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Huang Y, Yan MQ, Zhou D, Chen CL, Feng YQ. The U-shaped association of non-high-density lipoprotein cholesterol with all-cause and cardiovascular mortality in general adult population. Front Cardiovasc Med 2023; 10:1065750. [PMID: 36844732 PMCID: PMC9945232 DOI: 10.3389/fcvm.2023.1065750] [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: 10/10/2022] [Accepted: 01/13/2023] [Indexed: 02/11/2023] Open
Abstract
Background Non-high-density lipoprotein cholesterol (non-HDL-C) has been associated with atherosclerosis. However, the association between non-HDL-C and mortality in adult population remains unclear. We intended to investigate the association of non-HDL-C with cardiovascular and all-cause mortality using national representative data. Methods The study included 32,405 participants from the National Health and Nutrition Examination Survey (1999-2014). Mortality outcomes were ascertained by linkage to National Death Index records through December 31, 2015. Multivariable-adjusted Cox regression models were used to evaluate hazard ratio (HR) and 95% confidence interval (CI) of non-HDL-C concentrations in quintiles. Two-piecewise linear regression and restricted cubic spline analyzes were performed to test dose-response associations. Results After a median follow-up of 98.40 months, 2,859 (8.82%) all-cause and 551 (1.70%) cardiovascular deaths occurred. Compared with the highest group, the multivariable-adjusted hazard ratio (HR) of the first quintile for all-cause mortality was 1.53 (95%CI, 1.35-1.74). Higher non-HDL-C above a cutoff value of 4.9 mmol/L was related with cardiovascular mortality (HR = 1.33, 95%CI, 1.13-1.57). A U-shaped relationship between non-HDL-C and all-cause mortality was found in spline analysis with a cutoff value around 4 mmol/L. Similar results in subgroups analyzes were found among male, non-white population, participants who were not taking lipid-lowering drugs, and with body mass index (BMI) <25 kg/m2. Conclusion Our findings suggest a U-shaped association between non-HDL-C and mortality among adult population.
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Affiliation(s)
- Yu Huang
- School of Medicine, South China University of Technology, Guangzhou, China,Department of Cardiology, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China
| | - Meng Qi Yan
- Department of Cardiology, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China
| | - Dan Zhou
- Department of Cardiology, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China
| | - Chao Lei Chen
- Department of Cardiology, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China
| | - Ying Qing Feng
- School of Medicine, South China University of Technology, Guangzhou, China,Department of Cardiology, Guangdong Provincial People’s Hospital (Guangdong Academy of Medical Sciences), Southern Medical University, Guangzhou, China,*Correspondence: Ying Qing Feng,
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2
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Cheang I, Zhu X, Lu X, Shi S, Tang Y, Yue X, Liao S, Yao W, Zhou Y, Zhang H, Li Y, Li X. Association of Remnant Cholesterol and Non-High Density Lipoprotein Cholesterol with Risk of Cardiovascular Mortality Among US General Population. Heliyon 2022; 8:e10050. [PMID: 36033296 PMCID: PMC9399160 DOI: 10.1016/j.heliyon.2022.e10050] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Revised: 05/08/2022] [Accepted: 07/19/2022] [Indexed: 11/28/2022] Open
Abstract
Background There are strong association between remnant cholesterol (RC)/non-high density lipoprotein cholesterol (NHDL-C) and increase cardiovascular (CV) risk. The aim of present study was to investigate the association between target lipid parameters (RC and NHDL-C) and the risk of CV mortality in general population. Methods Data set from an open database—National Health and Nutrition Examination Surveys (NHANES) 2003–2014 were extracted (n = 14992). Kaplan-Meier, multivariable COX regression, and restricted cubic spline (RCS) parameters. Results Compared to the lowest quartile, RC (adjusted hazard ratio [HR] = 1.63 95%CI 1.05–2.52, P for trend = 0.037) and triglycerides (TG: Model 3: HR = 1.69 95%CI 1.10–2.60, P for trend = 0.049) in the highest quartile were independently associated with the increased cardiovascular mortality, while NHDL-C and apolipoprotein B (ApoB) in adjusted models did not show association (P for trend >0.05). In addition, RCS regression demonstrated that RC (P for nonlinearity = 0.011) and TG (P for nonlinearity = 0.010) levels had a similar J-shape association with CV mortality. Threshold effect analysis showed that when RC ≤ 29.3 mg/dL, the level of RC and CV mortality risk were positively correlated. Conclusions Our findings suggest high RC levels are associated with an increased risk of CV mortality, which support that the integration of TG-rich lipoproteins parameters in risk assessment might optimize the identification and management of selected population.
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Affiliation(s)
- Iokfai Cheang
- The First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, China
| | - Xu Zhu
- The First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, China
| | - Xinyi Lu
- The First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, China
| | - Shi Shi
- The First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, China
| | - Yuan Tang
- The First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, China
| | - Xin Yue
- The First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, China
| | - Shengen Liao
- The First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, China
| | - Wenming Yao
- The First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, China
| | - Yanli Zhou
- The First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, China
| | - Haifeng Zhang
- The First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, China
- The Affiliated Suzhou Hospital of Nanjing Medical University, Suzhou Municipal Hospital, Gusu School, Nanjing Medical University, Suzhou, 215000, China
| | - Yanxiu Li
- The First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, China
- Corresponding author.
| | - Xinli Li
- The First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, China
- Corresponding author.
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Zhang Q, Zhang M, Chen Y, Cao Y, Dong G. Nonlinear Relationship of Non-High-Density Lipoprotein Cholesterol and Cognitive Function in American Elders: A Cross-Sectional NHANES Study (2011-2014). J Alzheimers Dis 2022; 86:125-134. [PMID: 35001890 DOI: 10.3233/jad-215250] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Serum non-high-density lipoprotein-cholesterol (non-HDL-C) levels may be associated with cognitive function. OBJECTIVE The objective of this study was to evaluate the association between non-HDL-C and cognitive function among American elders. METHODS We used data from the 2011 to 2014 U.S. National Health and Nutrition Examination Survey (NHANES). A total of 3,001 participants aged over 60 years were enrolled in our analysis. The cognitive function was evaluated with the word learning subtest from the Consortium to Establish a Registry for Alzheimer's disease (CERAD W-L), the Animal Fluency Test (AFT), and the digit symbol substitution test (DSST). We also created a composite cognitive z-score to represent a global cognition. We applied multivariate linear regression analyses to estimate the associations between non-HDL-C levels and all domains of cognitive function. Further, the generalized additive model and the smooth curve were conducted to investigate the dose-response relationship between non-HDL-C and global cognition. RESULTS Serum non-HDL-C was positively associated with global cognition (β= 0.20, 95% CI: 0.11, 0.28), AFT score (β= 0.54, 95% CI: 0.33, 0.76), and DSST score (β= 1.13, 95% CI: 0.56, 1.69) after fully adjusted. While non-HDL-C was not related to CERAD W-L score. In addition, an inverted U-shape curve was observed in the dose-response relationship between non-HDL-C and global cognition (p for non-linearity < 0.001). CONCLUSION Serum non-HDL-C is positively and nonlinearly associated with cognitive function among American older adults. Maintaining serum cholesterol levels at an appropriate range may be helpful to the cognitive health of the elderly.
