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Choneva M, Shishmanova-Doseva M, Dimov I, Boyanov K, Dimitrov I, Vlaykova T, Georgieva K, Hrischev P, Bivolarska A. Xylooligosaccharides and aerobic training regulate metabolism and behavior in rats with streptozotocin-induced type 1 diabetes. Open Med (Wars) 2022; 17:1632-1644. [PMID: 36329786 PMCID: PMC9579861 DOI: 10.1515/med-2022-0579] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Revised: 09/06/2022] [Accepted: 09/09/2022] [Indexed: 11/15/2022] Open
Abstract
Type 1 diabetes mellitus is characterized with decreased microbial diversity. Gut microbiota is essential for the normal physiological functioning of many organs, especially the brain. Prebiotics are selectively fermentable oligosaccharides [xylooligosaccharides (XOS), galactooligosaccharides, etc.] that promote the growth and activity of gut microbes and influence the gut-brain axis. Aerobic exercise is a non-pharmacological approach for the control of diabetes and could improve cognitive functions. The potential beneficial effect of XOS and/or aerobic training on cognition, the lipid profile and oxidative stress markers of experimental rats were evaluated in this study. Male Wistar rats were randomly divided into three streptozotocin-induced diabetic groups and a control group. Some of the rats, either on a XOS treatment or a standard diet, underwent aerobic training. The results showed that the aerobic training independently lowered the total cholesterol levels compared to the sedentary diabetic rats (p = 0.032), while XOS lowers the malondialdehyde levels in the trained diabetic rats (p = 0.034). What is more the exercise, independently or in combination with XOS beneficially affected all parameters of the behavioral tests. We conclude that aerobic exercises alone or in a combination with the prebiotic XOS could ameliorate the dyslipidemia, oxidative stress, and cognitive abilities in experimental type 1 diabetic animals.
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Affiliation(s)
- Mariya Choneva
- Department of Medical Biochemistry, Faculty of Pharmacy, Medical University of Plovdiv, 15 A, Vassil Aprilov Blvd., Plovdiv, 4002, Bulgaria
| | - Michaela Shishmanova-Doseva
- Department of Pharmacology, Toxicology and Pharmacotherapy, Faculty of Pharmacy, Medical University of Plovdiv, 15 A, Vassil Aprilov Blvd., Plovdiv, 4002, Bulgaria
| | - Ivica Dimov
- Department of Medical Biochemistry, Faculty of Pharmacy, Medical University of Plovdiv, 15 A, Vassil Aprilov Blvd., Plovdiv, 4002, Bulgaria
| | - Krasimir Boyanov
- Department of Medical Biochemistry, Faculty of Pharmacy, Medical University of Plovdiv, 15 A, Vassil Aprilov Blvd., Plovdiv, 4002, Bulgaria
| | - Iliyan Dimitrov
- Department of Medical Biochemistry, Faculty of Pharmacy, Medical University of Plovdiv, 15 A, Vassil Aprilov Blvd., Plovdiv, 4002, Bulgaria
| | - Tatyana Vlaykova
- Department of Medical Biochemistry, Faculty of Pharmacy, Medical University of Plovdiv, 15 A, Vassil Aprilov Blvd., Plovdiv, 4002, Bulgaria
| | - Katerina Georgieva
- Department of Physiology, Faculty of Pharmacy, Medical University of Plovdiv, 15 A, Vassil Aprilov Blvd., Plovdiv, 4002, Bulgaria
| | - Petar Hrischev
- Department of Physiology, Faculty of Pharmacy, Medical University of Plovdiv, 15 A, Vassil Aprilov Blvd., Plovdiv, 4002, Bulgaria
| | - Anelia Bivolarska
- Department of Medical Biochemistry, Faculty of Pharmacy, Medical University of Plovdiv, 15 A, Vassil Aprilov Blvd., Plovdiv, 4002, Bulgaria
