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Li QY, Fu Y, Cui XJ, Wang ZT, Tan L. Association of modified dementia risk score with cerebrospinal fluid biomarkers and cognition in adults without dementia. Front Aging Neurosci 2024; 16:1339163. [PMID: 39081396 PMCID: PMC11286572 DOI: 10.3389/fnagi.2024.1339163] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2023] [Accepted: 07/01/2024] [Indexed: 08/02/2024] Open
Abstract
Introduction This study aimed to investigate the cognitive profile and prospective cognitive changes in non-demented adults with elevated Modified Dementia Risk Scores (MDRS), while also exploring the potential relationship between these associations and cerebrospinal fluid (CSF) biomarkers of Alzheimer's disease (AD) pathology and neuroinflammation. Methods Within the Chinese Alzheimer's Biomarker and LifestylE (CABLE) database, 994 participants without dementia were assessed on MDRS, CSF biomarkers and cognition. We examined the associations of the MDRS with CSF biomarkers and cognitive scores using linear regressions. Causal mediation analyses were conducted to analyze the associations among MDRS, brain pathologies, and cognition. The Alzheimer's Disease Neuroimaging Initiative (ADNI) study was used to validate the mediation effects and to investigate the longitudinal association between MDRS and cognitive decline. Results The results revealed that higher MDRS were linked to poorer cognitive performance (Model 1: PFDR < 0.001; Model 2: PFDR < 0.001) and increases in CSF levels of phosphorylated tau (P-tau, Model 1: PFDR < 0.001; Model 2: PFDR < 0.001), total tau (T-tau, Model 1: PFDR < 0.001; Model 2: PFDR < 0.001), P-tau/Aβ42 ratio (Model 1: PFDR = 0.023; Model 2: PFDR = 0.028), T-tau/Aβ42 ratio (Model 1: PFDR < 0.001; Model 2: PFDR < 0.001) and soluble triggering receptor expressed on myeloid cells 2 (sTrem2, Model 1: PFDR < 0.001; Model 2: PFDR < 0.001) in the CABLE study. The impact of MDRS on cognition was partially mediated by neuroinflammation and tau pathology. These mediation effects were replicated in the ADNI study. Baseline MDRS were significantly associated with future cognitive decline, as indicated by lower scores on the Mini-Mental State Examination (MMSE, Model 1: PFDR = 0.045; Model 2: PFDR < 0.001), ADNI composite memory score (ADNI-MEM, Model 1: PFDR = 0.005; Model 2: PFDR < 0.001), ADNI composite executive function score (ADNI-EF, Model 1: PFDR = 0.045; Model 2: PFDR < 0.001), and higher score on the Alzheimer's Disease Assessment Scale (ADAS13, Model 1: PFDR = 0.045; Model 2: PFDR < 0.001). Discussion The findings of this study revealed significant associations between MDRS and cognitive decline, suggesting a potential role of tau pathology and neuroinflammation in the link between MDRS and poorer cognitive performance in individuals without dementia. Consequently, the MDRS holds promise as a tool for targeted preventive interventions in individuals at high risk of cognitive impairment.
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Affiliation(s)
- Qiong-Yao Li
- Department of Neurology, Qingdao Municipal Hospital, Qingdao University, Qingdao, China
| | - Yan Fu
- Department of Neurology, Qingdao Municipal Hospital, Qingdao University, Qingdao, China
| | - Xin-Jing Cui
- Department of Outpatient, Qingdao Municipal Hospital, Qingdao, China
| | - Zuo-Teng Wang
- Department of Neurology, Qingdao Municipal Hospital, Qingdao University, Qingdao, China
- Department of Neurology, Qingdao Hospital, University of Health and Rehabilitation Sciences (Qingdao Municipal Hospital), Qingdao, China
| | - Lan Tan
- Department of Neurology, Qingdao Municipal Hospital, Qingdao University, Qingdao, China
- Department of Neurology, Qingdao Hospital, University of Health and Rehabilitation Sciences (Qingdao Municipal Hospital), Qingdao, China
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Pilgrim MJD, Beam CR, Nygaard M, Finkel D. Prospective Effects of Self-Rated Health on Dementia Risk in Two Twin Studies of Aging. Behav Genet 2024; 54:307-320. [PMID: 38822218 PMCID: PMC11196327 DOI: 10.1007/s10519-024-10182-1] [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: 05/16/2023] [Accepted: 04/13/2024] [Indexed: 06/02/2024]
Abstract
Subjective health ratings are associated with dementia risk such that those who rate their health more poorly have increased risk for dementia. The genetic and environmental mechanisms underlying this association are unclear, as prior research cannot rule out whether the association is due to genetic confounds. The current study addresses this gap in two samples of twins, one from Sweden (N = 548) and one from Denmark (N = 4,373). Using genetically-informed, bivariate regression models, we assessed whether additive genetic effects explained the association between subjective health and dementia risk as indexed by a latent variable proxy measure. Age at intake, sex, education, depressive symptomatology, and follow-up time between subjective health and dementia risk assessments were included as covariates. Results indicate that genetic variance and other sources of confounding accounted for the majority of the effect of subjective health ratings on dementia risk. After adjusting for genetic confounding and other covariates, a small correlation was observed between subjective health and latent dementia risk in the Danish sample (rE = - .09, p < .05). The results provide further support for the genetic association between subjective health and dementia risk, and also suggest that subjective ratings of health measures may be useful for predicting dementia risk.
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Affiliation(s)
- Matthew J D Pilgrim
- Department of Psychology, University of Southern California, Los Angeles, USA.
| | - Christopher R Beam
- Department of Psychology, University of Southern California, Los Angeles, USA
- Davis School of Gerontology, Universitty of Southern California, Los Angeles, USA
| | - Marianne Nygaard
- The Danish Twin Registry, Department of Public Health, University of Southern Denmark, Odense, Denmark
| | - Deborah Finkel
- Center for Economic and Social Research, University of Southern California, Los Angeles, USA
- Institute for Gerontology, School of Health and Welfare, Jönköping University, Jönköping, Sweden
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Li S, He X, Wu L, Tang X, Ouyang Y, Jing W, Yang Y, Yang J, Che K, Pan C, Chen X, Zhang X, Zheng X, Xu J, Liao S, Yin M, Ni J. The association of cognitive function and its changes with all-cause mortality among community-dwelling older adults. Front Aging Neurosci 2024; 16:1419235. [PMID: 38934019 PMCID: PMC11199401 DOI: 10.3389/fnagi.2024.1419235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2024] [Accepted: 05/30/2024] [Indexed: 06/28/2024] Open
Abstract
Background The association of cognitive function, its changes, and all-cause mortality has not reached a consensus, and the independence of the association between changes in cognitive function and mortality remains unclear. The purpose of this study was to evaluate the longitudinal association between baseline cognitive function and cognitive changes over 1 year with subsequent all-cause mortality among the older adults aged 60 and above. Methods A prospective cohort study utilizing the Community Older Adults Health Survey data. Initiated in 2018, the study annually assessed all individuals aged 60+ in Dalang Town, Dongguan City. Cognitive function was assessed using the Chinese version of the Mini-Mental State Examination (MMSE). A total of 6,042 older adults individuals were included, and multivariate Cox proportional hazard models were used to examine cognitive function's impact on mortality. Results Participants' median age was 70 years, with 39% men. Over a median 3.08-year follow-up, 525 died. Mortality risk increased by 6% per MMSE score decrease (adjusted HR = 1.06, 95%CI: 1.05-1.08). Compared to those with normal cognitive function at baseline, participants with mild cognitive impairment and moderate to severe cognitive impairment had significantly higher mortality risks (adjusted HR = 1.40, 95%CI: 1.07-1.82; HR = 2.49, 95%CI: 1.91-3.24, respectively). The risk of death was 5% higher for each one-point per year decrease in cognitive function change rate (HR = 1.05, 95%CI: 1.02-1.08). Compared with participants with stable cognitive function, those with rapid cognitive decline had a 79% increased risk of death (adjusted HR = 1.79, 95% CI: 1.11-2.87), with baseline cognitive function influencing this relationship significantly (P for interaction = 0.002). Conclusion Baseline cognitive impairment and rapid cognitive decline are associated with higher all-cause mortality risks in Chinese older adults. Baseline function influences the mortality impact of cognitive changes.
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Affiliation(s)
- Shangjie Li
- Shunde Women and Children’s Hospital, Maternal and Child Research Institute, Guangdong Medical University, Foshan, China
- Precision Key Laboratory of Public Health, School of Public Health, Guangdong Medical University, Dongguan, China
| | - Xiuping He
- Shunde Women and Children’s Hospital, Maternal and Child Research Institute, Guangdong Medical University, Foshan, China
- Precision Key Laboratory of Public Health, School of Public Health, Guangdong Medical University, Dongguan, China
| | - Liang Wu
- Shunde Women and Children’s Hospital, Maternal and Child Research Institute, Guangdong Medical University, Foshan, China
- Precision Key Laboratory of Public Health, School of Public Health, Guangdong Medical University, Dongguan, China
| | - Xinming Tang
- Shunde Women and Children’s Hospital, Maternal and Child Research Institute, Guangdong Medical University, Foshan, China
- Precision Key Laboratory of Public Health, School of Public Health, Guangdong Medical University, Dongguan, China
| | - Yijiang Ouyang
- Shunde Women and Children’s Hospital, Maternal and Child Research Institute, Guangdong Medical University, Foshan, China
- Precision Key Laboratory of Public Health, School of Public Health, Guangdong Medical University, Dongguan, China
| | - Wenyuan Jing
- Shunde Women and Children’s Hospital, Maternal and Child Research Institute, Guangdong Medical University, Foshan, China
- Precision Key Laboratory of Public Health, School of Public Health, Guangdong Medical University, Dongguan, China
| | - Ya Yang
- Shunde Women and Children’s Hospital, Maternal and Child Research Institute, Guangdong Medical University, Foshan, China
- Precision Key Laboratory of Public Health, School of Public Health, Guangdong Medical University, Dongguan, China
| | - Jiacheng Yang
- Shunde Women and Children’s Hospital, Maternal and Child Research Institute, Guangdong Medical University, Foshan, China
- Precision Key Laboratory of Public Health, School of Public Health, Guangdong Medical University, Dongguan, China
| | - Kechun Che
- Shunde Women and Children’s Hospital, Maternal and Child Research Institute, Guangdong Medical University, Foshan, China
- Precision Key Laboratory of Public Health, School of Public Health, Guangdong Medical University, Dongguan, China
| | - Congcong Pan
- Precision Key Laboratory of Public Health, School of Public Health, Guangdong Medical University, Dongguan, China
| | - Xiaoting Chen
- Community Health Center of Dongguan Songshan Lake (Public Health Office), Dongguan, China
| | - Xiaoxia Zhang
- Shunde Women and Children’s Hospital, Maternal and Child Research Institute, Guangdong Medical University, Foshan, China
- Precision Key Laboratory of Public Health, School of Public Health, Guangdong Medical University, Dongguan, China
| | - Xueting Zheng
- Shunde Women and Children’s Hospital, Maternal and Child Research Institute, Guangdong Medical University, Foshan, China
- Precision Key Laboratory of Public Health, School of Public Health, Guangdong Medical University, Dongguan, China
| | - Jiahao Xu
- Shunde Women and Children’s Hospital, Maternal and Child Research Institute, Guangdong Medical University, Foshan, China
- Precision Key Laboratory of Public Health, School of Public Health, Guangdong Medical University, Dongguan, China
| | - Shaobin Liao
- Shunde Women and Children’s Hospital, Maternal and Child Research Institute, Guangdong Medical University, Foshan, China
- Precision Key Laboratory of Public Health, School of Public Health, Guangdong Medical University, Dongguan, China
| | - Mingjuan Yin
- Shunde Women and Children’s Hospital, Maternal and Child Research Institute, Guangdong Medical University, Foshan, China
- Precision Key Laboratory of Public Health, School of Public Health, Guangdong Medical University, Dongguan, China
| | - Jindong Ni
- Shunde Women and Children’s Hospital, Maternal and Child Research Institute, Guangdong Medical University, Foshan, China
- Precision Key Laboratory of Public Health, School of Public Health, Guangdong Medical University, Dongguan, China
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Xu C, Wu W, Fan Y, Zhu S. Independent causal effect of migraines on Alzheimer's disease risk: a multivariate Mendelian randomization study. Front Neurol 2024; 15:1401880. [PMID: 38903170 PMCID: PMC11188460 DOI: 10.3389/fneur.2024.1401880] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2024] [Accepted: 05/23/2024] [Indexed: 06/22/2024] Open
Abstract
Background The observational studies investigated the impact of migraine on Alzheimer's Disease (AD). However, these findings were limited by confounding factors and reverse causation, leading to contradictory results. Methods We utilized Univariable Mendelian Randomization (UVMR) to explore the link between migraine (13,971 cases/470,627 controls) and AD risk (Bellenguez et al., 39,106 cases/46,828 controls; FinnGen, 111,471 cases/111,471 controls). Meta-analysis was performed for comprehensive synthesis. Employing Multivariable Mendelian Randomization (MVMR), we created models incorporating migraine and 35 potential AD risk factors, examining migraine's independent impact on AD onset risk under considering these factors. Results The meta-analysis of inverse variance weighted MR results, combining data from Bellenguez et al. (odds ratio (OR) [95% confidence interval (CI)]: 1.5717 [1.1868-2.0814], p = 0.0016) and FinnGen (OR [95% CI]: 1.2904 [0.5419-3.0730], p = 0.5646), provided evidence for a causal relationship between genetically predicted migraine and the heightened risk of AD occurrence (OR [95% CI]: 1.54 [1.18, 2.00], p < 0.01). After adjusting for Diastolic blood pressure (OR [95% CI]: 1.4120 [0.8487-2.3493], p = 0.1840) and Tumor necrosis factor alpha (OR [95% CI]: 1.2411 [0.8352-1.8443], p = 0.2852), no discernible association was detected between migraine and the risk of AD. Conclusion This study offers compelling evidence indicating a significant correlation between genetically predicted migraine and an elevated risk of AD.
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Affiliation(s)
- Chengfeng Xu
- Department of Anesthesiology, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital and Institute, Sichuan Cancer Center, Affiliated Cancer Hospital of University of Electronic Science and Technology of China, Chengdu, China
| | - Wen Wu
- Department of Anesthesiology, Xichang People's Hospital, Xichang, Sichuan, China
| | - Yuchao Fan
- Department of Anesthesiology, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital and Institute, Sichuan Cancer Center, Affiliated Cancer Hospital of University of Electronic Science and Technology of China, Chengdu, China
| | - Shuying Zhu
- Department of Anesthesiology, Sichuan Clinical Research Center for Cancer, Sichuan Cancer Hospital and Institute, Sichuan Cancer Center, Affiliated Cancer Hospital of University of Electronic Science and Technology of China, Chengdu, China
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Li Y, Xin J, Fang S, Wang F, Jin Y, Wang L. Development and Validation of a Predictive Model for Early Identification of Cognitive Impairment Risk in Community-Based Hypertensive Patients. J Appl Gerontol 2024:7334648241257795. [PMID: 38832577 DOI: 10.1177/07334648241257795] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/05/2024] Open
Abstract
Objective: To investigate the risk factors for the development of mild cognitive dysfunction in hypertensive patients in the community and to develop a risk prediction model. Method: The data used in this study were obtained from two sources: the China Health and Retirement Longitudinal Study (CHARLS) and the Chinese Longitudinal Healthy Longevity Survey (CLHLS). A total of 1121 participants from CHARLS were randomly allocated into a training set and a validation set, following a 70:30 ratio. Meanwhile, an additional 4016 participants from CLHLS were employed for external validation of the model. The patients in this study were divided into two groups: those with mild cognitive impairment and those without. General information, employment status, pension, health insurance, and presence of depressive symptoms were compared between the two groups. LASSO regression analysis was employed to identify the most predictive variables for the model, utilizing 14-fold cross-validation. The risk prediction model for cognitive impairment in hypertensive populations was developed using generalized linear models. The model's discriminatory power was evaluated through the area under the receiver operating characteristic (ROC) curve and calibration curves. Results: In the modeling group, eight variables such as gender, age, residence, education, alcohol use, depression, employment status, and health insurance were ultimately selected from an initial pool of 21 potential predictors to construct the risk prediction model. The area under the curve (AUC) values for the training, internal, and external validation sets were 0.777, 0.785, and 0.782, respectively. All exceeded the threshold of 0.7, suggesting that the model effectively predicts the incidence of mild cognitive dysfunction in community-based hypertensive patients. A risk prediction model was developed using a generalized linear model in conjunction with Lasso regression. The model's performance was evaluated using the area under the receiver operating characteristic (ROC) curve. Hosmer-Lemeshow test values yielded p = .346 and p = .626, both of which exceeded the 0.05 threshold. Calibration curves demonstrated a significant agreement between the nomogram model and observed outcomes, serving as an effective tool for evaluating the model's predictive performance. Discussion: The predictive model developed in this study serves as a promising and efficient tool for evaluating cognitive impairment in hypertensive patients, aiding community healthcare workers in identifying at-risk populations.
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Affiliation(s)
- Yan Li
- Shanxi Medical University, Taiyuan, China
- Department of Epidemiology and Health Statistics, School of Public Health, Shanxi Medical University, Taiyuan, China
| | - Jimei Xin
- Shanxi Medical University, Taiyuan, China
- Department of Epidemiology and Health Statistics, School of Public Health, Shanxi Medical University, Taiyuan, China
| | - Sen Fang
- Shanxi Medical University, Taiyuan, China
- Department of Geriatrics, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Third Hospital of Shanxi Medical University, Taiyuan, China
| | - Fang Wang
- Shanxi Medical University, Taiyuan, China
- Department of Epidemiology and Health Statistics, School of Public Health, Shanxi Medical University, Taiyuan, China
| | - Yufei Jin
- Shanxi Medical University, Taiyuan, China
- Department of Geriatrics, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Third Hospital of Shanxi Medical University, Taiyuan, China
| | - Lei Wang
- Shanxi Medical University, Taiyuan, China
- Department of Geriatrics, Shanxi Bethune Hospital, Shanxi Academy of Medical Sciences, Tongji Shanxi Hospital, Third Hospital of Shanxi Medical University, Taiyuan, China
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Van Asbroeck S, Köhler S, van Boxtel MPJ, Lipnicki DM, Crawford JD, Castro‐Costa E, Lima‐Costa MF, Blay SL, Shifu X, Wang T, Yue L, Lipton RB, Katz MJ, Derby CA, Guerchet M, Preux P, Mbelesso P, Norton J, Ritchie K, Skoog I, Najar J, Sterner TR, Scarmeas N, Yannakoulia M, Dardiotis T, Rolandi E, Davin A, Rossi M, Gureje O, Ojagbemi A, Bello T, Kim KW, Han JW, Oh DJ, Trompet S, Gussekloo J, Riedel‐Heller SG, Röhr S, Pabst A, Shahar S, Rivan NFM, Singh DKA, Jacobsen E, Ganguli M, Hughes T, Haan M, Aiello AE, Ding D, Zhao Q, Xiao Z, Narazaki K, Chen T, Chen S, Ng TP, Gwee X, Gao Q, Brodaty H, Trollor J, Kochan N, Lobo A, Santabárbara J, Gracia‐Garcia P, Sachdev PS, Deckers K. Lifestyle and incident dementia: A COSMIC individual participant data meta‐analysis. Alzheimers Dement 2024; 20:3972-3986. [PMID: 38676366 PMCID: PMC11180928 DOI: 10.1002/alz.13846] [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: 09/14/2023] [Revised: 03/19/2024] [Accepted: 03/19/2024] [Indexed: 04/28/2024]
Abstract
INTRODUCTION The LIfestyle for BRAin Health (LIBRA) index yields a dementia risk score based on modifiable lifestyle factors and is validated in Western samples. We investigated whether the association between LIBRA scores and incident dementia is moderated by geographical location or sociodemographic characteristics. METHODS We combined data from 21 prospective cohorts across six continents (N = 31,680) and conducted cohort-specific Cox proportional hazard regression analyses in a two-step individual participant data meta-analysis. RESULTS A one-standard-deviation increase in LIBRA score was associated with a 21% higher risk for dementia. The association was stronger for Asian cohorts compared to European cohorts, and for individuals aged ≤75 years (vs older), though only within the first 5 years of follow-up. No interactions with sex, education, or socioeconomic position were observed. DISCUSSION Modifiable risk and protective factors appear relevant for dementia risk reduction across diverse geographical and sociodemographic groups. HIGHLIGHTS A two-step individual participant data meta-analysis was conducted. This was done at a global scale using data from 21 ethno-regionally diverse cohorts. The association between a modifiable dementia risk score and dementia was examined. The association was modified by geographical region and age at baseline. Yet, modifiable dementia risk and protective factors appear relevant in all investigated groups and regions.
