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Matison AP, Flood VM, Lam BCP, Lipnicki DM, Tucker KL, Preux PM, Guerchet M, d'Orsi E, Quialheiro A, Rech CR, Skoog I, Najar J, Rydberg Sterner T, Scarmeas N, Kosmidis MH, Yannakoulia M, Gureje O, Ojagbemi A, Bello T, Shahar S, Fakhruddin NNINM, Rivan NFM, Anstey KJ, Cherbuin N, Mortby ME, Ho R, Brodaty H, Sachdev PS, Reppermund S, Mather KA. Associations between fruit and vegetable intakes and incident depression in middle-aged and older adults from 10 diverse international longitudinal cohorts. J Affect Disord 2024; 359:373-381. [PMID: 38788860 DOI: 10.1016/j.jad.2024.05.096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2024] [Revised: 04/26/2024] [Accepted: 05/18/2024] [Indexed: 05/26/2024]
Abstract
BACKGROUND Emerging observational evidence supports a role for higher fruit and vegetable intake in protecting against the development of depression. However, there is a scarcity of research in older adults or in low- to middle-income countries (LMICs). METHODS Participants were 7801 community-based adults (mean age 68.6 ± 8.0 years, 55.8 % female) without depression, from 10 diverse cohorts, including four cohorts from LMICs. Fruit and vegetable intake was self-reported via comprehensive food frequency questionnaire, short food questionnaire or diet history. Depressive symptoms were assessed using validated measures, and depression defined applying validated cut-offs. The associations between baseline fruit and vegetable intakes and incident depression over a follow-up period of three to nine years were examined using Cox regression. Analyses were performed by cohort with results meta-analysed. RESULTS There were 1630 cases of incident depression (21 % of participants) over 40,258 person-years of follow-up. Higher intake of fruit was associated with a lower risk of incident depression (HR 0.87, 95%CI [0.77, 0.99], I2 = 4 %). No association was found between vegetable intake and incident depression (HR 0.93, 95%CI [0.84, 1.04], I2 = 0 %). LIMITATIONS Diverse measures used across the different cohorts and the modest sample size of our study compared with prior studies may have prevented an association being detected for vegetable intake. CONCLUSIONS Our study supports a role for fruit, but not vegetable intake in protecting against depression. Research investigating different types of fruits and vegetables using standardised measures in larger cohorts of older adults from low- and middle-income countries is warranted.
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Affiliation(s)
- Annabel P Matison
- Centre for Healthy Brain Ageing, Discipline of Psychiatry and Mental Health, School of Clinical Medicine, Faculty of Medicine and Health, UNSW Sydney, New South Wales, Australia.
| | - Victoria M Flood
- The University of Sydney, Faculty of Medicine and Health, New South Wales, Australia; University Centre for Rural Health, Northern Rivers, Lismore, University of Sydney, New South Wales, Australia
| | - Ben C P Lam
- School of Psychology and Public Health, La Trobe University, Victoria, Australia
| | - Darren M Lipnicki
- Centre for Healthy Brain Ageing, Discipline of Psychiatry and Mental Health, School of Clinical Medicine, Faculty of Medicine and Health, UNSW Sydney, New South Wales, Australia
| | - Katherine L Tucker
- Department of Biomedical & Nutritional Sciences, Center for Population Health, University of Massachusetts Lowell, Lowell, USA
| | - Pierre-Marie Preux
- Inserm U1094, IRD UMR270, Univ. Limoges, CHU Limoges, EpiMaCT - Epidemiology of Chronic Diseases in Tropical Zone, Institute of Epidemiology and Tropical Neurology, OmegaHealth, Limoges, France
| | - Maëlenn Guerchet
- Inserm U1094, IRD UMR270, Univ. Limoges, CHU Limoges, EpiMaCT - Epidemiology of Chronic Diseases in Tropical Zone, Institute of Epidemiology and Tropical Neurology, OmegaHealth, Limoges, France
| | - Eleonora d'Orsi
- Federal University of Santa Catarina, Trindade University Campus, Florianópolis, Santa Catarina, Brazil
| | - Anna Quialheiro
- Federal University of Santa Catarina, Trindade University Campus, Florianópolis, Santa Catarina, Brazil; IA&Saúde - The Artificial Intelligence and Health Research Unit, Instituto Politécnico de Saúde do Norte, CESPU, Vila Nova de Famalicão, Portugal
| | - Cassiano R Rech
- Federal University of Santa Catarina, Program in Postgraduate Physical Education, Santa Catarina, Brazil
| | - Ingmar Skoog
- Section of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Sweden
| | - Jenna Najar
- Section of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Sweden; Department of Human Genetics, Genomics of Neurodegenerative Diseases and Aging at the Amsterdam University Medical Center, Amsterdam, Netherlands
| | - Therese Rydberg Sterner
- Section of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, University of Gothenburg, Sweden; Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden
| | - Nikolaos Scarmeas
- Department of Neurology, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece; Department of Neurology, Columbia University, New York, NY, USA
| | - Mary H Kosmidis
- Lab of Neuropsychology & Behavioral Neuroscience, School of Psychology, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Mary Yannakoulia
- Department of Nutrition and Dietetics, School of Health Sciences and Education, Harokopio University, Athens, Greece
| | - Oye Gureje
- University of Ibadan, World Health Organization Collaborating Centre for Research and Training in Mental Health, Neurosciences and Substance Abuse, Department of Psychiatry, Ibadan, Nigeria
| | - Akin Ojagbemi
- University of Ibadan, World Health Organization Collaborating Centre for Research and Training in Mental Health, Neurosciences and Substance Abuse, Department of Psychiatry, Ibadan, Nigeria
| | - Toyin Bello
- University of Ibadan, World Health Organization Collaborating Centre for Research and Training in Mental Health, Neurosciences and Substance Abuse, Department of Psychiatry, Ibadan, Nigeria
| | - Suzana Shahar
- Center for Healthy Ageing & Wellness (H-CARE), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, Kuala Lumpur, Malaysia
| | - Nik N I N M Fakhruddin
- Jeffrey Cheah School of Medicine & Health Sciences, Monash University Malaysia, Jalan Lagoon Selatan, 47500 Bandar Sunway, Selangor, Malaysia
| | - Nurul F M Rivan
- Center for Healthy Ageing & Wellness (H-CARE), Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda Abdul Aziz, Kuala Lumpur, Malaysia
| | - Kaarin J Anstey
- UNSW Ageing Futures Institute, University of New South Wales, Sydney, Australia; Neuroscience Research Australia, Sydney, Australia
| | - Nicolas Cherbuin
- National Centre for Epidemiology and Population Health, Australian National University, Canberra, Australia
| | - Moyra E Mortby
- UNSW Ageing Futures Institute, University of New South Wales, Sydney, Australia; Neuroscience Research Australia, Sydney, Australia
| | - Roger Ho
- Department of Psychological Medicine, National University of Singapore, Singapore
| | - Henry Brodaty
- Centre for Healthy Brain Ageing, Discipline of Psychiatry and Mental Health, School of Clinical Medicine, Faculty of Medicine and Health, UNSW Sydney, New South Wales, Australia
| | - Perminder S Sachdev
- Centre for Healthy Brain Ageing, Discipline of Psychiatry and Mental Health, School of Clinical Medicine, Faculty of Medicine and Health, UNSW Sydney, New South Wales, Australia; Neuropsychiatric Institute, Prince of Wales Hospital, New South Wales, Australia
| | - Simone Reppermund
- Centre for Healthy Brain Ageing, Discipline of Psychiatry and Mental Health, School of Clinical Medicine, Faculty of Medicine and Health, UNSW Sydney, New South Wales, Australia; Department of Developmental Disability Neuropsychiatry (3DN), Discipline of Psychiatry and Mental Health, Faculty of Medicine and Health, UNSW Sydney, New South Wales, Australia
| | - Karen A Mather
- Centre for Healthy Brain Ageing, Discipline of Psychiatry and Mental Health, School of Clinical Medicine, Faculty of Medicine and Health, UNSW Sydney, New South Wales, Australia
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Van Asbroeck S, Köhler S, van Boxtel MPJ, Lipnicki DM, Crawford JD, Castro‐Costa E, Lima‐Costa MF, Blay SL, Shifu X, Wang T, Yue L, Lipton RB, Katz MJ, Derby CA, Guerchet M, Preux P, Mbelesso P, Norton J, Ritchie K, Skoog I, Najar J, Sterner TR, Scarmeas N, Yannakoulia M, Dardiotis T, Rolandi E, Davin A, Rossi M, Gureje O, Ojagbemi A, Bello T, Kim KW, Han JW, Oh DJ, Trompet S, Gussekloo J, Riedel‐Heller SG, Röhr S, Pabst A, Shahar S, Rivan NFM, Singh DKA, Jacobsen E, Ganguli M, Hughes T, Haan M, Aiello AE, Ding D, Zhao Q, Xiao Z, Narazaki K, Chen T, Chen S, Ng TP, Gwee X, Gao Q, Brodaty H, Trollor J, Kochan N, Lobo A, Santabárbara J, Gracia‐Garcia P, Sachdev PS, Deckers K. Lifestyle and incident dementia: A COSMIC individual participant data meta‐analysis. Alzheimers Dement 2024; 20:3972-3986. [PMID: 38676366 PMCID: PMC11180928 DOI: 10.1002/alz.13846] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Revised: 03/19/2024] [Accepted: 03/19/2024] [Indexed: 04/28/2024]
Abstract
INTRODUCTION The LIfestyle for BRAin Health (LIBRA) index yields a dementia risk score based on modifiable lifestyle factors and is validated in Western samples. We investigated whether the association between LIBRA scores and incident dementia is moderated by geographical location or sociodemographic characteristics. METHODS We combined data from 21 prospective cohorts across six continents (N = 31,680) and conducted cohort-specific Cox proportional hazard regression analyses in a two-step individual participant data meta-analysis. RESULTS A one-standard-deviation increase in LIBRA score was associated with a 21% higher risk for dementia. The association was stronger for Asian cohorts compared to European cohorts, and for individuals aged ≤75 years (vs older), though only within the first 5 years of follow-up. No interactions with sex, education, or socioeconomic position were observed. DISCUSSION Modifiable risk and protective factors appear relevant for dementia risk reduction across diverse geographical and sociodemographic groups. HIGHLIGHTS A two-step individual participant data meta-analysis was conducted. This was done at a global scale using data from 21 ethno-regionally diverse cohorts. The association between a modifiable dementia risk score and dementia was examined. The association was modified by geographical region and age at baseline. Yet, modifiable dementia risk and protective factors appear relevant in all investigated groups and regions.
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Grants
- AG03949 NIH HHS
- Netherlands Programme for Research on Aging (NESTOR)
- The Alzheimer's Association Zenith Award
- 2009BAI77B03 China Ministry of Science and Technology
- CRC2017ZD02 Clinical Research Center, Shanghai Mental Health Center
- 03/0815 Spanish Ministry of Economy and Competitiveness, Madrid, Spain
- R01 AG057531 NIA NIH HHS
- Greek National Resources
- DCP-2017-002/1 Universiti Kebangsaan Malaysia Grand Challenge
- 20H04030 JSPS KAKENHI
- Stiftelsen Professor Bror Gadelius' Minnesfond
- 01/0255 Spanish Ministry of Economy and Competitiveness, Madrid, Spain
- The Alzheimer's Association Stephanie B Overstreet Scholars
- AgeCap-Center for Aging and Health
- The Bank of Sweden Tercentenary Foundation
- European Social Fund
- HJSV2023023 Stiftelsens Hjalmar Svenssons forskningsfond
- 06/0617 Spanish Ministry of Economy and Competitiveness, Madrid, Spain
- Fondo de Investigación Sanitaria
- R37AG02365 NIH/NIA
- Instituto de Salud Carlos III
- Epilife
- 16/00896 Spanish Ministry of Economy and Competitiveness, Madrid, Spain
- B15_23R Gobierno de Aragón
- B15_17R Gobierno de Aragón
- G03/128 Spanish Ministry of Economy and Competitiveness, Madrid, Spain
- AG03949 NIH/NIA
- LRGS/BU/2012/UKM-UKM/K/01 Long-term Research Grant Scheme (LGRS) Ministry of Higher Education, Malaysia
- Limoges University Hospital Appel à Projet des Equipes Émergentes et Labellisées scheme (APREL)
- 189 10276/8/9/2011 Alzheimer's Association
- NMRC/1108/2007 National Medical Research Council
- 97/1321E Spanish Ministry of Economy and Competitiveness, Madrid, Spain
- AG03949 NIA NIH HHS
- Swedish Brain Power
- FORTE
- 2012-Project Public Health Institute [Inserm]-PREUXPierre-Marie AXA Research Fund
- National Strategic Reference Framework (NSFR) - EU Program Excellence Grant (ARISTEIA)
- PI16/00896 Fondo Europeo de Desarrollo Regional (FEDER) of the European Union "Una manera de hacer Europa"
- Shanghai Brain Health Foundation
- JP17K09146 JSPS KAKENHI
- NMRC/CIRG/1409/2014 National Medical Research Council
- AF-967865 Alzheimersfonden
- R37AG02365 NIH HHS
- HJSV2022059 Stiftelsens Hjalmar Svenssons forskningsfond
- 98/0103 Spanish Ministry of Economy and Competitiveness, Madrid, Spain
- RF1AG057531 NIH HHS
- Riksbankens Jubileumsfond
- Handlanden Hjalmar Svenssons Forskningsfond
- Stiftelsen för Gamla Tjänarinnor
- P01 AG003949 NIA NIH HHS
- IIRG-09-133014 Alzheimer's Association
- LRGS/1/2019/UM-UKM/1/4 Long-term Research Grant Scheme (LGRS) Ministry of Higher Education, Malaysia
- Wellcome Trust
- Swedish Research Council
- Leonard and Sylvia Marx Foundation
- Maastricht University Medical Center
- 733050511 Netherlands Organisation for Health Research and Development (ZonMw)
- BMRC/08/1/21/19/567 Agency for Science Technology and Research (A*STAR) Biomedical Research Council
- Associazione Alzheimer Milano
- 2017-0557 Fondazione CARIPLO, FrailBioTrack Project
- DCP-2017-002/2 Universiti Kebangsaan Malaysia Grand Challenge
- PI/19/01874 Spanish Ministry of Economy and Competitiveness, Madrid, Spain
- 72660 ALF-agreement
- 12/02254 Spanish Ministry of Economy and Competitiveness, Madrid, Spain
- Ministry for Health and Social Solidarity (Greece)
- 94/1562 Spanish Ministry of Economy and Competitiveness, Madrid, Spain
- 01KS9504 Interdisciplinary Centre for Clinical Research University of Leipzig (Interdisziplinäres Zentrum für Klinische Forschung/IZKF)
- Czap Foundation
- ANR-09-MNPS-009-01 French National Research Agency
- Stiftelsen Söderström-Königska Sjukhemmet
- National Institute on Aging
- National Institutes of Health
- Wellcome Trust
- Gobierno de Aragón
- Alzheimer's Association
- National Medical Research Council
- French National Research Agency
- AXA Research Fund
- Riksbankens Jubileumsfond
- FORTE
- Swedish Brain Power
- Swedish Research Council
- Stiftelsen för Gamla Tjänarinnor
- Instituto de Salud Carlos III
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Affiliation(s)
- Stephanie Van Asbroeck
- Alzheimer Centrum LimburgDepartment of Psychiatry and NeuropsychologyMental Health and Neuroscience (MHeNs) Research InstituteMaastricht UniversityMaastrichtThe Netherlands
| | - Sebastian Köhler
- Alzheimer Centrum LimburgDepartment of Psychiatry and NeuropsychologyMental Health and Neuroscience (MHeNs) Research InstituteMaastricht UniversityMaastrichtThe Netherlands
| | - Martin P. J. van Boxtel
- Alzheimer Centrum LimburgDepartment of Psychiatry and NeuropsychologyMental Health and Neuroscience (MHeNs) Research InstituteMaastricht UniversityMaastrichtThe Netherlands
| | - Darren M. Lipnicki
- Centre for Healthy Brain Ageing (CHeBA)Discipline of Psychiatry and Mental HealthSchool of Clinical Medicine, University of New South WalesSydneyNew South WalesAustralia
| | - John D. Crawford
- Centre for Healthy Brain Ageing (CHeBA)Discipline of Psychiatry and Mental HealthSchool of Clinical Medicine, University of New South WalesSydneyNew South WalesAustralia
| | | | | | - Sergio Luis Blay
- Department of PsychiatryFederal University of São PauloSão PauloBrazil
| | - Xiao Shifu
- Department of Geriatric PsychiatryShanghai Mental Health Center, Shanghai Jiao Tong University School of MedicineShanghaiChina
| | - Tao Wang
- Department of Geriatric PsychiatryShanghai Mental Health Center, Shanghai Jiao Tong University School of MedicineShanghaiChina
- Department of Psychiatry & Affective Disorders CenterRuijin Hospital, Shanghai Jiao Tong University School of MedicineShanghaiChina
- Alzheimer's Disease and Related Disorders CenterShanghai Jiao Tong UniversityShanghaiChina
| | - Ling Yue
- Department of Geriatric PsychiatryShanghai Mental Health Center, Shanghai Jiao Tong University School of MedicineShanghaiChina
| | - Richard B. Lipton
- Saul R. Korey Department of NeurologyAlbert Einstein College of MedicineBronxNew YorkUSA
- Department of Epidemiology and Population HealthAlbert Einstein College of MedicineBronxNew YorkUSA
- Department of Psychiatry and Behavioral MedicineAlbert Einstein College of MedicineBronxNew YorkUSA
| | - Mindy J. Katz
- Saul R. Korey Department of NeurologyAlbert Einstein College of MedicineBronxNew YorkUSA
| | - Carol A. Derby
- Saul R. Korey Department of NeurologyAlbert Einstein College of MedicineBronxNew YorkUSA
- Department of Epidemiology and Population HealthAlbert Einstein College of MedicineBronxNew YorkUSA
| | - Maëlenn Guerchet
- Inserm U1094, IRD UMR270, University Limoges, CHU Limoges, EpiMaCT ‐ Epidemiology of chronic diseases in tropical zone, Institute of Epidemiology and Tropical Neurology, OmegaHealthLimogesFrance
| | - Pierre‐Marie Preux
- Inserm U1094, IRD UMR270, University Limoges, CHU Limoges, EpiMaCT ‐ Epidemiology of chronic diseases in tropical zone, Institute of Epidemiology and Tropical Neurology, OmegaHealthLimogesFrance
| | - Pascal Mbelesso
- Department of NeurologyAmitié HospitalBanguiCentral African Republic
| | - Joanna Norton
- Institute for Neurosciences of Montpellier (INM), University of Montpellier, InsermMontpellierFrance
| | - Karen Ritchie
- Institute for Neurosciences of Montpellier (INM), University of Montpellier, InsermMontpellierFrance
- Institut du Cerveau TrocadéroParisFrance
| | - Ingmar Skoog
- Department of Psychiatry and NeurochemistryNeuropsychiatric Epidemiology UnitInstitute of Neuroscience and Physiology, Sahlgrenska Academy, at the University of GothenburgGothenburgSweden
- Centre for Ageing and Health (AGECAP), University of GothenburgGothenburgSweden
- Region Västra Götaland, Sahlgrenska University Hospital, Psychiatry, Cognition and Old Age Psychiatry ClinicGothenburgSweden
| | - Jenna Najar
- Department of Psychiatry and NeurochemistryNeuropsychiatric Epidemiology UnitInstitute of Neuroscience and Physiology, Sahlgrenska Academy, at the University of GothenburgGothenburgSweden
- Centre for Ageing and Health (AGECAP), University of GothenburgGothenburgSweden
- Region Västra Götaland, Sahlgrenska University Hospital, Psychiatry, Cognition and Old Age Psychiatry ClinicGothenburgSweden
- Department of Clinical GeneticsSection Genomics of Neurodegenerative Diseases and Aging, Vrije Universiteit Amsterdam, Amsterdam UMCAmsterdamThe Netherlands
| | - Therese Rydberg Sterner
- Department of Psychiatry and NeurochemistryNeuropsychiatric Epidemiology UnitInstitute of Neuroscience and Physiology, Sahlgrenska Academy, at the University of GothenburgGothenburgSweden
- Centre for Ageing and Health (AGECAP), University of GothenburgGothenburgSweden
- Department of NeurobiologyAging Research CenterCare Sciences and Society, Karolinska Institute and Stockholm UniversityStockholmSweden
| | - Nikolaos Scarmeas
- 1st Department of NeurologyAiginition Hospital, Medical School, National and Kapodistrian University of AthensAthensGreece
- Department of NeurologyTaub Institute for Research on Alzheimer's Disease and the Aging Brain, Gertrude H. Sergievsky Center, Columbia UniversityNew YorkNew YorkUSA
| | - Mary Yannakoulia
- Department of Nutrition and DieteticsHarokopio UniversityAthensGreece
| | | | - Elena Rolandi
- Golgi Cenci FoundationMilanItaly
- Department of Brain and Behavioral SciencesUniversity of PaviaPaviaItaly
| | | | | | - Oye Gureje
- Department of PsychiatryWHO Collaborating Centre for Research and Training in Mental Health, Neuroscience and Substance Abuse, University of IbadanIbadanNigeria
| | - Akin Ojagbemi
- Department of PsychiatryCollege of Medicine University of IbadanIbadanNigeria
| | - Toyin Bello
- Department of PsychiatryCollege of Medicine University of IbadanIbadanNigeria
| | - Ki Woong Kim
- Department of NeuropsychiatrySeoul National University Bundang HospitalSeongnamRepublic of Korea
- Department of PsychiatrySeoul National University College of MedicineSeoulRepublic of Korea
- Department of Brain and Cognitive SciencesSeoul National University College of Natural SciencesSeoulRepublic of Korea
| | - Ji Won Han
- Department of NeuropsychiatrySeoul National University Bundang HospitalSeongnamRepublic of Korea
- Department of PsychiatrySeoul National University College of MedicineSeoulRepublic of Korea
| | - Dae Jong Oh
- Workplace Mental Health Institute, Kangbuk Samsung Hospital, Sungkyunkwan University School of MedicineSeoulRepublic of Korea
| | - Stella Trompet
- Department of Internal Medicinesection of Gerontology and GeriatricsLeiden University Medical CenterLeidenthe Netherlands
| | - Jacobijn Gussekloo
- Department of Internal Medicinesection of Gerontology and GeriatricsLeiden University Medical CenterLeidenthe Netherlands
- Department of Public Health and Primary CareLeiden University Medical CenterLeidenthe Netherlands
| | - Steffi G. Riedel‐Heller
- Institute of Social MedicineOccupational Health and Public HealthMedical FacultyUniversity of LeipzigLeipzigGermany
| | - Susanne Röhr
- Institute of Social MedicineOccupational Health and Public HealthMedical FacultyUniversity of LeipzigLeipzigGermany
- Health and Ageing Research Team (HART), School of Psychology, Massey UniversityPalmerston NorthAotearoa New Zealand
- Global Brain Health Institute (GBHI), Trinity College DublinDublinIreland
| | - Alexander Pabst
- Institute of Social MedicineOccupational Health and Public HealthMedical FacultyUniversity of LeipzigLeipzigGermany
| | - Suzana Shahar
- Center for Healthy Ageing & Wellness (H‐CARE)Faculty of Health SciencesUniversity Kebangsaan MalaysiaKuala LumpurMalaysia
| | - Nurul Fatin Malek Rivan
- Center for Healthy Ageing & Wellness (H‐CARE)Faculty of Health SciencesUniversity Kebangsaan MalaysiaKuala LumpurMalaysia
| | - Devinder Kaur Ajit Singh
- Center for Healthy Ageing & Wellness (H‐CARE)Faculty of Health SciencesUniversity Kebangsaan MalaysiaKuala LumpurMalaysia
| | - Erin Jacobsen
- Department of PsychiatryUniversity of Pittsburgh School of MedicinePittsburghPennsylvaniaUSA
| | - Mary Ganguli
- Department of PsychiatryUniversity of Pittsburgh School of MedicinePittsburghPennsylvaniaUSA
- Departments of Neurology, and EpidemiologyUniversity of Pittsburgh School of Medicine and School of Public HealthPittsburghPennsylvaniaUSA
| | - Tiffany Hughes
- Department of Graduate Studies in Health and Rehabilitation SciencesBitonte College of Health and Human Services, Youngstown State UniversityYoungstownOhioUSA
| | - Mary Haan
- Department of Epidemiology and BiostatisticsSchool of Medicine, University of California San FranciscoSan FranciscoCaliforniaUSA
| | - Allison E. Aiello
- Columbia Aging Center and the Department of EpidemiologyMailman School of Public Health, Columbia UniversityNew YorkNew YorkUSA
| | - Ding Ding
- Institute of NeurologyNational Center for Neurological Disorders, National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan UniversityShanghaiChina
| | - Qianhua Zhao
- Institute of NeurologyNational Center for Neurological Disorders, National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan UniversityShanghaiChina
| | - Zhenxu Xiao
- Institute of NeurologyNational Center for Neurological Disorders, National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan UniversityShanghaiChina
| | - Kenji Narazaki
- Center for Liberal Arts, Fukuoka Institute of TechnologyHigashi‐kuFukuokaJapan
| | - Tao Chen
- Department of Physical EducationSports and Health Research CenterTongji UniversityShanghaiChina
| | - Sanmei Chen
- Graduate School of Biomedical and Health Sciences, Hiroshima UniversityHiroshimaJapan
| | - Tze Pin Ng
- Department of Psychological MedicineGerontology Research Programme, Yong Loo Lin School of Medicine, National University of SingaporeSingaporeSingapore
| | - Xinyi Gwee
- Department of Psychological MedicineGerontology Research Programme, Yong Loo Lin School of Medicine, National University of SingaporeSingaporeSingapore
| | - Qi Gao
- Department of Psychological MedicineGerontology Research Programme, Yong Loo Lin School of Medicine, National University of SingaporeSingaporeSingapore
| | - Henry Brodaty
- Centre for Healthy Brain Ageing (CHeBA)Discipline of Psychiatry and Mental HealthSchool of Clinical Medicine, University of New South WalesSydneyNew South WalesAustralia
| | - Julian Trollor
- Centre for Healthy Brain Ageing (CHeBA)Discipline of Psychiatry and Mental HealthSchool of Clinical Medicine, University of New South WalesSydneyNew South WalesAustralia
- Department of Developmental Disability NeuropsychiatryDiscipline of Psychiatry and Mental Health, University of New South WalesSydneyNew South WalesAustralia
| | - Nicole Kochan
- Centre for Healthy Brain Ageing (CHeBA)Discipline of Psychiatry and Mental HealthSchool of Clinical Medicine, University of New South WalesSydneyNew South WalesAustralia
| | - Antonio Lobo
- Department of Medicine and PsychiatryUniversidad de ZaragozaZaragozaSpain
- Instituto de Investigación Sanitaria Aragón (IIS Aragón)ZaragozaSpain
- CIBERSAM, Instituto de Salud Carlos IIIMadridSpain
| | - Javier Santabárbara
- Instituto de Investigación Sanitaria Aragón (IIS Aragón)ZaragozaSpain
- CIBERSAM, Instituto de Salud Carlos IIIMadridSpain
- Department of Public HealthUniversidad de ZaragozaZaragozaSpain
| | - Patricia Gracia‐Garcia
- Department of Medicine and PsychiatryUniversidad de ZaragozaZaragozaSpain
- Instituto de Investigación Sanitaria Aragón (IIS Aragón)ZaragozaSpain
- CIBERSAM, Instituto de Salud Carlos IIIMadridSpain
| | - Perminder S. Sachdev
- Centre for Healthy Brain Ageing (CHeBA)Discipline of Psychiatry and Mental HealthSchool of Clinical Medicine, University of New South WalesSydneyNew South WalesAustralia
- Neuropsychiatric Institute, The Prince of Wales HospitalSydneyNew South WalesAustralia
| | - Kay Deckers
- Alzheimer Centrum LimburgDepartment of Psychiatry and NeuropsychologyMental Health and Neuroscience (MHeNs) Research InstituteMaastricht UniversityMaastrichtThe Netherlands
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3
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Sampatakakis SN, Mourtzi N, Charisis S, Mamalaki E, Ntanasi E, Hatzimanolis A, Ramirez A, Lambert JC, Yannakoulia M, Kosmidis MH, Dardiotis E, Hadjigeorgiou G, Megalou M, Sakka P, Scarmeas N. Walking time and genetic predisposition for Alzheimer's disease: Results from the HELIAD study. Clin Neuropsychol 2024:1-17. [PMID: 38741352 DOI: 10.1080/13854046.2024.2344869] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Accepted: 04/15/2024] [Indexed: 05/16/2024]
Abstract
Objective: Our study aimed to explore whether physical condition might affect the association between genetic predisposition for Alzheimer's Disease (AD) and AD incidence. Methods: The sample of participants consisted of 561 community-dwelling adults over 64 years old, without baseline dementia (508 cognitively normal and 53 with mild cognitive impairment), deriving from the HELIAD, an ongoing longitudinal study with follow-up evaluations every 3 years. Physical condition was assessed at baseline through walking time (WT), while a Polygenic Risk Score for late onset AD (PRS-AD) was used to estimate genetic predisposition. The association between WT and PRS-AD with AD incidence was evaluated with Cox proportional hazard models adjusted for age, sex, education years, global cognition score and APOE ε-4 genotype. Then, the association between WT and AD incidence was investigated after stratifying participants by low and high PRS-AD. Finally, we examined the association between PRS-AD and AD incidence after stratifying participants by WT. Results: Both WT and PRS-AD were connected with increased AD incidence (p < 0.05), after adjustments. In stratified analyses, in the slow WT group participants with a greater genetic risk had a 2.5-fold higher risk of developing AD compared to participants with lower genetic risk (p = 0.047). No association was observed in the fast WT group or when participants were stratified based on PRS-AD. Conclusions: Genetic predisposition for AD is more closely related to AD incidence in the group of older adults with slow WT. Hence, physical condition might be a modifier in the relationship of genetic predisposition with AD incidence.
