1
|
Zhao L, Wang Y, Bawa EM, Meng Z, Wei J, Newman-Norlund S, Trivedi T, Hasturk H, Newman-Norlund RD, Fridriksson J, Merchant AT. Identifying a group of factors predicting cognitive impairment among older adults. PLoS One 2024; 19:e0301979. [PMID: 38603668 PMCID: PMC11008866 DOI: 10.1371/journal.pone.0301979] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Accepted: 03/26/2024] [Indexed: 04/13/2024] Open
Abstract
BACKGROUND Cognitive impairment has multiple risk factors spanning several domains, but few studies have evaluated risk factor clusters. We aimed to identify naturally occurring clusters of risk factors of poor cognition among middle-aged and older adults and evaluate associations between measures of cognition and these risk factor clusters. METHODS We used data from the National Health and Nutrition Examination Survey (NHANES) III (training dataset, n = 4074) and the NHANES 2011-2014 (validation dataset, n = 2510). Risk factors were selected based on the literature. We used both traditional logistic models and support vector machine methods to construct a composite score of risk factor clusters. We evaluated associations between the risk score and cognitive performance using the logistic model by estimating odds ratios (OR) and 95% confidence intervals (CI). RESULTS Using the training dataset, we developed a composite risk score that predicted undiagnosed cognitive decline based on ten selected predictive risk factors including age, waist circumference, healthy eating index, race, education, income, physical activity, diabetes, hypercholesterolemia, and annual visit to dentist. The risk score was significantly associated with poor cognitive performance both in the training dataset (OR Tertile 3 verse tertile 1 = 8.15, 95% CI: 5.36-12.4) and validation dataset (OR Tertile 3 verse tertile 1 = 4.31, 95% CI: 2.62-7.08). The area under the receiver operating characteristics curve for the predictive model was 0.74 and 0.77 for crude model and model adjusted for age, sex, and race. CONCLUSION The model based on selected risk factors may be used to identify high risk individuals with cognitive impairment.
Collapse
Affiliation(s)
- Longgang Zhao
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, United States of America
| | - Yuan Wang
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, United States of America
| | - Eric Mishio Bawa
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, United States of America
| | - Zichun Meng
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, United States of America
| | - Jingkai Wei
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, United States of America
| | - Sarah Newman-Norlund
- Communication Sciences and Disorders, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, United States of America
| | - Tushar Trivedi
- Regional Medical Center Primary Care Stroke, Orangeburg, SC, United States of America
| | - Hatice Hasturk
- Center for Clinical and Translational Research, Forsyth Institute, Boston, MA, United States of America
| | - Roger D. Newman-Norlund
- Communication Sciences and Disorders, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, United States of America
| | - Julius Fridriksson
- Communication Sciences and Disorders, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, United States of America
| | - Anwar T. Merchant
- Department of Epidemiology and Biostatistics, Arnold School of Public Health, University of South Carolina, Columbia, South Carolina, United States of America
| |
Collapse
|
2
|
Hrelia S, Di Renzo L, Bavaresco L, Bernardi E, Malaguti M, Giacosa A. Moderate Wine Consumption and Health: A Narrative Review. Nutrients 2022; 15:175. [PMID: 36615832 PMCID: PMC9824172 DOI: 10.3390/nu15010175] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2022] [Revised: 12/21/2022] [Accepted: 12/28/2022] [Indexed: 12/31/2022] Open
Abstract
Although it is clearly established that the abuse of alcohol is seriously harmful to health, much epidemiological and clinical evidence seem to underline the protective role of moderate quantities of alcohol and in particular of wine on health. This narrative review aims to re-evaluate the relationship between the type and dose of alcoholic drink and reduced or increased risk of various diseases, in the light of the most current scientific evidence. In particular, in vitro studies on the modulation of biochemical pathways and gene expression of wine bioactive components were evaluated. Twenty-four studies were selected after PubMed, Scopus and Google Scholar searches for the evaluation of moderate alcohol/wine consumption and health effects: eight studies concerned cardiovascular diseases, three concerned type 2 diabetes, four concerned neurodegenerative diseases, five concerned cancer and four were related to longevity. A brief discussion on viticultural and enological practices potentially affecting the content of bioactive components in wine is included. The analysis clearly indicates that wine differs from other alcoholic beverages and its moderate consumption not only does not increase the risk of chronic degenerative diseases but is also associated with health benefits particularly when included in a Mediterranean diet model. Obviously, every effort must be made to promote behavioral education to prevent abuse, especially among young people.
Collapse
Affiliation(s)
- Silvana Hrelia
- Department for Life Quality Studies, University of Bologna, 47921 Rimini, Italy
| | - Laura Di Renzo
- Section of Clinical Nutrition and Nutrigenomics, Department of Biomedicine and Prevention, University of Tor Vergata, 00133 Rome, Italy
| | - Luigi Bavaresco
- Department of Sustainable Crop Production—Viticulture and Pomology Section, Università Cattolica del Sacro Cuore, 29122 Piacenza, Italy
| | - Elisabetta Bernardi
- Department of Biosciences, Biotechnologies and Biopharmaceutics, University of Bari “Aldo Moro”, 70121 Bari, Italy
| | - Marco Malaguti
- Department for Life Quality Studies, University of Bologna, 47921 Rimini, Italy
| | - Attilio Giacosa
- Department of Gastroenterology and Clinical Nutrition, Policlinico di Monza, 20900 Monza, Italy
| |
Collapse
|
3
|
Lucerón-Lucas-Torres M, Cavero-Redondo I, Martínez-Vizcaíno V, Saz-Lara A, Pascual-Morena C, Álvarez-Bueno C. Association Between Wine Consumption and Cognitive Decline in Older People: A Systematic Review and Meta-Analysis of Longitudinal Studies. Front Nutr 2022; 9:863059. [PMID: 35634389 PMCID: PMC9133879 DOI: 10.3389/fnut.2022.863059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2022] [Accepted: 03/18/2022] [Indexed: 11/13/2022] Open
Abstract
Background Low-to-moderate alcohol consumption appears to have potential health benefits. Existing evidence concludes that wine may be associated with a lower incidence of certain diseases. This systematic review and meta-analysis aim to examine evidence on the association between wine consumption and cognitive decline and to analyze whether this association varies depending on the wine consumption level or is affected by individual and study characteristics, including mean age, percentage of women participants, and follow-up time. Methods In this systematic review and meta-analysis, we undertook a search in MEDLINE (via PubMed), Scopus, Cochrane, and Web of Science databases for longitudinal studies measuring the association between wine consumption and cognitive decline from their inception to May 2021. Effect sizes were calculated using the DerSimonian and Laird and Hartung-Knapp-Sidik-Jonkman methods. Results The search retrieved 6,055 articles, 16 of which were included in this systematic review. In total, 12 studies were included in the meta-analysis. The studies were published between 1997 and 2019. They were conducted in nine different countries. The sample size of the included studies ranged from 360 to 10,308 with a mean age of 70 years old. Using the DerSimoniand and Laird method, the pooled RR for the effect of wine consumption on cognitive decline was 0.72 (95% CI 0.63–0.80; I2 = 82.4%; τ2: 0.0154). Using the Hartung-Knapp-Sidik-Jonkman method, the RR was 0.65 (95% CI 0.52–0.79; I2 = 94,531%; τ2: 0.057). Conclusions This study may show a protective effect of wine consumption against cognitive decline. However, it would be important for future research to differentiate the types of wine within consumption.
Collapse
Affiliation(s)
| | - Iván Cavero-Redondo
- Universidad de Castilla-La Mancha, Health and Social Research Center, Cuenca, Spain
- Universidad Autónoma de Chile, Facultad de Ciencias de la Salud, Talca, Chile
- *Correspondence: Iván Cavero-Redondo
| | - Vicente Martínez-Vizcaíno
- Universidad de Castilla-La Mancha, Health and Social Research Center, Cuenca, Spain
- Universidad Autónoma de Chile, Facultad de Ciencias de la Salud, Talca, Chile
| | - Alicia Saz-Lara
- Universidad de Castilla-La Mancha, Health and Social Research Center, Cuenca, Spain
| | | | - Celia Álvarez-Bueno
- Universidad de Castilla-La Mancha, Health and Social Research Center, Cuenca, Spain
- Universidad Politécnica y Artística del Paraguay, Asunción, Paraguay
| |
Collapse
|
4
|
Chosy EJ, Edland S, Launer L, White LR. Midlife alcohol consumption and later life cognitive impairment: Light drinking is not protective and APOE genotype does not change this relationship. PLoS One 2022; 17:e0264575. [PMID: 35275952 PMCID: PMC8916616 DOI: 10.1371/journal.pone.0264575] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Accepted: 02/12/2022] [Indexed: 11/30/2022] Open
Abstract
INTRODUCTION Much debate exists about the role of light to moderate alcohol intake and subsequent cognitive function. The apolipoprotein E genotype may modify the relationship. METHODS Using data from the Honolulu-Asia Aging Study, a longitudinal population-based cohort (n = 2,416), Cox proportional hazards regression analyses were performed to measure midlife alcohol intake (average age = 52 years) and later life cognitive function (average age = 87 years) and to explore the role of apolipoprotein E genotype. RESULTS No protective effect of light drinking (>1 drink/month- 1 drink/day) or moderate drinking (>1-2 drinks/day) was observed in the cohort in adjusted models (HR = 1.013, CI:0.88-1.16; HR = 1.104, CI:0.91-1.34, respectively). Heavy drinking (>2-4 drinks/day) and very heavy drinking (>4 drinks/day) increased the risk for incident moderate cognitive impairment (HR = 1.355, CI:1.09-1.68; HR = 1.462, CI:1.04-2.05, respectively). When examining the relationship by apolipoprotein E ε4 carrier status, a similar dose-response pattern was observed in both groups with higher hazard ratios for those carrying at least one copy of the apolipoprotein E ℇ4 allele. As alcohol level increased, the age at incident moderate cognitive impairment decreased, especially among those with at least one apolipoprotein E ℇ4 allele. DISCUSSION We did not observe a significant protective effect for light to moderate drinking in midlife and subsequent cognitive impairment in this cohort. Heavy drinking increased the risk for moderate cognitive impairment and decreased the age at incidence, as did carrying at least one allele of the apolipoprotein E ℇ4 gene.
Collapse
Affiliation(s)
- E. Julia Chosy
- Pacific Health Research and Education Institute, Honolulu, Hawaii, United States of America
| | - Steven Edland
- University of California at San Diego, La Jolla, California, United States of America
| | - Lenore Launer
- National Institute on Aging, National Institutes of Health, Bethesda, Maryland, United States of America
| | - Lon R. White
- Pacific Health Research and Education Institute, Honolulu, Hawaii, United States of America
| |
Collapse
|
5
|
Zhang Y, Li Y, Zheng X, Zhu L, Xu B. Association between alcohol consumption in midlife and cognitive function in old age: Findings from the China health and Nutrition Survey. Nutr Metab Cardiovasc Dis 2021; 31:3044-3053. [PMID: 34642057 DOI: 10.1016/j.numecd.2021.07.023] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Revised: 07/18/2021] [Accepted: 07/19/2021] [Indexed: 11/21/2022]
Abstract
BACKGROUND AND AIMS Alcohol consumption has been reported to impair the physical and mental health of the elderly. This study aimed to explore the association between alcohol consumption patterns in midlife and cognition in the elderly among the Chinese population. METHODS AND RESULTS Study subjects were individuals aged ≥45 years in the shared database of the China Health and Nutrition Survey in 1997, who were followed up in 2006. A questionnaire was used to collect information about alcohol consumption (frequency, amount and type). Alcohol consumption (grams/week) was classified into none, light (≤84), light-to-moderate (84.01-168), moderate-to-heavy (168.01-336) and heavy (≥336.01) categories in men, and none, light (<42) and moderate (≥42) categories in women. Cognitive function was measured in 2006 using a subset of items from the modified Telephone Interview for Cognitive Status. The lowest quintile was used as the cut-off point for cognitive impairment. A multivariate logistic regression model was applied. The study involved 1926 participants with a mean age of 56.91 years, and men accounted for 51.66% of the total participants. Drinking behaviours and cognitive scores had significant sexual difference (P < 0.001). Cognitive impairment was identified in 135 men and 237 women. Compared with light drinking, heavy drinking and non-drinking were associated with cognitive impairment in men [adjusted odds ratio (aOR) and 95% CI were 2.19 (1.59-3.00), 1.54 (1.21-1.96), respectively; P < 0.001]. Compared with light drinkers, female non-drinkers and moderate drinkers were associated with cognitive impairment [aOR and 95% CI were 1.54 (1.16-2.03) and 1.75 (1.08-2.85), respectively; P < 0.001]. CONCLUSIONS Scientific evidence on the adverse effects of heavy drinking on elderly cognition and the possibly protective effects of light drinking could influence policy decisions on alcohol consumption in China.
Collapse
Affiliation(s)
- Yuge Zhang
- Department of Epidemiology, School of Public Health, Fudan University, Shanghai, China; Key Laboratory of Health Technology Assessment, National Health Commission of the People's Republic of China (Fudan University), Shanghai, China
| | - Yang Li
- Department of Nephrology, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Xubin Zheng
- Department of Epidemiology, School of Public Health, Fudan University, Shanghai, China; Key Laboratory of Health Technology Assessment, National Health Commission of the People's Republic of China (Fudan University), Shanghai, China
| | - Liping Zhu
- Shanghai Center for Women and Children's Health, Shanghai, China
| | - Biao Xu
- Department of Epidemiology, School of Public Health, Fudan University, Shanghai, China; Key Laboratory of Health Technology Assessment, National Health Commission of the People's Republic of China (Fudan University), Shanghai, China.
| |
Collapse
|
6
|
Li CC, Chen YF, Liang J, Matthews AK, Barnes LL. Trajectories of Multiple Behavioral Risk Factors and Their Associations With Cognitive Function Trajectories Among Older African Americans and White Americans. J Aging Health 2021; 33:674-684. [PMID: 33788658 DOI: 10.1177/08982643211005905] [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
Objectives: This study examined the joint trajectories of behavioral risk factors (smoking, alcohol drinking, and body mass index) and their associations with cognitive function trajectories among older African Americans and white Americans. Methods: Data from the Health and Retirement Study (1998-2014) were used. Group-based mixture modeling and multinomial logistic regression analysis were performed. Results: Three joint trajectories of behavioral risk factors (overweight, smoking and drinking, and drinking and overweight) and three cognitive function trajectories (low, moderate, and high) were identified. A significantly higher percentage of African Americans were in the "overweight," "smoking and drinking," and "low" cognitive functioning groups as measured by the total cognition composite score compared to white Americans. After accounting for covariates, the "drinking and overweight" group was associated with the "moderate" or "high" cognitive functioning group. Discussion: Future interventions targeting the combinations of behavioral risk factors are needed to promote healthy aging among high-risk populations.
