1
|
Godos J, Micek A, Currenti W, Franchi C, Poli A, Battino M, Dolci A, Ricci C, Ungvari Z, Grosso G. Fish consumption, cognitive impairment and dementia: an updated dose-response meta-analysis of observational studies. Aging Clin Exp Res 2024; 36:171. [PMID: 39162889 PMCID: PMC11335789 DOI: 10.1007/s40520-024-02823-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2024] [Accepted: 07/28/2024] [Indexed: 08/21/2024]
Abstract
BACKGROUND Cognitive impairment is projected to affect a preponderant proportion of the aging population. Lifelong dietary habits have been hypothesized to play a role in preventing cognitive decline. Among the most studied dietary components, fish consumptionhas been extensively studied for its potential effects on the human brain. AIMS To perform a meta-analysis of observational studies exploring the association between fish intake and cognitive impairment/decline and all types of dementia. METHODS A systematic search of electronic databases was performed to identify observational studies providing quantitative data on fish consumption and outcomes of interest. Random effects models for meta-analyses using only extreme exposure categories, subgroup analyses, and dose-response analyses were performed to estimate cumulative risk ratios (RRs) and 95% confidence intervals (CIs). RESULTS The meta-analysis comprised 35 studies. Individuals reporting the highest vs. the lowest fish consumption were associated with a lower likelihood of cognitive impairment/decline (RR = 0.82, 95% CI: 0.75, 0.90, I2 = 61.1%), dementia (RR = 0.82, 95% CI: 0.73, 0.93, I2 = 38.7%), and Alzheimer's disease (RR = 0.80, 95% CI: 0.67, 0.96, I2 = 20.3%). The dose-response relation revealed a significantly decreased risk of cognitive impairment/decline and all cognitive outcomes across higher levels of fish intake up to 30% for 150 g/d (RR = 0.70, 95% CI: 0.52, 0.95). The results of this relation based on APOE ε4 allele status was mixed based on the outcome investigated. CONCLUSIONS Current findings suggest fish consumption is associated with a lower risk of cognitive impairment/decline in a dose-response manner, while for dementia and Alzheimer's disease there is a need for further studies to improve the strength of evidence.
Collapse
Affiliation(s)
- Justyna Godos
- Department of Biomedical and Biotechnological Sciences, University of Catania, Catania, Italy
- Center for Human Nutrition and Mediterranean Foods (NUTREA), University of Catania, Catania, Italy
| | - Agnieszka Micek
- Statistical Laboratory, Faculty of Health Sciences, Jagiellonian University Medical College, Kraków, 31-501, Poland
| | - Walter Currenti
- Department of Biomedical and Biotechnological Sciences, University of Catania, Catania, Italy
| | - Carlotta Franchi
- Laboratory of Pharmacoepidemiology and Human Nutrition, Department of Health Policy, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, 20156, Italy
- Italian Institute for Planetary Health (IIPH), Milan, 20124, Italy
| | - Andrea Poli
- Nutrition Foundation of Italy (NFI), Milan, 20124, Italy
| | - Maurizio Battino
- Department of Clinical Sciences, Università Politecnica Delle Marche, Ancona, Italy
- Research Group on Food, Nutritional Biochemistry and Health, Universidad Europea del Atlántico, Isabel Torres 21, Santander, 39011, Spain
- International Joint Research Laboratory of Intelligent Agriculture and Agri-Products Processing, Jiangsu University, Zhenjiang, Jiangsu, China
| | - Alberto Dolci
- Sustainable Development Department, Bolton Food SpA, Milan, 20124, Italy
| | - Cristian Ricci
- Africa Unit for Transdisciplinary Health Research (AUTHeR), North-West University, Potchefstroom, 2531, South Africa
| | - Zoltan Ungvari
- Vascular Cognitive Impairment, Neurodegeneration and Healthy Brain Aging Program, Department of Neurosurgery, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
- Oklahoma Center for Geroscience and Healthy Brain Aging, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
- International Training Program in Geroscience, Department of Public Health, Doctoral College, Semmelweis University, Budapest, Hungary
- Stephenson Cancer Center, University of Oklahoma, Oklahoma City, OK, USA
- Department of Health Promotion Sciences, College of Public Health, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Giuseppe Grosso
- Department of Biomedical and Biotechnological Sciences, University of Catania, Catania, Italy.
