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Ramadhana DR, Putra RP, Sibarani MA, Sulistiawati S, Sari DR, Rejeki PS, Herawati L, Argarini R. Short-term multicomponent exercise training improves executive function in postmenopausal women. PLoS One 2024; 19:e0307812. [PMID: 39141601 PMCID: PMC11324113 DOI: 10.1371/journal.pone.0307812] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Accepted: 07/11/2024] [Indexed: 08/16/2024] Open
Abstract
Declined cognitive function is commonly complained during the menopausal transition and continues afterward. Combining different exercises potentially leads to greater improvements in cognitive function, however, evidence of the benefits that accrue with multicomponent exercise training, specifically for postmenopausal women is limited. Therefore, this study aimed to investigate the effects of short-term multicomponent exercise training programs on executive function in postmenopausal women. Thirty women (59.8 ± 5.2 years), who were at least 12 months post menopause were allocated into a control (CON) group and an exercise (EX) training group. The EX group underwent a 2-week (five times/week) multicomponent exercise program comprising aerobic, strength, flexibility, and balance exercises for 40-60 min. Executive function was assessed by using the Stroop test and global cognitive function was assessed using the Mini-Mental State Examination (MMSE) at baseline (pre) and after 2 weeks (post) of exercise. The EX group showed improved performance in the Stroop test, with faster inhibition reaction time (ES (g) = 0.76; p = 0.039) and fewer errors across all tasks (color naming: g = 0.8, p = 0.032; word reading: g = 0.88, p = 0.019; inhibition: g = 0.99, p = 0.009; switching: g = 0.93, p = 0.012) following exercise intervention. Additionally, statistical analysis of the MMSE score showed a significant improvement (g = 1.27; p = 0.001). In conclusion, our findings suggest that a short-term multicomponent exercise program improves selective tasks of executive function in postmenopausal women along with global cognitive function. Trial registration ISRCTN13086152.
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Affiliation(s)
- Dani Rahmat Ramadhana
- Faculty of Medicine, Master Degree on Sport, Exercise and Health Sciences, Airlangga University, Surabaya, Indonesia
| | - Rizki Prayuda Putra
- Faculty of Medicine, Master Degree on Sport, Exercise and Health Sciences, Airlangga University, Surabaya, Indonesia
| | - Michelle Abigail Sibarani
- Faculty of Medicine, Master Degree on Sport, Exercise and Health Sciences, Airlangga University, Surabaya, Indonesia
| | - Sulistiawati Sulistiawati
- Faculty of Medicine, Department of Public Health and Preventive Medicine, Airlangga University, Surabaya, Indonesia
| | - Dewi Ratna Sari
- Faculty of Medicine, Department of Anatomy, Histology and Pharmacology, Airlangga University, Surabaya, Indonesia
| | - Purwo Sri Rejeki
- Faculty of Medicine, Master Degree on Sport, Exercise and Health Sciences, Airlangga University, Surabaya, Indonesia
- Faculty of Medicine, Undergraduate Medical Programme, Airlangga University, Surabaya, Indonesia
- Faculty of Medicine, Department of Medical Physiology and Biochemistry, Airlangga University, Surabaya, Indonesia
| | - Lilik Herawati
- Faculty of Medicine, Master Degree on Sport, Exercise and Health Sciences, Airlangga University, Surabaya, Indonesia
- Faculty of Medicine, Undergraduate Medical Programme, Airlangga University, Surabaya, Indonesia
- Faculty of Medicine, Department of Medical Physiology and Biochemistry, Airlangga University, Surabaya, Indonesia
| | - Raden Argarini
- Faculty of Medicine, Master Degree on Sport, Exercise and Health Sciences, Airlangga University, Surabaya, Indonesia
- Faculty of Medicine, Undergraduate Medical Programme, Airlangga University, Surabaya, Indonesia
- Faculty of Medicine, Department of Medical Physiology and Biochemistry, Airlangga University, Surabaya, Indonesia
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Falck RS, Cosco TD, Wister AV, Best JR. Age differences in the moderating effects of neighbourhood disadvantage on the relationship between physical activity and cognitive function: A longitudinal analysis of the Canadian Longitudinal Study on Aging. Maturitas 2024; 188:108088. [PMID: 39128262 DOI: 10.1016/j.maturitas.2024.108088] [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: 03/13/2024] [Revised: 07/30/2024] [Accepted: 08/06/2024] [Indexed: 08/13/2024]
Abstract
OBJECTIVES To explore whether the association between physical activity (PA) and cognition is moderated by neighbourhood disadvantage, and whether this relationship varies with age. STUDY DESIGN A longitudinal analysis of the Canadian Longitudinal Study on Aging, wherein we included participants (N = 41,599) from urban areas who did not change their residential postal code from baseline (2010-2015) to first follow-up (2015-2018). MAIN OUTCOME MEASURES At baseline, we measured PA using the Physical Activity Scale for the Elderly, and neighbourhood disadvantage using the Material and Social Deprivation Indices. RESULTS Using latent change score regression models, we determined that higher PA at baseline was independently associated with greater maintenance in memory performance from baseline to first follow-up both for adults aged 45-64 (B = 0.04, SE = 0.01, p = 0.001) and for those aged 65+ years (B = 0.12, SE = 0.02, p < 0.001). For participants aged 45-64 years, greater material deprivation was independently associated with declines in memory performance (B = -0.10, SE = 0.03, p < 0.001). In addition, greater social deprivation was associated with a stronger effect of PA on changes in executive functions (B = 0.17, SE = 0.08, p = 0.025) for adults aged 45-64 years; greater material deprivation was associated with a stronger effect of PA on changes in memory performance (B = 0.07, SE = 0.03, p = 0.022). We failed to detect any interactions between PA and neighbourhood disadvantage among adults aged 65+ years (all p values >0.05). CONCLUSION For middle-aged adults, the benefits of PA on cognitive performance may be strongest among adults living with greater neighbourhood social and material disadvantages. For older adults, PA may be beneficial to cognitive performance irrespective of neighbourhood disadvantages.
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Affiliation(s)
- Ryan S Falck
- School of Biomedical Engineering, University of British Columbia, Vancouver, Canada
| | - Theodore D Cosco
- Department of Gerontology, Simon Fraser University, Vancouver, British Columbia, Canada; Oxford Institute of Population Ageing, University of Oxford, Oxford, United Kingdom; School of Public Policy, Simon Fraser University, Vancouver, British Columbia, Canada
| | - Andrew V Wister
- Department of Gerontology, Simon Fraser University, Vancouver, British Columbia, Canada; Gerontology Research Centre, Simon Fraser University, Vancouver, Canada
| | - John R Best
- Department of Gerontology, Simon Fraser University, Vancouver, British Columbia, Canada; Gerontology Research Centre, Simon Fraser University, Vancouver, Canada; Department of Psychiatry, University of British Columbia, Vancouver, British Columbia, Canada.
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N'Diaye M, Ducourneau EG, Bakoyiannis I, Potier M, Lafenetre P, Ferreira G. Obesogenic diet induces sex-specific alterations of contextual fear memory and associated hippocampal activity in mice. Cereb Cortex 2024; 34:bhae254. [PMID: 38934712 DOI: 10.1093/cercor/bhae254] [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: 02/16/2024] [Revised: 05/28/2024] [Indexed: 06/28/2024] Open
Abstract
In addition to metabolic and cardiovascular disorders, obesity is associated with cognitive deficits in humans and animal models. We have previously shown that obesogenic high-fat and sugar diet intake during adolescence (adoHFSD) impairs hippocampus (HPC)-dependent memory in rodents. These results were obtained in males only and it remains to evaluate whether adoHFSD has similar effect in females. Therefore, here, we investigated the effects of adoHFSD consumption on HPC-dependent contextual fear memory and associated brain activation in male and female mice. Exposure to adoHFSD increased fat mass accumulation and glucose levels in both males and females but impaired contextual fear memory only in males. Compared with females, contextual fear conditioning induced higher neuronal activation in the dorsal and ventral HPC (CA1 and CA3 subfields) as well as in the medial prefrontal cortex in males. Also, adoHFSD-fed males showed enhanced c-Fos expression in the dorsal HPC, particularly in the dentate gyrus, and in the basolateral amygdala compared with the other groups. Finally, chemogenetic inactivation of the dorsal HPC rescued adoHFSD-induced memory deficits in males. Our results suggest that males are more vulnerable to the effects of adoHFSD on HPC-dependent aversive memory than females, due to overactivation of the dorsal HPC.
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Affiliation(s)
- Matéo N'Diaye
- NutriNeuro Lab, FoodCircus Team, Université de Bordeaux, UMR 1286 INRAE, Bordeaux INP, 146 rue Léo Saignat, 33076 Bordeaux, France
| | - Eva-Gunnel Ducourneau
- NutriNeuro Lab, FoodCircus Team, Université de Bordeaux, UMR 1286 INRAE, Bordeaux INP, 146 rue Léo Saignat, 33076 Bordeaux, France
| | - Ioannis Bakoyiannis
- NutriNeuro Lab, FoodCircus Team, Université de Bordeaux, UMR 1286 INRAE, Bordeaux INP, 146 rue Léo Saignat, 33076 Bordeaux, France
| | - Mylène Potier
- NutriNeuro Lab, FoodCircus Team, Université de Bordeaux, UMR 1286 INRAE, Bordeaux INP, 146 rue Léo Saignat, 33076 Bordeaux, France
| | - Pauline Lafenetre
- NutriNeuro Lab, FoodCircus Team, Université de Bordeaux, UMR 1286 INRAE, Bordeaux INP, 146 rue Léo Saignat, 33076 Bordeaux, France
| | - Guillaume Ferreira
- NutriNeuro Lab, FoodCircus Team, Université de Bordeaux, UMR 1286 INRAE, Bordeaux INP, 146 rue Léo Saignat, 33076 Bordeaux, France
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2024 Alzheimer's disease facts and figures. Alzheimers Dement 2024; 20:3708-3821. [PMID: 38689398 PMCID: PMC11095490 DOI: 10.1002/alz.13809] [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] [Indexed: 05/02/2024]
Abstract
This article describes the public health impact of Alzheimer's disease (AD), including prevalence and incidence, mortality and morbidity, use and costs of care and the ramifications of AD for family caregivers, the dementia workforce and society. The Special Report discusses the larger health care system for older adults with cognitive issues, focusing on the role of caregivers and non-physician health care professionals. An estimated 6.9 million Americans age 65 and older are living with Alzheimer's dementia today. This number could grow to 13.8 million by 2060, barring the development of medical breakthroughs to prevent or cure AD. Official AD death certificates recorded 119,399 deaths from AD in 2021. In 2020 and 2021, when COVID-19 entered the ranks of the top ten causes of death, Alzheimer's was the seventh-leading cause of death in the United States. Official counts for more recent years are still being compiled. Alzheimer's remains the fifth-leading cause of death among Americans age 65 and older. Between 2000 and 2021, deaths from stroke, heart disease and HIV decreased, whereas reported deaths from AD increased more than 140%. More than 11 million family members and other unpaid caregivers provided an estimated 18.4 billion hours of care to people with Alzheimer's or other dementias in 2023. These figures reflect a decline in the number of caregivers compared with a decade earlier, as well as an increase in the amount of care provided by each remaining caregiver. Unpaid dementia caregiving was valued at $346.6 billion in 2023. Its costs, however, extend to unpaid caregivers' increased risk for emotional distress and negative mental and physical health outcomes. Members of the paid health care and broader community-based workforce are involved in diagnosing, treating and caring for people with dementia. However, the United States faces growing shortages across different segments of the dementia care workforce due to a combination of factors, including the absolute increase in the number of people living with dementia. Therefore, targeted programs and care delivery models will be needed to attract, better train and effectively deploy health care and community-based workers to provide dementia care. Average per-person Medicare payments for services to beneficiaries age 65 and older with AD or other dementias are almost three times as great as payments for beneficiaries without these conditions, and Medicaid payments are more than 22 times as great. Total payments in 2024 for health care, long-term care and hospice services for people age 65 and older with dementia are estimated to be $360 billion. The Special Report investigates how caregivers of older adults with cognitive issues interact with the health care system and examines the role non-physician health care professionals play in facilitating clinical care and access to community-based services and supports. It includes surveys of caregivers and health care workers, focusing on their experiences, challenges, awareness and perceptions of dementia care navigation.
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Husna AA, Mustafa M, Prue E, Jahan A, Rahman NAS, Samiha M, Tabassum TT, Shaude SE. Cognitive Function in Urban and Rural Postmenopausal Women. Cureus 2024; 16:e58647. [PMID: 38770451 PMCID: PMC11104478 DOI: 10.7759/cureus.58647] [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] [Accepted: 04/20/2024] [Indexed: 05/22/2024] Open
Abstract
BACKGROUND Menopause is a well-known risk factor for decreasing cognitive function in women. Postmenopausal women are increasing in number but relevant studies are very scarce. This study compared the cognitive function between urban and rural postmenopausal women and assessed the influence of socio-demographic factors on cognitive function. OBJECTIVES The aim of the study was to assess the association between the cognitive function of urban and rural postmenopausal women. METHODS This comparative cross-sectional study was conducted among 87 urban and 87 rural postmenopausal women who were selected by purposive sampling method from the Nakhalpara and Dhamrai area of Dhaka district during the period from January to December 2020. Data were collected with a semi-structured questionnaire based on the Bengali version of the Mini-Mental State Examination (MMSE) scale through face-to-face interviews and record reviewing with a checklist. Statistical analyses of the results were obtained using Microsoft Excel (Microsoft Corporation, Redmond, WA) and SPSS version 24 (IBM Corp., Armonk, NY). RESULTS The mean age of postmenopausal women was 58.09 ± 8.163 years in urban areas and 60.00 ± 7.562 years in rural areas. The majority (31, 35.6%) of urban women were primary school pass whereas 58 (66.7%) rural women were illiterate. The mean family income of the women was 43022.99 ± 10992.57 Bangladeshi taka (BDT) in the urban group and 14022.99 ± 5023.14 BDT in the rural group. The study revealed that 31 (35.6%) women in the urban group and 53 (60.9%) women in the rural group had abnormal cognitive function. CONCLUSION The percentage of abnormal cognitive function was higher in rural postmenopausal women. Cognitive function has an association with monthly family income, housing condition, family type, age at the time of marriage, lifestyle, and co-morbidities. Policymakers can take the findings as a guide to formulate policies and programs for the improvement of cognitive function of postmenopausal women.
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Affiliation(s)
- Al Asmaul Husna
- Department of Community Medicine, Pabna Medical College, Pabna, BGD
| | - Munmun Mustafa
- Department of Community Medicine, Bangladesh Medical College, Dhaka, BGD
| | - Ely Prue
- Department of Community Medicine, Cox's Bazar Medical College, Cox's Bazar, BGD
| | - Afsana Jahan
- Department of Microbiology, Pabna Medical College, Pabna, BGD
| | | | - Maisha Samiha
- Department of Health and Nutrition, Safetynet Bangladesh, South Asia Field Epidemiology and Technology Network, Inc, Dhaka, BGD
| | | | - Syed E Shaude
- Department of Research and Development, International Network of Doctors Journal, Dhaka, BGD
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Heuer SE, Nickerson EW, Howell GR, Bloss EB. Genetic context drives age-related disparities in synaptic maintenance and structure across cortical and hippocampal neuronal circuits. Aging Cell 2024; 23:e14033. [PMID: 38130024 PMCID: PMC10861192 DOI: 10.1111/acel.14033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Revised: 10/16/2023] [Accepted: 10/19/2023] [Indexed: 12/23/2023] Open
Abstract
The disconnection of neuronal circuitry through synaptic loss is presumed to be a major driver of age-related cognitive decline. Age-related cognitive decline is heterogeneous, yet whether genetic mechanisms differentiate successful from unsuccessful cognitive decline through maintenance or vulnerability of synaptic connections remains unknown. Previous work using rodent and primate models leveraged various techniques to imply that age-related synaptic loss is widespread on pyramidal cells in prefrontal cortex (PFC) circuits but absent on those in area CA1 of the hippocampus. Here, we examined the effect of aging on synapses on projection neurons forming a hippocampal-cortico-thalamic circuit important for spatial working memory tasks from two genetically distinct mouse strains that exhibit susceptibility (C57BL/6J) or resistance (PWK/PhJ) to cognitive decline during aging. Across both strains, synapse density on CA1-to-PFC projection neurons appeared completely intact with age. In contrast, we found synapse loss on PFC-to-nucleus reuniens (RE) projection neurons from aged C57BL/6J but not PWK/PhJ mice. Moreover, synapses from aged PWK/PhJ mice but not from C57BL/6J exhibited altered morphologies that suggest increased efficiency to drive depolarization in the parent dendrite. Our findings suggest resistance to age-related cognitive decline results in part by age-related synaptic adaptations, and identification of these mechanisms in PWK/PhJ mice could uncover new therapeutic targets for promoting successful cognitive aging and extending human health span.
