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Reynolds A, Greenfield EA, Nepomnyaschy L. Disparate benefits of higher childhood socioeconomic status on cognition in young adulthood by intersectional social positions. ADVANCES IN LIFE COURSE RESEARCH 2024; 60:100608. [PMID: 38552532 PMCID: PMC11129928 DOI: 10.1016/j.alcr.2024.100608] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Revised: 01/16/2024] [Accepted: 01/16/2024] [Indexed: 04/12/2024]
Abstract
OBJECTIVES Emerging evidence supports the protective effects of higher childhood socioeconomic status (cSES) on cognition over the life course. However, less understood is if higher cSES confers benefits equally across intersecting social positions. Guided by a situational intersectionality perspective and the theory of Minority Diminished Returns (MDR), this study examined the extent to which associations between cSES and cognition in young adulthood are jointly moderated by racialized identity and region of childhood residence. METHODS Using data from the National Longitudinal Study of Adolescent to Adult Health (Add Health), we used multilevel modeling to test associations between cSES and delayed recall and working memory 14 years later when participants were ages 25-34. Further, we examined the influence of racialized identity and region of childhood residence on these associations. RESULTS Higher cSES was associated with higher delayed recall and working memory scores across social positions. However, the strength of the association between higher cSES and working memory differed across racialized subgroups and region of childhood residence. We found a statistically significant three-way interaction between cSES, race and region of childhood residence. Of particular important, a small yet statistically robust association was found in all groups, but was especially strong among White Southerners and especially weak among Black participants from the South. CONCLUSIONS This study contributes to a growing body of research indicating that the protective effects of higher cSES on cognition are not universal across subgroups of intersecting social positions, consistent with the theory of MDR. These findings provide evidence for the importance of considering the role of systemic racism across geographic contexts as part of initiatives to promote equity in life course cognitive aging and brain health.
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Affiliation(s)
- Addam Reynolds
- Andrus Gerontology Center, 3715 McClintock Ave, Los Angeles, CA 90089, USA; Leonard Davis School of Gerontology, University of Southern California, Los Angeles, CA, USA.
| | - Emily A Greenfield
- School of Social Work, Rutgers, The State University of New Jersey, New Brunswick, NJ, USA
| | - Lenna Nepomnyaschy
- School of Social Work, Rutgers, The State University of New Jersey, New Brunswick, NJ, USA
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Ouyang M, Chen T, Chen J, Liu C, Luo H, Yang S, Liao W. The association between sleep duration, bedtime, and cognitive ability in Chinese adults: Evidence from the China family panel studies. Heliyon 2024; 10:e30009. [PMID: 38737242 PMCID: PMC11088265 DOI: 10.1016/j.heliyon.2024.e30009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2023] [Revised: 04/09/2024] [Accepted: 04/18/2024] [Indexed: 05/14/2024] Open
Abstract
Introduction Dementia is marked by a steady decline or worsening in cognitive abilities, affecting memory, logic, and social competencies. While many studies suggest a potential link between the amount of sleep and dementia risk, the outcomes are not yet consistent. This research delved into the relationship between sleep length and bedtime on cognitive abilities using an extensive dataset from the China Family Panel Studies (CFPS) from 2014 to 2020. Methods Data from 175,702 observations were collected, including cognitive function test data from 22,848 participants. Various cognitive tests were used to assess cognitive function. Restricted cubic spline (RCS) models were used for data analysis. Results The optimal sleep duration for cognitive function was found to be 6-7 h, and the optimal bedtime was generally between 22:00-23:00. Longitudinal analysis revealed that sleep duration four years prior had a significant impact on current cognitive function. After accounting for various factors, those who slept for 7-8 h and over 8 h displayed lower cognitive function scores. Conversely, individuals sleeping less than 6 h had higher scores on the Vocabulary Test. Bedtime before 22:00 was associated with lower scores on the Vocabulary Test and Mathematical Test. Subgroup analyses based on age, gender, and urban residence showed variations in optimal sleep duration for different populations. Propensity Score Matching (PSM) analysis supported the findings. Conclusions Maintaining a sleep duration of 6-7 h and a regular bedtime between 22:00-23:00 is important for optimizing cognitive performance.
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Affiliation(s)
- Mengqian Ouyang
- Department of Economics, Guangdong Institute of Public Administration, Guangzhou, China
| | - Tao Chen
- Structural Cardiology, Affiliated Hospital of Guangdong Medical University, Zhanjiang, China
| | - Jiawei Chen
- Department of Neurology, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Chongxu Liu
- Department of Neurology, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Haoyu Luo
- Department of Neurology, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Shaoqing Yang
- Department of Neurology, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
| | - Wang Liao
- Department of Neurology, The Second Affiliated Hospital of Guangzhou Medical University, Guangzhou, China
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Zhang D, Zheng W, Li K. The relationship between marital status and cognitive impairment in Chinese older adults: the multiple mediating effects of social support and depression. BMC Geriatr 2024; 24:367. [PMID: 38658842 PMCID: PMC11040757 DOI: 10.1186/s12877-024-04975-6] [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: 11/08/2023] [Accepted: 04/15/2024] [Indexed: 04/26/2024] Open
Abstract
BACKGROUND Marital status is a potentially essential factor for cognitive impairment. Relevant research examining the potential pathways through which the marital status of spouseless older people is associated with cognitive impairment needs to be more adequate. Therefore, this study aims to investigate the serial mediating effects of various forms of social support and depression between marital status and cognitive impairment in older Chinese people. METHODS This study involved a secondary analysis of data from the 2014-2018 wave of the Chinese Longitudinal Healthy Longevity Survey (CLHLS), with a total of 2,647 Chinese older adults and 53.6% being males. Mediation analysis using the SPSS process macro was conducted. RESULTS The results indicated that marital status was significantly predictive of cognitive impairment among older people, and those with a spouse exhibited higher cognitive functioning. Informal social support and depression were found to play partial mediating roles in the association between marital status and cognitive impairment. The findings also revealed that marital status was unrelated to formal social support, and no association between formal social support and cognitive impairment was found. CONCLUSIONS The study findings highlight the need for social service providers to design programs for promoting connections associated with informal support to reduce their risk of depression and cognitive impairment and for policymakers to develop effective formal social support systems for older people without spouses. This study indicated that older people could regain the benefits of marriage to lower the risk of depression and improve their mental health.
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Affiliation(s)
- Donghang Zhang
- Department of Innovative Social Work, Faculty of Humanities and Social Sciences, City University of Macau, Macao, China
| | - Wenhao Zheng
- Faculty of Humanities and Social Sciences, City University of Macau, Avenida Padre Tomás Pereira Taipa, 999078, Macao, China
| | - Keyang Li
- Faculty of Humanities and Social Sciences, City University of Macau, Avenida Padre Tomás Pereira Taipa, 999078, Macao, China.
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Juul Rasmussen I, Frikke-Schmidt R. Modifiable cardiovascular risk factors and genetics for targeted prevention of dementia. Eur Heart J 2023; 44:2526-2543. [PMID: 37224508 PMCID: PMC10481783 DOI: 10.1093/eurheartj/ehad293] [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: 09/27/2022] [Revised: 02/22/2023] [Accepted: 05/04/2023] [Indexed: 05/26/2023] Open
Abstract
Dementia is a major global challenge for health and social care in the 21st century. A third of individuals >65 years of age die with dementia, and worldwide incidence numbers are projected to be higher than 150 million by 2050. Dementia is, however, not an inevitable consequence of old age; 40% of dementia may theoretically be preventable. Alzheimer's disease (AD) accounts for approximately two-thirds of dementia cases and the major pathological hallmark of AD is accumulation of amyloid-β. Nevertheless, the exact pathological mechanisms of AD remain unknown. Cardiovascular disease and dementia share several risk factors and dementia often coexists with cerebrovascular disease. In a public health perspective, prevention is crucial, and it is suggested that a 10% reduction in prevalence of cardiovascular risk factors could prevent more than nine million dementia cases worldwide by 2050. Yet this assumes causality between cardiovascular risk factors and dementia and adherence to the interventions over decades for a large number of individuals. Using genome-wide association studies, the entire genome can be scanned for disease/trait associated loci in a hypothesis-free manner, and the compiled genetic information is not only useful for pinpointing novel pathogenic pathways but also for risk assessments. This enables identification of individuals at high risk, who likely will benefit the most from a targeted intervention. Further optimization of the risk stratification can be done by adding cardiovascular risk factors. Additional studies are, however, highly needed to elucidate dementia pathogenesis and potential shared causal risk factors between cardiovascular disease and dementia.
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Affiliation(s)
- Ida Juul Rasmussen
- Department of Clinical Biochemistry, Rigshospitalet, Copenhagen University Hospital, Blegdamsvej 9, DK-2100 Copenhagen, Denmark
| | - Ruth Frikke-Schmidt
- Department of Clinical Biochemistry, Rigshospitalet, Copenhagen University Hospital, Blegdamsvej 9, DK-2100 Copenhagen, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
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Wang G, Zhou Y, Duan J, Kan Q, Cheng Z, Tang S. Effects of adverse childhood health experiences on cognitive function in Chinese middle-aged and older adults: mediating role of depression. BMC Public Health 2023; 23:1293. [PMID: 37407916 DOI: 10.1186/s12889-023-16169-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Accepted: 06/21/2023] [Indexed: 07/07/2023] Open
Abstract
BACKGROUND Adverse childhood experiences are critical factors in depression and cognitive decrease, but the effect of adverse childhood health experiences (ACHEs) on cognitive function and the role of depression have not been fully studied. METHODS Data were taken from the China Health and Retirement Longitudinal Study (CHARLS) of 2014 and 2018. This study used indicators of situational memory ability and mental status to measure cognitive capacity. Besides analyzing the different types of ACHEs, scores for ACHEs were calculated to represent the severity of ACHEs. The Center for Epidemiologic Studies Depression Scale (CES-D) was used to assess depression. The analysis of this study employed two different analytical strategies in order to examine the mediated effects of depression. We used Sobel's test and Baron and Kenny's causal step approach, which utilized a generalized least squares regression model. Furthermore, a logistic regression model was used to evaluate the robustness of the Karlson-Holm-Breen (KHB) approach. RESULTS In this study, 6301 individuals who met the requirements of the study were included. We found that being confined to bed (ACHE3) (β=-0.3846, p = 0.022) in childhood had a negative impact on cognitive function. Similarly, ACHEs had a negative effect on cognitive function (β=-0.0819, p = 0.090). And after the depression had been introduced into the model, the regression coefficient of ACHEs on cognitive function was no longer significant (β=-0.0170, p = 0.727). The Sobel test showed that for ACHE3, the mediated proportion of the total effect of depression was 36.92%. While for ACHEs, the proportion of the mediated effect of depression was 70.11%. Finally, a robustness test of the mediating effect using the KHB method revealed that the mediating effect still existed. Further, based on different gender, age, and educational levels, the heterogeneity test indicated that the relationship between ACHEs and cognitive function and mediating effects of the depression were different as well as passing the robustness test of the interaction. CONCLUSION The decline in cognition had been shown to be correlated with ACHEs and depression mediated this relationship. Positive interventions might help to improve cognitive performance in individuals suffering from ACHEs and depression.
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Affiliation(s)
- Gaoling Wang
- School of Health Economics and Management, Nanjing University of Chinese Medicine, 138 Xianlin Road, Qixia District, Nanjing, China
| | - Yuqin Zhou
- School of Health Economics and Management, Nanjing University of Chinese Medicine, 138 Xianlin Road, Qixia District, Nanjing, China
| | - Jing Duan
- School of Health Economics and Management, Nanjing University of Chinese Medicine, 138 Xianlin Road, Qixia District, Nanjing, China
| | - Qianqian Kan
- School of Health Economics and Management, Nanjing University of Chinese Medicine, 138 Xianlin Road, Qixia District, Nanjing, China
| | - Zhaopeng Cheng
- School of Health Economics and Management, Nanjing University of Chinese Medicine, 138 Xianlin Road, Qixia District, Nanjing, China
| | - Shaoliang Tang
- School of Health Economics and Management, Nanjing University of Chinese Medicine, 138 Xianlin Road, Qixia District, Nanjing, China.
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Araújo LF, Faerstein E. Family instability in childhood affects language and memory in adulthood: results from the Pró-Saúde Study, Brazil. CIENCIA & SAUDE COLETIVA 2023; 28:811. [PMID: 36888865 DOI: 10.1590/1413-81232023283.13782022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Accepted: 09/13/2022] [Indexed: 03/08/2023] Open
Abstract
The study aims to investigate associations between adverse childhood psychosocial exposures and declarative memory, language, and executive function in adults with secondary schooling or more and without dementia. In 361 participants from the Pró-Saúde Study, we estimated associations between maternal educational attainment, principal source of the family´s income, food insecurity, and childhood family structure and performance in learning, word recall, and semantic and phonemic verbal fluency tests using multiple linear regression models. Individuals whose mother was the family breadwinner (mean difference: -1.97, 95%CI: -3.27; -0.72) and head-of-household (mean difference: -1.62, 95%CI: -2.89; -0.35) or who lived with a non-parental caregiver or in institutions in childhood (mean difference: -2.19, 95%CI: -4.29; -0.09) showed a reduction in the mean number of words in language and memory in adulthood. The results provide further evidence of the effect of adverse exposures in childhood. Without effective interventions, such exposures are likely to have far-reaching impacts on cognition.
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Affiliation(s)
- Larissa Fortunato Araújo
- Departamento de Saúde Comunitária, Escola de Medicina, Universidade Federal do Ceará. R. Papi Júnior - de 511/512 a 1949/1950, Rodolfo Teófilo. 60430-235 Fortaleza CE Brasil.
| | - Eduardo Faerstein
- Instituto de Medicina Social, Universidade Estadual do Rio de Janeiro. Rio de Janeiro RJ Brasil
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O'Shea DM, Alaimo H, Davis JD, Galvin JE, Tremont G. A comparison of cognitive performances based on differing rates of DNA methylation GrimAge acceleration among older men and women. Neurobiol Aging 2023; 123:83-91. [PMID: 36641830 DOI: 10.1016/j.neurobiolaging.2022.12.011] [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: 10/17/2022] [Revised: 12/02/2022] [Accepted: 12/22/2022] [Indexed: 12/31/2022]
Abstract
Cognitive heterogeneity increases with age rendering sex differences difficult to identify. Given established sex differences in biological aging, we examined whether comparisons of men and women on neuropsychological test performances differed as a function of age rate. Data were obtained from 1921 adults enrolled in the 2016 wave of the Health and Retirement Study. The residual from regressing the DNA methylation GrimAge clock on chronological age was used as the measure of aging rate. Slow and fast age rates were predefined as 1 standard deviation below or above the sex-specific mean rates, respectively. ANCOVAs were used to test group differences in test performances. Pairwise comparisons revealed that slow aging men outperformed fast aging women (and vice versa) on measures of executive function/speed, visual memory and semantic fluency; however, when groups were matched by aging rates, no significant differences remained. In contrast, women, regardless of their aging rates, education or depressive symptoms maintained their advantage on verbal learning and memory. Implications for research on sex differences in cognitive aging are discussed.
