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Blodgett JM, Ahmadi M, Stamatakis E, Rockwood K, Hamer M. Fractal complexity of daily physical activity and cognitive function in a midlife cohort. Sci Rep 2023; 13:20340. [PMID: 37990028 PMCID: PMC10663528 DOI: 10.1038/s41598-023-47200-x] [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: 06/02/2023] [Accepted: 11/10/2023] [Indexed: 11/23/2023] Open
Abstract
High stability of fluctuation in physiological patterns across fixed time periods suggest healthy fractal complexity, while greater randomness in fluctuation patterns may indicate underlying disease processes. The importance of fractal stability in mid-life remains unexplored. We quantified fractal regulation patterns in 24-h accelerometer data and examined associations with cognitive function in midlife. Data from 5097 individuals (aged 46) from the 1970 British Cohort Study were analyzed. Participants wore thigh-mounted accelerometers for seven days and completed cognitive tests (verbal fluency, memory, processing speed; derived composite z-score). Detrended fluctuation analysis (DFA) was used to examine temporal correlations of acceleration magnitude across 25 time scales (range: 1 min-10 h). Linear regression examined associations between DFA scaling exponents (DFAe) and each standardised cognitive outcome. DFAe was normally distributed (mean ± SD: 0.90 ± 0.06; range: 0.72-1.25). In males, a 0.10 increase in DFAe was associated with a 0.30 (95% Confidence Interval: 0.14, 0.47) increase in composite cognitive z-score in unadjusted models; associations were strongest for verbal fluency (0.10 [0.04, 0.16]). Associations remained in fully-adjusted models for verbal fluency only (0.06 [0.00, 0.12]). There was no association between DFA and cognition in females. Greater fractal stability in men was associated with better cognitive function. This could indicate mechanisms through which fractal complexity may scale up to and contribute to cognitive clinical endpoints.
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Affiliation(s)
- Joanna M Blodgett
- Institute of Sport Exercise and Health, Division of Surgery and Interventional Science, University College London, London, UK.
| | - Matthew Ahmadi
- School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
- Mackenzie Wearables Research Hub, Charles Perkins Centre, University of Sydney, Sydney, NSW, Australia
| | - Emmanuel Stamatakis
- School of Health Sciences, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
- Mackenzie Wearables Research Hub, Charles Perkins Centre, University of Sydney, Sydney, NSW, Australia
| | - Kenneth Rockwood
- Geriatric Medicine Research, Department of Medicine, Dalhousie University, Halifax, NS, Canada
| | - Mark Hamer
- Institute of Sport Exercise and Health, Division of Surgery and Interventional Science, University College London, London, UK
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2
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James SN, Nicholas JM, Lu K, Keshavan A, Lane CA, Parker T, Buchanan SM, Keuss SE, Murray-Smith H, Wong A, Cash DM, Malone IB, Barnes J, Sudre CH, Coath W, Modat M, Ourselin S, Crutch SJ, Kuh D, Fox NC, Schott JM, Richards M. Adulthood cognitive trajectories over 26 years and brain health at 70 years of age: findings from the 1946 British Birth Cohort. Neurobiol Aging 2023; 122:22-32. [PMID: 36470133 PMCID: PMC10564626 DOI: 10.1016/j.neurobiolaging.2022.10.003] [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: 04/17/2020] [Revised: 10/06/2022] [Accepted: 10/10/2022] [Indexed: 11/06/2022]
Abstract
Few studies can address how adulthood cognitive trajectories relate to brain health in 70-year-olds. Participants (n = 468, 49% female) from the 1946 British birth cohort underwent 18F-Florbetapir PET/MRI. Cognitive function was measured in childhood (age 8 years) and across adulthood (ages 43, 53, 60-64 and 69 years) and was examined in relation to brain health markers of β-amyloid (Aβ) status, whole brain and hippocampal volume, and white matter hyperintensity volume (WMHV). Taking into account key contributors of adult cognitive decline including childhood cognition, those with greater Aβ and WMHV at age 70 years had greater decline in word-list learning memory in the preceding 26 years, particularly after age 60. In contrast, those with smaller whole brain and hippocampal volume at age 70 years had greater decline in processing search speed, subtly manifest from age 50 years. Subtle changes in memory and processing speed spanning 26 years of adulthood were associated with markers of brain health at 70 years of age, consistent with detectable prodromal cognitive effects in early older age.
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Affiliation(s)
- Sarah-Naomi James
- MRC Unit for Lifelong Health and Ageing at UCL, University College London, London, UK.
| | - Jennifer M Nicholas
- Dementia Research Centre, UCL Queen Square Institute of Neurology, University College London, London, UK; Department of Medical Statistics, London School of Hygiene and Tropical Medicine, University of London, London, UK
| | - Kirsty Lu
- Dementia Research Centre, UCL Queen Square Institute of Neurology, University College London, London, UK
| | - Ashvini Keshavan
- Dementia Research Centre, UCL Queen Square Institute of Neurology, University College London, London, UK
| | - Christopher A Lane
- Dementia Research Centre, UCL Queen Square Institute of Neurology, University College London, London, UK
| | - Thomas Parker
- Dementia Research Centre, UCL Queen Square Institute of Neurology, University College London, London, UK; UK Dementia Research Institute Centre for Care Research and Technology, Imperial College London, UK; Department of Medicine, Division of Brain Sciences, Imperial College London
| | - Sarah M Buchanan
- Dementia Research Centre, UCL Queen Square Institute of Neurology, University College London, London, UK
| | - Sarah E Keuss
- Dementia Research Centre, UCL Queen Square Institute of Neurology, University College London, London, UK
| | - Heidi Murray-Smith
- Dementia Research Centre, UCL Queen Square Institute of Neurology, University College London, London, UK
| | - Andrew Wong
- MRC Unit for Lifelong Health and Ageing at UCL, University College London, London, UK
| | - David M Cash
- Dementia Research Centre, UCL Queen Square Institute of Neurology, University College London, London, UK; UK Dementia Research Institute at UCL, University College London, London, UK
| | - Ian B Malone
- Dementia Research Centre, UCL Queen Square Institute of Neurology, University College London, London, UK
| | - Josephine Barnes
- Dementia Research Centre, UCL Queen Square Institute of Neurology, University College London, London, UK
| | - Carole H Sudre
- MRC Unit for Lifelong Health and Ageing at UCL, University College London, London, UK
| | - William Coath
- Dementia Research Centre, UCL Queen Square Institute of Neurology, University College London, London, UK
| | - Marc Modat
- Dementia Research Centre, UCL Queen Square Institute of Neurology, University College London, London, UK; School of Biomedical Engineering and Imaging Sciences, King's College London, London, UK
| | - Sebastien Ourselin
- Dementia Research Centre, UCL Queen Square Institute of Neurology, University College London, London, UK; School of Biomedical Engineering and Imaging Sciences, King's College London, London, UK
| | - Sebastian J Crutch
- Dementia Research Centre, UCL Queen Square Institute of Neurology, University College London, London, UK
| | - Diana Kuh
- MRC Unit for Lifelong Health and Ageing at UCL, University College London, London, UK
| | - Nick C Fox
- Dementia Research Centre, UCL Queen Square Institute of Neurology, University College London, London, UK; UK Dementia Research Institute at UCL, University College London, London, UK
| | - Jonathan M Schott
- MRC Unit for Lifelong Health and Ageing at UCL, University College London, London, UK; Dementia Research Centre, UCL Queen Square Institute of Neurology, University College London, London, UK; UK Dementia Research Institute at UCL, University College London, London, UK
| | - Marcus Richards
- MRC Unit for Lifelong Health and Ageing at UCL, University College London, London, UK
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3
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Pavisic IM, Lu K, Keuss SE, James SN, Lane CA, Parker TD, Keshavan A, Buchanan SM, Murray-Smith H, Cash DM, Coath W, Wong A, Fox NC, Crutch SJ, Richards M, Schott JM. Subjective cognitive complaints at age 70: associations with amyloid and mental health. J Neurol Neurosurg Psychiatry 2021; 92:1215-1221. [PMID: 34035132 PMCID: PMC8522456 DOI: 10.1136/jnnp-2020-325620] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Revised: 03/08/2021] [Accepted: 04/28/2021] [Indexed: 12/11/2022]
Abstract
OBJECTIVE To investigate subjective cognitive decline (SCD) in relation to β-amyloid pathology and to test for associations with anxiety, depression, objective cognition and family history of dementia in the Insight 46 study. METHODS Cognitively unimpaired ~70-year-old participants, all born in the same week in 1946 (n=460, 49% female, 18% amyloid-positive), underwent assessments including the SCD-Questionnaire (MyCog). MyCog scores were evaluated with respect to 18F-Florbetapir-PET amyloid status (positive/negative). Associations with anxiety, depression, objective cognition (measured by the Preclinical Alzheimer Cognitive Composite, PACC) and family history of dementia were also investigated. The informant's perspective on SCD was evaluated in relation to MyCog score. RESULTS Anxiety (mean (SD) trait anxiety score: 4.4 (3.9)) was associated with higher MyCog scores, especially in women. MyCog scores were higher in amyloid-positive compared with amyloid-negative individuals (adjusted means (95% CIs): 5.3 (4.4 to 6.1) vs 4.3 (3.9 to 4.7), p=0.044), after accounting for differences in anxiety. PACC (mean (SD) -0.05 (0.68)) and family history of dementia (prevalence: 23.9%) were not independently associated with MyCog scores. The informant's perception of SCD was generally in accordance with that of the participant. CONCLUSIONS This cross-sectional study demonstrates that symptoms of SCD are associated with both β-amyloid pathology, and more consistently, trait anxiety in a population-based cohort of older adults, at an age when those who are destined to develop dementia are still likely to be some years away from symptoms. This highlights the necessity of considering anxiety symptoms when assessing Alzheimer's disease pathology and SCD.