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Affiliation(s)
- Sarah E. Heuer
- The Jackson LaboratoryBar HarborMaineUSA
- Tufts University Graduate School of Biomedical SciencesBostonMassachusettsUSA
| | - Emily W. Nickerson
- The Jackson LaboratoryBar HarborMaineUSA
- Tufts University Graduate School of Biomedical SciencesBostonMassachusettsUSA
| | - Gareth R. Howell
- The Jackson LaboratoryBar HarborMaineUSA
- Tufts University Graduate School of Biomedical SciencesBostonMassachusettsUSA
- Graduate School of Biomedical Sciences and EngineeringUniversity of MaineOronoMaineUSA
| | - Erik B. Bloss
- The Jackson LaboratoryBar HarborMaineUSA
- Tufts University Graduate School of Biomedical SciencesBostonMassachusettsUSA
- Graduate School of Biomedical Sciences and EngineeringUniversity of MaineOronoMaineUSA
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Wang K, Zhang X, Zhang M, Li X, Xie J, Liu S, Huang Q, Wang J, Guo Q, Wang H. Hyperoside Prevents Aβ42-Induced Neurotoxicity in PC12 Cells and Caenorhabditis elegans. Mol Neurobiol 2023; 60:7136-7150. [PMID: 37535309 DOI: 10.1007/s12035-023-03521-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2022] [Accepted: 07/19/2023] [Indexed: 08/04/2023]
Abstract
Traditional Chinese medicines such as hyperoside-rich Acanthopanax senticosus and Crataegus pinnatifida have been confirmed to exhibit anti-oxidative stress properties. Hyperoside, the main ingredient of numerous antioxidant herbs, may have the ability to postpone the onset of neurodegenerative diseases. This study investigates the possible therapeutic mechanism of hyperoside as a natural antioxidant against Alzheimer's disease (AD) in Caenorhabditis elegans and PC12 cells. Specifically, hyperoside reduced reactive oxygen species (ROS) level and Aβ42-induced neurotoxicity in C. elegans worms. Meanwhile, hyperoside reduced ROS production and increased mitochondrial membrane potentialin Aβ42-induced PC12 cells, which possibly due to the increase of antioxidant enzymes activity and the diminution of malondialdehyde levels. Hoechst 33,342 staining and flow cytometry analysis results suggested that hyperoside reverses cell apoptosis. Network pharmacology predicts potentially relevant hyperoside targets and pathways in AD therapy. As anticipated, hyperoside reversed Aβ42-stimulated downregulation of the PI3K/Akt/Nrf2/HO-1. The PI3K inhibitor LY294002 partially abolished the protective capability of hyperoside. The results of molecular docking further indicated that the PI3K/Akt pathways may be involved in the protection of Aβ42-induced PC12 cells by hyperoside treatment. The study provides theoretical information for research and development of hyperoside as an antioxidant dietary supplement.
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Affiliation(s)
- Kexin Wang
- State Key Laboratory of Food Nutrition and Safety, Tianjin University of Science and Technology, No. 29, 13Th Avenue, Economic and Technological Development Area (TEDA), Tianjin, 300457, People's Republic of China
| | - Xinyue Zhang
- State Key Laboratory of Food Nutrition and Safety, Tianjin University of Science and Technology, No. 29, 13Th Avenue, Economic and Technological Development Area (TEDA), Tianjin, 300457, People's Republic of China
| | - Miaosi Zhang
- State Key Laboratory of Food Nutrition and Safety, Tianjin University of Science and Technology, No. 29, 13Th Avenue, Economic and Technological Development Area (TEDA), Tianjin, 300457, People's Republic of China
| | - Xin Li
- State Key Laboratory of Food Nutrition and Safety, Tianjin University of Science and Technology, No. 29, 13Th Avenue, Economic and Technological Development Area (TEDA), Tianjin, 300457, People's Republic of China
| | - Jiao Xie
- Key Laboratory of Environmental Pollution Monitoring and Disease Control, Ministry of Education, Guizhou Medical University, Guizhou, 550025, People's Republic of China
| | - Suwen Liu
- College of Food Science and Technology, Hebei Normal University of Science and Technology, Qinhuangdao, 066004, Hebei, China.
| | - Qun Huang
- Key Laboratory of Environmental Pollution Monitoring and Disease Control, Ministry of Education, Guizhou Medical University, Guizhou, 550025, People's Republic of China.
| | - Jilite Wang
- Department of Agriculture, Hetao College, Inner Mongolia Bayannur, 015000, China.
| | - Qingbin Guo
- State Key Laboratory of Food Nutrition and Safety, Tianjin University of Science and Technology, No. 29, 13Th Avenue, Economic and Technological Development Area (TEDA), Tianjin, 300457, People's Republic of China.
| | - Hao Wang
- State Key Laboratory of Food Nutrition and Safety, Tianjin University of Science and Technology, No. 29, 13Th Avenue, Economic and Technological Development Area (TEDA), Tianjin, 300457, People's Republic of China.
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Tsumura H, McConnell ES, Xue T(M, Wei S, Lee C, Pan W. Impact of Dementia on Incidence and Severity of Postoperative Pulmonary Complications Following Hip Fracture Surgery Among Older Patients. Clin Nurs Res 2023; 32:1145-1156. [PMID: 37592720 PMCID: PMC10811580 DOI: 10.1177/10547738231194098] [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] [Indexed: 08/19/2023]
Abstract
Postoperative pulmonary complications (PPCs) are the leading cause of death following hip fracture surgery. Dementia has been identified as a PPC risk factor that complicates the clinical course. By leveraging electronic health records, this retrospective observational study evaluated the impact of dementia on the incidence and severity of PPCs, hospital length of stay, and postoperative 30-day mortality among 875 older patients (≥65 years) who underwent hip fracture surgery between October 1, 2015 and December 31, 2018 at a health system in the southeastern United States. Inverse probability of treatment weighting using propensity scores was utilized to balance confounders between patients with and without dementia to isolate the impact of dementia on PPCs. Regression analyses revealed that dementia did not have a statistically significant impact on the incidence and severity of PPCs or postoperative 30-day mortality. However, dementia significantly extended the hospital length of stay by an average of 1.37 days.
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Affiliation(s)
| | - Eleanor S. McConnell
- Duke University School of Nursing Durham, NC, USA
- Geriatric Research, Education, and Clinical Center, Durham Veterans Affairs Health Care System Durham, NC, USA
| | - Tingzhong (Michelle) Xue
- Duke University School of Nursing Durham, NC, USA
- Geriatric Research, Education, and Clinical Center, Durham Veterans Affairs Health Care System Durham, NC, USA
| | - Sijia Wei
- Center for Education in Health Sciences, Institute for Public Health and Medicine Northwestern University Feinberg School of Medicine Chicago, IL, USA
| | - Chiyoung Lee
- University of Washington Bothell School of Nursing & Health Studies Bothell, WA, USA
| | - Wei Pan
- Duke University School of Nursing Durham, NC, USA
- Department of Population Health Sciences Duke University School of Medicine Durham, NC, USA
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Abghari M, Vu JTCM, Eckberg N, Aldana BI, Kohlmeier KA. Decanoic Acid Rescues Differences in AMPA-Mediated Calcium Rises in Hippocampal CA1 Astrocytes and Neurons in the 5xFAD Mouse Model of Alzheimer's Disease. Biomolecules 2023; 13:1461. [PMID: 37892143 PMCID: PMC10604953 DOI: 10.3390/biom13101461] [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: 08/29/2023] [Revised: 09/13/2023] [Accepted: 09/22/2023] [Indexed: 10/29/2023] Open
Abstract
Alzheimer's disease (AD), a devastating neurodegenerative disease characterized by cognitive dysfunctions, is associated with high levels of amyloid beta 42 (Aβ42), which is believed to play a role in cellular damage and signaling changes in AD. Decanoic acid has been shown to be therapeutic in AD. Glutamatergic signaling within neurons and astrocytes of the CA1 region of the hippocampus is critical in cognitive processes, and previous work has indicated deficiencies in this signaling in a mouse model of AD. In this study, we investigated glutamate-mediated signaling by evaluating AMPA-mediated calcium rises in female and male CA1 neurons and astrocytes in a mouse model of AD and examined the potential of decanoic acid to normalize this signaling. In brain slices from 5xFAD mice in which there are five mutations leading to increasing levels of Aβ42, AMPA-mediated calcium transients in CA1 neurons and astrocytes were significantly lower than that seen in wildtype controls in both females and males. Interestingly, incubation of 5xFAD slices in decanoic acid restored AMPA-mediated calcium levels in neurons and astrocytes in both females and males to levels indistinguishable from those seen in wildtype, whereas similar exposure to decanoic acid did not result in changes in AMPA-mediated transients in neurons or astrocytes in either sex in the wildtype. Our data indicate that one mechanism by which decanoic acid could improve cognitive functioning is through normalizing AMPA-mediated signaling in CA1 hippocampal cells.
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Fleischer AW, Frick KM. New perspectives on sex differences in learning and memory. Trends Endocrinol Metab 2023; 34:526-538. [PMID: 37500421 PMCID: PMC10617789 DOI: 10.1016/j.tem.2023.06.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/15/2023] [Revised: 06/12/2023] [Accepted: 06/14/2023] [Indexed: 07/29/2023]
Abstract
Females have historically been disregarded in memory research, including the thousands of studies examining roles for the hippocampus, medial prefrontal cortex, and amygdala in learning and memory. Even when included, females are often judged based on male-centric behavioral and neurobiological standards, generating and perpetuating scientific stereotypes that females exhibit worse memories compared with males in domains such as spatial navigation and fear. Recent research challenges these dogmas by identifying sex-specific strategies in common memory tasks. Here, we discuss rodent data illustrating sex differences in spatial and fear memory, as well as the neural mechanisms underlying memory formation. The influence of sex steroid hormones in both sexes is discussed, as is the importance to basic and translational neuroscience of studying sex differences.
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Affiliation(s)
- Aaron W Fleischer
- Department of Psychology, University of Wisconsin-Milwaukee, Milwaukee, WI 53211, USA.
| | - Karyn M Frick
- Department of Psychology, University of Wisconsin-Milwaukee, Milwaukee, WI 53211, USA.
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Gong J, Harris K, Lipnicki DM, Castro‐Costa E, Lima‐Costa MF, Diniz BS, Xiao S, Lipton RB, Katz MJ, Wang C, Preux P, Guerchet M, Gbessemehlan A, Ritchie K, Ancelin M, Skoog I, Najar J, Sterner TR, Scarmeas N, Yannakoulia M, Kosmidis MH, Guaita A, Rolandi E, Davin A, Gureje O, Trompet S, Gussekloo J, Riedel‐Heller S, Pabst A, Röhr S, Shahar S, Singh DKA, Rivan NFM, van Boxtel M, Köhler S, Ganguli M, Chang C, Jacobsen E, Haan M, Ding D, Zhao Q, Xiao Z, Narazaki K, Chen T, Chen S, Ng TP, Gwee X, Numbers K, Mather KA, Scazufca M, Lobo A, De‐la‐Cámara C, Lobo E, Sachdev PS, Brodaty H, Hackett ML, Peters SAE, Woodward M. Sex differences in dementia risk and risk factors: Individual-participant data analysis using 21 cohorts across six continents from the COSMIC consortium. Alzheimers Dement 2023; 19:3365-3378. [PMID: 36790027 PMCID: PMC10955774 DOI: 10.1002/alz.12962] [Citation(s) in RCA: 14] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2022] [Revised: 12/12/2022] [Accepted: 12/21/2022] [Indexed: 02/16/2023]
Abstract
INTRODUCTION Sex differences in dementia risk, and risk factor (RF) associations with dementia, remain uncertain across diverse ethno-regional groups. METHODS A total of 29,850 participants (58% women) from 21 cohorts across six continents were included in an individual participant data meta-analysis. Sex-specific hazard ratios (HRs), and women-to-men ratio of hazard ratios (RHRs) for associations between RFs and all-cause dementia were derived from mixed-effect Cox models. RESULTS Incident dementia occurred in 2089 (66% women) participants over 4.6 years (median). Women had higher dementia risk (HR, 1.12 [1.02, 1.23]) than men, particularly in low- and lower-middle-income economies. Associations between longer education and former alcohol use with dementia risk (RHR, 1.01 [1.00, 1.03] per year, and 0.55 [0.38, 0.79], respectively) were stronger for men than women; otherwise, there were no discernible sex differences in other RFs. DISCUSSION Dementia risk was higher in women than men, with possible variations by country-level income settings, but most RFs appear to work similarly in women and men.
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Affiliation(s)
- Jessica Gong
- The George Institute for Global HealthUniversity of New South WalesSydneyAustralia
- The George Institute for Global HealthImperial College LondonLondonUK
| | - Katie Harris
- The George Institute for Global HealthUniversity of New South WalesSydneyAustralia
| | - Darren M. Lipnicki
- Centre for Healthy Brain Ageing (CHeBA)Discipline of Psychiatry and Mental HealthFaculty of Medicine and HealthUNSW SydneySydneyAustralia
| | - Erico Castro‐Costa
- Center for Studies in Public Health and Aging Rene Rachou InstituteOswaldo Cruz FoundationBelo HorizonteBrazil
| | - Maria Fernanda Lima‐Costa
- Center for Studies in Public Health and Aging Rene Rachou InstituteOswaldo Cruz FoundationBelo HorizonteBrazil
| | - Breno S. Diniz
- UConn Center on AgingDepartment of PsychiatrySchool of MedicineUniversity of Connecticut Health CenterFarmingtonConnecticutUSA
| | - Shifu Xiao
- Department of Geriatric PsychiatryShanghai Mental Health CentreShanghai Jiaotong University School of MedicineShanghaiChina
| | - Richard B. Lipton
- Department of NeurologyAlbert Einstein College of MedicineBronxNew YorkUSA
| | - Mindy J. Katz
- Department of NeurologyAlbert Einstein College of MedicineBronxNew YorkUSA
| | - Cuiling Wang
- Department of Epidemiology and Community HeathAlbert Einstein College of MedicineBronxNew YorkUSA
| | - Pierre‐Marie Preux
- Inserm U1094, IRD U270, Univ. LimogesCHU Limoges, EpiMaCT ‐ Epidemiology of chronic diseases in tropical zoneInstitute of Epidemiology and Tropical NeurologyOmegaHealthLimogesFrance
| | - Maëlenn Guerchet
- Inserm U1094, IRD U270, Univ. LimogesCHU Limoges, EpiMaCT ‐ Epidemiology of chronic diseases in tropical zoneInstitute of Epidemiology and Tropical NeurologyOmegaHealthLimogesFrance
| | - Antoine Gbessemehlan
- Inserm U1094, IRD U270, Univ. LimogesCHU Limoges, EpiMaCT ‐ Epidemiology of chronic diseases in tropical zoneInstitute of Epidemiology and Tropical NeurologyOmegaHealthLimogesFrance
| | - Karen Ritchie
- INM Institute for Neurosciences of MontpellierUniv MontpellierINSERMMontpellierFrance
| | - Marie‐Laure Ancelin
- INM Institute for Neurosciences of MontpellierUniv MontpellierINSERMMontpellierFrance
| | - Ingmar Skoog
- Department of Psychiatry and NeurochemistryCenter for Ageing and Health (Age Cap)University of GothenburgGothenburgSweden
| | - Jenna Najar
- Department of Psychiatry and NeurochemistryCenter for Ageing and Health (Age Cap)University of GothenburgGothenburgSweden
| | - Therese Rydberg Sterner
- Department of Psychiatry and NeurochemistryCenter for Ageing and Health (Age Cap)University of GothenburgGothenburgSweden
| | - Nikolaos Scarmeas
- 1st Department of NeurologyAiginition HospitalNational and Kapodistrian University of Athens Medical SchoolAthensGreece
- Department of NeurologyColumbia UniversityNew YorkNew YorkUSA
| | - Mary Yannakoulia
- Department of Nutrition and DieteticsHarokopio UniversityAthensGreece
| | - Mary H. Kosmidis
- Lab of Cognitive NeuroscienceSchool of PsychologyAristotle University of ThessalonikiThessalonikiGreece
| | | | - Elena Rolandi
- Golgi Cenci FoundationAbbiategrassoItaly
- Department of Brain and Behavioral SciencesUniversity of PaviaPaviaItaly
| | | | - Oye Gureje
- WHO Collaborating Centre for Research and Training in Mental HealthNeurosciences and Substance AbuseDepartment of PsychiatryUniversity of IbadanIbadanNigeria
| | - Stella Trompet
- Section of Gerontology and GeriatricsDepartment of Internal MedicineLeiden University Medical CenterLeidenthe Netherlands
| | - Jacobijn Gussekloo
- Section of Gerontology and GeriatricsDepartment of Internal MedicineLeiden University Medical CenterLeidenthe Netherlands
- Department of Public Health and Primary CareLeidenthe Netherlands
| | - Steffi Riedel‐Heller
- Institute of Social MedicineOccupational Health and Public Health (ISAP)University of LeipzigLeipzigGermany
| | - Alexander Pabst
- Institute of Social MedicineOccupational Health and Public Health (ISAP)University of LeipzigLeipzigGermany
| | - Susanne Röhr
- Institute of Social MedicineOccupational Health and Public Health (ISAP)University of LeipzigLeipzigGermany
| | - Suzana Shahar
- Centre for Healthy Ageing and WellnessUniversiti Kebangsaan MalaysiaKuala LumpurMalaysia
| | | | | | - Martin van Boxtel
- Alzheimer Centrum LimburgSchool for Mental Health and NeuroscienceMaastricht UniversityMaastrichtthe Netherlands
| | - Sebastian Köhler
- Alzheimer Centrum LimburgSchool for Mental Health and NeuroscienceMaastricht UniversityMaastrichtthe Netherlands
| | - Mary Ganguli
- Department of MedicineUniversity of PittsburghPittsburghPennsylvaniaUSA
| | - Chung‐Chou Chang
- Department of MedicineUniversity of PittsburghPittsburghPennsylvaniaUSA
| | - Erin Jacobsen
- Department of MedicineUniversity of PittsburghPittsburghPennsylvaniaUSA
| | - Mary Haan
- Department of Epidemiology and BiostatisticsSchool of MedicineUniversity of California, San FranciscoSan FranciscoCaliforniaUSA
| | - Ding Ding
- Institute of NeurologyNational Center for Neurological DisordersNational Clinical Research Center for Aging and MedicineHuashan HospitalFudan UniversityShanghaiChina
| | - Qianhua Zhao
- Institute of NeurologyNational Center for Neurological DisordersNational Clinical Research Center for Aging and MedicineHuashan HospitalFudan UniversityShanghaiChina
| | - Zhenxu Xiao
- Institute of NeurologyNational Center for Neurological DisordersNational Clinical Research Center for Aging and MedicineHuashan HospitalFudan UniversityShanghaiChina
| | - Kenji Narazaki
- Center for Liberal ArtsFukuoka Institute of TechnologyFukuokaJapan
| | - Tao Chen
- Sports and Health Research CenterDepartment of Physical EducationTongji UniversityShanghaiChina
| | - Sanmei Chen
- Global Health NursingDepartment of Health SciencesGraduate School of Biomedical and Health SciencesHiroshima UniversityHiroshimaJapan
| | - Tze Pin Ng
- Gerontology Research ProgrammeDepartment of Psychological MedicineYong Loo Lin School of MedicineNational University of SingaporeQueenstownSingapore
| | - Xinyi Gwee
- Gerontology Research ProgrammeDepartment of Psychological MedicineYong Loo Lin School of MedicineNational University of SingaporeQueenstownSingapore
| | - Katya Numbers
- Centre for Healthy Brain Ageing (CHeBA)Discipline of Psychiatry and Mental HealthFaculty of Medicine and HealthUNSW SydneySydneyAustralia
| | - Karen A. Mather
- Centre for Healthy Brain Ageing (CHeBA)Discipline of Psychiatry and Mental HealthFaculty of Medicine and HealthUNSW SydneySydneyAustralia
| | - Marcia Scazufca
- Instituto de Psiquiátria e LIM‐23Hospital da ClínicasFaculdade de MedicinaUniversidade de São PauloSão PauloBrazil
| | - Antonio Lobo
- Department of Medicine and Psychiatry Universidad de ZaragozaZaragozaSpain
- Instituto de Investigación Sanitaria Aragón (IIS Aragón)ZaragozaSpain
- n°33 CIBERSAMMadridSpain
| | - Concepción De‐la‐Cámara
- Department of Medicine and Psychiatry Universidad de ZaragozaZaragozaSpain
- n°33 CIBERSAMMadridSpain
| | - Elena Lobo
- Instituto de Investigación Sanitaria Aragón (IIS Aragón)ZaragozaSpain
- n°33 CIBERSAMMadridSpain
- Department of Public Health Universidad de ZaragozaZaragozaSpain
| | - Perminder S. Sachdev
- Centre for Healthy Brain Ageing (CHeBA)Discipline of Psychiatry and Mental HealthFaculty of Medicine and HealthUNSW SydneySydneyAustralia
| | - Henry Brodaty
- Centre for Healthy Brain Ageing (CHeBA)Discipline of Psychiatry and Mental HealthFaculty of Medicine and HealthUNSW SydneySydneyAustralia
| | - Maree L. Hackett
- The George Institute for Global HealthUniversity of New South WalesSydneyAustralia
- Faculty of Health and WellbeingUniversity of Central LancashireLancashireUK
| | - Sanne A. E. Peters
- The George Institute for Global HealthUniversity of New South WalesSydneyAustralia
- The George Institute for Global HealthImperial College LondonLondonUK
- Julius Center for Health Sciences and Primary CareUniversity Medical Center UtrechtUtrecht UniversityUtrechtthe Netherlands
| | - Mark Woodward
- The George Institute for Global HealthUniversity of New South WalesSydneyAustralia
- The George Institute for Global HealthImperial College LondonLondonUK
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Gonçalves NG, Avila JC, Bertola L, Obregón AM, Ferri CP, Wong R, Suemoto CK. Education and cognitive function among older adults in Brazil and Mexico. ALZHEIMER'S & DEMENTIA (AMSTERDAM, NETHERLANDS) 2023; 15:e12470. [PMID: 37771429 PMCID: PMC10523452 DOI: 10.1002/dad2.12470] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Revised: 07/06/2023] [Accepted: 07/31/2023] [Indexed: 09/30/2023]
Abstract
Education is protective against cognitive impairment. We used nationally representative data from Mexico and Brazil to assess the association between education and cognitive function. The sample included adults ≥ 50 years from the Brazilian Longitudinal Study of Aging (ELSI) and the Mexican Health and Aging Study (MHAS). Participants were classified as cognitively impaired or not impaired. We used logistic regression models to estimate the association between education and cognitive function. Education level was higher in MHAS than in ELSI. Participants with at least 1 year of education were less likely to have cognitive impairment than those with no formal education in both cohorts. Men in ELSI had higher odds for cognitive impairment compared to men in MHAS. In both cohorts, higher educational level was associated with lower odds of cognitive impairment compared to no formal education. Sex was an effect modifier in MHAS but not in ELSI. HIGHLIGHTS Cognitive test batteries were harmonized using a regression-based approach.Even very low levels of education were associated with reduced odds of cognitive impairment compared to no formal education.Brazilians were more likely to have cognitive impairment than Mexicans given the same education level.The differences in the association of education with cognition between Brazil and Mexico were only observed among men.