- Center for Human Nutrition and Mediterranean Foods (NUTREA), University of Catania, Catania, Italy.
| |
Collapse
|
2
|
Ibanez A, Maito M, Botero-Rodríguez F, Fittipaldi S, Coronel C, Migeot J, Lacroix A, Lawlor B, Duran-Aniotz C, Baez S, Santamaria-Garcia H. Healthy aging meta-analyses and scoping review of risk factors across Latin America reveal large heterogeneity and weak predictive models. NATURE AGING 2024; 4:1153-1165. [PMID: 38886210 PMCID: PMC11333291 DOI: 10.1038/s43587-024-00648-6] [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: 10/13/2023] [Accepted: 05/13/2024] [Indexed: 06/20/2024]
Abstract
Models of healthy aging are typically based on the United States and Europe and may not apply to diverse and heterogeneous populations. In this study, our objectives were to conduct a meta-analysis to assess risk factors of cognition and functional ability across aging populations in Latin America and a scoping review focusing on methodological procedures. Our study design included randomized controlled trials and cohort, case-control and cross-sectional studies using multiple databases, including MEDLINE, the Virtual Health Library and Web of Science. From an initial pool of 455 studies, our meta-analysis included 38 final studies (28 assessing cognition and 10 assessing functional ability, n = 146,000 participants). Our results revealed significant but heterogeneous effects for cognition (odds ratio (OR) = 1.20, P = 0.03, confidence interval (CI) = (1.0127, 1.42); heterogeneity: I2 = 92.1%, CI = (89.8%, 94%)) and functional ability (OR = 1.20, P = 0.01, CI = (1.04, 1.39); I2 = 93.1%, CI = (89.3%, 95.5%)). Specific risk factors had limited effects, especially on functional ability, with moderate impacts for demographics and mental health and marginal effects for health status and social determinants of health. Methodological issues, such as outliers, inter-country differences and publication bias, influenced the results. Overall, we highlight the specific profile of risk factors associated with healthy aging in Latin America. The heterogeneity in results and methodological approaches in studying healthy aging call for greater harmonization and further regional research to understand healthy aging in Latin America.
Collapse
Affiliation(s)
- Agustin Ibanez
- Latin American Brain Health Institute (BrainLat), Universidad Adolfo Ibañez, Santiago de Chile, Chile.
- Global Brain Health Institute (GBHI), University of California, San Francisco (UCSF), San Francisco, CA, USA.
- University of Trinity Dublin, Dublin, Ireland.
- Cognitive Neuroscience Center (CNC), Universidad de San Andrés, Buenos Aires, Argentina.
- Trinity College Dublin, Dublin, Ireland.
| | - Marcelo Maito
- Latin American Brain Health Institute (BrainLat), Universidad Adolfo Ibañez, Santiago de Chile, Chile
| | - Felipe Botero-Rodríguez
- PhD Program of Neuroscience, Department of Psychiatry, Pontificia Universidad Javeriana, Bogotá, Colombia
- Hospital Universitario San Ignacio, Center for Brain and Cognition, Intellectus, Bogotá, Colombia
- Fundación para la Ciencia, Innovación y Tecnología - Fucintec, Bogotá, Colombia
| | - Sol Fittipaldi
- Latin American Brain Health Institute (BrainLat), Universidad Adolfo Ibañez, Santiago de Chile, Chile
- Trinity College Dublin, Dublin, Ireland
- Centro Interdisciplinario de Neurociencia de Valparaíso (CINV), Universidad de Valparaíso, Valparaíso, Chile
| | - Carlos Coronel
- Latin American Brain Health Institute (BrainLat), Universidad Adolfo Ibañez, Santiago de Chile, Chile
- Global Brain Health Institute (GBHI), University of California, San Francisco (UCSF), San Francisco, CA, USA
- University of Trinity Dublin, Dublin, Ireland
| | - Joaquin Migeot
- Latin American Brain Health Institute (BrainLat), Universidad Adolfo Ibañez, Santiago de Chile, Chile
| | - Andrea Lacroix
- Herbert Wertheim School of Public Health and Human Longevity Science, Health Sciences Office of Faculty Affairs, University California, San Diego (UCSD), San Diego, CA, USA
| | - Brian Lawlor
- Global Brain Health Institute (GBHI), University of California, San Francisco (UCSF), San Francisco, CA, USA
- University of Trinity Dublin, Dublin, Ireland
- Trinity College Dublin, Dublin, Ireland
| | - Claudia Duran-Aniotz
- Latin American Brain Health Institute (BrainLat), Universidad Adolfo Ibañez, Santiago de Chile, Chile
| | - Sandra Baez
- Global Brain Health Institute (GBHI), University of California, San Francisco (UCSF), San Francisco, CA, USA
- University of Trinity Dublin, Dublin, Ireland
- Universidad de los Andes, Bogotá, Colombia
| | - Hernando Santamaria-Garcia
- PhD Program of Neuroscience, Department of Psychiatry, Pontificia Universidad Javeriana, Bogotá, Colombia.
