1
|
Ourry V, Binette AP, St-Onge F, Strikwerda-Brown C, Chagnot A, Poirier J, Breitner J, Arenaza-Urquijo EM, Rabin JS, Buckley R, Gonneaud J, Marchant NL, Villeneuve S. How Do Modifiable Risk Factors Affect Alzheimer's Disease Pathology or Mitigate Its Effect on Clinical Symptom Expression? Biol Psychiatry 2024; 95:1006-1019. [PMID: 37689129 DOI: 10.1016/j.biopsych.2023.09.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Revised: 08/11/2023] [Accepted: 09/03/2023] [Indexed: 09/11/2023]
Abstract
Epidemiological studies show that modifiable risk factors account for approximately 40% of the population variability in risk of developing dementia, including sporadic Alzheimer's disease (AD). Recent findings suggest that these factors may also modify disease trajectories of people with autosomal-dominant AD. With positron emission tomography imaging, it is now possible to study the disease many years before its clinical onset. Such studies can provide key knowledge regarding pathways for either the prevention of pathology or the postponement of its clinical expression. The former "resistance pathway" suggests that modifiable risk factors could affect amyloid and tau burden decades before the appearance of cognitive impairment. Alternatively, the resilience pathway suggests that modifiable risk factors may mitigate the symptomatic expression of AD pathology on cognition. These pathways are not mutually exclusive and may appear at different disease stages. Here, in a narrative review, we present neuroimaging evidence that supports both pathways in sporadic AD and autosomal-dominant AD. We then propose mechanisms for their protective effect. Among possible mechanisms, we examine neural and vascular mechanisms for the resistance pathway. We also describe brain maintenance and functional compensation as bases for the resilience pathway. Improved mechanistic understanding of both pathways may suggest new interventions.
Collapse
Affiliation(s)
- Valentin Ourry
- Department of Psychiatry, Faculty of Medicine, McGill University, Montreal, Quebec, Canada; Douglas Mental Health University Institute, Montreal, Quebec, Canada.
| | - Alexa Pichet Binette
- Department of Psychiatry, Faculty of Medicine, McGill University, Montreal, Quebec, Canada; Douglas Mental Health University Institute, Montreal, Quebec, Canada; Clinical Memory Research Unit, Department of Clinical Sciences, Lunds Universitet, Malmö, Sweden
| | - Frédéric St-Onge
- Department of Psychiatry, Faculty of Medicine, McGill University, Montreal, Quebec, Canada; Douglas Mental Health University Institute, Montreal, Quebec, Canada; Integrated Program in Neuroscience, Faculty of Medicine, McGill University, Montreal, Quebec, Canada
| | - Cherie Strikwerda-Brown
- Department of Psychiatry, Faculty of Medicine, McGill University, Montreal, Quebec, Canada; Douglas Mental Health University Institute, Montreal, Quebec, Canada; School of Psychological Science, The University of Western Australia, Perth, Western Australia, Australia
| | - Audrey Chagnot
- UK Dementia Research Institute, Edinburgh Medical School, University of Edinburgh, Edinburgh, United Kingdom; Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, United Kingdom
| | - Judes Poirier
- Department of Psychiatry, Faculty of Medicine, McGill University, Montreal, Quebec, Canada; Douglas Mental Health University Institute, Montreal, Quebec, Canada
| | - John Breitner
- Department of Psychiatry, Faculty of Medicine, McGill University, Montreal, Quebec, Canada; Douglas Mental Health University Institute, Montreal, Quebec, Canada
| | - Eider M Arenaza-Urquijo
- Environment and Health over the Lifecourse Programme, Barcelona Institute for Global Health (ISGlobal), Barcelona, Spain; Department of Radiology, Mayo Clinic, Rochester, Minnesota
| | - Jennifer S Rabin
- Division of Neurology, Department of Medicine, Sunnybrook Health Sciences Centre, University of Toronto, Toronto, Ontario, Canada; Harquail Centre for Neuromodulation, Hurvitz Brain Sciences Program, Sunnybrook Research Institute, University of Toronto, Toronto, Ontario, Canada; Rehabilitation Sciences Institute, University of Toronto, Toronto, Ontario, Canada
| | - Rachel Buckley
- Melbourne School of Psychological Sciences University of Melbourne, Parkville, Victoria, Australia; Department of Neurology, Massachusetts General Hospital, Boston, Massachusetts; Harvard Medical School, Boston, Massachusetts; Center for Alzheimer Research and Treatment, Department of Neurology, Brigham and Women's Hospital, Boston, Massachusetts
| | - Julie Gonneaud
- Normandie University, UNICAEN, INSERM, U1237, PhIND "Physiopathology and Imaging of Neurological Disorders," Institut Blood and Brain @ Caen-Normandie, GIP Cyceron, Caen, France
| | - Natalie L Marchant
- Division of Psychiatry, University College London, London, United Kingdom
| | - Sylvia Villeneuve
- Department of Psychiatry, Faculty of Medicine, McGill University, Montreal, Quebec, Canada; Douglas Mental Health University Institute, Montreal, Quebec, Canada; McConnell Brain Imaging Center, Montreal Neurological Institute, McGill University, Montreal, Quebec, Canada.
| |
Collapse
|
2
|
Liu AC, Patel MD, Gross AL, Mosley TH, Schneider ALC, Kucharska-Newton AM, Sharrett AR, Gottesman RF, Koton S. Occupation, Retirement Age, and 20-Year Cognitive Decline: The Atherosclerosis Risk in Communities Neurocognitive Study. Neuroepidemiology 2024; 58:292-299. [PMID: 38387450 PMCID: PMC11300158 DOI: 10.1159/000534791] [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: 03/13/2023] [Accepted: 10/23/2023] [Indexed: 02/24/2024] Open
Abstract
INTRODUCTION We examined the association of both midlife occupation and age at retirement with cognitive decline in the Atherosclerosis Risk in Communities (ARIC) biracial community-based cohort. METHODS Current or most recent occupation at ARIC baseline (1987-1989; aged 45-64 years) was categorized based on 1980 US Census major occupation groups and tertiles of the Nam-Powers-Boyd occupational status score (n = 14,090). Retirement status via annual follow-up questionnaires administered ascertained in 1999-2007 was classified as occurring before or after age 70 (n = 7,503). Generalized estimating equation models were used to examine associations of occupation and age at retirement with trajectories of global cognitive factor scores, assessed from visit 2 (1990-1992) to visit 5 (2011-2013). Models were a priori stratified by race and sex and adjusted for demographics and comorbidities. RESULTS Low occupational status and blue-collar occupations were associated with low baseline cognitive scores in all race-sex strata. Low occupational status and homemaker status were associated with faster decline in white women but slower decline in black women compared to high occupational status. Retirement before age 70 was associated with slower cognitive decline in white men and women and in black men. Results did not change substantially after accounting for attrition. CONCLUSION Low occupational status was associated with cognitive decline in women but not in men. Earlier retirement was associated with a slower cognitive decline in white participants and in black men. Further research should explore reasons for the observed associations and race-sex differences.
Collapse
Affiliation(s)
- Albert C Liu
- Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA,
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina, USA,
| | - Mehul D Patel
- Department of Emergency Medicine, School of Medicine, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Alden L Gross
- Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA
| | - Thomas H Mosley
- School of Medicine, University of Mississippi Medical Center, Jackson, Mississippi, USA
| | - Andrea L C Schneider
- Department of Neurology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Anna M Kucharska-Newton
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina, USA
- Department of Epidemiology, College of Public Health, University of Kentucky, Lexington, Kentucky, USA
| | - A Richey Sharrett
- Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA
| | - Rebecca F Gottesman
- Stroke Branch, National Institute of Neurological Disorders and Stroke Intramural Research Program, Bethesda, Maryland, USA
| | - Silvia Koton
- Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA
- Stanley Steyer School of Health Professions, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| |
Collapse
|
3
|
Aravena JM, Lee J, Schwartz AE, Nyhan K, Wang SY, Levy BR. Beneficial Effect of Societal Factors on APOE-ε2 and ε4 Carriers' Brain Health: A Systematic Review. J Gerontol A Biol Sci Med Sci 2024; 79:glad237. [PMID: 37792627 PMCID: PMC10803122 DOI: 10.1093/gerona/glad237] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2023] [Indexed: 10/06/2023] Open
Abstract
BACKGROUND Apolipoprotein-E (APOE) ε4 and ε2 are the most prevalent risk-increasing and risk-reducing genetic predictors of Alzheimer's disease, respectively. However, the extent to which societal factors can reduce the harmful impact of APOE-ε4 and enhance the beneficial impact of APOE-ε2 on brain health has not yet been examined systematically. METHODS To fill this gap, we conducted a systematic review searching for studies in MEDLINE, Embase, PsycINFO, and Scopus until June 2023, that included: (a) 1 of 5 social determinants of health (SDH) identified by Healthy People 2030, (b) APOE-ε2 or APOE-ε4 allele carriers, (c) cognitive or brain-biomarker outcomes, and (d) studies with an analysis of how APOE-ε2 and/ or APOE-ε4 carriers differ on outcomes when exposed to SDH. RESULTS From 14 076 articles retrieved, 124 met the inclusion criteria. In most of the studies, exposure to favorable SDH reduced APOE-ε4's detrimental effect and enhanced APOE-ε2's beneficial effect on cognitive and brain-biomarker outcomes (cognition: 70.5%, n: 74/105; brain-biomarkers: 71.4%, n: 20/28). A similar pattern of results emerged in each of the 5 Healthy People 2030 SDH categories, where finishing high school, having resources to satisfy basic needs, less air pollution, less negative external stimuli that can generate stress (eg, negative age stereotypes), and exposure to multiple favorable SDH were associated with better cognitive and brain health among APOE-ε4 and APOE-ε2 carriers. CONCLUSIONS Societal factors can reduce the harmful impact of APOE-ε4 and enhance the beneficial impact of APOE-ε2 on cognitive outcomes. This suggests that plans to reduce dementia should include community-level policies promoting favorable SDH.
Collapse
Affiliation(s)
- José M Aravena
- Department of Social & Behavioral Sciences, School of Public Health, Yale University, New Haven, Connecticut, USA
| | - Jakyung Lee
- Institute for Community Care and Health Equity, Chung-Ang University, Seoul, Republic of South Korea
| | - Anna E Schwartz
- Department of Social & Behavioral Sciences, School of Public Health, Yale University, New Haven, Connecticut, USA
| | - Kate Nyhan
- Cushing/Whitney Medical Library, Department of Environmental Health Sciences, School of Public Health, Yale University, New Haven, Connecticut, USA
| | - Shi-Yi Wang
- Department of Chronic Disease Epidemiology, School of Public Health, Yale University, New Haven, Connecticut, USA
| | - Becca R Levy
- Department of Social & Behavioral Sciences, School of Public Health, Yale University, New Haven, Connecticut, USA
- Department of Psychology, Yale University, New Haven, Connecticut, USA
| |
Collapse
|
4
|
Kim HB, Kim SH, Um YH, Wang SM, Kim REY, Choe YS, Lee J, Kim D, Lim HK, Lee CU, Kang DW. Modulation of associations between education years and cortical volume in Alzheimer's disease vulnerable brain regions by Aβ deposition and APOE ε4 carrier status in cognitively normal older adults. Front Aging Neurosci 2023; 15:1248531. [PMID: 37829142 PMCID: PMC10565031 DOI: 10.3389/fnagi.2023.1248531] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Accepted: 09/05/2023] [Indexed: 10/14/2023] Open
Abstract
Background Education years, as a measure of cognitive reserve, have been shown to affect the progression of Alzheimer's disease (AD), both pathologically and clinically. However, inconsistent results have been reported regarding the association between years of education and intermediate structural changes in AD-vulnerable brain regions, particularly when AD risk factors were not considered during the preclinical phase. Objective This study aimed to examine how Aβ deposition and APOE ε4 carrier status moderate the relationship between years of education and cortical volume in AD-vulnerable regions among cognitively normal older adults. Methods A total of 121 participants underwent structural MRI, [18F] flutemetamol PET-CT imaging, and neuropsychological battery assessment. Multiple regression analysis was conducted to examine the interaction between years of education and the effects of potential modifiers on cortical volume. The associations between cortical volume and neuropsychological performance were further explored in subgroups categorized based on AD risk factors. Results The cortical volume of the left lateral occipital cortex and bilateral fusiform gyrus demonstrated a significant differential association with years of education, depending on the presence of Aβ deposition and APOE ε4 carrier status. Furthermore, a significant relationship between the cortical volume of the bilateral fusiform gyrus and AD-nonspecific cognitive function was predominantly observed in individuals without AD risk factors. Conclusion AD risk factors exerted varying influences on the association between years of education and cortical volume during the preclinical phase. Further investigations into the long-term implications of these findings would enhance our understanding of cognitive reserves in the preclinical stages of AD.
Collapse
Affiliation(s)
- Hak-Bin Kim
- Department of Psychiatry, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Sung-Hwan Kim
- Department of Psychiatry, Yeouido St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Yoo Hyun Um
- Department of Psychiatry, St. Vincent’s Hospital, College of Medicine, The Catholic University of Korea, Suwon, Republic of Korea
| | - Sheng-Min Wang
- Department of Psychiatry, Yeouido St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | | | - Yeong Sim Choe
- Research Institute, NEUROPHET Inc., Seoul, Republic of Korea
| | - Jiyeon Lee
- Research Institute, NEUROPHET Inc., Seoul, Republic of Korea
| | - Donghyeon Kim
- Research Institute, NEUROPHET Inc., Seoul, Republic of Korea
| | - Hyun Kook Lim
- Department of Psychiatry, Yeouido St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
- Research Institute, NEUROPHET Inc., Seoul, Republic of Korea
| | - Chang Uk Lee
- Department of Psychiatry, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| | - Dong Woo Kang
- Department of Psychiatry, Seoul St. Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
| |
Collapse
|
5
|
Duffner LA, DeJong NR, Jansen JFA, Backes WH, de Vugt M, Deckers K, Köhler S. Associations between social health factors, cognitive activity and neurostructural markers for brain health - A systematic literature review and meta-analysis. Ageing Res Rev 2023; 89:101986. [PMID: 37356551 DOI: 10.1016/j.arr.2023.101986] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Revised: 06/09/2023] [Accepted: 06/13/2023] [Indexed: 06/27/2023]
Abstract
Social health factors (e.g., social activities or social support) and cognitive activity engagement have been associated with dementia risk, but their neural substrates have not been well established. This systematic review and meta-analysis summarizes the available evidence regarding the association between these factors and cerebral macro- and micro-structure. A comprehensive literature search was conducted in various databases, following predefined criteria. Heterogeneity, risk of publication bias and overall certainty of evidence were assessed using standardized scales and, whenever appropriate, random effects meta-analysis was conducted. Of 6715 identified articles, 43 were included. Overall, consistency of findings was low and methodological heterogeneity high for all outcomes. However, in some studies cognitive and social activities were positively associated with total brain, global and cortical grey matter and hippocampal volume as well as white matter microstructural integrity. Furthermore, structural social network characteristics (e.g., social network size) were associated with regional grey matter volumes, while functional social network characteristics (e.g., social support) were additionally associated with total brain volume. Meta-analyses revealed small but significant partial correlations between cognitive and social activities and hippocampal (three studies; n = 892; rz =0.07) and white matter hyperintensity volume (three studies; n = 2934; rz =-0.04). More prospective studies are needed to assess temporal associations.
Collapse
Affiliation(s)
- Lukas A Duffner
- Alzheimer Centrum Limburg, Department of Psychiatry and Neuropsychology, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, the Netherlands; School for Mental Health and Neuroscience, Maastricht University, Maastricht, the Netherlands
| | - Nathan R DeJong
- Alzheimer Centrum Limburg, Department of Psychiatry and Neuropsychology, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, the Netherlands; School for Mental Health and Neuroscience, Maastricht University, Maastricht, the Netherlands; Department of Radiology and Nuclear Medicine, Maastricht University Medical Center+, Maastricht, the Netherlands
| | - Jacobus F A Jansen
- School for Mental Health and Neuroscience, Maastricht University, Maastricht, the Netherlands; Department of Radiology and Nuclear Medicine, Maastricht University Medical Center+, Maastricht, the Netherlands; Department of Electrical Engineering, Eindhoven University of Technology, Eindhoven, the Netherlands
| | - Walter H Backes
- School for Mental Health and Neuroscience, Maastricht University, Maastricht, the Netherlands; Department of Radiology and Nuclear Medicine, Maastricht University Medical Center+, Maastricht, the Netherlands
| | - Marjolein de Vugt
- Alzheimer Centrum Limburg, Department of Psychiatry and Neuropsychology, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, the Netherlands; School for Mental Health and Neuroscience, Maastricht University, Maastricht, the Netherlands
| | - Kay Deckers
- Alzheimer Centrum Limburg, Department of Psychiatry and Neuropsychology, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, the Netherlands; School for Mental Health and Neuroscience, Maastricht University, Maastricht, the Netherlands
| | - Sebastian Köhler
- Alzheimer Centrum Limburg, Department of Psychiatry and Neuropsychology, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, the Netherlands; School for Mental Health and Neuroscience, Maastricht University, Maastricht, the Netherlands.
| |
Collapse
|
6
|
Jin Y, Lin L, Xiong M, Sun S, Wu SC. Moderating effects of cognitive reserve on the relationship between brain structure and cognitive abilities in middle-aged and older adults. Neurobiol Aging 2023; 128:49-64. [PMID: 37163923 DOI: 10.1016/j.neurobiolaging.2023.04.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Revised: 03/31/2023] [Accepted: 04/05/2023] [Indexed: 05/12/2023]
Abstract
The cognitive reserve (CR) hypothesis is reinforced by negative moderating effects, suggesting that those with higher CR are less reliant on brain structure for cognitive function. Previous research on CR's moderating effects yielded inconsistent results, motivating our 3 studies using UK Biobank data. Study I examined five CR proxies' moderating effects on global, lobar, and regional brain-cognition models; study II extended study I by using a larger sample size; and study III investigated age-related moderating effects on the hippocampal regions. In study I, most moderating effects were negative and none survived the multiple comparison correction, but study II identified 13 global-level models with significant negative moderating effects that survived correction. Study III showed age influenced CR proxies' moderating effects in hippocampal regions. Our findings suggest that the effects of CR proxies on brain integrity and cognition varied depending on the proxy used, brain integrity indicators, cognitive domain, and age group. This study offers significant insights regarding the importance of CR for brain integrity and cognitive outcomes.