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Affiliation(s)
| | | | - Laiss Bertola
- Department of PsychiatryFederal University of São Paulo, São PaoloSão PauloBrazil
| | | | | | - Rebeca Wong
- Sealy Center on AgingUniversity of Texas Medical BranchGalvestonTexasUSA
| | - Claudia Kimie Suemoto
- Division of GeriatricsUniversity of São Paulo Medical SchoolSão PauloSão PauloBrazil
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13
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Leung Y, Barzilai N, Batko-Szwaczka A, Beker N, Boerner K, Brayne C, Brodaty H, Cheung KSL, Corrada MM, Crawford JD, Galbussera AA, Gondo Y, Holstege H, Hulsman M, Ishioka YL, Jopp D, Kawas CH, Kaye J, Kochan NA, Lau BHP, Lipnicki DM, Lo JW, Lucca U, Makkar SR, Marcon G, Martin P, Meguro K, Milman S, Poon LW, Recchia A, Ribeiro O, Riva E, Rott C, Sikkes SA, Skoog I, Stephan B, Szewieczek J, Teixeira L, Tettamanti M, Wilczyński K, Sachdev P. Cognition, function, and prevalent dementia in centenarians and near-centenarians: An individual participant data (IPD) meta-analysis of 18 studies. Alzheimers Dement 2023; 19:2265-2275. [PMID: 36453627 DOI: 10.1002/alz.12828] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Revised: 05/08/2022] [Accepted: 05/18/2022] [Indexed: 12/03/2022]
Abstract
INTRODUCTION There are limited data on prevalence of dementia in centenarians and near-centenarians (C/NC), its determinants, and whether the risk of dementia continues to rise beyond 100. METHODS Participant-level data were obtained from 18 community-based studies (N = 4427) in 11 countries that included individuals ≥95 years. A harmonization protocol was applied to cognitive and functional impairments, and a meta-analysis was performed. RESULTS The mean age was 98.3 years (SD = 2.67); 79% were women. After adjusting for age, sex, and education, dementia prevalence was 53.2% in women and 45.5% in men, with risk continuing to increase with age. Education (OR 0.95;0.92-0.98) was protective, as was hypertension (odds ratio [OR] 0.51;0.35-0.74) in five studies. Dementia was not associated with diabetes, vision and hearing impairments, smoking, and body mass index (BMI). DISCUSSION Among the exceptional old, dementia prevalence remains higher in the older participants. Education was protective against dementia, but other factors for dementia-free survival in C/NC remain to be understood.
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Affiliation(s)
- Yvonne Leung
- Centre for Healthy Brain Ageing (CHeBA), School of Psychiatry, University of New South Wales (UNSW), Sydney, Australia
| | - Nir Barzilai
- Albert Einstein College of Medicine, New York, USA
| | - Agnieszka Batko-Szwaczka
- Department of Geriatrics, School of Health Sciences in Katowice, Medical University of Silesia, Katowice, Poland
| | - Nina Beker
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands
| | - Kathrin Boerner
- Department of Gerontology, McCormack Graduate School, University of Massachusetts Boston, Boston, USA
| | - Carol Brayne
- University of Cambridge, Cambridge, United Kingdom
| | - Henry Brodaty
- Centre for Healthy Brain Ageing (CHeBA), School of Psychiatry, University of New South Wales (UNSW), Sydney, Australia
| | | | | | - John D Crawford
- Centre for Healthy Brain Ageing (CHeBA), School of Psychiatry, University of New South Wales (UNSW), Sydney, Australia
| | - Alessia A Galbussera
- Laboratory of Geriatric Neuropsychiatry, Department of Neuroscience, Istituto di Ricerche Farmacologiche "Mario Negri" IRCCS, Milano, Italy
| | - Yasuyuki Gondo
- Osaka University Graduate School of Human Sciences School of Human Sciences: Osaka, Osaka, Japan
| | - Henne Holstege
- Genomics of Neurodegenerative Diseases and Aging, Human Genetics, Vrije Universiteit Amsterdam, Amsterdam UMC location VUmc, Amsterdam, The Netherlands
| | - Marc Hulsman
- Genomics of Neurodegenerative Diseases and Aging, Human Genetics, Vrije Universiteit Amsterdam, Amsterdam UMC location VUmc, Amsterdam, The Netherlands
| | | | | | | | - Jeff Kaye
- NIA - sLayton Aging & Alzheimer's Disease Research Center, Oregon Health & Science University, Portland, USA
| | - Nicole A Kochan
- Centre for Healthy Brain Ageing (CHeBA), School of Psychiatry, University of New South Wales (UNSW), Sydney, Australia
| | - Bobo Hi-Po Lau
- Hong Kong Shue Yan University (HKSYU), Hong Kong SAR, Hong Kong
| | - Darren M Lipnicki
- Centre for Healthy Brain Ageing (CHeBA), School of Psychiatry, University of New South Wales (UNSW), Sydney, Australia
| | - Jessica W Lo
- Centre for Healthy Brain Ageing (CHeBA), School of Psychiatry, University of New South Wales (UNSW), Sydney, Australia
| | - Ugo Lucca
- Laboratory of Geriatric Neuropsychiatry, Department of Neuroscience, Istituto di Ricerche Farmacologiche "Mario Negri" IRCCS, Milano, Italy
| | - Steve R Makkar
- Centre for Healthy Brain Ageing (CHeBA), School of Psychiatry, University of New South Wales (UNSW), Sydney, Australia
| | - Gabriella Marcon
- University of Trieste, Trieste, Italy
- University of Udine, Udine, Italy
| | | | - Kenichi Meguro
- Geriatric Behavioral Neurology, Tohoku University, Sendai, Japan
| | | | | | - Angela Recchia
- Laboratory of Geriatric Neuropsychiatry, Department of Neuroscience, Istituto di Ricerche Farmacologiche "Mario Negri" IRCCS, Milano, Italy
| | - Oscar Ribeiro
- Center for Health Technology and Services Research (CINTESIS), University of Aveiro and ICBAS-University of Porto, Porto, Portugal
| | - Emma Riva
- Laboratory of Geriatric Neuropsychiatry, Department of Neuroscience, Istituto di Ricerche Farmacologiche "Mario Negri" IRCCS, Milano, Italy
| | - Christoph Rott
- Institute of Gerontology, Heidelberg University, Heidelberg, Germany
| | - Sietske Am Sikkes
- Alzheimer Center Amsterdam, Department of Neurology, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands
- Section Clinical, Neuro- and Developmental Psychology, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | | | - Blossom Stephan
- Institute for Ageing and Institute for Health & Society, Newcastle University, Newcastle, UK
| | - Jan Szewieczek
- Department of Geriatrics, School of Health Sciences in Katowice, Medical University of Silesia, Katowice, Poland
| | - Laetitia Teixeira
- Center for Health Technology and Services Research (CINTESIS), University of Aveiro and ICBAS-University of Porto, Porto, Portugal
| | - Mauro Tettamanti
- Mario Negri Institute for Pharmacological Research, Milan, Italy
| | - Krzysztof Wilczyński
- Department of Geriatrics, School of Health Sciences in Katowice, Medical University of Silesia, Katowice, Poland
| | - Perminder Sachdev
- Centre for Healthy Brain Ageing (CHeBA), School of Psychiatry, University of New South Wales (UNSW), Sydney, Australia
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14
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Kommaddi RP, Verma A, Muniz-Terrera G, Tiwari V, Chithanathan K, Diwakar L, Gowaikar R, Karunakaran S, Malo PK, Graff-Radford NR, Day GS, Laske C, Vöglein J, Nübling G, Ikeuchi T, Kasuga K, Ravindranath V. Sex difference in evolution of cognitive decline: studies on mouse model and the Dominantly Inherited Alzheimer Network cohort. Transl Psychiatry 2023; 13:123. [PMID: 37045867 PMCID: PMC10097702 DOI: 10.1038/s41398-023-02411-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Revised: 03/15/2023] [Accepted: 03/24/2023] [Indexed: 04/14/2023] Open
Abstract
Women carry a higher burden of Alzheimer's disease (AD) compared to men, which is not accounted entirely by differences in lifespan. To identify the mechanisms underlying this effect, we investigated sex-specific differences in the progression of familial AD in humans and in APPswe/PS1ΔE9 mice. Activity dependent protein translation and associative learning and memory deficits were examined in APPswe/PS1ΔE9 mice and wild-type mice. As a human comparator group, progression of cognitive dysfunction was assessed in mutation carriers and non-carriers from DIAN (Dominantly Inherited Alzheimer Network) cohort. Female APPswe/PS1ΔE9 mice did not show recall deficits after contextual fear conditioning until 8 months of age. Further, activity dependent protein translation and Akt1-mTOR signaling at the synapse were impaired in male but not in female mice until 8 months of age. Ovariectomized APPswe/PS1ΔE9 mice displayed recall deficits at 4 months of age and these were sustained until 8 months of age. Moreover, activity dependent protein translation was also impaired in 4 months old ovariectomized APPswe/PS1ΔE9 mice compared with sham female APPswe/PS1ΔE9 mice. Progression of memory impairment differed between men and women in the DIAN cohort as analyzed using linear mixed effects model, wherein men showed steeper cognitive decline irrespective of the age of entry in the study, while women showed significantly greater performance and slower decline in immediate recall (LOGIMEM) and delayed recall (MEMUNITS) than men. However, when the performance of men and women in several cognitive tasks (such as Wechsler's logical memory) are compared with the estimated year from expected symptom onset (EYO) we found no significant differences between men and women. We conclude that in familial AD patients and mouse models, females are protected, and the onset of disease is delayed as long as estrogen levels are intact.
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Affiliation(s)
- Reddy Peera Kommaddi
- Centre for Brain Research, Indian Institute of Science, Bangalore, 560012, India.
| | - Aditi Verma
- Centre for Neuroscience, Indian Institute of Science, Bangalore, 560012, India
| | - Graciela Muniz-Terrera
- Centre for Clinical Brain Sciences, The University of Edinburgh, Edinburgh, Scotland, UK
- The Department of Social Medicine, Ohio University, Athens, OH, 45701, USA
| | - Vivek Tiwari
- Centre for Brain Research, Indian Institute of Science, Bangalore, 560012, India
| | | | - Latha Diwakar
- Centre for Brain Research, Indian Institute of Science, Bangalore, 560012, India
| | - Ruturaj Gowaikar
- Centre for Neuroscience, Indian Institute of Science, Bangalore, 560012, India
| | - Smitha Karunakaran
- Centre for Neuroscience, Indian Institute of Science, Bangalore, 560012, India
| | - Palash Kumar Malo
- Centre for Brain Research, Indian Institute of Science, Bangalore, 560012, India
| | - Neill R Graff-Radford
- Department of Neurology, Mayo Clinic Florida, Mayo Clinic College of Medicine and Science, 4500 San Pablo Road S, Jacksonville, FL, 32224, USA
| | - Gregory S Day
- Department of Neurology, Mayo Clinic Florida, Mayo Clinic College of Medicine and Science, 4500 San Pablo Road S, Jacksonville, FL, 32224, USA
| | - Christoph Laske
- German Center for Neurodegenerative Diseases, Munich, Germany
- Section for Dementia Research, Department of Cellular Neurology, Hertie Institute for Clinical Brain Research, Department of Psychiatry and Psychotherapy, University of Tübingen, Tübingen, Germany
| | - Jonathan Vöglein
- Department of Neurology, Ludwig-Maximilians-Universität München, Munich, Germany
- German Center for Neurodegenerative Diseases (DZNE), Munich, Germany
| | - Georg Nübling
- Department of Neurology, Ludwig-Maximilians-Universität München, Munich, Germany
- German Center for Neurodegenerative Diseases (DZNE), Munich, Germany
| | - Takeshi Ikeuchi
- Department of Molecular Genetics, Center for Bioresources, Brain Research Institute, Niigata University, 1-757 Asahimachi-dori, Chuo-ku, Niigata City, Niigata, 951-8585, Japan
| | - Kensaku Kasuga
- Department of Molecular Genetics, Center for Bioresources, Brain Research Institute, Niigata University, 1-757 Asahimachi-dori, Chuo-ku, Niigata City, Niigata, 951-8585, Japan
| | - Vijayalakshmi Ravindranath
- Centre for Brain Research, Indian Institute of Science, Bangalore, 560012, India
- Centre for Neuroscience, Indian Institute of Science, Bangalore, 560012, India
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15
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Mougias M, Beratis IN, Moustaka K, Alexopoulos P, Assimakopoulos K. The Differential Role of Executive Apathy in Alzheimer's Disease Dementia, Mild Cognitive Impairment and Healthy Cognitive Ageing. Geriatrics (Basel) 2023; 8:geriatrics8020038. [PMID: 36960993 PMCID: PMC10037581 DOI: 10.3390/geriatrics8020038] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2022] [Revised: 03/10/2023] [Accepted: 03/13/2023] [Indexed: 03/18/2023] Open
Abstract
The objective of the present work was to compare the levels of executive, emotional, and initiation apathy in individuals with mild cognitive impairment (MCI), mild Alzheimer's disease dementia (ADD), and cognitively intact healthy controls (HCs). Fifty-two patients with mild ADD, 40 individuals with MCI, and 37 cognitively intact individuals were included in the current study. The participants were consecutive visitors to the Outpatient Memory Clinic of "Nestor" Alzheimer's Center. The symptoms of apathy were measured with the dimensional apathy scale. Analyses showed that ADD patients had significantly higher degrees of executive, emotional, initiation, and overall apathy compared with both the MCI group and the HCs. Additionally, a significant difference was observed in the dimension of executive apathy between individuals with MCI and the HCs. In conclusion, the dimension of executive apathy was the most sensitive measure regarding the differentiation of individuals with mild ADD or MCI and HCs. Hence, detailed evaluation of executive apathy in older individuals referred to a memory clinic may provide useful information contributing to their diagnostic categorization and to the differentiation between neurocognitive disorders and healthy cognitive ageing.