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Grants
- AG03949 NIH HHS
- Netherlands Programme for Research on Aging (NESTOR)
- The Alzheimer's Association Zenith Award
- 2009BAI77B03 China Ministry of Science and Technology
- CRC2017ZD02 Clinical Research Center, Shanghai Mental Health Center
- 03/0815 Spanish Ministry of Economy and Competitiveness, Madrid, Spain
- R01 AG057531 NIA NIH HHS
- Greek National Resources
- DCP-2017-002/1 Universiti Kebangsaan Malaysia Grand Challenge
- 20H04030 JSPS KAKENHI
- Stiftelsen Professor Bror Gadelius' Minnesfond
- 01/0255 Spanish Ministry of Economy and Competitiveness, Madrid, Spain
- The Alzheimer's Association Stephanie B Overstreet Scholars
- AgeCap-Center for Aging and Health
- The Bank of Sweden Tercentenary Foundation
- European Social Fund
- HJSV2023023 Stiftelsens Hjalmar Svenssons forskningsfond
- 06/0617 Spanish Ministry of Economy and Competitiveness, Madrid, Spain
- Fondo de Investigación Sanitaria
- R37AG02365 NIH/NIA
- Instituto de Salud Carlos III
- Epilife
- 16/00896 Spanish Ministry of Economy and Competitiveness, Madrid, Spain
- B15_23R Gobierno de Aragón
- B15_17R Gobierno de Aragón
- G03/128 Spanish Ministry of Economy and Competitiveness, Madrid, Spain
- AG03949 NIH/NIA
- LRGS/BU/2012/UKM-UKM/K/01 Long-term Research Grant Scheme (LGRS) Ministry of Higher Education, Malaysia
- Limoges University Hospital Appel à Projet des Equipes Émergentes et Labellisées scheme (APREL)
- 189 10276/8/9/2011 Alzheimer's Association
- NMRC/1108/2007 National Medical Research Council
- 97/1321E Spanish Ministry of Economy and Competitiveness, Madrid, Spain
- AG03949 NIA NIH HHS
- Swedish Brain Power
- FORTE
- 2012-Project Public Health Institute [Inserm]-PREUXPierre-Marie AXA Research Fund
- National Strategic Reference Framework (NSFR) - EU Program Excellence Grant (ARISTEIA)
- PI16/00896 Fondo Europeo de Desarrollo Regional (FEDER) of the European Union "Una manera de hacer Europa"
- Shanghai Brain Health Foundation
- JP17K09146 JSPS KAKENHI
- NMRC/CIRG/1409/2014 National Medical Research Council
- AF-967865 Alzheimersfonden
- R37AG02365 NIH HHS
- HJSV2022059 Stiftelsens Hjalmar Svenssons forskningsfond
- 98/0103 Spanish Ministry of Economy and Competitiveness, Madrid, Spain
- RF1AG057531 NIH HHS
- Riksbankens Jubileumsfond
- Handlanden Hjalmar Svenssons Forskningsfond
- Stiftelsen för Gamla Tjänarinnor
- P01 AG003949 NIA NIH HHS
- IIRG-09-133014 Alzheimer's Association
- LRGS/1/2019/UM-UKM/1/4 Long-term Research Grant Scheme (LGRS) Ministry of Higher Education, Malaysia
- Wellcome Trust
- Swedish Research Council
- Leonard and Sylvia Marx Foundation
- Maastricht University Medical Center
- 733050511 Netherlands Organisation for Health Research and Development (ZonMw)
- BMRC/08/1/21/19/567 Agency for Science Technology and Research (A*STAR) Biomedical Research Council
- Associazione Alzheimer Milano
- 2017-0557 Fondazione CARIPLO, FrailBioTrack Project
- DCP-2017-002/2 Universiti Kebangsaan Malaysia Grand Challenge
- PI/19/01874 Spanish Ministry of Economy and Competitiveness, Madrid, Spain
- 72660 ALF-agreement
- 12/02254 Spanish Ministry of Economy and Competitiveness, Madrid, Spain
- Ministry for Health and Social Solidarity (Greece)
- 94/1562 Spanish Ministry of Economy and Competitiveness, Madrid, Spain
- 01KS9504 Interdisciplinary Centre for Clinical Research University of Leipzig (Interdisziplinäres Zentrum für Klinische Forschung/IZKF)
- Czap Foundation
- ANR-09-MNPS-009-01 French National Research Agency
- Stiftelsen Söderström-Königska Sjukhemmet
- National Institute on Aging
- National Institutes of Health
- Wellcome Trust
- Gobierno de Aragón
- Alzheimer's Association
- National Medical Research Council
- French National Research Agency
- AXA Research Fund
- Riksbankens Jubileumsfond
- FORTE
- Swedish Brain Power
- Swedish Research Council
- Stiftelsen för Gamla Tjänarinnor
- Instituto de Salud Carlos III
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Affiliation(s)
- Stephanie Van Asbroeck
- Alzheimer Centrum LimburgDepartment of Psychiatry and NeuropsychologyMental Health and Neuroscience (MHeNs) Research InstituteMaastricht UniversityMaastrichtThe Netherlands
| | - Sebastian Köhler
- Alzheimer Centrum LimburgDepartment of Psychiatry and NeuropsychologyMental Health and Neuroscience (MHeNs) Research InstituteMaastricht UniversityMaastrichtThe Netherlands
| | - Martin P. J. van Boxtel
- Alzheimer Centrum LimburgDepartment of Psychiatry and NeuropsychologyMental Health and Neuroscience (MHeNs) Research InstituteMaastricht UniversityMaastrichtThe Netherlands
| | - Darren M. Lipnicki
- Centre for Healthy Brain Ageing (CHeBA)Discipline of Psychiatry and Mental HealthSchool of Clinical Medicine, University of New South WalesSydneyNew South WalesAustralia
| | - John D. Crawford
- Centre for Healthy Brain Ageing (CHeBA)Discipline of Psychiatry and Mental HealthSchool of Clinical Medicine, University of New South WalesSydneyNew South WalesAustralia
| | | | | | - Sergio Luis Blay
- Department of PsychiatryFederal University of São PauloSão PauloBrazil
| | - Xiao Shifu
- Department of Geriatric PsychiatryShanghai Mental Health Center, Shanghai Jiao Tong University School of MedicineShanghaiChina
| | - Tao Wang
- Department of Geriatric PsychiatryShanghai Mental Health Center, Shanghai Jiao Tong University School of MedicineShanghaiChina
- Department of Psychiatry & Affective Disorders CenterRuijin Hospital, Shanghai Jiao Tong University School of MedicineShanghaiChina
- Alzheimer's Disease and Related Disorders CenterShanghai Jiao Tong UniversityShanghaiChina
| | - Ling Yue
- Department of Geriatric PsychiatryShanghai Mental Health Center, Shanghai Jiao Tong University School of MedicineShanghaiChina
| | - Richard B. Lipton
- Saul R. Korey Department of NeurologyAlbert Einstein College of MedicineBronxNew YorkUSA
- Department of Epidemiology and Population HealthAlbert Einstein College of MedicineBronxNew YorkUSA
- Department of Psychiatry and Behavioral MedicineAlbert Einstein College of MedicineBronxNew YorkUSA
| | - Mindy J. Katz
- Saul R. Korey Department of NeurologyAlbert Einstein College of MedicineBronxNew YorkUSA
| | - Carol A. Derby
- Saul R. Korey Department of NeurologyAlbert Einstein College of MedicineBronxNew YorkUSA
- Department of Epidemiology and Population HealthAlbert Einstein College of MedicineBronxNew YorkUSA
| | - Maëlenn Guerchet
- Inserm U1094, IRD UMR270, University Limoges, CHU Limoges, EpiMaCT ‐ Epidemiology of chronic diseases in tropical zone, Institute of Epidemiology and Tropical Neurology, OmegaHealthLimogesFrance
| | - Pierre‐Marie Preux
- Inserm U1094, IRD UMR270, University Limoges, CHU Limoges, EpiMaCT ‐ Epidemiology of chronic diseases in tropical zone, Institute of Epidemiology and Tropical Neurology, OmegaHealthLimogesFrance
| | - Pascal Mbelesso
- Department of NeurologyAmitié HospitalBanguiCentral African Republic
| | - Joanna Norton
- Institute for Neurosciences of Montpellier (INM), University of Montpellier, InsermMontpellierFrance
| | - Karen Ritchie
- Institute for Neurosciences of Montpellier (INM), University of Montpellier, InsermMontpellierFrance
- Institut du Cerveau TrocadéroParisFrance
| | - Ingmar Skoog
- Department of Psychiatry and NeurochemistryNeuropsychiatric Epidemiology UnitInstitute of Neuroscience and Physiology, Sahlgrenska Academy, at the University of GothenburgGothenburgSweden
- Centre for Ageing and Health (AGECAP), University of GothenburgGothenburgSweden
- Region Västra Götaland, Sahlgrenska University Hospital, Psychiatry, Cognition and Old Age Psychiatry ClinicGothenburgSweden
| | - Jenna Najar
- Department of Psychiatry and NeurochemistryNeuropsychiatric Epidemiology UnitInstitute of Neuroscience and Physiology, Sahlgrenska Academy, at the University of GothenburgGothenburgSweden
- Centre for Ageing and Health (AGECAP), University of GothenburgGothenburgSweden
- Region Västra Götaland, Sahlgrenska University Hospital, Psychiatry, Cognition and Old Age Psychiatry ClinicGothenburgSweden
- Department of Clinical GeneticsSection Genomics of Neurodegenerative Diseases and Aging, Vrije Universiteit Amsterdam, Amsterdam UMCAmsterdamThe Netherlands
| | - Therese Rydberg Sterner
- Department of Psychiatry and NeurochemistryNeuropsychiatric Epidemiology UnitInstitute of Neuroscience and Physiology, Sahlgrenska Academy, at the University of GothenburgGothenburgSweden
- Centre for Ageing and Health (AGECAP), University of GothenburgGothenburgSweden
- Department of NeurobiologyAging Research CenterCare Sciences and Society, Karolinska Institute and Stockholm UniversityStockholmSweden
| | - Nikolaos Scarmeas
- 1st Department of NeurologyAiginition Hospital, Medical School, National and Kapodistrian University of AthensAthensGreece
- Department of NeurologyTaub Institute for Research on Alzheimer's Disease and the Aging Brain, Gertrude H. Sergievsky Center, Columbia UniversityNew YorkNew YorkUSA
| | - Mary Yannakoulia
- Department of Nutrition and DieteticsHarokopio UniversityAthensGreece
| | | | - Elena Rolandi
- Golgi Cenci FoundationMilanItaly
- Department of Brain and Behavioral SciencesUniversity of PaviaPaviaItaly
| | | | | | - Oye Gureje
- Department of PsychiatryWHO Collaborating Centre for Research and Training in Mental Health, Neuroscience and Substance Abuse, University of IbadanIbadanNigeria
| | - Akin Ojagbemi
- Department of PsychiatryCollege of Medicine University of IbadanIbadanNigeria
| | - Toyin Bello
- Department of PsychiatryCollege of Medicine University of IbadanIbadanNigeria
| | - Ki Woong Kim
- Department of NeuropsychiatrySeoul National University Bundang HospitalSeongnamRepublic of Korea
- Department of PsychiatrySeoul National University College of MedicineSeoulRepublic of Korea
- Department of Brain and Cognitive SciencesSeoul National University College of Natural SciencesSeoulRepublic of Korea
| | - Ji Won Han
- Department of NeuropsychiatrySeoul National University Bundang HospitalSeongnamRepublic of Korea
- Department of PsychiatrySeoul National University College of MedicineSeoulRepublic of Korea
| | - Dae Jong Oh
- Workplace Mental Health Institute, Kangbuk Samsung Hospital, Sungkyunkwan University School of MedicineSeoulRepublic of Korea
| | - Stella Trompet
- Department of Internal Medicinesection of Gerontology and GeriatricsLeiden University Medical CenterLeidenthe Netherlands
| | - Jacobijn Gussekloo
- Department of Internal Medicinesection of Gerontology and GeriatricsLeiden University Medical CenterLeidenthe Netherlands
- Department of Public Health and Primary CareLeiden University Medical CenterLeidenthe Netherlands
| | - Steffi G. Riedel‐Heller
- Institute of Social MedicineOccupational Health and Public HealthMedical FacultyUniversity of LeipzigLeipzigGermany
| | - Susanne Röhr
- Institute of Social MedicineOccupational Health and Public HealthMedical FacultyUniversity of LeipzigLeipzigGermany
- Health and Ageing Research Team (HART), School of Psychology, Massey UniversityPalmerston NorthAotearoa New Zealand
- Global Brain Health Institute (GBHI), Trinity College DublinDublinIreland
| | - Alexander Pabst
- Institute of Social MedicineOccupational Health and Public HealthMedical FacultyUniversity of LeipzigLeipzigGermany
| | - Suzana Shahar
- Center for Healthy Ageing & Wellness (H‐CARE)Faculty of Health SciencesUniversity Kebangsaan MalaysiaKuala LumpurMalaysia
| | - Nurul Fatin Malek Rivan
- Center for Healthy Ageing & Wellness (H‐CARE)Faculty of Health SciencesUniversity Kebangsaan MalaysiaKuala LumpurMalaysia
| | - Devinder Kaur Ajit Singh
- Center for Healthy Ageing & Wellness (H‐CARE)Faculty of Health SciencesUniversity Kebangsaan MalaysiaKuala LumpurMalaysia
| | - Erin Jacobsen
- Department of PsychiatryUniversity of Pittsburgh School of MedicinePittsburghPennsylvaniaUSA
| | - Mary Ganguli
- Department of PsychiatryUniversity of Pittsburgh School of MedicinePittsburghPennsylvaniaUSA
- Departments of Neurology, and EpidemiologyUniversity of Pittsburgh School of Medicine and School of Public HealthPittsburghPennsylvaniaUSA
| | - Tiffany Hughes
- Department of Graduate Studies in Health and Rehabilitation SciencesBitonte College of Health and Human Services, Youngstown State UniversityYoungstownOhioUSA
| | - Mary Haan
- Department of Epidemiology and BiostatisticsSchool of Medicine, University of California San FranciscoSan FranciscoCaliforniaUSA
| | - Allison E. Aiello
- Columbia Aging Center and the Department of EpidemiologyMailman School of Public Health, Columbia UniversityNew YorkNew YorkUSA
| | - Ding Ding
- Institute of NeurologyNational Center for Neurological Disorders, National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan UniversityShanghaiChina
| | - Qianhua Zhao
- Institute of NeurologyNational Center for Neurological Disorders, National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan UniversityShanghaiChina
| | - Zhenxu Xiao
- Institute of NeurologyNational Center for Neurological Disorders, National Clinical Research Center for Aging and Medicine, Huashan Hospital, Fudan UniversityShanghaiChina
| | - Kenji Narazaki
- Center for Liberal Arts, Fukuoka Institute of TechnologyHigashi‐kuFukuokaJapan
| | - Tao Chen
- Department of Physical EducationSports and Health Research CenterTongji UniversityShanghaiChina
| | - Sanmei Chen
- Graduate School of Biomedical and Health Sciences, Hiroshima UniversityHiroshimaJapan
| | - Tze Pin Ng
- Department of Psychological MedicineGerontology Research Programme, Yong Loo Lin School of Medicine, National University of SingaporeSingaporeSingapore
| | - Xinyi Gwee
- Department of Psychological MedicineGerontology Research Programme, Yong Loo Lin School of Medicine, National University of SingaporeSingaporeSingapore
| | - Qi Gao
- Department of Psychological MedicineGerontology Research Programme, Yong Loo Lin School of Medicine, National University of SingaporeSingaporeSingapore
| | - Henry Brodaty
- Centre for Healthy Brain Ageing (CHeBA)Discipline of Psychiatry and Mental HealthSchool of Clinical Medicine, University of New South WalesSydneyNew South WalesAustralia
| | - Julian Trollor
- Centre for Healthy Brain Ageing (CHeBA)Discipline of Psychiatry and Mental HealthSchool of Clinical Medicine, University of New South WalesSydneyNew South WalesAustralia
- Department of Developmental Disability NeuropsychiatryDiscipline of Psychiatry and Mental Health, University of New South WalesSydneyNew South WalesAustralia
| | - Nicole Kochan
- Centre for Healthy Brain Ageing (CHeBA)Discipline of Psychiatry and Mental HealthSchool of Clinical Medicine, University of New South WalesSydneyNew South WalesAustralia
| | - Antonio Lobo
- Department of Medicine and PsychiatryUniversidad de ZaragozaZaragozaSpain
- Instituto de Investigación Sanitaria Aragón (IIS Aragón)ZaragozaSpain
- CIBERSAM, Instituto de Salud Carlos IIIMadridSpain
| | - Javier Santabárbara
- Instituto de Investigación Sanitaria Aragón (IIS Aragón)ZaragozaSpain
- CIBERSAM, Instituto de Salud Carlos IIIMadridSpain
- Department of Public HealthUniversidad de ZaragozaZaragozaSpain
| | - Patricia Gracia‐Garcia
- Department of Medicine and PsychiatryUniversidad de ZaragozaZaragozaSpain
- Instituto de Investigación Sanitaria Aragón (IIS Aragón)ZaragozaSpain
- CIBERSAM, Instituto de Salud Carlos IIIMadridSpain
| | - Perminder S. Sachdev
- Centre for Healthy Brain Ageing (CHeBA)Discipline of Psychiatry and Mental HealthSchool of Clinical Medicine, University of New South WalesSydneyNew South WalesAustralia
- Neuropsychiatric Institute, The Prince of Wales HospitalSydneyNew South WalesAustralia
| | - Kay Deckers
- Alzheimer Centrum LimburgDepartment of Psychiatry and NeuropsychologyMental Health and Neuroscience (MHeNs) Research InstituteMaastricht UniversityMaastrichtThe Netherlands
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Owens JH, Fiala J, Jones RN, Marsiske M. The Mediating Effects of Education and Occupational Complexity Between Race and Longitudinal Change in Late Life Cognition in ACTIVE. Res Aging 2024:1640275241248825. [PMID: 38648193 DOI: 10.1177/01640275241248825] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/25/2024]
Abstract
This study examined educational and occupational inequality as two aspects of social determinants of health that might mediate the longitudinal relationship between racialization and late life cognitive level and change. Participants were 2371 individuals racialized as Black and White from the ACTIVE study who provided occupational data. Data were analyzed from baseline and five assessments over 10-years using structural equation modeling. Black/White race served as the predictor, occupational complexity (OC) and years of education as mediators, and cognitive (memory, reasoning, and speed of processing) intercept, linear slope, and quadratic slope as the dependent variables. Black/White race showed significant indirect associations through education and OC on level of performance in cognition, linear change in reasoning and memory, and quadratic change in reasoning. Education and OC accounted for 11-16% of the association between race and cognitive level and represent modifiable social determinants of health that are associated with disparities in cognitive aging.
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Affiliation(s)
- Joshua H Owens
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, USA
| | - Jacob Fiala
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, USA
| | - Richard N Jones
- Department of Psychiatry and Human Behavior, Alpert Medical School, Brown University, Providence, USA
| | - Michael Marsiske
- Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, USA
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8
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Kushwaha A, Basera DS, Kumari S, Sutar RF, Singh V, Das S, Agrawal A. Assessment of memory deficits in psychiatric disorders: A systematic literature review. J Neurosci Rural Pract 2024; 15:182-193. [PMID: 38746499 PMCID: PMC11090569 DOI: 10.25259/jnrp_456_2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Accepted: 12/12/2023] [Indexed: 05/16/2024] Open
Abstract
Memory deficits are observed across psychiatric disorders ranging from the prodrome of psychosis to common mental disorders such as anxiety, depression, and dissociative disorders. Memory deficits among patients recovering from psychiatric disorders could be directly related to the primary illness or secondary to the adverse effect of a treatment such as Electroconvulsive Therapy (ECT). The trouble in the meaningful integration of working-memory and episodic memory is the most commonly affected domain that requires routine assessments. An update on the recent trends of methods of assessment of memory deficits is the first step towards understanding and correcting these deficits to target optimum recovery. A systematic literature search was conducted from October 2018 to October 2022 to review the recent methods of assessment of memory deficits in psychiatric disorders. The definition of 'Memory deficit' was operationalized as 'selective processes of memory, commonly required for activities of daily living, and affected among psychiatric disorders resulting in subjective distress and dysfunction'. We included 110 studies, most of them being conducted in western countries on patients with schizophrenia. Other disorders included dementia and mild cognitive impairment. Brief Assessment of Cognition in Schizophrenia, Cambridge Automated Neuropsychological Test Battery, California Verbal Learning Test, Trail Making Test Part A and B, Rey Auditory Verbal Learning Test, Wechsler Memory Scale, Wechsler Adults Intelligence Scale-IV were the most common neuropsychological assessments used. Mini-Mental State Examination and Montreal Cognitive Assessment were the most common bedside assessment tools used while Squire Subjective Memory Questionnaire was commonly used to measure ECT-related memory deficits. The review highlights the recent developments in the field of assessment of memory deficits in psychiatric disorders. Findings recommend and emphasize routine assessment of memory deficits among psychiatric disorders in developing countries especially severe mental illnesses. It remains interesting to see the role of standardized assessments in diagnostic systems given more than a decade of research on memory deficits in psychiatric disorders.
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Affiliation(s)
- Anuradha Kushwaha
- Department of Psychiatry, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh, India
| | - Devendra Singh Basera
- Department of Psychiatry, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh, India
| | - Sangita Kumari
- Department of Psychiatry, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh, India
| | - Roshan Fakirchand Sutar
- Department of Psychiatry, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh, India
| | - Vijender Singh
- Department of Psychiatry, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh, India
| | - Saikat Das
- Department of Radiotherapy, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh, India
| | - Amit Agrawal
- Department of Neurosurgery, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh, India
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9
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Fujimoto Y, Matsue Y, Maeda D, Kagiyama N, Sunayama T, Dotare T, Jujo K, Saito K, Kamiya K, Saito H, Ogasahara Y, Maekawa E, Konishi M, Kitai T, Iwata K, Wada H, Hiki M, Kasai T, Nagamatsu H, Ozawa T, Izawa K, Yamamoto S, Aizawa N, Wakaume K, Oka K, Momomura SI, Minamino T. Association and Prognostic Value of Multidomain Frailty Defined by Cumulative Deficit and Phenotype Models in Patients With Heart Failure. Can J Cardiol 2024; 40:677-684. [PMID: 38007218 DOI: 10.1016/j.cjca.2023.11.020] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Revised: 11/18/2023] [Accepted: 11/20/2023] [Indexed: 11/27/2023] Open
Abstract
BACKGROUND Frailty is associated with a poor prognosis in older patients with heart failure (HF). However, multidomain frailty assessment tools have not been established in patients with HF, and the association between the frailty phenotype and the deficit-accumulation frailty index in these patients is unclear. We aimed to understand this relationship and evaluate the prognostic value of the deficit-accumulation frailty index in older patients with HF. METHODS We retrospectively analyzed FRAGILE-HF cohort, which consisted of prospectively registered hospitalized patients with HF aged ≥ 65 years. The frailty index was calculated using 34 health-related items. The physical, social, and cognitive domains of frailty were evaluated using a phenotypic approach. The primary endpoint was all-cause mortality. RESULTS Among 1027 patients with HF (median age, 81 years; male, 58.1%; median frailty index, 0.44), a higher frailty index was associated with a higher prevalence in all domains of cognitive, physical, and social frailty defined by the phenotype model. During the 2-year follow-up period, a higher frailty index was independently associated with all-cause death even after adjustment for Meta-Analysis Global Group in Chronic Heart Failure (MAGGIC) score plus log B-type natriuretic peptide (per 0.1 increase: hazard ratio, 1.21; 95% confidence interval, 1.07-1.37; P = 0.002). The addition of the frailty index to the baseline model yielded statistically significant incremental prognostic value (net reclassification improvement, 0.165; 95% confidence interval, 0.012-0.318; P = 0.034). CONCLUSIONS A higher frailty index was associated with a higher prevalence of all domains of frailty defined by the phenotype model and provided incremental prognostic information with pre-existing risk factors in older patients with HF.