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Jagadeesan T, Choudhary AK, Loganathan S, Rajendran K, Allu AR, Kuppusamy M. Yoga practice ( Sheetali Pranayama) on cognition in patients with hypertension: A randomized controlled study. Integr Med Res 2021; 10:100716. [PMID: 33665101 PMCID: PMC7903354 DOI: 10.1016/j.imr.2021.100716] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Revised: 12/21/2020] [Accepted: 12/26/2020] [Indexed: 11/27/2022] Open
Affiliation(s)
| | | | | | - Kannan Rajendran
- Department of Medicine, Saveetha Medical College, Chennai, Tamil Nadu, India
| | | | - Maheshkumar Kuppusamy
- Department of Physiology and Biochemistry, Government Yoga and Naturopathy Medical College, Chennai, Tamil Nadu, India
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Affiliation(s)
- Nadine E Stephenson
- School of Psychological Science, Faculty of Science, Technology and Engineering, La Trobe University,
| | - Simon F Crowe
- School of Psychological Science, Faculty of Science, Technology and Engineering, La Trobe University,
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Cappellari M, Forlivesi S, Zucchella C, Valbusa V, Sajeva G, Musso AM, Micheletti N, Tomelleri G, Bovi T, Bonetti B, Bovi P. Factors influencing cognitive performance after 1-year treatment with direct oral anticoagulant in patients with atrial fibrillation and previous ischemic stroke: a pilot study. J Thromb Thrombolysis 2020; 51:767-778. [PMID: 32728909 DOI: 10.1007/s11239-020-02233-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
Anticoagulant treatment as stroke prevention, particularly direct oral anticoagulant (DOAC), may reduce the risk of dementia in patients with atrial fibrillation (AF). We aimed to assess factors influencing cognitive performance after 1-year treatment with DOAC in patients with AF and previous ischemic stroke. We recruited 33 ischemic stroke patients who were discharged from Verona Stroke Unit with diagnosis of AF and prescription of treatment with DOAC. For each cognitive test, we estimated the effect of T0 (first session) variables on T1 (1-year session) cognitive performance using ordinal logistic regression fitted to a 1 point-shift from 4 to 0 on ESs. The effect of T0 clinical variables was presented as odds ratio (OR) with 95% confidence interval (CI) after adjustment for T0 total score of the corresponding cognitive test. Sustained AF (OR: 4.259, 95% CI 1.071-16.942) and ischemic heart disease (OR: 6.654, 95% CI 1.329-33.300) showed a significant effect on T1 MoCA Test; congestive heart failure on T1 RAVLT Immediate recall (OR: 9.128, 95% CI 1.055-78.995), T1 RAVLT Delayed recall (OR: 7.134, 95% CI 1.214-52.760), and T1 Trail Making Test (Part A) (OR: 16.989, 95% CI 1.765-163.565); sustained AF (OR: 5.055, 95% CI 1.224-20.878) and hyperlipidemia (OR: 4.764, 95% CI 1.175-19.310) on T1 Digit span forward Test; ischemic heart disease (aOR: 8.460, 95% CI 1.364-52.471) on T1 Stroop Color and Word Test (time); Dabigatran use (aOR: 0.084, 95% CI 0.013-0.544) on FAB; age ≥ 75 years (aOR: 0.058, 95% CI 0.006-0.563) and hyperlipidemia (aOR: 5.809, 95% CI 1.059-31.870) on T1 Phonemic word fluency Test; female sex (aOR: 6.105, 95% CI 1.146-32.519), hyperlipidemia (aOR: 21.099, 95% CI 2.773-160.564), total Modified Fazekas Scale score > 1 (aOR: 78.530, 95% CI 3.131-1969.512) on Semantic word fluency Test. Sustained AF, ischemic heart disease, congestive heart failure, hyperlipidemia, and female sex were the factors influencing cognitive performance after 1-year treatment with DOAC in patients with AF and previous ischemic stroke. Modified Fazekas Scale score in the first session was the only radiological variable that had a significant effect on cognitive performance.
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Affiliation(s)
- Manuel Cappellari
- Neurology and Stroke Unit, Azienda Ospedaliera Universitaria Integrata, Verona, Italy.