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Affiliation(s)
- Michalis Mougias
- Alzheimer's Center, "Nestor" Greek Psychogeriatric Association, 22, Ioanni Drossopoulou Street, 112 57 Athens, Greece
- Department of Psychiatry, School of Medicine, University of Patras, 265 04 Patras, Greece
| | - Ion N Beratis
- Alzheimer's Center, "Nestor" Greek Psychogeriatric Association, 22, Ioanni Drossopoulou Street, 112 57 Athens, Greece
- Psychology Department, The American College of Greece, Deree, 6, Gravias Street, 153 42 Athens, Greece
| | - Kleio Moustaka
- Alzheimer's Center, "Nestor" Greek Psychogeriatric Association, 22, Ioanni Drossopoulou Street, 112 57 Athens, Greece
- Psychology Department, The American College of Greece, Deree, 6, Gravias Street, 153 42 Athens, Greece
| | - Panagiotis Alexopoulos
- Department of Psychiatry, School of Medicine, University of Patras, 265 04 Patras, Greece
- Department of Psychiatry and Psychotherapy, Klinikum Rechts der Isar, Technical University of Munich, 21, Arcisstraße Street, 80 333 Munich, Germany
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16
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Abstract
This article describes the public health impact of Alzheimer's disease, including prevalence and incidence, mortality and morbidity, use and costs of care, and the overall impact on family caregivers, the dementia workforce and society. The Special Report examines the patient journey from awareness of cognitive changes to potential treatment with drugs that change the underlying biology of Alzheimer's. An estimated 6.7 million Americans age 65 and older are living with Alzheimer's dementia today. This number could grow to 13.8 million by 2060 barring the development of medical breakthroughs to prevent, slow or cure AD. Official death certificates recorded 121,499 deaths from AD in 2019, and Alzheimer's disease was officially listed as the sixth-leading cause of death in the United States. In 2020 and 2021, when COVID-19 entered the ranks of the top ten causes of death, Alzheimer's was the seventh-leading cause of death. Alzheimer's remains the fifth-leading cause of death among Americans age 65 and older. Between 2000 and 2019, deaths from stroke, heart disease and HIV decreased, whereas reported deaths from AD increased more than 145%. This trajectory of deaths from AD was likely exacerbated by the COVID-19 pandemic in 2020 and 2021. More than 11 million family members and other unpaid caregivers provided an estimated 18 billion hours of care to people with Alzheimer's or other dementias in 2022. These figures reflect a decline in the number of caregivers compared with a decade earlier, as well as an increase in the amount of care provided by each remaining caregiver. Unpaid dementia caregiving was valued at $339.5 billion in 2022. Its costs, however, extend to family caregivers' increased risk for emotional distress and negative mental and physical health outcomes - costs that have been aggravated by COVID-19. Members of the paid health care workforce are involved in diagnosing, treating and caring for people with dementia. In recent years, however, a shortage of such workers has developed in the United States. This shortage - brought about, in part, by COVID-19 - has occurred at a time when more members of the dementia care workforce are needed. Therefore, programs will be needed to attract workers and better train health care teams. Average per-person Medicare payments for services to beneficiaries age 65 and older with AD or other dementias are almost three times as great as payments for beneficiaries without these conditions, and Medicaid payments are more than 22 times as great. Total payments in 2023 for health care, long-term care and hospice services for people age 65 and older with dementia are estimated to be $345 billion. The Special Report examines whether there will be sufficient numbers of physician specialists to provide Alzheimer's care and treatment now that two drugs are available that change the underlying biology of Alzheimer's disease.
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17
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Lopez-de-Andres A, Jimenez-Garcia R, Zamorano-Leon JJ, Omaña-Palanco R, Carabantes-Alarcon D, Hernández-Barrera V, De Miguel-Diez J, Cuadrado-Corrales N. Prevalence of Dementia among Patients Hospitalized with Type 2 Diabetes Mellitus in Spain, 2011-2020: Sex-Related Disparities and Impact of the COVID-19 Pandemic. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4923. [PMID: 36981830 PMCID: PMC10049429 DOI: 10.3390/ijerph20064923] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Revised: 03/08/2023] [Accepted: 03/09/2023] [Indexed: 06/18/2023]
Abstract
(1) Background: To assess changes in the prevalence of dementia among patients hospitalized with type 2 diabetes (T2DM), to analyze the effects of dementia on in-hospital mortality (IHM) in this population, to evaluate sex differences, and to determine the impact of the COVID-19 pandemic on these parameters. (2) Methods: We used a nationwide discharge database to select all patients with T2DM aged 60 years or over admitted to Spanish hospitals from 2011 to 2020. We identified those with all-cause dementia, Alzheimer's disease (AD), and vascular dementia (VaD). The effect of sex, age, comorbidity, and COVID-19 on the prevalence of dementia subtypes and on IHM was assessed using multivariable logistic regression. (3) Results: We identified 5,250,810 hospitalizations with T2DM. All-cause dementia was detected in 8.31%, AD in 3.00%, and VaD in 1.55%. The prevalence of all subtypes of dementia increased significantly over time. After multivariable adjustment, higher values were observed in women for all-cause dementia (OR 1.34; 95% CI 1.33-1.35), AD (OR 1.6; 95% CI 1.58-1.62), and VaD (OR 1.12; 95% CI 1.11-1.14). However, female sex was a protective factor for IHM in patients with all-cause dementia (OR 0.90; 95% CI 0.89-0.91), AD (OR 0.89; 95% CI 0.86-0.91), and VaD (OR 0.95; 95% CI 0.91-0.99). IHM among patients with dementia remained stable over time, until 2020, when it increased significantly. Higher age, greater comorbidity, and COVID-19 were associated with IHM in all dementia subtypes. (4) Conclusions: The prevalence of dementia (all-cause, AD, and VaD) in men and women with T2DM increased over time; however, the IHM remained stable until 2020, when it increased significantly, probably because of the COVID-19 pandemic. The prevalence of dementia is higher in women than in men, although female sex is a protective factor for IHM.
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Affiliation(s)
- Ana Lopez-de-Andres
- Department of Public Health and Maternal & Child Health, Faculty of Medicine, Universidad Complutense de Madrid, 28040 Madrid, Spain
| | - Rodrigo Jimenez-Garcia
- Department of Public Health and Maternal & Child Health, Faculty of Medicine, Universidad Complutense de Madrid, 28040 Madrid, Spain
| | - Jose J. Zamorano-Leon
- Department of Public Health and Maternal & Child Health, Faculty of Medicine, Universidad Complutense de Madrid, 28040 Madrid, Spain
| | - Ricardo Omaña-Palanco
- Department of Public Health and Maternal & Child Health, Faculty of Medicine, Universidad Complutense de Madrid, 28040 Madrid, Spain
| | - David Carabantes-Alarcon
- Department of Public Health and Maternal & Child Health, Faculty of Medicine, Universidad Complutense de Madrid, 28040 Madrid, Spain
| | - Valentin Hernández-Barrera
- Preventive Medicine and Public Health Teaching and Research Unit, Health Sciences Faculty, Universidad Rey Juan Carlos, 28922 Alcorcón, Spain
| | - Javier De Miguel-Diez
- Respiratory Care Department, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Universidad Complutense de Madrid, 28007 Madrid, Spain
| | - Natividad Cuadrado-Corrales
- Department of Public Health and Maternal & Child Health, Faculty of Medicine, Universidad Complutense de Madrid, 28040 Madrid, Spain
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18
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Wimo A, Handels R, Antikainen R, Eriksdotter M, Jönsson L, Knapp M, Kulmala J, Laatikainen T, Lehtisalo J, Peltonen M, Sköldunger A, Soininen H, Solomon A, Strandberg T, Tuomilehto J, Ngandu T, Kivipelto M. Dementia prevention: The potential long-term cost-effectiveness of the FINGER prevention program. Alzheimers Dement 2023; 19:999-1008. [PMID: 35841619 DOI: 10.1002/alz.12698] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Revised: 03/15/2022] [Accepted: 04/27/2022] [Indexed: 11/10/2022]
Abstract
INTRODUCTION The aim of this study was to estimate the potential cost-effectiveness of the Finnish Geriatric Intervention Study to Prevent Cognitive Impairment and Disability (FINGER) program. METHODS A life-time Markov model with societal perspective, simulating a cohort of people at risk of dementia reflecting usual care and the FINGER program. RESULTS Costs were 1,653,275 and 1,635,346 SEK and quality-adjusted life years (QALYs) were 8.636 and 8.679 for usual care and the FINGER program, respectively, resulting in savings of 16,928 SEK (2023 US$) and 0.043 QALY gains per person, supporting extended dominance for the FINGER program. A total of 1623 dementia cases were avoided with 0.17 fewer person-years living with dementia. The sensitivity analysis confirmed the conclusions in most scenarios. DISCUSSION The model provides support that programs like FINGER have the potential to be cost-effective in preventing dementia. Results at the individual level are rather modest, but the societal benefits can be substantial because of the large potential target population.
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Affiliation(s)
- Anders Wimo
- Department of NVS, Centre of Alzheimer Research, Division of Neurogeriatrics, Karolinska Institutet, Stockholm, Sweden
| | - Ron Handels
- Department of NVS, Centre of Alzheimer Research, Division of Neurogeriatrics, Karolinska Institutet, Stockholm, Sweden
- Deperatment of Psychiatry and Neuropsychology, Maastricht University, Alzheimer Centre Limburg, School for Mental Health and Neurosciences, Maastricht, the Netherlands
| | - Riitta Antikainen
- Center for Life Course Health Research/Geriatrics, University of Oulu, Medical Research Center, Oulu University Hospital, Oulu, Finland
| | - Maria Eriksdotter
- Department of NVS, Centre of Alzheimer Research, Division of Clinical Geriatrics Karolinska Institutet, Stockholm, Sweden
- Theme Inflammation and Aging, Karolinska University Hospital, Stockholm, Sweden
| | - Linus Jönsson
- Department of NVS, Centre of Alzheimer Research, Division of Neurogeriatrics, Karolinska Institutet, Stockholm, Sweden
| | - Martin Knapp
- Care Policy and Evaluation Centre, Department of Health Policy, London School of Economics and Political Science, London, UK
| | - Jenni Kulmala
- Faculty of Social Sciences (Health Sciences) and Gerontology Research Center (GEREC), Tampere University, Tampere, Finland
- Division of Clinical Geriatrics, Center for Alzheimer Research, NVS, Karolinska Institutet, Stockholm, Sweden
- Population Health Unit, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Tiina Laatikainen
- Department of Public Health and Welfare, Finnish Institute for Health and Welfare, Helsinki, Finland
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
| | - Jenni Lehtisalo
- Population Health Unit, Finnish Institute for Health and Welfare, Helsinki, Finland
- Department of Neurology, Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland
| | - Markku Peltonen
- Population Health Unit, Finnish Institute for Health and Welfare, Helsinki, Finland
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | - Anders Sköldunger
- Department of NVS, Centre of Alzheimer Research, Division of Neurogeriatrics, Karolinska Institutet, Stockholm, Sweden
| | - Hilkka Soininen
- Institute of Clinical Medicine, Neurology, University of Eastern Finland, Kuopio, Finland
| | - Alina Solomon
- Division of Clinical Geriatrics, Center for Alzheimer Research, NVS, Karolinska Institutet, Stockholm, Sweden
- Population Health Promotion Unit, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Timo Strandberg
- Department of Public Health, University of Helsinki, Helsinki, Finland
- National School of Public Health, Madrid, Spain
- Public Health Promotion Unit, National Institute for Health and Welfare, Helsinki, Finland
| | - Jaakko Tuomilehto
- Department of Public Health, University of Helsinki, Helsinki, Finland
- Public Health Promotion Unit, National Institute for Health and Welfare, Helsinki, Finland
- South Ostrobothnia Central Hospital, Seinäjoki, Finland
- Diabetes Research Group, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Tiia Ngandu
- Population Health Unit, Finnish Institute for Health and Welfare, Helsinki, Finland
- Division of Clinical Geriatrics, NVS, Karolinska Institutet, Stockholm, Sweden
| | - Miia Kivipelto
- Theme Inflammation and Aging, Karolinska University Hospital, Stockholm, Sweden
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
- Division of Clinical Geriatrics, NVS, Karolinska Institutet, Stockholm, Sweden
- Ageing Epidemiology Research Unit, School of Public Health, Imperial College London, London, UK
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Wang L, Davis PB, Kaelber DC, Xu R. COVID-19 breakthrough infections and hospitalizations among vaccinated patients with dementia in the United States between December 2020 and August 2021. Alzheimers Dement 2023; 19:421-432. [PMID: 35417628 PMCID: PMC9073984 DOI: 10.1002/alz.12669] [Citation(s) in RCA: 29] [Impact Index Per Article: 29.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2022] [Revised: 01/31/2022] [Accepted: 03/02/2022] [Indexed: 01/05/2023]
Abstract
INTRODUCTION There is lack of data on COVID-19 breakthrough infections in vaccinated patients with dementia in the United States. METHODS This is a retrospective cohort study of 262,847 vaccinated older adults (age 73.8 ± 6.81 years old) between December 2020 and August 2021. RESULTS Among the fully vaccinated patients with dementia, the overall risk of COVID-19 breakthrough infections ranged from 8.6% to 12.4%. Patients with dementia were at increased risk for breakthrough infections compared with patients without dementia, with the highest odds for patients with Lewy body dementia (LBD) (adjusted odds ratio or AOR: 3.06, 95% confidence interval or CI [1.45 to 6.66]), followed by vascular dementia (VD) (AOR: 1.99, 95% CI [1.42 to 2.80]), Alzheimer's disease (AD) (1.53, 95% CI [1.22 to 1.92]), and mild cognitive impairment (MCI) (AOR: 1.78, 95% CI [1.51 to 2.11]). The incidence rate of breakthrough infections among fully vaccinated patients with dementia increased since December 2020 and accelerated after May 2021. The overall risk for hospitalization after breakthrough infections in patients with dementia was 39.5% for AD, 46.2% for VD, and 30.4% for MCI. DISCUSSION These results highlight the need to continuously monitor breakthrough severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections and outcomes in vaccinated patients with dementia.
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Affiliation(s)
- Lindsey Wang
- Center for Artificial Intelligence in Drug Discovery, Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | - Pamela B Davis
- Center for Community Health Integration, Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | - David C. Kaelber
- The Center for Clinical Informatics Research and Education, The MetroHealth System, Cleveland, OH, USA
| | - Rong Xu
- Center for Artificial Intelligence in Drug Discovery, Case Western Reserve University School of Medicine, Cleveland, OH, USA
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20
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Abstract
BackgroundWomen in many cohorts have a higher risk for Alzheimer's disease (AD), the most common form of dementia. Sex is a biological construct whereby differences in disease manifestation and prevalence are rooted in genetic differences between XX and XY combinations of chromosomes. This chapter focuses specifically on sex-driven differences in dementia, as opposed to differences driven by gender - a social construct referring to the societal norms that influence people's roles, relationships, and positional power throughout their lifetime.MethodsUsing a narrative review, this chapter explored the characteristics and risk factors for the dementias, alongside a discussion of sex differences including loss of sex steroid hormones in middle-aged women, differences in the prevalence of cardiovascular diseases and engagement in lifestyle protective factors for dementia.ResultsThe sex difference in AD prevalence may exist because of systematic and historic differences in risk and protective factors for dementia, including level of education obtained and socioeconomic status differences, which can impact on health and dementia risk.Levels of sex steroids decline significantly after menopause in women, whereas this is more gradual in men with age. Animal and cell culture studies show strong biological plausibility for sex steroids to protect the ageing brain against dementia. Sex steroid hormone replacement therapy has in some observational studies shown to protect against AD, but treatment studies in humans have mainly shown disappointing results. Cardiovascular disease (CVD) shares midlife medical risk (e.g. hypertension, hyperlipidaemia, obesity etc.) factors with AD and other forms of dementia, but also with related lifestyle risk - and protective factors (e.g. exercise, not smoking etc.). Men tend to die earlier of CVD, so fewer survive to develop AD at an older age. Those who do survive may have healthier lifestyles and fewer risk factors for both CVD and AD. An earlier age at menopause also confers great risk for both without hormone treatment.DiscussionIt could be the case that the decline in sex steroids around the menopause make women more susceptible to lifestyle-related risk factors associated with dementia and CVD, but this remains to be further investigated. Combining hormone treatment with lifestyle changes in midlife (e.g. exercise) could be an important preventative treatment for dementia and CVD in later life, but this also requires further research.
