1
|
Du XL, Song L, Schulz PE, Xu H, Chan W. Associations Between Vascular Diseases and Alzheimer's Disease or Related Dementias in a Large Cohort of Men and Women with Colorectal Cancer. J Alzheimers Dis 2022; 90:211-231. [PMID: 36093703 PMCID: PMC9661325 DOI: 10.3233/jad-220548] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/09/2022] [Indexed: 11/15/2022]
Abstract
BACKGROUND Long term risk of Alzheimer's disease (AD) and related dementias (ADRD) associated with vascular diseases in people with colorectal cancer is unknown. OBJECTIVE To determine the risk of ADRD in association with cardiovascular diseases (CVD), stroke, hypertension, and diabetes in a cohort of patients with colorectal cancer. METHODS This retrospective cohort study consisted of 210,809 patients diagnosed with colorectal cancer at age≥65 years in 1991-2015 from the Surveillance, Epidemiology, and End Results (SEER)-Medicare linked database with follow-up from 1991-2016, who were free of any ADRD at the baseline (<12 months prior to or < 30 days after the date of cancer diagnosis). RESULTS The crude 26-year cumulative incidence of total ADRD in men and women with colorectal cancer was higher in those with versus without CVD (31.92% versus 28.12%), with versus without stroke (39.82% versus 26.39%), with versus without hypertension (31.88% versus 24.88%), and with versus without diabetes (32.01% versus 27.66%). After adjusting for socio-demographic and tumor factors, the risk of developing ADRD was significantly higher in patients with CVD (adjusted hazard ratio: 1.17, 95% confidence intervals: 1.14-1.20), stroke (1.65, 1.62-1.68), hypertension (1.07, 1.05-1.09), and diabetes (1.26, 1.24-1.29) versus persons without. For those with 1, 2, 3 and 4 vascular diseases present versus absent, the risk of AD increased from 1.12 (1.07-1.16) to 1.31 (1.25-1.36), 1.66 (1.57-1.75), and 2.03 (1.82-2.27). CONCLUSION In older patients with colorectal cancer, a significant dose-response relationship was observed between an increasing number of these vascular diseases and the risk of all types of dementia.
Collapse
Affiliation(s)
- Xianglin L. Du
- Department of Epidemiology, Human Genetics and Environmental Sciences, School of Public Health, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Lulu Song
- Department of Epidemiology, Human Genetics and Environmental Sciences, School of Public Health, The University of Texas Health Science Center at Houston, Houston, TX, USA
- Department of Biostatistics and Data Science, School of Public Health, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Paul E. Schulz
- Department of Neurology, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Hua Xu
- School of Biomedical Informatics, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Wenyaw Chan
- Department of Biostatistics and Data Science, School of Public Health, The University of Texas Health Science Center at Houston, Houston, TX, USA
| |
Collapse
|
2
|
Nicoli CD, Howard VJ, Judd SE, Struck J, Manly JJ, Cushman M. Pro-Neurotensin/Neuromedin N and Risk of Cognitive Impairment in a Prospective Study. J Alzheimers Dis 2021; 76:1403-1412. [PMID: 32623400 DOI: 10.3233/jad-200456] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
BACKGROUND The neuropeptide neurotensin (NT) has been linked to cardiometabolic disease. Cardiovascular risk factors are being recognized as risk factors for cognitive impairment. OBJECTIVE To examine the association of the stable precursor of NT, pro-neurotensin/neuromedin N (pro-NT/NMN), with incident cognitive impairment (ICI). METHODS We conducted a prospective nested case-control study in the REasons for Geographic And Racial Differences in Stroke (REGARDS) cohort. In 2003-2007, REGARDS enrolled 30,239 Black and White adults aged ≥45 years. ICI was identified using a 3-test cognitive battery administered biannually. Baseline pro-NT/NMN was measured by immunoassay in 393 cases of ICI and 490 controls after 3.4 years follow up. Multivariable logistic regression was used to calculate odds ratios (OR) of ICI by pro-NT/NMN quartiles. Race, age, and sex differences were studied with stratified models and interaction testing. RESULTS Pro-NT/NMN was higher in Black participants and those with hypertension and diabetes. Women with a 4th versus 1st-quartile pro-NT/NMN had 2.28-fold increased odds of ICI (95% CI 1.08-4.78) after adjusting for risk factors and incident stroke. There was no association of higher pro-NT/NMN quartiles with ICI in the overall group or men. There were no race or age differences in associations. CONCLUSION In this biracial population-based study, elevated systemic pro-NT/NMN was associated with more than doubled risk of ICI in women but not men. Others reported sex-specific associations in women for cardiovascular mortality and diabetes with higher pro-NT/NMN, supporting a role for future research on sex differences in the neurotensinergic system.