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Affiliation(s)
- Ivanna M Pavisic
- Dementia Research Centre, Queen Square Institute of Neurology, University College London, London, UK
- UK Dementia Research Institute, University College London, London, UK
| | - Kirsty Lu
- Dementia Research Centre, Queen Square Institute of Neurology, University College London, London, UK
| | - Sarah E Keuss
- Dementia Research Centre, Queen Square Institute of Neurology, University College London, London, UK
| | - Sarah-Naomi James
- Medical Research Council Unit for Lifelong Health and Ageing, University College London, London, UK
| | - Christopher A Lane
- Dementia Research Centre, Queen Square Institute of Neurology, University College London, London, UK
| | - Thomas D Parker
- Dementia Research Centre, Queen Square Institute of Neurology, University College London, London, UK
| | - Ashvini Keshavan
- Dementia Research Centre, Queen Square Institute of Neurology, University College London, London, UK
| | - Sarah M Buchanan
- Dementia Research Centre, Queen Square Institute of Neurology, University College London, London, UK
| | - Heidi Murray-Smith
- Dementia Research Centre, Queen Square Institute of Neurology, University College London, London, UK
| | - David M Cash
- Dementia Research Centre, Queen Square Institute of Neurology, University College London, London, UK
- UK Dementia Research Institute, University College London, London, UK
| | - William Coath
- Dementia Research Centre, Queen Square Institute of Neurology, University College London, London, UK
| | - Andrew Wong
- Medical Research Council Unit for Lifelong Health and Ageing, University College London, London, UK
| | - Nick C Fox
- Dementia Research Centre, Queen Square Institute of Neurology, University College London, London, UK
- UK Dementia Research Institute, University College London, London, UK
| | - Sebastian J Crutch
- Dementia Research Centre, Queen Square Institute of Neurology, University College London, London, UK
| | - Marcus Richards
- Medical Research Council Unit for Lifelong Health and Ageing, University College London, London, UK
| | - Jonathan M Schott
- Dementia Research Centre, Queen Square Institute of Neurology, University College London, London, UK
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Salzmann A, James SN, Williams DM, Richards M, Cadar D, Schott JM, Coath W, Sudre CH, Chaturvedi N, Garfield V. Investigating the Relationship Between IGF-I, IGF-II, and IGFBP-3 Concentrations and Later-Life Cognition and Brain Volume. J Clin Endocrinol Metab 2021; 106:1617-1629. [PMID: 33631000 PMCID: PMC8118585 DOI: 10.1210/clinem/dgab121] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Indexed: 01/18/2023]
Abstract
BACKGROUND The insulin/insulin-like signaling (IIS) pathways, including insulin-like growth factors (IGFs), vary with age. However, their association with late-life cognition and neuroimaging parameters is not well characterized. METHODS Using data from the British 1946 birth cohort, we investigated associations of IGF-I, IGF-II and IGF binding protein 3 (IGFBP-3; measured at 53 and 60-64 years of age) with cognitive performance [word-learning test (WLT) and visual letter search (VLS) at 60-64 years and 69 years of age] and cognitive state [Addenbrooke's Cognitive Exam III (ACE-III) at 69-71 years of age], and in a proportion, quantified neuroimaging measures [whole brain volume (WBV), white matter hyperintensity volume (WMHV), hippocampal volume (HV)]. Regression models included adjustments for demographic, lifestyle, and health factors. RESULTS Higher IGF-I and IGF-II at 53 years of age was associated with higher ACE-III scores [ß 0.07 95% confidence interval (CI) (0.02, 0.12); scoreACE-III 89.48 (88.86, 90.1), respectively). IGF-II at 53 years of age was additionally associated with higher WLT scores [scoreWLT 20 (19.35, 20.65)]. IGFBP-3 at 60 to 64 years of age was associated with favorable VLS score at 60 to 64 and 69 years of age [ß 0.07 (0.01, 0.12); ß 0.07 (0.02, 0.12), respectively], higher memory and cognitive state at 69 years of age [ß 0.07 (0.01, 0.12); ß 0.07 (0.01, 0.13), respectively], and reduced WMHV [ß -0.1 (-0.21, -0.00)]. IGF-I/IGFBP-3 at 60 to 64 years of was associated with lower VLS scores at 69 years of age [ß -0.08 (-0.15, -0.02)]. CONCLUSIONS Increased measure in IIS parameters (IGF-I, IGF-II, and IGFBP-3) relate to better cognitive state in later life. There were apparent associations with specific cognitive domains (IGF-II relating to memory; IGFBP-3 relating to memory, processing speed, and WMHV; and IGF-I/IGFBP-3 molar ratio related to slower processing speed). IGFs and IGFBP-3 are associated with favorable cognitive function outcomes.
