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Wei W, Ma D, Li L, Zhang L. Cognitive impairment in cerebral small vessel disease induced by hypertension. Neural Regen Res 2024; 19:1454-1462. [PMID: 38051887 PMCID: PMC10883517 DOI: 10.4103/1673-5374.385841] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Accepted: 08/22/2023] [Indexed: 12/07/2023] Open
Abstract
ABSTRACT Hypertension is a primary risk factor for the progression of cognitive impairment caused by cerebral small vessel disease, the most common cerebrovascular disease. However, the causal relationship between hypertension and cerebral small vessel disease remains unclear. Hypertension has substantial negative impacts on brain health and is recognized as a risk factor for cerebrovascular disease. Chronic hypertension and lifestyle factors are associated with risks for stroke and dementia, and cerebral small vessel disease can cause dementia and stroke. Hypertension is the main driver of cerebral small vessel disease, which changes the structure and function of cerebral vessels via various mechanisms and leads to lacunar infarction, leukoaraiosis, white matter lesions, and intracerebral hemorrhage, ultimately resulting in cognitive decline and demonstrating that the brain is the target organ of hypertension. This review updates our understanding of the pathogenesis of hypertension-induced cerebral small vessel disease and the resulting changes in brain structure and function and declines in cognitive ability. We also discuss drugs to treat cerebral small vessel disease and cognitive impairment.
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Affiliation(s)
- Weipeng Wei
- Department of Pharmacy, Xuanwu Hospital of Capital Medical University, Beijing, China
- Beijing Geriatric Medical Research Center; Beijing Engineering Research Center for Nervous System Drugs; National Center for Neurological Disorders; National Clinical Research Center for Geriatric Diseases, Beijing, China
| | - Denglei Ma
- Department of Pharmacy, Xuanwu Hospital of Capital Medical University, Beijing, China
- Beijing Geriatric Medical Research Center; Beijing Engineering Research Center for Nervous System Drugs; National Center for Neurological Disorders; National Clinical Research Center for Geriatric Diseases, Beijing, China
| | - Lin Li
- Department of Pharmacy, Xuanwu Hospital of Capital Medical University, Beijing, China
- Beijing Geriatric Medical Research Center; Beijing Engineering Research Center for Nervous System Drugs; National Center for Neurological Disorders; National Clinical Research Center for Geriatric Diseases, Beijing, China
| | - Lan Zhang
- Department of Pharmacy, Xuanwu Hospital of Capital Medical University, Beijing, China
- Beijing Geriatric Medical Research Center; Beijing Engineering Research Center for Nervous System Drugs; National Center for Neurological Disorders; National Clinical Research Center for Geriatric Diseases, Beijing, China
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Alateeq K, Walsh EI, Ambikairajah A, Cherbuin N. Association between dietary magnesium intake, inflammation, and neurodegeneration. Eur J Nutr 2024:10.1007/s00394-024-03383-1. [PMID: 38597977 DOI: 10.1007/s00394-024-03383-1] [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: 06/08/2023] [Accepted: 03/29/2024] [Indexed: 04/11/2024]
Abstract
BACKGROUND Consistent evidence shows that magnesium (Mg) intake is associated with lower blood pressure (BP), and that lower BP is associated with improved cerebral health. However, recent findings indicate that the positive effect of dietary Mg intake on cerebral health is not mediated by a decrease in BP. As Mg's anti-inflammatory action is a plausible alternative mechanism, the objective of this study was to investigate the associations between Mg intake and inflammation to determine whether it mediates any neuroprotective effect. METHODS Participants from the UK Biobank (n = 5775, aged 40-73 years, 54.7% female) were assessed for dietary magnesium using an online food questionnaire, brain and white matter lesion (WML) volumes were segmented with FreeSurfer software, and inflammation markers including high-sensitivity C-reactive protein (hs-CRP), leukocyte, erythrocyte count, and Glycoprotein acetylation (GlycA) were measured using specific laboratory techniques such as immunoturbidimetry, automated cell counting, and nuclear magnetic resonance. Hierarchical linear regression models were performed to investigate the association between dietary Mg, and inflammatory markers and between dietary Mg, brain and WMLs volumes. Mediation analysis was performed to test a possible mediation role of inflammation on the association between dietary Mg and brain and WMLs volumes. RESULTS Higher dietary Mg intake was associated with lower inflammation: hs-CRP level (- 0.0497%; 95% confidence interval [CI] - 0.0497%, - 0.0199%) leukocytes count (- 0.0015%; 95%CI - 0.00151%, - 0.0011%), and GlycA (- 0.0519%; 95%CI - 0.1298%, - 0.0129%). Moreover, higher dietary Mg intake was associated with larger grey matter volume (0.010%; 95%CI 0.004%, 0.017%), white matter volume (0.012%; 95%CI 0.003, 0.022) and right hippocampal volume (0.002%; 95%CI 0.0007, -0.0025%). Lower hs-CRP levels mediated the positive association between higher dietary Mg intake and larger grey matter volume. CONCLUSIONS The anti-inflammatory effects of dietary Mg intake in the general population, appears to mediate its neuroprotective effect.