Collapse
Affiliation(s)
- Charles D Nicoli
- University of Vermont Larner College of Medicine, Burlington, VT, USA
| | - Virginia J Howard
- Department of Epidemiology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Suzanne E Judd
- Department of Biostatistics, University of Alabama at Birmingham, Birmingham, AL, USA
| | | | - Jennifer J Manly
- Department of Neurology, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA
| | - Mary Cushman
- Departments of Medicine and Pathology and Laboratory Medicine, University of Vermont Larner College of Medicine, Burlington, VT, USA
| |
Collapse
|
3
|
Rizzi L, Aventurato ÍK, Balthazar MLF. Neuroimaging Research on Dementia in Brazil in the Last Decade: Scientometric Analysis, Challenges, and Peculiarities. Front Neurol 2021; 12:640525. [PMID: 33790850 PMCID: PMC8005640 DOI: 10.3389/fneur.2021.640525] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Accepted: 02/18/2021] [Indexed: 12/12/2022] Open
Abstract
The last years have evinced a remarkable growth in neuroimaging studies around the world. All these studies have contributed to a better understanding of the cerebral outcomes of dementia, even in the earliest phases. In low- and middle-income countries, studies involving structural and functional neuroimaging are challenging due to low investments and heterogeneous populations. Outstanding the importance of diagnosing mild cognitive impairment and dementia, the purpose of this paper is to offer an overview of neuroimaging dementia research in Brazil. The review includes a brief scientometric analysis of quantitative information about the development of this field over the past 10 years. Besides, discusses some peculiarities and challenges that have limited neuroimaging dementia research in this big and heterogeneous country of Latin America. We systematically reviewed existing neuroimaging literature with Brazilian authors that presented outcomes related to a dementia syndrome, published from 2010 to 2020. Briefly, the main neuroimaging methods used were morphometrics, followed by fMRI, and DTI. The major diseases analyzed were Alzheimer's disease, mild cognitive impairment, and vascular dementia, respectively. Moreover, research activity in Brazil has been restricted almost entirely to a few centers in the Southeast region, and funding could be the main driver for publications. There was relative stability concerning the number of publications per year, the citation impact has historically been below the world average, and the author's gender inequalities are not relevant in this specific field. Neuroimaging research in Brazil is far from being developed and widespread across the country. Fortunately, increasingly collaborations with foreign partnerships contribute to the impact of Brazil's domestic research. Although the challenges, neuroimaging researches performed in the native population regarding regional peculiarities and adversities are of pivotal importance.