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Affiliation(s)
- Antoine Salzmann
- MRC Unit for Lifelong Health and Ageing at UCL, University College London, London, UK
| | - Sarah-Naomi James
- MRC Unit for Lifelong Health and Ageing at UCL, University College London, London, UK
| | - Dylan M Williams
- MRC Unit for Lifelong Health and Ageing at UCL, University College London, London, UK
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Marcus Richards
- MRC Unit for Lifelong Health and Ageing at UCL, University College London, London, UK
| | - Dorina Cadar
- Department of Behavioural Science and Health, University College London, London, UK
| | - Jonathan M Schott
- Department of Neurodegenerative Disease, The Dementia Research Centre, UCL Queen Square Institute of Neurology, London, UK
| | - William Coath
- Department of Neurodegenerative Disease, The Dementia Research Centre, UCL Queen Square Institute of Neurology, London, UK
| | - Carole H Sudre
- Department of Neurodegenerative Disease, The Dementia Research Centre, UCL Queen Square Institute of Neurology, London, UK
- School of Biomedical Engineering and Imaging Sciences, King’s College London, London, UK
| | - Nishi Chaturvedi
- MRC Unit for Lifelong Health and Ageing at UCL, University College London, London, UK
| | - Victoria Garfield
- MRC Unit for Lifelong Health and Ageing at UCL, University College London, London, UK
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5
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Lord J, Jermy B, Green R, Wong A, Xu J, Legido-Quigley C, Dobson R, Richards M, Proitsi P. Mendelian randomization identifies blood metabolites previously linked to midlife cognition as causal candidates in Alzheimer's disease. Proc Natl Acad Sci U S A 2021; 118:e2009808118. [PMID: 33879569 PMCID: PMC8072203 DOI: 10.1073/pnas.2009808118] [Citation(s) in RCA: 35] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Accepted: 02/23/2021] [Indexed: 12/29/2022] Open
Abstract
There are currently no disease-modifying treatments for Alzheimer's disease (AD), and an understanding of preclinical causal biomarkers to help target disease pathogenesis in the earliest phases remains elusive. Here, we investigated whether 19 metabolites previously associated with midlife cognition-a preclinical predictor of AD-translate to later clinical risk, using Mendelian randomization (MR) to tease out AD-specific causal relationships. Summary statistics from the largest genome-wide association studies (GWASs) for AD and metabolites were used to perform bidirectional univariable MR. Bayesian model averaging (BMA) was additionally performed to address high correlation between metabolites and identify metabolite combinations that may be on the AD causal pathway. Univariable MR indicated four extra-large high-density lipoproteins (XL.HDL) on the causal pathway to AD: free cholesterol (XL.HDL.FC: 95% CI = 0.78 to 0.94), total lipids (XL.HDL.L: 95% CI = 0.80 to 0.97), phospholipids (XL.HDL.PL: 95% CI = 0.81 to 0.97), and concentration of XL.HDL particles (95% CI = 0.79 to 0.96), significant at an adjusted P < 0.009. MR-BMA corroborated XL.HDL.FC to be among the top three causal metabolites, in addition to total cholesterol in XL.HDL (XL.HDL.C) and glycoprotein acetyls (GP). Both XL.HDL.C and GP demonstrated suggestive univariable evidence of causality (P < 0.05), and GP successfully replicated within an independent dataset. This study offers insight into the causal relationship between metabolites demonstrating association with midlife cognition and AD. It highlights GP in addition to several XL.HDLs-particularly XL.HDL.FC-as causal candidates warranting further investigation. As AD pathology is thought to develop decades prior to symptom onset, expanding on these findings could inform risk reduction strategies.
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Affiliation(s)
- Jodie Lord
- Department of Basic and Clinical Neuroscience, Maurice Wohl Clinical Neuroscience Institute, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, SE5 5AF, United Kingdom
| | - Bradley Jermy
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, SE5 8AF, United Kingdom
- National Institute for Health Research Maudsley Biomedical Research Centre, South London and Maudsley National Health Service (NHS) Foundation Trust, London, SE5 8AF, United Kingdom
| | - Rebecca Green
- Department of Basic and Clinical Neuroscience, Maurice Wohl Clinical Neuroscience Institute, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, SE5 5AF, United Kingdom
- National Institute for Health Research Maudsley Biomedical Research Centre, South London and Maudsley National Health Service (NHS) Foundation Trust, London, SE5 8AF, United Kingdom
| | - Andrew Wong
- MRC Unit for Lifelong Health and Ageing at UCL, University College London, London, WC1E 7HB, United Kingdom
| | - Jin Xu
- Department of Basic and Clinical Neuroscience, Maurice Wohl Clinical Neuroscience Institute, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, SE5 5AF, United Kingdom
- Institute of Pharmaceutical Science, King's College London, London, SE1 9NH, United Kingdom
| | - Cristina Legido-Quigley
- Institute of Pharmaceutical Science, King's College London, London, SE1 9NH, United Kingdom
- Systems Medicine, Steno Diabetes Centre Copenhagen, 2820 Gentofte, Denmark
| | - Richard Dobson
- Department of Biostatistics and Health Informatics, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, SE5 8AF, United Kingdom
- National Institute for Health Research Biomedical Research at South London and Maudsley NHS Foundation Trust and King's College London, London, SE5 8AF, United Kingdom
- Health Data Research UK London, University College London, London, NW1 2DA, United Kingdom
- Institute of Health Informatics, University College London, London, NW1 2DA, United Kingdom
- National Institute for Health Research Biomedical Research Centre at University College London Hospitals NHS Foundation Trust, London, NW1 2DA, United Kingdom
| | - Marcus Richards
- MRC Unit for Lifelong Health and Ageing at UCL, University College London, London, WC1E 7HB, United Kingdom;
| | - Petroula Proitsi
- Department of Basic and Clinical Neuroscience, Maurice Wohl Clinical Neuroscience Institute, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, SE5 5AF, United Kingdom;
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James SN, Nicholas JM, Lane CA, Parker TD, Lu K, Keshavan A, Buchanan SM, Keuss SE, Murray-Smith H, Wong A, Cash DM, Malone IB, Barnes J, Sudre CH, Coath W, Prosser L, Ourselin S, Modat M, Thomas DL, Cardoso J, Heslegrave A, Zetterberg H, Crutch SJ, Schott JM, Richards M, Fox NC. A population-based study of head injury, cognitive function and pathological markers. Ann Clin Transl Neurol 2021; 8:842-856. [PMID: 33694298 PMCID: PMC8045921 DOI: 10.1002/acn3.51331] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Accepted: 02/12/2021] [Indexed: 02/01/2023] Open
Abstract
Objective To assess associations between head injury (HI) with loss of consciousness (LOC), ageing and markers of later‐life cerebral pathology; and to explore whether those effects may help explain subtle cognitive deficits in dementia‐free individuals. Methods Participants (n = 502, age = 69–71) from the 1946 British Birth Cohort underwent cognitive testing (subtests of Preclinical Alzheimer Cognitive Composite), 18F‐florbetapir Aβ‐PET and MR imaging. Measures include Aβ‐PET status, brain, hippocampal and white matter hyperintensity (WMH) volumes, normal appearing white matter (NAWM) microstructure, Alzheimer’s disease (AD)‐related cortical thickness, and serum neurofilament light chain (NFL). LOC HI metrics include HI occurring: (i) >15 years prior to the scan (ii) anytime up to age 71. Results Compared to those with no evidence of an LOC HI, only those reporting an LOC HI>15 years prior (16%, n = 80) performed worse on cognitive tests at age 69–71, taking into account premorbid cognition, particularly on the digit‐symbol substitution test (DSST). Smaller brain volume (BV) and adverse NAWM microstructural integrity explained 30% and 16% of the relationship between HI and DSST, respectively. We found no evidence that LOC HI was associated with Aβ load, hippocampal volume, WMH volume, AD‐related cortical thickness or NFL (all p > 0.01). Interpretation Having a LOC HI aged 50’s and younger was linked with lower later‐life cognitive function at age ~70 than expected. This may reflect a damaging but small impact of HI; explained in part by smaller BV and different microstructure pathways but not via pathology related to AD (amyloid, hippocampal volume, AD cortical thickness) or ongoing neurodegeneration (serum NFL).