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Affiliation(s)
- Khawlah Alateeq
- National Centre for Epidemiology and Population Health, Australian National University, 54 Mills Road, Canberra, ACT, 2601, Australia.
- Radiological Science, College of Applied Medical Science, King Saud University, Riyadh, Saudi Arabia.
| | - Erin I Walsh
- National Centre for Epidemiology and Population Health, Australian National University, 54 Mills Road, Canberra, ACT, 2601, Australia
| | - Ananthan Ambikairajah
- National Centre for Epidemiology and Population Health, Australian National University, 54 Mills Road, Canberra, ACT, 2601, Australia
- Discipline of Psychology, Faculty of Health, University of Canberra, Canberra, ACT, 2617, Australia
- Centre for Ageing Research and Translation, Faculty of Health, University of Canberra, Canberra, 2617, Australia
| | - Nicolas Cherbuin
- National Centre for Epidemiology and Population Health, Australian National University, 54 Mills Road, Canberra, ACT, 2601, Australia
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Li Z, Sang F, Zhang Z, Li X. Effect of the duration of hypertension on white matter structure and its link with cognition. J Cereb Blood Flow Metab 2024; 44:580-594. [PMID: 37950676 PMCID: PMC10981405 DOI: 10.1177/0271678x231214073] [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: 05/14/2023] [Revised: 09/22/2023] [Accepted: 10/21/2023] [Indexed: 11/13/2023]
Abstract
The relation between hypertension (HTN) and cognition has been reported inclusive results, which may be affected by disease duration. Our study aimed to examine the influence of HTN duration on cognition and its underlying white matter (WM) changes including macrostructural WM hyperintensities (WMH) and microstructural WM integrity. A total of 1218 patients aged ≥55 years with neuropsychological assessment and a subgroup of 233 people with imaging data were recruited and divided into 3 groups (short duration: <5 years, medium duration: 5-20 years, long duration: >20 years). We found that greater HTN duration was preferentially related to worse executive function (EF), processing speed (PS), and more severe WMH, which became more significant during long duration stage. The reductions in WM integrity were evident at the early stage especially in long-range association fibers and then scattered through the whole brain. Increasing WMH and decreasing integrity of specific tracts consistently undermined EF. Furthermore, free water imaging method greatly enhanced the sensitivity in detecting HTN-related WM alterations. These findings supported that the neurological damaging effects of HTN is cumulative and neuroimaging markers of WM at macro- and microstructural level underlie the progressive effect of HTN on cognition.
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Affiliation(s)
- Zilin Li
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing, China
- Beijing Aging Brain Rejuvenation Initiative Centre, Beijing Normal University, Beijing, China
| | - Feng Sang
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing, China
- Beijing Aging Brain Rejuvenation Initiative Centre, Beijing Normal University, Beijing, China
| | - Zhanjun Zhang
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing, China
- Beijing Aging Brain Rejuvenation Initiative Centre, Beijing Normal University, Beijing, China
| | - Xin Li
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing, China
- Beijing Aging Brain Rejuvenation Initiative Centre, Beijing Normal University, Beijing, China
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Gannon O, Tremble SM, McGinn C, Guth R, Scoppettone N, Hunt RD, Prakash K, Johnson AC. Angiotensin II-mediated hippocampal hypoperfusion and vascular dysfunction contribute to vascular cognitive impairment in aged hypertensive rats. Alzheimers Dement 2024; 20:890-903. [PMID: 37817376 PMCID: PMC10917018 DOI: 10.1002/alz.13491] [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: 07/24/2023] [Revised: 09/06/2023] [Accepted: 09/07/2023] [Indexed: 10/12/2023]
Abstract
INTRODUCTION Chronic hypertension increases the risk of vascular cognitive impairment (VCI) by ∼60%; however, how hypertension affects the vasculature of the hippocampus remains unclear but could contribute to VCI. METHODS Memory, hippocampal perfusion, and hippocampal arteriole (HA) function were investigated in male Wistar rats or spontaneously hypertensive rats (SHR) in early (4 to 5 months old), mid (8 to 9 months old), or late adulthood (14 to 15 months old). SHR in late adulthood were chronically treated with captopril (angiotensin converting enzyme inhibitor) or apocynin (antioxidant) to investigate the mechanisms by which hypertension contributes to VCI. RESULTS Impaired memory in SHR in late adulthood was associated with HA endothelial dysfunction, hyperconstriction, and ∼50% reduction in hippocampal blood flow. Captopril, but not apocynin, improved HA function, restored perfusion, and rescued memory function in aged SHR. DISCUSSION Hippocampal vascular dysfunction contributes to hypertension-induced memory decline through angiotensin II signaling, highlighting the therapeutic potential of HAs in protecting neurocognitive health later in life. HIGHLIGHTS Vascular dysfunction in the hippocampus contributes to vascular cognitive impairment. Memory declines with age during chronic hypertension. Angiotensin II causes endothelial dysfunction in the hippocampus in hypertension. Angiotensin II-mediated hippocampal arteriole dysfunction reduces blood flow. Vascular dysfunction in the hippocampus impairs perfusion and memory function.