| | - Stefano Forlivesi
- IRCCS Istituto delle Scienze Neurologiche di Bologna, Neurology and Stroke Unit, Maggiore Hospital, Bologna, Italy
| | - Chiara Zucchella
- Neurology and Stroke Unit, Azienda Ospedaliera Universitaria Integrata, Verona, Italy
| | - Valeria Valbusa
- Neurology and Stroke Unit, Azienda Ospedaliera Universitaria Integrata, Verona, Italy
| | - Giulia Sajeva
- Neurology and Stroke Unit, Azienda Ospedaliera Universitaria Integrata, Verona, Italy
| | - Anna Maria Musso
- Neurology and Stroke Unit, Azienda Ospedaliera Universitaria Integrata, Verona, Italy
| | - Nicola Micheletti
- Neurology and Stroke Unit, Azienda Ospedaliera Universitaria Integrata, Verona, Italy
| | - Giampaolo Tomelleri
- Neurology and Stroke Unit, Azienda Ospedaliera Universitaria Integrata, Verona, Italy
| | - Tommaso Bovi
- Neurology and Stroke Unit, Azienda Ospedaliera Universitaria Integrata, Verona, Italy
| | - Bruno Bonetti
- Neurology and Stroke Unit, Azienda Ospedaliera Universitaria Integrata, Verona, Italy
| | - Paolo Bovi
- Neurology and Stroke Unit, Azienda Ospedaliera Universitaria Integrata, Verona, Italy
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Wang J, Wang L, Zhou X, Wen X, Zhen X. Risk factors for predicting progression from normal cognition to mild cognitive impairment: protocol for a systematic review and meta-analysis of cohort studies. BMJ Open 2019; 9:e027313. [PMID: 31189678 PMCID: PMC6576133 DOI: 10.1136/bmjopen-2018-027313] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2018] [Revised: 03/15/2019] [Accepted: 05/15/2019] [Indexed: 12/19/2022] Open
Abstract
INTRODUCTION Mild cognitive impairment (MCI) often represents the earliest stage of Alzheimer's disease. There has been considerable research investigating specific risk factors regarding the progression from normal cognition to MCI. However, different studies have come to different conclusions on the impact of particular risk factors. Therefore, it is necessary to conduct a meta-analysis of the risk factors that predict cognitive disruption in individuals based on associations with MCI. METHODS AND ANALYSIS We will search seven electronic databases without time limit, including MEDLINE, EMBASE, The Cochrane Library, Web of Science, China National Knowledge Infrastructure, the Wan Fang Database and China Biology Medicine. Two researchers will independently screen for eligibility and perform data extraction. Data were extracted from cohort studies meeting the inclusive criteria according to the Newcastle Ottawa Scale (NOS) methods. A third member of the research team will be contacted when a consensus cannot be reached. Any disagreement will be settled by consensus. The NOS will be used to assess the quality of the studies. All analyses were performed using Stata V.15.1. ETHICS AND DISSEMINATION We will report this review in accordance with the Preferred Reporting Items for Systematic Review and Meta-Analysis statement. We will disseminate our findings through a publication in a peer-reviewed journal. This systematic review does not require ethical approval as no primary data are collected. PROSPERO REGISTRATION NUMBER CRD42018109099.
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Affiliation(s)
- Jie Wang
- School of Nursing, Huzhou University, Huzhou, Zhejiang, China
| | - Lina Wang
- School of Nursing, Huzhou University, Huzhou, Zhejiang, China
| | - Xianglian Zhou
- School of Nursing, Huzhou University, Huzhou, Zhejiang, China
| | - Xiaohong Wen
- Huzhou First People’s Hospital, Huzhou, Zhejiang, China
| | - Xueting Zhen
- School of Nursing, Huzhou University, Huzhou, Zhejiang, China
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Shalimova A, Graff B, Gąsecki D, Wolf J, Sabisz A, Szurowska E, Jodzio K, Narkiewicz K. Cognitive Dysfunction in Type 1 Diabetes Mellitus. J Clin Endocrinol Metab 2019; 104:2239-2249. [PMID: 30657922 DOI: 10.1210/jc.2018-01315] [Citation(s) in RCA: 74] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2018] [Accepted: 01/15/2019] [Indexed: 02/02/2023]
Abstract
CONTEXT We have summarized key studies assessing the epidemiology, mechanisms, and consequences of cognitive dysfunction (CD) in type 1 diabetes. EVIDENCE SYNTHESIS In a number of studies, the severity of CD in type 1 diabetes was affected by the age of onset and duration, and the presence of proliferative retinopathy and autonomic neuropathy. Diabetes-related CD has been observed, not only in adults, but also in children and adolescents. Most neuroimaging studies of patients with type 1 diabetes did not show any differences in whole brain volumes; however, they did reveal selective deficits in gray matter volume or density within the frontal, posterior, and temporal cortex and subcortical gray matter. Studies of middle-age adults with long-standing type 1 diabetes using diffusion tensor imaging have demonstrated partial lesions in the white matter and decreased fractional anisotropy in posterior brain regions. The mechanisms underlying diabetes-related CD are very complex and include factors related to diabetes per se and to diabetes-related cardiovascular disease and microvascular dysfunction, including chronic hyperglycemia, hypoglycemia, macro- and microvascular disease, and increased inflammatory cytokine expression. These mechanisms might contribute to the development and progression of both vascular dementia and Alzheimer disease. CONCLUSIONS Higher rates of CD and faster progression in type 1 diabetes can be explained by both the direct effects of altered glucose metabolism on the brain and diabetes-related cardiovascular disease. Because the presence and progression of CD significantly worsens the quality of life of patients with diabetes, further multidisciplinary studies incorporating the recent progress in both neuroimaging and type 1 diabetes management are warranted to investigate this problem.