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Affiliation(s)
- Qiaoyang Zhang
- Department of Psychology, The Affiliated Changzhou No. 2 People's Hospital of Nanjing Medical University, Changzhou, Jiangsu Province, China
| | - Min Zhang
- Department of Neurology, The Affiliated Changzhou No. 2 People's Hospital of Nanjing Medical University, Changzhou, Jiangsu Province, China
| | - Yun Chen
- Department of Neurology, The Affiliated Changzhou No. 2 People's Hospital of Nanjing Medical University, Changzhou, Jiangsu Province, China
| | - Yin Cao
- Department of Psychology, The Affiliated Changzhou No. 2 People's Hospital of Nanjing Medical University, Changzhou, Jiangsu Province, China
| | - Guanzhong Dong
- Department of Neurology, The Affiliated Changzhou No. 2 People's Hospital of Nanjing Medical University, Changzhou, Jiangsu Province, China
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Tang Y, Wang S, Yi Q, Xia Y, Geng B. High-density Lipoprotein Cholesterol Is Negatively Correlated with Bone Mineral Density and Has Potential Predictive Value for Bone Loss. Lipids Health Dis 2021; 20:75. [PMID: 34304735 PMCID: PMC8310606 DOI: 10.1186/s12944-021-01497-7] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Accepted: 06/29/2021] [Indexed: 12/14/2022] Open
Abstract
Background Many studies have shown that lipids play important roles in bone metabolism. However, the association between high-density lipoprotein cholesterol (HDL-C) and bone mineral density (BMD) is unclear. Therefore, this study aimed to investigate the linear or nonlinear relation between HDL-C levels and BMD and addressed whether the HDL-C levels had the potential values for predicting the risk of osteoporosis or osteopenia. Methods Two researchers independently extracted all information from the National Health and Nutrition Examination Survey (NHANES) database. Participants over 20 years of age with available HDL-C and BMD data were enrolled in the final analysis. The linear relationship between HDL-C levels and BMD was assessed using multivariate linear regression models. Moreover, the nonlinear relationship was also characterized by fitted smoothing curves and generalized additive models. In addition, the odds ratio (OR) for osteopenia and osteoporosis was evaluated with multiple logistic regression models. Results The weighted multivariable linear regression models demonstrated that HDL-C levels displayed an inverse association with BMD, especially among females and subjects aged 30 to 39 or 50 to 59. Moreover, the nonlinear relationship characterized by smooth curve fittings and generalized additive models suggested that (i) HDL-C levels displayed an inverted U-shaped relationship with BMD among women 30 to 39 or over 60 years of age; (ii) HDL-C levels exhibited a U-shaped association with BMD among women 20 to 29 or 50 to 59 years of age. In addition, females with high HDL levels (62-139 mg/dL) had an increased risk of osteopenia or osteoporosis. Conclusion This study demonstrated that HDL-C levels exhibit an inverse correlation with BMD. Especially in females, clinicians need to be alert to patients with high HDL-C levels, which may indicate an increased risk of osteoporosis or osteopenia. For these patients, close monitoring of BMD and early intervention may be necessary. Supplementary Information The online version contains supplementary material available at 10.1186/s12944-021-01497-7.
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Affiliation(s)
- Yuchen Tang
- Department of Orthopaedics, Lanzhou University Second Hospital, #82 Cuiyingmen, Lanzhou, Gansu, People's Republic of China, 730000.,Orthopaedics Key Laboratory of Gansu Province, Lanzhou, Gansu, China.,Orthopaedic Clinical Research Center of Gansu Province, Lanzhou, Gansu, China
| | - Shenghong Wang
- Department of Orthopaedics, Lanzhou University Second Hospital, #82 Cuiyingmen, Lanzhou, Gansu, People's Republic of China, 730000.,Orthopaedics Key Laboratory of Gansu Province, Lanzhou, Gansu, China.,Orthopaedic Clinical Research Center of Gansu Province, Lanzhou, Gansu, China
| | - Qiong Yi
- Department of Orthopaedics, Lanzhou University Second Hospital, #82 Cuiyingmen, Lanzhou, Gansu, People's Republic of China, 730000.,Orthopaedics Key Laboratory of Gansu Province, Lanzhou, Gansu, China.,Orthopaedic Clinical Research Center of Gansu Province, Lanzhou, Gansu, China
| | - Yayi Xia
- Department of Orthopaedics, Lanzhou University Second Hospital, #82 Cuiyingmen, Lanzhou, Gansu, People's Republic of China, 730000.,Orthopaedics Key Laboratory of Gansu Province, Lanzhou, Gansu, China.,Orthopaedic Clinical Research Center of Gansu Province, Lanzhou, Gansu, China
| | - Bin Geng
- Department of Orthopaedics, Lanzhou University Second Hospital, #82 Cuiyingmen, Lanzhou, Gansu, People's Republic of China, 730000. .,Orthopaedics Key Laboratory of Gansu Province, Lanzhou, Gansu, China. .,Orthopaedic Clinical Research Center of Gansu Province, Lanzhou, Gansu, China.
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Fiocco AJ, Krieger L, D'Amico D, Parrott MD, Laurin D, Gaudreau P, Greenwood C, Ferland G. A systematic review of existing peripheral biomarkers of cognitive aging: Is there enough evidence for biomarker proxies in behavioral modification interventions?: An initiative in association with the nutrition, exercise and lifestyle team of the Canadian Consortium on Neurodegeneration in Aging. Ageing Res Rev 2019; 52:72-119. [PMID: 31059801 DOI: 10.1016/j.arr.2019.04.008] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2018] [Revised: 03/09/2019] [Accepted: 04/29/2019] [Indexed: 12/15/2022]
Abstract
Peripheral biomarkers have shown significant value in predicting brain health and may serve as a useful proxy measurement in the assessment of evidence-based lifestyle behavior modification programs, including physical activity and nutrition programs, that aim to maintain cognitive function in late life. The aim of this systematic review was to elucidate which peripheral biomarkers are robustly associated with cognitive function among relatively healthy non-demented older adults. Following the standards for systematic reviews (PICO, PRIMSA), and employing MEDLINE and Scopus search engines, 222 articles were included in the review. Based on the review of biomarker proxies of cognitive health, it is recommended that a comprehensive biomarker panel, or biomarker signature, be developed as a clinical end point for behavior modification trials aimed at enhancing cognitive function in late life. The biomarker signature should take a multisystemic approach, including lipid, immune/inflammatory, and metabolic biomarkers in the biological signature index of cognitive health.