Collapse
Affiliation(s)
- Yue Jin
- Intelligent Physiological Measurement and Clinical Translation, Beijing International Base for Scientific and Technological Cooperation, Department of Biomedical Engineering, Faculty of Environment and Life, Beijing University of Technology, Beijing, China
| | - Lan Lin
- Intelligent Physiological Measurement and Clinical Translation, Beijing International Base for Scientific and Technological Cooperation, Department of Biomedical Engineering, Faculty of Environment and Life, Beijing University of Technology, Beijing, China.
| | - Min Xiong
- Intelligent Physiological Measurement and Clinical Translation, Beijing International Base for Scientific and Technological Cooperation, Department of Biomedical Engineering, Faculty of Environment and Life, Beijing University of Technology, Beijing, China
| | - Shen Sun
- Intelligent Physiological Measurement and Clinical Translation, Beijing International Base for Scientific and Technological Cooperation, Department of Biomedical Engineering, Faculty of Environment and Life, Beijing University of Technology, Beijing, China
| | - Shui-Cai Wu
- Intelligent Physiological Measurement and Clinical Translation, Beijing International Base for Scientific and Technological Cooperation, Department of Biomedical Engineering, Faculty of Environment and Life, Beijing University of Technology, Beijing, China
| |
Collapse
|
7
|
Fingelkurts AA, Fingelkurts AA. Turning Back the Clock: A Retrospective Single-Blind Study on Brain Age Change in Response to Nutraceuticals Supplementation vs. Lifestyle Modifications. Brain Sci 2023; 13:brainsci13030520. [PMID: 36979330 PMCID: PMC10046544 DOI: 10.3390/brainsci13030520] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Revised: 03/17/2023] [Accepted: 03/19/2023] [Indexed: 03/30/2023] Open
Abstract
BACKGROUND There is a growing consensus that chronological age (CA) is not an accurate indicator of the aging process and that biological age (BA) instead is a better measure of an individual's risk of age-related outcomes and a more accurate predictor of mortality than actual CA. In this context, BA measures the "true" age, which is an integrated result of an individual's level of damage accumulation across all levels of biological organization, along with preserved resources. The BA is plastic and depends upon epigenetics. Brain state is an important factor contributing to health- and lifespan. METHODS AND OBJECTIVE Quantitative electroencephalography (qEEG)-derived brain BA (BBA) is a suitable and promising measure of brain aging. In the present study, we aimed to show that BBA can be decelerated or even reversed in humans (N = 89) by using customized programs of nutraceutical compounds or lifestyle changes (mean duration = 13 months). RESULTS We observed that BBA was younger than CA in both groups at the end of the intervention. Furthermore, the BBA of the participants in the nutraceuticals group was 2.83 years younger at the endpoint of the intervention compared with their BBA score at the beginning of the intervention, while the BBA of the participants in the lifestyle group was only 0.02 years younger at the end of the intervention. These results were accompanied by improvements in mental-physical health comorbidities in both groups. The pre-intervention BBA score and the sex of the participants were considered confounding factors and analyzed separately. CONCLUSIONS Overall, the obtained results support the feasibility of the goal of this study and also provide the first robust evidence that halting and reversal of brain aging are possible in humans within a reasonable (practical) timeframe of approximately one year.
Collapse
|
8
|
Maruszak A, Silajdžić E, Lee H, Murphy T, Liu B, Shi L, de Lucia C, Douiri A, Salta E, Nevado AJ, Teunissen CE, Visser PJ, Price J, Zetterberg H, Lovestone S, Thuret S. Predicting progression to Alzheimer's disease with human hippocampal progenitors exposed to serum. Brain 2023; 146:2045-2058. [PMID: 36703180 PMCID: PMC10151193 DOI: 10.1093/brain/awac472] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Revised: 10/11/2022] [Accepted: 11/10/2022] [Indexed: 01/28/2023] Open
Abstract
Adult hippocampal neurogenesis is important for learning and memory and is altered early in Alzheimer's disease. As hippocampal neurogenesis is modulated by the circulatory systemic environment, evaluating a proxy of how hippocampal neurogenesis is affected by the systemic milieu could serve as an early biomarker for Alzheimer's disease progression. Here, we used an in vitro assay to model the impact of systemic environment on hippocampal neurogenesis. A human hippocampal progenitor cell line was treated with longitudinal serum samples from individuals with mild cognitive impairment, who either progressed to Alzheimer's disease or remained cognitively stable. Mild cognitive impairment to Alzheimer's disease progression was characterized most prominently with decreased proliferation, increased cell death and increased neurogenesis. A subset of 'baseline' cellular readouts together with education level were able to predict Alzheimer's disease progression. The assay could provide a powerful platform for early prognosis, monitoring disease progression and further mechanistic studies.
Collapse
Affiliation(s)
- Aleksandra Maruszak
- Department of Basic and Clinical Neuroscience, Institute of Psychiatry Psychology & Neuroscience, King's College London, London, SE5 9RX, UK
| | - Edina Silajdžić
- Department of Basic and Clinical Neuroscience, Institute of Psychiatry Psychology & Neuroscience, King's College London, London, SE5 9RX, UK
| | - Hyunah Lee
- Department of Basic and Clinical Neuroscience, Institute of Psychiatry Psychology & Neuroscience, King's College London, London, SE5 9RX, UK
| | - Tytus Murphy
- Department of Basic and Clinical Neuroscience, Institute of Psychiatry Psychology & Neuroscience, King's College London, London, SE5 9RX, UK
| | - Benjamine Liu
- Department of Psychiatry, University of Oxford, Oxford, OX3 7JX, UK
| | - Liu Shi
- Department of Psychiatry, University of Oxford, Oxford, OX3 7JX, UK
| | - Chiara de Lucia
- Department of Basic and Clinical Neuroscience, Institute of Psychiatry Psychology & Neuroscience, King's College London, London, SE5 9RX, UK
| | - Abdel Douiri
- Department of Population Health Sciences, King's College London, London, SE1 1UL, UK
| | - Evgenia Salta
- Netherlands Institute for Neuroscience, 1105 BA Amsterdam, The Netherlands.,Neurochemistry Lab and Biobank, Department of Clinical Chemistry, Amsterdam Neuroscience, VU University Medical Center, 1007 MB Amsterdam, The Netherlands
| | - Alejo J Nevado
- Department of Psychiatry, University of Oxford, Oxford, OX3 7JX, UK
| | - Charlotte E Teunissen
- Neurochemistry Lab and Biobank, Department of Clinical Chemistry, Amsterdam Neuroscience, VU University Medical Center, 1007 MB Amsterdam, The Netherlands
| | - Pieter J Visser
- Department of Psychiatry and Neuropsychology, Alzheimer Center Limburg, School for Mental Health and Neuroscience, Maastricht University, 6200 MD Maastricht, The Netherlands.,Department of Neurology, Alzheimer Center, VU University Medical Center, 1081 HZ Amsterdam, The Netherlands
| | - Jack Price
- Department of Basic and Clinical Neuroscience, Institute of Psychiatry Psychology & Neuroscience, King's College London, London, SE5 9RX, UK
| | - Henrik Zetterberg
- Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, S-431 80 Mölndal, Sweden.,Department of Neurodegenerative Disease, UCL Institute of Neurology, London, WC1N 3BG, UK.,Institute of Neuroscience and Physiology, Department of Psychiatry and Neurochemistry, the Sahlgrenska Academy at the University of Gothenburg, S-431 80 Mölndal, Sweden.,UK Dementia Research Institute at UCL, London, WC1E 6BT, UK
| | - Simon Lovestone
- Department of Psychiatry, University of Oxford, Oxford, OX3 7JX, UK.,Janssen Medical UK, B-2340 Beerse, Belgium
| | - Sandrine Thuret
- Department of Basic and Clinical Neuroscience, Institute of Psychiatry Psychology & Neuroscience, King's College London, London, SE5 9RX, UK
| |
Collapse
|
9
|
Amofa-Ho PA, Stickel AM, Chen R, Kobayashi LC, Glymour MM, Eng CW. The Mediating Roles of Neurobiomarkers in the Relationship Between Education and Late-Life Cognition. J Alzheimers Dis 2023; 95:1405-1416. [PMID: 37694365 PMCID: PMC10578223 DOI: 10.3233/jad-230244] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/24/2023] [Indexed: 09/12/2023]
Abstract
BACKGROUND The mediating roles of neuropathologies and neurovascular damage in the relationship between early-life education and later-life cognitive function are unknown. OBJECTIVE To examine whether Alzheimer's and neurovascular biomarkers mediate the relationships between education and cognitive functions. METHODS Data were from 537 adults aged 55-94 in the Alzheimer's Disease Neuroimaging Initiative 3. We tested whether the relationships between education (continuous, years) and cognitive function (memory, executive functioning, and language composites) were mediated by neuroimaging biomarkers (hippocampal volumes, cortical gray matter volumes, meta-temporal tau PET standard uptake value ratio, and white matter hyperintensity volumes). Models were adjusted for age, race, sex/gender, cardiovascular history, body mass index, depression, and Apolipoprotein E-ɛ4 status. RESULTS Hippocampal volumes and white matter hyperintensities partially mediated the relationships between education and cognitive function across all domains (6.43% to 15.72% mediated). The direct effects of education on each cognitive domain were strong and statistically significant. CONCLUSIONS Commonly measured neurobiomarkers only partially mediate the relationships between education and multi-domain cognitive function.
Collapse
Affiliation(s)
- Priscilla A. Amofa-Ho
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, USA
| | - Ariana M. Stickel
- Department of Psychology, San Diego State University, San Diego, CA, USA
| | - Ruijia Chen
- Department of Epidemiology and Biostatistics, University of California, San Francisco, CA, USA
| | - Lindsay C. Kobayashi
- Center for Social Epidemiology and Population Health, Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI, USA
| | - M. Maria Glymour
- Department of Epidemiology and Biostatistics, University of California, San Francisco, CA, USA
| | - Chloe W. Eng
- Department of Epidemiology and Biostatistics, University of California, San Francisco, CA, USA
- Department of Epidemiology, Stanford University, Palo Alto, CA, USA
| | | |
Collapse
|
10
|
de Oliveira FF, Bertolucci PHF, Chen ES, Smith MC. Pharmacogenetic Analyses of Therapeutic Effects of Lipophilic Statins on Cognitive and Functional Changes in Alzheimer’s Disease. J Alzheimers Dis 2022; 87:359-372. [DOI: 10.3233/jad-215735] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Background: Pharmacogenetic effects of statins on clinical changes in Alzheimer’s disease (AD) could be mediated by epistatic interactions among relevant genetic variants involved in cholesterol metabolism. Objective: To investigate associations of HMGCR (rs3846662), NR1H2 (rs2695121), or CETP (rs5882&rs708272) with cognitive and functional changes in AD, with stratification according to APOE ɛ4 carrier status and lipid-lowering treatment with lipophilic statins. Methods: Consecutive outpatients with late-onset AD were screened with cognitive tests, while caregivers scored functionality and global ratings, with prospective neurotranslational associations documented for one year. Results: Considering n = 190:142 had hypercholesterolemia, 139 used lipophilic statins; minor allele frequencies were 0.379 (rs2695121-T:46.3% heterozygotes), 0.368 (rs5882-G:49.5% heterozygotes), and 0.371 (rs708272-A:53.2% heterozygotes), all in Hardy-Weinberg equilibrium. For APOE ɛ4 carriers: rs5882-GG protected from cognitive decline; rs5882-AA caused faster cognitive decline; carriers of rs2695121-CC or rs5882-AA were more susceptible to harmful cognitive effects of lipophilic statins; carriers of rs5882-GG or rs708272-AG had functional benefits when using lipophilic statins. APOE ɛ4 non-carriers resisted any cognitive or functional effects of lipophilic statins, while invariability of rs3846662 (all AA) prevented the assessment of HMGCR effects. When assessing CETP haplotypes only: rs5882-GG protected from cognitive and functional decline, regardless of lipophilic statin therapy; lipophilic statins usually caused cognitive and functional harm to carriers of rs5882-A and/or rs708272-A; lipophilic statins benefitted cognition and functionality of carriers of rs5882-G and/or rs708272-G. Conclusion: Reportedly protective variants of CETP and NR1H2 also slowed cognitive and functional decline particularly for APOE ɛ4 carriers, and regardless of cholesterol variations, while therapy with lipophilic statins might affect carriers of specific genetic variants.
Collapse
Affiliation(s)
- Fabricio Ferreira de Oliveira
- Department of Morphology and Genetics and Neurosurgery, Escola Paulista de Medicina, Federal University of São Paulo (UNIFESP), São Paulo, SP, Brazil
| | | | - Elizabeth Suchi Chen
- Department of Morphology and Genetics and Neurosurgery, Escola Paulista de Medicina, Federal University of São Paulo (UNIFESP), São Paulo, SP, Brazil
| | - Marilia Cardoso Smith
- Department of Morphology and Genetics and Neurosurgery, Escola Paulista de Medicina, Federal University of São Paulo (UNIFESP), São Paulo, SP, Brazil
| |
Collapse
|
11
|
Pearce AM, Marr C, Dewar M, Gow AJ. Apolipoprotein E Genotype Moderation of the Association Between Physical Activity and Brain Health. A Systematic Review and Meta-Analysis. Front Aging Neurosci 2022; 13:815439. [PMID: 35153725 PMCID: PMC8833849 DOI: 10.3389/fnagi.2021.815439] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Accepted: 12/17/2021] [Indexed: 12/12/2022] Open
Abstract
Introduction Possession of one or two e4 alleles of the apolipoprotein E (APOE) gene is associated with cognitive decline and dementia risk. Some evidence suggests that physical activity may benefit carriers of the e4 allele differently. Method We conducted a systematic review and meta-analysis of studies which assessed APOE differences in the association between physical activity and: lipid profile, Alzheimer's disease pathology, brain structure and brain function in healthy adults. Searches were carried out in PubMed, SCOPUS, Web of Science and PsycInfo. Results Thirty studies were included from 4,896 papers screened. Carriers of the e4 allele gained the same benefit from physical activity as non-carriers on most outcomes. For brain activation, e4 carriers appeared to gain a greater benefit from physical activity on task-related and resting-state activation and resting-state functional connectivity compared to non-carriers. Post-hoc analysis identified possible compensatory mechanisms allowing e4 carriers to maintain cognitive function. Discussion Though there is evidence suggesting physical activity may benefit e4 carriers differently compared to non-carriers, this may vary by the specific brain health outcome, perhaps limited to brain activation. Further research is required to confirm these findings and elucidate the mechanisms.
Collapse
|
12
|
Price CC. The New Frontier of Perioperative Cognitive Medicine for Alzheimer's Disease and Related Dementias. Neurotherapeutics 2022; 19:132-142. [PMID: 35084722 PMCID: PMC9130373 DOI: 10.1007/s13311-021-01180-w] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/29/2021] [Indexed: 01/03/2023] Open
Abstract
This is a review of preoperative cognitive assessment and other healthcare gaps in the care of older adults at risk for Alzheimer's disease and related dementias (ADRD) who have elected surgery with anesthesia. It summarizes concerns regarding ADRD perioperative healthcare, perioperative cognitive, and neuronal domains of vulnerability. It also offers a plan for phased preoperative cognitive screening and perioperative cognitive intervention opportunities. An argument is made for why medical professionals in the perioperative setting need fundamental training in cognitive-behavioral principles, an understanding of neurodegenerative diseases of aging, and an appreciation of the immediate and long-term medical risks for such patients undergoing anesthesia. The author's goal is to encourage readers to consider perioperative cognitive medicine as a new frontier for generating evidence-based care approaches for at-risk older adults with neurodegenerative disorders who require procedures with anesthesia.