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Affiliation(s)
- Anna Shalimova
- Department of Hypertension and Diabetology, Medical University of Gdańsk, Faculty of Medicine, Gdańsk, Poland
| | - Beata Graff
- Department of Hypertension and Diabetology, Medical University of Gdańsk, Faculty of Medicine, Gdańsk, Poland
| | - Dariusz Gąsecki
- Department of Adult Neurology, Medical University of Gdańsk, Faculty of Medicine, Gdańsk, Poland
| | - Jacek Wolf
- Department of Hypertension and Diabetology, Medical University of Gdańsk, Faculty of Medicine, Gdańsk, Poland
| | - Agnieszka Sabisz
- Department of Radiology, Medical University of Gdańsk, Faculty of Medicine, Gdańsk, Poland
| | - Edyta Szurowska
- Department of Radiology, Medical University of Gdańsk, Faculty of Medicine, Gdańsk, Poland
| | - Krzysztof Jodzio
- Institute of Psychology, University of Gdańsk, 80-308 Gdańsk, Poland
| | - Krzysztof Narkiewicz
- Department of Hypertension and Diabetology, Medical University of Gdańsk, Faculty of Medicine, Gdańsk, Poland
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Oral administration of Pantoea agglomerans-derived lipopolysaccharide prevents metabolic dysfunction and Alzheimer's disease-related memory loss in senescence-accelerated prone 8 (SAMP8) mice fed a high-fat diet. PLoS One 2018; 13:e0198493. [PMID: 29856882 PMCID: PMC5983504 DOI: 10.1371/journal.pone.0198493] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2018] [Accepted: 05/20/2018] [Indexed: 12/30/2022] Open
Abstract
The pathogenesis of Alzheimer’s disease (AD) remains unclear, but an imbalance between the production and clearance of amyloid-β (Aβ) peptides is known to play a critical role in AD progression. A promising preventative approach is to enhance the normal Aβ clearance activity of brain phagocytes such as microglia. In mice, the intraperitoneal injection of Toll-like receptor 4 agonist was shown to enhance Aβ clearance and exhibit a preventative effect on AD-related pathology. Our previous clinical study demonstrated that orally administered Pantoea agglomerans-derived lipopolysaccharide (LPSp) exhibited an LDL (low-density lipoprotein)-lowering effect in human volunteers with hyperlipidemia, a known risk factor for AD. In vitro studies have shown that LPSp treatment increases Aβ phagocytosis by microglial cells; however it is still unclear whether orally administered LPSp exhibits a preventive effect on AD progression. We show here that in senescence-accelerated prone 8 (SAMP8) mice fed a high-fat diet, oral administration of LPSp at 0.3 or 1 mg/kg body weight·day for 18 weeks significantly improved glucose metabolism and lipid profiles. The LPSp treatment also reduced pro-inflammatory cytokine expression and oxidative-burst activity in the peripheral blood. Moreover, LPSp significantly reduced brain Aβ burden and memory impairment as seen in the water maze test, although we could not confirm a significant enhancement of Aβ phagocytosis in microglia isolated from the brains after treatment. Taken together, our results show that LPSp holds promise as a preventative therapy for AD or AD-related diseases induced by impairment of metabolic functions.
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Solov'eva EY, Dzhutova ED, Knyazeva VS. [Pathogenetic approaches to treatment of cognitive disorders in patients with diabetes mellitus]. Zh Nevrol Psikhiatr Im S S Korsakova 2016. [PMID: 28635936 DOI: 10.17116/jnevro20161167185-93] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
The article presents the currents concepts on the mechanisms of brain lesions and development of cognitive impairment in diabetes mellitus (DM) including DM type 2. Metabolic and vascular mechanisms, oxidative stress, hyperglycemia, glutamate excitotoxicity, insulin insufficiency and brain insulin resistance, general vascular and microcirculatory disturbances, death of cortical neurons, decrease in the newly synthesized acetylcholine, activation of lipid peroxidation are considered. A review of the main domestic and international drugs used in clinical practice for treatment of cognitive impairment in patients with DM is presented.