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Affiliation(s)
- Stefanos N Sampatakakis
- 1st Department of Neurology, Aiginition Hospital, National and Kapodistrian University of Athens Medical School, Athens, Greece
| | - Niki Mourtzi
- 1st Department of Neurology, Aiginition Hospital, National and Kapodistrian University of Athens Medical School, Athens, Greece
| | - Sokratis Charisis
- Department of Neurology, UT Health San Antonio, San Antonio, TX, USA
| | - Eirini Mamalaki
- 1st Department of Neurology, Aiginition Hospital, National and Kapodistrian University of Athens Medical School, Athens, Greece
| | - Eva Ntanasi
- 1st Department of Neurology, Aiginition Hospital, National and Kapodistrian University of Athens Medical School, Athens, Greece
| | - Alex Hatzimanolis
- Department of Psychiatry, National and Kapodistrian University of Athens Medical School, Aiginition Hospital, Athens, Greece
| | - Alfredo Ramirez
- Division of Neurogenetics and Molecular Psychiatry, Department of Psychiatry and Psychotherapy, Medical Faculty, University of Cologne, Cologne, Germany
- Department of Neurodegenerative Diseases and Geriatric Psychiatry, University Hospital Bonn, Bonn, Germany
- German Center for Neurodegenerative Diseases (DZNE Bonn), Bonn, Germany
- Department of Psychiatry, Glenn Biggs Institute for Alzheimer's and Neurodegenerative Diseases, San Antonio, TX, USA
- Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), University of Cologne, Cologne, Germany
| | - Jean-Charles Lambert
- U1167-RID-AGE facteurs de risque et déterminants moléculaires des maladies liés au vieillissement, Univ. Lille, Inserm, CHU Lille, Institut Pasteur de Lille, Lille, France
| | - Mary Yannakoulia
- Department of Nutrition and Dietetics, Harokopio University, Athens, Greece
| | - Mary H Kosmidis
- Lab of Cognitive Neuroscience, School of Psychology, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Efthimios Dardiotis
- Department of Neurology, Faculty of Medicine, School of Health Sciences, University Hospital of Larissa, University of Thessaly, Larissa, Greece
| | | | | | - Paraskevi Sakka
- Athens Association of Alzheimer's Disease and Related Disorders, Marousi, Greece
| | - Nikolaos Scarmeas
- 1st Department of Neurology, Aiginition Hospital, National and Kapodistrian University of Athens Medical School, Athens, Greece
- Department of Neurology, The Gertrude H. Sergievsky Center, Taub Institute for Research in Alzheimer's Disease and the Aging Brain, Columbia University, New York, NY, USA
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Sampatakakis SN, Mourtzi N, Charisis S, Kalligerou F, Mamalaki E, Ntanasi E, Hatzimanolis A, Koutsis G, Ramirez A, Lambert JC, Yannakoulia M, Kosmidis MH, Dardiotis E, Hadjigeorgiou G, Sakka P, Rouskas K, Patas K, Scarmeas N. Cerebral Amyloidosis in Individuals with Subjective Cognitive Decline: From Genetic Predisposition to Actual Cerebrospinal Fluid Measurements. Biomedicines 2024; 12:1053. [PMID: 38791015 PMCID: PMC11118196 DOI: 10.3390/biomedicines12051053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2024] [Revised: 04/30/2024] [Accepted: 05/09/2024] [Indexed: 05/26/2024] Open
Abstract
The possible relationship between Subjective Cognitive Decline (SCD) and dementia needs further investigation. In the present study, we explored the association between specific biomarkers of Alzheimer's Disease (AD), amyloid-beta 42 (Aβ42) and Tau with the odds of SCD using data from two ongoing studies. In total, 849 cognitively normal (CN) individuals were included in our analyses. Among the participants, 107 had available results regarding cerebrospinal fluid (CSF) Aβ42 and Tau, while 742 had available genetic data to construct polygenic risk scores (PRSs) reflecting their genetic predisposition for CSF Aβ42 and plasma total Tau levels. The associations between AD biomarkers and SCD were tested using logistic regression models adjusted for possible confounders such as age, sex, education, depression, and baseline cognitive test scores. Abnormal values of CSF Aβ42 were related to 2.5-fold higher odds of SCD, while higher polygenic loading for Aβ42 was associated with 1.6-fold higher odds of SCD. CSF Tau, as well as polygenic loading for total Tau, were not associated with SCD. Thus, only cerebral amyloidosis appears to be related to SCD status, either in the form of polygenic risk or actual CSF measurements. The temporal sequence of amyloidosis being followed by tauopathy may partially explain our findings.
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Affiliation(s)
- Stefanos N. Sampatakakis
- 1st Department of Neurology, Aiginition Hospital, Athens Medical School, National and Kapodistrian University, 11528 Athens, Greece; (S.N.S.); (N.M.); (F.K.); (E.M.); (E.N.)
| | - Niki Mourtzi
- 1st Department of Neurology, Aiginition Hospital, Athens Medical School, National and Kapodistrian University, 11528 Athens, Greece; (S.N.S.); (N.M.); (F.K.); (E.M.); (E.N.)
| | - Sokratis Charisis
- Department of Neurology, UT Health San Antonio, San Antonio, TX 78229, USA;
| | - Faidra Kalligerou
- 1st Department of Neurology, Aiginition Hospital, Athens Medical School, National and Kapodistrian University, 11528 Athens, Greece; (S.N.S.); (N.M.); (F.K.); (E.M.); (E.N.)
| | - Eirini Mamalaki
- 1st Department of Neurology, Aiginition Hospital, Athens Medical School, National and Kapodistrian University, 11528 Athens, Greece; (S.N.S.); (N.M.); (F.K.); (E.M.); (E.N.)
| | - Eva Ntanasi
- 1st Department of Neurology, Aiginition Hospital, Athens Medical School, National and Kapodistrian University, 11528 Athens, Greece; (S.N.S.); (N.M.); (F.K.); (E.M.); (E.N.)
| | - Alex Hatzimanolis
- Department of Psychiatry, Aiginition Hospital, Athens Medical School, National and Kapodistrian University, 11528 Athens, Greece;
| | - Georgios Koutsis
- Neurogenetics Unit, 1st Department of Neurology, Aiginition Hospital, Athens Medical School, National and Kapodistrian University, 11528 Athens, Greece;
| | - Alfredo Ramirez
- Division of Neurogenetics and Molecular Psychiatry, Department of Psychiatry and Psychotherapy, Medical Faculty, University of Cologne, 50923 Cologne, Germany;
- Department of Neurodegenerative Diseases and Geriatric Psychiatry, University Hospital Bonn, 53127 Bonn, Germany
- German Center for Neurodegenerative Diseases (DZNE Bonn), 53127 Bonn, Germany
- Department of Psychiatry, Glenn Biggs Institute for Alzheimer’s and Neurodegenerative Diseases, San Antonio, TX 78229, USA
- Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), University of Cologne, 50923 Cologne, Germany
| | - Jean-Charles Lambert
- Inserm, CHU Lille, Institut Pasteur de Lille, U1167-RID-AGE Facteurs de Risque et Déterminants Moléculaires des Maladies Liés au Vieillissement, University of Lille, 59000 Lille, France;
| | - Mary Yannakoulia
- Department of Nutrition and Dietetics, Harokopio University, 17676 Athens, Greece;
| | - Mary H. Kosmidis
- Lab of Neuropsychology and Behavioral Neuroscience, School of Psychology, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece;
| | - Efthimios Dardiotis
- Department of Neurology, University Hospital of Larissa, Faculty of Medicine, School of Health Sciences, University of Thessaly, 41334 Larissa, Greece;
| | | | - Paraskevi Sakka
- Athens Association of Alzheimer’s Disease and Related Disorders, 11636 Marousi, Greece;
| | - Konstantinos Rouskas
- Institute of Applied Biosciences, Centre for Research & Technology Hellas, 54124 Thessaloniki, Greece;
| | - Kostas Patas
- Department of Medical Biopathology and Clinical Microbiology, Aiginition Hospital, Athens Medical School, National and Kapodistrian University, 11528 Athens, Greece;
| | - Nikolaos Scarmeas
- 1st Department of Neurology, Aiginition Hospital, Athens Medical School, National and Kapodistrian University, 11528 Athens, Greece; (S.N.S.); (N.M.); (F.K.); (E.M.); (E.N.)
- Department of Neurology, The Gertrude H. Sergievsky Center, Taub Institute for Research in Alzheimer’s Disease and the Aging Brain, Columbia University, New York, NY 10027, USA
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Liampas I, Siokas V, Kyrozis A, Sakoutis G, Yannakoulia M, Kosmidis MH, Sakka P, Scarmeas N, Hadjigeorgiou GM, Dardiotis E. Longitudinal Cognitive Trajectories in Older Adults with Restless Legs Syndrome or Willis-Ekbom Disease. Life (Basel) 2024; 14:430. [PMID: 38672702 PMCID: PMC11051192 DOI: 10.3390/life14040430] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2024] [Revised: 02/21/2024] [Accepted: 03/22/2024] [Indexed: 04/28/2024] Open
Abstract
Background: Restless legs syndrome/Willis-Ekbom disease (RLS/WED) has occasionally but not consistently been associated with cognitive and most notably language and executive impairment. The present study was conducted to investigate the cognitive trajectories of older individuals with RLS/WED. Methods: Participants were drawn from the randomly selected, older (>64 years), population-based HELIAD cohort. Individuals without dementia and with available neuropsychological evaluations at baseline and follow-up were considered for potential eligibility. A comprehensive assessment examining five principal components of cognition (memory, visuo-spatial ability, attention, executive function, and language) was administered to the participants. Generalized estimating equation analyses were used to examine the unadjusted and adjusted (for critical factors and covariates) effects of RLS/WED on cognition over time. Results: A total of 1003 predominantly female (59.5%), older (72.9 ± 4.9 years) participants with follow-up evaluations after a mean of 3.09 ± 0.85 years and without dementia at baseline and follow-up were included in the present study. Among them, 81 were diagnosed with RLS/WED at baseline. Global cognition, memory, attention, and executive and visuo-perceptual skills did not differ between those with and without RLS/WED. However, the RLS/WED group performed worse on language at baseline by a standard deviation of 0.249, while demonstrating a mitigated language decline over time, by a standard deviation of 0.063. The unadjusted models yielded similar results. Conclusions: Our findings were indicative of a baseline language disadvantage among older individuals with RLS/WED, but the initial discrepancy tends to dissolve over time.
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Affiliation(s)
- Ioannis Liampas
- Department of Neurology, University Hospital of Larissa, School of Medicine, University of Thessaly, 41100 Larissa, Greece; (V.S.); (G.S.); (G.M.H.); (E.D.)
| | - Vasileios Siokas
- Department of Neurology, University Hospital of Larissa, School of Medicine, University of Thessaly, 41100 Larissa, Greece; (V.S.); (G.S.); (G.M.H.); (E.D.)
| | - Andreas Kyrozis
- 1st Department of Neurology, Aiginition Hospital, National and Kapodistrian University of Athens Medical School, 11528 Athens, Greece; (A.K.); (N.S.)
| | - George Sakoutis
- Department of Neurology, University Hospital of Larissa, School of Medicine, University of Thessaly, 41100 Larissa, Greece; (V.S.); (G.S.); (G.M.H.); (E.D.)
| | - Mary Yannakoulia
- Department of Nutrition and Dietetics, Harokopio University, 17671 Athens, Greece
| | - Mary H. Kosmidis
- Laboratory of Cognitive Neuroscience, School of Psychology, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece;
| | - Paraskevi Sakka
- Athens Association of Alzheimer’s Disease and Related Disorders, 11636 Marousi, Greece;
| | - Nikolaos Scarmeas
- 1st Department of Neurology, Aiginition Hospital, National and Kapodistrian University of Athens Medical School, 11528 Athens, Greece; (A.K.); (N.S.)
- Taub Institute for Research in Alzheimer’s Disease and the Aging Brain, The Gertrude H. Sergievsky Center, Department of Neurology, Columbia University, New York, NY 10032, USA
| | - Georgios M. Hadjigeorgiou
- Department of Neurology, University Hospital of Larissa, School of Medicine, University of Thessaly, 41100 Larissa, Greece; (V.S.); (G.S.); (G.M.H.); (E.D.)
- Department of Neurology, Medical School, University of Cyprus, 2408 Nicosia, Cyprus
| | - Efthimios Dardiotis
- Department of Neurology, University Hospital of Larissa, School of Medicine, University of Thessaly, 41100 Larissa, Greece; (V.S.); (G.S.); (G.M.H.); (E.D.)
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Eliza Georgiou EZ, Politis A, Kosmidis MH, Yannakoulia M, Dardiotis E, Hadjigeorgiou G, Sakka P, Scarmeas N, Economou P, Alexopoulos P. Depressive symptoms in the entire spectrum of cognitive ageing in Greece: evidence from the Hellenic Longitudinal Investigation of Aging and Diet (HELIAD). Int J Psychiatry Clin Pract 2024; 28:27-34. [PMID: 38145312 DOI: 10.1080/13651501.2023.2296889] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2023] [Accepted: 12/14/2023] [Indexed: 12/26/2023]
Abstract
OBJECTIVES To study (i) the prevalence of mild and moderate-to-severe depressive symptoms in the entire spectrum of cognitive ageing in Greece and (ii) the relationship between these symptoms and demographic and clinical data. METHODS The study was based on the randomly selected cohort of the Hellenic Longitudinal Investigation of Aging and Diet (HELIAD). Depressive symptoms were assessed with the 15-item version of the Geriatric Depression Scale. Participants also received a comprehensive neuropsychological assessment, while the clinical diagnoses of dementia and mild cognitive impairment were established according to international diagnostic criteria. Statistical analyses relied on comparison tests and a logistic (proportional odds) ordinal regression model. RESULTS Depressive symptoms were detected in 19.5% of the 1936 study participants, while 11.3% of both people with MCI and dementia had moderate-to-severe depressive symptoms. The regression model revealed that older adults with more severe depressive symptoms were more likely female, cognitively impaired, less educated, were treated with psychotropic medication and lived in Attica versus Thessaly. CONCLUSIONS Since depressive symptoms were detected in almost one in five older adults, healthcare professionals in Greece should safeguard the timely detection and effective treatment of such symptoms and the post-diagnostic care of older adults with depression.
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Affiliation(s)
- Eleni-Zacharoula Eliza Georgiou
- Department of Medicine, School of Health Sciences, Mental Health Services, Patras University General Hospital, University of Patras, Patras, Greece
| | - Antonios Politis
- First Department of Psychiatry, School of Medicine, Eginition Hospital, National and Kapodistrian University of Athens, Athens, Greece
- Department of Psychiatry, Division of Geriatric Psychiatry and Neuropsychiatry, Johns Hopkins Medical School, Baltimore, MD, USA
| | - Mary H Kosmidis
- School of Psychology, Lab of Cognitive Neuroscience, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Mary Yannakoulia
- Department of Nutrition and Dietetics, Harokopio University, Athens, Greece
| | | | | | - Paraskevi Sakka
- Athens Association of Alzheimer's Disease and Related Disorders, Maroussi, Greece
| | - Nikolaos Scarmeas
- 1st Department of Neurology, Eginition Hospital, National and Kapodistrian University of Athens Medical School, Athens, Greece
- Department of Neurology, Taub Institute for Research in Alzheimer's Disease and the Aging Brain, The Gertrude H. Sergievsky Center, Columbia University, New York, NY, USA
| | - Polychronis Economou
- Department of Civil Engineering (Statistics), School of Engineering, University of Patras, Patras, Greece
| | - Panagiotis Alexopoulos
- Department of Medicine, School of Health Sciences, Mental Health Services, Patras University General Hospital, University of Patras, Patras, Greece
- Medical School, Global Brain Health Institute, Trinity College Dublin, The University of Dublin, Dublin, Republic of Ireland
- Department of Psychiatry and Psychotherapy, Faculty of Medicine, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
- Patras Dementia Day Care Centre, Patras, Greece
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Arampatzi X, Margioti ES, Messinis L, Yannakoulia M, Hadjigeorgiou G, Dardiotis E, Sakka P, Scarmeas N, Kosmidis MH. Development of robust normative data for the neuropsychological assessment of Greek older adults. J Int Neuropsychol Soc 2024:1-9. [PMID: 38282389 DOI: 10.1017/s1355617723011499] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/30/2024]
Abstract
OBJECTIVE Normative data for older adults may be tainted by inadvertent inclusion of undiagnosed individuals at the very early stage of a neurodegenerative process. To avoid this pitfall, we developed norms for a cohort of older adults without MCI/dementia at 3-year follow-up. METHODS A randomly selected sample of 1041 community-dwelling individuals (age ≥ 65) received a full neurological and neuropsychological examination on two occasions [mean interval = 3.1 (SD = 0.9) years]. RESULTS Of these, 492 participants (Group 1; 65-87 years old) were without dementia on both evaluations (CDR=0 and MMSE ≥ 26); their baseline data were used for norms development. Group 2 (n = 202) met the aforementioned criteria only at baseline, but not at follow-up. Multiple linear regressions included demographic predictors for regression-based normative formulae and raw test scores as dependent variables for each test variable separately. Standardized scaled scores and stratified discrete norms were also calculated. Group 2 performed worse than Group 1 on most tests (p-values < .001-.021). Education was associated with all test scores, age with most, and sex effects were consistent with the literature. CONCLUSIONS We provide a model for developing sound normative data for widely used neuropsychological tests among older adults, untainted by potential early, undiagnosed cognitive impairment, reporting regression-based, scaled, and discrete norms for use in clinical settings to identify cognitive decline in older adults. Additionally, our co-norming of a variety of tests may enable intra-individual comparisons for diagnostic purposes. The present work addresses the challenge of developing robust normative data for neuropsychological tests in older adults.
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Affiliation(s)
- Xanthi Arampatzi
- Lab of Cognitive Neuroscience, School of Psychology, Aristotle University of Thessaloniki, Thessaloniki, Greece
- Athens Alzheimer's Association, Athens, Greece
| | - Eleni S Margioti
- Lab of Cognitive Neuroscience, School of Psychology, Aristotle University of Thessaloniki, Thessaloniki, Greece
- Athens Alzheimer's Association, Athens, Greece
| | - Lambros Messinis
- Lab of Cognitive Neuroscience, School of Psychology, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Mary Yannakoulia
- Department of Nutrition and Dietetics, Harokopio University, Athens, Greece
| | | | | | | | - Nikolaos Scarmeas
- 1st Department of Neurology, Aiginition Hospital, National and Kapodistrian University of Athens Medical School, Athens, Greece
- Department of Neurology, Taub Institute for Research in Alzheimer's Disease and the Aging Brain, The Gertrude H. Sergievsky Center, Columbia University, New York, USA
| | - Mary H Kosmidis
- Lab of Cognitive Neuroscience, School of Psychology, Aristotle University of Thessaloniki, Thessaloniki, Greece
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8
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Sampatakakis SN, Mourtzi N, Charisis S, Mamalaki E, Ntanasi E, Hatzimanolis A, Ramirez A, Lambert JC, Yannakoulia M, Kosmidis MH, Dardiotis E, Hadjigeorgiou G, Sakka P, Scarmeas N. Genetic Predisposition for White Matter Hyperintensities and Risk of Mild Cognitive Impairment and Alzheimer's Disease: Results from the HELIAD Study. Curr Issues Mol Biol 2024; 46:934-947. [PMID: 38275674 PMCID: PMC10814944 DOI: 10.3390/cimb46010060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2023] [Revised: 01/13/2024] [Accepted: 01/19/2024] [Indexed: 01/27/2024] Open
Abstract
The present study investigated the association of genetic predisposition for white matter hyperintensities (WMHs) with incident amnestic mild cognitive impairment (aMCI) or Alzheimer's disease (AD), as well as whether such an association was influenced by age, sex, and cognitive reserve. Overall, 537 individuals without aMCI or dementia at baseline were included. Among them, 62 individuals developed aMCI/AD at follow up. Genetic propensity to WMH was estimated using a polygenic risk score for WMHs (PRS WMH). The association of PRS WMH with aMCI/AD incidence was examined using COX models. A higher PRS WMH was associated with a 47.2% higher aMCI/AD incidence (p = 0.015) in the fully adjusted model. Subgroup analyses showed significant results in the older age group, in which individuals with a higher genetic predisposition for WMHs had a 3.4-fold higher risk for developing aMCI/AD at follow up (p < 0.001), as well as in the lower cognitive reserve (CR, proxied by education years) group, in which individuals with a higher genetic predisposition for WMHs had an over 2-fold higher risk (p = 0.013). Genetic predisposition for WMHs was associated with aMCI/AD incidence, particularly in the group of participants with a low CR. Thus, CR might be a modifier in the relationship between genetic predisposition for WMHs and incident aMCI/AD.
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Affiliation(s)
- Stefanos N. Sampatakakis
- 1st Department of Neurology, Aiginition Hospital, Athens Medical School, National and Kapodistrian University, 11528 Athens, Greece; (S.N.S.); (N.M.); (E.M.); (E.N.)
| | - Niki Mourtzi
- 1st Department of Neurology, Aiginition Hospital, Athens Medical School, National and Kapodistrian University, 11528 Athens, Greece; (S.N.S.); (N.M.); (E.M.); (E.N.)
| | - Sokratis Charisis
- Department of Neurology, UT Health San Antonio, San Antonio, TX 78229, USA;
| | - Eirini Mamalaki
- 1st Department of Neurology, Aiginition Hospital, Athens Medical School, National and Kapodistrian University, 11528 Athens, Greece; (S.N.S.); (N.M.); (E.M.); (E.N.)
| | - Eva Ntanasi
- 1st Department of Neurology, Aiginition Hospital, Athens Medical School, National and Kapodistrian University, 11528 Athens, Greece; (S.N.S.); (N.M.); (E.M.); (E.N.)
| | - Alexandros Hatzimanolis
- Department of Psychiatry, Aiginition Hospital, Athens Medical School, National and Kapodistrian University, 11528 Athens, Greece;
| | - Alfredo Ramirez
- Division of Neurogenetics and Molecular Psychiatry, Department of Psychiatry and Psychotherapy, Medical Faculty, University of Cologne, 50923 Cologne, Germany
- Department of Neurodegenerative Diseases and Geriatric Psychiatry, University Hospital Bonn, 53127 Bonn, Germany
- German Center for Neurodegenerative Diseases (DZNE Bonn), 53127 Bonn, Germany
- Department of Psychiatry, Glenn Biggs Institute for Alzheimer’s and Neurodegenerative Diseases, San Antonio, TX 78229, USA
- Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), University of Cologne, 50923 Cologne, Germany
| | - Jean-Charles Lambert
- Inserm, CHU Lille, Institut Pasteur de Lille, U1167-RID-AGE Facteurs de Risque et Déterminants Moléculaires des Maladies Liés au Vieillissement, University of Lille, 59000 Lille, France;
| | - Mary Yannakoulia
- Department of Nutrition and Dietetics, Harokopio University, 17676 Athens, Greece;
| | - Mary H. Kosmidis
- Lab of Neuropsychology and Behavioral Neuroscience, School of Psychology, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece;
| | - Efthimios Dardiotis
- Department of Neurology, University Hospital of Larissa, Faculty of Medicine, School of Health Sciences, University of Thessaly, 41334 Larissa, Greece;
| | | | - Paraskevi Sakka
- Athens Association of Alzheimer’s Disease and Related Disorders, 11636 Marousi, Greece;
| | - Nikolaos Scarmeas
- 1st Department of Neurology, Aiginition Hospital, Athens Medical School, National and Kapodistrian University, 11528 Athens, Greece; (S.N.S.); (N.M.); (E.M.); (E.N.)
- Department of Neurology, The Gertrude H. Sergievsky Center, Taub Institute for Research in Alzheimer’s Disease and the Aging Brain, Columbia University, New York, NY 10027, USA
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9
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Rizkallah J, Staios M, Analytis P, Kosmidis MH, March E, Stolwyk RJ. Exploring How Sociocultural Factors Affect the Experience of Completing Neuropsychological Assessments Within Older Greek-Australians. Arch Clin Neuropsychol 2024; 39:65-77. [PMID: 37332261 PMCID: PMC10802220 DOI: 10.1093/arclin/acad044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/18/2023] [Indexed: 06/20/2023] Open
Abstract
OBJECTIVE The field of cultural neuropsychology has grown exponentially over the last three decades. With a limited culturally informed evidence base to guide neuropsychological practice, the acceptability of existing paradigms has been called into question when applied to culturally diverse and educationally disadvantaged groups. This qualitative study aimed to explore the experiences of Greek Australian older adults who underwent a cognitive assessment to better understand potential barriers and facilitators to engagement and to improve neuropsychological assessment outcomes. METHOD Semi-structured interviews were developed to explore cultural attitudes and contextual factors relating to neuropsychological assessment. Interviews were conducted by Greek-speaking neuropsychologists using a sample of 10 healthy elderly Greek Australians following the completion of a comprehensive neuropsychological assessment. Data were analyzed using a phenomenological design within a critical realist framework. RESULTS Analysis revealed the emergence of three broad themes: sociocultural factors, experiences within the broader medical system, and the assessment experience. Engagement with cognitive assessment was influenced by several factors, including rapport building, understanding of the assessment, and use of inappropriate tests. Furthermore, level and quality of education, sex differences, language barriers, acculturation, previous experiences of prejudice, anxiety, and a preference for Greek-speaking clinicians were additional factors reported to affect the client experience and validity of assessment outcomes. CONCLUSION Neuropsychological assessment is, in part, affected by culturally reinforced attitudes. Failing to adjust the relationship between the clinician and client, test environment, style of communication, and the use of culturally inappropriate tests is likely to affect the validity of assessment outcomes.
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Affiliation(s)
- Joyce Rizkallah
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Melbourne, Australia
- Monash-Epworth Rehabilitation Research Centre, Monash University, Melbourne, Australia
| | - Mathew Staios
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Melbourne, Australia
- Monash-Epworth Rehabilitation Research Centre, Monash University, Melbourne, Australia
| | - Penelope Analytis
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Melbourne, Australia
- Monash-Epworth Rehabilitation Research Centre, Monash University, Melbourne, Australia
| | - Mary H Kosmidis
- Lab of Cognitive Neuroscience, School of Psychology, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Evrim March
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Melbourne, Australia
| | - Renerus J Stolwyk
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Melbourne, Australia
- Monash-Epworth Rehabilitation Research Centre, Monash University, Melbourne, Australia
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10
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Gkotzamanis V, Panagiotakos DB, Yannakoulia M, Maraki M, Kosmidis M, Dardiotis E, Hadjigeorgiou G, Sakka P, Ntanasi E, Mamalaki E, Scarmeas N. Trajectories of healthy aging and their association with prodromal parkinson disease: The HELIAD study. APPLIED NEUROPSYCHOLOGY. ADULT 2023:1-8. [PMID: 38048313 DOI: 10.1080/23279095.2023.2289548] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/06/2023]
Abstract
Background: The aim of the present study was to investigate the association of prodromal PD (pPD) with trajectories of healthy aging, according to its latest definition by the WHO.Methods: In a sample of 1,226 older adults (704 women), PD diagnosis was reached through standard clinical research procedures. Probability of pPD was calculated according to the International Parkinson and Movement Disorder Society's research criteria for PD-free participants. A healthy aging metric was introduced using an item response theory approach (IRT) based on information from validated questionnaires assessing functionality. Four trajectories of healthy aging were created based on whether the healthy aging status of participants was above or below the median at baseline and follow up: High-High, High-Low, Low-High and Low-Low.Results: 34.3% belonged to the High-High group, 15.7% to the High-Low, 18.6% to the Low-High and 31.4% to the Low-Low group. Participants with possible/probable pPD were 78% less likely to belong in High-High trajectory of healthy aging as compared to those without pPD (OR = 0.22, 95%CI 0.06-0.79, p-value = 0,02).Conclusion: Our findings suggest an inverse association of pPD probability with healthy aging among older adults; Further research is needed to investigate the clinical implications of this association.
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Affiliation(s)
- Viktor Gkotzamanis
- Department of Nutrition and Dietetics, School of Health Sciences and Education, Harokopio University, Athens, Greece
| | - Demosthenes B Panagiotakos
- Department of Nutrition and Dietetics, School of Health Sciences and Education, Harokopio University, Athens, Greece
| | - Mary Yannakoulia
- Department of Nutrition and Dietetics, School of Health Sciences and Education, Harokopio University, Athens, Greece
| | - Maria Maraki
- Department of Nutrition and Dietetics, School of Health Sciences and Education, Harokopio University, Athens, Greece
| | - Mary Kosmidis
- Lab of Cognitive Neuroscience, School of Psychology, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | | | | | - Paraskevi Sakka
- Athens Association of Alzheimer's Disease and Related Disorders, Athens, Greece
| | - Eva Ntanasi
- 1st Department of Neurology, Aiginition Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Eirini Mamalaki
- Department of Nutrition and Dietetics, School of Health Sciences and Education, Harokopio University, Athens, Greece
| | - Nikolaos Scarmeas
- 1st Department of Neurology, Aiginition Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
- Department of Neurology, Columbia University, New York, NY, USA
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11
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Damigou E, Faka A, Kouvari M, Anastasiou C, Kosti RI, Chalkias C, Panagiotakos D. Adherence to a Mediterranean type of diet in the world: a geographical analysis based on a systematic review of 57 studies with 1,125,560 participants. Int J Food Sci Nutr 2023; 74:799-813. [PMID: 37771002 DOI: 10.1080/09637486.2023.2262781] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Accepted: 09/20/2023] [Indexed: 09/30/2023]
Abstract
This systematic review aimed to assess the level and time-trends of adherence to Mediterranean-type diets (MTD) among the general population, globally. According to Preferred Reporting Items for Systematic Reviews and Meta-Analyses, a comprehensive literature search of the MEDLINE and Scopus databases was carried out, until 04/09/2023, based on specific criteria. Fifty-seven studies with 1,125,560 apparently healthy adults from Europe (n = 37), US (n = 8), Asia (n = 8), Australia (n = 4) and Africa (n = 1) were included. Adherence to an MTD was moderate with a significant decline observed in the last decade. European countries, mainly driven by Mediterranean countries, showed higher adherence than other regions. Geographical analysis revealed that adherence to an MTD is related to both geographic location and socioeconomic status throughout the world.
