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Chiang KH, Cheng TJ, Kan WC, Wang HY, Li JC, Cai YL, Cheng CH, Liu YC, Chang CY, Chuu JJ. Orthosiphon aristatus (Blume) Miq. Extracts attenuate Alzheimer-like pathology through anti-inflammatory, anti-oxidative, and β-amyloid inhibitory activities. JOURNAL OF ETHNOPHARMACOLOGY 2024; 320:117132. [PMID: 37704121 DOI: 10.1016/j.jep.2023.117132] [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: 07/06/2023] [Revised: 08/29/2023] [Accepted: 09/04/2023] [Indexed: 09/15/2023]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Orthosiphon aristatus (Blume) Miq. (OA) is a traditional folk-herb, which is usually used to treat acute and chronic nephritis, epilepsy, cystitis, and other diseases. Phenols and flavonoids are the main active compound compounds of OA, with proven anti-inflammatory and antioxidant activities. AIMS OF THIS STUDY Based on evidenced therapeutic activities, we aimed to investigate the impact of OA on Alzheimer's disease (AD) which is the most common age-related neurodegenerative disease, and the pathological features include accumulation of beta-amyloid (Aβ) and neurofibrillary tangles (NFT). MATERIALS AND METHODS OA was extracted with water, methanol, chloroform, and ethyl acetate, and determined its total flavonoid and phenolic contents. Initially, Aβ1-42 based cytotoxicity was induced in BV2 cells and C6 cells to investigate the therapeutic impact of OA therapy by MTT, RT-PCR, Western blot, and ELISA. Further, Aβ1-42 Oligomer (400 pmol)-induced AD mice model was established to evaluate the impact of OA extract on improving learning and memory impairment. RESULTS The results showed that the extract of OA could increase cell survival, inhibit the expression of TNF-α, IL-6, IL-1β, COX-2, and iNOS, and increase BDNF levels. We infer that the OA extract may attenuate Aβ-induced cytotoxicity by retarding the production of inflammatory-related factors. In the animal behavior test, the number of mice entering darkroom and the time of arriving at the platform were significantly reduced, indicating the learning and memory-improving ability of OA extract. CONCLUSIONS These findings imply that the OA ethanolic extract demonstrated an improving effect on memory and hence could serve as a potential therapeutic target for the treatment of neurodegenerative diseases like AD.
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Affiliation(s)
- Kuang-Hsing Chiang
- Taipei Heart Institute, Taipei Medical University, Taipei 11031, Taiwan; Division of Cardiology and Cardiovascular Research Center, Taipei Medical University Hospital, Taipei 11031, Taiwan; Department of Internal Medicine, School of Medicine, College of Medicine, Taipei Medical University, Taipei 11031, Taiwan; Graduate Institute of Biomedical Electronics and Bioinformatics, National Taiwan University, Taipei 10617, Taiwan
| | - Tain-Junn Cheng
- Department of Neurology, Chi Mei Medical Center, Yong-Kang District, Tainan 71004, Taiwan; Department of Occupational Medicine Chi Mei Medical Center, Yong-Kang District, Tainan 71004, Taiwan
| | - Wei-Chih Kan
- Division of Nephrology, Chi Mei Medical Center, Yong-Kang District, Tainan 71004, Taiwan; Department of Medical Laboratory Science and Biotechnology, Chung Hwa University of Medical Technology, Tainan 71703, Taiwan
| | - Hsien-Yi Wang
- Division of Nephrology, Chi Mei Medical Center, Yong-Kang District, Tainan 71004, Taiwan; Department of Sport Management, College of Leisure and Recreation Management, Chia Nan University of Pharmacy and Science, Tainan 71710, Taiwan
| | - Jui-Chen Li
- Pharmacy Department, Wei-Gong Memorial Hospital, Miaoli 35159, Taiwan
| | - Yan-Ling Cai
- Department of Biotechnology and Food Technology, College of Engineering, Southern Taiwan University of Science and Technology, Tainan 71005, Taiwan
| | - Chia-Hui Cheng
- Department of Biotechnology and Food Technology, College of Engineering, Southern Taiwan University of Science and Technology, Tainan 71005, Taiwan
| | - Yi-Chien Liu
- Department of Biotechnology and Food Technology, College of Engineering, Southern Taiwan University of Science and Technology, Tainan 71005, Taiwan
| | - Chia-Yu Chang
- Department of Neurology, Chi Mei Medical Center, Yong-Kang District, Tainan 71004, Taiwan; Center for General Education, Southern Taiwan University of Science and Technology, Tainan 71005, Taiwan.
| | - Jiunn-Jye Chuu
- Pharmacy Department, Wei-Gong Memorial Hospital, Miaoli 35159, Taiwan; Department of Biotechnology and Food Technology, College of Engineering, Southern Taiwan University of Science and Technology, Tainan 71005, Taiwan.