Collapse
Affiliation(s)
- Catherine C Price
- Clinical and Health Psychology, Anesthesiology, University of Florida, Gainesville, FL, USA.
| |
Collapse
|
13
|
Pedraza OL, Camacho I, Sierra FA, Cladelis RG, Salazar AM, Montalvo MC, Morillo HD, Lozano A, Gutiérrez-Castañeda LD, Torres-Tobar L, Piñeros C. Association between Apoϵ4 allele and cardiometabolic and social risk factors with cognitive impairment in elderly population from Bogota. Dement Neuropsychol 2021; 15:497-509. [PMID: 35509799 PMCID: PMC9018086 DOI: 10.1590/1980-57642021dn15-040011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2020] [Accepted: 05/07/2021] [Indexed: 11/22/2022] Open
Abstract
Being an ϵ4 carrier in the Apoϵ gene has been suggested as a modifying factor for the interaction between cardio-metabolic, social risk factors, and the development of cognitive impairment.
Collapse
Affiliation(s)
| | - Isis Camacho
- Neurosciences Group, Colombia; Interdisciplinary Memory Group, Colombia
| | | | | | - Ana Maria Salazar
- Neurosciences Group, Colombia; Interdisciplinary Memory Group, Colombia; Psychology, Cognitive Processes and Education Group, Colombia
| | | | | | - Angela Lozano
- Neurosciences Group, Colombia; Interdisciplinary Memory Group, Colombia
| | | | | | - Cesar Piñeros
- Epidemiology and Biostatistics Research Group, Colombia
| |
Collapse
|
14
|
Genetic effects on longitudinal cognitive decline during the early stages of Alzheimer's disease. Sci Rep 2021; 11:19853. [PMID: 34615922 PMCID: PMC8494841 DOI: 10.1038/s41598-021-99310-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Accepted: 09/22/2021] [Indexed: 11/08/2022] Open
Abstract
Cognitive decline in early-stage Alzheimer's disease (AD) may depend on genetic variability. In the Swedish BioFINDER study, we used polygenic scores (PGS) (for AD, intelligence, and educational attainment) to predict longitudinal cognitive change (measured by mini-mental state examination (MMSE) [primary outcome] and other cognitive tests) over a mean of 4.2 years. We included 260 β-amyloid (Aβ) negative cognitively unimpaired (CU) individuals, 121 Aβ-positive CU (preclinical AD), 50 Aβ-negative mild cognitive impairment (MCI) patients, and 127 Aβ-positive MCI patients (prodromal AD). Statistical significance was determined at Bonferroni corrected p value < 0.05. The PGS for intelligence (beta = 0.1, p = 2.9e-02) was protective against decline in MMSE in CU and MCI participants regardless of Aβ status. The polygenic risk score for AD (beta = - 0.12, p = 9.4e-03) was correlated with the rate of change in MMSE and was partially mediated by Aβ-pathology (mediation effect 20%). There was no effect of education PGS on cognitive measures. Genetic variants associated with intelligence mitigate cognitive decline independent of Aβ-pathology, while effects of genetic variants associated with AD are partly mediated by Aβ-pathology.
Collapse
|
15
|
Leonenko G, Baker E, Stevenson-Hoare J, Sierksma A, Fiers M, Williams J, de Strooper B, Escott-Price V. Identifying individuals with high risk of Alzheimer's disease using polygenic risk scores. Nat Commun 2021; 12:4506. [PMID: 34301930 PMCID: PMC8302739 DOI: 10.1038/s41467-021-24082-z] [Citation(s) in RCA: 83] [Impact Index Per Article: 27.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Accepted: 06/02/2021] [Indexed: 11/09/2022] Open
Abstract
Polygenic Risk Scores (PRS) for AD offer unique possibilities for reliable identification of individuals at high and low risk of AD. However, there is little agreement in the field as to what approach should be used for genetic risk score calculations, how to model the effect of APOE, what the optimal p-value threshold (pT) for SNP selection is and how to compare scores between studies and methods. We show that the best prediction accuracy is achieved with a model with two predictors (APOE and PRS excluding APOE region) with pT<0.1 for SNP selection. Prediction accuracy in a sample across different PRS approaches is similar, but individuals' scores and their associated ranking differ. We show that standardising PRS against the population mean, as opposed to the sample mean, makes the individuals' scores comparable between studies. Our work highlights the best strategies for polygenic profiling when assessing individuals for AD risk.
Collapse
Affiliation(s)
- Ganna Leonenko
- UK Dementia Research Institute, Cardiff University, Cardiff, UK
| | - Emily Baker
- UK Dementia Research Institute, Cardiff University, Cardiff, UK
| | | | - Annerieke Sierksma
- VIB Center for Brain & Disease Research, Leuven, Belgium
- Laboratory for the Research of Neurodegenerative Diseases, Department of Neurosciences, Leuven Brain Institute (LBI), KU Leuven (University of Leuven), Leuven, Belgium
| | - Mark Fiers
- VIB Center for Brain & Disease Research, Leuven, Belgium
- Laboratory for the Research of Neurodegenerative Diseases, Department of Neurosciences, Leuven Brain Institute (LBI), KU Leuven (University of Leuven), Leuven, Belgium
- UK Dementia Research Institute, University College London, London, UK
| | - Julie Williams
- UK Dementia Research Institute, Cardiff University, Cardiff, UK
- Division of Psychological Medicine and Clinical Neurosciences, School of Medicine, Cardiff University, Cardiff, UK
| | - Bart de Strooper
- VIB Center for Brain & Disease Research, Leuven, Belgium
- Laboratory for the Research of Neurodegenerative Diseases, Department of Neurosciences, Leuven Brain Institute (LBI), KU Leuven (University of Leuven), Leuven, Belgium
- UK Dementia Research Institute, University College London, London, UK
| | - Valentina Escott-Price
- UK Dementia Research Institute, Cardiff University, Cardiff, UK.
- Division of Psychological Medicine and Clinical Neurosciences, School of Medicine, Cardiff University, Cardiff, UK.
| |
Collapse
|
16
|
Tandon A, Singh SJ, Chaturvedi RK. Nanomedicine against Alzheimer's and Parkinson's Disease. Curr Pharm Des 2021; 27:1507-1545. [PMID: 33087025 DOI: 10.2174/1381612826666201021140904] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Revised: 08/06/2020] [Accepted: 08/18/2020] [Indexed: 11/22/2022]
Abstract
Alzheimer's and Parkinson's are the two most rampant neurodegenerative disorders worldwide. Existing treatments have a limited effect on the pathophysiology but are unable to fully arrest the progression of the disease. This is due to the inability of these therapeutic molecules to efficiently cross the blood-brain barrier. We discuss how nanotechnology has enabled researchers to develop novel and efficient nano-therapeutics against these diseases. The development of nanotized drug delivery systems has permitted an efficient, site-targeted, and controlled release of drugs in the brain, thereby presenting a revolutionary therapeutic approach. Nanoparticles are also being thoroughly studied and exploited for their role in the efficient and precise diagnosis of neurodegenerative conditions. We summarize the role of different nano-carriers and RNAi-conjugated nanoparticle-based therapeutics for their efficacy in pre-clinical studies. We also discuss the challenges underlying the use of nanomedicine with a focus on their route of administration, concentration, metabolism, and any toxic effects for successful therapeutics in these diseases.
Collapse
Affiliation(s)
- Ankit Tandon
- Developmental Toxicology Laboratory, Systems Toxicology and Health Risk Assessment Group, CSIR-Indian Institute of Toxicology Research (CSIR-IITR), Vishvigyan Bhawan, 31, Mahatma Gandhi Marg, Lucknow 226001, Uttar Pradesh, India
| | - Sangh J Singh
- Developmental Toxicology Laboratory, Systems Toxicology and Health Risk Assessment Group, CSIR-Indian Institute of Toxicology Research (CSIR-IITR), Vishvigyan Bhawan, 31, Mahatma Gandhi Marg, Lucknow 226001, Uttar Pradesh, India
| | - Rajnish K Chaturvedi
- Developmental Toxicology Laboratory, Systems Toxicology and Health Risk Assessment Group, CSIR-Indian Institute of Toxicology Research (CSIR-IITR), Vishvigyan Bhawan, 31, Mahatma Gandhi Marg, Lucknow 226001, Uttar Pradesh, India
| |
Collapse
|
17
|
Mather M. How Do Cognitively Stimulating Activities Affect Cognition and the Brain Throughout Life? Psychol Sci Public Interest 2021; 21:1-5. [PMID: 32772802 DOI: 10.1177/1529100620941808] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Affiliation(s)
- Mara Mather
- Leonard Davis School of Gerontology and Department of Psychology, University of Southern California
| |
Collapse
|
18
|
Whitwell JL, Tosakulwong N, Weigand SD, Graff-Radford J, Duffy JR, Clark HM, Machulda MM, Botha H, Utianski RL, Schwarz CG, Senjem ML, Strand EA, Ertekin-Taner N, Jack CR, Lowe VJ, Josephs KA. Longitudinal Amyloid-β PET in Atypical Alzheimer's Disease and Frontotemporal Lobar Degeneration. J Alzheimers Dis 2021; 74:377-389. [PMID: 32039841 DOI: 10.3233/jad-190699] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
BACKGROUND Rates of amyloid-β (Aβ) accumulation have been characterized across the cognitively normal to typical Alzheimer's dementia spectrum, but little is known about Aβ accumulation in atypical Alzheimer's disease (AD) and other neurodegenerative diseases, such as frontotemporal lobar degeneration (FTLD). OBJECTIVE We aimed tocharacterize longitudinal Aβ accumulation anddetermine the influence of age, apolipoprotein E (APOE) genotype, disease duration, and sexin atypical AD and FTLD. METHODS 322 patients (138 atypical AD, 184 FTLD) underwent Pittsburgh compound B PET scanning, with 73 having serialPiB-PET scans (42 atypical AD, 31 FTLD). Global Aβ standard uptake value ratios were calculated for every scan. Mixed effects models were used to assess the effect of age, APOE genotype, disease duration, and sex on baseline and change measures of Aβ. RESULTS Atypical AD showed higher baseline Aβ than FTLD. Rate of Aβ accumulation was not associated with baseline Aβ in either group. Older age was associated with greater baseline Aβ and faster rates of accumulation in FTLD. In patients under age 70, atypical AD showed faster rates of accumulation than FTLD. APOEɛ4 genotype was associated with greater baseline Aβ in FTLD but did not influence rates of accumulation. Rates of Aβ accumulation were faster in FTLD patents with time from onset-to-PET≤4 years. Female sex was associated with faster rates of accumulation in atypical AD. CONCLUSION Accumulation of Aβ is observed in atypical AD and FTLD, although different demographic factors influence accumulation in these diseases providing insight into potentially different biological mechanisms of Aβ deposition.
Collapse
Affiliation(s)
| | | | - Stephen D Weigand
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
| | - Jonathan Graff-Radford
- Department of Neurology, Division of Behavioral Neurology, Mayo Clinic, Rochester, MN, USA
| | - Joseph R Duffy
- Department of Neurology, Division of Speech Pathology, Mayo Clinic, Rochester, MN, USA
| | - Heather M Clark
- Department of Neurology, Division of Speech Pathology, Mayo Clinic, Rochester, MN, USA
| | - Mary M Machulda
- Department of Psychology and Psychiatry, Mayo Clinic, Rochester, MN, USA
| | - Hugo Botha
- Department of Neurology, Division of Behavioral Neurology, Mayo Clinic, Rochester, MN, USA
| | - Rene L Utianski
- Department of Neurology, Division of Speech Pathology, Mayo Clinic, Rochester, MN, USA
| | | | - Matthew L Senjem
- Department of Radiology, Mayo Clinic, Rochester, MN, USA.,Department of Information Technology, Mayo Clinic, Rochester, MN, USA
| | - Edythe A Strand
- Department of Neurology, Division of Speech Pathology, Mayo Clinic, Rochester, MN, USA
| | | | | | - Val J Lowe
- Department of Radiology, Mayo Clinic, Rochester, MN, USA
| | - Keith A Josephs
- Department of Neurology, Division of Behavioral Neurology, Mayo Clinic, Rochester, MN, USA
| |
Collapse
|
19
|
Treyer V, Meyer RS, Buchmann A, Crameri GAG, Studer S, Saake A, Gruber E, Unschuld PG, Nitsch RM, Hock C, Gietl AF. Physical activity is associated with lower cerebral beta-amyloid and cognitive function benefits from lifetime experience-a study in exceptional aging. PLoS One 2021; 16:e0247225. [PMID: 33606797 PMCID: PMC7895362 DOI: 10.1371/journal.pone.0247225] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2020] [Accepted: 02/03/2021] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND Exceptional agers (85+ years) are characterized by preserved cognition presumably due to high cognitive reserve. In the current study, we examined whether personality, risk and protective factors for dementia as well as quality of life are associated with core features of Alzheimer's disease (amyloid-deposition and hippocampal volume) as well as cognition in exceptional aging. METHODS We studied 49 exceptional agers (average 87.8 years, range 84-94 years), with preserved activities of daily living and absence of dementia. All participants received a detailed clinical and neuropsychological examination. We used established questionnaires to measure lifetime experience, personality, recent physical and cognitive activity as well as quality of life. Cerebral amyloid-deposition was estimated by 18-[F]-Flutemetamol-PET and manual hippocampal volumetry was performed on 3D T1 MRI images. RESULTS In this sample of exceptional agers with preserved activities of daily living, we found intact cognitive performance in the subjects with the highest amyloid-load in the brain, but a lower quality of life with respect to autonomy as well as higher neuroticism. Higher self-reported physical activity in the last twelve months went with a lower amyloid load. Higher self-reported leisure-time/ not work-related activity went with better executive functioning at older age. CONCLUSION Even in exceptional aging, high amyloid load may subtly influence personality and quality of life. Our findings support a close relationship between high physical activity and low amyloid-deposition and underscore the importance of extracurricular activities for executive functions. As executive functions are known to be a central resource for everyday functioning in fostering extracurricular activities may be effective in delaying the onset of dementia.
Collapse
Affiliation(s)
- Valerie Treyer
- Institute for Regenerative Medicine (IREM), University of Zurich, Zurich, Switzerland
- Department of Nuclear Medicine, University Hospital of Zurich, University of Zurich, Zurich, Switzerland
| | - Rafael S. Meyer
- Institute for Regenerative Medicine (IREM), University of Zurich, Zurich, Switzerland
| | - Andreas Buchmann
- Institute for Regenerative Medicine (IREM), University of Zurich, Zurich, Switzerland
| | | | - Sandro Studer
- Institute for Regenerative Medicine (IREM), University of Zurich, Zurich, Switzerland
| | - Antje Saake
- Institute for Regenerative Medicine (IREM), University of Zurich, Zurich, Switzerland
| | - Esmeralda Gruber
- Institute for Regenerative Medicine (IREM), University of Zurich, Zurich, Switzerland
| | - Paul G. Unschuld
- Institute for Regenerative Medicine (IREM), University of Zurich, Zurich, Switzerland
- Hospital for Psychogeriatric Medicine, Psychiatric University Hospital Zurich, Zurich, Switzerland
| | - Roger M. Nitsch
- Institute for Regenerative Medicine (IREM), University of Zurich, Zurich, Switzerland
- Neurimmune, Schlieren-Zurich, Switzerland
| | - Christoph Hock
- Institute for Regenerative Medicine (IREM), University of Zurich, Zurich, Switzerland
- Neurimmune, Schlieren-Zurich, Switzerland
| | - Anton F. Gietl
- Institute for Regenerative Medicine (IREM), University of Zurich, Zurich, Switzerland
| |
Collapse
|
20
|
You B, Jackson T. Gray Matter Volume Differences Between More Versus Less Resilient Adults with Chronic Musculoskeletal Pain: A Voxel-based Morphology Study. Neuroscience 2021; 457:155-164. [PMID: 33484820 DOI: 10.1016/j.neuroscience.2021.01.019] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Revised: 12/21/2020] [Accepted: 01/12/2021] [Indexed: 12/15/2022]
Abstract
Resilience, a personality construct that reflects capacities to persevere, maintain a positive outlook and/or thrive despite ongoing stressors, has emerged as an important focus of research on chronic pain (CP). Although behavior studies have found more resilient persons with CP experience less pain-related dysfunction than less resilient cohorts do, the presence and nature of associated brain structure differences has received scant attention. To address this gap, we examined gray matter volume (GMV) differences between more versus less resilient adults with chronic musculoskeletal pain. Participants (75 women, 43 men) were community-dwellers who reported ongoing musculoskeletal pain for at least three months. More (n = 57) and less (n = 61) resilient subgroups, respectively, were identified on the basis of scoring above and below median scores on two validated resilience questionnaires. Voxel-based morphology (VBM) undertaken to examine resilience subgroup differences in GMV indicated more resilient participants displayed significantly larger GMV in the (1) bilateral precuneus, (2) left superior and inferior parietal lobules, (3) orbital right middle frontal gyrus and medial right superior frontal gyrus, and (4) bilateral median cingulate and paracingulate gyri, even after controlling for subgroup differences on demographics and measures of pain-related distress. Together, results underscored the presence and nature of specific GMV differences underlying subjective reports of more versus less resilient responses to ongoing musculoskeletal pain.