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Affiliation(s)
- Evangelia Damigou
- Department of Nutrition and Dietetics, School of Health Sciences and Education, Harokopio University, Athens, Greece
| | - Antigoni Faka
- Department of Geography, School of Environmental Sciences, Harokopio University, Athens, Greece
| | - Matina Kouvari
- Department of Nutrition and Dietetics, School of Health Sciences and Education, Harokopio University, Athens, Greece
| | - Costas Anastasiou
- Department of Nutrition and Dietetics, School of Health Sciences and Education, Harokopio University, Athens, Greece
| | - Rena I Kosti
- Department of Nutrition and Dietetics, School of Physical Education, Sport Science and Dietetics, University of Thessaly Trikala, Greece
| | - Christos Chalkias
- Department of Geography, School of Environmental Sciences, Harokopio University, Athens, Greece
| | - Demosthenes Panagiotakos
- Department of Nutrition and Dietetics, School of Health Sciences and Education, Harokopio University, Athens, Greece
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12
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Tsiaras Y, Kiosseoglou G, Dardiotis E, Yannakoulia M, Hadjigeorgiou GM, Sakka P, Ntanasi E, Scarmeas N, Kosmidis MH. Predictive ability of the clock drawing test to detect mild cognitive impairment and dementia over time: Results from the HELIAD study. Clin Neuropsychol 2023; 37:1651-1668. [PMID: 36645823 DOI: 10.1080/13854046.2023.2167736] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2022] [Accepted: 01/06/2023] [Indexed: 01/18/2023]
Abstract
Objective: We investigated the diagnostic accuracy of the Clock Drawing Test (CDT) in discriminating Mild Cognitive Impairment (MCI) and dementia from normal cognition. Additionally, its clinical utility in predicting the transition from normal cognition to MCI and dementia over the course of several years was explored. Method: In total, 1037 older adults (633 women) who completed the CDT in a baseline assessment were drawn from the population-based HELIAD cohort. Among these, 848 participants were identified as cognitively normal, 142 as having MCI and 47 with dementia during the baseline assessment. Of these individuals, 565 attended the follow-up assessment (mean interval: 3.21 years). ROC curve and binary logistic regression analyses were performed. Results: The CDT exhibited good diagnostic accuracy for the discrimination between dementia and normal cognition (AUC = .879, SN = .813, SP = .778, LR+ = 3.66, LR- = .240, < .001, d = 1.655) and acceptable diagnostic accuracy for the discrimination between dementia and MCI (AUC=.761, SN= .750, SP= .689, LR+ = 2.41, LR- = .362, p < .001, d = 1.003). We found limited diagnostic accuracy, however, for the discrimination between MCI and normal cognition (AUC = .686, SN = .764, SP = .502, LR+ = 1.53, LR- = .470, p < .001, d = .685). Moreover, the CDT significantly predicted the transition from normal cognition to dementia [Exp(B)= 1.257, p = .022], as well as the transition from MCI to normal cognition [Exp(B) = 1.334, p = .023] during the longitudinal investigation. Conclusions: The CDT is a neuropsychological test with acceptable diagnostic accuracy for the discrimination of dementia from MCI and normal cognition. Furthermore, it has an important predictive value for the transition from normal cognition to dementia and from MCI to normal cognition.
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Affiliation(s)
- Yiannis Tsiaras
- Lab of Cognitive Neuroscience, School of Psychology, Aristotle University of Thessaloniki, Thessaloniki, Greece
- Psychiatric Department, 424 General Military Hospital, Thessaloniki, Greece
| | - Grigoris Kiosseoglou
- Lab of Cognitive Neuroscience, School of Psychology, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Efthimios Dardiotis
- Department of Neurology, Faculty of Medicine, University of Thessaly, Volos, Greece
| | - Mary Yannakoulia
- Department of Nutrition and-Dietetics, Harokopio University, Kallithea, Greece
| | | | - Paraskevi Sakka
- Athens Association of Alzheimer's Disease and Related Disorders, Athens, Greece
| | - Eva Ntanasi
- Athens Association of Alzheimer's Disease and Related Disorders, Athens, Greece
- 1st Department of Neurology, Aiginition Hospital, National and Kapodistrian University of Athens Medical School, Athens, Greece
| | - Nikolaos Scarmeas
- 1st Department of Neurology, Aiginition Hospital, National and Kapodistrian University of Athens Medical School, Athens, Greece
- Taub Institute for Research in Alzheimer's Disease and the Aging Brain, Τhe Gertrude H. Sergievsky Center, Department of Neurology, Columbia University, New York, ΝΥ, USA
| | - Mary H Kosmidis
- Lab of Cognitive Neuroscience, School of Psychology, Aristotle University of Thessaloniki, Thessaloniki, Greece
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13
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Bairami S, Folia V, Liampas I, Ntanasi E, Patrikelis P, Siokas V, Yannakoulia M, Sakka P, Hadjigeorgiou G, Scarmeas N, Dardiotis E, Kosmidis MH. Exploring Verbal Fluency Strategies among Individuals with Normal Cognition, Amnestic and Non-Amnestic Mild Cognitive Impairment, and Alzheimer's Disease. MEDICINA (KAUNAS, LITHUANIA) 2023; 59:1860. [PMID: 37893577 PMCID: PMC10608566 DOI: 10.3390/medicina59101860] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Revised: 10/14/2023] [Accepted: 10/17/2023] [Indexed: 10/29/2023]
Abstract
Background and Objectives: The present study explored the utilization of verbal fluency (VF) cognitive strategies, including clustering, switching, intrusions, and perseverations, within both semantic (SVF) and phonemic (PVF) conditions, across a continuum of neurocognitive decline, spanning from normal cognitive ageing (NC) to mild cognitive impairment (MCI) and its subtypes, amnestic (aMCI) and non-amnestic (naMCI), as well as AD. Materials and Methods: The study sample was derived from the Hellenic Longitudinal Investigation of Aging and Diet (HELIAD) cohort. The sample included 1607 NC individuals, 146 with aMCI (46 single-domain and 100 multi-domain), 92 with naMCI (41 single-domain and 51 multi-domain), and 79 with AD. Statistical analyses, adjusting for sex, age, and education, employed multivariate general linear models to probe differences among these groups. Results: Results showed that AD patients exhibited poorer performance in switching in both VF tasks and SVF clustering compared to NC. Similarly, the aMCI group performed worse than the NC in switching and clustering in both tasks, with aMCI performing similarly to AD, except for SVF switching. In contrast, the naMCI subgroup performed similarly to those with NC across most strategies, surpassing AD patients. Notably, the aMCI subgroup's poor performance in SVF switching was mainly due to the subpar performance of the multi-domain aMCI subgroup. This subgroup was outperformed in switching in both VF tasks by the single-domain naMCI, who also performed better than the multi-domain naMCI in SVF switching. No significant differences emerged in terms of perseverations and intrusions. Conclusions: Overall, these findings suggest a continuum of declining switching ability in the SVF task, with NC surpassing both aMCI and AD, and aMCI outperforming those with AD. The challenges in SVF switching suggest executive function impairment associated with multi-domain MCI, particularly driven by the multi-domain aMCI.
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Affiliation(s)
- Styliani Bairami
- Lab of Cognitive Neuroscience, School of Psychology, Aristotle University of Thessaloniki, University Campus, 54124 Thessaloniki, Greece
| | - Vasiliki Folia
- Lab of Cognitive Neuroscience, School of Psychology, Aristotle University of Thessaloniki, University Campus, 54124 Thessaloniki, Greece
| | - Ioannis Liampas
- Department of Neurology, University Hospital of Larissa, School of Medicine, University of Thessaly, Mezourlo Hill, 41110 Larissa, Greece
| | - Eva Ntanasi
- Department of Nutrition and Dietetics, Harokopio University, 70 El. Venizelou, 17671 Athens, Greece
- 1st Department of Neurology, Aiginition Hospital, National and Kapodistrian University of Athens Medical School, Vassilissis Sofias Ave 72, 11528 Athens, Greece
| | - Panayiotis Patrikelis
- Lab of Cognitive Neuroscience, School of Psychology, Aristotle University of Thessaloniki, University Campus, 54124 Thessaloniki, Greece
| | - Vasileios Siokas
- Department of Neurology, University Hospital of Larissa, School of Medicine, University of Thessaly, Mezourlo Hill, 41110 Larissa, Greece
| | - Mary Yannakoulia
- Department of Nutrition and Dietetics, Harokopio University, 70 El. Venizelou, 17671 Athens, Greece
| | - Paraskevi Sakka
- Athens Alzheimer’s Association, 89 M. Mousourou & 33 Stilponos St, 11636 Athens, Greece
| | - Georgios Hadjigeorgiou
- Department of Neurology, University Hospital of Larissa, School of Medicine, University of Thessaly, Mezourlo Hill, 41110 Larissa, Greece
- School of Medicine, University of Cyprus, 93 Agiou Nikolaou St, Engomi, Nicosia 2408, Cyprus
| | - Nikolaos Scarmeas
- 1st Department of Neurology, Aiginition Hospital, National and Kapodistrian University of Athens Medical School, Vassilissis Sofias Ave 72, 11528 Athens, Greece
- Taub Institute for Research in Alzheimer’s Disease and the Aging Brain, The Gertrude H. Sergievsky Center, Department of Neurology, Columbia University, 710 West 168th St, New York, NY 10032, USA
| | - Efthimios Dardiotis
- Department of Neurology, University Hospital of Larissa, School of Medicine, University of Thessaly, Mezourlo Hill, 41110 Larissa, Greece
| | - Mary H. Kosmidis
- Lab of Cognitive Neuroscience, School of Psychology, Aristotle University of Thessaloniki, University Campus, 54124 Thessaloniki, Greece
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14
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Lennon MJ, Lam BCP, Lipnicki DM, Crawford JD, Peters R, Schutte AE, Brodaty H, Thalamuthu A, Rydberg-Sterner T, Najar J, Skoog I, Riedel-Heller SG, Röhr S, Pabst A, Lobo A, De-la-Cámara C, Lobo E, Bello T, Gureje O, Ojagbemi A, Lipton RB, Katz MJ, Derby CA, Kim KW, Han JW, Oh DJ, Rolandi E, Davin A, Rossi M, Scarmeas N, Yannakoulia M, Dardiotis T, Hendrie HC, Gao S, Carrière I, Ritchie K, Anstey KJ, Cherbuin N, Xiao S, Yue L, Li W, Guerchet MM, Preux PM, Aboyans V, Haan MN, Aiello AE, Ng TP, Nyunt MSZ, Gao Q, Scazufca M, Sachdev PSS. Use of Antihypertensives, Blood Pressure, and Estimated Risk of Dementia in Late Life: An Individual Participant Data Meta-Analysis. JAMA Netw Open 2023; 6:e2333353. [PMID: 37698858 PMCID: PMC10498335 DOI: 10.1001/jamanetworkopen.2023.33353] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Accepted: 07/28/2023] [Indexed: 09/13/2023] Open
Abstract
Importance The utility of antihypertensives and ideal blood pressure (BP) for dementia prevention in late life remains unclear and highly contested. Objectives To assess the associations of hypertension history, antihypertensive use, and baseline measured BP in late life (age >60 years) with dementia and the moderating factors of age, sex, and racial group. Data Source and Study Selection Longitudinal, population-based studies of aging participating in the Cohort Studies of Memory in an International Consortium (COSMIC) group were included. Participants were individuals without dementia at baseline aged 60 to 110 years and were based in 15 different countries (US, Brazil, Australia, China, Korea, Singapore, Central African Republic, Republic of Congo, Nigeria, Germany, Spain, Italy, France, Sweden, and Greece). Data Extraction and Synthesis Participants were grouped in 3 categories based on previous diagnosis of hypertension and baseline antihypertensive use: healthy controls, treated hypertension, and untreated hypertension. Baseline systolic BP (SBP) and diastolic BP (DBP) were treated as continuous variables. Reporting followed the Preferred Reporting Items for Systematic Review and Meta-Analyses of Individual Participant Data reporting guidelines. Main Outcomes and Measures The key outcome was all-cause dementia. Mixed-effects Cox proportional hazards models were used to assess the associations between the exposures and the key outcome variable. The association between dementia and baseline BP was modeled using nonlinear natural splines. The main analysis was a partially adjusted Cox proportional hazards model controlling for age, age squared, sex, education, racial group, and a random effect for study. Sensitivity analyses included a fully adjusted analysis, a restricted analysis of those individuals with more than 5 years of follow-up data, and models examining the moderating factors of age, sex, and racial group. Results The analysis included 17 studies with 34 519 community dwelling older adults (20 160 [58.4%] female) with a mean (SD) age of 72.5 (7.5) years and a mean (SD) follow-up of 4.3 (4.3) years. In the main, partially adjusted analysis including 14 studies, individuals with untreated hypertension had a 42% increased risk of dementia compared with healthy controls (hazard ratio [HR], 1.42; 95% CI 1.15-1.76; P = .001) and 26% increased risk compared with individuals with treated hypertension (HR, 1.26; 95% CI, 1.03-1.53; P = .02). Individuals with treated hypertension had no significant increased dementia risk compared with healthy controls (HR, 1.13; 95% CI, 0.99-1.28; P = .07). The association of antihypertensive use or hypertension status with dementia did not vary with baseline BP. There was no significant association of baseline SBP or DBP with dementia risk in any of the analyses. There were no significant interactions with age, sex, or racial group for any of the analyses. Conclusions and Relevance This individual patient data meta-analysis of longitudinal cohort studies found that antihypertensive use was associated with decreased dementia risk compared with individuals with untreated hypertension through all ages in late life. Individuals with treated hypertension had no increased risk of dementia compared with healthy controls.
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Affiliation(s)
- Matthew J. Lennon
- Faculty of Medicine, University of New South Wales, Sydney, Australia
- Centre for Healthy Brain Aging, Discipline of Psychiatry & Mental Health, School of Clinical Medicine, University of New South Wales, Sydney, Australia
| | - Ben Chun Pan Lam
- Faculty of Medicine, University of New South Wales, Sydney, Australia
- Centre for Healthy Brain Aging, Discipline of Psychiatry & Mental Health, School of Clinical Medicine, University of New South Wales, Sydney, Australia
- School of Psychology and Public Health, La Trobe University, Melbourne, Australia
| | - Darren M. Lipnicki
- Faculty of Medicine, University of New South Wales, Sydney, Australia
- Centre for Healthy Brain Aging, Discipline of Psychiatry & Mental Health, School of Clinical Medicine, University of New South Wales, Sydney, Australia
| | - John D. Crawford
- Faculty of Medicine, University of New South Wales, Sydney, Australia
- Centre for Healthy Brain Aging, Discipline of Psychiatry & Mental Health, School of Clinical Medicine, University of New South Wales, Sydney, Australia
| | - Ruth Peters
- The George Institute for Global Health, Sydney, Australia
- School of Biomedical Sciences, University of New South Wales, Sydney, Australia
- School of Public Health, Imperial College London, London, United Kingdom
| | - Aletta E. Schutte
- The George Institute for Global Health, Sydney, Australia
- School of Population Health, University of New South Wales, Sydney, Australia
| | - Henry Brodaty
- Faculty of Medicine, University of New South Wales, Sydney, Australia
- Centre for Healthy Brain Aging, Discipline of Psychiatry & Mental Health, School of Clinical Medicine, University of New South Wales, Sydney, Australia
- Eastern Suburbs Older Persons’ Mental Health Service, Sydney, Australia
| | - Anbupalam Thalamuthu
- Faculty of Medicine, University of New South Wales, Sydney, Australia
- Centre for Healthy Brain Aging, Discipline of Psychiatry & Mental Health, School of Clinical Medicine, University of New South Wales, Sydney, Australia
| | - Therese Rydberg-Sterner
- Neuropsychiatric Epidemiology Unit, Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy, Centre for Ageing and Health at the University of Gothenburg, Gothenburg, Sweden
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden
| | - Jenna Najar
- Neuropsychiatric Epidemiology Unit, Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy, Centre for Ageing and Health at the University of Gothenburg, Gothenburg, Sweden
- Psychiatry, Cognition and Old Age Psychiatry Clinic, Region Västra Götaland, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Ingmar Skoog
- Neuropsychiatric Epidemiology Unit, Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy, Centre for Ageing and Health at the University of Gothenburg, Gothenburg, Sweden
- Psychiatry, Cognition and Old Age Psychiatry Clinic, Region Västra Götaland, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Steffi G. Riedel-Heller
- Institute of Social Medicine, Occupational Health and Public Health, Medical Faculty, University of Leipzig, Leipzig, Germany
| | - Susanne Röhr
- Institute of Social Medicine, Occupational Health and Public Health, Medical Faculty, University of Leipzig, Leipzig, Germany
- School of Psychology, Manawatu Campus, Massey University, Palmerston North, New Zealand
- Global Brain Health Institute, Trinity College Dublin, Dublin, Ireland
| | - Alexander Pabst
- Institute of Social Medicine, Occupational Health and Public Health, Medical Faculty, University of Leipzig, Leipzig, Germany
| | - Antonio Lobo
- Department of Medicine and Psychiatry, Universidad de Zaragoza, Zaragoza, Spain
- Instituto de Investigación Sanitaria Aragón, Zaragoza, Spain
- Centro de Investigación Biomédica en Red de Salud Mental, Madrid, Spain
| | - Concepción De-la-Cámara
- Department of Medicine and Psychiatry, Universidad de Zaragoza, Zaragoza, Spain
- Instituto de Investigación Sanitaria Aragón, Zaragoza, Spain
- Centro de Investigación Biomédica en Red de Salud Mental, Madrid, Spain
| | - Elena Lobo
- Department of Medicine and Psychiatry, Universidad de Zaragoza, Zaragoza, Spain
- Instituto de Investigación Sanitaria Aragón, Zaragoza, Spain
- Centro de Investigación Biomédica en Red de Salud Mental, Madrid, Spain
| | - Toyin Bello
- World Health Organization Collaborating Centre for Research and Training in Mental Health, Neuroscience, and Substance Abuse, Department of Psychiatry, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Oye Gureje
- World Health Organization Collaborating Centre for Research and Training in Mental Health, Neuroscience, and Substance Abuse, Department of Psychiatry, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Akin Ojagbemi
- World Health Organization Collaborating Centre for Research and Training in Mental Health, Neuroscience, and Substance Abuse, Department of Psychiatry, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Richard B. Lipton
- Department of Neurology, Albert Einstein College of Medicine, Bronx, New York
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York
| | - Mindy J. Katz
- Department of Neurology, Albert Einstein College of Medicine, Bronx, New York
| | - Carol A. Derby
- Department of Neurology, Albert Einstein College of Medicine, Bronx, New York
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York
| | - Ki Woong Kim
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, Korea
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, Korea
- Department of Brain and Cognitive Sciences, Seoul National University College of Natural Sciences, Seoul, Korea
| | - Ji Won Han
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, Korea
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, Korea
| | - Dae Jong Oh
- Workplace Mental Health Institute, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Elena Rolandi
- Golgi Cenci Foundation, Abbiategrasso, Italy
- Department of Brain and Behavioural Sciences, University of Pavia, Pavia, Italy
| | | | | | - Nikolaos Scarmeas
- First Department of Neurology, Aiginition Hospital, National and Kapodistrian University of Athens, Athens, Greece
- Department of Neurology, Columbia University, New York, New York
| | - Mary Yannakoulia
- Department of Nutrition and Dietetics, School of Health Sciences and Education, Harokopio University, Athens, Greece
| | - Themis Dardiotis
- Department of Neurology, University Hospital of Larissa, Larissa, Greece
- Faculty of Medicine, School of Health Sciences, University of Thessaly, Larissa, Greece
| | - Hugh C. Hendrie
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis
- Indiana Alzheimer Disease Research Center, Indiana Alzheimer Disease Research Center, Indianapolis
| | - Sujuan Gao
- Indiana Alzheimer Disease Research Center, Indiana Alzheimer Disease Research Center, Indianapolis
- Department of Biostatistics and Health Data Science, Indiana University School of Medicine, Indianapolis
| | - Isabelle Carrière
- Institut for Neurosciences of Montpellier, University Montpellier, National Institute for Health and Medical Research, Montpellier, France
| | - Karen Ritchie
- Institut for Neurosciences of Montpellier, University Montpellier, National Institute for Health and Medical Research, Montpellier, France
- Institut du Cerveau Trocadéro, Paris, France
| | - Kaarin J. Anstey
- University of New South Wales, School of Psychology, Sydney, Australia
- Ageing Futures Institute, University of New South Wales, Sydney, Australia
- Neuroscience Research Australia, Sydney, Australia
| | - Nicolas Cherbuin
- National Centre for Epidemiology and Population Health, Australian National University, Canberra, Australia
| | - Shifu Xiao
- Department of Geriatric Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Alzheimer’s Disease and Related Disorders Center, Shanghai Jiao Tong University, Shanghai, China
| | - Ling Yue
- Department of Geriatric Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Alzheimer’s Disease and Related Disorders Center, Shanghai Jiao Tong University, Shanghai, China
| | - Wei Li
- Department of Geriatric Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Alzheimer’s Disease and Related Disorders Center, Shanghai Jiao Tong University, Shanghai, China
| | - Maëlenn M. Guerchet
- National Institute for Health and Medical Research U1094, Institut de Recherche pour le Developpement UMR270, Epidemiology of Chronic Diseases in Tropical Zone, Institute of Epidemiology and Tropical Neurology, OmegaHealth, University Limoges, Centre Hospitalier et Universitaire Limoges, Limoges, France
| | - Pierre-Marie Preux
- National Institute for Health and Medical Research U1094, Institut de Recherche pour le Developpement UMR270, Epidemiology of Chronic Diseases in Tropical Zone, Institute of Epidemiology and Tropical Neurology, OmegaHealth, University Limoges, Centre Hospitalier et Universitaire Limoges, Limoges, France
| | - Victor Aboyans
- National Institute for Health and Medical Research U1094, Institut de Recherche pour le Developpement UMR270, Epidemiology of Chronic Diseases in Tropical Zone, Institute of Epidemiology and Tropical Neurology, OmegaHealth, University Limoges, Centre Hospitalier et Universitaire Limoges, Limoges, France
- Department of Cardiology, Dupuytren 2 University Hospital, Limoges, France
| | - Mary N. Haan
- School of Medicine, University of California, San Francisco
| | - Allison E. Aiello
- Robert N. Butler Columbia Aging Center, Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York
| | - Tze Pin Ng
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Geriatric Education and Research Institute, Ministry of Health, Singapore, Singapore
| | - Ma Shwe Zin Nyunt
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Qi Gao
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Marcia Scazufca
- Departamento de Psiquiatria, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Perminder S. S. Sachdev
- Faculty of Medicine, University of New South Wales, Sydney, Australia
- Centre for Healthy Brain Aging, Discipline of Psychiatry & Mental Health, School of Clinical Medicine, University of New South Wales, Sydney, Australia
- Neuropsychiatric Institute, Prince of Wales Hospital, Sydney, Australia
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15
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Giaquinto F, Tosi G, Abbatantuono C, Pepe I, Iaia M, Macchitella L, Rizzi E, De Caro MF, Romano D, Taurisano P, Angelelli P. The indirect effect of cognitive reserve on the relationship between age and cognition in pathological ageing: A cross-sectional retrospective study in an unselected and consecutively enrolled sample. J Neuropsychol 2023; 17:477-490. [PMID: 37184066 DOI: 10.1111/jnp.12323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Revised: 04/26/2023] [Accepted: 05/03/2023] [Indexed: 05/16/2023]
Abstract
Cognitive reserve (CR) allows individuals to maintain cognitive functionality even in the presence of pathologies. The compensation hypothesis suggests that CR plays an indirect role between age and cognitive decline, contrasting the negative effect of ageing on cognition. We test this hypothesis in an unselected and consecutively enrolled sample of memory clinic attendees (n = 134) who completed the CR Index questionnaire and three neuropsychological tests assessing global cognition (MMSE, FAB, CDT). Participants were divided into two groups based on standard diagnostic criteria (DSM-5): those who were cognitively impaired (n = 92) and those who were preserved (n = 42). A principal component analysis was used to extract a composite measure of global cognitive functioning from the three neuropsychological tests, and mediation analysis was used to examine the relationship between CR, age and global cognitive functioning in the two groups. Results revealed that: (i) age had a significant direct negative effect on the global cognitive score in both groups; (ii) the three socio-behavioural proxies of CR together suppress the direct negative relationship between age and global cognitive score in cognitively impaired patients but not in cognitively preserved participants. This study confirms the association between CR, age and cognition and allows us to validate its role in a population with cognitive impairment and extend findings to a low-to-middle educated population. These results hold important implications for public health and wellness promotion, emphasising the beneficial role of maintaining healthy and active physical, cognitive and social lifestyles.
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Affiliation(s)
- Francesco Giaquinto
- Laboratory of Applied Psychology and Intervention, Department of Human and Social Sciences, University of Salento, Lecce, Italy
| | - Giorgia Tosi
- Laboratory of Applied Psychology and Intervention, Department of Human and Social Sciences, University of Salento, Lecce, Italy
- Psychology Department, University of Milano-Bicocca, Milan, Italy
| | - Chiara Abbatantuono
- Department of Translational Biomedicine and Neuroscience "DiBraiN", University of Bari "Aldo Moro", Bari, Italy
| | - Ilaria Pepe
- Department of Translational Biomedicine and Neuroscience "DiBraiN", University of Bari "Aldo Moro", Bari, Italy
| | - Marika Iaia
- Laboratory of Applied Psychology and Intervention, Department of Human and Social Sciences, University of Salento, Lecce, Italy
| | - Luigi Macchitella
- Laboratory of Applied Psychology and Intervention, Department of Human and Social Sciences, University of Salento, Lecce, Italy
- Scientific Institute I.R.C.C.S. "E. Medea"- Unit for Severe Disabilities in Developmental Age and Young Adults (Developmental Neurology and Neurorehabilitation), Brindisi, Italy
| | - Ezia Rizzi
- Laboratory of Applied Psychology and Intervention, Department of Human and Social Sciences, University of Salento, Lecce, Italy
- Psychology Department, University of Milano-Bicocca, Milan, Italy
| | - Maria Fara De Caro
- Department of Translational Biomedicine and Neuroscience "DiBraiN", University of Bari "Aldo Moro", Bari, Italy
| | - Daniele Romano
- Psychology Department, University of Milano-Bicocca, Milan, Italy
| | - Paolo Taurisano
- Department of Translational Biomedicine and Neuroscience "DiBraiN", University of Bari "Aldo Moro", Bari, Italy
| | - Paola Angelelli
- Laboratory of Applied Psychology and Intervention, Department of Human and Social Sciences, University of Salento, Lecce, Italy
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Taglino F, Cumbo F, Antognoli G, Arisi I, D'Onofrio M, Perazzoni F, Voyat R, Fiscon G, Conte F, Canevelli M, Bruno G, Mecocci P, Bertolazzi P. An ontology-based approach for modelling and querying Alzheimer's disease data. BMC Med Inform Decis Mak 2023; 23:153. [PMID: 37553569 PMCID: PMC10408169 DOI: 10.1186/s12911-023-02211-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Accepted: 06/15/2023] [Indexed: 08/10/2023] Open
Abstract
BACKGROUND The recent advances in biotechnology and computer science have led to an ever-increasing availability of public biomedical data distributed in large databases worldwide. However, these data collections are far from being "standardized" so to be harmonized or even integrated, making it impossible to fully exploit the latest machine learning technologies for the analysis of data themselves. Hence, facing this huge flow of biomedical data is a challenging task for researchers and clinicians due to their complexity and high heterogeneity. This is the case of neurodegenerative diseases and the Alzheimer's Disease (AD) in whose context specialized data collections such as the one by the Alzheimer's Disease Neuroimaging Initiative (ADNI) are maintained. METHODS Ontologies are controlled vocabularies that allow the semantics of data and their relationships in a given domain to be represented. They are often exploited to aid knowledge and data management in healthcare research. Computational Ontologies are the result of the combination of data management systems and traditional ontologies. Our approach is i) to define a computational ontology representing a logic-based formal conceptual model of the ADNI data collection and ii) to provide a means for populating the ontology with the actual data in the Alzheimer Disease Neuroimaging Initiative (ADNI). These two components make it possible to semantically query the ADNI database in order to support data extraction in a more intuitive manner. RESULTS We developed: i) a detailed computational ontology for clinical multimodal datasets from the ADNI repository in order to simplify the access to these data; ii) a means for populating this ontology with the actual ADNI data. Such computational ontology immediately makes it possible to facilitate complex queries to the ADNI files, obtaining new diagnostic knowledge about Alzheimer's disease. CONCLUSIONS The proposed ontology will improve the access to the ADNI dataset, allowing queries to extract multivariate datasets to perform multidimensional and longitudinal statistical analyses. Moreover, the proposed ontology can be a candidate for supporting the design and implementation of new information systems for the collection and management of AD data and metadata, and for being a reference point for harmonizing or integrating data residing in different sources.