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Affiliation(s)
- Olivia Gannon
- Department of Neurological SciencesUniversity of Vermont Larner College of MedicineBurlingtonVermontUSA
| | - Sarah M. Tremble
- Department of Neurological SciencesUniversity of Vermont Larner College of MedicineBurlingtonVermontUSA
| | - Conor McGinn
- Department of Neurological SciencesUniversity of Vermont Larner College of MedicineBurlingtonVermontUSA
| | - Ruby Guth
- Department of Neurological SciencesUniversity of Vermont Larner College of MedicineBurlingtonVermontUSA
| | - Nadia Scoppettone
- Department of Neurological SciencesUniversity of Vermont Larner College of MedicineBurlingtonVermontUSA
| | - Ryan D. Hunt
- Department of Neurological SciencesUniversity of Vermont Larner College of MedicineBurlingtonVermontUSA
| | - Kirtika Prakash
- Department of Neurological SciencesUniversity of Vermont Larner College of MedicineBurlingtonVermontUSA
| | - Abbie C. Johnson
- Department of Neurological SciencesUniversity of Vermont Larner College of MedicineBurlingtonVermontUSA
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Defina S, Silva CCV, Cecil CAM, Tiemeier H, Felix JF, Mutzel RL, Jaddoe VWV. Associations of Arterial Thickness, Stiffness, and Blood Pressure With Brain Morphology in Early Adolescence: A Prospective Population-Based Study. Hypertension 2024; 81:162-171. [PMID: 37942629 DOI: 10.1161/hypertensionaha.123.21672] [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: 06/17/2023] [Accepted: 10/26/2023] [Indexed: 11/10/2023]
Abstract
BACKGROUND Arterial wall thickness and stiffness, and high blood pressure have been repeatedly associated with poorer brain health. However, previous studies largely focused on mid- or late-life stages. It is unknown whether any arterial health-related brain changes may be observable already in adolescence. METHODS We examined whether (1) carotid intima-media thickness, (2) carotid distensibility, and (3) systolic blood pressure and diastolic blood pressure, measured at the age of 10 years, were associated with brain volumes and white matter microstructure (ie, fractional anisotropy and mean diffusivity) at the age of 14 years. In addition to cross-sectional analyses, we explored associations with longitudinal change in each brain outcome from 10 to 14 years. Analyses were based on 5341 children from the Generation R Study. RESULTS Higher diastolic blood pressure was associated with lower total brain volume (β, -0.04 [95% CI, -0.07 to -0.01]) and gray matter volume (β, -0.04 [95% CI, -0.07 to -0.01]) at the age of 14 years, with stronger associations in higher diastolic blood pressure ranges. Similar associations emerged between systolic blood pressure and brain volumes, but these were no longer significant after adjusting for birth weight. No associations were observed between blood pressure and white matter microstructure or between carotid intima-media thickness or distensibility and brain morphology. CONCLUSIONS Arterial blood pressure, but not intima-media thickness and distensibility, is associated with structural neuroimaging markers in early adolescence. Volumetric measures may be more sensitive to these early arterial health differences compared with microstructural properties of the white matter, but further studies are needed to confirm these results and assess potential causal mechanisms.