Collapse
Affiliation(s)
- Chien-Ching Li
- Department of Health Systems Management, 2461Rush University, Chicago, IL, USA
| | - Yi-Fan Chen
- Center for Clinical Translational Science, 14681University of Illinois at Chicago, Chicago, IL, USA
| | - Jersey Liang
- Department of Health Management and Policy, 1259University of Michigan, Ann Arbor, MI, USA
| | - Alicia K Matthews
- Department of Population Health Nursing Science, 14681University of Illinois at Chicago, Chicago, IL, USA
| | - Lisa L Barnes
- Alzheimer's Disease Center, 2461Rush University Medical Center, Chicago, IL, USA
| |
Collapse
|
7
|
Slayday RE, Gustavson DE, Elman JA, Beck A, McEvoy LK, Tu XM, Fang B, Hauger RL, Lyons MJ, McKenzie RE, Sanderson-Cimino ME, Xian H, Kremen WS, Franz CE. Interaction between Alcohol Consumption and Apolipoprotein E (ApoE) Genotype with Cognition in Middle-Aged Men. J Int Neuropsychol Soc 2021; 27:56-68. [PMID: 32662384 PMCID: PMC7856052 DOI: 10.1017/s1355617720000570] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Heavy alcohol consumption is associated with poorer cognitive function in older adults. Although understudied in middle-aged adults, the relationship between alcohol and cognition may also be influenced by genetics such as the apolipoprotein (ApoE) ε4 allele, a risk factor for Alzheimer's disease. We examined the relationship between alcohol consumption, ApoE genotype, and cognition in middle-aged adults and hypothesized that light and/or moderate drinkers (≤2 drinks per day) would show better cognitive performance than heavy drinkers or non-drinkers. Additionally, we hypothesized that the association between alcohol use and cognitive function would differ by ApoE genotype (ε4+ vs. ε4-). METHOD Participants were 1266 men from the Vietnam Era Twin Study of Aging (VETSA; M age = 56; range 51-60) who completed a neuropsychological battery assessing seven cognitive abilities: general cognitive ability (GCA), episodic memory, processing speed, executive function, abstract reasoning, verbal fluency, and visuospatial ability. Alcohol consumption was categorized into five groups: never, former, light, moderate, and heavy. RESULTS In fully adjusted models, there was no significant main effect of alcohol consumption on cognitive functions. However, there was a significant interaction between alcohol consumption and ApoE ε4 status for GCA and episodic memory, such that the relationship of alcohol consumption and cognition was stronger in ε4 carriers. The ε4+ heavy drinking subgroup had the poorest GCA and episodic memory. CONCLUSIONS Presence of the ε4 allele may increase vulnerability to the deleterious effects of heavy alcohol consumption. Beneficial effects of light or moderate alcohol consumption were not observed.
Collapse
Affiliation(s)
- Riki E. Slayday
- Department of Psychology, San Diego State University, San
Diego, CA, USA
| | - Daniel E. Gustavson
- Department of Psychiatry, University of California San
Diego, La Jolla CA, USA
| | - Jeremy A. Elman
- Department of Psychiatry, University of California San
Diego, La Jolla CA, USA
| | - Asad Beck
- University of Washington, Graduate Program in Neuroscience,
Seattle, WA, USA
| | - Linda K. McEvoy
- Department of Radiology, University of California San
Diego, La Jolla, CA, USA
| | - Xin M. Tu
- Department of Family Medicine, University of California San
Diego, La Jolla, CA, USA
| | - Bin Fang
- Department of Psychiatry, University of California San
Diego, La Jolla CA, USA
| | - Richard L. Hauger
- Department of Psychiatry, University of California San
Diego, La Jolla CA, USA
- Center of Excellence for Stress and Mental Health, VA San
Diego Healthcare System, San Diego, CA, USA
| | - Michael J. Lyons
- Department of Psychological and Brain Sciences, Boston
University, Boston, MA, USA
| | - Ruth E. McKenzie
- Department of Psychological and Brain Sciences, Boston
University, Boston, MA, USA
| | - Mark E. Sanderson-Cimino
- Department of Psychology, San Diego State University, San
Diego, CA, USA
- Department of Psychiatry, University of California San
Diego, La Jolla CA, USA
| | - Hong Xian
- Department of Biostatistics, St Louis University, St.
Louis, MO, USA
| | - William S. Kremen
- Department of Psychiatry, University of California San
Diego, La Jolla CA, USA
- Center of Excellence for Stress and Mental Health, VA San
Diego Healthcare System, San Diego, CA, USA
- Center for Behavior Genetics of Aging, University of
California San Diego, La Jolla CA, USA
| | - Carol E. Franz
- Department of Psychiatry, University of California San
Diego, La Jolla CA, USA
- Center for Behavior Genetics of Aging, University of
California San Diego, La Jolla CA, USA
| |
Collapse
|
8
|
Danso SO, Muniz-Terrera G, Luz S, Ritchie C. Application of Big Data and Artificial Intelligence technologies to dementia prevention research: an opportunity for low-and-middle-income countries. J Glob Health 2020; 9:020322. [PMID: 32257177 PMCID: PMC7101511 DOI: 10.7189/jogh.09.020322] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Samuel O Danso
- Edinburgh Dementia Prevention, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, Scotland, UK
| | - Graciela Muniz-Terrera
- Edinburgh Dementia Prevention, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, Scotland, UK
| | - Saturnino Luz
- Usher Institute of Population Health Sciences and Informatics, Edinburgh Medical School, Molecular, Genetic and Population Health Sciences, University of Edinburgh, Edinburgh, Scotland, UK
| | - Craig Ritchie
- Edinburgh Dementia Prevention, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, Scotland, UK
| | | |
Collapse
|
9
|
Kim JW, Byun MS, Yi D, Lee JH, Ko K, Jeon SY, Sohn BK, Lee JY, Kim YK, Shin SA, Sohn CH, Lee DY. Association of moderate alcohol intake with in vivo amyloid-beta deposition in human brain: A cross-sectional study. PLoS Med 2020; 17:e1003022. [PMID: 32097439 PMCID: PMC7041799 DOI: 10.1371/journal.pmed.1003022] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2019] [Accepted: 01/17/2020] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND An emerging body of literature has indicated that moderate alcohol intake may be protective against Alzheimer disease (AD) dementia. However, little information is available regarding whether moderate alcohol intake is related to reductions in amyloid-beta (Aβ) deposition, or is protective via amyloid-independent mechanisms in the living human brain. Here we examined the associations of moderate alcohol intake with in vivo AD pathologies, including cerebral Aβ deposition, neurodegeneration of AD-signature regions, and cerebral white matter hyperintensities (WMHs) in the living human brain. METHODS AND FINDINGS The present study was part of the Korean Brain Aging Study for Early Diagnosis and Prediction of Alzheimer's Disease (KBASE), an ongoing prospective cohort study that started in 2014. As of November 2016, 414 community-dwelling individuals with neither dementia nor alcohol-related disorders (280 cognitively normal [CN] individuals and 134 individuals with mild cognitive impairment [MCI]) between 56 and 90 years of age (mean age 70.9 years ± standard deviation 7.8; male, n [%] = 180 [43.5]) were recruited from 4 sites (i.e., 2 university hospitals and 2 public centers for dementia prevention and management) around Seoul, South Korea. All the participants underwent comprehensive clinical assessments comprising lifetime and current histories of alcohol intake and multimodal brain imaging, including [11C] Pittsburgh compound B positron emission tomography (PET), [18F] fluorodeoxyglucose (FDG) PET, and magnetic resonance imaging (MRI) scans. Lifetime and current alcohol intake were categorized as follows: no drinking, <1 standard drink (SD)/week, 1-13 SDs/week, and 14+ SDs/week. A moderate lifetime alcohol intake (1-13 SDs/week) was significantly associated with a lower Aβ positivity rate compared to the no drinking group, even after controlling for potential confounders (odds ratio 0.341, 95% confidence interval 0.163-0.714, p = 0.004). In contrast, current alcohol intake was not associated with amyloid deposition. Additionally, alcohol intake was not related to neurodegeneration of AD-signature regions or cerebral WMH volume. The present study had some limitations in that it had a cross-sectional design and depended on retrospective recall for alcohol drinking history. CONCLUSIONS In this study, we observed in middle- and old-aged individuals with neither dementia nor alcohol-related disorders that moderate lifetime alcohol intake was associated with lower cerebral Aβ deposition compared to a lifetime history of not drinking. Moderate lifetime alcohol intake may have a beneficial influence on AD by reducing pathological amyloid deposition rather than amyloid-independent neurodegeneration or cerebrovascular injury.
Collapse
Affiliation(s)
- Jee Wook Kim
- Department of Neuropsychiatry, Hallym University Dongtan Sacred Heart Hospital, Hwaseong, Republic of Korea
- Department of Psychiatry, Hallym University College of Medicine, Chuncheon, Republic of Korea
| | - Min Soo Byun
- Institute of Human Behavioral Medicine, Medical Research Center, Seoul National University, Seoul, Republic of Korea
| | - Dahyun Yi
- Institute of Human Behavioral Medicine, Medical Research Center, Seoul National University, Seoul, Republic of Korea
| | - Jun Ho Lee
- Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Republic of Korea
| | - Kang Ko
- Department of Geriatric Psychiatry, National Center for Mental Health, Seoul, Republic of Korea
| | - So Yeon Jeon
- Department of Psychiatry, Chungnam National University Hospital, Daejeon, Republic of Korea
| | - Bo Kyung Sohn
- Department of Psychiatry, Sanggye Paik Hospital, Inje University College of Medicine, Seoul, Republic of Korea
| | - Jun-Young Lee
- Department of Neuropsychiatry, SMG-SNU Boramae Medical Center, Seoul, Republic of Korea
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Yu Kyeong Kim
- Department of Nuclear Medicine, SMG-SNU Boramae Medical Center, Seoul, Republic of Korea
| | - Seong A Shin
- Department of Nuclear Medicine, SMG-SNU Boramae Medical Center, Seoul, Republic of Korea
| | - Chul-Ho Sohn
- Department of Radiology, Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Dong Young Lee
- Institute of Human Behavioral Medicine, Medical Research Center, Seoul National University, Seoul, Republic of Korea
- Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Republic of Korea
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, Republic of Korea
- * E-mail:
| | | |
Collapse
|
10
|
Schubert CR, Fischer ME, Pinto AA, Chen Y, Klein BE, Klein R, Tsai MY, Tweed TS, Cruickshanks KJ. Brain Aging in Midlife: The Beaver Dam Offspring Study. J Am Geriatr Soc 2019; 67:1610-1616. [PMID: 30934109 PMCID: PMC6684355 DOI: 10.1111/jgs.15886] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2018] [Revised: 01/22/2019] [Accepted: 02/21/2019] [Indexed: 12/19/2022]
Abstract
OBJECTIVES Middle age has been identified as a critical time period for health later in life. Identifying factors associated with worse brain function in middle-aged adults may help identify ways to preserve brain function with aging. Our objective was to evaluate factors associated with a novel measure of brain aging in middle-aged and older adults. DESIGN Longitudinal cohort study. SETTING Beaver Dam Offspring Study (BOSS) baseline (2005-2008), 5-year (2010-2013), and 10-year examinations (2015-2017). PARTICIPANTS A total of 2285 adults, 22 to 84 years of age, with complete sensorineural and neurocognitive data at the 5-year examination. MEASUREMENTS Principal component analysis (PCA) was performed combining 5-year sensorineural (hearing, vision, olfaction) and cognitive (Trail Making Test A and B, Digit Symbol Substitution Test, Verbal Fluency Test, Auditory Verbal Learning Test) test data. Participants with a standardized PCA score less than -1 were classified as having brain aging. Incident brain aging was defined as a PCA score less than -1 at 10 years among participants who had a PCA score of -1 or higher at 5 years. Logistic regression and Poisson models were used to estimate associations between baseline factors and prevalent or incident brain aging, respectively. RESULTS Older age, being male, current smoking, larger waist circumference, not consuming alcohol, cardiovascular disease, and interleukin-6 were associated with greater odds of prevalent brain aging, whereas more education and exercise were associated with decreased odds. In addition to age and sex, less than a college education, higher levels of soluble intercellular adhesion molecule-1, diabetes, depressive symptoms, and history of head injury were associated with an increased 5-year risk of incident brain aging. CONCLUSION In the current study, vascular and inflammatory factors were associated with a new brain aging marker in middle-aged and older adults. Many of these factors are modifiable, highlighting the importance of addressing health and lifestyle factors in midlife to potentially preserve function for better brain health later in life. J Am Geriatr Soc 67:1610-1616, 2019.
Collapse
Affiliation(s)
- Carla R. Schubert
- Department of Ophthalmology and Visual Sciences, School of Medicine and Public Health, University of Wisconsin-Madison, 610 Walnut Street, Madison, WI 53726, USA
| | - Mary E. Fischer
- Department of Ophthalmology and Visual Sciences, School of Medicine and Public Health, University of Wisconsin-Madison, 610 Walnut Street, Madison, WI 53726, USA
| | - A. Alex Pinto
- Department of Ophthalmology and Visual Sciences, School of Medicine and Public Health, University of Wisconsin-Madison, 610 Walnut Street, Madison, WI 53726, USA
| | - Yanjun Chen
- Department of Ophthalmology and Visual Sciences, School of Medicine and Public Health, University of Wisconsin-Madison, 610 Walnut Street, Madison, WI 53726, USA
| | - Barbara E.K. Klein
- Department of Ophthalmology and Visual Sciences, School of Medicine and Public Health, University of Wisconsin-Madison, 610 Walnut Street, Madison, WI 53726, USA
| | - Ronald Klein
- Department of Ophthalmology and Visual Sciences, School of Medicine and Public Health, University of Wisconsin-Madison, 610 Walnut Street, Madison, WI 53726, USA
| | - Michael Y. Tsai
- Department of Laboratory Medicine and Pathology, University of Minnesota, 420 Delaware Street S.E., Minneapolis, MN 55455
| | - Ted S. Tweed
- Department of Ophthalmology and Visual Sciences, School of Medicine and Public Health, University of Wisconsin-Madison, 610 Walnut Street, Madison, WI 53726, USA
| | - Karen J. Cruickshanks
- Department of Ophthalmology and Visual Sciences, School of Medicine and Public Health, University of Wisconsin-Madison, 610 Walnut Street, Madison, WI 53726, USA
- Department of Population Health Sciences, School of Medicine and Public Health, University of Wisconsin-Madison, 610 Walnut Street, Madison, WI 53726, USA
| |
Collapse
|
11
|
Liu Y, Mitsuhashi T, Yamakawa M, Sasai M, Tsuda T, Doi H, Hamada J. Alcohol consumption and incident dementia in older Japanese adults: The Okayama Study. Geriatr Gerontol Int 2019; 19:740-746. [PMID: 31173440 DOI: 10.1111/ggi.13694] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2018] [Revised: 04/03/2019] [Accepted: 04/23/2019] [Indexed: 11/30/2022]
Abstract
AIM To evaluate the association between the amount and frequency of alcohol consumption and incident dementia in older Japanese adults using large sample size data over a long follow-up period. METHODS This was a retrospective cohort study carried out in Japan. A total of 53 311 older adults were followed from 2008 to 2014. A health checkup questionnaire was used to assess the amount and frequency of alcohol consumption. The Dementia Scale of long-term care insurance was used as a measure of incident dementia. Cox proportional hazards models were used to calculate adjusted hazard ratios, with their 95% confidence intervals, for the incidence of dementia across the categories of alcohol consumption by sex. RESULTS During a 7-year follow-up period, 14 479 participants were regarded as having incident dementia. Compared with non-drinkers, the multivariate adjusted hazard ratios for participants with alcohol consumption ≤2 units per day, occasionally (0.88, 95% CI 0.81-0.96 in men and 0.84, 95% 0.79-0.90 in women) and daily (0.79, 95% 0.73-0.85 in men and 0.87, 95% 0.78-0.97 in women) were statistically significant, and the difference between occasional and daily consumption was only statistically significant in men; however, for participants with alcohol consumption >2 units per day, occasionally (0.91, 95% 0.71-1.16 in men and 1.09, 95% 0.72-1.67 in women) and daily (0.89, 95% 0.81-1.00 in men and 1.16, 95% 0.84-1.81 in women) were not significant. CONCLUSIONS Alcohol consumption of ≤2 units per day, occasionally or daily, could reduce the risk of incident dementia, with greater benefit for men with such daily consumption. Geriatr Gerontol Int 2019; 19: 740-746.