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Affiliation(s)
- Francesco Taglino
- Institute of Systems Analysis and Computer Science "Antonio Ruberti" (IASI), National Research Council (CNR), Via dei Taurini 19, 00185, Rome, Italy.
| | - Fabio Cumbo
- Institute of Systems Analysis and Computer Science "Antonio Ruberti" (IASI), National Research Council (CNR), Via dei Taurini 19, 00185, Rome, Italy
- Genomic Medicine Institute, Lerner Research Institute, Cleveland Clinic, 9500 Euclid Avenue, 44195, Cleveland, Ohio, USA
| | - Giulia Antognoli
- Institute of Systems Analysis and Computer Science "Antonio Ruberti" (IASI), National Research Council (CNR), Via dei Taurini 19, 00185, Rome, Italy
| | - Ivan Arisi
- European Brain Research Institute (EBRI) "Rita Levi-Montalcini", Viale Regina Elena 295, 00161, Rome, Italy
| | - Mara D'Onofrio
- European Brain Research Institute (EBRI) "Rita Levi-Montalcini", Viale Regina Elena 295, 00161, Rome, Italy
| | - Federico Perazzoni
- Department of Engineering, Uninettuno International University, Corso Vittorio Emanuele II 39, 00186, Rome, Italy
| | - Roger Voyat
- Department of Engineering, University of Roma Tre, Via della Vasca Navale 79/81, 00146, Rome, Italy
| | - Giulia Fiscon
- Department of Computer, Control, and Management Engineering "Antonio Ruberti", Sapienza University of Rome, Via Ariosto 25, 00185, Rome, Italy
| | - Federica Conte
- Institute of Systems Analysis and Computer Science "Antonio Ruberti" (IASI), National Research Council (CNR), Via dei Taurini 19, 00185, Rome, Italy
| | - Marco Canevelli
- Department of Human Neuroscience, Sapienza University of Rome, Via Ariosto 25, 00185, Rome, Italy
| | - Giuseppe Bruno
- Department of Human Neuroscience, Sapienza University of Rome, Via Ariosto 25, 00185, Rome, Italy
| | - Patrizia Mecocci
- Department of Medicine and Surgery, University of Perugia, Piazzale Gambuli 1, 06129, Perugia, Italy
- Division of Clinical Geriatrics, NVS Department, Karolinska Institutet, Nobels väg 5, Solna, 17177, Stockholm, Sweden
| | - Paola Bertolazzi
- Institute of Systems Analysis and Computer Science "Antonio Ruberti" (IASI), National Research Council (CNR), Via dei Taurini 19, 00185, Rome, Italy
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17
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Oh DJ, Bae JB, Lipnicki DM, Han JW, Sachdev PS, Kim TH, Kwak KP, Kim BJ, Kim SG, Kim JL, Moon SW, Park JH, Ryu SH, Youn JC, Lee DY, Lee DW, Lee SB, Lee JJ, Jhoo JH, Skoog I, Najar J, Sterner TR, Guaita A, Vaccaro R, Rolandi E, Scarmeas N, Yannakoulia M, Kosmidis MH, Riedel-Heller SG, Roehr S, Dominguez J, Guzman MFD, Fowler KC, Lobo A, Saz P, Lopez-Anton R, Anstey KJ, Cherbuin N, Mortby ME, Brodaty H, Trollor J, Kochan N, Kim KW. Parental history of dementia and the risk of dementia: A cross-sectional analysis of a global collaborative study. Psychiatry Clin Neurosci 2023; 77:449-456. [PMID: 37165609 PMCID: PMC10524874 DOI: 10.1111/pcn.13561] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2023] [Revised: 04/06/2023] [Accepted: 05/02/2023] [Indexed: 05/12/2023]
Abstract
BACKGROUND Parental history of dementia appears to increase the risk of dementia, but there have been inconsistent results. We aimed to investigate whether the association between parental history of dementia and the risk of dementia are different by dementia subtypes and sex of parent and offspring. METHODS For this cross-sectional study, we harmonized and pooled data for 17,194 older adults from nine population-based cohorts of eight countries. These studies conducted face-to-face diagnostic interviews, physical and neurological examinations, and neuropsychological assessments to diagnose dementia. We investigated the associations of maternal and paternal history of dementia with the risk of dementia and its subtypes in offspring. RESULTS The mean age of the participants was 72.8 ± 7.9 years and 59.2% were female. Parental history of dementia was associated with higher risk of dementia (odds ratio [OR] = 1.47, 95% confidence interval [CI] = 1.15-1.86) and Alzheimer's disease (AD) (OR = 1.72, 95% CI = 1.31-2.26), but not with the risk of non-AD. This was largely driven by maternal history of dementia, which was associated with the risk of dementia (OR = 1.51, 95% CI = 1.15-1.97) and AD (OR = 1.80, 95% CI = 1.33-2.43) whereas paternal history of dementia was not. These results remained significant when males and females were analyzed separately (OR = 2.14, 95% CI = 1.28-3.55 in males; OR = 1.68, 95% CI = 1.16-2.44 for females). CONCLUSIONS Maternal history of dementia was associated with the risk of dementia and AD in both males and females. Maternal history of dementia may be a useful marker for identifying individuals at higher risk of AD and stratifying the risk for AD in clinical trials.
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Affiliation(s)
- Dae Jong Oh
- Workplace Mental Health Institute, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Jong Bin Bae
- Department of Psychiatry, Seoul National University, College of Medicine, Seoul, South Korea
| | - Darren M Lipnicki
- Centre for Healthy Brain Ageing, Discipline of Psychiatry and Mental Health, University of New South Wales, Sydney, Australia
| | - Ji Won Han
- Department of Psychiatry, Seoul National University, College of Medicine, Seoul, South Korea
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, South Korea
| | - Perminder S Sachdev
- Centre for Healthy Brain Ageing, Discipline of Psychiatry and Mental Health, University of New South Wales, Sydney, Australia
- Dementia Collaborative Research Centre, University of New South Wales, Sydney, Australia
| | - Tae Hui Kim
- Department of Psychiatry, Yonsei University Wonju Severance Christian Hospital, Wonju, South Korea
| | - Kyung Phil Kwak
- Department of Psychiatry, Dongguk University Gyeongju Hospital, Gyeongju, South Korea
| | - Bong Jo Kim
- Department of Psychiatry, Gyeongsang National University, School of Medicine, Jinju, South Korea
| | - Shin Gyeom Kim
- Department of Neuropsychiatry, Soonchunhyang University Bucheon Hospital, Bucheon, South Korea
| | - Jeong Lan Kim
- Department of Psychiatry, School of Medicine, Chungnam National University, Daejeon, South Korea
| | - Seok Woo Moon
- Department of Psychiatry, School of Medicine, Konkuk University and Konkuk University Chungju Hospital, Chungju, South Korea
| | - Joon Hyuk Park
- Department of Neuropsychiatry, Jeju National University Hospital, Jeju, South Korea
| | - Seung-Ho Ryu
- Department of Psychiatry, School of Medicine, Konkuk University and Konkuk University Medical Center, Seoul, South Korea
| | - Jong Chul Youn
- Department of Neuropsychiatry, Kyunggi Provincial Hospital for the Elderly, Yongin, South Korea
| | - Dong Young Lee
- Department of Psychiatry, Seoul National University, College of Medicine, Seoul, South Korea
- Department of Neuropsychiatry, Seoul National University Hospital, Seoul, South Korea
| | - Dong Woo Lee
- Department of Neuropsychiatry, Inje University Sanggye Paik Hospital, Seoul, South Korea
| | - Seok Bum Lee
- Department of Psychiatry, Dankook University Hospital, Cheonan, South Korea
| | - Jung Jae Lee
- Department of Psychiatry, Dankook University Hospital, Cheonan, South Korea
| | - Jin Hyeong Jhoo
- Department of Neuropsychiatry, Kangwon National University Hospital, Chuncheon, South Korea
| | - Ingmar Skoog
- Department of Psychiatry and Neurochemistry, Neuropsychiatric Epidemiology Unit, Institute of Neuroscience and Physiology, the Sahlgrenska Academy, Centre for Ageing and Health (AGECAP), at the University of Gothenburg,Mölndal, Sweden
- Region Västra Götaland, Sahlgrenska University Hospital, Psychiatry, Cognition and Old Age Psychiatry Clinic, Gothenburg, Sweden
| | - Jenna Najar
- Department of Psychiatry and Neurochemistry, Neuropsychiatric Epidemiology Unit, Institute of Neuroscience and Physiology, the Sahlgrenska Academy, Centre for Ageing and Health (AGECAP), at the University of Gothenburg,Mölndal, Sweden
- Region Västra Götaland, Sahlgrenska University Hospital, Psychiatry, Cognition and Old Age Psychiatry Clinic, Gothenburg, Sweden
| | - Therese R Sterner
- Department of Psychiatry and Neurochemistry, Neuropsychiatric Epidemiology Unit, Institute of Neuroscience and Physiology, the Sahlgrenska Academy, Centre for Ageing and Health (AGECAP), at the University of Gothenburg,Mölndal, Sweden
| | - Antonio Guaita
- Golgi Cenci Foundation, c. San Martino 10, 20081 Abbiategrasso (MI), Italy
| | - Roberta Vaccaro
- Golgi Cenci Foundation, c. San Martino 10, 20081 Abbiategrasso (MI), Italy
| | - Elena Rolandi
- Golgi Cenci Foundation, c. San Martino 10, 20081 Abbiategrasso (MI), Italy
| | - Nikolaos Scarmeas
- Department of Neurology, Aiginition Hospital, National and Kapodistrian University of Athens, Athens, Greece
- Department of Neurology, Columbia University, New York, NY
| | - Mary Yannakoulia
- Department of Nutrition and Dietetics, Harokopio University, Athens, Greece
| | - Mary H Kosmidis
- Lab of Cognitive Neuroscience, School of Psychology, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Steffi G Riedel-Heller
- Institute of Social Medicine, Occupational Health and Public Health (ISAP), Medical Faculty, University of Leipzig, Leipzig, Germany
| | - Susanne Roehr
- Institute of Social Medicine, Occupational Health and Public Health (ISAP), Medical Faculty, University of Leipzig, Leipzig, Germany
- Global Brain Health Institute (GBHI), Trinity College Dublin, Dublin, Ireland
| | - Jacqueline Dominguez
- Institute for Neurosciences, St. Luke’s Medical Center, Quezon City, Philippines
- Institute for Dementia Care Asia, Quezon City, Philippines
| | | | | | - Antonio Lobo
- Department of Medicine and Psychiatry. Zaragoza University. Aragon, Spain
| | - Pedro Saz
- Department of Medicine and Psychiatry. Zaragoza University. Aragon, Spain
| | - Raul Lopez-Anton
- Departamento de Psicología y Sociología. Universidad de Zaragoza, Aragon, Spain
| | - Kaarin J Anstey
- School of Psychology, University of New South Wales, Sydney, Australia
- Centre for Mental Health Research, Australian National University, Canberra, Australia
- Neuroscience Australia, Sydney, Australia
| | - Nicolas Cherbuin
- Centre for Mental Health Research, Australian National University, Canberra, Australia
| | - Moyra E Mortby
- School of Psychology, University of New South Wales, Sydney, Australia
- Neuroscience Australia, Sydney, Australia
| | - Henry Brodaty
- Centre for Healthy Brain Ageing, Discipline of Psychiatry and Mental Health, University of New South Wales, Sydney, Australia
| | - Julian Trollor
- Centre for Healthy Brain Ageing, Discipline of Psychiatry and Mental Health, University of New South Wales, Sydney, Australia
- Department of Developmental Disability Neuropsychiatry, School of Psychiatry, UNSW Medicine & Health, University of New South Wales, Sydney, Australia
| | - Nicole Kochan
- Centre for Healthy Brain Ageing, Discipline of Psychiatry and Mental Health, University of New South Wales, Sydney, Australia
| | - Ki Woong Kim
- Department of Psychiatry, Seoul National University, College of Medicine, Seoul, South Korea
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, South Korea
- Department of Brain and Cognitive Science, Seoul National University College of Natural Sciences, Seoul, South Korea
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Liampas I, Folia V, Morfakidou R, Siokas V, Yannakoulia M, Sakka P, Scarmeas N, Hadjigeorgiou G, Dardiotis E, Kosmidis MH. Language Differences Among Individuals with Normal Cognition, Amnestic and Non-Amnestic MCI, and Alzheimer's Disease. Arch Clin Neuropsychol 2023; 38:525-536. [PMID: 36244060 PMCID: PMC10202551 DOI: 10.1093/arclin/acac080] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/07/2022] [Indexed: 10/29/2023] Open
Abstract
OBJECTIVE To investigate differences in language performance among older adults with normal cognition (CN), mild cognitive impairment (MCI), and Alzheimer's disease (ad). Owing to the conflicting literature concerning MCI, discrepancies between amnestic (aMCI) and non-amnestic MCI (naMCI) were explored in greater detail. METHOD The study sample was drawn from the older (>64 years) HELIAD cohort. Language performance was assessed via semantic and phonemic fluency, confrontation naming, verbal comprehension, verbal repetition as well as a composite language index. Age, sex, and education adjusted general linear models were used to quantify potential pairwise differences in language performance. RESULTS The present analysis involved 1607 participants with CN, 146 with aMCI [46 single and 100 multi-domain aMCI], 92 with naMCI [41 single and 51 multi-domain naMCI], and 79 with ad. The mean age and education of our predominantly female (60%) participants were 73.82 (±5.43) and 7.98 (±4.93) years, respectively. MCI individuals performed between those with CN and ad, whereas participants with aMCI performed worse compared to those with naMCI, especially in the semantic fluency and verbal comprehension tasks. Discrepancies between the aMCI and naMCI groups were driven by the exquisitely poor performance of multi-domain aMCI subgroup. CONCLUSIONS Overall, individuals could be hierarchically arranged in a continuum of language impairment with the CN individuals constituting the healthy reference and naMCI, aMCI, ad patients representing gradually declining classes in terms of language performance. Exploration of language performance via separation of single from multi-domain naMCI provided a potential explanation for the conflicting evidence of previous research.
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Affiliation(s)
- Ioannis Liampas
- Department of Neurology, University Hospital of Larissa, School of Medicine, University of Thessaly, Larissa, Greece
| | - Vasiliki Folia
- Lab of Cognitive Neuroscience, School of Psychology, Aristotle University of Thessaloniki, Greece
| | - Renia Morfakidou
- Lab of Cognitive Neuroscience, School of Psychology, Aristotle University of Thessaloniki, Greece
| | - Vasileios Siokas
- Department of Neurology, University Hospital of Larissa, School of Medicine, University of Thessaly, Larissa, Greece
| | - Mary Yannakoulia
- Department of Nutrition and Dietetics, Harokopio University, Athens, Greece
| | - Paraskevi Sakka
- Association of Alzheimer's Disease and Related Disorders, Marousi, Athens, Greece
| | - Nikolaos Scarmeas
- First Department of Neurology, Aeginition Hospital, National and Kapodistrian University of Athens Medical School, Athens, Greece
- Taub Institute for Research in Alzheimer's Disease and the Aging Brain, The Gertrude H. Sergievsky Center, Department of Neurology, Columbia University, New York, USA
| | - Georgios Hadjigeorgiou
- Department of Neurology, University Hospital of Larissa, School of Medicine, University of Thessaly, Larissa, Greece
- Department of Neurology, Medical School, University of Cyprus, Nicosia, Cyprus
| | - Efthimios Dardiotis
- Department of Neurology, University Hospital of Larissa, School of Medicine, University of Thessaly, Larissa, Greece
| | - Mary H Kosmidis
- Lab of Cognitive Neuroscience, School of Psychology, Aristotle University of Thessaloniki, Greece
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19
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Maraki MI, Yannakoulia M, Xiromerisiou G, Stefanis L, Charisis S, Giagkou N, Kosmidis MH, Dardiotis E, Hadjigeorgiou GM, Sakka P, Scarmeas N, Stamelou M. Mediterranean diet is associated with a lower probability of prodromal Parkinson's disease and risk for Parkinson's disease/dementia with Lewy bodies: A longitudinal study. Eur J Neurol 2023; 30:934-942. [PMID: 36692092 DOI: 10.1111/ene.15698] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Revised: 01/14/2023] [Accepted: 01/18/2023] [Indexed: 01/25/2023]
Abstract
BACKGROUND AND PURPOSE Lifestyle factors have been implicated in the long-lasting neurodegenerative process in prodromal Parkinson's disease (pPD). The aim was to investigate the associations between adherence to a Mediterranean diet (MeDi) and longitudinal changes of pPD probability and the development of Parkinson's disease (PD) or pPD in a Mediterranean older population. METHODS Data from the Hellenic Longitudinal Investigation of Aging and Diet cohort (community-dwelling individuals, aged ≥ 65 years) were used. A detailed food frequency questionnaire was used to evaluate dietary intake and calculate MeDi adherence score, ranging from 0 to 55, with higher scores indicating higher adherence. The probability of pPD was calculated according to the updated Movement Disorder Society research criteria. RESULTS In all, 1047 non-PD/dementia with Lewy bodies (DLB) participants were followed for 3 ± 1 years. MeDi adherence was associated with lower increase in pPD probability over time (b = -0.003, 95% confidence interval -0.006 to -0.001, p = 0.010). Forty-nine participants had incident possible/probable pPD (i.e., pPD probability ≥ 30%). Compared to the participants in the lowest quartile of MeDi adherence, those in the higher quartiles had an approximately 60%-70% lower risk for possible/probable pPD (p for trend 0.003). MeDi-pPD associations were driven by both motor and non-motor pPD markers and not from risk markers. Also, 21 participants were diagnosed with PD/DLB at follow-up. For each unit increase in the MeDi score, there was a 9%-10% lower risk for PD/DLB (hazard ratio 0.906 [95% confidence interval 0.823-0.997], p = 0.044). CONCLUSIONS Mediterranean diet adherence is associated with lower increase in pPD probability over time and lower possible/probable pPD and PD/DLB incidence in older Mediterranean people. More studies are needed to confirm our results in other populations.
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Affiliation(s)
- Maria I Maraki
- Department of Nutrition and Dietetics, School of Health Sciences, Hellenic Mediterranean University, Crete, Greece
- Section of Sport Medicine and Biology of Exercise, School of Physical Education and Sport Science, National and Kapodistrian University of Athens, Athens, Greece
| | - Mary Yannakoulia
- Department of Nutrition and Dietetics, Harokopio University, Athens, Greece
| | | | - Leonidas Stefanis
- Center of Clinical, Experimental Surgery and Translational Research, Biomedical Research Foundation of the Academy of Athens, Athens, Greece
- First Department of Neurology, Aiginition Hospital, National and Kapodistrian University of Athens Medical School, Greece
| | - Sokratis Charisis
- First Department of Neurology, Aiginition Hospital, National and Kapodistrian University of Athens Medical School, Greece
- Department of Neurology, University of Texas Health Science Center at San Antonio, San Antonio, Texas, USA
| | - Nikolaos Giagkou
- First Department of Neurology, Aiginition Hospital, National and Kapodistrian University of Athens Medical School, Greece
| | - Mary H Kosmidis
- Laboratory of Cognitive Neuroscience, School of Psychology, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | | | | | - Paraskevi Sakka
- Athens Association of Alzheimer's Disease and Related Disorders, Marousi, Greece
| | - Nikolaos Scarmeas
- First Department of Neurology, Aiginition Hospital, National and Kapodistrian University of Athens Medical School, Greece
- Department of Neurology, Taub Institute for Research in Alzheimer's Disease and the Aging Brain, Gertrude H. Sergievsky Center, Columbia University, New York, USA
| | - Maria Stamelou
- First Department of Neurology, Aiginition Hospital, National and Kapodistrian University of Athens Medical School, Greece
- Parkinson's Disease and Movement Disorders Department HYGEIA Hospital, Athens, Greece
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20
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Koutentaki E, Basta M, Antypa D, Zaganas I, Panagiotakis S, Simos P, Vgontzas AN. IL-6 Enhances the Negative Impact of Cortisol on Cognition among Community-Dwelling Older People without Dementia. Healthcare (Basel) 2023; 11:healthcare11070951. [PMID: 37046878 PMCID: PMC10094120 DOI: 10.3390/healthcare11070951] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Revised: 03/19/2023] [Accepted: 03/23/2023] [Indexed: 03/29/2023] Open
Abstract
There is growing evidence that high basal cortisol levels and systemic inflammation independently contribute to cognitive decline among older people without dementia. The present cross-sectional study examined (a) the potential synergistic effect of cortisol levels and systemic inflammation on executive function and (b) whether this effect is more prominent among older people with mild cognitive impairment (MCI). A sub-sample of 99 patients with MCI and 84 older people without cognitive impairment (CNI) (aged 73.8 ± 7.0 years) were recruited from a large population-based cohort in Crete, Greece, and underwent comprehensive neuropsychiatric and neuropsychological evaluation and a single morning measurement of cortisol and IL-6 plasma levels. Using moderated regression models, we found that the relation between cortisol and executive function in the total sample was moderated by IL-6 levels (b = −0.994, p = 0.044) and diagnostic group separately (b = −0.632, p < 0.001). Moreover, the interaction between cortisol and IL-6 levels was significant only among persons with MCI (b = −0.562, p < 0.001). The synergistic effect of stress hormones and systemic inflammation on cognitive status appears to be stronger among older people who already display signs of cognitive decline. Targeting hypercortisolemia and inflammation may be a promising strategy toward improving the course of cognitive decline.
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21
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Staios M, Kosmidis MH, Nielsen TR, Papadopoulos A, Kokkinis N, Stogiannidou A, March E, Stolwyk RJ. The Wechsler Adult Intelligence Scale-Fourth Edition, Greek Adaptation (WAIS-IV GR): confirmatory factor analysis and specific reference group normative data for Greek Australian older adults. AUSTRALIAN PSYCHOLOGIST 2023. [DOI: 10.1080/00050067.2023.2179387] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/06/2023]
Affiliation(s)
- Mathew Staios
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Melbourne, Australia
- Monash-Epworth Rehabilitation Research Centre, Monash University, Melbourne, Australia
| | - Mary H. Kosmidis
- Lab of Cognitive Neuroscience, School of Psychology, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - T. Rune Nielsen
- Department of Neurology, Danish Dementia Research Centre, Rigshospitalet, Copenhagen, Denmark
| | - Alexandra Papadopoulos
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Melbourne, Australia
| | - Nikolaos Kokkinis
- Lab of Cognitive Neuroscience, School of Psychology, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Ariadni Stogiannidou
- Lab of Cognitive Neuroscience, School of Psychology, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Evrim March
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Melbourne, Australia
| | - Renerus J. Stolwyk
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Melbourne, Australia
- Monash-Epworth Rehabilitation Research Centre, Monash University, Melbourne, Australia
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22
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Mewton L, Visontay R, Hoy N, Lipnicki DM, Sunderland M, Lipton RB, Guerchet M, Ritchie K, Najar J, Scarmeas N, Kim K, Riedel Heller S, van Boxtel M, Jacobsen E, Brodaty H, Anstey KJ, Haan M, Scazufca M, Lobo E, Sachdev PS. The relationship between alcohol use and dementia in adults aged more than 60 years: a combined analysis of prospective, individual-participant data from 15 international studies. Addiction 2023; 118:412-424. [PMID: 35993434 PMCID: PMC9898084 DOI: 10.1111/add.16035] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2021] [Accepted: 08/04/2022] [Indexed: 02/06/2023]
Abstract
AIM To synthesize international findings on the alcohol-dementia relationship, including representation from low- and middle-income countries. METHODS Individual participant data meta-analysis of 15 prospective epidemiological cohort studies from countries situated in six continents. Cox regression investigated the dementia risk associated with alcohol use in older adults aged over 60 years. Additional analyses assessed the alcohol-dementia relationship in the sample stratified by sex and by continent. Participants included 24 478 community dwelling individuals without a history of dementia at baseline and at least one follow-up dementia assessment. The main outcome measure was all-cause dementia as determined by clinical interview. RESULTS At baseline, the mean age across studies was 71.8 (standard deviation = 7.5, range = 60-102 years), 14 260 (58.3%) were female and 13 269 (54.2%) were current drinkers. During 151 636 person-years of follow-up, there were 2124 incident cases of dementia (14.0 per 1000 person-years). When compared with abstainers, the risk for dementia was lower in occasional [hazard ratio (HR) = 0.78; 95% confidence interval (CI) = 0.68-0.89], light-moderate (HR = 0.78; 95% CI = 0.70-0.87) and moderate-heavy drinkers (HR = 0.62; 95% CI = 0.51-0.77). There was no evidence of differences between life-time abstainers and former drinkers in terms of dementia risk (HR = 0.98; 95% CI = 0.81-1.18). In dose-response analyses, moderate drinking up to 40 g/day was associated with a lower risk of dementia when compared with lif-time abstaining. Among current drinkers, there was no consistent evidence for differences in terms of dementia risk. Results were similar when the sample was stratified by sex. When analysed at the continent level, there was considerable heterogeneity in the alcohol-dementia relationship. CONCLUSIONS Abstinence from alcohol appears to be associated with an increased risk for all-cause dementia. Among current drinkers, there appears to be no consistent evidence to suggest that the amount of alcohol consumed in later life is associated with dementia risk.
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Affiliation(s)
- Louise Mewton
- Centre for Healthy Brain AgeingUniversity of New South WalesSydneyAustralia
| | - Rachel Visontay
- Centre for Healthy Brain AgeingUniversity of New South WalesSydneyAustralia
| | - Nicholas Hoy
- Centre for Healthy Brain AgeingUniversity of New South WalesSydneyAustralia
| | - Darren M. Lipnicki
- Centre for Healthy Brain AgeingUniversity of New South WalesSydneyAustralia
| | | | - Richard B. Lipton
- The Matilda Centre for Mental Health and Substance UseUniversity of SydneySydneyAustralia
- Saul R. Korey, Department of Neurology, Albert Einstein College of MedicineYeshiva UniversityNew YorkNYUSA
- Department of Epidemiology and Population Health, Albert Einstein College of MedicineYeshiva UniversityNew YorkNYUSA
| | - Maëlenn Guerchet
- Department of Psychiatry and Behavioral Medicine, Albert Einstein College of MedicineYeshiva UniversityNew YorkNYUSA
| | - Karen Ritchie
- Limoges University, CHU Limoges, EpiMaCT, Institute of Epidemiology and Tropical Neurology, OmegaHealthLimogesFrance
- Neuropsychiatry, Epidemiological and Clinical Research, La Colombière HospitalMontpellierFrance
- Université de MontpellierMontpellierFrance
| | - Jenna Najar
- Centre for Clinical Brain SciencesUniversity of EdinburghEdinburghUK
- Neuropsychiatric Epidemiology Unit, Department of Psychiatry and NeurochemistryInstitute of Neuroscience and Physiology, Sahlgrenska Academy, Centre for Ageing and Health (AGECAP) at the University of GothenburgMölndalSweden
| | - Nikolaos Scarmeas
- Region Västra GötalandSahlgrenska University Hospital, Psychiatry, Cognition and Old Age Psychiatry ClinicGothenburgSweden
- Department of Neurology, Aiginition HospitalNational and Kapodistrian University of AthensAthensGreece
| | - Ki‐Woong Kim
- Department of NeurologyColumbia UniversityNew YorkNYUSA
- Department of NeuropsychiatrySeoul National University Bundang HospitalSeongnamSouth Korea
- Department of Psychiatry, College of MedicineSeoul National UniversitySeoulSouth Korea
| | - Steffi Riedel Heller
- Department of Brain and Cognitive SciencesSeoul National UniversitySeoulSouth Korea
| | - Martin van Boxtel
- Institute of Social Medicine, Occupational Health and Public Health (ISAP), Medical FacultyUniversity of LeipzigLeipzigGermany
| | - Erin Jacobsen
- School for Mental Health and Neuroscience/Alzheimer Centrum Limburg, Department of Psychiatry and NeuropsychologyMaastricht UniversityMaastrichtthe Netherlands
| | - Henry Brodaty
- Centre for Healthy Brain AgeingUniversity of New South WalesSydneyAustralia
| | - Kaarin J. Anstey
- Department of Psychiatry, School of MedicineUniversity of PittsburghPittsburghPAUSA
- School of PsychologyUniversity of New South WalesSydneyAustralia
- Neuroscience Research AustraliaUniversity of New South WalesSydneyAustralia
| | - Mary Haan
- Centre for Research on Ageing, Health and WellbeingAustralian National UniversityCanberraAustralia
| | - Marcia Scazufca
- Department of Epidemiology and Biostatistics, School of MedicineUniversity of CaliforniaSan FranciscoCAUSA
| | - Elena Lobo
- LIM‐23, Hospital das Clinicas (HCFMUSP), Faculdade de MedicinaUniversidade de São PauloSão PauloBrazil
- Department of Preventive Medicine and Public HealthUniversidad de ZaragozaZaragozaSpain
- Instituto de Investigacion Sanitaria AragonZaragozaSpain
| | - Perminder S. Sachdev
- Centre for Healthy Brain AgeingUniversity of New South WalesSydneyAustralia
- Centro de Investigacion Biomedica en Red de Salud Mental (CIBERSAM)Ministry of Science and InnovationMadridSpain
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Basta M, Skourti E, Alexopoulou C, Zampetakis A, Ganiaris A, Aligizaki M, Simos P, Vgontzas AN. Cretan Aging Cohort-Phase III: Methodology and Descriptive Characteristics of a Long-Term Longitudinal Study on Predictors of Cognitive Decline in Non-Demented Elderly from Crete, Greece. Healthcare (Basel) 2023; 11:healthcare11050703. [PMID: 36900708 PMCID: PMC10000452 DOI: 10.3390/healthcare11050703] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2023] [Revised: 02/23/2023] [Accepted: 02/25/2023] [Indexed: 03/06/2023] Open
Abstract
Identifying modifiable factors that may predict long-term cognitive decline in the elderly with adequate daily functionality is critical. Such factors may include poor sleep quality and quantity, sleep-related breathing disorders, inflammatory cytokines and stress hormones, as well as mental health problems. This work reports the methodology and descriptive characteristics of a long-term, multidisciplinary study on modifiable risk factors for cognitive status progression, focusing on the 7-year follow-up. Participants were recruited from a large community-dwelling cohort residing in Crete, Greece (CAC; Cretan Aging Cohort). Baseline assessments were conducted in 2013-2014 (Phase I and II, circa 6-month time interval) and follow-up in 2020-2022 (Phase III). In total, 151 individuals completed the Phase III evaluation. Of those, 71 were cognitively non-impaired (CNI group) in Phase II and 80 had been diagnosed with mild cognitive impairment (MCI). In addition to sociodemographic, lifestyle, medical, neuropsychological, and neuropsychiatric data, objective sleep was assessed based on actigraphy (Phase II and III) and home polysomnography (Phase III), while inflammation markers and stress hormones were measured in both phases. Despite the homogeneity of the sample in most sociodemographic indices, MCI persons were significantly older (mean age = 75.03 years, SD = 6.34) and genetically predisposed for cognitive deterioration (APOE ε4 allele carriership). Also, at follow-up, we detected a significant increase in self-reported anxiety symptoms along with a substantial rise in psychotropic medication use and incidence of major medical morbidities. The longitudinal design of the CAC study may provide significant data on possible modifiable factors in the course of cognitive progression in the community-dwelling elderly.