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Affiliation(s)
- Serena Defina
- Generation R Study Group (S.D., C.C.V.S., J.F.F., V.W.V.J.), Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
- Department of Child and Adolescent Psychiatry (S.D., C.A.M.C., R.L.M.), Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Carolina C V Silva
- Generation R Study Group (S.D., C.C.V.S., J.F.F., V.W.V.J.), Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
- Department of Paediatrics (C.C.V.S., J.F.F., V.W.V.J.), Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Charlotte A M Cecil
- Department of Child and Adolescent Psychiatry (S.D., C.A.M.C., R.L.M.), Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
- Department of Epidemiology (C.A.M.C., H.T.), Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
- Molecular Epidemiology, Department of Biomedical Data Sciences, Leiden University Medical Center, Leiden, The Netherlands (C.A.M.C.)
| | - Henning Tiemeier
- Department of Epidemiology (C.A.M.C., H.T.), Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
- Department of Social and Behavioral Sciences, T.H. Chan School of Public Health, Harvard University, Boston, MA (H.T.)
| | - Janine F Felix
- Generation R Study Group (S.D., C.C.V.S., J.F.F., V.W.V.J.), Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
- Department of Paediatrics (C.C.V.S., J.F.F., V.W.V.J.), Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Ryan L Mutzel
- Department of Child and Adolescent Psychiatry (S.D., C.A.M.C., R.L.M.), Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
- Department of Radiology and Department Nuclear Medicine (R.L.M.), Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
| | - Vincent W V Jaddoe
- Generation R Study Group (S.D., C.C.V.S., J.F.F., V.W.V.J.), Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
- Department of Paediatrics (C.C.V.S., J.F.F., V.W.V.J.), Erasmus MC, University Medical Center Rotterdam, Rotterdam, The Netherlands
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Lin K, Wen W, Lipnicki DM, Mewton L, Chen R, Du J, Wang D, Skoog I, Sterner TR, Najar J, Kim KW, Han JW, Kim JS, Ng TP, Ho R, Chua DQL, Anstey KJ, Cherbuin N, Mortby ME, Brodaty H, Kochan N, Sachdev PS, Jiang J. Risk factors and cognitive correlates of white matter hyperintensities in ethnically diverse populations without dementia: The COSMIC consortium. ALZHEIMER'S & DEMENTIA (AMSTERDAM, NETHERLANDS) 2024; 16:e12567. [PMID: 38487075 PMCID: PMC10937819 DOI: 10.1002/dad2.12567] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Revised: 01/18/2024] [Accepted: 02/06/2024] [Indexed: 03/17/2024]
Abstract
INTRODUCTION White matter hyperintensities (WMHs) are an important imaging marker for cerebral small vessel diseases, but their risk factors and cognitive associations have not been well documented in populations of different ethnicities and/or from different geographical regions. METHODS We investigated how WMHs were associated with vascular risk factors and cognition in both Whites and Asians, using data from five population-based cohorts of non-demented older individuals from Australia, Singapore, South Korea, and Sweden (N = 1946). WMH volumes (whole brain, periventricular, and deep) were quantified with UBO Detector and harmonized using the ComBat model. We also harmonized various vascular risk factors and scores for global cognition and individual cognitive domains. RESULTS Factors associated with larger whole brain WMH volumes included diabetes, hypertension, stroke, current smoking, body mass index, higher alcohol intake, and insufficient physical activity. Hypertension and stroke had stronger associations with WMH volumes in Whites than in Asians. No associations between WMH volumes and cognitive performance were found after correction for multiple testing. CONCLUSION The current study highlights ethnic differences in the contributions of vascular risk factors to WMHs.