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Annual Incidence of Dementia from 2003 to 2018 in Metropolitan Seoul, Korea: A Population-Based Study. J Clin Med 2022; 11:jcm11030819. [PMID: 35160270 PMCID: PMC8836574 DOI: 10.3390/jcm11030819] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Revised: 01/20/2022] [Accepted: 01/29/2022] [Indexed: 12/10/2022] Open
Abstract
National dementia plans were applied in dementia support centers established in Seoul, Korea between 2007 and 2009. However, the annual incidence rates of dementia in Seoul have not been reported. We investigated this annual incidence and the characteristics of incident cases from 2003 to 2018. The customized research database of the Korean National Health Insurance Services was used. The annual crude and age-standardized incidence of dementia patients and their characteristics were analyzed. This study analyzed 108,596 incident dementia cases aged ≥60 years. The incidence rate increased from 2003 to 2011, including a rapid increment from 2007 to 2011. From 2011 to 2018, the crude (age-standardized) incidence per 105 person-years decreased from 641.51 (577.12) to 448.26 (361.23). The proportion of incident dementia cases was highest in the highest income group every year. However, the proportion of incident dementia cases in the lowest income group increased from 10.4% in 2003 to 25.8% in 2011. The annual incidence rate of dementia showed a sharp increase immediately after 2007, the year dementia support centers began to be introduced, and then stabilized after 2011. The characteristics of incident dementia cases have changed, including the proportion in the low-income group.
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Wong HY, Zhong H, Zhong M, Zhou X, Chan PY, Kwok TC, Mok K, Hardy J, Ip FC, Fu AK, Ip NY. Demographics and Medication Use of Patients with Late-Onset Alzheimer's Disease in Hong Kong. J Alzheimers Dis 2022; 87:1205-1213. [PMID: 35466936 PMCID: PMC9198724 DOI: 10.3233/jad-215312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Alzheimer's disease (AD) is the most common cause of dementia in the elderly population. However, epidemiological studies on the demographics of AD in Hong Kong population are lacking. OBJECTIVE We investigated the demographics, comorbidities, mortality rates, and medication use of patients with AD in Hong Kong to understand how the disease has been managed locally. METHODS This was a collaborative study of The Hong Kong University of Science and Technology and the Hospital Authority Data Collaboration Lab. We analyzed the demographic data, clinical records, diagnoses, and medication records of patients with AD under the care of the Hospital Authority between January 1, 2007 and December 31, 2017. RESULTS We identified 23,467 patients diagnosed with AD. The median age at diagnosis was 84 years old, and 71% of patients were female. The most common comorbidity was hypertension (52.6%). 39.9% of patients received medications for dementia; of those, 68.4% had taken those medications for > 1 year. Compared to nonusers, long-term AD medication users had a significantly younger age of AD onset and were taking more lipid-regulating medication, diabetes medication, or antidepressants. Surprisingly, the use of antipsychotics in patients with AD was quite common; 50.7% of patients had received any type of antipsychotic during disease progression. CONCLUSION This study provides detailed information on the demographics and medication use of patients with AD in Hong Kong. The data from this AD cohort will aid our future research aiming to identify potential AD risk factors and associations between AD and other diseases.