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Affiliation(s)
| | - Laura Krieger
- Department of Psychology, Ryerson University, Toronto, ON, Canada
| | - Danielle D'Amico
- Department of Psychology, Ryerson University, Toronto, ON, Canada
| | | | - Danielle Laurin
- Laval University, Centre de recherche du CHU de Québec, QC, Canada
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Colesterol total y discapacidad en ancianos hospitalizados: más allá de la enfermedad cardiovascular. REVISTA COLOMBIANA DE CARDIOLOGÍA 2018. [DOI: 10.1016/j.rccar.2017.08.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
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7
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Combining LDL-C and HDL-C to predict survival in late life: The InChianti study. PLoS One 2017; 12:e0185307. [PMID: 28957382 PMCID: PMC5619755 DOI: 10.1371/journal.pone.0185307] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2017] [Accepted: 09/11/2017] [Indexed: 01/21/2023] Open
Abstract
Background While the relationship between total cholesterol (TC) and cardiovascular disease (CVD) progressively weakens with aging, several studies have shown that low TC is associated with increased mortality in older individuals. However, the possible additive/synergic contribution of the two most important cholesterol rich fractions (LDL-C and HDL-C) to mortality risk has not been previously investigated. Our study aimed to investigate the relationship between baseline LDL-C and HDL-C, both separately and combined, and 9-years mortality in a sample of community dwelling older individuals from the InCHIANTI study. Methods and findings 1044 individuals over 64 years were included. CVD and cancer mortality were defined by ICD-9 codes 390–459 and 140–239, respectively. LDL-C <130 mg/dL (3.36 mmol/L) was defined as “optimal/near optimal”. Low HDL-C was defined as <40/50 mg/dL (1.03/1.29 mmol/L) in males/females, respectively. Nine-years mortality risk was calculated by multivariate Cox proportional hazards model. We found that, compared to subjects with high LDL-C and normal HDL-C (reference group), total mortality was significantly increased in subjects with optimal/near optimal LDL-C and low HDL-C (H.R.:1.58; 95%CI:1.11–2.25). As regards the specific cause of death, CVD mortality was not affected by LDL-C/HDL-C levels, while cancer mortality was significantly increased in all subjects with optimal/near optimal LDL-C (with normal HDL-C: H.R.: 2.49; with low HDL-C: H.R.: 4.52). Results were unchanged after exclusion of the first three years of follow-up, and of subjects with low TC (<160 g/dL—4.13 mmol/L). Conclusions Our findings suggest that, in community dwelling older individuals, the combined presence of optimal/near optimal LDL-C and low HDL-C represents a marker of increased future mortality.
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Anstey KJ, Ashby-Mitchell K, Peters R. Updating the Evidence on the Association between Serum Cholesterol and Risk of Late-Life Dementia: Review and Meta-Analysis. J Alzheimers Dis 2017; 56:215-228. [PMID: 27911314 PMCID: PMC5240556 DOI: 10.3233/jad-160826] [Citation(s) in RCA: 208] [Impact Index Per Article: 29.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/19/2016] [Indexed: 01/11/2023]
Abstract
BACKGROUND Cohort studies have reported that midlife high total serum cholesterol (TC) is associated with increased risk of Alzheimer's disease (AD) in late-life but findings have been based on few studies and previous reviews have been limited by a lack of compatible data. OBJECTIVE We synthesized all high quality data from cohort studies reporting on the association between total serum cholesterol measured and late-life cognitive outcomes including Alzheimer's disease (AD), vascular dementia (VaD), any dementia, mild cognitive impairment (MCI), and cognitive decline. METHODS The literature was searched up to October 2016 using a registered protocol. Thirty-four articles meeting study criteria were identified. Seventeen studies published from 1996 to 2014, including 23,338 participants were included in meta-analyses. RESULTS Relative risk of developing AD for adults with high TC in midlife was 2.14 (95% CI 1.33-3.44) compared with normal cholesterol. Individual studies that could not be pooled also reported high TC in midlife increased the risk of MCI and cognitive decline in late-life. High TC in late-life was not associated with MCI, AD, VaD, any dementia, or cognitive decline. Late-life measured HDL cholesterol and triglycerides were not associated with increased risk of VaD, and HDL was not associated with risk of MCI, AD, or any dementia. There were insufficient data to examine other cholesterol sub-fractions, sex differences, or APOE interactions. CONCLUSIONS Significant gaps in the literature regarding TC and late-life dementia remain. Evidence suggests that high midlife TC increases risk of late-life AD, and may correlate with the onset of AD pathology.
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Affiliation(s)
- Kaarin J. Anstey
- Dementia Collaborative Research Centre – Early Diagnosis and Prevention, Research School of Population Health, The Australian National University, Australia
- Centre for Research on Ageing, Health and Wellbeing, Research School of Population Health, The Australian National University, Australia
| | - Kimberly Ashby-Mitchell
- Centre for Research on Ageing, Health and Wellbeing, Research School of Population Health, The Australian National University, Australia
| | - Ruth Peters
- Dementia Collaborative Research Centre – Early Diagnosis and Prevention, Research School of Population Health, The Australian National University, Australia
- Centre for Research on Ageing, Health and Wellbeing, Research School of Population Health, The Australian National University, Australia
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Abstract
BACKGROUND We examined the associations between serum cholesterol measures, statin use, and cognitive function measured in childhood and in old age. The possibility that lifelong (trait) cognitive ability accounts for any cross-sectional associations between cholesterol and cognitive performance in older age, seen in observational studies, has not been tested to date. METHODS Participants were 1,043 men and women from the Lothian Birth Cohort 1936 Study, most of whom had participated in a nationwide IQ-type test in childhood (Scottish Mental Survey of 1947), and were followed up at about age 70 years. Serum cholesterol measures included total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), triglycerides, and cholesterol:HDL cholesterol ratio. Cognitive outcome measures were age 70 IQ (using the same test as at age 11 years), general cognitive ability (g), processing speed, memory, and verbal ability. RESULTS Higher TC, higher HDL-C, and lower triglycerides were associated with higher age 70 cognitive scores in most cognitive domains. These relationships were no longer significant after covarying for childhood IQ, with the exception a markedly attenuated association between TC and processing speed, and triglycerides and age 70 IQ. In the fully adjusted model, all conventionally significant (p < 0.05) effects were removed. Childhood IQ predicted statin use in old age. Statin users had lower g, processing speed, and verbal ability scores at age 70 years after covarying for childhood IQ, but significance was lost after adjusting for TC levels. CONCLUSIONS These results suggest that serum cholesterol and cognitive function are associated in older age via the lifelong stable trait of intelligence. Potential mechanisms, including lifestyle factors, are discussed.