Collapse
Affiliation(s)
- Yangyang Liu
- Department of Epidemiology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, Japan
| | - Toshiharu Mitsuhashi
- Center for Innovative Clinical Medicine, Okayama University Hospital, Okayama, Japan
| | - Michiyo Yamakawa
- Department of Epidemiology and Preventive Medicine, Graduate School of Medicine, Gifu University, Gifu, Japan
| | - Megumi Sasai
- Department of Human Ecology, Graduate School of Environmental and Life Science, Okayama University, Okayama, Japan
| | - Toshihide Tsuda
- Department of Human Ecology, Graduate School of Environmental and Life Science, Okayama University, Okayama, Japan
| | - Hiroyuki Doi
- Department of Epidemiology, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, Japan
| | - Jun Hamada
- Department of Health Economics and Policy, Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University, Okayama, Japan
| |
Collapse
|
12
|
Hooshmand B, Rusanen M, Ngandu T, Leiviskä J, Sindi S, von Arnim CAF, Falkai P, Soininen H, Tuomilehto J, Kivipelto M. Serum Insulin and Cognitive Performance in Older Adults: A Longitudinal Study. Am J Med 2019; 132:367-373. [PMID: 30502316 DOI: 10.1016/j.amjmed.2018.11.013] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/17/2018] [Revised: 11/17/2018] [Accepted: 11/19/2018] [Indexed: 01/26/2023]
Abstract
PURPOSE The aim of this study was to examine the association of serum glucose, insulin, and insulin resistance with cognitive functioning 7 years later in a longitudinal population-based study of Finnish older adults. METHODS Serum glucose and insulin were measured at baseline in 269 dementia-free individuals aged 65-79 years, from the Cardiovascular Risk Factors, Aging, and Dementia (CAIDE) study. Insulin resistance was estimated with the homeostasis model assessment (HOMA-IR). Participants were reexamined 7 years later, and global cognition, episodic memory, executive functioning, verbal expression, and psychomotor speed were assessed, both at baseline and at follow-up. Multiple linear regression was used to investigate the associations with cognitive performance at follow-up, after adjusting for several potential confounders, including common vascular risk factors. RESULTS In the multivariable-adjusted linear regression models, no associations of insulin resistance with cognitive functioning were observed. After excluding 19 incident dementia cases, higher baseline HOMA-IR values were related to worse performance in global cognition (β [standard error (SE)] -.050 [0.02]; P = .043) and psychomotor speed (β [SE] -.064 [.03]; P = [.043]) 7 years later. Raised serum insulin levels were associated with lower scores on global cognition (β [SE] -.054 [.03]; P = .045) and tended to relate to poorer performance in psychomotor speed (β [SE] -.061 [.03]; P = .070). CONCLUSIONS Serum insulin and insulin resistance may be independent predictors of cognitive performance 7 years later in elderly individuals without dementia. Randomized controlled trials are needed to determine this issue.
Collapse
Affiliation(s)
- Babak Hooshmand
- Aging Research Center, Karolinska Institute, Stockholm, Sweden; Department of Neurology, Ulm University Hospital, Germany.
| | - Minna Rusanen
- Department of Neurology, Institute of Clinical Medicine, University of Eastern Finland, Kuopio; Chronic Disease Prevention Unit, Department of Public Health Solutions, National Institute for Health and Welfare, University of Helsinki, Finland
| | - Tiia Ngandu
- Chronic Disease Prevention Unit, Department of Public Health Solutions, National Institute for Health and Welfare, University of Helsinki, Finland
| | - Jaana Leiviskä
- Genomics and Biomarkers Unit, Department of Public Health Solutions, National Institute for Health and Welfare, University of Helsinki, Finland
| | - Shireen Sindi
- Aging Research Center, Karolinska Institute, Stockholm, Sweden
| | | | - Peter Falkai
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Germany
| | - Hilkka Soininen
- Department of Neurology, Institute of Clinical Medicine, University of Eastern Finland, Kuopio; Neurocenter, Neurology, Kuopio University Hospital, Finland
| | - Jaakko Tuomilehto
- Genomics and Biomarkers Unit, Department of Public Health Solutions, National Institute for Health and Welfare, University of Helsinki, Finland; Department of Public Health, HJELT Institute, University of Helsinki, Finland; University of Helsinki, Helsinki University Central Hospital, Finland; South Ostrobothnia Central Hospital, Seinäjoki, Finland; Diabetes Research Group, King Abdulaziz University, Jeddah, Saudi Arabia; Dasman Diabetes Institute, Kuwait City, Kuwait
| | - Miia Kivipelto
- Aging Research Center, Karolinska Institute, Stockholm, Sweden; Department of Neurology, Institute of Clinical Medicine, University of Eastern Finland, Kuopio; Division of Clinical Geriatrics, Center for Alzheimer Research, Karolinska Institute, Stockholm, Sweden
| |
Collapse
|
13
|
Wu J, Dong W, Pan XF, Feng L, Yuan JM, Pan A, Koh WP. Relation of cigarette smoking and alcohol drinking in midlife with risk of cognitive impairment in late life: the Singapore Chinese Health Study. Age Ageing 2019; 48:101-107. [PMID: 30307472 DOI: 10.1093/ageing/afy166] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2018] [Indexed: 02/06/2023] Open
Abstract
Background the relations of cigarette smoking and alcohol drinking with risk of cognitive impairment remain inconsistent. Methods to examine the independent and joint relations of smoking and alcohol drinking with cognitive impairment, we used data from 16,948 men and women, who had been followed-up for 16-23 (mean of 20) years as participants of the Singapore Chinese Health Study, a population-based prospective cohort. Data on smoking and alcohol drinking were collected at baseline (1993-98), when participants were aged 45-74 (mean 53) years. Cognition was assessed using a 30-item Mini-Mental State Examination during follow-up three visits (2014-16), when participants were aged 61-96 (mean 73) years. Multivariable logistic regression models were used to estimate the odd ratios (ORs) and 95% confidence intervals (CIs). Results cognitive impairment was present in 2,443 (14.4%) participants. Compared with non-current smokers, current smokers had 20% increased risk (OR = 1.20, 95% CI = 1.04-1.39). Compared with those who drank less than weekly, regular alcohol drinking (at least weekly) had 17% increased risk (OR = 1.17, 95% CI = 1.01-1.36). Compared with those who were neither smokers nor drinkers, those who were either current smokers or regular drinkers alone had no significantly increased risk, while the risk was highest in those who were both current smokers and regular drinkers (OR = 1.77, 95% CI = 1.39-2.26, Pinteraction = 0.003). Conclusions co-existence of smoking and regular alcohol drinking at midlife had a much stronger impact than the individual factors on risk of cognitive impairment in late life.
Collapse
Affiliation(s)
- Jing Wu
- Department of Epidemiology and Biostatistics, and Ministry of Education Key Laboratory of Environment and Health, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, China
| | - Wenhong Dong
- Department of Epidemiology and Biostatistics, and Ministry of Education Key Laboratory of Environment and Health, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, China
| | - Xiong-Fei Pan
- Department of Epidemiology and Biostatistics, and Ministry of Education Key Laboratory of Environment and Health, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, China
| | - Lei Feng
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Jian-Min Yuan
- UPMC Hillman Cancer Center, University of Pittsburgh, Pittsburgh, PA, USA
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA
| | - An Pan
- Department of Epidemiology and Biostatistics, and Ministry of Education Key Laboratory of Environment and Health, and State Key Laboratory of Environmental Health (Incubating), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei Province, China
| | - Woon-Puay Koh
- Health Services and Systems Research, Duke-NUS Medical School, Singapore, Singapore
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore
| |
Collapse
|
14
|
Pekkala T, Hall A, Lötjönen J, Mattila J, Soininen H, Ngandu T, Laatikainen T, Kivipelto M, Solomon A. Development of a Late-Life Dementia Prediction Index with Supervised Machine Learning in the Population-Based CAIDE Study. J Alzheimers Dis 2018; 55:1055-1067. [PMID: 27802228 PMCID: PMC5147511 DOI: 10.3233/jad-160560] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
BACKGROUND AND OBJECTIVE This study aimed to develop a late-life dementia prediction model using a novel validated supervised machine learning method, the Disease State Index (DSI), in the Finnish population-based CAIDE study. METHODS The CAIDE study was based on previous population-based midlife surveys. CAIDE participants were re-examined twice in late-life, and the first late-life re-examination was used as baseline for the present study. The main study population included 709 cognitively normal subjects at first re-examination who returned to the second re-examination up to 10 years later (incident dementia n = 39). An extended population (n = 1009, incident dementia 151) included non-participants/non-survivors (national registers data). DSI was used to develop a dementia index based on first re-examination assessments. Performance in predicting dementia was assessed as area under the ROC curve (AUC). RESULTS AUCs for DSI were 0.79 and 0.75 for main and extended populations. Included predictors were cognition, vascular factors, age, subjective memory complaints, and APOE genotype. CONCLUSION The supervised machine learning method performed well in identifying comprehensive profiles for predicting dementia development up to 10 years later. DSI could thus be useful for identifying individuals who are most at risk and may benefit from dementia prevention interventions.
Collapse
Affiliation(s)
- Timo Pekkala
- Institute of Clinical Medicine, Neurology, University of Eastern Finland, Kuopio, Finland
| | - Anette Hall
- Institute of Clinical Medicine, Neurology, University of Eastern Finland, Kuopio, Finland
| | - Jyrki Lötjönen
- VTT Technical Research Centre of Finland, Tampere, Finland.,Combinostics, Tampere, Finland
| | | | - Hilkka Soininen
- Institute of Clinical Medicine, Neurology, University of Eastern Finland, Kuopio, Finland.,Department of Neurology, Kuopio University Hospital, Kuopio, Finland
| | - Tiia Ngandu
- Chronic Disease Prevention Unit, National Institute for Health and Welfare, Helsinki, Finland
| | - Tiina Laatikainen
- Chronic Disease Prevention Unit, National Institute for Health and Welfare, Helsinki, Finland.,Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland.,Hospital District of North Karelia, Joensuu, Finland
| | - Miia Kivipelto
- Institute of Clinical Medicine, Neurology, University of Eastern Finland, Kuopio, Finland.,Chronic Disease Prevention Unit, National Institute for Health and Welfare, Helsinki, Finland.,Division of Clinical Geriatrics, Center for Alzheimer Research, Karolinska Institutet, Stockholm, Sweden
| | - Alina Solomon
- Institute of Clinical Medicine, Neurology, University of Eastern Finland, Kuopio, Finland.,Division of Clinical Geriatrics, Center for Alzheimer Research, Karolinska Institutet, Stockholm, Sweden
| |
Collapse
|
15
|
Vafeas C, Graham R, de Jong G, Sharp J, Ngune I, Maes S. Alcohol consumption patterns of older adults: a study in a regional town in Western Australia. Contemp Nurse 2017; 53:647-657. [PMID: 29279033 DOI: 10.1080/10376178.2017.1421051] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
AIM This study aimed to demonstrate that opportunistic health screening at health expos can provide an overall impression of alcohol consumption patterns. DESIGN A repeated cross-sectional survey design, completed over a four-year period (2011-2014), was used to assess the risk of harmful alcohol consumption, within a community setting of older adults, in the South West region of Western Australia. METHODS An alcohol screening survey (AUDIT) was used to collect data on alcohol consumption patterns on those aged 65 years and over. A total of 411 surveys were completed. RESULTS There was a statistically significant difference in mean risk scores across the four years (p < .001). 6.3-22.2% of survey completers presented as 'risky', and a further 3.8-12.3% as 'high risk' in terms of alcohol consumption. CONCLUSIONS Opportunistic screening for alcohol consumption during health expos can aid the identification of at-risk individuals who may require further education or treatment.
Collapse
Affiliation(s)
- Caroline Vafeas
- a School of Nursing & Midwifery , Edith Cowan University , Joondalup , Australia
| | - Renee Graham
- a School of Nursing & Midwifery , Edith Cowan University , Joondalup , Australia
| | - Gideon de Jong
- a School of Nursing & Midwifery , Edith Cowan University , Joondalup , Australia
| | - Jennie Sharp
- b School of Nursing & Midwifery , Edith Cowan University , Bunbury , Australia
| | - Irene Ngune
- c School of Nursing, Midwifery & Paramedicine , Curtin University , Bentley , Australia
| | - Saskia Maes
- d Edith Cowan College, Edith Cowan University , Joondalup , Australia
| |
Collapse
|
16
|
Herring D, Paulson D. Moderate alcohol use and apolipoprotein E-4 (ApoE-4): Independent effects on cognitive outcomes in later life. J Clin Exp Neuropsychol 2017; 40:326-337. [PMID: 28659024 DOI: 10.1080/13803395.2017.1343803] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
OBJECTIVES Substantive past research suggests that moderate alcohol use confers beneficial health outcomes. The study of moderate alcohol use and cognition has produced variable findings. The primary goal was to examine the relationship between alcohol use and cognitive aging over time (Experiment 1), in a demographically representative, longitudinal survey of older adults. Experiment 2 examined the hypothesis that apolipoprotein E-4 (ApoE-4) would moderate the relationship between moderate drinking and performance on cognitive domains. METHOD The sample was drawn from the Aging, Demographics, and Memory Study (ADAMS) supplement of the Health and Retirement Study (HRS) and included 856 participants over age 65 in 2001. Follow-up data were from 2002, 2006, and 2008. Alcohol use was measured via self-report. Control variables included gender, age, race, number of years of education, medical burden (total number of medical diseases), and marital status. RESULTS Results of Experiment 1 indicated that moderate alcohol use was significantly associated with better baseline functioning across cognitive measures (p ≤ .05), but had no significant effect on rate of change over time across cognitive domains. Results of Experiment 2 indicated that while ApoE-4 carriage did not moderate the relationship between alcohol use and cognitive performance, generally, both ApoE-4 and moderate alcohol use were significant predictors of cognitive performance. CONCLUSIONS Overall, findings from this study support past findings that moderate alcohol use is associated with better cognitive functioning among community-dwelling older adults, and these relative benefits appear to persist throughout later life. However, the role of individual differences on manifestation of benefit remain very poorly understood. Future research should further examine the respective roles of demographic differences associated with cognitive aging, genetic moderators, and the influence of social interaction.
