology, Tulane National Primate Research Center, Covington, LA, United States
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16
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Chen Y, Yang K, Huang Y, Wang X, Zhao Y, Ping P, Guan S, Fu S. Associations between lipid profiles and late-life cognitive impairment among oldest-old and centenarian adults. MedComm (Beijing) 2023; 4:e362. [PMID: 37692108 PMCID: PMC10484073 DOI: 10.1002/mco2.362] [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] [Received: 03/01/2023] [Revised: 07/23/2023] [Accepted: 08/06/2023] [Indexed: 09/12/2023] Open
Abstract
Dyslipidemia and cognitive impairment are common among old adults and the occurrence of them rises exponentially with increasing age. Evidences of the relationships between serum lipids and cognitive impairment are inconsistent or equivocal among older adults. This study aimed to investigate the associations between lipid profiles and late-life cognitive impairment among oldest-old and centenarian adults. In this cross-sectional study, serum lipids were biochemically measured among 606 oldest-old adults and 653 centenarians, and cognitive function was evaluated using mini-mental state examination (MMSE). Multivariate linear and logistic regression analyses were performed to explore the associations between serum lipids and cognitive impairment. Results showed participants with cognitive impairment had lower total cholesterol (TC) levels compared with those without cognitive impairment (p < 0.05). TC levels were positively associated with MMSE (p < 0.05). Furthermore, a negative association was observed between TC levels and cognitive impairment (p for trend = 0.002). This negative association remained statistically significant after adjusting for confounders (p for trend = 0.028). These results suggested that older adults with higher TC levels were likely to have better cognitive function. Taking immoderate cholesterol-lowering drugs among older adults is questionable and requires investigation, and cognitive performance of old adults with lower TC levels deserves more attention.
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Affiliation(s)
- Yujian Chen
- Central LaboratoryHainan Hospital of Chinese People's Liberation Army General HospitalSanyaChina
| | - Kaidi Yang
- Oncology DepartmentHainan Hospital of Chinese People's Liberation Army General HospitalSanyaChina
| | - Ya Huang
- Blood Transfusion DepartmentHainan Hospital of Chinese People's Liberation Army General HospitalSanyaChina
| | - Xuejiao Wang
- Pediatric DepartmentHainan Hospital of Chinese People's Liberation Army General HospitalSanyaChina
| | - Yali Zhao
- Central LaboratoryHainan Hospital of Chinese People's Liberation Army General HospitalSanyaChina
| | - Ping Ping
- General Station for Drug and Instrument Supervision and ControlJoint Logistic Support Force of Chinese People's Liberation ArmyBeijingChina
| | - Shasha Guan
- Oncology DepartmentHainan Hospital of Chinese People's Liberation Army General HospitalSanyaChina
| | - Shihui Fu
- Department of CardiologyHainan Hospital of Chinese People's Liberation Army General HospitalSanyaChina
- Department of Geriatric CardiologyChinese People's Liberation Army General HospitalBeijingChina
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17
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Nakamura Y, Kabayama M, Godai K, Tseng W, Akasaka H, Yamamoto K, Takami Y, Takeya Y, Gondo Y, Yasumoto S, Ogawa M, Kasuga A, Masui Y, Ikebe K, Arai Y, Ishizaki T, Rakugi H, Kamide K. Longitudinal association of hypertension and dyslipidemia with cognitive function in community-dwelling older adults: the SONIC study. Hypertens Res 2023; 46:1829-1839. [PMID: 37095338 PMCID: PMC10404512 DOI: 10.1038/s41440-023-01271-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Revised: 03/20/2023] [Accepted: 03/22/2023] [Indexed: 04/26/2023]
Abstract
The associations among cognitive function, hypertension, and dyslipidemia in older adults are controversial. Therefore, we investigated the associations among cognitive decline, hypertension, dyslipidemia, and their combination in community-dwelling older people in their 70s, 80s, and 90s in the long-term observational Septuagenarians, Octogenarians, Nonagenarians, Investigation with Centenarians (SONIC) study. We administered the Montreal Cognitive Assessment Japanese version (MoCA-J) by trained geriatricians and psychologists, and conducted blood testing and blood pressure (BP) measuring by medical staff involving 1186 participants. We performed multiple regression analysis to assess the relationships among hypertension, dyslipidemia, their combination, and lipid and BP levels with cognitive function at the 3-year follow-up after adjusting for covariate factors. At the baseline, the percentage of the combination of hypertension and dyslipidemia was 46.6% (n = 553), hypertension was 25.6% (n = 304), dyslipidemia was 15.0% (n = 178), and that without hypertension or dyslipidemia was 12.7% (n = 151). Conducting multiple regression analysis, no significant correlation was found between the combination of hypertension and dyslipidemia and MoCA-J score. In the group with the combination, high high-density lipoprotein cholesterol (HDL) levels resulted in higher MoCA-J scores at the follow-up (β = 0.06; P < 0.05) and high diastolic BP (DBP) also resulted in higher MoCA-J scores (β = 0.08; P < 0.05). The results suggest that high HDL and DBP levels of individuals with HT & DL and high SBP levels of individuals with HT were associated with cognitive function in community-dwelling older adults. In the SONIC study, which is an epidemiological study of Japanese older persons aged 70 years or older, a disease-specific examination suggested that high HDL and DBP levels of individuals with hypertension & dyslipidemia and high SBP levels of individuals with hypertension were associated with maintaining cognitive function in community-dwelling older adults.
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Affiliation(s)
- Yuko Nakamura
- Division of Health Sciences, Osaka University, Graduate School of Medicine, 1-7 Yamadaoka, Suita, Osaka, 567-0871, Japan
| | - Mai Kabayama
- Division of Health Sciences, Osaka University, Graduate School of Medicine, 1-7 Yamadaoka, Suita, Osaka, 567-0871, Japan
| | - Kayo Godai
- Division of Health Sciences, Osaka University, Graduate School of Medicine, 1-7 Yamadaoka, Suita, Osaka, 567-0871, Japan
| | - Winston Tseng
- School of Public Health, University of California, Berkeley, 2199 Addison Street Room 50, Berkeley, CA, 94720-7358, USA
| | - Hiroshi Akasaka
- Department of Geriatric and General Medicine, Osaka University, Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka, 567-0871, Japan
| | - Koichi Yamamoto
- Department of Geriatric and General Medicine, Osaka University, Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka, 567-0871, Japan
| | - Yoichi Takami
- Department of Geriatric and General Medicine, Osaka University, Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka, 567-0871, Japan
| | - Yasushi Takeya
- Division of Health Sciences, Osaka University, Graduate School of Medicine, 1-7 Yamadaoka, Suita, Osaka, 567-0871, Japan
| | - Yasuyuki Gondo
- Department of Clinical Thanatology and Geriatric Behavioral Sciences, Osaka University, Graduate School of Human Sciences, 1-2 Yamadaoka, Suita, Osaka, 567-0871, Japan
| | - Saori Yasumoto
- Department of Clinical Thanatology and Geriatric Behavioral Sciences, Osaka University, Graduate School of Human Sciences, 1-2 Yamadaoka, Suita, Osaka, 567-0871, Japan
| | - Madoka Ogawa
- Department of Clinical Thanatology and Geriatric Behavioral Sciences, Osaka University, Graduate School of Human Sciences, 1-2 Yamadaoka, Suita, Osaka, 567-0871, Japan
| | - Ayaka Kasuga
- Department of Clinical Thanatology and Geriatric Behavioral Sciences, Osaka University, Graduate School of Human Sciences, 1-2 Yamadaoka, Suita, Osaka, 567-0871, Japan
| | - Yukie Masui
- Research Team for Human Care, Tokyo Metropolitan Institute of Gerontology, 35-2 Sakae-cho, Itabashi-ku, Tokyo, 173-0015, Japan
| | - Kazunori Ikebe
- Center for Super Centenarian Medical Research, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Yasumichi Arai
- Center for Super Centenarian Medical Research, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo, 160-8582, Japan
| | - Tatsuro Ishizaki
- Research Team for Human Care, Tokyo Metropolitan Institute of Gerontology, 35-2 Sakae-cho, Itabashi-ku, Tokyo, 173-0015, Japan
| | - Hiromi Rakugi
- Department of Geriatric and General Medicine, Osaka University, Graduate School of Medicine, 2-2 Yamadaoka, Suita, Osaka, 567-0871, Japan
| | - Kei Kamide
- Division of Health Sciences, Osaka University, Graduate School of Medicine, 1-7 Yamadaoka, Suita, Osaka, 567-0871, Japan.
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18
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de Sousa AA, Rigby Dames BA, Graff EC, Mohamedelhassan R, Vassilopoulos T, Charvet CJ. Going beyond established model systems of Alzheimer's disease: companion animals provide novel insights into the neurobiology of aging. Commun Biol 2023; 6:655. [PMID: 37344566 DOI: 10.1038/s42003-023-05034-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Accepted: 06/12/2023] [Indexed: 06/23/2023] Open
Abstract
Alzheimer's disease (AD) is characterized by brain plaques, tangles, and cognitive impairment. AD is one of the most common age-related dementias in humans. Progress in characterizing AD and other age-related disorders is hindered by a perceived dearth of animal models that naturally reproduce diseases observed in humans. Mice and nonhuman primates are model systems used to understand human diseases. Still, these model systems lack many of the biological characteristics of Alzheimer-like diseases (e.g., plaques, tangles) as they grow older. In contrast, companion animal models (cats and dogs) age in ways that resemble humans. Both companion animal models and humans show evidence of brain atrophy, plaques, and tangles, as well as cognitive decline with age. We embrace a One Health perspective, which recognizes that the health of humans is connected to those of animals, and we illustrate how such a perspective can work synergistically to enhance human and animal health. A comparative biology perspective is ideally suited to integrate insights across veterinary and human medical disciplines and solve long-standing problems in aging.
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Affiliation(s)
- Alexandra A de Sousa
- Centre for Health and Cognition, Bath Spa University, Bath, UK
- Department of Psychology, University of Bath, Bath, UK
| | - Brier A Rigby Dames
- Department of Psychology, University of Bath, Bath, UK
- Department of Computer Science, University of Bath, Bath, UK
- Department of Biology and Biochemistry, Milner Centre for Evolution, University of Bath, Bath, UK
| | - Emily C Graff
- Department of Pathobiology, College of Veterinary Medicine, Auburn University, Auburn, AL, USA
| | - Rania Mohamedelhassan
- Department of Anatomy, Physiology and Pharmacology, College of Veterinary Medicine, Auburn University, Auburn, AL, USA
| | - Tatianna Vassilopoulos
- Department of Anatomy, Physiology and Pharmacology, College of Veterinary Medicine, Auburn University, Auburn, AL, USA
| | - Christine J Charvet
- Department of Anatomy, Physiology and Pharmacology, College of Veterinary Medicine, Auburn University, Auburn, AL, USA.
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19
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Reekes TH, Ledbetter CR, Alexander JS, Stokes KY, Pardue S, Bhuiyan MAN, Patterson JC, Lofton KT, Kevil CG, Disbrow EA. Elevated plasma sulfides are associated with cognitive dysfunction and brain atrophy in human Alzheimer's disease and related dementias. Redox Biol 2023; 62:102633. [PMID: 36924684 PMCID: PMC10026043 DOI: 10.1016/j.redox.2023.102633] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 02/10/2023] [Indexed: 02/19/2023] Open
Abstract
Emerging evidence indicates that vascular stress is an important contributor to the pathophysiology of Alzheimer's disease and related dementias (ADRD). Hydrogen sulfide (H2S) and its metabolites (acid-labile (e.g., iron-sulfur clusters) and bound (e.g., per-, poly-) sulfides) have been shown to modulate both vascular and neuronal homeostasis. We recently reported that elevated plasma sulfides were associated with cognitive dysfunction and measures of microvascular disease in ADRD. Here we extend our previous work to show associations between elevated sulfides and magnetic resonance-based metrics of brain atrophy and white matter integrity. Elevated bound sulfides were associated with decreased grey matter volume, while increased acid labile sulfides were associated with decreased white matter integrity and greater ventricular volume. These findings are consistent with alterations in sulfide metabolism in ADRD which may represent maladaptive responses to oxidative stress.
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Affiliation(s)
- Tyler H Reekes
- Department of Pharmacology, Toxicology & Neuroscience, LSU Health Shreveport, United States; Center for Brain Health, LSU Health Shreveport, United States
| | - Christina R Ledbetter
- Center for Brain Health, LSU Health Shreveport, United States; Department of Neurosurgery, LSU Health Shreveport, United States
| | - J Steven Alexander
- Center for Brain Health, LSU Health Shreveport, United States; Center for Cardiovascular Diseases and Sciences, LSU Health Shreveport, United States; Department of Neurology, LSU Health Shreveport, United States; Department of Molecular and Cellular Physiology, LSU Health Shreveport, United States
| | - Karen Y Stokes
- Center for Brain Health, LSU Health Shreveport, United States; Center for Cardiovascular Diseases and Sciences, LSU Health Shreveport, United States; Department of Molecular and Cellular Physiology, LSU Health Shreveport, United States
| | - Sibile Pardue
- Center for Cardiovascular Diseases and Sciences, LSU Health Shreveport, United States; Department of Pathology and Translational Pathobiology, LSU Health Shreveport, United States
| | | | - James C Patterson
- Center for Brain Health, LSU Health Shreveport, United States; Department of Psychiatry and Behavioral Medicine, LSU Health Shreveport, United States
| | - Katelyn T Lofton
- Center for Brain Health, LSU Health Shreveport, United States; Department of Neurology, LSU Health Shreveport, United States; Department of Psychiatry and Behavioral Medicine, LSU Health Shreveport, United States
| | - Christopher G Kevil
- Center for Brain Health, LSU Health Shreveport, United States; Center for Cardiovascular Diseases and Sciences, LSU Health Shreveport, United States; Department of Pathology and Translational Pathobiology, LSU Health Shreveport, United States.
| | - Elizabeth A Disbrow
- Department of Pharmacology, Toxicology & Neuroscience, LSU Health Shreveport, United States; Center for Brain Health, LSU Health Shreveport, United States; Center for Cardiovascular Diseases and Sciences, LSU Health Shreveport, United States; Department of Neurology, LSU Health Shreveport, United States.