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Joosten H, Visser ST, van Eersel ME, Gansevoort RT, Bilo HJG, Slaets JP, Izaks GJ. Statin use and cognitive function: population-based observational study with long-term follow-up. PLoS One 2014; 9:e115755. [PMID: 25541708 PMCID: PMC4277319 DOI: 10.1371/journal.pone.0115755] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2014] [Accepted: 11/12/2014] [Indexed: 01/18/2023] Open
Abstract
We aimed to evaluate the association between statin use and cognitive function. Cognitive function was measured with the Ruff Figural Fluency Test (RFFT; worst score, 0; best score, 175 points) and the Visual Association Test (VAT; low performance, 0-10; high performance, 11-12 points) in an observational study that included 4,095 community-dwelling participants aged 35-82 years. Data on statin use were obtained from a computerized pharmacy database. Analysis were done for the total cohort and subsamples matched on cardiovascular risk (N = 1232) or propensity score for statin use (N = 3609). We found that a total of 904 participants (10%) used a statin. Statin users were older than non-users: mean age (SD) 61 (10) vs. 52 (11) years (p<0.001). The median duration of statin use was 3.8 (interquartile range, 1.6-4.5) years. Unadjusted, statin users had worse cognitive performance than non-users. The mean RFFT score (SD) in statin users and non-users was 58 (23) and 72 (26) points, respectively (p<0.001). VAT performance was high in 261 (29%) statin users and 1351 (43%) non-users (p<0.001). However, multiple regression analysis did not show a significant association of RFFT score with statin use (B, -0.82; 95%CI, -2.77 to 1.14; p = 0.41) nor with statin solubility, statin dose or duration of statin use. Statin users with high doses or long-term use had similar cognitive performance as non-users. This was found in persons with low as well as high cardiovascular risk, and in younger as well as older subjects. Also, the mean RFFT score per quintile of propensity score for statin use was comparable for statin users and non-users. Similar results were found for the VAT score as outcome measure. In conclusion, statin use was not associated with cognitive function. This was independent of statin dose or duration of statin use.
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Affiliation(s)
- Hanneke Joosten
- University of Groningen, University Medical Center Groningen (UMCG), Department of Internal medicine, Groningen, The Netherlands
| | - Sipke T. Visser
- University of Groningen, Department of Pharmacy, PharmacoEpidemiology and PharmacoEconomics (PE2), Groningen, The Netherlands
| | - Marlise E. van Eersel
- University of Groningen, University Medical Center Groningen (UMCG), University Center for Geriatric Medicine, Groningen, The Netherlands
| | - Ron T. Gansevoort
- University of Groningen, University Medical Center Groningen (UMCG), Department of Internal medicine, Division of Nephrology, Groningen, The Netherlands
| | - Henk J. G. Bilo
- University of Groningen, University Medical Center Groningen (UMCG), Department of Internal medicine, Groningen, The Netherlands
- Department of Internal medicine, Diabetes Centre, Isala Clinics, Zwolle, The Netherlands
| | - Joris P. Slaets
- University of Groningen, University Medical Center Groningen (UMCG), University Center for Geriatric Medicine, Groningen, The Netherlands
| | - Gerbrand J. Izaks
- University of Groningen, University Medical Center Groningen (UMCG), University Center for Geriatric Medicine, Groningen, The Netherlands
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11
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Abstract
Few studies have examined associations between different subcategories of cholesterol and cognitive function. We examined relationships between total cholesterol (TC), high-density lipoprotein cholesterol (HDL), low-density lipoprotein cholesterol (LDL), triglyceride levels and cognitive performance in the Maine-Syracuse Longitudinal Study, a community-based study of cardiovascular risk factors. Cross-sectional analyses were undertaken on data from 540 participants, aged 60 to 98 years, free of dementia and stroke. TC, HDL, LDL, and triglyceride levels were obtained. Cognitive function was assessed using a thorough neuropsychological test battery, including domains of cognitive function indexed by multiple cognitive tests. The cognitive outcomes studied were as follows: Visual-Spatial Memory and Organization, Verbal and Working Memory, Scanning and Tracking, Abstract Reasoning, a Global Composite score, and the Mini-Mental State Examination (MMSE). Significant positive associations were observed between HDL-cholesterol and the Global Composite score, Working Memory, and the MMSE after adjustment for demographic and cardiovascular risk factors. Participants with desirable levels of HDL (≥60 mg/dL) had the highest scores on all cognitive outcomes. There were no significant associations observed between TC, LDL, or triglyceride concentrations and cognition. In older individuals, HDL-cholesterol was related to a composite of Working Memory tests and for general measures of cognitive ability when adjusted for cardiovascular variables. We speculate that persons over 60 are survivors and thus less likely to show cognitive deficit in relation to TC, LDL-cholesterol, and triglycerides. Longitudinal studies are needed to examine relations between specific cognitive abilities and the different subcategories of cholesterol.
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Bertolotti M, Mussi C, Pellegrini E, Magni A, Del Puppo M, Ognibene S, Carulli L, Anzivino C, Baldelli E, Loria P, Carulli N. Age-associated alterations in cholesterol homeostasis: evidence from a cross-sectional study in a Northern Italy population. Clin Interv Aging 2014; 9:425-32. [PMID: 24669190 PMCID: PMC3962317 DOI: 10.2147/cia.s57714] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
Background The modifications of cholesterol metabolism associated with aging are ill-defined. The objective of this study was to define age-associated alterations of the different metabolic pathways controlling cholesterol homeostasis by analyzing circulating sterols. Methods We analyzed serum samples collected from 201 adult (75 male, 126 female) subjects within the epidemiological MICOL study (Multicentrica Italiana Colelitiasi). The age range was 38–79 years; 103 had evidence of gallstones. The concentrations of the different sterols, recognized as markers of the main pathways of cholesterol homeostasis, were analyzed by gas chromatography-mass spectrometry, including lathosterol (synthesis), campesterol and sitosterol (absorption), and 7α-hydroxy-4-cholesten-3-one (degradation to bile acids). Results A significant direct correlation was detected between age and cholesterol levels (r =0.34, P<0.01). The lathosterol/cholesterol ratio was lower in older age quartiles (P<0.05 by analysis of variance), with an inverse correlation between the lathosterol/cholesterol ratio and age (r=−0.32, P<0.01). Such correlation was particularly evident in females. The campesterol/cholesterol and sitosterol/cholesterol ratios were inversely correlated with aging in control, but not in gallstone patients. The levels of 7α-hydroxy-4-cholesten-3-one were not correlated with age. Conclusion These data show a reduction of cholesterol synthesis with aging which is associated with increased circulating cholesterol levels. The finding might be related to a reduced metabolic need for cholesterol in advancing age, leading to a downregulation of the main mechanisms of cholesterol intake in the liver. A different age-related behavior was observed in gallstone-free versus gallstone patients regarding cholesterol absorption. The possible implications in terms of the pharmacological management of hypercholesterolemia in the elderly remain to be defined.