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21
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Akushevich I, Yashkin A, Ukraintseva S, Yashin AI, Kravchenko J. The Construction of a Multidomain Risk Model of Alzheimer's Disease and Related Dementias. J Alzheimers Dis 2023; 96:535-550. [PMID: 37840484 PMCID: PMC10657690 DOI: 10.3233/jad-221292] [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] [Accepted: 08/28/2023] [Indexed: 10/17/2023]
Abstract
BACKGROUND Alzheimer's disease (AD) and related dementia (ADRD) risk is affected by multiple dependent risk factors; however, there is no consensus about their relative impact in the development of these disorders. OBJECTIVE To rank the effects of potentially dependent risk factors and identify an optimal parsimonious set of measures for predicting AD/ADRD risk from a larger pool of potentially correlated predictors. METHODS We used diagnosis record, survey, and genetic data from the Health and Retirement Study to assess the relative predictive strength of AD/ADRD risk factors spanning several domains: comorbidities, demographics/socioeconomics, health-related behavior, genetics, and environmental exposure. A modified stepwise-AIC-best-subset blanket algorithm was then used to select an optimal set of predictors. RESULTS The final predictive model was reduced to 10 features for AD and 19 for ADRD; concordance statistics were about 0.85 for one-year and 0.70 for ten-year follow-up. Depression, arterial hypertension, traumatic brain injury, cerebrovascular diseases, and the APOE4 proxy SNP rs769449 had the strongest individual associations with AD/ADRD risk. AD/ADRD risk-related co-morbidities provide predictive power on par with key genetic vulnerabilities. CONCLUSION Results confirm the consensus that circulatory diseases are the main comorbidities associated with AD/ADRD risk and show that clinical diagnosis records outperform comparable self-reported measures in predicting AD/ADRD risk. Model construction algorithms combined with modern data allows researchers to conserve power (especially in the study of disparities where disadvantaged groups are often grossly underrepresented) while accounting for a high proportion of AD/ADRD-risk-related population heterogeneity stemming from multiple domains.
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Affiliation(s)
- Igor Akushevich
- Biodemography of Aging Research Unit, Social Science Research Institute, Duke University, Durham, NC, USA
| | - Arseniy Yashkin
- Biodemography of Aging Research Unit, Social Science Research Institute, Duke University, Durham, NC, USA
| | - Svetlana Ukraintseva
- Biodemography of Aging Research Unit, Social Science Research Institute, Duke University, Durham, NC, USA
| | - Anatoliy I. Yashin
- Biodemography of Aging Research Unit, Social Science Research Institute, Duke University, Durham, NC, USA
| | - Julia Kravchenko
- Department of Surgery, Duke University Medical Center, Durham, NC, USA
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22
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Gao F, Zeng D, Wang Y. Semiparametric regression analysis of bivariate censored events in a family study of Alzheimer's disease. Biostatistics 2022; 24:32-51. [PMID: 33948627 DOI: 10.1093/biostatistics/kxab014] [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: 06/19/2020] [Revised: 03/21/2021] [Accepted: 03/25/2021] [Indexed: 12/16/2022] Open
Abstract
Assessing disease comorbidity patterns in families represents the first step in gene mapping for diseases and is central to the practice of precision medicine. One way to evaluate the relative contributions of genetic risk factor and environmental determinants of a complex trait (e.g., Alzheimer's disease [AD]) and its comorbidities (e.g., cardiovascular diseases [CVD]) is through familial studies, where an initial cohort of subjects are recruited, genotyped for specific loci, and interviewed to provide extensive disease history in family members. Because of the retrospective nature of obtaining disease phenotypes in family members, the exact time of disease onset may not be available such that current status data or interval-censored data are observed. All existing methods for analyzing these family study data assume single event subject to right-censoring so are not applicable. In this article, we propose a semiparametric regression model for the family history data that assumes a family-specific random effect and individual random effects to account for the dependence due to shared environmental exposures and unobserved genetic relatedness, respectively. To incorporate multiple events, we jointly model the onset of the primary disease of interest and a secondary disease outcome that is subject to interval-censoring. We propose nonparametric maximum likelihood estimation and develop a stable Expectation-Maximization (EM) algorithm for computation. We establish the asymptotic properties of the resulting estimators and examine the performance of the proposed methods through simulation studies. Our application to a real world study reveals that the main contribution of comorbidity between AD and CVD is due to genetic factors instead of environmental factors.
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Affiliation(s)
- Fei Gao
- Division of Vaccine and Infectious Disease, Fred Hutchinson Cancer Research Center, Seattle, WA 98109, USA
| | - Donglin Zeng
- Department of Biostatistics, University of North Carolina, Chapel Hill, NC 27599, USA
| | - Yuanjia Wang
- Department of Biostatistics, Columbia University, New York, NY 10032, USA
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23
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Liu Y, Yu X, Han P, Chen X, Wang F, Lian X, Li J, Li R, Wang B, Xu C, Li J, Zheng Y, Zhang Z, Li M, Yu Y, Guo Q. Gender-specific prevalence and risk factors of mild cognitive impairment among older adults in Chongming, Shanghai, China. Front Aging Neurosci 2022; 14:900523. [PMID: 36118698 PMCID: PMC9475287 DOI: 10.3389/fnagi.2022.900523] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2022] [Accepted: 08/15/2022] [Indexed: 11/13/2022] Open
Abstract
Objective This study explores the gender differences in the prevalence of mild cognitive impairment (MCI) and the correlation between multiple influencing factors. Materials and methods The sample was comprised of 1325 relatively healthy participants aged ≥ 60 years in a Shanghai community-dwelling (557 males and 768 females). Cognitive function was assessed by Mini-Mental State Examination (MMSE). The Instrumental Activities of Daily Living (IADL) scale was used to assess the activities of daily living. Results The overall prevalence of MCI was 15.2%, with 10.2% in men and 18.9% in women. In older male subjects, those with higher the Geriatric Depression Scale (GDS) scores [odds ratio (OR) = 1.07, 95% confidence interval (CI) = 1.01–1.14] and hypertension (OR = 2.33, 95% CI = 1.15–4.73) had a higher risk of MCI. female subjects who were illiterate (OR = 2.95, 95% CI = 1.82–4.78), had a farming background (OR = 1.69, 95% CI = 1.05–2.72), and a history of stroke (OR = 1.96, 95% CI = 1.07–3.59) had a higher risk of MCI, but this was not true for males. However, Male subjects who never smoked were less likely to have MCI (OR = 0.22, 95% CI = 0.09–0.54). Additionally, the prevalence of MCI was lower in older women with high grip strength (OR = 0.96, 95% CI = 0.92–0.99) and hyperlipidemia (OR = 0.45, 95% CI = 0.22–0.96). Conclusion The prevalence of MCI was higher in the population of elderly women compared to men. Moreover, it was found that members with MCI tended to having higher GDS scores, smoking, and hypertension; whereas a history of farming, illiteracy, stroke, grip strength, and hyperlipidemia were correlated with MCI in women.
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Affiliation(s)
- Yuewen Liu
- Shanghai University of Medicine and Health Sciences, Shanghai, China
- Shanghai University of Medicine and Health Sciences Affiliated Zhoupu Hospital, Shanghai, China
| | - Xing Yu
- Shanghai University of Medicine and Health Sciences, Shanghai, China
| | - Peipei Han
- Shanghai University of Medicine and Health Sciences, Shanghai, China
| | - Xiaoyu Chen
- Shanghai University of Medicine and Health Sciences, Shanghai, China
| | - Feng Wang
- Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Xuan Lian
- Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Jiayu Li
- Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Ruijin Li
- Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Beibei Wang
- Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Chunliu Xu
- Shanghai University of Traditional Chinese Medicine, Shanghai, China
| | - Junxue Li
- Shanghai Health Rehabilitation Hospital, Shanghai, China
| | | | | | - Ming Li
- Shanghai University of Medicine and Health Sciences Affiliated Zhoupu Hospital, Shanghai, China
| | - Ying Yu
- Shanghai University of Medicine and Health Sciences, Shanghai, China
- *Correspondence: Ying Yu,
| | - Qi Guo
- Shanghai University of Medicine and Health Sciences Affiliated Zhoupu Hospital, Shanghai, China
- Qi Guo,
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TDP-43 drives synaptic and cognitive deterioration following traumatic brain injury. Acta Neuropathol 2022; 144:187-210. [PMID: 35713704 PMCID: PMC9945325 DOI: 10.1007/s00401-022-02449-w] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Revised: 05/31/2022] [Accepted: 05/31/2022] [Indexed: 11/01/2022]
Abstract
Traumatic brain injury (TBI) has been recognized as an important risk factor for Alzheimer's disease (AD). However, the molecular mechanisms by which TBI contributes to developing AD remain unclear. Here, we provide evidence that aberrant production of TDP-43 is a key factor in promoting AD neuropathology and synaptic and cognitive deterioration in mouse models of mild closed head injury (CHI). We observed that a single mild CHI is sufficient to exacerbate AD neuropathology and accelerate synaptic and cognitive deterioration in APP transgenic mice but repeated mild CHI are required to induce neuropathological changes and impairments in synaptic plasticity, spatial learning, and memory retention in wild-type animals. Importantly, these changes in animals exposed to a single or repeated mild CHI are alleviated by silencing of TDP-43 but reverted by rescue of the TDP-43 knockdown. Moreover, overexpression of TDP-43 in the hippocampus aggravates AD neuropathology and provokes cognitive impairment in APP transgenic mice, mimicking single mild CHI-induced changes. We further discovered that neuroinflammation triggered by TBI promotes NF-κB-mediated transcription and expression of TDP-43, which in turn stimulates tau phosphorylation and Aβ formation. Our findings suggest that excessive production of TDP-43 plays an important role in exacerbating AD neuropathology and in driving synaptic and cognitive declines following TBI.
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Characterization of Retinal Drusen in Subjects at High Genetic Risk of Developing Sporadic Alzheimer’s Disease: An Exploratory Analysis. J Pers Med 2022; 12:jpm12050847. [PMID: 35629270 PMCID: PMC9145327 DOI: 10.3390/jpm12050847] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Revised: 05/17/2022] [Accepted: 05/19/2022] [Indexed: 11/16/2022] Open
Abstract
Having a family history (FH+) of Alzheimer’s disease (AD) and being a carrier of at least one ɛ4 allele of the ApoE gene are two of the main risk factors for the development of AD. AD and age-related macular degeneration (AMD) share one of the main risk factors, such as age, and characteristics including the presence of deposits (Aβ plaques in AD and drusen in AMD); however, the role of apolipoprotein E isoforms in both pathologies is controversial. We analyzed and characterized retinal drusen by optical coherence tomography (OCT) in subjects, classifying them by their AD FH (FH- or FH+) and their allelic characterization of ApoE ɛ4 (ApoE ɛ4- or ApoE ɛ4+) and considering cardiovascular risk factors (hypercholesterolemia, hypertension, and diabetes mellitus). In addition, we analyzed the choroidal thickness by OCT and the area of the foveal avascular zone with OCTA. We did not find a relationship between a family history of AD or any of the ApoE isoforms and the presence or absence of drusen. Subjects with drusen show choroidal thinning compared to patients without drusen, and thinning could trigger changes in choroidal perfusion that may give rise to the deposits that generate drusen.
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26
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Late-onset depression: A risk factor for major neurocognitive disorder? CLINICAL EPIDEMIOLOGY AND GLOBAL HEALTH 2022. [DOI: 10.1016/j.cegh.2022.101041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
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Taxier LR, Philippi SM, York JM, LaDu MJ, Frick KM. APOE4 genotype or ovarian hormone loss influence open field exploration in an EFAD mouse model of Alzheimer's disease. Horm Behav 2022; 140:105124. [PMID: 35101701 PMCID: PMC8976745 DOI: 10.1016/j.yhbeh.2022.105124] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Revised: 01/20/2022] [Accepted: 01/21/2022] [Indexed: 01/24/2023]
Abstract
Anxiety is a prominent and debilitating symptom in Alzheimer's disease (AD) patients. Carriers of APOE4, the greatest genetic risk factor for late-onset AD, may experience increased anxiety relative to carriers of other APOE genotypes. However, whether APOE4 genotype interacts with other AD risk factors to promote anxiety-like behaviors is less clear. Here, we used open field exploration to assess anxiety-like behavior in an EFAD mouse model of AD that expresses five familial AD mutations (5xFAD) and human APOE3 or APOE4. We first examined whether APOE4 genotype exacerbates anxiety-like exploratory behavior in the open field relative to APOE3 genotype in a sex-specific manner among six-month-old male and female E3FAD (APOE3+/+/5xFAD+/-) and E4FAD mice (APOE4+/+/5xFAD+/-). Next, we determined whether circulating ovarian hormone loss influences exploratory behavior in the open field among female E3FAD and E4FADs. APOE4 genotype was associated with decreased time in the center of the open field, particularly among female EFADs. Furthermore, ovariectomy (OVX) decreased time in the center of the open field among female E3FADs to levels similar to intact and OVXed E4FAD females. Our results suggest that APOE4 genotype increased anxiety-like behavior in the open field, and that ovarian hormones may protect against an anxiety-like phenotype in female E3FAD, but not E4FAD mice.
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Affiliation(s)
- Lisa R Taxier
- Department of Psychology, University of Wisconsin-Milwaukee, Milwaukee, WI 53211, United States of America.
| | - Sarah M Philippi
- Department of Psychology, University of Wisconsin-Milwaukee, Milwaukee, WI 53211, United States of America
| | - Jason M York
- Department of Anatomy and Cell Biology, University of Illinois at Chicago, Chicago, IL 60612, United States of America.
| | - Mary Jo LaDu
- Department of Anatomy and Cell Biology, University of Illinois at Chicago, Chicago, IL 60612, United States of America.
| | - Karyn M Frick
- Department of Psychology, University of Wisconsin-Milwaukee, Milwaukee, WI 53211, United States of America.
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Abstract
This article describes the public health impact of Alzheimer's disease (AD), including incidence and prevalence, mortality and morbidity, use and costs of care, and the overall impact on family caregivers, the dementia workforce and society. The Special Report discusses consumers' and primary care physicians' perspectives on awareness, diagnosis and treatment of mild cognitive impairment (MCI), including MCI due to Alzheimer's disease. An estimated 6.5 million Americans age 65 and older are living with Alzheimer's dementia today. This number could grow to 13.8 million by 2060 barring the development of medical breakthroughs to prevent, slow or cure AD. Official death certificates recorded 121,499 deaths from AD in 2019, the latest year for which data are available. Alzheimer's disease was officially listed as the sixth-leading cause of death in the United States in 2019 and the seventh-leading cause of death in 2020 and 2021, when COVID-19 entered the ranks of the top ten causes of death. Alzheimer's remains the fifth-leading cause of death among Americans age 65 and older. Between 2000 and 2019, deaths from stroke, heart disease and HIV decreased, whereas reported deaths from AD increased more than 145%. More than 11 million family members and other unpaid caregivers provided an estimated 16 billion hours of care to people with Alzheimer's or other dementias in 2021. These figures reflect a decline in the number of caregivers compared with a decade earlier, as well as an increase in the amount of care provided by each remaining caregiver. Unpaid dementia caregiving was valued at $271.6 billion in 2021. Its costs, however, extend to family caregivers' increased risk for emotional distress and negative mental and physical health outcomes - costs that have been aggravated by COVID-19. Members of the dementia care workforce have also been affected by COVID-19. As essential care workers, some have opted to change jobs to protect their own health and the health of their families. However, this occurs at a time when more members of the dementia care workforce are needed. Average per-person Medicare payments for services to beneficiaries age 65 and older with AD or other dementias are almost three times as great as payments for beneficiaries without these conditions, and Medicaid payments are more than 22 times as great. Total payments in 2022 for health care, long-term care and hospice services for people age 65 and older with dementia are estimated to be $321 billion. A recent survey commissioned by the Alzheimer's Association revealed several barriers to consumers' understanding of MCI. The survey showed low awareness of MCI among Americans, a reluctance among Americans to see their doctor after noticing MCI symptoms, and persistent challenges for primary care physicians in diagnosing MCI. Survey results indicate the need to improve MCI awareness and diagnosis, especially in underserved communities, and to encourage greater participation in MCI-related clinical trials.
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Srinivasan G, Brafman DA. The Emergence of Model Systems to Investigate the Link Between Traumatic Brain Injury and Alzheimer’s Disease. Front Aging Neurosci 2022; 13:813544. [PMID: 35211003 PMCID: PMC8862182 DOI: 10.3389/fnagi.2021.813544] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Accepted: 12/20/2021] [Indexed: 12/12/2022] Open
Abstract
Numerous epidemiological studies have demonstrated that individuals who have sustained a traumatic brain injury (TBI) have an elevated risk for developing Alzheimer’s disease and Alzheimer’s-related dementias (AD/ADRD). Despite these connections, the underlying mechanisms by which TBI induces AD-related pathology, neuronal dysfunction, and cognitive decline have yet to be elucidated. In this review, we will discuss the various in vivo and in vitro models that are being employed to provide more definite mechanistic relationships between TBI-induced mechanical injury and AD-related phenotypes. In particular, we will highlight the strengths and weaknesses of each of these model systems as it relates to advancing the understanding of the mechanisms that lead to TBI-induced AD onset and progression as well as providing platforms to evaluate potential therapies. Finally, we will discuss how emerging methods including the use of human induced pluripotent stem cell (hiPSC)-derived cultures and genome engineering technologies can be employed to generate better models of TBI-induced AD.
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30
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Kotlarz P, Nino JC, Febo M. Connectomic analysis of Alzheimer's disease using percolation theory. Netw Neurosci 2022; 6:213-233. [PMID: 36605889 PMCID: PMC9810282 DOI: 10.1162/netn_a_00221] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Accepted: 12/08/2021] [Indexed: 01/09/2023] Open
Abstract
Alzheimer's disease (AD) is a severe neurodegenerative disorder that affects a growing worldwide elderly population. Identification of brain functional biomarkers is expected to help determine preclinical stages for targeted mechanistic studies and development of therapeutic interventions to deter disease progression. Connectomic analysis, a graph theory-based methodology used in the analysis of brain-derived connectivity matrices was used in conjunction with percolation theory targeted attack model to investigate the network effects of AD-related amyloid deposition. We used matrices derived from resting-state functional magnetic resonance imaging collected on mice with extracellular amyloidosis (TgCRND8 mice, n = 17) and control littermates (n = 17). Global, nodal, spatial, and percolation-based analysis was performed comparing AD and control mice. These data indicate a short-term compensatory response to neurodegeneration in the AD brain via a strongly connected core network with highly vulnerable or disconnected hubs. Targeted attacks demonstrated a greater vulnerability of AD brains to all types of attacks and identified progression models to mimic AD brain functional connectivity through betweenness centrality and collective influence metrics. Furthermore, both spatial analysis and percolation theory identified a key disconnect between the anterior brain of the AD mice to the rest of the brain network.