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20
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Yahagi-Estevam M, Farias-Itao DS, Leite REP, Rodriguez RD, Pasqualucci CA, Nitrini R, Jacob-Filho W, Power MC, Suemoto CK. The Potential Role of Selection Bias in the Association Between Coronary Atherosclerosis and Cognitive Impairment. J Alzheimers Dis 2023:JAD220820. [PMID: 37182864 DOI: 10.3233/jad-220820] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
Abstract
BACKGROUND Coronary atherosclerosis assessed in vivo was associated with cognitive impairment; however, conflicting findings have been reported in autopsy samples. OBJECTIVE Our aims were to assess the association between atherosclerotic stenosis in the coronary arteries and cognitive impairment and to investigate the possibility of selection bias in an autopsy study. METHODS Coronary arteries were collected, and the largest luminal stenosis was measured. Sociodemographic, clinical, and cognitive information were reported by a reliable next-of-kin. The association was tested using logistic and linear regressions adjusted for sociodemographic and clinical variables. We restricted the sample to individuals that were born in 1935 or earlier and stratified the analysis by cause of death to investigate the role of selection bias. RESULTS In 253 participants (mean age = 78.0±8.5 years old, 48% male), stenosis was not associated with cognitive impairment (OR = 0.85, 95% CI = 0.69; 1.06, p = 0.15). In individuals who were born before 1936 in the absence of cardiovascular disease as the cause of death, greater stenosis was associated with cognitive impairment (OR = 4.02, 95% CI = 1.39; 11.6, p = 0.01). On the other hand, this association was not present among those born in 1935 or earlier who died of cardiovascular diseases (OR = 0.83, 95% CI = 0.60; 1.16, p = 0.28). CONCLUSION We found that higher coronary stenosis was associated with cognitive impairment only in individuals born in 1935 or earlier and who had not died from cardiovascular diseases. Selection bias may be an important issue when investigating risk factors for chronic degenerative diseases in older individuals using autopsy samples.
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Affiliation(s)
| | | | - Renata Elaine Paraizo Leite
- Physiopathology in Aging Lab/Brazilian Aging Brain Study Group - LIM22, University of Sao Paulo Medical School, Sao Paulo, Brazil
- Discipline of Geriatrics, University of Sao Paulo Medical School, Sao Paulo, Brazil
| | | | - Carlos Augusto Pasqualucci
- Department of Pathology, University of Sao Paulo Medical School, Sao Paulo, Brazil
- Physiopathology in Aging Lab/Brazilian Aging Brain Study Group - LIM22, University of Sao Paulo Medical School, Sao Paulo, Brazil
| | - Ricardo Nitrini
- Physiopathology in Aging Lab/Brazilian Aging Brain Study Group - LIM22, University of Sao Paulo Medical School, Sao Paulo, Brazil
- Department of Neurology, University of Sao Paulo Medical School, Sao Paulo, Brazil
| | - Wilson Jacob-Filho
- Physiopathology in Aging Lab/Brazilian Aging Brain Study Group - LIM22, University of Sao Paulo Medical School, Sao Paulo, Brazil
- Discipline of Geriatrics, University of Sao Paulo Medical School, Sao Paulo, Brazil
| | - Melinda C Power
- Department of Epidemiology, George Washington University, Washington, DC, USA
| | - Claudia Kimie Suemoto
- Physiopathology in Aging Lab/Brazilian Aging Brain Study Group - LIM22, University of Sao Paulo Medical School, Sao Paulo, Brazil
- Discipline of Geriatrics, University of Sao Paulo Medical School, Sao Paulo, Brazil
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21
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Zhang G, Ye X, Wang X, Lin Y, Zhu C, Pan J, Yin X, Ye M, Lv W, Tang W, Liu J, Yang X, Hui L, Zheng K. Serum total cholesterol levels associated with immediate memory performance in patients with chronic schizophrenia. Schizophr Res 2023; 255:256-260. [PMID: 37060796 DOI: 10.1016/j.schres.2023.03.046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Revised: 03/13/2023] [Accepted: 03/26/2023] [Indexed: 04/17/2023]
Abstract
Cognitive impairments are common in patients with schizophrenia. Changes in total cholesterol (TC) may be involved in the development of schizophrenia and associated with cognitive function. This study aimed to investigate differences in serum TC level and cognitive function between schizophrenia patients and healthy controls and explore the relationship between serum TC level and cognitive function in patients with schizophrenia. A total of 105 schizophrenia patients and 105 healthy controls were recruited. Results showed that patients with schizophrenia had significantly lower scores on the overall RBANS scale and subscales (i.e., immediate memory, language, attention, and delayed memory) than those of healthy controls. Pearson's correlation analyses showed that in patients with schizophrenia, serum TC levels were positively associated with RBANS subscale scores of immediate memory and language. Furthermore, multivariate regression analyses showed that serum TC level was positively associated with the immediate memory index in patients with schizophrenia. However, no significant association was found between serum TC level and RBANS score in the healthy control group. Our results suggest that elevated serum TC level may be related to improved cognitive function in patients with schizophrenia, especially that of immediate memory.
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Affiliation(s)
- Guohua Zhang
- School of Mental Health, Zhejiang Provincial Clinical Research Center for Mental Disorders, The Affiliated Kangning Hospital, Wenzhou Medical University, Wenzhou 325035, PR China.
| | - Xiaodan Ye
- The affiliated Kangning Hospital, Wenzhou Medical University, Wenzhou 325000, PR China
| | - Xin Wang
- Center for Health Behaviours Research, JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China.
| | - Yixuan Lin
- School of Psychology and Cognitive Science, East China Normal University, Shanghai, PR China
| | - Cheng Zhu
- The affiliated Kangning Hospital, Wenzhou Medical University, Wenzhou 325000, PR China
| | - Jianshe Pan
- The affiliated Kangning Hospital, Wenzhou Medical University, Wenzhou 325000, PR China
| | - Xiaoli Yin
- The affiliated Kangning Hospital, Wenzhou Medical University, Wenzhou 325000, PR China
| | - Minjie Ye
- The affiliated Kangning Hospital, Wenzhou Medical University, Wenzhou 325000, PR China
| | - Wei Lv
- The affiliated Kangning Hospital, Wenzhou Medical University, Wenzhou 325000, PR China
| | - Wei Tang
- The affiliated Kangning Hospital, Wenzhou Medical University, Wenzhou 325000, PR China
| | - Jiahong Liu
- The affiliated Kangning Hospital, Wenzhou Medical University, Wenzhou 325000, PR China
| | - Xue Yang
- Center for Health Behaviours Research, JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China.
| | - Li Hui
- Institute of Mental Health, Suzhou Psychiatric Hospital, The Affiliated Guangji Hospital of Soochow University, Suzhou 215137, PR China.
| | - Ke Zheng
- The affiliated Kangning Hospital, Wenzhou Medical University, Wenzhou 325000, PR China.
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22
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Alanko V, Gaminde-Blasco A, Quintela-López T, Loera-Valencia R, Solomon A, Björkhem I, Cedazo-Minguez A, Maioli S, Tabacaru G, Latorre-Leal M, Matute C, Kivipelto M, Alberdi E, Sandebring-Matton A. 27-hydroxycholesterol promotes oligodendrocyte maturation: Implications for hypercholesterolemia-associated brain white matter changes. Glia 2023; 71:1414-1428. [PMID: 36779429 DOI: 10.1002/glia.24348] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Revised: 01/19/2023] [Accepted: 01/23/2023] [Indexed: 02/14/2023]
Abstract
Oxidized cholesterol metabolite 27-hydroxycholesterol (27-OH) is a potential link between hypercholesterolemia and neurodegenerative diseases since unlike peripheral cholesterol, 27-OH is transported across the blood-brain barrier. However, the effects of high 27-OH levels on oligodendrocyte function remain unexplored. We hypothesize that during hypercholesterolemia 27-OH may impact oligodendrocytes and myelin and thus contribute to the disconnection of neural networks in neurodegenerative diseases. To test this idea, we first investigated the effects of 27-OH in cultured oligodendrocytes and found that it induces cell death of immature O4+ /GalC+ oligodendrocytes along with stimulating differentiation of PDGFR+ oligodendrocyte progenitors (OPCs). Next, transgenic mice with increased systemic 27-OH levels (Cyp27Tg) underwent behavioral testing and their brains were immunohistochemically stained and lysed for immunoblotting. Chronic exposure to 27-OH in mice resulted in increased myelin basic protein (MBP) but not 2',3'-cyclic-nucleotide 3'-phosphodiesterase (CNPase) or myelin oligodendrocyte glycoprotein (MOG) levels in the corpus callosum and cerebral cortex. Intriguingly, we also found impairment of spatial learning suggesting that subtle changes in myelinated axons of vulnerable areas like the hippocampus caused by 27-OH may contribute to impaired cognition. Finally, we found that 27-OH levels in cerebrospinal fluid from memory clinic patients were associated with levels of the myelination regulating CNPase, independently of Alzheimer's disease markers. Thus, 27-OH promotes OPC differentiation and is toxic to immature oligodendrocytes as well as it subtly alters myelin by targeting oligodendroglia. Taken together, these data indicate that hypercholesterolemia-derived higher 27-OH levels change the oligodendrocytic capacity for appropriate myelin remodeling which is a crucial factor in neurodegeneration and aging.
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Affiliation(s)
- Vilma Alanko
- Division of Clinical Geriatrics, Center for Alzheimer Research, NVS, Karolinska Institutet, Stockholm, Sweden.,Division of Neurogeriatrics, Center for Alzheimer Research, NVS, Karolinska Institutet, Stockholm, Sweden
| | - Adhara Gaminde-Blasco
- Department of Neuroscience, University of Basque Country (UPV/EHU) and CIBERNED, Leioa, Spain.,Achucarro Basque Center for Neuroscience, Leioa, Spain
| | - Tania Quintela-López
- Department of Neuroscience, University of Basque Country (UPV/EHU) and CIBERNED, Leioa, Spain.,Achucarro Basque Center for Neuroscience, Leioa, Spain
| | - Raúl Loera-Valencia
- Division of Neurogeriatrics, Center for Alzheimer Research, NVS, Karolinska Institutet, Stockholm, Sweden
| | - Alina Solomon
- Division of Clinical Geriatrics, Center for Alzheimer Research, NVS, Karolinska Institutet, Stockholm, Sweden.,Institute of Clinical Medicine/Neurology, University of Eastern Finland, Kuopio, Finland.,Ageing Epidemiology (AGE) Research Unit, School of Public Health, Imperial College London, London, UK
| | - Ingemar Björkhem
- Department of Laboratory Medicine, Karolinska University Hospital, Huddinge, Sweden
| | - Angel Cedazo-Minguez
- Division of Neurogeriatrics, Center for Alzheimer Research, NVS, Karolinska Institutet, Stockholm, Sweden
| | - Silvia Maioli
- Division of Neurogeriatrics, Center for Alzheimer Research, NVS, Karolinska Institutet, Stockholm, Sweden
| | - Graziella Tabacaru
- Division of Neurogeriatrics, Center for Alzheimer Research, NVS, Karolinska Institutet, Stockholm, Sweden
| | - María Latorre-Leal
- Division of Neurogeriatrics, Center for Alzheimer Research, NVS, Karolinska Institutet, Stockholm, Sweden
| | - Carlos Matute
- Department of Neuroscience, University of Basque Country (UPV/EHU) and CIBERNED, Leioa, Spain.,Achucarro Basque Center for Neuroscience, Leioa, Spain
| | - Miia Kivipelto
- Division of Clinical Geriatrics, Center for Alzheimer Research, NVS, Karolinska Institutet, Stockholm, Sweden.,Institute of Clinical Medicine/Neurology, University of Eastern Finland, Kuopio, Finland.,Ageing Epidemiology (AGE) Research Unit, School of Public Health, Imperial College London, London, UK.,Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
| | - Elena Alberdi
- Department of Neuroscience, University of Basque Country (UPV/EHU) and CIBERNED, Leioa, Spain.,Achucarro Basque Center for Neuroscience, Leioa, Spain
| | - Anna Sandebring-Matton
- Division of Clinical Geriatrics, Center for Alzheimer Research, NVS, Karolinska Institutet, Stockholm, Sweden.,Division of Neurogeriatrics, Center for Alzheimer Research, NVS, Karolinska Institutet, Stockholm, Sweden.,Ageing Epidemiology (AGE) Research Unit, School of Public Health, Imperial College London, London, UK
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23
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Brain J, Greene L, Tang EYH, Louise J, Salter A, Beach S, Turnbull D, Siervo M, Stephan BCM, Tully PJ. Cardiovascular disease, associated risk factors, and risk of dementia: An umbrella review of meta-analyses. FRONTIERS IN EPIDEMIOLOGY 2023; 3:1095236. [PMID: 38455934 PMCID: PMC10910908 DOI: 10.3389/fepid.2023.1095236] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Accepted: 01/12/2023] [Indexed: 03/09/2024]
Abstract
Introduction Cardiovascular diseases (CVDs) have been associated with an increased risk of dementia; yet the evidence is mixed. This review critically appraises and synthesises current evidence exploring associations between dementia risk and CVD and their risk factors, including coronary heart disease, heart failure, atrial fibrillation, hypertension, hyperlipidaemia, and arterial stiffness. Methods MEDLINE, Embase, PsycINFO, and the Cochrane Database of Systematic Reviews were searched to identify systematic reviews with meta-analyses investigating the association between at least one of the CVDs of interest and dementia risk. The Joanna Briggs Institute (JBI) Critical Appraisal Checklist for Systematic Reviews was used to assess methodological quality. Results Twenty-five meta-analyses published between 2007 and 2021 were included. Studies largely consisted of cohorts from North America and Europe. Findings were variable, with coronary heart disease, heart failure, and atrial fibrillation consistently associated with increased risk for all-cause dementia, but results were inconsistent for Alzheimer's disease. Hypertension was more frequently associated with dementia during mid-life compared to late life. Findings concerning cholesterol were complex, and while results were inconsistent for low-density lipoprotein cholesterol and total cholesterol, there appeared to be no associations between triglycerides and high-density lipoprotein cholesterol. All meta-analyses investigating hypercholesterolaemia showed significant increases in dementia risk. There was a paucity of research on the association between arterial stiffness and dementia risk. Conclusion Targeted CVD dementia prevention strategies could reduce dementia prevalence. Future research should determine the underpinning mechanisms linking heart and brain health to determine the most effective strategies for dementia risk reduction in CVD populations.