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Affiliation(s)
- E Yu Solov'eva
- Pirogov Russian National Research Medical University, Moscow, Russia
| | - E D Dzhutova
- Pirogov Russian National Research Medical University, Moscow, Russia
| | - V S Knyazeva
- Pirogov Russian National Research Medical University, Moscow, Russia
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Tromp D, Dufour A, Lithfous S, Pebayle T, Després O. Episodic memory in normal aging and Alzheimer disease: Insights from imaging and behavioral studies. Ageing Res Rev 2015; 24:232-62. [PMID: 26318058 DOI: 10.1016/j.arr.2015.08.006] [Citation(s) in RCA: 201] [Impact Index Per Article: 22.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2015] [Accepted: 08/20/2015] [Indexed: 12/30/2022]
Abstract
Age-related cognitive changes often include difficulties in retrieving memories, particularly those that rely on personal experiences within their temporal and spatial contexts (i.e., episodic memories). This decline may vary depending on the studied phase (i.e., encoding, storage or retrieval), according to inter-individual differences, and whether we are talking about normal or pathological (e.g., Alzheimer disease; AD) aging. Such cognitive changes are associated with different structural and functional alterations in the human neural network that underpins episodic memory. The prefrontal cortex is the first structure to be affected by age, followed by the medial temporal lobe (MTL), the parietal cortex and the cerebellum. In AD, however, the modifications occur mainly in the MTL (hippocampus and adjacent structures) before spreading to the neocortex. In this review, we will present results that attempt to characterize normal and pathological cognitive aging at multiple levels by integrating structural, behavioral, inter-individual and neuroimaging measures of episodic memory.
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Affiliation(s)
- D Tromp
- Laboratoire de Neurosciences Cognitives et Adaptatives (LNCA - UMR 7364 - CNRS/UDS) - 21 rue Becquerel, 67087 Strasbourg, France.
| | - A Dufour
- Laboratoire de Neurosciences Cognitives et Adaptatives (LNCA - UMR 7364 - CNRS/UDS) - 21 rue Becquerel, 67087 Strasbourg, France; Centre d'Investigations Neurocognitives et Neurophysiologiques (CI2N - UMS 3489 - CNRS/UDS) - 21 rue Becquerel, 67087 Strasbourg, France
| | - S Lithfous
- Laboratoire de Neurosciences Cognitives et Adaptatives (LNCA - UMR 7364 - CNRS/UDS) - 21 rue Becquerel, 67087 Strasbourg, France
| | - T Pebayle
- Centre d'Investigations Neurocognitives et Neurophysiologiques (CI2N - UMS 3489 - CNRS/UDS) - 21 rue Becquerel, 67087 Strasbourg, France
| | - O Després
- Laboratoire de Neurosciences Cognitives et Adaptatives (LNCA - UMR 7364 - CNRS/UDS) - 21 rue Becquerel, 67087 Strasbourg, France.
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Apostolo J, Holland C, O'Connell MDL, Feeney J, Tabares-Seisdedos R, Tadros G, Campos E, Santos N, Robertson DA, Marcucci M, Varela-Nieto I, Crespo-Facorro B, Vieta E, Navarro-Pardo E, Selva-Vera G, Balanzá-Martínez V, Cano A. Mild cognitive decline. A position statement of the Cognitive Decline Group of the European Innovation Partnership for Active and Healthy Ageing (EIPAHA). Maturitas 2015; 83:83-93. [PMID: 26520249 DOI: 10.1016/j.maturitas.2015.10.008] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2015] [Revised: 10/08/2015] [Accepted: 10/09/2015] [Indexed: 01/01/2023]
Abstract
INTRODUCTION Mild cognitive impairment (MCI) is a term used to describe a level of decline in cognition which is seen as an intermediate stage between normal ageing and dementia, and which many consider to be a prodromal stage of neurodegeneration that may become dementia. That is, it is perceived as a high risk level of cognitive change. The increasing burden of dementia in our society, but also our increasing understanding of its risk factors and potential interventions, require diligent management of MCI in order to find strategies that produce effective prevention of dementia. AIM To update knowledge regarding mild cognitive impairment, and to bring together and appraise evidence about the main features of clinical interest: definitions, prevalence and stability, risk factors, screening, and management and intervention. METHODS Literature review and consensus of expert opinion. RESULTS AND CONCLUSION MCI describes a level of impairment in which deteriorating cognitive functions still allow for reasonable independent living, including some compensatory strategies. While there is evidence for some early risk factors, there is still a need to more precisely delineate and distinguish early manifestations of frank dementia from cognitive impairment that is less likely to progress to dementia, and furthermore to develop improved prospective evidence for positive response to intervention. An important limitation derives from the scarcity of studies that take MCI as an endpoint. Strategies for effective management suffer from the same limitation, since most studies have focused on dementia. Behavioural changes may represent the most cost-effective approach.