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Affiliation(s)
- Parker Kotlarz
- Department of Materials Science and Engineering, University of Florida, Gainesville, FL, USA,* Corresponding Author:
| | - Juan C. Nino
- Department of Materials Science and Engineering, University of Florida, Gainesville, FL, USA
| | - Marcelo Febo
- Department of Psychiatry, University of Florida, Gainesville, FL, USA
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31
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Endreddy A, Chennareddy L, Harshitha V. The association of depression and quality of life in patients with neurocognitive disorder in a tertiary care center: An observational study. TAIWANESE JOURNAL OF PSYCHIATRY 2022. [DOI: 10.4103/tpsy.tpsy_34_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
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32
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Mielke MM, Ransom JE, Mandrekar J, Turcano P, Savica R, Brown AW. Traumatic Brain Injury and Risk of Alzheimer's Disease and Related Dementias in the Population. J Alzheimers Dis 2022; 88:1049-1059. [PMID: 35723103 PMCID: PMC9378485 DOI: 10.3233/jad-220159] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
BACKGROUND Epidemiological studies examining associations between traumatic brain injury (TBI) and Alzheimer's disease and related dementias (ADRD) have yielded conflicting results, which may be due to methodological differences. OBJECTIVE To examine the relationship between the presence and severity of TBI and risk of ADRD using a population-based cohort with medical record abstraction for confirmation of TBI and ADRD. METHODS All TBI events among Olmsted County, Minnesota residents aged > 40 years from 1985-1999 were confirmed by manual review and classified by severity. Each TBI case was randomly matched to two age-, sex-, and non-head injury population-based referents without TBI. For TBI events with non-head trauma, the Trauma Mortality Prediction Model was applied to assign an overall measure of non-head injury severity and corresponding referents were matched on this variable. Medical records were manually abstracted to confirm ADRD diagnosis. Cox proportional hazards models examined the relationship between TBI and severity with risk of ADRD. RESULTS A total of 1,418 residents had a confirmed TBI (865 Possible, 450 Probable, and 103 Definite) and were matched to 2,836 referents. When combining all TBI severities, the risk of any ADRD was significantly higher for those with a confirmed TBI compared to referents (HR = 1.32, 95% CI: 1.11, 1.58). Stratifying by TBI severity, Probable (HR = 1.42, 95% CI: 1.05, 1.92) and Possible (HR = 1.29, 95% CI: 1.02-1.62) TBI was associated with an increased risk of ADRD, but not Definite TBI (HR = 1.22, 95% CI: 0.68, 2.18). CONCLUSION Our analyses support including TBI as a potential risk factor for developing ADRD.
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Affiliation(s)
- Michelle M. Mielke
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN USA
- Department of Epidemiology and Prevention, Wake Forest University School of Medicine, Winston-Salem, NC, USA
| | - Jeanine E. Ransom
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN USA
| | - Jay Mandrekar
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN USA
| | | | - Rodolfo Savica
- Department of Neurology, Mayo Clinic, Rochester, MN, USA
| | - Allen W. Brown
- Department of Physical Medicine and Rehabilitation, Mayo Clinic, Rochester, MN, USA
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33
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Corrêa JC, Ávila MPW, Lucchetti ALG, Lucchetti G. Altruism, Volunteering and Cognitive Performance Among Older Adults: A 2-Year Longitudinal Study. J Geriatr Psychiatry Neurol 2022; 35:66-77. [PMID: 33021137 DOI: 10.1177/0891988720964260] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
This study aims to investigate whether altruism and volunteering are associated differently with cognitive functioning in community-dwelling older adults. A 2-year longitudinal study of 291 Brazilian older adults was conducted. In the baseline analysis, altruism, but not volunteering, was associated with higher scores for the composite cognitive score, the Mini-Mental State Examination, the verbal fluency and the CERAD Recall. Concerning the longitudinal analyses, volunteering at baseline, but not altruism, was associated with verbal fluency and CERAD Word List Recall after 2 years of follow up. Same results were obtained while investigating changes in score. Altruism and volunteering were associated with cognitive tests, albeit in different ways. Volunteering, but not altruism, was associated with lower cognitive decline. However, altruism, but not volunteering, was associated with higher absolute score on these tests. These findings can further understanding of this new field of health research.
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Affiliation(s)
- Jimilly Caputo Corrêa
- Division of Geriatrics, School of Medicine, 28113Federal University of Juiz de Fora, Minas Gerais, Brazil
| | | | | | - Giancarlo Lucchetti
- Division of Geriatrics, School of Medicine, 28113Federal University of Juiz de Fora, Minas Gerais, Brazil
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34
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Hogervorst E, Craig J, O'Donnell E. Cognition and mental health in menopause: A review. Best Pract Res Clin Obstet Gynaecol 2021; 81:69-84. [PMID: 34969617 DOI: 10.1016/j.bpobgyn.2021.10.009] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Accepted: 10/25/2021] [Indexed: 11/02/2022]
Abstract
Cognitive and mood changes are frequently mentioned as complaints before, during and after menopausal transition. There is substantial biological evidence for such associations to occur, as there are many mechanisms through which oestrogens can affect the brain: by regulating metabolism, increasing cerebral blood flow and dendritic outgrowth, by acting on nerve growth factors through the co-localisation of receptors via neurotransmitter synthesis and turnover and many more. However, the evidence for objective and longer-term changes in cognitive function and mental health over the menopausal transition and beyond is less clear. While hormone treatment (HT) including oestrogens could potentially reverse these psychological issues, the evidence of long-term benefit is also inconclusive. However, for women with severe menopausal complaints, and particularly for those who undergo early menopause, including women with premature ovarian insufficiency, personalised HT at least up to the natural age of menopause around 50 should be considered, which is probably safe up to 10 years of treatment, unless contraindicated. This paper reviews the evidence for changes in psychological health related to menopausal transition and HTs.
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Affiliation(s)
- Eef Hogervorst
- School of Sports Exercise and Health Sciences, Loughborough University, UK.
| | - Jen Craig
- School of Sports Exercise and Health Sciences, Loughborough University, UK
| | - Emma O'Donnell
- School of Sports Exercise and Health Sciences, Loughborough University, UK
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35
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Dams-O'Connor K, Bellgowan PSF, Corriveau R, Pugh MJ, Smith DH, Schneider JA, Whittaker K, Zetterberg H. Alzheimer's Disease-Related Dementias Summit 2019: National research priorities for the investigation of traumatic brain injury as a risk factor for Alzheimer's Disease and Related Dementias. J Neurotrauma 2021; 38:3186-3194. [PMID: 34714152 DOI: 10.1089/neu.2021.0216] [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: 12/18/2022] Open
Abstract
TBI is a risk factor for later life dementia. Clinical and preclinical studies have elucidated multiple mechanisms through which TBI may influence or exacerbate multiple pathological processes underlying Alzheimer's Disease and Alzheimer's Disease Related Dementias (AD/ADRD). The National Institutes of Health hosts triennial ADRD Summits to inform a national research agenda, and the 2019 ADRD Summit was the first to highlight 'TBI and AD/ADRD Risk' as an emerging topic in the field. A multidisciplinary committee of TBI researchers with relevant expertise reviewed extant literature, identified research gaps and opportunities, and proposed draft research recommendations at the 2019 ADRD Summit. These research recommendations, further refined after broad stakeholder input at the Summit, cover four overall areas: (1) Encourage crosstalk and interdisciplinary collaboration between TBI and dementia researchers, (2) Establish infrastructure to study TBI as a risk factor for AD/ADRD, (3) Promote basic and clinical research examining the development and progression of TBI AD/ADRD neuropathologies and associated clinical symptoms, and (4) Characterize the clinical phenotype of progressive dementia associated with TBI and develop non-invasive diagnostic approaches. These recommendations recognize a need to strengthen communication and build frameworks to connect the complexity of TBI with rapidly evolving AD/ADRD research. Recommendations acknowledge TBI as a clinically and pathologically heterogeneous disease whose associations with AD/ADRDs remain incompletely understood. The recommendations highlight the scientific advantage of investigating AD/ADRD in the context of a known TBI exposure, the study of which can directly inform on disease mechanisms and treatment targets for AD/ADRDs with shared common pathways.
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Affiliation(s)
- Kristen Dams-O'Connor
- Icahn School of Medicine at Mount Sinai, 5925, Department of Rehabilitation and Human Performance, New York, New York, United States.,Icahn School of Medicine at Mount Sinai, 5925, Department of Neurology, New York, New York, United States; kristen.dams-o'
| | - Patrick S F Bellgowan
- National Institute of Neurological Disorders and Stroke, 35046, Bethesda, Maryland, United States;
| | - Roderick Corriveau
- National Institute of Neurological Disorders and Stroke, 35046, Bethesda, Maryland, United States;
| | - Mary Jo Pugh
- The University of Utah School of Medicine, 12348, Department of Medicine, Division of Epidemiology, Salt Lake City, Utah, United States.,VA Salt Lake City Health Care System, 20122, Salt Lake City, Utah, United States;
| | - Douglas H Smith
- University of Pennsylvania, Department of Neurosurgery, Philadelphia, Pennsylvania, United States;
| | - Julie A Schneider
- Rush University Medical Center, Department of Pathology, Chicago, Illinois, United States;
| | - Keith Whittaker
- National Institute of Neurological Disorders and Stroke, 35046, Bethesda, Maryland, United States;
| | - Henrik Zetterberg
- Sahlgrenska Academy at the University of Gothenburg, Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, S-431 80 Mölndal, Sweden.,Sahlgrenska University Hospital, Clinical Neurochemistry Laboratory, S-431 80 Mölndal, Sweden.,UCL Institute of Neurology, Department of Neurodegenerative Disease, Queen Square, London, WC1E 6BT, United Kingdom of Great Britain and Northern Ireland.,UK Dementia Research Institute at UCL, London, WC1E 6BT, United Kingdom of Great Britain and Northern Ireland;
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36
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Kimura NRS, Simões JP, Santos RL, Baptista MAT, Portugal MDG, Johannessen A, Barca ML, Engedal K, Laks J, Rodrigues VM, Dourado MCN. Young- and Late-Onset Dementia: A Comparative Study of Quality of Life, Burden, and Depressive Symptoms in Caregivers. J Geriatr Psychiatry Neurol 2021; 34:434-444. [PMID: 32552216 DOI: 10.1177/0891988720933355] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
OBJECTIVE To compare the quality of life, burden, and depressive symptoms of caregivers of individuals with young-onset dementia (YOD) and late-onset dementia (LOD). METHODS Using a cross-sectional design, a convenience sample of 110 dyads of individuals with dementia and their caregivers, all living in the community, was included. The care recipients completed assessments about cognition, quality of life, and awareness of disease. Caregivers' quality of life, resilience, depressive and anxiety symptoms, hopelessness, and burden of care were assessed. RESULTS A significant difference was found in caregivers' burden and depressive symptoms according to the age of onset. However, there was no difference in caregivers' quality of life between YOD and LOD groups. In both groups, a linear regression analysis indicated that caregivers' perspective of quality of life of care recipient and caregivers' hopelessness were associated with their quality of life. In addition, in the LOD group, caregivers' burden was associated with their perspective of the quality of life of care recipient, type of kinship, and presence of emotional problems. In the YOD group, caregivers' burden was associated with duration of caregiving role, cohabitating with care recipient, and their anxiety symptoms. Caregivers' depressive symptoms were associated with anxiety symptoms in the YOD group, whereas hopelessness was associated with caregivers' depressive symptoms in both the groups. CONCLUSION Our findings suggest that the factors that affect quality of life, burden, and depressive symptoms of caregivers of individuals with LOD differ from those that affect the caregivers of individuals with YOD.
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Affiliation(s)
- Nathália R S Kimura
- Center for Alzheimer's Disease and Related Disorders, Institute of Psychiatry, 28125Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - José Pedro Simões
- Department of Sociology and Political Science, Center for Philosophy and Human Sciences, Federal University of Santa Catarina, Florianópolis, Santa Catarina, Brazil
| | - Raquel Luiza Santos
- Center for Alzheimer's Disease and Related Disorders, Institute of Psychiatry, 28125Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Maria Alice Tourinho Baptista
- Center for Alzheimer's Disease and Related Disorders, Institute of Psychiatry, 28125Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Maria da Glória Portugal
- Center for Alzheimer's Disease and Related Disorders, Institute of Psychiatry, 28125Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Aud Johannessen
- Norwegian National Advisory Unit on Aging and Health, Vestfold Hospital Trust, Tønsberg, Norway.,Campus Vestfold, University of South-Eastern Norway, Tønsberg, Norway
| | - Maria Lage Barca
- Norwegian National Advisory Unit on Aging and Health, Vestfold Hospital Trust, Tønsberg, Norway.,Department of Geriatric Medicine, Oslo University Hospital, Oslo, Norway
| | - Knut Engedal
- Norwegian National Advisory Unit on Aging and Health, Vestfold Hospital Trust, Tønsberg, Norway.,Department of Geriatric Medicine, Oslo University Hospital, Oslo, Norway
| | - Jerson Laks
- Center for Alzheimer's Disease and Related Disorders, Institute of Psychiatry, 28125Federal University of Rio de Janeiro, Rio de Janeiro, Brazil.,Postgraduation Program of Translational Biomedicine, Universidade do Grande Rio (Unigranrio), Duque de Caxias, Rio de Janeiro, Brazil
| | - Valeska Marinho Rodrigues
- Center for Alzheimer's Disease and Related Disorders, Institute of Psychiatry, 28125Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
| | - Marcia C N Dourado
- Center for Alzheimer's Disease and Related Disorders, Institute of Psychiatry, 28125Federal University of Rio de Janeiro, Rio de Janeiro, Brazil
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37
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Soler JE, Xiong H, Samad F, Manfredsson FP, Robison AJ, Núñez AA, Yan L. Orexin (hypocretin) mediates light-dependent fluctuation of hippocampal function in a diurnal rodent. Hippocampus 2021; 31:1104-1114. [PMID: 34263969 DOI: 10.1002/hipo.23376] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Revised: 05/30/2021] [Accepted: 07/07/2021] [Indexed: 12/24/2022]
Abstract
Environmental lighting conditions play a central role in cognitive function, but the underlying mechanisms remain unclear. Utilizing a diurnal rodent model, the Nile grass rat (Arvicanthis niloticus), we previously found that daytime light intensity affects hippocampal function in this species in a manner similar to its effects in humans. Compared to animals housed in a 12:12 h bright light-dark (brLD) cycle, grass rats kept in a 12:12 h dim light-dark (dimLD) cycle showed impaired spatial memory in the Morris water maze (MWM) and reduced CA1 apical dendritic spine density. The present study explored the neural substrates mediating the effects of daylight intensity on hippocampal function focusing on the hypothalamic orexin (hypocretin) system. First, animals housed in dimLD were treated with daily intranasal administration of orexin A peptide over five training days of the MWM task. Compared to vehicle controls, this treatment led to superior spatial memory accompanied by increased phosphorylation of Ca2+ /calmodulin-dependent protein kinase II α and glutamate receptor 1 within the CA1. To assess the role of hippocampal orexinergic signaling, an adeno-associated viral vector (AAV) expressing an orexin receptor 1 (OX1R) shRNA was injected into the dorsal hippocampus targeting the CA1 of animals housed in brLD. AAV-mediated knockdown of OX1R within the hippocampus resulted in deficits in MWM performance and reduced CA1 apical dendritic spine density. These results are consistent with the view that the hypothalamic orexinergic system underlies the modulatory role of daytime illumination on hippocampal function in diurnal mammals.
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Affiliation(s)
- Joel E Soler
- Department of Psychology, Michigan State University, East Lansing, Michigan, USA
| | - Hang Xiong
- Department of Psychology, Michigan State University, East Lansing, Michigan, USA
| | - Faiez Samad
- Department of Psychology, Michigan State University, East Lansing, Michigan, USA
| | - Fredric P Manfredsson
- Translational Science and Molecular Medicine, Michigan State University, Grand Rapids, Michigan, USA.,Neuroscience Program, Michigan State University, East Lansing, Michigan, USA
| | - Alfred J Robison
- Neuroscience Program, Michigan State University, East Lansing, Michigan, USA.,Department of Physiology, Michigan State University, East Lansing, Michigan, USA
| | - Antonio A Núñez
- Department of Psychology, Michigan State University, East Lansing, Michigan, USA.,Neuroscience Program, Michigan State University, East Lansing, Michigan, USA
| | - Lily Yan
- Department of Psychology, Michigan State University, East Lansing, Michigan, USA.,Neuroscience Program, Michigan State University, East Lansing, Michigan, USA
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38
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Lewis CR, Talboom JS, De Both MD, Schmidt AM, Naymik MA, Håberg AK, Rundek T, Levin BE, Hoscheidt S, Bolla Y, Brinton RD, Hay M, Barnes CA, Glisky E, Ryan L, Huentelman MJ. Smoking is associated with impaired verbal learning and memory performance in women more than men. Sci Rep 2021; 11:10248. [PMID: 33986309 PMCID: PMC8119711 DOI: 10.1038/s41598-021-88923-z] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2020] [Accepted: 04/09/2021] [Indexed: 02/03/2023] Open
Abstract
Vascular contributions to cognitive impairment and dementia (VCID) include structural and functional blood vessel injuries linked to poor neurocognitive outcomes. Smoking might indirectly increase the likelihood of cognitive impairment by exacerbating vascular disease risks. Sex disparities in VCID have been reported, however, few studies have assessed the sex-specific relationships between smoking and memory performance and with contradictory results. We investigated the associations between sex, smoking, and cardiovascular disease with verbal learning and memory function. Using MindCrowd, an observational web-based cohort of ~ 70,000 people aged 18-85, we investigated whether sex modifies the relationship between smoking and cardiovascular disease with verbal memory performance. We found significant interactions in that smoking is associated with verbal learning performance more in women and cardiovascular disease more in men across a wide age range. These results suggest that smoking and cardiovascular disease may impact verbal learning and memory throughout adulthood differently for men and women.