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Affiliation(s)
- Maria Basta
- Division of Psychiatry and Behavioral Sciences, School of Medicine, University of Crete, 71003 Heraklion, Greece
- Sleep Research and Treatment Center, Department of Psychiatry, Penn State University, State College, PA 16802, USA
- Correspondence: ; Tel.: +30-2810-392-402; Fax: +30-2810-392-859
| | - Eleni Skourti
- Division of Psychiatry and Behavioral Sciences, School of Medicine, University of Crete, 71003 Heraklion, Greece
| | - Christina Alexopoulou
- Department of Intensive Care Unit, University Hospital of Heraklion, 71500 Heraklion, Greece
| | - Alexandros Zampetakis
- Division of Psychiatry and Behavioral Sciences, School of Medicine, University of Crete, 71003 Heraklion, Greece
| | - Andronikos Ganiaris
- Division of Psychiatry and Behavioral Sciences, School of Medicine, University of Crete, 71003 Heraklion, Greece
| | - Marina Aligizaki
- Division of Psychiatry and Behavioral Sciences, School of Medicine, University of Crete, 71003 Heraklion, Greece
| | - Panagiotis Simos
- Division of Psychiatry and Behavioral Sciences, School of Medicine, University of Crete, 71003 Heraklion, Greece
- Computational Biomedicine Lab, Institute of Computer Science, Foundation for Research and Technology-Hellas, 70013 Heraklion, Greece
| | - Alexandros N. Vgontzas
- Division of Psychiatry and Behavioral Sciences, School of Medicine, University of Crete, 71003 Heraklion, Greece
- Sleep Research and Treatment Center, Department of Psychiatry, Penn State University, State College, PA 16802, USA
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24
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Liampas I, Folia V, Ntanasi E, Yannakoulia M, Sakka P, Hadjigeorgiou G, Scarmeas N, Dardiotis E, Kosmidis MH. Longitudinal episodic memory trajectories in older adults with normal cognition. Clin Neuropsychol 2023; 37:304-321. [PMID: 35400289 DOI: 10.1080/13854046.2022.2059011] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
OBJECTIVE To determine the longitudinal trajectories and normative standards of episodic memory in older adults. METHODS Participants were drawn from the cognitively normal(CN) subgroup of the population-based HELIAD cohort, a fairly representative cohort of the older Greek population. Verbal and non-verbal memory were assessed using the Greek Verbal Learning Test and Medical College of Georgia-Complex Figure Test. Baseline and longitudinal associations of memory performance with age, sex and formal education were explored with linear regression analysis and generalized estimated equations. RESULTS A total of 1607 predominantly female (60%) individuals (73.82 ± 5.43 years), with a mean educational attainment of 8.17(±4.86) years were CN at baseline. Baseline analysis revealed a continuum of memory decline with aging and lower educational attainment. Women performed better in composite and verbal memory measures, while men performed better in non-verbal memory tasks. A subgroup of 761 participants with available assessments after 3.07(±0.82) years remained CN at follow-up. Composite memory scores yearly diminished by an additional 0.007 of a SD for each additional year of age at baseline. Regarding verbal learning, immediate free verbal recall, delayed free verbal recall and delayed cued verbal recall, an additional yearly decrease of 0.107, 0.043, 0.036 and 0.026 words were respectively recorded at follow-up, for each additional year of age at baseline. Women underwent steeper yearly decreases of 0.227 words in delayed cued verbal recall. No significant longitudinal associations emerged for immediate non-verbal memory, delayed non-verbal memory and immediate cued verbal recall. CONCLUSIONS In the present study, aging (but not educational attainment) was consistently associated with steeper verbal memory decline. Supplemental data for this article is available online at https://doi.org/10.1080/13854046.2022.2059011 .
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Affiliation(s)
- Ioannis Liampas
- Department of Neurology, University Hospital of Larissa, School of Medicine, University of Thessaly, Larissa, Greece
| | - Vasiliki Folia
- Lab of Cognitive Neuroscience, School of Psychology, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Eva Ntanasi
- Department of Nutrition and Dietetics, Harokopio University, Athens, Greece.,1st Department of Neurology, Aiginition Hospital, National and Kapodistrian University of Athens Medical School, Athens, Greece
| | - Mary Yannakoulia
- Department of Nutrition and Dietetics, Harokopio University, Athens, Greece
| | - Paraskevi Sakka
- Athens Association of Alzheimer's Disease and Related Disorders, Marousi, Greece
| | - Georgios Hadjigeorgiou
- Department of Neurology, University Hospital of Larissa, School of Medicine, University of Thessaly, Larissa, Greece.,Department of Neurology, Medical School, University of Cyprus, Nicosia, Cyprus
| | - Nikolaos Scarmeas
- 1st Department of Neurology, Aiginition Hospital, National and Kapodistrian University of Athens Medical School, Athens, Greece.,Taub Institute for Research in Alzheimer's Disease and the Aging Brain, the Gertrude H. Sergievsky Center, Department of Neurology, Columbia University, New York, NY, USA
| | - Efthimios Dardiotis
- Department of Neurology, University Hospital of Larissa, School of Medicine, University of Thessaly, Larissa, Greece
| | - Mary H Kosmidis
- Lab of Cognitive Neuroscience, School of Psychology, Aristotle University of Thessaloniki, Thessaloniki, Greece
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Staios M, Kosmidis MH, Kokkinis N, Papadopoulos A, Nielsen TR, Kalinowski P, March E, Stolwyk RJ. The Greek Australian neuropsychological normative study: tests & norms for Greek Australians aged 70-85 years. AUSTRALIAN PSYCHOLOGIST 2023. [DOI: 10.1080/00050067.2022.2151337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Affiliation(s)
- Mathew Staios
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Melbourne, Australia
| | - Mary H. Kosmidis
- Lab of Cognitive Neuroscience, School of Psychology, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Nikolaos Kokkinis
- Lab of Cognitive Neuroscience, School of Psychology, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Alexandra Papadopoulos
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Melbourne, Australia
| | - T. Rune Nielsen
- Department of Neurology, Danish Dementia Research Centre, Copenhagen, Denmark
| | - Pawel Kalinowski
- Melbourne Dementia Research Centre, The Florey Institute of Neuroscience and Mental Health, Melbourne, Australia
| | - Evrim March
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Melbourne, Australia
| | - Renerus J. Stolwyk
- Turner Institute for Brain and Mental Health, School of Psychological Sciences, Monash University, Melbourne, Australia
- Monash-Epworth Rehabilitation Research Centre, Melbourne, Australia
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26
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Wu W, Ding D, Zhao Q, Xiao Z, Luo J, Ganguli M, Hughes TF, Jacobsen E, Haan MN, van Dang K, Lima-Costa MF, Blay SL, de Castro-Costa E, Ng TP, Gwee X, Gao Q, Gureje O, Ojagbemi A, Bello T, Shahar S, Ludin AFM, Rivan NFM, Scarmeas N, Anastasiou CA, Yannakoulia M, Brodaty H, Crawford JD, Lipton RB, Derby CA, Katz MJ, Lipnicki DM, Sachdev PS. Dose-response relationship between late-life physical activity and incident dementia: A pooled analysis of 10 cohort studies of memory in an international consortium. Alzheimers Dement 2023; 19:107-122. [PMID: 35290713 PMCID: PMC9652610 DOI: 10.1002/alz.12628] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Revised: 01/22/2022] [Accepted: 01/24/2022] [Indexed: 01/28/2023]
Abstract
INTRODUCTION Though consistent evidence suggests that physical activity may delay dementia onset, the duration and amount of activity required remains unclear. METHODS We harmonized longitudinal data of 11,988 participants from 10 cohorts in eight countries to examine the dose-response relationship between late-life physical activity and incident dementia among older adults. RESULTS Using no physical activity as a reference, dementia risk decreased with duration of physical activity up to 3.1 to 6.0 hours/week (hazard ratio [HR] 0.88, 95% confidence interval [CI] 0.67 to 1.15 for 0.1 to 3.0 hours/week; HR 0.68, 95% CI 0.52 to 0.89 for 3.1 to 6.0 hours/week), but plateaued with higher duration. For the amount of physical activity, a similar pattern of dose-response curve was observed, with an inflection point of 9.1 to 18.0 metabolic equivalent value (MET)-hours/week (HR 0.92, 95% CI 0.70 to 1.22 for 0.1 to 9.0 MET-hours/week; HR 0.70, 95% CI 0.53 to 0.93 for 9.1 to 18.0 MET-hours/week). DISCUSSION This cross-national analysis suggests that performing 3.1 to 6.0 hours of physical activity and expending 9.1 to 18.0/MET-hours of energy per week may reduce dementia risk.
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Affiliation(s)
- Wanqing Wu
- Institute of Neurology, National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai, China
| | - Ding Ding
- Institute of Neurology, National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai, China
| | - Qianhua Zhao
- Institute of Neurology, National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai, China
| | - Zhenxu Xiao
- Institute of Neurology, National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan University, Shanghai, China
| | - Jianfeng Luo
- Department of Biostatistics, School of Public Health, Fudan University, Shanghai, China
| | - Mary Ganguli
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, USA
| | - Tiffany F Hughes
- Department of Health Professions, Youngstown State University, OH, USA
| | - Erin Jacobsen
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, USA
| | - Mary N Haan
- Department of Epidemiology and Biostatistics, University of California at San Francisco, San Francisco, USA
| | - Kristine van Dang
- Department of Epidemiology and Biostatistics, University of California at San Francisco, San Francisco, USA
| | - Maria Fernanda Lima-Costa
- Center for Studies in Public Health and Aging’ René Rachou Research Center, Oswaldo Cruz Foundation, Belo Horizonte, Brazil
| | - Sergio Luis Blay
- Department of Psychiatry, Federal University of Sao Paulo, Sao Paulo, Brazil
| | - Erico de Castro-Costa
- Center for Studies in Public Health and Aging’ René Rachou Research Center, Oswaldo Cruz Foundation, Belo Horizonte, Brazil
| | - Tze Pin Ng
- Department of Psychological Medicine, National University of Singapore, Singapore, Singapore
| | - Xinyi Gwee
- Department of Psychological Medicine, National University of Singapore, Singapore, Singapore
| | - Qi Gao
- National Public Health and Epidemiology Unit, National Centre for Infectious Diseases, Singapore, Singapore
| | - Oye Gureje
- Department of Psychiatry, University of Ibadan, Ibadan, Nigeria
| | - Akin Ojagbemi
- Department of Psychiatry, University of Ibadan, Ibadan, Nigeria
| | - Toyin Bello
- Department of Psychiatry, University of Ibadan, Ibadan, Nigeria
| | - Suzana Shahar
- Dietetic Program, Centre for Healthy Aging, University Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Arimi Fitri Mat Ludin
- Biomedical Science Program, Centre for Healthy Aging, University Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Nurul Fatin Malek Rivan
- Nutritional Sciences Program, Centre for Healthy Aging, University Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | | | | | - Mary Yannakoulia
- Department of Nutrition and Dietetics, Harokopio University, Athens, Greece
| | - Henry Brodaty
- Centre for Healthy Brain Ageing, University of New South Wales, Sydney, Australia
| | - John D Crawford
- Centre for Healthy Brain Ageing, University of New South Wales, Sydney, Australia
| | - Richard B Lipton
- Department of Neurology, Albert Einstein College of Medicine, New York, USA
| | - Carol A Derby
- Department of Neurology, Albert Einstein College of Medicine, New York, USA
| | - Mindy J Katz
- Department of Neurology, Albert Einstein College of Medicine, New York, USA
| | - Darren M Lipnicki
- Centre for Healthy Brain Ageing, University of New South Wales, Sydney, Australia
| | - Perminder S Sachdev
- Centre for Healthy Brain Ageing, University of New South Wales, Sydney, Australia
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Peterson RL, Gilsanz P, Lor Y, George KM, Ko M, Wagner J, Soh Y, Meyer OL, Glymour MM, Whitmer RA. Rural residence across the life course and late-life cognitive decline in KHANDLE: A causal inference study. ALZHEIMER'S & DEMENTIA (AMSTERDAM, NETHERLANDS) 2023; 15:e12399. [PMID: 36762299 PMCID: PMC9896964 DOI: 10.1002/dad2.12399] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Revised: 11/01/2022] [Accepted: 01/03/2023] [Indexed: 02/05/2023]
Abstract
Background Modifiable risks for dementia are more prevalent in rural populations, yet there is a dearth of research examining life course rural residence on late-life cognitive decline. Methods The association of rural residence and socioeconomic status (SES) in childhood and adulthood with late-life cognitive domains (verbal episodic memory, executive function, and semantic memory) and cognitive decline in the Kaiser Healthy Aging and Diverse Life Experiences cohort was estimated using marginal structural models with stabilized inverse probability weights. Results After adjusting for time-varying SES, the estimated marginal effect of rural residence in childhood was harmful for both executive function (β = -0.19, 95% confidence interval [CI] = -0.32, -0.06) and verbal episodic memory (β = -0.22, 95% CI = -0.35, -0.08). Effects of adult rural residence were imprecisely estimated with beneficial point estimates for both executive function (β = 0.19; 95% CI = -0.07, 0.44) and verbal episodic memory (β = 0.24, 95% CI = -0.07, 0.55). Conclusions Childhood rurality is associated with poorer late-life cognition independent of SES.
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Affiliation(s)
- Rachel L. Peterson
- School of Public and Community Health SciencesUniversity of MontanaMissoulaMontanaUSA
| | - Paola Gilsanz
- Division of ResearchKaiser Permanente Northern CaliforniaOaklandCaliforniaUSA
| | - Yi Lor
- Department of Public Health SciencesUniversity of California DavisDavisCaliforniaUSA
| | - Kristen M. George
- Department of Public Health SciencesUniversity of California DavisDavisCaliforniaUSA
| | - Michelle Ko
- Department of Public Health SciencesUniversity of California DavisDavisCaliforniaUSA
| | - Jenny Wagner
- Department of Public Health SciencesUniversity of California DavisDavisCaliforniaUSA
| | - Yenee Soh
- Division of ResearchKaiser Permanente Northern CaliforniaOaklandCaliforniaUSA
| | - Oanh L. Meyer
- Department of NeurologyUniversity of California DavisSacramentoCaliforniaUSA
| | - M. Maria Glymour
- Department of Epidemiology and BiostatisticsUniversity of California San FranciscoSan FranciscoCaliforniaUSA
| | - Rachel A. Whitmer
- Department of Public Health SciencesUniversity of California DavisDavisCaliforniaUSA
- Department of NeurologyUniversity of California DavisSacramentoCaliforniaUSA
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Liampas I, Folia V, Zoupa E, Siokas V, Yannakoulia M, Sakka P, Hadjigeorgiou G, Scarmeas N, Dardiotis E, Kosmidis MH. Qualitative Verbal Fluency Components as Prognostic Factors for Developing Alzheimer's Dementia and Mild Cognitive Impairment: Results from the Population-Based HELIAD Cohort. Medicina (B Aires) 2022; 58:medicina58121814. [PMID: 36557016 PMCID: PMC9786933 DOI: 10.3390/medicina58121814] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Revised: 11/29/2022] [Accepted: 12/06/2022] [Indexed: 12/13/2022] Open
Abstract
Background and Objectives: The aim of the present study was to investigate the prognostic value of the qualitative components of verbal fluency (clustering, switching, intrusions, and perseverations) on the development of mild cognitive impairment (MCI) and dementia. Materials and Methods: Participants were drawn from the multidisciplinary, population-based, prospective HELIAD (Hellenic Longitudinal Investigation of Aging and Diet) cohort. Two participant sets were separately analysed: those with normal cognition and MCI at baseline. Verbal fluency was assessed via one category and one letter fluency task. Separate Cox proportional hazards regressions adjusted for important sociodemographic parameters were performed for each qualitative semantic and phonemic verbal fluency component. Results: There were 955 cognitively normal (CN), older (72.9 years ±4.9), predominantly female (~60%) individuals with available follow-up assessments after a mean of 3.09 years (±0.83). Among them, 34 developed dementia at follow-up (29 of whom progressed to Alzheimer's dementia (AD)), 160 developed MCI, and 761 remained CN. Each additional perseveration on the semantic condition increased the risk of developing all-cause dementia and AD by 52% and 55%, respectively. Of note, participants with two or more perseverations on the semantic task presented a much more prominent risk for incident dementia compared to those with one or no perseverations. Among the remaining qualitative indices, none were associated with the hazard of developing all-cause dementia, AD, and MCI at follow-up. Conclusions: Perseverations on the semantic fluency condition were related to an increased risk of incident all-cause dementia or AD in older, CN individuals.
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Affiliation(s)
- Ioannis Liampas
- Department of Neurology, University Hospital of Larissa, School of Medicine, University of Thessaly, Mezourlo Hill, 41110 Larissa, Greece
| | - Vasiliki Folia
- Lab of Cognitive Neuroscience, School of Psychology, Aristotle University of Thessaloniki, University Campus, 54124 Thessaloniki, Greece
- Correspondence:
| | - Elli Zoupa
- Lab of Cognitive Neuroscience, School of Psychology, Aristotle University of Thessaloniki, University Campus, 54124 Thessaloniki, Greece
| | - Vasileios Siokas
- Department of Neurology, University Hospital of Larissa, School of Medicine, University of Thessaly, Mezourlo Hill, 41110 Larissa, Greece
| | - Mary Yannakoulia
- Department of Nutrition and Dietetics, Harokopio University, 70 El. Venizelou, 17671 Athens, Greece
| | - Paraskevi Sakka
- Athens Alzheimer’s Association, 89 M. Mousourou & 33 Stilponos St, 11636 Athens, Greece
| | - Georgios Hadjigeorgiou
- Department of Neurology, University Hospital of Larissa, School of Medicine, University of Thessaly, Mezourlo Hill, 41110 Larissa, Greece
- School of Medicine, University of Cyprus, 93 Agiou Nikolaou St, Engomi, Nicosia 2408, Cyprus
| | - Nikolaos Scarmeas
- 1st Department of Neurology, Aiginition Hospital, National and Kapodistrian University of Athens Medical School, 72-74 Vassilissis Sofias Ave, 11528 Athens, Greece
- Taub Institute for Research in Alzheimer’s Disease and the Aging Brain, The Gertrude H. Sergievsky Center, Department of Neurology, Columbia University, 710 West 168th St, New York, NY 10032, USA
| | - Efthimios Dardiotis
- Department of Neurology, University Hospital of Larissa, School of Medicine, University of Thessaly, Mezourlo Hill, 41110 Larissa, Greece
| | - Mary H. Kosmidis
- Lab of Cognitive Neuroscience, School of Psychology, Aristotle University of Thessaloniki, University Campus, 54124 Thessaloniki, Greece
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29
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Funk-White M, Moore AA, McEvoy LK, Bondi MW, Bergstrom J, Kaufmann CN. Alcohol use and cognitive performance: a comparison between Greece and the United States. Aging Ment Health 2022; 26:2440-2446. [PMID: 34842012 PMCID: PMC9161584 DOI: 10.1080/13607863.2021.1998355] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2021] [Accepted: 10/17/2021] [Indexed: 02/01/2023]
Abstract
OBJECTIVES To examine associations between alcohol use and cognitive performance among older adults in Greece and the United States, and assess potential differences due to differing drinking practices in the two countries. METHODS Data came from Hellenic Longitudinal Investigation of Aging and Diet (HELIAD) and National Alzheimer's Coordinating Center Uniform Dataset (NACC). We examined those aged 65-90 years at baseline who had no cognitive impairment and complete data for cognitive and alcohol use variables (N = 1110 from HELIAD; N = 2455 from NACC). We examined associations between current alcohol use and frequency of such use with cognitive performance on various cognitive tasks stratified by gender. RESULTS In NACC, use of alcohol was associated with better cognitive performance. Men drinkers performed better than non-drinkers on Trail A (standardized mean 0.07 vs. -0.24, p<.001), Trail B (0.06 vs. -0.19, p=.001), and women drinkers performed better on Trail A (0.04 vs. -0.09, p=.016), Trail B (0.04 vs. -0.10, p=.005), verbal fluency (Animals: 0.05 vs. -0.13, p<.001; Vegetables: 0.04 vs. -0.09, p=.027), and MoCA (0.03 vs. -0.08, p=.039). In HELIAD, fewer differences were seen with only women drinkers exhibiting better performance than non-drinkers on the Boston Naming Task (0.11 vs. -0.05, p=.016). In general, more frequent drinkers performed better on cognitive tasks than less frequent drinkers, although this was only statistically significant in the NACC dataset. CONCLUSION While drinking alcohol may be associated with better cognitive performance across both the US and Greece, more research is needed to assess the cultural factors that may modify this association.
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Affiliation(s)
- Makaya Funk-White
- San Diego State University/University of California San Diego, San Diego, CA, USA
| | - Alison A. Moore
- Division of Geriatrics, Gerontology and Palliative Care, Department of Medicine, University of California San Diego, La Jolla, CA, USA
| | - Linda K McEvoy
- Department of Radiology, University of California San Diego, La Jolla, CA, USA
| | - Mark W. Bondi
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
- Veterans Affairs San Diego Healthcare System, San Diego, CA, USA
| | - Jaclyn Bergstrom
- Division of Geriatrics, Gerontology and Palliative Care, Department of Medicine, University of California San Diego, La Jolla, CA, USA
- Department of Radiology, University of California San Diego, La Jolla, CA, USA
| | - Christopher N. Kaufmann
- Division of Epidemiology and Data Science in Gerontology, Department of Aging and Geriatric Research, University of Florida College of Medicine, Gainesville, FL, USA
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Samtani S, Mahalingam G, Lam BCP, Lipnicki DM, Lima-Costa MF, Blay SL, Castro-Costa E, Shifu X, Guerchet M, Preux PM, Gbessemehlan A, Skoog I, Najar J, Rydberg Sterner T, Scarmeas N, Kim KW, Riedel-Heller S, Röhr S, Pabst A, Shahar S, Numbers K, Ganguli M, Jacobsen E, Hughes TF, Crowe M, Ng TP, Maddock J, Marseglia A, Mélis R, Szcześniak D, Wiegelmann H, Vernooij-Dassen M, Jeon YH, Sachdev PS, Brodaty H. Associations between social connections and cognition: a global collaborative individual participant data meta-analysis. THE LANCET. HEALTHY LONGEVITY 2022; 3:e740-e753. [PMID: 36273484 PMCID: PMC9750173 DOI: 10.1016/s2666-7568(22)00199-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2022] [Revised: 08/16/2022] [Accepted: 08/19/2022] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND Poor social connections (eg, small networks, infrequent interactions, and loneliness) are modifiable risk factors for cognitive decline. Existing meta-analyses are limited by reporting aggregate responses, a focus on global cognition, and combining social measures into single constructs. We aimed to investigate the association between social connection markers and the rate of annual change in cognition (ie, global and domain-specific), as well as sex differences, using an individual participant data meta-analysis. METHODS We harmonised data from 13 longitudinal cohort studies of ageing in North America, South America, Europe, Africa, Asia, and Australia. Studies were eligible for inclusion if they had baseline data for social connection markers and at least two waves of cognitive scores. Follow-up periods ranged from 0 years to 15 years across cohorts. We included participants with cognitive data for at least two waves and social connection data for at least one wave. We then identified and excluded people with dementia at baseline. Primary outcomes were annual rates of change in global cognition and cognitive domain scores over time until final follow-up within each cohort study analysed by use of an individual participant data meta-analysis. Linear mixed models within cohorts used baseline social connection markers as predictors of the primary outcomes. Effects were pooled in two stages using random-effects meta-analyses. We assessed the primary outcomes in the main (partially adjusted) and fully adjusted models. Partially adjusted models controlled for age, sex, and education; fully adjusted models additionally controlled for diabetes, hypertension, smoking, cardiovascular risk, and depression. FINDINGS Of the 40 006 participants in the 13 cohort studies, we excluded 1392 people with dementia at baseline. 38 614 individual participants were included in our analyses. For the main models, being in a relationship or married predicted slower global cognitive decline (b=0·010, 95% CI 0·000-0·019) than did being single or never married; living with others predicted slower global cognitive (b=0·007, 0·002-0·012), memory (b=0·017, 0·006-0·028), and language (b=0·008, 0·000-0·015) decline than did living alone; and weekly interactions with family and friends (b=0·016, 0·006-0·026) and weekly community group engagement (b=0·030, 0·007-0·052) predicted slower memory decline than did no interactions and no engagement. Never feeling lonely predicted slower global cognitive (b=0·047, 95% CI 0·018-0·075) and executive function (b=0·047, 0·017-0·077) decline than did often feeling lonely. Degree of social support, having a confidante, and relationship satisfaction did not predict cognitive decline across global cognition or cognitive domains. Heterogeneity was low (I2=0·00-15·11%) for all but two of the significant findings (association between slower memory decline and living with others [I2=58·33%] and community group engagement, I2=37·54-72·19%), suggesting robust results across studies. INTERPRETATION Good social connections (ie, living with others, weekly community group engagement, interacting weekly with family and friends, and never feeling lonely) are associated with slower cognitive decline. FUNDING EU Joint Programme-Neurodegenerative Disease Research grant, funded by the National Health and Medical Research Council Australia, and the US National Institute on Aging of the US National Institutes of Health.
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Affiliation(s)
- Suraj Samtani
- Centre for Healthy Brain Ageing, Discipline of Psychiatry, Faculty of Medicine and Health, UNSW Sydney, Sydney, NSW, Australia.
| | - Gowsaly Mahalingam
- Centre for Healthy Brain Ageing, Discipline of Psychiatry, Faculty of Medicine and Health, UNSW Sydney, Sydney, NSW, Australia
| | - Ben Chun Pan Lam
- Centre for Healthy Brain Ageing, Discipline of Psychiatry, Faculty of Medicine and Health, UNSW Sydney, Sydney, NSW, Australia
| | - Darren M Lipnicki
- Centre for Healthy Brain Ageing, Discipline of Psychiatry, Faculty of Medicine and Health, UNSW Sydney, Sydney, NSW, Australia
| | - Maria Fernanda Lima-Costa
- Center for Studies in Public Health and Aging, René Rachou Research Center, Oswaldo Cruz Foundation, Belo Horizonte, Brazil
| | - Sergio Luís Blay
- Department of Psychiatry, Federal University of São Paulo, São Paulo, Brazil
| | - Erico Castro-Costa
- Center for Studies in Public Health and Aging, René Rachou Research Center, Oswaldo Cruz Foundation, Belo Horizonte, Brazil
| | - Xiao Shifu
- Department of Geriatric Psychiatry, Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Maëlenn Guerchet
- Inserm U1094, IRD UMR270, University of Limoges, CHU Limoges, Epidemiology of Chronic Diseases in Tropical Zone, Institute of Epidemiology and Tropical Neurology, OmegaHealth, Limoges, France
| | - Pierre-Marie Preux
- Inserm U1094, IRD UMR270, University of Limoges, CHU Limoges, Epidemiology of Chronic Diseases in Tropical Zone, Institute of Epidemiology and Tropical Neurology, OmegaHealth, Limoges, France
| | - Antoine Gbessemehlan
- Inserm U1094, IRD UMR270, University of Limoges, CHU Limoges, Epidemiology of Chronic Diseases in Tropical Zone, Institute of Epidemiology and Tropical Neurology, OmegaHealth, Limoges, France
| | - Ingmar Skoog
- Department of Psychiatry and Neurochemistry, Neuropsychiatric Epidemiology Unit, Institute of Neuroscience and Physiology, Sahlgrenska Academy, Centre for Ageing and Health, University of Gothenburg, Mölndal, Sweden; Psychiatry, Cognition and Old Age Psychiatry Clinic, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Jenna Najar
- Department of Psychiatry and Neurochemistry, Neuropsychiatric Epidemiology Unit, Institute of Neuroscience and Physiology, Sahlgrenska Academy, Centre for Ageing and Health, University of Gothenburg, Mölndal, Sweden; Psychiatry, Cognition and Old Age Psychiatry Clinic, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Therese Rydberg Sterner
- Department of Psychiatry and Neurochemistry, Neuropsychiatric Epidemiology Unit, Institute of Neuroscience and Physiology, Sahlgrenska Academy, Centre for Ageing and Health, University of Gothenburg, Mölndal, Sweden
| | - Nikolaos Scarmeas
- 1st Department of Neurology, Aiginition University Hospital of Athens, National and Kapodistrian University of Athens, Athens, Greece; Taub Institute for Research in Alzheimer's Disease and the Aging Brain, The Gertrude H Sergievsky Center, Department of Neurology, Columbia University, New York, NY, USA
| | - Ki-Woong Kim
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, South Korea; Department of Psychiatry, Seoul National University College of Medicine and Department of Brain and Cognitive Science, College of Natural Sciences, Seoul National University, Seoul, South Korea
| | - Steffi Riedel-Heller
- Institute of Social Medicine, Occupational Health and Public Health, Faculty of Medicine, University of Leipzig, Leipzig, Germany
| | - Susanne Röhr
- Institute of Social Medicine, Occupational Health and Public Health, Faculty of Medicine, University of Leipzig, Leipzig, Germany; Global Brain Health Institute, Trinity College Dublin, Dublin, Ireland
| | - Alexander Pabst
- Institute of Social Medicine, Occupational Health and Public Health, Faculty of Medicine, University of Leipzig, Leipzig, Germany
| | - Suzana Shahar
- Centre for Healthy Aging and Wellness, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia
| | - Katya Numbers
- Centre for Healthy Brain Ageing, Discipline of Psychiatry, Faculty of Medicine and Health, UNSW Sydney, Sydney, NSW, Australia
| | - Mary Ganguli
- Department of Psychiatry, School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA; Department of Epidemiology, School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA; Department of Neurology, School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA
| | - Erin Jacobsen
- Department of Psychiatry, School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA
| | - Tiffany F Hughes
- Department of Sociology, Anthropology, and Gerontology, Youngstown State University, Youngstown, OH, USA
| | - Michael Crowe
- Department of Psychology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Tze Pin Ng
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Jane Maddock
- MRC Unit for Lifelong Health and Ageing, University College London, London, UK
| | - Anna Marseglia
- Division of Clinical Geriatrics, Centre for Alzheimer Research, Department of Neurobiology, Care Sciences, and Society, Karolinska Institutet, Stockholm, Sweden
| | - René Mélis
- Department of Geriatrics, Radboud University Medical Centre, Nijmegen, Netherlands
| | - Dorota Szcześniak
- Department of Psychiatry, Wroclaw Medical University, Wroclaw, Poland
| | - Henrik Wiegelmann
- Department of Health Care Research, Institute of Public Health and Nursing Research, University of Bremen, Bremen, Germany
| | | | - Yun-Hee Jeon
- Susan Wakil School of Nursing and Midwifery, Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
| | - Perminder S Sachdev
- Centre for Healthy Brain Ageing, Discipline of Psychiatry, Faculty of Medicine and Health, UNSW Sydney, Sydney, NSW, Australia
| | - Henry Brodaty
- Centre for Healthy Brain Ageing, Discipline of Psychiatry, Faculty of Medicine and Health, UNSW Sydney, Sydney, NSW, Australia
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Language performance as a prognostic factor for developing Alzheimer's clinical syndrome and mild cognitive impairment: Results from the population-based HELIAD cohort. J Int Neuropsychol Soc 2022; 29:450-458. [PMID: 36268843 DOI: 10.1017/s1355617722000376] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVES There is limited research on the prognostic value of language tasks regarding mild cognitive impairment (MCI) and Alzheimer's clinical syndrome (ACS) development in the cognitively normal (CN) elderly, as well as MCI to ACS conversion. METHODS Participants were drawn from the population-based Hellenic Longitudinal Investigation of Aging and Diet (HELIAD) cohort. Language performance was evaluated via verbal fluency [semantic (SVF) and phonemic (PVF)], confrontation naming [Boston Naming Test short form (BNTsf)], verbal comprehension, and repetition tasks. An additional language index was estimated using both verbal fluency tasks: SVF-PVF discrepancy. Cox proportional hazards analyses adjusted for important sociodemographic parameters (age, sex, education, main occupation, and socioeconomic status) and global cognitive status [Mini Mental State Examination score (MMSE)] were performed. RESULTS A total of 959 CN and 118 MCI older (>64 years) individuals had follow-up investigations after a mean of ∼3 years. Regarding the CN group, each standard deviation increase in the composite language score reduced the risk of ACS and MCI by 49% (8-72%) and 32% (8-50%), respectively; better SVF and BNTsf performance were also independently associated with reduced risk of ACS and MCI. On the other hand, using the smaller MCI participant set, no language measurement was related to the risk of MCI to ACS conversion. CONCLUSIONS Impaired language performance is associated with elevated risk of ACS and MCI development. Better SVF and BNTsf performance are associated with reduced risk of ACS and MCI in CN individuals, independent of age, sex, education, main occupation, socioeconomic status, and MMSE scores at baseline.