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Affiliation(s)
- Keshuo Lin
- Centre for Healthy Brain AgeingSchool of Clinical MedicineUniversity of New South WalesSydneyNew South WalesAustralia
| | - Wei Wen
- Centre for Healthy Brain AgeingSchool of Clinical MedicineUniversity of New South WalesSydneyNew South WalesAustralia
| | - Darren M. Lipnicki
- Centre for Healthy Brain AgeingSchool of Clinical MedicineUniversity of New South WalesSydneyNew South WalesAustralia
| | - Louise Mewton
- Centre for Healthy Brain AgeingSchool of Clinical MedicineUniversity of New South WalesSydneyNew South WalesAustralia
| | - Rory Chen
- Centre for Healthy Brain AgeingSchool of Clinical MedicineUniversity of New South WalesSydneyNew South WalesAustralia
| | - Jing Du
- Centre for Healthy Brain AgeingSchool of Clinical MedicineUniversity of New South WalesSydneyNew South WalesAustralia
| | - Dadong Wang
- Quantitative Imaging Research TeamCSIRO Informatics and StatisticsNorth RydeNew South WalesAustralia
| | - Ingmar Skoog
- Neuropsychiatric Epidemiology UnitDepartment of Psychiatry and NeurochemistryInstitute of Neuroscience and PhysiologySahlgrenska AcademyUniversity of GothenburgGothenburgSweden
- Centre for Ageing and Health (AGECAP)University of GothenburgGothenburgSweden
- Psychiatry, Cognition and Old Age Psychiatry ClinicSahlgrenska University HospitalGothenburgSweden
| | - Therese Rydberg Sterner
- Neuropsychiatric Epidemiology UnitDepartment of Psychiatry and NeurochemistryInstitute of Neuroscience and PhysiologySahlgrenska AcademyUniversity of GothenburgGothenburgSweden
- Centre for Ageing and Health (AGECAP)University of GothenburgGothenburgSweden
- Aging Research CenterDepartment of NeurobiologyCare Sciences and SocietyKarolinska Institutet and Stockholm UniversityStockholmSweden
| | - Jenna Najar
- Neuropsychiatric Epidemiology UnitDepartment of Psychiatry and NeurochemistryInstitute of Neuroscience and PhysiologySahlgrenska AcademyUniversity of GothenburgGothenburgSweden
- Centre for Ageing and Health (AGECAP)University of GothenburgGothenburgSweden
- Section Genomics of Neurodegenerative Diseases and AgingDepartment of Human GeneticsAmsterdam Universitair Medische CentraAmsterdamthe Netherlands
| | - Ki Woong Kim
- Department of NeuropsychiatrySeoul National University Bundang HospitalSeongnamSouth Korea
- Department of PsychiatrySeoul National University College of MedicineSeoulSouth Korea
- Department of Brain and Cognitive SciencesSeoul National University College of Natural SciencesSeoulSouth Korea
| | - Ji Won Han
- Department of NeuropsychiatrySeoul National University Bundang HospitalSeongnamSouth Korea
- Department of PsychiatrySeoul National University College of MedicineSeoulSouth Korea
| | - Jun Sung Kim
- Department of NeuropsychiatrySeoul National University Bundang HospitalSeongnamSouth Korea
| | - Tze Pin Ng
- Department of Psychological MedicineKhoo Teck Puat HospitalYishunSingapore
- Geriatric Education and Research InstituteMinistry of HealthSingaporeSingapore
| | - Roger Ho
- Institute for Health Innovation and Technology (iHealthtech)National University of SingaporeSingaporeSingapore
| | - Denise Qian Ling Chua
- Department of Psychological MedicineNational University of SingaporeSingaporeSingapore
| | - Kaarin J. Anstey
- School of PsychologyUniversity of New South WalesSydneyNew South WalesAustralia
- Department of NeurodegenerationNeuroscience Research AustraliaSydneyNew South WalesAustralia
- Ageing Futures InstituteUniversity of New South WalesSydneyNew South WalesAustralia
| | - Nicolas Cherbuin
- National Centre for Epidemiology and Population HealthCollege of Health and MedicineAustralian National UniversityCanberraAustralian Capital TerritoryAustralia
| | - Moyra E. Mortby
- School of PsychologyUniversity of New South WalesSydneyNew South WalesAustralia
- Department of NeurodegenerationNeuroscience Research AustraliaSydneyNew South WalesAustralia
- Ageing Futures InstituteUniversity of New South WalesSydneyNew South WalesAustralia
| | - Henry Brodaty
- Centre for Healthy Brain AgeingSchool of Clinical MedicineUniversity of New South WalesSydneyNew South WalesAustralia
| | - Nicole Kochan
- Centre for Healthy Brain AgeingSchool of Clinical MedicineUniversity of New South WalesSydneyNew South WalesAustralia
| | - Perminder S. Sachdev
- Centre for Healthy Brain AgeingSchool of Clinical MedicineUniversity of New South WalesSydneyNew South WalesAustralia
- Neuropsychiatric InstituteThe Prince of Wales HospitalSydneyNew South WalesAustralia
| | - Jiyang Jiang
- Centre for Healthy Brain AgeingSchool of Clinical MedicineUniversity of New South WalesSydneyNew South WalesAustralia
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Liu S, Wang M, Gu D, Li Y, Zhang X, Li H, Ji C, Nie X, Liu J. Optimal systolic and diastolic blood pressure threshold that associated with lower risk of white matter hyperintensity progression. Front Aging Neurosci 2023; 15:1254463. [PMID: 37927340 PMCID: PMC10620971 DOI: 10.3389/fnagi.2023.1254463] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Accepted: 10/05/2023] [Indexed: 11/07/2023] Open
Abstract