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Affiliation(s)
- Yudai Fujimoto
- Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Yuya Matsue
- Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan.
| | - Daichi Maeda
- Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Nobuyuki Kagiyama
- Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan; Department of Cardiology, The Sakakibara Heart Institute of Okayama, Okayama, Japan; Department of Digital Health and Telemedicine R&D, Juntendo University, Tokyo, Japan
| | - Tsutomu Sunayama
- Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Taishi Dotare
- Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Kentaro Jujo
- Department of Cardiology, Nishiarai Heart Centre Hospital, Tokyo, Japan
| | - Kazuya Saito
- Department of Rehabilitation, The Sakakibara Heart Institute of Okayama, Okayama, Japan
| | - Kentaro Kamiya
- Department of Rehabilitation, School of Allied Health Sciences, Kitasato University, Sagamihara, Japan
| | - Hiroshi Saito
- Department of Rehabilitation, Kameda Medical Centre, Kamogawa, Japan
| | - Yuki Ogasahara
- Department of Nursing, National Hospital Organization Kure Medical Centre and Chugoku Cancer Centre, Hiroshima, Japan
| | - Emi Maekawa
- Department of Cardiovascular Medicine, Kitasato University School of Medicine, Sagamihara, Japan
| | - Masaaki Konishi
- Division of Cardiology, Yokohama City University Medical Centre, Yokohama, Japan
| | - Takeshi Kitai
- Department of Cardiovascular Medicine, National Cerebral and Cardiovascular Centre, Osaka, Japan
| | - Kentaro Iwata
- Department of Rehabilitation, Kobe City Medical Centre General Hospital, Kobe, Japan
| | - Hiroshi Wada
- Department of Cardiovascular Medicine, Saitama Medical Centre, Jichi Medical University, Saitama, Japan
| | - Masaru Hiki
- Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Takatoshi Kasai
- Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan; Cardiovascular Respiratory Sleep Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Hirofumi Nagamatsu
- Department of Cardiology, Tokai University School of Medicine, Isehara, Japan
| | - Tetsuya Ozawa
- Department of Rehabilitation, Odawara Municipal Hospital, Odawara, Japan
| | - Katsuya Izawa
- Department of Rehabilitation, Matsui Heart Clinic, Saitama, Japan
| | - Shuhei Yamamoto
- Department of Rehabilitation, Shinshu University Hospital, Matsumoto, Japan
| | - Naoki Aizawa
- Department of Cardiovascular Medicine, Nephrology and Neurology, University of the Ryukyus, Okinawa, Japan
| | - Kazuki Wakaume
- Department of Rehabilitation, Kitasato University Medical Centre, Saitama, Japan
| | - Kazuhiro Oka
- Department of Rehabilitation, Saitama Citizens Medical Centre, Saitama, Japan
| | | | - Tohru Minamino
- Department of Cardiovascular Biology and Medicine, Juntendo University Graduate School of Medicine, Tokyo, Japan; Japan Agency for Medical Research and Development-Core Research for Evolutionary Medical Science and Technology (AMED-CREST), Japan Agency for Medical Research and Development, Tokyo, Japan
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Ayala-Garcia A, Soldevila-Domenech N, Yi SY, de la Torre R, Steffen LM. Diet patterns associated with cognitive decline: methods to harmonize data from European and US cohort studies. Front Nutr 2024; 11:1379531. [PMID: 38577153 PMCID: PMC10992460 DOI: 10.3389/fnut.2024.1379531] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2024] [Accepted: 03/11/2024] [Indexed: 04/06/2024] Open
Abstract
The impact of dietary intake on cognitive outcomes and dementia prevention is a topic of increasing interest. Meta-analyses of observational studies, mostly conducted within US and European populations, have reported benefits of healthy diet patterns on cognitive performance, but results from individual studies have been inconsistent. These inconsistencies are likely due to the diverse methodology used in studies, including different diet and cognitive function assessment instruments, follow-up periods, and analytical methods, which make drawing conclusions relevant to dietary guidance challenging. The objective of this project is to describe a protocol to conduct a retrospective harmonization study on dietary intake and cognitive health using data from European and US studies. The recommendations resulting from the project can be used to support evidence-based synthesis for future iterations of the Dietary Guidelines for Americans or other population-based dietary guidance. Additionally, this study will serve as a harmonization guide for future research on the relationship between diet patterns and cognition. The approach outlined ultimately aims to optimize resources and expedite research efforts for dementia prevention.
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Affiliation(s)
- Amaia Ayala-Garcia
- Integrative Pharmacology and Systems Neurosciences Research Group, Neurosciences Research Program, Hospital del Mar Research Institute (HMRI), Barcelona, Spain
| | - Natalia Soldevila-Domenech
- Integrative Pharmacology and Systems Neurosciences Research Group, Neurosciences Research Program, Hospital del Mar Research Institute (HMRI), Barcelona, Spain
| | - So-Yun Yi
- Division of Epidemiology and Community Health, University of Minnesota School of Public Health, Minneapolis, MN, United States
| | - Rafael de la Torre
- Integrative Pharmacology and Systems Neurosciences Research Group, Neurosciences Research Program, Hospital del Mar Research Institute (HMRI), Barcelona, Spain
- Department of Medicine and Life Sciences, Universitat Pompeu Fabra, Barcelona, Spain
- CIBER de Fisiopatología de la Obesidad y Nutrición, Instituto de Salud Carlos III, Madrid, Spain
| | - Lyn M. Steffen
- Division of Epidemiology and Community Health, University of Minnesota School of Public Health, Minneapolis, MN, United States
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11
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Tu L, Lv X, Yuan C, Chen H, Yu X, Wang H, Zhang Q. Sex differences in cognitive function trajectories and their determinants in older adults: Evidence from the Chinese longitudinal healthy longevity survey. Int J Geriatr Psychiatry 2024; 39:e6072. [PMID: 38488836 DOI: 10.1002/gps.6072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Accepted: 02/14/2024] [Indexed: 03/19/2024]
Abstract
OBJECTIVES To examine sex differences in the cognitive trajectories of a nationally representative sample of older people living in China and to explore potential determinants of these trajectories. METHODS The study included 2230 women and 2171 men who were cognitively healthy and aged over 60 at the first observation from the Chinese Longitudinal Healthy Longevity Survey based on the 2008-2018 cohort. Cognitive function was measured using the Chinese version of the Mini-Mental State Examination (MMSE). Group-based trajectory modeling was used to identify potential heterogeneity of longitudinal changes over the 10 years in each gender. Logistic regression was used to investigate associations between baseline characteristics (age, education, fertility history, sleep length, physical activity, and health status and behaviors) and trajectory classes. RESULTS Three trajectories (labeled stable, slow decline, and rapid decline) were identified according to the changes in MMSE scores for both women and men. For the women, both the slow and rapid decline groups accounted for a larger proportion (14.7% and 11.0%, respectively) than the male decline groups (8.1% and 6.6%, respectively), and the women had a lower baseline MMSE score with a faster decline. In the multivariable logistic regression analyses, older age, less education, older age at first birth, poorer functional abilities, hearing impairment, and lower baseline MMSE scores were significantly associated with cognitive decline in both the female and male groups compared to the stable group. For the women, sleeping over 9 h was also associated with a rapid cognitive decline trajectory, while current exercise and being overweight/obese were protective factors against cognitive decline. CONCLUSIONS The women had an overall more serious cognitive decline than men. The potential determinants of cognitive decline identified in this study could be considered for developing specific intervention strategies aimed at promoting a healthy brain and preventing cognitive decline in different sexes, especially in low-income and developing countries.
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Affiliation(s)
- Lihui Tu
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China
- Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
| | - Xiaozhen Lv
- Beijing Dementia Key Lab, Peking University Institute of Mental Health (Sixth Hospital), National Clinical Research Center for Mental Disorders, NHC Key Laboratory of Mental Health (Peking University), Beijing, China
| | - Changzheng Yuan
- School of Public Health, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Hui Chen
- School of Public Health, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | - Xin Yu
- Beijing Dementia Key Lab, Peking University Institute of Mental Health (Sixth Hospital), National Clinical Research Center for Mental Disorders, NHC Key Laboratory of Mental Health (Peking University), Beijing, China
| | - Huali Wang
- Beijing Dementia Key Lab, Peking University Institute of Mental Health (Sixth Hospital), National Clinical Research Center for Mental Disorders, NHC Key Laboratory of Mental Health (Peking University), Beijing, China
| | - Qinge Zhang
- The National Clinical Research Center for Mental Disorders & Beijing Key Laboratory of Mental Disorders, Beijing Anding Hospital, Capital Medical University, Beijing, China
- Advanced Innovation Center for Human Brain Protection, Capital Medical University, Beijing, China
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12
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Oliveira WL, Melo RCD, Cachioni M, Falcão DVDS, Batistoni SST, Ordonez TN, Neri AL, Yassuda MS. Higher purpose in life and education were associated with better cognition among older adults. ARQUIVOS DE NEURO-PSIQUIATRIA 2024; 82:1-10. [PMID: 38395051 PMCID: PMC10890907 DOI: 10.1055/s-0044-1779506] [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: 07/21/2023] [Accepted: 12/03/2023] [Indexed: 02/25/2024]
Abstract
BACKGROUND With aging, some cognitive abilities change because of neurobiological processes. Cognition may also be influenced by psychosocial aspects. OBJECTIVE To describe the relationship between a measure of neuroticism, depression symptoms, purpose in life, and cognitive performance in community-dwelling older adults. METHODS This was a cross-sectional analysis based on the data from the second wave of the Frailty in Brazilian Older Adults (FIBRA) study, carried out between 2016 and 2017. The sample consisted of 419 older people (≥ 72 years old) cognitively unimpaired and mostly with low education. The variables of interest were sociodemographic, Neuroticism domain from the NEO-PI-R, Geriatric Depression Scale (GDS), Purpose in Life (PiL) scale, and a cognitive composite score which included the Mini-Mental State Examination (MMSE), and the scores for the sub-items of the Mini-Addenbrooke's Cognitive Examination (M-ACE), namely, Verbal Fluency (VF) - Animal, Clock Drawing Test (CDT), Episodic Memory (name and address). RESULTS There was a greater number of women (70%), with older age (median = 80 years, IQR = 77-82), and low education (median = 4 years, IQR = 2-5). In the bivariate correlations, years of education (ρ = 0.415; p < 0.001) and PiL (ρ = 0.220; p < 0.001) were positively associated with cognition. Neuroticism (ρ = -0.175; p < 0.001) and depression symptoms (ρ = -0.185; p < 0.001) were negatively associated with cognition. In the logistic regression, after including confounding variables, the associations between cognition and PiL (OR = 2.04; p = 0.007) and education (OR = 1.32; p < 0.001) remained significant. CONCLUSION Low PiL and low education levels were associated with worse cognition among older adults. Such results may be of relevance in programs that aim to improve cognition among older adults.
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Affiliation(s)
- Wellington Lourenço Oliveira
- Universidade de São Paulo, Escola de Artes, Ciências e Humanidades, Departamento de Gerontologia, São Paulo SP, Brazil.
| | - Ruth Caldeira de Melo
- Universidade de São Paulo, Escola de Artes, Ciências e Humanidades, Departamento de Gerontologia, São Paulo SP, Brazil.
- Universidade Estadual de Campinas, Faculdade de Ciências Médicas, Departamento de Gerontologia, Campinas SP, Brazil.
| | - Meire Cachioni
- Universidade de São Paulo, Escola de Artes, Ciências e Humanidades, Departamento de Gerontologia, São Paulo SP, Brazil.
- Universidade Estadual de Campinas, Faculdade de Ciências Médicas, Departamento de Gerontologia, Campinas SP, Brazil.
| | | | - Samila Sathler Tavares Batistoni
- Universidade de São Paulo, Escola de Artes, Ciências e Humanidades, Departamento de Gerontologia, São Paulo SP, Brazil.
- Universidade Estadual de Campinas, Faculdade de Ciências Médicas, Departamento de Gerontologia, Campinas SP, Brazil.
| | - Tiago Nascimento Ordonez
- Universidade de São Paulo, Escola de Artes, Ciências e Humanidades, Departamento de Gerontologia, São Paulo SP, Brazil.
| | - Anita Liberalesso Neri
- Universidade Estadual de Campinas, Faculdade de Ciências Médicas, Departamento de Gerontologia, Campinas SP, Brazil.
| | - Mônica Sanches Yassuda
- Universidade de São Paulo, Escola de Artes, Ciências e Humanidades, Departamento de Gerontologia, São Paulo SP, Brazil.
- Universidade Estadual de Campinas, Faculdade de Ciências Médicas, Departamento de Gerontologia, Campinas SP, Brazil.
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13
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Cermelli A, Roveta F, Giorgis L, Boschi S, Grassini A, Ferrandes F, Lombardo C, Marcinnò A, Rubino E, Rainero I. Is headache a risk factor for dementia? A systematic review and meta-analysis. Neurol Sci 2024; 45:1017-1030. [PMID: 37721571 PMCID: PMC10858119 DOI: 10.1007/s10072-023-07069-0] [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: 04/11/2023] [Accepted: 09/09/2023] [Indexed: 09/19/2023]
Abstract
OBJECTIVE In this systematic review and meta-analysis, we critically evaluate available evidence regarding the association between primary headaches and subsequent decline of cognitive function and dementia. BACKGROUND Recent studies suggested that headache disorders may increase the risk for dementia. However, available studies are conflicting. METHODS To identify qualifying studies, we searched scientific databases, including Pubmed, Scopus, Web of Science, Science Direct and BMC, screening for relevant papers. In order to reduce the heterogeneity between different studies, the analyses were further subdivided according to the clinical diagnoses and the study methodologies. RESULTS We identified 23 studies investigating the association between primary headaches and the risk of dementia. Of these, 18 met our inclusion criteria for meta-analysis (covering 924.140 individuals). Overall effect-size shows that primary headaches were associated with a small increase in dementia risk (OR = 1,15; CI 95%: 1,03-1,28; p = 0,02). Analyzing subgroups, we found that migraine was associated with both a moderate increased risk of all-cause dementia (OR = 1,26; p = 0,00; 95% CI: 1,13-1,40) as well as a moderate increased risk of Alzheimer's disease (OR = 2,00; p = 0,00; 95% CI: 1,46-2,75). This association was significant in both case-control and retrospective cohort studies but not in prospective studies. CONCLUSIONS Our study supports the presence of a link between primary headaches and dementia. However, in the subgroup analysis, only patients with migraine showed a moderate increase risk for all-cause dementia and for Alzheimer's disease. Additional rigorous studies are needed to elucidate the possible role of primary headaches on the risk of developing cognitive impairment and dementia.
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Affiliation(s)
- Aurora Cermelli
- Headache Center, Department of Neuroscience, ''Rita Levi Montalcini'', University of Torino, Via Cherasco 15, 10126, Turin, Italy
| | - Fausto Roveta
- Headache Center, Department of Neuroscience, ''Rita Levi Montalcini'', University of Torino, Via Cherasco 15, 10126, Turin, Italy
| | - Lia Giorgis
- Headache Center, Department of Neuroscience, ''Rita Levi Montalcini'', University of Torino, Via Cherasco 15, 10126, Turin, Italy
| | - Silvia Boschi
- Headache Center, Department of Neuroscience, ''Rita Levi Montalcini'', University of Torino, Via Cherasco 15, 10126, Turin, Italy
| | - Alberto Grassini
- Headache Center, Department of Neuroscience, ''Rita Levi Montalcini'', University of Torino, Via Cherasco 15, 10126, Turin, Italy
| | - Fabio Ferrandes
- Headache Center, Department of Neuroscience, ''Rita Levi Montalcini'', University of Torino, Via Cherasco 15, 10126, Turin, Italy
| | - Chiara Lombardo
- Headache Center, Department of Neuroscience, ''Rita Levi Montalcini'', University of Torino, Via Cherasco 15, 10126, Turin, Italy
| | - Andrea Marcinnò
- Headache Center, Department of Neuroscience, ''Rita Levi Montalcini'', University of Torino, Via Cherasco 15, 10126, Turin, Italy
| | - Elisa Rubino
- Headache Center, Department of Neuroscience, ''Rita Levi Montalcini'', University of Torino, Via Cherasco 15, 10126, Turin, Italy
- Department of Neuroscience and Mental Health, Città della Salute e della Scienza, Corso Bramante 88, Turin, Italy
| | - Innocenzo Rainero
- Headache Center, Department of Neuroscience, ''Rita Levi Montalcini'', University of Torino, Via Cherasco 15, 10126, Turin, Italy.
- Department of Neuroscience and Mental Health, Città della Salute e della Scienza, Corso Bramante 88, Turin, Italy.
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Chen A, Li Q, Huang Y, Li Y, Chuang YN, Hu X, Guo S, Wu Y, Guo Y, Bian J. Feasibility of Identifying Factors Related to Alzheimer's Disease and Related Dementia in Real-World Data. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2024:2024.02.10.24302621. [PMID: 38405723 PMCID: PMC10889002 DOI: 10.1101/2024.02.10.24302621] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/27/2024]
Abstract
A comprehensive view of factors associated with AD/ADRD will significantly aid in studies to develop new treatments for AD/ADRD and identify high-risk populations and patients for prevention efforts. In our study, we summarized the risk factors for AD/ADRD by reviewing existing meta-analyses and review articles on risk and preventive factors for AD/ADRD. In total, we extracted 477 risk factors in 10 categories from 537 studies. We constructed an interactive knowledge map to disseminate our study results. Most of the risk factors are accessible from structured Electronic Health Records (EHRs), and clinical narratives show promise as information sources. However, evaluating genomic risk factors using RWD remains a challenge, as genetic testing for AD/ADRD is still not a common practice and is poorly documented in both structured and unstructured EHRs. Considering the constantly evolving research on AD/ADRD risk factors, literature mining via NLP methods offers a solution to automatically update our knowledge map.
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Affiliation(s)
- Aokun Chen
- Department of Health Outcomes and Biomedical Informatics, College of Medicine, University of Florida, 1889 Museum Rd, Suite 7000, Gainesville, FL 32610
| | - Qian Li
- Department of Health Outcomes and Biomedical Informatics, College of Medicine, University of Florida, 1889 Museum Rd, Suite 7000, Gainesville, FL 32610
| | - Yu Huang
- Department of Health Outcomes and Biomedical Informatics, College of Medicine, University of Florida, 1889 Museum Rd, Suite 7000, Gainesville, FL 32610
| | - Yongqiu Li
- Department of Health Outcomes and Biomedical Informatics, College of Medicine, University of Florida, 1889 Museum Rd, Suite 7000, Gainesville, FL 32610
| | - Yu-Neng Chuang
- Department of Computer Science, George R. Brown School of Engineering, Rice University, 6100 Main St., Houston, TX 77005
| | - Xia Hu
- Department of Computer Science, George R. Brown School of Engineering, Rice University, 6100 Main St., Houston, TX 77005
| | - Serena Guo
- Department of Pharmaceutical Outcomes & Policy, College of Pharmacy, University of Florida, 1225 Center Drive, Gainesville, FL 32610
| | - Yonghui Wu
- Department of Health Outcomes and Biomedical Informatics, College of Medicine, University of Florida, 1889 Museum Rd, Suite 7000, Gainesville, FL 32610
| | - Yi Guo
- Department of Health Outcomes and Biomedical Informatics, College of Medicine, University of Florida, 1889 Museum Rd, Suite 7000, Gainesville, FL 32610
| | - Jiang Bian
- Department of Health Outcomes and Biomedical Informatics, College of Medicine, University of Florida, 1889 Museum Rd, Suite 7000, Gainesville, FL 32610
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15
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Birnie K, Catov J, Anderson EL, Lapidaire W, Kilpi F, Lawlor DA, Fraser A. Hypertensive disorders of pregnancy and midlife maternal cognition in a prospective cohort study. J Clin Hypertens (Greenwich) 2024; 26:166-176. [PMID: 38214209 PMCID: PMC10857467 DOI: 10.1111/jch.14765] [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: 08/07/2023] [Revised: 12/01/2023] [Accepted: 12/05/2023] [Indexed: 01/13/2024]
Abstract
Hypertensive disorders of pregnancy (HDP) are associated with an increased risk of cardiovascular disorders, with recent evidence linking pre-eclampsia with vascular dementia. We examined associations of HDP with cognitive performance measured in midlife, in a prospective cohort study, the Avon Longitudinal Study of Parents and Children. Six cognitive function domains were measured 20 years after pregnancy at a mean age of 51 years. The cognition tests were repeated at clinics in the following two years. Cognitive function domains measured were immediate and delayed verbal episodic memory, working memory, processing speed, verbal intelligence, and verbal fluency. Exposures were pre-eclampsia, gestational hypertension (GH), and a combined category of any HDP, all compared to normotensive pregnancy. Of 3393 pregnancies included in the analysis, GH was experienced by 417 (12.3%) and pre-eclampsia by 57 (1.7%). GH was associated with lower verbal episodic memory, in the delayed logic memory test (-0.16 SDs; 95% CI -0.30, -0.03; p = .015) and there was weak evidence of an association with the immediate logic memory test (-0.13 SDs; -0.27, 0.001; p = .058). However, we did not see steeper declines by age for women with GH and there was no evidence of associations with other cognitive domains or for pre-eclampsia with any domains. Results were not substantially changed after controlling for midlife blood pressure. Our findings suggest that a history of GH is associated with slightly reduced episodic memory 20 years after pregnancy, but we found no evidence of a quicker age-related decline compared to women with normotensive pregnancies.
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Affiliation(s)
- Kate Birnie
- Population Health Sciences, Bristol Medical SchoolBristolUK
- MRC Integrative Epidemiology Unit at the University of Bristol, Oakfield House, Oakfield GroveBristolUK
| | - Janet Catov
- Department of Obstetrics and GynecologyUniversity of PittsburghPittsburghPennsylvaniaUSA
- Magee‐Womens Research InstitutePittsburghPennsylvaniaUSA
| | - Emma L. Anderson
- Population Health Sciences, Bristol Medical SchoolBristolUK
- MRC Integrative Epidemiology Unit at the University of Bristol, Oakfield House, Oakfield GroveBristolUK
- Department of Mental Health of Older PeopleDivision of PsychiatryUniversity College LondonLondonUK
| | - Winok Lapidaire
- Division of Cardiovascular MedicineRadcliffe Department of MedicineUniversity of OxfordOxfordUK
| | - Fanny Kilpi
- Population Health Sciences, Bristol Medical SchoolBristolUK
- MRC Integrative Epidemiology Unit at the University of Bristol, Oakfield House, Oakfield GroveBristolUK
| | - Deborah A. Lawlor
- Population Health Sciences, Bristol Medical SchoolBristolUK
- MRC Integrative Epidemiology Unit at the University of Bristol, Oakfield House, Oakfield GroveBristolUK
| | - Abigail Fraser
- Population Health Sciences, Bristol Medical SchoolBristolUK
- MRC Integrative Epidemiology Unit at the University of Bristol, Oakfield House, Oakfield GroveBristolUK
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Jaarsma E, Nooyens A, Kok AAL, Köhler S, van Boxtel M, Verschuren WMM, Huisman M. Modifiable Risk Factors for Accelerated Decline in Processing Speed: Results from Three Dutch Population Cohorts. J Prev Alzheimers Dis 2024; 11:108-116. [PMID: 38230723 PMCID: PMC10994989 DOI: 10.14283/jpad.2023.64] [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: 02/06/2023] [Accepted: 04/20/2023] [Indexed: 01/18/2024]
Abstract
BACKGROUND Several lifestyle, cardiovascular and psychosocial factors are associated with risk of cognitive decline and dementia. We studied the independent associations of a broad set of modifiable risk factors with decline in processing speed in three large population-based cohorts with up to 23 years of follow-up. METHODS We used data of 9,666 participants from the Doetinchem Cohort Study, the Longitudinal Aging Study Amsterdam, and the Maastricht Aging Study. Decline in processing speed was measured with the letter digit substitution task or the alphabet coding task and modeled using quadratic latent growth curves. Associations of modifiable risk factors with level and rate of decline in processing speed were investigated by estimating associations with level of processing speed at different centering ages. RESULTS Latent growth curves showed that decline in processing speed accelerated with age. Smoking, not drinking alcohol and depressive symptoms were associated with a lower level of processing speed in all cohorts. In two of the cohorts, more physical activity, drinking more than two glasses of alcohol per day, higher BMI and diabetes were associated with a lower level of processing speed. Depressive symptoms and diabetes were also associated with faster decline in processing speed. CONCLUSION Several modifiable risk factors are associated with the level of processing speed in older age, while few are also related to the rate of decline.
