Interaction between ω-6 fatty acids intake and blood cadmium on the risk of low cognitive performance in older adults from National Health and Nutrition Examination Survey (NHANES) 2011-2014

Environmental, Metabolic, and Nutritional Factors Concerning Dementia in African-Americans and Hispanic Populations

African-Americans and Hispanic Americans experience a higher incidence and prevalence of dementia than white Americans while also experiencing more environmental, metabolic and nutritional factors potentially promoting such disparities. Greater exposure to air, water and soil pollutants including toxic metals associated with neurodegeneration accrue to both minorities, as does worse dental care than whites exposing them to periodontitis raising dementia risk. Hispanic Americans experience greater occupational exposure to herbicides and pesticides develop more non-alcoholic fatty liver disease (NAFLD) predisposing to dementia. African-Americans have a greater likelihood of both Vitamin D deficiency and magnesium deficiency increasing neuroinflammation and dementia risk. Both have greater air pollution exposure, a known dementia risk. Nutritional changes including greater nut consumption and reduced sugar drink consumption, improved dental care, and reduced toxicant exposure may help reduce this higher risk of dementia among African Americans and Hispanic Americans.

Protective effect of unsaturated fatty acids on cognitive impairment in CKD patients: Results from the National Health and Nutrition Examination Survey (2011-2014)

BACKGROUND

It is still unknown whether unsaturated fatty acids (UFA) have the same effect on preventing cognitive impairment in chronic kidney disease (CKD) patients as in healthy people.

OBJECTIVE

To investigate the protective effect of dietary UFA intake and proportion on cognitive impairment in patients with CKD.

METHODS

We extracted data from the National Health and Nutrition Examination Survey (NHANES, 2011-2014) on participants with a previous diagnosis of CKD and at least one complete cognitive assessment (Consortium to Establish a Registry for Alzheimer's Disease test, Animal Fluency Test and Digit Symbol Substitution Test). We used the lower quartile of the total scores of these three tests as the cut-off point, and divided the participants into two groups of normal cognitive performance and low cognitive performance to extract participants' intake of various UFA from the NHANES dietary module.

Association of vitamin B1 intake with geriatric cognitive function: An analysis of the National Health and Nutrition Examination Survey (NHANES) from 2011 to 2014

Background

The association between dietary vitamin B1 intake and cognitive performance in the noninstitutionalized older adult population of the United States remains unclear.

Purpose

This study aimed to investigate the association between vitamin B1 intake and cognitive performance in older adults in the United States.

Methods

Vitamin B1 intake was assessed through two 24-h dietary recalls. Weighted logistic regression was used to evaluate the association between vitamin B1 intake and three cognitive scores (immediate recall test [IRT], animal fluency test [AFT], and digit symbol substitution test [DSST]). Cognitive performance was measured by these three tests, and individuals scoring below the lowest quartile were categorized as cognitive impairment. Sensitivity analysis, including dose-response curves, subgroup analyses, interaction effects, per 1 SD, and quartiles, were performed to ensure the accuracy of the conclusion.

Results

A total of 2896 participants over the age of 60 were included in this study. In the adjusted final model, the association between vitamin B1 intake and low cognitive performance in old age was statistically significant, with the following odds ratios (ORs) and 95% confidence intervals (CIs): IRT, 0.75 (0.57, 0.97), P = 0.018; AFT, 0.68 (0.50, 0.92), P = 0.007; DSST, 0.71 (0.54, 0.92), P = 0.005. Subgroup analyses showed that this association was statistically significant among males, white, low-education, and no memory impairment. The results of the sensitivity analyses confirmed the association between VB1 and cognitive function in old age and the absence of interactions in the final calibrated model.

Conclusion

Dietary vitamin B1 intake is negatively associated with cognitive performance in older adults.

The impact of modifiable health metrics on mortality for older adults with low cognitive function

Objectives

Cognitive impairment has emerged as a major contributing factor to mortality for older adults. Identifying the strong modifiable health metrics against mortality is of high priority, especially in this high-risk population.

Methods

This population-based study used data of US adults aged≥60 years old from the National Health and Nutrition Examination Survey 2011-2014 cycles. De-identified data for participants who completed cognitive function test were extracted. Mortality data was obtained by linking to the 2019 public-use linked mortality file.

Results

Participants with low global cognition had higher risk of all-cause mortality (HR = 1.46; 95%CI, 1.04-2.05). The highest prevalence of ideal level of health metrics was observed for sleep duration (54.36% vs. 62.37%), and the lowest was noted for blood pressure (12.06% vs. 21.25%) for participants with low and average to high global cognition, respectively. Ideal status of physical activity and diet quality were significantly associated with all-cause mortality among participants with low global cognition (HR = 0.48, 95%CI: 0.28-0.82; HR = 0.63, 95%CI: 0.43-0.95). The corresponding population-attributable fractions were 26.58 and 15.90%, respectively.