Collapse
Affiliation(s)
- Beibei You
- Key Laboratory of Cognition and Personality, China Education Ministry, Southwest University, Chongqing 400715, China; Qiannan Preschool Education College, Guizhou 551300, China
| | - Todd Jackson
- Department of Psychology, University of Macau, Taipa 999078, Macau, SAR, China; Key Laboratory of Cognition and Personality, China Education Ministry, Southwest University, Chongqing 400715, China.
| |
Collapse
|
21
|
Anatürk M, Suri S, Zsoldos E, Filippini N, Mahmood A, Singh-Manoux A, Kivimäki M, Mackay CE, Ebmeier KP, Sexton CE. Associations Between Longitudinal Trajectories of Cognitive and Social Activities and Brain Health in Old Age. JAMA Netw Open 2020; 3:e2013793. [PMID: 32816032 PMCID: PMC7441365 DOI: 10.1001/jamanetworkopen.2020.13793] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2020] [Accepted: 06/01/2020] [Indexed: 12/12/2022] Open
Abstract
Importance Prior neuroimaging studies have found that late-life participation in cognitive (eg, reading) and social (eg, visiting friends and family) leisure activities are associated with magnetic resonance imaging (MRI) markers of the aging brain, but little is known about the neural and cognitive correlates of changes in leisure activities during the life span. Objectives To examine trajectories of cognitive and social activities from midlife to late life and evaluate whether these trajectories are associated with brain structure, functional connectivity, and cognition. Design, Setting, and Participants This prospective cohort included participants enrolled in the Whitehall II study and its MRI substudy based in the UK. Participants provided information on their leisure activities at 5 times during calendar years 1997 to 1999, 2002 to 2004, 2006, 2007 to 2009, and 2011 to 2013 and underwent MRI and cognitive battery testing from January 1, 2012, to December 31, 2016. Data analysis was performed from October 7, 2017, to July 15, 2019. Main Outcome and Measures Growth curve models and latent class growth analysis were used to identify longitudinal trajectories of cognitive and social activities. Multiple linear regression was used to evaluate associations between activity trajectories and gray matter, white matter microstructure, functional connectivity, and cognition. Results A total of 574 individuals (468 [81.5%] men; mean [SD] age, 69.9 [4.9] years; median Montreal Cognitive Assessment score, 28 [interquartile range, 26-28]) were included in the present analysis. During a mean (SD) of 15 (4.2) years, cognitive and social activity levels increased during midlife before reaching a plateau in late life. Both baseline (global cognition: unstandardized β [SE], 0.955 [0.285], uncorrected P = .001; executive function: β [SE], 1.831 [0.499], uncorrected P < .001; memory: β [SE], 1.394 [0.550], uncorrected P = .01; processing speed: β [SE], 1.514 [0.528], uncorrected P = .004) and change (global cognition: β [SE], -1.382 [0.492], uncorrected P = .005, executive function: β [SE], -2.219 [0.865], uncorrected P = .01; memory: β [SE], -2.355 [0.948], uncorrected P = .01) in cognitive activities were associated with multiple domains of cognition as well as global gray matter volume (β [SE], -0.910 [0.388], uncorrected P = .02). Baseline (β [SE], 1.695 [0.525], uncorrected P = .001) and change (β [SE], 2.542 [1.026], uncorrected P = .01) in social activities were associated only with executive function, in addition to voxelwise measures of functional connectivity that involved sensorimotor (quadratic change in social activities: number of voxels, 306; P = 0.01) and temporoparietal (linear change in social activities: number of voxels, 16; P = .02) networks. Otherwise, no voxelwise associations were found with gray matter, white matter, or resting-state functional connectivity. False discovery rate corrections for multiple comparisons suggested that the association between cognitive activity levels and executive function was robust (β [SE], 1.831 [0.499], false discovery rate P < .001). Conclusions and Relevance The findings suggest that a life course approach may delineate the association between leisure activities and cognitive and brain health and that interventions aimed at improving and maintaining cognitive engagement may be valuable for the cognitive health of community-dwelling older adults.
Collapse
Affiliation(s)
- Melis Anatürk
- Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford, UK
- Wellcome Centre for Integrative Neuroimaging, Oxford Centre for Functional MRI of the Brain, Oxford, UK
- Nuffield Department of Clinical Neurosciences, University of Oxford, John Radcliffe Hospital, Oxford, UK
| | - Sana Suri
- Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford, UK
- Wellcome Centre for Integrative Neuroimaging, Oxford Centre for Human Brain Activity, University of Oxford, Warneford Hospital, Oxford, UK
| | - Enikő Zsoldos
- Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford, UK
- Wellcome Centre for Integrative Neuroimaging, Oxford Centre for Functional MRI of the Brain, Oxford, UK
- Nuffield Department of Clinical Neurosciences, University of Oxford, John Radcliffe Hospital, Oxford, UK
| | - Nicola Filippini
- Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford, UK
- Wellcome Centre for Integrative Neuroimaging, Oxford Centre for Functional MRI of the Brain, Oxford, UK
- Nuffield Department of Clinical Neurosciences, University of Oxford, John Radcliffe Hospital, Oxford, UK
| | - Abda Mahmood
- Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford, UK
| | - Archana Singh-Manoux
- Department of Epidemiology and Public Health, University College London, London, UK
- Inserm U1153, Epidemiology of Ageing and Neurodegenerative Diseases, Université Paris-Descartes, Paris, France
| | - Mika Kivimäki
- Department of Epidemiology and Public Health, University College London, London, UK
| | - Clare E. Mackay
- Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford, UK
- Wellcome Centre for Integrative Neuroimaging, Oxford Centre for Human Brain Activity, University of Oxford, Warneford Hospital, Oxford, UK
| | - Klaus P. Ebmeier
- Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford, UK
| | - Claire E. Sexton
- Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford, UK
- Wellcome Centre for Integrative Neuroimaging, Oxford Centre for Human Brain Activity, University of Oxford, Warneford Hospital, Oxford, UK
| |
Collapse
|
22
|
Riphagen JM, Schmiedek L, Gronenschild EHBM, Yassa MA, Priovoulos N, Sack AT, Verhey FRJ, Jacobs HIL. Associations between pattern separation and hippocampal subfield structure and function vary along the lifespan: A 7 T imaging study. Sci Rep 2020; 10:7572. [PMID: 32371923 PMCID: PMC7200747 DOI: 10.1038/s41598-020-64595-z] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2019] [Accepted: 04/20/2020] [Indexed: 12/04/2022] Open
Abstract
Pattern separation (PS) describes the process by which the brain discriminates similar stimuli from previously encoded stimuli. This fundamental process requires the intact processing by specific subfields in the hippocampus and can be examined using mnemonic discrimination tasks. Previous studies reported different patterns for younger and older individuals between mnemonic discrimination performance and hippocampal subfield activation. Here, we investigated the relationship between the lure discrimination index (LDI) and hippocampal subfield volume and activity across the adult lifespan (20-70 years old). Using ultra-high field functional and structural magnetic resonance imaging at 7 T, we found that lower DG volume and higher CA3 activation was associated with worse LDI performance in individuals (>60 years), suggesting that this higher activation may be an indication of aberrant neurodegenerative-related processes. In fact, higher activation in the CA1 and DG was associated with lower volumes in these subfields. For individuals around 40-50 years old, we observed that greater left and right DG volume, and greater activity in the CA3 was associated with lower LDI performance. Taken together, these results suggest that the relationship between memory and hippocampal subfield structure or function varies nonlinearly and possibly reciprocally with age, with midlife being a critically vulnerable period in life.
Collapse
Affiliation(s)
- Joost M Riphagen
- Faculty of Health, Medicine and Life Sciences, School for Mental Health and Neuroscience, Alzheimer Centre Limburg, Maastricht University, Maastricht, The Netherlands.
| | - Lisa Schmiedek
- Faculty of Health, Medicine and Life Sciences, School for Mental Health and Neuroscience, Alzheimer Centre Limburg, Maastricht University, Maastricht, The Netherlands
| | - Ed H B M Gronenschild
- Faculty of Health, Medicine and Life Sciences, School for Mental Health and Neuroscience, Alzheimer Centre Limburg, Maastricht University, Maastricht, The Netherlands
| | - Michael A Yassa
- Department of Neurobiology and Behavior, Center for the Neurobiology of Learning and Memory, University of California, Irvine, CA, USA
| | - Nikos Priovoulos
- Faculty of Health, Medicine and Life Sciences, School for Mental Health and Neuroscience, Alzheimer Centre Limburg, Maastricht University, Maastricht, The Netherlands
| | - Alexander T Sack
- Faculty of Psychology and Neuroscience, Department of Cognitive Neuroscience, Maastricht University, PO BOX 616, 6200, MD, Maastricht, The Netherlands
| | - Frans R J Verhey
- Faculty of Health, Medicine and Life Sciences, School for Mental Health and Neuroscience, Alzheimer Centre Limburg, Maastricht University, Maastricht, The Netherlands
| | - Heidi I L Jacobs
- Faculty of Health, Medicine and Life Sciences, School for Mental Health and Neuroscience, Alzheimer Centre Limburg, Maastricht University, Maastricht, The Netherlands
- Faculty of Psychology and Neuroscience, Department of Cognitive Neuroscience, Maastricht University, PO BOX 616, 6200, MD, Maastricht, The Netherlands
- Gordon Center for Medical Imaging, Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| |
Collapse
|
23
|
Iso-Markku P, Waller K, Hautasaari P, Kaprio J, Kujala UM, Tarkka IM. Twin studies on the association of physical activity with cognitive and cerebral outcomes. Neurosci Biobehav Rev 2020; 114:1-11. [PMID: 32325068 DOI: 10.1016/j.neubiorev.2020.04.015] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2019] [Revised: 02/25/2020] [Accepted: 04/09/2020] [Indexed: 11/24/2022]
Abstract
Regular physical activity (PA) offers positive effects on the human body. However, the effects of PA on cognition and in the brain are less clear. In this paper, we narratively review the relationship of PA with cognition and dementia, first from general perspective and then through genetically informed studies on the topic. Then we move on to imaging studies on exercise and brain anatomy first by presenting an overall picture of the topic and then discussing brain imaging studies addressing PA and brain structure in twins in more detailed way. Regarding PA and cognition or dementia, genetically informed studies are uncommon, even though the relationship between PA and cognitive ageing has been extensively studied. It is challenging to find twin pairs discordant for PA and dementia. Concerning brain imaging studies, among PA discordant young adult twin pairs, the more active co-twins showed larger gray matter volumes in striatal, prefrontal, and hippocampal regions and in electrophysiological studies automatic deviance-detection processes differed in brain regions involved with sensorimotor, visual and memory functions.
Collapse
Affiliation(s)
- Paula Iso-Markku
- Department of Clinical Physiology and Nuclear Medicine, HUS Medical Imaging Center, Helsinki 42, University Central Hospital and University of Helsinki, Helsinki, Finland; Institute for Molecular Medicine FIMM, University of Helsinki, Helsinki, Finland
| | - Katja Waller
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Pekka Hautasaari
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Jaakko Kaprio
- Institute for Molecular Medicine FIMM, University of Helsinki, Helsinki, Finland; Department of Public Health, University of Helsinki, Helsinki, Finland
| | - Urho M Kujala
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Ina M Tarkka
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland.
| |
Collapse
|
24
|
Arenaza-Urquijo EM, Przybelski SA, Machulda MM, Knopman DS, Lowe VJ, Mielke MM, Reddy AL, Geda YE, Jack CR, Petersen RC, Vemuri P. Better stress coping associated with lower tau in amyloid-positive cognitively unimpaired older adults. Neurology 2020; 94:e1571-e1579. [PMID: 31964689 PMCID: PMC7251516 DOI: 10.1212/wnl.0000000000008979] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/07/2019] [Accepted: 10/16/2019] [Indexed: 12/17/2022] Open
Abstract
OBJECTIVE Research in animals has shown that chronic stress exacerbates tau pathology. In humans, psychological stress has been associated with higher risk of Alzheimer disease clinical syndrome. The objective of this cross-sectional study was to assess the hypothesis that stress coping ability (assessed via the Brief Resilience Scale [BRS]) is associated with tau burden and to evaluate whether these associations differed by sex and amyloid status (A+/A-) in cognitively unimpaired (CU) older adults. METHODS We included 225 CU participants (mean age 70.4 ± 10.2 years, 48% female) enrolled in the population-based Mayo Clinic Study of Aging who completed the BRS and underwent amyloid-PET (Pittsburgh compound B-PET) and tau-PET (AV1451-PET). We fitted multiple regression and analysis of covariance models to assess the associations between BRS and tau-PET and the interaction with amyloid status and sex. We focused on entorhinal cortex (ERC) tau burden and also performed voxel-wise analyses. Age, sex, education, depression, and anxiety were considered as covariates. RESULTS Higher stress coping ability was associated with lower tau burden in the medial temporal lobe (including ERC) and occipito-temporal and cuneal/precuneal cortices. The association was present in both A+ and A- but weaker in A- CU older adults. There was an interaction between amyloid status and stress coping ability that was restricted to the medial temporal lobe tau such that A+ CU older adults with lower stress coping abilities showed higher tau. There were no significant interactions between stress coping and sex. CONCLUSIONS A faster termination of the stress response (higher coping ability) may limit the negative effects of stress on tau deposition. Conversely, lower stress coping ability may be an early sign of accumulating tau pathology. Longitudinal studies are warranted to clarify whether stress mechanisms act to exacerbate tau pathology or tau influences stress-related brain mechanisms and lowers the ability to cope with stress.
Collapse
Affiliation(s)
- Eider M Arenaza-Urquijo
- From the Departments of Radiology (E.M.A.-U., V.J.L., A.L.R., C.R.J., P.V.), Health Sciences Research (S.A.P., M.M.M.), Psychiatry and Psychology (M.M. Machulda), and Neurology (D.S.K., M.M. Mielke, R.C.P.), Mayo Clinic, Rochester, MN; and Department of Neurology (Y.E.G.), Mayo Clinic, Scottsdale, AZ
| | - Scott A Przybelski
- From the Departments of Radiology (E.M.A.-U., V.J.L., A.L.R., C.R.J., P.V.), Health Sciences Research (S.A.P., M.M.M.), Psychiatry and Psychology (M.M. Machulda), and Neurology (D.S.K., M.M. Mielke, R.C.P.), Mayo Clinic, Rochester, MN; and Department of Neurology (Y.E.G.), Mayo Clinic, Scottsdale, AZ
| | - Mary M Machulda
- From the Departments of Radiology (E.M.A.-U., V.J.L., A.L.R., C.R.J., P.V.), Health Sciences Research (S.A.P., M.M.M.), Psychiatry and Psychology (M.M. Machulda), and Neurology (D.S.K., M.M. Mielke, R.C.P.), Mayo Clinic, Rochester, MN; and Department of Neurology (Y.E.G.), Mayo Clinic, Scottsdale, AZ
| | - David S Knopman
- From the Departments of Radiology (E.M.A.-U., V.J.L., A.L.R., C.R.J., P.V.), Health Sciences Research (S.A.P., M.M.M.), Psychiatry and Psychology (M.M. Machulda), and Neurology (D.S.K., M.M. Mielke, R.C.P.), Mayo Clinic, Rochester, MN; and Department of Neurology (Y.E.G.), Mayo Clinic, Scottsdale, AZ
| | - Val J Lowe
- From the Departments of Radiology (E.M.A.-U., V.J.L., A.L.R., C.R.J., P.V.), Health Sciences Research (S.A.P., M.M.M.), Psychiatry and Psychology (M.M. Machulda), and Neurology (D.S.K., M.M. Mielke, R.C.P.), Mayo Clinic, Rochester, MN; and Department of Neurology (Y.E.G.), Mayo Clinic, Scottsdale, AZ
| | - Michelle M Mielke
- From the Departments of Radiology (E.M.A.-U., V.J.L., A.L.R., C.R.J., P.V.), Health Sciences Research (S.A.P., M.M.M.), Psychiatry and Psychology (M.M. Machulda), and Neurology (D.S.K., M.M. Mielke, R.C.P.), Mayo Clinic, Rochester, MN; and Department of Neurology (Y.E.G.), Mayo Clinic, Scottsdale, AZ
| | - Ashritha L Reddy
- From the Departments of Radiology (E.M.A.-U., V.J.L., A.L.R., C.R.J., P.V.), Health Sciences Research (S.A.P., M.M.M.), Psychiatry and Psychology (M.M. Machulda), and Neurology (D.S.K., M.M. Mielke, R.C.P.), Mayo Clinic, Rochester, MN; and Department of Neurology (Y.E.G.), Mayo Clinic, Scottsdale, AZ
| | - Yonas E Geda
- From the Departments of Radiology (E.M.A.-U., V.J.L., A.L.R., C.R.J., P.V.), Health Sciences Research (S.A.P., M.M.M.), Psychiatry and Psychology (M.M. Machulda), and Neurology (D.S.K., M.M. Mielke, R.C.P.), Mayo Clinic, Rochester, MN; and Department of Neurology (Y.E.G.), Mayo Clinic, Scottsdale, AZ
| | - Clifford R Jack
- From the Departments of Radiology (E.M.A.-U., V.J.L., A.L.R., C.R.J., P.V.), Health Sciences Research (S.A.P., M.M.M.), Psychiatry and Psychology (M.M. Machulda), and Neurology (D.S.K., M.M. Mielke, R.C.P.), Mayo Clinic, Rochester, MN; and Department of Neurology (Y.E.G.), Mayo Clinic, Scottsdale, AZ
| | - Ronald C Petersen
- From the Departments of Radiology (E.M.A.-U., V.J.L., A.L.R., C.R.J., P.V.), Health Sciences Research (S.A.P., M.M.M.), Psychiatry and Psychology (M.M. Machulda), and Neurology (D.S.K., M.M. Mielke, R.C.P.), Mayo Clinic, Rochester, MN; and Department of Neurology (Y.E.G.), Mayo Clinic, Scottsdale, AZ
| | - Prashanthi Vemuri
- From the Departments of Radiology (E.M.A.-U., V.J.L., A.L.R., C.R.J., P.V.), Health Sciences Research (S.A.P., M.M.M.), Psychiatry and Psychology (M.M. Machulda), and Neurology (D.S.K., M.M. Mielke, R.C.P.), Mayo Clinic, Rochester, MN; and Department of Neurology (Y.E.G.), Mayo Clinic, Scottsdale, AZ.