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Affiliation(s)
- Hiu Yi Wong
- Division of Life Science, State Key Laboratory of Molecular Neuroscience, Molecular Neuroscience Center, The Hong Kong University of Science and Technology, Clear Water Bay, Hong Kong, China
- Hong Kong Center for Neurodegenerative Diseases, Hong Kong Science Park Hong Kong, China
| | - Huan Zhong
- Division of Life Science, State Key Laboratory of Molecular Neuroscience, Molecular Neuroscience Center, The Hong Kong University of Science and Technology, Clear Water Bay, Hong Kong, China
- Hong Kong Center for Neurodegenerative Diseases, Hong Kong Science Park Hong Kong, China
| | - Mingqian Zhong
- Division of Life Science, State Key Laboratory of Molecular Neuroscience, Molecular Neuroscience Center, The Hong Kong University of Science and Technology, Clear Water Bay, Hong Kong, China
- Hong Kong Center for Neurodegenerative Diseases, Hong Kong Science Park Hong Kong, China
| | - Xiaopu Zhou
- Division of Life Science, State Key Laboratory of Molecular Neuroscience, Molecular Neuroscience Center, The Hong Kong University of Science and Technology, Clear Water Bay, Hong Kong, China
- Hong Kong Center for Neurodegenerative Diseases, Hong Kong Science Park Hong Kong, China
- Guangdong Provincial Key Laboratory of Brain Science, Disease and Drug Development, HKUST Shenzhen Research Institute, Shenzhen–Hong Kong Institute of Brain Science, Shenzhen, Guangdong, China
| | - Phillip Y.C. Chan
- Division of Life Science, State Key Laboratory of Molecular Neuroscience, Molecular Neuroscience Center, The Hong Kong University of Science and Technology, Clear Water Bay, Hong Kong, China
- Hong Kong Center for Neurodegenerative Diseases, Hong Kong Science Park Hong Kong, China
| | - Timothy C.Y. Kwok
- Therese Pei Fong Chow Research Centre for Prevention of Dementia, Division of Geriatrics, Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Shatin, Hong Kong, China
| | - Kin Mok
- Division of Life Science, State Key Laboratory of Molecular Neuroscience, Molecular Neuroscience Center, The Hong Kong University of Science and Technology, Clear Water Bay, Hong Kong, China
- Hong Kong Center for Neurodegenerative Diseases, Hong Kong Science Park Hong Kong, China
- Department of Neurodegenerative Disease, UCL Institute of Neurology, London, UK
- UK Dementia Research Institute at UCL, London, UK
| | - John Hardy
- Hong Kong Center for Neurodegenerative Diseases, Hong Kong Science Park Hong Kong, China
- Department of Neurodegenerative Disease, UCL Institute of Neurology, London, UK
- UK Dementia Research Institute at UCL, London, UK
| | - Fanny C.F. Ip
- Division of Life Science, State Key Laboratory of Molecular Neuroscience, Molecular Neuroscience Center, The Hong Kong University of Science and Technology, Clear Water Bay, Hong Kong, China
- Hong Kong Center for Neurodegenerative Diseases, Hong Kong Science Park Hong Kong, China
- Guangdong Provincial Key Laboratory of Brain Science, Disease and Drug Development, HKUST Shenzhen Research Institute, Shenzhen–Hong Kong Institute of Brain Science, Shenzhen, Guangdong, China
| | - Amy K.Y. Fu
- Division of Life Science, State Key Laboratory of Molecular Neuroscience, Molecular Neuroscience Center, The Hong Kong University of Science and Technology, Clear Water Bay, Hong Kong, China
- Hong Kong Center for Neurodegenerative Diseases, Hong Kong Science Park Hong Kong, China
- Guangdong Provincial Key Laboratory of Brain Science, Disease and Drug Development, HKUST Shenzhen Research Institute, Shenzhen–Hong Kong Institute of Brain Science, Shenzhen, Guangdong, China
| | - Nancy Y. Ip
- Division of Life Science, State Key Laboratory of Molecular Neuroscience, Molecular Neuroscience Center, The Hong Kong University of Science and Technology, Clear Water Bay, Hong Kong, China
- Hong Kong Center for Neurodegenerative Diseases, Hong Kong Science Park Hong Kong, China
- Guangdong Provincial Key Laboratory of Brain Science, Disease and Drug Development, HKUST Shenzhen Research Institute, Shenzhen–Hong Kong Institute of Brain Science, Shenzhen, Guangdong, China
- Correspondence to: Nancy Y. Ip, The Hong Kong University of Science and Technology, Clear Water Bay, Hong Kong, China. Tel.: +852 2358 6161; E-mail:
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Power MC, Gianattasio KZ, Ciarleglio A. Implications of the Use of Algorithmic Diagnoses or Medicare Claims to Ascertain Dementia. Neuroepidemiology 2020; 54:462-471. [PMID: 33075766 DOI: 10.1159/000510753] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Accepted: 08/07/2020] [Indexed: 11/19/2022] Open
Abstract
INTRODUCTION Formal dementia ascertainment with research criteria is resource-intensive, prompting the growing use of alternative approaches. Our objective was to illustrate the potential bias and implications for study conclusions introduced through the use of alternate dementia ascertainment approaches. METHODS We compared dementia prevalence and risk factor associations obtained using criterion-standard dementia diagnoses to those obtained using algorithmic or Medicare-based dementia ascertainment in participants of the baseline visit of the Aging, Demographics, and Memory Study (ADAMS), a Health and Retirement Study (HRS) sub-study. RESULTS Estimates of dementia prevalence derived using algorithmic or Medicare-based ascertainment differ substantially from those obtained using criterion-standard ascertainment. Use of algorithmic or Medicare-based dementia ascertainment can, but does not always, lead to risk factor associations that substantially differ from those obtained using criterion-standard ascertainment. DISCUSSION/CONCLUSIONS Absolute estimates of dementia prevalence should rely on samples with formal dementia ascertainment. The use of multiple algorithms is recommended for risk factor studies when formal dementia ascertainment is not available.
