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Simargi Y, Turana Y, Icksan AG, Harahap AR, Siste K, Mansyur M, Damayanti T, Maryastuti M, Fazharyasti V, Dewi IP, Ramli Y, Prasetyo M, Rumende CM. A Multicenter Study of COPD and Cognitive Impairment: Unraveling the Interplay of Quantitative CT, Lung Function, HIF-1α, and Clinical Variables. Int J Chron Obstruct Pulmon Dis 2024; 19:1741-1753. [PMID: 39099608 PMCID: PMC11296506 DOI: 10.2147/copd.s466173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2024] [Accepted: 07/20/2024] [Indexed: 08/06/2024] Open
Abstract
Purpose The exact link between cognitive impairment (CI) and chronic obstructive pulmonary disease (COPD) is still limited. Thus, we aim to find the relationship and interaction of quantitative CT (QCT), lung function, HIF-1α, and clinical factors with the development of CI among COPD patients. Patients and Methods A cross-sectional multicentre study was conducted from January 2022 to December 2023. We collected clinical data, spirometry, CT images, and venous blood samples from 114 COPD participants. Cognitive impairment assessment using the Montreal Cognitive Assessment Indonesian version (MoCA-Ina) with a cutoff value 26. The QCT analysis consists of lung density, airway wall thickness, pulmonary artery-to-aorta ratio (PA:A), and pectoralis muscles using 3D Slicer software. Serum HIF-1α analysis was performed using ELISA. Results We found significant differences between %LAA-950, age, COPD duration, BMI, FEV1 pp, and FEV1/FVC among GOLD grades I-IV. Only education duration was found to correlate with CI (r = 0.40; p < 0.001). We found no significant difference in HIF-1α among GOLD grades (p = 0.149) and no correlation between HIF-1α and CI (p = 0.105). From multiple linear regression, we observed that the MoCA-Ina score was influenced mainly by %LAA-950 (p = 0.02) and education duration (p = 0.01). The path analysis model showed both %LAA and education duration directly and indirectly through FEV1 pp contributing to CI. Conclusion We conclude that the utilization of QCT parameters is beneficial as it can identify abnormalities and contribute to the development of CI, indicating its potential utility in clinical decision-making. The MoCA-Ina score in COPD is mainly affected by %LAA-950 and education duration. Contrary to expectations, this study concludes that HIF-1α does not affect CI among COPD patients.
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Affiliation(s)
- Yopi Simargi
- Doctoral Program in Medical Science, Faculty of Medicine, University of Indonesia, Jakarta, Indonesia
- Department of Radiology, School of Medicine and Health Sciences, Atma Jaya Catholic University of Indonesia, Jakarta, Indonesia
- Department of Radiology, Atma Jaya Hospital, Jakarta, Indonesia
| | - Yuda Turana
- Department of Neurology, School of Medicine and Health Sciences, Atma Jaya Catholic University of Indonesia, Jakarta, Indonesia
| | | | - Alida Roswita Harahap
- Doctoral Program in Medical Science, Faculty of Medicine, University of Indonesia, Jakarta, Indonesia
| | - Kristiana Siste
- Department of Psychiatry, Faculty of Medicine, University of Indonesia, Jakarta, Indonesia
- Department of Psychiatry, Cipto Mangunkusumo National Central General Hospital, Jakarta, Indonesia
| | - Muchtaruddin Mansyur
- Department of Community, Occupational and Family Medicine, Faculty of Medicine, University of Indonesia, Depok, Indonesia
| | - Triya Damayanti
- Department of Pulmonology and Respiratory Medicine, Faculty of Medicine, University of Indonesia, Jakarta, Indonesia
- Department of Pulmonology and Respiratory Medicine, National Respiratory Center Persahabatan Hospital, Jakarta, Indonesia
| | - Maryastuti Maryastuti
- Department of Radiology, National Respiratory Center Persahabatan Hospital, Jakarta, Indonesia
| | | | - Indah Puspita Dewi
- Department of Radiology, Faculty of Medicine and Health, University of Muhammadiyah Jakarta, Jakarta, Indonesia
- Department of Radiology, Jakarta Islamic Hospital Cempaka Putih, Jakarta, Indonesia
| | - Yetty Ramli
- Department of Neurology, Faculty of Medicine, University of Indonesia, Jakarta, Indonesia
- Department Neurology, Cipto Mangunkusumo National Central General Hospital, Jakarta, Indonesia
| | - Marcel Prasetyo
- Department of Radiology, Faculty of Medicine, University of Indonesia, Jakarta, Indonesia
- Department of Radiology, Cipto Mangunkusumo National Central General Hospital, Jakarta, Indonesia
| | - Cleopas Martin Rumende
- Department of Internal Medicine, Faculty of Medicine, University of Indonesia, Jakarta, Indonesia
- Department of Internal Medicine, Cipto Mangunkusumo National Central General Hospital, Jakarta, Indonesia
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Mian M, Tahiri J, Eldin R, Altabaa M, Sehar U, Reddy PH. Overlooked cases of mild cognitive impairment: Implications to early Alzheimer's disease. Ageing Res Rev 2024; 98:102335. [PMID: 38744405 PMCID: PMC11180381 DOI: 10.1016/j.arr.2024.102335] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2024] [Revised: 05/02/2024] [Accepted: 05/08/2024] [Indexed: 05/16/2024]