Background The optimal control thresholds for systolic blood pressure (SBP) and diastolic blood pressure (DBP) in patients with white matter hyperintensity (WMH) are still unclear. Method A longitudinal retrospective study of patients with brain magnetic resonance imaging (MRI) scans with intervals of more than 3 years was conducted. Blood pressure records during hospitalization and from outpatient visits between baseline and the last MRI scan were collected. The outcome was the change in total WMH from baseline to the final visit. Results Among the 965 patients with MRI scans, 457 patients with detailed longitudinal blood pressure records were ultimately included and classified into the WMH absent group (n = 121), mild WMH group (n = 126), and moderate to severe WMH group (n = 210). Both baseline and longitudinal mean SBP, DBP, and SBP SD were significantly associated with WMH severity (p < 0.05). An average SBP of 130-140 mmHg [vs. <130 mmHg, aOR, 1.80, (95% CI, 1.05-3.07), p = 0.03] was associated with a higher risk of WMH progression. DBP ≥ 90 mmHg [vs. <80 mmHg, OR, 1.81, (95% CI, 0.88-3.74), p = 0.02, aOR, 1.54, (95% CI, 0.66-3.53), p = 0.32] was associated with a higher risk of WMH progression, but was not after adjusted for other covariates. Longitudinal BP variability was not significantly associated with WMH progression. Conclusion Both SBP and DBP had a stronger relationship with the severity of WMH. A target mean SBP of <130 mmHg and mean DBP of <80 mmHg was associated with a lower risk of WMH progression.
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Affiliation(s)
- Sibo Liu
- Intensive Care Unit, Dalian Municipal Central Hospital Affiliated Dalian University of Technology, Dalian, China
| | - Mengxing Wang
- China National Clinical Research Center for Neurological Diseases Beijing China, Beijing, China
| | - De’an Gu
- Department of Neurology, Affiliated Qingdao Central Hospital of Qingdao University, Qingdao Cancer Hospital, Qingdao, China
| | - Yanzhao Li
- Department of Neurosurgery, Affiliated Zhongshan Hospital of Dalian University, Dalian, China
| | - Xin Zhang
- Department of General Medicine, Dalian Municipal Central Hospital Affiliated Dalian University of Technology, Dalian, China
| | - Hang Li
- Department of Geriatrics, Affiliated Dalian Friendship Hospital of Dalian Medical University, Dalian, China
| | - Chenhua Ji
- Department of General Medicine, Dalian Municipal Central Hospital Affiliated Dalian University of Technology, Dalian, China
| | - Ximing Nie
- Neurocritical Care Unit, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Jinjie Liu
- Department of General Medicine, Dalian Municipal Central Hospital Affiliated Dalian University of Technology, Dalian, China
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Hirabayashi N, Honda T, Hata J, Furuta Y, Shibata M, Ohara T, Tatewaki Y, Taki Y, Nakaji S, Maeda T, Ono K, Mimura M, Nakashima K, Iga JI, Takebayashi M, Ninomiya T. Association Between Frequency of Social Contact and Brain Atrophy in Community-Dwelling Older People Without Dementia: The JPSC-AD Study. Neurology 2023; 101:e1108-e1117. [PMID: 37438128 DOI: 10.1212/wnl.0000000000207602] [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: 12/28/2022] [Accepted: 05/16/2023] [Indexed: 07/14/2023] Open
Abstract
BACKGROUND AND OBJECTIVES Epidemiologic evidence has shown that social isolation, a low frequency of social contact with others, is associated with the risk of dementia and late-life depressive symptoms. Therefore, we hypothesized that low frequency of social contact may be involved in brain atrophy, and depressive symptoms may play some role in this relationship. We aimed to evaluate the association between low frequency of social contact and the volumes of various brain regions and to assess the extent to which depressive symptoms mediate these relationships from a large population-based multisite cohort study. METHODS Dementia-free community-dwelling Japanese aged 65 years or older underwent brain MRI scans and a comprehensive health examination. Frequency of contact with noncohabiting relatives and friends was determined by asking a single question with 4 categories: everyday, several times a week, several times a month, and seldom. Total and regional brain volumes, intracranial volume (ICV), and white matter lesion volume were estimated using FreeSurfer software. The associations between frequency of social contact and brain volumes per ICV were examined using analyses of covariance. Mediation analyses were conducted to calculate the proportion of the associations explained by depressive symptoms. RESULTS We included 8,896 participants. The multivariable-adjusted mean of the total brain volume in the group with the lowest frequency of social contact was significantly lower compared with that in the group with the highest frequency of social contact (67.3% vs 67.8%), with a significant increasing trend across the groups (p value for trend <0.001). The white matter lesion volume increased significantly with lower frequency of social contact (0.30% in the lowest frequency group vs 0.26% in the highest frequency group, p value for trend <0.001). Lower frequency of social contact was associated with smaller volumes in the temporal lobe, occipital lobe, cingulum, hippocampus, and amygdala (all q values of false discovery rate correction <0.05). The relationships seemed to be partly mediated by depressive symptoms, which accounted for 15%-29% of the observed associations. DISCUSSION Lower frequency of social contact was associated with decreased total and cognitive function-related regional brain volumes. In addition, depressive symptoms partially explained the association in community-dwelling older people without dementia in Japan.