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Affiliation(s)
- E Jaarsma
- Almar Kok Amsterdam UMC Locatie De Boelelaan: Amsterdam UMC Locatie VUmc, The Netherlands,
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Lin K, Wen W, Lipnicki DM, Mewton L, Chen R, Du J, Wang D, Skoog I, Sterner TR, Najar J, Kim KW, Han JW, Kim JS, Ng TP, Ho R, Chua DQL, Anstey KJ, Cherbuin N, Mortby ME, Brodaty H, Kochan N, Sachdev PS, Jiang J. Risk factors and cognitive correlates of white matter hyperintensities in ethnically diverse populations without dementia: The COSMIC consortium. ALZHEIMER'S & DEMENTIA (AMSTERDAM, NETHERLANDS) 2024; 16:e12567. [PMID: 38487075 PMCID: PMC10937819 DOI: 10.1002/dad2.12567] [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: 08/16/2023] [Revised: 01/18/2024] [Accepted: 02/06/2024] [Indexed: 03/17/2024]
Abstract
INTRODUCTION White matter hyperintensities (WMHs) are an important imaging marker for cerebral small vessel diseases, but their risk factors and cognitive associations have not been well documented in populations of different ethnicities and/or from different geographical regions. METHODS We investigated how WMHs were associated with vascular risk factors and cognition in both Whites and Asians, using data from five population-based cohorts of non-demented older individuals from Australia, Singapore, South Korea, and Sweden (N = 1946). WMH volumes (whole brain, periventricular, and deep) were quantified with UBO Detector and harmonized using the ComBat model. We also harmonized various vascular risk factors and scores for global cognition and individual cognitive domains. RESULTS Factors associated with larger whole brain WMH volumes included diabetes, hypertension, stroke, current smoking, body mass index, higher alcohol intake, and insufficient physical activity. Hypertension and stroke had stronger associations with WMH volumes in Whites than in Asians. No associations between WMH volumes and cognitive performance were found after correction for multiple testing. CONCLUSION The current study highlights ethnic differences in the contributions of vascular risk factors to WMHs.
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Affiliation(s)
- Keshuo Lin
- Centre for Healthy Brain AgeingSchool of Clinical MedicineUniversity of New South WalesSydneyNew South WalesAustralia
| | - Wei Wen
- Centre for Healthy Brain AgeingSchool of Clinical MedicineUniversity of New South WalesSydneyNew South WalesAustralia
| | - Darren M. Lipnicki
- Centre for Healthy Brain AgeingSchool of Clinical MedicineUniversity of New South WalesSydneyNew South WalesAustralia
| | - Louise Mewton
- Centre for Healthy Brain AgeingSchool of Clinical MedicineUniversity of New South WalesSydneyNew South WalesAustralia
| | - Rory Chen
- Centre for Healthy Brain AgeingSchool of Clinical MedicineUniversity of New South WalesSydneyNew South WalesAustralia
| | - Jing Du
- Centre for Healthy Brain AgeingSchool of Clinical MedicineUniversity of New South WalesSydneyNew South WalesAustralia
| | - Dadong Wang
- Quantitative Imaging Research TeamCSIRO Informatics and StatisticsNorth RydeNew South WalesAustralia
| | - Ingmar Skoog
- Neuropsychiatric Epidemiology UnitDepartment of Psychiatry and NeurochemistryInstitute of Neuroscience and PhysiologySahlgrenska AcademyUniversity of GothenburgGothenburgSweden
- Centre for Ageing and Health (AGECAP)University of GothenburgGothenburgSweden
- Psychiatry, Cognition and Old Age Psychiatry ClinicSahlgrenska University HospitalGothenburgSweden
| | - Therese Rydberg Sterner
- Neuropsychiatric Epidemiology UnitDepartment of Psychiatry and NeurochemistryInstitute of Neuroscience and PhysiologySahlgrenska AcademyUniversity of GothenburgGothenburgSweden
- Centre for Ageing and Health (AGECAP)University of GothenburgGothenburgSweden
- Aging Research CenterDepartment of NeurobiologyCare Sciences and SocietyKarolinska Institutet and Stockholm UniversityStockholmSweden
| | - Jenna Najar
- Neuropsychiatric Epidemiology UnitDepartment of Psychiatry and NeurochemistryInstitute of Neuroscience and PhysiologySahlgrenska AcademyUniversity of GothenburgGothenburgSweden
- Centre for Ageing and Health (AGECAP)University of GothenburgGothenburgSweden
- Section Genomics of Neurodegenerative Diseases and AgingDepartment of Human GeneticsAmsterdam Universitair Medische CentraAmsterdamthe Netherlands
| | - Ki Woong Kim
- Department of NeuropsychiatrySeoul National University Bundang HospitalSeongnamSouth Korea
- Department of PsychiatrySeoul National University College of MedicineSeoulSouth Korea
- Department of Brain and Cognitive SciencesSeoul National University College of Natural SciencesSeoulSouth Korea
| | - Ji Won Han
- Department of NeuropsychiatrySeoul National University Bundang HospitalSeongnamSouth Korea
- Department of PsychiatrySeoul National University College of MedicineSeoulSouth Korea
| | - Jun Sung Kim
- Department of NeuropsychiatrySeoul National University Bundang HospitalSeongnamSouth Korea
| | - Tze Pin Ng
- Department of Psychological MedicineKhoo Teck Puat HospitalYishunSingapore
- Geriatric Education and Research InstituteMinistry of HealthSingaporeSingapore
| | - Roger Ho
- Institute for Health Innovation and Technology (iHealthtech)National University of SingaporeSingaporeSingapore
| | - Denise Qian Ling Chua
- Department of Psychological MedicineNational University of SingaporeSingaporeSingapore
| | - Kaarin J. Anstey
- School of PsychologyUniversity of New South WalesSydneyNew South WalesAustralia
- Department of NeurodegenerationNeuroscience Research AustraliaSydneyNew South WalesAustralia
- Ageing Futures InstituteUniversity of New South WalesSydneyNew South WalesAustralia
| | - Nicolas Cherbuin
- National Centre for Epidemiology and Population HealthCollege of Health and MedicineAustralian National UniversityCanberraAustralian Capital TerritoryAustralia
| | - Moyra E. Mortby
- School of PsychologyUniversity of New South WalesSydneyNew South WalesAustralia
- Department of NeurodegenerationNeuroscience Research AustraliaSydneyNew South WalesAustralia
- Ageing Futures InstituteUniversity of New South WalesSydneyNew South WalesAustralia
| | - Henry Brodaty
- Centre for Healthy Brain AgeingSchool of Clinical MedicineUniversity of New South WalesSydneyNew South WalesAustralia
| | - Nicole Kochan
- Centre for Healthy Brain AgeingSchool of Clinical MedicineUniversity of New South WalesSydneyNew South WalesAustralia
| | - Perminder S. Sachdev
- Centre for Healthy Brain AgeingSchool of Clinical MedicineUniversity of New South WalesSydneyNew South WalesAustralia
- Neuropsychiatric InstituteThe Prince of Wales HospitalSydneyNew South WalesAustralia
| | - Jiyang Jiang
- Centre for Healthy Brain AgeingSchool of Clinical MedicineUniversity of New South WalesSydneyNew South WalesAustralia
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Soh Y, Whitmer RA, Mayeda ER, Glymour MM, Eng CW, Peterson RL, George KM, Chen R, Quesenberry CP, Mungas DM, DeCarli CS, Gilsanz P. Timing and level of educational attainment and late-life cognition in the KHANDLE study. Alzheimers Dement 2024; 20:593-600. [PMID: 37751937 PMCID: PMC10842991 DOI: 10.1002/alz.13475] [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: 04/03/2023] [Revised: 07/07/2023] [Accepted: 08/23/2023] [Indexed: 09/28/2023]
Abstract
INTRODUCTION The timing of educational attainment may modify its effects on late-life cognition, yet most studies evaluate education only at a single time point. METHODS Kaiser Healthy Aging and Diverse Life Experiences (KHANDLE) Study cohort participants (N = 554) reported educational attainment (dichotomized at any college education) at two time points, and we classified them as having low, high, or later-life high educational attainment. Linear mixed-effects models estimated associations between educational attainment change groups and domain-specific cognitive outcomes (z-standardized). RESULTS Compared to low educational attainment, high (β= 0.59 SD units; 95% confidence interval [CI]: 0.39, 0.79) and later-life high educational attainment (β = 0.22; 95% CI: 0.00, 0.44) were associated with higher executive function. Only high educational attainment was associated with higher verbal episodic memory (β = 0.27; 95% CI: 0.06, 0.48). DISCUSSION Level and timing of educational attainment are both associated with domain-specific cognition. A single assessment for educational attainment may inadequately characterize protective associations with late-life cognition. HIGHLIGHTS Few studies have examined both level and timing of educational attainment on cognition. Marginalized populations are more likely to attain higher education in adulthood. Higher educational attainment in late life is also associated with higher cognition.
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Affiliation(s)
- Yenee Soh
- Kaiser Permanente Division of ResearchOaklandCaliforniaUSA
| | - Rachel A. Whitmer
- Kaiser Permanente Division of ResearchOaklandCaliforniaUSA
- Department of NeurologySchool of MedicineUniversity of CaliforniaDavisCaliforniaUSA
- Department of Public Health SciencesUniversity of CaliforniaDavisCaliforniaUSA
| | - Elizabeth Rose Mayeda
- Department of EpidemiologyUniversity of California, Los Angeles Fielding School of Public HealthLos AngelesCaliforniaUSA
| | - M. Maria Glymour
- Department of Epidemiology and BiostatisticsUniversity of CaliforniaSan FranciscoCaliforniaUSA
| | - Chloe W. Eng
- Department of Epidemiology and Population HealthStanford UniversityStanfordCaliforniaUSA
| | - Rachel L. Peterson
- School of Public and Community Health SciencesUniversity of MontanaMissoulaMontanaUSA
| | - Kristen M. George
- Department of Public Health SciencesUniversity of CaliforniaDavisCaliforniaUSA
| | - Ruijia Chen
- Department of Epidemiology and BiostatisticsUniversity of CaliforniaSan FranciscoCaliforniaUSA
| | | | - Dan M. Mungas
- Department of NeurologySchool of MedicineUniversity of CaliforniaDavisCaliforniaUSA
| | - Charles S. DeCarli
- Department of NeurologySchool of MedicineUniversity of CaliforniaDavisCaliforniaUSA
| | - Paola Gilsanz
- Kaiser Permanente Division of ResearchOaklandCaliforniaUSA
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Xu C, Acevedo P, Lu Y, Su BB, Ozuna K, Padilla V, Karithara A, Mao C, Navia RO, Piamjariyakul U, Wang K. Racial differences in the effect of APOE-ε4 genotypes on trail making test B in Alzheimer's disease: A longitudinal study. Int J Geriatr Psychiatry 2023; 38:e6037. [PMID: 38100638 DOI: 10.1002/gps.6037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Accepted: 11/28/2023] [Indexed: 12/17/2023]
Abstract
OBJECTIVES The trail making test part B (TMT-B) evaluates executive functions, memory, and sensorimotor functions. No previous study was found to examine the longitudinal effect of APOE-ε4 genotypes on the TMT-B scores in Alzheimer's disease (AD) across racial groups. METHODS This study used the data from Alzheimer's Disease Neuroimaging Initiative (ADNI): 382 participants with AD, 503 with cognitive normal (CN), 1293 with mild cognitive impairment (MCI) at baseline and follow-up of four years. The multivariable linear mixed model was used to investigate the effect of APOE-ε4 genotypes on changes in TMT-B scores. RESULTS Compared with Whites, African Americans (AA) and Hispanics had higher TMT-B scores (poor cognitive function). Furthermore, Whites subjects with 1 or 2 APOE-ε4 alleles had significantly higher TMT-B scores compared with individuals without APOE-ε4 allele at baseline and four follow-up visits; however, no differences in TMT-B were found between APOE-ε4 alleles in the Hispanic and AA groups. No APOE-ε4 by visit interactions was found for 3 racial groups. Stratified by AD diagnosis, the APOE-ε4 allele was associated with TMT-B scores only in the MCI group, while there were significant interactions for visit by education, APOE-ε4 allele, and the Mini Mental State Examination (MMSE) score in the MCI group. In addition, TMT-B was significantly correlated with the MMSE, AD Assessment Scale-cognitive subscale 13 (ADAS13), tTau, pTau, Aβ42, and hippocampus. CONCLUSIONS APOE-ɛ4 allele is associated with TMT-B scores in Whites subjects, but not in the Hispanic and AA groups. APOE-ε4 showed interaction with visit in the MCI group.
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Affiliation(s)
- Chun Xu
- Department of Health and Biomedical Sciences, College of Health Professions, University of Texas Rio Grande Valley, Brownsville, Texas, USA
| | - Priscila Acevedo
- Department of Health and Biomedical Sciences, College of Health Professions, University of Texas Rio Grande Valley, Brownsville, Texas, USA
| | - Yongke Lu
- Department of Biomedical Sciences, Joan C. Edwards School of Medicine, Marshall University, Huntington, West Virginia, USA
| | - Brenda Bin Su
- Department of Pediatrics - Allergy and Immunology, Baylor College of Medicine, Houston, Texas, USA
| | - Kaysie Ozuna
- Department of Health and Biomedical Sciences, College of Health Professions, University of Texas Rio Grande Valley, Brownsville, Texas, USA
| | - Victoria Padilla
- Department of Health and Biomedical Sciences, College of Health Professions, University of Texas Rio Grande Valley, Brownsville, Texas, USA
| | - Annu Karithara
- Department of Health and Biomedical Sciences, College of Health Professions, University of Texas Rio Grande Valley, Brownsville, Texas, USA
| | - ChunXiang Mao
- Department of Health and Biomedical Sciences, College of Health Professions, University of Texas Rio Grande Valley, Brownsville, Texas, USA
| | - R Osvaldo Navia
- Department of Medicine and Rockefeller Neuroscience Institute, West Virginia University, Morgantown, West Virginia, USA
| | - Ubolrat Piamjariyakul
- School of Nursing, Health Sciences Center, West Virginia University, Morgantown, West Virginia, USA
| | - Kesheng Wang
- School of Nursing, Health Sciences Center, West Virginia University, Morgantown, West Virginia, USA
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Bidzan L, Jurek P, Olech M, Bidzan-Wiącek M, Bidzan-Bluma I, Bidzan M. Somatic comorbidity and the progression of cognitive impairment. Front Aging Neurosci 2023; 15:1219449. [PMID: 38046465 PMCID: PMC10691469 DOI: 10.3389/fnagi.2023.1219449] [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: 05/09/2023] [Accepted: 11/02/2023] [Indexed: 12/05/2023] Open
Abstract
Background There are usually multiple factors underlying dementia in old age. Somatic comorbidity is one important element that influences the progression of cognitive impairment. Objective The goal of this study was to assess the relationship between the progression of cognitive impairment and the presence and severity of comorbidities based on a four-year observation. Material Out of 128 patients from the Clinic for Outpatients in Gdansk, who were recruited into the study based on the criteria of the Working Group on Mild Cognitive Impairment, a total of 93 participants completed the four-year observation. Only the data from participants who completed the full period of observations were analysed. The mean age of the group was M = 75.93 (SD = 9.43). The level of progression of cognitive impairment was measured using the Clinical Dementia Rating Scale - Sum of Boxes, the severity of comorbidities was measured using the modified Cumulative Illness Rating Scale, and, additionally, at the time of inclusion in the study, participants were assessed using the MMSE scale and the Activity Scale, and sociodemographic data were collected. The Generalized Estimating Equations method was employed to fit a marginal model for analyzing the data collected in a repeated measures design. The tested model elucidated the role of the overall severity of comorbidities in explaining the progression of cognitive impairment, while controlling for everyday activity and basic demographic variables. Results During the four-year observation, a significant decline in cognitive function (B = 1.86, p < 0.01) was observed in the examined sample. The statistical analysis revealed that individuals with higher overall severity of comorbidities exhibited significantly more pronounced progression of cognitive impairment over time. Regarding particular comorbidities, metabolic diseases were found to be associated with a poorer prognosis (rho = 0.41, p < 0.05). Furthermore, a time physical activity interaction was identified as predicting cognitive impairment, indicating that individuals who were more physically active at the beginning of the study exhibited significantly less pronounced progression of cognitive impairment over the course of the 4 years. Conclusion This study suggests the important roles of comorbidities and physical activity for the prognosis of mild cognitive impairment.
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Affiliation(s)
- Leszek Bidzan
- Faculty of Medicine, Medical University of Gdańsk, Gdańsk, Poland
- Department of Health Sciences, Pomeranian University in Słupsk, Słupsk, Poland
| | - Paweł Jurek
- Institute of Psychology, University of Gdańsk, Gdańsk, Poland
| | - Michał Olech
- Faculty of Health Sciences, Medical University of Gdańsk, Gdańsk, Poland
| | | | - Ilona Bidzan-Bluma
- Institute of Psychology, University of Gdańsk, Gdańsk, Poland
- Institute of Pedagogy and Languages, University of Applied Sciences in Elbląg, Elbląg, Poland
| | - Mariola Bidzan
- Institute of Psychology, University of Gdańsk, Gdańsk, Poland
- Institute of Pedagogy and Languages, University of Applied Sciences in Elbląg, Elbląg, Poland
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Kahlenberg H, Jiroutek MR, Misciagno SA. Ethnic and Racial Disparities in the Association between Type II Diabetes Mellitus and Dementia. J Racial Ethn Health Disparities 2023:10.1007/s40615-023-01848-3. [PMID: 37943389 DOI: 10.1007/s40615-023-01848-3] [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: 06/20/2023] [Revised: 10/17/2023] [Accepted: 10/24/2023] [Indexed: 11/10/2023]
Abstract
Evidence in the literature suggests an association between Type 2 Diabetes Mellitus (T2DM) and dementia, but this relationship has not been studied in the most recently available nationally representative datasets. This retrospective, observational, cross-sectional study of adults (60+ years of age) seeks to investigate this association across racial and ethnic groups in the most recently available National Ambulatory Medical Care Survey (NAMCS) datasets. A multivariable logistic regression model is employed to investigate the association between T2DM and the diagnosis of dementia and assess disparities in racial and ethnic groups, while controlling for available covariates of interest. The analysis found no evidence of a relationship between T2DM and dementia even after adjusting for available covariates of interest (OR 1.13, 95% CI = 0.81-1.57). However, evidence of differences in the proportion with dementia was observed between ethnicities and race groups. Hispanic/Latinos were found to have more than double the odds of dementia compared to Non-Hispanic/Latinos (OR 2.08, 95% CI = 1.05-4.14), while the Other race group had 74% lower odds of dementia compared to the White race group (OR 0.26, 95% CI = 0.10-0.64). This study suggests that disparities in the risk of dementia remain for ethnic/racial groups. As minority populations continue to grow, educational and preventative measures for both diabetes and dementia are vital public health priorities. Perceptions of cognitive impairment, its association with T2DM, and the interventions needed to address the deficits may vary by culture and ethnic background; therefore, specific characteristics relevant to these populations should be further evaluated.
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Affiliation(s)
- Halle Kahlenberg
- Department of Pharmaceutical & Clinical Sciences, Campbell University, Buies Creek, NC, USA
| | - Michael R Jiroutek
- Department of Pharmaceutical & Clinical Sciences, Campbell University, Buies Creek, NC, USA
| | - Susan Avila Misciagno
- Department of Pharmaceutical & Clinical Sciences, Campbell University, Buies Creek, NC, USA.
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22
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Lennon MJ, Lam BCP, Lipnicki DM, Crawford JD, Peters R, Schutte AE, Brodaty H, Thalamuthu A, Rydberg-Sterner T, Najar J, Skoog I, Riedel-Heller SG, Röhr S, Pabst A, Lobo A, De-la-Cámara C, Lobo E, Bello T, Gureje O, Ojagbemi A, Lipton RB, Katz MJ, Derby CA, Kim KW, Han JW, Oh DJ, Rolandi E, Davin A, Rossi M, Scarmeas N, Yannakoulia M, Dardiotis T, Hendrie HC, Gao S, Carrière I, Ritchie K, Anstey KJ, Cherbuin N, Xiao S, Yue L, Li W, Guerchet MM, Preux PM, Aboyans V, Haan MN, Aiello AE, Ng TP, Nyunt MSZ, Gao Q, Scazufca M, Sachdev PSS. Use of Antihypertensives, Blood Pressure, and Estimated Risk of Dementia in Late Life: An Individual Participant Data Meta-Analysis. JAMA Netw Open 2023; 6:e2333353. [PMID: 37698858 PMCID: PMC10498335 DOI: 10.1001/jamanetworkopen.2023.33353] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Accepted: 07/28/2023] [Indexed: 09/13/2023] Open
Abstract
Importance The utility of antihypertensives and ideal blood pressure (BP) for dementia prevention in late life remains unclear and highly contested. Objectives To assess the associations of hypertension history, antihypertensive use, and baseline measured BP in late life (age >60 years) with dementia and the moderating factors of age, sex, and racial group. Data Source and Study Selection Longitudinal, population-based studies of aging participating in the Cohort Studies of Memory in an International Consortium (COSMIC) group were included. Participants were individuals without dementia at baseline aged 60 to 110 years and were based in 15 different countries (US, Brazil, Australia, China, Korea, Singapore, Central African Republic, Republic of Congo, Nigeria, Germany, Spain, Italy, France, Sweden, and Greece). Data Extraction and Synthesis Participants were grouped in 3 categories based on previous diagnosis of hypertension and baseline antihypertensive use: healthy controls, treated hypertension, and untreated hypertension. Baseline systolic BP (SBP) and diastolic BP (DBP) were treated as continuous variables. Reporting followed the Preferred Reporting Items for Systematic Review and Meta-Analyses of Individual Participant Data reporting guidelines. Main Outcomes and Measures The key outcome was all-cause dementia. Mixed-effects Cox proportional hazards models were used to assess the associations between the exposures and the key outcome variable. The association between dementia and baseline BP was modeled using nonlinear natural splines. The main analysis was a partially adjusted Cox proportional hazards model controlling for age, age squared, sex, education, racial group, and a random effect for study. Sensitivity analyses included a fully adjusted analysis, a restricted analysis of those individuals with more than 5 years of follow-up data, and models examining the moderating factors of age, sex, and racial group. Results The analysis included 17 studies with 34 519 community dwelling older adults (20 160 [58.4%] female) with a mean (SD) age of 72.5 (7.5) years and a mean (SD) follow-up of 4.3 (4.3) years. In the main, partially adjusted analysis including 14 studies, individuals with untreated hypertension had a 42% increased risk of dementia compared with healthy controls (hazard ratio [HR], 1.42; 95% CI 1.15-1.76; P = .001) and 26% increased risk compared with individuals with treated hypertension (HR, 1.26; 95% CI, 1.03-1.53; P = .02). Individuals with treated hypertension had no significant increased dementia risk compared with healthy controls (HR, 1.13; 95% CI, 0.99-1.28; P = .07). The association of antihypertensive use or hypertension status with dementia did not vary with baseline BP. There was no significant association of baseline SBP or DBP with dementia risk in any of the analyses. There were no significant interactions with age, sex, or racial group for any of the analyses. Conclusions and Relevance This individual patient data meta-analysis of longitudinal cohort studies found that antihypertensive use was associated with decreased dementia risk compared with individuals with untreated hypertension through all ages in late life. Individuals with treated hypertension had no increased risk of dementia compared with healthy controls.