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Affiliation(s)
- Deirdre M O'Shea
- Department of Psychiatry & Human Behavior, Warren Alpert Medical School, Brown University, Providence, RI, USA; Rhode Island Hospital, Providence, RI, USA; Comprehensive Center for Brain Health, Department of Neurology, University of Miami Miller School of Medicine, Boca Raton, FL, USA.
| | | | - Jennifer D Davis
- Department of Psychiatry & Human Behavior, Warren Alpert Medical School, Brown University, Providence, RI, USA; Rhode Island Hospital, Providence, RI, USA
| | - James E Galvin
- Comprehensive Center for Brain Health, Department of Neurology, University of Miami Miller School of Medicine, Boca Raton, FL, USA
| | - Geoffrey Tremont
- Department of Psychiatry & Human Behavior, Warren Alpert Medical School, Brown University, Providence, RI, USA; Rhode Island Hospital, Providence, RI, USA
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Distressing dreams in childhood and risk of cognitive impairment or Parkinson's disease in adulthood: a national birth cohort study. EClinicalMedicine 2023; 57:101872. [PMID: 37064510 PMCID: PMC10102896 DOI: 10.1016/j.eclinm.2023.101872] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Revised: 01/30/2023] [Accepted: 02/01/2023] [Indexed: 02/28/2023] Open
Abstract
Background Distressing dreams in middle-aged and older adults have been associated with an increased risk of developing cognitive impairment (including dementia) and Parkinson's disease (PD). Whether distressing dreams in younger people might be associated with an increased risk of developing these conditions is unknown. This study investigated the association between distressing dreams in childhood and the risk of developing cognitive impairment or PD by age 50. Methods Data from the 1958 British Birth Cohort Study - a prospective birth cohort which included all people born in Britain during a single week in 1958, were used in this longitudinal analysis. Information on distressing dreams were obtained prospectively from the children's mothers at ages 7 (1965) and 11 (1969). Cognitive impairment and PD at age 50 (2008) were determined by cognitive assessment and doctor-diagnosis respectively. The association between distressing dreams at ages 7 and 11 (no time point, 1 time point, 2 time points) and cognitive impairment or PD at age 50, was evaluated using multivariable Firth logistic regression, with adjustment for potential confounders. Findings Among 6991 children (50.6% female) with follow-up available at age 50, 267 (3.8%) developed cognitive impairment or PD. After adjustment for all covariates, having more regular distressing dreams during childhood was linearly and statistically significantly associated with higher risk of developing cognitive impairment or PD by age 50 (P for trend = 0.037). Compared with children who never had distressing dreams (no time point), children who had persistent distressing dreams (2 time points) had an 85% increased risk of developing cognitive impairment or PD by age 50 (adjusted odds ratio = 1.85; 95% CI: 1.10, 3.11). Interpretation Having persistent distressing dreams during childhood may be associated with an increased risk of developing cognitive impairment or PD in adulthood. Future studies are needed to confirm these findings and to determine whether treating distressing dreams during early life may lower the risk of dementia and PD. Funding The study received no external funding.
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Islamoska S, Hansen JM, Hansen ÅM, Garde AH, Waldemar G, Nabe-Nielsen K. The association between migraine and dementia - a national register-based matched cohort study. Public Health 2022; 213:54-60. [PMID: 36351328 DOI: 10.1016/j.puhe.2022.09.018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2022] [Revised: 09/19/2022] [Accepted: 09/21/2022] [Indexed: 11/07/2022]
Abstract
OBJECTIVES Migraine and dementia, two major public health challenges, are associated, but more knowledge is needed to understand their relationship. Objectives of this study were to investigate 1) the association between non-self-reported measures of migraine and dementia, and whether dementia was associated with 2) migraine without aura (MO) and with aura (MA) in combination with migraine medication use, and 3) migraine severity operationalized as the number of migraine prescriptions. STUDY DESIGN Matched cohort study. METHODS National register data were obtained from individuals born between 1934 and 1958. Migraine cases (aged 25-58 years) were identified by migraine diagnoses and redeemed migraine medication. Migraine cases were matched with non-cases (N = 340,850) and date of diagnosis or medication redemption was defined as index year. Dementia was identified by dementia diagnoses and redeemed dementia medication. RESULTS We observed a 1.46 (95% CI: 1.26-1.69) times higher dementia rate in individuals with a migraine diagnosis and a 0.86 (95% CI: 0.76-0.97) times lower rate when using migraine medication. We found the highest dementia rate among individuals with MA, who also used migraine medication (HR = 2.23; 95% CI: 1.19-4.17), and the lowest rate among individuals with MO, who also used medication (HR = 1.25; 95% CI: 0.75-2.10). The number of migraine medication prescriptions was not associated with dementia. CONCLUSIONS Being registered with a migraine diagnosis was associated with a higher dementia rate, while use of prescribed migraine medication was not. The differences in the dementia rate among migraine cases identified via diagnoses versus medications warrants further investigation.
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Affiliation(s)
- S Islamoska
- Department of Public Health, University of Copenhagen, Øster Farimagsgade 5, 1014 Copenhagen, Denmark.
| | - J M Hansen
- Danish Headache Center, Rigshospitalet - Glostrup, Valdemar Hansens Vej 5, 2600 Glostrup, Denmark.
| | - Å M Hansen
- Department of Public Health, University of Copenhagen, Øster Farimagsgade 5, 1014 Copenhagen, Denmark; The National Research Centre for the Working Environment, Lersø Parkallé 105, 2100 Copenhagen, Denmark.
| | - A H Garde
- Department of Public Health, University of Copenhagen, Øster Farimagsgade 5, 1014 Copenhagen, Denmark; The National Research Centre for the Working Environment, Lersø Parkallé 105, 2100 Copenhagen, Denmark.
| | - G Waldemar
- Danish Dementia Research Centre, Department of Neurology, Rigshospitalet, Inge Lehmannsvej 8, 2100 Copenhagen, Denmark; Department of Clinical Medicine, University of Copenhagen, Blegdamsvej 3B, 2200 Copenhagen, Denmark.
| | - K Nabe-Nielsen
- Department of Public Health, University of Copenhagen, Øster Farimagsgade 5, 1014 Copenhagen, Denmark.
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Wang J, Dove A, Song R, Qi X, Ma J, Bennett DA, Xu W. Poor pulmonary function is associated with mild cognitive impairment, its progression to dementia, and brain pathologies: A community-based cohort study. Alzheimers Dement 2022; 18:2551-2559. [PMID: 35184372 PMCID: PMC10078691 DOI: 10.1002/alz.12625] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Revised: 01/10/2022] [Accepted: 01/25/2022] [Indexed: 01/31/2023]
Abstract
INTRODUCTION The relationship between pulmonary function (PF) and mild cognitive impairment (MCI), dementia, and brain pathologies remains unclear. METHODS A total of 1312 dementia-free participants, including a cognitively intact group (n = 985) and an MCI group (n = 327), were followed for up to 21 years to detect incident MCI and dementia. PF was assessed at baseline with a composite score and tertiled. Over follow-up, 540 participants underwent autopsies for neuropathological assessment. RESULTS Compared to the highest PF, the hazard ratios (95% confidence intervals [CIs]) of the lowest PF were 1.95 (1.43-2.66) for MCI in the cognitively intact group and 1.55 (1.03-2.33) for dementia in the MCI group. Low PF was further related to Alzheimer's disease pathology (odds ratio [OR] 1.32, 95% CI 1.19-1.47) and vascular pathology (OR 3.05, 95% CI 1.49-6.25). DISCUSSION Low PF increases MCI risk and accelerates MCI progression to dementia. Both neurodegenerative and vascular mechanisms may underlie the PF-dementia association.
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Affiliation(s)
- Jiao Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University, Tianjin, China.,Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin, China.,Center for International Collaborative Research on Environment, Nutrition and Public Health, Tianjin, China
| | - Abigail Dove
- Department of Neurobiology, Karolinska Institutet, Care Sciences and Society, Stockholm, Sweden
| | - Ruixue Song
- Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University, Tianjin, China.,Shandong Provincial Clinical Research Center for Emergency and Critical Care Medicine, Institute of Emergency and Critical Care Medicine of Shangdong University, Qilu Hospital of Shangdong University, Jinan, China
| | - Xiuying Qi
- Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University, Tianjin, China.,Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin, China.,Center for International Collaborative Research on Environment, Nutrition and Public Health, Tianjin, China
| | - Jun Ma
- Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University, Tianjin, China
| | - David A Bennett
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, Illinois, USA
| | - Weili Xu
- Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University, Tianjin, China.,Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin, China.,Center for International Collaborative Research on Environment, Nutrition and Public Health, Tianjin, China.,Department of Neurobiology, Karolinska Institutet, Care Sciences and Society, Stockholm, Sweden
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Haberstumpf S, Leinweber J, Lauer M, Polak T, Deckert J, Herrmann MJ. Factors associated with dropout in the longitudinal Vogel study of cognitive decline. Eur J Neurosci 2022; 56:5587-5600. [PMID: 34490950 DOI: 10.1111/ejn.15446] [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: 06/01/2021] [Revised: 08/20/2021] [Accepted: 08/25/2021] [Indexed: 12/14/2022]
Abstract
Dementia, including Alzheimer's disease, is a growing problem worldwide. Prevention or early detection of the disease or a prodromal cognitive decline is necessary. By means of our long-term follow-up 'Vogel study', we aim to predict the pathological cognitive decline of a German cohort (mean age was 73.9 ± 1.55 years at first visit) with three measurement time points within 6 years per participant. Especially in samples of the elderly and subjects with chronic or co-morbid diseases, dropouts are one of the biggest problems of long-term studies. In contrast to the large number of research articles conducted on the course of dementia, little research has been done on the completion of treatment. To ensure unbiased and reliable predictors of cognitive decline from study completers, our objective was to determine predictors of dropout. We conducted multivariate analyses of covariance and multinomial logistic regression analyses to compare and predict the subject's dropout behaviour at the second visit 3 years after baseline (full participation, partial participation and no participation/dropout) with neuropsychiatric, cognitive, blood and lifestyle variables. Lower performance in declarative memory, attention and visual-spatial processing predicted dropout rather than full participation. Lower performance in visual-spatial processing predicted partial participation as opposed to full participation. Furthermore, lower performance in mini-mental status examination predicted whether subjects dropped out or participated partially instead of full participation. Baseline cognitive parameters are associated with dropouts at follow-up with a loss of impaired participants. We expect a bias into a healthier sample over time.
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Affiliation(s)
- Sophia Haberstumpf
- Center for Mental Health, Department of Psychiatry, Psychosomatics and Psychotherapy, University Hospital Würzburg, Würzburg, Germany
| | - Jonas Leinweber
- Department of Psychotherapy, Alexianer Psychiatric Hospital Köln-Porz, Köln, Germany
| | - Martin Lauer
- Center for Mental Health, Department of Psychiatry, Psychosomatics and Psychotherapy, University Hospital Würzburg, Würzburg, Germany
| | - Thomas Polak
- Center for Mental Health, Department of Psychiatry, Psychosomatics and Psychotherapy, University Hospital Würzburg, Würzburg, Germany
| | - Jürgen Deckert
- Center for Mental Health, Department of Psychiatry, Psychosomatics and Psychotherapy, University Hospital Würzburg, Würzburg, Germany
| | - Martin J Herrmann
- Center for Mental Health, Department of Psychiatry, Psychosomatics and Psychotherapy, University Hospital Würzburg, Würzburg, Germany
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Kim J, Kim MY, Kim JA, Lee Y. Factors affecting preventive behaviors of Alzheimer's disease in family members of patients with Alzheimer's disease. Medicine (Baltimore) 2022; 101:e31136. [PMID: 36281127 PMCID: PMC9592491 DOI: 10.1097/md.0000000000031136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
As genetic factors increase the risk of Alzheimer's disease (AD), the families of dementia patients are at risk of AD. We aimed to evaluate the factors affecting preventive behaviors of AD in family members of AD patients. Using constructed questionnaire based on the Health Belief Model (HBM) theoretical framework, this cross-sectional study investigated factors influencing preventive behaviors of AD such the intention to take AD-preventive medicines, prior experience of taking cognitive function supplements, and AD-preventive lifestyle. 147 family members of AD patients were recruited through the Korea Alzheimer's Caregiver Association. Out of 147 participants, 94.6% had intention to take AD-preventive medicines and 46.3% had experience of taking cognitive function supplements. The intention to take AD-preventive medicines were significantly influenced by self-efficacy (odds ratio [OR] 1.39, 95% confidence interval [CI] 1.03, 1.87) and dementia knowledge (OR 3.42, 95% CI 1.13, 10.39), whereas prior experience of cognitive function supplements was significantly associated with cue to action (OR 1.22, 95% CI 1.07, 1.40). AD-preventive lifestyle was significantly influenced by socio-demographics such as age, sex, and marital status, and the HBM factors such as perceived susceptibility, self-efficacy, and cue to action. Self-efficacy, cue to action, dementia knowledge, and perceived susceptibility were significantly associated with preventive behaviors of AD. Also, family members of dementia patients, who are at risk of dementia due to genetic factors, lifestyles, and environment factors, had high level of AD-preventive lifestyle and strong intention to take AD-preventive medicines. Further research could be suggested to understand AD-preventive behavior and intention to take AD-preventive medicines in general population.