Conclusion

Low cognitive function was associated with increased risk of all-cause death for older adults. Attainment of healthy metrics, especially sufficient physical activity, consuming healthy diet and being never smoked, provided strong protection against death risk.

Metals linked with the most prevalent primary neurodegenerative dementias in the elderly: A narrative review

The ageing population has been steadily increasing worldwide, leading to a higher risk of cognitive decline and dementia. Environmental toxicants, particularly metals, have been identified as modifiable risk factors for cognitive impairment. Continuous exposure to metals occurs mainly through dietary sources, with older adults being particularly vulnerable. However, imbalances in the gut microbiota, known as dysbiosis, have also been associated with dementia. A literature review was conducted to explore the potential role of metals in the development of cognitive decline and the most prevalent primary neurodegenerative dementias, as well as their interaction with the gut microbiota. High levels of iron (Fe) and copper (Cu) are associated with mild cognitive impairment (MCI) and Alzheimer's disease (AD), while low selenium (Se) levels are linked to poor cognitive status. Parkinson's disease dementia (PDD) is associated with elevated levels of iron (Fe), manganese (Mn), and zinc (Zn), but the role of copper (Cu) remains unclear. The relationship between metals and Lewy body dementia (LBD) requires further investigation. High aluminium (Al) exposure is associated with frontotemporal dementia (FTD), and elevated selenium (Se) levels may be linked to its onset. Challenges in comparing studies arise from the heterogeneity of metal analysis matrices and analytical techniques, as well as the limitations of small study cohorts. More research is needed to understand the influence of metals on cognition through the gut microbiota (GMB) and its potential relevance in the development of these diseases.

A machine learning-based diagnosis modelling of type 2 diabetes mellitus with environmental metal exposure

BACKGROUND AND OBJECTIVE

Increasing and compelling evidence has been proved that urinary and dietary metal exposure are underappreciated but potentially modifiable biomarkers for type 2 diabetes mellitus (T2DM). The aims of this study were (1) to identify the key potential biomarkers which contributed to T2DM with effective and parsimonious features and (2) to assess the utility of baseline variables and metal exposure in the diagnosis of T2DM.

METHODS

Based on the National Health and Nutrition Examination Survey (NHANES), we selected 9822 screening records with 82 significant variables covering demographics, lifestyle, anthropometric measures, diet and metal exposure for this study. Combining extreme gradient boosting (XGBoost), random forest and light gradient boosting machine (lightGBM), a soft voting ensemble model was proposed to measure the importance of 82 features. With this soft voting ensemble model and variance inflation factor (VIF), strong multicollinear features with low importance scores were further removed from candidate biomarkers. Then, a soft voting ensemble classifier was adopted to demonstrate the efficiency of the proposed feature selection method.

RESULTS

With the novel feature selection method, 12 baseline variables and 3 metal variables were selected to detect patients at risk for T2DM in our study. For metal variables, the dietary copper (Cu), urinary cadmium (Cd) and urinary mercury (Hg) metals were selected as the most remarkable metal exposure and the corresponding P-values were all less than 0.05. In a classification model of T2DM with 12 baseline biomarkers, the addition of 3 metal exposure improved the classification accuracy of T2DM from a traditional area under the curve (AUC) 0.792 of the receiver operating characteristic (ROC) to an AUC 0.847.

CONCLUSIONS

This was the first demonstration of T2DM classification with machine learning under urinary and dietary metal exposure. Improved prediction precision illustrated the effectiveness of the proposed machine learning-based diagnosis model facilitated lifestyle/dietary intervention for T2DM prevention.

Metals in Alzheimer's Disease

The role of metals in the pathogenesis of Alzheimer's disease (AD) is still debated. Although previous research has linked changes in essential metal homeostasis and exposure to environmental heavy metals to the pathogenesis of AD, more research is needed to determine the relationship between metals and AD. In this review, we included human studies that (1) compared the metal concentrations between AD patients and healthy controls, (2) correlated concentrations of AD cerebrospinal fluid (CSF) biomarkers with metal concentrations, and (3) used Mendelian randomization (MR) to assess the potential metal contributions to AD risk. Although many studies have examined various metals in dementia patients, understanding the dynamics of metals in these patients remains difficult due to considerable inconsistencies among the results of individual studies. The most consistent findings were for Zn and Cu, with most studies observing a decrease in Zn levels and an increase in Cu levels in AD patients. However, several studies found no such relation. Because few studies have compared metal levels with biomarker levels in the CSF of AD patients, more research of this type is required. Given that MR is revolutionizing epidemiologic research, additional MR studies that include participants from diverse ethnic backgrounds to assess the causal relationship between metals and AD risk are critical.