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Affiliation(s)
- Matthew J. Lennon
- Faculty of Medicine, University of New South Wales, Sydney, Australia
- Centre for Healthy Brain Aging, Discipline of Psychiatry & Mental Health, School of Clinical Medicine, University of New South Wales, Sydney, Australia
| | - Ben Chun Pan Lam
- Faculty of Medicine, University of New South Wales, Sydney, Australia
- Centre for Healthy Brain Aging, Discipline of Psychiatry & Mental Health, School of Clinical Medicine, University of New South Wales, Sydney, Australia
- School of Psychology and Public Health, La Trobe University, Melbourne, Australia
| | - Darren M. Lipnicki
- Faculty of Medicine, University of New South Wales, Sydney, Australia
- Centre for Healthy Brain Aging, Discipline of Psychiatry & Mental Health, School of Clinical Medicine, University of New South Wales, Sydney, Australia
| | - John D. Crawford
- Faculty of Medicine, University of New South Wales, Sydney, Australia
- Centre for Healthy Brain Aging, Discipline of Psychiatry & Mental Health, School of Clinical Medicine, University of New South Wales, Sydney, Australia
| | - Ruth Peters
- The George Institute for Global Health, Sydney, Australia
- School of Biomedical Sciences, University of New South Wales, Sydney, Australia
- School of Public Health, Imperial College London, London, United Kingdom
| | - Aletta E. Schutte
- The George Institute for Global Health, Sydney, Australia
- School of Population Health, University of New South Wales, Sydney, Australia
| | - Henry Brodaty
- Faculty of Medicine, University of New South Wales, Sydney, Australia
- Centre for Healthy Brain Aging, Discipline of Psychiatry & Mental Health, School of Clinical Medicine, University of New South Wales, Sydney, Australia
- Eastern Suburbs Older Persons’ Mental Health Service, Sydney, Australia
| | - Anbupalam Thalamuthu
- Faculty of Medicine, University of New South Wales, Sydney, Australia
- Centre for Healthy Brain Aging, Discipline of Psychiatry & Mental Health, School of Clinical Medicine, University of New South Wales, Sydney, Australia
| | - Therese Rydberg-Sterner
- Neuropsychiatric Epidemiology Unit, Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy, Centre for Ageing and Health at the University of Gothenburg, Gothenburg, Sweden
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden
| | - Jenna Najar
- Neuropsychiatric Epidemiology Unit, Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy, Centre for Ageing and Health at the University of Gothenburg, Gothenburg, Sweden
- Psychiatry, Cognition and Old Age Psychiatry Clinic, Region Västra Götaland, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Ingmar Skoog
- Neuropsychiatric Epidemiology Unit, Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy, Centre for Ageing and Health at the University of Gothenburg, Gothenburg, Sweden
- Psychiatry, Cognition and Old Age Psychiatry Clinic, Region Västra Götaland, Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Steffi G. Riedel-Heller
- Institute of Social Medicine, Occupational Health and Public Health, Medical Faculty, University of Leipzig, Leipzig, Germany
| | - Susanne Röhr
- Institute of Social Medicine, Occupational Health and Public Health, Medical Faculty, University of Leipzig, Leipzig, Germany
- School of Psychology, Manawatu Campus, Massey University, Palmerston North, New Zealand
- Global Brain Health Institute, Trinity College Dublin, Dublin, Ireland
| | - Alexander Pabst
- Institute of Social Medicine, Occupational Health and Public Health, Medical Faculty, University of Leipzig, Leipzig, Germany
| | - Antonio Lobo
- Department of Medicine and Psychiatry, Universidad de Zaragoza, Zaragoza, Spain
- Instituto de Investigación Sanitaria Aragón, Zaragoza, Spain
- Centro de Investigación Biomédica en Red de Salud Mental, Madrid, Spain
| | - Concepción De-la-Cámara
- Department of Medicine and Psychiatry, Universidad de Zaragoza, Zaragoza, Spain
- Instituto de Investigación Sanitaria Aragón, Zaragoza, Spain
- Centro de Investigación Biomédica en Red de Salud Mental, Madrid, Spain
| | - Elena Lobo
- Department of Medicine and Psychiatry, Universidad de Zaragoza, Zaragoza, Spain
- Instituto de Investigación Sanitaria Aragón, Zaragoza, Spain
- Centro de Investigación Biomédica en Red de Salud Mental, Madrid, Spain
| | - Toyin Bello
- World Health Organization Collaborating Centre for Research and Training in Mental Health, Neuroscience, and Substance Abuse, Department of Psychiatry, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Oye Gureje
- World Health Organization Collaborating Centre for Research and Training in Mental Health, Neuroscience, and Substance Abuse, Department of Psychiatry, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Akin Ojagbemi
- World Health Organization Collaborating Centre for Research and Training in Mental Health, Neuroscience, and Substance Abuse, Department of Psychiatry, College of Medicine, University of Ibadan, Ibadan, Nigeria
| | - Richard B. Lipton
- Department of Neurology, Albert Einstein College of Medicine, Bronx, New York
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York
| | - Mindy J. Katz
- Department of Neurology, Albert Einstein College of Medicine, Bronx, New York
| | - Carol A. Derby
- Department of Neurology, Albert Einstein College of Medicine, Bronx, New York
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Bronx, New York
| | - Ki Woong Kim
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, Korea
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, Korea
- Department of Brain and Cognitive Sciences, Seoul National University College of Natural Sciences, Seoul, Korea
| | - Ji Won Han
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, Korea
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, Korea
| | - Dae Jong Oh
- Workplace Mental Health Institute, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Elena Rolandi
- Golgi Cenci Foundation, Abbiategrasso, Italy
- Department of Brain and Behavioural Sciences, University of Pavia, Pavia, Italy
| | | | | | - Nikolaos Scarmeas
- First Department of Neurology, Aiginition Hospital, National and Kapodistrian University of Athens, Athens, Greece
- Department of Neurology, Columbia University, New York, New York
| | - Mary Yannakoulia
- Department of Nutrition and Dietetics, School of Health Sciences and Education, Harokopio University, Athens, Greece
| | - Themis Dardiotis
- Department of Neurology, University Hospital of Larissa, Larissa, Greece
- Faculty of Medicine, School of Health Sciences, University of Thessaly, Larissa, Greece
| | - Hugh C. Hendrie
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis
- Indiana Alzheimer Disease Research Center, Indiana Alzheimer Disease Research Center, Indianapolis
| | - Sujuan Gao
- Indiana Alzheimer Disease Research Center, Indiana Alzheimer Disease Research Center, Indianapolis
- Department of Biostatistics and Health Data Science, Indiana University School of Medicine, Indianapolis
| | - Isabelle Carrière
- Institut for Neurosciences of Montpellier, University Montpellier, National Institute for Health and Medical Research, Montpellier, France
| | - Karen Ritchie
- Institut for Neurosciences of Montpellier, University Montpellier, National Institute for Health and Medical Research, Montpellier, France
- Institut du Cerveau Trocadéro, Paris, France
| | - Kaarin J. Anstey
- University of New South Wales, School of Psychology, Sydney, Australia
- Ageing Futures Institute, University of New South Wales, Sydney, Australia
- Neuroscience Research Australia, Sydney, Australia
| | - Nicolas Cherbuin
- National Centre for Epidemiology and Population Health, Australian National University, Canberra, Australia
| | - Shifu Xiao
- Department of Geriatric Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Alzheimer’s Disease and Related Disorders Center, Shanghai Jiao Tong University, Shanghai, China
| | - Ling Yue
- Department of Geriatric Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Alzheimer’s Disease and Related Disorders Center, Shanghai Jiao Tong University, Shanghai, China
| | - Wei Li
- Department of Geriatric Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Alzheimer’s Disease and Related Disorders Center, Shanghai Jiao Tong University, Shanghai, China
| | - Maëlenn M. Guerchet
- National Institute for Health and Medical Research U1094, Institut de Recherche pour le Developpement UMR270, Epidemiology of Chronic Diseases in Tropical Zone, Institute of Epidemiology and Tropical Neurology, OmegaHealth, University Limoges, Centre Hospitalier et Universitaire Limoges, Limoges, France
| | - Pierre-Marie Preux
- National Institute for Health and Medical Research U1094, Institut de Recherche pour le Developpement UMR270, Epidemiology of Chronic Diseases in Tropical Zone, Institute of Epidemiology and Tropical Neurology, OmegaHealth, University Limoges, Centre Hospitalier et Universitaire Limoges, Limoges, France
| | - Victor Aboyans
- National Institute for Health and Medical Research U1094, Institut de Recherche pour le Developpement UMR270, Epidemiology of Chronic Diseases in Tropical Zone, Institute of Epidemiology and Tropical Neurology, OmegaHealth, University Limoges, Centre Hospitalier et Universitaire Limoges, Limoges, France
- Department of Cardiology, Dupuytren 2 University Hospital, Limoges, France
| | - Mary N. Haan
- School of Medicine, University of California, San Francisco
| | - Allison E. Aiello
- Robert N. Butler Columbia Aging Center, Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, New York
| | - Tze Pin Ng
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Geriatric Education and Research Institute, Ministry of Health, Singapore, Singapore
| | - Ma Shwe Zin Nyunt
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Qi Gao
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Marcia Scazufca
- Departamento de Psiquiatria, Faculdade de Medicina, Universidade de Sao Paulo, Sao Paulo, Brazil
| | - Perminder S. S. Sachdev
- Faculty of Medicine, University of New South Wales, Sydney, Australia
- Centre for Healthy Brain Aging, Discipline of Psychiatry & Mental Health, School of Clinical Medicine, University of New South Wales, Sydney, Australia
- Neuropsychiatric Institute, Prince of Wales Hospital, Sydney, Australia
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23
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Lin K, Wen W, Lipnicki DM, Mewton L, Chen R, Du J, Wang D, Skoog I, Sterner TR, Najar J, Kim KW, Han JW, Kim JS, Ng TP, Ho R, Chua DQL, Anstey KJ, Cherbuin N, Mortby ME, Brodaty H, Kochan N, Sachdev PS, Jiang J. Risk factors and cognitive correlates of white matter hyperintensities in ethnically diverse populations without dementia: the COSMIC consortium. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2023:2023.08.30.23294876. [PMID: 37693599 PMCID: PMC10491386 DOI: 10.1101/2023.08.30.23294876] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/12/2023]
Abstract
INTRODUCTION White matter hyperintensities (WMH) are an important imaging marker for cerebral small vessel diseases, but their risk factors and cognitive associations have not been well-documented in populations of different ethnicities and/or from different geographical regions. METHOD Magnetic resonance imaging data of five population-based cohorts of non-demented older individuals from Australia, Singapore, South Korea, and Sweden (N = 1,946) were examined for WMH and their associations with vascular risk factors and cognition. RESULT Factors associated with larger whole brain WMH volumes included diabetes, hypertension, stroke, current smoking, body mass index, higher alcohol intake and insufficient physical activity. Participants with moderate or higher physical activity had less WMH than those who never exercised, but the former two groups did not differ. Hypertension and stroke had stronger associations with WMH volumes in the White, compared to Asian subsample. DISCUSSION The current study highlighted the ethnic differences in the contributions of vascular risk factors to WMH.
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Affiliation(s)
- Keshuo Lin
- Centre for Healthy Brain Ageing, School of Clinical Medicine, University of New South Wales, Sydney, NSW 2052, Australia
| | - Wei Wen
- Centre for Healthy Brain Ageing, School of Clinical Medicine, University of New South Wales, Sydney, NSW 2052, Australia
| | - Darren M. Lipnicki
- Centre for Healthy Brain Ageing, School of Clinical Medicine, University of New South Wales, Sydney, NSW 2052, Australia
| | - Louise Mewton
- Centre for Healthy Brain Ageing, School of Clinical Medicine, University of New South Wales, Sydney, NSW 2052, Australia
| | - Rory Chen
- Centre for Healthy Brain Ageing, School of Clinical Medicine, University of New South Wales, Sydney, NSW 2052, Australia
| | - Jing Du
- Centre for Healthy Brain Ageing, School of Clinical Medicine, University of New South Wales, Sydney, NSW 2052, Australia
| | - Dadong Wang
- CSIRO Informatics and Statistics, Locked Bag 17, North Ryde, NSW 1670, Australia
| | - Ingmar Skoog
- Neuropsychiatric Epidemiology Unit, Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, Box 100, 405 30, at the University of Gothenburg, Sweden
- Centre for Ageing and Health (AGECAP) at the University of Gothenburg, Box 100, 405 30, Sweden
- Region Västra Götaland, Sahlgrenska University Hospital, Psychiatry, Cognition and Old Age Psychiatry Clinic, Gothenburg, Box 100, Goeteborg, Vaestra Goetaland 405 30, Sweden
| | - Therese Rydberg Sterner
- Neuropsychiatric Epidemiology Unit, Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, Box 100, 405 30, at the University of Gothenburg, Sweden
- Centre for Ageing and Health (AGECAP) at the University of Gothenburg, Box 100, 405 30, Sweden
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Nobels väg 6, 171 77 Stockholm, Sweden
| | - Jenna Najar
- Neuropsychiatric Epidemiology Unit, Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, Box 100, 405 30, at the University of Gothenburg, Sweden
- Centre for Ageing and Health (AGECAP) at the University of Gothenburg, Box 100, 405 30, Sweden
- Section Genomics of Neurodegenerative Diseases and Aging, Department of Human Genetics, Amsterdam Universitair Medische Centra, PO Box 7057, 1007 MB, Amsterdam, the Netherlands
| | - Ki Woong Kim
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Gyeonggi-do 13620, Seongnam, Korea
- Department of Psychiatry, Seoul National University College of Medicine, Seoul 03080, Korea
- Department of Brain and Cognitive Sciences, Seoul National University College of Natural Sciences, Seoul 03080, Korea
| | - Ji Won Han
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Gyeonggi-do 13620, Seongnam, Korea
- Department of Psychiatry, Seoul National University College of Medicine, Seoul 03080, Korea
| | - Jun Sung Kim
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Gyeonggi-do 13620, Seongnam, Korea
| | - Tze Pin Ng
- Khoo Teck Puat Hospital, 768828, Singapore
- Geriatric Education and Research Institute, Ministry of Health, 768024, Singapore
| | - Roger Ho
- Institute for Health Innovation and Technology (iHealthtech), National University of Singapore, 119077, Singapore
| | - Denise Qian Ling Chua
- Department of Psychological Medicine, National University of Singapore, 119077, Singapore
| | - Kaarin J. Anstey
- School of Psychology, University of New South Wales, NSW 2052,Australia
- Neuroscience Research Australia, NSW 2031, Australia
- Ageing Futures Institute, University of New South Wales, NSW 2052,Australia
| | - Nicolas Cherbuin
- National Centre for Epidemiology and Population Health, College of Health and Medicine, Australian National University, ACT 2600, Canberra, Australia
| | - Moyra E. Mortby
- School of Psychology, University of New South Wales, NSW 2052,Australia
- Neuroscience Research Australia, NSW 2031, Australia
- Ageing Futures Institute, University of New South Wales, NSW 2052,Australia
| | - Henry Brodaty
- Centre for Healthy Brain Ageing, School of Clinical Medicine, University of New South Wales, Sydney, NSW 2052, Australia
| | - Nicole Kochan
- Centre for Healthy Brain Ageing, School of Clinical Medicine, University of New South Wales, Sydney, NSW 2052, Australia
| | - Perminder S. Sachdev
- Centre for Healthy Brain Ageing, School of Clinical Medicine, University of New South Wales, Sydney, NSW 2052, Australia
- Neuropsychiatric Institute, The Prince of Wales Hospital, Sydney, NSW 2031, Australia
| | - Jiyang Jiang
- Centre for Healthy Brain Ageing, School of Clinical Medicine, University of New South Wales, Sydney, NSW 2052, Australia
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24
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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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25
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Shi X, Wang Y, Wu Y, Li J. The effect of the leisure activities based on chess and cards for improving cognition of older adults: study protocol for a cluster randomized controlled trial. Trials 2023; 24:484. [PMID: 37516846 PMCID: PMC10386780 DOI: 10.1186/s13063-023-07528-1] [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: 04/18/2023] [Accepted: 07/20/2023] [Indexed: 07/31/2023] Open
Abstract
BACKGROUND With the increase in age, the probability of cognitive impairment in the older people is increasing. More and more evidence shows that participating in leisure activities, especially chess and cards, is beneficial to the cognition and mental state of the older people. But the evidence for causal inference is limited. There is a need to conduct a fully powered randomized controlled trial (RCT) and long-term follow-up to test the effectiveness of intervention measures in improving cognitive function and mental state. This paper describes the methodology of a cluster RCT designed to determine the effect of chess and cards leisure activities on the cognitive function of the older people over 60 years old. METHODS/DESIGN A cluster RCT consisting of 8 clusters will be conducted in four regions of Ningxia, China (Helan, Litong, Qingtongxia, and Shapotou). Clusters will be randomly assigned to the advocacy intervention group, which is also delivered with free leisure activities tools (chess and cards), or the control group. A baseline survey will be conducted before the intervention. A mid-term and final survey will be carried out twelve and twenty-four months after the intervention, respectively. The primary outcome is a change in cognitive function, and the secondary outcomes are changes in anxiety, depression, and loneliness. DISCUSSION The results of this RCT will be helpful to (1) confirm the effectiveness of chess and cards leisure activities in improving the cognitive function of the older people over 60 years old; (2) determine the relationship between the frequency and duration of chess and cards leisure activities and cognitive function; (3) provide evidence of promoting participation in leisure activities through education campaigns and free provision of chess and cards tools; and (4) provide valuable information for successful aging. TRIAL REGISTRATION Chinese Clinical Trial Registry: ChiCTR2200066817. Registered on 19 December 2022.
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Affiliation(s)
- Xiaojuan Shi
- Department of Epidemiology and Health Statistics, School of Public Health, Ningxia Medical University, Yinchuan, 750004, China
| | - Yanrong Wang
- Department of Epidemiology and Health Statistics, School of Public Health, Ningxia Medical University, Yinchuan, 750004, China
| | - Yueping Wu
- Department of Epidemiology and Health Statistics, School of Public Health, Ningxia Medical University, Yinchuan, 750004, China
| | - Jiangping Li
- Department of Epidemiology and Health Statistics, School of Public Health, Ningxia Medical University, Yinchuan, 750004, China.
- Key Laboratory of Environmental Factors and Chronic Disease Control, Ningxia Medical University, Hui Autonomous Region, Yinchuan, 750004, Ningxia, China.
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26
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Vásquez E, Kuniholm MH, Appleton AA, Rubin LH, Adimora AA, Fischl MA, Fox E, Mack WJ, Holman S, Moran CA, Minkoff H, Plankey MW, Sharma A, Tien PC, Weber KM, Gustafson DR. Midlife body mass index, central adiposity and neuropsychological performance over 10 years in women living with and without HIV. Front Endocrinol (Lausanne) 2023; 14:1108313. [PMID: 37484940 PMCID: PMC10361616 DOI: 10.3389/fendo.2023.1108313] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Accepted: 06/09/2023] [Indexed: 07/25/2023] Open
Abstract
Background and objective Observations of overweight and obesity in association with neuropsychological performance (NP) vary over the adult life course depending on baseline levels, biological sex, age, race, temporality of measurements, and other factors. Therefore, similar published analyses across cohorts are inconsistent. In our sample of women living with HIV (WLWH) and women without HIV (WWOH), we conducted comparable analyses as those published in men with and without HIV. We examined cross-sectional and longitudinal associations between body mass index (BMI) and waist circumference (WC) and NP. Methods Four hundred thirty two 432 virologically-suppressed WLWH and 367 WWOH, ≥40 years in the Women's Interagency HIV Study (WIHS) with anthropometry and NP assessments every two years from 2009-2019 were included in the study. Demographically-adjusted T-scores were calculated for six NP domains: learning, memory, executive function, processing speed, attention and working memory, and motor function. Multivariable linear regression models stratified by HIV status were used to examine cross-sectional associations of BMI and WC by NP domain; repeated measures analyses assessed baseline BMI and WC in association with longitudinal change in NP. Covariates included sociodemographic, behavioral, and HIV-related characteristics. Results At baseline among all women, the median age was 45 years, 65% were Non-Latinx Black women, and 45% were obese women. Obese WLWH (BMI≥30.0 kg/m2) had poorer executive function (β=-2.27, 95%CI [-4.46, -0.07]) versus WLWH with healthy BMI (18.5-24.9 kg/m2). Longitudinally over ~8 years, obese versus overweight WWOH improved on memory (β=2.19, 95%CI [0.13, 4.26]), however overweight versus healthy WWOH experienced declining memory (β= -2.67, 95%CI [-5.40, -0.07]). Increasing WC was associated with declining executive, processing speed, and motor function (p's<0.05); an at-risk WC was associated with improved memory (β=1.81, 95%CI [0.19, 3.44]) among WWOH. Among WLWH, increasing BMI was associated with improved learning (β=0.07, 95%CI [0.00, 0.15]. Conclusion Our cross-sectional and longitudinal analyses evaluating the associations of BMI and WC and NP were mixed compared to previous reports. This illustrates the importance of sociodemographic characteristics, baseline levels of exposures and outcomes, HIV status, temporality of measurements, and other factors when evaluating aging HIV epidemiology study results.