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Affiliation(s)
- JiEun Kim
- Medical, Eisai Korea Inc, Gangnam-gu, Seoul, Republic of Korea
- *Correspondence: JiEun Kim, Department of Medical, Eisai Korea Inc, 6 Bongeunsa-ro 86-gil, Gangnam-gu, Seoul, Republic of Korea (e-mail: )
| | - Min Young Kim
- Medical, Eisai Korea Inc, Gangnam-gu, Seoul, Republic of Korea
| | - Jung-Ae Kim
- Real World Solutions, IQVIA Korea, Jung-gu, Seoul, Republic of Korea
| | - Youngeun Lee
- Real World Solutions, IQVIA Korea, Jung-gu, Seoul, Republic of Korea
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13
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Residential trajectories across the life course and their association with cognitive functioning in later life. Sci Rep 2022; 12:17004. [PMID: 36220827 PMCID: PMC9553870 DOI: 10.1038/s41598-022-18501-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Accepted: 08/12/2022] [Indexed: 12/29/2022] Open
Abstract
Previous work has found that later life urban-rural differences in cognitive health can be largely explained by indicators of cognitive reserve such as education or occupation. However, previous research concentrated on residence in limited, specific, periods. This study offers a detailed investigation on the association between urban (vs. rural) residence from birth, and cognitive functioning in older age. Using data from the Survey of Health Ageing and Retirement in Europe we created residential trajectories from birth to survey enrolment with a combination of sequence and cluster analysis. Using mixed-effects models, we investigated the association between residential trajectories in early, mid, and later life and three cognitive functioning outcomes: immediate recall, delayed recall, and verbal fluency. In a sample of 38,165 participants, we found that, even after accounting for differences related to education and occupation, rural (vs. urban) residence in early life remained associated with poorer cognitive performance later in life. This suggests that growing up in rural regions leads to a long-term disadvantage in cognitive functioning. Thus, public health policies should consider that urban-rural inequalities in early life may have long-lasting associations with inequalities in cognitive health in old and very old age.
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14
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Xiang X, Cho J, Sun Y, Wang X. Childhood adversity and cognitive impairment in later life. Front Psychol 2022; 13:935254. [PMID: 36051218 PMCID: PMC9424901 DOI: 10.3389/fpsyg.2022.935254] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Accepted: 07/26/2022] [Indexed: 11/13/2022] Open
Abstract
Objectives This study examined the association between childhood adversity and cognitive impairment in later life and explored the potential moderation effect of gender and race. Methods The study sample included 15,133 participants of the Health and Retirement Study (1998-2016 surveys) who had complete data on key study measures and were more than 50. The outcome variable is a dichotomous indicator of cognitive impairment as assessed by the Telephone Interview for Cognitive Status for self-respondents and the 16-item Informant Questionnaire on Cognitive Decline in the Elderly for proxies. A total of six childhood adversity indicators included grade retention, parental substance abuse, physical abuse, trouble with the police, moving due to financial hardship, and receipt of help due to financial hardship in early life. The estimation of the association between childhood adversity and cognitive impairment involved Cox proportional hazards regression. Results: Grade retention had the largest effect on incident cognitive impairment (HR = 1.3, 95% CI = 1.23-1.38, p < 0.001), followed by physical abuse by a parent (HR = 1.10, 95% CI = 1.00-1.20, p = 0.001). The impact of grade retention was more detrimental to women than men (interaction term HR = 0.89, 95% CI = 0.80-1.00, p = 0.048, female as the reference). Parental substance abuse was associated with a lower risk of incident cognitive impairment for most racial groups (HR = 0.89, 95% CI = 0.83-0.95, p = 0.001), but this association was reversed in "non-Hispanic other" race, consisting mainly of Asians (HR = 1.54, 95% CI = 1.05-2.26, p = 0.025). Discussion Some aspects of childhood adversity continue to harm cognitive functioning in later life, while some events may have the opposite effect, with evidence of heterogeneity across gender and race.
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Affiliation(s)
- Xiaoling Xiang
- School of Social Work, University of Michigan, Ann Arbor, MI, United States
| | - Joonyoung Cho
- School of Social Work, University of Michigan, Ann Arbor, MI, United States
| | - Yihang Sun
- School of Social Work, Columbia University, New York, NY, United States
| | - Xiafei Wang
- School of Social Work, David B. Falk College of Sport and Human Dynamics, Syracuse University, New York, NY, United States
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15
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Zhang Y. Fertility History and Risk of Cognitive Impairment Among Older Parents in the United States. J Gerontol B Psychol Sci Soc Sci 2022; 77:2326-2337. [PMID: 35796743 PMCID: PMC9799211 DOI: 10.1093/geronb/gbac091] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Indexed: 01/13/2023] Open
Abstract
OBJECTIVES I work from a gendered life-course perspective to examine the association between older parents' fertility history (i.e., timing and parity) and their risk of cognitive impairment in the United States. METHODS I analyze nationally representative data from 9 waves over 16 years of the Health and Retirement Study (2000-2016). The sample includes 14,543 respondents (6,108 men and 8,435 women) aged 50 and older at the baseline survey. I examine the relationship between parity, age at first birth, and age at last birth with risk of cognitive impairment using nonlinear discrete-time hazard models. RESULTS Adjusting for the effects of full covariates, there are U-shaped relationships between women's age at last birth and risk of cognitive impairment and between women's parity and risk of cognitive impairment. In the sensitivity tests, the relationships remain robust when sampling weights are applied, or mortality selection is corrected. DISCUSSION Fertility timing and parity are likely factors associated with the risk of cognitive impairment for older women. Understanding fertility history and its impact on cognition can help identify the most vulnerable subpopulations, so that more effective interventions can be made to improve cognitive functioning among older adults.
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Affiliation(s)
- Yan Zhang
- Address correspondence to: Center for Demography of Health and Aging, University of Wisconsin–Madison, Madison, Wisconsin, USA. E-mail:
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16
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Sun M, Tran D, Bach A, Ngo U, Tran T, Do T, Meyer OL. Impact of War and Resettlement on Vietnamese Families Facing Dementia: A Qualitative Study. Clin Gerontol 2022; 45:798-807. [PMID: 35485807 PMCID: PMC9680835 DOI: 10.1080/07317115.2022.2071661] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
OBJECTIVES Most Vietnamese immigrants in the U.S. today arrived as political refugees due to the Vietnam War in the late 20th century. Refugees are disproportionally affected by health and mental health disparities as a result of experiencing distress and potentially traumatic experiences before, during, and after their migration processes. This study involved Vietnamese families facing dementia and used a qualitative approach to investigate participants' experiences before, during, and right after their resettlement in the U.S. METHODS In-person interviews were conducted with 11 Vietnamese adults who cared for their family member with dementia. A descriptive analysis approach was used. RESULTS Five major themes emerged from the interviews:1) immigrating separately from family members, 2) difficult and unsafe journeys, 3) experiences of loss, 4) lack of support systems in the U.S., and 5) feelings of unhappiness, sadness, or signs of depression. CONCLUSIONS This study provides a close examination of Vietnamese refugees' unique backgrounds and how individuals with dementia and their caregivers from this population may be disproportionally impacted by stress. CLINICAL IMPLICATIONS To reduce health disparities, we recommend that providers and policymakers allocate more resources for culturally appropriate routine assessment, treatment, and referrals of those with dementia and their caregivers.
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Affiliation(s)
- Mengxue Sun
- University of California, Davis, Davis, CA 95616, USA
| | - Duyen Tran
- University of California, Davis, Davis, CA 95616, USA
- University of California, Davis School of Medicine, Sacramento, CA 95817, USA
| | - Anna Bach
- University of California, Davis, Davis, CA 95616, USA
- University of California, Davis School of Medicine, Sacramento, CA 95817, USA
| | - Uyen Ngo
- University of California, Davis, Davis, CA 95616, USA
| | - Tiffany Tran
- University of California, Davis, Davis, CA 95616, USA
| | - Thuy Do
- Asian Resources Inc., Sacramento, CA 95824, USA
| | - Oanh L. Meyer
- University of California, Davis School of Medicine, Sacramento, CA 95817, USA
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17
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Hachinski V, Avan A. From Dementia to Eumentia: A New Approach to Dementia Prevention. Neuroepidemiology 2022; 56:151-156. [PMID: 35613542 DOI: 10.1159/000525219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Accepted: 05/22/2022] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND During the past 40 years, dementia prevention approaches have ranged from searching for a drug to prevent progression to Alzheimer's disease to prevention of dementia through multi-domain lifestyle interventions. Current Approaches: The search for a silver bullet has yielded good science but no clinical results. The multi-model lifestyle intervention approach has shown encouraging results. The largest proportion of resources in prevention have been devoted to finding a drug to prevent, mitigate or delay what is being called "Alzheimer's disease of late onset." The reality is that Alzheimer pathology is common among the elderly, but it seldom only occurs alone. The only treatable and preventable pathology currently is vascular. Hence arose the concept of "vascular cognitive impairment" meaning any vascular cause or risk factor associated with cognitive impairment. The majority of cases of cognitive in the elderly have a vascular component that is treatable and preventable and identifiable by several means, including a simple ischemic score. CONCLUSION Since environmental, socioeconomic and individual risk factors contribute to dementia, we proposed a Comprehensive, Customized, Cost-effective APProach (The CCC-APP) implemented in actionable units with the focus on promoting brain health (eumentia).
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Affiliation(s)
- Vladimir Hachinski
- Robarts Research Institute, Schulich School of Medicine and Dentistry, University of Western Ontario, London, Ontario, Canada
- Department of Clinical Neurological Sciences, Schulich School of Medicine and Dentistry, University of Western Ontario, London, Ontario, Canada
- Department of Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, University of Western Ontario, London, Ontario, Canada
| | - Abolfazl Avan
- Department of Public Health, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
- Department of Family Medicine, School of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
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18
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Rosenich E, Bransby L, Yassi N, Fripp J, Laws SM, Martins RN, Fowler C, Rainey-Smith SR, Rowe CC, Masters CL, Maruff P, Lim YY. Differential Effects of APOE and Modifiable Risk Factors on Hippocampal Volume Loss and Memory Decline in Aβ- and Aβ+ Older Adults. Neurology 2022; 98:e1704-e1715. [PMID: 35169009 PMCID: PMC9071368 DOI: 10.1212/wnl.0000000000200118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2021] [Accepted: 01/11/2022] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND AND OBJECTIVES This prospective study sought to determine the association of modifiable/nonmodifiable components included in the Cardiovascular Risk Factors, Aging, and Incidence of Dementia (CAIDE) risk score with hippocampal volume (HV) loss and episodic memory (EM) decline in cognitively normal (CN) older adults classified as brain β-amyloid (Aβ) negative (Aβ-) or positive (Aβ+). METHODS Australian Imaging, Biomarkers and Lifestyle study participants (age 58-91 years) who completed ≥2 neuropsychological assessments and a brain Aβ PET scan (n = 592) were included in this study. We computed the CAIDE risk score (age, sex, APOE ε4 status, education, hypertension, body mass index [BMI], hypercholesterolemia, physical inactivity) and a modifiable CAIDE risk score (CAIDE-MR; education, hypertension, BMI, hypercholesterolemia, physical inactivity) for each participant. Aβ+ was classified using Centiloid >25. Linear mixed models assessed interactions between each CAIDE score, Aβ group, and time on HV loss and EM decline. Age, sex, and APOE ε4 were included as separate predictors in CAIDE-MR models to assess differential associations. Exploratory analyses examined relationships between individual modifiable risk factors and outcomes in Aβ- cognitively normal (CN) adults. RESULTS We observed a significant Aβ group × CAIDE × time interaction on HV loss (β [SE] = -0.04 [0.01]; p < 0.000) but not EM decline (β [SE] = -2.33 [9.96]; p = 0.98). Decomposition revealed a significant CAIDE × time interaction in Aβ+ participants only. When modifiable/nonmodifiable CAIDE components were considered separately, we observed a significant Aβ group × CAIDE-MR × time interaction on EM decline only (β [SE] = 3.03 [1.18]; p = 0.01). A significant CAIDE-MR score × time interaction was observed in Aβ- participants only. Significant interactions between APOE ε4 and age × time on HV loss and EM decline were observed in both groups. Exploratory analyses in Aβ- CN participants revealed a significant interaction between BMI × time on EM decline (β [SE] = -3.30 [1.43]; p = 0.02). DISCUSSION These results are consistent with studies showing that increasing age and APOE ε4 are associated with increased rates of HV loss and EM decline. In Aβ- CN adults, lower prevalence of modifiable cardiovascular risk factors was associated with less HV loss and EM decline over ∼10 years, suggesting interventions to reduce modifiable cardiovascular risk factors could be beneficial in this group.