| |
Collapse
|
25
|
Jeon SY, Byun MS, Yi D, Lee JH, Ko K, Sohn BK, Lee JY, Ryu SH, Lee DW, Shin SA, Kim YK, Kang KM, Sohn CH, Lee DY. Midlife Lifestyle Activities Moderate APOE ε4 Effect on in vivo Alzheimer's Disease Pathologies. Front Aging Neurosci 2020; 12:42. [PMID: 32256335 PMCID: PMC7093017 DOI: 10.3389/fnagi.2020.00042] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2019] [Accepted: 02/07/2020] [Indexed: 12/24/2022] Open
Abstract
This study aimed to investigate whether the midlife cognitive activity and physical activity moderate the relationship between apolipoprotein Eε4 (APOE4) and in vivo Alzheimer's disease (AD) pathologies. In total, 287 non-demented older adults (mean age 72 years) from the Korean Brain Aging Study for the Early diagnosis and prediction of Alzheimer's disease cohort were included. Participants underwent a comprehensive clinical assessment including the evaluation for midlife CA and physical activity, [11C]-Pittsburgh-Compound-B-positron emission tomography (PET), [18F]-fluorodeoxyglucose PET, structural magnetic resonance imaging (MRI), and APOE genotyping. We used linear regression and regression-based mediated-moderation models for statistical analyses. Neither midlife cognitive activity nor physical activity moderated the effect of APOE4 on β-amyloid (Aβ) retention itself. Midlife cognitive activity significantly moderated the effect of APOE4 on hippocampal volume [B (SE) = - 627.580 (252.327), t = -2.488, p = 0.014]: APOE4 carriers had smaller hippocampal volume than non-carriers at relatively high cognitive activity state (p = 0.004), but not at relatively low cognitive activity condition (p = 0.937). Midlife physical activity significantly moderated the effect of Aβ retention, which was closely related to APOE4, on AD-signature region cerebral glucose metabolism [AD-CM; B (SE) = 0.004 (0.002), t = 2.030, p = 0.043]: higher Aβ accumulation was associated with lower AD-CM in relatively low physical activity condition (p < 0.001), whereas no such association was observed in relatively high physical activity state (p = 0.791). The findings suggest that high midlife cognitive activity may accelerate hippocampal atrophy induced by APOE4, whereas high midlife physical activity may delay AD-related cerebral hypometabolism by weakening the influence of APOE4-associated Aβ retention.
Collapse
Affiliation(s)
- So Yeon Jeon
- Department of Psychiatry, Chungnam National University Hospital, Daejeon, South Korea
| | - Min Soo Byun
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, South Korea
| | - Dahyun Yi
- Institute of Human Behavioral Medicine, Medical Research Center, Seoul National University, Seoul, South Korea
| | - Jun-Ho Lee
- Department of Psychiatry, National Center for Mental Health, Seoul, South Korea
| | - Kang Ko
- Department of Psychiatry, National Center for Mental Health, Seoul, South Korea
| | - Bo Kyung Sohn
- Department of Neuropsychiatry, Sanggye Paik Hospital, Inje University College of Medicine, Seoul, South Korea
| | - Jun-Young Lee
- Department of Neuropsychiatry, SMG-SNU Boramae Medical Center, Seoul, South Korea
| | - Seung-Ho Ryu
- Department of Psychiatry, School of Medicine, Konkuk University Medical Center, Konkuk University, Seoul, South Korea
| | - Dong Woo Lee
- Department of Neuropsychiatry, Sanggye Paik Hospital, Inje University College of Medicine, Seoul, South Korea
| | - Seoung A Shin
- Department of Nuclear Medicine, SMG-SNU Boramae Medical Center, Seoul, South Korea
| | - Yu Kyeong Kim
- Department of Nuclear Medicine, SMG-SNU Boramae Medical Center, Seoul, South Korea
| | - Koung Mi Kang
- Department of Radiology, Seoul National University Hospital, Seoul, South Korea
| | - Chul-Ho Sohn
- Department of Radiology, Seoul National University Hospital, Seoul, South Korea
| | - Dong Young Lee
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, South Korea.,Institute of Human Behavioral Medicine, Medical Research Center, Seoul National University, Seoul, South Korea.,Department of Psychiatry, Seoul National University College of Medicine, Seoul, South Korea
| |
Collapse
|
26
|
|
27
|
Walhovd KB, Fjell AM, Westerhausen R, Nyberg L, Ebmeier KP, Lindenberger U, Bartrés-Faz D, Baaré WF, Siebner HR, Henson R, Drevon CA, Strømstad Knudsen GP, Ljøsne IB, Penninx BW, Ghisletta P, Rogeberg O, Tyler L, Bertram L. Healthy minds 0–100 years: Optimising the use of European brain imaging cohorts (“Lifebrain”). Eur Psychiatry 2020; 50:47-56. [DOI: 10.1016/j.eurpsy.2017.12.006] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2017] [Revised: 10/04/2017] [Accepted: 10/05/2017] [Indexed: 12/26/2022] Open
Abstract
AbstractThe main objective of “Lifebrain” is to identify the determinants of brain, cognitive and mental (BCM) health at different stages of life. By integrating, harmonising and enriching major European neuroimaging studies across the life span, we will merge fine-grained BCM health measures of more than 5000 individuals. Longitudinal brain imaging, genetic and health data are available for a major part, as well as cognitive and mental health measures for the broader cohorts, exceeding 27,000 examinations in total. By linking these data to other databases and biobanks, including birth registries, national and regional archives, and by enriching them with a new online data collection and novel measures, we will address the risk factors and protective factors of BCM health. We will identify pathways through which risk and protective factors work and their moderators. Exploiting existing European infrastructures and initiatives, we hope to make major conceptual, methodological and analytical contributions towards large integrative cohorts and their efficient exploitation. We will thus provide novel information on BCM health maintenance, as well as the onset and course of BCM disorders. This will lay a foundation for earlier diagnosis of brain disorders, aberrant development and decline of BCM health, and translate into future preventive and therapeutic strategies. Aiming to improve clinical practice and public health we will work with stakeholders and health authorities, and thus provide the evidence base for prevention and intervention.
Collapse
|
28
|
Casaletto KB, Renteíıa MA, Pa J, Tom SE, Harrati A, Armstrong NM, Rajan KB, Mungas D, Walters S, Kramer J, Zahodne LB. Late-Life Physical and Cognitive Activities Independently Contribute to Brain and Cognitive Resilience. J Alzheimers Dis 2020; 74:363-376. [PMID: 32039854 PMCID: PMC7233450 DOI: 10.3233/jad-191114] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
BACKGROUND Active lifestyles are related to better cognitive aging outcomes, yet the unique role of different types of activity are unknown. OBJECTIVE To examine the independent contributions of physical (PA) versus cognitive (CA) leisure activities to brain and cognitive aging. METHODS Independent samples of non-demented older adults from University of California, San Francisco Hillblom Aging Network (UCSF; n = 344 typically aging) and University of California, Davis Diversity cohort (UCD; n = 485 normal to MCI) completed: 1) self-reported engagement in current PA and CA (UCSF: Physical Activity Scale for the Elderly and Cognitive Activity Scale; UCD: Life Experiences Assessment Form); 2) neuropsychological batteries; and 3) neuroimaging total gray matter volume, white matter hyperintensities, and/or global fractional anisotropy. PA and CA were simultaneously entered into multivariable linear regression models, adjusting for demographic characteristics and functional impairment severity. RESULTS Brain outcomes: In UCSF, only PA was positively associated with gray matter volume and attenuated the relationship between age and fractional anisotropy. In UCD, only CA was associated with less white matter hyperintensities and attenuated the relationship between age and gray matter volume. Cognitive outcomes: In both cohorts, greater CA, but not PA, related to better cognition, independent of age and brain structure. In UCSF, CA attenuated the relationship between fractional anisotropy and cognition. In UCD, PA attenuated the association between white matter hyperintensities and cognition. CONCLUSIONS Although their specificity was not easily teased apart, both PA and CA are clearly related to better brain and cognitive resilience markers across cohorts with differing educational, racial, and disease statuses. PA and CA may independently contribute to converging neuroprotective pathways for brain and cognitive aging.
Collapse
Affiliation(s)
- Kaitlin B. Casaletto
- Department of Neurology, Memory and Aging Center, University of California, San Francisco, San Francisco, CA, USA
| | - Miguel Arce Renteíıa
- Department of Neurology, Taub Institute for Research on Alzheimer’s Disease and the Aging Brain, Columbia University, New York, NY, USA
| | - Judy Pa
- Department of Neurology, Mark and Mary Stevens Neuroimaging and Informatics Institute, University of Southern California, Los Angeles, CA, USA
| | - Sarah E. Tom
- Department of Neurology, Vagelos College of Physicians and Surgeons and Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Amal Harrati
- Department of Primary Care and Population Health, Center for Population Health Sciences, Stanford University, Stanford, CA, USA
| | - Nicole M. Armstrong
- Laboratory of Behavioral Neuroscience, National Institute on Aging, Baltimore, MD, USA
| | | | - Dan Mungas
- University of California, Davis, Davis, CA, USA
| | - Samantha Walters
- Department of Neurology, Memory and Aging Center, University of California, San Francisco, San Francisco, CA, USA
| | - Joel Kramer
- Department of Neurology, Memory and Aging Center, University of California, San Francisco, San Francisco, CA, USA
| | - Laura B. Zahodne
- Department of Psychology, University of Michigan, Ann Arbor, MI, USA
| |
Collapse
|
29
|
Ramanan VK, Castillo AM, Knopman DS, Graff-Radford J, Lowe VJ, Petersen RC, Jack CR, Mielke MM, Vemuri P. Association of Apolipoprotein E ɛ4, Educational Level, and Sex With Tau Deposition and Tau-Mediated Metabolic Dysfunction in Older Adults. JAMA Netw Open 2019; 2:e1913909. [PMID: 31642932 PMCID: PMC6820045 DOI: 10.1001/jamanetworkopen.2019.13909] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022] Open
Abstract
IMPORTANCE While amyloidosis is an early event in the Alzheimer disease (AD) biomarker cascade, a complex interplay among the apolipoprotein E (APOE) ɛ4 allele, educational levels, and sex may be associated with an individual's resilience to dementia. OBJECTIVE To assess whether APOE ɛ4, educational levels, and sex are associated with regional tau deposition and tau-mediated metabolic dysfunction in older adults. DESIGN, SETTING, AND PARTICIPANTS Population-based cohort study of individuals aged 65 years and older enrolled between January 1, 2004, and May 1, 2018, in the Mayo Clinic Study of Aging, a prospective longitudinal study of cognitive aging in Olmsted County, Minnesota. MAIN OUTCOMES AND MEASURES The primary outcomes were cross-sectional tau burden and the fluorodeoxyglucose (FDG) to tau ratio (as a measure of tau-mediated metabolic dysfunction) assessed by positron emission tomography for 43 atlas-defined regions, with specific focus on the entorhinal, inferior temporal, and posterior cingulate cortices. EXPOSURES Using linear regression, APOE ɛ4 status and years of education were the primary exposure variables, with sex additionally investigated through interaction models. RESULTS The sample included 325 individuals (173 [53%] male; mean [SD] age, 76.1 [7.2] years; 291 [90%] cognitively unimpaired). Although APOE ɛ4 was nominally associated with higher tau deposition (β = 0.05 [95% CI, 0.02-0.09]; P = .001; Cohen d = 0.40) and lower FDG to tau ratio (β = -0.05 [95% CI, -0.08 to -0.01]; P = .008; Cohen d = 0.33) in the entorhinal cortex, these associations were completely attenuated after controlling for global amyloid burden. Education was not associated with regional tau burden or FDG to tau ratio. In the 3 regions of interest, global amyloid burden accounted for the largest proportion of variance in tau deposition among the candidate variables assessed. In the entorhinal cortex, significant interactions were identified between APOE ɛ4 and global amyloid burden on tau (β = 0.25; SE = 0.06; P < .001) and between sex and tau burden on FDG metabolism (β = 0.10; SE = 0.05; P = .049). CONCLUSIONS AND RELEVANCE These results suggest that (1) tau deposition is most significantly associated with amyloidosis; (2) in the presence of abundant amyloidosis, APOE ɛ4 may be associated with accelerated entorhinal cortex tau deposition; and (3) women may have lower resilience to tau, manifested by a higher degree of metabolic dysfunction in the entorhinal cortex in response to tau pathology.
Collapse
Affiliation(s)
- Vijay K Ramanan
- Department of Neurology, Mayo Clinic–Rochester, Rochester, Minnesota
| | - Anna M. Castillo
- Department of Health Sciences Research, Mayo Clinic–Rochester, Rochester, Minnesota
| | - David S. Knopman
- Department of Neurology, Mayo Clinic–Rochester, Rochester, Minnesota
| | | | - Val J. Lowe
- Department of Radiology, Mayo Clinic–Rochester, Rochester, Minnesota
| | - Ronald C. Petersen
- Department of Neurology, Mayo Clinic–Rochester, Rochester, Minnesota
- Department of Health Sciences Research, Mayo Clinic–Rochester, Rochester, Minnesota
| | - Clifford R. Jack
- Department of Radiology, Mayo Clinic–Rochester, Rochester, Minnesota
| | - Michelle M. Mielke
- Department of Neurology, Mayo Clinic–Rochester, Rochester, Minnesota
- Department of Health Sciences Research, Mayo Clinic–Rochester, Rochester, Minnesota
| | - Prashanthi Vemuri
- Department of Radiology, Mayo Clinic–Rochester, Rochester, Minnesota
| |
Collapse
|
30
|
Abstract
Technologies for imaging the pathophysiology of Alzheimer disease (AD) now permit studies of the relationships between the two major proteins deposited in this disease - amyloid-β (Aβ) and tau - and their effects on measures of neurodegeneration and cognition in humans. Deposition of Aβ in the medial parietal cortex appears to be the first stage in the development of AD, although tau aggregates in the medial temporal lobe (MTL) precede Aβ deposition in cognitively healthy older people. Whether aggregation of tau in the MTL is the first stage in AD or a fairly benign phenomenon that may be transformed and spread in the presence of Aβ is a major unresolved question. Despite a strong link between Aβ and tau, the relationship between Aβ and neurodegeneration is weak; rather, it is tau that is associated with brain atrophy and hypometabolism, which, in turn, are related to cognition. Although there is support for an interaction between Aβ and tau resulting in neurodegeneration that leads to dementia, the unknown nature of this interaction, the strikingly different patterns of brain Aβ and tau deposition and the appearance of neurodegeneration in the absence of Aβ and tau are challenges to this model that ultimately must be explained.
Collapse
|
31
|
Weisenbach SL, Kim J, Hammers D, Konopacki K, Koppelmans V. Linking late life depression and Alzheimer's disease: mechanisms and resilience. Curr Behav Neurosci Rep 2019; 6:103-112. [PMID: 33134032 PMCID: PMC7597973 DOI: 10.1007/s40473-019-00180-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
PURPOSE OF REVIEW This review summarizes recent literature linking Alzheimer's disease (AD) and late life depression (LLD). It describes shared neurobiological features associated with both conditions, as well as factors that may increase resilience to onset and severity of cognitive decline and AD. Finally, we pose a number of future research directions toward improving detection, management, and treatment of both conditions. RECENT FINDINGS Epidemiological studies have consistently shown a significant relationship between LLD and AD, with support for depression as a prodromal feature of AD, a risk factor for AD, and observation of some shared risk factors underlying both disease processes. Three major neurobiological features shared by LLD and AD include neurodegeneration, disruption to cerebrovascular functioning, and increased levels of neuroinflammation. There are also potentially modifiable factors that can increase resilience to AD and LLD, including social support, physical and cognitive engagement, and cognitive reserve. SUMMARY We propose that, in the context of depression, neurobiological events, such as neurodegeneration, cerebrovascular disease, and neuroinflammation result in a brain that is more vulnerable to the consequences of the pathophysiological features of AD, lowering the threshold for the onset of the behavioral presentation of AD (i.e., cognitive decline and dementia). We discuss factors that can increase resilience to AD and LLD, including social support, physical and cognitive engagement, and cognitive reserve. We conclude with a discussion of future research directions.