Abstract
Mild cognitive impairment (MCI) marks the initial phase of memory decline or other cognitive functions like language or spatial perception, while individuals typically retain the capacity to carry out everyday tasks independently. Our comprehensive article investigates the intricate landscape of cognitive disorders, focusing on MCI and Alzheimer's disease (AD) and Alzheimer's disease-related dementias (ADRD). The study aims to understand the signs of MCI, early Alzheimer's disease, and healthy brain aging while assessing factors influencing disease progression, pathology development and susceptibility. A systematic literature review of over 100 articles was conducted, emphasizing MCI, AD and ADRD within the elderly populations. The synthesis of results reveals significant findings regarding ethnicity, gender, lifestyle, comorbidities, and diagnostic tools. Ethnicity was found to influence MCI prevalence, with disparities observed across diverse populations. Gender differences were evident in cognitive performance and decline, highlighting the need for personalized management strategies. Lifestyle factors and comorbidities were identified as crucial influencers of cognitive health. Regarding diagnostic tools, the Montreal Cognitive Assessment (MoCA) emerged as superior to the Mini-Mental State Examination (MMSE) in early MCI detection. Overall, our article provides insights into the multifaceted nature of cognitive disorders, emphasizing the importance of tailored interventions and comprehensive assessment strategies for effective cognitive health management.
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Affiliation(s)
- Maamoon Mian
- Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, TX 79430, USA
| | - Jihane Tahiri
- School of Biology, Texas Tech University, Lubbock, TX 79430, USA
| | - Ryan Eldin
- Department of Biomedical Sciences, Texas A&M University College of Dentistry, Dallas, TX 75246, USA
| | - Mohamad Altabaa
- Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, TX 79430, USA
| | - Ujala Sehar
- Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, TX 79430, USA
| | - P Hemachandra Reddy
- Department of Internal Medicine, Texas Tech University Health Sciences Center, Lubbock, TX 79430, USA; Nutritional Sciences Department, College Human Sciences, Texas Tech University, Lubbock, TX 79409; Department of Pharmacology and Neuroscience, Texas Tech University Health Sciences Center, Lubbock, TX 79430, USA; Department of Neurology, Texas Tech University Health Sciences Center, Lubbock, TX 79430, USA; Department of Public Health, Graduate School of Biomedical Sciences, Texas Tech University Health Sciences Center, Lubbock, TX 79430, USA; Department of Speech, Language, and Hearing Sciences, Texas Tech University Health Sciences Center, Lubbock, TX 79430, USA.
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Gonzalez Casanova I, Alonso-Gómez ÁM, Romaguera D, Toledo E, Li L, Fortuny E, López L, Ramallal R, Salas-Salvadó J, Tojal-Sierra L, Castañer O, Alonso A. Lifestyles, Left Atrial Structure and Function, and Cognitive Decline in Adults with Metabolic Syndrome. J Clin Med 2023; 12:6066. [PMID: 37763005 PMCID: PMC10532379 DOI: 10.3390/jcm12186066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2023] [Revised: 09/11/2023] [Accepted: 09/13/2023] [Indexed: 09/29/2023] Open
Abstract
Evidence supports associations of lifestyle (including diet and physical activity) and weight with cognitive functioning, but the pathways responsible for these associations have not been fully elucidated. Because healthier lifestyles have been associated with better left atrial structure and function, which in turn is associated with better cognitive functioning, we tested the hypothesis that left atrial structure and function is a potential mediator of the association between lifestyle and cognition. We included 476 participants classed as overweight or obese with metabolic syndrome from three centers in Spain. These participants underwent lifestyle assessments and transthoracic echocardiography at baseline and repeated measurements of the Trail Making A test, a measure of executive function, taken at baseline and at the two-year follow-up. We conducted mediation analyses to test if measures of left atrial structure and function mediated associations between adherence to the Mediterranean diet scores, physical activity, and weight at baseline, as well as a two-year change in Trail Making A scores. The analysis did not find an association between these factors and Trail Making A scores, and no indirect effects appeared to be mediated by echocardiographic measurements. The modest sample size in this analysis is a limitation, and larger studies should be conducted to determine potential cardiovascular factors mediating the association between lifestyle and cognition.