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Affiliation(s)
- Joao Apostolo
- Portugal Centre for Evidence Based Practice, Health Sciences Research Unit: Nursing (UICISA: E), Nursing School of Coimbra, Portugal.
| | - Carol Holland
- Aston Research Centre for Healthy Ageing, Aston University, Birmingham, UK.
| | | | - Joanne Feeney
- Centre for Public Health, Queen's University Belfast, United Kingdom.
| | - Rafael Tabares-Seisdedos
- Department of Medicine, University of Valencia, INCLIVA, Valencia, Spain; CIBERSAM, Madrid, Spain.
| | - George Tadros
- Birmingham & Solihull Mental Health Foundation Trust, Old Age Psychiatry, Queen Elizabeth Psychiatric Hospital, Birmingham, UK.
| | - Elzbieta Campos
- Portugal Centre for Evidence Based Practice, Health Sciences Research Unit: Nursing (UICISA: E), Nursing School of Coimbra, Portugal.
| | - Nadine Santos
- Life and Health Sciences Research Institute (ICVS), School of Health Sciences, University of Minho, Braga, Portugal; ICVS/3B's, PT Government Associate Laboratory, Braga, Guimarães, Portugal.
| | | | - Maura Marcucci
- Geriatric Unit, Fondazione IRCCS Ca' Granda, Ospedale Maggiore Policlinico & Department of Clinical Sciences and Community Health, University of Milan, Milan, Italy.
| | - Isabel Varela-Nieto
- Institute for Biomedical Research, CSIC-UAM and IdiPAZ-CIBERER, Madrid 28029, Spain.
| | - Benedicto Crespo-Facorro
- Department of Psychiatry, School of Medicine, University of Cantabria, Marqués de Valdecilla Hospital, Santander, Spain; IDIVAL, Santander, Spain; CIBERSAM, Madrid, Spain.
| | - Eduard Vieta
- Barcelona Bipolar Disorders Programme, Hospital Clinic, IDIBAPS, CIBERSAM, University of Barcelona, Barcelona, Spain.
| | | | - Gabriel Selva-Vera
- Department of Medicine, University of Valencia, INCLIVA, Valencia, Spain; CIBERSAM, Madrid, Spain.
| | - Vicent Balanzá-Martínez
- Department of Medicine, La Fe University and Polytechnic Hospital, CIBERSAM, University of Valencia, Valencia, Spain.
| | - Antonio Cano
- Department of Pediatrics, Obstetrics and Gynecology, University of Valencia, Spain; Service of Obstetrics and Gynecology, INCLIVA, Valencia, Spain.
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Goh DA, Dong Y, Lee WY, Koay WI, Tay SZ, Soon D, Chen C, Brittain CF, Lowe SL, Wong BS. A pilot study to examine the correlation between cognition and blood biomarkers in a Singapore Chinese male cohort with type 2 diabetes mellitus. PLoS One 2014; 9:e96874. [PMID: 24816647 PMCID: PMC4016130 DOI: 10.1371/journal.pone.0096874] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2013] [Accepted: 04/12/2014] [Indexed: 12/19/2022] Open
Abstract
Background Diabetes is reported to be linked to poorer cognitive function. The purpose of this study is to examine (a) clinical correlation between cognitive function and the biochemical perturbations in T2DM, and (b) the impact of statin treatment on cognitive function in diabetic subjects. Methods Forty Singaporean Chinese males with diabetes and twenty Singaporean Chinese males without diabetes were recruited for this study. Twenty-two of the diabetic subjects were on statin therapy and all subjects were non-demented. This was a 2-period non-interventional case-control study in which subjects were assessed for cognitive function in period 1 and blood samples taken over 2 periods, approximately 1 week apart. Blood was collected to determine the level of total cholesterol, high-density lipoprotein (HDL), low-density lipoprotein (LDL), triglycerides, glucose and insulin. Cognitive performance was measured by a neuropsychological battery covering domains of attention, language, verbal and visual memory, visuomotor speed and executive function. Z-scores were derived for each cognitive domain using the mean and standard deviations (SDs), and they were used to compare between (a) diabetic and non-diabetic groups, and (b) diabetic subjects with and without statin treatment. ANCOVAs with age, education, BMI, and the duration of diabetes as covariates were employed to examine differences in mean score of cognitive domains and subtests between the two groups. Results Overall cognitive function was similar among diabetics and age matched non-diabetic controls. Among diabetic statin users, HDL, LDL and total cholesterol were negatively correlated with executive function, whereas peripheral insulin levels and insulin resistance were negatively associated with attention. Conclusion Diabetic statin users were likely to have poorer performance in attention and executive function. Increasing levels of the peripheral biomarkers are likely to contribute to poorer cognitive performance.