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Affiliation(s)
- Sarah-Naomi James
- MRC Unit for Lifelong Health and Ageing at UCL, University College London, London, United Kingdom.,Dementia Research Centre, UCL Queen Square Institute of Neurology, University College London, London, United Kingdom
| | - Jennifer M Nicholas
- Dementia Research Centre, UCL Queen Square Institute of Neurology, University College London, London, United Kingdom.,Department of Medical Statistics, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Christopher A Lane
- Dementia Research Centre, UCL Queen Square Institute of Neurology, University College London, London, United Kingdom
| | - Thomas D Parker
- Dementia Research Centre, UCL Queen Square Institute of Neurology, University College London, London, United Kingdom
| | - Kirsty Lu
- Dementia Research Centre, UCL Queen Square Institute of Neurology, University College London, London, United Kingdom
| | - Ashvini Keshavan
- Dementia Research Centre, UCL Queen Square Institute of Neurology, University College London, London, United Kingdom
| | - Sarah M Buchanan
- Dementia Research Centre, UCL Queen Square Institute of Neurology, University College London, London, United Kingdom
| | - Sarah E Keuss
- Dementia Research Centre, UCL Queen Square Institute of Neurology, University College London, London, United Kingdom
| | - Heidi Murray-Smith
- Dementia Research Centre, UCL Queen Square Institute of Neurology, University College London, London, United Kingdom
| | - Andrew Wong
- MRC Unit for Lifelong Health and Ageing at UCL, University College London, London, United Kingdom
| | - David M Cash
- Dementia Research Centre, UCL Queen Square Institute of Neurology, University College London, London, United Kingdom
| | - Ian B Malone
- Dementia Research Centre, UCL Queen Square Institute of Neurology, University College London, London, United Kingdom
| | - Josephine Barnes
- Dementia Research Centre, UCL Queen Square Institute of Neurology, University College London, London, United Kingdom
| | - Carole H Sudre
- MRC Unit for Lifelong Health and Ageing at UCL, University College London, London, United Kingdom.,Dementia Research Centre, UCL Queen Square Institute of Neurology, University College London, London, United Kingdom.,School of Biomedical Engineering and Imaging Sciences, King's College London, Institute of Nuclear Medicine, University College London Hospitals, London, United Kingdom.,Centre for Medical Image Computing, Department of Computer Science, University College London, London, United Kingdom
| | - William Coath
- Dementia Research Centre, UCL Queen Square Institute of Neurology, University College London, London, United Kingdom
| | - Lloyd Prosser
- Dementia Research Centre, UCL Queen Square Institute of Neurology, University College London, London, United Kingdom
| | - Sebastien Ourselin
- School of Biomedical Engineering and Imaging Sciences, King's College London, Institute of Nuclear Medicine, University College London Hospitals, London, United Kingdom
| | - Marc Modat
- Dementia Research Centre, UCL Queen Square Institute of Neurology, University College London, London, United Kingdom.,School of Biomedical Engineering and Imaging Sciences, King's College London, Institute of Nuclear Medicine, University College London Hospitals, London, United Kingdom
| | - David L Thomas
- Dementia Research Centre, UCL Queen Square Institute of Neurology, University College London, London, United Kingdom
| | - Jorge Cardoso
- School of Biomedical Engineering and Imaging Sciences, King's College London, Institute of Nuclear Medicine, University College London Hospitals, London, United Kingdom
| | - Amanda Heslegrave
- UK Dementia Research Institute at UCL, University College London, London, United Kingdom.,Department of Neurodegenerative Disease, UCL Institute of Neurology, London, United Kingdom
| | - Henrik Zetterberg
- UK Dementia Research Institute at UCL, University College London, London, United Kingdom.,Department of Neurodegenerative Disease, UCL Institute of Neurology, London, United Kingdom.,Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden.,Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden
| | - Sebastian J Crutch
- Dementia Research Centre, UCL Queen Square Institute of Neurology, University College London, London, United Kingdom
| | - Jonathan M Schott
- Dementia Research Centre, UCL Queen Square Institute of Neurology, University College London, London, United Kingdom
| | - Marcus Richards
- MRC Unit for Lifelong Health and Ageing at UCL, University College London, London, United Kingdom
| | - Nick C Fox
- Dementia Research Centre, UCL Queen Square Institute of Neurology, University College London, London, United Kingdom.,UK Dementia Research Institute at UCL, University College London, London, United Kingdom
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7
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Mostafa T, Narayanan M, Pongiglione B, Dodgeon B, Goodman A, Silverwood RJ, Ploubidis GB. Missing at random assumption made more plausible: evidence from the 1958 British birth cohort. J Clin Epidemiol 2021; 136:44-54. [PMID: 33652080 DOI: 10.1016/j.jclinepi.2021.02.019] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2020] [Revised: 02/10/2021] [Accepted: 02/24/2021] [Indexed: 01/27/2023]
Abstract
OBJECTIVE Non-response is unavoidable in longitudinal surveys. The consequences are lower statistical power and the potential for bias. We implemented a systematic data-driven approach to identify predictors of non-response in the National Child Development Study (NCDS; 1958 British birth cohort). Such variables can help make the missing at random assumption more plausible, which has implications for the handling of missing data STUDY DESIGN AND SETTING: We identified predictors of non-response using data from the 11 sweeps (birth to age 55) of the NCDS (n = 17,415), employing parametric regressions and the LASSO for variable selection. RESULTS Disadvantaged socio-economic background in childhood, worse mental health and lower cognitive ability in early life, and lack of civic and social participation in adulthood were consistently associated with non-response. Using this information, along with other data from NCDS, we were able to replicate the "population distribution" of educational attainment and marital status (derived from external data), and the original distributions of key early life characteristics. CONCLUSION The identified predictors of non-response have the potential to improve the plausibility of the missing at random assumption. They can be straightforwardly used as "auxiliary variables" in analyses with principled methods to reduce bias due to missing data.
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Taivalantti M, Barnett JH, Halt AH, Koskela J, Auvinen J, Timonen M, Järvelin MR, Veijola J. Depressive symptoms as predictors of visual memory deficits in middle-age. J Affect Disord 2020; 264:29-34. [PMID: 31846899 DOI: 10.1016/j.jad.2019.11.125] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2019] [Revised: 10/29/2019] [Accepted: 11/29/2019] [Indexed: 12/19/2022]
Abstract
BACKGROUND Depression has been known to affect memory and other cognitive domains. The objective of this longitudinal cohort study was to investigate longitudinal associations between depressive symptoms at age 31 years and visual memory and new learning at the age of 46 years. We investigated whether depressive symptoms at age 31 predicted visual memory deficits at age 46 years, and whether changes in depressive symptoms between 31 and 46 years predicted visual memory at age 46. METHODS Participants were members of the Northern Finland Birth Cohort 1966. Depressive symptoms were assessed with the Symptom Checklist-25 (SCL-25) on both occasions. Visual memory and new learning were assessed using Paired Associative Learning (PAL) test at the age 46 follow-up. PAL total errors adjusted and first trial memory score were used as outcomes and basic educational level, relationship status, physical activity and diet at baseline were considered as confounding factors in linear regression analysis. RESULTS A total of 5029 (57% female) participants were included in the main analysis. No associations were found between depressive symptoms or change in depressive symptoms and visual memory and new learning scores. The result did not change following cut-offs 1.55 and 1.75 for depression. LIMITATIONS SCL-25 only measures symptoms during the past week. Only one cognitive domain was assessed. CONCLUSIONS Contrary to our hypothesis, neither baseline depressive symptoms nor change in depressive symptoms predicted visual memory scores 15 years later. It appears that sub-clinical depressive symptoms do not effect this cognitive domain in the middle-aged population.
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Affiliation(s)
- Marjo Taivalantti
- Department of Psychiatry, Research Unit of Clinical Neuroscience, University of Oulu, Oulu, Finland.