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Affiliation(s)
- Ines Gonzalez Casanova
- Department of Applied Health Science, School of Public Health, Indiana University Bloomington, Bloomington, IN 47404, USA
| | - Ángel M. Alonso-Gómez
- Bioaraba Health Research Institute, Osakidetza Basque Health Service, Araba University Hospital, University of the Basque Country UPV/EHU, 01009 Vitoria-Gasteiz, Spain
- CIBER Consortium, M.P. Physiopathology of Obesity and Nutrition (CIBERObn), Carlos III Health Institute (ISCIII), 28029 Madrid, Spain (E.T.); (J.S.-S.)
| | - Dora Romaguera
- CIBER Consortium, M.P. Physiopathology of Obesity and Nutrition (CIBERObn), Carlos III Health Institute (ISCIII), 28029 Madrid, Spain (E.T.); (J.S.-S.)
- Health Research Institute of the Balearic Islands (IdISBa), 07120 Palma de Mallorca, Spain
| | - Estefanía Toledo
- CIBER Consortium, M.P. Physiopathology of Obesity and Nutrition (CIBERObn), Carlos III Health Institute (ISCIII), 28029 Madrid, Spain (E.T.); (J.S.-S.)
- Department of Preventive Medicine and Public Health, University of Navarra, 31008 Pamplona, Spain;
- IdiSNA, Navarra Institute for Health Research, 31008 Pamplona, Spain
| | - Linzi Li
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA 30322, USA (A.A.)
| | - Elena Fortuny
- Health Research Institute of the Balearic Islands (IdISBa), 07120 Palma de Mallorca, Spain
- Cardiology Service, Manacor Hospital, 07500 Palma de Mallorca, Spain
| | - Luis López
- Cardiology Service, Son Espases University Hospital, 07120 Palma de Mallorca, Spain;
| | - Raúl Ramallal
- Department of Preventive Medicine and Public Health, University of Navarra, 31008 Pamplona, Spain;
- IdiSNA, Navarra Institute for Health Research, 31008 Pamplona, Spain
- Department of Cardiology, University Hospital of Navarra, Servicio Navarro de Salud Osasunbidea, 31008 Pamplona, Spain
| | - Jordi Salas-Salvadó
- CIBER Consortium, M.P. Physiopathology of Obesity and Nutrition (CIBERObn), Carlos III Health Institute (ISCIII), 28029 Madrid, Spain (E.T.); (J.S.-S.)
- Group ANUT-DSM, Human Nutrition Unit, Department of Biochemistry and Biotechnology, Universitat Rovira i Virgili, 43201 Reus, Spain
- Human Nutrition Unit, Institut d’Investigació Sanitària Pere Virgili (IISPV), 43204 Reus, Spain
| | - Lucas Tojal-Sierra
- Bioaraba Health Research Institute, Osakidetza Basque Health Service, Araba University Hospital, University of the Basque Country UPV/EHU, 01009 Vitoria-Gasteiz, Spain
| | - Olga Castañer
- Cardiovascular Risk and Nutrition Research Group, Institut Hospital del Mar d’Investigacions Mèdiques (IMIM), 08003 Barcelona, Spain;
- CIBER Consortium, M.P. Epidemiology and Public Health (CIBEROESP), Carlos III Health Institute (ISCIII), 28029 Madrid, Spain
| | - Alvaro Alonso
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA 30322, USA (A.A.)
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Casanova IG, Alonso-Gómez ÁM, Romaguera D, Toledo E, Li L, Fortuny E, López L, Ramallal R, Salas-Salvadó J, Tojal-Sierra L, Castañer O, Alonso A. Lifestyles, left atrial structure and function, and cognitive decline in adults with the metabolic syndrome. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2023:2023.06.23.23291821. [PMID: 37425874 PMCID: PMC10327255 DOI: 10.1101/2023.06.23.23291821] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/11/2023]
Abstract
Evidence supports associations of lifestyle-including diet and physical activity-and weight with cognitive functioning, but the pathways responsible for these associations have not been fully elucidated. Because healthier lifestyles have been associated with better left atrial structure and function, which in turn is associated with better cognitive functioning, we tested the hypothesis that left atrial structure and function is a potential mediator of the association between lifestyles and cognition. We included 476 participants with overweight or obesity and metabolic syndrome from three centers in Spain who underwent lifestyle assessment and transthoracic echocardiography at baseline and had repeated measurements of the Trail Making A test, a measure of executive function, at baseline and at the two-year follow-up. We conducted mediation analyses to test if measures of left atrial structure and function mediated associations between adherence to the Mediterranean diet scores, physical activity, or weight at baseline, and two-year change in Trail Making A scores. The analysis did not find an effect between these factors and Trail Making A scores, and no indirect effects mediated through the echocardiographic measurements. The modest sample size in this analysis is a limitation, and larger studies should be conducted to determine potential cardiovascular factors mediating the association between lifestyle and cognition.