Collapse
Affiliation(s)
- Danielle Herring
- a Department of Psychology , University of Central Florida , Orlando , FL , USA
| | - Daniel Paulson
- a Department of Psychology , University of Central Florida , Orlando , FL , USA
| |
Collapse
|
17
|
Imtiaz B, Tolppanen AM, Solomon A, Soininen H, Kivipelto M. Estradiol and Cognition in the Cardiovascular Risk Factors, Aging and Dementia (CAIDE) Cohort Study. J Alzheimers Dis 2017; 56:453-458. [DOI: 10.3233/jad-160643] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Bushra Imtiaz
- Institute of Clinical Medicine–Neurology, University of Eastern Finland, Kuopio, Finland
| | - Anna Maija Tolppanen
- Research Center for Comparative Effectiveness and Patient Safety (RECEPS) and School of Pharmacy, University of Eastern Finland, Kuopio, Finland
| | - Alina Solomon
- Institute of Clinical Medicine–Neurology, University of Eastern Finland, Kuopio, Finland
- Karolinska Institutet Center for Alzheimer Research, Stockholm, Sweden
| | - Hilkka Soininen
- Institute of Clinical Medicine–Neurology, University of Eastern Finland, Kuopio, Finland
- Neurocenter, Neurology, Kuopio University Hospital, Kuopio, Finland
| | - Miia Kivipelto
- Department of Neurology, University of Eastern Finland, Kuopio, Finland
- National Institute for Health and Welfare, Helsinki, Finland
- Aging Research Center (ARC) and center for Alzheimer Research, Karolinska Institutet and Stockholm University, Stockholm, Sweden
| |
Collapse
|
18
|
Xu X, Ha SU, Basnet R. A Review of Epidemiological Research on Adverse Neurological Effects of Exposure to Ambient Air Pollution. Front Public Health 2016; 4:157. [PMID: 27547751 PMCID: PMC4974252 DOI: 10.3389/fpubh.2016.00157] [Citation(s) in RCA: 107] [Impact Index Per Article: 13.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2016] [Accepted: 07/19/2016] [Indexed: 12/28/2022] Open
Abstract
There is a growing body of epidemiological research reporting the neurological effects of ambient air pollution. We examined current evidence, identified the strengths and weaknesses of published epidemiological studies, and suggest future directions for research in this area. Studies were identified through a systematic search of online scientific databases, in addition to a manual search of the reference lists from the identified papers. Despite being a relatively new area of investigation, overall, there is mounting evidence implicating adverse effects of air pollution on neurobehavioral function in both adults and children. Further research is needed to expand our understanding of these relationships, including improvement in the accuracy of exposure assessments; focusing on specific toxicants and their relationships to specific health endpoints, such as neurodevelopmental disorders and neurodegenerative diseases; investigating the combined neurological effects of multiple air pollutants; and further exploration of genetic susceptibility for neurotoxicity of air pollution. In order to achieve these goals collaborative efforts are needed from multidisciplinary teams, including experts in toxicology, biostatistics, geographical science, epidemiology, and neurology.
Collapse
Affiliation(s)
- Xiaohui Xu
- Department of Epidemiology and Biostatistics, School of Public Health, Texas A&M Health Science Center , College Station, TX , USA
| | - Sandie Uyen Ha
- College of Public Health and Health Professions, University of Florida , Gainesville, FL , USA
| | - Rakshya Basnet
- Department of Epidemiology and Biostatistics, School of Public Health, Texas A&M Health Science Center , College Station, TX , USA
| |
Collapse
|
19
|
Kuiper JS, Zuidersma M, Zuidema SU, Burgerhof JG, Stolk RP, Oude Voshaar RC, Smidt N. Social relationships and cognitive decline: a systematic review and meta-analysis of longitudinal cohort studies. Int J Epidemiol 2016; 45:1169-1206. [PMID: 27272181 DOI: 10.1093/ije/dyw089] [Citation(s) in RCA: 90] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/30/2016] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Although poor social relationships are assumed to contribute to cognitive decline, meta-analytic approaches have not been applied. Individual study results are mixed and difficult to interpret due to heterogeneity in measures of social relationships. We conducted a systematic review and meta-analysis to investigate the relation between poor social relationships and cognitive decline. METHODS MEDLINE, Embase and PsycINFO were searched for longitudinal cohort studies examining various aspects of social relationships and cognitive decline in the general population. Odds ratios (ORs) with 95% confidence intervals (CIs) were pooled using random effects meta-analysis. Sources of heterogeneity were explored and likelihood of publication bias was assessed. We stratified analyses according to three aspects of social relationships: structural, functional and a combination of these. RESULTS We identified 43 articles. Poor social relationships predicted cognitive decline; for structural (19 studies): pooled OR: 1.08 (95% CI: 1.05-1.11); functional (8 studies): pooled OR: 1.15 (95% CI: 1.00-1.32); and combined measures (7 studies): pooled OR: 1.12 (95% CI: 1.01-1.24). Meta-regression and subgroup analyses showed that the heterogeneity could be explained by the type of social relationship measurement and methodological quality of included studies. CONCLUSIONS Despite heterogeneity in study design and measures, our meta-analyses show that multiple aspects of social relationships are associated with cognitive decline. As evidence for publication bias was found, the association might be overestimated and should therefore be interpreted with caution. Future studies are needed to better define the mechanisms underlying these associations. Potential causality of this prognostic association should be examined in future randomized controlled studies.
Collapse
Affiliation(s)
- Jisca S Kuiper
- Department of Epidemiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Marij Zuidersma
- Department of Psychiatry, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Sytse U Zuidema
- Department of General Practice, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Johannes Gm Burgerhof
- Department of Epidemiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Ronald P Stolk
- Department of Epidemiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Richard C Oude Voshaar
- Department of Psychiatry, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Nynke Smidt
- Department of Epidemiology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands .,Department of Geriatrics, University Medical Center Groningen, Groningen, The Netherlands
| |
Collapse
|
20
|
Aalbers T, Baars MA, Qin L, de Lange A, Kessels RP, Olde Rikkert MG. Using an eHealth Intervention to Stimulate Health Behavior for the Prevention of Cognitive Decline in Dutch Adults: A Study Protocol for the Brain Aging Monitor. JMIR Res Protoc 2015; 4:e130. [PMID: 26554496 PMCID: PMC4704922 DOI: 10.2196/resprot.4468] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2015] [Revised: 08/04/2015] [Accepted: 08/05/2015] [Indexed: 11/23/2022] Open
Abstract
Background Internet-delivered intervention programs are an effective way of changing health behavior in an aging population. The same population has an increasing number of people with cognitive decline or cognitive impairments. Modifiable lifestyle risk factors such as physical activity, nutrition, smoking, alcohol consumption, sleep, and stress all influence the probability of developing neurodegenerative diseases such as Alzheimer’s disease. Objective This study aims to answer two questions: (1) Is the use of a self-motivated, complex eHealth intervention effective in changing multiple health behaviors related to cognitive aging in Dutch adults in the work force, especially those aged 40 and over? and (2) Does this health behavior change result in healthier cognitive aging patterns and contribute to preventing or delaying future onset of neurodegenerative syndromes? Methods The Brain Aging Monitor study uses a quasi-experimental 2-year pre-posttest design. The Brain Aging Monitor is an online, self-motivated lifestyle intervention program. Recruitment is done both in medium to large organizations and in the Dutch general population over the age of 40. The main outcome measure is the relationship between lifestyle change and cognitive aging. The program uses different strategies and modalities such as Web content, email, online newsletters, and online games to aid its users in behavior change. To build self-regulatory skills, the Brain Aging Monitor offers its users goal-setting activities, skill-building activities, and self-monitoring. Results Study results are expected to be published in early 2016. Conclusions This study will add to the body of evidence on the effectiveness of eHealth intervention programs with the combined use of state-of-the-art applied games and established behavior change techniques. This will lead to new insights on how to use behavior change techniques and theory in multidimensional lifestyle eHealth research, and how these techniques and theories apply when they are used in a setting where no professional back-end is available. Trial Registration Nederlands Trial Register: NTR4144; http://www.trialregister.nl/trialreg/admin/rctview.asp?TC=4144 (Archived by WebCite at http://www.webcitation.org/6cZzwZSg3)
Collapse
Affiliation(s)
- Teun Aalbers
- Department of Geriatric Medicine, Radboud University Medical Center, Nijmegen, Netherlands.
| | | | | | | | | | | |
Collapse
|
21
|
Lista S, Dubois B, Hampel H. Paths to Alzheimer's disease prevention: from modifiable risk factors to biomarker enrichment strategies. J Nutr Health Aging 2015; 19:154-63. [PMID: 25651440 DOI: 10.1007/s12603-014-0515-3] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Alzheimer's disease (AD) represents an increasing worldwide healthcare epidemic. Secondary preventive disease-modifying treatments under clinical development are considered most effective when initiated as early as possible in the pathophysiological course and progression of the disease. Major targets are to enhance clearance and to reduce cerebral accumulation of amyloid, decrease hyperphosphorylation of tau and the generation of neurofibrillary tangles, reduce inflammation, and finally progressive neurodegeneration. Comprehensive sets of biological markers are needed to characterize the pathophysiological mechanisms, indicate effects of treatment and to facilitate early characterisation and detection of AD during the prodromal or even at asymptomatic stages. No primary or secondary preventive treatments for AD have been approved. Epidemiological research, however, has provided evidence of specifically modifiable risk and protective factors. Among them are vascular, lifestyle and psychological risk factors that may act both independently and by potentiating each other. These factors may be substantially impacted by single or multi-domain strategies to prevent or postpone the onset of AD-related pathophysiology. Researchers have recently started the European Dementia Prevention Initiative (EDPI), an international consortium to improve strategies for preventing dementia. EDPI, in particular, includes the Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability (FINGER) which aims at optimizing the early identification of subjects at increased risk of late-life cognitive deterioration, and at the evaluation of multi-domain intervention strategies. The ongoing discussion on new diagnostic criteria provided by the International Working Group (IWG), as well as by the recommendations summoned by the National Institute on Aging and Alzheimer's Association (NIA-AA) initiative, has inspired the creation of novel study designs and the definition of earlier target populations for trials in pre- and asymptomatic at-risk and prodromal stages of AD. As a result, a number of promising international prevention trials are currently ongoing. In this review, we critically discuss the main paths to AD prevention through control of modifiable risk factors and lifestyle changes. We will also review the role of biomarkers to identify subgroups of patients who would most likely benefit from secondary prevention strategies, and to evaluate the benefit of treatment in such patients.
Collapse
Affiliation(s)
- S Lista
- S. Lista, Sorbonne Universités, Université Pierre et Marie Curie, Paris 06, Institut de la Mémoire et de la Maladie d'Alzheimer (IM2A) and Institut du Cerveau et de la Moelle épinière (ICM), Département de Neurologie, Hôpital de la Pitié-Salpétrière, Paris, France,
| | | | | |
Collapse
|
22
|
Day AM, Kahler CW, Ahern DC, Clark US. Executive Functioning in Alcohol Use Studies: A Brief Review of Findings and Challenges in Assessment. CURRENT DRUG ABUSE REVIEWS 2015; 8:26-40. [PMID: 25877524 PMCID: PMC4638323 DOI: 10.2174/1874473708666150416110515] [Citation(s) in RCA: 78] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/23/2015] [Revised: 04/06/2015] [Accepted: 04/09/2015] [Indexed: 11/22/2022]
Abstract
There is a wealth of research about the links between executive functioning (EF) and alcohol use. However, difficulty may arise in interpreting findings because of the variability between studies regarding the specific components of EF measured, as well as the variability of tasks used to examine each EF construct. The current article considers each of these problems within the context of a literature review that focuses on two topics: (1) the efficacy of EF in predicting alcohol use and alcohol-related consequences, and (2) the effect of acute alcohol intoxication on EF task performance. An additional goal was to identify and describe commonly used EF measures with the intention of providing alcohol researchers information on the assessment of different EF domains. Our findings indicate that there is strong evidence supporting a relation between EF difficulties (particularly response inhibition and information updating) and alcohol use, with additional evidence of a significant interaction between EF and implicit associations on alcohol use. In contrast, research supporting a link between set shifting abilities and later alcohol use is scarce. Additionally, this review found evidence of alcohol acutely affecting many EF processes (particularly response inhibition). Overall, there is a need to replicate these findings with commonly used EF tasks (versus developing numerous tasks within individual laboratories) to better advance our understanding of the relation between EF and alcohol use.
Collapse
Affiliation(s)
- Anne M Day
- Center for Alcohol and Addiction Studies, Brown University, Box G-S121-4, Providence, RI 02912, USA.
| | | | | | | |
Collapse
|
23
|
Beydoun MA, Beydoun HA, Gamaldo AA, Teel A, Zonderman AB, Wang Y. Epidemiologic studies of modifiable factors associated with cognition and dementia: systematic review and meta-analysis. BMC Public Health 2014; 14:643. [PMID: 24962204 PMCID: PMC4099157 DOI: 10.1186/1471-2458-14-643] [Citation(s) in RCA: 481] [Impact Index Per Article: 48.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2013] [Accepted: 05/13/2014] [Indexed: 12/15/2022] Open
Abstract
Background Cognitive impairment, including dementia, is a major health concern with the increasing aging population. Preventive measures to delay cognitive decline are of utmost importance. Alzheimer’s disease (AD) is the most frequent cause of dementia, increasing in prevalence from <1% below the age of 60 years to >40% above 85 years of age. Methods We systematically reviewed selected modifiable factors such as education, smoking, alcohol, physical activity, caffeine, antioxidants, homocysteine (Hcy), n-3 fatty acids that were studied in relation to various cognitive health outcomes, including incident AD. We searched MEDLINE for published literature (January 1990 through October 2012), including cross-sectional and cohort studies (sample sizes > 300). Analyses compared study finding consistency across factors, study designs and study-level characteristics. Selecting studies of incident AD, our meta-analysis estimated pooled risk ratios (RR), population attributable risk percent (PAR%) and assessed publication bias. Results In total, 247 studies were retrieved for systematic review. Consistency analysis for each risk factor suggested positive findings ranging from ~38.9% for caffeine to ~89% for physical activity. Education also had a significantly higher propensity for “a positive finding” compared to caffeine, smoking and antioxidant-related studies. Meta-analysis of 31 studies with incident AD yielded pooled RR for low education (RR = 1.99; 95% CI: 1.30-3.04), high Hcy (RR = 1.93; 95% CI: 1.50-2.49), and current/ever smoking status (RR = 1.37; 95% CI: 1.23-1.52) while indicating protective effects of higher physical activity and n-3 fatty acids. Estimated PAR% were particularly high for physical activity (PAR% = 31.9; 95% CI: 22.7-41.2) and smoking (PAR%=31.09%; 95% CI: 17.9-44.3). Overall, no significant publication bias was found. Conclusions Higher Hcy levels, lower educational attainment, and decreased physical activity were particularly strong predictors of incident AD. Further studies are needed to support other potential modifiable protective factors, such as caffeine.