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Affiliation(s)
- Jacob Brain
- Institute of Mental Health, School of Medicine, University of Nottingham, Innovation Park, Jubilee Campus, Nottingham, United Kingdom
- Freemasons Foundation Centre for Men’s Health, Discipline of Medicine, School of Psychology, The University of Adelaide, Adelaide, SA, Australia
| | - Leanne Greene
- Freemasons Foundation Centre for Men’s Health, Discipline of Medicine, School of Psychology, The University of Adelaide, Adelaide, SA, Australia
| | - Eugene Y. H. Tang
- Population Health Sciences Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Jennie Louise
- Discipline of Obstetrics & Gynaecology, the Robinson Research Institute, The University of Adelaide, Adelaide, SA, Australia
| | - Amy Salter
- School of Public Health, Faculty of Health and Medical Sciences, University of Adelaide, Adelaide, SA, Australia
| | - Sarah Beach
- University of Nottingham Libraries, University of Nottingham, King’s Meadow Campus, Nottingham, United Kingdom
| | - Deborah Turnbull
- Freemasons Foundation Centre for Men’s Health, Discipline of Medicine, School of Psychology, The University of Adelaide, Adelaide, SA, Australia
| | - Mario Siervo
- School of Life Sciences, The University of Nottingham Medical School, Queen's Medical Centre, Nottingham, United Kingdom
| | - Blossom C. M. Stephan
- Institute of Mental Health, School of Medicine, University of Nottingham, Innovation Park, Jubilee Campus, Nottingham, United Kingdom
| | - Phillip J. Tully
- Faculty of Medicine and Health, School of Psychology, University of New England, Armidale, NSW, Australia
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24
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Effect of Avena sativa (Oats) on cognitive function: A systematic review of randomized controlled trials. Clin Nutr ESPEN 2023; 53:144-150. [PMID: 36657906 DOI: 10.1016/j.clnesp.2022.12.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Revised: 11/17/2022] [Accepted: 12/07/2022] [Indexed: 12/14/2022]
Abstract
BACKGROUND AND AIM The effect of polyphenol-rich diets or supplements on cognitive function remains a contentious topic. The objective of this study was to investigate the effects of Avena sativa (oat extracts) on cognitive function among healthy adults. METHODS A structured literature search was undertaken using PubMed, Web of Science, and Scopus from the database's establishment until March 17, 2022. Data on cognitive function, regarding accuracy and speed of performance, were gathered from randomized controlled trials (RCTs) that investigated the acute or chronic effects of Avena sativa in healthy subjects. The Cochrane Collaboration risk-of-bias tool was used to assess the quality of included studies. RESULTS We included six RCTs, of which three were crossover designs, with a total of 287 individuals. Four studies investigated the acute effect of Avena sativa, while two investigated its chronic effect. Acute ingestion of Avena sativa appeared to positively influence the accuracy and speed of performance. While short-term chronic supplementation resulted in a significant improvement in cognitive function, long-term chronic supplementation did not. Overall, the evidence was of average quality. CONCLUSION Acute supplementation with Avena sativa may improve cognitive function in healthy volunteers. Given the small number of trials included and the disparity of the intervention dose, the conclusions of this study should be interpreted with caution. More high-quality, long-term studies are warranted.
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25
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Ueno H, Takahashi Y, Murakami S, Wani K, Miyazaki T, Matsumoto Y, Okamoto M, Ishihara T. Comprehensive behavioral study of C57BL/6.KOR-ApoE shl mice. Transl Neurosci 2023; 14:20220284. [PMID: 37396111 PMCID: PMC10314129 DOI: 10.1515/tnsci-2022-0284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2022] [Revised: 04/04/2023] [Accepted: 04/05/2023] [Indexed: 07/04/2023] Open
Abstract
Background Apolipoprotein E (ApoE) is associated with Alzheimer's disease (AD) and cognitive dysfunction in elderly individuals. There have been extensive studies on behavioral abnormalities in ApoE-deficient (Apoeshl) mice, which have been described as AD mouse models. Spontaneously hyperlipidemic mice were discovered in 1999 as ApoE-deficient mice due to ApoE gene mutations. However, behavioral abnormalities in commercially available Apoeshl mice remain unclear. Accordingly, we aimed to investigate the behavioral abnormalities of Apoeshl mice. Results Apoeshl mice showed decreased motor skill learning and increased anxiety-like behavior toward heights. Apoeshl mice did not show abnormal behavior in the Y-maze test, open-field test, light/dark transition test, and passive avoidance test. Conclusion Our findings suggest the utility of Apoeshl mice in investigating the function of ApoE in the central nervous system.
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Affiliation(s)
- Hiroshi Ueno
- Department of Medical Technology, Kawasaki University of Medical Welfare, 288, Matsushima, Kurashiki, Okayama, 701-0193, Japan
| | - Yu Takahashi
- Department of Psychiatry, Kawasaki Medical School, Kurashiki, 701-0192, Japan
| | - Shinji Murakami
- Department of Psychiatry, Kawasaki Medical School, Kurashiki, 701-0192, Japan
| | - Kenta Wani
- Department of Psychiatry, Kawasaki Medical School, Kurashiki, 701-0192, Japan
| | - Tetsuji Miyazaki
- Department of Psychiatry, Kawasaki Medical School, Kurashiki, 701-0192, Japan
| | - Yosuke Matsumoto
- Department of Neuropsychiatry, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, 700-8558, Japan
| | - Motoi Okamoto
- Department of Medical Technology, Graduate School of Health Sciences, Okayama University, Okayama, 700-8558, Japan
| | - Takeshi Ishihara
- Department of Psychiatry, Kawasaki Medical School, Kurashiki, 701-0192, Japan
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26
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Huan S, Liu M, Liu Z, Gao J, Yin G. Association Between Dietary and Serum Cholesterol and Cognitive Function Among the U.S. Elderly from NHANES 2011-2014. J Alzheimers Dis 2023; 95:625-640. [PMID: 37574736 DOI: 10.3233/jad-230422] [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] [Indexed: 08/15/2023]
Abstract
BACKGROUND The association between dietary or serum cholesterol and cognitive performance in older adults has not been well-established. OBJECTIVE This study aimed to investigate the potential association between dietary or serum cholesterol and cognitive performance in the elderly population. METHODS A cross-sectional analysis was conducted using data from the National Health and Nutrition Examination Survey (NHANES) 2011-2012 and 2013-2014. Diet and supplement cholesterol was estimated based on two non-consecutive 24-hour dietary recalls. Cognitive function was assessed using various statistical tests. Poor cognitive performance was defined as scores below the lowest quartile within age groups. Regression models were adjusted for demographic factors, and subgroup analyses were performed for non-Hispanic White (NHW) and non-Hispanic Black (NHB) individuals. RESULTS Among 759 participants aged 60 years and above, dietary cholesterol was only associated with dietary saturated fatty acids and serum high-density lipoprotein cholesterol. There was no evidence of an association between dietary cholesterol and cognitive function, except for NHB individuals, where dietary cholesterol showed a positive correlation with cognitive function. In the overall sample and NHW participants, there were consistent positive associations between serum total cholesterol and cognitive performance across statistical tests, while such associations were rare among NHB individuals. Although not statistically significant, NHB individuals had higher dietary/supplementary/total cholesterol intake compared with NHW individuals. CONCLUSION Within the normal range, increasing serum cholesterol may be a potential factor to prevent or relieve cognitive dysfunction. However, ethnic differences should be taken into account when considering the association between cholesterol and cognitive performance.
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Affiliation(s)
- Sheng Huan
- Department of Anesthesiology and Perioperative Medicine, the First Affiliated Hospital of Nanjing Medical University, Nanjing, Jiangsu Province, P.R. China
- Nanjing University of Chinese Medicine, Nanjing, Jiangsu Province, P.R. China
| | - Mengling Liu
- Nanjing University of Chinese Medicine, Nanjing, Jiangsu Province, P.R. China
| | - Ziqiu Liu
- Nanjing University of Chinese Medicine, Nanjing, Jiangsu Province, P.R. China
- Nanjing Drum Tower Hospital Clinical College of Nanjing University of Chinese Medicine, Nanjing, Jiangsu Province, P.R. China
| | - Jing Gao
- Nanjing University of Chinese Medicine, Nanjing, Jiangsu Province, P.R. China
| | - Guoping Yin
- Nanjing University of Chinese Medicine, Nanjing, Jiangsu Province, P.R. China
- Department of Anesthesiology, Nanjing Second Hospital, Nanjing, Jiangsu Province, P.R. China
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27
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Cui Y, Tang TY, Lu CQ, Ju S. Insulin Resistance and Cognitive Impairment: Evidence From Neuroimaging. J Magn Reson Imaging 2022; 56:1621-1649. [PMID: 35852470 DOI: 10.1002/jmri.28358] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2022] [Revised: 07/02/2022] [Accepted: 07/05/2022] [Indexed: 01/04/2023] Open
Abstract
Insulin is a peptide well known for its role in regulating glucose metabolism in peripheral tissues. Emerging evidence from human and animal studies indicate the multifactorial role of insulin in the brain, such as neuronal and glial metabolism, glucose regulation, and cognitive processes. Insulin resistance (IR), defined as reduced sensitivity to the action of insulin, has been consistently proposed as an important risk factor for developing neurodegeneration and cognitive impairment. Although the exact mechanism of IR-related cognitive impairment still awaits further elucidation, neuroimaging offers a versatile set of novel contrasts to reveal the subtle cerebral abnormalities in IR. These imaging contrasts, including but not limited to brain volume, white matter (WM) microstructure, neural function and brain metabolism, are expected to unravel the nature of the link between IR, cognitive decline, and brain abnormalities, and their changes over time. This review summarizes the current neuroimaging studies with multiparametric techniques, focusing on the cerebral abnormalities related to IR and therapeutic effects of IR-targeting treatments. According to the results, brain regions associated with IR pathophysiology include the medial temporal lobe, hippocampus, prefrontal lobe, cingulate cortex, precuneus, occipital lobe, and the WM tracts across the globe. Of these, alterations in the temporal lobe are highly reproducible across different imaging modalities. These structures have been known to be vulnerable to Alzheimer's disease (AD) pathology and are critical in cognitive processes such as memory and executive functioning. Comparing to asymptomatic subjects, results are more mixed in patients with metabolic disorders such as type 2 diabetes and obesity, which might be attributed to a multifactorial mechanism. Taken together, neuroimaging, especially MRI, is beneficial to reveal early abnormalities in cerebral structure and function in insulin-resistant brain, providing important evidence to unravel the underlying neuronal substrate that reflects the cognitive decline in IR. EVIDENCE LEVEL: 5 TECHNICAL EFFICACY: Stage 2.
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Affiliation(s)
- Ying Cui
- Department of Radiology, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, China
| | - Tian-Yu Tang
- Jiangsu Key Laboratory of Molecular and Functional Imaging, Department of Radiology, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, China
| | - Chun-Qiang Lu
- Department of Radiology, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, China
| | - Shenghong Ju
- Department of Radiology, Zhongda Hospital, School of Medicine, Southeast University, Nanjing, China
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Tapias-Merino E, De Hoyos-Alonso MDC, Contador-Castillo I, Rodríguez-Sánchez E, Sanz-Cuesta T, Becerro-Muñoz CM, Hernández-Gallego J, Vega-Quiroga S, Bermejo-Pareja F. Cardiovascular risk in subjects over 55 years of age and cognitive performance after five years. NEDICES2-RISK study. Study protocol. PLoS One 2022; 17:e0274589. [PMID: 36441718 PMCID: PMC9704606 DOI: 10.1371/journal.pone.0274589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Accepted: 09/11/2021] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Cognitive impairment and dementia have a high prevalence among the elderly and cause significant socio-economic impact. Any progress in their prevention can benefit millions of people. Current data indicate that cardiovascular risk (CVR) factors increase the risk of developing cognitive impairment and dementia. Using models to calculate CVR specific for the Spanish population can be useful for estimating the risk of cognitive deterioration since research on this topic is limited and predicting this risk is mainly based on outcomes in the Anglo-Saxon population. The aim of this study is to assess the relationship between CVR in the Spanish population, as calculated using the FRESCO (Función de Riesgo Española de acontecimientos Coronarios y Otros) and REGICOR (Registre Gironí del Cor) CVR tables, and the change in cognitive performance at a 5-year follow-up. METHODS Design: Observational, analytic, prospective cohort study, with a 5-year follow-up. Ambit: Population. Population: Subjects 55 to 74 years of age, included in the NEDICES2 (2014-2017) cohort, who did not present dementia and had undergone the neuropsychological evaluation (N = 962). Variables: Exposure factors (CVR factors and estimated risk according to the CVR predictors by REGICOR and FRESCO), dependent variables (change in the score of the brief neuropsychological test in the study NEDICES2 five years after the first evaluation), and clinical and socio-demographic variables. Statistical analysis: Analysis of data quality. Descriptive analysis: socio-demographic and clinical variables of subjects. Bivariate analysis: relationship between basal CVR and change in neuropsychological tests. Multivariate analysis: relationship between basal CVR and change in neuropsychological tests adjusted by co-variables. Analysis and comparison of the reliable change in independent samples. DISCUSSION The Spanish population can benefit from determining if individuals with high CVR, which is commonly detected in usual clinical practice, will present decreased cognitive performance compared to subjects with lower CVR. This study can affect how to address CVR factors and the design of effective prevention strategies for cognitive deterioration. TRIAL REGISTRATION Clinicaltrials.gov, NCT03925844.