Collapse
Affiliation(s)
- Liara Rizzi
- Department of Neurology, University of Campinas (UNICAMP), Campinas, Brazil
| | | | | |
Collapse
|
4
|
Hansra GK, Popov G, Banaczek PO, Vogiatzis M, Jegathees T, Goldsbury CS, Cullen KM. The neuritic plaque in Alzheimer's disease: perivascular degeneration of neuronal processes. Neurobiol Aging 2019; 82:88-101. [PMID: 31437721 DOI: 10.1016/j.neurobiolaging.2019.06.009] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2018] [Revised: 06/27/2019] [Accepted: 06/28/2019] [Indexed: 12/14/2022]
Abstract
Cerebrovascular pathology is common in aging and Alzheimer's disease (AD). The microvasculature is particularly vulnerable, with capillary-level microhemorrhages coinciding with amyloid beta deposits in senile plaques. In the current analysis, we assessed the relationship between cerebral microvessels and the neuritic component of the plaque in cortical and hippocampal 50- to 200-μm sections from 11 AD, 3 Down syndrome, and 7 nondemented cases in neuritic disease stages 0-VI. We report that 77%-97% of neuritic plaques are perivascular, independently of disease stage or dementia diagnosis. Within neuritic plaques, dystrophic hyperphosphorylated tau-positive neurites appear as clusters of punctate, bulbous, and thread-like structures focused around capillaries and colocalize with iron deposits characteristic of microhemorrhage. Microvessels within the neuritic plaque are narrowed by 1.0 ± 1.0 μm-4.4 ± 2.0 μm, a difference of 16%-65% compared to blood vessel segments with diameters 7.9 ± 2.0-6.4 ± 0.8 μm (p < 0.01) outside the plaque domain. The reduced capacity of microvessels within plaques, frequently below patency, likely compromises normal microlocal cerebrovascular perfusion. These data link the neuritic and amyloid beta components of the plaque directly to microvascular degeneration. Strategies focused on cerebrovascular antecedents to neuritic dystrophy in AD have immediate potential for prevention, detection, and therapeutic intervention.
Collapse
Affiliation(s)
- Gurpreet Kaur Hansra
- Discipline of Anatomy & Histology, School of Medical Sciences, Faculty of Medicine and Health, University of Sydney, New South Wales, Australia
| | - Glib Popov
- Discipline of Anatomy & Histology, School of Medical Sciences, Faculty of Medicine and Health, University of Sydney, New South Wales, Australia
| | - Patricia O Banaczek
- Discipline of Anatomy & Histology, School of Medical Sciences, Faculty of Medicine and Health, University of Sydney, New South Wales, Australia
| | - Monica Vogiatzis
- Discipline of Anatomy & Histology, School of Medical Sciences, Faculty of Medicine and Health, University of Sydney, New South Wales, Australia
| | - Thuvarahan Jegathees
- Discipline of Anatomy & Histology, School of Medical Sciences, Faculty of Medicine and Health, University of Sydney, New South Wales, Australia
| | - Claire S Goldsbury
- Discipline of Anatomy & Histology, School of Medical Sciences, Faculty of Medicine and Health, University of Sydney, New South Wales, Australia; Brain and Mind Centre, Faculty of Medicine and Health, University of Sydney, New South Wales, Australia
| | - Karen M Cullen
- Discipline of Anatomy & Histology, School of Medical Sciences, Faculty of Medicine and Health, University of Sydney, New South Wales, Australia.
| |
Collapse
|
5
|
Liu Y, Liu Z, Wei M, Hu M, Yue K, Bi R, Zhai S, Pi Z, Song F, Liu Z. Pharmacodynamic and urinary metabolomics studies on the mechanism of Schisandra polysaccharide in the treatment of Alzheimer's disease. Food Funct 2019; 10:432-447. [DOI: 10.1039/c8fo02067a] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
This study was designed to investigate the antagonism of SCP in Aβ25–35-induced AD rats by intervening in neurotransmitters and metabolites.