| | - Jennifer H Barnett
- Department of Psychiatry, University of Cambridge, Cambridge Cognition Ltd, Cambridge, UK
| | - Anu-Helmi Halt
- Department of Psychiatry, Research Unit of Clinical Neuroscience, University of Oulu, Oulu, Finland
| | - Jari Koskela
- Department of Psychiatry, Research Unit of Clinical Neuroscience, University of Oulu, Oulu, Finland
| | - Juha Auvinen
- Center for Life Course Health Research, Faculty of Medicine, University of Oulu, Oulu Finland; Oulunkaari Health Centre, Ii, Finland
| | - Markku Timonen
- Center for Life Course Health Research, Faculty of Medicine, University of Oulu, Oulu Finland
| | - Marjo-Riitta Järvelin
- Center for Life Course Health Research, Faculty of Medicine, University of Oulu, Oulu Finland; Department of Epidemiology and Biostatistics, MRC Health Protection Agency (HPE), Centre for Environment and Health, School of Public Health, Imperial College London, London, UK; Biocenter Oulu, University of Oulu, Oulu, Finland; Unit of Primary Care, Oulu University Hospital, Oulu, Finland; Department of Life Sciences, College of Health and Life Sciences, Brunel University London, United Kingdom
| | - Juha Veijola
- Department of Psychiatry, Research Unit of Clinical Neuroscience, University of Oulu, Oulu, Finland; Medical Research Centre Oulu, University Hospital of Oulu and University of Oulu and Department of psychiatry, University Hospital of Oulu, Oulu, Finland
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Li Y, Wang Y, Ren Z, Gao M, Liu Q, Qiu C, Zhang W. The influence of environmental pressure on Internet Use Disorder in adolescents: The potential mediating role of cognitive function. Addict Behav 2020; 101:105976. [PMID: 31101387 DOI: 10.1016/j.addbeh.2019.04.034] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2018] [Revised: 04/26/2019] [Accepted: 04/27/2019] [Indexed: 11/18/2022]
Abstract
PURPOSE The current study attempts to clarify the mediating role of cognitive function on the relationship between environmental pressure (pressure caused by negative parenting styles and dysfunctional school environments) and Internet Use Disorder (IUD); this study explores the effects of sex and left-behind children (LBC). METHODS A cross-sectional sample of adolescents aged 12-15 years was recruited in 2018. A total of 3048 junior high school adolescents in rural areas of the Sichuan province in western China completed a series of psychological inventories, including the Adolescent Pathological Internet Use Scale (APIUS), the Junior High School Students' Perceived School Climate Inventory (PSCI-M), the Egna Minnen av. Barndoms Uppfostran (EMBU), and the Mental Health Screening Inventory for Children and Adolescents (MHS-C), for an analysis of IUD, school climate, parenting styles and cognition, respectively. RESULTS Among the participants, 18.5% (N = 565) exhibited significant symptoms of IUD. The correlation analysis showed that IUD was positively correlated with parents' punishment, rejection and over-interference and academic pressure, whereas IUD was negatively associated with good teacher-student relationships, good schoolmate relationships and cognitive function scores. Structural equation modelling (SEM) showed that cognitive function partially contributed to the association between family and school pressures and IUD. DISCUSSION Cognitive function is one of the mediating pathways through which environmental pressures may predict IUD among junior high school students. Interventions may target the mediating pathway of cognitive function to alleviate the negative impact of environmental pressure on IUD.
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Affiliation(s)
- Yuchen Li
- Mental Health Center, West China Hospital of Sichuan University, Chengdu, China
| | - Yue Wang
- Mental Health Center, West China Hospital of Sichuan University, Chengdu, China
| | - Zhengjia Ren
- Department of Clinical Psychology, Southwest Hospital, Army Medical University (The Third Military Medical University), Chongqing, China
| | - Meng Gao
- Mental Health Center, West China Hospital of Sichuan University, Chengdu, China
| | - Qiaolan Liu
- Department of health-related social and behavioral sciences, West China School of Public Health, Sichuan University, No. 17, Section 3, South Renmin Road, Chengdu, Sichuan 610041, PR China.
| | - Changjian Qiu
- Mental Health Center, West China Hospital of Sichuan University, Chengdu, China.
| | - Wei Zhang
- Mental Health Center, West China Hospital of Sichuan University, Chengdu, China.
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10
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Blodgett JM, Kuh D, Hardy R, Davis DHJ, Cooper R. Childhood Cognition and Age-Related Change in Standing Balance Performance From Mid to Later Life: Findings From a British Birth Cohort. J Gerontol A Biol Sci Med Sci 2020; 75:155-161. [PMID: 30535263 PMCID: PMC6909897 DOI: 10.1093/gerona/gly275] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2018] [Indexed: 01/23/2023] Open
Abstract
BACKGROUND Cognitive processing plays a crucial role in the integration of sensory input and motor output that facilitates balance. However, whether balance ability in adulthood is influenced by cognitive pathways established in childhood is unclear, especially as no study has examined if these relationships change with age. We aimed to investigate associations between childhood cognition and age-related change in standing balance between mid and later life. METHODS Data on 2,380 participants from the MRC National Survey of Health and Development were included in analyses. Repeated measures multilevel models estimated the association between childhood cognition, assessed at age 15, and log-transformed balance time, assessed at ages 53, 60-64, and 69 using the one-legged stand with eyes closed. Adjustments were made for sex, death, attrition, anthropometric measures, health conditions, health behaviors, education, other indicators of socioeconomic position (SEP), and adult verbal memory. RESULTS In a sex-adjusted model, 1 standard deviation increase in childhood cognition was associated with a 13% (95% confidence interval: 10, 16; p < .001) increase in balance time at age 53, and this association got smaller with age (cognition × age interaction: p < .001). Adjustments for education, adult verbal memory, and SEP largely explained these associations. CONCLUSIONS Higher childhood cognition was associated with better balance performance in midlife, with diminishing associations with increasing age. The impact of adjustment for education, cognition and other indicators of SEP suggested a common pathway through which cognition is associated with balance across life. Further research is needed to understand underlying mechanisms, which may have important implications for falls risk and maintenance of physical capability.
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Affiliation(s)
| | - Diana Kuh
- MRC Unit for Lifelong Health and Ageing at UCL, London, UK
| | - Rebecca Hardy
- MRC Unit for Lifelong Health and Ageing at UCL, London, UK
| | | | - Rachel Cooper
- MRC Unit for Lifelong Health and Ageing at UCL, London, UK
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11
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John A, James SN, Rusted J, Richards M, Gaysina D. Effects of affective symptoms in adolescence and adulthood on trajectories of cognitive function from middle to late adulthood. J Affect Disord 2019; 259:424-431. [PMID: 31610999 DOI: 10.1016/j.jad.2019.08.077] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2018] [Revised: 05/30/2019] [Accepted: 08/23/2019] [Indexed: 11/28/2022]
Abstract
BACKGROUND Little is known about the link between affective symptoms and cognitive function across the life course. This study aims to investigate whether affective symptoms in adolescence and adulthood predict trajectories of cognitive function from middle to late-adulthood. METHODS Data from the MRC National Survey of Health and Development (NSHD), a cohort of 5362 individuals born in mainland UK in 1946, were utilised. Linear mixed models were used to model cognitive trajectories (memory and processing speed) over a three-decade period (from 43 to 69) and to test effects of affective symptoms in adolescence (ages 13-15) and adulthood (ages 36 and 43) on cognitive function at first testing (age 43) and decline in cognitive function (from 43 to 69). Models were adjusted for sex, childhood cognition, childhood socioeconomic position, and education. RESULTS A quadratic model best fitted memory and processing speed data. Models revealed that adolescent affective symptoms were associated with lower memory (b = -1.11, SE = 0.53, p = .04) and processing speed (b = -18.17, SE = 7.53, p = .02) at first cognitive testing, but not with rates of decline from 43 to 69. There were no significant associations between adult affective symptoms and cognitive trajectories. LIMITATIONS Missing data is a potential limitation of this study. This was dealt with using maximum likelihood estimation and multiple imputation. CONCLUSIONS Findings suggest that adolescent, but not adult, affective symptoms are important predictors of cognitive function in midlife, but not rate of cognitive decline. This highlights the importance of early intervention to manage mental health in adolescence to protect later cognitive function.