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Affiliation(s)
- Marco Bertolotti
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Chiara Mussi
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Elisa Pellegrini
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Alessandro Magni
- Department of Health Sciences, University of Milano Bicocca, Monza, Italy
| | - Marina Del Puppo
- Department of Health Sciences, University of Milano Bicocca, Monza, Italy
| | - Silvia Ognibene
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Lucia Carulli
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Claudia Anzivino
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Enrica Baldelli
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Paola Loria
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
| | - Nicola Carulli
- Department of Biomedical, Metabolic and Neural Sciences, University of Modena and Reggio Emilia, Modena, Italy
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Luo L, Yang M, Hao Q, Yue J, Dong B. Cross-Sectional Study Examining the Association Between Metabolic Syndrome and Cognitive Function Among the Oldest Old. J Am Med Dir Assoc 2013. [DOI: 10.1016/j.jamda.2012.10.001] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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14
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Yashin AI, Arbeev KG, Wu D, Arbeeva LS, Kulminski A, Akushevich I, Culminskaya I, Stallard E, Ukraintseva SV. How lifespan associated genes modulate aging changes: lessons from analysis of longitudinal data. Front Genet 2013; 4:3. [PMID: 23346098 PMCID: PMC3551204 DOI: 10.3389/fgene.2013.00003] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2012] [Accepted: 01/04/2013] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND AND OBJECTIVE The influence of genes on human lifespan is mediated by biological processes that characterize body's functioning. The age trajectories of these processes contain important information about mechanisms linking aging, health, and lifespan. The objective of this paper is to investigate regularities of aging changes in different groups of individuals, including individuals with different genetic background, as well as their connections with health and lifespan. DATA AND METHOD To reach this objective we used longitudinal data on four physiological variables, information about health and lifespan collected in the Framingham Heart Study (FHS), data on longevity alleles detected in earlier study, as well as methods of statistical modeling. RESULTS We found that phenotypes of exceptional longevity and health are linked to distinct types of changes in physiological indices during aging. We also found that components of aging changes differ in groups of individuals with different genetic background. CONCLUSIONS These results suggest that factors responsible for exceptional longevity and health are not necessary the same, and that postponing aging changes is associated with extreme longevity. The genetic factors which increase lifespan are associated with physiological changes typical of healthy and long-living individuals, smaller mortality risks from cancer and CVD and better estimates of adaptive capacity in statistical modeling. This indicates that extreme longevity and health related traits are likely to be less heterogeneous phenotypes than lifespan, and studying these phenotypes separately from lifespan may provide additional information about mechanisms of human aging and its relation to chronic diseases and lifespan.
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Gender Differences in Acculturation, Stress, and Salivary Cortisol Response Among Former Soviet Immigrants. J Immigr Minor Health 2012; 15:540-52. [DOI: 10.1007/s10903-012-9752-x] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Sex differences in the association of Framingham Cardiac Risk Score with cognitive decline in community-dwelling elders without clinical heart disease. Psychosom Med 2011; 73:683-9. [PMID: 21949428 PMCID: PMC3188670 DOI: 10.1097/psy.0b013e31822f9089] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
OBJECTIVE To investigate a possible link between cardiovascular risk factors and age-related cognitive decline, the association of the 1998 Framingham Cardiac Risk Score (FCRS) with the trajectory of cognitive function test (CFT) performance over an 18 year period was examined in adults 50 years and older without clinical heart disease at baseline. METHODS Participants were 985 men and women who had assessments of cognitive function at 3- to 4-year intervals. The association of FCRS category with CFT score trajectory was examined using mixed-effects models stratified by sex and controlling for age, educational level, and number of successive cognitive assessments. RESULTS At baseline, median FCRS corresponded to a 14% risk of a coronary heart disease event within 10 years for men and an 8% risk for women; 31% of men and 6% of women were at high (>20%) risk. In longitudinal analyses, women with FCRS risk higher than 7% had a higher rate of decline on tests of verbal fluency (p values < .05) and long-term recall (p values < .01) compared with low-risk women; modest, but significant (p values < .05), differences in the trajectory of Mini-Mental State Examination and Trail-Making Test B scores were also apparent. FCRS category was not related to the rate of decline in CFT performance in men. CONCLUSIONS For older women, very low levels of risk of coronary heart disease were associated with preservation of cognitive function for 10 years, suggesting that the maintenance of cardiovascular health may slow cognitive decline. The minimal association in men, who were at higher baseline risk, may be due to the selective attrition of men with greater cognitive decline.
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Crimmins EM, Vasunilashorn S. Links Between Biomarkers and Mortality. INTERNATIONAL HANDBOOK OF ADULT MORTALITY 2011. [DOI: 10.1007/978-90-481-9996-9_18] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
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18
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Tournoy J, Lee DM, Pendleton N, O'Neill TW, O'Connor DB, Bartfai G, Casanueva FF, Finn JD, Forti G, Giwercman A, Han TS, Huhtaniemi IT, Kula K, Lean MEJ, Moseley CM, Punab M, Silman AJ, Vanderschueren D, Wu FCW, Boonen S. Association of cognitive performance with the metabolic syndrome and with glycaemia in middle-aged and older European men: the European Male Ageing Study. Diabetes Metab Res Rev 2010; 26:668-76. [PMID: 21043047 DOI: 10.1002/dmrr.1144] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
BACKGROUND AND AIMS Metabolic syndrome has been reported to have adverse effects on cognition although the results are conflicting. We investigated the association between metabolic syndrome and cognitive function in a population sample of middle-aged and older European men and whether any observed association could be explained by lifestyle or other confounding factors. METHODS A total of 3369 men in the 40- to 79-year age group were recruited from population registers in eight centres for participation in the European Male Ageing Study. The subjects completed a questionnaire instrument and several cognitive function tests including the Rey-Osterrieth Complex Figure test, the Camden Topographical Recognition Memory test and the Digit Symbol Substitution Test. Metabolic syndrome data were assessed at an invited visit and metabolic syndrome was defined by the National Cholesterol Education Program's Adult Treatment Panel-III criteria. Associations between cognitive performance and metabolic syndrome were explored using linear regression. RESULTS Complete cognitive and metabolic syndrome data from 3152 subjects were included in the analysis, of whom 1007 (32%) fulfilled criteria for metabolic syndrome. After adjustment for putative health and lifestyle confounders, no significant associations were found between any of the cognitive function scores and metabolic syndrome or between cognitive performance and high-sensitivity C-reactive protein. Analysis of the individual metabolic syndrome factors, however, revealed an inverse association between the level of glucose and cognitive performance. CONCLUSIONS Metabolic syndrome was not associated with cognitive impairment in this population. Of the individual components of the syndrome, diabetes was associated with poorer performances in memory, executive functions and processing speed, associations that warrant further investigation.
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Affiliation(s)
- Jos Tournoy
- Department of Experimental Medicine, Division of Gerontology and Geriatrics, Katholieke Universiteit Leuven, Herestraat 49, Leuven, Belgium.
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Cesari M, Onder G, Zamboni V, Capoluongo E, Russo A, Bernabei R, Pahor M, Landi F. C-reactive protein and lipid parameters in older persons aged 80 years and older. J Nutr Health Aging 2009; 13:587-93. [PMID: 19621193 PMCID: PMC4386631 DOI: 10.1007/s12603-009-0168-9] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVES Aims of the study were 1) to investigate the association of C-reactive protein (CRP) with lipid (i.e. total, LDL, and HDL cholesterol, triglycerides) concentrations, and to evaluate their predictive value for mortality in very old subjects. DESIGN Cross-sectional and longitudinal analyses in a prospective cohort study. SETTING Participants. Data are from 336 community-dwelling subjects aged > or = 80 years old enrolled in the "Invecchiamento e Longevità nel Sirente" (ilSIRENTE) study. MEASUREMENTS High sensitivity CRP and lipid concentrations were measured at the baseline clinical visit. High sensitivity CRP concentrations were measured by ELISA assessment. Mortality outcome was evaluated over a 24-month follow-up. RESULTS Participants had a mean age of 85.8 (SD 4.8) years old. Spearman's correlations showed significant (p values < 0.01) inverse correlations between CRP and lipid parameters (except triglycerides). Adjusted linear regressions between CRP and lipid parameters concentrations showed no significant association in participants aged lower than 85 years old (all p values > 0.5). In the older age group, significant inverse associations of CRP with total (p=0.002), LDL (p=0.007), and HDL cholesterol (p=0.002) were found, even after adjustment for potential confounders. Adjusted Cox proportional hazard models demonstrated that CRP was the only biomarker significantly predictive of mortality, independently of age and lipid parameters. CONCLUSION An inverse relationship of total, LDL, and HDL cholesterol with CRP is present in very old persons. The prognostic value of CRP is particularly important among very old persons whereas lipid parameters tend to lose their capacity to predict events.