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Affiliation(s)
- Ester Tapias-Merino
- Healthcare Centre Comillas, Gerencia Asistencial Atención Primaria, Servicio Madrileño de Salud, Madrid, Spain
- Spanish Research Network for Preventive Activities and Health Promotion in Primary Care (REDIAPP), Spain
- Research Institute Hospital 12 de Octubre i+12, Group for Research in Health Services and Results, Madrid, Spain
- Faculty of Medicine, Department of Medicine, Complutense University of Madrid, Madrid, Spain
- * E-mail:
| | | | - Israel Contador-Castillo
- Faculty of Psychology, Department of Basic Psychology, Psychobiology and Methodology of Behavioral Sciences, University of Salamanca, Salamanca, Spain
| | - Emiliano Rodríguez-Sánchez
- Spanish Research Network for Preventive Activities and Health Promotion in Primary Care (REDIAPP), Spain
- Research Unit for Primary Health Care, Institute for Biomedical Research of Salamanca (IBSAL), Castilla y León Health Service, Salamanca, Spain
- Department of Medicine, University of Salamanca, Salamanca, Spain
| | - Teresa Sanz-Cuesta
- Research Unit, Gerencia Asistencial de Atención Primaria (GAAP), Madrid, Spain
- Health Services Research on Chronic Patients Network (REDISSEC), Instituto Salud Carlos III, Madrid, Spain
| | - Concepción María Becerro-Muñoz
- Spanish Research Network for Preventive Activities and Health Promotion in Primary Care (REDIAPP), Spain
- Research Unit for Primary Health Care, Institute for Biomedical Research of Salamanca (IBSAL), Castilla y León Health Service, Salamanca, Spain
| | - Jesús Hernández-Gallego
- Faculty of Medicine, Department of Medicine, Complutense University of Madrid, Madrid, Spain
- Department of Neurology, Hospital Universitario 12 de Octubre (Madrid, Spain)
- Research Institute Hospital 12 de Octubre i+12, Neurosciences Group CIBERNED, Madrid, Spain
| | - Saturio Vega-Quiroga
- Healthcare Centre Arévalo, Gerencia Asistencial Atención Primaria, Sanidad de Castilla y León, Arévalo, Spain
| | - Félix Bermejo-Pareja
- Department of Neurology, Hospital Universitario 12 de Octubre (Madrid, Spain)
- Research Institute Hospital 12 de Octubre i+12, Neurosciences Group CIBERNED, Madrid, Spain
- Consulting Neurologist, Hospital 12 de Octubre, Madrid, Spain
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Wang T, Huynh K, Giles C, Mellett NA, Duong T, Nguyen A, Lim WLF, Smith AAT, Olshansky G, Cadby G, Hung J, Hui J, Beilby J, Watts GF, Chatterjee P, Martins I, Laws SM, Bush AI, Rowe CC, Villemagne VL, Ames D, Masters CL, Taddei K, Doré V, Fripp J, Arnold M, Kastenmüller G, Nho K, Saykin AJ, Baillie R, Han X, Martins RN, Moses EK, Kaddurah‐Daouk R, Meikle PJ. APOE ε2 resilience for Alzheimer's disease is mediated by plasma lipid species: Analysis of three independent cohort studies. Alzheimers Dement 2022; 18:2151-2166. [PMID: 35077012 PMCID: PMC9787288 DOI: 10.1002/alz.12538] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Revised: 10/19/2021] [Accepted: 10/25/2021] [Indexed: 01/31/2023]
Abstract
INTRODUCTION The apolipoprotein E (APOE) genotype is the strongest genetic risk factor for late-onset Alzheimer's disease. However, its effect on lipid metabolic pathways, and their mediating effect on disease risk, is poorly understood. METHODS We performed lipidomic analysis on three independent cohorts (the Australian Imaging, Biomarkers and Lifestyle [AIBL] flagship study, n = 1087; the Alzheimer's Disease Neuroimaging Initiative [ADNI] 1 study, n = 819; and the Busselton Health Study [BHS], n = 4384), and we defined associations between APOE ε2 and ε4 and 569 plasma/serum lipid species. Mediation analysis defined the proportion of the treatment effect of the APOE genotype mediated by plasma/serum lipid species. RESULTS A total of 237 and 104 lipid species were associated with APOE ε2 and ε4, respectively. Of these 68 (ε2) and 24 (ε4) were associated with prevalent Alzheimer's disease. Individual lipid species or lipidomic models of APOE genotypes mediated up to 30% and 10% of APOE ε2 and ε4 treatment effect, respectively. DISCUSSION Plasma lipid species mediate the treatment effect of APOE genotypes on Alzheimer's disease and as such represent a potential therapeutic target.
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Pal L, Morgan K, Santoro NF, Manson JE, Taylor HS, Miller VM, Brinton EA, Lobo R, Neal-Perry G, Cedars MI, Harman SM, James TT, Gleason CE. Cardiometabolic measures and cognition in early menopause - Analysis of baseline data from a randomized controlled trial. Maturitas 2022; 162:58-65. [PMID: 35617770 PMCID: PMC10089771 DOI: 10.1016/j.maturitas.2022.04.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2021] [Revised: 01/31/2022] [Accepted: 04/06/2022] [Indexed: 10/18/2022]
Abstract
OBJECTIVE The relationships between cardiometabolic indices and cognition were examined in recently menopausal women. METHODS Cross-sectional analysis of baseline data from the KEEPS (Kronos Early Estrogen Prevention Study)-Cognitive ancillary study (n = 621). Cognitive performance was assessed by the Modified Mini Mental Status (3MS) score (primary outcome). Physical cardiometabolic indices included body mass index (BMI), waist circumference (WC), waist-to-hip ratio (WHR), and blood pressure (BP). Biochemical cardiometabolic indices included serum levels of high sensitivity C-reactive protein (hs-CRP), total cholesterol (TC), low-density lipoprotein (LDL-C), high-density lipoprotein (HDL-C), non-HDL (non-HDL-C), triglycerides (TG), fasting serum glucose (FSG), and insulin resistance (HOMA-IR). Socio-demographic variables included age, race/ethnicity, education, and lifestyle (physical activity, smoking). Central adiposity was defined as WC > 88 cm (>35 in) and WHR > 0.8. Separate stepwise multivariable analyses (GLM, ordinal logistic regression and logistic regression) assessed relationships between 3MS scores (as continuous, in tertiles and dichotomized at 90 respectively) with the measures of central adiposity (predictor variables); socio-demographic variables (age, time since menopause, race, educational status and lifestyle) and cardiometabolic variables (BP, lipids, FSG, HOMA-IR and hs-CRP) were examined as covariates. The final multivariable models included time since menopause, race, ethnicity, educational status, strenuous exercise, BMI ≥30 kg/m2, non-HDL-C and hs-CRP as covariates. Due to the high collinearity between the two indices of central adiposity, within each analytic strategy, separate models examined the respective associations of WC > 88 cm and WHR > 0.8 with 3MS score. RESULTS On adjusted analyses, indices of central adiposity were independent predictors of significantly lower 3MS scores (p < 0.05). Consistency in this relationship was observed across the three different multivariable regression analytic approaches (GLM, ordinal and logistic regression). CONCLUSIONS Among recently menopausal women, WC > 88 cm and WHR > 0.8 were associated with significantly lower cognitive function, as reflected by lower 3MS scores. The mechanisms that might explain the observed negative implications of central adiposity for cognitive function warrant further study.
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Affiliation(s)
- Lubna Pal
- Department of Obstetrics, Gynecology & Reproductive Sciences, Yale University School of Medicine, New Haven, CT, United States.
| | - Kelly Morgan
- SSM Health Dean Medical Group, Madison, WI, United States
| | - Nanette F Santoro
- Department of Obstetrics, Gynecology, University of Colorado, Denver, United States
| | - JoAnn E Manson
- Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, United States
| | - Hugh S Taylor
- Department of Obstetrics, Gynecology & Reproductive Sciences, Yale University School of Medicine, New Haven, CT, United States
| | - Virginia M Miller
- Department of Surgery, Mayo Clinic, United States; Department of Physiology and Biomedical Engineering, Mayo Clinic, United States
| | | | - Rogerio Lobo
- Department of Obstetrics and Gynecology, Columbia University, United States
| | - Genevieve Neal-Perry
- Department of Obstetrics and Gynecology, The University of North Carolina at Chapel Hill, United States
| | - Marcelle I Cedars
- Department of Obstetrics, Gynecology and Reproductive Sciences, UCSF, United States
| | - S Mitchell Harman
- Kronos Longevity Research Institute and the Phoenix Veterans Administration Health Care System, Phoenix, AZ, United States
| | - Taryn T James
- Division of Geriatrics, Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison Geriatric Research Education and Clinical Center (GRECC), United States
| | - Carey E Gleason
- Division of Geriatrics, Department of Medicine, University of Wisconsin School of Medicine and Public Health, Madison Geriatric Research Education and Clinical Center (GRECC), United States
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Brain J, Tully PJ, Turnbull D, Tang E, Greene L, Beach S, Siervo M, Stephan BCM. Risk factors for dementia in the context of cardiovascular disease: A protocol of an overview of reviews. PLoS One 2022; 17:e0271611. [PMID: 35862400 PMCID: PMC9302739 DOI: 10.1371/journal.pone.0271611] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2022] [Accepted: 07/01/2022] [Indexed: 11/18/2022] Open
Abstract
Background
Dementia is a major public health priority. Although there is abundant evidence of an association between dementia and poor cardiovascular health, findings have been inconsistent and uncertain in identifying which factors increase dementia risk in those with cardiovascular disease. Indeed, multiple variables including sociodemographic, economic, health, lifestyle and education may indicate who is at higher vs. lower dementia risk and could be used in prediction modelling. Therefore, the aim of this review is to synthesise evidence on the key risk factors for dementia in those with a history of cardiovascular disease.
Methods
This is an overview of reviews protocol, registered on PROSPERO (CRD42021265363). Four electronic databases including MEDLINE, EMBASE, PsycINFO, and the Cochrane Database of Systematic Reviews will be searched. Studies will be included if they are systematic reviews and/or meta-analyses that have investigated the risk of incident dementia (all-cause and subtypes including Alzheimer’s disease and vascular dementia) in people with a history of coronary heart disease, heart failure, atrial fibrillation, hypertension, hyperlipidaemia, and vascular stiffness. Study selection will be completed by two independent researchers according to the eligibility criteria, and conflicts resolved by a third reviewer. References will be exported into Covidence for title and abstract sifting, full-text review, and data extraction. Methodological quality will be assessed using the AMSTAR-2 criteria and confidence of evidence will be assessed using the GRADE classification. This overview of reviews will follow PRISMA guidelines. If there is sufficient homogeneity in the data, the results will be pooled, and a meta-analysis conducted to determine the strength of association between each risk factor and incident all-cause dementia and its subtypes for each cardiovascular diagnoses separately.
Discussion
We will create a comprehensive summary of the key risk factors linking cardiovascular diseases to risk of incident dementia. This knowledge is essential for informing risk predictive model development as well as the development of risk reduction and prevention strategies.
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Affiliation(s)
- Jacob Brain
- Institute of Mental Health, School of Medicine, University of Nottingham, Innovation Park, Jubilee Campus, Nottingham, United Kingdom
- Freemasons Foundation Centre for Men’s Health, Discipline of Medicine, School of Psychology, The University of Adelaide, Adelaide, Australia
| | - Phillip J. Tully
- Faculty of Medicine and Health, School of Psychology, University of New England, Armidale, Australia
| | - Deborah Turnbull
- Freemasons Foundation Centre for Men’s Health, Discipline of Medicine, School of Psychology, The University of Adelaide, Adelaide, Australia
| | - Eugene Tang
- Population Health Sciences Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, United Kingdom
| | - Leanne Greene
- Clinical Trials Unit, College of Medicine and Health, University of Exeter, St Luke’s Campus, Exeter, United Kingdom
- * E-mail:
| | - Sarah Beach
- University of Nottingham Libraries, University of Nottingham, King’s Meadow Campus, Nottingham, United Kingdom
| | - Mario Siervo
- Institute of Mental Health, School of Medicine, University of Nottingham, Innovation Park, Jubilee Campus, Nottingham, United Kingdom
| | - Blossom C. M. Stephan
- Institute of Mental Health, School of Medicine, University of Nottingham, Innovation Park, Jubilee Campus, Nottingham, United Kingdom
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Sharma K, Basu-Ray I, Sayal N, Vora A, Bammidi S, Tyagi R, Modgil S, Bali P, Kaur P, Goyal AK, Pal DK, Arvind H, Jindal K, Garg V, Matyal B, Thakur N, Chhikara A, Kaur N, Maanju P, Bhatia KS, Pannu V, Gupta V, Malik N, Malik R, Kumar R, Kaur R, Bhatt V, Bhalla A, Mohanty M, Singh G, Sharma SK, Sivapuram MS, Mathur D, Khanra D, Anand A. Yoga as a Preventive Intervention for Cardiovascular Diseases and Associated Comorbidities: Open-Label Single Arm Study. Front Public Health 2022; 10:843134. [PMID: 35769774 PMCID: PMC9234218 DOI: 10.3389/fpubh.2022.843134] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2021] [Accepted: 04/27/2022] [Indexed: 11/20/2022] Open
Abstract
Aim Common Yoga Protocol (CYP) is a standardized yoga protocol authored by experts from all over the world under the aegis of the Ministry of AYUSH, Ayurveda, Yoga and Naturopathy, Unani, Siddha, Sowa Rigpa and Homeopathy (AYUSH). The potential of CYP can be determined as a cost-effective lifestyle modification to prevent the risk of developing cardiovascular diseases (CVD). Methods In this prospective trial, we compared the effect of CYP at baseline and after 1 month. A total of 374 yoga-naïve participants performed CYP under the supervision of experienced trainers. Physiological [body mass index (BMI), blood pressure, percent oxygen saturation], biochemical (fasting blood glucose and lipid profile), and neurocognitive parameters were measured before and after the intervention. Results At day 30 of yoga practice, serum levels of low-density lipoprotein (LDL), total cholesterol (TC), and high-density lipoprotein (HDL) were found significantly improved as compared to the baseline levels observed at the time of enrollment. Similarly, the lipid profile was also obtained from experienced trainers and found to be significantly different from those of yoga-naïve volunteers. When the intervention was compared between the healthy yoga-naïve participants with yoga-naïve participants suffering from medical issues, it was found that cholesterol profile improved significantly in the healthy-naive group as compared to the diseased group (hypertension, diabetes, underwent surgery, and CVD). Conclusion These results highlight the need for further research to better understand the effects of yoga on the primary prevention of CVD.