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Affiliation(s)
- Amber John
- EDGE Lab, School of Psychology, University of Sussex, Pevensey 1 2C8, Brighton, United Kingdom.
| | - Sarah-Naomi James
- MRC Unit for Lifelong Health and Ageing at UCL, London, United Kingdom
| | - Jennifer Rusted
- School of Psychology, University of Sussex, Brighton, United Kingdom
| | - Marcus Richards
- MRC Unit for Lifelong Health and Ageing at UCL, London, United Kingdom
| | - Darya Gaysina
- EDGE Lab, School of Psychology, University of Sussex, Pevensey 1 2C8, Brighton, United Kingdom
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12
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John A, James SN, Patel U, Rusted J, Richards M, Gaysina D. Longitudinal associations of affective symptoms with mid-life cognitive function: evidence from a British birth cohort. Br J Psychiatry 2019; 215:675-682. [PMID: 30894229 DOI: 10.1192/bjp.2019.24] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
BACKGROUND Affective disorders are associated with poorer cognition in older adults; however, whether this association can already be observed in mid-life remains unclear. AIMS To investigate the effects of affective symptoms over a period of 30 years on mid-life cognitive function. First, we explored whether timing (sensitive period) or persistence (accumulation) of affective symptoms predicted cognitive function. Second, we tested how different longitudinal trajectories of affective symptoms were associated with cognitive function. METHOD The study used data from the National Child Development Study. Memory, verbal fluency, information processing speed and accuracy were measured at age 50. Affective symptoms were measured at ages 23, 33, 42 and 50 and used to derive longitudinal trajectories. A structured modelling approach compared a set of nested models in order to test accumulation versus sensitive period hypotheses. Linear regressions and structural equation modelling were used to test for longitudinal associations of affective symptoms with cognitive function. RESULTS Accumulation of affective symptoms was found to be the best fit for the data, with persistent affective symptoms being associated with poorer immediate memory (b = -0.07, s.e. = 0.03, P = 0.01), delayed memory (b = -0.13, s.e. = 0.04, P < 0.001) and information processing accuracy (b = 0.18, s.e. = 0.08, P = 0.03), but not with information processing speed (b = 3.15, s.e. = 1.89, P = 0.10). Longitudinal trajectories of repeated affective symptoms were associated with poorer memory, verbal fluency and information processing accuracy. CONCLUSIONS Persistent affective symptoms can affect cognitive function in mid-life. Effective management of affective disorders to prevent recurrence may reduce risk of poor cognitive outcomes and promote healthy cognitive ageing. DECLARATION OF INTEREST None.
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Affiliation(s)
- Amber John
- PhD Student, EDGE Lab, School of Psychology, University of Sussex, UK
| | - Sarah-Naomi James
- Postdoctoral researcher, MRC Unit for Lifelong Health and Ageing at UCL, UK
| | - Urvisha Patel
- MSc Student, EDGE Lab, School of Psychology, University of Sussex, UK
| | - Jennifer Rusted
- Professor of Experimental Psychology, School of Psychology, University of Sussex, UK
| | - Marcus Richards
- Programme Leader, MRC Unit for Lifelong Health and Ageing at UCL, UK
| | - Darya Gaysina
- Senior Lecturer in Psychology, EDGE Lab, School of Psychology, University of Sussex, UK
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13
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Dietary glycaemic index and cognitive function: prospective associations in adults of the 1946 British birth cohort. Public Health Nutr 2018; 22:1415-1424. [PMID: 30585572 PMCID: PMC6906611 DOI: 10.1017/s136898001800352x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Objective Evidence suggests that the rate of glucose release following consumption of carbohydrate-containing foods, defined as the glycaemic index (GI), is inversely associated with cognitive function. To date, most of the evidence stems from either single-meal studies or highly heterogeneous cohort studies. We aimed to study the prospective associations of diet GI at age 53 years with outcomes of verbal memory and letter search tests at age 69 years and rate of decline between 53 and 69 years. Design Longitudinal population-based birth cohort study. Setting MRC National Survey for Health and Development. Participants Cohort members (n 1252). Results Using multivariable linear and logistic regression, adjusted for potential confounders, associations of higher-GI diet with lower verbal memory, lower letter search speed and lower number of hits in a letter search test were attenuated after adjustments for cognitive ability at age 15 years, educational attainment, further training and occupational social class. No association was observed between diet GI at 53 years and letter search accuracy or speed–accuracy trade-off at 69 years, or between diet GI at 53 years and rate of decline between 53 and 69 years in any cognitive measure. Conclusions Diet GI does not appear to predict cognitive function or decline, which was mainly explained by childhood cognitive ability, education and occupational social class. Our findings confirm the need for further research on the association between diet and cognition from a life-course perspective.
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14
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James SN, Davis D, O'Hare C, Sharma N, John A, Gaysina D, Hardy R, Kuh D, Richards M. Lifetime affective problems and later-life cognitive state: Over 50 years of follow-up in a British birth cohort study. J Affect Disord 2018; 241:348-355. [PMID: 30144717 PMCID: PMC6137547 DOI: 10.1016/j.jad.2018.07.078] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2018] [Revised: 06/27/2018] [Accepted: 07/27/2018] [Indexed: 12/29/2022]
Abstract
BACKGROUND Affective problems increase the risk of dementia and cognitive impairment, yet the life course dimension of this association is not clearly understood. We aimed to investigate how affective problems across the life course relate to later-life cognitive state. METHODS Data from 1269 participants from the Medical Research Council National Survey of Health and Development (NSHD, the British 1946 birth cohort) were used. Prospectively-assessed measures of affective symptoms spanning ages 13-69 and categorised into case-level thresholds. Outcomes consisted of a comprehensive measure of cognitive state (Addenbrooke's Cognitive Examination (ACE-III)), verbal memory, and letter search speed and accuracy at age 69. RESULTS Complementary life course models demonstrated that having 2 or more case-level problems across the life course was most strongly associated with poorer cognitive outcomes, before and after adjusting for sex, childhood cognition, childhood and midlife occupational position and education. LIMITATIONS A disproportionate loss to follow-up of those who had lower childhood cognitive scores may have led to underestimation of the strength of associations. DISCUSSION Using a population-based prospective study we provide evidence that recurrent lifetime affective problems predicts poorer later-life cognitive state, and this risk can be already manifest in early old age (age 69). Our findings raise the possibility that effective management to minimise affective problems reoccurring across the life course may reduce the associated risk of cognitive impairment and decline.
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Affiliation(s)
- Sarah-Naomi James
- MRC Unit for Lifelong Health and Aging at UCL, 33 Bedford Place, WC1B 5JU, London, United Kingdom
| | - Daniel Davis
- MRC Unit for Lifelong Health and Aging at UCL, 33 Bedford Place, WC1B 5JU, London, United Kingdom
| | - Celia O'Hare
- MRC Unit for Lifelong Health and Aging at UCL, 33 Bedford Place, WC1B 5JU, London, United Kingdom
| | - Nikhil Sharma
- MRC Unit for Lifelong Health and Aging at UCL, 33 Bedford Place, WC1B 5JU, London, United Kingdom
| | - Amber John
- EDGE Lab, School of Psychology, University of Sussex, BN1 9RH, Brighton, United Kingdom
| | - Darya Gaysina
- EDGE Lab, School of Psychology, University of Sussex, BN1 9RH, Brighton, United Kingdom
| | - Rebecca Hardy
- MRC Unit for Lifelong Health and Aging at UCL, 33 Bedford Place, WC1B 5JU, London, United Kingdom
| | - Diana Kuh
- MRC Unit for Lifelong Health and Aging at UCL, 33 Bedford Place, WC1B 5JU, London, United Kingdom
| | - Marcus Richards
- MRC Unit for Lifelong Health and Aging at UCL, 33 Bedford Place, WC1B 5JU, London, United Kingdom.
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15
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Proitsi P, Kuh D, Wong A, Maddock J, Bendayan R, Wulaningsih W, Hardy R, Richards M. Lifetime cognition and late midlife blood metabolites: findings from a British birth cohort. Transl Psychiatry 2018; 8:203. [PMID: 30258059 PMCID: PMC6158182 DOI: 10.1038/s41398-018-0253-0] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2017] [Revised: 04/25/2018] [Accepted: 05/11/2018] [Indexed: 11/24/2022] Open
Abstract
Maintenance of healthy cognitive ageing is vital for independence and wellbeing in the older general population. We investigated the association between blood metabolites and cognitive function and decline. Participants from the MRC National Survey of Health and Development (NSHD, the British 1946 birth cohort) were studied; 233 nuclear magnetic resonance circulating metabolite measures were quantified in 909 men and women at ages 60-64. Short-term and delayed verbal memory and processing speed were concurrently assessed and these tests were repeated at age 69. Linear regression analyses tested associations between metabolites and cognitive function at ages 60-64, and changes in these measures by age 69, adjusting for childhood cognition, education, socio-economic status and lifestyle factors. In cross-sectional analyses, metabolite levels, particularly fatty acid composition and different lipid sub-classes, were associated with short-term verbal memory (4 measures in females and 11 measures in the whole sample), delayed verbal memory (2 measures in females) and processing speed (8 measures in males and 2 measures in the whole sample) (p < 0.002). One metabolite was associated with change in cognition in females. Most of the observed associations were attenuated after adjustment for childhood cognition and education. A life course perspective can improve the understanding of how peripheral metabolic processes underlie cognitive ageing.