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Affiliation(s)
- Emily Rosenich
- From the Turner Institute for Brain and Mental Health, School of Psychological Sciences (E.R., L.B., P.M., Y.Y.L.), Monash University, Clayton; Departments of Medicine and Neurology, Melbourne Brain Centre at The Royal Melbourne Hospital (N.Y., C.C.R.), and Florey Institute of Neuroscience and Mental Health (C.F., C.L.M., P.M.), University of Melbourne; Population Health and Immunity Division (N.Y.), The Walter and Eliza Hall Institute of Medical Research, Parkville; CSIRO Health and Biosecurity (J.F.), Australian e-Health Research Centre, Brisbane; Collaborative Genomics and Translation Group, School of Medical and Health Sciences (S.M.L.), and Centre of Excellence for Alzheimer's Disease Research and Care (R.N.M.), Edith Cowan University, Joondalup; School of Pharmacy and Biomedical Sciences, Faculty of Health Sciences (S.M.L.), Curtin Health Innovation Research Institute, Curtin University, Bentley; Centre for Healthy Ageing, Health Futures Institute (S.R.R.-G.), Murdoch University; Australian Alzheimer's Research Foundation (S.R.R.-G.), Sarich Neuroscience Research Institute, Nedlands; Department of Nuclear Medicine and Centre for PET (C.C.R.), Austin Health, Heidelberg; Department of Medicine (C.C.R.), Austin Health, University of Melbourne; and Cogstate Ltd. (P.M.), Melbourne, Australia
| | - Lisa Bransby
- From the Turner Institute for Brain and Mental Health, School of Psychological Sciences (E.R., L.B., P.M., Y.Y.L.), Monash University, Clayton; Departments of Medicine and Neurology, Melbourne Brain Centre at The Royal Melbourne Hospital (N.Y., C.C.R.), and Florey Institute of Neuroscience and Mental Health (C.F., C.L.M., P.M.), University of Melbourne; Population Health and Immunity Division (N.Y.), The Walter and Eliza Hall Institute of Medical Research, Parkville; CSIRO Health and Biosecurity (J.F.), Australian e-Health Research Centre, Brisbane; Collaborative Genomics and Translation Group, School of Medical and Health Sciences (S.M.L.), and Centre of Excellence for Alzheimer's Disease Research and Care (R.N.M.), Edith Cowan University, Joondalup; School of Pharmacy and Biomedical Sciences, Faculty of Health Sciences (S.M.L.), Curtin Health Innovation Research Institute, Curtin University, Bentley; Centre for Healthy Ageing, Health Futures Institute (S.R.R.-G.), Murdoch University; Australian Alzheimer's Research Foundation (S.R.R.-G.), Sarich Neuroscience Research Institute, Nedlands; Department of Nuclear Medicine and Centre for PET (C.C.R.), Austin Health, Heidelberg; Department of Medicine (C.C.R.), Austin Health, University of Melbourne; and Cogstate Ltd. (P.M.), Melbourne, Australia
| | - Nawaf Yassi
- From the Turner Institute for Brain and Mental Health, School of Psychological Sciences (E.R., L.B., P.M., Y.Y.L.), Monash University, Clayton; Departments of Medicine and Neurology, Melbourne Brain Centre at The Royal Melbourne Hospital (N.Y., C.C.R.), and Florey Institute of Neuroscience and Mental Health (C.F., C.L.M., P.M.), University of Melbourne; Population Health and Immunity Division (N.Y.), The Walter and Eliza Hall Institute of Medical Research, Parkville; CSIRO Health and Biosecurity (J.F.), Australian e-Health Research Centre, Brisbane; Collaborative Genomics and Translation Group, School of Medical and Health Sciences (S.M.L.), and Centre of Excellence for Alzheimer's Disease Research and Care (R.N.M.), Edith Cowan University, Joondalup; School of Pharmacy and Biomedical Sciences, Faculty of Health Sciences (S.M.L.), Curtin Health Innovation Research Institute, Curtin University, Bentley; Centre for Healthy Ageing, Health Futures Institute (S.R.R.-G.), Murdoch University; Australian Alzheimer's Research Foundation (S.R.R.-G.), Sarich Neuroscience Research Institute, Nedlands; Department of Nuclear Medicine and Centre for PET (C.C.R.), Austin Health, Heidelberg; Department of Medicine (C.C.R.), Austin Health, University of Melbourne; and Cogstate Ltd. (P.M.), Melbourne, Australia
| | - Jurgen Fripp
- From the Turner Institute for Brain and Mental Health, School of Psychological Sciences (E.R., L.B., P.M., Y.Y.L.), Monash University, Clayton; Departments of Medicine and Neurology, Melbourne Brain Centre at The Royal Melbourne Hospital (N.Y., C.C.R.), and Florey Institute of Neuroscience and Mental Health (C.F., C.L.M., P.M.), University of Melbourne; Population Health and Immunity Division (N.Y.), The Walter and Eliza Hall Institute of Medical Research, Parkville; CSIRO Health and Biosecurity (J.F.), Australian e-Health Research Centre, Brisbane; Collaborative Genomics and Translation Group, School of Medical and Health Sciences (S.M.L.), and Centre of Excellence for Alzheimer's Disease Research and Care (R.N.M.), Edith Cowan University, Joondalup; School of Pharmacy and Biomedical Sciences, Faculty of Health Sciences (S.M.L.), Curtin Health Innovation Research Institute, Curtin University, Bentley; Centre for Healthy Ageing, Health Futures Institute (S.R.R.-G.), Murdoch University; Australian Alzheimer's Research Foundation (S.R.R.-G.), Sarich Neuroscience Research Institute, Nedlands; Department of Nuclear Medicine and Centre for PET (C.C.R.), Austin Health, Heidelberg; Department of Medicine (C.C.R.), Austin Health, University of Melbourne; and Cogstate Ltd. (P.M.), Melbourne, Australia
| | - Simon M Laws
- From the Turner Institute for Brain and Mental Health, School of Psychological Sciences (E.R., L.B., P.M., Y.Y.L.), Monash University, Clayton; Departments of Medicine and Neurology, Melbourne Brain Centre at The Royal Melbourne Hospital (N.Y., C.C.R.), and Florey Institute of Neuroscience and Mental Health (C.F., C.L.M., P.M.), University of Melbourne; Population Health and Immunity Division (N.Y.), The Walter and Eliza Hall Institute of Medical Research, Parkville; CSIRO Health and Biosecurity (J.F.), Australian e-Health Research Centre, Brisbane; Collaborative Genomics and Translation Group, School of Medical and Health Sciences (S.M.L.), and Centre of Excellence for Alzheimer's Disease Research and Care (R.N.M.), Edith Cowan University, Joondalup; School of Pharmacy and Biomedical Sciences, Faculty of Health Sciences (S.M.L.), Curtin Health Innovation Research Institute, Curtin University, Bentley; Centre for Healthy Ageing, Health Futures Institute (S.R.R.-G.), Murdoch University; Australian Alzheimer's Research Foundation (S.R.R.-G.), Sarich Neuroscience Research Institute, Nedlands; Department of Nuclear Medicine and Centre for PET (C.C.R.), Austin Health, Heidelberg; Department of Medicine (C.C.R.), Austin Health, University of Melbourne; and Cogstate Ltd. (P.M.), Melbourne, Australia
| | - Ralph N Martins
- From the Turner Institute for Brain and Mental Health, School of Psychological Sciences (E.R., L.B., P.M., Y.Y.L.), Monash University, Clayton; Departments of Medicine and Neurology, Melbourne Brain Centre at The Royal Melbourne Hospital (N.Y., C.C.R.), and Florey Institute of Neuroscience and Mental Health (C.F., C.L.M., P.M.), University of Melbourne; Population Health and Immunity Division (N.Y.), The Walter and Eliza Hall Institute of Medical Research, Parkville; CSIRO Health and Biosecurity (J.F.), Australian e-Health Research Centre, Brisbane; Collaborative Genomics and Translation Group, School of Medical and Health Sciences (S.M.L.), and Centre of Excellence for Alzheimer's Disease Research and Care (R.N.M.), Edith Cowan University, Joondalup; School of Pharmacy and Biomedical Sciences, Faculty of Health Sciences (S.M.L.), Curtin Health Innovation Research Institute, Curtin University, Bentley; Centre for Healthy Ageing, Health Futures Institute (S.R.R.-G.), Murdoch University; Australian Alzheimer's Research Foundation (S.R.R.-G.), Sarich Neuroscience Research Institute, Nedlands; Department of Nuclear Medicine and Centre for PET (C.C.R.), Austin Health, Heidelberg; Department of Medicine (C.C.R.), Austin Health, University of Melbourne; and Cogstate Ltd. (P.M.), Melbourne, Australia
| | - Christopher Fowler
- From the Turner Institute for Brain and Mental Health, School of Psychological Sciences (E.R., L.B., P.M., Y.Y.L.), Monash University, Clayton; Departments of Medicine and Neurology, Melbourne Brain Centre at The Royal Melbourne Hospital (N.Y., C.C.R.), and Florey Institute of Neuroscience and Mental Health (C.F., C.L.M., P.M.), University of Melbourne; Population Health and Immunity Division (N.Y.), The Walter and Eliza Hall Institute of Medical Research, Parkville; CSIRO Health and Biosecurity (J.F.), Australian e-Health Research Centre, Brisbane; Collaborative Genomics and Translation Group, School of Medical and Health Sciences (S.M.L.), and Centre of Excellence for Alzheimer's Disease Research and Care (R.N.M.), Edith Cowan University, Joondalup; School of Pharmacy and Biomedical Sciences, Faculty of Health Sciences (S.M.L.), Curtin Health Innovation Research Institute, Curtin University, Bentley; Centre for Healthy Ageing, Health Futures Institute (S.R.R.-G.), Murdoch University; Australian Alzheimer's Research Foundation (S.R.R.-G.), Sarich Neuroscience Research Institute, Nedlands; Department of Nuclear Medicine and Centre for PET (C.C.R.), Austin Health, Heidelberg; Department of Medicine (C.C.R.), Austin Health, University of Melbourne; and Cogstate Ltd. (P.M.), Melbourne, Australia
| | - Stephanie R Rainey-Smith
- From the Turner Institute for Brain and Mental Health, School of Psychological Sciences (E.R., L.B., P.M., Y.Y.L.), Monash University, Clayton; Departments of Medicine and Neurology, Melbourne Brain Centre at The Royal Melbourne Hospital (N.Y., C.C.R.), and Florey Institute of Neuroscience and Mental Health (C.F., C.L.M., P.M.), University of Melbourne; Population Health and Immunity Division (N.Y.), The Walter and Eliza Hall Institute of Medical Research, Parkville; CSIRO Health and Biosecurity (J.F.), Australian e-Health Research Centre, Brisbane; Collaborative Genomics and Translation Group, School of Medical and Health Sciences (S.M.L.), and Centre of Excellence for Alzheimer's Disease Research and Care (R.N.M.), Edith Cowan University, Joondalup; School of Pharmacy and Biomedical Sciences, Faculty of Health Sciences (S.M.L.), Curtin Health Innovation Research Institute, Curtin University, Bentley; Centre for Healthy Ageing, Health Futures Institute (S.R.R.-G.), Murdoch University; Australian Alzheimer's Research Foundation (S.R.R.-G.), Sarich Neuroscience Research Institute, Nedlands; Department of Nuclear Medicine and Centre for PET (C.C.R.), Austin Health, Heidelberg; Department of Medicine (C.C.R.), Austin Health, University of Melbourne; and Cogstate Ltd. (P.M.), Melbourne, Australia
| | - Christopher C Rowe
- From the Turner Institute for Brain and Mental Health, School of Psychological Sciences (E.R., L.B., P.M., Y.Y.L.), Monash University, Clayton; Departments of Medicine and Neurology, Melbourne Brain Centre at The Royal Melbourne Hospital (N.Y., C.C.R.), and Florey Institute of Neuroscience and Mental Health (C.F., C.L.M., P.M.), University of Melbourne; Population Health and Immunity Division (N.Y.), The Walter and Eliza Hall Institute of Medical Research, Parkville; CSIRO Health and Biosecurity (J.F.), Australian e-Health Research Centre, Brisbane; Collaborative Genomics and Translation Group, School of Medical and Health Sciences (S.M.L.), and Centre of Excellence for Alzheimer's Disease Research and Care (R.N.M.), Edith Cowan University, Joondalup; School of Pharmacy and Biomedical Sciences, Faculty of Health Sciences (S.M.L.), Curtin Health Innovation Research Institute, Curtin University, Bentley; Centre for Healthy Ageing, Health Futures Institute (S.R.R.-G.), Murdoch University; Australian Alzheimer's Research Foundation (S.R.R.-G.), Sarich Neuroscience Research Institute, Nedlands; Department of Nuclear Medicine and Centre for PET (C.C.R.), Austin Health, Heidelberg; Department of Medicine (C.C.R.), Austin Health, University of Melbourne; and Cogstate Ltd. (P.M.), Melbourne, Australia
| | - Colin L Masters
- From the Turner Institute for Brain and Mental Health, School of Psychological Sciences (E.R., L.B., P.M., Y.Y.L.), Monash University, Clayton; Departments of Medicine and Neurology, Melbourne Brain Centre at The Royal Melbourne Hospital (N.Y., C.C.R.), and Florey Institute of Neuroscience and Mental Health (C.F., C.L.M., P.M.), University of Melbourne; Population Health and Immunity Division (N.Y.), The Walter and Eliza Hall Institute of Medical Research, Parkville; CSIRO Health and Biosecurity (J.F.), Australian e-Health Research Centre, Brisbane; Collaborative Genomics and Translation Group, School of Medical and Health Sciences (S.M.L.), and Centre of Excellence for Alzheimer's Disease Research and Care (R.N.M.), Edith Cowan University, Joondalup; School of Pharmacy and Biomedical Sciences, Faculty of Health Sciences (S.M.L.), Curtin Health Innovation Research Institute, Curtin University, Bentley; Centre for Healthy Ageing, Health Futures Institute (S.R.R.-G.), Murdoch University; Australian Alzheimer's Research Foundation (S.R.R.-G.), Sarich Neuroscience Research Institute, Nedlands; Department of Nuclear Medicine and Centre for PET (C.C.R.), Austin Health, Heidelberg; Department of Medicine (C.C.R.), Austin Health, University of Melbourne; and Cogstate Ltd. (P.M.), Melbourne, Australia
| | - Paul Maruff
- From the Turner Institute for Brain and Mental Health, School of Psychological Sciences (E.R., L.B., P.M., Y.Y.L.), Monash University, Clayton; Departments of Medicine and Neurology, Melbourne Brain Centre at The Royal Melbourne Hospital (N.Y., C.C.R.), and Florey Institute of Neuroscience and Mental Health (C.F., C.L.M., P.M.), University of Melbourne; Population Health and Immunity Division (N.Y.), The Walter and Eliza Hall Institute of Medical Research, Parkville; CSIRO Health and Biosecurity (J.F.), Australian e-Health Research Centre, Brisbane; Collaborative Genomics and Translation Group, School of Medical and Health Sciences (S.M.L.), and Centre of Excellence for Alzheimer's Disease Research and Care (R.N.M.), Edith Cowan University, Joondalup; School of Pharmacy and Biomedical Sciences, Faculty of Health Sciences (S.M.L.), Curtin Health Innovation Research Institute, Curtin University, Bentley; Centre for Healthy Ageing, Health Futures Institute (S.R.R.-G.), Murdoch University; Australian Alzheimer's Research Foundation (S.R.R.-G.), Sarich Neuroscience Research Institute, Nedlands; Department of Nuclear Medicine and Centre for PET (C.C.R.), Austin Health, Heidelberg; Department of Medicine (C.C.R.), Austin Health, University of Melbourne; and Cogstate Ltd. (P.M.), Melbourne, Australia
| | - Yen Ying Lim
- From the Turner Institute for Brain and Mental Health, School of Psychological Sciences (E.R., L.B., P.M., Y.Y.L.), Monash University, Clayton; Departments of Medicine and Neurology, Melbourne Brain Centre at The Royal Melbourne Hospital (N.Y., C.C.R.), and Florey Institute of Neuroscience and Mental Health (C.F., C.L.M., P.M.), University of Melbourne; Population Health and Immunity Division (N.Y.), The Walter and Eliza Hall Institute of Medical Research, Parkville; CSIRO Health and Biosecurity (J.F.), Australian e-Health Research Centre, Brisbane; Collaborative Genomics and Translation Group, School of Medical and Health Sciences (S.M.L.), and Centre of Excellence for Alzheimer's Disease Research and Care (R.N.M.), Edith Cowan University, Joondalup; School of Pharmacy and Biomedical Sciences, Faculty of Health Sciences (S.M.L.), Curtin Health Innovation Research Institute, Curtin University, Bentley; Centre for Healthy Ageing, Health Futures Institute (S.R.R.-G.), Murdoch University; Australian Alzheimer's Research Foundation (S.R.R.-G.), Sarich Neuroscience Research Institute, Nedlands; Department of Nuclear Medicine and Centre for PET (C.C.R.), Austin Health, Heidelberg; Department of Medicine (C.C.R.), Austin Health, University of Melbourne; and Cogstate Ltd. (P.M.), Melbourne, Australia
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Reynolds A, Greenfield EA, Moorman S, Reyes L. Race, Childhood Socioeconomic Status, and Region of Childhood Residence as Intersectional Life Course Predictors of Cognitive Aging in the U.S. Innov Aging 2022; 6:igac020. [PMID: 35663274 PMCID: PMC9154061 DOI: 10.1093/geroni/igac020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2021] [Indexed: 11/15/2022] Open
Abstract
Abstract
Background and Objectives
Race, childhood socioeconomic status (cSES), and region of childhood residence are each associated with later life cognition, but no studies have examined how the confluence of these factors influence later life cognitive performance. Guided by intersectionality theory, we examined individuals’ social positionality across these dimensions as a predictor of cognitive performance in later life among non-Hispanic White (NHW) and Black (NHB) older adults.