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Affiliation(s)
- Naoki Hirabayashi
- From the Department of Epidemiology and Public Health (N.H., T.H., J.H., Y.F., M.S., T.O., T.N.), Department of Psychosomatic Medicine (N.H., M.S.), Ito Clinic (N.H.), Center for Cohort Studies (T.H., J.H., M.S., T.N.), Department of Medicine and Clinical Science (J.H., Y.F.), and Department of Neuropsychiatry (T.O.), Graduate School of Medical Sciences, Kyushu University, Fukuoka; Department of Aging Research and Geriatric Medicine (Y. Tatewaki, Y. Taki), Institute of Development, Aging and Cancer, Tohoku University, Sendai; Department of Social Medicine (S.N.), Graduate School of Medicine, Hirosaki University; Division of Neurology and Gerontology (T.M.), Department of Internal Medicine, School of Medicine, Iwate Medical University, Yahaba; Department of Neurology (K.O.), Kanazawa University Graduate School of Medical Sciences, Kanazawa University; Department of Neuropsychiatry (M.M.), Keio University School of Medicine, Tokyo; National Hospital Organization (K.N.), Matsue Medical Center; Department of Neuropsychiatry (J.I.), Ehime University Graduate School of Medicine, Ehime University, Matsuyama; and Department of Neuropsychiatry (M.T.), Faculty of Life Sciences, Kumamoto University, Japan
| | - Takanori Honda
- From the Department of Epidemiology and Public Health (N.H., T.H., J.H., Y.F., M.S., T.O., T.N.), Department of Psychosomatic Medicine (N.H., M.S.), Ito Clinic (N.H.), Center for Cohort Studies (T.H., J.H., M.S., T.N.), Department of Medicine and Clinical Science (J.H., Y.F.), and Department of Neuropsychiatry (T.O.), Graduate School of Medical Sciences, Kyushu University, Fukuoka; Department of Aging Research and Geriatric Medicine (Y. Tatewaki, Y. Taki), Institute of Development, Aging and Cancer, Tohoku University, Sendai; Department of Social Medicine (S.N.), Graduate School of Medicine, Hirosaki University; Division of Neurology and Gerontology (T.M.), Department of Internal Medicine, School of Medicine, Iwate Medical University, Yahaba; Department of Neurology (K.O.), Kanazawa University Graduate School of Medical Sciences, Kanazawa University; Department of Neuropsychiatry (M.M.), Keio University School of Medicine, Tokyo; National Hospital Organization (K.N.), Matsue Medical Center; Department of Neuropsychiatry (J.I.), Ehime University Graduate School of Medicine, Ehime University, Matsuyama; and Department of Neuropsychiatry (M.T.), Faculty of Life Sciences, Kumamoto University, Japan
| | - Jun Hata
- From the Department of Epidemiology and Public Health (N.H., T.H., J.H., Y.F., M.S., T.O., T.N.), Department of Psychosomatic Medicine (N.H., M.S.), Ito Clinic (N.H.), Center for Cohort Studies (T.H., J.H., M.S., T.N.), Department of Medicine and Clinical Science (J.H., Y.F.), and Department of Neuropsychiatry (T.O.), Graduate School of Medical Sciences, Kyushu University, Fukuoka; Department of Aging Research and Geriatric Medicine (Y. Tatewaki, Y. Taki), Institute of Development, Aging and Cancer, Tohoku University, Sendai; Department of Social Medicine (S.N.), Graduate School of Medicine, Hirosaki University; Division of Neurology and Gerontology (T.M.), Department of Internal Medicine, School of Medicine, Iwate Medical University, Yahaba; Department of Neurology (K.O.), Kanazawa University Graduate School of Medical Sciences, Kanazawa University; Department of Neuropsychiatry (M.M.), Keio University School of Medicine, Tokyo; National Hospital Organization (K.N.), Matsue Medical Center; Department of Neuropsychiatry (J.I.), Ehime University Graduate School of Medicine, Ehime University, Matsuyama; and Department of Neuropsychiatry (M.T.), Faculty of Life Sciences, Kumamoto University, Japan