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Affiliation(s)
| | - Diana Kuh
- 0000 0004 0427 2580grid.268922.5MRC Unit for Lifelong Health and Ageing at UCL, London, UK
| | - Andrew Wong
- 0000 0004 0427 2580grid.268922.5MRC Unit for Lifelong Health and Ageing at UCL, London, UK
| | - Jane Maddock
- 0000 0004 0427 2580grid.268922.5MRC Unit for Lifelong Health and Ageing at UCL, London, UK
| | - Rebecca Bendayan
- 0000 0004 0427 2580grid.268922.5MRC Unit for Lifelong Health and Ageing at UCL, London, UK
| | - Wahyu Wulaningsih
- 0000 0004 0427 2580grid.268922.5MRC Unit for Lifelong Health and Ageing at UCL, London, UK
| | - Rebecca Hardy
- 0000 0004 0427 2580grid.268922.5MRC Unit for Lifelong Health and Ageing at UCL, London, UK
| | - Marcus Richards
- 0000 0004 0427 2580grid.268922.5MRC Unit for Lifelong Health and Ageing at UCL, London, UK
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16
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Lane CA, Parker TD, Cash DM, Macpherson K, Donnachie E, Murray-Smith H, Barnes A, Barker S, Beasley DG, Bras J, Brown D, Burgos N, Byford M, Jorge Cardoso M, Carvalho A, Collins J, De Vita E, Dickson JC, Epie N, Espak M, Henley SMD, Hoskote C, Hutel M, Klimova J, Malone IB, Markiewicz P, Melbourne A, Modat M, Schrag A, Shah S, Sharma N, Sudre CH, Thomas DL, Wong A, Zhang H, Hardy J, Zetterberg H, Ourselin S, Crutch SJ, Kuh D, Richards M, Fox NC, Schott JM. Study protocol: Insight 46 - a neuroscience sub-study of the MRC National Survey of Health and Development. BMC Neurol 2017; 17:75. [PMID: 28420323 PMCID: PMC5395844 DOI: 10.1186/s12883-017-0846-x] [Citation(s) in RCA: 57] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2017] [Accepted: 03/21/2017] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Increasing age is the biggest risk factor for dementia, of which Alzheimer's disease is the commonest cause. The pathological changes underpinning Alzheimer's disease are thought to develop at least a decade prior to the onset of symptoms. Molecular positron emission tomography and multi-modal magnetic resonance imaging allow key pathological processes underpinning cognitive impairment - including β-amyloid depostion, vascular disease, network breakdown and atrophy - to be assessed repeatedly and non-invasively. This enables potential determinants of dementia to be delineated earlier, and therefore opens a pre-symptomatic window where intervention may prevent the onset of cognitive symptoms. METHODS/DESIGN This paper outlines the clinical, cognitive and imaging protocol of "Insight 46", a neuroscience sub-study of the MRC National Survey of Health and Development. This is one of the oldest British birth cohort studies and has followed 5362 individuals since their birth in England, Scotland and Wales during one week in March 1946. These individuals have been tracked in 24 waves of data collection incorporating a wide range of health and functional measures, including repeat measures of cognitive function. Now aged 71 years, a small fraction have overt dementia, but estimates suggest that ~1/3 of individuals in this age group may be in the preclinical stages of Alzheimer's disease. Insight 46 is recruiting 500 study members selected at random from those who attended a clinical visit at 60-64 years and on whom relevant lifecourse data are available. We describe the sub-study design and protocol which involves a prospective two time-point (0, 24 month) data collection covering clinical, neuropsychological, β-amyloid positron emission tomography and magnetic resonance imaging, biomarker and genetic information. Data collection started in 2015 (age 69) and aims to be completed in 2019 (age 73). DISCUSSION Through the integration of data on the socioeconomic environment and on physical, psychological and cognitive function from 0 to 69 years, coupled with genetics, structural and molecular imaging, and intensive cognitive and neurological phenotyping, Insight 46 aims to identify lifetime factors which influence brain health and cognitive ageing, with particular focus on Alzheimer's disease and cerebrovascular disease. This will provide an evidence base for the rational design of disease-modifying trials.
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Affiliation(s)
- Christopher A. Lane
- Dementia Research Centre, Institute of Neurology, University College London, London, UK
| | - Thomas D. Parker
- Dementia Research Centre, Institute of Neurology, University College London, London, UK
| | - Dave M. Cash
- Dementia Research Centre, Institute of Neurology, University College London, London, UK
- Translational Imaging Group, Centre for Medical Image Computing, University College London, London, UK
| | - Kirsty Macpherson
- Dementia Research Centre, Institute of Neurology, University College London, London, UK
| | - Elizabeth Donnachie
- Leonard Wolfson Experimental Neurology Centre, Institute of Neurology, University College London, London, UK
| | - Heidi Murray-Smith
- Dementia Research Centre, Institute of Neurology, University College London, London, UK
| | - Anna Barnes
- Institute of Nuclear Medicine, University College London Hospitals, London, UK
| | - Suzie Barker
- Dementia Research Centre, Institute of Neurology, University College London, London, UK
| | - Daniel G. Beasley
- Translational Imaging Group, Centre for Medical Image Computing, University College London, London, UK
| | - Jose Bras
- Department of Molecular Neuroscience, Institute of Neurology, University College London, London, UK
- Department of Medical Sciences and Institute of Biomedicine - iBiMED, University of Aveiro, Aveiro, Portugal
| | - David Brown
- Institute of Nuclear Medicine, University College London Hospitals, London, UK
| | - Ninon Burgos
- Translational Imaging Group, Centre for Medical Image Computing, University College London, London, UK
| | | | - M. Jorge Cardoso
- Translational Imaging Group, Centre for Medical Image Computing, University College London, London, UK
| | - Ana Carvalho
- Institute of Nuclear Medicine, University College London Hospitals, London, UK
| | - Jessica Collins
- Dementia Research Centre, Institute of Neurology, University College London, London, UK
| | - Enrico De Vita
- Lysholm Department of Neuroradiology, The National Hospital for Neurology and Neurosurgery, Queen Square, London, UK
- Neuroradiological Academic Unit, Department of Brain Repair and Rehabilitation, Institute of Neurology, University College London, London, UK
| | - John C. Dickson
- Institute of Nuclear Medicine, University College London Hospitals, London, UK
| | - Norah Epie
- Dementia Research Centre, Institute of Neurology, University College London, London, UK
| | - Miklos Espak
- Translational Imaging Group, Centre for Medical Image Computing, University College London, London, UK
| | - Susie M. D. Henley
- Dementia Research Centre, Institute of Neurology, University College London, London, UK
| | - Chandrashekar Hoskote
- Lysholm Department of Neuroradiology, The National Hospital for Neurology and Neurosurgery, Queen Square, London, UK
| | - Michael Hutel
- Dementia Research Centre, Institute of Neurology, University College London, London, UK
- Translational Imaging Group, Centre for Medical Image Computing, University College London, London, UK
| | - Jana Klimova
- Dementia Research Centre, Institute of Neurology, University College London, London, UK
| | - Ian B. Malone
- Dementia Research Centre, Institute of Neurology, University College London, London, UK
| | - Pawel Markiewicz
- Translational Imaging Group, Centre for Medical Image Computing, University College London, London, UK
| | - Andrew Melbourne
- Translational Imaging Group, Centre for Medical Image Computing, University College London, London, UK
| | - Marc Modat
- Dementia Research Centre, Institute of Neurology, University College London, London, UK
- Translational Imaging Group, Centre for Medical Image Computing, University College London, London, UK
| | - Anette Schrag
- Department of Clinical Neuroscience, Institute of Neurology, University College London, London, UK
| | - Sachit Shah
- Lysholm Department of Neuroradiology, The National Hospital for Neurology and Neurosurgery, Queen Square, London, UK
- Neuroradiological Academic Unit, Department of Brain Repair and Rehabilitation, Institute of Neurology, University College London, London, UK
| | - Nikhil Sharma
- MRC Unit for Lifelong Health and Ageing at UCL, London, UK
- National Hospital for Neurology and Neurosurgery, London, UK
| | - Carole H. Sudre
- Dementia Research Centre, Institute of Neurology, University College London, London, UK
- Translational Imaging Group, Centre for Medical Image Computing, University College London, London, UK
| | - David L. Thomas