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Affiliation(s)
- Kaushal Sharma
- Neuroscience Research Lab, Department of Neurology, Post-graduate Institute of Medical Education and Research, Chandigarh, India
- Centre for Systems Biology and Bioinformatics, Panjab University, Chandigarh, India
| | - Indranill Basu-Ray
- Department of Cardiology, St. Francis Hospital, Memphis, TN, United States
- Department of Cardiology, All India Institute of Medical Sciences, Virbhadra Marg, Rishikesh, India
- Department of Cardiology, Swami Vivekananda Yoga Anusandhana Samsthana, Union Territory (SVYASA), Bengaluru, India
| | - Natasha Sayal
- Neuroscience Research Lab, Department of Neurology, Post-graduate Institute of Medical Education and Research, Chandigarh, India
| | - Ariana Vora
- Department of Physical Medicine and Rehabilitation, Massachusetts General Hospital, Boston, MA, United States
| | - Sridhar Bammidi
- Neuroscience Research Lab, Department of Neurology, Post-graduate Institute of Medical Education and Research, Chandigarh, India
| | - Rahul Tyagi
- Neuroscience Research Lab, Department of Neurology, Post-graduate Institute of Medical Education and Research, Chandigarh, India
| | - Shweta Modgil
- Neuroscience Research Lab, Department of Neurology, Post-graduate Institute of Medical Education and Research, Chandigarh, India
- Department of Zoology, Panjab University, Chandigarh, India
| | - Parul Bali
- Neuroscience Research Lab, Department of Neurology, Post-graduate Institute of Medical Education and Research, Chandigarh, India
- Department of Biophysics, Panjab University, Chandigarh, India
| | - Paramvir Kaur
- Neuroscience Research Lab, Department of Neurology, Post-graduate Institute of Medical Education and Research, Chandigarh, India
| | - Atul Kumar Goyal
- Neuroscience Research Lab, Department of Neurology, Post-graduate Institute of Medical Education and Research, Chandigarh, India
- Department of Otolaryngology, Post-graduate Institute of Medical Education and Research, Chandigarh, India
| | - Deepak Kumar Pal
- Neuroscience Research Lab, Department of Neurology, Post-graduate Institute of Medical Education and Research, Chandigarh, India
| | - Harshita Arvind
- Neuroscience Research Lab, Department of Neurology, Post-graduate Institute of Medical Education and Research, Chandigarh, India
| | - Khushboo Jindal
- Department of Bioinformatics, Jaypee University, Shimla, India
| | - Vincy Garg
- Department of Cardiology, Swami Vivekananda Yoga Anusandhana Samsthana, Union Territory (SVYASA), Bengaluru, India
| | - Bandu Matyal
- Department of Zoology, Panjab University, Chandigarh, India
| | - Neha Thakur
- Department of Zoology, Panjab University, Chandigarh, India
| | - Amit Chhikara
- Department of Physical Education, Panjab University, Chandigarh, India
| | - Navneet Kaur
- Department of Physical Education, Panjab University, Chandigarh, India
| | - Preety Maanju
- Department of Physical Education, Panjab University, Chandigarh, India
| | | | | | | | - Neeru Malik
- Department of Physical Education, Dev Samaj College of Education, Chandigarh, India
| | - Rakesh Malik
- Department of Physical Education and Sports, Panjab University, Chandigarh, India
| | | | - Ravneet Kaur
- Department of Zoology, Panjab University, Chandigarh, India
| | - Vinod Bhatt
- Neuroscience Research Lab, Department of Neurology, Post-graduate Institute of Medical Education and Research, Chandigarh, India
| | - Ashish Bhalla
- Department of Internal Medicine, Post-graduate Institute of Medical Education and Research, Chandigarh, India
| | - Manju Mohanty
- Department of Neurosurgery, Post-graduate Institute of Medical Education and Research, Chandigarh, India
| | - Gurmeet Singh
- Department of Physical Education, Panjab University, Chandigarh, India
| | - Suresh Kumar Sharma
- Centre for Systems Biology and Bioinformatics, Panjab University, Chandigarh, India
- Department of Statistics, Panjab University, Chandigarh, India
| | - Madhava Sai Sivapuram
- Dr. Pinnamaneni Siddhartha Institute of Medical Sciences and Research Foundation, Vijayawada, India
| | - Deepali Mathur
- School of Biotechnology, KIIT University, Bhubaneswar, India
| | - Dibbendu Khanra
- Department of Cardiology, All India Institute of Medical Sciences, Virbhadra Marg, Rishikesh, India
| | - Akshay Anand
- Neuroscience Research Lab, Department of Neurology, Post-graduate Institute of Medical Education and Research, Chandigarh, India
- *Correspondence: Akshay Anand
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Lin F, Pa J, Karim R, Hodis HN, Han SD, Henderson VW, St John JA, Mack WJ. Subclinical carotid artery atherosclerosis and cognitive function in older adults. Alzheimers Res Ther 2022; 14:63. [PMID: 35526057 PMCID: PMC9077926 DOI: 10.1186/s13195-022-00997-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2021] [Accepted: 04/02/2022] [Indexed: 12/01/2022]
Abstract
Background The combined effects of increased life expectancy and the considerable number of persons reaching old age will magnify the dementia epidemic in the USA. Demonstration that subclinical atherosclerosis precedes and is associated with cognitive impairment suggests a modifiable risk factor for age-associated cognitive impairment and dementia. The purpose of this study is to determine whether subclinical atherosclerosis as measured by carotid artery intima-media thickness (CIMT) is associated with changes in cognitive function over time in older adults. Methods This study combined longitudinal data from three clinical trials conducted between 2000 and 2013: the B-Vitamin Atherosclerosis Intervention Trial (BVAIT), the Women’s Isoflavone Soy Health (WISH) trial, and the Early versus Late Intervention Trial with Estradiol (ELITE). Participants were recruited from the general population in the Greater Los Angeles area and were free of cardiovascular disease and diabetes; no cognitive or psychiatric exclusion criteria were specified. The same standardized protocol for ultrasound image acquisition and measurement of CIMT was used in all trials. CIMT measurements performed at baseline and 2.5 years were used in these analyses. Cognitive function was assessed at baseline and 2.5 years using a battery of 14 standardized cognitive tests. All clinical trials were conducted at the University of Southern California Atherosclerosis Research Unit, Los Angeles, and had at least 2.5 years of cognitive follow-up. Results A total of 308 men and 1187 women, mean age of 61 years, were included in the combined longitudinal dataset for the primary analysis. No associations were found between CIMT and cognitive function at baseline or at 2.5 years. There was a weak inverse association between CIMT measured at baseline and change in global cognition assessed over 2.5 years (β (SE) = − 0.056 (0.028) units per 0.1 mm CIMT, 95% CI − 0.110, − 0.001, p = 0.046). No associations between CIMT at baseline and changes in executive function, verbal memory, or visual memory were found. Conclusions In this sample of healthy older adults, our findings suggest an association between subclinical atherosclerosis and change in global cognitive function over 2.5 years. Stronger associations were observed longitudinally over 2.5 years than cross-sectionally. When analysis was stratified by age group (<65 and ≥65 years old), the inverse association remained statistically significant for participants in the older age group. Subclinical atherosclerosis of the carotid artery may be a modifiable correlate of cognitive decline in middle and older age. Trial registration BVAIT, NCT00114400. WISH, NCT00118846. ELITE, NCT00114517.
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Affiliation(s)
- Felice Lin
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Soto Street Building Suite 202Y, 2001 North Soto St, Los Angeles, CA, 90089, USA.
| | - Judy Pa
- Mark and Mary Stevens Neuroimaging and Informatics Institute, University of Southern California, Los Angeles, CA, USA
| | - Roksana Karim
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Soto Street Building Suite 202Y, 2001 North Soto St, Los Angeles, CA, 90089, USA.,Atherosclerosis Research Unit, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Howard N Hodis
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Soto Street Building Suite 202Y, 2001 North Soto St, Los Angeles, CA, 90089, USA.,Atherosclerosis Research Unit, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.,Department of Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - S Duke Han
- Department of Family Medicine, University of Southern California, Los Angeles, CA, USA.,Department of Neurology, University of Southern California, Los Angeles, CA, USA.,Department of Psychology, University of Southern California, Los Angeles, CA, USA.,School of Gerontology, University of Southern California, Los Angeles, CA, USA
| | - Victor W Henderson
- Departments of Epidemiology and Population Health and of Neurology and Neurological Sciences, Stanford University, Stanford, CA, USA
| | - Jan A St John
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Soto Street Building Suite 202Y, 2001 North Soto St, Los Angeles, CA, 90089, USA.,Atherosclerosis Research Unit, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Wendy J Mack
- Department of Population and Public Health Sciences, Keck School of Medicine, University of Southern California, Soto Street Building Suite 202Y, 2001 North Soto St, Los Angeles, CA, 90089, USA.,Atherosclerosis Research Unit, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA.,School of Gerontology, University of Southern California, Los Angeles, CA, USA
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Raisi-Estabragh Z, M'Charrak A, McCracken C, Biasiolli L, Ardissino M, Curtis EM, Aung N, Suemoto CK, Mackay C, Suri S, Nichols TE, Harvey NC, Petersen SE, Neubauer S. Associations of cognitive performance with cardiovascular magnetic resonance phenotypes in the UK Biobank. Eur Heart J Cardiovasc Imaging 2022; 23:663-672. [PMID: 33987659 PMCID: PMC9016359 DOI: 10.1093/ehjci/jeab075] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2021] [Accepted: 04/07/2021] [Indexed: 01/22/2023] Open
Abstract
AIMS Existing evidence suggests links between brain and cardiovascular health. We investigated associations between cognitive performance and cardiovascular magnetic resonance (CMR) phenotypes in the UK Biobank, considering a range of potential confounders. METHODS AND RESULTS We studied 29 763 participants with CMR and cognitive testing, specifically, fluid intelligence (FI, 13 verbal-numeric reasoning questions), and reaction time (RT, a timed pairs matching exercise); both were considered continuous variables for modelling. We included the following CMR metrics: left and right ventricular (LV and RV) volumes in end-diastole and end-systole, LV/RV ejection fractions, LV/RV stroke volumes, LV mass, and aortic distensibility. Multivariable linear regression models were used to estimate the association of each CMR measure with FI and RT, adjusting for age, sex, smoking, education, deprivation, diabetes, hypertension, high cholesterol, prior myocardial infarction, alcohol intake, and exercise level. We report standardized beta-coefficients, 95% confidence intervals, and P-values adjusted for multiple testing. In this predominantly healthy cohort (average age 63.0 ± 7.5 years), better cognitive performance (higher FI, lower RT) was associated with larger LV/RV volumes, higher LV/RV stroke volumes, greater LV mass, and greater aortic distensibility in fully adjusted models. There was some evidence of non-linearity in the relationship between FI and LV end-systolic volume, with reversal of the direction of association at very high volumes. Associations were consistent for men and women and in different ages. CONCLUSION Better cognitive performance is associated with CMR measures likely representing a healthier cardiovascular phenotype. These relationships remained significant after adjustment for a range of cardiometabolic, lifestyle, and demographic factors, suggesting possible involvement of alternative disease mechanisms.