Collapse
|
32
|
Meyer PF, McSweeney M, Gonneaud J, Villeneuve S. AD molecular: PET amyloid imaging across the Alzheimer's disease spectrum: From disease mechanisms to prevention. PROGRESS IN MOLECULAR BIOLOGY AND TRANSLATIONAL SCIENCE 2019; 165:63-106. [PMID: 31481172 DOI: 10.1016/bs.pmbts.2019.05.001] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
The advent of amyloid-beta (Aβ) positron emission tomography (PET) imaging has transformed the field of Alzheimer's disease (AD) by enabling the quantification of cortical Aβ accumulation and propagation in vivo. This revolutionary tool has made it possible to measure direct associations between Aβ and other AD biomarkers, to identify factors that influence Aβ accumulation and to redefine entry criteria into clinical trials as well as measure drug target engagement. This chapter summarizes the main findings on the associations of Aβ with other biomarkers of disease progression across the AD spectrum. It discusses investigations of the timing at which Aβ pathology starts to accumulate, demonstrates the clinical utility of Aβ PET imaging and discusses some ethical implications. Finally, it presents genetic and potentially modifiable lifestyle factors that might influence Aβ accumulation and therefore be targets for AD prevention.
Collapse
Affiliation(s)
- Pierre-François Meyer
- Centre for Studies on the Prevention of Alzheimer's Disease, Douglas Mental Health University Institute, Montréal, Canada; McGill University, Montréal, Canada
| | - Melissa McSweeney
- Centre for Studies on the Prevention of Alzheimer's Disease, Douglas Mental Health University Institute, Montréal, Canada; McGill University, Montréal, Canada
| | - Julie Gonneaud
- Centre for Studies on the Prevention of Alzheimer's Disease, Douglas Mental Health University Institute, Montréal, Canada; McGill University, Montréal, Canada
| | - Sylvia Villeneuve
- Centre for Studies on the Prevention of Alzheimer's Disease, Douglas Mental Health University Institute, Montréal, Canada; McGill University, Montréal, Canada.
| |
Collapse
|
33
|
Zhu QB, Bao AM, Swaab D. Activation of the Brain to Postpone Dementia: A Concept Originating from Postmortem Human Brain Studies. Neurosci Bull 2019; 35:253-266. [PMID: 30721394 PMCID: PMC6426905 DOI: 10.1007/s12264-019-00340-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2018] [Accepted: 10/29/2018] [Indexed: 01/27/2023] Open
Abstract
Alzheimer's disease (AD) is characterized by decreased neuronal activity and atrophy, while hyperactivity of neurons seems to make them resistant to aging and neurodegeneration, a phenomenon which we have paraphrased as 'use it or lose it'. Our hypothesis proposes that (1) during their functioning, neurons are damaged; (2) accumulation of damage that is not repaired is the basis of aging; (3) the vulnerability to AD is determined by the genetic background and the balance between the amount of damage and the efficiency of repair, and (4) by stimulating the brain, repair mechanisms are stimulated and cognitive reserve is increased, resulting in a decreased rate of aging and risk for AD. Environmental stimulating factors such as bilingualism/multilingualism, education, occupation, musical experience, physical exercise, and leisure activities have been reported to reduce the risk of dementia and decrease the rate of cognitive decline, although methodological problems are present.
Collapse
Affiliation(s)
- Qiong-Bin Zhu
- Department of Neurology, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, 310020, China
- Department of Neurobiology, Key Laboratory of Medical Neurobiology of the Ministry of Health of China, Zhejiang Province Key Laboratory of Neurobiology, Zhejiang University School of Medicine, Hangzhou, 310058, China
| | - Ai-Min Bao
- Department of Neurobiology, Key Laboratory of Medical Neurobiology of the Ministry of Health of China, Zhejiang Province Key Laboratory of Neurobiology, Zhejiang University School of Medicine, Hangzhou, 310058, China.
| | - Dick Swaab
- Department of Neurobiology, Key Laboratory of Medical Neurobiology of the Ministry of Health of China, Zhejiang Province Key Laboratory of Neurobiology, Zhejiang University School of Medicine, Hangzhou, 310058, China
- Netherlands Institute for Neuroscience, Institute of the Royal Netherlands Academy of Arts and Sciences, Meibergdreef 47, 1105 BA, Amsterdam, The Netherlands
| |
Collapse
|
34
|
Abstract
PURPOSE OF REVIEW The aim of this review is to summarize current conceptual models of cognitive reserve (CR) and related concepts and to discuss evidence for these concepts within the context of aging and Alzheimer's disease. RECENT FINDINGS Evidence to date supports the notion that higher levels of CR, as measured by proxy variables reflective of lifetime experiences, are associated with better cognitive performance, and with a reduced risk of incident mild cognitive impairment/dementia. However, the impact of CR on longitudinal cognitive trajectories is unclear and may be influenced by a number of factors. Although there is promising evidence that some proxy measures of CR may influence structural brain measures, more research is needed. The protective effects of CR may provide an important mechanism for preserving cognitive function and cognitive well-being with age, in part because it can be enhanced throughout the lifespan. However, more research on the mechanisms by which CR is protective is needed.
Collapse
Affiliation(s)
- Corinne Pettigrew
- Department of Neurology, Johns Hopkins University School of Medicine, 1620 McElderry St., Reed Hall 1-West, Baltimore, MD, 21205, USA
| | - Anja Soldan
- Department of Neurology, Johns Hopkins University School of Medicine, 1620 McElderry St., Reed Hall 1-West, Baltimore, MD, 21205, USA.
| |
Collapse
|
35
|
Abstract
Population-based clinic-pathological studies have established that the most common pathological substrate of dementia in community-dwelling elderly people is mixed, especially Alzheimer's disease (AD) and cerebrovascular ischemic disease (CVID), rather than pure AD. While these could be just two frequent unrelated comorbidities in the elderly, epidemiological research has reinforced the idea that mid-life (age <65 years) vascular risk factors increase the risk of late-onset (age ≥ 65 years) dementia, and specifically AD. By contrast, healthy lifestyle choices such as leisure activities, physical exercise, and Mediterranean diet are considered protective against AD. Remarkably, several large population-based longitudinal epidemiological studies have recently indicated that the incidence and prevalence of dementia might be decreasing in Western countries. Although it remains unclear whether these positive trends are attributable to neuropathologically definite AD versus CVID, based on these epidemiological data it has been estimated that a sizable proportion of AD cases could be preventable. In this review, we discuss the current evidence about modifiable risk factors for AD derived from epidemiological, preclinical, and interventional studies, and analyze the opportunities for therapeutic and preventative interventions.
Collapse
Affiliation(s)
- Alberto Serrano-Pozo
- Department of Neurology, Massachusetts General Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - John H. Growdon
- Department of Neurology, Massachusetts General Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| |
Collapse
|
36
|
Walters MJ, Sterling J, Quinn C, Ganzer C, Osorio RS, Andrews RD, Matthews DC, Vallabhajosula S, de Leon MJ, Isaacson RS, Mosconi L. Associations of lifestyle and vascular risk factors with Alzheimer's brain biomarker changes during middle age: a 3-year longitudinal study in the broader New York City area. BMJ Open 2018; 8:e023664. [PMID: 30478117 PMCID: PMC6254410 DOI: 10.1136/bmjopen-2018-023664] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
OBJECTIVE To investigate the associations between lifestyle and vascular risk factors and changes in Alzheimer's disease (AD) biomarkers (beta-amyloid load via 11C-PiB PET, glucose metabolism via 18F-FDG PET and neurodegeneration via structural MRI) and global cognition in middle-aged asymptomatic participants at risk for AD. DESIGN Prospective, longitudinal. SETTING The study was conducted at New York University Langone/Weill Cornell Medical Centres in New York City. PARTICIPANTS Seventy cognitively normal participants from multiple community sources, aged 30-60 years with lifestyle measures (diet, intellectual activity and physical activity), vascular risk measures and two imaging biomarkers visits over at least 2 years, were included in the study. OUTCOME MEASURES We examined MRI-based cortical thickness, fluoro-deoxy-glucose (FDG) glucose metabolism and PiB beta-amyloid in AD-vulnerable regions. A global cognitive z-score served as our summary cognition measure. We used regression change models to investigate the associations of clinical, lifestyle and vascular risk measures with changes in AD biomarkers and global cognition. RESULTS Diet influenced changes in glucose metabolism, but not amyloid or cortical thickness changes. With and without accounting for demographic measures, vascular risk and baseline FDG measures, lower adherence to a Mediterranean-style diet was associated with faster rates of FDG decline in the posterior cingulate cortex (p≤0.05) and marginally in the frontal cortex (p=0.07). None of the other lifestyle variables or vascular measures showed associations with AD biomarker changes. Higher baseline plasma homocysteine was associated with faster rates of decline in global cognition, with and without accounting for lifestyle and biomarker measures (p=0.048). None of the lifestyle variables were associated with cognition. CONCLUSIONS Diet influenced brain glucose metabolism in middle-aged participants, while plasma homocysteine explained variability in cognitive performance. These findings suggest that these modifiable risk factors affect AD risk through different pathways and support further investigation of risk reduction strategies in midlife.
Collapse
Affiliation(s)
| | - Joanna Sterling
- Department of Psychology, Woodrow Wilson School of Public and International Affairs, Princeton University, Princeton, New Jersey, USA
| | - Crystal Quinn
- Department of Psychiatry, New York University School of Medicine, New York, USA
- The Graduate Center, City University of New York, New York, USA
| | - Christine Ganzer
- Hunter-Bellevue School of Nursing, Hunter College, New York, USA
| | - Ricardo S Osorio
- Department of Psychiatry, New York University School of Medicine, New York, USA
| | | | | | | | - Mony J de Leon
- Department of Psychiatry, New York University School of Medicine, New York, USA
| | | | - Lisa Mosconi
- Department of Neurology, Weill Cornell Medical College, New York, USA
- Department of Psychiatry, New York University School of Medicine, New York, USA
- Department of Nutrition and Food Studies, New York University Steinhardt School of Culture, Education, and Human Development, New York, USA
| |
Collapse
|
37
|
The Relationship of Current Cognitive Activity to Brain Amyloid Burden and Glucose Metabolism. Am J Geriatr Psychiatry 2018; 26:977-984. [PMID: 29885987 PMCID: PMC6482956 DOI: 10.1016/j.jagp.2018.03.018] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2017] [Revised: 03/20/2018] [Accepted: 03/29/2018] [Indexed: 11/20/2022]
Abstract
Several studies have investigated how lifetime cognitive engagement affects levels of amyloid-beta (Aβ) deposition in the brain. However, there has been some disagreement, leaving the relationship of cognitive activity (CA) to Aβ a largely open question. The present study investigated the relationship between CA, Aβ deposition, and glucose metabolism. One hundred nine cognitively normal participants underwent Pittsburgh Compound-B (PiB) and [18F]fluorodeoxyglucose-positron emission tomography and completed a questionnaire designed to measure current CA. Statistical analyses revealed significant differences in PiB retention between those in the high and low CA groups. Linear regression models revealed a significant negative relationship between PiB retention and CA and a significant positive relationship between glucose metabolism and CA. These data suggest that CA may have a direct beneficial effect on the pathophysiology of AD or reflect another underlying process that results in both higher CA and lower AD pathophysiology.
Collapse
|
38
|
Okonkwo OC, Vemuri P. Stemming the Alzheimer tsunami: introduction to the special issue on reserve and resilience in Alzheimer's disease. Brain Imaging Behav 2018; 11:301-303. [PMID: 28116651 DOI: 10.1007/s11682-017-9677-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Affiliation(s)
- Ozioma C Okonkwo
- Department of Medicine, University of Wisconsin School of Medicine and Public Health, 600 Highland Avenue, Madison, WI, 53792, USA. .,Wisconsin Alzheimer's Disease Research Center, University of Wisconsin School of Medicine and Public Health, Madison, WI, 53792, USA. .,Wisconsin Alzheimer's Institute, University of Wisconsin School of Medicine and Public Health, Madison, WI, 53792, USA.
| | - Prashanthi Vemuri
- Department of Radiology, Mayo Clinic and Foundation, 200 First Street SW, Rochester, MN, 55905, USA.
| |
Collapse
|
39
|
Anatürk M, Demnitz N, Ebmeier KP, Sexton CE. A systematic review and meta-analysis of structural magnetic resonance imaging studies investigating cognitive and social activity levels in older adults. Neurosci Biobehav Rev 2018; 93:71-84. [PMID: 29940239 PMCID: PMC6562200 DOI: 10.1016/j.neubiorev.2018.06.012] [Citation(s) in RCA: 33] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2018] [Revised: 06/13/2018] [Accepted: 06/15/2018] [Indexed: 11/29/2022]
Abstract
Population aging has prompted considerable interest in identifying modifiable factors that may help protect the brain and its functions. Collectively, epidemiological studies show that leisure activities with high mental and social demands are linked with better cognition in old age. The extent to which socio-intellectual activities relate to the brain's structure is, however, not yet fully understood. This systematic review and meta-analysis summarizes magnetic resonance imaging studies that have investigated whether cognitive and social activities correlate with measures of gray and white matter volume, white matter microstructure and white matter lesions. Across eighteen included studies (total n = 8429), activity levels were associated with whole-brain white matter volume, white matter lesions and regional gray matter volume, although effect sizes were small. No associations were found for global gray matter volume and the evidence concerning white matter microstructure was inconclusive. While the causality of the reviewed associations needs to be established, our findings implicate socio-intellectual activity levels as promising targets for interventions aimed at promoting healthy brain aging.
Collapse
Affiliation(s)
- M Anatürk
- Department of Psychiatry, University of Oxford, Warneford Hospital, Warneford Lane, Oxford, OX3 7JX, United Kingdom
| | - N Demnitz
- Department of Psychiatry, University of Oxford, Warneford Hospital, Warneford Lane, Oxford, OX3 7JX, United Kingdom
| | - K P Ebmeier
- Department of Psychiatry, University of Oxford, Warneford Hospital, Warneford Lane, Oxford, OX3 7JX, United Kingdom
| | - C E Sexton
- Wellcome Centre for Integrative Neuroimaging, Oxford Centre for Human Brain Activity, Department of Psychaitry, University of Oxford, Warneford Hospital, Warneford Lane, Oxford, OX3 7JX, United Kingdom; Global Brain Health Institute, Memory and Aging Center, Department of Neurology, University of California, San Francisco, CA, 94158, USA.
| |
Collapse
|
40
|
Vos SJ, Visser PJ. Preclinical Alzheimer’s Disease: Implications for Refinement of the Concept. J Alzheimers Dis 2018; 64:S213-S227. [DOI: 10.3233/jad-179943] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Affiliation(s)
- Stephanie J.B. Vos
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Alzheimer Center Limburg, Maastricht University, Maastricht, Netherlands
| | - Pieter Jelle Visser
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Alzheimer Center Limburg, Maastricht University, Maastricht, Netherlands
- Department of Neurology, Alzheimer Center, VU University Medical Center, Amsterdam, Netherlands
| |
Collapse
|
41
|
Vemuri P. "Exceptional brain aging" without Alzheimer's disease: triggers, accelerators, and the net sum game. ALZHEIMERS RESEARCH & THERAPY 2018; 10:53. [PMID: 29859131 PMCID: PMC5984828 DOI: 10.1186/s13195-018-0373-z] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Background As human longevity increases and Alzheimer’s disease (AD) increasingly becomes a significant societal burden, finding pathways or protective factors that facilitate exceptional brain aging without AD pathophysiologies (ADP) will be critical. The goal of this viewpoint is two-fold: 1) to present evidence for “exceptional brain aging” without ADP; and 2) to bring together ideas and observations from the literature and present them as testable hypotheses for biomarker studies to discover protective factors for “exceptional brain aging” without ADP and AD dementia. Discovering pathways to exceptional aging There are three testable hypotheses. First, discovering and quantifying links between risk factor(s) and early ADP changes in midlife using longitudinal biomarker studies will be fundamental to understanding why the majority of individuals deviate from normal aging to the AD pathway. Second, a risk factor may have quantifiably greater impact as a trigger and/or accelerator on a specific component of the biomarker cascade (amyloid, tau, neurodegeneration). Finally, and most importantly, while each risk factor may have a different mechanism of action on AD biomarkers, “exceptional aging” and protection against AD dementia will come from “net sum” protection against all components of the biomarker cascade. The knowledge of the mechanism of action of risk factor(s) from hypotheses 1 and 2 will aid in better characterization of their effect on outcomes, identification of subpopulations that would benefit, and the timing at which the risk factor(s) would have the maximal impact. Additionally, hypothesis 3 highlights the importance of multifactorial or multi-domain approaches to “exceptional aging” as well as prevention of AD dementia. Conclusion While important strides have been made in identifying risk factors for AD dementia incidence, further efforts are needed to translate these into effective preventive strategies. Using biomarker studies for understanding the mechanism of action, effect size estimation, selection of appropriate end-points, and better subject recruitment based on subpopulation effects are fundamental for better design and success of prevention trials.