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Affiliation(s)
- C. R. Lewis
- grid.250942.80000 0004 0507 3225The Translational Genomics Research Institute, Phoenix, AZ 85004 USA ,Arizona Alzheimer’s Consortium, Phoenix, AZ 85004 USA
| | - J. S. Talboom
- grid.250942.80000 0004 0507 3225The Translational Genomics Research Institute, Phoenix, AZ 85004 USA ,Arizona Alzheimer’s Consortium, Phoenix, AZ 85004 USA
| | - M. D. De Both
- grid.250942.80000 0004 0507 3225The Translational Genomics Research Institute, Phoenix, AZ 85004 USA ,Arizona Alzheimer’s Consortium, Phoenix, AZ 85004 USA
| | - A. M. Schmidt
- grid.250942.80000 0004 0507 3225The Translational Genomics Research Institute, Phoenix, AZ 85004 USA ,Arizona Alzheimer’s Consortium, Phoenix, AZ 85004 USA
| | - M. A. Naymik
- grid.250942.80000 0004 0507 3225The Translational Genomics Research Institute, Phoenix, AZ 85004 USA ,Arizona Alzheimer’s Consortium, Phoenix, AZ 85004 USA
| | - A. K. Håberg
- grid.5947.f0000 0001 1516 2393Norwegian University of Science and Technology, 7491 Trondheim, Norway
| | - T. Rundek
- grid.134563.60000 0001 2168 186XEvelyn F. McKnight Brain Institute, University of Arizona, Tucson, AZ 85721 USA ,grid.26790.3a0000 0004 1936 8606Miami Clinical and Translational Science Institute, University of Miami, Miami, FL 33136 USA
| | - B. E. Levin
- grid.134563.60000 0001 2168 186XEvelyn F. McKnight Brain Institute, University of Arizona, Tucson, AZ 85721 USA
| | - S. Hoscheidt
- Arizona Alzheimer’s Consortium, Phoenix, AZ 85004 USA ,grid.134563.60000 0001 2168 186XUniversity of Arizona, Tucson, AZ 85721 USA
| | - Y. Bolla
- Arizona Alzheimer’s Consortium, Phoenix, AZ 85004 USA ,grid.134563.60000 0001 2168 186XUniversity of Arizona, Tucson, AZ 85721 USA
| | - R. D. Brinton
- Arizona Alzheimer’s Consortium, Phoenix, AZ 85004 USA ,grid.134563.60000 0001 2168 186XUniversity of Arizona, Tucson, AZ 85721 USA
| | - M. Hay
- Arizona Alzheimer’s Consortium, Phoenix, AZ 85004 USA ,grid.134563.60000 0001 2168 186XUniversity of Arizona, Tucson, AZ 85721 USA
| | - C. A. Barnes
- Arizona Alzheimer’s Consortium, Phoenix, AZ 85004 USA ,grid.134563.60000 0001 2168 186XUniversity of Arizona, Tucson, AZ 85721 USA
| | - E. Glisky
- Arizona Alzheimer’s Consortium, Phoenix, AZ 85004 USA ,grid.134563.60000 0001 2168 186XUniversity of Arizona, Tucson, AZ 85721 USA
| | - L. Ryan
- Arizona Alzheimer’s Consortium, Phoenix, AZ 85004 USA ,grid.134563.60000 0001 2168 186XUniversity of Arizona, Tucson, AZ 85721 USA
| | - M. J. Huentelman
- grid.250942.80000 0004 0507 3225The Translational Genomics Research Institute, Phoenix, AZ 85004 USA ,Arizona Alzheimer’s Consortium, Phoenix, AZ 85004 USA
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Petersen JD, Wehberg S, Packness A, Svensson NH, Hyldig N, Raunsgaard S, Andersen MK, Ryg J, Mercer SW, Søndergaard J, Waldorff FB. Association of Socioeconomic Status With Dementia Diagnosis Among Older Adults in Denmark. JAMA Netw Open 2021; 4:e2110432. [PMID: 34003271 PMCID: PMC8132141 DOI: 10.1001/jamanetworkopen.2021.10432] [Citation(s) in RCA: 50] [Impact Index Per Article: 16.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
IMPORTANCE Low socioeconomic status (SES) has been identified as a risk factor for the development of dementia. However, few studies have focused on the association between SES and dementia diagnostic evaluation on a population level. OBJECTIVE To investigate whether household income (HHI) is associated with dementia diagnosis and cognitive severity at the time of diagnosis. DESIGN, SETTING, AND PARTICIPANTS This population- and register-based cross-sectional study analyzed health, social, and economic data obtained from various Danish national registers. The study population comprised individuals who received a first-time referral for a diagnostic evaluation for dementia to the secondary health care sector of Denmark between January 1, 2017, and December 17, 2018. Dementia-related health data were retrieved from the Danish Quality Database for Dementia. Data analysis was conducted from October 2019 to December 2020. EXPOSURES Annual HHI (used as a proxy for SES) for 2015 and 2016 was obtained from Statistics Denmark and categorized into upper, middle, and lower tertiles within 5-year interval age groups. MAIN OUTCOMES AND MEASURES Dementia diagnoses (Alzheimer disease, vascular dementia, mixed dementia, dementia with Lewy bodies, Parkinson disease dementia, or other) and cognitive stages at diagnosis (cognitively intact; mild cognitive impairment but not dementia; or mild, moderate, or severe dementia) were retrieved from the database. Univariable and multivariable logistic and linear regressions adjusted for age group, sex, region of residence, household type, period (2017 and 2018), medication type, and medical conditions were analyzed for a possible association between HHI and receipt of dementia diagnosis. RESULTS Among the 10 191 individuals (mean [SD] age, 75 [10] years; 5476 women [53.7%]) included in the study, 8844 (86.8%) were diagnosed with dementia. Individuals with HHI in the upper tertile compared with those with lower-tertile HHI were less likely to receive a dementia diagnosis after referral (odds ratio, 0.65; 95% CI, 0.55-0.78) and, if diagnosed with dementia, had less severe cognitive stage (β, -0.16; 95% CI, -0.21 to -0.10). Individuals with middle-tertile HHI did not significantly differ from those with lower-tertile HHI in terms of dementia diagnosis (odds ratio, 0.92; 95% CI, 0.77-1.09) and cognitive stage at diagnosis (β, 0.01; 95% CI, -0.04 to 0.06). CONCLUSIONS AND RELEVANCE The results of this study revealed a social inequality in dementia diagnostic evaluation: in Denmark, people with higher income seem to receive an earlier diagnosis. Public health strategies should target people with lower SES for earlier dementia detection and intervention.
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Affiliation(s)
- Jindong Ding Petersen
- Research Unit of General Practice, Department of Public Health, University of Southern Denmark, Odense, Denmark
| | - Sonja Wehberg
- Research Unit of General Practice, Department of Public Health, University of Southern Denmark, Odense, Denmark
| | - Aake Packness
- Research Unit of General Practice, Department of Public Health, University of Southern Denmark, Odense, Denmark
- Psychiatric Research Unit, Psychiatry Region Zealand, Slagelse, Denmark
| | - Nanna Herning Svensson
- Research Unit of General Practice, Department of Public Health, University of Southern Denmark, Odense, Denmark
| | - Nana Hyldig
- OPEN (Open Patient Data Explorative Network), Odense University Hospital, Region of Southern Denmark, Odense, Denmark
| | - Søren Raunsgaard
- Research Unit of General Practice, Department of Public Health, University of Southern Denmark, Odense, Denmark
| | - Merethe Kirstine Andersen
- Research Unit of General Practice, Department of Public Health, University of Southern Denmark, Odense, Denmark
| | - Jesper Ryg
- Geriatric Research Unit, Department of Geriatric Medicine, Odense University Hospital, Odense, Denmark
- Department of Clinical Research, University of Southern Denmark, Odense, Denmark
| | - Stewart W. Mercer
- Advanced Care Research Centre, Usher Institute, University of Edinburgh, Edinburgh, Scotland
| | - Jens Søndergaard
- Research Unit of General Practice, Department of Public Health, University of Southern Denmark, Odense, Denmark
| | - Frans Boch Waldorff
- Research Unit of General Practice, Department of Public Health, University of Southern Denmark, Odense, Denmark
- Section of General Practice, Research Unit of General Practice, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
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Multimodal neuroimaging of sex differences in cognitively impaired patients on the Alzheimer's continuum: greater tau-PET retention in females. Neurobiol Aging 2021; 105:86-98. [PMID: 34049062 DOI: 10.1016/j.neurobiolaging.2021.04.003] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Revised: 04/03/2021] [Accepted: 04/05/2021] [Indexed: 12/23/2022]
Abstract
We assessed sex differences in amyloid- and tau-PET retention in 119 amyloid positive patients with mild cognitive impairment or Alzheimer's disease (AD) dementia. Patients underwent 3T-MRI, 11C-PIB amyloid-PET and 18F-Flortaucipir tau-PET. Linear ordinary least squares regression models tested sex differences in Flortaucipir-PET SUVR in a summary temporal region of interest as well as global PIB-PET. No sex differences were observed in demographics, Clinical Dementia Rating Sum of Boxes (CDR-SoB), Mini-Mental State Exam (MMSE), raw episodic memory scores, or cortical thickness. Females had higher global PIB SUVR (ηp²=.043, p=.025) and temporal Flortaucipir SUVR (ηp²=.070, p=.004), adjusting for age and CDR-SoB. Sex differences in temporal Flortaucipir-PET remained significant when controlling additionally for PIB SUVR and APOE4 status (ηp²=.055, p=.013), or when using partial volume-corrected data. No sex differences were present in areas of known Flortaucipir off-target binding. Overall, females demonstrated greater AD regional tau-PET burden than males despite clinical comparability. Further characterization of sex differences will provide insight into AD pathogenesis and support development of personalized therapeutic strategies.
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Chosy EJ, Gross N, Meyer M, Liu CY, Edland SD, Launer LJ, White LR. Brain Injury and Later-Life Cognitive Impairment and Neuropathology: The Honolulu-Asia Aging Study. J Alzheimers Dis 2021; 73:317-325. [PMID: 31771050 DOI: 10.3233/jad-190053] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
BACKGROUND Findings are inconsistent regarding the role of traumatic head injury in the subsequent development of neurologic outcomes. OBJECTIVE Examine the relationship between head injury and later cognitive impairment. METHODS A sample of 3,123 Japanese-American men was assessed for history of head injury and evaluated for cognitive impairment using the Cognitive Abilities Screening Instrument (CASI). For a subsample of 676 respondents, neuropathologic results from those with and without head injury were compared. RESULTS Although the crude model showed an association between history of head injury and later severe cognitive impairment, the relationship lost significance in the adjusted model (OR = 1.320, CI: 0.90-1.93), regardless of time between injury and impairment. Similar to cognitive impairment, hippocampal sclerosis was observed significantly more in the brains of respondents with a history of head injury in the crude model, but the relationship weakened in the adjusted model (OR = 1.462, CI: 0.68-3.12). After adjustment, decedents with a head injury demonstrated marginally higher brain weight (OR = 1.003, CI: 1.00-1.01). CONCLUSION We did not find a relationship between head injury and subsequent cognitive decline in this cohort. The neuropathology results also displayed no strong association between history of head injury and specific brain lesions and characteristics. These results support other findings in prospective cohorts. However, they could be influenced by the demographic make-up of the sample (male Japanese-Americans) or by the observation that the majority reported only a single head injury.
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Affiliation(s)
- E Julia Chosy
- Pacific Health Research and Education Institute, Honolulu, HI, USA
| | - Noele Gross
- Pacific Health Research and Education Institute, Honolulu, HI, USA
| | - Marnie Meyer
- Pacific Health Research and Education Institute, Honolulu, HI, USA
| | - Catherine Y Liu
- Pacific Health Research and Education Institute, Honolulu, HI, USA
| | | | - Lenore J Launer
- National Institute on Aging, National Institutes of Health, Bethesda, MD, USA
| | - Lon R White
- Pacific Health Research and Education Institute, Honolulu, HI, USA
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Abstract
This article describes the public health impact of Alzheimer's disease (AD), including incidence and prevalence, mortality and morbidity, use and costs of care, and the overall impact on caregivers and society. The Special Report discusses the challenges of providing equitable health care for people with dementia in the United States. An estimated 6.2 million Americans age 65 and older are living with Alzheimer's dementia today. This number could grow to 13.8 million by 2060 barring the development of medical breakthroughs to prevent, slow or cure AD. Official death certificates recorded 121,499 deaths from AD in 2019, the latest year for which data are available, making Alzheimer's the sixth-leading cause of death in the United States and the fifth-leading cause of death among Americans age 65 and older. Between 2000 and 2019, deaths from stroke, heart disease and HIV decreased, whereas reported deaths from AD increased more than 145%. This trajectory of deaths from AD was likely exacerbated in 2020 by the COVID-19 pandemic. More than 11 million family members and other unpaid caregivers provided an estimated 15.3 billion hours of care to people with Alzheimer's or other dementias in 2020. These figures reflect a decline in the number of caregivers compared with a decade earlier, as well as an increase in the amount of care provided by each remaining caregiver. Unpaid dementia caregiving was valued at $256.7 billion in 2020. Its costs, however, extend to family caregivers' increased risk for emotional distress and negative mental and physical health outcomes - costs that have been aggravated by COVID-19. Average per-person Medicare payments for services to beneficiaries age 65 and older with AD or other dementias are more than three times as great as payments for beneficiaries without these conditions, and Medicaid payments are more than 23 times as great. Total payments in 2021 for health care, long-term care and hospice services for people age 65 and older with dementia are estimated to be $355 billion. Despite years of efforts to make health care more equitable in the United States, racial and ethnic disparities remain - both in terms of health disparities, which involve differences in the burden of illness, and health care disparities, which involve differences in the ability to use health care services. Blacks, Hispanics, Asian Americans and Native Americans continue to have a higher burden of illness and lower access to health care compared with Whites. Such disparities, which have become more apparent during COVID-19, extend to dementia care. Surveys commissioned by the Alzheimer's Association recently shed new light on the role of discrimination in dementia care, the varying levels of trust between racial and ethnic groups in medical research, and the differences between groups in their levels of concern about and awareness of Alzheimer's disease. These findings emphasize the need to increase racial and ethnic diversity in both the dementia care workforce and in Alzheimer's clinical trials.
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Postupna N, Rose SE, Gibbons LE, Coleman NM, Hellstern LL, Ritchie K, Wilson AM, Cudaback E, Li X, Melief EJ, Beller AE, Miller JA, Nolan AL, Marshall DA, Walker R, Montine TJ, Larson EB, Crane PK, Ellenbogen RG, Lein ES, Dams-O'Connor K, Keene CD. The Delayed Neuropathological Consequences of Traumatic Brain Injury in a Community-Based Sample. Front Neurol 2021; 12:624696. [PMID: 33796061 PMCID: PMC8008107 DOI: 10.3389/fneur.2021.624696] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2020] [Accepted: 02/12/2021] [Indexed: 12/14/2022] Open
Abstract
The late neuropathological effects of traumatic brain injury have yet to be fully elucidated, particularly with respect to community-based cohorts. To contribute to this critical gap in knowledge, we designed a multimodal neuropathological study, integrating traditional and quantitative approaches to detect pathologic changes in 532 consecutive brain autopsies from participants in the Adult Changes in Thought (ACT) study. Diagnostic evaluation including assessment for chronic traumatic encephalopathy (CTE) and quantitative immunoassay-based methods were deployed to examine levels of pathological (hyperphosphorylated) tau (pTau) and amyloid (A) β in brains from ACT participants with (n = 107) and without (n = 425) history of remote TBI with loss of consciousness (w/LOC). Further neuropathological assessments included immunohistochemistry for α-synuclein and phospho-TDP-43 pathology and astro- (GFAP) and micro- (Iba1) gliosis, mass spectrometry analysis of free radical injury, and gene expression evaluation (RNA sequencing) in a smaller sub-cohort of matched samples (49 cases with TBI and 49 non-exposed matched controls). Out of 532 cases, only 3 (0.6%-none with TBI w/LOC history) showed evidence of the neuropathologic signature of chronic traumatic encephalopathy (CTE). Across the entire cohort, the levels of pTau and Aβ showed expected differences for brain region (higher levels in temporal cortex), neuropathological diagnosis (higher in participants with Alzheimer's disease), and APOE genotype (higher in participants with one or more APOE ε4 allele). However, no differences in PHF-tau or Aβ1-42 were identified by Histelide with respect to the history of TBI w/LOC. In a subset of TBI cases with more carefully matched control samples and more extensive analysis, those with TBI w/LOC history had higher levels of hippocampal pTau but no significant differences in Aβ, α-synuclein, pTDP-43, GFAP, Iba1, or free radical injury. RNA-sequencing also did not reveal significant gene expression associated with any measure of TBI exposure. Combined, these findings suggest long term neuropathological changes associated with TBI w/LOC may be subtle, involve non-traditional pathways of neurotoxicity and neurodegeneration, and/or differ from those in autopsy cohorts specifically selected for neurotrauma exposure.