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Affiliation(s)
- Elizabeth Vásquez
- Department of Epidemiology and Biostatistics, University at Albany School of Public Health State University of New York, Rensselaer, NY, United States
| | - Mark H. Kuniholm
- Department of Epidemiology and Biostatistics, University at Albany School of Public Health State University of New York, Rensselaer, NY, United States
| | - Allison A. Appleton
- Department of Epidemiology and Biostatistics, University at Albany School of Public Health State University of New York, Rensselaer, NY, United States
| | - Leah H. Rubin
- Department of Neurology, Johns Hopkins University, Baltimore, MD, United States
- Department of Psychology, Johns Hopkins University, Baltimore, MD, United States
- Department Epidemiology, Johns Hopkins University, Baltimore, MD, United States
| | - Ada A. Adimora
- Department of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
- Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States
| | - Margaret A. Fischl
- Department of Medicine, University of Miami Miller School of Medicine, Miami, FL, United States
| | - Ervin Fox
- Department of Medicine, University of Mississippi Medical Center, Jackson, MS, United States
| | - Wendy J. Mack
- Population and Public Health Sciences, University of Southern California, Los Angeles, CA, United States
| | - Susan Holman
- Department of Medicine/STAR Program, State University of New York Health Sciences University, Brooklyn, NY, United States
| | - Caitlin Anne Moran
- Department of Medicine, Emory University School of Medicine, Atlanta, GA, United States
- Grady Healthcare System, Infectious Diseases Program, Atlanta, United States
| | - Howard Minkoff
- Department of Neurology, State of New York Downstate Health Sciences University, Brooklyn, NY, United States
| | - Michael W. Plankey
- Department of Medicine, Georgetown University, Washington, DC, United States
| | - Anjali Sharma
- Department of Medicine, Albert Einstein College of Medicine, Bronx, NY, United States
| | - Phyllis C. Tien
- Department of Medicine, University of California, San Francisco, CA, United States
- Department of Veterans Affairs, San Francisco, CA, United States
| | - Kathleen M. Weber
- Cook County Health/Hektoen Institute of Medicine, Chicago, IL, United States
| | - Deborah R. Gustafson
- Department of Neurology, State of New York Downstate Health Sciences University, Brooklyn, NY, United States
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27
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Calvert P, Kollias G, Pürerfellner H, Narasimhan C, Osorio J, Lip GYH, Gupta D. Silent cerebral lesions following catheter ablation for atrial fibrillation: a state-of-the-art review. Europace 2023; 25:euad151. [PMID: 37306314 PMCID: PMC10259069 DOI: 10.1093/europace/euad151] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Accepted: 04/25/2023] [Indexed: 06/13/2023] Open
Abstract
Atrial fibrillation is associated with neurocognitive comorbidities such as stroke and dementia. Evidence suggests that rhythm control-especially if implemented early-may reduce the risk of cognitive decline. Catheter ablation is highly efficacious for restoring sinus rhythm in the setting of atrial fibrillation; however, ablation within the left atrium has been shown to result in MRI-detected silent cerebral lesions. In this state-of-the-art review article, we discuss the balance of risk between left atrial ablation and rhythm control. We highlight suggestions to lower the risk, as well as the evidence behind newer forms of ablation such as very high power short duration radiofrequency ablation and pulsed field ablation.
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Affiliation(s)
- Peter Calvert
- Liverpool Centre for Cardiovascular Science at University of Liverpool, Liverpool John Moores University and Liverpool Heart & Chest Hospital, Liverpool, UK
- Department of Cardiology, Liverpool Heart & Chest Hospital NHS Foundation Trust, Thomas Drive, Liverpool L14 3PE, UK
| | | | | | - Calambur Narasimhan
- Department of Cardiac Electrophysiology, AIG Hospitals, 1-66/AIG/2 to 5, Mindspace Road, Gachibowli Hyderabad, Telangana 500032, India
| | - Jose Osorio
- Grandview Medical Center, Arrhythmia Institute at Grandview, 3686 Grandview Parkway Suite 720, Birmingham, AL 35243, USA
| | - Gregory Y H Lip
- Liverpool Centre for Cardiovascular Science at University of Liverpool, Liverpool John Moores University and Liverpool Heart & Chest Hospital, Liverpool, UK
- Department of Cardiology, Liverpool Heart & Chest Hospital NHS Foundation Trust, Thomas Drive, Liverpool L14 3PE, UK
- Danish Centre for Clinical Health Services Research, Aalborg University, Aalborg, Denmark
| | - Dhiraj Gupta
- Liverpool Centre for Cardiovascular Science at University of Liverpool, Liverpool John Moores University and Liverpool Heart & Chest Hospital, Liverpool, UK
- Department of Cardiology, Liverpool Heart & Chest Hospital NHS Foundation Trust, Thomas Drive, Liverpool L14 3PE, UK
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28
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Hyun J, Katz MJ, Derby CA, Roque N, Muñoz E, Sliwinski MJ, Lovasi GS, Lipton RB. Availability of healthy foods, fruit and vegetable consumption, and cognition among urban older adults. BMC Geriatr 2023; 23:302. [PMID: 37198552 PMCID: PMC10189949 DOI: 10.1186/s12877-023-04003-z] [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: 11/14/2022] [Accepted: 04/26/2023] [Indexed: 05/19/2023] Open
Abstract
BACKGROUND . Although prior studies have examined the associations between neighborhood characteristics and cognitive health, little is known about whether local food environments, which are critical for individuals' daily living, are associated with late-life cognition. Further, little is known about how local environments may shape individuals' health-related behaviors and impact cognitive health. The aim of this study is to examine whether objective and subjective measures of healthy food availability are associated with ambulatory cognitive performance and whether behavioral and cardiovascular factors mediate these associations among urban older adults. METHODS . The sample consisted of systematically recruited, community-dwelling older adults (N = 315, mean age = 77.5, range = 70-91) from the Einstein Aging Study. Objective availability of healthy foods was defined as density of healthy food stores. Subjective availability of healthy foods and fruit/vegetable consumption were assessed using self-reported questionnaires. Cognitive performance was assessed using smartphone-administered cognitive tasks that measured processing speed, short-term memory binding, and spatial working memory performance 6 times a day for 14 days. RESULTS . Results from multilevel models showed that subjective availability of healthy foods, but not objective food environments, was associated with better processing speed (estimate= -0.176, p = .003) and more accurate memory binding performance (estimate = 0.042, p = .012). Further, 14~16% of the effects of subjective availability of healthy foods on cognition were mediated through fruit and vegetable consumption. CONCLUSIONS . Local food environments seem to be important for individuals' dietary behavior and cognitive health. Specifically, subjective measures of food environments may better reflect individuals' experiences regarding their local food environments not captured by objective measures. Future policy and intervention strategies will need to include both objective and subjective food environment measures in identifying impactful target for intervention and evaluating effectiveness of policy changes.
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Affiliation(s)
- Jinshil Hyun
- The Saul R. Korey Department of Neurology, Albert Einstein College of Medicine, 1300 Morris Park Avenue, Bronx, NY, 10461, USA.
| | - Mindy J Katz
- The Saul R. Korey Department of Neurology, Albert Einstein College of Medicine, 1300 Morris Park Avenue, Bronx, NY, 10461, USA
| | - Carol A Derby
- The Saul R. Korey Department of Neurology, Albert Einstein College of Medicine, 1300 Morris Park Avenue, Bronx, NY, 10461, USA
| | - Nelson Roque
- Department of Psychology, University of Central Florida, Orlando, FL, USA
| | - Elizabeth Muñoz
- Department of Human Development and Family Sciences, University of Texas Austin, Austin, TX, USA
| | - Martin J Sliwinski
- Department of Human Development and Family Studies, The Pennsylvania State University, University Park, PA, USA
- Center for Healthy Aging, The Pennsylvania State University, University Park, PA, USA
| | - Gina S Lovasi
- Department of Epidemiology and Biostatistics, Drexel University, Philadelphia, PA, USA
- Urban Health Collaborative, Dornsife School of Public Health, Drexel University, Philadelphia, PA, USA
| | - Richard B Lipton
- The Saul R. Korey Department of Neurology, Albert Einstein College of Medicine, 1300 Morris Park Avenue, Bronx, NY, 10461, USA
- Headache Center, Montefiore Medical Center, Bronx, NY, USA
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29
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Zhang H, Ni R, Cao Y, Chen Y, Fang W, Hu W, Pan G. Interaction between home and community-based services and PM 2.5 on cognition: A prospective cohort study of Chinese elderly. ENVIRONMENTAL RESEARCH 2023; 231:116048. [PMID: 37146931 DOI: 10.1016/j.envres.2023.116048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/05/2023] [Revised: 04/27/2023] [Accepted: 05/02/2023] [Indexed: 05/07/2023]
Abstract
PM2.5 and home and community-based services (HCBSs) had been shown to affect cognition, but the evidence on their joint effects was limited. Aimed to study the joint effects of HCBSs and PM2.5 on cognition, we utilized the follow-up data of participants in the Chinese Longitudinal Health Longevity Survey (CLHLS) who were 65 years of age or older and had normal cognitive function at baseline for the 2008-2018, 2011-2018, and 2014-2018 waves. 16,954, 9,765, and 7192 participants from each of these three waves were initially recruited, respectively. The PM2.5 concentration data of each province in China from 2008 to 2018 was obtained from the Atmospheric Composition Analysis Group. Participants were asked what kind of HCBSs were available in their community. The cognitive status of the participants was evaluated by the Chinese version of Mini-Mental State Examination (CMMSE). We applied the Cox proportional hazard regression model to investigate the joint effects of HCBSs and PM2.5 on cognition and further stratified the analysis according to HCBSs. Hazard ratio (HR) and 95% confidence interval (95% CI) were calculated based on Cox models. During a median follow-up period of 5.2 years, 911 (8.8%) participants with normal baseline cognitive function developed cognitive impairment. Compared to participants without HCBSs and exposed to the highest level of PM2.5, those with HCBSs and exposed to the lowest level of PM2.5 had a significantly reduced risk of developing cognitive impairment (HR = 0.428, 95% CI: 0.303-0.605). The results from the stratified analysis revealed that the detrimental effect of PM2.5 on cognition was more pronounced in participants without HCBSs (HR = 3.44, 95% CI: 2.18-5.41) compared with those with HCBSs (HR = 1.42, 95% CI: 0.77-2.61). HCBSs may attenuate the harmful impact of PM2.5 on cognitive status in the elderly Chinese and the government should further promote the application of HCBSs.
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Affiliation(s)
- Hengchuan Zhang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui, 230032, China
| | - Ruyu Ni
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui, 230032, China
| | - Yawen Cao
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui, 230032, China
| | - Yingying Chen
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui, 230032, China
| | - Wenbin Fang
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui, 230032, China
| | - Wan Hu
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui, 230032, China
| | - Guixia Pan
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, 81 Meishan Road, Hefei, Anhui, 230032, China; Key Laboratory of Population Health Across Life Cycle (Anhui Medical University), Ministry of Education of the People's Republic of China, No 81 Meishan Road, Hefei, Anhui, China.
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30
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Mina T, Yew YW, Ng HK, Sadhu N, Wansaicheong G, Dalan R, Low DYW, Lam BCC, Riboli E, Lee ES, Ngeow J, Elliott P, Griva K, Loh M, Lee J, Chambers J. Adiposity impacts cognitive function in Asian populations: an epidemiological and Mendelian Randomization study. THE LANCET REGIONAL HEALTH. WESTERN PACIFIC 2023; 33:100710. [PMID: 36851942 PMCID: PMC9957736 DOI: 10.1016/j.lanwpc.2023.100710] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/01/2022] [Revised: 01/19/2023] [Accepted: 01/26/2023] [Indexed: 02/15/2023]
Abstract
Background Obesity and related metabolic disturbances including diabetes, hypertension and hyperlipidemia predict future cognitive decline. Asia has a high prevalence of both obesity and metabolic disease, potentially amplifying the future burden of dementia in the region. We aimed to investigate the impact of adiposity and metabolic risk on cognitive function in Asian populations, using an epidemiological analysis and a two-sample Mendelian Randomization (MR) study. Methods The Health for Life in Singapore (HELIOS) Study is a population-based cohort of South-East-Asian men and women in Singapore, aged 30-84 years. We analyzed 8769 participants with metabolic and cognitive data collected between 2018 and 2021. Whole-body fat mass was quantified with Dual X-Ray Absorptiometry (DEXA). Cognition was assessed using a computerized cognitive battery. An index of general cognition ' g ' was derived through factor analysis. We tested the relationship of fat mass indices and metabolic measures with ' g ' using regression approaches. We then performed inverse-variance-weighted MR of adiposity and metabolic risk factors on ' g ', using summary statistics for genome-wide association studies of BMI, visceral adipose tissue (VAT), waist-hip-ratio (WHR), blood pressure, HDL cholesterol, triglycerides, fasting glucose, HbA1c, and general cognition. Findings Participants were 58.9% female, and aged 51.4 (11.3) years. In univariate analysis, all 29 adiposity and metabolic measures assessed were associated with ' g ' at P < 0.05. In multivariable analyses, reduced ' g ' was consistently associated with increased visceral fat mass index and lower HDL cholesterol (P < 0.001), but not with blood pressure, triglycerides, or glycemic indices. The reduction in ' g ' associated with 1SD higher visceral fat, or 1SD lower HDL cholesterol, was equivalent to a 0.7 and 0.9-year increase in chronological age respectively (P < 0.001). Inverse variance MR analyses showed that reduced ' g ' is associated with genetically determined elevation of VAT, BMI and WHR (all P < 0.001). In contrast, MR did not support a causal role for blood pressure, lipid, or glycemic indices on cognition. Interpretation We show an independent relationship between adiposity and cognition in a multi-ethnic Asian population. MR analyses suggest that both visceral adiposity and raised BMI are likely to be causally linked to cognition. Our findings have important implications for preservation of cognitive health, including further motivation for action to reverse the rising burden of obesity in the Asia-Pacific region. Funding The Nanyang Technological University-the Lee Kong Chian School of Medicine, National Healthcare Group, National Medical Research Council, Ministry of Education, Singapore.
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Affiliation(s)
- Theresia Mina
- Nanyang Technological University Lee Kong Chian School of Medicine, Level 18 Clinical Sciences Building, 11 Mandalay Road, 308232, Singapore
| | - Yik Weng Yew
- Nanyang Technological University Lee Kong Chian School of Medicine, Level 18 Clinical Sciences Building, 11 Mandalay Road, 308232, Singapore.,National Skin Centre, Research Division, 1 Mandalay Rd, 308205, Singapore
| | - Hong Kiat Ng
- Nanyang Technological University Lee Kong Chian School of Medicine, Level 18 Clinical Sciences Building, 11 Mandalay Road, 308232, Singapore
| | - Nilanjana Sadhu
- Nanyang Technological University Lee Kong Chian School of Medicine, Level 18 Clinical Sciences Building, 11 Mandalay Road, 308232, Singapore
| | - Gervais Wansaicheong
- Nanyang Technological University Lee Kong Chian School of Medicine, Level 18 Clinical Sciences Building, 11 Mandalay Road, 308232, Singapore.,Department of Diagnostic Radiology, Tan Tock Seng Hospital (TTSH), 11 Jalan Tan Tock Seng, 308433, Singapore
| | - Rinkoo Dalan
- Nanyang Technological University Lee Kong Chian School of Medicine, Level 18 Clinical Sciences Building, 11 Mandalay Road, 308232, Singapore.,Department of Endocrinology, TTSH, Singapore
| | - Dorrain Yan Wen Low
- Nanyang Technological University Lee Kong Chian School of Medicine, Level 18 Clinical Sciences Building, 11 Mandalay Road, 308232, Singapore
| | - Benjamin Chih Chiang Lam
- Nanyang Technological University Lee Kong Chian School of Medicine, Level 18 Clinical Sciences Building, 11 Mandalay Road, 308232, Singapore.,Khoo Teck Puat Hospital, Integrated Care for Obesity & Diabetes, 90 Yishun Central, 768828, Singapore
| | - Elio Riboli
- Nanyang Technological University Lee Kong Chian School of Medicine, Level 18 Clinical Sciences Building, 11 Mandalay Road, 308232, Singapore.,Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, 152 Medical School, St Mary's Campus, London, W2 1NY, United Kingdom
| | - Eng Sing Lee
- Nanyang Technological University Lee Kong Chian School of Medicine, Level 18 Clinical Sciences Building, 11 Mandalay Road, 308232, Singapore.,Clinical Research Unit, National Healthcare Group Polyclinic, 3 Fusionopolis Link, Nexus@one-north, #05-10, 138543, Singapore
| | - Joanne Ngeow
- Nanyang Technological University Lee Kong Chian School of Medicine, Level 18 Clinical Sciences Building, 11 Mandalay Road, 308232, Singapore.,Division of Medical Oncology, National Cancer Centre, 11 Hospital Drive, 169610, Singapore
| | - Paul Elliott
- Nanyang Technological University Lee Kong Chian School of Medicine, Level 18 Clinical Sciences Building, 11 Mandalay Road, 308232, Singapore.,Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, 152 Medical School, St Mary's Campus, London, W2 1NY, United Kingdom
| | - Konstadina Griva
- Nanyang Technological University Lee Kong Chian School of Medicine, Level 18 Clinical Sciences Building, 11 Mandalay Road, 308232, Singapore
| | - Marie Loh
- Nanyang Technological University Lee Kong Chian School of Medicine, Level 18 Clinical Sciences Building, 11 Mandalay Road, 308232, Singapore.,National Skin Centre, Research Division, 1 Mandalay Rd, 308205, Singapore
| | - Jimmy Lee
- Nanyang Technological University Lee Kong Chian School of Medicine, Level 18 Clinical Sciences Building, 11 Mandalay Road, 308232, Singapore.,Research Division, Institute of Mental Health, 539747, Singapore
| | - John Chambers
- Nanyang Technological University Lee Kong Chian School of Medicine, Level 18 Clinical Sciences Building, 11 Mandalay Road, 308232, Singapore.,Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, 152 Medical School, St Mary's Campus, London, W2 1NY, United Kingdom
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31
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Baillet M, Morello R, Vittecoq O, Chavoix C, Marcelli C. Bone, cognitive, and anthropometric profiles and their relation to fracture sites in fallers: a cross-sectional study. Osteoporos Int 2023; 34:901-913. [PMID: 36959306 DOI: 10.1007/s00198-023-06701-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Accepted: 02/08/2023] [Indexed: 03/25/2023]
Abstract
UNLABELLED Risk factors involved in the different osteoporotic fracture locations are not well-known. The results of this study suggest that there is not one typical profile characterising a particular fracture site but that the occurrence of a fracture may result from the combination of different bone, cognitive, and anthropometrics characteristics. PURPOSE Risk factors involved in the different osteoporotic fracture locations are not well-known. The aim of this study was to identify the differences in bone, cognitive, and anthropometric characteristics between different fracture sites, and to determine whether the site of a fall-related fracture is related to a specific profile. METHODS One hundred six women aged 55 years and older with a recent fall-related fracture of the hip (n = 30), humerus (n = 28), wrist (n = 32), or ankle (n = 16) were included. Bone, cognitive, and anthropometric characteristics were first compared among the four fracture site groups. Then, a principal component analysis (PCA) was performed and a comparison was made between the four profiles identified by the first two PCA components. RESULTS The four fracture site groups differed significantly in their education level, bone mineral density (BMD), body mass index (BMI), fear of falling, and number of errors in the Trail Making Test B, an executive function test. Each of the four fracture sites was found in each four PCA profiles, albeit with a different distribution. The profiles differed mainly by bone, cognitive, and anthropometric characteristics, but also by fear of falling. CONCLUSIONS The fall-related fracture sites differ significantly in anthropometric and bone parameters, in fear of falling and in cognitive abilities. There is not one typical bone, cognitive, and anthropometric profile characterising a particular fall-related site, but rather several possible profiles for a given site. This suggests that the fracture site depends on a combination of several characteristics of the patient.
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Affiliation(s)
- Maëlle Baillet
- INSERM, UniCaen, U1075, COMETE, PFRS, Normandie University, Caen, France
- Department of Rheumatology, Caen University Hospital, Caen, France
| | - Rémy Morello
- Department of Statistics and Clinical Research, Caen University Hospital, Caen, France
| | - Olivier Vittecoq
- Department of Rheumatology, Rouen University Hospital, Rouen, France
| | - Chantal Chavoix
- INSERM, UniCaen, U1075, COMETE, PFRS, Normandie University, Caen, France
| | - Christian Marcelli
- INSERM, UniCaen, U1075, COMETE, PFRS, Normandie University, Caen, France.
- Department of Rheumatology, Caen University Hospital, Caen, France.
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Li Y, Yang Y, Zhao P, Wang J, Mi B, Zhao Y, Pei L, Yan H, Chen F. Longitudinal associations between specific types/amounts social contact and cognitive function among middle-aged and elderly Chinese: A causal inference and longitudinal targeted maximum likelihood estimation analysis. J Affect Disord 2023; 331:158-166. [PMID: 36963512 DOI: 10.1016/j.jad.2023.03.039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Revised: 03/03/2023] [Accepted: 03/15/2023] [Indexed: 03/26/2023]
Abstract
BACKGROUND Social contact has demonstrated associations with cognitive function, while the literature on the effect of specific social relationship subdomains on cognitive function is limited. This study aimed to examine the causal effects of specific types/amounts of social contact on cognitive function among middle-aged and elderly Chinese. METHODS A total of 38,883 middle-aged and elderly adults from the China Health and Retirement Longitudinal Study were involved. Social contact in this study included interaction with families, taking care of grandchildren, interaction with friends, and participation in three types of social activities. We performed the linear mixed-effects model analysis with propensity score approach and the longitudinal targeted maximum likelihood-based estimation analysis after adjusting for potential covariates and confounders. RESULTS Interaction with families, caring for grandchildren, interaction with friends and participation in social activities were all associated with cognitive z-scores. Participants who interacted with families "2-3 times a week" and "once a week" versus "almost every day" had higher cognitive z-scores. Those who interacted with friends and participated in social activities "almost every week" versus "almost daily" had higher cognitive z-scores. LIMITATIONS The assessment of cognition was biased against people with poor education due to elements of language and mathematical testing, and against those with visual impairment. CONCLUSIONS Social contact was associated with better cognitive function among middle-aged and elderly Chinese. Social contact "1-3 times a week" was optimal for cognitive function. More social contact in middle-aged and elderly Chinese led to less cognitive decline in later life than in their inactive peers.
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Affiliation(s)
- Yemian Li
- Department of Epidemiology and Biostatistics, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi 710061, China
| | - Yuhui Yang
- Department of Epidemiology and Biostatistics, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi 710061, China
| | - Peng Zhao
- Department of Epidemiology and Biostatistics, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi 710061, China
| | - Jingxian Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi 710061, China
| | - Baibing Mi
- Department of Epidemiology and Biostatistics, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi 710061, China
| | - Yaling Zhao
- Department of Epidemiology and Biostatistics, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi 710061, China
| | - Leilei Pei
- Department of Epidemiology and Biostatistics, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi 710061, China
| | - Hong Yan
- Department of Epidemiology and Biostatistics, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi 710061, China
| | - Fangyao Chen
- Department of Epidemiology and Biostatistics, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi 710061, China; Department of Radiology, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi 710061, China.