- Leonard Wolfson Experimental Neurology Centre, Institute of Neurology, University College London, London, UK
- Neuroradiological Academic Unit, Department of Brain Repair and Rehabilitation, Institute of Neurology, University College London, London, UK
| | - Andrew Wong
- MRC Unit for Lifelong Health and Ageing at UCL, London, UK
| | - Hui Zhang
- Department of Computer Science and Centre for Medical Image Computing, University College London, London, UK
| | - John Hardy
- Reta Lila Weston Research Laboratories, Department of Molecular Neuroscience, Institute of Neurology, University College London, London, UK
| | - Henrik Zetterberg
- Department of Molecular Neuroscience, Institute of Neurology, University College London, London, UK
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, the Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden
- Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden
| | - Sebastien Ourselin
- Translational Imaging Group, Centre for Medical Image Computing, University College London, London, UK
| | - Sebastian J. Crutch
- Dementia Research Centre, Institute of Neurology, University College London, London, UK
| | - Diana Kuh
- MRC Unit for Lifelong Health and Ageing at UCL, London, UK
| | | | - Nick C. Fox
- Dementia Research Centre, Institute of Neurology, University College London, London, UK
| | - Jonathan M. Schott
- Dementia Research Centre, Institute of Neurology, University College London, London, UK
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de Carvalho LPN, Monteiro DQ, Orlandi FDS, Zazzetta MS, Pavarini SCI. Effect of educational status on performance of older adults in digital cognitive tasks: A systematic review. Dement Neuropsychol 2017; 11:114-120. [PMID: 29213502 PMCID: PMC5710679 DOI: 10.1590/1980-57642016dn11-020003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2016] [Accepted: 04/17/2017] [Indexed: 11/21/2022] Open
Abstract
As people age, cognitive abilities may decline resulting in serious disabilities. Neuropsychological instruments can provide information on the cognitive state of older adults. Researchers worldwide have been using digital cognitive tests to assess cognitive domains. OBJECTIVE To determine whether educational status affects the performance of older adults on digital cognitive tasks. METHODS A systematic review of articles in English, Portuguese, or Spanish published in the last 5 years was conducted. The databases searched were SCOPUS, PubMed, Lilacs, Scielo and PsychInfo. The PRISMA method was used. RESULTS A total of 7,089 articles were initially retrieved. After search and exclusion with justification, seven articles were selected for further review. CONCLUSION The findings revealed that researchers using digital tasks generally employed paper-based tests to compare results. Also, no association between years of education and test performance was found. Finally, a dearth of studies using digital tests published by Brazilian researchers was evident.
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Affiliation(s)
| | - Diana Quirino Monteiro
- Mestrando do Programa de Pós-graduação em
Enfermagem - Universidade Federal de São Carlos, SP, Brazil
| | - Fabiana de Souza Orlandi
- Professor Adjunto do Curso de Graduação em
Gerontologia - Universidade Federal de São Carlos, SP, Brazil
| | - Marisa Silvana Zazzetta
- Professor Adjunto do Curso de Graduação em
Gerontologia - Universidade Federal de São Carlos, SP, Brazil
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18
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Lugtenburg A, Zuidersma M, Oude Voshaar RC, Schoevers RA. Symptom Dimensions of Depression and 3-Year Incidence of Dementia: Results From the Amsterdam Study of the Elderly. J Geriatr Psychiatry Neurol 2016; 29:99-107. [PMID: 26404165 DOI: 10.1177/0891988715606235] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
OBJECTIVE To evaluate the association between depressive symptom dimensions and incident dementia in a community sample of older persons. METHODS Depressive symptoms at baseline and incident dementia at 3-year follow-up were assessed with the Geriatric Mental State (GMS)-Automated Geriatric Examination for Computer Assisted Taxonomy in nondemented persons aged 65 years or older. Exploratory and confirmatory bifactor analysis on the depression items yielded a general depression factor characterized by all GMS items and a cognitive/motivational factor characterized by cognitive and motivational "depressive" symptoms and the absence of depressed mood. RESULTS Ninety-three of 1911 persons had developed dementia at follow-up. The general depression factor increased the risk of dementia after adjustment for covariates (odds ratio [OR]: 1.48, 95% confidence interval [CI]: 1.14-1.92), but the cognitive/motivational factor did not (OR: 1.05, 95% CI: 0.75-1.47). However, in 1725 nondepressed older persons, the cognitive/motivational factor significantly predicted dementia after adjustment for covariates (OR: 1.53, 95% CI: 1.03-2.28) but not anymore after additional adjustment for subjective memory complaints (OR: 1.41, 95% CI: 0.94-2.13). The general depression factor did not significantly predict dementia in nondepressed older persons (OR: 1.15, 95% CI: 0.80-1.66). CONCLUSION Our findings suggest that the increased risk of dementia associated with depressive symptoms in many previous studies appears to be heterogeneous, that is, it is likely due to different underlying pathways, including a pathway involving depression itself and a pathway in which cognitive and motivational symptoms reflect subjective cognitive complaints, particularly in the absence of depressed mood. These different pathways might warrant a different treatment approach.
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Affiliation(s)
- Astrid Lugtenburg
- Department of Psychiatry, Interdisciplinary Center for Psychopathology and Emotion Regulation (ICPE), University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - Marij Zuidersma
- Department of Psychiatry, Interdisciplinary Center for Psychopathology and Emotion Regulation (ICPE), University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - Richard C Oude Voshaar
- Department of Psychiatry, Interdisciplinary Center for Psychopathology and Emotion Regulation (ICPE), University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - Robert A Schoevers
- Department of Psychiatry, Interdisciplinary Center for Psychopathology and Emotion Regulation (ICPE), University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
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Duff K, Tometich D, Dennett K. The Modified Telephone Interview for Cognitive Status is More Predictive of Memory Abilities Than the Mini-Mental State Examination. J Geriatr Psychiatry Neurol 2015; 28:193-7. [PMID: 25722349 PMCID: PMC4869996 DOI: 10.1177/0891988715573532] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2014] [Accepted: 01/21/2015] [Indexed: 11/15/2022]
Abstract
Although not as popular as the Mini-Mental State Examination (MMSE), the modified Telephone Interview for Cognitive Status (mTICS) has some distinct advantages when screening cognitive functioning in older adults. The current study compared these 2 cognitive screening measures in their ability to predict performance on a memory composite (ie, delayed recall of verbal and visual information) in a cohort of 121 community-dwelling older adults, both at baseline and after 1 year. Both the MMSE and the mTICS significantly correlated with the memory composite at baseline (r's of .41 and .62, respectively) and at 1 year (r's of .36 and .50, respectively). At baseline, stepwise linear regression indicated that the mTICS and gender best predicted the memory composite score (R (2) = .45, P < .001), and the MMSE and other demographic variables did not significantly improve the prediction. At 1 year, the results were very similar. Despite its lesser popularity, the mTICS may be a more attractive option when screening for cognitive abilities in this age range.
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Affiliation(s)
- Kevin Duff
- Department of Neurology, University of Utah, Salt Lake City, UT, USA
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20
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Gillis I, Wilhelm K, Batchelor J, Burke D. Information processing speed remains low in school teachers a decade after recovery from depression. Int J Geriatr Psychiatry 2014; 29:1098-100. [PMID: 25256311 DOI: 10.1002/gps.4162] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- Inika Gillis
- Faces in the Street, Urban Mental Health and Wellbeing Research Institute, St Vincent's Hospital, Sydney, Australia
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