- Hospital Universitario San Ignacio, Center for Brain and Cognition, Intellectus, Bogotá, Colombia.
| |
Collapse
|
3
|
Iso-Markku P, Kujala UM, Knittle K, Polet J, Vuoksimaa E, Waller K. Physical activity as a protective factor for dementia and Alzheimer's disease: systematic review, meta-analysis and quality assessment of cohort and case-control studies. Br J Sports Med 2022; 56:701-709. [PMID: 35301183 PMCID: PMC9163715 DOI: 10.1136/bjsports-2021-104981] [Citation(s) in RCA: 96] [Impact Index Per Article: 48.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/20/2022] [Indexed: 01/20/2023]
Abstract
Objective Physical activity (PA) is associated with a decreased incidence of dementia, but much of the evidence comes from short follow-ups prone to reverse causation. This meta-analysis investigates the effect of study length on the association. Design A systematic review and meta-analysis. Pooled effect sizes, dose–response analysis and funnel plots were used to synthesise the results. Data sources CINAHL (last search 19 October 2021), PsycInfo, Scopus, PubMed, Web of Science (21 October 2021) and SPORTDiscus (26 October 2021). Eligibility criteria Studies of adults with a prospective follow-up of at least 1 year, a valid cognitive measure or cohort in mid-life at baseline and an estimate of the association between baseline PA and follow-up all-cause dementia, Alzheimer’s disease or vascular dementia were included (n=58). Results PA was associated with a decreased risk of all-cause dementia (pooled relative risk 0.80, 95% CI 0.77 to 0.84, n=257 983), Alzheimer’s disease (0.86, 95% CI 0.80 to 0.93, n=128 261) and vascular dementia (0.79, 95% CI 0.66 to 0.95, n=33 870), even in longer follow-ups (≥20 years) for all-cause dementia and Alzheimer’s disease. Neither baseline age, follow-up length nor study quality significantly moderated the associations. Dose–response meta-analyses revealed significant linear, spline and quadratic trends within estimates for all-cause dementia incidence, but only a significant spline trend for Alzheimer’s disease. Funnel plots showed possible publication bias for all-cause dementia and Alzheimer’s disease. Conclusion PA was associated with lower incidence of all-cause dementia and Alzheimer’s disease, even in longer follow-ups, supporting PA as a modifiable protective lifestyle factor, even after reducing the effects of reverse causation.
Collapse
Affiliation(s)
- Paula Iso-Markku
- Institute for Molecular Medicine Finland (FIMM), HiLIFE, University of Helsinki, Helsinki, Finland .,HUS Diagnostic Center, Clinical Physiology and Nuclear Medicine, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Urho M Kujala
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Keegan Knittle
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Juho Polet
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Eero Vuoksimaa
- Institute for Molecular Medicine Finland (FIMM), HiLIFE, University of Helsinki, Helsinki, Finland
| | - Katja Waller
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| |
Collapse
|
4
|
Ong PA, Annisafitrie FR, Purnamasari N, Calista C, Sagita N, Sofiatin Y, Dikot Y. Dementia Prevalence, Comorbidities, and Lifestyle Among Jatinangor Elders. Front Neurol 2021; 12:643480. [PMID: 34367043 PMCID: PMC8345013 DOI: 10.3389/fneur.2021.643480] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Accepted: 06/22/2021] [Indexed: 11/13/2022] Open
Abstract
Introduction: Research on dementia prevalence and the potentially related risk factors from Indonesia is scarce. We sought to identify the prevalence of dementia, health risk factors, and lifestyle in Jatinangor elders. Methods: A total of 686 participants completed questionnaires on lifestyle, health risk factors, and cognitive and functional tests from September 2013 to December 2013. We determined the prevalence of dementia; and the associations between health, leisure activities, dietary pattern, and dementia were analyzed using logistic regression. Results: The prevalence of dementia was 29.15%. The risk factors differed between age groups. Those aged 60–74 years and who have a lower education level, lower occupational attainment, and less active intellectual and recreational activities were associated with higher dementia risk. Those aged > 75 years living in a rural area and who take less fruit were associated with a higher risk of dementia. Conclusions: The prevalence of dementia in Jatinangor is high. The identified modifiable risk factors are a potential target for intervention and valuable for designing public health policies.