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Affiliation(s)
- Ines Gonzalez Casanova
- Department of Applied Health Science, Indiana University Bloomington School of Public Health, Bloomington, IN, USA
| | - Ángel M Alonso-Gómez
- Bioaraba Health Research Institute; Osakidetza Basque Health Service, Araba University Hospital; University of the Basque Country UPV/EHU; Vitoria-Gasteiz, Spain
- CIBER Consortium, M.P. Physiopathology of Obesity and Nutrition (CIBERObn), Carlos III Health Institute (ISCIII), Madrid, Spain
| | - Dora Romaguera
- CIBER Consortium, M.P. Physiopathology of Obesity and Nutrition (CIBERObn), Carlos III Health Institute (ISCIII), Madrid, Spain
- Health Research Institute of the Balearic Islands (IdISBa), Palma de Mallorca, Spain
| | - Estefanía Toledo
- CIBER Consortium, M.P. Physiopathology of Obesity and Nutrition (CIBERObn), Carlos III Health Institute (ISCIII), Madrid, Spain
- Department of Preventive Medicine and Public Health, University of Navarra, Pamplona, Spain
- IdiSNA, Navarra Institute for Health Research, Pamplona, Spain
| | - Linzi Li
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Elena Fortuny
- Health Research Institute of the Balearic Islands (IdISBa), Palma de Mallorca, Spain
- Cardiology Service, Manacor Hospital, Palma de Mallorca, Spain
| | - Luis López
- Cardiology Service, Son Espases University Hospital, Palma de Mallorca, Spain
| | - Raúl Ramallal
- IdiSNA, Navarra Institute for Health Research, Pamplona, Spain
- Department of Cardiology, University Hospital of Navarra, Servicio Navarro de Salud Osasunbidea, Pamplona, Spain
| | - Jordi Salas-Salvadó
- CIBER Consortium, M.P. Physiopathology of Obesity and Nutrition (CIBERObn), Carlos III Health Institute (ISCIII), Madrid, Spain
- Universitat Rovira i Virgili, Department of Biochemistry and Biotechnology, Human Nutrition Unit, Reus, Spain
- Institut d'Investigació Sanitària Pere Virgili (IISPV), Human Nutrition Unit, Reus, Spain
| | - Lucas Tojal-Sierra
- Bioaraba Health Research Institute; Osakidetza Basque Health Service, Araba University Hospital; University of the Basque Country UPV/EHU; Vitoria-Gasteiz, Spain
- CIBER Consortium, M.P. Physiopathology of Obesity and Nutrition (CIBERObn), Carlos III Health Institute (ISCIII), Madrid, Spain
| | - Olga Castañer
- CIBER Consortium, M.P. Physiopathology of Obesity and Nutrition (CIBERObn), Carlos III Health Institute (ISCIII), Madrid, Spain
- Cardiovascular risk and nutrition research group, Institut Hospital del Mar d'Investigacions Mèdiques (IMIM), Barcelona, Spain
| | - Alvaro Alonso
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
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Qin Y, Han H, Li Y, Cui J, Jia H, Ge X, Ma Y, Bai W, Zhang R, Chen D, Yi F, Yu H. Estimating Bidirectional Transitions and Identifying Predictors of Mild Cognitive Impairment. Neurology 2023; 100:e297-e307. [PMID: 36220593 PMCID: PMC9869761 DOI: 10.1212/wnl.0000000000201386] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Accepted: 08/26/2022] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND AND OBJECTIVES Various resources exist for treating mild cognitive impairment (MCI) or dementia separately as terminal events or for focusing solely on a 1-way path from MCI to dementia without taking into account heterogeneous transitions. Little is known about the trajectory of reversion from MCI to normal cognition (NC) or near-NC and patterns of postreversion, which refers to cognitive trajectories of patients who have reversed from MCI to NC. Our objectives were to (1) quantitatively predict bidirectional transitions of MCI (reversion and progression), (2) explore patterns of future cognitive trajectories for postreversion, and (3) estimate the effects of demographic characteristics, APOE, cognition, daily activity ability, depression, and neuropsychiatric symptoms on transition probabilities. METHODS We constructed a retrospective cohort by reviewing patients with an MCI diagnosis at study entry and at least 2 follow-up visits between June 2005 and February 2021. Defining NC or near-NC and MCI as transient states and dementia as an absorbing state, we used continuous-time multistate Markov models to estimate instantaneous transition intensity between states, transition probabilities from one state to another at any given time during follow-up, and hazard ratios of reversion-related variables. RESULTS Among 24,220 observations from 6,651 participants, there were 2,729 transitions to dementia and 1,785 reversions. As for postreversion, there were 630 and 73 transitions of progression to MCI and dementia, respectively. The transition intensity of progression to MCI for postreversion was 0.317 (2.48-fold greater than that for MCI progression or reversion). For postreversion participants, the probability of progressing to dementia increased by 2% yearly. Participants who progressed to MCI were likely to reverse again (probability of 40% over 15 years). Age, independence level, APOE, cognition, daily activity ability, depression, and neuropsychiatric symptoms were significant predictors of bidirectional transitions. DISCUSSION The nature of bidirectional transitions cannot be ignored in multidimensional MCI research. We found that postreversion participants remained at an increased risk of progression to MCI or dementia over the longer term and experienced recurrent reversions. Our findings may serve as a valuable reference for future research and enable health care professionals to better develop proactive management plans and targeted interventions.