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Affiliation(s)
- Deborah Amanda Goh
- Department of Physiology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Yanhong Dong
- Department of Pharmacology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Memory Ageing and Cognition Centre (MACC), National University Health System (NUHS), Singapore, Singapore
- Centre for Healthy Brain Ageing and Dementia Collaborative Research Centre, School of Psychiatry, The University of New South Wales, Sydney, New South Wales, Australia
- * E-mail: (YD); (BW)
| | - Wah Yean Lee
- Department of Pharmacology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Memory Ageing and Cognition Centre (MACC), National University Health System (NUHS), Singapore, Singapore
| | - Way Inn Koay
- Department of Pharmacology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Memory Ageing and Cognition Centre (MACC), National University Health System (NUHS), Singapore, Singapore
| | - Stephen Ziyang Tay
- Department of Physiology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Department of Pharmacology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Memory Ageing and Cognition Centre (MACC), National University Health System (NUHS), Singapore, Singapore
| | - Danny Soon
- Lilly-NUS Centre for Clinical Pharmacology, Singapore, Singapore
| | - Christopher Chen
- Department of Pharmacology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Memory Ageing and Cognition Centre (MACC), National University Health System (NUHS), Singapore, Singapore
| | | | | | - Boon-Seng Wong
- Department of Physiology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- * E-mail: (YD); (BW)
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Abstract
During recent years, increasing knowledge has been obtained from clinical studies about the impact that vascular factors have on cognitive function and dementia. Due to demographic reasons and still insufficient control of all vascular risk factors, dementia and associated problems are of increasing importance and will have impact on economical and social development in most countries. The incidence of cognitive impairment and dementia will increase exponentially. As long as no causal therapy for dementia exists, diagnosis and control of risk factors for dementia will need much more attention. Hypertension is not only the most important risk factor for stroke that often leads to dementia but also for silent brain infarcts, which are also associated with onset of dementia. Uncontrolled hypertension is associated with cognitive impairment and sufficient control of hypertension in middle-aged patients can reduce the risk of dementia in older ages. Nevertheless, treatment of all other risk factors (e.g., diabetes mellitus, hyperlipidemia, atrial fibrillation) is important to reduce the onset of not only vascular but also Alzheimer dementia.
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Köhler M, Kliegel M, Kaduszkiewicz H, Bachmann C, Wiese B, Bickel H, Mösch E, Weyerer S, Werle J, Fuchs A, Pentzek M, Leicht H, König HH, Luppa M, Riedel-Heller S, Jessen F, Maier W, Scherer M, Wagner M. Effect of cardiovascular and metabolic disease on cognitive test performance and cognitive change in older adults. J Am Geriatr Soc 2012; 60:1286-91. [PMID: 22703453 DOI: 10.1111/j.1532-5415.2012.04032.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
OBJECTIVES To examine the effect of cardiovascular and metabolic diseases on initial cognitive test performance and rate of change in three cognitive measures. DESIGN Prospective cohort study. SETTING General practices in six towns throughout Germany. PARTICIPANTS Three thousand three hundred twenty-seven participants aged 75 and older (average 79.7 ± 3.6). MEASUREMENTS Data were collected during home visits every 18 months and included sociodemographic variables, depression, disease status, drug intake, and cognition. RESULTS Although the presence of transient ischemic attack (TIA) or stroke and diabetes mellitus was related to poor initial cognitive test performance, the presence of those and other far-reaching chronic diseases or a higher disease burden were not related to the rate of change in cognition over time. CONCLUSION Diabetes mellitus, stroke and TIA affect cognitive test performance beyond well-known sociodemographic variables and depressive symptoms, although none of these diseases contributed to cognitive decline over time. In practical terms, prevention and diagnosis of cardiovascular and metabolic diseases may be essential to cognitively healthy aging.
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Affiliation(s)
- Mirjam Köhler
- Department of Primary Medical Care, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany.