Research Design and Methods
We used data from the 2010-2016 waves of the Health and Retirement Study (HRS) with participants ages 65 and older in 2010. We employed growth curve modeling to estimate associations among race, cSES and region of childhood residence, as well as their interactions, and cognitive performance at baseline and over time.
Results
Identifying as NHB, residing in the South, and having lower cSES each were associated with poorer later life cognition at baseline. Childhood residence in the South was an especially strong risk factor for poorer cognition among NHBs. Among NHWs, higher cSES was associated with better baseline cognitive performance, especially among those from the South. NHBs from the South demonstrated a small advantage of higher cSES, but regardless of cSES, NHBs from the South had lower levels of baseline cognitive scores compared to all other subgroups. We found that Southern childhood residence predicted faster rates of change in over a 6-year period.
Discussion and Implications
Our findings suggest that intersectional social positions across race, cSES, and region of childhood residence primarily influence baseline cognition in later life. Results implicate the importance of attention to multiple social positions in the context of racism within social policies and other initiatives to promote equity in life course brain health.
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Affiliation(s)
- Addam Reynolds
- Address correspondence to: Addam Reynolds, MSW, School of Social Work, Rutgers, the State University of New Jersey, 390 George Street, Room 609, New Brunswick, NJ 08901, USA. E-mail:
| | - Emily A Greenfield
- School of Social Work, Rutgers, the State University of New Jersey, New Brunswick, New Jersey, USA
| | - Sara Moorman
- Department of Sociology, Boston College, Chestnut Hill, Massachusetts, USA
| | - Laurent Reyes
- School of Social Welfare, University of California, Berkeley, Berkeley, California, USA
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20
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Greenfield EA, Reynolds A, Moorman SM. Life course linkages between enriching early-life activities and later life cognition: Evidence from the Wisconsin Longitudinal Study. Soc Sci Med 2022; 294:114673. [PMID: 34974386 PMCID: PMC8821159 DOI: 10.1016/j.socscimed.2021.114673] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Revised: 12/17/2021] [Accepted: 12/18/2021] [Indexed: 02/03/2023]
Abstract
Prior research suggests that participation in enriching early-life activities (EELAs) has long-term benefits for cognitive health and aging. This study aims to examine the life course processes underlying these associations by drawing on theoretical models from life course epidemiology. Specifically, we tested sensitive-period effects, social pathways, and selection effects as potential explanations for linkages between greater participation in EELAs and better later life cognition. We drew on data from the Wisconsin Longitudinal Study (WLS), which is among the longest-running cohort studies in the U.S. that has followed graduates (all identified as non-Hispanic White) from Wisconsin high schools since 1957. We used prospective measures of key variables, including information from high school yearbooks, with assessments of cognitive performance at ages 65 and 72. Results from multilevel modeling indicated that greater participation in cognitively oriented extracurricular activities (but not physically nor socially oriented activities) was associated with both better language/executive functioning and memory at age 65. Although the size of these associations was reduced when accounting for other cognitive resources in adolescence (childhood socioeconomic status and adolescent cognitive ability) and in midlife (adult socioeconomic status and formal group participation), there remained small, yet statistically robust, associations. We did not find robust associations between greater EELA engagement and slower rates of decline in cognition between ages 65 and 72, nor did we find evidence of gender differences. Results suggest that for this cohort of older adults, EELA participation is part of life course "protective chains," whereby exposures to assets at one point in the life course increase the likelihood of subsequent exposures, each sequentially and in their own right, toward better later life cognition. We discuss how results support the importance of policies and practices to promote healthy cognitive development among youth for the long-term cognitive health of a rapidly aging U.S. population.
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Affiliation(s)
- Emily A. Greenfield
- Corresponding author. Telephone number: 732-391-4986.,Rutgers, The State University of New Jersey; 390 George Street; New Brunswick, NJ 08901 U.S
| | - Addam Reynolds
- Rutgers, The State University of New Jersey; 390 George Street; New Brunswick, NJ 08901 U.S
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21
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Akhter F, Persaud A, Zaokari Y, Zhao Z, Zhu D. Vascular Dementia and Underlying Sex Differences. Front Aging Neurosci 2021; 13:720715. [PMID: 34566624 PMCID: PMC8457333 DOI: 10.3389/fnagi.2021.720715] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2021] [Accepted: 08/13/2021] [Indexed: 11/29/2022] Open
Abstract
Vascular dementia (VaD) is the second most common form of dementia after Alzheimer's disease (AD); where Alzheimer's accounts for 60-70% of cases of dementia and VaD accounts for 20% of all dementia cases. VaD is defined as a reduced or lack of blood flow to the brain that causes dementia. VaD is also known occasionally as vascular contributions to cognitive impairment and dementia (VCID) or multi-infarct dementia (MID). VCID is the condition arising from stroke and other vascular brain injuries that cause significant changes to memory, thinking, and behavior, and VaD is the most severe stage while MID is produced by the synergistic effects caused by multiple mini strokes in the brain irrespective of specific location or volume. There are also subtle differences in the presentation of VaD in males and females, but they are often overlooked. Since 1672 when the first case of VaD was reported until now, sex and gender differences have had little to no research done when it comes to the umbrella term of dementia in general. This review summarizes the fundamentals of VaD followed by a focus on the differences between sex and gender when an individual is diagnosed. In addition, we provide critical evidence concerning sex and gender differences with a few of the main risk factors of VaD including pre-existing health conditions and family history, gene variants, aging, hormone fluctuations, and environmental risk factors. Additionally, the pharmaceutical treatments and possible mitigation of risk factors is explored.
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Affiliation(s)
- Firoz Akhter
- Department of Biomedical Engineering, Stony Brook University, Stony Brook, NY, United States
| | - Alicia Persaud
- Department of Biomedical Engineering, Stony Brook University, Stony Brook, NY, United States
| | - Younis Zaokari
- Department of Biomedical Engineering, Stony Brook University, Stony Brook, NY, United States
| | - Zhen Zhao
- Department of Physiology and Neuroscience, Zilkha Neurogenetic Institute, Keck School of Medicine, University of Southern California, Los Angeles, CA, United States
| | - Donghui Zhu
- Department of Biomedical Engineering, Stony Brook University, Stony Brook, NY, United States
- Neuroscience Graduate Program, Renaissance School of Medicine, Stony Brook University, Stony Brook, NY, United States
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22
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Associations between Early-Life Food Deprivation and Risk of Frailty of Middle-Age and Elderly People: Evidence from the China Health and Retirement Longitudinal Study. Nutrients 2021; 13:nu13093066. [PMID: 34578943 PMCID: PMC8472025 DOI: 10.3390/nu13093066] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Revised: 08/30/2021] [Accepted: 08/30/2021] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND The association between childhood food deprivation (FD) and health in later life has been extensively studied; however, studies on the association between childhood food deprivation and frailty are scarce. This study assessed the associations between childhood FD and the risk of frailty at middle-age and old age. METHODS Three waves of the China Health and Retirement Longitudinal Study (CHARLS), including 11,615 individuals aged over 45 years, were used for this research. Frailty was operationalized according to the FRAIL scale as a sum of fatigue, resistance, ambulation, illness, and the loss of weight. Childhood FD experiences and levels were measured by self-reported FD and historical content. Logistic mixed-effects models and proportional odds ordered logistic regression models were used to analyse the association between childhood FD and frailty. FINDINGS Childhood FD increased the odds of frailty at old age (1.30, 95% CI: 1.26-1.36). Compared with subjects with mild FD, those with extreme FD experiences had increased risks of frailty (1.34, 95% CI: 1.26-1.43). Subjects exposed to hunger at different ages all had an increased risk of frailty, and subjects who had FD during ages 6-12 (1.15, 95% CI: 1.09-1.22) were more likely to have an increased risk of frailty than those who had experienced FD in younger ages. The interaction of experience of FD at ages 0-6 and the experience of FD at ages 6-12 is not statistically significant after adjusting all covariates. CONCLUSIONS Our findings suggest that childhood FD exerts long-lasting effects on frailty among older adults in China. The prevention of childhood FD may delay or even avert the emergence of frailty in people of middle-age and old age.
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23
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Daccarett S, Wiese LK, Ángeles Ordóñez ML. Enhancing Dementia Education and Cognitive Screening in A Haitian Population: A Faith-based Approach. J Community Health Nurs 2021; 38:103-119. [PMID: 33949259 DOI: 10.1080/07370016.2021.1887566] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Ethnically diverse Americans experience 1.8-2.5 times higher risk of developing Alzheimer's disease than Whites (Mayeda, et al., 2016), yet cognitive screening is not routinely conducted among Haitian American communities. Dementia risk awareness is beneficial for improving management of chronic illness and behaviors that impact risk of cognitive decline. A quasiexperimental paired samples t-test design was employed to test the effectiveness of an educational intervention among 50 older faith- based Haitian adults using the Basic Knowledge of Alzheimer's Disease (BKAD) scale, cognitive screening using the Cognitive State Test (COST), and referrals to a local memory/wellness center. A significant difference was seen in knowledge scores: pre-test (M = 18.5, SD = 3.12) and post-test (M = 23.1, SD = 2.42); conditions t(41.9) = -9.5, p = .000. All of those who volunteered for screening completed follow-up neuropsychological evaluations. Outreach to faith-based settings is suggested as an avenue for improving dementia knowledge and detection.
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Affiliation(s)
- Sandra Daccarett
- Nurse Practitioner Louis and Anne Green Memory & Wellness Center, Christine E. Lynn College of Nursing, Florida Atlantic University, Boca Raton, USA
| | - Lisa Kirk Wiese
- Assistant Professor of Nursing C. E. Lynn College of Nursing, Florida Atlantic University, Boca Raton, USA
| | - María Los Ángeles Ordóñez
- Louis and Anne Green Memory and Wellness Center FAU Memory Disorder Clinic Coordinator, Alzheimer's Disease Initiative Member, Federal Advisory Council on Alzheimer's Research, Care, and Services, Associate Professor of the Christine E. Lynn College of Nursing Assistant Professor of Clinical Biomedical Science (Secondary) Charles E. Schmidt College of Medicine Florida Atlantic University, Boca Raton, USA
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24
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Kucera M, Wolfova K, Cermakova P. Association Between Season of Birth and Cognitive Aging in Older Adults: Pan-European Population-Based Study on 70,000 Individuals. J Alzheimers Dis 2021; 82:1703-1713. [PMID: 34219722 DOI: 10.3233/jad-210289] [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: 11/15/2022]
Abstract
BACKGROUND Several early-life factors have been associated with higher risk of developing dementia. It is unclear whether season of birth (SOB) can affect cognitive aging in older adults or not. OBJECTIVE We aimed to study the association of SOB with the level of cognitive performance as well as with the rate of cognitive decline. METHODS We studied 70,203 individuals who participated in the Survey of Health, Aging and Retirement in Europe. Cognition was measured with tests on verbal fluency and immediate and delayed recall. We assessed the association of SOB with the level of cognitive performance using multiple linear regression and with the rate of cognitive decline using linear mixed-effects models. RESULTS When compared to individuals born in winter and adjusted for sociodemographic and health-related characteristics, being born in summer was associated with a higher level of delayed recall (B 0.05; 95%CI 0.01 to 0.09) and verbal fluency (B 0.15; 95%CI 0.00 to 0.29) and being born in fall with a higher level of immediate recall (B 0.04; 95%CI 0.01 to 0.08) and verbal fluency (B 0.15; 95%CI 0.01 to 0.29). Individuals born in summer had a higher yearly decline in delayed recall (B -0.005; 95%CI -0.009 to 0.000), while the scores in delayed recall in participants born in spring showed an inverse trend (B 0.005; 95%CI 0.000 to 0.010). CONCLUSION Individuals born in winter seem to carry a life-long disadvantage in a lower level of cognitive performance; however, being born in winter does not seem to affect the rate of cognitive decline.
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Affiliation(s)
- Matej Kucera
- Third Faculty of Medicine, Charles University, Prague, Czech Republic.,National Institute of Mental Health, Klecany, Czech Republic.,Second Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Katrin Wolfova
- Third Faculty of Medicine, Charles University, Prague, Czech Republic.,National Institute of Mental Health, Klecany, Czech Republic.,Second Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Pavla Cermakova
- Third Faculty of Medicine, Charles University, Prague, Czech Republic.,National Institute of Mental Health, Klecany, Czech Republic.,Second Faculty of Medicine, Charles University, Prague, Czech Republic
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25
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Lobo E, Gracia-García P, Lobo A, Saz P, De-la-Cámara C. Differences in Trajectories and Predictive Factors of Cognition over Time in a Sample of Cognitively Healthy Adults, in Zaragoza, Spain. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:7092. [PMID: 34281039 PMCID: PMC8297330 DOI: 10.3390/ijerph18137092] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/29/2021] [Revised: 06/28/2021] [Accepted: 06/30/2021] [Indexed: 11/16/2022]
Abstract
Great inter-individual variability has been reported in the maintenance of cognitive function in aging. We examined this heterogeneity by modeling cognitive trajectories in a population-based longitudinal study of adults aged 55+ years. We hypothesized that (1) distinct classes of cognitive trajectories would be found, and (2) between-class differences in associated factors would be observed. The sample comprised 2403 cognitively healthy individuals from the Zaragoza Dementia and Depression (ZARADEMP) project, who had at least three measurements of the Mini-Mental State Examination (MMSE) in a 12-year follow-up. Longitudinal changes in cognitive functioning were modeled using growth mixture models (GMM) in the data. The best-fitting age-adjusted model showed 3 distinct trajectories, with 1-high-to-moderate (21.2% of participants), 2-moderate-stable (67.5%) and, 3-low-and-declining (9.9%) cognitive function over time, respectively. Compared with the reference 2-trajectory, the association of education and depression was significantly different in trajectories 1 and 3. Instrumental activities of daily living (iADLs) were only associated with the declining trajectory. This suggests that intervention strategies should be tailored specifically to individuals with different trajectories of cognitive aging, and intervention strategies designed to maintain cognitive function might be different from those to prevent decline. A stable cognitive performance ('successful cognitive aging') rather than a mild decline, might be more 'normal' than generally expected.