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Affiliation(s)
- M Cesari
- Department of Aging and Geriatric Research, University of Florida-Institute on Aging, Gainesville, FL 32611, USA.
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Mielke MM, Xue QL, Zhou J, Chaves PHM, Fried LP, Carlson MC. Baseline serum cholesterol is selectively associated with motor speed and not rates of cognitive decline: the Women's Health and Aging Study II. J Gerontol A Biol Sci Med Sci 2008; 63:619-24. [PMID: 18559637 DOI: 10.1093/gerona/63.6.619] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Although several studies have investigated the association between cholesterol and dementia, few have examined cholesterol and decline across cognitive domains. We examined serum total and high-density lipoprotein (HDL) cholesterol, total-to-HDL ratio, and trajectories across cognitive domains. METHODS Participants were 436 community-residing women (70-79 years old) in the Women's Health and Aging Study II; they were screened to be physically high-functioning and cognitively intact at baseline. Cognition and other health-related variables were assessed at five intervals spanning 9 years. Cognitive assessments included Trail Making Test Parts A (TMT-A) and B (TMT-B), Hopkins Verbal Learning Test-Revised, Purdue Pegboard, and Mini-Mental State Examination (MMSE). The association between baseline levels of serum lipids and cognitive trajectories were evaluated using Generalized Estimating Equations (GEE). Covariates included age, education, race, vascular disease, serum creatinine, depression, and lipid-lowering medications. RESULTS In multivariate analyses, baseline higher total (p =.02) and HDL (p =.03) cholesterol were associated with better performance on the Purdue Pegboard. Using clinical cholesterol cutoffs, baseline serum total cholesterol levels >240 mg/dL were associated with the best performance (p =.02). Baseline lipids were not associated with any other cognitive tests; there were no Lipid x Time interactions. CONCLUSION Higher baseline serum lipid levels predicted better performance over time on a measure of motor speed, but not memory or psychomotor or executive functioning in this population of elderly women. This association suggests that peripheral cholesterol levels, measured in late-life, may not be a good predictor of subsequent cognitive decline. Future research examining peripheral cholesterol over the life span and its relationship with cognition is needed.
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Affiliation(s)
- Michelle M Mielke
- Johns Hopkins University School of Medicine, Center on Aging and Health and Department of Psychiatry, Division of Geriatric Psychiatry and Behavioral Sciences, 550 N. Broadway, Suite 308, Baltimore, MD 21205, USA.
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Laudisio A, Marzetti E, Pagano F, Cocchi A, Franceschi C, Bernabei R, Zuccalà G. Association of metabolic syndrome with cognitive function: the role of sex and age. Clin Nutr 2008; 27:747-54. [PMID: 18715681 DOI: 10.1016/j.clnu.2008.07.001] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2008] [Revised: 07/03/2008] [Accepted: 07/06/2008] [Indexed: 11/19/2022]
Abstract
BACKGROUND & AIMS Cognitive impairment is a prevalent condition in older populations, independently associated with disability and mortality. Some studies have suggested a negative correlation between metabolic syndrome (MetS) and cognitive functioning, but results in older subjects are controversial. The aim of this study was to evaluate the association of cognitive performance with MetS in an older unselected population. METHODS We evaluated the association of the Hodkinson Abbreviated Mental Test (AMT) score with MetS, as defined by the National Cholesterol Education Program's ATP-III criteria, in all 353 subjects aged 75+ living in Tuscania (Italy). RESULTS MetS was positively associated with the AMT score in multivariable linear regression analysis, after adjusting (B=0.45, 95% CI=0.04-0.90; p=0.03). When the same regression model was analyzed after stratifying for sex, such an association was significant in women (B=0.76, 95% CI=0.16-1.36; p=0.01), but not in men. Also, when the regression model was analyzed in women, MetS was associated with better cognition (B=1.41, 95% CI=0.51-2.30; p<0.01) among participants aged 80+. CONCLUSIONS MetS is associated with better cognitive performance in community-dwelling elderly; such an association seems to depend upon the oldest female subjects.
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Affiliation(s)
- Alice Laudisio
- Department of Gerontology and Geriatrics, Catholic University of Medicine, L.go F. Vito 1, 00168 Rome, Italy.
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Cholesterol as a Risk Factor for Dementia and Cognitive Decline: A Systematic Review of Prospective Studies With Meta-Analysis. Am J Geriatr Psychiatry 2008. [PMID: 18448847 DOI: 10.1097/01.jgp.0000310778.20870.ae] [Citation(s) in RCA: 233] [Impact Index Per Article: 14.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
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Abstract
Biomarkers are increasingly employed in empirical studies of human populations to understand physiological processes that change with age, diseases whose onset appears linked to age, and the aging process itself. In this chapter, we describe some of the most commonly used biomarkers in population aging research, including their collection, associations with other markers, and relationships to health outcomes. We discuss biomarkers of the cardiovascular system, metabolic processes, inflammation, activity in the hypothalamic-pituitary axis (HPA) and sympathetic nervous system (SNS), and organ functioning (including kidney, lung, and heart). In addition, we note that markers of functioning of the central nervous system and genetic markers are now becoming part of population measurement. Where possible, we detail interrelationships between these markers by providing correlations between high risk levels of each marker from three population-based surveys: the National Health and Nutrition Examination Survey (NHANES) III, NHANES 1999-2002, and the MacArthur Study of Successful Aging. NHANES III is used instead of NHANES 1999-2002 when specific markers of interest are available only in NHANES III and when we examine the relationship of biomarkers to mortality which is only known for NHANES III. We also describe summary measures combining biomarkers across systems. Finally, we examine associations between individual markers and mortality and provide information about biomarkers of growing interest for future research in population aging and health.