Collapse
Affiliation(s)
- Yuanyuan Liu
- State Key Laboratory of Electroanalytical Chemistry
- National Center of Mass Spectrometry in Changchun
- Jilin Province Key Laboratory of Chinese Medicine Chemistry and Mass Spectrometry
- Changchun Institute of Applied Chemistry
- Chinese Academy of Sciences
| | - Zhongying Liu
- School of Pharmaceutical Sciences
- Jilin University
- Changchun 130021
- China
| | - Mengying Wei
- School of Pharmaceutical Sciences
- Jilin University
- Changchun 130021
- China
| | - Mingxin Hu
- School of Pharmaceutical Sciences
- Jilin University
- Changchun 130021
- China
| | - Kexin Yue
- School of Pharmaceutical Sciences
- Jilin University
- Changchun 130021
- China
| | - Rongbing Bi
- Institute of special animal and plant sciences of CAAS
- Changchun 130112
- China
| | - Shan Zhai
- School of Pharmaceutical Sciences
- Jilin University
- Changchun 130021
- China
| | - Zifeng Pi
- State Key Laboratory of Electroanalytical Chemistry
- National Center of Mass Spectrometry in Changchun
- Jilin Province Key Laboratory of Chinese Medicine Chemistry and Mass Spectrometry
- Changchun Institute of Applied Chemistry
- Chinese Academy of Sciences
| | - Fengrui Song
- State Key Laboratory of Electroanalytical Chemistry
- National Center of Mass Spectrometry in Changchun
- Jilin Province Key Laboratory of Chinese Medicine Chemistry and Mass Spectrometry
- Changchun Institute of Applied Chemistry
- Chinese Academy of Sciences
| | - Zhiqiang Liu
- State Key Laboratory of Electroanalytical Chemistry
- National Center of Mass Spectrometry in Changchun
- Jilin Province Key Laboratory of Chinese Medicine Chemistry and Mass Spectrometry
- Changchun Institute of Applied Chemistry
- Chinese Academy of Sciences
| |
Collapse
|
6
|
Keine D, Walker JQ, Kennedy BK, Sabbagh MN. Development, Application, and Results from a Precision-medicine Platform that Personalizes Multi-modal Treatment Plans for Mild Alzheimer's Disease and At-risk Individuals. Curr Aging Sci 2018; 11:173-181. [PMID: 30338750 PMCID: PMC6388425 DOI: 10.2174/1874609811666181019101430] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2018] [Revised: 10/04/2018] [Accepted: 10/05/2018] [Indexed: 01/02/2023]
Abstract
INTRODUCTION Alzheimer's Disease (AD) is a progressive neurodegenerative condition in which individuals exhibit memory loss, dementia, and impaired metabolism. Nearly all previous single-treatment studies to treat AD have failed, likely because it is a complex disease with multiple underlying drivers contributing to risk, onset, and progression. Here, we explored the efficacy of a multi-therapy approach based on the disease risk factor status specific to individuals with AD diagnosis or concern. METHODS Novel software from uMETHOD Health was designed to execute a precision-medicinebased approach to develop personalized treatment recommendations with the goal of slowing or reversing biologic drivers of AD. AD-associated inputs encompassed genomic data, bio-specimen measurements, imaging data (such as MRIs or PET scans), medical histories, medications, allergies, co-morbidities, relevant lifestyle factors, and results of neuropsychological testing. Algorithms were then employed to prioritize physiologic and lifestyle states with the highest probability of contributing to disease status, and these priorities were incorporated into a personalized care plan, which was delivered to physicians and supported by health coaches to increase adherence. The sample included 40 subjects with Subjective Cognitive Decline patients (SCD), and Mild Cognitive Impairment Patients (MCI). RESULTS Software analysis was completed for 40 individuals. They remained on their treatment plan for an average of 8.4 months, equal to 2.8 iterations of care plans. 80% of individuals overall showed improved memory function scores or held steady, as measured by standardized cognitive evaluations. Cognitive assessments showed significant improvement in the SCD group (Composite P value .002, Executive P value .01), and the CNS-VS Executive domain showed significant results in the combined group as well (P value .01). There was also biomarker improvement over time observed from the blood panels. 8 out of 12 selected biomarkers showed slight, though statistically non-significant, improvement overall for symptomatic individuals, and 6 out of 12 for the overall population. Only one biomarker, homocysteine, showed significant improvement, though (P values .03, .04, .002). CONCLUSIONS Our analysis of these individuals lead to several interesting observations together suggesting that AD risk factors comprise a network of interlocking feedback loops that may be modifiable. Our findings indicate previously unidentified connectivity between AD risk factors, suggesting that treatment regimens should be tailored to the individual and multi-modal to simultaneously return several risk factors to a normative state. If successfully performed, the possibility to slow progression of AD and possibly reverse aspects of cognitive decline may become achievable.