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Affiliation(s)
- Yao Qin
- From the Department of Health Statistics (Y.Q., H.H., J.C., X.G., Y.M., W.B., R.Z., D.C., F.Y., H.Y.), School of Public Health, Shanxi Medical University, Taiyuan; Department of Medical Device Ethics (Y.L.), Shanxi Province Cancer Hospital, Taiyuan; Department of Neurology (H.J.), First Hospital of Shanxi Medical University, Taiyuan; and Shanxi Provincial Key Laboratory of Major Diseases Risk Assessment (H.Y.), Taiyuan, China
| | - Hongjuan Han
- From the Department of Health Statistics (Y.Q., H.H., J.C., X.G., Y.M., W.B., R.Z., D.C., F.Y., H.Y.), School of Public Health, Shanxi Medical University, Taiyuan; Department of Medical Device Ethics (Y.L.), Shanxi Province Cancer Hospital, Taiyuan; Department of Neurology (H.J.), First Hospital of Shanxi Medical University, Taiyuan; and Shanxi Provincial Key Laboratory of Major Diseases Risk Assessment (H.Y.), Taiyuan, China
| | - Yang Li
- From the Department of Health Statistics (Y.Q., H.H., J.C., X.G., Y.M., W.B., R.Z., D.C., F.Y., H.Y.), School of Public Health, Shanxi Medical University, Taiyuan; Department of Medical Device Ethics (Y.L.), Shanxi Province Cancer Hospital, Taiyuan; Department of Neurology (H.J.), First Hospital of Shanxi Medical University, Taiyuan; and Shanxi Provincial Key Laboratory of Major Diseases Risk Assessment (H.Y.), Taiyuan, China
| | - Jing Cui
- From the Department of Health Statistics (Y.Q., H.H., J.C., X.G., Y.M., W.B., R.Z., D.C., F.Y., H.Y.), School of Public Health, Shanxi Medical University, Taiyuan; Department of Medical Device Ethics (Y.L.), Shanxi Province Cancer Hospital, Taiyuan; Department of Neurology (H.J.), First Hospital of Shanxi Medical University, Taiyuan; and Shanxi Provincial Key Laboratory of Major Diseases Risk Assessment (H.Y.), Taiyuan, China
| | - Haixia Jia
- From the Department of Health Statistics (Y.Q., H.H., J.C., X.G., Y.M., W.B., R.Z., D.C., F.Y., H.Y.), School of Public Health, Shanxi Medical University, Taiyuan; Department of Medical Device Ethics (Y.L.), Shanxi Province Cancer Hospital, Taiyuan; Department of Neurology (H.J.), First Hospital of Shanxi Medical University, Taiyuan; and Shanxi Provincial Key Laboratory of Major Diseases Risk Assessment (H.Y.), Taiyuan, China
| | - Xiaoyan Ge
- From the Department of Health Statistics (Y.Q., H.H., J.C., X.G., Y.M., W.B., R.Z., D.C., F.Y., H.Y.), School of Public Health, Shanxi Medical University, Taiyuan; Department of Medical Device Ethics (Y.L.), Shanxi Province Cancer Hospital, Taiyuan; Department of Neurology (H.J.), First Hospital of Shanxi Medical University, Taiyuan; and Shanxi Provincial Key Laboratory of Major Diseases Risk Assessment (H.Y.), Taiyuan, China
| | - Yifei Ma
- From the Department of Health Statistics (Y.Q., H.H., J.C., X.G., Y.M., W.B., R.Z., D.C., F.Y., H.Y.), School of Public Health, Shanxi Medical University, Taiyuan; Department of Medical Device Ethics (Y.L.), Shanxi Province Cancer Hospital, Taiyuan; Department of Neurology (H.J.), First Hospital of Shanxi Medical University, Taiyuan; and Shanxi Provincial Key Laboratory of Major Diseases Risk Assessment (H.Y.), Taiyuan, China
| | - Wenlin Bai
- From the Department of Health Statistics (Y.Q., H.H., J.C., X.G., Y.M., W.B., R.Z., D.C., F.Y., H.Y.), School of Public Health, Shanxi Medical University, Taiyuan; Department of Medical Device Ethics (Y.L.), Shanxi Province Cancer Hospital, Taiyuan; Department of Neurology (H.J.), First Hospital of Shanxi Medical University, Taiyuan; and Shanxi Provincial Key Laboratory of Major Diseases Risk Assessment (H.Y.), Taiyuan, China
| | - Rong Zhang
- From the Department of Health Statistics (Y.Q., H.H., J.C., X.G., Y.M., W.B., R.Z., D.C., F.Y., H.Y.), School of Public Health, Shanxi Medical University, Taiyuan; Department of Medical Device Ethics (Y.L.), Shanxi Province Cancer Hospital, Taiyuan; Department of Neurology (H.J.), First Hospital of Shanxi Medical University, Taiyuan; and Shanxi Provincial Key Laboratory of Major Diseases Risk Assessment (H.Y.), Taiyuan, China