Collapse
Affiliation(s)
- Prashanthi Vemuri
- Department of Radiology, Mayo Clinic and Foundation, 200 First Street SW, Rochester, MN, 55905, USA.
| |
Collapse
|
42
|
Bauckneht M, Chincarini A, Piva R, Arnaldi D, Girtler N, Massa F, Pardini M, Grazzini M, Efeturk H, Pagani M, Sambuceti G, Nobili F, Morbelli S. Metabolic correlates of reserve and resilience in MCI due to Alzheimer's Disease (AD). ALZHEIMERS RESEARCH & THERAPY 2018; 10:35. [PMID: 29615111 PMCID: PMC5883593 DOI: 10.1186/s13195-018-0366-y] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/08/2017] [Accepted: 03/08/2018] [Indexed: 12/23/2022]
Abstract
Background We explored the presence of both reserve and resilience in late-converter mild cognitive impairment due to Alzheimer’s disease (MCI-AD) and in patients with slowly progressing amyloid-positive MCI by assessing the topography and extent of neurodegeneration with respect to both “aggressive” and typically progressing phenotypes and in the whole group of patients with MCI, grounding the stratification on education level. Methods We analyzed 94 patients with MCI-AD followed until conversion to dementia and 39 patients with MCI who had brain amyloidosis (AMY+ MCI), all with available baseline 18F-fluorodeoxyglucose positron emission tomography (FDG-PET) results. Using a data-driven approach based on conversion time, patients with MCI-AD were divided into typical AD and late-converter subgroups. Similarly, on the basis of annual rate of Mini Mental State Examination score reduction, AMY+ MCI group was divided, obtaining smoldering (first tertile) and aggressive (third tertile) subgroups. Finally, we divided the whole group (MCI-AD and AMY+ MCI) according to years of schooling, obtaining four subgroups: poorly educated (Low-EDUC; first quartile), patients with average education (Average-EDUC; second quartile), highly educated (High-EDUC; third quartile), and exceptionally educated (Except-EDUC; fourth quartile). FDG-PET of typical AD, late converters, and aggressive and smoldering AMY+ MCI subgroups, as well as education level-based subgroups, were compared with healthy volunteer control subjects (CTR) and within each group using a two-samples t test design (SPM8; p < 0.05 family-wise error-corrected). Results Late converters were characterized by relatively preserved metabolism in the right middle temporal gyrus (Brodmann area [BA] 21) and in the left orbitofrontal cortex (BA 47) with respect to typical AD. When compared with CTR, the High-EDUC subgroup demonstrated a more extended bilateral hypometabolism in the posterior parietal cortex, posterior cingulate cortex, and precuneus than the Low- and Average-EDUC subgroups expressing the same level of cognitive impairment. The Except-EDUC subgroup showed a cluster of significant hypometabolism including only the left posterior parietal cortex (larger than the Low- and Average-EDUC subgroups but not further extended with respect to the High-EDUC subgroup). Conclusions Middle and inferior temporal gyri may represent sites of resilience rather than a hallmark of a more aggressive pattern (when hypometabolic). These findings thus support the existence of a relatively homogeneous AD progression pattern of hypometabolism despite AD heterogeneity and interference of cognitive reserve. In fact, cortical regions whose “metabolic resistance” was associated with slower clinical progression had different localization with respect to the regions affected by education-related reserve. Electronic supplementary material The online version of this article (10.1186/s13195-018-0366-y) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Matteo Bauckneht
- Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy.,Nuclear Medicine Unit, Polyclinic San Martino Hospital, Genoa, Italy
| | | | - Roberta Piva
- Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy.,Nuclear Medicine Unit, Polyclinic San Martino Hospital, Genoa, Italy
| | - Dario Arnaldi
- Department of Neuroscience (Dipartimento di Neuroscienze, Riabilitazione, Oftalmologia, Genetica e Scienze Materno-Infantili [DINOGMI]), University of Genoa, Genoa, Italy.,Neurology Clinics, San Martino Hospital Polyclinic, Genoa, Italy
| | - Nicola Girtler
- Department of Neuroscience (Dipartimento di Neuroscienze, Riabilitazione, Oftalmologia, Genetica e Scienze Materno-Infantili [DINOGMI]), University of Genoa, Genoa, Italy.,Neurology Clinics, San Martino Hospital Polyclinic, Genoa, Italy
| | - Federico Massa
- Department of Neuroscience (Dipartimento di Neuroscienze, Riabilitazione, Oftalmologia, Genetica e Scienze Materno-Infantili [DINOGMI]), University of Genoa, Genoa, Italy.,Neurology Clinics, San Martino Hospital Polyclinic, Genoa, Italy
| | - Matteo Pardini
- Department of Neuroscience (Dipartimento di Neuroscienze, Riabilitazione, Oftalmologia, Genetica e Scienze Materno-Infantili [DINOGMI]), University of Genoa, Genoa, Italy.,Neurology Clinics, San Martino Hospital Polyclinic, Genoa, Italy
| | - Matteo Grazzini
- Department of Neuroscience (Dipartimento di Neuroscienze, Riabilitazione, Oftalmologia, Genetica e Scienze Materno-Infantili [DINOGMI]), University of Genoa, Genoa, Italy.,Neurology Clinics, San Martino Hospital Polyclinic, Genoa, Italy
| | - Hulya Efeturk
- Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy.,Nuclear Medicine Unit, Polyclinic San Martino Hospital, Genoa, Italy
| | - Marco Pagani
- Institute of Cognitive Sciences and Technologies (ICST), Consiglio Nazionale delle Ricerche (CNR), Rome, Italy.,Department of Nuclear Medicine, Karolinska Hospital Stockholm, Stockholm, Sweden
| | - Gianmario Sambuceti
- Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy.,Nuclear Medicine Unit, Polyclinic San Martino Hospital, Genoa, Italy
| | - Flavio Nobili
- Department of Neuroscience (Dipartimento di Neuroscienze, Riabilitazione, Oftalmologia, Genetica e Scienze Materno-Infantili [DINOGMI]), University of Genoa, Genoa, Italy.,Neurology Clinics, San Martino Hospital Polyclinic, Genoa, Italy
| | - Silvia Morbelli
- Department of Health Sciences (DISSAL), University of Genoa, Genoa, Italy. .,Nuclear Medicine Unit, Polyclinic San Martino Hospital, Genoa, Italy.
| |
Collapse
|
43
|
Mosconi L, Walters M, Sterling J, Quinn C, McHugh P, Andrews RE, Matthews DC, Ganzer C, Osorio RS, Isaacson RS, De Leon MJ, Convit A. Lifestyle and vascular risk effects on MRI-based biomarkers of Alzheimer's disease: a cross-sectional study of middle-aged adults from the broader New York City area. BMJ Open 2018; 8:e019362. [PMID: 29574441 PMCID: PMC5875649 DOI: 10.1136/bmjopen-2017-019362] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
OBJECTIVE To investigate the effects of lifestyle and vascular-related risk factors for Alzheimer's disease (AD) on in vivo MRI-based brain atrophy in asymptomatic young to middle-aged adults. DESIGN Cross-sectional, observational. SETTING Broader New York City area. Two research centres affiliated with the Alzheimer's disease Core Center at New York University School of Medicine. PARTICIPANTS We studied 116 cognitively normal healthy research participants aged 30-60 years, who completed a three-dimensional T1-weighted volumetric MRI and had lifestyle (diet, physical activity and intellectual enrichment), vascular risk (overweight, hypertension, insulin resistance, elevated cholesterol and homocysteine) and cognition (memory, executive function, language) data. Estimates of cortical thickness for entorhinal (EC), posterior cingulate, orbitofrontal, inferior and middle temporal cortex were obtained by use of automated segmentation tools. We applied confirmatory factor analysis and structural equation modelling to evaluate the associations between lifestyle, vascular risk, brain and cognition. RESULTS Adherence to a Mediterranean-style diet (MeDi) and insulin sensitivity were both positively associated with MRI-based cortical thickness (diet: βs≥0.26, insulin sensitivity βs≥0.58, P≤0.008). After accounting for vascular risk, EC in turn explained variance in memory (P≤0.001). None of the other lifestyle and vascular risk variables were associated with brain thickness. In addition, the path associations between intellectual enrichment and better cognition were significant (βs≥0.25 P≤0.001), as were those between overweight and lower cognition (βs≥-0.22, P≤0.01). CONCLUSIONS In cognitively normal middle-aged adults, MeDi and insulin sensitivity explained cortical thickness in key brain regions for AD, and EC thickness predicted memory performance in turn. Intellectual activity and overweight were associated with cognitive performance through different pathways. Our findings support further investigation of lifestyle and vascular risk factor modification against brain ageing and AD. More studies with larger samples are needed to replicate these research findings in more diverse, community-based settings.
Collapse
Affiliation(s)
- Lisa Mosconi
- Department of Neurology, Weill Cornell Medical College, New York City, New York, USA
- Department of Psychiatry, New York University School of Medicine, New York City, New York, USA
- Department of Nutrition and Food Studies, New York University Steinhardt School of Public Health, New York City, New York, USA
| | - Michelle Walters
- Department of Nutrition and Food Studies, New York University Steinhardt School of Public Health, New York City, New York, USA
| | - Joanna Sterling
- Department of Psychology, New York University, New York City, New York, USA
| | - Crystal Quinn
- Department of Psychiatry, New York University School of Medicine, New York City, New York, USA
| | - Pauline McHugh
- Department of Psychiatry, New York University School of Medicine, New York City, New York, USA
| | | | | | - Christine Ganzer
- Hunter-Bellevue School of Nursing, Hunter College, The City University of New York, New York City, New York, USA
| | - Ricardo S Osorio
- Department of Psychiatry, New York University School of Medicine, New York City, New York, USA
| | - Richard S Isaacson
- Department of Neurology, Weill Cornell Medical College, New York City, New York, USA
| | - Mony J De Leon
- Department of Psychiatry, New York University School of Medicine, New York City, New York, USA
| | - Antonio Convit
- Department of Psychiatry, New York University School of Medicine, New York City, New York, USA
| |
Collapse
|
44
|
Ko K, Byun MS, Yi D, Lee JH, Kim CH, Lee DY. Early-Life Cognitive Activity Is Related to Reduced Neurodegeneration in Alzheimer Signature Regions in Late Life. Front Aging Neurosci 2018; 10:70. [PMID: 29623037 PMCID: PMC5875443 DOI: 10.3389/fnagi.2018.00070] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2017] [Accepted: 03/01/2018] [Indexed: 01/16/2023] Open
Abstract
Background: Although increased cognitive activity (CA), both current and past, is known to be associated with a decreased occurrence of Alzheimer’s disease (AD) dementia in older adults, the exact neural mechanisms underlying the association between CA during different stages of life and human dementia remain unclear. Therefore, we investigated whether CA during different life stages is associated with cerebral amyloid-beta (Aβ) pathology and AD-related neurodegeneration in non-demented older adults. Methods: Cross-sectional analyses of data collected between April 2014 and March 2016 from the Korean Brain Aging Study for Early Diagnosis and Prediction of Alzheimer’s Disease (KBASE), an ongoing prospective cohort. In total, 321 community-dwelling, non-demented older adults were involved in this study. Cerebral Aβ deposition and Aβ positivity were measured using 11C-Pittsburgh compound B (PiB)-positron emission tomography (PET). AD-signature region cerebral glucose metabolism (AD-CMglu) and AD-signature region neurodegeneration (AD-ND) positivity were measured using 18F-fluorodeoxyglucose (FDG)-PET. In addition, CA in early, mid, and late life was systematically evaluated using a structured questionnaire. Results: Of the 321 participants, 254 were cognitively normal (CN) and 67 had mild cognitive impairment (MCI). The mean age of participants was 69.6 years old [standard deviation (SD) = 8.0]. Higher early-life CA (CAearly) was associated with significantly increased AD-CMglu (B = 0.035, SE = 0.013, P = 0.009) and a decreasing trend of AD-ND positivity (OR = 0.65, 95% CI 0.43–0.98, P = 0.04) but was not associated with Aβ deposition or positivity. We observed no association between midlife CA (CAmid) and any AD-related brain changes. Late-life CA (CAlate) showed an association with both global Aβ deposition and AD-CMglu, although it was not statistically significant. Sensitivity analyses controlling for current depression or conducted only for CN individuals revealed similar results. Conclusion: Our results suggest that CA in early life may be protective against late-life AD-related neurodegeneration, independently of cerebral Aβ pathology.
Collapse
Affiliation(s)
- Kang Ko
- Department of Neuropsychiatry, Seoul National University Hospital, Seoul, South Korea.,Department of Psychiatry, Yonsei University College of Medicine, Seoul, South Korea
| | - Min Soo Byun
- Institute of Human Behavioral Medicine, Medical Research Center, Seoul National University, Seoul, South Korea
| | - Dahyun Yi
- Institute of Human Behavioral Medicine, Medical Research Center, Seoul National University, Seoul, South Korea
| | - Jun Ho Lee
- Department of Neuropsychiatry, Seoul National University Hospital, Seoul, South Korea.,Department of Psychiatry, Seoul National University College of Medicine, Seoul, South Korea
| | - Chan Hyung Kim
- Department of Psychiatry, Yonsei University College of Medicine, Seoul, South Korea.,Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, South Korea
| | - Dong Young Lee
- Department of Neuropsychiatry, Seoul National University Hospital, Seoul, South Korea.,Institute of Human Behavioral Medicine, Medical Research Center, Seoul National University, Seoul, South Korea.,Department of Psychiatry, Seoul National University College of Medicine, Seoul, South Korea
| |
Collapse
|
45
|
Keegan AP, Paris D, Luis CA, Abdullah L, Ait-Ghezala G, Beaulieu-Abdelahad D, Pryor M, Chaykin J, Crynen G, Crawford F, Mullan M. Plasma cytokine IL-6 levels and subjective cognitive decline: preliminary findings. Int J Geriatr Psychiatry 2018. [PMID: 28639714 DOI: 10.1002/gps.4752] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
OBJECTIVE Detection of Alzheimer's disease (AD) prior to clinical inception will be paramount for introducing disease modifying treatments. We have begun collecting baseline characteristics of a community cohort for longitudinal assessment and testing of antecedent blood-based biomarkers. We describe the baseline visit from the first 131 subjects in relationship to a commonly described cytokine, interleukin 6 (IL-6). METHODS Subjects from the community presented for a free memory screening with varying degrees of memory concern. We quantified the baseline plasma levels of the cytokine IL-6 and assessed cognition (Montreal Cognitive Assessment, MoCA) and mood (Geriatric Depression Scale, GDS) in relationship to their memory concern. RESULTS Baseline MoCA scores were inversely related to age, and this association was influenced by an AD risk factor, Apolipoprotein E (APOE4) carrier status. The degree of subjective cognitive decline correlated with GDS and was inversely related to MoCA scores. Interleukin 6 levels were related to age, body mass index, and years of education. CONCLUSIONS It will be important to assess how these baseline IL-6 levels and forthcoming novel biomarkers relate to future cognitive decline. Copyright © 2017 John Wiley & Sons, Ltd.
Collapse
|
46
|
Walhovd KB, Fjell AM, Westerhausen R, Nyberg L, Ebmeier KP, Lindenberger U, Bartrés-Faz D, Baaré WFC, Siebner HR, Henson R, Drevon CA, Knudsen GP, Budin-Ljøsne I, Penninx BWJH, Ghisletta P, Rogeberg O, Tyler L, Bertram L. Healthy minds from 0-100 years: Optimising the use of European brain imaging cohorts ("Lifebrain"). Eur Psychiatry 2017; 47:76-87. [PMID: 29127911 DOI: 10.1016/j.eurpsy.2017.10.005] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2017] [Revised: 10/04/2017] [Accepted: 10/05/2017] [Indexed: 11/17/2022] Open
Abstract
The main objective of "Lifebrain" is to identify the determinants of brain, cognitive and mental (BCM) health at different stages of life. By integrating, harmonising and enriching major European neuroimaging studies across the life span, we will merge fine-grained BCM health measures of more than 5,000 individuals. Longitudinal brain imaging, genetic and health data are available for a major part, as well as cognitive and mental health measures for the broader cohorts, exceeding 27,000 examinations in total. By linking these data to other databases and biobanks, including birth registries, national and regional archives, and by enriching them with a new online data collection and novel measures, we will address the risk factors and protective factors of BCM health. We will identify pathways through which risk and protective factors work and their moderators. Exploiting existing European infrastructures and initiatives, we hope to make major conceptual, methodological and analytical contributions towards large integrative cohorts and their efficient exploitation. We will thus provide novel information on BCM health maintenance, as well as the onset and course of BCM disorders. This will lay a foundation for earlier diagnosis of brain disorders, aberrant development and decline of BCM health, and translate into future preventive and therapeutic strategies. Aiming to improve clinical practice and public health we will work with stakeholders and health authorities, and thus provide the evidence base for prevention and intervention.