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Abstract
OBJECTIVES We investigated the utility of traditional neuropsychological tests in older uneducated/illiterate individuals without dementia to determine the possibility that they are likely not appropriate for this group. METHODS We assessed the neuropsychological performance of 1122 older adults [≥65 years old; mean age: 74.03 (SD = 5.46); mean education: 4.76 (SD = 2.5) years; women: n = 714], in the context of the Hellenic Longitudinal Investigation of Aging and Diet (HELIAD), a population-based study conducted in Greece. RESULTS We based our analyses on three groups: high-functioning/cognitively healthy (i.e., without dementia) uneducated/illiterate individuals (n = 80), high-functioning/cognitively healthy educated/literate individuals (n = 932), and low-functioning/cognitively impaired educated/literate individuals (presumably with dementia; n = 110). We used binary regression analyses with Bonferroni correction to investigate whether test performance differentiated uneducated/illiterate from educated/literate individuals. Models were adjusted for age and sex; raw test scores were the predictor variables. The uneducated/illiterate cohort was at a disadvantage relative to the healthy educated/literate group on all variables but verbal memory recognition and consolidation, congruent motor responses, and phonological fluency clustering (p > .002). Moreover, only word list learning immediate and delayed free recall and delayed cued recall differentiated the high-functioning/cognitively healthy uneducated/illiterate from the low-functioning/cognitively impaired educated/literate group, favoring the former (p's < .002). CONCLUSIONS Our findings suggest that only particular verbal memory test variables are fair in determining whether older uneducated/illiterate individuals have functional/cognitive impairment suggestive of a neurodegenerative process. On all other neuropsychological variables, this cohort was at a disadvantage. Therefore, we highlight the need for identifying appropriate methods of assessment for older uneducated/illiterate individuals.
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Wezeman SL, Uleman JF, Scarmeas N, Kosmidis MH, Dardiotis E, Peeters G(G, Olde Rikkert MG. Population Attributable Fractions for Modifiable Risk Factors of Incident Dementia in Cognitively Normal and Mild Cognitively Impaired Older Adults: Data from Two Cohort Studies. J Alzheimers Dis 2022; 89:151-162. [PMID: 35871325 PMCID: PMC9484110 DOI: 10.3233/jad-215386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
BACKGROUND Recent global meta-analyses show that 40% of dementia cases can be attributed to twelve modifiable risk factors. OBJECTIVE To investigate how health promotion strategies may differ in specific populations, this study estimated population attributable fractions (PAFs) of these risk factors for dementia in cognitively normal (CN) individuals and individuals with mild cognitive impairment (MCI) in United States and Greek cohorts. METHODS We re-analyzed data from the National Alzheimer's Coordinating Centre (NACC, n = 16,147, mean age 75.2±6.9 years, 59.0% female) and the Hellenic Longitudinal Investigation of Aging and Diet (HELIAD, n = 1,141, mean age 72.9±5.0 years, 58.0% female). PAFs for the total samples and CN and MCI subgroups were calculated based on hazard ratios for the risk of dementia and risk factor prevalence in NACC (9 risk factors) and HELIAD (10 risk factors). RESULTS In NACC, 2,630 participants developed MCI (25.1%) and 3,333 developed dementia (20.7%) during a mean follow-up of 4.9±3.5 years. Weighted overall PAFs were 19.4% in the total sample, 15.9% in the CN subgroup, and 3.3% in the MCI subgroup. In HELIAD, 131 participants developed MCI (11.2%) and 68 developed dementia (5.9%) during an average follow-up of 3.1±0.86 years. Weighted overall PAFs were 65.5% in the total sample, 65.8% in the CN subgroup and 64.6% in the MCI subgroup. CONCLUSION Translation of global meta-analysis data on modifiable risk factors should be carefully carried out per population. The PAFs of risk factors differ substantially across populations, directing health policy making to tailored risk factor modification plans.
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Affiliation(s)
- Sandra L. Wezeman
- Department of Geriatric Medicine, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Jeroen F. Uleman
- Department of Geriatric Medicine, Radboud University Medical Center, Nijmegen, The Netherlands,Radboudumc Alzheimer Center, Donders Center of Medical Neurosciences, Nijmegen, The Netherlands,Institute for Advanced Study, Amsterdam, The Netherlands
| | - Nikolaos Scarmeas
- 1st Department of Neurology, Aiginition Hospital, National and Kapodistrian University of Athens, Athens, Greece,
Department of Neurology, Columbia University, New York, NY, USA
| | - Mary H. Kosmidis
- Lab of Cognitive Neuroscience, School of Psychology, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Efthimios Dardiotis
- Department of Neurology, Faculty of Medicine, University of Thessaly, University Hospital of Larissa, Volos, Larissa, Greece
| | - G.M.E.E. (Geeske) Peeters
- Department of Geriatric Medicine, Radboud University Medical Center, Nijmegen, The Netherlands,Radboudumc Alzheimer Center, Donders Center of Medical Neurosciences, Nijmegen, The Netherlands,Global Brain Health Institute, Trinity College Dublin, Dublin, Ireland,Correspondence to: G.M.E.E. (Geeske) Peeters, Reinier Postlaan 4, 6525 GC Nijmegen, The Netherlands. Tel.: +31 24 3617397; E-mail:
| | - Marcel G.M. Olde Rikkert
- Department of Geriatric Medicine, Radboud University Medical Center, Nijmegen, The Netherlands,Radboudumc Alzheimer Center, Donders Center of Medical Neurosciences, Nijmegen, The Netherlands
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Liampas I, Siokas V, Kyrozis A, Sakoutis G, Yannakoulia M, Kosmidis MH, Sakka P, Sakkas GK, Giannaki CD, Stefanidis I, Scarmeas N, Dardiotis E, Hadjigeorgiou GM. Prevalence and Determinants of Restless Legs Syndrome (Willis-Ekbom Disease) in an Older Greek Population. Behav Sleep Med 2022:1-13. [PMID: 35994615 DOI: 10.1080/15402002.2022.2112194] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
OBJECTIVES The present study aimed to explore the descriptive and analytic epidemiology of restless legs syndrome (RLS) in the older Greek population, with a specific focus on lifestyle indicators. METHODS Baseline data from the randomly selected non-demented older participants of the population-based HELIAD cohort were analyzed. Multivariable binary logistic regression with RLS diagnosis as the dichotomous dependent outcome was performed. Demographic, socioeconomic, anthropometric, dietary, sleep-related and psychological parameters, physical activity, use of psychoactive substances and personal medical history were investigated for potential associations. RESULTS A total of 133 from the eligible sample of 1,838 participants were diagnosed with RLS. The mean age-sex standardized prevalence of RLS among the elderly was estimated at 6.1% (95%CI = 5.0-7.2), with a female (8.0%, 95%CI = 6.4-9.6) to male (3.7%, 95%CI = 2.4-5.1) ratio of 2.1. The prevalence of RLS peaked during the 8th decade of life and diminished thereafter. The positive associations of RLS with female sex [OR = 2.06, 95%CI = (1.19-3.57)], anxiety levels [assessed by the 22-point HADS scale, OR = 1.08, 95%CI = (1.03-1.13)] and traumatic brain injury [OR = 2.22, 95%CI = (1.37-3.62)] were reproduced. Good sleep quality was related to 55% [95%CI~(24-83%)] lower odds of having RLS in comparison with both poor and moderate quality. Adherence to the Mediterranean dietary pattern [assessed by a 55-point scale, OR = 1.06, 95%CI = (1.01-1.11)], and low daily energy intake [low-moderate vs. low: OR = 0.45, 95%CI = (0.26-0.79)]; [moderate-high vs. low: OR = 0.69, 95%CI = (0.40-1.22)]; [high vs. low: OR = 0.31, 95%CI = (0.13-0.69)] were related to RLS for the first time. CONCLUSIONS More emphasis should be placed on the dietary-nutritional aspects of RLS.
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Affiliation(s)
- Ioannis Liampas
- Department of Neurology, University Hospital of Larissa, School of Medicine, University of Thessaly, Larissa, Greece
| | - Vasileios Siokas
- Department of Neurology, University Hospital of Larissa, School of Medicine, University of Thessaly, Larissa, Greece
| | - Andreas Kyrozis
- 1st Department of Neurology, Aiginition Hospital, National and Kapodistrian University of Athens Medical School, Greece
| | - George Sakoutis
- Department of Neurology, University Hospital of Larissa, School of Medicine, University of Thessaly, Larissa, Greece
| | - Mary Yannakoulia
- Department of Nutrition and Dietetics, Harokopio University, Athens, Greece
| | - Mary H Kosmidis
- Lab of Cognitive Neuroscience, School of Psychology, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Paraskevi Sakka
- Athens Association of Alzheimer's Disease and Related Disorders, Marousi, Greece
| | - Giorgos K Sakkas
- School of Physical Education and Sport Science, University of Thessaly, Trikala, Greece.,School of Sport and Health Sciences, Cardiff Metropolitan University, Cardiff, UK
| | | | - Ioannis Stefanidis
- Department of Nephology, University Hospital of Larissa, School of Medicine, University of Thessaly, Larissa, Greece
| | - Nikolaos Scarmeas
- 1st Department of Neurology, Aiginition Hospital, National and Kapodistrian University of Athens Medical School, Greece.,Taub Institute for Research in Alzheimer's Disease and the Aging Brain, The Gertrude H. Sergievsky Center, Department of Neurology, Columbia University, New York, USA
| | - Efthimios Dardiotis
- Department of Neurology, University Hospital of Larissa, School of Medicine, University of Thessaly, Larissa, Greece
| | - Georgios M Hadjigeorgiou
- Department of Neurology, University Hospital of Larissa, School of Medicine, University of Thessaly, Larissa, Greece.,Department of Neurology, Medical School, University of Cyprus, Nicosia, Cyprus
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Liampas I, Hatzimanolis A, Siokas V, Yannakoulia M, Kosmidis MH, Sakka P, Hadjigeorgiou GM, Scarmeas N, Dardiotis E. Antihypertensive Medication Class and the Risk of Dementia and Cognitive Decline in Older Adults: A Secondary Analysis of the Prospective HELIAD Cohort. J Alzheimers Dis 2022; 89:709-719. [PMID: 35912747 DOI: 10.3233/jad-220439] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
BACKGROUND It is unclear whether the main antihypertensive medication classes (diuretics, calcium channel blockers, beta-blockers, angiotensin converting enzyme inhibitors, and angiotensin receptor blockers (ARBs)) are associated with different risks of cognitive decline. Published evidence is conflicting and stems mainly from observational studies. OBJECTIVE To investigate the differential effects of antihypertensives on the risks of developing dementia and cognitive decline, with a specific focus on the vascular component of the mechanisms underlying these interactions. METHODS Older adults with a history of hypertension and without dementia were drawn from the population-based HELIAD cohort. Age-, gender-, education-, and antihypertensive medication- (five dichotomous exposures) adjusted Cox proportional-hazards models and generalized estimating equations were performed to appraise the associations of baseline antihypertensive therapy with dementia incidence and cognitive decline (quantified using a comprehensive neuropsychological battery). Analyses were subsequently adjusted for clinical vascular risk (dyslipidemia, diabetes mellitus, smoking, cardiovascular, and cerebrovascular history) and genetic susceptibility to stroke (using polygenic risk scores generated according to the MEGASTROKE consortium GWAS findings). RESULTS A total of 776 predominantly female participants (73.61±4.94 years) with hypertension and a mean follow-up of 3.02±0.82 years were analyzed. Baseline treatment was not associated with the risk of incident dementia. ARB users experienced a slower yearly global cognitive [2.5% of a SD, 95% CI = (0.1, 4.9)] and language [4.4% of a SD, 95% CI = (1.4, 7.4)] decline compared to non-users. The fully adjusted model reproduced similar associations for both global cognitive [β= 0.027, 95% CI = (-0.003, 0.057)], and language decline [β= 0.063, 95% CI = (0.023, 0.104)]. CONCLUSION ARBs may be superior to other antihypertensive agents in the preservation of cognition, an association probably mediated by vascular-independent mechanisms.
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Affiliation(s)
- Ioannis Liampas
- Department of Neurology, University Hospital of Larissa, School of Medicine, University of Thessaly, Larissa, Greece
| | - Alex Hatzimanolis
- Department of Psychiatry, Aiginition Hospital, National and Kapodistrian University of Athens Medical School, Athens, Greece
| | - Vasileios Siokas
- Department of Neurology, University Hospital of Larissa, School of Medicine, University of Thessaly, Larissa, Greece
| | - Mary Yannakoulia
- Department of Nutrition and Dietetics, Harokopio University, Athens, Greece
| | - Mary H Kosmidis
- Lab of Cognitive Neuroscience, School of Psychology, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Paraskevi Sakka
- Athens Association of Alzheimer's Disease and Related Disorders, Marousi, Athens, Greece
| | - Georgios M Hadjigeorgiou
- Department of Neurology, University Hospital of Larissa, School of Medicine, University of Thessaly, Larissa, Greece.,Department of Neurology, Medical School, University of Cyprus, Nicosia, Cyprus
| | - Nikolaos Scarmeas
- 1st Department of Neurology, Aiginition Hospital, National and Kapodistrian University of Athens Medical School, Athens, Greece.,Taub Institute for Research in Alzheimer's Disease and the Aging Brain, The Gertrude H. Sergievsky Center, Department of Neurology, Columbia University, New York, NY, USA
| | - Efthimios Dardiotis
- Department of Neurology, University Hospital of Larissa, School of Medicine, University of Thessaly, Larissa, Greece
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36
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Georgakis MK, Ntanasi E, Ramirez A, Grenier-Boley B, Lambert JC, Sakka P, Yannakoulia M, Kosmidis MH, Dardiotis E, Hadjigeorgiou GM, Charissis S, Mourtzi N, Hatzimanolis A, Scarmeas N. Vascular burden and genetic risk in association with cognitive performance and dementia in a population-based study. CEREBRAL CIRCULATION - COGNITION AND BEHAVIOR 2022; 3:100145. [PMID: 36324400 PMCID: PMC9616333 DOI: 10.1016/j.cccb.2022.100145] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Revised: 02/19/2022] [Accepted: 04/28/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND AND PURPOSE Vascular risk factors may influence cognitive function and thus represent possible targets for preventive approaches against dementia. Yet it remains unknown, if they associate with cognition independently of the individual genetic risk for dementia. METHODS In a population-based study of 1172 community-dwelling individuals aged ≥65 years in Greece, we constructed a vascular burden score (VBS; based on presence of hypertension, diabetes, hyperlipidemia, heart disease, and cerebrovascular disease, range 0-5) and a polygenic risk score (PRS) for clinically-diagnosed Alzheimer's disease (AD) based on 23 genetic variants. We then explored in joint models the associations of the PRS for AD and VBS with global cognitive performance, cognitive performance across multiple cognitive domains, and odds of dementia. RESULTS The mean age of study participants was 73.9 ± 5.2 years (57.1% females). Both the PRS for AD and VBS were associated with worse global cognitive performance (beta per-SD-increment in PRS: -0.06, 95%CI: -0.10 to -0.02, beta per-point-increment in VBS: -0.05, 95%CI: -0.09 to -0.02), worse performance across individual cognitive domains (memory, executive function, attention, language, visuospatial ability), and higher odds of dementia (OR per-SD increment in PRS: 1.56, 95%CI: 1.17-2.09, OR per-point increment in VBS: 1.38, 95%CI: 1.05-1.81). There was no evidence of an interaction between the two scores. Higher VBS was associated with worse cognitive performance equally across tertiles of the PRS for AD, even among individuals at the highest tertile. CONCLUSIONS Both genetic risk and vascular burden are independently and additively associated with worse cognitive performance and higher odds of dementia.
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Affiliation(s)
- Marios K. Georgakis
- Institute for Stroke and Dementia Research (ISD), University Hospital, Ludwig-Maximilians-University LMU, Feodor-Lynen-Str. 17, Munich 81377, Germany
- Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, USA
- Programme in Medical and Population Genetics, Broad Institute of MIT and Harvard, Cambridge, MA, USA
| | - Eva Ntanasi
- 1st Department of Neurology, Eginition Hospital, National and Kapodistrian University of Athens Medical School, Athens, Greece
- Department of Nutrition and Dietetics, Harokopio University, Athens, Greece
| | - Alfredo Ramirez
- Department of Psychiatry, Medical Faculty, University of Cologne, Cologne, Germany
- Department of Neurodegenerative Diseases and Geriatric Psychiatry, University of Bonn, Bonn, Germany
| | - Benjamin Grenier-Boley
- U1167-RID-AGE Facteurs de Risque et Déterminants Moléculaires des Maladies Liés au Vieillissement, University of Lille, Inserm, CHU Lille, Institut Pasteur de Lille, Lille, France
| | - Jean-Charles Lambert
- U1167-RID-AGE Facteurs de Risque et Déterminants Moléculaires des Maladies Liés au Vieillissement, University of Lille, Inserm, CHU Lille, Institut Pasteur de Lille, Lille, France
| | - Paraskevi Sakka
- Athens Association of Alzheimer's Disease and Related Disorders, Marousi, Greece
| | - Mary Yannakoulia
- Department of Nutrition and Dietetics, Harokopio University, Athens, Greece
| | - Mary H. Kosmidis
- Lab of Cognitive Neuroscience, School of Psychology, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Efthimios Dardiotis
- Department of Neurology, Faculty of Medicine, School of Health Sciences, University Hospital of Larissa, University of Thessaly, Larissa, Greece
| | | | - Sokratis Charissis
- 1st Department of Neurology, Eginition Hospital, National and Kapodistrian University of Athens Medical School, Athens, Greece
| | - Niki Mourtzi
- 1st Department of Neurology, Eginition Hospital, National and Kapodistrian University of Athens Medical School, Athens, Greece
| | - Alexandros Hatzimanolis
- Department of Psychiatry, National and Kapodistrian University of Athens Medical School, Eginition Hospital, Athens, Greece
- Theodor-Theohari Cozzika Foundation, Neurobiology Research Institute, Athens, Greece
| | - Nikolaos Scarmeas
- 1st Department of Neurology, Eginition Hospital, National and Kapodistrian University of Athens Medical School, Athens, Greece
- Department of Neurology, The Gertrude H. Sergievsky Center, Taub Institute for Research in Alzheimer's Disease and the Aging Brain, Columbia University, New York, NY, USA
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Ntanasi E, Charisis S, Yannakoulia M, Georgiadi K, Balomenos V, Kosmidis M, Dardiotis Ε, Hadjigeorgiou G, Sakka P, Maraki M, Scarmeas N. Adherence to the Mediterranean diet and incident frailty: Results from a longitudinal study. Maturitas 2022; 162:44-51. [DOI: 10.1016/j.maturitas.2022.05.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Revised: 04/21/2022] [Accepted: 05/01/2022] [Indexed: 11/26/2022]
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Vasiliadis HM, Gournellis R, Efstathiou V, Stefanis N, Kosmidis MH, Yannakoulia M, Dardiotis E, Hadjigeorgiou G, Sakka P, Ntanasi E, Pachi I, Stefanis L, Scarmeas N. The factors associated with the presence of psychotic symptoms in the HELIAD Greek community study of older adults. Aging Ment Health 2022; 26:1044-1052. [PMID: 33467891 DOI: 10.1080/13607863.2021.1871882] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
BACKGROUND The prevalence and associated factors related to psychotic symptoms in older adults are understudied. The objectives were to assess the prevalence, incidence and factors associated with psychotic symptoms in a representative Greek sample of community living older adults. METHODS The sample includes n = 1,904 residents of the cities of Larissa and Maroussi in Greece participating in the Hellenic Longitudinal Investigation of Aging and Diet study with available data at baseline and n = 947 individuals at the 3-year follow-up. Past-month presence of delusions and hallucinations was assessed on the grounds of the 17 symptoms of the Columbia University Scale for Psychopathology in Alzheimer's Disease and 14 symptoms of the Neuropsychiatric Inventory Questionnaire. A comprehensive neuropsychological assessment for probable diagnosis of dementia and physical comorbidity was carried out by neurologists. Penalized logistic regression analyses were used to assess the socio-economic and clinical factors associated with psychotic symptoms. RESULTS Past-month prevalence of psychotic symptoms was 1.9% and 1.0% when excluding cases of dementia. The prevalence of any delusion and hallucination was 0.8% and 0.3% when excluding dementia. The incidence of psychotic symptoms without dementia was 1.3%. Recent widows and farmers/breeders/craftsmen, versus public servants/teachers/executives, had both six times the odds of experiencing psychotic symptoms without dementia. Hearing impairment and the number of health conditions also increased the odds while increased age was protective. CONCLUSION Psychotic symptoms unrelated to dementia constitute a considerable mental health problem in old age. Paranoid delusions were the most prevalent. Socio-economic and health status factors are significant predictors of psychotic symptoms.
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Affiliation(s)
- Helen-Maria Vasiliadis
- Faculty of Medicine and Health Sciences, University of Sherbrooke, Charles-Le Moyne - Saguenay-Lac-Saint-Jean, Longueuil, Canada
| | - Rossetos Gournellis
- Second Department of Psychiatry, School of Medicine, National and Kapodistrian University of Athens, University General Hospital Attikon, Athens, Greece
| | - Vasiliki Efstathiou
- Postgraduate Program: "Liaison Psychiatry: Integrative Care of Physical and Mental Health", National and Kapodistrian University of Athens, Athens, Greece
| | - Nikos Stefanis
- First Department of Psychiatry, School of Medicine, National and Kapodistrian University of Athens, University Mental Health Research Institute, Athens, Greece
| | - Mary H Kosmidis
- Laboratory of Cognitive Neuroscience, School of Psychology, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Mary Yannakoulia
- Department of Nutrition and Dietetics, Harokopio University, Athens, Greece
| | - Efthimios Dardiotis
- Department of Neurology, Faculty of Medicine, University of Thessaly, Larissa, Greece
| | | | - Paraskevi Sakka
- Athens Association of Alzheimer's Disease and Related Disorders, Athens, Greece
| | - Eva Ntanasi
- First Department of Neurology, Aiginition Hospital, National and Kapodistrian University of Athens Medical School, Athens, Greece
| | - Ioanna Pachi
- First Department of Neurology, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece.,2nd Neurology Clinic, Attikon Hospital, Athens University Medical School, Athens, Greece
| | - Leonidas Stefanis
- First Department of Neurology, School of Medicine, National and Kapodistrian University of Athens, Biomedical Research Foundation of the Academy of Athens, Athens, Greece
| | - Nikolaos Scarmeas
- Department of Social Medicine, Psychiatry and Neurology, National and Kapodistrian University of Athens, Athens, Greece.,Columbia University, New York, NY, USA
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Balomenos V, Bounou L, Charisis S, Stamelou M, Ntanasi E, Georgiadi K, Mourtzinos I, Tzima K, Anastasiou CA, Xiromerisiou G, Maraki M, Yannakoulia M, Kosmidis MH, Dardiotis E, Hadjigeorgiou G, Sakka P, Stefanis L, Scarmeas N. Dietary Inflammatory Index score and prodromal Parkinson's disease incidence: The HELIAD study. J Nutr Biochem 2022; 105:108994. [PMID: 35341916 DOI: 10.1016/j.jnutbio.2022.108994] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2021] [Revised: 12/21/2021] [Accepted: 02/22/2022] [Indexed: 11/30/2022]
Abstract
AIM The aim of the present study was to investigate the association of the inflammatory potential of diet with prodromal Parkinson's disease (pPD) probability and incidence among community-dwelling older individuals without clinical features of parkinsonism at baseline. METHODS The sample consisted of 1,030 participants 65 years old or older, drawn from a population-based cohort study of older adults in Greece (Hellenic Longitudinal Investigation of Aging and Diet - HELIAD). We calculated pPD probability, according to International Parkinson and Movement Disorder Society research criteria. Dietary Inflammatory Index (DII) was used to measure the dietary inflammatory potential, with higher index score reflecting a more pro-inflammatory diet. Associations of baseline DII with pPD probability cross-sectionally, and with possible/probable pPD incidence (pPD probability ≥30%) during the follow-up period, were examined via general linear models and generalized estimating equations, respectively. RESULTS Cross-sectionally, one unit increase of DII score[DII (min, max) = -5.83, 6.01]was associated with 4.9% increased pPD probability [β=0.049, 95%CI (0.025-0.090), p<0.001]. Prospectively, 62 participants developed pPD during 3.1±0.9 (mean±SD) years of follow-up. One unit increase in DII was associated with 20.3% increased risk for developing pPD [RR=1.203, 95%CI (1.070-1.351), p=0.002]. Participants in the highest tertile of DII score were 2.6 times more likely to develop pPD [β=2.594, 95%CI (1.332-5.050), p=0.005], compared to those in the lowest tertile. CONCLUSION More pro-inflammatory diet was related with higher pPD probability and pPD incidence (pPD probability ≥30%) in a community-dwelling older adult population. Further studies are needed to confirm these findings.