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Affiliation(s)
- Zahra Raisi-Estabragh
- Centre for Advanced Cardiovascular Imaging, William Harvey Research Institute, NIHR Barts Biomedical Research Centre, Queen Mary University of London, Charterhouse Square, London EC1M 6BQ, UK
- Barts Heart Centre, St Bartholomew’s Hospital, Barts Health NHS Trust, London EC1A 7BE, UK
| | - Amine M'Charrak
- Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, National Institute for Health Research Oxford Biomedical Research Centre, Oxford University Hospitals NHS Foundation Trust, Oxford, OX3 9DU, UK
| | - Celeste McCracken
- Centre for Advanced Cardiovascular Imaging, William Harvey Research Institute, NIHR Barts Biomedical Research Centre, Queen Mary University of London, Charterhouse Square, London EC1M 6BQ, UK
- Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, National Institute for Health Research Oxford Biomedical Research Centre, Oxford University Hospitals NHS Foundation Trust, Oxford, OX3 9DU, UK
| | - Luca Biasiolli
- Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, National Institute for Health Research Oxford Biomedical Research Centre, Oxford University Hospitals NHS Foundation Trust, Oxford, OX3 9DU, UK
| | | | - Elizabeth M Curtis
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
| | - Nay Aung
- Centre for Advanced Cardiovascular Imaging, William Harvey Research Institute, NIHR Barts Biomedical Research Centre, Queen Mary University of London, Charterhouse Square, London EC1M 6BQ, UK
- Barts Heart Centre, St Bartholomew’s Hospital, Barts Health NHS Trust, London EC1A 7BE, UK
| | - Claudia K Suemoto
- Division of Geriatrics, Department of Internal Medicine, University of Sao Paulo Medical School, Sao Paulo, Brazil
| | - Clare Mackay
- Department of Psychiatry, University of Oxford, Oxford, UK
| | - Sana Suri
- Department of Psychiatry, University of Oxford, Oxford, UK
| | - Thomas E Nichols
- Nuffield Department of Population Health, Oxford Big Data Institute, Li Ka Shing Centre for Health Information and Discovery, University of Oxford, Oxford OX3 7LF, UK
- Nuffield Department of Clinical Neurosciences, Wellcome Centre for Integrative Neuroimaging, FMRIB, University of Oxford, Oxford OX3 9DU, UK
| | - Nicholas C Harvey
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
- NIHR Southampton Biomedical Research Centre, University of Southampton and University Hospital Southampton NHS Foundation Trust, Southampton, UK
| | - Steffen E Petersen
- Centre for Advanced Cardiovascular Imaging, William Harvey Research Institute, NIHR Barts Biomedical Research Centre, Queen Mary University of London, Charterhouse Square, London EC1M 6BQ, UK
- Barts Heart Centre, St Bartholomew’s Hospital, Barts Health NHS Trust, London EC1A 7BE, UK
| | - Stefan Neubauer
- Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, National Institute for Health Research Oxford Biomedical Research Centre, Oxford University Hospitals NHS Foundation Trust, Oxford, OX3 9DU, UK
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Zhu Y, Liu X, Zhu R, Zhao J, Wang Q. Lipid levels and the risk of dementia: A dose-response meta-analysis of prospective cohort studies. Ann Clin Transl Neurol 2022; 9:296-311. [PMID: 35202496 PMCID: PMC8935316 DOI: 10.1002/acn3.51516] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Revised: 01/18/2022] [Accepted: 01/23/2022] [Indexed: 12/15/2022] Open
Abstract
OBJECTIVES We performed a dose-response meta-analysis to estimate the association between lipid profiles with the risk of dementia and the potential differences according to the subtype of dementia based on prospective studies. METHODS We searched PubMed, Embase and Web of Science for relevant articles and performed a meta-analysis. We applied fixed or random-effects models to calculate pooled relative risk (RR) with their 95% confidence intervals (CI). The dose-response relationship was assessed by restricted cubic spline. RESULTS Twenty-five prospective studies comprising 362,443 participants and 20,121 cases were included in the final analysis. We found that increased risk of all-cause dementia could be predicted by elevated total cholesterol (TC) (RR = 1.13, 95% CI 1.04-1.22). When looking at dementia subtypes, we also observed high TC and triglycerides (TG) may increase the future risk of Alzheimer's disease (AD), with a pooled RR of 1.13 (95% CI: 1.06-1.21) and 1.10 (95% CI: 1.04-1.15) respectively. Moreover, a dose-response analysis revealed a linear association between TC or TG and the risk of AD, with a pooled RR of 1.09 (95% CI: 1.02-1.16) and 1.12 (95% CI: 1.05-1.21) for per 3-mmol/L increment in TC and TG, respectively. CONCLUSIONS Current evidence suggest that every 3-mmol/L increase in blood TC or TG is linearly associated with a 9% or 12% increase in RR of AD, supporting the notion that high TC and TG levels appear to play a causal role in the development of AD.
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Affiliation(s)
- Ying Zhu
- Department of Neurology, The First Hospital of China Medical University, Shenyang, China
| | - Xu Liu
- Department of Neurology, The First Hospital of China Medical University, Shenyang, China
| | - Ruixia Zhu
- Department of Neurology, The First Hospital of China Medical University, Shenyang, China
| | - Jingjing Zhao
- Department of Neurology, The First Hospital of China Medical University, Shenyang, China
| | - Qianwen Wang
- Department of Neurology, The First Hospital of China Medical University, Shenyang, China
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Annual Incidence of Dementia from 2003 to 2018 in Metropolitan Seoul, Korea: A Population-Based Study. J Clin Med 2022; 11:jcm11030819. [PMID: 35160270 PMCID: PMC8836574 DOI: 10.3390/jcm11030819] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Revised: 01/20/2022] [Accepted: 01/29/2022] [Indexed: 12/10/2022] Open
Abstract
National dementia plans were applied in dementia support centers established in Seoul, Korea between 2007 and 2009. However, the annual incidence rates of dementia in Seoul have not been reported. We investigated this annual incidence and the characteristics of incident cases from 2003 to 2018. The customized research database of the Korean National Health Insurance Services was used. The annual crude and age-standardized incidence of dementia patients and their characteristics were analyzed. This study analyzed 108,596 incident dementia cases aged ≥60 years. The incidence rate increased from 2003 to 2011, including a rapid increment from 2007 to 2011. From 2011 to 2018, the crude (age-standardized) incidence per 105 person-years decreased from 641.51 (577.12) to 448.26 (361.23). The proportion of incident dementia cases was highest in the highest income group every year. However, the proportion of incident dementia cases in the lowest income group increased from 10.4% in 2003 to 25.8% in 2011. The annual incidence rate of dementia showed a sharp increase immediately after 2007, the year dementia support centers began to be introduced, and then stabilized after 2011. The characteristics of incident dementia cases have changed, including the proportion in the low-income group.
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Loera-Valencia R, Ismail MAM, Goikolea J, Lodeiro M, Mateos L, Björkhem I, Puerta E, Romão MA, Gomes CM, Merino-Serrais P, Maioli S, Cedazo-Minguez A. Hypercholesterolemia and 27-Hydroxycholesterol Increase S100A8 and RAGE Expression in the Brain: a Link Between Cholesterol, Alarmins, and Neurodegeneration. Mol Neurobiol 2021; 58:6063-6076. [PMID: 34449045 PMCID: PMC8639576 DOI: 10.1007/s12035-021-02521-8] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Accepted: 08/04/2021] [Indexed: 12/20/2022]
Abstract
Alterations in cholesterol metabolism in the brain have a major role in the physiology of Alzheimer's disease (AD). Oxysterols are cholesterol metabolites with multiple implications in memory functions and in neurodegeneration. Previous studies have shown detrimental effects of cholesterol metabolites in neurons, but its effect in glial cells is unknown. We used a high-fat/high-cholesterol diet in mice to study the effects of hypercholesterolemia over the alarmin S100A8 cascade in the hippocampus. Using CYP27Tg, a transgenic mouse model, we show that the hypercholesterolemia influence on the brain is mediated by the excess of 27-hydroxycholesterol (27-OH), a cholesterol metabolite. We also employed an acute model of 27-OH intraventricular injection in the brain to study RAGE and S100A8 response. We used primary cultures of neurons and astrocytes to study the effect of high levels of 27-OH over the S100A8 alarmin cascade. We report that a high-fat/high-cholesterol diet leads to an increase in S100A8 production in the brain. In CYP27Tg, we report an increase of S100A8 and its receptor RAGE in the hippocampus under elevated 27-OH in the brain. Using siRNA, we found that 27-OH upregulation of RAGE in astrocytes and neurons is mediated by the nuclear receptor RXRγ. Silencing RXRγ in neurons prevented 27-OH-mediated upregulation of RAGE. These results show that S100A8 alarmin and RAGE respond to high levels of 27-OH in the brain in both neurons and astrocytes through RXRγ. Our study supports the notion that 27-OH mediates detrimental effects of hypercholesterolemia to the brain via alarmin signaling.
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Affiliation(s)
- Raúl Loera-Valencia
- Division of Neurogeriatrics, Department of Neurobiology Care Sciences and Society, Center for Alzheimer Research, Karolinska Institutet, Stockholm, Sweden
| | - Muhammad-Al-Mustafa Ismail
- Division of Neurogeriatrics, Department of Neurobiology Care Sciences and Society, Center for Alzheimer Research, Karolinska Institutet, Stockholm, Sweden
| | - Julen Goikolea
- Division of Neurogeriatrics, Department of Neurobiology Care Sciences and Society, Center for Alzheimer Research, Karolinska Institutet, Stockholm, Sweden
| | - Maria Lodeiro
- Division of Neurogeriatrics, Department of Neurobiology Care Sciences and Society, Center for Alzheimer Research, Karolinska Institutet, Stockholm, Sweden
| | - Laura Mateos
- Division of Neurogeriatrics, Department of Neurobiology Care Sciences and Society, Center for Alzheimer Research, Karolinska Institutet, Stockholm, Sweden
| | - Ingemar Björkhem
- Division of Clinical Chemistry, Department of Laboratory Medicine, Karolinska University Hospital, Huddinge, Sweden
| | - Elena Puerta
- Division of Neurogeriatrics, Department of Neurobiology Care Sciences and Society, Center for Alzheimer Research, Karolinska Institutet, Stockholm, Sweden
- Department of Pharmacology and Toxicology, University of Navarra, Pamplona, Spain
| | - Mariana A. Romão
- Biosystems and Integrative Sciences Institute, Faculdade de Ciências, Universidade de Lisboa, 1749-016 Lisboa, Portugal
- Departamento de Química E Bioquímica, Faculdade de Ciências, Universidade de Lisboa, 1749-016 Lisboa, Portugal
| | - Cláudio M. Gomes
- Biosystems and Integrative Sciences Institute, Faculdade de Ciências, Universidade de Lisboa, 1749-016 Lisboa, Portugal
- Departamento de Química E Bioquímica, Faculdade de Ciências, Universidade de Lisboa, 1749-016 Lisboa, Portugal
| | - Paula Merino-Serrais
- Division of Neurogeriatrics, Department of Neurobiology Care Sciences and Society, Center for Alzheimer Research, Karolinska Institutet, Stockholm, Sweden
- Laboratorio Cajal de Circuitos Corticales (CTB), Universidad Politécnica de Madrid, Madrid, Spain
- Departamento de Neurobiología Funcional y de Sistemas, Instituto Cajal, CSIC, Madrid, Spain
| | - Silvia Maioli
- Division of Neurogeriatrics, Department of Neurobiology Care Sciences and Society, Center for Alzheimer Research, Karolinska Institutet, Stockholm, Sweden
| | - Angel Cedazo-Minguez
- Division of Neurogeriatrics, Department of Neurobiology Care Sciences and Society, Center for Alzheimer Research, Karolinska Institutet, Stockholm, Sweden
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Dutta S, Rahman S, Ahmad R, Kumar T, Dutta G, Banerjee S, Abubakar AR, Rowaiye AB, Dhingra S, Ravichandiran V, Kumar S, Sharma P, Haque M, Charan J. An evidence-based review of neuronal cholesterol role in dementia and statins as a pharmacotherapy in reducing risk of dementia. Expert Rev Neurother 2021; 21:1455-1472. [PMID: 34756134 DOI: 10.1080/14737175.2021.2003705] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
INTRODUCTION Dementia is a progressive neurodegenerative disorder impairing memory and cognition. Alzheimer's Disease, followed by vascular dementia - the most typical form. Risk factors for vascular dementia include diabetes, cardiovascular disease, hyperlipidemia. Lipids' levels are significantly associated with vascular changes in the brain. AREAS COVERED The present article reviews the cholesterol metabolism in the brain, which includes: the synthesis, transport, storage, and elimination process. Additionally, it reviews the role of cholesterol in the pathogenesis of dementia and statin as a therapeutic intervention in dementia. In addition to the above, it further reviews evidence in support of as well as against statin therapy in dementia, recent updates of statin pharmacology, and demerits of use of statin pharmacotherapy. EXPERT OPINION Amyloid-β peptides and intraneuronal neurofibrillary tangles are markers of Alzheimer's disease. Evidence shows cholesterol modulates the functioning of enzymes associated with Amyloid-β peptide processing and synthesis. Lowering cholesterol using statin may help prevent or delay the progression of dementia. This paper reviews the role of statin in dementia and recommends extensive future studies, including genetic research, to obtain a precise medication approach for patients with dementia.
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Affiliation(s)
- Siddhartha Dutta
- Department of Pharmacology, All India Institute of Medical Sciences, Rajkot, Gujrat, India
| | - Sayeeda Rahman
- School of Medicine, American University of Integrative Sciences, Bridgetown, Barbados
| | - Rahnuma Ahmad
- Department of Physiology, Medical College for Women and Hospital, Dhaka, Bangladesh
| | - Tarun Kumar
- Department of Pharmacology, All India Institute of Medical Sciences (AIIMS), Jodhpur, Rajasthan, India
| | - Gitashree Dutta
- Department of Community Medicine, Neigrihms, Shillong, India
| | | | - Abdullahi Rabiu Abubakar
- Department of Pharmacology and Therapeutics, Faculty of Pharmaceutical Sciences, Bayero University, Kano, Nigeria
| | - Adekunle Babajide Rowaiye
- Department of Pharmaceutical Microbiology and Biotechnology, Faculty of Pharmaceutical Sciences, Nnamdi Azikiwe University, Awka, Nigeria
| | - Sameer Dhingra
- Department of Pharmacy Practice, National Institute of Pharmaceutical Education and Research (NIPER), Hajipur, India
| | - Velayutham Ravichandiran
- Department of Natural Products, National Institute of Pharmaceutical Education and Research-Kolkata, Kolkata, India
| | - Santosh Kumar
- Department of Periodontology and Implantology, Karnavati University, Gandhinagar, India
| | - Paras Sharma
- Department of Pharmacognosy, BVM College of Pharmacy, Gwalior, India
| | - Mainul Haque
- Unit of Pharmacology, Faculty of Medicine and Defence Health, Universiti Pertahanan Nasional Malaysia (National Defence University of Malaysia), Kem Perdana Sungai Besi, Kuala Lumpur, Malaysia
| | - Jaykaran Charan
- Department of Pharmacology, All India Institute of Medical Sciences, Rajkot, Gujrat, India
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Ozawa H, Miyazawa T, Miyazawa T. Effects of Dietary Food Components on Cognitive Functions in Older Adults. Nutrients 2021; 13:2804. [PMID: 34444965 PMCID: PMC8398286 DOI: 10.3390/nu13082804] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2021] [Revised: 08/10/2021] [Accepted: 08/13/2021] [Indexed: 12/21/2022] Open
Abstract
Population aging has recently been an important issue as the number of elderly people is growing worldwide every year, and the extension of social security costs is financially costly. The increase in the number of elderly people with cognitive decline is a serious problem related to the aging of populations. Therefore, it is necessary to consider not only physical care but also cognitive patterns in the future care of older adults. Since food contains a variety of bioactive substances, dietary patterns may help improve age-related cognitive decline. However, the relationship between cognitive function and individual food components remains ambiguous as no clear efficacy or mechanism has been confirmed. Against this background, this review summarizes previous reports on the biological process of cognitive decline in the elderly and the relationship between individual compounds in foods and cognitive function, as well as the role of individual components of food in cognitive function, in the following order: lipids, carotenoids, vitamins, phenolic compounds, amino acids, peptides, and proteins. Based on the research presented in this review, a proper diet that preserves cognitive function has the potential to improve age-related cognitive decline, Alzheimer's disease, and Parkinson's disease. Hopefully, this review will help to trigger the development of new foods and technologies that improve aging and cognitive functions and extend the healthy life span.