Collapse
Affiliation(s)
- May A Beydoun
- Laboratory of Epidemiology and Population Sciences, National Institute on Aging, NIA/NIH/IRP, 251 Bayview Blvd,, Suite 100, Room #: 04B118, Baltimore, MD 21224, USA.
| | | | | | | | | | | |
Collapse
|
24
|
Beydoun MA, Gamaldo AA, Beydoun HA, Tanaka T, Tucker KL, Talegawkar SA, Ferrucci L, Zonderman AB. Caffeine and alcohol intakes and overall nutrient adequacy are associated with longitudinal cognitive performance among U.S. adults. J Nutr 2014; 144:890-901. [PMID: 24744319 PMCID: PMC4018952 DOI: 10.3945/jn.113.189027] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Among modifiable lifestyle factors, diet may affect cognitive health. Cross-sectional and longitudinal associations may exist between dietary exposures [e.g., caffeine (mg/d), alcohol (g/d), and nutrient adequacy] and cognitive performance and change over time. This was a prospective cohort study, the Baltimore Longitudinal Study of Aging (n = 628-1305 persons depending on the cognitive outcome; ∼2 visits/person). Outcomes included 10 cognitive scores, spanning various domains of cognition. Caffeine and alcohol intakes and a nutrient adequacy score (NAS) were estimated from 7-d food diaries. Among key findings, caffeine intake was associated with better baseline global cognition among participants with a baseline age (Agebase) of ≥70 y. A higher NAS was associated with better baseline global cognition performance (overall, women, Agebase <70 y), better baseline verbal memory (immediate and delayed recall, Agebase ≥70 y), and slower rate of decline or faster improvement in the attention domain (women). For an Agebase of <70 y, alcohol consumption was associated with slower improvement on letter fluency and global cognition over time. Conversely, for an Agebase of ≥70 y and among women, alcohol intake was related to better baseline attention and working memory. In sum, patterns of diet and cognition associations indicate stratum-specific associations by sex and baseline age. The general observed trend was that of putative beneficial effects of caffeine intake and nutrient adequacy on domains of global cognition, verbal memory, and attention, and mixed effects of alcohol on domains of letter fluency, attention, and working memory. Further longitudinal studies conducted on larger samples of adults are needed to determine whether dietary factors individually or in combination are modifiers of cognitive trajectories among adults.
Collapse
Affiliation(s)
- May A. Beydoun
- Intramural Research Program (NIA/NIH/IRP), National Institute on Aging, Baltimore, MD,To whom correspondence should be addressed. E-mail:
| | - Alyssa A. Gamaldo
- Intramural Research Program (NIA/NIH/IRP), National Institute on Aging, Baltimore, MD,School of Aging Studies, University of South Florida, Tampa, FL
| | - Hind A. Beydoun
- Graduate Program in Public Health, Eastern Virginia Medical School, Norfolk, VA
| | - Toshiko Tanaka
- Intramural Research Program (NIA/NIH/IRP), National Institute on Aging, Baltimore, MD
| | | | - Sameera A. Talegawkar
- Department of International Health, Center for Human Nutrition, Johns Hopkins School of Public Health, Baltimore, MD
| | - Luigi Ferrucci
- Intramural Research Program (NIA/NIH/IRP), National Institute on Aging, Baltimore, MD
| | - Alan B. Zonderman
- Intramural Research Program (NIA/NIH/IRP), National Institute on Aging, Baltimore, MD
| |
Collapse
|
25
|
Santos NC, Costa PS, Cunha P, Portugal-Nunes C, Amorim L, Cotter J, Cerqueira JJ, Palha JA, Sousa N. Clinical, physical and lifestyle variables and relationship with cognition and mood in aging: a cross-sectional analysis of distinct educational groups. Front Aging Neurosci 2014; 6:21. [PMID: 24605100 PMCID: PMC3932406 DOI: 10.3389/fnagi.2014.00021] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2013] [Accepted: 02/04/2014] [Indexed: 12/01/2022] Open
Abstract
It is relevant to unravel the factors that may mediate the cognitive decline observed during aging. Previous reports indicate that education has a positive influence on cognitive performance, while age, female gender and, especially, depressed mood were associated with poorer performances across multiple cognitive dimensions (memory and general executive function). Herein, the present study aimed to characterize the cognitive performance of community-dwelling individuals within distinct educational groups categorized by the number of completed formal school years: “less than 4,” “4, completed primary education,” and “more than 4.” Participants (n = 1051) were randomly selected from local health registries and representative of the Portuguese population for age and gender. Neurocognitive and clinical assessments were conducted in local health care centers. Structural equation modeling was used to derive a cognitive score, and hierarchical linear regressions were conducted for each educational group. Education, age and depressed mood were significant variables in directly explaining the obtained cognitive score, while gender was found to be an indirect variable. In all educational groups, mood was the most significant factor with effect on cognitive performance. Specifically, a depressed mood led to lower cognitive performance. The clinical disease indices cardiac and stroke associated with a more negative mood, while moderate increases in BMI, alcohol consumption and physical activity associated positively with improved mood and thus benefitted cognitive performance. Results warrant further research on the cause-effect (longitudinal) relationship between clinical indices of disease and risk factors and mood and cognition throughout aging.
Collapse
Affiliation(s)
- Nadine C Santos
- Life and Health Sciences Research Institute (ICVS), School of Health Sciences, University of Minho Braga, Portugal ; ICVS/3B's, PT Government Associate Laboratory Braga/Guimarães, Portugal ; Clinical Academic Center - Braga Braga, Portugal
| | - Patrício S Costa
- Life and Health Sciences Research Institute (ICVS), School of Health Sciences, University of Minho Braga, Portugal ; ICVS/3B's, PT Government Associate Laboratory Braga/Guimarães, Portugal ; Clinical Academic Center - Braga Braga, Portugal
| | - Pedro Cunha
- Life and Health Sciences Research Institute (ICVS), School of Health Sciences, University of Minho Braga, Portugal ; ICVS/3B's, PT Government Associate Laboratory Braga/Guimarães, Portugal ; Centro Hospitalar do Alto Ave - EPE Guimarães, Portugal
| | - Carlos Portugal-Nunes
- Life and Health Sciences Research Institute (ICVS), School of Health Sciences, University of Minho Braga, Portugal ; ICVS/3B's, PT Government Associate Laboratory Braga/Guimarães, Portugal ; Clinical Academic Center - Braga Braga, Portugal
| | - Liliana Amorim
- Life and Health Sciences Research Institute (ICVS), School of Health Sciences, University of Minho Braga, Portugal ; ICVS/3B's, PT Government Associate Laboratory Braga/Guimarães, Portugal ; Clinical Academic Center - Braga Braga, Portugal
| | - Jorge Cotter
- Life and Health Sciences Research Institute (ICVS), School of Health Sciences, University of Minho Braga, Portugal ; ICVS/3B's, PT Government Associate Laboratory Braga/Guimarães, Portugal ; Centro Hospitalar do Alto Ave - EPE Guimarães, Portugal
| | - João J Cerqueira
- Life and Health Sciences Research Institute (ICVS), School of Health Sciences, University of Minho Braga, Portugal ; ICVS/3B's, PT Government Associate Laboratory Braga/Guimarães, Portugal ; Clinical Academic Center - Braga Braga, Portugal
| | - Joana A Palha
- Life and Health Sciences Research Institute (ICVS), School of Health Sciences, University of Minho Braga, Portugal ; ICVS/3B's, PT Government Associate Laboratory Braga/Guimarães, Portugal ; Clinical Academic Center - Braga Braga, Portugal
| | - Nuno Sousa
- Life and Health Sciences Research Institute (ICVS), School of Health Sciences, University of Minho Braga, Portugal ; ICVS/3B's, PT Government Associate Laboratory Braga/Guimarães, Portugal ; Clinical Academic Center - Braga Braga, Portugal
| |
Collapse
|
26
|
Hogenkamp PS, Benedict C, Sjögren P, Kilander L, Lind L, Schiöth HB. Late-life alcohol consumption and cognitive function in elderly men. AGE (DORDRECHT, NETHERLANDS) 2014; 36:243-249. [PMID: 23649646 PMCID: PMC3889878 DOI: 10.1007/s11357-013-9538-7] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/12/2013] [Accepted: 04/24/2013] [Indexed: 06/02/2023]
Abstract
Moderate alcohol consumption (one to two drinks per day) has been associated with better cognitive function and lower risk of developing dementia in the elderly. In light of alcohol's well-known neurotoxic properties, more evidence from well-controlled population-based studies is required. The objective of this study was to examine whether self-reported alcohol intake at age 70 is linked to cognitive function (assessed by trail making tests (TMTs) A and B, which are measures of attention, mental speed, and flexibility) in a population-based cohort consisting of 652 cognitively healthy elderly men. Linear regression models were used to assess both cross-sectional (i.e., age 70) and prospective (i.e., age 77) associations between alcohol intake and cognitive function. The analyses were adjusted for education, body mass index, energy intake, self-reported physical activity, smoking, a history of hypertension or diabetes, apolipoprotein E ε4 status, and cholesterol levels at the age of 70. Baseline data were obtained from 1990 to 1996. Self-reported alcohol intake (mean 6.9 ± 7.1 g/day) was associated with better performance on TMT-B at ages 70 and 77 (β = -0.87, p < 0.001). In contrast, alcohol intake was not predictive of the difference in performance on these tests between ages 70 and 77. Despite cross-sectional associations with performance in a test of executive functioning, moderate intake of alcohol was not linked to differences in cognitive performance between ages 70 and 77 in the present study. Thus, our findings do not support the view that daily moderate alcohol consumption is a recommendable strategy to slow cognitive aging in elderly populations.
Collapse
Affiliation(s)
- Pleunie S. Hogenkamp
- />Department of Neuroscience, Uppsala University, Box 593, 751 24 Uppsala, Sweden
| | - Christian Benedict
- />Department of Neuroscience, Uppsala University, Box 593, 751 24 Uppsala, Sweden
| | - Per Sjögren
- />Section of Clinical Nutrition and Metabolism, Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
| | - Lena Kilander
- />Section of Geriatrics, Department of Public Health and Caring Sciences, Uppsala University, Uppsala, Sweden
| | - Lars Lind
- />Department of Medical Sciences, Uppsala University, Uppsala, Sweden
| | - Helgi B. Schiöth
- />Department of Neuroscience, Uppsala University, Box 593, 751 24 Uppsala, Sweden
| |
Collapse
|
27
|
Imtiaz B, Tolppanen AM, Kivipelto M, Soininen H. Future directions in Alzheimer's disease from risk factors to prevention. Biochem Pharmacol 2014; 88:661-70. [PMID: 24418410 DOI: 10.1016/j.bcp.2014.01.003] [Citation(s) in RCA: 152] [Impact Index Per Article: 15.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2013] [Revised: 12/30/2013] [Accepted: 01/03/2014] [Indexed: 12/21/2022]
Abstract
The increase in life expectancy has resulted in a high occurrence of dementia and Alzheimer's disease (AD). Research on AD has undergone a paradigm shift from viewing it as a disease of old age to taking a life course perspective. Several vascular, lifestyle, psychological and genetic risk factors influencing this latent period have been recognized and they may act both independently and by potentiating each other. These risk factors have consequently been used to derive risk scores for predicting the likelihood of dementia. Despite population differences, age, low education and vascular risk factors were identified as key factors in all scoring systems. Risk scores can help to identify high-risk individuals who might benefit from different interventions. The European Dementia Prevention Initiative (EDPI), an international collaboration, encourages data sharing between different randomized controlled trials. At the moment, it includes three large ongoing European trials: Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability (FINGER), Prevention of Dementia by Intensive Vascular Care (preDIVA), and Multidomain Alzheimer Prevention study (MAPT). Recently EDPI has developed a "Healthy Aging through Internet Counseling in Elderly" (HATICE) program, which intends to manage modifiable risk factors in an aged population through an easily accessible Internet platform. Thus, the focus of dementia research has shifted from identification of potential risk factors to using this information for developing interventions to prevent or delay the onset of dementia as well as identifying special high-risk populations who could be targeted in intervention trials.
Collapse
Affiliation(s)
- Bushra Imtiaz
- Institute of Clinical Medicine - Neurology, University of Eastern Finland, Kuopio, Finland
| | - Anna-Maija Tolppanen
- Research Center for Comparative Effectiveness and Patient Safety (RECEPS) and School of Pharmacy, University of Eastern Finland, Kuopio, Finland
| | - Miia Kivipelto
- Institute of Clinical Medicine - Neurology, University of Eastern Finland, Kuopio, Finland; Aging Research Center (ARC), Karolinska Institute and Stockholm University, Stockholm, Sweden
| | - Hilkka Soininen
- Institute of Clinical Medicine - Neurology, University of Eastern Finland, Kuopio, Finland; Neurocenter Neurology, Kuopio University Hospital, Kuopio, Finland.
| |
Collapse
|
28
|
Consumption of alcoholic beverages and cognitive decline at middle age: the Doetinchem Cohort Study. Br J Nutr 2013; 111:715-23. [DOI: 10.1017/s0007114513002845] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Accelerated cognitive decline increases the risk of dementia. Slowing down the rate of cognitive decline leads to the preservation of cognitive functioning in the elderly, who can live independently for a longer time. Alcohol consumption may influence the rate of cognitive decline. The aim of the present study was to evaluate the associations between the total consumption of alcoholic beverages and different types of alcoholic beverages and cognitive decline at middle age. In 2613 men and women of the Doetinchem Cohort Study, aged 43–70 years at baseline (1995–2002), cognitive function (global cognitive function and the domains memory, speed and flexibility) was assessed twice, with a 5-year time interval. In linear regression analyses, the consumption of different types of alcoholic beverages was analysed in relation to cognitive decline, adjusting for confounders. We observed that, in women, the total consumption of alcoholic beverages was inversely associated with the decline in global cognitive function over a 5-year period (P for trend = 0·02), while no association was observed in men. Regarding the consumption of different types of alcoholic beverages in men and women together, red wine consumption was inversely associated with the decline in global cognitive function (P for trend < 0·01) as well as memory (P for trend < 0·01) and flexibility (P for trend = 0·03). Smallest declines were observed at a consumption of about 1·5 glasses of red wine per d. No other types of alcoholic beverages were associated with cognitive decline. In conclusion, only (moderate) red wine consumption was consistently associated with less strong cognitive decline. Therefore, it is most likely that non-alcoholic substances in red wine are responsible for any cognition-preserving effects.