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Affiliation(s)
- Melinda C Power
- Department of Epidemiology, Milken Institute School of Public Health, George Washington University, Washington, District of Columbia, USA,
| | - Kan Z Gianattasio
- Department of Epidemiology, Milken Institute School of Public Health, George Washington University, Washington, District of Columbia, USA
| | - Adam Ciarleglio
- Department of Biostatistics and Bioinformatics, Milken Institute School of Public Health, George Washington University, Washington, District of Columbia, USA
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Lindeza P, Rodrigues M, Costa J, Guerreiro M, Rosa MM. Impact of dementia on informal care: a systematic review of family caregivers' perceptions. BMJ Support Palliat Care 2020:bmjspcare-2020-002242. [PMID: 33055092 DOI: 10.1136/bmjspcare-2020-002242] [Citation(s) in RCA: 69] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2020] [Revised: 08/08/2020] [Accepted: 08/14/2020] [Indexed: 11/04/2022]
Abstract
INTRODUCTION Caregivers play a major role in providing all the support and care in daily activities for their relatives with dementia. To fully describe the influence of dementia caregiving on family caregivers' life, we conducted a systematic review including caregivers' perceptions about the positive and negative aspects of caring and the expressed factors. MATERIALS AND METHODS We conducted a systematic review including articles from January 1998 to July 2020. Qualitative studies reporting family caregivers' perceptions about their experiences and the effects/impact of dementia caregiving were eligible. Two authors extracted the data independently, and the analysis focused on the positive and negative aspects of dementia caregiving in caregivers' life. RESULTS Eighty-one studies with 3347 participants were included in this review. The positive aspects of caregiving in caregivers' life encompass personal accomplishment and strengthening relationships, which were enhanced by good medical counselling/formal care support and family/friends support. The negative aspects included emotional and social aspects experienced by caregivers. Other factors such as inappropriate medical/formal care support, illness progression and the costs of dementia contributed to negative appraisal. DISCUSSION AND IMPLICATIONS The findings provide insights into the holistic experience of caring for a person with dementia revelling the major positive and negative aspects underlying the caregiver role. The evidence emphasises the need 'to focus on positive aspects' and targeted interventions aimed at reducing the negative impact of caregiving, which has serious consequences on caregivers' quality of life. A multicomplex intervention for dementia informal caregiving should be developed, committing the society to promote mental health, address these community needs and improve the quality of life of the person with dementia and their family caregivers.
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Affiliation(s)
- Patrícia Lindeza
- ISAMB, Universidade de Lisboa Instituto de Saude Ambiental, Lisboa, Lisboa, Portugal
| | | | - João Costa
- Universidade de Lisboa Centro de Estudos de Medicina Baseada na Evidência, Lisboa, Lisboa, Portugal
| | | | - Mario Miguel Rosa
- Lab Farmacologia Clínica, Universidade de Lisboa Faculdade de Medicina, Lisboa, Portugal
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Data Sources for Health Expectancy Research. INTERNATIONAL HANDBOOK OF HEALTH EXPECTANCIES 2020. [DOI: 10.1007/978-3-030-37668-0_5] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
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Yong SB, Yeh WC, Wu HJ, Chen HH, Huang JY, Chang TM, Wei JCC. Impact of mycoplasma pneumonia infection on urticaria: A nationwide, population-based retrospective cohort study in Taiwan. PLoS One 2019; 14:e0226759. [PMID: 31860676 PMCID: PMC6924643 DOI: 10.1371/journal.pone.0226759] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2019] [Accepted: 12/03/2019] [Indexed: 11/19/2022] Open
Abstract
Mycoplasma pneumonia (MP) infection might be pathogenically closely related to urticaria. This study is a nationwide population-based cohort study from 1997 to 2013, which investigated the association between MP infection and urticaria in Taiwan. A total of 1,175 patients were included for the study group, and 2,350 for the control group. Multivariate Cox regression analysis was performed to estimate the adjusted hazard ratio (aHR) for urticaria. Result showed that 254 patients with new-onset urticaria were involved in the study group and 465 incident cases in the control group. The incidence rates (per 100,000 person-months) of urticaria were 37.2 and 32.5 in the study and control groups, respectively. The relative risk is 1.1 (95% CI = 1.0–1.3) indicating no significant correlation between MP and urticaria. The multivariate analysis revealed that the risk of urticaria with MP infection (aHR = 1.1, P = 0.1058) had no statistically significance difference compared to the control group. However, the risk of urticaria in MP-infected patients aged between 20 and 59 years old was found to have increased (aHR = 1.6, 95% CI = 1.1–2.2) prior to a diagnosis.