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Affiliation(s)
- Vassilis Balomenos
- School of Medicine, Democritus University of Thrace, Dragana, Alexandroupolis, GR-68100, Greece
| | - Lamprini Bounou
- 1st Department of Neurology, Aiginition Hospital, National and Kapodistrian University of Athens, Medical School, 72-74 Vasilissis Sofias Str., Athens, GR-115 28, Greece
| | - Socratis Charisis
- 1st Department of Neurology, Aiginition Hospital, National and Kapodistrian University of Athens, Medical School, 72-74 Vasilissis Sofias Str., Athens, GR-115 28, Greece; Department of Neurology, Health Science Center at San Antonio, University of Texas, 7703 Floyd Curl Drive, San Antonio, Texas, TX 78229, USA
| | - Maria Stamelou
- 1st Department of Neurology, Aiginition Hospital, National and Kapodistrian University of Athens, Medical School, 72-74 Vasilissis Sofias Str., Athens, GR-115 28, Greece; Parkinson's Disease and Movement Disorders Department, Hygeia Hospital, 4, Erythrou Stavrou Str. & Kifisias Av., Marousi, Athens, GR-151 23, Greece; Medical School, University of Cyprus, 93 Ayiou Nikolaou Str., Egkomi Nicosia, CY-2408, Cyprus
| | - Eva Ntanasi
- 1st Department of Neurology, Aiginition Hospital, National and Kapodistrian University of Athens, Medical School, 72-74 Vasilissis Sofias Str., Athens, GR-115 28, Greece
| | - Kyriaki Georgiadi
- School of Medicine, Democritus University of Thrace, Dragana, Alexandroupolis, GR-68100, Greece
| | - Ioannis Mourtzinos
- Department of Food Science and Technology, Faculty of Agriculture, Aristotle University of Thessaloniki, P.O. Box 256, Thessaloniki, GR-54124, Greece
| | - Katerina Tzima
- Department of Food Biosciences, Teagasc Food Research Centre, Ashtown, D15 DY05, Dublin, Ireland
| | - Costas A Anastasiou
- Department of Nutrition and Dietetics, Harokopio University, 70 Eleftheriou Venizelou Str., Kallithea, Athens, GR-176 76, Greece
| | - Georgia Xiromerisiou
- School of Medicine, University of Thessaly, 22 Papakiriazi Str., Larissa, GR-41222, Greece
| | - Maria Maraki
- Department of Nutrition and Dietetics, Harokopio University, 70 Eleftheriou Venizelou Str., Kallithea, Athens, GR-176 76, Greece; Section of Sport Medicine and Biology of Exercise, School of Physical Education and Sport Science, National and Kapodistrian University of Athens, 41 Ethnikis Antistasis Str., Dafni, Athens, GR-17237, Greece
| | - Mary Yannakoulia
- Department of Nutrition and Dietetics, Harokopio University, 70 Eleftheriou Venizelou Str., Kallithea, Athens, GR-176 76, Greece.
| | - Mary H Kosmidis
- Laboratory of Cognitive Neuroscience, School of Psychology, Aristotle University of Thessaloniki, University Campus, Thessaloniki, GR- 54124, Greece
| | - Efthimios Dardiotis
- School of Medicine, University of Thessaly, 22 Papakiriazi Str., Larissa, GR-41222, Greece
| | - Georgios Hadjigeorgiou
- Medical School, University of Cyprus, 93 Ayiou Nikolaou Str., Egkomi Nicosia, CY-2408, Cyprus
| | - Paraskevi Sakka
- Athens Association of Alzheimer's Disease and Related Disorders, 8 Zinonos Eleatou Str., Marousi, GR-151 23, Greece
| | - Leonidas Stefanis
- 1st Department of Neurology, Aiginition Hospital, National and Kapodistrian University of Athens, Medical School, 72-74 Vasilissis Sofias Str., Athens, GR-115 28, Greece; Center of Clinical, Experimental Surgery and Translational Research, Biomedical Research Foundation of the Academy of Athens, 4 Soranou Ephessiou Str., Athens, GR-115 27, Greece
| | - Nikolaos Scarmeas
- 1st Department of Neurology, Aiginition Hospital, National and Kapodistrian University of Athens, Medical School, 72-74 Vasilissis Sofias Str., Athens, GR-115 28, Greece; Taub Institute for Research in Alzheimer's Disease and the Aging Brain, The Gertrude H. Sergievsky Center, Department of Neurology, Columbia University, 630 West 168th Str., New York, NY 10032, USA
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Chakrabarti A, Geurts L, Hoyles L, Iozzo P, Kraneveld AD, La Fata G, Miani M, Patterson E, Pot B, Shortt C, Vauzour D. The microbiota-gut-brain axis: pathways to better brain health. Perspectives on what we know, what we need to investigate and how to put knowledge into practice. Cell Mol Life Sci 2022; 79:80. [PMID: 35044528 PMCID: PMC8770392 DOI: 10.1007/s00018-021-04060-w] [Citation(s) in RCA: 58] [Impact Index Per Article: 29.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Revised: 11/16/2021] [Accepted: 11/25/2021] [Indexed: 12/16/2022]
Abstract
The gut and brain link via various metabolic and signalling pathways, each with the potential to influence mental, brain and cognitive health. Over the past decade, the involvement of the gut microbiota in gut-brain communication has become the focus of increased scientific interest, establishing the microbiota-gut-brain axis as a field of research. There is a growing number of association studies exploring the gut microbiota's possible role in memory, learning, anxiety, stress, neurodevelopmental and neurodegenerative disorders. Consequently, attention is now turning to how the microbiota can become the target of nutritional and therapeutic strategies for improved brain health and well-being. However, while such strategies that target the gut microbiota to influence brain health and function are currently under development with varying levels of success, still very little is yet known about the triggers and mechanisms underlying the gut microbiota's apparent influence on cognitive or brain function and most evidence comes from pre-clinical studies rather than well controlled clinical trials/investigations. Filling the knowledge gaps requires establishing a standardised methodology for human studies, including strong guidance for specific focus areas of the microbiota-gut-brain axis, the need for more extensive biological sample analyses, and identification of relevant biomarkers. Other urgent requirements are new advanced models for in vitro and in vivo studies of relevant mechanisms, and a greater focus on omics technologies with supporting bioinformatics resources (training, tools) to efficiently translate study findings, as well as the identification of relevant targets in study populations. The key to building a validated evidence base rely on increasing knowledge sharing and multi-disciplinary collaborations, along with continued public-private funding support. This will allow microbiota-gut-brain axis research to move to its next phase so we can identify realistic opportunities to modulate the microbiota for better brain health.
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Affiliation(s)
| | - Lucie Geurts
- International Life Sciences Institute, European Branch, Brussels, Belgium.
| | - Lesley Hoyles
- Department of Biosciences, Nottingham Trent University, Nottingham, UK
| | - Patricia Iozzo
- Institute of Clinical Physiology, National Research Council (CNR), Pisa, Italy
| | - Aletta D Kraneveld
- Division of Pharmacology, Utrecht Institute for Pharmaceutical Sciences, Faculty of Science, Utrecht University, Utrecht, The Netherlands
| | | | - Michela Miani
- International Life Sciences Institute, European Branch, Brussels, Belgium
| | | | - Bruno Pot
- Yakult Europe BV, Almere, The Netherlands
| | | | - David Vauzour
- Norwich Medical School, Faculty of Medicine and Health Sciences, University of East Anglia, Norwich, UK
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Basta M, Belogianni C, Yannakoulia M, Zaganas I, Panagiotakis S, Simos P, Vgontzas AN. Poor Diet, Long Sleep, and Lack of Physical Activity Are Associated with Inflammation among Non-Demented Community-Dwelling Elderly. Healthcare (Basel) 2022; 10:healthcare10010143. [PMID: 35052306 PMCID: PMC8775386 DOI: 10.3390/healthcare10010143] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Revised: 01/06/2022] [Accepted: 01/11/2022] [Indexed: 02/06/2023] Open
Abstract
Inflammation in elderly is associated with physical and cognitive morbidity and mortality. We aimed to explore the association of modifiable lifestyle parameters with inflammation among non-demented, community-dwelling elderly. A sub-sample of 117 patients with mild cognitive impairment (MCI, n = 63) and cognitively non-impaired controls (CNI, n = 54) were recruited from a large, population-based cohort in Crete, Greece, of 3140 elders (>60 years old). All participants underwent assessment of medical history/physical examination, extensive neuropsychiatric/neuropsychological evaluation, diet, three-day 24-h actigraphy, subjective sleep, physical activity, and measurement of IL-6 and TNFα plasma levels. Associations between inflammatory markers and diet, objective sleep duration, subjective sleep quality, and lack of physical activity were assessed using multivariate models. Regression analyses in the total group revealed significant associations between TNF-α and low vegetable consumption (p = 0.003), and marginally with objective long nighttime sleep duration (p = 0.04). In addition, IL-6 was associated with low vegetable consumption (p = 0.001) and lack of physical activity (p = 0.001). Poor diet and lack of physical activity appear to be modifiable risk factors of inflammation, whereas long sleep appears to be a marker of increased inflammatory response in elderly. Our findings may have clinical implications given the association of inflammatory response with morbidity, including cognitive decline, and mortality in elderly.
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Affiliation(s)
- Maria Basta
- Department of Psychiatry, University Hospital of Heraklion, 71500 Heraklion, Greece; (C.B.); (P.S.); (A.N.V.)
- Sleep Research and Treatment Center, Department of Psychiatry, Penn State University, State College, PA 16802, USA
- Correspondence: ; Tel.: +30-2810392402; Fax: +30-2810392859
| | - Christina Belogianni
- Department of Psychiatry, University Hospital of Heraklion, 71500 Heraklion, Greece; (C.B.); (P.S.); (A.N.V.)
| | - Mary Yannakoulia
- Department of Nutrition and Dietetics, School of Health Science and Education, Harokopio University of Athens, 17671 Athens, Greece;
| | - Ioannis Zaganas
- Department of Neurology, University Hospital of Heraklion, 71500 Heraklion, Greece;
| | - Symeon Panagiotakis
- Department of Internal Medicine, University Hospital of Heraklion, 71500 Heraklion, Greece;
| | - Panagiotis Simos
- Department of Psychiatry, University Hospital of Heraklion, 71500 Heraklion, Greece; (C.B.); (P.S.); (A.N.V.)
| | - Alexandros N. Vgontzas
- Department of Psychiatry, University Hospital of Heraklion, 71500 Heraklion, Greece; (C.B.); (P.S.); (A.N.V.)
- Sleep Research and Treatment Center, Department of Psychiatry, Penn State University, State College, PA 16802, USA
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Maraki MI, Hatzimanolis A, Mourtzi N, Stefanis L, Yannakoulia M, Kosmidis MH, Dardiotis E, Hadjigeorgiou GM, Sakka P, Ramirez A, Grenier-Boley B, Lambert JC, Heilmann-Heimbach S, Stamelou M, Scarmeas N, Xiromerisiou G. Association of the Polygenic Risk Score With the Probability of Prodromal Parkinson's Disease in Older Adults. Front Mol Neurosci 2022; 14:739571. [PMID: 34992521 PMCID: PMC8724535 DOI: 10.3389/fnmol.2021.739571] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2021] [Accepted: 11/29/2021] [Indexed: 12/19/2022] Open
Abstract
Several studies have investigated the association of the Parkinson’s disease (PD) polygenic risk score (PRS) with several aspects of well-established PD. We sought to evaluate the association of PRS with the prodromal stage of PD. We calculated PRS in a longitudinal sample (n = 1120) of community dwelling individuals ≥ 65 years from the HELIAD (The Hellenic Longitudinal Investigation of Aging and Diet) study in order to evaluate the association of this score with the probability of prodromal PD or any of the established risk and prodromal markers in MDS research criteria, using regression multi-adjusted models. Increases in PRS estimated from GWAS summary statistics’ ninety top SNPS with p < 5 × 10–8 was associated with increased odds of having probable/possible prodromal PD (i.e., ≥ 30% probability, OR = 1.033, 95%CI: 1.009–1.057 p = 0.006). From the prodromal PD risk markers, significant association was found between PRS and global cognitive deficit exclusively (p = 0.003). To our knowledge, our study is the first population based study investigating the association between PRS scores and prodromal markers of Parkinson’s disease. Our results suggest a strong relationship between the accumulation of many common genetic variants, as measured by PRS, and cognitive deficits.
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Affiliation(s)
- Maria I Maraki
- Section of Sport Medicine and Biology of Exercise, School of Physical Education and Sport Science, National and Kapodistrian University of Athens, Athens, Greece.,Department of Nutrition and Dietetics, School of Health Sciences, Hellenic Mediterranean University, Crete, Greece
| | - Alexandros Hatzimanolis
- Department of Psychiatry, National and Kapodistrian University of Athens Medical School, Eginition Hospital, Athens, Greece.,Neurobiology Research Institute, Theodor-Theohari Cozzika Foundation, Athens, Greece
| | - Niki Mourtzi
- First Department of Neurology, Eginition Hospital, National and Kapodistrian University of Athens Medical School, Athens, Greece
| | - Leonidas Stefanis
- First Department of Neurology, Eginition Hospital, National and Kapodistrian University of Athens Medical School, Athens, Greece.,Center of Clinical, Experimental Surgery and Translational Research, Biomedical Research Foundation of the Academy of Athens, Athens, Greece
| | - Mary Yannakoulia
- Department of Nutrition and Dietetics, School of Health Sciences, Hellenic Mediterranean University, Crete, Greece
| | - Mary H Kosmidis
- Laboratory of Cognitive Neuroscience, School of Psychology, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | | | - Georgios M Hadjigeorgiou
- School of Medicine, University of Thessaly, Larissa, Greece.,Department of Neurology, Medical School, University of Cyprus, Nicosia, Cyprus
| | - Paraskevi Sakka
- Athens Association of Alzheimer's Disease and Related Disorders, Marousi, Greece
| | - Alfredo Ramirez
- Division of Neurogenetics and Molecular Psychiatry, Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany.,Department of Neurodegenerative Diseases and Geriatric Psychiatry, University Hospital Bonn, Bonn, Germany.,German Center for Neurodegenerative Diseases (DZNE Bonn), Bonn, Germany.,Department of Psychiatry and Glenn Biggs Institute for Alzheimer's and Neurodegenerative Diseases, San Antonio, TX, United States.,Department of Psychiatry and Glenn Biggs Institute for Alzheimer's and Neurodegenerative Diseases, San Antonio, TX, United States
| | - Benjamin Grenier-Boley
- INSERM, CHU Lille, Institut Pasteur de Lille, U1167-RID-AGE Facteurs de Risque et Determinants Moléculaires des Maladies Liées au Vieillissement, University of Lille, Lille, France
| | - Jean-Charles Lambert
- INSERM, CHU Lille, Institut Pasteur de Lille, U1167-RID-AGE Facteurs de Risque et Determinants Moléculaires des Maladies Liées au Vieillissement, University of Lille, Lille, France
| | - Stefanie Heilmann-Heimbach
- Institute of Human Genetics, School of Medicine and University Hospital Bonn, University of Bonn, Bonn, Germany
| | - Maria Stamelou
- First Department of Neurology, Eginition Hospital, National and Kapodistrian University of Athens Medical School, Athens, Greece.,Parkinson's Disease and Movement Disorders Department, HYGEIA Hospital, Athens, Greece
| | - Nikolaos Scarmeas
- First Department of Neurology, Eginition Hospital, National and Kapodistrian University of Athens Medical School, Athens, Greece.,Taub Institute for Research in Alzheimer's Disease and the Aging Brain, The Gertrude H. Sergievsky Center, Department of Neurology, Columbia University, New York, NY, United States
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Basta M, Vgontzas AN, Fernandez-Mendoza J, Antypa D, Li Y, Zaganas I, Panagiotakis S, Karagkouni E, Simos P. Basal Cortisol Levels Are Increased in Patients with Mild Cognitive Impairment: Role of Insomnia and Short Sleep Duration. J Alzheimers Dis 2022; 87:933-944. [PMID: 35404277 DOI: 10.3233/jad-215523] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
BACKGROUND Mild cognitive impairment (MCI) is frequent in elderly and a risk factor for dementia. Both insomnia and increased cortisol levels are risk factors for MCI. OBJECTIVE We examined cross-sectionally whether increased cortisol levels are associated with short sleep duration (SSD) and/or the insomnia short sleep duration (ISS) phenotype, in elderly with MCI. METHODS One hundred twenty-four participants with MCI and 84 cognitively non-impaired controls (CNI)≥60 years underwent medical history, physical examination, neuropsychiatric evaluation, neuropsychological testing, 3-day actigraphy, assessment of subjective insomnia symptoms, and a single morning plasma cortisol level. The short sleep phenotypes were defined by sleep efficiency below the median of the entire sample (i.e.,≤81%) with at least one insomnia symptom (ISS) or without (SSD). ANOVA models were used to compare the various sleep phenotypes to those who did not present either short sleep or insomnia symptoms [non-insomnia (NI)]. RESULTS MCI participants had higher cortisol levels compared to the CNI group (p = 0.009). MCI participants with insomnia (n = 44) or SSD (n = 38) had higher cortisol levels compared to the NI group (n = 42; p = 0.014 and p = 0.045, respectively). Furthermore, MCI participants with ISS phenotype but not those with insomnia with normal sleep duration had higher cortisol levels compared to NI (p = 0.011 and p = 0.4, respectively). Both linear trend analyses showed that cortisol reached the highest levels in the ISS phenotype. CONCLUSION The ISS and SSD phenotypes are associated with increased cortisol levels in elderly with MCI. Improving sleep quality and duration and decreasing cortisol levels may delay further cognitive decline.
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Affiliation(s)
- Maria Basta
- Department of Psychiatry, University Hospital of Heraklion, Heraklion, Crete, Greece
- Sleep Research and Treatment Center, Department of Psychiatry, Penn State University, Hershey, PA, USA
| | - Alexandros N Vgontzas
- Department of Psychiatry, University Hospital of Heraklion, Heraklion, Crete, Greece
- Sleep Research and Treatment Center, Department of Psychiatry, Penn State University, Hershey, PA, USA
| | - Julio Fernandez-Mendoza
- Sleep Research and Treatment Center, Department of Psychiatry, Penn State University, Hershey, PA, USA
| | - Despina Antypa
- Department of Psychiatry, University Hospital of Heraklion, Heraklion, Crete, Greece
| | - Yun Li
- Department of Sleep Medicine, Mental Health Center of Shantou University, Shantou, Guangdong, China
- Sleep Medicine Center, Shantou University Medical College, Shantou, Guangdong, China
| | - Ioannis Zaganas
- Department of Neurology, University Hospital of Heraklion, Heraklion, Crete, Greece
| | - Symeon Panagiotakis
- Department of Internal Medicine, University Hospital of Heraklion, Heraklion, Crete, Greece
| | - Efthalia Karagkouni
- Sleep Research and Treatment Center, Department of Psychiatry, Penn State University, Hershey, PA, USA
| | - Panagiotis Simos
- Department of Psychiatry, University Hospital of Heraklion, Heraklion, Crete, Greece
- Computational Biomedicine Laboratory, Institute of Computer Science, Foundation for Research and Technology-Hellas, Greece
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Tsapanou A, Mourtzi N, Charisis S, Hatzimanolis A, Ntanasi E, Kosmidis MH, Yannakoulia M, Hadjigeorgiou G, Dardiotis E, Sakka P, Stern Y, Scarmeas N. Sleep Polygenic Risk Score Is Associated with Cognitive Changes over Time. Genes (Basel) 2021; 13:63. [PMID: 35052403 PMCID: PMC8774850 DOI: 10.3390/genes13010063] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2021] [Revised: 12/21/2021] [Accepted: 12/22/2021] [Indexed: 11/16/2022] Open
Abstract
Sleep problems have been associated with cognition, both cross-sectionally and longitudinally. Specific genes have been also associated with both sleep regulation and cognition. In a large group of older non-demented adults, we aimed to (a) validate the association between Sleep Polygenic Risk Score (Sleep PRS) and self-reported sleep duration, and (b) examine the association between Sleep PRS and cognitive changes in a three-year follow-up. Participants were drawn from the Hellenic Longitudinal Investigation of Aging and Diet (HELIAD). A structured, in-person interview, consisting of a medical history report and physical examination, was conducted for each participant during each of the visits (baseline and first follow-up). In total, 1376 participants were included, having all demographic, genetic, and cognitive data, out of which, 688 had at least one follow-up visit. In addition, an extensive neuropsychological assessment examining five cognitive domains (memory, visuo-spatial ability, attention/speed of processing, executive function, and language) was administered. A PRS for sleep duration was created based on previously published, genome-wide association study meta-analysis results. In order to assess the relationship between the Sleep PRS and the rate of cognitive change, we used generalized estimating equations analyses. Age, sex, education, ApolipoproteinE-ε4 genotype status, and specific principal components were used as covariates. On a further analysis, sleep medication was used as a further covariate. Results validated the association between Sleep PRS and self-reported sleep duration (B = 1.173, E-6, p = 0.001). Further, in the longitudinal analyses, significant associations were indicated between increased Sleep PRS and decreased visuo-spatial ability trajectories, in both the unadjusted (B = -1305.220, p = 0.018) and the adjusted for the covariates model (B = -1273.59, p = 0.031). Similarly, after adding sleep medication as a covariate (B = -1372.46, p = 0.019), none of the associations between Sleep PRS and the remaining cognitive domains were significant. PRS indicating longer sleep duration was associated with differential rates of cognitive decline over time in a group of non-demented older adults. Common genetic variants may influence the association between sleep duration and healthy aging/cognitive health.
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Affiliation(s)
- Angeliki Tsapanou
- Columbia University Irving Medical Center, Cognitive Neuroscience Division, New York, NY 10032, USA;
| | - Niki Mourtzi
- 1st Neurology Clinic, Department of Social Medicine, Psychiatry and Neurology, Eginition Hospital, National and Kapodistrian University of Athens, 11528 Athens, Greece; (N.M.); (S.C.); (A.H.); (E.N.)
| | - Sokratis Charisis
- 1st Neurology Clinic, Department of Social Medicine, Psychiatry and Neurology, Eginition Hospital, National and Kapodistrian University of Athens, 11528 Athens, Greece; (N.M.); (S.C.); (A.H.); (E.N.)
| | - Alex Hatzimanolis
- 1st Neurology Clinic, Department of Social Medicine, Psychiatry and Neurology, Eginition Hospital, National and Kapodistrian University of Athens, 11528 Athens, Greece; (N.M.); (S.C.); (A.H.); (E.N.)
| | - Eva Ntanasi
- 1st Neurology Clinic, Department of Social Medicine, Psychiatry and Neurology, Eginition Hospital, National and Kapodistrian University of Athens, 11528 Athens, Greece; (N.M.); (S.C.); (A.H.); (E.N.)
| | - Mary H. Kosmidis
- Laboratory of Cognitive Neuroscience, School of Psychology, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece; (M.H.K.); (N.S.)
| | - Mary Yannakoulia
- Department of Nutrition and Dietetics, Harokopio University, 17671 Athens, Greece;
| | | | - Efthimios Dardiotis
- School of Medicine, University of Thessaly, 41334 Larissa, Greece; (G.H.); (E.D.)
| | | | - Yaakov Stern
- Columbia University Irving Medical Center, Cognitive Neuroscience Division, New York, NY 10032, USA;
| | - Nikolaos Scarmeas
- Laboratory of Cognitive Neuroscience, School of Psychology, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece; (M.H.K.); (N.S.)
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Charisis S, Ntanasi E, Yannakoulia M, Anastasiou CA, Kosmidis MH, Dardiotis E, Gargalionis AN, Patas K, Chatzipanagiotou S, Mourtzinos I, Tzima K, Hadjigeorgiou G, Sakka P, Kapogiannis D, Scarmeas N. Diet Inflammatory Index and Dementia Incidence: A Population-Based Study. Neurology 2021; 97:e2381-e2391. [PMID: 34759053 PMCID: PMC8673721 DOI: 10.1212/wnl.0000000000012973] [Citation(s) in RCA: 39] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2021] [Accepted: 09/29/2021] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Aging is characterized by a functional shift of the immune system toward a proinflammatory phenotype. This derangement has been associated with cognitive decline and has been implicated in the pathogenesis of dementia. Diet can modulate systemic inflammation; thus, it may be a valuable tool to counteract the associated risk for cognitive impairment and dementia. The present study aimed to explore the associations between the inflammatory potential of diet, assessed with an easily applicable, population-based, biomarker-validated diet inflammatory index (DII), and the risk for dementia in community-dwelling older adults. METHODS Individuals from the Hellenic Longitudinal Investigation of Aging and Diet (HELIAD) were included in the present cohort study. Participants were recruited through random population sampling and were followed up for a mean of 3.05 (standard deviation 0.85) years. Dementia diagnosis was based on standard clinical criteria. Those with baseline dementia or missing cognitive follow-up data were excluded from the analyses. The inflammatory potential of diet was assessed through a DII score that considers literature-derived associations of 45 food parameters with levels of proinflammatory and anti-inflammatory cytokines in the blood; higher values indicated a more proinflammatory diet. Consumption frequencies were derived from a detailed food frequency questionnaire and were standardized to representative dietary intake normative data from 11 different countries. Analysis of dementia incidence as a function of baseline DII scores was performed by Cox proportional hazards models. RESULTS Analyses included 1,059 individuals (mean age 73.1 years, 40.3% male, mean education 8.2 years), 62 of whom developed incident dementia. Each additional unit of DII score was associated with a 21% increase in the risk for dementia incidence (hazard ratio 1.21 [95% confidence interval 1.03-1.42]; p = 0.023). Compared to participants in the lowest DII score tertile, participants in the highest one (maximal proinflammatory diet potential) were 3 (95% confidence interval 1.2-7.3; p = 0.014) times more likely to develop incident dementia. The test for trend was also significant, indicating a potential dose-response relationship (p = 0.014). DISCUSSION In the present study, higher DII scores (indicating greater proinflammatory diet potential) were associated with an increased risk for incident dementia. These findings might avail the development of primary dementia preventive strategies through tailored and precise dietary interventions.