Collapse
|
29
|
Hagger-Johnson G, Sabia S, Brunner EJ, Shipley M, Bobak M, Marmot M, Kivimaki M, Singh-Manoux A. Combined impact of smoking and heavy alcohol use on cognitive decline in early old age: Whitehall II prospective cohort study. Br J Psychiatry 2013; 203:120-5. [PMID: 23846998 PMCID: PMC3730115 DOI: 10.1192/bjp.bp.112.122960] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
BACKGROUND Identifying modifiable risk factors for cognitive decline may inform prevention of dementia. AIMS To examine the combined impact of cigarette smoking and heavy alcohol consumption on cognitive decline from midlife. METHOD Prospective cohort study (Whitehall II cohort) with three clinical examinations in 1997/99, 2002/04 and 2007/09. Participants were 6473 adults (72% men), mean age 55.76 years (s.d. = 6.02) in 1997/99. Four cognitive tests, assessed three times over 10 years, combined into a global z-score (mean 0, s.d. = 1). RESULTS Age-related decline in the global cognitive score was faster in individuals who were smoking heavy drinkers than in non-smoking moderate alcohol drinkers (reference group). The interaction term (P = 0.04) suggested that the combined effects of smoking and alcohol consumption were greater than their individual effects. Adjusting for age, gender, education and chronic diseases, 10-year decline in global cognition was -0.42 z-scores (95% CI -0.45 to -0.39) for the reference group. In individuals who were heavy alcohol drinkers who also smoked the decline was -0.57 z-scores (95% CI -0.67 to -0.48); 36% faster than the reference group. CONCLUSIONS Individuals who were smokers who drank alcohol heavily had a 36% faster cognitive decline, equivalent to an age-effect of 2 extra years over 10-year follow-up, compared with individuals who were non-smoking moderate drinkers.
Collapse
|
30
|
Kesse-Guyot E, Andreeva VA, Jeandel C, Ferry M, Touvier M, Hercberg S, Galan P. Alcohol consumption in midlife and cognitive performance assessed 13 years later in the SU.VI.MAX 2 cohort. PLoS One 2012; 7:e52311. [PMID: 23284983 PMCID: PMC3526526 DOI: 10.1371/journal.pone.0052311] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2012] [Accepted: 11/16/2012] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Associations between alcohol consumption and cognitive function are discordant and data focusing on midlife exposure are scarce. OBJECTIVE To estimate the association between midlife alcohol consumption and cognitive performance assessed 13 y later while accounting for comorbidities and diet. METHODS 3,088 French middle-aged adults included in the SU.VI.MAX (1994) study with available neuropsychological evaluation 13 y later. Data on alcohol consumption were obtained from repeated 24h dietary records collected in 1994-1996. Cognitive performance was assessed in 2007-2009 via a battery of 6 neuropsychological tests. A composite score was built as the mean of the standardized individual test scores (mean=50, SD=10). ANCOVA were performed to estimate mean differences in cognitive performance and 95% confidence intervals (CI). RESULTS In women, abstainers displayed lower cognitive scores than did low-to-moderate alcohol drinkers (1 to 2 drinks/day) (mean difference= -1.77; 95% CI: -3.29, -0.25). In men, heavy drinkers (>3 drinks/day) had higher cognitive scores than did low-to-moderate (1 to 3 drinks/day) (mean difference=1.05; 95% CI: 0.10, 1.99). However, a lower composite cognitive score was detected in male drinkers consuming ≥ 90 g/d (≈8 drinks/d). A higher proportion of alcohol intake from beer was also associated with lower cognitive scores. These associations remained significant after adjustment for diet, comorbidities and sociodemographic factors. CONCLUSION In men, heavy but not extreme drinking was associated with higher global cognitive scores. Given the known harmful effects of alcohol even in low doses regarding risk of cancer, the study does not provide a basis for modifying current public health messages. TRIAL REGISTRATION ClinicalTrials.gov NCT00272428.
Collapse
Affiliation(s)
- Emmanuelle Kesse-Guyot
- UMR Inserm U557; Inra U1125; Cnam; Université Paris 13 Sorbonne Paris-Cité, CRNH Ile-de-France, Bobigny, France.
| | | | | | | | | | | | | |
Collapse
|
31
|
Panza F, Frisardi V, Seripa D, Logroscino G, Santamato A, Imbimbo BP, Scafato E, Pilotto A, Solfrizzi V. Alcohol consumption in mild cognitive impairment and dementia: harmful or neuroprotective? Int J Geriatr Psychiatry 2012; 27:1218-38. [PMID: 22396249 DOI: 10.1002/gps.3772] [Citation(s) in RCA: 80] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2010] [Accepted: 01/05/2012] [Indexed: 11/08/2022]
Abstract
OBJECTIVE In several longitudinal studies, light-to-moderate drinking of alcoholic beverages has been proposed as being protective against the development of age-related changes in cognitive function, predementia syndromes, and cognitive decline of degenerative (Alzheimer's disease, AD) or vascular origin (vascular dementia). However, contrasting findings also exist. METHOD The English literature published in this area before September 2011 was evaluated, and information relating to the various factors that may impact upon the relationship between alcohol consumption and dementia or predementia syndromes is presented in the succeeding texts. RESULTS Light-to-moderate alcohol consumption may be associated with a reduced risk of incident overall dementia and AD; however, protective benefits afforded to vascular dementia, cognitive decline, and predementia syndromes are less clear. The equivocal findings may relate to many of the studies being limited to cross-sectional designs, restrictions by age or gender, or incomplete ascertainment. Different outcomes, beverages, drinking patterns, and study follow-up periods or possible interactions with other lifestyle-related (e.g., smoking) or genetic factors (e.g., apolipoprotein E gene variation) may all contribute to the variability of findings. CONCLUSION Protective effects of moderate alcohol consumption against cognitive decline are suggested to be more likely in the absence of the AD-associated apolipoprotein E ε4 allele and where wine is the beverage. At present, there is no indication that light-to-moderate alcohol drinking would be harmful to cognition and dementia, and attempts to define what might be deemed beneficial levels of alcohol intake in terms of cognitive performance would be highly problematic and contentious.
Collapse
Affiliation(s)
- Francesco Panza
- Geriatric Unit and Gerontology-Geriatric Research Laboratory, IRCCS Casa Sollievo della Sofferenza, San Giovanni Rotondo, Italy.
| | | | | | | | | | | | | | | | | |
Collapse
|
32
|
Kapogiannis D, Kisser J, Davatzikos C, Ferrucci L, Metter J, Resnick S. Alcohol consumption and premotor corpus callosum in older adults. Eur Neuropsychopharmacol 2012; 22:704-10. [PMID: 22401959 PMCID: PMC3378772 DOI: 10.1016/j.euroneuro.2012.02.003] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2011] [Revised: 10/27/2011] [Accepted: 02/11/2012] [Indexed: 10/28/2022]
Abstract
Heavy alcohol consumption is toxic to the brain, especially to the frontal white matter (WM), but whether lesser amounts of alcohol negatively impact the brain WM is unclear. In this study, we examined the relationship between self-reported alcohol consumption and regional WM and grey matter (GM) volume in fifty-six men and thirty-seven women (70+- 7years) cognitively intact participants of the Baltimore Longitudinal Study of Aging (BLSA) with no history of alcohol abuse. We used regional analysis of volumes examined in normalized space (RAVENS) maps methodology for WM and GM segmentation and normalization followed by voxel based morphometry (VBM) implemented in SPM8 to examine the cross-sectional association between alcohol consumption and regional WM (and, separately, GM) volume controlling for age, sex, smoking, blood pressure and dietary thiamine intake. WM VBM revealed that in men, but not in women, higher alcohol consumption was associated with lower volume in premotor frontal corpus callosum. This finding suggests that even moderate amounts of alcohol may be detrimental to corpus callosum and white matter integrity.
Collapse
Affiliation(s)
- Dimitrios Kapogiannis
- National Institute on Aging/National Institutes of Health (NIA/NIH), Clinical Research Branch, 3001 South Hanover St., Baltimore, MD, 21225, U.S.A., , Telephone: 410-350-3953, Fax: 410-350-7308
| | - Jason Kisser
- National Institute on Aging/National Institutes of Health (NIA/NIH), Clinical Research Branch, 3001 South Hanover St., Baltimore, MD, 21225, U.S.A., , Telephone: 410-350-3953, Fax: 410-350-7308
| | | | - Luigi Ferrucci
- National Institute on Aging/National Institutes of Health (NIA/NIH), Clinical Research Branch, 3001 South Hanover St., Baltimore, MD, 21225, U.S.A., , Telephone: 410-350-3953, Fax: 410-350-7308
| | - Jeffrey Metter
- National Institute on Aging/National Institutes of Health (NIA/NIH), Clinical Research Branch, 3001 South Hanover St., Baltimore, MD, 21225, U.S.A., , Telephone: 410-350-3953, Fax: 410-350-7308
| | - Susan Resnick
- NIA/NIH, Laboratory of personality and cognition (U.S.A.)
| |
Collapse
|
33
|
Anderson ML, Nokia MS, Govindaraju KP, Shors TJ. Moderate drinking? Alcohol consumption significantly decreases neurogenesis in the adult hippocampus. Neuroscience 2012; 224:202-9. [PMID: 22906480 DOI: 10.1016/j.neuroscience.2012.08.018] [Citation(s) in RCA: 38] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2012] [Revised: 07/30/2012] [Accepted: 08/10/2012] [Indexed: 10/28/2022]
Abstract
Drinking alcohol in moderation is often considered a health-conscious behavior, associated with improved cardiovascular and brain health. However, "moderate" amounts of alcohol include drinking 3-4 alcohol beverages in a day, which is closer to binge drinking and may do more harm than good. Here we examined how daily drinking of moderate-high alcohol alters the production of new neurons in the adult hippocampus. Male and female adult Sprague-Dawley rats were provided free access to a liquid replacement diet that was supplemented with either 4% ethanol or Maltodextrin for a period of 2 weeks. Proliferating cells were labeled with 5-bromo-2-deoxyuridine (BrdU) and the number of BrdU-positive cells in the hippocampus was assessed after the final day of drinking. A subset of rats was also exposed to a motor skill or associative learning task to examine the functional effects of alcohol consumption. The drinking regime resulted in an average blood alcohol concentration of approximately 0.08%, which is comparable to the human legal driving limit in many countries. This level of intoxication did not impair motor skill learning or function in either sex, nor did the alcohol consumption disrupt associative learning 2 days after drinking. Therefore, moderate alcohol consumption did not disrupt basic sensory, motor or learning processes. However, the number of cells produced in the dentate gyrus of the hippocampus was reduced by nearly 40%. Thus, even moderate consumption of alcohol for a relatively short period of time can have profound effects on structural plasticity in the adult brain.
Collapse
Affiliation(s)
- M L Anderson
- Department of Neuroscience, Rutgers University/UMDNJ - Robert Wood Johnson Medical School, 683 Hoes Lane, RWJSPH 363, Piscataway, NJ 08854, USA.
| | | | | | | |
Collapse
|
34
|
Kim JW, Lee DY, Lee BC, Jung MH, Kim H, Choi YS, Choi IG. Alcohol and cognition in the elderly: a review. Psychiatry Investig 2012; 9:8-16. [PMID: 22396679 PMCID: PMC3285745 DOI: 10.4306/pi.2012.9.1.8] [Citation(s) in RCA: 77] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2011] [Revised: 07/17/2011] [Accepted: 08/01/2011] [Indexed: 12/13/2022] Open
Abstract
Consumption of large amounts of alcohol is known to have negative effects, but consumption in smaller amounts may be protective. The effect of alcohol may be greater in the elderly than in younger adults, particularly with regard to cognition. However, the drinking pattern that will provide optimal protection against dementia and cognitive decline in the elderly has not been systematically investigated. The present paper is a critical review of research on the effect of alcohol on cognitive function and dementia in the elderly. Studies published from 1971 to 2011 related to alcohol and cognition in the elderly were reviewed using a PubMed search. Alcohol may have both a neurotoxic and neuroprotective effect. Longitudinal and brain imaging studies in the elderly show that excessive alcohol consumption may increase the risk of cognitive dysfunction and dementia, but low to moderate alcohol intake may protect against cognitive decline and dementia and provide cardiovascular benefits. Evidence suggesting that low to moderate alcohol consumption in the elderly protects against cognitive decline and dementia exists; however, because of varying methodology and a lack of standardized definitions, these findings should be interpreted with caution. It is important to conduct more, well-designed studies to identify the alcohol drinking pattern that will optimally protect the elderly against cognitive decline and dementia.