Collapse
Affiliation(s)
- Paulus Anam Ong
- Department of Neurology, Hasan Sadikin Hospital, Universitas Padjadjaran, Bandung, Indonesia
| | - Febby Rosa Annisafitrie
- Department of Neurology, Hasan Sadikin Hospital, Universitas Padjadjaran, Bandung, Indonesia
| | - Novita Purnamasari
- Department of Neurology, Hasan Sadikin Hospital, Universitas Padjadjaran, Bandung, Indonesia
| | - Chandra Calista
- Department of Neurology, Hasan Sadikin Hospital, Universitas Padjadjaran, Bandung, Indonesia
| | - Noveline Sagita
- Department of Neurology, Immanuel Hospital, Maranatha Christian University, Bandung, Indonesia
| | - Yulia Sofiatin
- Department of Public Health, Faculty of Medicine, Universitas Padjadjaran, Bandung, Indonesia
| | - Yustiani Dikot
- Department of Neurology, Faculty of Medicine, Achmad Yani University, Bandung, Indonesia
| |
Collapse
|
5
|
Dominguez J, Jiloca L, Fowler KC, De Guzman MF, Dominguez-Awao JK, Natividad B, Domingo J, Dominguez JD, Reandelar M, Ligsay A, Yu JR, Aichele S, Phung TKT. Dementia Incidence, Burden and Cost of Care: A Filipino Community-Based Study. Front Public Health 2021; 9:628700. [PMID: 34055712 PMCID: PMC8160123 DOI: 10.3389/fpubh.2021.628700] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Accepted: 04/12/2021] [Indexed: 11/26/2022] Open
Abstract
Background: In the midst of competing priorities and limited resources in low-middle-income countries (LMIC), convincing epidemiological evidence is critical for urging governments to develop national dementia plans. The majority of primary epidemiological studies on dementia are from high income countries (HIC). Implications for developing countries are typically extrapolated from these outcomes through modeling, meta-analyses, and systematic reviews. In this study, we directly assessed the incidence of dementia, disability adjusted life years (DALYs), and cost of care among community-dwelling Filipino elderly. Methods: This was a follow-up study of the prospective cohort Marikina Memory Ageing Project (MMAP). Baseline assessment was performed in 2011–2012, and follow-up was done in 2015–2016 (N = 748 at follow-up). Incident dementia was determined. Disease burden was computed using the incidence rates and DALYs. Both indirect and direct (medical and non-medical) costs of dementia care were computed. Results: The crude incidence rate was 16 (CI: 13–20) cases per 1,000 person-years (pyr) with 17 (CI: 12–21) per 1,000 pyr for females and 14 (CI: 9–21) per 1,000 pyr for males. Based on this incidence, we project an estimation of 220,632 new cases in 2030, 295,066 in 2040, and 378,461 in 2050. Disease burden was at 2,876 DALYsper 100,000 persons. The economic burden per patient was around Php 196,000 annually (i.e., ~4,070 USD, or 36.7% of average family annual income in the Philippines). The majority (86.29%) of this care expense was indirect cost attributed to estimated lost potential earning of unpaid family caregivers whereas direct medical cost accounted for only 13.48%. Conclusions: We provide the first Filipino community-based data on the incidence of dementia, DALYs, and cost of care to reflect the epidemiologic and economic impact of disease. The findings of this study serve to guide the development of a national dementia plan.
Collapse
Affiliation(s)
- Jacqueline Dominguez
- Institute for Neurosciences, St. Luke's Medical Center, Quezon City, Philippines.,Institute for Dementia Care Asia, Quezon City, Philippines
| | - Leo Jiloca
- Geriatric Center, St. Luke's Medical Center, Quezon City, Philippines
| | - Krizelle Cleo Fowler
- Research and Biotechnology Division, St. Luke's Medical Center, Quezon City, Philippines
| | - Ma Fe De Guzman
- Research and Biotechnology Division, St. Luke's Medical Center, Quezon City, Philippines
| | - Jhozel Kim Dominguez-Awao
- Institute for Dementia Care Asia, Quezon City, Philippines.,Department of Internal Medicine, St. Louis University Hospital, Baguio, Philippines
| | - Boots Natividad
- Research and Biotechnology Division, St. Luke's Medical Center, Quezon City, Philippines
| | - Jeffrey Domingo
- Institute for Dementia Care Asia, Quezon City, Philippines.,Research and Biotechnology Division, St. Luke's Medical Center, Quezon City, Philippines
| | - Jayvee Dyne Dominguez
- Institute for Dementia Care Asia, Quezon City, Philippines.,Research and Biotechnology Division, St. Luke's Medical Center, Quezon City, Philippines
| | - Macario Reandelar
- Research and Biotechnology Division, St. Luke's Medical Center, Quezon City, Philippines
| | - Antonio Ligsay
- Section of Clinical Research, St. Luke's Medical Center - College of Medicine, Quezon City, Philippines
| | - Jeryl Ritzi Yu
- Institute for Neurosciences, St. Luke's Medical Center, Quezon City, Philippines
| | - Stephen Aichele
- Department of Human Development and Family Studies, Colorado State University, Fort Collins, CO, United States
| | - Thien Kieu Thi Phung
- Danish Dementia Research Center, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| |
Collapse
|