| | - Durong Chen
- From the Department of Health Statistics (Y.Q., H.H., J.C., X.G., Y.M., W.B., R.Z., D.C., F.Y., H.Y.), School of Public Health, Shanxi Medical University, Taiyuan; Department of Medical Device Ethics (Y.L.), Shanxi Province Cancer Hospital, Taiyuan; Department of Neurology (H.J.), First Hospital of Shanxi Medical University, Taiyuan; and Shanxi Provincial Key Laboratory of Major Diseases Risk Assessment (H.Y.), Taiyuan, China
| | - Fuliang Yi
- From the Department of Health Statistics (Y.Q., H.H., J.C., X.G., Y.M., W.B., R.Z., D.C., F.Y., H.Y.), School of Public Health, Shanxi Medical University, Taiyuan; Department of Medical Device Ethics (Y.L.), Shanxi Province Cancer Hospital, Taiyuan; Department of Neurology (H.J.), First Hospital of Shanxi Medical University, Taiyuan; and Shanxi Provincial Key Laboratory of Major Diseases Risk Assessment (H.Y.), Taiyuan, China
| | - Hongmei Yu
- From the Department of Health Statistics (Y.Q., H.H., J.C., X.G., Y.M., W.B., R.Z., D.C., F.Y., H.Y.), School of Public Health, Shanxi Medical University, Taiyuan; Department of Medical Device Ethics (Y.L.), Shanxi Province Cancer Hospital, Taiyuan; Department of Neurology (H.J.), First Hospital of Shanxi Medical University, Taiyuan; and Shanxi Provincial Key Laboratory of Major Diseases Risk Assessment (H.Y.), Taiyuan, China.
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Zhang P, Wang T, Zhu X, Feng L, Wang J, Li Y, Zhang X, Cui T, Li M. Jiedu Yizhi Formula Improves Cognitive Function by Regulating the Gut Dysbiosis and TLR4/NF-κB Signaling Pathway. Neuropsychiatr Dis Treat 2023; 19:49-62. [PMID: 36627886 PMCID: PMC9826640 DOI: 10.2147/ndt.s393773] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Accepted: 12/07/2022] [Indexed: 01/12/2023] Open
Abstract
OBJECTIVE The objective of this study was to explore the neuroprotective mechanism of JDYZF in treating AD from the perspective of inflammation and intestinal microflora. METHODS A total of 24 APP/PS1 mice were randomly divided into four groups: model (n = 6), JDYZF low-dose (n = 6), JDYZF high-dose (n = 6), and positive drug (n = 6), six C57 mice were used as the control group. The body weights and diets of all mice were examined daily. After 8 weeks of administration, the learning and memory of mice were evaluated by the Morris water maze test. The histopathological changes of hippocampus, liver and kidney in mice were observed by HE staining after being euthanized. The expression of p-tau in hippocampus tissue was detected by immunohistochemistry. After that, 16S rDNA sequencing was used to investigate the relationship between JDYZF and intestinal microbiota. Finally, a comparison of TLR4, p65, p-p65, iκB, p-iκB, and IL-1β protein expression in the hippocampus tissue of mice in each group was measured by Western blot. RESULTS The results showed that APP/PS1 mice taking JDYZF orally were generally in good condition. Compared with the control group, JDYZF significantly improved learning and memory ability in ethology. Histology showed that JDYZF improved the hippocampal structure of mice and inhibited the deposition of p-tau. JDYZF treatment could regulate the gut microbiota of APP/PS1 mice by increasing the richness of Lachnospiraceae, Ruminococcaceae, and Actinobacteria and reducing that of Alistipes and Muribaculaceae. It also significantly inhibited the activation of the TLR4/NF-κB signaling pathway in the brain. In addition, no obvious toxic reactions were found in the liver and kidney of APP/PS1 mice after taking JDYZF for 8 weeks. CONCLUSION The findings revealed that JDYZF improved cognitive ability and alleviated the TLR4/NF-κB signaling pathway in APP/PS1 mice, and the modulating the gut microbiota presented here may help illuminate its activation mechanism.