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Affiliation(s)
- Su-Boon Yong
- Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan
- Division of Pediatric Allergy, Immunology and Rheumatology, Department of Pediatrics, Show Chwan Memorial Hospital, Changhua, Taiwan
- Department of Nursing, Meiho University, Pingtung, Taiwan
| | - Wei-Chu Yeh
- Department of Emergency, Show Chwan Memorial Hospital, Changhua, Taiwan
| | - Hsing-Ju Wu
- Research Assistant Center, Show Chwan Memorial Hospital, Changhua, Taiwan
- Department of Medical Research, Chang Bing Show Chwan Memorial Hospital, Lukang Town, Changhua County, Taiwan
| | - Huang-Hsi Chen
- Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan
- Department of Medical Research, Chung Shan Medical University Hospital, Taichung, Taiwan
| | - Jing-Yang Huang
- Department of Medical Research, Chung Shan Medical University Hospital, Taichung, Taiwan
| | - Tung-Ming Chang
- Graduate Institute of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan
| | - James Cheng-Chung Wei
- Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan
- Division of Allergy, Immunology and Rheumatology, Chung Shan Medical University Hospital, Taichung, Taiwan
- Graduate Institute of Integrated Medicine, China Medical University, Taichung, Taiwan
- * E-mail:
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Gender and Age Differences and the Trend in the Incidence and Prevalence of Dementia and Alzheimer's Disease in Taiwan: A 7-Year National Population-Based Study. BIOMED RESEARCH INTERNATIONAL 2019; 2019:5378540. [PMID: 31815145 PMCID: PMC6878786 DOI: 10.1155/2019/5378540] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/05/2019] [Revised: 09/11/2019] [Accepted: 10/03/2019] [Indexed: 11/18/2022]
Abstract
Background Very few nationwide studies have focused on the variations in the incidence and prevalence of dementia and Alzheimer's disease (AD) in Asian countries. This study aims to describe the gender and age differences in the incidence and prevalence of dementia and AD in Taiwan. Methods The data on dementia and AD were acquired from the Taiwan National Health Insurance Research Database from 2004 to 2010. The sex and age-specific rates were standardized, and the differences of gender and age on dementia or AD were assessed using Poisson regression analysis. Results Over seven years, the prevalence of dementia and AD significantly increased from 4.7 to 7.6 per hundred people (β = 0.0784, p < 0.0001) and 2.3 to 3.5 per hundred people (β = 0.0696, p < 0.0001), respectively. However, the incidence of both dementia and AD decreased but not significantly from 10.9 to 10.7 and 4.9 to 4.6 per thousand person-years, respectively. Noticeably, both incidence and prevalence increased with age and were higher in women than in men. Conclusions The standardized incidence rates of dementia and AD are much lower than the data reported in some studies from Europe, the US, and Japan. Further studies are warranted to explore which factors are associated with the differences in the incidence of dementia and AD in Taiwan.
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Radnaabaatar M, Kim Y, Go D, Jung Y, Jung J, Yoon S. Burden of dental caries and periodontal disease in South Korea: An analysis using the national health insurance claims database. Community Dent Oral Epidemiol 2019; 47:513-519. [DOI: 10.1111/cdoe.12493] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2019] [Revised: 08/07/2019] [Accepted: 08/08/2019] [Indexed: 01/26/2023]
Affiliation(s)
| | - Young‐Eun Kim
- Department of Preventive Medicine Korea University College of Medicine Seoul Korea
| | - Dun‐Sol Go
- Department of Public Health, Graduate School Korea University Seoul Korea
| | - Yunsun Jung
- Department of Public Health, Graduate School Korea University Seoul Korea
| | - Jaehun Jung
- Department of Preventive Medicine Gachon University College of Medicine Incheon Korea
| | - Seok‐Jun Yoon
- Department of Preventive Medicine Korea University College of Medicine Seoul Korea
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Liu CC, Li CY, Kung SF, Kuo HW, Huang NC, Sun Y, Hu SC. Association of Environmental Features and the Risk of Alzheimer's Dementia in Older Adults: A Nationwide Longitudinal Case-Control Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2019; 16:ijerph16162828. [PMID: 31398817 PMCID: PMC6721060 DOI: 10.3390/ijerph16162828] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/04/2019] [Revised: 07/31/2019] [Accepted: 07/31/2019] [Indexed: 12/19/2022]
Abstract
Little is known about the association between environmental features and the risk of Alzheimer’s dementia (AD). This study aims to investigate the association of physical and social environments with the incidence of AD. We identified 12,401 newly diagnosed AD cases aged ≥65 years in 2010, with the same no. of matched controls from National Health Insurance claims in Taiwan. Environmental data were collected from government statistics including three physical environments and three social environments. Multilevel logistic regression was conducted to calculate the odds ratios (OR) of AD in association with environmental features at the township level. Results showed that living in the areas with higher availability of playgrounds and sport venues was associated with a 3% decreased odds of AD (95% CI = 0.96–0.99), while higher density of elderly living alone was associated with a 5% increased odds of AD (95% CI = 1.01–1.11), after controlling for individual and other environmental factors. In further examination by urbanization level, the above relationships were found only in rural areas but not in urban areas. This study provides evidence that specific physical and social environmental features have different impacts on the risk of AD.