Collapse
Affiliation(s)
- Jee Wook Kim
- Department of Neuropsychiatry, Hallym University Hangang Sacred Heart Hospital, Seoul, Korea
- Hallym University Burn Institute, Hallym University, Seoul, Korea
| | - Dong Young Lee
- Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Korea
| | - Boung Chul Lee
- Department of Neuropsychiatry, Hallym University Hangang Sacred Heart Hospital, Seoul, Korea
- Hallym University Burn Institute, Hallym University, Seoul, Korea
| | - Myung Hun Jung
- Department of Neuropsychiatry, Hallym University Sacred Heart Hospital, Anyang, Korea
| | - Hano Kim
- Department of Neuropsychiatry, Keyo Hospital, Uiwang, Korea
| | - Yong Sung Choi
- Department of Neuropsychiatry, St. Andrew's Neuropsychiatric Hospital, Icheon, Korea
| | - Ihn-Geun Choi
- Department of Neuropsychiatry, Hallym University Hangang Sacred Heart Hospital, Seoul, Korea
- Hallym University Burn Institute, Hallym University, Seoul, Korea
| |
Collapse
|
35
|
Hooshmand B, Solomon A, Kåreholt I, Rusanen M, Hänninen T, Leiviskä J, Winblad B, Laatikainen T, Soininen H, Kivipelto M. Associations between serum homocysteine, holotranscobalamin, folate and cognition in the elderly: a longitudinal study. J Intern Med 2012; 271:204-12. [PMID: 22077644 DOI: 10.1111/j.1365-2796.2011.02484.x] [Citation(s) in RCA: 78] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
OBJECTIVES To examine the associations between serum homocysteine (tHcy), holotranscobalamin (holoTC, the biologically active fraction of vitamin B12) and folate and cognitive functioning in a longitudinal population-based study of Finnish elderly subjects. SUBJECTS AND DESIGN tHcy, holoTC and folate were measured at baseline in 274 dementia-free subjects aged 65-79years from the Cardiovascular Risk Factors, Aging and Dementia study. Subjects were re-examined 7years later, and global cognition, episodic memory, executive functioning, verbal expression and psychomotor speed were assessed. RESULTS Higher baseline tHcy levels were associated with poorer performance in global cognition, relative difference: 0.90 [95% confidence interval (CI) 0.81-0.99]; episodic memory: 0.87 (95% CI 0.77-0.99); executive functions: 0.86 (95% CI 0.75-0.98); and verbal expression: 0.89 (95% CI 0.81-0.97) at follow-up. Increased holoTC levels were related to better performance on global cognition: 1.09 (95% CI 1.00-1.19); executive functions: 1.11 (95% CI 1.01-1.21); and psychomotor speed: 1.13 (95% CI 1.01-1.26). After excluding 20 cases of incident dementia, increased tHcy remained associated with poorer performance in episodic memory, execution functions and verbal expression. Higher holoTC levels tended to be related to better performance in executive functions and psychomotor speed, while elevated serum folate concentrations were significantly related to higher scores in global cognition and verbal expression tests. CONCLUSIONS tHcy, holoTC and folate levels are related to cognitive performance 7years later even in nondemented elderly subjects. Randomized trials are needed to determine the impact of vitamin B12 and folate supplementation on preventing cognitive decline in the elderly.
Collapse
Affiliation(s)
- B Hooshmand
- Aging Research Center, KarolinskaInstitutet, Stockholm, Sweden.
| | | | | | | | | | | | | | | | | | | |
Collapse
|
36
|
Solfrizzi V, Panza F, Frisardi V, Seripa D, Logroscino G, Imbimbo BP, Pilotto A. Diet and Alzheimer's disease risk factors or prevention: the current evidence. Expert Rev Neurother 2011; 11:677-708. [PMID: 21539488 DOI: 10.1586/ern.11.56] [Citation(s) in RCA: 174] [Impact Index Per Article: 13.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Preventing or postponing the onset of Alzheimer's disease (AD) and delaying or slowing its progression would lead to a consequent improvement of health status and quality of life in older age. Elevated saturated fatty acids could have negative effects on age-related cognitive decline and mild cognitive impairment (MCI). Furthermore, at present, epidemiological evidence suggests a possible association between fish consumption, monounsaturated fatty acids and polyunsaturated fatty acids (PUFA; in particular, n-3 PUFA) and a reduced risk of cognitive decline and dementia. Poorer cognitive function and an increased risk of vascular dementia (VaD) were found to be associated with a lower consumption of milk or dairy products. However, the consumption of whole-fat dairy products may be associated with cognitive decline in the elderly. Light-to-moderate alcohol use may be associated with a reduced risk of incident dementia and AD, while for VaD, cognitive decline and predementia syndromes, the current evidence is only suggestive of a protective effect. The limited epidemiological evidence available on fruit and vegetable consumption and cognition generally supports a protective role of these macronutrients against cognitive decline, dementia and AD. Only recently, higher adherence to a Mediterranean-type diet was associated with decreased cognitive decline, although the Mediterranean diet (MeDi) combines several foods, micro- and macro-nutrients already separately proposed as potential protective factors against dementia and predementia syndromes. In fact, recent prospective studies provided evidence that higher adherence to a Mediterranean-type diet could be associated with slower cognitive decline, reduced risk of progression from MCI to AD, reduced risk of AD and a decreased all-cause mortality in AD patients. These findings suggested that adherence to the MeDi may affect not only the risk of AD, but also of predementia syndromes and their progression to overt dementia. Based on the current evidence concerning these factors, no definitive dietary recommendations are possible. However, following dietary advice for lowering the risk of cardiovascular and metabolic disorders, high levels of consumption of fats from fish, vegetable oils, nonstarchy vegetables, low glycemic index fruits and a diet low in foods with added sugars and with moderate wine intake should be encouraged. Hopefully this will open new opportunities for the prevention and management of dementia and AD.
Collapse
Affiliation(s)
- Vincenzo Solfrizzi
- Department of Geriatrics, Center for Aging Brain, Memory Unit, University of Bari, Bari, Italy
| | | | | | | | | | | | | |
Collapse
|
37
|
Leoni V, Caccia C. Relationship between cholesterol metabolism, ApoE and brain volumes in Alzheimer’s disease. FUTURE NEUROLOGY 2011. [DOI: 10.2217/fnl.11.38] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
APOE genotype, aging and midlife hypercholesterolemia are well-established risk factors for late-onset Alzheimer’s disease (AD). ApoE and cholesterol are involved in the pathogenesis of AD since they influence amyloid-β accumulation and Tau pathology. APOE ε4 carriers were found to present lower levels of amyloid-β1–42, higher tau and phosphorylated tau and a higher degree of brain atrophy at any disease stage. Presence of ApoE4 shifts the onset of the disease towards a younger age and makes progression faster. Hypercholesterolemia together with other major cardiovascular risk factors were found to be involved in the pathogenesis of AD, but reduced plasma cholesterol levels were described in demented patients. Significant correlations were found between cholesterol precursors lathosterol, lanosterol and 24S-hydroxycholesterol (a putative marker of brain cholesterol turnover) in plasma and brain atrophy as quantified by MRI. It is likely that neurodegeneration affects both brain and whole-body cholesterol metabolism in AD.
Collapse
Affiliation(s)
- Valerio Leoni
- Laboratory of Clinical Pathology & Medical Genetics, R17, IRCCS National Institute of Neurology ‘C Besta’, Via Celoria 11, 20133 Milano, Italy
| | - Claudio Caccia
- Laboratory of Clinical Pathology & Medical Genetics, R17, IRCCS National Institute of Neurology ‘C Besta’, Via Celoria 11, 20133 Milano, Italy
| |
Collapse
|
38
|
Arntzen KA, Schirmer H, Wilsgaard T, Mathiesen EB. Moderate wine consumption is associated with better cognitive test results: a 7 year follow up of 5033 subjects in the Tromsø Study. Acta Neurol Scand 2011:23-9. [PMID: 20586731 DOI: 10.1111/j.1600-0404.2010.01371.x] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
BACKGROUND The impact of moderate alcohol consumption on cognitive function and dementia is unclear. We examined the relationship between consumption of different alcoholic beverages and cognitive function in a large population-based study. METHODS Subjects were 5033 stroke-free men and women who participated in a longitudinal population-based study in Tromsø, Norway. Alcohol consumption and other cardiovascular risk factors were measured at baseline and cognitive function was assessed after 7 years follow up with verbal memory test, digit-symbol coding test and tapping test. RESULTS Moderate wine consumption was independently associated with better performance on all cognitive tests in both men and women. There was no consistent association between consumption of beer and spirits and cognitive test results. Alcohol abstention was associated with lower cognitive performance in women. CONCLUSIONS Light-to-moderate wine consumption was associated with better performance on cognitive tests after 7 years follow up.
Collapse
Affiliation(s)
- K A Arntzen
- Department of Community Medicine, University of Tromsø, Tromsø, Norway.
| | | | | | | |
Collapse
|
39
|
Sabia S, Guéguen A, Berr C, Berkman L, Ankri J, Goldberg M, Zins M, Singh-Manoux A. High alcohol consumption in middle-aged adults is associated with poorer cognitive performance only in the low socio-economic group. Results from the GAZEL cohort study. Addiction 2011; 106:93-101. [PMID: 20840170 PMCID: PMC3006084 DOI: 10.1111/j.1360-0443.2010.03106.x] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
AIMS To examine the association of alcohol consumption over 10 years with cognitive performance in different socio-economic groups. DESIGN Prospective cohort study, the French GAZEL study. SETTING France. PARTICIPANTS Employees of France's national electricity and gas company. MEASUREMENTS Alcohol intake was assessed annually, beginning in 1992, using questions on frequency and quantity of alcoholic beverages consumed in a week; used to define mean consumption and trajectory of alcohol intake over 10 years. Cognitive performance among participants aged ≥ 55 years (n = 4073) was assessed in 2002-04 using the Digit Symbol Substitution Test (DSST), a measure of psychomotor speed, attention and reasoning. Occupational position at age 35 and education were used as the markers of socio-economic position. FINDINGS All analyses were stratified by socio-economic position. In the low occupational group, participants consuming a mean of more than 21 drinks per week had 2.1 points lower (95% CI: -3.9, -0.3) DSST score compared to those consuming four to 14 drinks per week. In participants with primary school education, the corresponding difference was 3.6 points (95% CI: -7.1, -0.0). No association between alcohol consumption and cognitive performance was observed in the intermediate and high socio-economic groups, defined using either occupation or education. Analysis of trajectories of alcohol consumption showed that in the low socio-economic groups large increase or decrease in alcohol consumption was associated with lower cognitive scores compared to stable consumption. CONCLUSIONS Our results suggest that high alcohol consumption is associated with poorer cognitive performance only in the low socio-economic group, due possibly to greater cognitive reserve in the higher socio-economic groups.
Collapse
Affiliation(s)
- Séverine Sabia
- Centre for Research in Epidemiology and Population Health, Hôpital Paul Brousse, Villejuif, France.
| | - Alice Guéguen
- INSERM U1018, Centre for Research in Epidemiology and Population Health. Hôpital Paul Brousse, 16 avenue Paul Vaillant Couturier, Bâtiment 15/16, 94807 Villejuif Cedex. France
| | - Claudine Berr
- INSERM U888, Hôpital La Colombière, Montpellier, France,University Montpellier 1, Service de Neurologie, CMRR, CHU Montpellier, Montpellier, France
| | - Lisa Berkman
- Department of Society, Human Development and Health, Harvard School of Public Health, Boston, MA,US
| | - Joël Ankri
- INSERM U1018, Centre for Research in Epidemiology and Population Health. Hôpital Paul Brousse, 16 avenue Paul Vaillant Couturier, Bâtiment 15/16, 94807 Villejuif Cedex. France,Université de Versailles Saint-Quentin, Yvelines, France,Centre de Gérontologie, Hôpital Ste Perine, AP-HP, France
| | - Marcel Goldberg
- INSERM U1018, Centre for Research in Epidemiology and Population Health. Hôpital Paul Brousse, 16 avenue Paul Vaillant Couturier, Bâtiment 15/16, 94807 Villejuif Cedex. France,Université de Versailles Saint-Quentin, Yvelines, France
| | - Marie Zins
- INSERM U1018, Centre for Research in Epidemiology and Population Health. Hôpital Paul Brousse, 16 avenue Paul Vaillant Couturier, Bâtiment 15/16, 94807 Villejuif Cedex. France
| | - Archana Singh-Manoux
- INSERM U1018, Centre for Research in Epidemiology and Population Health. Hôpital Paul Brousse, 16 avenue Paul Vaillant Couturier, Bâtiment 15/16, 94807 Villejuif Cedex. France,Centre de Gérontologie, Hôpital Ste Perine, AP-HP, France,Department of Epidemiology and Public Health, University College London, UK
| |
Collapse
|
40
|
Abstract
We reviewed 143 papers that described the relationship between moderate drinking of alcohol and some aspect of cognition. Two types of papers were found: (1) those that provided ratios of risk between drinkers and nondrinkers (74 papers in total) and (2) those that, although they did not provide such ratios, allowed cognition in drinkers to be rated as "better," "no different," or "worse" than cognition in nondrinkers (69 papers in total). The history of research on moderate drinking and cognition can be divided into two eras: 1977-1997 and 1998-present. Phase I (1977-1997) was the era of neuropsychological evaluation involving mostly young to middle-aged (18-50 years old) subjects. Although initial studies indicated moderate drinking impaired cognition, many later studies failed to confirm this, instead finding no difference in cognition between drinkers and nondrinkers. Phase II (1998-present) was and is the era of mental status exam evaluation involving mostly older (≥55 years old) subjects. These studies overwhelmingly found that moderate drinking either reduced or had no effect on the risk of dementia or cognitive impairment. When all the ratios of risk from all the studies in phase II providing such ratios are entered into a comprehensive meta-analysis, the average ratio of risk for cognitive risk (dementia or cognitive impairment/decline) associated with moderate "social" (not alcoholic) drinking of alcohol is 0.77, with nondrinkers as the reference group. The benefit of moderate drinking applied to all forms of dementia (dementia unspecified, Alzheimer's disease, and vascular dementia) and to cognitive impairment (low test scores), but no significant benefit against cognitive decline (rate of decline in test scores) was found. Both light and moderate drinking provided a similar benefit, but heavy drinking was associated with nonsignificantly higher cognitive risk for dementia and cognitive impairment. Although the meta-analysis also indicated that wine was better than beer or spirits, this was based on a relatively small number of studies because most studies did not distinguish among these different types of alcohol. Furthermore, a number of the studies that did make the distinction reported no difference among the effects of these different types of alcohol. Therefore, at present this question remains unanswered. Analysis also showed that the presence of the apolipoprotein E epsilon 4 allele eliminated the benefit of moderate drinking. However, this was based on a relatively small number of studies and several other studies have found a beneficial effect of the epsilon e4 allele. Further studies are necessary to settle this question. The benefit of moderate alcohol for cognition was seen in both men and women, although the amount and pattern of drinking is very different between the two sexes. Lastly, the finding of unaffected or significantly reduced cognitive risk in light to moderate drinkers was seen in 14/19 countries for which country-specific ratio data were available, with three of the five remaining countries showing nonsignificant reductions as well. Overall, light to moderate drinking does not appear to impair cognition in younger subjects and actually seems to reduce the risk of dementia and cognitive decline in older subjects.