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Affiliation(s)
- Pengqi Zhang
- College of Traditional Chinese Medicine, Changchun University of Chinese Medicine, Changchun, Jilin Province, People’s Republic of China
| | - Tianye Wang
- College of Traditional Chinese Medicine, Changchun University of Chinese Medicine, Changchun, Jilin Province, People’s Republic of China
| | - Xiaoting Zhu
- Neurology Department, Third Affiliated Clinical Hospital of Changchun University of Traditional Chinese Medicine, Changchun, Jilin Province, People’s Republic of China
| | - Lina Feng
- College of Traditional Chinese Medicine, Changchun University of Chinese Medicine, Changchun, Jilin Province, People’s Republic of China
| | - Jiale Wang
- College of Traditional Chinese Medicine, Changchun University of Chinese Medicine, Changchun, Jilin Province, People’s Republic of China
| | - Yunqiang Li
- College of Traditional Chinese Medicine, Changchun University of Chinese Medicine, Changchun, Jilin Province, People’s Republic of China
| | - Xinyue Zhang
- College of Traditional Chinese Medicine, Changchun University of Chinese Medicine, Changchun, Jilin Province, People’s Republic of China
| | - Tingting Cui
- College of Traditional Chinese Medicine, Changchun University of Chinese Medicine, Changchun, Jilin Province, People’s Republic of China
| | - Mingquan Li
- Neurology Department, Third Affiliated Clinical Hospital of Changchun University of Traditional Chinese Medicine, Changchun, Jilin Province, People’s Republic of China
- Correspondence: Mingquan Li, Neurology Department, Third Affiliated Clinical Hospital of Changchun University of Traditional Chinese Medicine, Changchun, 130033, People’s Republic of China, Tel +86-15543120222, Email
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Zhong X, Yu J, Jiang F, Chen H, Wang Z, Teng J, Jiao H. A risk prediction model based on machine learning for early cognitive impairment in hypertension: Development and validation study. Front Public Health 2023; 11:1143019. [PMID: 36969637 PMCID: PMC10034177 DOI: 10.3389/fpubh.2023.1143019] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Accepted: 02/13/2023] [Indexed: 03/29/2023] Open
Abstract
Background Clinical practice guidelines recommend early identification of cognitive impairment in individuals with hypertension with the help of risk prediction tools based on risk factors. Objective The aim of this study was to develop a superior machine learning model based on easily collected variables to predict the risk of early cognitive impairment in hypertensive individuals, which could be used to optimize early cognitive impairment risk assessment strategies. Methods For this cross-sectional study, 733 patients with hypertension (aged 30-85, 48.98% male) enrolled in multi-center hospitals in China were divided into a training group (70%) and a validation group (30%). After least absolute shrinkage and selection operator (LASSO) regression analysis with 5-fold cross-validation determined the modeling variables, three machine learning classifiers, logistic regression (LR), XGBoost (XGB), and gaussian naive bayes (GNB), were developed. The area under the ROC curve (AUC), accuracy, sensitivity, specificity, and F1 score were used to evaluate the model performance. Shape Additive explanation (SHAP) analysis was performed to rank feature importance. Further decision curve analysis (DCA) assessed the clinical performance of the established model and visualized it by nomogram. Results Hip circumference, age, education levels, and physical activity were considered significant predictors of early cognitive impairment in hypertension. The AUC (0.88), F1 score (0.59), accuracy (0.81), sensitivity (0.84), and specificity (0.80) of the XGB model were superior to LR and GNB classifiers. Conclusion The XGB model based on hip circumference, age, educational level, and physical activity has superior predictive performance and it shows promise in predicting the risk of cognitive impairment in hypertensive clinical settings.