Collapse
Affiliation(s)
- K B Walhovd
- Department of Psychology, University of Oslo Centre for Lifespan Changes in Brain and Cognition (UiO), Harald Schelderups Hus, Forskningsveien 3A, N-0373 Oslo, Norway.
| | - A M Fjell
- Department of Psychology, University of Oslo Centre for Lifespan Changes in Brain and Cognition (UiO), Harald Schelderups Hus, Forskningsveien 3A, N-0373 Oslo, Norway
| | - R Westerhausen
- Department of Psychology, University of Oslo Centre for Lifespan Changes in Brain and Cognition (UiO), Harald Schelderups Hus, Forskningsveien 3A, N-0373 Oslo, Norway
| | - L Nyberg
- Centre for Functional Brain Imaging (Umeå), Umeå Universitet, SE-90187 Umeå, Sweden.
| | - K P Ebmeier
- Department of Psychiatry (UOXF), University of Oxford Wellcome Centre for Integrative Neuroimaging, Warneford Hospital, University of Oxford, OX37JX Oxford, UK.
| | - U Lindenberger
- Centre for Lifespan Psychology (MPIB), Max-Planck Institute for Human Development, Lentzeallee 94, D-14195 Berlin, Germany.
| | - D Bartrés-Faz
- Facultat de Medicina, Campus Clínic, C/. Casanova, University of Barcelona Brain Stimulation Lab (UB), 143, Ala Nord, 5a planta, S-08036 Barcelona, Spain.
| | - W F C Baaré
- Region Hovedstaden (RegionH), Danish Research Centre for Magnetic Resonance, Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital Hvidovre, Section 714, Kettegard Allé 30, DK-2650 Hvidovre, Denmark.
| | - H R Siebner
- Region Hovedstaden (RegionH), Danish Research Centre for Magnetic Resonance, Centre for Functional and Diagnostic Imaging and Research, Copenhagen University Hospital Hvidovre, Section 714, Kettegard Allé 30, DK-2650 Hvidovre, Denmark
| | - R Henson
- Medical Research Council Cognition and Brain Science Unit (MRC), University of Cambridge, 15, Chaucer Road, CB2 7EF Cambridge, UK.
| | - C A Drevon
- Vitas AS (Analytical Services), Gaustadalléen 21, N-0349 Oslo, Norway.
| | - G P Knudsen
- Norwegian Institute of Public Health Oslo (NIPH), PO Box 4404 Nydalen, N-0403 Oslo, Norway.
| | - I Budin-Ljøsne
- Norwegian Institute of Public Health Oslo (NIPH), PO Box 4404 Nydalen, N-0403 Oslo, Norway
| | - B W J H Penninx
- VU University Medical Centre (VUmc), PO Box 7057, NL-1007 Amsterdam, MB, USA.
| | - P Ghisletta
- Research Group: Methodology and Data Analysis, Faculty of Psychology and Educational Sciences, University of Geneva (UNIGE), Sandrine Amstutz, Uni Mail, 4(e) étage, boulevard du Pont-d'Arve 40, 1205 Geneva, Switzerland; Swiss Distance Learning University, Überlandstrasse 12, Postfach 689 CH-3900 Brig, Switzerland.
| | - O Rogeberg
- Ragnar Frisch Centre for Economic Research (Frisch), Gaustadalleen 21, N-0349 Oslo, Norway.
| | - L Tyler
- University of Cambridge Department of Psychology (UCAM), Downing Street, CB2 3EB Cambridge, UK.
| | - L Bertram
- University of Lübeck Interdisciplinary Platform for Genome Analytics (LIGA-UzL), University of Lübeck, Maria-Goeppert-Str. 1 (MFC1), 23562 D-Lübeck, Germany.
| |
Collapse
|
47
|
Soldan A, Pettigrew C, Cai Q, Wang J, Wang MC, Moghekar A, Miller MI, Albert M. Cognitive reserve and long-term change in cognition in aging and preclinical Alzheimer's disease. Neurobiol Aging 2017; 60:164-172. [PMID: 28968586 DOI: 10.1016/j.neurobiolaging.2017.09.002] [Citation(s) in RCA: 113] [Impact Index Per Article: 16.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2017] [Revised: 08/30/2017] [Accepted: 09/04/2017] [Indexed: 12/19/2022]
Abstract
We examined if baseline levels of cognitive reserve (CR) and of Alzheimer's disease (AD) biomarkers modify the rate of change in cognition among individuals with normal cognition at baseline (n = 303, mean baseline age = 57 years, mean follow-up = 12 years); 66 participants subsequently developed mild cognitive impairment (MCI) or dementia due to AD. CR was indexed by years of education, reading, and vocabulary measures. AD biomarkers were measured with a composite score composed of measures of amyloid, phosphorylated tau, and neurodegeneration. Higher CR scores were associated with better cognitive performance but did not modify the rate of change in cognition among those who remained cognitively normal, nor among those who progressed to MCI before symptom onset, independent of baseline biomarker levels. However, higher CR scores were associated with faster cognitive decline after symptom onset of MCI. These results suggest that the mechanism by which CR mediates the relationship between pathology and cognitive function is by delaying the onset of symptoms rather than reducing the rate of cognitive decline.
Collapse
Affiliation(s)
- Anja Soldan
- Department of Neurology, The Johns Hopkins University School of Medicine, Baltimore, MD, USA.
| | - Corinne Pettigrew
- Department of Neurology, The Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Qing Cai
- Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Jiangxia Wang
- Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Mei-Cheng Wang
- Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Abhay Moghekar
- Department of Neurology, The Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Michael I Miller
- Department of Biomedical Engineering, Johns Hopkins University, Baltimore, MD, USA
| | - Marilyn Albert
- Department of Neurology, The Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | | |
Collapse
|
48
|
Besser LM, McDonald NC, Song Y, Kukull WA, Rodriguez DA. Neighborhood Environment and Cognition in Older Adults: A Systematic Review. Am J Prev Med 2017; 53:241-251. [PMID: 28455123 PMCID: PMC5522645 DOI: 10.1016/j.amepre.2017.02.013] [Citation(s) in RCA: 125] [Impact Index Per Article: 17.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2016] [Revised: 01/10/2017] [Accepted: 02/16/2017] [Indexed: 01/14/2023]
Abstract
CONTEXT Some evidence suggests that treating vascular risk factors and performing mentally stimulating activities may delay cognitive impairment onset in older adults. Exposure to a complex neighborhood environment may be one mechanism to help delay cognitive decline. EVIDENCE ACQUISITION PubMed, Web of Science, and ProQuest Dissertation and Theses Global database were systematically reviewed, identifying 25 studies published from February 1, 1989 to March 5, 2016 (data synthesized, May 3, 2015 to October 7, 2016). The review was restricted to quantitative studies focused on: (1) neighborhood social and built environment and cognition; and (2) community-dwelling adults aged ≥45 years. EVIDENCE SYNTHESIS The majority of studies were cross-sectional, U.S.-based, and found at least one significant association. The diversity of measures and neighborhood definitions limited the synthesis of findings in many instances. Evidence was moderately strong for an association between neighborhood SES and cognition, and modest for associations between neighborhood demographics, design, and destination accessibility and cognition. Most studies examining effect modification found significant associations, with some evidence for effect modification of the neighborhood SES-cognition association by individual-level SES. No studies had low risk of bias and many tested multiple associations that increased the chance of a statistically significant finding. Considering the studies to date, the evidence for an association between neighborhood characteristics and cognition is modest. CONCLUSIONS Future studies should include longitudinal measures of neighborhood characteristics and cognition; examine potential effect modifiers, such as sex and disability; and study mediators that may help elucidate the biological mechanisms linking neighborhood environment and cognition.
Collapse
Affiliation(s)
- Lilah M Besser
- Department of City and Regional Planning, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; Department of Epidemiology, National Alzheimer's Coordinating Center, University of Washington, Seattle, Washington.
| | - Noreen C McDonald
- Department of City and Regional Planning, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Yan Song
- Department of City and Regional Planning, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Walter A Kukull
- Department of Epidemiology, National Alzheimer's Coordinating Center, University of Washington, Seattle, Washington
| | - Daniel A Rodriguez
- Department of City and Regional Planning, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina; Department of City and Regional Planning, University of California, Berkeley, Berkeley, California
| |
Collapse
|
49
|
Arenaza-Urquijo EM, Bejanin A, Gonneaud J, Wirth M, La Joie R, Mutlu J, Gaubert M, Landeau B, de la Sayette V, Eustache F, Chételat G. Association between educational attainment and amyloid deposition across the spectrum from normal cognition to dementia: neuroimaging evidence for protection and compensation. Neurobiol Aging 2017; 59:72-79. [PMID: 28764930 DOI: 10.1016/j.neurobiolaging.2017.06.016] [Citation(s) in RCA: 57] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2017] [Revised: 06/13/2017] [Accepted: 06/20/2017] [Indexed: 11/16/2022]
Abstract
The brain mechanisms underlying the effect of intellectual enrichment may evolve along the normal aging Alzheimer's disease (AD) cognitive spectrum and may include both protective and compensatory mechanisms. We assessed the association between early intellectual enrichment (education, years) and average cortical florbetapir standardized uptake value ratio as well as performed voxel-wise analyses in a total of 140 participants, including cognitively normal older adults, mild cognitive impairment (MCI), and AD patients. Higher education was associated with lower cortical florbetapir positron emission tomography (florbetapir-PET) uptake, notably in the frontal lobe in normal older adults, but with higher uptake in frontal, temporal, and parietal regions in MCI after controlling for global cognitive status. No association was found in AD. In MCI, we observed an increased fluorodeoxyglucose positron emission tomography (FDG-PET) uptake with education within the regions of higher florbetapir-PET uptake, suggesting a compensatory increase. Early intellectual enrichment may be associated with protection and compensation for amyloid beta (Aβ) deposition later in life, before the onset of dementia. Previous investigations have been controversial as regard to the effects of intellectual enrichment variables on Aβ deposition; the present findings call for approaches aiming to evaluate mechanisms of resilience across disease stages.
Collapse
Affiliation(s)
- Eider M Arenaza-Urquijo
- INSERM, U1077, Caen, France; Université de Caen-Normandie, UMR-S1077, Caen, France; Ecole Pratique des Hautes Etudes, UMR-S1077, Caen, France; CHU de Caen, U1077, Caen, France.
| | - Alexandre Bejanin
- INSERM, U1077, Caen, France; Université de Caen-Normandie, UMR-S1077, Caen, France; Ecole Pratique des Hautes Etudes, UMR-S1077, Caen, France; CHU de Caen, U1077, Caen, France
| | - Julie Gonneaud
- INSERM, U1077, Caen, France; Université de Caen-Normandie, UMR-S1077, Caen, France; Ecole Pratique des Hautes Etudes, UMR-S1077, Caen, France; CHU de Caen, U1077, Caen, France
| | - Miranka Wirth
- INSERM, U1077, Caen, France; Université de Caen-Normandie, UMR-S1077, Caen, France; Ecole Pratique des Hautes Etudes, UMR-S1077, Caen, France; CHU de Caen, U1077, Caen, France
| | - Renaud La Joie
- INSERM, U1077, Caen, France; Université de Caen-Normandie, UMR-S1077, Caen, France; Ecole Pratique des Hautes Etudes, UMR-S1077, Caen, France; CHU de Caen, U1077, Caen, France
| | - Justine Mutlu
- INSERM, U1077, Caen, France; Université de Caen-Normandie, UMR-S1077, Caen, France; Ecole Pratique des Hautes Etudes, UMR-S1077, Caen, France; CHU de Caen, U1077, Caen, France
| | - Malo Gaubert
- INSERM, U1077, Caen, France; Université de Caen-Normandie, UMR-S1077, Caen, France; Ecole Pratique des Hautes Etudes, UMR-S1077, Caen, France; CHU de Caen, U1077, Caen, France
| | - Brigitte Landeau
- INSERM, U1077, Caen, France; Université de Caen-Normandie, UMR-S1077, Caen, France; Ecole Pratique des Hautes Etudes, UMR-S1077, Caen, France; CHU de Caen, U1077, Caen, France
| | - Vincent de la Sayette
- INSERM, U1077, Caen, France; Université de Caen-Normandie, UMR-S1077, Caen, France; Ecole Pratique des Hautes Etudes, UMR-S1077, Caen, France; CHU de Caen, Service de Neurologie, Caen, France
| | - Francis Eustache
- INSERM, U1077, Caen, France; Université de Caen-Normandie, UMR-S1077, Caen, France; Ecole Pratique des Hautes Etudes, UMR-S1077, Caen, France; CHU de Caen, U1077, Caen, France
| | - Gaël Chételat
- INSERM, U1077, Caen, France; Université de Caen-Normandie, UMR-S1077, Caen, France; Ecole Pratique des Hautes Etudes, UMR-S1077, Caen, France; CHU de Caen, U1077, Caen, France
| |
Collapse
|
50
|
Vemuri P, Knopman DS, Lesnick TG, Przybelski SA, Mielke MM, Graff-Radford J, Murray ME, Roberts RO, Vassilaki M, Lowe VJ, Machulda MM, Jones DT, Petersen RC, Jack CR. Evaluation of Amyloid Protective Factors and Alzheimer Disease Neurodegeneration Protective Factors in Elderly Individuals. JAMA Neurol 2017; 74:718-726. [PMID: 28418521 PMCID: PMC5649401 DOI: 10.1001/jamaneurol.2017.0244] [Citation(s) in RCA: 97] [Impact Index Per Article: 13.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2016] [Accepted: 02/28/2017] [Indexed: 01/11/2023]
Abstract
Importance While amyloid and neurodegeneration are viewed together as Alzheimer disease pathophysiology (ADP), the factors that influence amyloid and AD-pattern neurodegeneration may be considerably different. Protection from these ADP factors may be important for aging without significant ADP. Objective To identify the combined and independent protective factors for amyloid and AD-pattern neurodegeneration in a population-based sample and to test the hypothesis that "exceptional agers" with advanced ages do not have significant ADP because they have protective factors for amyloid and neurodegeneration. Design, Setting, and Participants This cohort study conducted a prospective analysis of 942 elderly individuals (70-≥90 years) with magnetic resonance imaging and Pittsburgh compound B-positron emission tomography scans enrolled in the Mayo Clinic Study of Aging, a longitudinal population-based study of cognitive aging in Olmsted County, Minnesota. We operationalized "exceptional aging" without ADP by considering individuals 85 years or older to be without significant evidence of ADP. Main Outcomes and Measures We evaluated predictors including demographics, APOE, intellectual enrichment, midlife risk factors (physical inactivity, obesity, smoking, diabetes, hypertension, and dyslipidemia), and the total number of late-life cardiac and metabolic conditions. We used multivariate linear regression models to identify the combined and independent protective factors for amyloid and AD-pattern neurodegeneration. Using a subsample of the cohort 85 years of age or older, we computed Cohen d-based effect size estimations to compare the quantitative strength of each predictor variable in their contribution with exceptional aging without ADP. Results The study participants included 423 (45%) women and the average age of participants was 79.7 (5.9) years. Apart from demographics and the APOE genotype, only midlife dyslipidemia was associated with amyloid deposition. Obesity, smoking, diabetes, hypertension, and cardiac and metabolic conditions, but not intellectual enrichment, were associated with greater AD-pattern neurodegeneration. In the 85 years or older cohort, the Cohen d results showed small to moderate effects (effect sizes > 0.2) of several variables except job score and midlife hypertension in predicting exceptional aging without ADP. Conclusions and Relevance The protective factors that influence amyloid and AD-pattern neurodegeneration are different. "Exceptional aging" without ADP may be possible with a greater number of protective factors across the lifespan but warrants further investigation.
Collapse
Affiliation(s)
- Prashanthi Vemuri
- Department of Radiology, Mayo Clinic–Rochester, Rochester, Minnesota
| | - David S. Knopman
- Department of Neurology, Mayo Clinic–Rochester, Rochester, Minnesota
| | - Timothy G. Lesnick
- Department of Health Sciences Research, Mayo Clinic–Rochester, Rochester, Minnesota
| | - Scott A. Przybelski
- Department of Health Sciences Research, Mayo Clinic–Rochester, Rochester, Minnesota
| | - Michelle M. Mielke
- Department of Health Sciences Research, Mayo Clinic–Rochester, Rochester, Minnesota
| | | | - Melissa E. Murray
- Department of Neuroscience, Mayo Clinic–Jacksonville, Jacksonville, Florida
| | - Rosebud O. Roberts
- Department of Health Sciences Research, Mayo Clinic–Rochester, Rochester, Minnesota
| | - Maria Vassilaki
- Department of Health Sciences Research, Mayo Clinic–Rochester, Rochester, Minnesota
| | - Val J. Lowe
- Department of Radiology, Mayo Clinic–Rochester, Rochester, Minnesota
| | - Mary M. Machulda
- Department of Psychology, Mayo Clinic–Rochester, Rochester, Minnesota
| | - David T. Jones
- Department of Neurology, Mayo Clinic–Rochester, Rochester, Minnesota
| | | | - Clifford R. Jack
- Department of Radiology, Mayo Clinic–Rochester, Rochester, Minnesota
| |
Collapse
|