Collapse
Affiliation(s)
- Edward J Neafsey
- Department of Molecular Pharmacology and Therapeutics, Loyola University Chicago, Stritch School of Medicine, Maywood, IL, USA
| | | |
Collapse
|
41
|
Lobo E, Dufouil C, Marcos G, Quetglas B, Saz P, Guallar E, Lobo A. Is there an association between low-to-moderate alcohol consumption and risk of cognitive decline? Am J Epidemiol 2010; 172:708-16. [PMID: 20699263 DOI: 10.1093/aje/kwq187] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
The authors evaluated the association of low-to-moderate alcohol consumption with risk of cognitive decline in a census-based cohort study of men and women aged ≥55 years conducted in Zaragoza, Spain (1994-1999). Participants free of dementia at baseline (N = 3,888) were examined after 2.5 and 4.5 years of follow-up. Information on alcohol intake was collected with the EURODEM Risk Factors Questionnaire and the History and Aetiology Schedule. The study endpoint was severe cognitive decline, defined as loss of ≥1 point/year on the Mini-Mental State Examination or a diagnosis of incident dementia (Diagnostic and Statistical Manual of Mental Disorders: DSM-IV, Text Revision criteria). Compared with those for abstainers, the multivariate-adjusted odds ratios for severe cognitive decline for male drinkers of <12 g alcohol/day, drinkers of 12-24 g alcohol/day, and former drinkers were 0.61 (95% confidence interval (CI): 0.31, 1.20), 1.19 (95% CI: 0.61, 2.32), and 1.03 (95% CI: 0.59, 1.82), respectively. The corresponding odds ratios for women were 0.88 (95% CI: 0.45, 1.72), 2.38 (95% CI: 0.98, 5.77), and 1.03 (95% CI: 0.48, 2.23). This study did not support the hypothesis that low-to-moderate alcohol consumption prevents cognitive decline. The inverse association between low-to-moderate alcohol intake and cognitive decline observed in other studies may have been due to inclusion of former drinkers in the abstainers reference category.
Collapse
Affiliation(s)
- Elena Lobo
- Departamento de Medicina Preventiva y Salud Pública, Universidad de Zaragoza, Zaragoza, Spain.
| | | | | | | | | | | | | |
Collapse
|
42
|
Caspers K, Arndt S, Yucuis R, McKirgan L, Spinks R. Effects of alcohol- and cigarette-use disorders on global and specific measures of cognition in middle-age adults. J Stud Alcohol Drugs 2010; 71:192-200. [PMID: 20230716 DOI: 10.15288/jsad.2010.71.192] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE This study examined the effects of alcohol- and tobacco-use disorders on global and specific cognitive abilities in middle age. METHOD The sample consisted of 118 men and 169 women ranging in age from 31 to 60 years (M [SD] = 43.59 [6.58]). Lifetime diagnoses were determined from a semistructured interview. Information about current levels of alcohol and cigarette use was also collected. A comprehensive neurocognitive assessment measuring global cognition, memory, and executive-functioning abilities was administered. Baseline cognition was estimated from average composite scores of the Iowa Test of Basic Skills school-achievement tests administered from third through eighth grade. Repeated-measures analysis of variance was used. Covariates comprised baseline cognition, current depression symptoms, and medication use. RESULTS Lifetime alcohol- and tobacco-use disorders were not associated with cognition among men. Women having a diagnosis of tobacco dependence (according to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition [DSM-IV]) performed less well on measures of global cognition and executive functioning. A lifetime diagnosis of DSM-IV alcohol abuse or dependence was associated with higher working memory among women only. CONCLUSIONS These results demonstrate few negative effects of alcohol-use disorders on midlife cognition, especially if current consumption is light. Differential susceptibility to the effects of cigarette use on cognition was found with women showing greater deficits in visuospatial abilities, processing speed, and executive-functioning abilities.
Collapse
Affiliation(s)
- Kristin Caspers
- Department of Psychiatry, Psychiatry Research/Medical Education Building, Carver College of Medicine, University of Iowa, Iowa City, Iowa 52242-1000, USA.
| | | | | | | | | |
Collapse
|
43
|
Abstract
BACKGROUND An increasing body of evidence suggests that health behaviors may protect against cognitive impairment and dementia. The purpose of this study was to summarize the current evidence on health behavioral factors predicting cognitive health through a systematic review of the published literature. METHODS PubMed, Embase, and PsycINFO databases were searched for studies on community representative samples aged 65 and older, with prospective cohort design and multivariate analysis. The outcome--cognitive health--was defined as a continuum of cognitive function ranging from cognitive decline to impairment and dementia, and health behaviors included physical activity, smoking, alcohol drinking, body mass index, and diet and nutrition. RESULTS Of 12,105 abstracts identified, 690 relevant full-texts were reviewed. The final yield amounted to 115 articles of which 37 studies were chosen that met the highest standards of quality. Leisure time physical activity, even of moderate level, showed protective effects against dementia, whereas smoking elevated the risk of Alzheimer's disease. Moderate alcohol consumption tended to be protective against cognitive decline and dementia, but nondrinkers and frequent drinkers exhibited a higher risk for dementia and cognitive impairment. Midlife obesity had an adverse effect on cognitive function in later life. Analysis showed vegetable and fish consumption to be of benefit, whereas, persons consuming a diet high in saturated fat had an increased dementia risk. CONCLUSION The review demonstrates accumulating evidence supporting health behavioral effects in reducing the risk of cognitive decline and dementia. Results indicate potential benefits of healthy lifestyles in protecting cognitive health in later life.
Collapse
|
44
|
Carvalho SDA, Barreto SM, Guerra HL, Gama ACC. Oral language comprehension assessment among elderly: a population based study in Brazil. Prev Med 2009; 49:541-5. [PMID: 19800364 DOI: 10.1016/j.ypmed.2009.09.017] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2009] [Revised: 09/24/2009] [Accepted: 09/25/2009] [Indexed: 11/28/2022]
Abstract
BACKGROUND Determinants of oral language comprehension, a complex skill, are not clearly established, but may include age, schooling, health condition, depression and quality of life. OBJECTIVE To assess oral comprehension skill among Brazilian elderly and identify factors explaining elderly variability in the Token test performance. METHODS A population-based random sample of 373 elderly (> or = 60 years) in Belo Horizonte, 2007, answered standardized questionnaire including socio-demographic and health-related questions and performed the Token Test short version (SVTT), Snellen Test, Mini Mental State Examination, General Health Questionnaire, and Health Survey Short Form (SF12). RESULTS Token Test scores ranged from 8 to 35 points; 50% of participants scored < or = 24 points with no sex variation. Age, schooling, literacy, cognitive status, hypertension, self-rated conversational understanding and SF12 mental component explained 62% of SVTT variability. CONCLUSIONS Language comprehension disorder was quite common and test performance was highly influenced by education and cognitive status. Association between test performance and self-rated conversational comprehension indicated that elderly were aware of their difficulty.
Collapse
|
45
|
Serum total cholesterol, statins and cognition in non-demented elderly. Neurobiol Aging 2009; 30:1006-9. [DOI: 10.1016/j.neurobiolaging.2007.09.012] [Citation(s) in RCA: 97] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2007] [Revised: 09/04/2007] [Accepted: 09/18/2007] [Indexed: 11/24/2022]
|
46
|
Naismith SL, Glozier N, Burke D, Carter PE, Scott E, Hickie IB. Early intervention for cognitive decline: is there a role for multiple medical or behavioural interventions? Early Interv Psychiatry 2009; 3:19-27. [PMID: 21352171 DOI: 10.1111/j.1751-7893.2008.00102.x] [Citation(s) in RCA: 56] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
AIM Early medical or behavioural intervention to slow cognitive decline might be a viable strategy for reducing disability and rates of institutional care in older persons. This paper details the published work supporting cross-sectional and longitudinal associations between vascular risk factors, depressive symptoms and progressive cognitive decline. Evidence for the beneficial effects of providing relevant interventions is assessed. METHODS Relevant published work from the areas of dementia research, 'vascular depression' and the cognitive benefits that might result from treating vascular risk factors, managing depression or promoting nutrition, cognitive or physical exercise was ascertained from electronic database searches and recent reviews of key areas. RESULTS The existing published work does not provide many examples of early intervention strategies that target vascular strategies or active treatment of depression to reduce the rate of cognitive decline. Most studies have major limitations including the evaluation of only single-risk-factor interventions, the observational designs and the inadequate measurement of cognition. An optimal early intervention strategy might be to target multiple risk factors within relevant experimental or health service frameworks. CONCLUSIONS Early identification and multifaceted reduction of vascular risk factors, active management of depression, engagement in cognitive activity and physical exercise and promotion of better nutrition might together help to slow some forms of cognitive decline or progression to dementia. This health services approach now requires systematic evaluation.
Collapse
Affiliation(s)
- Sharon L Naismith
- Brain & Mind Research Institute, The George Institute for International Health, University of Sydney, Sydney, New South Wales, Australia
| | | | | | | | | | | |
Collapse
|
47
|
Keary TA, Gunstad J, Neal DJ, Spitznagel MB, Glickman E, Juvancic-Heltzel J, Alexander T. Light to moderate alcohol consumption is associated with S100beta and amyloid beta levels in healthy older adults. Exp Aging Res 2008; 34:101-13. [PMID: 18351497 DOI: 10.1080/03610730701876920] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Heavy alcohol consumption has been associated with several adverse neurocognitive outcomes in older adults, though little is known about lower consumption levels. No study has investigated the associations between S100beta and amyloid beta (Abeta) serum levels (biomarkers that provide evidence of neurological pathology) and light to moderate alcohol consumption in healthy older adults without neurological conditions. Thirty-five healthy older adults underwent neuropsychological testing and fasting blood draw with subsequent serum S100beta and Abeta 1-40 level quantification. Increased S100beta levels were associated with increased frequency of alcohol consumption and increased total monthly consumption of alcohol. Increased Abeta levels were associated with increased quantity of alcohol consumption. Further work investigating possible mechanisms is needed, particularly longitudinal studies and studies employing neuroimaging.
Collapse
Affiliation(s)
- Therese A Keary
- Department of Psychology, Kent State University, Kent, Ohio 44242, USA
| | | | | | | | | | | | | |
Collapse
|
48
|
Eskelinen MH, Ngandu T, Helkala EL, Tuomilehto J, Nissinen A, Soininen H, Kivipelto M. Fat intake at midlife and cognitive impairment later in life: a population-based CAIDE study. Int J Geriatr Psychiatry 2008; 23:741-7. [PMID: 18188871 DOI: 10.1002/gps.1969] [Citation(s) in RCA: 210] [Impact Index Per Article: 13.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
OBJECTIVE To investigate the association of midlife dietary fat intake to cognitive performance, and to the occurrence of clinical mild cognitive impairment (MCI) later in life in a non-demented population. DESIGN A longitudinal population-based study. SETTING Populations of Kuopio and Joensuu, Eastern Finland. PARTICIPANTS AND METHODS Participants of the CAIDE study were derived from random, population-based samples studied at midlife (1972, 1977, 1982 or 1987). After an average follow-up of 21 years, a total of 1449 (72%) individuals aged 65-80 years participated in the re-examination in 1998. Altogether 82 (5.7%) people were diagnosed as having MCI. Dietary information was collected with a structured questionnaire and an interview at midlife. MAIN OUTCOME MEASURES MCI, global cognitive and executive functions, episodic, semantic and prospective memory and psychomotor speed. RESULTS Abundant saturated fat (SFA) intake from milk products and spreads at midlife was associated with poorer global cognitive function and prospective memory and with an increased risk of MCI (OR 2.36, 95% CI 1.17-4.74) after adjusting for demographic and vascular factors, other fats and ApoE. On the contrary, high intake of polyunsaturated fatty acids (PUFA) was associated with better semantic memory. Also frequent fish consumption was associated with better global cognitive function and semantic memory. Further, higher PUFA-SFA ratio was associated with better psychomotor speed and executive function. CONCLUSIONS Our data suggests that dietary fat intake at midlife affects cognitive performance and occurrence of MCI later in life. The impact of dietary interventions needs to be tested in clinical trials.
Collapse
|
49
|
Sachdev PS, Chen X, Wen W, Anstey KJ. Light to moderate alcohol use is associated with increased cortical gray matter in middle-aged men: a voxel-based morphometric study. Psychiatry Res 2008; 163:61-9. [PMID: 18407470 DOI: 10.1016/j.pscychresns.2007.08.009] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2007] [Revised: 08/22/2007] [Accepted: 08/23/2007] [Indexed: 10/22/2022]
Abstract
We examined the associations of current alcohol consumption with brain morphometric measures in a healthy, community-dwelling cohort. Cranial T1-weighted 3D-structural MRI scans were obtain in 383 adults (men=211) aged 60-64 years, randomly selected form the larger PATH Through Life study. Voxel-based morphometric analyses were applied to detect regional gray matter and white matter volume changes related to reported weekly alcohol consumption (mean 7.04+/-8.15 drinks per week). Alcohol consumption in men had a linear association with greater gray matter in bilateral superior and medial frontal gyrus, bilateral middle occipital gyrus, right inferior parietal gyrus, bilateral precentral gyrus, left paracentral gyrus, left uncus and left inferior occipital gyrus, and with lesser white matter in bilateral superior temporal and left parahippocampal gyrus, after adjustment for age, education, total intracranial volume, smoking, hypertension, diabetes and hyperlipidemia. In women, there was no significant linear association between alcohol consumption and total or regional brain volumes. Our results showed a dose-related, sexually dimorphic impact of alcohol on brain tissue volumes independent of cerebrovascular risk factors. These findings are consistent with an inverse-U association between alcohol use and brain morphometry, while suggesting an increased vulnerability of white matter to alcohol-related brain damage.
Collapse
|
50
|
Beydoun MA, Beydoun H, Wang Y. Obesity and central obesity as risk factors for incident dementia and its subtypes: a systematic review and meta-analysis. Obes Rev 2008; 9:204-18. [PMID: 18331422 PMCID: PMC4887143 DOI: 10.1111/j.1467-789x.2008.00473.x] [Citation(s) in RCA: 342] [Impact Index Per Article: 21.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
While dementia affects 6-10% of persons 65 years or older, industrialized countries have witnessed an alarming rise in obesity. However, obesity's influence on dementia remains poorly understood. We conducted a systematic review and meta-analysis. PUBMED search (1995-2007) resulted in 10 relevant prospective cohort studies of older adults (40-80 years at baseline) with end points being dementia and predictors including adiposity measures, such as body mass index (BMI) and waist circumference (WC). There was a significant U-shaped association between BMI and dementia (P = 0.034), with dementia risk increased for obesity and underweight. Pooled odds ratios (OR) and 95% confidence intervals (CI) for underweight, overweight and obesity compared with normal weight in relation to incident dementia were: 1.36 (1.07, 1.73), 0.88 (0.60, 1.27) and 1.42 (0.93, 2.18) respectively. Pooled ORs and 95% CI for obesity and incident Alzheimer's disease (AD) and vascular dementia were 1.80 (1.00, 3.29) vs. 1.73 (0.47, 6.31) and were stronger in studies with long follow-up (>10 years) and young baseline age (<60 years). Weight gain and high WC or skin-fold thickness increased risks of dementia in all included studies. The meta-analysis shows a moderate association between obesity and the risks for dementia and AD. Future studies are needed to understand optimal weight and biological mechanisms.
Collapse
Affiliation(s)
- May A. Beydoun
- Center for Human Nutrition, Department of International Health,
Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD
| | - Hind Beydoun
- Department of Epidemiology, College of Public Health, University of
Iowa, IA
| | - Youfa Wang
- Center for Human Nutrition, Department of International Health,
Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD
| |
Collapse
|