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Affiliation(s)
- Elena Lobo
- Department of Preventive Medicine and Public Health, Universidad de Zaragoza, 50009 Zaragoza, Spain
- Instituto de Investigación Sanitaria de Aragón (IIS Aragón), 50009 Zaragoza, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Ministry of Science and Innovation, 28029 Madrid, Spain
| | - Patricia Gracia-García
- Instituto de Investigación Sanitaria de Aragón (IIS Aragón), 50009 Zaragoza, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Ministry of Science and Innovation, 28029 Madrid, Spain
- Psychiatry Service, Hospital Universitario Miguel Servet, 50009 Zaragoza, Spain
- Department of Medicine and Psychiatry, Universidad de Zaragoza, 50009 Zaragoza, Spain
| | - Antonio Lobo
- Instituto de Investigación Sanitaria de Aragón (IIS Aragón), 50009 Zaragoza, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Ministry of Science and Innovation, 28029 Madrid, Spain
- Department of Medicine and Psychiatry, Universidad de Zaragoza, 50009 Zaragoza, Spain
| | - Pedro Saz
- Instituto de Investigación Sanitaria de Aragón (IIS Aragón), 50009 Zaragoza, Spain
- Department of Medicine and Psychiatry, Universidad de Zaragoza, 50009 Zaragoza, Spain
| | - Concepción De-la-Cámara
- Instituto de Investigación Sanitaria de Aragón (IIS Aragón), 50009 Zaragoza, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Ministry of Science and Innovation, 28029 Madrid, Spain
- Department of Medicine and Psychiatry, Universidad de Zaragoza, 50009 Zaragoza, Spain
- Psychiatry Service, Hospital Clínico Universitario, 50009 Zaragoza, Spain
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26
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Life-course pathways from childhood socioeconomic status to type 2 diabetes in mid-late Chinese adulthood. Sci Rep 2021; 11:13051. [PMID: 34158532 PMCID: PMC8219676 DOI: 10.1038/s41598-021-91768-1] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2020] [Accepted: 05/19/2021] [Indexed: 11/17/2022] Open
Abstract
The relationship between childhood socioeconomic status (SES) and type 2 diabetes (T2D) remains inconclusive, and the pathways and mechanisms driving this relationship have yet to be clarified. This study aimed to examine the pathways linking childhood SES to T2D prevalence in mid-late adulthood in a low- and middle-income country. The incidence of T2D diagnosed in mid-late Chinese adulthood was assessed using self-reports from the Health and Retirement Longitudinal Study (CHARLS). Childhood SES was assessed by the education, occupation, survivorship of the parents and the financial situation of the family, whereas adulthood SES was assessed by education and wage. This study performed structural equation modeling to clarify the direct and indirect pathways from childhood SES to T2D via childhood health, childhood food shortage, adulthood SES and physical activity. A total of 15,132 participants were included, and the prevalence of T2D was 5.24%. This study found that childhood SES was directly associated with T2D in mid-late adulthood, the probability of developing T2D increased by 9.20% of the standard deviation for each decrease in standard deviation in childhood SES. Childhood SES was indirectly associated with T2D via adulthood SES, physical activity, childhood health and food shortage. Adulthood SES and physical activity mainly mediated the indirect pathway from childhood SES and T2D. This study showed direct and indirect pathways from disadvantaged childhood SES to increased risk of T2D in mid-late Chinese adulthood. Childhood SES, adulthood SES, physical activity, childhood health and food shortage were identified as life-course interventional targets that should be considered in the development of effective strategies to reduce the burden of T2D and SES-related health inequities in childhood.
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Racine Maurice S, Hébert A, Turcotte V, Potvin O, Hudon C, Duchesne S. Childhood Socioeconomic Status Does Not Predict Late-Life Cognitive Decline in the 1936 Lothian Birth Cohort. Front Psychol 2021; 12:679044. [PMID: 34248779 PMCID: PMC8265392 DOI: 10.3389/fpsyg.2021.679044] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Accepted: 05/31/2021] [Indexed: 01/28/2023] Open
Abstract
This study examined childhood socioeconomic status (SES) as a predictor of later life cognitive decline. Data came from 519 participants in the Lothian Birth Cohort 1936 (LBC1936) study. SES measures at 11 years of age included parental educational attainment, father's occupational status, household characteristics and a composite measure of global childhood SES (i.e., a total of low SES childhood indicators). Cognitive abilities were assessed by the Mini-Mental State Exam at ages 69.8, 72.8 and 76.7 years. Most indicators of low childhood SES (i.e., father manual worker, less than secondary school father education, household overcrowding, exterior located toilet, and global childhood SES) did not predict cognitive decline between the ages of 69.8 and 76.7. Participants with less educated mothers showed an increase in cognitive decline (β = -0.132, p = 0.048, and CI = -0.80, -0.00). The relationship between maternal educational attainment and cognitive decline became non-significant when controlling for adult SES (i.e., participant educational attainment and occupation). Adult SES did not mediate the latter relationship. This study provides new evidence that childhood SES alone is not strongly associated with cognitive decline. New knowledge is critical to improving population health by identifying life span stages in which interventions might be effective in preventing cognitive decline.
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Affiliation(s)
| | - Alisone Hébert
- Faculté des Sciences Sociales, Êcole de psychologie, Université Laval, Quebec, Canada
| | - Valérie Turcotte
- Faculté des Sciences Sociales, Êcole de psychologie, Université Laval, Quebec, Canada
- CERVO Brain Research Center, Centre Intégré Universitaire en Santé et Services Sociaux de la Capitale Nationale, Quebec, Canada
| | - Olivier Potvin
- CERVO Brain Research Center, Centre Intégré Universitaire en Santé et Services Sociaux de la Capitale Nationale, Quebec, Canada
| | - Carol Hudon
- Faculté des Sciences Sociales, Êcole de psychologie, Université Laval, Quebec, Canada
- CERVO Brain Research Center, Centre Intégré Universitaire en Santé et Services Sociaux de la Capitale Nationale, Quebec, Canada
| | - Simon Duchesne
- CERVO Brain Research Center, Centre Intégré Universitaire en Santé et Services Sociaux de la Capitale Nationale, Quebec, Canada
- Département de radiologie et médecine nucléaire, Faculté de médecine, Université Laval, Quebec, Canada
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Neuropsychiatric Disorders, Emotional Disturbances, and Their Associations with HIV-Associated Neurocognitive Disorder. Curr Top Behav Neurosci 2021; 50:347-366. [PMID: 34081306 DOI: 10.1007/7854_2021_233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
The current chapter provides a critical and narrative review of recent research on the neuropsychiatric disorders, emotional disturbances, and their associations with neurocognitive functioning in people living with HIV infection. We review a range of neuropsychiatric disorders including depression and anxiety disorders, but also emotional disturbances, which can be partly distinguished from depression and anxiety (apathy, alexithymia, and emotional processing impairment). While reviewing the research into the neuropsychiatric disorders and HIV-associated neurocognitive disorders, we also cover the questions of self-reported cognitive symptoms evaluation and interpretation. The chapter includes research on the role of coping skills, perceived stress and response to stressful life events, and connections to neurocognitive impairment in people living with HIV. Promising non-pharmacological interventions are highlighted. The chapter concludes with the clinical implications on how to best consider neuropsychiatric disorders and cognitive symptoms for the diagnosis of HIV-associated neurocognitive disorders, as well as future research directions.
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Krishnan A, Waite LM, Stanaway FF. Representation of racial and ethnic minority groups in cohort studies evaluating risk factors for dementia: protocol for a scoping review. BMJ Open 2021; 11:e044404. [PMID: 33986050 PMCID: PMC8126304 DOI: 10.1136/bmjopen-2020-044404] [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] [Indexed: 12/05/2022] Open
Abstract
INTRODUCTION Available evidence suggests that some racial/ethnic minority populations may be disproportionately burdened by dementia. Cohort studies are an important tool for defining and understanding the causes behind these racial and ethnic inequalities. However, ethnic minority populations may be more likely to be excluded from such research. Therefore, the aim of this study is to systematically investigate and quantify racial and ethnic minority representation in dementia risk factor research. METHODS AND ANALYSIS The elements of this protocol have been designed in accordance with the relevant sections of the Preferred Reporting Items for Systematic Reviews and Meta-Analysis Protocols which are specifically applicable to scoping review protocols. We will include population-based cohort studies looking at risk factors for dementia incidence in our review and assess the representation of racial and ethnic minority populations in these studies. We will use multiple strategies to identify relevant studies, including a systematic search of the following electronic databases: MEDLINE (Ovid SP), Embase (Ovid SP) and Scopus. Two review authors will independently perform title and abstract screening, full-text screening and data extraction. Included cohort studies will be evaluated using a comprehensive framework to assess racial/ethnic minority representation. Logistic regression will also be performed to describe associations between cohort study characteristics and outcomes related to racial and ethnic minority representation. ETHICS AND DISSEMINATION Formal ethical approval is not required to conduct this review as no primary data are to be collected. The final results of this scoping review will be disseminated through publication in peer-reviewed journals and conference presentations.
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Affiliation(s)
- Arjun Krishnan
- School of Public Health, University of Sydney, Sydney, New South Wales, Australia
- Fiona Stanley Hospital, Murdoch, Western Australia, Australia
| | - Louise M Waite
- Faculty of Medicine and Health, The University of Sydney Concord Clinical School, Sydney, New South Wales, Australia
- The University of Sydney Centre for Education and Research on Ageing, Sydney, New South Wales, Australia
| | - Fiona F Stanaway
- School of Public Health, University of Sydney, Sydney, New South Wales, Australia
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Lazar RM, Howard VJ, Kernan WN, Aparicio HJ, Levine DA, Viera AJ, Jordan LC, Nyenhuis DL, Possin KL, Sorond FA, White CL. A Primary Care Agenda for Brain Health: A Scientific Statement From the American Heart Association. Stroke 2021; 52:e295-e308. [PMID: 33719523 DOI: 10.1161/str.0000000000000367] [Citation(s) in RCA: 37] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
A healthy brain is critical for living a longer and fuller life. The projected aging of the population, however, raises new challenges in maintaining quality of life. As we age, there is increasing compromise of neuronal activity that affects functions such as cognition, also making the brain vulnerable to disease. Once pathology-induced decline begins, few therapeutic options are available. Prevention is therefore paramount, and primary care can play a critical role. The purpose of this American Heart Association scientific statement is to provide an up-to-date summary for primary care providers in the assessment and modification of risk factors at the individual level that maintain brain health and prevent cognitive impairment. Building on the 2017 American Heart Association/American Stroke Association presidential advisory on defining brain health that included "Life's Simple 7," we describe here modifiable risk factors for cognitive decline, including depression, hypertension, physical inactivity, diabetes, obesity, hyperlipidemia, poor diet, smoking, social isolation, excessive alcohol use, sleep disorders, and hearing loss. These risk factors include behaviors, conditions, and lifestyles that can emerge before adulthood and can be routinely identified and managed by primary care clinicians.
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Weinstein G, Lutski M, Keinan-Boker L, Goldbourt U, Tanne D. Holocaust exposure and late-life cognitive performance in men with coronary heart disease. J Psychiatr Res 2021; 134:1-7. [PMID: 33360219 DOI: 10.1016/j.jpsychires.2020.12.044] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2020] [Revised: 11/24/2020] [Accepted: 12/17/2020] [Indexed: 10/22/2022]
Abstract
BACKGROUND Holocaust victims experienced extreme physical and mental stress that could lead to prolonged deficits in psychological and physiological well-being. We aimed to examine whether exposure to Holocaust conditions is associated with cognitive function and decline in a sample of old male adults with coronary heart disease (CHD). METHODS The sample included 346 individuals with CHD who participated in a clinical trial in 1990-1997 (mean age 56.7 ± 6.5 y). During 2004-2008 (mean age 71.8 ± 6.5 y) and 2011-2013 (mean age 77.1 ± 6.4 y) participants underwent computerized cognitive assessments. Exposure to Holocaust conditions was based on self-report at the second assessment. Linear regression and mixed-effect models were conducted to evaluate the associations between Holocaust survivorship and subsequent cognitive performance and rate of cognitive decline. RESULTS Forty-Three participants (12%) survived concentration camps/ghettos, 69 (20%) were Holocaust survivors who escaped concentration camps/ghettos, and 234 (68%) were not Holocaust survivors. After adjustment for potential confounders, concentration camp/ghetto survivors had poorer global cognitive performance and poorer attention (β = -3.90; 95%CI: 7.11;-0.68 and β = -4.11; 95%CI: 7.83;-0.38, respectively) compared to individuals who were not exposed to Holocaust conditions. Additionally, participants who reported being at concentration camps/ghettoes had increased cognitive decline in global performance and executive function (β = -0.19; 95%CI: 0.37;-0.008 and β = -0.29; 95%CI: 0.53;-0.06, respectively) compared to participants who were not Holocaust survivors. Lastly, those who were Holocaust survivors but not in concentration camps/ghettos had greater decline in attention (β = -0.11; 95%CI: 0.21;-0.01). DISCUSSION Exposure to Holocaust conditions in early-life may be linked with poorer cognitive function and greater cognitive decline decades later in old-adults with CHD.