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14
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Etgen T, Sander D, Bickel H, Förstl H. Mild cognitive impairment and dementia: the importance of modifiable risk factors. DEUTSCHES ARZTEBLATT INTERNATIONAL 2011; 108:743-50. [PMID: 22163250 DOI: 10.3238/arztebl.2011.0743] [Citation(s) in RCA: 68] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/17/2011] [Accepted: 06/27/2011] [Indexed: 12/22/2022]
Abstract
BACKGROUND Mild cognitive impairment (MCI), a common condition among the elderly, is defined as a deterioration of memory, attention, and cognitive function that exceeds what would be expected for the individual's age and level of education, yet does not interfere significantly with the activities of daily living. MCI may be a precursor of dementia; the rate of transition from MCI to dementia is 10% to 20% per year. The role of somatic diseases and modifiable risk factors in MCI and dementia needs further study. METHODS We analyzed pertinent original articles and reviews published 1990 up to December 2010 that were retrieved by a selective search in PubMed and the Cochrane Library. RESULTS MCI and dementia are associated with many somatic disorders and modifiable risk factors. MCI has biologically plausible associations with hypertension, diabetes mellitus, and hyperlipidemia, although the interventional trials performed to date have yielded negative results. Recently, chronic renal failure has also been recognized as a risk factor. Insufficient evidence supports a putative benefit on MCI from the substitution of vitamin B12, vitamin D, or testosterone (when these substances are deficient), the treatment of hyperhomocysteinemia or subclinical thyroid dysfunction, or hormone replacement therapy after menopause. Epidemiological data suggest that a Mediterranean diet, physical activity, and moderate alcohol consumption protect against MCI, while cigarette smoking promotes it and should be stopped. CONCLUSION Modifiable risk factors for MCI should be sought (at the very latest) in persons who already have MCI, as their optimal treatment may improve these patients' cognitive performance or keep the existing deficits from progressing.
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Affiliation(s)
- Thorleif Etgen
- Klinik und Poliklinik für Psychiatrie und Psychotherapie, Technische Universität München, Germany.
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15
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Abstract
Diabetic encephalopathies are now accepted complications of diabetes. They appear to differ in type 1 and type 2 diabetes as to underlying mechanisms and the nature of resulting cognitive deficits. The increased incidence of Alzheimer's disease in type 2 diabetes is associated with insulin resistance, hyperinsulinemia and hyperglycemia, and commonly accompanying attributes such as hypercholesterolemia, hypertension and obesity. The relevance of these disorders as to the emergence of dementia and Alzheimer's disease is discussed based on epidemiological studies. The pathobiology of accumulation of β-amyloid and tau the hallmarks of Alzheimer's disease are discussed based on experimental data. Type 1 diabetic encephalopathy is likely to increase as a result of the global increase in the incidence of type 1 diabetes and its occurrence in increasingly younger patients. Alzheimer-like changes and dementia are not prominently increased in type 1 diabetes. Instead, the type 1 diabetic encephalopathy involves learning abilities, intelligence development and memory retrieval resulting in impaired school and professional performances. The major underlying component here appears to be insulin deficiency with downstream effects on the expression of neurotrophic factors, neurotransmitters, oxidative and apoptotic stressors resulting in defects in neuronal integrity, connectivity and loss commonly occurring in the still developing brain. Recent experimental data emphasize the role of impaired central insulin action and provide information as to potential therapies. Therefore, the underlying mechanisms resulting in diabetic encephalopathies are complex and appear to differ between the two types of diabetes. Major headway has been made in our understanding of their pathobiology; however, many questions remain to be clarified. In view of the increasing incidence of both type 1 and type 2 diabetes, intensified investigations are called for to expand our understanding of these complications and to find therapeutic means by which these disastrous consequences can be prevented and modified.
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MESH Headings
- Amyloid/metabolism
- Animals
- Brain Diseases, Metabolic/diagnosis
- Brain Diseases, Metabolic/epidemiology
- Brain Diseases, Metabolic/etiology
- Diabetes Complications/diagnosis
- Diabetes Complications/epidemiology
- Diabetes Complications/psychology
- Diabetes Mellitus, Type 1/complications
- Diabetes Mellitus, Type 1/epidemiology
- Diabetes Mellitus, Type 1/psychology
- Diabetes Mellitus, Type 2/complications
- Diabetes Mellitus, Type 2/epidemiology
- Diabetes Mellitus, Type 2/psychology
- Disease Models, Animal
- Humans
- Models, Biological
- tau Proteins/metabolism
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Affiliation(s)
- Anders A F Sima
- Department of Pathology, Wayne State University, Detroit, MI 48201, USA.
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