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33
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Zhou R, Wang Y, Gao L, Dang L, Shang S, Hu N, Peng W, Zhao Y, Wei S, Yuan Y, Gao F, Wang J, Qu Q. Nonlinear relationship between pulse pressure and risk of cognitive impairment: A 4-year community-based cohort study in Xi'an, China. J Neurol Sci 2023; 447:120613. [PMID: 36924588 DOI: 10.1016/j.jns.2023.120613] [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: 08/12/2022] [Revised: 02/11/2023] [Accepted: 03/06/2023] [Indexed: 03/13/2023]
Abstract
OBJECTIVES It has been known that pulse pressure (PP) is a risk factor for cardiovascular disease and stroke, however, the relationship between PP and cognitive impairment is unclear. METHODS This was a community-based cohort study. Participates were followed-up for 4 years and new-onset cognitive impairment was diagnosed. Multivariable logistic regression and restricted cubic spline (RCS) were used to investigate the relationship between PP and cognitive impairment. Propensity score matching (PSM) and sensitivity analysis among ApoEε4 non-carriers were performed to confirm the results. RESULTS 1462 participants were included at baseline and 1173 completed the follow-up. There were 42 (3.5%) new-onset cognitive impairment of whom 31 were diagnosed with MCI and 11 with dementia during the follow-up. Multivariable logistic regression analysis showed that PP was positively associated with cognitive impairment (OR = 2.853, 95% CI 1.079-7.548, p = 0.035), and RCS suggested a non-linear relationship (Pnon-linear = 0.034). The risk of cognitive impairment merely changed when the PP was below about 46.7 mmHg and increased rapidly thereafter. After the covariates were well balanced using PSM (standardized mean differences <0.1 for all covariates), logistic regression analysis revealed the risk of cognitive impairment was still higher for those with high PP (OR = 3.369, 95% CI 1.202-9.441, p = 0.021). Sensitivity analysis showed consistent results with primary analysis. CONCLUSION PP is associated with cognitive impairment in a non-linear manner among middle-aged and elderly. The risk of cognitive impairment increases rapidly when PP exceeds about 46.7 mmHg, which may be informative for subsequent research of PP control ranges.
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Affiliation(s)
- Rong Zhou
- Department of Neurology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Yanyu Wang
- Department of Neurology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Ling Gao
- Department of Neurology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Liangjun Dang
- Department of Neurology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Suhang Shang
- Department of Neurology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Ningwei Hu
- Department of Neurology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Wei Peng
- Department of Neurology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Yi Zhao
- Department of Neurology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Shan Wei
- Department of Neurology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Ye Yuan
- Department of Neurology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Fan Gao
- Clinical Research Center, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Jin Wang
- Department of Neurology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.
| | - Qiumin Qu
- Department of Neurology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China; Center for Brain Science, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.
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34
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Teoh NSN, Gyanwali B, Lai MKP, Chai YL, Chong JR, Chong EJY, Chen C, Tan CS, Hilal S. Association of Interleukin-6 and Interleukin-8 with Cognitive Decline in an Asian Memory Clinic Population. J Alzheimers Dis 2023; 92:445-455. [PMID: 36776060 DOI: 10.3233/jad-220971] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
Abstract
BACKGROUND Neuroinflammation has been postulated to play an important role in cognitive impairment, cognitive decline, and dementia. Inflammatory biomarkers such as interleukin-6 (IL-6) and IL-8 are found to be associated with the neuro-inflammatory process and worse cognitive function. However, it is unknown whether these interleukins are associated with long-term cognitive function. OBJECTIVE To investigate the association of baseline IL-6 and IL-8 with cognitive function at baseline as well as its association with cognitive decline over five-year follow-up. METHODS 387 patients were recruited from an ongoing memory clinic-based study who underwent comprehensive physical, medical, neuropsychological and blood assessments together with brain MRI. IL-6 and IL-8 were measured using LUMINEX assays. The National Institute of Neurological Disorders and Stroke-Canadian Stroke Network neuropsychological battery was used to assess cognitive decline across multiple domains. RESULTS Among the 387 (mean age = 72.9 years and 53.7% males) participants, 322 had at least two follow-up assessments and were included in the longitudinal analysis. Negative linear trend associations were found between tertiles of IL-8 with baseline global cognition (p-trend< 0.001), attention (p-trend = 0.005), executive function (p-trend< 0.001), and visuospatial function (p-trend = 0.002) domains. No association was found between baseline IL-8 and cognitive decline. IL-6 was not associated with both baseline and follow-up cognition. CONCLUSION IL-8 was associated with worse cognition especially in attention, executive function, and visuospatial function, suggesting the role of neuroinflammation in cognitive impairment. Hence, blood inflammatory biomarkers may be useful indicators in identifying patients at risk of cognitive impairment and warrant consideration for inclusion in treatment trials.
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Affiliation(s)
- Nicole Shu Ning Teoh
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore
| | - Bibek Gyanwali
- Memory Aging & Cognition Centre, National University Health System, Singapore
| | - Mitchell K P Lai
- Memory Aging & Cognition Centre, National University Health System, Singapore.,Department of Pharmacology, National University of Singapore, Singapore
| | - Yuek Ling Chai
- Memory Aging & Cognition Centre, National University Health System, Singapore.,Department of Pharmacology, National University of Singapore, Singapore
| | - Joyce R Chong
- Memory Aging & Cognition Centre, National University Health System, Singapore.,Department of Pharmacology, National University of Singapore, Singapore
| | - Eddie Jun Yi Chong
- Memory Aging & Cognition Centre, National University Health System, Singapore.,Department of Psychological Medicine, National University Hospital, Singapore
| | - Christopher Chen
- Memory Aging & Cognition Centre, National University Health System, Singapore.,Department of Pharmacology, National University of Singapore, Singapore.,Department of Psychological Medicine, National University Hospital, Singapore
| | - Chuen Seng Tan
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore
| | - Saima Hilal
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore.,Memory Aging & Cognition Centre, National University Health System, Singapore.,Department of Pharmacology, National University of Singapore, Singapore
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35
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Masini A, Sanmarchi F, Kawalec A, Esposito F, Scrimaglia S, Tessari A, Scheier LM, Sacchetti R, Dallolio L. Mediterranean diet, physical activity, and family characteristics associated with cognitive performance in Italian primary school children: analysis of the I-MOVE project. Eur J Pediatr 2023; 182:917-927. [PMID: 36525096 DOI: 10.1007/s00431-022-04756-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2022] [Revised: 11/29/2022] [Accepted: 12/05/2022] [Indexed: 12/23/2022]
Abstract
UNLABELLED Working memory (WM) is a multicomponent system that supports cognitive functioning. It has been linked to a wide variety of outcomes including academic success and general well-being. The present study examined the relations between adherence to the Mediterranean diet (MD) and WM among Italian children, adjusting for important parent characteristics and children's lifestyle habits. Data for this study was obtained from 106 children attending primary school in Imola (Italy) who were part of the I-MOVE study emphasizing school-based physical activity. Children's adherence to the MD was calculated using the KIDMED index (KI) based on the ZOOM-8 questionnaire. Physical activity (PA) levels were assessed using an actigraph accelerometer and WM using the backward digit span test. Univariate regression was used to select significant child-level and family measures associated with WM, which were then tested in a single multivariate regression model. Older age is positively associated with higher WM (β = 0.36; 95% CI 0.25, 0.47). Dietary adherence (KI) (β = 0.07; 95% CI 0.01, 0.14) and engagement in organized PA outside school hours (β = 0.58; 95% CI 0.09, 1.10) are positively related to WM. Among the family measures, father's education was positively associated with WM for high school education and for university vs. middle school or lower, respectively. CONCLUSION Adherence to the MD was associated with better WM capacity in primary school children. These findings can be used to guide policymakers in designing health promotion programs and instituting policies emphasizing healthy nutrition to improve physical health and boost cognitive functioning. WHAT IS KNOWN • The development of working memory involves the entire childhood with a rapid spurt between 2 and 8 years of age. • Working memory plays a critical role in children's learning and academic performance and underlies higher-order cognitive abilities. WHAT IS NEW • Adherence to the Mediterranean Diet was associated with higher working memory capacity in primary school children. • Health promotion interventions based on PA and sound nutrition involving children benefit not only physical and mental health, but also cognitive health.
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Affiliation(s)
- Alice Masini
- Department of Biomedical and Neuromotor Science Alma Mater Studiorum, University of Bologna, Bologna, Italy
| | - Francesco Sanmarchi
- Department of Biomedical and Neuromotor Science Alma Mater Studiorum, University of Bologna, Bologna, Italy
| | - Anna Kawalec
- Department and Clinic of Paediatric Nephrology, Wroclaw Medical University, Wroclaw, Poland
| | - Francesco Esposito
- Department of Biomedical and Neuromotor Science Alma Mater Studiorum, University of Bologna, Bologna, Italy.
| | - Susan Scrimaglia
- Department of Biomedical and Neuromotor Science Alma Mater Studiorum, University of Bologna, Bologna, Italy
| | - Alessia Tessari
- Department of Psychology "Renzo Canestrari", Alma Mater Studiorum, University of Bologna, Bologna, Italy
| | - Lawrence M Scheier
- LARS Research Institute, Inc., Sun City, AZ, USA
- Prevention Strategies, Greensboro, NC, USA
| | - Rossella Sacchetti
- Department of Education Studies "Giovanni Maria Bertin", Alma Mater Studiorum, University of Bologna, Bologna, Italy
| | - Laura Dallolio
- Department of Biomedical and Neuromotor Science Alma Mater Studiorum, University of Bologna, Bologna, Italy
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Lipnicki DM, Lam BCP, Mewton L, Crawford JD, Sachdev PS. Harmonizing Ethno-Regionally Diverse Datasets to Advance the Global Epidemiology of Dementia. Clin Geriatr Med 2023; 39:177-190. [PMID: 36404030 PMCID: PMC9767705 DOI: 10.1016/j.cger.2022.07.009] [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: 11/23/2022]
Abstract
Understanding dementia and cognitive impairment is a global effort needing data from multiple sources across diverse ethno-regional groups. Methodological heterogeneity means that these data often require harmonization to make them comparable before analysis. We discuss the benefits and challenges of harmonization, both retrospective and prospective, broadly and with a focus on data types that require particular sorts of approaches, including neuropsychological test scores and neuroimaging data. Throughout our discussion, we illustrate general principles and give examples of specific approaches in the context of contemporary research in dementia and cognitive impairment from around the world.
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Affiliation(s)
- Darren M Lipnicki
- Centre for Healthy Brain Ageing, University of New South Wales, Level 1, AGSM (G27), Gate 11, Botany Street, Sydney, New South Wales 2052, Australia.
| | - Ben C P Lam
- Centre for Healthy Brain Ageing, University of New South Wales, Level 1, AGSM (G27), Gate 11, Botany Street, Sydney, New South Wales 2052, Australia
| | - Louise Mewton
- Centre for Healthy Brain Ageing, University of New South Wales, Level 1, AGSM (G27), Gate 11, Botany Street, Sydney, New South Wales 2052, Australia
| | - John D Crawford
- Centre for Healthy Brain Ageing, University of New South Wales, Level 1, AGSM (G27), Gate 11, Botany Street, Sydney, New South Wales 2052, Australia
| | - Perminder S Sachdev
- Centre for Healthy Brain Ageing, University of New South Wales, Level 1, AGSM (G27), Gate 11, Botany Street, Sydney, New South Wales 2052, Australia; Neuropsychiatric Institute, The Prince of Wales Hospital, Sydney, Australia
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37
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Pulse Pressure Is Associated with Rapid Cognitive Decline over 4 Years: A Population-Based Cohort Study. Brain Sci 2022; 12:brainsci12121691. [PMID: 36552151 PMCID: PMC9775404 DOI: 10.3390/brainsci12121691] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2022] [Revised: 11/23/2022] [Accepted: 12/06/2022] [Indexed: 12/14/2022] Open
Abstract
Aiming to investigate the relationship between pulse pressure (PP) and cognitive decline, cognitively normal subjects from a community-based longitudinal cohort were followed-up for 4 years. The Mini-Mental State Examination (MMSE) was used to evaluate global cognitive function, and a ≥2-point decrease in the MMSE score from baseline was defined as cognitive decline. Restricted cubic spline, multivariable linear regression and logistic regression were used to investigate the relationship between PP and cognitive decline. A total of 1173 participants completed the follow-up, and 205 (17.5%) met the criteria for cognitive decline. Restricted cubic splines showed no nonlinear relationship between PP and ΔMMSE (Poverall = 0.037, Pnon-linear = 0.289) or cognitive decline (Poverall = 0.003, Pnon-linear = 0.845). Multivariable linear regression analysis showed that PP was positively related to ΔMMSE (b = 0.021, p = 0.020). Multivariable logistic regression analysis showed that PP was positively associated with cognitive decline (OR = 1.020, p = 0.023). A stratified analysis found an association between PP and cognitive decline in participants who were aged ≤65 years, male, and APOEε4 noncarriers and who had school education ≤6 years or hypertension. A sensitivity analysis after propensity-score matching did not alter our findings. These findings highlight that elevated PP is associated with rapid cognitive decline, particularly in males, middle-aged, low-educated, hypertensive individuals and APOEε4 noncarriers.
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Rao R, Creese B, Aarsland D, Kalafatis C, Khan Z, Corbett A, Ballard C. Risky drinking and cognitive impairment in community residents aged 50 and over. Aging Ment Health 2022; 26:2432-2439. [PMID: 34766529 DOI: 10.1080/13607863.2021.2000938] [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: 01/25/2023]
Abstract
OBJECTIVES Alcohol misuse is known to be a risk factor for dementia. This study aimed to explore the association between risky drinking and cognitive impairment in a cohort study of middle aged and older people at risk of dementia. METHOD The sample comprised 15,582 people aged 50 and over drawn from the PROTECT study. Risky drinking was defined according to a score of 4 or above on the Alcohol Use Disorders Identification Test (AUDIT). Cognitive function was assessed on visual episodic memory, spatial working memory, verbal working memory and verbal reasoning. RESULTS Risky drinkers at baseline were more likely to be younger, male, white British, married, of higher educational status, current or past tobacco smokers and to have moderate to severe depression than non-risky drinkers. Risky drinkers were also more likely to be impaired on self-reported instrumental activities of daily living and subjective cognitive decline. At baseline, risky drinkers were less likely than non-risky drinkers to show impairment on verbal reasoning and spatial working memory but not on visual episodic memory or verbal working memory. Risky drinking at baseline predicted decline in cognitive function on visual episodic memory, verbal reasoning and spatial working memory at 2 year follow-up, but only verbal working memory and spatial working memory remained significant outcomes after controlling for possible confounders. CONCLUSION Although of small effect size, the association between risky drinking and impairment on measures of working memory and visuospatial function warrants further examination; particularly given the possibility of partial reversibility in alcohol related cognitive impairment.
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Affiliation(s)
- Rahul Rao
- Department of Old Age Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College, London, UK
| | - Byron Creese
- The University of Exeter Medical School, Exeter, UK
| | - Dag Aarsland
- Department of Old Age Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College, London, UK
| | - Chris Kalafatis
- Department of Old Age Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College, London, UK
| | - Zunera Khan
- Department of Old Age Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College, London, UK
| | - Anne Corbett
- The University of Exeter Medical School, Exeter, UK
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Functional Capacity, Lipid Profile, and Associated Factors in Older Adults Living in Urban and Rural Areas. J Aging Res 2022; 2022:9820221. [PMID: 36262929 PMCID: PMC9576435 DOI: 10.1155/2022/9820221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2022] [Accepted: 09/13/2022] [Indexed: 11/17/2022] Open
Abstract
This study aimed to analyze the relationship between sociodemographic and lifestyle variables, functional strength, aerobic capacity, and lipid profile of older adults living in urban and rural areas. For this purpose, 208 older adults were evaluated (132 living in rural areas and 73 living in urban areas). Sociodemographic data were collected, and functional strength, aerobic capacity, and lipid profile of older adults living in the southern region of Brazil were evaluated. Only total cholesterol and LDL cholesterol were associated with place of residence (p < 0.05), and living in the countryside was associated with low aerobic capacity (p=0.010). The use of medication (OR = 3.01; p=0.012) and smoking (OR = 0.30; p=0.027) were the only variables that explained aerobic performance, regardless of place of residence. In conclusion, place of residence is not a factor that, alone or in combination with other conditions, affects the functional performance or lipid profile of the older adult population.
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40
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Esbjörnsson M, Ullberg T. Safety and usability of wearable accelerometers for stroke detection the STROKE ALARM PRO 1 study. J Stroke Cerebrovasc Dis 2022; 31:106762. [PMID: 36115106 DOI: 10.1016/j.jstrokecerebrovasdis.2022.106762] [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: 07/04/2022] [Revised: 08/16/2022] [Accepted: 09/04/2022] [Indexed: 11/18/2022] Open
Abstract
OBJECTIVES The introduction of time-dependent reperfusion therapies in acute ischemic stroke has increased the need for early identification. We explore the safety and feasibility of STROKE ALARM which detects sudden arm paresis, the most frequent symptom in stroke. MATERIALS AND METHODS Consecutive patients admitted with a stroke or TIA at Skåne University Hospital were screened according to inclusion and exclusion criteria, and included in the STROKE ALARM PRO 1 Study aiming to explore the feasibility of prolonged use (30 days) of the system in the community. STROKE ALARM consists of paired arm bracelets with accelerometers, coupled with a stroke test in a smartphone application. In case of an imbalance in arm movements, the user is prompted to perform an app-based stroke test. Failure to respond or to complete the stroke test correctly, triggers notification by SMS to predefined emergency contacts. Patients were followed up by telephone after completion. RESULTS Thirty patients were included and 28 completed follow-up. Median age was 68 years and 36.7% were female. No stroke events were recorded during follow-up. False indications occurred in all but one patient, and 22 (78.6%) experienced alarms to their emergency contacts. Despite a high level of false alarms, general user experience was rated in a positive or neutral manner by almost 90%. Very frequent alarms were probably due to mild arm paresis not detected in routine clinical assessment. CONCLUSIONS Use of STROKE ALARM for 30 days after stroke/TIA was well tolerated warranting further study for early automated detection of stroke recurrence.
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Affiliation(s)
- Magnus Esbjörnsson
- Institution of Clinical Sciences Lund, Neurology, Lund University, Department of Internal Medicine, Hässleholm Hospital, S-28125 Hässleholm, Sweden.
| | - Teresa Ullberg
- Institution of Clinical Sciences Lund, Neurology, Lund University, Department of neurology, Skåne University Hospital Lund, S-20502 Malmö, Sweden
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41
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Calatayud E, Lozano-Berges G, Peralta-Marrupe P, Latorre E, Gomez-Soria I. Job demands may determine cognitive and physical aging after retirement. J Appl Gerontol 2022; 41:2435-2446. [PMID: 35959648 DOI: 10.1177/07334648221120080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
During adulthood, we spend most of our time and efforts at work. However, the impact of employment in aging is poorly explored. Our study addressed how job demands can affect aging after retirement. We have developed a descriptive observational study carried out in 367 older adults with a mean age of 73.9 years (66.5% women and 33.5% men), measuring cognition and functional status. Our results demonstrate that older adults who had high mental demands in their jobs, show better scores in cognition. However, they show poor functional development of basic and instrumental activities of daily life (p< .05). In contrast, former workers who had high physical demands, display lower scores in cognition and lower functional performance in instrumental activities (p< .05). Work life activities contribute to cognitive and physical decline after retirement. Therefore, healthy aging should include interventions that consider the job influence on the age impairment.
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Affiliation(s)
- Estela Calatayud
- Department of Physiatry and Nursing, Faculty of Health Sciences, 16765Universidad de Zaragoza, Zaragoza, Spain.,Institute of Health Research of Aragón (IIS Aragón), Zaragoza, Spain
| | - Gabriel Lozano-Berges
- Department of Physiatry and Nursing, Faculty of Health and Sport Sciences, 16765Universidad de Zaragoza, Zaragoza, Spain.,Growth, Exercise, Nutrition and Development (GENUD) Research Group, 16765Universidad de Zaragoza, Zaragoza, Spain
| | - Patricia Peralta-Marrupe
- Department of Physiatry and Nursing, Faculty of Health Sciences, 16765Universidad de Zaragoza, Zaragoza, Spain
| | - Eva Latorre
- Institute of Health Research of Aragón (IIS Aragón), Zaragoza, Spain.,Department of Biochemistry and Molecular and Cell Biology, Faculty of Sciences, 16765Universidad de Zaragoza, Zaragoza, Spain
| | - Isabel Gomez-Soria
- Department of Physiatry and Nursing, Faculty of Health Sciences, 16765Universidad de Zaragoza, Zaragoza, Spain.,Institute of Health Research of Aragón (IIS Aragón), Zaragoza, Spain
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Sun J, Wang W, Zhang R, Duan H, Tian X, Xu C, Li X, Zhang D. Multivariate genome-wide association study of depression, cognition, and memory phenotypes and validation analysis identify 12 cross-ethnic variants. Transl Psychiatry 2022; 12:304. [PMID: 35907915 PMCID: PMC9338946 DOI: 10.1038/s41398-022-02074-x] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2021] [Revised: 07/15/2022] [Accepted: 07/19/2022] [Indexed: 11/10/2022] Open
Abstract
To date, little is known about the pleiotropic genetic variants among depression, cognition, and memory. The current research aimed to identify the potential pleiotropic single nucleotide polymorphisms (SNPs), genes, and pathways of the three phenotypes by conducting a multivariate genome-wide association study and an additional pleiotropy analysis among Chinese individuals and further validate the top variants in the UK Biobank (UKB). In the discovery phase, the participants were 139 pairs of dizygotic twins from the Qingdao Twins Registry. The genome-wide efficient mixed-model analysis identified 164 SNPs reaching suggestive significance (P < 1 × 10-5). Among them, rs3967317 (P = 1.21 × 10-8) exceeded the genome-wide significance level (P < 5 × 10-8) and was also demonstrated to be associated with depression and memory in pleiotropy analysis, followed by rs9863698, rs3967316, and rs9261381 (P = 7.80 × 10-8-5.68 × 10-7), which were associated with all three phenotypes. After imputation, a total of 457 SNPs reached suggestive significance. The top SNP chr6:24597173 was located in the KIAA0319 gene, which had biased expression in brain tissues. Genes and pathways related to metabolism, immunity, and neuronal systems demonstrated nominal significance (P < 0.05) in gene-based and pathway enrichment analyses. In the validation phase, 12 of the abovementioned SNPs reached the nominal significance level (P < 0.05) in the UKB. Among them, three SNPs were located in the KIAA0319 gene, and four SNPs were identified as significant expression quantitative trait loci in brain tissues. These findings may provide evidence for pleiotropic variants among depression, cognition, and memory and clues for further exploring the shared genetic pathogenesis of depression with Alzheimer's disease.
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Affiliation(s)
- Jing Sun
- Department of Epidemiology and Health Statistics, The School of Public Health of Qingdao University, Qingdao, Shandong Province, China
- Department of Big Data in Health Science School of Public Health, Center of Clinical Big Data and Analytics of The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Weijing Wang
- Department of Epidemiology and Health Statistics, The School of Public Health of Qingdao University, Qingdao, Shandong Province, China
| | - Ronghui Zhang
- Department of Epidemiology and Health Statistics, The School of Public Health of Qingdao University, Qingdao, Shandong Province, China
| | - Haiping Duan
- Qingdao Municipal Center for Disease Control and Prevention, No. 175 Shandong Road, Shibei District, Qingdao, Shandong Province, China
| | - Xiaocao Tian
- Qingdao Municipal Center for Disease Control and Prevention, No. 175 Shandong Road, Shibei District, Qingdao, Shandong Province, China
| | - Chunsheng Xu
- Qingdao Municipal Center for Disease Control and Prevention, No. 175 Shandong Road, Shibei District, Qingdao, Shandong Province, China
| | - Xue Li
- Department of Big Data in Health Science School of Public Health, Center of Clinical Big Data and Analytics of The Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China.
| | - Dongfeng Zhang
- Department of Epidemiology and Health Statistics, The School of Public Health of Qingdao University, Qingdao, Shandong Province, China.