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Affiliation(s)
- Galit Weinstein
- School of Public Health, University of Haifa, Haifa, Israel.
| | - Miri Lutski
- The Israel Center for Disease Control, Israel Ministry of Health, Ramat-Gan, Israel; Department of Epidemiology and Preventive Medicine, School of Public Health, Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Lital Keinan-Boker
- School of Public Health, University of Haifa, Haifa, Israel; The Israel Center for Disease Control, Israel Ministry of Health, Ramat-Gan, Israel
| | - Uri Goldbourt
- Department of Epidemiology and Preventive Medicine, School of Public Health, Sackler Faculty of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - David Tanne
- Department of Neurology, Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel; Stroke and Cognition Institute, Rambam Health Care Campus, Haifa, Israel
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Williams VJ, Carlsson CM, Fischer A, Johnson SC, Lange K, Partridge E, Roan C, Asthana S, Herd P. Assessing Dementia Prevalence in the Wisconsin Longitudinal Study: Cohort Profile, Protocol, and Preliminary Findings. J Alzheimers Dis 2021; 81:751-768. [PMID: 33843672 PMCID: PMC10551824 DOI: 10.3233/jad-201422] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND There is growing consensus that non-genetic determinants of dementia can be linked to various risk- and resiliency-enhancing factors accumulating throughout the lifespan, including socioeconomic conditions, early life experiences, educational attainment, lifestyle behaviors, and physical/mental health. Yet, the causal impact of these diverse factors on dementia risk remain poorly understood due to few longitudinal studies prospectively characterizing these influences across the lifespan. OBJECTIVE The Initial Lifespan's Impact on Alzheimer's Disease and Related Dementia (ILIAD) study aims to characterize dementia prevalence in the Wisconsin Longitudinal Study (WLS), a 60-year longitudinal study documenting life course trajectories of educational, family, occupational, psychological, cognitive, and health measures. METHODS Participants are surveyed using the modified Telephone Interview for Cognitive Status (TICS-m) to identify dementia risk. Those scoring below cutoff undergo home-based neuropsychological, physical/neurological, and functional assessments. Dementia diagnosis is determined by consensus panel and merged with existing WLS data for combined analysis. RESULTS Preliminary findings demonstrate the initial success of the ILIAD protocol in detecting dementia prevalence in the WLS. Increasing age, hearing issues, lower IQ, male sex, APOE4 positivity, and a steeper annualized rate of memory decline assessed in the prior two study waves, all increased likelihood of falling below the TICS-m cutoff for dementia risk. TICS-m scores significantly correlated with standard neuropsychological performance and functional outcomes. CONCLUSION We provide an overview of the WLS study, describe existing key lifespan variables relevant to studies of dementia and cognitive aging, detail the current WLS-ILIAD study protocol, and provide a first glimpse of preliminary study findings.
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Affiliation(s)
- Victoria J. Williams
- Division of Geriatrics and Gerontology, Department of Medicine, University of Wisconsin at Madison, School of Medicine and Public Health, Madison, WI, USA
- Wisconsin Alzheimer’s Disease Research Center, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
| | - Cynthia M. Carlsson
- Division of Geriatrics and Gerontology, Department of Medicine, University of Wisconsin at Madison, School of Medicine and Public Health, Madison, WI, USA
- Wisconsin Alzheimer’s Disease Research Center, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
- Geriatric Research, Education, and Clinical Center (GRECC), William S. Middleton Memorial Veterans Hospital, Madison, WI, USA
| | - Anne Fischer
- Division of Geriatrics and Gerontology, Department of Medicine, University of Wisconsin at Madison, School of Medicine and Public Health, Madison, WI, USA
| | - Sterling C. Johnson
- Division of Geriatrics and Gerontology, Department of Medicine, University of Wisconsin at Madison, School of Medicine and Public Health, Madison, WI, USA
- Wisconsin Alzheimer’s Disease Research Center, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
- Geriatric Research, Education, and Clinical Center (GRECC), William S. Middleton Memorial Veterans Hospital, Madison, WI, USA
| | - Kate Lange
- Division of Geriatrics and Gerontology, Department of Medicine, University of Wisconsin at Madison, School of Medicine and Public Health, Madison, WI, USA
| | - Eileen Partridge
- Division of Geriatrics and Gerontology, Department of Medicine, University of Wisconsin at Madison, School of Medicine and Public Health, Madison, WI, USA
| | - Carol Roan
- Department of Sociology, University of Wisconsin at Madison, Department of Sociology, Madison, WI, USA
| | - Sanjay Asthana
- Division of Geriatrics and Gerontology, Department of Medicine, University of Wisconsin at Madison, School of Medicine and Public Health, Madison, WI, USA
- Wisconsin Alzheimer’s Disease Research Center, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
- Geriatric Research, Education, and Clinical Center (GRECC), William S. Middleton Memorial Veterans Hospital, Madison, WI, USA
| | - Pamela Herd
- McCourt School of Public Policy, Georgetown University, Washington, DC, USA
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Oriá RB, de Almeida JZ, Moreira CN, Guerrant RL, Figueiredo JR. Apolipoprotein E Effects on Mammalian Ovarian Steroidogenesis and Human Fertility. Trends Endocrinol Metab 2020; 31:872-883. [PMID: 32684408 DOI: 10.1016/j.tem.2020.06.003] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Revised: 05/27/2020] [Accepted: 06/22/2020] [Indexed: 02/07/2023]
Abstract
Apolipoprotein E (ApoE) is a glycoprotein consisting of 299 amino acids, highly produced in the mammalian ovaries. The main function of the ApoE is to transport cholesterol from the peripheral tissues to be metabolized in the liver. In humans, the ApoE gene is polymorphic, with three alleles in a single chromosome-19 locus: APOE2, APOE3, and APOE4. ApoE has also been implicated in cholesterol transport within ovarian follicles to regulate steroidogenesis. Ovarian thecal and granulosa cell cholesterol uptake requires ApoE either by participating in the lipoprotein-receptor complex or lipid endocytosis. In this review, we summarize ApoE role on mammalian ovarian steroidogenesis and on human fertility and discuss recent findings of ApoE4 as an antagonistic pleiotropy gene under adverse environments.
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Affiliation(s)
- Reinaldo Barreto Oriá
- Laboratory of the Biology of Tissue Healing, Ontogeny and Nutrition, Department of Morphology and Institute of Biomedicine, School of Medicine, Federal University of Ceara, 1315 Rua Cel. Nunes de Melo, Fortaleza, CE 60430270, Brazil.
| | - Juliana Zani de Almeida
- Laboratory of the Biology of Tissue Healing, Ontogeny and Nutrition, Department of Morphology and Institute of Biomedicine, School of Medicine, Federal University of Ceara, 1315 Rua Cel. Nunes de Melo, Fortaleza, CE 60430270, Brazil
| | - Carolyne Neves Moreira
- Laboratory of the Biology of Tissue Healing, Ontogeny and Nutrition, Department of Morphology and Institute of Biomedicine, School of Medicine, Federal University of Ceara, 1315 Rua Cel. Nunes de Melo, Fortaleza, CE 60430270, Brazil
| | - Richard L Guerrant
- Center for Global Health, Division of Infectious Diseases and International Health, 345 Crispell Drive, University of Virginia, Charlottesville, VA 434-924-9672, USA
| | - José Ricardo Figueiredo
- Faculty of Veterinary Medicine, Laboratory of Manipulation of Oocytes and Preantral Follicles (LAMOFOPA), State University of Ceara, 1700 Av. Dr. Silas Munguba, Fortaleza, CE 60740-903, Brazil
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Cohn-Schwartz E, Weinstein G. Early-life food deprivation and cognitive performance among older Europeans. Maturitas 2020; 141:26-32. [PMID: 33036699 DOI: 10.1016/j.maturitas.2020.06.020] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2019] [Revised: 06/01/2020] [Accepted: 06/24/2020] [Indexed: 12/15/2022]
Abstract
BACKGROUND Early-life adversity, including food deprivation, has been linked with late-life cognitive function. Our aim was to explore the association between the early experience of hunger (the age at which it was experienced and its duration) and cognitive performance and decline among older Europeans. METHODS Our sample comprised dementia-free individuals aged ≥65 years who participated in waves 3 and 4 of the Survey of Health, Ageing and Retirement in Europe (SHARE). Information on periods of hunger during the life course was gathered in wave 3 (2009; SHARELIFE). Cognitive performance was assessed using tests of memory, verbal fluency and numeracy in waves 4 (2011) and 5 (2013). Regression models were used to assess the relationship between the experience of hunger at different ages and its duration and cognitive performance and decline while adjusting for age, sex, education, lifestyle and health factors. RESULTS Among a sample of 2131 individuals (mean age = 76.2 years; 50 % women), the experience of hunger when aged 0-4 years was associated with poorer immediate and delayed recall, fluency and impaired numeracy factors (B±SE=-0.58 ± 0.12; p < 0.001; B±SE=-0.74 ± 0.13; p < 0.001, B±SE=-1.60 ± 0.42; p < 0.001 and OR [95 % CI] = 0.57 [0.42-0.79], respectively). These results attenuated after controlling for duration of the experience of hunger but remained significant for immediate and delayed recall. The experience of hunger at ages 12-18 years was associated with better immediate recall, delayed recall and fluency (B±SE = 0.38 ± 0.15; p = 0.010; B±SE = 0.37 ± 0.17; p = 0.026, B±SE = 1.57 ± 0.53; p = 0.003, respectively). The associations of hunger with cognitive decline were similar but less robust. CONCLUSIONS Our findings suggest that severe nutritional deprivation in early childhood may be associated with poor cognitive function in later life, while food deprivation in later childhood and adolescence may be protective.
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Affiliation(s)
- Ella Cohn-Schwartz
- Department of Public Health, Faculty of Health Sciences, Ben-Gurion University of the Negev, Be'er Sheva, Israel.
| | - Galit Weinstein
- School of Public Health, Faculty of Social Welfare & Health Sciences, University of Haifa, Israel
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Flores-Dorantes MT, Díaz-López YE, Gutiérrez-Aguilar R. Environment and Gene Association With Obesity and Their Impact on Neurodegenerative and Neurodevelopmental Diseases. Front Neurosci 2020; 14:863. [PMID: 32982666 PMCID: PMC7483585 DOI: 10.3389/fnins.2020.00863] [Citation(s) in RCA: 53] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2020] [Accepted: 07/24/2020] [Indexed: 12/12/2022] Open
Abstract
Obesity is a multifactorial disease in which environmental conditions and several genes play an important role in the development of this disease. Obesity is associated with neurodegenerative diseases (Alzheimer, Parkinson, and Huntington diseases) and with neurodevelopmental diseases (autism disorder, schizophrenia, and fragile X syndrome). Some of the environmental conditions that lead to obesity are physical activity, alcohol consumption, socioeconomic status, parent feeding behavior, and diet. Interestingly, some of these environmental conditions are shared with neurodegenerative and neurodevelopmental diseases. Obesity impairs neurodevelopment abilities as memory and fine-motor skills. Moreover, maternal obesity affects the cognitive function and mental health of the offspring. The common biological mechanisms involved in obesity and neurodegenerative/neurodevelopmental diseases are insulin resistance, pro-inflammatory cytokines, and oxidative damage, among others, leading to impaired brain development or cell death. Obesogenic environmental conditions are not the only factors that influence neurodegenerative and neurodevelopmental diseases. In fact, several genes implicated in the leptin–melanocortin pathway (LEP, LEPR, POMC, BDNF, MC4R, PCSK1, SIM1, BDNF, TrkB, etc.) are associated with obesity and neurodegenerative and neurodevelopmental diseases. Moreover, in the last decades, the discovery of new genes associated with obesity (FTO, NRXN3, NPC1, NEGR1, MTCH2, GNPDA2, among others) and with neurodegenerative or neurodevelopmental diseases (APOE, CD38, SIRT1, TNFα, PAI-1, TREM2, SYT4, FMR1, TET3, among others) had opened new pathways to comprehend the common mechanisms involved in these diseases. In conclusion, the obesogenic environmental conditions, the genes, and the interaction gene–environment would lead to a better understanding of the etiology of these diseases.
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Affiliation(s)
- María Teresa Flores-Dorantes
- Laboratorio de Biología Molecular y Farmacogenómica, Centro de Investigación de Ciencia y Tecnología Aplicada de Tabasco, División Académica de Ciencias Básicas, Universidad Juárez Autónoma de Tabasco, Villahermosa, Mexico
| | - Yael Efren Díaz-López
- Laboratorio de Enfermedades Metabólicas: Obesidad y Diabetes, Hospital Infantil de México "Federico Gómez," Mexico City, Mexico.,División de Investigación, Facultad de Medicina, Universidad Nacional Autónoma de México (UNAM), Mexico City, Mexico
| | - Ruth Gutiérrez-Aguilar
- Laboratorio de Enfermedades Metabólicas: Obesidad y Diabetes, Hospital Infantil de México "Federico Gómez," Mexico City, Mexico.,División de Investigación, Facultad de Medicina, Universidad Nacional Autónoma de México (UNAM), Mexico City, Mexico
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Lövdén M, Fratiglioni L, Glymour MM, Lindenberger U, Tucker-Drob EM. Education and Cognitive Functioning Across the Life Span. Psychol Sci Public Interest 2020; 21:6-41. [PMID: 32772803 PMCID: PMC7425377 DOI: 10.1177/1529100620920576] [Citation(s) in RCA: 348] [Impact Index Per Article: 87.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Cognitive abilities are important predictors of educational and occupational performance, socioeconomic attainment, health, and longevity. Declines in cognitive abilities are linked to impairments in older adults' everyday functions, but people differ from one another in their rates of cognitive decline over the course of adulthood and old age. Hence, identifying factors that protect against compromised late-life cognition is of great societal interest. The number of years of formal education completed by individuals is positively correlated with their cognitive function throughout adulthood and predicts lower risk of dementia late in life. These observations have led to the propositions that prolonging education might (a) affect cognitive ability and (b) attenuate aging-associated declines in cognition. We evaluate these propositions by reviewing the literature on educational attainment and cognitive aging, including recent analyses of data harmonized across multiple longitudinal cohort studies and related meta-analyses. In line with the first proposition, the evidence indicates that educational attainment has positive effects on cognitive function. We also find evidence that cognitive abilities are associated with selection into longer durations of education and that there are common factors (e.g., parental socioeconomic resources) that affect both educational attainment and cognitive development. There is likely reciprocal interplay among these factors, and among cognitive abilities, during development. Education-cognitive ability associations are apparent across the entire adult life span and across the full range of education levels, including (to some degree) tertiary education. However, contrary to the second proposition, we find that associations between education and aging-associated cognitive declines are negligible and that a threshold model of dementia can account for the association between educational attainment and late-life dementia risk. We conclude that educational attainment exerts its influences on late-life cognitive function primarily by contributing to individual differences in cognitive skills that emerge in early adulthood but persist into older age. We also note that the widespread absence of educational influences on rates of cognitive decline puts constraints on theoretical notions of cognitive aging, such as the concepts of cognitive reserve and brain maintenance. Improving the conditions that shape development during the first decades of life carries great potential for improving cognitive ability in early adulthood and for reducing public-health burdens related to cognitive aging and dementia.