Collapse
Affiliation(s)
- Dorothy Keine
- uMETHOD Health, Raleigh, North Carolina, United States
| | - John Q Walker
- uMETHOD Health, Raleigh, North Carolina, United States
| | - Brian K Kennedy
- AFFIRMATIVhealth, PLLC, Sonoma, California, United States
- Departments of Biochemistry and Physiology, National University of Singapore, Singapore
- Centre for Healthy Ageing, National University Health System, Singapore
- Buck Institute For Research on Aging, Novato, California, United States
| | - Marwan N Sabbagh
- Cleveland Clinic Lou Ruvo Center for Brain Health, Las Vegas, NV, United States
| |
Collapse
|
7
|
Oliveira FFD, Chen ES, Smith MC, Bertolucci PH. Associations of cerebrovascular metabolism genotypes with neuropsychiatric symptoms and age at onset of Alzheimer's disease dementia. ACTA ACUST UNITED AC 2017; 39:95-103. [PMID: 28099631 PMCID: PMC7111454 DOI: 10.1590/1516-4446-2016-1991] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2016] [Accepted: 07/05/2016] [Indexed: 12/03/2022]
Abstract
Objective: To study associations of cerebrovascular metabolism genotypes and haplotypes with age at Alzheimer’s disease dementia (AD) onset and with neuropsychiatric symptoms according to each dementia stage. Methods: Consecutive outpatients with late-onset AD were assessed for age at dementia onset and Neuropsychiatric Inventory scores according to Clinical Dementia Rating scores, apolipoprotein E gene (APOE) haplotypes, angiotensin-converting enzyme gene (ACE) variants rs1800764 and rs4291, low-density lipoprotein cholesterol receptor gene (LDLR) variants rs11669576 and rs5930, cholesteryl ester transfer protein gene (CETP) variants I422V and TaqIB, and liver X receptor beta gene (NR1H2) polymorphism rs2695121. Results: Considering 201 patients, only APOE-ɛ4 carriers had earlier dementia onset in multiple correlations, as well as less apathy, more delusions, and more aberrant motor behavior. Both ACE polymorphisms were associated with less intense frontally mediated behaviors. Regarding LDLR variants, carriers of the A allele of rs11669576 had less anxiety and more aberrant motor behavior, whereas carriers of the A allele of rs5930 had less delusions, less anxiety, more apathy, and more irritability. CETP variants that included G alleles of I422V and TaqIB were mostly associated with less intense frontally mediated behaviors, while severely impaired carriers of the T allele of rs2695121 had more anxiety and more aberrant motor behavior. Conclusion: Though only APOE haplotypes affected AD onset, cerebrovascular metabolism genotypes were associated with differences in several neuropsychiatric manifestations of AD.
Collapse
Affiliation(s)
- Fabricio F de Oliveira
- Departamento de Neurologia e Neurocirurgia, Escola Paulista de Medicina (EPM), Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil
| | - Elizabeth S Chen
- Departamento de Morfologia e Genética, EPM, UNIFESP, São Paulo, SP, Brazil
| | - Marilia C Smith
- Departamento de Morfologia e Genética, EPM, UNIFESP, São Paulo, SP, Brazil
| | - Paulo H Bertolucci
- Departamento de Neurologia e Neurocirurgia, Escola Paulista de Medicina (EPM), Universidade Federal de São Paulo (UNIFESP), São Paulo, SP, Brazil
| |
Collapse
|