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Affiliation(s)
| | | | - Teruo Miyazawa
- New Industry Creation Hatchery Center (NICHe), Tohoku University, Sendai 980-8579, Japan; (H.O.); (T.M.)
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40
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Liu L, Li H, Iyer H, Liu AJ, Zeng Y, Ji JS. Apolipoprotein E Induced Cognitive Dysfunction: Mediation Analysis of Lipids and Glucose Biomarkers in an Elderly Cohort Study. Front Aging Neurosci 2021; 13:727289. [PMID: 34483892 PMCID: PMC8415114 DOI: 10.3389/fnagi.2021.727289] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Accepted: 07/20/2021] [Indexed: 11/13/2022] Open
Abstract
INTRODUCTION Prior evidence suggested Apolipoprotein E (APOE), lipids, and glucose metabolism may act through the same pathways on the pathogenesis of Alzheimer's disease (AD). METHODS This prospective study used data from the Chinese Longitudinal Healthy Longevity Study. We tested the associations of APOE genotype (ε2ε2, ε2ε3, ε2ε4, ε3ε3, ε3ε4, and ε4ε4) and cognitive function using generalized estimating equations (GEE). We examined for possible mediation and effect modification by lipids and glucose level in this association. RESULTS APOE ε2 showed significant direct protective effect and indirect harmful effect through TC on cognitive function. Abnormal lipids or glucose levels were not consistently associated with cognitive dysfunction in our study. We did not detect significant indirect effects through lipids for APOE ε4 or any indirect effects through glucose. DISCUSSION These findings suggested complicated relationships among APOE, lipids, glucose, and cognitive function. Further study can make validations in other populations.
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Affiliation(s)
- Linxin Liu
- Environmental Research Center, Duke Kunshan University, Suzhou, China
| | - Huichu Li
- Harvard TH Chan School of Public Health, Harvard University, Boston, MA, United States
| | - Hari Iyer
- Harvard TH Chan School of Public Health, Harvard University, Boston, MA, United States
- Division of Population Sciences, Dana-Farber Cancer Institute, Boston, MA, United States
| | - Andy J. Liu
- Duke Department of Neurology, Duke University School of Medicine, Durham, NC, United States
| | - Yi Zeng
- Center for Healthy Aging and Development Studies, National School of Development, Peking University, Beijing, China
- Duke Center for the Study of Aging and Human Development, Duke Medical School, Durham, NC, United States
| | - John S. Ji
- Vanke School of Public Health, Tsinghua University, Beijing, China
- Global Health Research Center, Duke Kunshan University, Suzhou, China
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Koponen S, Nykänen I, Savela RM, Välimäki T, Suominen AL, Schwab U. Inadequate Intake of Energy and Nutrients Is Common in Older Family Caregivers. Nutrients 2021; 13:nu13082763. [PMID: 34444923 PMCID: PMC8400852 DOI: 10.3390/nu13082763] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Revised: 08/10/2021] [Accepted: 08/11/2021] [Indexed: 12/28/2022] Open
Abstract
The aim of this study was to investigate the nutritional status, determinants of nutritional status, and adequacy of energy and nutrient intake of older family caregivers (FC). Nutritional status was measured using the Mini Nutritional Assessment (MNA), plasma albumin, plasma pre-albumin, and blood hemoglobin concentrations. Dietary intake was assessed with a three-day food record. Comorbidity (B −0.283, 95% CI: −0.492, −0.073), quality of life (B 0.045, 95% CI: 0.018, 0.072) and energy intake (B 0.001, 95% CI: 0.000, 0.002) were significantly associated with the MNA scores of the older FCs (n = 125). It was common for FCs to have lower than recommended intakes of energy and several nutrients, independent of the risk of malnutrition assessed by the MNA. Over half of the FCs had inadequate intake of protein, vitamin A, folate, and fiber, and 25–40% of the FCs had a low intake of vitamin D, vitamin E, thiamine, magnesium, iron, and selenium. It is important to follow both the nutritional status and dietary intake of older FCs regularly to find those with lower than recommended nutrient intake and to avoid poor nutritional status and its adverse effects hampering their ability to serve as FCs.
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Affiliation(s)
- Sohvi Koponen
- Institution of Public Health and Clinical Nutrition, School of Medicine, University of Eastern Finland, P.O. Box 1627, FI-70211 Kuopio, Finland; (I.N.); (U.S.)
- Department of Medicine, Endocrinology and Clinical Nutrition, Kuopio University Hospital, P.O. Box 100, FI-70029 Kuopio, Finland
- Correspondence:
| | - Irma Nykänen
- Institution of Public Health and Clinical Nutrition, School of Medicine, University of Eastern Finland, P.O. Box 1627, FI-70211 Kuopio, Finland; (I.N.); (U.S.)
| | - Roosa-Maria Savela
- Department of Nursing Science, University of Eastern Finland, P.O. Box 1627, FI-70211 Kuopio, Finland; (R.-M.S.); (T.V.)
| | - Tarja Välimäki
- Department of Nursing Science, University of Eastern Finland, P.O. Box 1627, FI-70211 Kuopio, Finland; (R.-M.S.); (T.V.)
| | - Anna Liisa Suominen
- Institution of Dentistry, School of Medicine, University of Eastern Finland, P.O. Box 1627, FI-70211 Kuopio, Finland;
- Department of Oral and Maxillofacial Diseases, Kuopio University Hospital, P.O. Box 100, FI-70029 Kuopio, Finland
| | - Ursula Schwab
- Institution of Public Health and Clinical Nutrition, School of Medicine, University of Eastern Finland, P.O. Box 1627, FI-70211 Kuopio, Finland; (I.N.); (U.S.)
- Department of Medicine, Endocrinology and Clinical Nutrition, Kuopio University Hospital, P.O. Box 100, FI-70029 Kuopio, Finland
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Iwagami M, Qizilbash N, Gregson J, Douglas I, Johnson M, Pearce N, Evans S, Pocock S. Blood cholesterol and risk of dementia in more than 1·8 million people over two decades: a retrospective cohort study. THE LANCET HEALTHY LONGEVITY 2021; 2:e498-e506. [DOI: 10.1016/s2666-7568(21)00150-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Revised: 06/10/2021] [Accepted: 06/16/2021] [Indexed: 01/27/2023]
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43
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Zeki Al Hazzouri A, Jawadekar N, Grasset L, Kaiser P, Kezios K, Calonico S, Glymour MM, Hirsch C, Arnold AM, Varadhan R, Opoodden MC. Statins and cognitive decline in the Cardiovascular Health Study: A comparison of different analytical approaches. J Gerontol A Biol Sci Med Sci 2021; 77:994-1001. [PMID: 34331536 DOI: 10.1093/gerona/glab220] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Despite their well-established benefits for the prevention of cardiovascular disease, robust evidence on the effects of statins on cognition is largely inconclusive. We apply various study designs and analytical approaches to mimic randomized controlled trial (RCT) effects from observational data. METHODS We used observational data from 5,580 participants enrolled in the Cardiovascular Health Study from 1989/90 to 1999/2000. We conceptualized the cohort as an overlapping sequence of non-randomized trials. We compared multiple selection (eligible population, prevalent users, new-users) and analytic approaches (multivariable adjustment, inverse probability treatment weights, propensity score matching) to evaluate the association between statin use and 5-year change in global cognitive function, assessed using the Modified Mini-Mental State (3MS) examination. RESULTS When comparing prevalent users to non-users (N=2,772), statin use was associated with slower cognitive decline over 5 years (adjusted annual change in 3MSE = 0.34 points/year; 95% CI:0.05;0.63). Compared to prevalent user design, estimates from new user designs (e.g. comparing eligible statin initiators to non-initiators) were attenuated showing either null or negative association, though not significant. For example, in a propensity score-matched sample of statin-eligible individuals (N=454), annual 3MS change comparing statin initiators to non-initiators was -0.21 points/year (95% CI:-0.81;0.39). CONCLUSIONS The association of statin use and cognitive decline is attenuated towards the null when using rigorous analytical approaches that more closely mimic RCTs. Point estimates, even within the same study, may vary depending on the analytical methods used. Further studies that leverage natural or quasi experiments around statin use are needed to replicate our findings.
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Affiliation(s)
| | - Neal Jawadekar
- Department of Epidemiology, Mailman School of Public Health, Columbia University
| | - Leslie Grasset
- University of Bordeaux, Inserm, Bordeaux Population Health Research Center, Team VINTAGE, UMR 1219, F-33000 Bordeaux, France; Inserm, CIC1401-EC, F-33000 Bordeaux, France
| | - Paulina Kaiser
- College of Public Health & Human Sciences, Oregon State University, Corvallis, Oregon
| | - Katrina Kezios
- Department of Epidemiology, Mailman School of Public Health, Columbia University
| | - Sebastian Calonico
- Department of Health Policy and Management, Mailman School of Public Health, Columbia University
| | - M Maria Glymour
- Department of Epidemiology & Biostatistics, University of California San Francisco
| | - Calvin Hirsch
- Center for Healthcare Policy and Research, Division of General Medicine, University of California Davis Medical Center, Sacramento, California
| | - Alice M Arnold
- Department of Biostatistics, School of Public Health, University of Washington, Seattle, Washington
| | - Ravi Varadhan
- Division of Biostatistics and Bioinformatics, Sidney Kimmel Cancer Care Center, Johns Hopkins University School of Medicine
| | - Michelle C Opoodden
- Department of Epidemiology and Population Health, Stanford University, Stanford, CA
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44
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Di Cesare F, Tenori L, Meoni G, Gori AM, Marcucci R, Giusti B, Molino-Lova R, Macchi C, Pancani S, Luchinat C, Saccenti E. Lipid and metabolite correlation networks specific to clinical and biochemical covariate show differences associated with sexual dimorphism in a cohort of nonagenarians. GeroScience 2021; 44:1109-1128. [PMID: 34324142 PMCID: PMC9135919 DOI: 10.1007/s11357-021-00404-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2021] [Accepted: 06/13/2021] [Indexed: 12/26/2022] Open
Abstract
This study defines and estimates the metabolite-lipidic component association networks constructed from an array of 20 metabolites and 114 lipids identified and quantified via NMR spectroscopy in the serum of a cohort of 355 Italian nonagenarians and ultra-nonagenarian. Metabolite-lipid association networks were built for men and women and related to an array of 101 clinical and biochemical parameters, including the presence of diseases, bio-humoral parameters, familiarity diseases, drugs treatments, and risk factors. Different connectivity patterns were observed in lipids, branched chains amino acids, alanine, and ketone bodies, suggesting their association with the sex-related and sex-clinical condition-related intrinsic metabolic changes. Furthermore, our results demonstrate, using a holistic system biology approach, that the characterization of metabolic structures and their dynamic inter-connections is a promising tool to shed light on the dimorphic pathophysiological mechanisms of aging at the molecular level.
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Affiliation(s)
- Francesca Di Cesare
- Magnetic Resonance Center (CERM), University of Florence, Sesto Fiorentino, Italy
| | - Leonardo Tenori
- Magnetic Resonance Center (CERM), University of Florence, Sesto Fiorentino, Italy.,Department of Chemistry "Ugo Schiff", University of Florence, Sesto Fiorentino, Italy
| | | | - Anna Maria Gori
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy.,Atherothrombotic Unit, Careggi University Hospital, Florence, Italy
| | - Rossella Marcucci
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy.,Atherothrombotic Unit, Careggi University Hospital, Florence, Italy
| | - Betti Giusti
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy.,Atherothrombotic Unit, Careggi University Hospital, Florence, Italy
| | | | - Claudio Macchi
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy.,IRCCS Fondazione Don Carlo Gnocchi, Florence, Italy
| | | | - Claudio Luchinat
- Magnetic Resonance Center (CERM), University of Florence, Sesto Fiorentino, Italy.,Department of Chemistry "Ugo Schiff", University of Florence, Sesto Fiorentino, Italy.,Consorzio Interuniversitario Risonanze Magnetiche di Metallo Proteine (CIRMMP), Sesto Fiorentino, Italy
| | - Edoardo Saccenti
- Laboratory of Systems and Synthetic Biology, Wageningen University & Research, Wageningen, the Netherlands.