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Affiliation(s)
- Martin Lövdén
- Aging Research Center, Department of Neurobiology, Care Sciences, and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden
- Department of Psychology, University of Gothenburg, Gothenburg, Sweden
| | - Laura Fratiglioni
- Aging Research Center, Department of Neurobiology, Care Sciences, and Society, Karolinska Institutet and Stockholm University, Stockholm, Sweden
- Stockholm Gerontology Research Center, Stockholm, Sweden
| | - M. Maria Glymour
- Department of Epidemiology and Biostatistics, University of California, San Francisco
| | - Ulman Lindenberger
- Center for Lifespan Psychology, Max Planck Institute for Human Development, Berlin, Germany
- Max Planck UCL Centre for Computational Psychiatry and Ageing Research, Berlin, Germany, and London, United Kingdom
| | - Elliot M. Tucker-Drob
- Department of Psychology and Population Research Center, University of Texas at Austin
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Osler M, Okholm GT, Sørensen TIA, Jørgensen TSH. Body mass index in young adulthood and risk of subsequent dementia at different levels of intelligence and education in Danish men. Eur J Epidemiol 2020; 35:843-850. [PMID: 32728913 DOI: 10.1007/s10654-020-00665-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2020] [Accepted: 07/16/2020] [Indexed: 12/15/2022]
Abstract
The risk of dementia seems to be established already early in life, which leads to the question if overweight early in life is an important risk factor for dementia as it appears to be later in life. We examined the association between body mass index (BMI) at entry to adult life and subsequent risk of dementia in men and assessed whether the relationship differed by levels of intelligence and education. The study population consisted of 377,598 Danish men born 1939-1959 with measures of height, weight, intelligence test score (ITS), and educational level (EL) at conscript board examinations around the age of 19 years. Dementia outcomes were obtained from National Patient and Prescription Registries between 1969 and 2016. The association between BMI and dementia was analysed using Cox proportional hazard regression including interactions between BMI and ITS and EL, respectively. During the follow-up through age 77 years, 6144 (1.6%) developed dementia. The frequency was highest in men with lowest BMI, lowest ITS and lowest EL. Young adult BMI below the mean of 21.8 kg/m2 was inversely associated with subsequent dementia, whereas there was no association with higher levels of BMI. Adjustment for young adult ITS and EL attenuated the risk estimates slightly, and interaction analyses showed that the shape of the association between BMI and dementia was unaffected by the levels of ITS and EL. Regardless of levels of ITS and EL, young adult BMI below the mean is inversely associated with subsequent dementia, whereas there is no association with higher levels of BMI.
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Affiliation(s)
- Merete Osler
- Center for Clinical Research and Prevention, Bispebjerg and Frederiksberg Hospital, Nordre Fasanvej 57, 2000, Frederiksberg, Denmark.
- Department of Public Health, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
| | - Gunhild Tidemann Okholm
- Center for Clinical Research and Prevention, Bispebjerg and Frederiksberg Hospital, Nordre Fasanvej 57, 2000, Frederiksberg, Denmark
- Department of Public Health, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Thorkild I A Sørensen
- Department of Public Health, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Terese Sara Høj Jørgensen
- Center for Clinical Research and Prevention, Bispebjerg and Frederiksberg Hospital, Nordre Fasanvej 57, 2000, Frederiksberg, Denmark
- Department of Public Health, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
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Charting the life course: Emerging opportunities to advance scientific approaches using life course research. J Clin Transl Sci 2020; 5:e9. [PMID: 33948236 PMCID: PMC8057465 DOI: 10.1017/cts.2020.492] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Life course research embraces the complexity of health and disease development, tackling the extensive interactions between genetics and environment. This interdisciplinary blueprint, or theoretical framework, offers a structure for research ideas and specifies relationships between related factors. Traditionally, methodological approaches attempt to reduce the complexity of these dynamic interactions and decompose health into component parts, ignoring the complex reciprocal interaction of factors that shape health over time. New methods that match the epistemological foundation of the life course framework are needed to fully explore adaptive, multilevel, and reciprocal interactions between individuals and their environment. The focus of this article is to (1) delineate the differences between lifespan and life course research, (2) articulate the importance of complex systems science as a methodological framework in the life course research toolbox to guide our research questions, (3) raise key questions that can be asked within the clinical and translational science domain utilizing this framework, and (4) provide recommendations for life course research implementation, charting the way forward. Recent advances in computational analytics, computer science, and data collection could be used to approximate, measure, and analyze the intertwining and dynamic nature of genetic and environmental factors involved in health development.
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Jørgensen TSH, Okholm GT, Christensen K, Sørensen TI, Osler M. Body height in young adult men and risk of dementia later in adult life. eLife 2020; 9:51168. [PMID: 32041683 PMCID: PMC7012597 DOI: 10.7554/elife.51168] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2019] [Accepted: 01/16/2020] [Indexed: 12/24/2022] Open
Abstract
This study examined the relationship between body height and dementia and explored the impact of intelligence level, educational attainment, early life environment and familial factors. A total of 666,333 men, 70,608 brothers, and 7388 twin brothers born 1939-1959 and examined at the conscript board were followed in Danish nationwide registers (1969-2016). Cox regression models were applied to analyze the association between body height and dementia. Within-brothers and within-twin pair analyses were conducted to explore the role of shared familial factors including partly shared genetics. In total, 10,599 men were diagnosed with dementia. The association between one z-score difference in body height and dementia (HR: 0.90, 95% CI: 0.89;0.90) was inverse and weakened slightly after adjustment for intelligence test scores and educational level. The associations persisted in within-brother analysis and revealed a stronger, but less precise, point estimate than the cohort analysis of brothers. The twin analysis showed similar, but imprecise estimates.
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Affiliation(s)
- Terese Sara Høj Jørgensen
- Center for Clinical Research and Prevention, Bispebjerg and Frederiksberg Hospital, Copenhagen, Denmark.,Department of Public Health, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Gunhild Tidemann Okholm
- Center for Clinical Research and Prevention, Bispebjerg and Frederiksberg Hospital, Copenhagen, Denmark.,Department of Public Health, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Kaare Christensen
- Danish Aging Research Center, Department of Public Health, University of Southern Denmark, Copenhagen, Denmark
| | - Thorkild Ia Sørensen
- Department of Public Health, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.,Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Merere Osler
- Center for Clinical Research and Prevention, Bispebjerg and Frederiksberg Hospital, Copenhagen, Denmark.,Department of Public Health, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
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Cheng F, Cui S, Zhang C, Zhang L, Wang L, Yuan Q, Huang C, Zhang K, Zhou X. Association Between Cognitive Function and Early Life Experiences in Patients with Alcohol Use Disorder. Front Psychiatry 2020; 11:792. [PMID: 32903659 PMCID: PMC7438706 DOI: 10.3389/fpsyt.2020.00792] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Accepted: 07/23/2020] [Indexed: 01/10/2023] Open
Abstract
INTRODUCTION Early life experiences could be potential risk factors for the development of alcohol use disorder. In similar circumstances, it might also influence cognitive impairment in later life. However, the relationship between early life experience and cognitive function in people with alcohol use disorders is unclear. The current study examined the effects of early social environments and experiences on cognitive function in patients with alcohol use disorder. METHODS A total of 37 adult male patients with alcohol use disorder and 30 healthy control (HC) subjects were enrolled. The MATRICS Cognitive Consensus Battery (MCCB) was used to evaluate cognitive function. The Childhood Trauma Questionnaire (CTQ) and the Revised Adult Attachment Scale (RAAS) were used to evaluate early life experiences of the participants. The RAAS was used to evaluate the attachment patterns of participants. RESULTS Compared with the HC group, the alcohol use disorder group reported higher levels of childhood abuse and were more likely to form an insecure attachment style. Patients with alcohol use disorder who experienced trauma performed worse in terms of discrete cognitive parameters such as social cognition, reasoning and problem solving compared to patients without trauma. Importantly, emotional neglect and social comfort were significantly associated with individual social cognitive skills. CONCLUSIONS Our results suggest that the cognitive function of patients with alcohol use disorder, especially social cognitive function, is affected by early life experiences.
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Affiliation(s)
- Fangshuo Cheng
- Department of Psychiatry, Chaohu Hospital, Anhui Medical University, Hefei, China.,Anhui Psychiatric Center, Anhui Medical University, Hefei, China
| | - Shu Cui
- Department of Psychiatry, Chaohu Hospital, Anhui Medical University, Hefei, China.,Anhui Psychiatric Center, Anhui Medical University, Hefei, China
| | - Chao Zhang
- Department of Pediatrics, Fuyang People's Hospital, Fuyang, China
| | - Ling Zhang
- Department of Psychiatry, Chaohu Hospital, Anhui Medical University, Hefei, China.,Anhui Psychiatric Center, Anhui Medical University, Hefei, China
| | - Lei Wang
- Department of Psychiatry, Chaohu Hospital, Anhui Medical University, Hefei, China.,Anhui Psychiatric Center, Anhui Medical University, Hefei, China
| | - Qiuyu Yuan
- Department of Psychiatry, Chaohu Hospital, Anhui Medical University, Hefei, China.,Anhui Psychiatric Center, Anhui Medical University, Hefei, China
| | - Cui Huang
- Department of Psychiatry, Chaohu Hospital, Anhui Medical University, Hefei, China.,Anhui Psychiatric Center, Anhui Medical University, Hefei, China
| | - Kai Zhang
- Department of Psychiatry, Chaohu Hospital, Anhui Medical University, Hefei, China.,Anhui Psychiatric Center, Anhui Medical University, Hefei, China
| | - Xiaoqin Zhou
- Department of Psychiatry, Chaohu Hospital, Anhui Medical University, Hefei, China.,Anhui Psychiatric Center, Anhui Medical University, Hefei, China
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Risk classification for conversion from mild cognitive impairment to Alzheimer's disease in primary care. Psychiatry Res 2019; 278:19-26. [PMID: 31132572 DOI: 10.1016/j.psychres.2019.05.027] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2019] [Revised: 05/14/2019] [Accepted: 05/15/2019] [Indexed: 11/20/2022]
Abstract
There is a pressing need to identify individuals at high risk of conversion from mild cognitive impairment (MCI) to Alzheimer's disease (AD) based on available repeated cognitive measures in primary care. Using data from the Alzheimer's Disease Neuroimaging Initiative (ADNI), we applied a joint latent class mixed model (JLCM) to derive a 3-class solution: low risk (72.65%), medium risk (20.41%) and high risk (6.94%). In the low-risk group, individuals with lower daily activity and ApoEε4 carriers were at greater risk of conversion from MCI to AD. In the medium-risk group, being female, single, and an ApoEε4 carrier increased risk of conversion to AD. In the high-risk group, individuals with lower education level and single individuals were at greater risk of conversion to AD. Individual dynamic prediction for conversion from MCI to AD after 10 years was derived. Accurate identification of conversion from MCI to AD contributes to earlier close monitoring, appropriate management, and targeted interventions. Thereby, it can reduce avoidable hospitalizations for the high-risk MCI population. Moreover, it can avoid expensive follow-up tests that may provoke unnecessary anxiety for low-risk individuals and their families.
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Borda MG, Santacruz JM, Aarsland D, Camargo-Casas S, Cano-Gutierrez CA, Suárez-Monsalve S, Campos-Fajardo S, Pérez-Zepeda MU. ASSOCIATION OF DEPRESSIVE SYMPTOMS AND SUBJECTIVE MEMORY COMPLAINTS WITH THE INCIDENCE OF COGNITIVE IMPAIRMENT IN OLDER ADULTS WITH HIGH BLOOD PRESSURE. Eur Geriatr Med 2019; 10:413-420. [PMID: 31186819 PMCID: PMC6557430 DOI: 10.1007/s41999-019-00185-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2018] [Accepted: 03/22/2019] [Indexed: 01/22/2023]
Abstract
PURPOSE High blood pressure is a relevant risk factor for vascular damage, leading to development of depressive symptoms and dementia in older adults. Moreover, subjective memory complaints are recognized as an early marker of cognitive impairment. However, it has been established that subjective memory complaints could also be a reflection of depressive symptoms. The objective of this paper is to assess the impact of depressive symptoms and subjective memory complaints on the incidence of cognitive impairment in older adults with high blood pressure. METHODS This is a secondary analysis of the Mexican Health and Aging Study, a representative cohort composed by individuals aged ≥ 50 years. Participants with cognitive impairment in 2012 were excluded since the outcome was incident cognitive impairment in 2015. Four groups were created according to depressive symptomatology and subjective memory complaints status, analyses were stratified according to blood pressure status. The odds incident cognitive impairment was estimated through logistic regression models. RESULTS A total of 6,327 participants were included, from which 6.44% developed cognitive impairment. No differences were seen regarding the development of cognitive impairment in participants without high blood pressure. However, increased risk was evident in those with both high blood pressure and depressive symptoms (OR=2.1, 95% CI 1.09 - 4.09, p =0.026) as with high blood pressure, depressive symptoms and subjective memory complaints (OR=1.91, 9% CI 1.4 - 3.2, p= 0.001). CONCLUSION Individuals with high blood pressure have a higher risk of developing incident cognitive impairment when depressive symptoms and/or subjective memory complaints are present. Our results suggest that a sequence of events related to altered cerebral vascular dynamics is possible.
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Affiliation(s)
- Miguel Germán Borda
- Centre for Age-Related Medicine (SESAM), Stavanger University Hospital. Stavanger, Norway
- Semillero de Neurociencias y Envejecimiento, Ageing Institute, Medical School, Pontificia Universidad Javeriana. Bogotá, Colombia
- Faculty of Health Sciences, University of Stavanger, Stavanger, Norway
| | - José Manuel Santacruz
- Cognition and Memory Center, Intellectus. Hospital Universitario San Ignacio. Bogotá Colombia
- Psychiatry Department, Hospital Universitario San Ignacio. Bogotá, Colombia
| | - Dag Aarsland
- Centre for Age-Related Medicine (SESAM), Stavanger University Hospital. Stavanger, Norway
- Department of Old Age Psychiatry, King’s College. London, United Kingdom
| | - Sandy Camargo-Casas
- Semillero de Neurociencias y Envejecimiento, Ageing Institute, Medical School, Pontificia Universidad Javeriana. Bogotá, Colombia
| | - Carlos Alberto Cano-Gutierrez
- Semillero de Neurociencias y Envejecimiento, Ageing Institute, Medical School, Pontificia Universidad Javeriana. Bogotá, Colombia
- Geriatrics Unit, Internal Medicine Department, Hospital Universitario San Ignacio. Bogotá, Colombia
| | - Silvia Suárez-Monsalve
- Semillero de Neurociencias y Envejecimiento, Ageing Institute, Medical School, Pontificia Universidad Javeriana. Bogotá, Colombia
| | - Santiago Campos-Fajardo
- Semillero de Neurociencias y Envejecimiento, Ageing Institute, Medical School, Pontificia Universidad Javeriana. Bogotá, Colombia
| | - Mario Ulises Pérez-Zepeda
- Semillero de Neurociencias y Envejecimiento, Ageing Institute, Medical School, Pontificia Universidad Javeriana. Bogotá, Colombia
- Geriatric Epidemiology Research Department, Instituto Nacional De Geriatría. Mexico D.F, Mexico
- Geriatric Medicine Research Unit, Department of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada
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