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Affiliation(s)
- Sokratis Charisis
- From the 1st Department of Neurology (S.C., E.N., N.S.) and Department of Medical Biopathology and Clinical Microbiology (A.N.G., K.P., S.C.), Aiginition Hospital, National and Kapodistrian University of Athens Medical School, Greece; Department of Neurology (S.C.), University of Texas Health Science Center at San Antonio; Department of Nutrition and Dietetics (E.N., M.Y., C.A.A.), Harokopio University, Athens; Lab of Cognitive Neuroscience (M.H.K.), School of Psychology, and Department of Food Science and Technology (I.M.), Faculty of Agriculture, Aristotle University of Thessaloniki; School of Medicine (E.D.), University of Thessaly, Larissa, Greece; Department of Food BioSciences (K.T.), Teagasc Food Research Centre Ashtown, Dublin, Ireland; Department of Neurology (G.H.), Medical School, University of Cyprus; Athens Association of Alzheimer's Disease and Related Disorders (P.S.), Greece; National Institute on Aging/NIH (D.K.), Baltimore, MD; and Taub Institute for Research in Alzheimer's Disease and the Aging Brain (N.S.), Gertrude H. Sergievsky Center, Department of Neurology, Columbia University, New York, NY
| | - Eva Ntanasi
- From the 1st Department of Neurology (S.C., E.N., N.S.) and Department of Medical Biopathology and Clinical Microbiology (A.N.G., K.P., S.C.), Aiginition Hospital, National and Kapodistrian University of Athens Medical School, Greece; Department of Neurology (S.C.), University of Texas Health Science Center at San Antonio; Department of Nutrition and Dietetics (E.N., M.Y., C.A.A.), Harokopio University, Athens; Lab of Cognitive Neuroscience (M.H.K.), School of Psychology, and Department of Food Science and Technology (I.M.), Faculty of Agriculture, Aristotle University of Thessaloniki; School of Medicine (E.D.), University of Thessaly, Larissa, Greece; Department of Food BioSciences (K.T.), Teagasc Food Research Centre Ashtown, Dublin, Ireland; Department of Neurology (G.H.), Medical School, University of Cyprus; Athens Association of Alzheimer's Disease and Related Disorders (P.S.), Greece; National Institute on Aging/NIH (D.K.), Baltimore, MD; and Taub Institute for Research in Alzheimer's Disease and the Aging Brain (N.S.), Gertrude H. Sergievsky Center, Department of Neurology, Columbia University, New York, NY
| | - Mary Yannakoulia
- From the 1st Department of Neurology (S.C., E.N., N.S.) and Department of Medical Biopathology and Clinical Microbiology (A.N.G., K.P., S.C.), Aiginition Hospital, National and Kapodistrian University of Athens Medical School, Greece; Department of Neurology (S.C.), University of Texas Health Science Center at San Antonio; Department of Nutrition and Dietetics (E.N., M.Y., C.A.A.), Harokopio University, Athens; Lab of Cognitive Neuroscience (M.H.K.), School of Psychology, and Department of Food Science and Technology (I.M.), Faculty of Agriculture, Aristotle University of Thessaloniki; School of Medicine (E.D.), University of Thessaly, Larissa, Greece; Department of Food BioSciences (K.T.), Teagasc Food Research Centre Ashtown, Dublin, Ireland; Department of Neurology (G.H.), Medical School, University of Cyprus; Athens Association of Alzheimer's Disease and Related Disorders (P.S.), Greece; National Institute on Aging/NIH (D.K.), Baltimore, MD; and Taub Institute for Research in Alzheimer's Disease and the Aging Brain (N.S.), Gertrude H. Sergievsky Center, Department of Neurology, Columbia University, New York, NY
| | - Costas A Anastasiou
- From the 1st Department of Neurology (S.C., E.N., N.S.) and Department of Medical Biopathology and Clinical Microbiology (A.N.G., K.P., S.C.), Aiginition Hospital, National and Kapodistrian University of Athens Medical School, Greece; Department of Neurology (S.C.), University of Texas Health Science Center at San Antonio; Department of Nutrition and Dietetics (E.N., M.Y., C.A.A.), Harokopio University, Athens; Lab of Cognitive Neuroscience (M.H.K.), School of Psychology, and Department of Food Science and Technology (I.M.), Faculty of Agriculture, Aristotle University of Thessaloniki; School of Medicine (E.D.), University of Thessaly, Larissa, Greece; Department of Food BioSciences (K.T.), Teagasc Food Research Centre Ashtown, Dublin, Ireland; Department of Neurology (G.H.), Medical School, University of Cyprus; Athens Association of Alzheimer's Disease and Related Disorders (P.S.), Greece; National Institute on Aging/NIH (D.K.), Baltimore, MD; and Taub Institute for Research in Alzheimer's Disease and the Aging Brain (N.S.), Gertrude H. Sergievsky Center, Department of Neurology, Columbia University, New York, NY
| | - Mary H Kosmidis
- From the 1st Department of Neurology (S.C., E.N., N.S.) and Department of Medical Biopathology and Clinical Microbiology (A.N.G., K.P., S.C.), Aiginition Hospital, National and Kapodistrian University of Athens Medical School, Greece; Department of Neurology (S.C.), University of Texas Health Science Center at San Antonio; Department of Nutrition and Dietetics (E.N., M.Y., C.A.A.), Harokopio University, Athens; Lab of Cognitive Neuroscience (M.H.K.), School of Psychology, and Department of Food Science and Technology (I.M.), Faculty of Agriculture, Aristotle University of Thessaloniki; School of Medicine (E.D.), University of Thessaly, Larissa, Greece; Department of Food BioSciences (K.T.), Teagasc Food Research Centre Ashtown, Dublin, Ireland; Department of Neurology (G.H.), Medical School, University of Cyprus; Athens Association of Alzheimer's Disease and Related Disorders (P.S.), Greece; National Institute on Aging/NIH (D.K.), Baltimore, MD; and Taub Institute for Research in Alzheimer's Disease and the Aging Brain (N.S.), Gertrude H. Sergievsky Center, Department of Neurology, Columbia University, New York, NY
| | - Efthimios Dardiotis
- From the 1st Department of Neurology (S.C., E.N., N.S.) and Department of Medical Biopathology and Clinical Microbiology (A.N.G., K.P., S.C.), Aiginition Hospital, National and Kapodistrian University of Athens Medical School, Greece; Department of Neurology (S.C.), University of Texas Health Science Center at San Antonio; Department of Nutrition and Dietetics (E.N., M.Y., C.A.A.), Harokopio University, Athens; Lab of Cognitive Neuroscience (M.H.K.), School of Psychology, and Department of Food Science and Technology (I.M.), Faculty of Agriculture, Aristotle University of Thessaloniki; School of Medicine (E.D.), University of Thessaly, Larissa, Greece; Department of Food BioSciences (K.T.), Teagasc Food Research Centre Ashtown, Dublin, Ireland; Department of Neurology (G.H.), Medical School, University of Cyprus; Athens Association of Alzheimer's Disease and Related Disorders (P.S.), Greece; National Institute on Aging/NIH (D.K.), Baltimore, MD; and Taub Institute for Research in Alzheimer's Disease and the Aging Brain (N.S.), Gertrude H. Sergievsky Center, Department of Neurology, Columbia University, New York, NY
| | - Antonios N Gargalionis
- From the 1st Department of Neurology (S.C., E.N., N.S.) and Department of Medical Biopathology and Clinical Microbiology (A.N.G., K.P., S.C.), Aiginition Hospital, National and Kapodistrian University of Athens Medical School, Greece; Department of Neurology (S.C.), University of Texas Health Science Center at San Antonio; Department of Nutrition and Dietetics (E.N., M.Y., C.A.A.), Harokopio University, Athens; Lab of Cognitive Neuroscience (M.H.K.), School of Psychology, and Department of Food Science and Technology (I.M.), Faculty of Agriculture, Aristotle University of Thessaloniki; School of Medicine (E.D.), University of Thessaly, Larissa, Greece; Department of Food BioSciences (K.T.), Teagasc Food Research Centre Ashtown, Dublin, Ireland; Department of Neurology (G.H.), Medical School, University of Cyprus; Athens Association of Alzheimer's Disease and Related Disorders (P.S.), Greece; National Institute on Aging/NIH (D.K.), Baltimore, MD; and Taub Institute for Research in Alzheimer's Disease and the Aging Brain (N.S.), Gertrude H. Sergievsky Center, Department of Neurology, Columbia University, New York, NY
| | - Kostas Patas
- From the 1st Department of Neurology (S.C., E.N., N.S.) and Department of Medical Biopathology and Clinical Microbiology (A.N.G., K.P., S.C.), Aiginition Hospital, National and Kapodistrian University of Athens Medical School, Greece; Department of Neurology (S.C.), University of Texas Health Science Center at San Antonio; Department of Nutrition and Dietetics (E.N., M.Y., C.A.A.), Harokopio University, Athens; Lab of Cognitive Neuroscience (M.H.K.), School of Psychology, and Department of Food Science and Technology (I.M.), Faculty of Agriculture, Aristotle University of Thessaloniki; School of Medicine (E.D.), University of Thessaly, Larissa, Greece; Department of Food BioSciences (K.T.), Teagasc Food Research Centre Ashtown, Dublin, Ireland; Department of Neurology (G.H.), Medical School, University of Cyprus; Athens Association of Alzheimer's Disease and Related Disorders (P.S.), Greece; National Institute on Aging/NIH (D.K.), Baltimore, MD; and Taub Institute for Research in Alzheimer's Disease and the Aging Brain (N.S.), Gertrude H. Sergievsky Center, Department of Neurology, Columbia University, New York, NY
| | - Stylianos Chatzipanagiotou
- From the 1st Department of Neurology (S.C., E.N., N.S.) and Department of Medical Biopathology and Clinical Microbiology (A.N.G., K.P., S.C.), Aiginition Hospital, National and Kapodistrian University of Athens Medical School, Greece; Department of Neurology (S.C.), University of Texas Health Science Center at San Antonio; Department of Nutrition and Dietetics (E.N., M.Y., C.A.A.), Harokopio University, Athens; Lab of Cognitive Neuroscience (M.H.K.), School of Psychology, and Department of Food Science and Technology (I.M.), Faculty of Agriculture, Aristotle University of Thessaloniki; School of Medicine (E.D.), University of Thessaly, Larissa, Greece; Department of Food BioSciences (K.T.), Teagasc Food Research Centre Ashtown, Dublin, Ireland; Department of Neurology (G.H.), Medical School, University of Cyprus; Athens Association of Alzheimer's Disease and Related Disorders (P.S.), Greece; National Institute on Aging/NIH (D.K.), Baltimore, MD; and Taub Institute for Research in Alzheimer's Disease and the Aging Brain (N.S.), Gertrude H. Sergievsky Center, Department of Neurology, Columbia University, New York, NY
| | - Ioannis Mourtzinos
- From the 1st Department of Neurology (S.C., E.N., N.S.) and Department of Medical Biopathology and Clinical Microbiology (A.N.G., K.P., S.C.), Aiginition Hospital, National and Kapodistrian University of Athens Medical School, Greece; Department of Neurology (S.C.), University of Texas Health Science Center at San Antonio; Department of Nutrition and Dietetics (E.N., M.Y., C.A.A.), Harokopio University, Athens; Lab of Cognitive Neuroscience (M.H.K.), School of Psychology, and Department of Food Science and Technology (I.M.), Faculty of Agriculture, Aristotle University of Thessaloniki; School of Medicine (E.D.), University of Thessaly, Larissa, Greece; Department of Food BioSciences (K.T.), Teagasc Food Research Centre Ashtown, Dublin, Ireland; Department of Neurology (G.H.), Medical School, University of Cyprus; Athens Association of Alzheimer's Disease and Related Disorders (P.S.), Greece; National Institute on Aging/NIH (D.K.), Baltimore, MD; and Taub Institute for Research in Alzheimer's Disease and the Aging Brain (N.S.), Gertrude H. Sergievsky Center, Department of Neurology, Columbia University, New York, NY
| | - Katerina Tzima
- From the 1st Department of Neurology (S.C., E.N., N.S.) and Department of Medical Biopathology and Clinical Microbiology (A.N.G., K.P., S.C.), Aiginition Hospital, National and Kapodistrian University of Athens Medical School, Greece; Department of Neurology (S.C.), University of Texas Health Science Center at San Antonio; Department of Nutrition and Dietetics (E.N., M.Y., C.A.A.), Harokopio University, Athens; Lab of Cognitive Neuroscience (M.H.K.), School of Psychology, and Department of Food Science and Technology (I.M.), Faculty of Agriculture, Aristotle University of Thessaloniki; School of Medicine (E.D.), University of Thessaly, Larissa, Greece; Department of Food BioSciences (K.T.), Teagasc Food Research Centre Ashtown, Dublin, Ireland; Department of Neurology (G.H.), Medical School, University of Cyprus; Athens Association of Alzheimer's Disease and Related Disorders (P.S.), Greece; National Institute on Aging/NIH (D.K.), Baltimore, MD; and Taub Institute for Research in Alzheimer's Disease and the Aging Brain (N.S.), Gertrude H. Sergievsky Center, Department of Neurology, Columbia University, New York, NY
| | - Georgios Hadjigeorgiou
- From the 1st Department of Neurology (S.C., E.N., N.S.) and Department of Medical Biopathology and Clinical Microbiology (A.N.G., K.P., S.C.), Aiginition Hospital, National and Kapodistrian University of Athens Medical School, Greece; Department of Neurology (S.C.), University of Texas Health Science Center at San Antonio; Department of Nutrition and Dietetics (E.N., M.Y., C.A.A.), Harokopio University, Athens; Lab of Cognitive Neuroscience (M.H.K.), School of Psychology, and Department of Food Science and Technology (I.M.), Faculty of Agriculture, Aristotle University of Thessaloniki; School of Medicine (E.D.), University of Thessaly, Larissa, Greece; Department of Food BioSciences (K.T.), Teagasc Food Research Centre Ashtown, Dublin, Ireland; Department of Neurology (G.H.), Medical School, University of Cyprus; Athens Association of Alzheimer's Disease and Related Disorders (P.S.), Greece; National Institute on Aging/NIH (D.K.), Baltimore, MD; and Taub Institute for Research in Alzheimer's Disease and the Aging Brain (N.S.), Gertrude H. Sergievsky Center, Department of Neurology, Columbia University, New York, NY
| | - Paraskevi Sakka
- From the 1st Department of Neurology (S.C., E.N., N.S.) and Department of Medical Biopathology and Clinical Microbiology (A.N.G., K.P., S.C.), Aiginition Hospital, National and Kapodistrian University of Athens Medical School, Greece; Department of Neurology (S.C.), University of Texas Health Science Center at San Antonio; Department of Nutrition and Dietetics (E.N., M.Y., C.A.A.), Harokopio University, Athens; Lab of Cognitive Neuroscience (M.H.K.), School of Psychology, and Department of Food Science and Technology (I.M.), Faculty of Agriculture, Aristotle University of Thessaloniki; School of Medicine (E.D.), University of Thessaly, Larissa, Greece; Department of Food BioSciences (K.T.), Teagasc Food Research Centre Ashtown, Dublin, Ireland; Department of Neurology (G.H.), Medical School, University of Cyprus; Athens Association of Alzheimer's Disease and Related Disorders (P.S.), Greece; National Institute on Aging/NIH (D.K.), Baltimore, MD; and Taub Institute for Research in Alzheimer's Disease and the Aging Brain (N.S.), Gertrude H. Sergievsky Center, Department of Neurology, Columbia University, New York, NY
| | - Dimitrios Kapogiannis
- From the 1st Department of Neurology (S.C., E.N., N.S.) and Department of Medical Biopathology and Clinical Microbiology (A.N.G., K.P., S.C.), Aiginition Hospital, National and Kapodistrian University of Athens Medical School, Greece; Department of Neurology (S.C.), University of Texas Health Science Center at San Antonio; Department of Nutrition and Dietetics (E.N., M.Y., C.A.A.), Harokopio University, Athens; Lab of Cognitive Neuroscience (M.H.K.), School of Psychology, and Department of Food Science and Technology (I.M.), Faculty of Agriculture, Aristotle University of Thessaloniki; School of Medicine (E.D.), University of Thessaly, Larissa, Greece; Department of Food BioSciences (K.T.), Teagasc Food Research Centre Ashtown, Dublin, Ireland; Department of Neurology (G.H.), Medical School, University of Cyprus; Athens Association of Alzheimer's Disease and Related Disorders (P.S.), Greece; National Institute on Aging/NIH (D.K.), Baltimore, MD; and Taub Institute for Research in Alzheimer's Disease and the Aging Brain (N.S.), Gertrude H. Sergievsky Center, Department of Neurology, Columbia University, New York, NY
| | - Nikolaos Scarmeas
- From the 1st Department of Neurology (S.C., E.N., N.S.) and Department of Medical Biopathology and Clinical Microbiology (A.N.G., K.P., S.C.), Aiginition Hospital, National and Kapodistrian University of Athens Medical School, Greece; Department of Neurology (S.C.), University of Texas Health Science Center at San Antonio; Department of Nutrition and Dietetics (E.N., M.Y., C.A.A.), Harokopio University, Athens; Lab of Cognitive Neuroscience (M.H.K.), School of Psychology, and Department of Food Science and Technology (I.M.), Faculty of Agriculture, Aristotle University of Thessaloniki; School of Medicine (E.D.), University of Thessaly, Larissa, Greece; Department of Food BioSciences (K.T.), Teagasc Food Research Centre Ashtown, Dublin, Ireland; Department of Neurology (G.H.), Medical School, University of Cyprus; Athens Association of Alzheimer's Disease and Related Disorders (P.S.), Greece; National Institute on Aging/NIH (D.K.), Baltimore, MD; and Taub Institute for Research in Alzheimer's Disease and the Aging Brain (N.S.), Gertrude H. Sergievsky Center, Department of Neurology, Columbia University, New York, NY.
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Charisis S, Ntanasi E, Stamelou M, Xiromerisiou G, Maraki M, Veskoukis AS, Yannakoulia M, Kosmidis MH, Anastasiou CA, Giagkou N, Dardiotis E, Hadjigeorgiou G, Sakka P, Kouretas D, Stefanis L, Scarmeas N. Plasma Glutathione and Prodromal Parkinson's Disease Probability. Mov Disord 2021; 37:200-205. [PMID: 34695238 DOI: 10.1002/mds.28826] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2021] [Revised: 09/08/2021] [Accepted: 09/30/2021] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND A decrease in glutathione (GSH) levels is considered one of the earliest biochemical changes in Parkinson's disease (PD). OBJECTIVE The authors explored the potential role of plasma GSH as a risk/susceptibility biomarker for prodromal PD (pPD) by examining its longitudinal associations with pPD probability trajectories. METHODS A total of 405 community-dwelling participants (median age [interquartile range] = 73.2 [7.41] years) without clinical features of parkinsonism were followed for a mean (standard deviation) of 3.0 (0.9) years. RESULTS A 1 μmol/L increase in plasma GSH was associated with 0.4% (95% confidence interval [CI], 0.1%-0.7%; P = 0.017) less increase in pPD probability for 1 year of follow-up. Compared with participants in the lowest GSH tertile, participants in the highest GSH tertile had a 12.9% (95% CI, 22.4%-2.2%; P = 0.020) slower rate of increase of pPD probability for 1 year of follow-up. CONCLUSION Plasma GSH was associated with pPD probability trajectories; therefore, it might assist in the identification of individuals who are likely to reach the threshold for pPD diagnosis more rapidly. © 2021 International Parkinson and Movement Disorder Society.
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Affiliation(s)
- Sokratis Charisis
- 1st Department of Neurology, Aiginition Hospital, National and Kapodistrian University of Athens Medical School, Athens, Greece.,Department of Neurology, University of Texas Health Science Center at San Antonio, San Antonio, Texas, USA
| | - Eva Ntanasi
- 1st Department of Neurology, Aiginition Hospital, National and Kapodistrian University of Athens Medical School, Athens, Greece.,Department of Nutrition and Dietetics, Harokopio University, Athens, Greece
| | - Maria Stamelou
- Parkinson's Disease and Movement Disorders Department, HYGEIA Hospital, Athens, Greece.,Department of Neurology, Philipps University, Marburg, Germany
| | | | - Maria Maraki
- Section of Sport Medicine and Biology of Exercise, School of Physical Education and Sport Science, National and Kapodistrian University of Athens, Athens, Greece.,Department of Nutrition and Dietetics, School of Health Sciences, Hellenic Mediterranean University, Crete, Greece
| | | | - Mary Yannakoulia
- Department of Nutrition and Dietetics, Harokopio University, Athens, Greece
| | - Mary H Kosmidis
- Laboratory of Cognitive Neuroscience, School of Psychology, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | | | - Nikolaos Giagkou
- 1st Department of Neurology, Aiginition Hospital, National and Kapodistrian University of Athens Medical School, Athens, Greece.,Parkinson's Disease and Movement Disorders Department, HYGEIA Hospital, Athens, Greece
| | | | | | - Paraskevi Sakka
- Athens Association of Alzheimer's Disease and Related Disorders, Athens, Greece
| | - Demetrios Kouretas
- Department of Biochemistry-Biotechnology, University of Thessaly, Larisa, Greece
| | - Leonidas Stefanis
- 1st Department of Neurology, Aiginition Hospital, National and Kapodistrian University of Athens Medical School, Athens, Greece.,Center of Clinical, Experimental Surgery and Translational Research, Biomedical Research Foundation of the Academy of Athens, Athens, Greece
| | - Nikolaos Scarmeas
- 1st Department of Neurology, Aiginition Hospital, National and Kapodistrian University of Athens Medical School, Athens, Greece.,Taub Institute for Research in Alzheimer's Disease and the Aging Brain, the Gertrude H. Sergievsky Center, Department of Neurology, Columbia University, New York, New York, USA
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Vlachos GS, Kosmidis MH, Yannakoulia M, Dardiotis E, Hadjigeorgiou G, Tzoulaki I, Georgiou AN, Sakka P, Anastasiou CA, Stefanis L, Scarmeas N. Incidence of mild cognitive impairment in the elderly population in Greece: results from the HELIAD study. Aging Clin Exp Res 2021; 33:2679-2688. [PMID: 33686543 DOI: 10.1007/s40520-021-01819-w] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Accepted: 02/17/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND There are no published data on Mild Cognitive Impairment (MCI) incidence in people over 65 years of age in Greece, relevant literature is scarce for Southern Europe, and reported rates worldwide show great variability. AIMS To investigate the incidence and risk factors of MCI and its subtypes in the elderly population in Greece. METHODS The incidence cohort of the HELIAD study (Hellenic Epidemiological Longitudinal Investigation of Aging and Diet) comprised 955 individuals who received full neurological and neuropsychological evaluation on two separate occasions about three years apart. RESULTS The MCI incidence rate in our cohort is 54.07 new cases per 1000 person-years, standardized by age and sex to 59.99. Each additional year of age over 65 raises the probability of novel MCI by 6.2%, while lower educational attainment more than doubles the risk for incident MCI. Apolipoprotein E-ε4 (APOE-ε4) carriage results in increased risk for MCI by more than 1.7 times. Incidence rates for amnestic MCI are slightly higher than for the non-amnestic subtype, and AD is the most common potential underlying etiology. DISCUSSION The MCI incidence rate in the Greek population over 65 years of age is 54/1000 person-years. Advanced age and APOE-ε4 carriage are predisposing factors, while higher educational attainment was found to exert a protective effect. CONCLUSIONS MCI incidence in people over 65 years-old in Greece is consistent with reported rates around the world. Larger studies encompassing neuroimaging and cerebrospinal fluid biomarkers will hopefully shed more light on MCI epidemiology in Greece in the future.
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Affiliation(s)
- George S Vlachos
- 1st Department of Neurology, Aeginition University Hospital, National and Kapodistrian University of Athens Medical School, 72 Vassilissis Sophias Avenue, 11528, Athens, Greece.
| | - Mary H Kosmidis
- Lab of Cognitive Neuroscience, School of Psychology, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Mary Yannakoulia
- Department of Nutrition and Dietetics, Harokopio University, Athens, Greece
| | | | - Georgios Hadjigeorgiou
- School of Medicine, University of Thessaly, Larissa, Greece
- Department of Neurology, Medical School, University of Cyprus, Nicosia, Cyprus
| | - Ioanna Tzoulaki
- Department of Hygiene and Epidemiology, University of Ioannina School of Medicine, Ioannina, Greece
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
| | - Andrea N Georgiou
- Department of Hygiene and Epidemiology, University of Ioannina School of Medicine, Ioannina, Greece
| | - Paraskevi Sakka
- Athens Association of Alzheimer's Disease and Related Disorders, Maroussi, Greece
| | | | - Leonidas Stefanis
- 1st Department of Neurology, Aeginition University Hospital, National and Kapodistrian University of Athens Medical School, 72 Vassilissis Sophias Avenue, 11528, Athens, Greece
- Center of Clinical, Experimental Surgery and Translational Research, Biomedical Research Foundation of the Academy of Athens, Athens, Greece
| | - Nikolaos Scarmeas
- 1st Department of Neurology, Aeginition University Hospital, National and Kapodistrian University of Athens Medical School, 72 Vassilissis Sophias Avenue, 11528, Athens, Greece
- The Gertrude H. Sergievsky Center, Department of Neurology, Taub Institute for Research in Alzheimer's Disease and the Aging Brain, Columbia University, New York, USA
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48
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Tsolaki M, Tsatali M, Gkioka M, Poptsi E, Tsolaki A, Papaliagkas V, Tabakis IM, Lazarou I, Makri M, Kazis D, Papagiannopoulos S, Kiryttopoulos A, Koutsouraki E, Tegos T. Memory Clinics and Day Care Centers in Thessaloniki, Northern Greece: 30 Years of Clinical Practice and Experience. Front Neurol 2021; 12:683131. [PMID: 34512506 PMCID: PMC8425245 DOI: 10.3389/fneur.2021.683131] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2021] [Accepted: 06/25/2021] [Indexed: 11/17/2022] Open
Abstract
Background: This review describes the diagnostic and interventional procedures conducted in two university memory clinics (established network of G. Papanikolaou Hospital: 1988–2017 and AHEPA hospital: 2017–today) and 2 day care centers (established network of DCCs: 2005–today) in North Greece and their contribution in the scientific field of dementia. The aims of this work are (1) to provide a diagnosis and treatment protocol established in the network of memory clinics and DCCs and (2) to present further research conducted in the aforementioned network during the last 30 years of clinical practice. Methods: The guidelines to set a protocol demand a series of actions as follows: (1) set the diagnosis criteria, neuropsychological assessment, laboratory examinations, and examination of neurophysiological, neuroimaging, cerebrospinal fluid, blood, and genetic markers; and (2) apply non-pharmacological interventions according to the needs and specialized psychosocial interventions of the patient to the caregivers of the patient. Results: In addition to the guidelines followed in memory clinics at the 1st and 3rd Department of Neurology and two DCCs, a database of patients, educational programs, and further participation in international research programs, including clinical trials, make our contribution in the dementia field strong. Conclusion: In the current paper, we provide useful guidelines on how major and minor neurocognitive disorders are being treated in Thessaloniki, Greece, describing successful practices which have been adapted in the last 30 years.
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Affiliation(s)
- Magda Tsolaki
- Greek Association of Alzheimer's Disease and Related Disorders (GAADRD), Thessaloniki, Greece.,1st University Department of Neurology UH "AHEPA", School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece.,Laboratory of Neurodegenerative Diseases, Center for Interdisciplinary Research and Innovation (CIRI - AUTh) Balkan Center, Buildings A & B, Aristotle University of Thessaloniki, Thessaloniki, Greece.,3rd University Department of Neurology "G. Papanikolaou" Hospital, Faculty of Health Sciences, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Marianna Tsatali
- Greek Association of Alzheimer's Disease and Related Disorders (GAADRD), Thessaloniki, Greece
| | - Mara Gkioka
- Greek Association of Alzheimer's Disease and Related Disorders (GAADRD), Thessaloniki, Greece.,1st University Department of Neurology UH "AHEPA", School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Eleni Poptsi
- Greek Association of Alzheimer's Disease and Related Disorders (GAADRD), Thessaloniki, Greece
| | - Anthoula Tsolaki
- Greek Association of Alzheimer's Disease and Related Disorders (GAADRD), Thessaloniki, Greece.,1st University Department of Neurology UH "AHEPA", School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Vasileios Papaliagkas
- Greek Association of Alzheimer's Disease and Related Disorders (GAADRD), Thessaloniki, Greece.,Department of Biomedical Sciences International Hellenic University, Thessaloniki, Greece
| | - Irene-Maria Tabakis
- Greek Association of Alzheimer's Disease and Related Disorders (GAADRD), Thessaloniki, Greece
| | - Ioulietta Lazarou
- 1st University Department of Neurology UH "AHEPA", School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Marina Makri
- Greek Association of Alzheimer's Disease and Related Disorders (GAADRD), Thessaloniki, Greece.,1st University Department of Neurology UH "AHEPA", School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Dimitrios Kazis
- 3rd University Department of Neurology "G. Papanikolaou" Hospital, Faculty of Health Sciences, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Sotirios Papagiannopoulos
- 3rd University Department of Neurology "G. Papanikolaou" Hospital, Faculty of Health Sciences, School of Medicine, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Andreas Kiryttopoulos
- 1st University Department of Neurology UH "AHEPA", School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Efrosyni Koutsouraki
- 1st University Department of Neurology UH "AHEPA", School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Thomas Tegos
- 1st University Department of Neurology UH "AHEPA", School of Medicine, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece
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49
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Jin H, Chien S, Meijer E, Khobragade P, Lee J. Learning From Clinical Consensus Diagnosis in India to Facilitate Automatic Classification of Dementia: Machine Learning Study. JMIR Ment Health 2021; 8:e27113. [PMID: 33970122 PMCID: PMC8145077 DOI: 10.2196/27113] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Revised: 03/11/2021] [Accepted: 04/17/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND The Harmonized Diagnostic Assessment of Dementia for the Longitudinal Aging Study in India (LASI-DAD) is the first and only nationally representative study on late-life cognition and dementia in India (n=4096). LASI-DAD obtained clinical consensus diagnosis of dementia for a subsample of 2528 respondents. OBJECTIVE This study develops a machine learning model that uses data from the clinical consensus diagnosis in LASI-DAD to support the classification of dementia status. METHODS Clinicians were presented with the extensive data collected from LASI-DAD, including sociodemographic information and health history of respondents, results from the screening tests of cognitive status, and information obtained from informant interviews. Based on the Clinical Dementia Rating (CDR) and using an online platform, clinicians individually evaluated each case and then reached a consensus diagnosis. A 2-step procedure was implemented to train several candidate machine learning models, which were evaluated using a separate test set for predictive accuracy measurement, including the area under receiver operating curve (AUROC), accuracy, sensitivity, specificity, precision, F1 score, and kappa statistic. The ultimate model was selected based on overall agreement as measured by kappa. We further examined the overall accuracy and agreement with the final consensus diagnoses between the selected machine learning model and individual clinicians who participated in the clinical consensus diagnostic process. Finally, we applied the selected model to a subgroup of LASI-DAD participants for whom the clinical consensus diagnosis was not obtained to predict their dementia status. RESULTS Among the 2528 individuals who received clinical consensus diagnosis, 192 (6.7% after adjusting for sampling weight) were diagnosed with dementia. All candidate machine learning models achieved outstanding discriminative ability, as indicated by AUROC >.90, and had similar accuracy and specificity (both around 0.95). The support vector machine model outperformed other models with the highest sensitivity (0.81), F1 score (0.72), and kappa (.70, indicating substantial agreement) and the second highest precision (0.65). As a result, the support vector machine was selected as the ultimate model. Further examination revealed that overall accuracy and agreement were similar between the selected model and individual clinicians. Application of the prediction model on 1568 individuals without clinical consensus diagnosis classified 127 individuals as living with dementia. After applying sampling weight, we can estimate the prevalence of dementia in the population as 7.4%. CONCLUSIONS The selected machine learning model has outstanding discriminative ability and substantial agreement with a clinical consensus diagnosis of dementia. The model can serve as a computer model of the clinical knowledge and experience encoded in the clinical consensus diagnostic process and has many potential applications, including predicting missed dementia diagnoses and serving as a clinical decision support tool or virtual rater to assist diagnosis of dementia.
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Affiliation(s)
- Haomiao Jin
- Center for Economic and Social Research, University of Southern California, Los Angeles, CA, United States
| | - Sandy Chien
- Center for Economic and Social Research, University of Southern California, Los Angeles, CA, United States
| | - Erik Meijer
- Center for Economic and Social Research, University of Southern California, Los Angeles, CA, United States
- RAND Corporation, Santa Monica, CA, United States
| | - Pranali Khobragade
- Center for Economic and Social Research, University of Southern California, Los Angeles, CA, United States
| | - Jinkook Lee
- Center for Economic and Social Research, University of Southern California, Los Angeles, CA, United States
- RAND Corporation, Santa Monica, CA, United States
- Department of Economics, University of Southern California, Los Angeles, CA, United States
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50
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Basta M, Koutentaki E, Vgontzas A, Zaganas I, Vogiatzi E, Gouna G, Bourbouli M, Panagiotakis S, Kapetanaki S, Fernandez-Mendoza J, Simos P. Objective Daytime Napping is Associated with Disease Severity and Inflammation in Patients with Mild to Moderate Dementia1. J Alzheimers Dis 2021; 74:803-815. [PMID: 32116246 DOI: 10.3233/jad-190483] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
BACKGROUND Patients with dementia report excessive daytime sleep/sleepiness, which is associated with worse cognitive performance. Inflammatory markers may be elevated in patients with dementia and have been proposed as mediators of sleep/sleepiness. OBJECTIVE To examine the association of objective daytime napping with cognitive performance and peripheral markers of inflammation in patients with dementia as compared to not cognitively impaired (NCI) controls. METHODS A sub-sample of 46 patients with mild-to-moderate dementia and 85 NCI controls, were recruited from a large, population-based cohort of 3,140 elders (≥60 years) in Crete, Greece. All participants underwent medical history/physical examination, extensive neuropsychiatric and neuropsychological evaluation, 3-day 24 h actigraphy and a single morning measure of IL-6 and TNFα plasma levels. Comparisons of sleep parameters and inflammation markers between diagnostic groups, and between nappers and non-nappers within each diagnostic group, were conducted using ANCOVA controlling for demographics/related clinical factors. Associations between inflammatory markers, sleep variables, and neuropsychological performance were assessed within each group using partial correlation analysis controlling for confounders. RESULTS Patients with dementia slept 15 minutes longer during the day than NCI. Within dementia patients, nappers had significantly worse performance on autobiographic memory (p = 0.002), working memory (p = 0.007), episodic memory (p = 0.010), and assessment of daily function (p = 0.012) than non-nappers. Finally, IL-6 levels were significantly associated with nap duration within dementia patients who napped (r = 0.500, p = 0.01). CONCLUSIONS Daytime napping in patients with dementia is associated with worse cognitive performance and increased IL-6 levels. In dementia, objective daytime napping, may be a marker of the severity of the disease.
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Affiliation(s)
- Maria Basta
- Department of Psychiatry, University Hospital of Heraklion, Heraklion, Crete, Greece.,Sleep Research and Treatment Center, Department of Psychiatry, Penn State University, Hershey, PA, USA
| | - Eirini Koutentaki
- Department of Psychiatry, University Hospital of Heraklion, Heraklion, Crete, Greece
| | - Alexandros Vgontzas
- Department of Psychiatry, University Hospital of Heraklion, Heraklion, Crete, Greece.,Sleep Research and Treatment Center, Department of Psychiatry, Penn State University, Hershey, PA, USA
| | - Ioannis Zaganas
- Department of Neurology, University Hospital of Heraklion, Heraklion, Crete, Greece
| | - Emmanouela Vogiatzi
- Department of Neurology, University Hospital of Heraklion, Heraklion, Crete, Greece
| | - Garyfalia Gouna
- Department of Neurology, University Hospital of Heraklion, Heraklion, Crete, Greece
| | - Mara Bourbouli
- Department of Neurology, University Hospital of Heraklion, Heraklion, Crete, Greece
| | - Symeon Panagiotakis
- Department of Internal Medicine, University Hospital of Heraklion, Heraklion, Crete, Greece
| | - Stefania Kapetanaki
- Department of Neurology, University Hospital of Heraklion, Heraklion, Crete, Greece
| | - Julio Fernandez-Mendoza
- Sleep Research and Treatment Center, Department of Psychiatry, Penn State University, Hershey, PA, USA
| | - Panagiotis Simos
- Department of Psychiatry, University Hospital of Heraklion, Heraklion, Crete, Greece
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