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Wang RS, Wang BL, Huang YN, Wan TTH. The combined effect of physical activity and fruit and vegetable intake on decreasing cognitive decline in older Taiwanese adults. Sci Rep 2022; 12:9825. [PMID: 35701477 PMCID: PMC9198009 DOI: 10.1038/s41598-022-14219-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2021] [Accepted: 06/02/2022] [Indexed: 11/18/2022] Open
Abstract
The factors associated with cognitive decline among older adults include physical activity and fruit and vegetable intake. However, the long-term effects of concomitant physical activity and fruit and vegetable intake are unknown. This 16-year longitudinal study explored the joint effect of mitigating cognitive decline in a cohort of older Taiwanese individuals. Five population-based surveys (Taiwan Longitudinal Survey on Aging [1999–2015]) involving 4440 respondents over 53 years old in 1999 were conducted. Cognitive function was assessed using the Short Portable Mental Status Questionnaire (SPMSQ). The demographic, socioeconomic, health-related, behavioral, and disease status covariates were adjusted in the regression analysis. Trends in cognitive decline were observed over 16 years. The risk of cognitive decline decreased by 63% when high physical activity and high fruit and vegetable intake were combined (odds ratio 0.37; 95% confidence interval 0.23–0.59), indicating a potential combined effect of physical activity and fruit and vegetable intake on mitigating cognitive decline. These personal actions are safe, effective, and economical approaches to health promotion and disease prevention.
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Affiliation(s)
- Richard Szewei Wang
- Affiliation Program of Data Analytics and Business Computing, Stern School of Business, New York University, New York, 10012, USA
| | - Bing-Long Wang
- School of Health Policy and Management, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100730, China.
| | - Yu-Ni Huang
- College of Public Health, National Taiwan University, 100, Taipei, Taiwan
| | - Thomas T H Wan
- School of Global Health Management and Informatics, University of Central Florida, Orlando, FL, 32816, USA
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Bellia C, Lombardo M, Meloni M, Della-Morte D, Bellia A, Lauro D. Diabetes and cognitive decline. Adv Clin Chem 2022; 108:37-71. [PMID: 35659061 DOI: 10.1016/bs.acc.2021.07.006] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Epidemiologic studies have documented an association between diabetes and increased risk of cognitive decline in the elderly. Based on animal model studies, several mechanisms have been proposed to explain such an association, including central insulin signaling, neurodegeneration, brain amyloidosis, and neuroinflammation. Nevertheless, the exact mechanisms in humans remain poorly defined. It is reasonable, however, that many pathways may be involved in these patients leading to cognitive impairment. A major aim of clinicians is identifying early onset of neurologic signs and symptoms in elderly diabetics to improve quality of life of those with cognitive impairment and reduce costs associated with long-term complications. Several biomarkers have been proposed to identify diabetics at higher risk of developing dementia and diagnose early stage dementia. Although biomarkers of brain amyloidosis, neurodegeneration and synaptic plasticity are commonly used to diagnose dementia, especially Alzheimer disease, their role in diabetes remains unclear. The aim of this review is to explore the molecular mechanisms linking diabetes with cognitive decline and present the most important findings on the clinical use of biomarkers for diagnosing and predicting early cognitive decline in diabetics.
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Affiliation(s)
- Chiara Bellia
- Department of Biomedicine, Neurosciences, and Advanced Diagnostics, University of Palermo, Palermo, Italy.
| | - Mauro Lombardo
- Department of Human Sciences and Quality of Life Promotion, San Raffaele Open University, Rome, Italy
| | - Marco Meloni
- Department of Systems Medicine, University of Rome "Tor Vergata", Rome, Italy
| | - David Della-Morte
- Department of Human Sciences and Quality of Life Promotion, San Raffaele Open University, Rome, Italy; Department of Systems Medicine, University of Rome "Tor Vergata", Rome, Italy; Department of Neurology and Evelyn F. McKnight Brain Institute, Miller School of Medicine, University of Miami, Miami, FL, United States
| | - Alfonso Bellia
- Department of Systems Medicine, University of Rome "Tor Vergata", Rome, Italy
| | - Davide Lauro
- Department of Systems Medicine, University of Rome "Tor Vergata", Rome, Italy
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Nagaratnam JM, Sharmin S, Diker A, Lim WK, Maier AB. Trajectories of Mini-Mental State Examination Scores over the Lifespan in General Populations: A Systematic Review and Meta-Regression Analysis. Clin Gerontol 2022; 45:467-476. [PMID: 32374211 DOI: 10.1080/07317115.2020.1756021] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Objectives: Over the lifespan cumulative changes to the brain lead to cognitive decline and eventually to dementia in 20-25% of adults 85 years and older. A commonly used screening tool for cognitive function is the Standard 30 point Mini-Mental State Examination (MMSE). Though the MMSE is used to screen for dementia, little is known about the changes in scores over the lifespan in general populations.Method: A systematic search was conducted using Cochrane, EMBASE, MEDLINE and PsycINFO for articles published from January 1, 2007 to May 25, 2017. Articles were included if they had a longitudinal design reporting at least two MMSE scores. A mixed-effect meta-regression analysis was conducted to examine the influence of age on MMSE score followed by a change-point regression analysis determining the age at which MMSE declines.Results: 45 articles including 58,939 individuals (age range 18-108 years, 61.2% female) summarized 222 MMSE point estimates from 35 cohorts. The meta-regression demonstrated a significant decrease in MMSE scores with higher age (regression coefficient of age: -0.10 (Confidence Interval (CI) -0.15, -0.05)). The average annual decline in MMSE scores identified by the change-point analysis at the age of 41 years and 84 years were -0.04 (95% CI: -0.05, -0.03) and -0.53 (95% CI: -0.55, -0.50), respectively.Conclusions: Between the age of 29 and 105 years MMSE scores decline, with the highest decline between age 84 and 105 years.Clinical Implementations: The use of MMSE should be restricted to higher age categories in aging general populations.
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Affiliation(s)
- Julius M Nagaratnam
- Department of Medicine and Aged Care, @AgeMelbourne, The University of Melbourne, The Royal Melbourne Hospital, Parkville, Victoria, Australia
| | - Sifat Sharmin
- Department of Medicine and Aged Care, @AgeMelbourne, The University of Melbourne, The Royal Melbourne Hospital, Parkville, Victoria, Australia.,Clinical Outcomes Research Unit, Department of Medicine, The Royal Melbourne Hospital, The University of Melbourne, Parkville, Victoria, Australia
| | - Aaron Diker
- Department of Medicine and Aged Care, @AgeMelbourne, The University of Melbourne, The Royal Melbourne Hospital, Parkville, Victoria, Australia
| | - Wen Kwang Lim
- Department of Medicine and Aged Care, @AgeMelbourne, The University of Melbourne, The Royal Melbourne Hospital, Parkville, Victoria, Australia
| | - Andrea B Maier
- Department of Medicine and Aged Care, @AgeMelbourne, The University of Melbourne, The Royal Melbourne Hospital, Parkville, Victoria, Australia.,Department of Human Movement Sciences, @AgeAmsterdam, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam Movement Sciences, Amsterdam, The Netherlands
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46
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Migeot J, Calivar M, Granchetti H, Ibáñez A, Fittipaldi S. Socioeconomic status impacts cognitive and socioemotional processes in healthy ageing. Sci Rep 2022; 12:6048. [PMID: 35410333 PMCID: PMC9001669 DOI: 10.1038/s41598-022-09580-4] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Accepted: 03/25/2022] [Indexed: 11/16/2022] Open
Abstract
Socioeconomic status (SES) negatively impacts cognitive and executive functioning in older adults, yet its effects on socioemotional abilities have not been studied in this population. Also, evidence on neurocognitive processes associated with ageing primarily comes from Western, educated, industrialized, rich, and democratic (WEIRD) populations, hindering the generalization of findings to persons from upper-middle- and low-middle-income countries, such as those of Latin America. Here, we compared the performance of low- and high-SES older adults from Argentina in cognitive state, executive functions, social cognition (emotion recognition and theory of mind), and counter-empathic social emotions (envy and Schadenfreude; displeasure at others' fortune and pleasure at others' misfortune, respectively). Subsequently, we developed a path analysis to test the relationship among those variables in a theoretically plausible model and tested the main paths via multiple regression analyses. Relative to the high-SES group, low-SES older adults showed poorer performance on all assessed domains. Convergent evidence from covariance analysis, path analysis, and linear regressions suggested that low-SES impact on socioemotional processes was not primary but mediated by cognitive and executive impairment. These findings offer the first characterization of SES impacts on cognitive and socioemotional processes in a non-WEIRD population and have relevant equity-related implications for brain health.
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Affiliation(s)
- Joaquín Migeot
- Latin American Brain Health Institute (BrainLat), Universidad Adolfo Ibáñez, Santiago de Chile, Chile
- Center for Social and Cognitive Neuroscience (CSCN), School of Psychology, Universidad Adolfo Ibáñez, Santiago de Chile, Chile
| | - Mariela Calivar
- Centro de Atención Primaria de la salud Zonda, Ministerio de Salud Pública de La Provincia de San Juan, San Juan, Argentina
| | - Hugo Granchetti
- Facultad de Farmacia y Bioquímica, Universidad de Buenos Aires, Buenos Aires, Argentina
| | - Agustín Ibáñez
- Latin American Brain Health Institute (BrainLat), Universidad Adolfo Ibáñez, Santiago de Chile, Chile
- Cognitive Neuroscience Center (CNC), Universidad de San Andrés, Victoria, Buenos Aires, Argentina
- National Scientific and Technical Research Council (CONICET), Buenos Aires, Argentina
- Global Brain Health Institute, University of California San Francisco (UCSF), San Francisco, USA
- Trinity College Dublin (TCD), Dublin, Ireland
| | - Sol Fittipaldi
- Latin American Brain Health Institute (BrainLat), Universidad Adolfo Ibáñez, Santiago de Chile, Chile.
- Cognitive Neuroscience Center (CNC), Universidad de San Andrés, Victoria, Buenos Aires, Argentina.
- National Scientific and Technical Research Council (CONICET), Buenos Aires, Argentina.
- Facultad de Psicología, Universidad Nacional de Córdoba, Córdoba, Argentina.
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Huuha AM, Norevik CS, Moreira JBN, Kobro-Flatmoen A, Scrimgeour N, Kivipelto M, Van Praag H, Ziaei M, Sando SB, Wisløff U, Tari AR. Can exercise training teach us how to treat Alzheimer's disease? Ageing Res Rev 2022; 75:101559. [PMID: 34999248 DOI: 10.1016/j.arr.2022.101559] [Citation(s) in RCA: 27] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2021] [Revised: 12/20/2021] [Accepted: 01/04/2022] [Indexed: 01/02/2023]
Abstract
Alzheimer's disease (AD) is the most common cause of dementia and there is currently no cure. Novel approaches to treat AD and curb the rapidly increasing worldwide prevalence and costs of dementia are needed. Physical inactivity is a significant modifiable risk factor for AD, estimated to contribute to 12.7% of AD cases worldwide. Exercise interventions in humans and animals have shown beneficial effects of exercise on brain plasticity and cognitive functions. In animal studies, exercise also improved AD pathology. The mechanisms underlying these effects of exercise seem to be associated mainly with exercise performance or cardiorespiratory fitness. In addition, exercise-induced molecules of peripheral origin seem to play an important role. Since exercise affects the whole body, there likely is no single therapeutic target that could mimic all the benefits of exercise. However, systemic strategies may be a viable means to convey broad therapeutic effects in AD patients. Here, we review the potential of physical activity and exercise training in AD prevention and treatment, shining light on recently discovered underlying mechanisms and concluding with a view on future development of exercise-free treatment strategies for AD.
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Affiliation(s)
- Aleksi M Huuha
- Cardiac Exercise Research Group (CERG), Department of Circulation and Medical Imaging, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway; Department of Neurology and Clinical Neurophysiology, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
| | - Cecilie S Norevik
- Cardiac Exercise Research Group (CERG), Department of Circulation and Medical Imaging, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway; Department of Neurology and Clinical Neurophysiology, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
| | - José Bianco N Moreira
- Cardiac Exercise Research Group (CERG), Department of Circulation and Medical Imaging, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
| | - Asgeir Kobro-Flatmoen
- Kavli Institute for Systems Neuroscience, Centre for Neural Computation, and Egil and Pauline Braathen and Fred Kavli Centre for Cortical Microcircuits, Norwegian University of Science and Technology, Trondheim, Norway; K.G. Jebsen Centre for Alzheimer's Disease, Norwegian University of Science and Technology, Trondheim, Norway
| | - Nathan Scrimgeour
- Cardiac Exercise Research Group (CERG), Department of Circulation and Medical Imaging, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
| | - Miia Kivipelto
- Karolinska Institute, Department of Neurobiology, Care Sciences and Society, Division of Clinical Geriatrics, Stockholm, Sweden; Karolinska University Hospital, Theme Aging and Inflammation, Stockholm, Sweden
| | - Henriette Van Praag
- Brain Institute and Charles E. Schmidt College of Medicine, Florida Atlantic University, Jupiter, FL, United States
| | - Maryam Ziaei
- Kavli Institute for Systems Neuroscience, Centre for Neural Computation, and Egil and Pauline Braathen and Fred Kavli Centre for Cortical Microcircuits, Norwegian University of Science and Technology, Trondheim, Norway; Queensland Brain Institute, University of Queensland, Brisbane, Australia
| | - Sigrid Botne Sando
- Department of Neurology and Clinical Neurophysiology, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway; Department of Neuromedicine and Movement Science, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
| | - Ulrik Wisløff
- Cardiac Exercise Research Group (CERG), Department of Circulation and Medical Imaging, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway; Centre for Research on Exercise, Physical Activity and Health, School of Human Movement and Nutrition Sciences, University of Queensland, St. Lucia, Brisbane, Queensland, Australia
| | - Atefe R Tari
- Cardiac Exercise Research Group (CERG), Department of Circulation and Medical Imaging, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway; Department of Neurology and Clinical Neurophysiology, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway.
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Shen J, Li J, Hua Y, Ding B, Zhou C, Yu H, Xiao R, Ma W. Association between the Erythrocyte Membrane Fatty Acid Profile and Cognitive Function in the Overweight and Obese Population Aged from 45 to 75 Years Old. Nutrients 2022; 14:nu14040914. [PMID: 35215564 PMCID: PMC8878599 DOI: 10.3390/nu14040914] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Revised: 02/11/2022] [Accepted: 02/13/2022] [Indexed: 12/21/2022] Open
Abstract
Dietary fatty acid intake is closely related to the cognitive function of the overweight and obese population. However, few studies have specified the correlation between exact fatty acids and cognitive functions in different body mass index (BMI) groups. We aimed to explain these relationships and reference guiding principles for the fatty acid intake of the overweight and obese population. Normal weight, overweight, and obese participants were recruited to receive a cognitive function assessment and dietary survey, dietary fatty acids intake was calculated, and the erythrocyte membrane fatty acid profile was tested by performing a gas chromatography analysis. The percentages of saturated fatty acids (SFAs) in the obese group were higher, while monounsaturated fatty acids (MUFAs) and polyunsaturated fatty acids (PUFAs) were lower than in the normal weight and overweight groups. In the erythrocyte membrane, the increase of n-3 PUFAs was accompanied by cognitive decline in the overweight group, which could be a protective factor for cognitive function in the obese group. High n-6 PUFAs intake could exacerbate the cognitive decline in the obese population. Dietary fatty acid intake had different effects on the cognitive function of overweight and obese people, especially the protective effect of n-3 PUFAs; more precise dietary advice is needed to prevent cognitive impairment.
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Affiliation(s)
- Jingyi Shen
- School of Public Health, Beijing Key Laboratory of Environmental Toxicology, Capital Medical University, Beijing 100069, China; (J.S.); (J.L.); (Y.H.); (C.Z.); (H.Y.); (R.X.)
| | - Jinchen Li
- School of Public Health, Beijing Key Laboratory of Environmental Toxicology, Capital Medical University, Beijing 100069, China; (J.S.); (J.L.); (Y.H.); (C.Z.); (H.Y.); (R.X.)
| | - Yinan Hua
- School of Public Health, Beijing Key Laboratory of Environmental Toxicology, Capital Medical University, Beijing 100069, China; (J.S.); (J.L.); (Y.H.); (C.Z.); (H.Y.); (R.X.)
| | - Bingjie Ding
- Department of Clinical Nutrition, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China;
| | - Cui Zhou
- School of Public Health, Beijing Key Laboratory of Environmental Toxicology, Capital Medical University, Beijing 100069, China; (J.S.); (J.L.); (Y.H.); (C.Z.); (H.Y.); (R.X.)
| | - Huiyan Yu
- School of Public Health, Beijing Key Laboratory of Environmental Toxicology, Capital Medical University, Beijing 100069, China; (J.S.); (J.L.); (Y.H.); (C.Z.); (H.Y.); (R.X.)
| | - Rong Xiao
- School of Public Health, Beijing Key Laboratory of Environmental Toxicology, Capital Medical University, Beijing 100069, China; (J.S.); (J.L.); (Y.H.); (C.Z.); (H.Y.); (R.X.)
| | - Weiwei Ma
- School of Public Health, Beijing Key Laboratory of Environmental Toxicology, Capital Medical University, Beijing 100069, China; (J.S.); (J.L.); (Y.H.); (C.Z.); (H.Y.); (R.X.)
- Correspondence:
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Rubin-Norowitz M, Lipton RB, Petersen K, Ezzati A. Association of Depressive Symptoms and Cognition in Older Adults Without Dementia Across Different Biomarker Profiles. J Alzheimers Dis 2022; 88:1385-1395. [PMID: 35786653 PMCID: PMC9723980 DOI: 10.3233/jad-215665] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
BACKGROUND Depression is a late-life risk factor for cognitive decline. Evidence suggests an association between Alzheimer's disease (AD) associated pathologic changes and depressive symptoms. OBJECTIVE To investigate the influence of AT(N) biomarker profile (amyloid-β [A], p-tau [T], and neurodegeneration [N]) and gender on cross-sectional associations between subclinical depressive symptoms and cognitive function among older adults without dementia. METHODS Participants included 868 individuals without dementia from the Alzheimer's Disease Neuroimaging Initiative (ADNI). Depressive symptoms were measured using the Geriatric Depression Scale (GDS). ADNI neuropsychological composite scores assessed memory and executive function (EF). PET, cerebrospinal fluid, and MRI modalities classified the study sample into biomarker profiles: normal biomarkers (A-T-N-), AD continuum (A+T±N±), and suspect non-AD pathology (SNAP; A-T±N-or A-T-N±). Multivariate regression models were used to investigate associations between GDS and cognitive domains. RESULTS GDS was negatively associated with memory (β= -0.156, p < 0.001) and EF (β= -0.147, p < 0.001) in the whole sample. When classified by biomarker profile, GDS was negatively associated with memory and EF in AD continuum (memory: β= -0.174, p < 0.001; EF: β= -0.129 p = 0.003) and SNAP (memory: β= -0.172, p = 0.005; EF: β= -0.197, p = 0.001) subgroups. When stratified by sex, GDS was negatively associated with memory (β= -0.227, p < 0.001) and EF (β= -0.205, p < 0.001) in men only. CONCLUSION The association between subclinical depressive symptoms and cognitive function is highly influenced by the AT(N) biomarker profile.
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Affiliation(s)
- Mariel Rubin-Norowitz
- Albert Einstein College of Medicine, Bronx, NY, USA,Department of Neurology, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY, USA,Correspondence to: Mariel Rubin-Norowitz, Albert Einstein College of Medicine, 1225 Morris Park Avenue, Van Etten 3C, Bronx, NY 10461, USA. Tel.: +1 718 430 3885; Fax: +1 718 430 3870;
| | - Richard B. Lipton
- Department of Neurology, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY, USA
| | - Kellen Petersen
- Saul R. Korey Department of Neurology, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY, USA
| | - Ali Ezzati
- Saul R. Korey Department of Neurology, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY, USA
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50
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Zhang Q, Zhang M, Chen Y, Zhu S, Zhou W, Zhang L, Dong G, Cao Y. Smoking Status and Cognitive Function in a National Sample of Older Adults. Front Psychiatry 2022; 13:926708. [PMID: 35873239 PMCID: PMC9301276 DOI: 10.3389/fpsyt.2022.926708] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Accepted: 06/06/2022] [Indexed: 11/26/2022] Open
Abstract
AIMS To examine the correlation between smoking status and different domains of cognitive function in elderly Americans. METHODS We used data from the 2011 to 2014 U.S. National Health and Nutrition Examination Survey (NHANES). Participants over 60 years with available smoking history and cognitive function data were enrolled in our analysis. The NHANES study included the Consortium to Establish a Registry for Alzheimer's Disease (CERAD) assessment, the Animal Fluency Test (AFT), and the Digit Symbol Substitution Test (DSST) to assess cognition. Multivariate regression analyses were used to estimate the association between cigarette smoking and cognitive function. RESULTS A total of 2,932 participants were enrolled in the analysis, including 372 (12.7%) current smokers, 1,115 (38%) former smokers, and 1,445 (49.3%) never smokers. Never smokers had in average 3.82 (95% CI, 2.21 to 5.43) points more than current smokers in the DSST, whereas former smokers had 3.12 (95% CI, 1.51 to 4.73) points more than current smokers. Besides, smoking was not associated with the results of the AFT or the CERAD test. CONCLUSIONS This study suggests that cigarette smoking is associated with processing speed among the American elderly.
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Affiliation(s)
- Qiaoyang Zhang
- Department of Psychology, The Affiliated Changzhou No. 2 People's Hospital of Nanjing Medical University, Changzhou, China
| | - Min Zhang
- Department of Neurology, The Affiliated Changzhou No. 2 People's Hospital of Nanjing Medical University, Changzhou, China
| | - Yun Chen
- Department of Neurology, The Affiliated Changzhou No. 2 People's Hospital of Nanjing Medical University, Changzhou, China
| | - Shumin Zhu
- Department of Neurology, The Affiliated Changzhou No. 2 People's Hospital of Nanjing Medical University, Changzhou, China
| | - Wang Zhou
- Department of Neurology, The Affiliated Changzhou No. 2 People's Hospital of Nanjing Medical University, Changzhou, China
| | - Lihao Zhang
- Department of Neurology, The Affiliated Changzhou No. 2 People's Hospital of Nanjing Medical University, Changzhou, China
| | - Guanzhong Dong
- Department of Psychology, The Affiliated Changzhou No. 2 People's Hospital of Nanjing Medical University, Changzhou, China
| | - Yin Cao
- Department of Psychology, The Affiliated Changzhou No. 2 People's Hospital of Nanjing Medical University, Changzhou, China
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