The relationship between cadmium and cognition in the elderly: a systematic review

Context: The relationship between cadmium (Cd) and the cognition of the elderly is indistinct.Objective: To summarise the studies on the relationship between the cognition of the elderly and Cd.Methods: Literatures were searched in PubMed, Web of Science, China National Knowledge Infrastructure (CNKI), and Wan fang database on April 25, 2022. The entries in the STROBE statement were used to evaluate the literature quality; all the quantitative studies that met the requirements were systematically summarised.Results: Blood Cd was negatively correlated with the cognitive ability of the elderly, corresponding to different cognitive ability assessment methods, the regression coefficients were: -0.11 (-0.20, -0.03), -0.46 (-0.71, -0.21), -0.54 (-0.90, -0.17), -0.19 (-0.37, -0.01), and -2.29 (-3.41, -1.16). The regression coefficients between urinary Cd level and cognition score were -1.42 (-2.38, -0.46), and 0.76 (-1.28, -0.23). When dietary Cd increased by 1 μg/kg, the composite z-score decreased by 3.64 (p = 0.001). There was no significant correlation between drinking water Cd, fingernail Cd and cognition (p > 0.05).Conclusion: We concluded that blood Cd (including whole blood and plasma), urine Cd and dietary Cd were negatively correlated with the cognition of the elderly, but the relationship between Cd in drinking water and fingernails and cognition was not statistically significant.

The combined associations of depression and cognitive impairment with functional disability and mortality in older adults: a population-based study from the NHANES 2011-2014

Objective

The present study aimed to explore the combined associations of depression and cognitive impairment with functional disability and mortality, and whether the joint effects of depression and cognitive impairment on mortality were influenced by functional disability.

Methods

A total of 2,345 participants aged 60 and above from the 2011-2014 cycle of the National Health and Nutrition Examination Survey (NHANES) were included in the analyses. Questionnaires were used to evaluated depression, global cognitive function and functional disability (including disability in activities of daily living (ADLs), instrumental activities of daily living (IADLs), leisure and social activities (LSA), lower extremity mobility (LEM), and general physical activity (GPA)). Mortality status was ascertained up to December 31, 2019. Multivariable logistic regression was performed to investigate the associations of depression and low global cognition with functional disability. Cox proportional hazards regression models were conducted to evaluate the effect of depression and low global cognition on mortality.

Results

Interactions between depression and low global cognition were observed when exploring associations of depression and low global cognition with IADLs disability, LEM disability, and cardiovascular mortality. Compared with normal participants, participants with both depression and low global cognition had the highest odds ratios of disability in ADLs, IADLs, LSA, LEM, and GPA. Besides, participants with both depression and low global cognition also had the highest hazard ratios of all-cause mortality and cardiovascular mortality, and these associations remained after adjusting for disability in ADLs, IADLs, LSA, LEM, and GPA.

Conclusion

Older adults with both depression and low global cognition were more likely to have functional disability, and had the highest risk of all-cause mortality and cardiovascular mortality.

Association between 19 dietary fatty acids intake and rheumatoid arthritis: Results of a nationwide survey

BACKGROUND

The relationship between dietary fatty acid intakes and rheumatoid arthritis (RA) is unclear and the available studies have focused on only a few fatty acids. This study investigated the association between the intake of 19 dietary fatty acids and RA in U.S. adults.

METHODS

This cross-sectional study using nationally representative data from the 2010-2020 National Health and Nutrition Examination Survey (NHANES). Multivariate linear regression model, multivariate logic regression models, smoothing curve fitting, and two-segment linear regression model were used to explore the relationships between 19 dietary fatty acids intakes with high-sensitivity C-reactive protein (Hs-CRP) and RA risk.

RESULTS

A total of 16,530 participants were included (1053 participants with RA). Intake of hexadecanoic acid and octadecanoic acid were significantly associated with higher Hs-CRP levels, intake of hexadecenoic acid was significantly associated with higher RA risk, and intake of docosahexaenoic acid was significantly associated with lower RA risk. In addition, there was an inverted U-shaped relationship between total monounsaturated fatty acids (MUFAs) intake and RA risk, with the inflection point reached at 15.77% .

CONCLUSIONS

Among the 19 dietary fatty acids, only 4 subclasses were significantly associated with Hs-CRP or RA risk. The inverted U-shaped relationship between MUFAs and RA risk may provide insights to find potential prevention strategies for RA.