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Affiliation(s)
- Eileen Crimmins
- Andrus Gerontology Center, Davis School of Gerontology, University of Southern California, Los Angeles, California 90089, USA
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Gaudreau P, Morais JA, Shatenstein B, Gray-Donald K, Khalil A, Dionne I, Ferland G, Fülöp T, Jacques D, Kergoat MJ, Tessier D, Wagner R, Payette H. Nutrition as a Determinant of Successful Aging: Description of the Quebec Longitudinal Study NuAge and Results from Cross-Sectional Pilot Studies. Rejuvenation Res 2007; 10:377-86. [PMID: 17708689 DOI: 10.1089/rej.2007.0596] [Citation(s) in RCA: 101] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Optimal nutrition is essential for general well being, maintenance of physical and functional capacities and prevention of chronic disease in the elderly. The 5-year longitudinal study, NuAge, was designed to assess the pivotal role of nutrition on physical and cognitive status, functional autonomy and social functioning. A cohort of 1793 men and women, selected from three age groups (68-72, 73-77, 78-82) at recruitment, has been followed annually since 2003-2004. A plurimethodological approach, including basic, clinical, epidemiologic, and social research has been used. Data on various facets of nutritional status (diet, food habits, appetite, anthropometry and body composition), and functional (muscle strength, physical activity, physical and functional capacities and performance), medical (physical, mental and cognitive health, medication) and social data (network, support, participation) are collected by questionnaires or direct measurements. Blood, urine, and saliva samples are also collected and processed for genomic, transcriptomic, proteomic, and biochemical analyses and to study markers of endocrine, immune, and cognitive functions. Selected bio-psycho-social characteristics of the cohort, consumption of macronutrients, and biologic variables are presented, including the impact of intake of certain foods on total antioxidant status. Understanding the aging process as regulated by a modifiable factor such as nutrition should facilitate the development of targeted strategies for promoting successful aging.
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Affiliation(s)
- Pierrette Gaudreau
- Laboratory of Neuroendocrinology of Aging, Centre hospitalier de l'Université de Montréal Research Center and Department of Medicine, Institut Universitaire de Gériatrie de Montréal, Canada.
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Bermejo LM, Aparicio A, Andrés P, López-Sobaler AM, Ortega RM. The influence of fruit and vegetable intake on the nutritional status and plasma homocysteine levels of institutionalised elderly people. Public Health Nutr 2007; 10:266-72. [PMID: 17288624 DOI: 10.1017/s1368980007246580] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
OBJECTIVE To determine the difference in the nutritional status of elderly people depending on their consumption of fruits and vegetables, and to study the possible association between the consumption of these foods and different cardiovascular risk factors, especially total plasma homocysteine (t-Hcys) levels. DESIGN, SETTING AND SUBJECTS A cross-sectional study in 152 institutionalised older people from Madrid aged > or = 65 years. Food and nutrient intakes were recorded over 7 days using the 'precise individual weighing' method. The weight, height, and waist and hip circumferences of all subjects were recorded, as were their alpha-erythrocyte glutathione reductase, serum B6, B12 and folate levels, erythrocyte folate levels, t-Hcys levels, serum lipids and blood pressure. The experimental population was then divided into tertiles depending on the serving intake of fruit and vegetables (T1, < 2.29 servings day(-1); T2, 2.29-2.79 servings day(-1); and T3, >2.79 servings day(-1)). RESULTS Compared with T1 subjects, T3 subjects showed consumptions of cereals, pulses, meat, fish and eggs closer to those recommended (P < 0.05). In addition, the contribution of their diet towards covering the recommended daily intake of vitamin B1, niacin, vitamin B6, folic acid, vitamin C, B12, vitamin A, and P, Mg, Zn and Fe was higher. The intake of fibre increased with consumption of fruit and vegetables (r = 0.6839, P < 0.001). T3 subjects also had better serum and erythrocyte folate levels than T1 and T2 subjects (P < 0.05). A positive correlation was found between the consumption of fruit and vegetables and serum folate (r = 0.2665, P < 0.01) and with erythrocyte folate levels (r = 0.2034, P < 0.05), and a negative correlation with t-Hcys (r = -0.2493, P < 0.01). CONCLUSIONS Greater consumption of fruit and vegetables is associated with better food habits, increased vitamin and mineral intakes and lower t-Hcys levels. Considering that the fruit and vegetable intake in Spanish elderly people is very low, it is recommended that the consumption of fruits and vegetables by elderly people be increased.
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Affiliation(s)
- L M Bermejo
- Departamento de Nutrición, Facultad de Farmacia, Universidad Complutense, Madrid, Spain
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Abstract
There have been few studies that examine the relation between body mass index (BMI) and cholesterol in consideration of potential interactions between age, sex, BMI and cholesterol. We determined age-, sex- and BMI-specific cholesterol levels of Japanese adults using the 2001 health examination data (337,690 men and 293,918 women). Both total cholesterol (T-C) and low-density lipoprotein cholesterol (LDL-C) levels increased with age until 50 years of age in men and until 60 years of age in women. Linear regression analysis showed significant BMI-dependent increases of T-C and LDL-C in all age groups, but the regression coefficients of BMI in relation to T-C and LDL-C became lower in older age groups until 60 years of age, with the highest value at ages 20-29 years in men and at ages 30-39 years in women. This result was consistent with the result of multiple logistic regression analysis regarding the risk of having hypercholesterolaemia. Weight reduction should be more strongly recommended to younger people, especially men aged under 40 years and women aged under 50 years, to prevent developing hypercholesterolaemia.
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Affiliation(s)
- M Suka
- Department of Preventive medicine, St Marianna University School of Medicine, Kawasaki, Japan.
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Onder G, Volpato S, Liperoti R, D'Arco C, Maraldi C, Fellin R, Bernabei R, Landi F. Total Serum Cholesterol and Recovery From Disability Among Hospitalized Older Adults. J Gerontol A Biol Sci Med Sci 2006; 61:736-42. [PMID: 16870637 DOI: 10.1093/gerona/61.7.736] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND The association between total serum cholesterol and health outcomes among older adults is controversial. The objective of the present study was to determine within a cohort of acutely hospitalized disabled elderly patients whether total cholesterol predicts recovery from disability in basic activities of daily living (ADL). METHODS Patients (3150) 65 years old or older admitted to 81 acute care units in Italy and presenting with ADL disability at hospital admission were included in this study. ADL disability was defined as need of assistance or total dependence in one or more ADLs (eating, dressing, personal hygiene, transferring, and toilet use). Recovery was defined as no disability at hospital discharge in any of the five ADLs considered. RESULTS Mean age of study participants was 80.5 +/- 7.2 years, and 1305 (41.1%) were men. The rate of recovery from ADL disability was 14.5% for participants with total cholesterol < 200 mg/dL (n = 306/2108), 20.2% for those with total cholesterol between 200 and 239 mg/dL (n = 144/713), and 23.1% for those with total cholesterol > or = 240 mg/dL (n = 76/329). After adjustment for potential confounders, relative to that of patients with cholesterol < 200 mg/dL, risk ratios for recovery were 1.31 for participants with cholesterol between 200 and 239 mg/dL (95% confidence interval [CI], 1.07-1.62) and 1.36 (95% CI, 1.04-1.79) for those with cholesterol > or = 240 mg/dL. After exclusion of 769 patients with total cholesterol < 145 mg/dL, the risk ratios (compared with those for participants with cholesterol < 200 mg/dL) for recovery were 1.33 (95% CI, 1.07-1.66) for participants with cholesterol between 200 and 239 mg/dL and 1.41 (95% CI, 1.06-1.88) for patients with cholesterol > or = 240 mg/dL. CONCLUSIONS Among hospitalized disabled older adults, elevated levels of cholesterol are associated with increased rate of recovery from ADL disability.