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Affiliation(s)
- Chih-Ching Liu
- Department of Public Health, College of Medicine, National Cheng Kung University, Tainan 701, Taiwan
| | - Chung-Yi Li
- Department of Public Health, College of Medicine, National Cheng Kung University, Tainan 701, Taiwan
- Department of Public Health, College of Public Health, China Medical University, Taichung 404, Taiwan
| | - Shiann-Far Kung
- Department of Urban Planning, National Cheng Kung University, Tainan 701, Taiwan
- Healthy Cities Research Center, Research and Services Headquarters, National Cheng Kung University, Tainan 701, Taiwan
| | - Hsien-Wen Kuo
- Institute of Environmental and Occupational Health Sciences, National Yang-Ming University, Taipei 112, Taiwan
| | - Nuan-Ching Huang
- Healthy Cities Research Center, Research and Services Headquarters, National Cheng Kung University, Tainan 701, Taiwan
| | - Yu Sun
- Department of Neurology, En Chu Kong Hospital, New Taipei City 23702, Taiwan.
| | - Susan C Hu
- Department of Public Health, College of Medicine, National Cheng Kung University, Tainan 701, Taiwan.
- Healthy Cities Research Center, Research and Services Headquarters, National Cheng Kung University, Tainan 701, Taiwan.
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Gut Microbiota Disorder, Gut Epithelial and Blood-Brain Barrier Dysfunctions in Etiopathogenesis of Dementia: Molecular Mechanisms and Signaling Pathways. Neuromolecular Med 2019; 21:205-226. [PMID: 31115795 DOI: 10.1007/s12017-019-08547-5] [Citation(s) in RCA: 34] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2018] [Accepted: 05/17/2019] [Indexed: 12/12/2022]
Abstract
Emerging evidences indicate a critical role of the gut microbiota in etiopathogenesis of dementia, a debilitating multifactorial disorder characterized by progressive deterioration of cognition and behavior that interferes with the social and professional functions of the sufferer. Available data suggest that gut microbiota disorder that triggers development of dementia is characterized by substantial reduction in specific species belonging to the Firmicutes and Bacteroidetes phyla and presence of pathogenic species, predominantly, pro-inflammatory bacteria of the Proteobacteria phylum. These changes in gut microbiota microecology promote the production of toxic metabolites and pro-inflammatory cytokines, and reduction in beneficial substances such as short chain fatty acids and other anti-inflammatory factors, thereby, enhancing destruction of the gut epithelial barrier with concomitant activation of local and distant immune cells as well as dysregulation of enteric neurons and glia. This subsequently leads to blood-brain barrier dysfunctions that trigger neuroinflammatory reactions and predisposes to apoptotic neuronal and glial cell death, particularly in the hippocampus and cerebral cortex, which underlie the development of dementia. However, the molecular switches that control these processes in the histo-hematic barriers of the gut and brain are not exactly known. This review integrates very recent data on the molecular mechanisms that link gut microbiota disorder to gut epithelial and blood-brain barrier dysfunctions, underlying the development of dementia. The signaling pathways that link gut microbiota disorder with impairment in cognition and behavior are also discussed. The review also highlights potential therapeutic options for dementia.