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George KM, Gilsanz P, Peterson RL, Barnes LL, DeCarli CS, Mayeda ER, Mungas DM, Whitmer RA. Impact of Cardiovascular Risk Factors in Adolescence, Young Adulthood, and Midlife on Late-Life Cognition: Study of Healthy Aging in African Americans. J Gerontol A Biol Sci Med Sci 2021; 76:1692-1698. [PMID: 34387334 DOI: 10.1093/gerona/glab143] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2021] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Midlife cardiovascular risk factors (CVRFs) increase risk of dementia. Black Americans experience an elevated prevalence of CVRFs and dementia. However, little is known of how CVRFs prior to midlife affect late-life cognition. We examined CVRFs in adolescence, young adulthood, and midlife with late-life cognition in the Study of Healthy Aging in African Americans (STAR). METHOD STAR assesses cognitive aging among 764 Black Americans aged ≥50 (mean age = 69; SD = 9; range = 53-95). Participants' body mass index, blood pressure, glucose, and total cholesterol were collected during Multiphasic Health Checkups (MHC; 1964-1985). At STAR baseline (2018-2019), executive function, verbal episodic memory, and semantic memory were measured using the Spanish and English Neuropsychological Assessment Scales. Linear regression models examined associations between CVRFs and cognition adjusting for demographics and years since MHC. RESULTS At MHC, 36% of participants had 1 CVRF and 26% had ≥2. Twenty-two percent of participants were adolescents (age 12-20), 62% young adults (age 21-34), and 16% midlife adults (age 35-56). Overweight/obesity was not associated with cognition. Hypertension was associated with worse executive function (β [95% CI]: -0.14 [-0.28, -0.0003]) and verbal episodic memory (β [95% CI]: -0.22 [-0.37, -0.07]) compared to normotension. Diabetes was associated with worse executive function (β [95% CI]: -0.43 [-0.83, -0.03]). Having ≥2 CVRFs (vs 0) was associated with worse executive function (β [95% CI]: -0.19 [-0.34, -0.03]) and verbal episodic memory (β [95% CI]: -0.25 [-0.41, -0.08]). Adolescents with hypertension had lower late-life executive function compared to normotensive adolescents (β [95% CI]: -0.39 [-0.67, -0.11]). Young adulthood hypertension (β [95% CI]: -0.29 [-0.49, -0.09]) and midlife hyperlipidemia (β [95% CI]: -0.386 [-0.70, -0.02]) were associated with lower verbal episodic memory. CONCLUSIONS Among Black Americans, life-course CVRFs were associated with poorer executive function and verbal episodic memory emphasizing the importance of cardiovascular health on the aging brain.
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Affiliation(s)
- Kristen M George
- Department of Neurology, University of California Davis School of Medicine, Sacramento, USA
| | - Paola Gilsanz
- Kaiser Permanente Division of Research, Oakland, California, USA
| | - Rachel L Peterson
- Department of Neurology, University of California Davis School of Medicine, Sacramento, USA
| | - Lisa L Barnes
- Rush Alzheimer's Disease Center, Rush Medical College, Chicago, Illinois, USA
| | - Charles S DeCarli
- Department of Neurology, University of California Davis School of Medicine, Sacramento, USA
| | - Elizabeth Rose Mayeda
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, USA
| | - Dan M Mungas
- Department of Neurology, University of California Davis School of Medicine, Sacramento, USA
| | - Rachel A Whitmer
- Department of Neurology, University of California Davis School of Medicine, Sacramento, USA.,Kaiser Permanente Division of Research, Oakland, California, USA.,Department of Public Health Sciences, University of California Davis School of Medicine, Sacramento, USA
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Aschwanden D, Aichele S, Ghisletta P, Terracciano A, Kliegel M, Sutin AR, Brown J, Allemand M. Predicting Cognitive Impairment and Dementia: A Machine Learning Approach. J Alzheimers Dis 2021; 75:717-728. [PMID: 32333585 DOI: 10.3233/jad-190967] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
BACKGROUND Efforts to identify important risk factors for cognitive impairment and dementia have to date mostly relied on meta-analytic strategies. A comprehensive empirical evaluation of these risk factors within a single study is currently lacking. OBJECTIVE We used a combined methodology of machine learning and semi-parametric survival analysis to estimate the relative importance of 52 predictors in forecasting cognitive impairment and dementia in a large, population-representative sample of older adults. METHODS Participants from the Health and Retirement Study (N = 9,979; aged 50-98 years) were followed for up to 10 years (M = 6.85 for cognitive impairment; M = 7.67 for dementia). Using a split-sample methodology, we first estimated the relative importance of predictors using machine learning (random forest survival analysis), and we then used semi-parametric survival analysis (Cox proportional hazards) to estimate effect sizes for the most important variables. RESULTS African Americans and individuals who scored high on emotional distress were at relatively highest risk for developing cognitive impairment and dementia. Sociodemographic (lower education, Hispanic ethnicity) and health variables (worse subjective health, increasing BMI) were comparatively strong predictors for cognitive impairment. Cardiovascular factors (e.g., smoking, physical inactivity) and polygenic scores (with and without APOEɛ4) appeared less important than expected. Post-hoc sensitivity analyses underscored the robustness of these results. CONCLUSIONS Higher-order factors (e.g., emotional distress, subjective health), which reflect complex interactions between various aspects of an individual, were more important than narrowly defined factors (e.g., clinical and behavioral indicators) when evaluated concurrently to predict cognitive impairment and dementia.
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Affiliation(s)
| | - Stephen Aichele
- Faculty of Psychology and Educational Sciences, University of Geneva, Switzerland.,Colorado State University, Fort Collins, CO, USA
| | - Paolo Ghisletta
- Faculty of Psychology and Educational Sciences, University of Geneva, Switzerland.,Swiss Distance University Institute, Switzerland.,Swiss National Centre of Competence in Research LIVES - Overcoming Vulnerability: Life Course Perspectives, Universities of Lausanne and of Geneva, Switzerland
| | | | - Matthias Kliegel
- Faculty of Psychology and Educational Sciences, University of Geneva, Switzerland.,Swiss National Centre of Competence in Research LIVES - Overcoming Vulnerability: Life Course Perspectives, Universities of Lausanne and of Geneva, Switzerland
| | | | | | - Mathias Allemand
- University of Zurich, Zurich, Switzerland.,University Research Priority Program Dynamics of Healthy Aging, University of Zurich, Switzerland
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Strategies and cognitive reserve to preserve lexical production in aging. GeroScience 2021; 43:1725-1765. [PMID: 33970414 PMCID: PMC8492841 DOI: 10.1007/s11357-021-00367-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2021] [Accepted: 04/09/2021] [Indexed: 10/28/2022] Open
Abstract
In the absence of any neuropsychiatric condition, older adults may show declining performance in several cognitive processes and among them, in retrieving and producing words, reflected in slower responses and even reduced accuracy compared to younger adults. To overcome this difficulty, healthy older adults implement compensatory strategies, which are the focus of this paper. We provide a review of mainstream findings on deficient mechanisms and possible neurocognitive strategies used by older adults to overcome the deleterious effects of age on lexical production. Moreover, we present findings on genetic and lifestyle factors that might either be protective or risk factors of cognitive impairment in advanced age. We propose that "aging-modulating factors" (AMF) can be modified, offering prevention opportunities against aging effects. Based on our review and this proposition, we introduce an integrative neurocognitive model of mechanisms and compensatory strategies for lexical production in older adults (entitled Lexical Access and Retrieval in Aging, LARA). The main hypothesis defended in LARA is that cognitive aging evolves heterogeneously and involves complementary domain-general and domain-specific mechanisms, with substantial inter-individual variability, reflected at behavioral, cognitive, and brain levels. Furthermore, we argue that the ability to compensate for the effect of cognitive aging depends on the amount of reserve specific to each individual which is, in turn, modulated by the AMF. Our conclusion is that a variety of mechanisms and compensatory strategies coexist in the same individual to oppose the effect of age. The role of reserve is pivotal for a successful coping with age-related changes and future research should continue to explore the modulating role of AMF.
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Orland Y, Beeri MS, Levy S, Israel A, Ravona-Springer R, Segev S, Elkana O. Physical fitness mediates the association between age and cognition in healthy adults. Aging Clin Exp Res 2021; 33:1359-1366. [PMID: 32557334 DOI: 10.1007/s40520-020-01621-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Accepted: 06/03/2020] [Indexed: 11/28/2022]
Abstract
BACKGROUND Physical fitness is an important contributor to healthy aging that improves cognition. Older adults who engage in cardiorespiratory fitness activities show less cognitive decline. AIMS To examine whether physical fitness acts as a potential protective mechanism shielding against the negative associations between age and cognition. Specifically, we examined whether physical fitness mediates the relationship between age and processing speed. METHODS 114 (M = 63.80, SD = 10.63) senior executives completed a computerized cognitive battery composed of four processing speed tasks. Level of physical fitness was assessed on a treadmill stress test and reported in metabolic equivalents (METs). RESULTS Older age was associated with slower processing speed (r = 0.25, p = 0.007), whereas greater physical fitness was associated with faster processing speed (r = -0.30, p = 0.001). Path analysis indicated that the association between age and processing speed was fully mediated by the level of physical fitness (Indirect effect: β = 0.10, p = 0.008; Direct effect: β = 0.16, p = 0.20). CONCLUSIONS AND DISCUSSION The findings indicate that physical fitness is a strong mediator of the relationship between age and processing speed and imply that physical fitness makes a major contribution to cognitive reserve during the aging process. The results may suggest that the decrease in physical fitness during aging may partially account for slower cognitive processing.
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Affiliation(s)
- Yaara Orland
- Behavioral Sciences, Academic College of Tel Aviv-Yaffo, Rabeinu Yerucham St., P.O.Box 8401, 68114, Yaffo, Israel
| | - Michal Schnaider Beeri
- The Joseph Sagol Neuroscience Center, Sheba Medical Center, Tel Hashomer, Ramat Gan, Israel
- Department of Psychiatry, The Icahn School of Medicine at Mount Sinai Hospital, New York, NY, USA
| | - Sigal Levy
- Behavioral Sciences, Academic College of Tel Aviv-Yaffo, Rabeinu Yerucham St., P.O.Box 8401, 68114, Yaffo, Israel
| | - Ariel Israel
- The Joseph Sagol Neuroscience Center, Sheba Medical Center, Tel Hashomer, Ramat Gan, Israel
| | | | - Shlomo Segev
- Institute of Medical Screening, Sheba Medical Center, Tel Hashomer, Ramat Gan, Israel
| | - Odelia Elkana
- Behavioral Sciences, Academic College of Tel Aviv-Yaffo, Rabeinu Yerucham St., P.O.Box 8401, 68114, Yaffo, Israel.
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Peterson RL, George KM, Gilsanz P, Ackley S, Mayeda ER, Glymour MM, Mungas DM, DeCarli C, Whitmer RA. Racial/Ethnic Disparities in Young Adulthood and Midlife Cardiovascular Risk Factors and Late-life Cognitive Domains: The Kaiser Healthy Aging and Diverse Life Experiences (KHANDLE) Study. Alzheimer Dis Assoc Disord 2021; 35:99-105. [PMID: 34006727 PMCID: PMC8862715 DOI: 10.1097/wad.0000000000000436] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2020] [Accepted: 12/13/2020] [Indexed: 11/25/2022]
Abstract
BACKGROUND Midlife cardiovascular risk factors (CVRF) increase dementia risk. Less is known about whether CVRF identified before midlife impact late-life cognition in diverse populations. METHODS Linear regression models examined hypertension, hyperlipidemia, and overweight/obesity at ages 30 to 59 with late-life executive function, semantic memory, verbal episodic memory, and global cognition in a cohort of Asians, blacks, Latinos, and whites (n=1127; mean age=75.8, range=65 to 98). Models adjusted for age at CVRF, age at cognitive assessment, sex, race/ethnicity, participant education, and parental education. RESULTS Overall, 34% had 1 CVRF at ages 30 to 59; 19% had 2+. Blacks (26%) and Latinos (23%) were more likely to have 2+ CVRF than Asians (14%) or whites (13%). Having 2+ CVRF was associated with lower global cognition [β=-0.33; 95% confidence interval (CI)=-0.45, -0.21], executive function (β=-0.26; 95% CI=-0.39, -0.13), verbal episodic memory (β=-0.34; 95% CI=-0.48, -0.20), and semantic memory (β=-0.20; 95% CI=-0.33, -0.07). Interaction by age (P=0.06) indicated overweight/obesity was negatively associated with executive function at ages 30 to 39 but not at ages 40 to 59. Race/ethnic-specific effects showed disparities in CVRF prevalence impact population disparities in late-life cognition. CONCLUSION Being overweight/obese in early adulthood and having 2+ CVRF in early adulthood/midlife are modifiable targets to redress racial/ethnic disparities in cognitive impairment and dementia.
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Affiliation(s)
| | | | - Paola Gilsanz
- Kaiser Permanente Northern California Division of Research, Oakland
| | - Sarah Ackley
- University of California San Francisco School of Medicine, San Francisco
| | - Elizabeth R Mayeda
- University of California Los Angeles School of Public Health, Los Angeles, CA
| | - M M Glymour
- University of California San Francisco School of Medicine, San Francisco
| | - Dan M Mungas
- University of California Davis School of Medicine, Davis
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50
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Abstract
PURPOSE OF REVIEW The current review evaluates the recent literature on the impact of metabolic dysfunction in human cognition, focusing on epidemiological studies and meta-analyses of these. RECENT FINDINGS Worldwide around 50 million people live with dementia, a number projected to triple by 2050. Recent reports from the Lancet Commission suggest that 40% of dementia cases may be preventable primarily by focusing on well established metabolic dysfunction components and cardiovascular risk factors. SUMMARY There is robust evidence that type 2 diabetes and midlife hypertension increase risk of dementia in late life. Obesity and elevated levels of LDL cholesterol in midlife probably increase risk of dementia, but further research is needed in these areas. Physical activity, diet, alcohol, and smoking might also influence the risk of dementia through their effect on metabolic dysfunction. A key recommendation is to be ambitious about prevention, focusing on interventions to promote healthier lifestyles combating metabolic dysfunction. Only comprehensive multidomain and staff-requiring interventions are however efficient to maintain or improve cognition in at-risk individuals and will be unrealistic economic burdens for most societies to implement. Therefore, a risk score that identifies high-risk individuals will enable a targeted early intensive intervention toward those high-risk individuals that will benefit the most from a prevention against cardiovascular risk factors and metabolic dysfunction.
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Affiliation(s)
| | | | - Ruth Frikke-Schmidt
- Department of Clinical Biochemistry, Rigshospitalet
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
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