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Affiliation(s)
- Xia Zhong
- Department of First Clinical Medical College, Shandong University of Traditional Chinese Medicine, Jinan, Shandong, China
| | - Jie Yu
- Shandong University of Traditional Chinese Medicine, Jinan, Shandong, China
| | - Feng Jiang
- Department of Cardiology, Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan, Shandong, China
| | - Haoyu Chen
- Department of Cardiology, Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan, Shandong, China
| | - Zhenyuan Wang
- Department of Cardiology, Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan, Shandong, China
| | - Jing Teng
- Department of First Clinical Medical College, Shandong University of Traditional Chinese Medicine, Jinan, Shandong, China
| | - Huachen Jiao
- Department of Cardiology, Affiliated Hospital of Shandong University of Traditional Chinese Medicine, Jinan, Shandong, China
- *Correspondence: Huachen Jiao
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Body mass index, genetic susceptibility, and Alzheimer's disease: a longitudinal study based on 475,813 participants from the UK Biobank. J Transl Med 2022; 20:417. [PMID: 36085169 PMCID: PMC9463868 DOI: 10.1186/s12967-022-03621-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2022] [Accepted: 09/01/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The association between body mass index (BMI) and Alzheimer's disease (AD) remains controversial. Genetic and environmental factors are now considered contributors to AD risk. However, little is known about the potential interaction between genetic risk and BMI on AD risk. OBJECTIVE To study the causal relationship between BMI and AD, and the potential interaction between AD genetic risk and BMI on AD risk. METHODS AND RESULTS Using the UK Biobank database, 475,813 participants were selected for an average follow-up time of more than 10 years. MAIN FINDINGS 1) there was a nonlinear relationship between BMI and AD risk in participants aged 60 years or older (p for non-linear < 0.001), but not in participants aged 37-59 years (p for non-linear = 0.717) using restricted cubic splines; 2) for participants aged 60 years and older, compared with the BMI (23-30 kg/m2) group, the BMI (< 23 kg/m2) group was associated with a higher AD risk (HR = 1.585; 95% CI 1.304-1.928, p < 0.001) and the BMI (> 30 kg/m2) group was associated with a lower AD risk (HR = 0.741; 95% CI 0.618-0.888, p < 0.01) analyzed using the Cox proportional risk model; 3) participants with a combination of high AD genetic risk score (AD-GRS) and BMI (< 23 kg/m2) were associated with the highest AD risk (HR = 3.034; 95% CI 2.057-4.477, p < 0.001). In addition, compared with the BMI (< 23 kg/m2), the higher BMI was associated with a lower risk of AD in participants with the same intermediate or high AD-GRS; 4) there was a reverse causality between BMI and AD when analyzed using bidirectional Mendelian randomization (MR). CONCLUSION There was a reverse causality between BMI and AD analyzed using MR. For participants aged 60 years and older, the higher BMI was associated with a lower risk of AD in participants with the same intermediate or high AD genetic risk. BMI (23-30 kg/m2) may be a potential intervention for AD.
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Tsujimoto M, Suzuki K, Saji N, Sakurai T, Ito K, Toba K. Organized Registration for the Assessment of Dementia by the Nationwide General Consortium Toward Effective Treatment (ORANGE) Registry: Current Status and Perspectives of Mild Cognitive Impairment. J Alzheimers Dis 2022; 88:1423-1433. [DOI: 10.3233/jad-220039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background: With increasingly aging societies, a comprehensive strategy for dementia research is important. The Organized Registration for the Assessment of dementia by the Nationwide General consortium toward Effective treatment (ORANGE) Registry is the first longitudinal multicenter prospective trial-ready cohort in Japan. Objective: To establish a large cohort for use in clinical trials and research in Japan. Methods: This registry, based on communities, hospitals, and nursing homes, covers three dementia stages (preclinical, mild cognitive impairment [MCI], and advanced dementia), and includes more than 30 hospitals. We analyzed enrollment and 1-year follow-up data for disease progression. Results: There were 1450 registered patients (649 men, 801 women; mean age, 77.92±6.70 years; mean Mini-Mental State Examination [MMSE] score, 25.19±2.76). The conversion rates from MCI to dementia and MCI to normal were 14.3% and 1.1%, respectively. High Clinical Dementia Rating score (odds ratio [OR] = 11.085, 95% confidence interval [CI]:1.619–75.913, p = 0.014), low MMSE score (OR = 0.835, 95% CI: 0.761–0.917, p < 0.001), high Geriatric Depression Scale score (OR = 1.093, 95% CI: 1.005–1.189, p = 0.038), and low body mass index (OR = 0.895, 95% CI: 0.829–0.967, p = 0.005) at enrollment were significant factors for conversion. Conclusion: The ORANGE MCI Registry is an established registry that facilitates creation of trial-ready cohorts to accelerate promotion of clinical trials with low reversion rates as it originates from a hospital. One-year follow-up analysis suggested assessing various factors for conversion risk. Further analyses will be possible in future with registry expansion. We will continue to refine this registry, including how it can be used more efficiently.
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Affiliation(s)
- Masashi Tsujimoto
- Innovation Center for Translational Research, National Center for Geriatrics and Gerontology, Obu, Aichi, Japan
| | - Keisuke Suzuki
- Innovation Center for Translational Research, National Center for Geriatrics and Gerontology, Obu, Aichi, Japan
| | - Naoki Saji
- Innovation Center for Translational Research, National Center for Geriatrics and Gerontology, Obu, Aichi, Japan
| | - Takashi Sakurai
- Innovation Center for Translational Research, National Center for Geriatrics and Gerontology, Obu, Aichi, Japan
| | - Kengo Ito
- Innovation Center for Translational Research, National Center for Geriatrics and Gerontology, Obu, Aichi, Japan
- Centre for Comprehensive Care and Research on Memory Disorders, National Center for Geriatrics and Gerontology, Obu, Aichi, Japan
| | - Kenji Toba
- Centre for Comprehensive Care and Research on Memory Disorders, National Center for Geriatrics and Gerontology, Obu, Aichi, Japan
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