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Welcome MO. Current Perspectives and Mechanisms of Relationship between Intestinal Microbiota Dysfunction and Dementia: A Review. Dement Geriatr Cogn Dis Extra 2018; 8:360-381. [PMID: 30483303 PMCID: PMC6244112 DOI: 10.1159/000492491] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2018] [Accepted: 07/26/2018] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Accumulating data suggest a crucial role of the intestinal microbiota in the development and progression of neurodegenerative diseases. More recently, emerging reports have revealed an association between intestinal microbiota dysfunctions and dementia, a debilitating multifactorial disorder, characterized by progressive deterioration of cognition and behavior that interferes with the social and professional life of the sufferer. However, the mechanisms of this association are not fully understood. SUMMARY In this review, I discuss recent data that suggest mechanisms of cross-talk between intestinal microbiota dysfunction and the brain that underlie the development of dementia. Potential therapeutic options for dementia are also discussed. The pleiotropic signaling of the metabolic products of the intestinal microbiota together with their specific roles in the maintenance of both the intestinal and blood-brain barriers as well as regulation of local, distant, and circulating immunocytes, and enteric, visceral, and central neural functions are integral to a healthy gut and brain. KEY MESSAGES Research investigating the effect of intestinal microbiota dysfunctions on brain health should focus on multiple interrelated systems involving local and central neuroendocrine, immunocyte, and neural signaling of microbial products and transmitters and neurohumoral cells that not only maintain intestinal, but also blood brain-barrier integrity. The change in intestinal microbiome/dysbiome repertoire is crucial to the development of dementia.
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Affiliation(s)
- Menizibeya O. Welcome
- Department of Physiology, Faculty of Basic Medical Sciences, College of Health Sciences, Nile University of Nigeria, Abuja, Nigeria
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Grossman MR, Zak DK, Zelinski EM. Mobile Apps for Caregivers of Older Adults: Quantitative Content Analysis. JMIR Mhealth Uhealth 2018; 6:e162. [PMID: 30061093 PMCID: PMC6090169 DOI: 10.2196/mhealth.9345] [Citation(s) in RCA: 64] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2017] [Revised: 05/26/2018] [Accepted: 06/18/2018] [Indexed: 02/06/2023] Open
Abstract
Background Informal caregivers of older adults provide critical support for their loved ones but are subject to negative health outcomes because of burden and stress. Interventions to provide information and resources as well as social and emotional support reduce burden. Mobile apps featuring access to information, assistance with scheduling, and other features can automate support functions inexpensively and conveniently and reach a greater proportion of caregivers than otherwise possible. Objective The aim of this study was to identify mobile apps geared towards caregivers of older adults, catalog features, and suggest best practices for adoption based on empirical findings of beneficial interventions in the caregiving literature. Methods Search for apps focused on ones catered for caregivers of older adults in Google Play and iTunes, compiling their features, and identifying features reflecting categories of support identified in successful intervention studies to negative caregiver outcomes. Intervention research indicates that provision of information and resources, assistance in practical problem solving, coordinating care among multiple caregivers, and emotional support reduce caregiver burden. Results Despite approximately over 200,000 mobile health–related apps, the availability of mobile apps for caregivers is relatively sparse (n=44 apps) as of October 2017. Apps generally addressed specific categories of support, including information and resources, family communication, and caregiver-recipient interactions. Few apps were comprehensive. Only 8 out of 44 (18%) had features that addressed three or more categories. Few apps provided specific stress reduction exercises for caregivers, which is important for reducing burden. Conclusions Mobile apps have the potential to provide resources, just-in-time information for problem-solving, and stress reduction strategies for caregivers. Many apps offer functions that have been shown to reduce burden and improve health outcomes in caregivers, but few provide emotional support. Using an evidence-based practice approach, mobile apps for caregivers can provide multiple beneficial support functions. Apps can serve a much larger proportion of this highly underserved population in their mobile form than more traditional means, improving their health and quality of life.
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Affiliation(s)
- Molli R Grossman
- Leonard Davis School of Gerontology, University of Southern California, Los Angeles, CA, United States
| | - Deanah Kim Zak
- Leonard Davis School of Gerontology, University of Southern California, Los Angeles, CA, United States
| | - Elizabeth M Zelinski
- Leonard Davis School of Gerontology, University of Southern California, Los Angeles, CA, United States
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Abstract
BACKGROUND The purpose of this paper was to examine whether glaucoma could be a non-memory manifestation of Alzheimer's disease in older people. METHODS We conducted a population-based, retrospective, case-control study to analyze the database of the Taiwan National Health Insurance Program. There were 1,351 subjects ≥65 years old with newly diagnosed Alzheimer's disease as the cases, and 5,329 subjects without any type of dementias as the controls during 2000-2011. The odds ratio (OR) and 95% confidence interval (CI) for the risk of Alzheimer's disease associated with glaucoma was estimated by the multivariable unconditional logistic regression model. RESULTS After controlling for confounders, the multivariable logistic regression model demonstrated that the adjusted OR of Alzheimer's disease was 1.50 in subjects with glaucoma (95% CI 1.19, 1.89), compared to subjects without glaucoma. CONCLUSIONS Older people with glaucoma are associated with 1.5-fold increased odds of Alzheimer's disease in Taiwan. Glaucoma may be a non-memory manifestation of Alzheimer's disease in older people. Further research is needed to confirm this issue.