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Affiliation(s)
- Nadia Postupna
- Department of Laboratory Medicine and Pathology, University of Washington School of Medicine, Seattle, WA, United States
| | - Shannon E. Rose
- Department of Laboratory Medicine and Pathology, University of Washington School of Medicine, Seattle, WA, United States
| | - Laura E. Gibbons
- Department of Medicine, University of Washington School of Medicine, Seattle, WA, United States
| | - Natalie M. Coleman
- Department of Laboratory Medicine and Pathology, University of Washington School of Medicine, Seattle, WA, United States
| | - Leanne L. Hellstern
- Department of Laboratory Medicine and Pathology, University of Washington School of Medicine, Seattle, WA, United States
| | - Kayla Ritchie
- Department of Laboratory Medicine and Pathology, University of Washington School of Medicine, Seattle, WA, United States
| | - Angela M. Wilson
- Department of Laboratory Medicine and Pathology, University of Washington School of Medicine, Seattle, WA, United States
| | - Eiron Cudaback
- Department of Laboratory Medicine and Pathology, University of Washington School of Medicine, Seattle, WA, United States
| | - Xianwu Li
- Department of Laboratory Medicine and Pathology, University of Washington School of Medicine, Seattle, WA, United States
| | - Erica J. Melief
- Department of Laboratory Medicine and Pathology, University of Washington School of Medicine, Seattle, WA, United States
| | - Allison E. Beller
- Department of Laboratory Medicine and Pathology, University of Washington School of Medicine, Seattle, WA, United States
| | | | - Amber L. Nolan
- Department of Laboratory Medicine and Pathology, University of Washington School of Medicine, Seattle, WA, United States
| | - Desiree A. Marshall
- Department of Laboratory Medicine and Pathology, University of Washington School of Medicine, Seattle, WA, United States
| | - Rod Walker
- Kaiser Permanente Washington Health Research Institute, Seattle, WA, United States
| | - Thomas J. Montine
- Department of Pathology, Stanford University School of Medicine, Palo Alto, CA, United States
| | - Eric B. Larson
- Kaiser Permanente Washington Health Research Institute, Seattle, WA, United States
| | - Paul K. Crane
- Department of Medicine, University of Washington School of Medicine, Seattle, WA, United States
| | - Richard G. Ellenbogen
- Department of Neurological Surgery, University of Washington School of Medicine, Seattle, WA, United States
| | - Edward S. Lein
- Allen Institute for Brain Science, Seattle, WA, United States
- Department of Neurological Surgery, University of Washington School of Medicine, Seattle, WA, United States
| | - Kristen Dams-O'Connor
- Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - C. Dirk Keene
- Department of Laboratory Medicine and Pathology, University of Washington School of Medicine, Seattle, WA, United States
- Department of Neurological Surgery, University of Washington School of Medicine, Seattle, WA, United States
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Liang HY, Zhang PP, Zhang XL, Zheng YY, Huang YR, Zheng GQ, Lin Y. Preclinical systematic review of ginsenoside Rg1 for cognitive impairment in Alzheimer's disease. Aging (Albany NY) 2021; 13:7549-7569. [PMID: 33686024 PMCID: PMC7993717 DOI: 10.18632/aging.202619] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Accepted: 10/01/2020] [Indexed: 05/02/2023]
Abstract
Ginseng has been used for the treatment of aging and memory impairment for thousands of years. Several studies have found that ginsenoside Rg1, as one of the main active components of ginseng, could potentially improve cognitive function in several different animal models. A preclinical systematic review to evaluate the efficacy and mechanisms of ginsenoside Rg1 for ameliorating cognitive impairments in Alzheimer's disease is reported here. We searched six databases from their inceptions to January 2019. Thirty-two studies were selected, which included a total of 1,643 animals. According to various cognitive behavioral tests, the results of the meta-analyses showed that ginsenoside Rg1 significantly improved cognitive behavioral impairments in most Alzheimer's disease models (P < 0.05), but there were no significant effects in animals with neuronal degeneration induced by chronic stress or in SAMP8 transgenic mice. The potential mechanisms included antioxidant and anti-inflammatory effects, amelioration of Alzheimer's disease-related pathology, synapse protection, and up-regulation of nerve cells via multiple signaling pathways.
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Affiliation(s)
- Hai-Yong Liang
- Department of Neurology, The Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical University, Wenzhou 325000, China
| | - Pei-Pei Zhang
- Department of Neurology, The Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical University, Wenzhou 325000, China
| | - Xi-Le Zhang
- Department of Neurology, The Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical University, Wenzhou 325000, China
| | - Yan-Yan Zheng
- Department of Neurology, The Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical University, Wenzhou 325000, China
| | - Yan-Ran Huang
- Department of Neurology, The Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical University, Wenzhou 325000, China
| | - Guo-Qing Zheng
- Department of Neurology, The Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical University, Wenzhou 325000, China
| | - Yan Lin
- Department of Neurology, The Second Affiliated Hospital and Yuying Children’s Hospital of Wenzhou Medical University, Wenzhou 325000, China
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Kozyrev N, Albers S, Yang J, Prado VF, Prado MAM, Fonseca GJ, Rylett RJ, Dekaban GA. Infiltrating Hematogenous Macrophages Aggregate Around β-Amyloid Plaques in an Age- and Sex-Dependent Manner in a Mouse Model of Alzheimer Disease. J Neuropathol Exp Neurol 2021; 79:1147-1162. [PMID: 33011810 DOI: 10.1093/jnen/nlaa093] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023] Open
Abstract
β-Amyloid (Aβ) plaques can trigger chronic inflammation in the cellular environment that recruits infiltrating macrophages during the course of Alzheimer disease (AD). Activated macrophages release pro-inflammatory cytokines that increase neurotoxicity associated with AD. A major impediment to investigating neuroinflammation involving macrophage activity is the inability to discriminate resident microglial macrophages (mMϕ) from hematogenous macrophages (hMϕ), as they are morphologically and phenotypically similar when activated. To distinguish between mMϕ and hMϕ and to determine their respective roles in chronic inflammation associated with the progression of amyloidosis, we used lys-EGFP-ki transgenic mice that express enhanced green fluorescent protein in hMϕ, but not in mMϕ. These mice were crossed with 5XFAD mice. The offspring demonstrated robust AD pathology and enabled visual discrimination of mMϕ from hMϕ. Mutant mice demonstrated robust increases in Aβ1-42, area of Aβ plaques, gliosis and deficits in spatial learning by age 5 months. The time-course of Aβ accumulation, paralleled by the accumulation of hMϕ around Aβ plaques, was more robust in female compared with male mice and preceded behavioral changes. Thus, the accumulation of infiltrating hMϕ around Aβ plaques was age- and sex-dependent and preceded cognitive impairment.
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Affiliation(s)
- Natalie Kozyrev
- Molecular Medicine Research Laboratories, Robarts Research Institute, Western University, London, Ontario
| | - Shawn Albers
- Molecular Medicine Research Laboratories, Robarts Research Institute, Western University, London, Ontario.,Department of Physiology and Pharmacology, Western University, London, Ontario, Canada
| | - Jennifer Yang
- Department of Microbiology and Immunology, Western University, London, Ontario, Canada
| | - Vania F Prado
- Molecular Medicine Research Laboratories, Robarts Research Institute, Western University, London, Ontario.,Department of Physiology and Pharmacology, Western University, London, Ontario, Canada.,Department of Anatomy & Cell Biology (VFP, MAMP), Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada
| | - Marco A M Prado
- Molecular Medicine Research Laboratories, Robarts Research Institute, Western University, London, Ontario.,Department of Physiology and Pharmacology, Western University, London, Ontario, Canada.,Department of Anatomy & Cell Biology (VFP, MAMP), Schulich School of Medicine & Dentistry, Western University, London, Ontario, Canada
| | - Gregory J Fonseca
- Division of Experimental Medicine, Department of Medicine, McGill University, Canada
| | - R Jane Rylett
- Molecular Medicine Research Laboratories, Robarts Research Institute, Western University, London, Ontario.,Department of Physiology and Pharmacology, Western University, London, Ontario, Canada
| | - Gregory A Dekaban
- Molecular Medicine Research Laboratories, Robarts Research Institute, Western University, London, Ontario.,Department of Microbiology and Immunology, Western University, London, Ontario, Canada
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Subramaniapillai S, Almey A, Natasha Rajah M, Einstein G. Sex and gender differences in cognitive and brain reserve: Implications for Alzheimer's disease in women. Front Neuroendocrinol 2021; 60:100879. [PMID: 33137359 DOI: 10.1016/j.yfrne.2020.100879] [Citation(s) in RCA: 79] [Impact Index Per Article: 26.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2020] [Revised: 10/14/2020] [Accepted: 10/27/2020] [Indexed: 12/11/2022]
Abstract
Women represent ⅔ of the cases of Alzheimer's disease (AD). Current research has focused on differential risks to explain higher rates of AD in women. However, factors that reduce risk for AD, like cognitive/brain reserve, are less well explored. We asked: what is known about sex and gender differences in how reserve mitigates risk for AD? We conducted a narrative review of the literature, with keywords: "sex/gender differences", "cognitive/brain reserve", "Alzheimer's Disease", and the following cognitive reserve contributors: "education", "IQ", "occupation", "cognitive stimulation", "bilingualism", "socioeconomic status", "physical activity", "social support". Sixteen papers disaggregated their data by sex. Those papers observed sex and gender differences in reserve contributors. There is also evidence that greater reserve may be more beneficial in lowering AD risk in women, although more research is needed. We discuss how traditional reserve contributors are gendered and may not capture factors that support cognition in aging women.
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Affiliation(s)
- Sivaniya Subramaniapillai
- Department of Psychology, McGill University, 2001 Avenue McGill College, Montréal, QC H3A 1G1, Canada; Brain Imaging Centre, Douglas Institute Research Centre, 6875 LaSalle Blvd Verdun, Montréal, QC H4H 1R3, Canada.
| | - Anne Almey
- Department of Psychology, University of Toronto, 100 St. George Street, Toronto, ON M5S 3G3, Canada
| | - M Natasha Rajah
- Brain Imaging Centre, Douglas Institute Research Centre, 6875 LaSalle Blvd Verdun, Montréal, QC H4H 1R3, Canada; Department of Psychiatry, Faculty of Medicine, McGill University, 1033 Avenue des Pins, Montréal, QC H3A 1A1, Canada
| | - Gillian Einstein
- Department of Psychology, University of Toronto, 100 St. George Street, Toronto, ON M5S 3G3, Canada; Rotman Research Institute, Baycrest Hospital, 3560 Bathurst St, Toronto, ON M6A 2E1, Canada; Tema Genus, Linköping University, TEMA-huset, Entrance 37, Room E433, Campus Valla, Linköping, Sweden
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Tripathi R, Tripathi S, Pandey N, Srivastava A, Usman K, Ali W, Tiwari S. Cognitive status of older adults with diabetes mellitus, hypertension, and dyslipidemia on Hindi Cognitive Screening Test and Saint Louis University Mental State. JOURNAL OF GERIATRIC MENTAL HEALTH 2021. [DOI: 10.4103/jgmh.jgmh_43_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Vlachos GS, Kosmidis MH, Yannakoulia M, Dardiotis E, Hadjigeorgiou G, Tzoulaki I, Georgiou AN, Sakka P, Anastasiou CA, Stefanis L, Scarmeas N. Dementia Incidence in the Elderly Population of Greece: Results From the HELIAD Study. Alzheimer Dis Assoc Disord 2021; 35:48-54. [PMID: 33009037 DOI: 10.1097/wad.0000000000000407] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2020] [Accepted: 08/16/2020] [Indexed: 11/26/2022]
Abstract
OBJECTIVES Recently a declining trend in dementia incidence rates has been reported in high-income countries. We investigated dementia incidence in a representative sample of the Greek population in the age group of 65 years and above. METHODS This research is part of the Hellenic Epidemiological Longitudinal Investigation of Aging and Diet (HELIAD). The incidence cohort consisted of 1072 participants who were reevaluated after a mean period of 3.09 years. RESULTS The incidence rate of dementia was 19.0 cases per 1000 person-years (age-standardized and sex-standardized incidence: 25.4/1000 person-years), of which 16.3 per 1000 person-years were attributable to Alzheimer disease. Each additional year of age increased dementia risk by 19.3% and each additional year of education decreased dementia risk by 12.1%. Apolipoprotein E (APOE)-ε4 homozygous participants were 18 times more likely to be diagnosed with dementia. A baseline diagnosis of mild cognitive decline (MCI) resulted in a risk for dementia increased by 3.7 times compared with the cognitively normal; in participants with MCI at baseline, APOE-ε4 carriage increased dementia risk by 4.5 times. CONCLUSIONS The incidence rate of dementia in people 65 years and above in Greece is generally consistent with recently published rates in Europe and North America. Advancing age, baseline MCI, and APOE-ε4 homozygosity are risk factors, while higher educational attainment seems protective.
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Affiliation(s)
- George S Vlachos
- 1st Department of Neurology, Aiginition Hospital, National and Kapodistrian University of Athens Medical School
| | - Mary H Kosmidis
- Lab of Cognitive Neuroscience, School of Psychology, Aristotle University of Thessaloniki, Thessaloniki
| | | | | | - Georgios Hadjigeorgiou
- School of Medicine, University of Thessaly, Larissa
- Department of Neurology, Medical School, University of Cyprus, Nicosia, Cyprus
| | - Ioanna Tzoulaki
- Department of Hygiene and Epidemiology, University of Ioannina School of Medicine, Ioannina
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
| | - Andrea N Georgiou
- Department of Hygiene and Epidemiology, University of Ioannina School of Medicine, Ioannina
| | - Paraskevi Sakka
- Athens Association of Alzheimer's Disease and Related Disorders, Maroussi, Greece
| | | | - Leonidas Stefanis
- 1st Department of Neurology, Aiginition Hospital, National and Kapodistrian University of Athens Medical School
- Center of Clinical, Experimental Surgery and Translational Research, Biomedical Research Foundation of the Academy of Athens, Athens
| | - Nikolaos Scarmeas
- 1st Department of Neurology, Aiginition Hospital, National and Kapodistrian University of Athens Medical School
- Department of Neurology, Taub Institute for Research in Alzheimer's Disease and the Aging Brain, the Gertrude H. Sergievsky Center, Columbia University, New York, NY
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Potential Nutraceutical Properties of Leaves from Several Commonly Cultivated Plants. Biomolecules 2020; 10:biom10111556. [PMID: 33203123 PMCID: PMC7698063 DOI: 10.3390/biom10111556] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Revised: 11/09/2020] [Accepted: 11/13/2020] [Indexed: 12/12/2022] Open
Abstract
Chronic dietary ingestion of suitable phytochemicals may assist with limiting or negating neurodegenerative decline. Current therapeutics used to treat Alzheimer disease elicit broad adverse drug reactions, and alternative sources of cholinesterase inhibitors (ChEIs) are required. Herein, we screened methanolic extracts from seven commonly cultivated plants for their nutraceutical potential; ability to inhibit acetylcholinesterase (AChE) and butyryl-cholinesterase (BuChE), and provision of antioxidant activity through their 2,2-diphenyl-1-picryl-hydrazyl-hydrate (DPPH) free radical scavenging capabilities. Potential neurotoxicity of plant extracts was examined via application to SHSY-5Y neuroblastoma cells and quantitation of cell viability. Methanolic extracts of Citrus limon (Lemon), Bombax ceiba (Red silk-cotton), Lawsonia inermis (Henna), Eucalyptus globulus (Eucalyptus), Ocimum basilicum (Basil), Citrus reticulata (Mandarin orange), and Mentha spicata (Spearmint) all displayed concentration-dependent inhibition of AChE and BuChE. The majority of extracts inhibited AChE and BuChE to near equipotency, with Henna and Eucalyptus extracts the two most potent ChEIs. All plant extracts were able to scavenge free radicals in a concentration-dependent manner, with Eucalyptus the most potent antioxidant. Toxicity of plant extracts to neuronal cells was concentration dependent, with Eucalyptus also the most toxic extract. Fractionation of plant extracts and analysis by mass spectrometry identified a number of plant polyphenols that might have contributed to the cholinesterase inhibition: 3-caffeoylquinic acid, methyl 4-caffeoylquinate, kaempferol-acetyl-glycoside, quercetin 3-rutinoside, quercetin-acetyl-glycoside, kaempferol 3-O-glucoside, and quercetin 3-O-glucoside. In silico molecular modeling of these polyphenols demonstrated their improved AChE and BuChE binding affinities compared to the current FDA-approved dual ChEI, galantamine. Collectively, all the plant extracts contained nutraceutical agents as antioxidants and ChEIs and, therefore, their chronic consumption may prove beneficial to combat the pathological deficits that accrue in Alzheimer disease.
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Shalev N, Brosnan MB, Chechlacz M. Right Lateralized Brain Reserve Offsets Age-Related Deficits in Ignoring Distraction. Cereb Cortex Commun 2020; 1:tgaa049. [PMID: 33073236 PMCID: PMC7545855 DOI: 10.1093/texcom/tgaa049] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2020] [Revised: 07/11/2020] [Accepted: 08/07/2020] [Indexed: 11/12/2022] Open
Abstract
Age-related deterioration of attention decreases the ability to stay focused on the task at hand due to less efficient selection of relevant information and increased distractibility in the face of irrelevant, but salient stimuli. While older (compared with younger) adults may have difficulty suppressing salient distractors, the extent of these challenges differs vastly across individuals. Cognitive reserve measured by proxies of cognitively enriching life experiences, such as education, occupation, and leisure activities, is thought to mitigate the effects of the aging process and account for variability in trajectories of cognitive decline. Based on combined behavioral and neuroimaging (voxel-based morphometry) analyses of demographic, cognitive, and neural markers of aging and cognitive reserve proxy measures, we examine here predictors of variability in the age-related changes in attention function, indexed by ability to suppress salient distraction. Our findings indicate that in healthy (neurotypical), aging gray matter volume within several right lateralized fronto-parietal brain regions varies according to both levels of cognitive reserve (education) and the capacity to effectively select visual stimuli amid salient distraction. Thus, we provide here novel experimental evidence supporting Robertson's theory of a right lateralized neural basis for cognitive reserve.
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Affiliation(s)
- Nir Shalev
- Department of Experimental Psychology, University of Oxford, Oxford OX2 6GG, UK
| | - Méadhbh B Brosnan
- Department of Experimental Psychology, University of Oxford, Oxford OX2 6GG, UK
| | - Magdalena Chechlacz
- Centre for Human Brain Health, University of Birmingham, Birmingham B15 2TT, UK
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