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Affiliation(s)
- Graziano Onder
- Department of Geriatrics, Catholic University of the Sacred Heart, Rome, Italy.
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Karlamangla AS, Singer BH, Seeman TE. Reduction in allostatic load in older adults is associated with lower all-cause mortality risk: MacArthur studies of successful aging. Psychosom Med 2006; 68:500-7. [PMID: 16738085 DOI: 10.1097/01.psy.0000221270.93985.82] [Citation(s) in RCA: 188] [Impact Index Per Article: 10.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES To study the association between change in allostatic load (a risk score constructed from multiple biological markers) over a 2.5-year period and mortality in the following 4.5 years in older adults. METHODS We measured 10 physiologic parameters at baseline (1988) in a cohort of 171 high-functioning, community-dwelling, 70- to 79-year-old adults. These measurements were repeated 2.5 years later, in 1991. Summary allostatic load scores for 1988 and 1991 were created as the weighted sum of the 10 biological markers and their second-order terms. Mortality status (alive or dead) for participants was determined 4.5 years later, in 1995. The association between change in allostatic load score (1988-1991) and subsequent mortality (1991-1995) was studied using logistic regression. RESULTS Compared with participants whose allostatic load score decreased between 1988 and 1991, individuals whose allostatic load score increased had higher risk of all-cause mortality between 1991 and 1995 (15% versus 5%, p = .047). Adjusted for age and baseline allostatic load, each unit increment in the allostatic load change score was associated with mortality odds ratio of 3.3 (95% confidence interval, 1.1-9.8). CONCLUSION Our results suggest that even in older ages, change in risk scores can be followed to improve assessment of mortality risk.
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Affiliation(s)
- Arun S Karlamangla
- Division of Geriatrics, Department of Medicine, David Geffen School of Medicine at UCLA, Los Angeles, California, USA.
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Melton PE, Zlojutro M, Kimminau K, Crawford MH. Biological aging and Cox hazard analysis of mortality trends in a Mennonite community from south-central Kansas. Am J Hum Biol 2006; 18:387-401. [PMID: 16634024 DOI: 10.1002/ajhb.20514] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
This study investigated mortality in 568 individuals from the Goessel Mennonite community in rural central Kansas. There were three main objectives to this research: 1) characterize mortality trends within a biologically well-defined Mennonite community; 2) determine what biochemical, morphological, and physiological risk factors could be related to all-cause mortality, stratified by age and sex; and 3) compare these results to previously described variables that were associated with both biological age and mortality in this population. Mortality data were obtained from three sources: Kansas Vital Records, the Social Security death index, and church records. In total, 221 (39%) individuals were found to have died in this population between January 1980-June 2002. Analogous to the larger US population, the three leading causes of death in this community were heart disease, cancer, and stroke, accounting for 60% of all deaths. Besides advancing age, the greatest biological risk factor in this population was decreased amounts of albumin in men (relative risk, 2.47), potentially indicating underreported cases of either chronic kidney disease or frailty syndrome for males. Cox proportional hazard models demonstrated that increased amounts of total cholesterol may provide a protective effect for elderly individuals. We conclude, based on the previously described heritability of both albumin (h(2) = 0.40) and total cholesterol (h(2) = 0.50) in this population, that underlying genetic factors associated with both chronic degenerative diseases and biological aging may have important implications for understanding mortality patterns in this community.
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Affiliation(s)
- Phillip E Melton
- Department of Anthropology, University of Kansas, Lawrence, 66045, USA.
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Vergani C, Lucchi T, Caloni M, Ceconi I, Calabresi C, Scurati S, Arosio B. I405V polymorphism of the cholesteryl ester transfer protein (CETP) gene in young and very old people. Arch Gerontol Geriatr 2005; 43:213-21. [PMID: 16384616 DOI: 10.1016/j.archger.2005.10.008] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2005] [Revised: 10/11/2005] [Accepted: 10/19/2005] [Indexed: 10/25/2022]
Abstract
This study was designed to analyse the prevalence of I405V polymorphism in the cholesteryl ester transfer protein (CETP) gene, the CETP serum concentration, the lipoprotein profile, and certain clinical end-points in two populations, one young and another of very old people. We recruited 100 healthy young people (median age 31 years) and 100 very old people (median age 89 years) and analysed their DNA for the presence of I405V polymorphism. The frequency of the VV genotype in very old people was more than double that in the young population. Subjects with this genotype had lower serum concentrations of CETP. Young people with the V/V genotype had a less atherogenic lipoprotein profile (lower total cholesterol, LDL cholesterol, Apo B, and Apo B/Apo A-I ratio) than those with the I/V or I/I genotypes. The older subjects, particularly the older women with the V/V genotype, had larger LDL than the young people. The prevalence of clinical endpoints was much lower among the very old people with the V/V genotype. In conclusion, the V/V genotype of the I405V CETP polymorphism is more frequent among very old people than young ones, and is associated with a lower incidence of vascular damage.
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Affiliation(s)
- Carlo Vergani
- University of Milan, Geriatrics Unit, Ospedale Maggiore Policlinico, Mangialli e Regina Elena, Fondazione IRCCS, Via Pace 9, 20122 Milan, Italy.
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Kawamoto R, Oka Y, Tomita H, Kodama A. Non-HDL Cholesterol as a Predictor of Carotid Atherosclerosis in the Elderly. J Atheroscler Thromb 2005; 12:143-8. [PMID: 16020914 DOI: 10.5551/jat.12.143] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022] Open
Abstract
The aim of the present study was to evaluate sclerotic lesions of the common carotid artery by ultrasonography in 921 in-patients aged 65 years and older (77 +/- 7 years) and investigate whether lipid levels were associated with carotid atherosclerosis. In men, an increased risk for carotid atherosclerosis was associated with increased levels of low-density lipoprotein cholesterol (LDL-C) and non-high-density lipoprotein cholesterol (non-HDL-C). Compared to men with the lowest tertile of LDL-C levels (< 83.4 mg/dl), the adjusted odds ratio was 2.502 (95% confidence interval: 1.426-4.390) in those with the middle tertile (83.4-115.2 mg/dl), and 2.688 (1.509-4.790) in those with the highest tertile ( > 115.2 mg/dl). Like the LDL-C level, the non-HDL-C level showed a positive and linear relationship with carotid atherosclerosis. Compared to men with the lowest tertile of non-HDL-C levels ( < 101 mg/dl), the adjusted odds ratio was 2.881 (1.633-5.081) for those with the middle tertile (101-135 mg/dl), and 2.990 (1.651-5.415) for those with the highest tertile ( > 135 mg/dl). Similarly, in women, an increased risk for carotid atherosclerosis was also positively and linearly associated with LDL-C and non-HDL-C. The Non-HDL-C level is a potential predictor of risk for carotid atherosclerosis in the elderly.
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Affiliation(s)
- Ryuichi Kawamoto
- Department of Internal Medicine, Seiyo Municipal Nomura Hospital, Ehime, Japan.
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