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Affiliation(s)
- Shih-Wei Lai
- College of Medicine,China Medical University,Taichung,Taiwan
| | - Cheng-Li Lin
- College of Medicine,China Medical University,Taichung,Taiwan
| | - Kuan-Fu Liao
- College of Medicine,Tzu Chi University,Hualien,Taiwan
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15
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Huang CF, Liu JC, Huang HC, Chuang SY, Chen CI, Lin KC. Longitudinal transition trajectory of gouty arthritis and its comorbidities: a population-based study. Rheumatol Int 2016; 37:313-322. [PMID: 28004164 DOI: 10.1007/s00296-016-3634-9] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2016] [Accepted: 12/09/2016] [Indexed: 10/20/2022]
Abstract
The aim of the study was to investigate the longitudinal transition trajectory of gout and its comorbidities in male patients with gout in different age groups. A total of 3973 male patients who received a new diagnosis of gouty arthritis were identified from the Taiwan Longitudinal Health Insurance Database and divided into two age cohorts (<50 and ≥50 years). Each patient was individually followed from 2000 to 2009 to identify associated comorbidities, namely hypertension, hypercholesterolemia, diabetes mellitus, cardiovascular diseases, and chronic kidney disease. Two outcome measurements of stroke and all-cause cancer were further identified until 2010. The transition trajectory was divided into the following five phenotype groups: persistent hypertension combined with a high prevalence of various gout-related comorbidities, persistent hypercholesterolemia combined with a moderate prevalence of various gout-related comorbidities, persistent low prevalence of various gout-related comorbidities, moderate to high prevalence of various gout-related comorbidities, and low to high prevalence of various gout-related comorbidities. Although the younger and older patients had a similar longitudinal transition trajectory of gout-related comorbidities, the older patients had a higher 10-year likelihood of transition from a low or moderate to a high prevalence of various gout-related comorbidities. In addition, the incidences of stroke and all-cause cancer were higher in the groups with high and moderate to high prevalences of various gout-related comorbidities than in the other groups. The occurrence of gouty arthritis in different life stages can cause cluster effects involving varying degrees of comorbidities over time. The findings of the current study can provide additional knowledge and increase clinical awareness regarding the early assessment and management of gout-related comorbidities in clinical practice.
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Affiliation(s)
- Chien-Fang Huang
- Division of Quality Improvement, Joint Commission of Taiwan, 5F No. 31, Sec. 2, Sanmin Road, Banqiao District, New Taipei City, Taiwan, ROC
| | - Ju-Chi Liu
- Division of Cardiovascular Medicine, Department of Internal Medicine, Taipei Medical University - Shuang Ho Hospital, No. 291, Zhongzheng Road, Zhonghe District, New Taipei City, Taiwan, ROC.,Department of Internal Medicine, School of Medicine, Medical College, Taipei Medical University, No. 252, Wu-Hsing Street, Taipei City, Taiwan, ROC
| | - Hui-Chuan Huang
- Accelerated Bachelor of Science in Nursing, College of Nursing, Taipei Medical University, No. 250 Wu-Hsing Street, Taipei City, Taiwan, ROC.,School of Nursing, College of Nursing, Taipei Medical University, No. 250 Wu-Hsing Street, Taipei City, Taiwan, ROC
| | - Shao-Yuan Chuang
- Division of Preventive Medicine and Health Services Research, Institute of Population Health Sciences, National Health Research Institutes, No. 35, Keyan Road, Miaoli County, Taiwan, ROC
| | - Chang-I Chen
- Taipei Cancer Center, Taipei Medical University, No. 252, Wu-Hsing Street, Taipei City, Taiwan, ROC.,Department of Healthcare Administration, School of Management, Taipei Medical University, No. 250 Wu-Hsing Street, Taipei City, Taiwan, ROC
| | - Kuan-Chia Lin
- Institute of Hospital and Health Care Administration, Community Research Center, National Yang-Ming University, No. 155, Sec. 2, Linong Street, Beitou District, Taipei City, 11221, Taiwan, ROC.
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