| | - Yoshihiko Furuta
- From the Department of Epidemiology and Public Health (N.H., T.H., J.H., Y.F., M.S., T.O., T.N.), Department of Psychosomatic Medicine (N.H., M.S.), Ito Clinic (N.H.), Center for Cohort Studies (T.H., J.H., M.S., T.N.), Department of Medicine and Clinical Science (J.H., Y.F.), and Department of Neuropsychiatry (T.O.), Graduate School of Medical Sciences, Kyushu University, Fukuoka; Department of Aging Research and Geriatric Medicine (Y. Tatewaki, Y. Taki), Institute of Development, Aging and Cancer, Tohoku University, Sendai; Department of Social Medicine (S.N.), Graduate School of Medicine, Hirosaki University; Division of Neurology and Gerontology (T.M.), Department of Internal Medicine, School of Medicine, Iwate Medical University, Yahaba; Department of Neurology (K.O.), Kanazawa University Graduate School of Medical Sciences, Kanazawa University; Department of Neuropsychiatry (M.M.), Keio University School of Medicine, Tokyo; National Hospital Organization (K.N.), Matsue Medical Center; Department of Neuropsychiatry (J.I.), Ehime University Graduate School of Medicine, Ehime University, Matsuyama; and Department of Neuropsychiatry (M.T.), Faculty of Life Sciences, Kumamoto University, Japan
| | - Mao Shibata
- From the Department of Epidemiology and Public Health (N.H., T.H., J.H., Y.F., M.S., T.O., T.N.), Department of Psychosomatic Medicine (N.H., M.S.), Ito Clinic (N.H.), Center for Cohort Studies (T.H., J.H., M.S., T.N.), Department of Medicine and Clinical Science (J.H., Y.F.), and Department of Neuropsychiatry (T.O.), Graduate School of Medical Sciences, Kyushu University, Fukuoka; Department of Aging Research and Geriatric Medicine (Y. Tatewaki, Y. Taki), Institute of Development, Aging and Cancer, Tohoku University, Sendai; Department of Social Medicine (S.N.), Graduate School of Medicine, Hirosaki University; Division of Neurology and Gerontology (T.M.), Department of Internal Medicine, School of Medicine, Iwate Medical University, Yahaba; Department of Neurology (K.O.), Kanazawa University Graduate School of Medical Sciences, Kanazawa University; Department of Neuropsychiatry (M.M.), Keio University School of Medicine, Tokyo; National Hospital Organization (K.N.), Matsue Medical Center; Department of Neuropsychiatry (J.I.), Ehime University Graduate School of Medicine, Ehime University, Matsuyama; and Department of Neuropsychiatry (M.T.), Faculty of Life Sciences, Kumamoto University, Japan
| | - Tomoyuki Ohara
- From the Department of Epidemiology and Public Health (N.H., T.H., J.H., Y.F., M.S., T.O., T.N.), Department of Psychosomatic Medicine (N.H., M.S.), Ito Clinic (N.H.), Center for Cohort Studies (T.H., J.H., M.S., T.N.), Department of Medicine and Clinical Science (J.H., Y.F.), and Department of Neuropsychiatry (T.O.), Graduate School of Medical Sciences, Kyushu University, Fukuoka; Department of Aging Research and Geriatric Medicine (Y. Tatewaki, Y. Taki), Institute of Development, Aging and Cancer, Tohoku University, Sendai; Department of Social Medicine (S.N.), Graduate School of Medicine, Hirosaki University; Division of Neurology and Gerontology (T.M.), Department of Internal Medicine, School of Medicine, Iwate Medical University, Yahaba; Department of Neurology (K.O.), Kanazawa University Graduate School of Medical Sciences, Kanazawa University; Department of Neuropsychiatry (M.M.), Keio University School of Medicine, Tokyo; National Hospital Organization (K.N.), Matsue Medical Center; Department of Neuropsychiatry (J.I.), Ehime University Graduate School of Medicine, Ehime University, Matsuyama; and Department of Neuropsychiatry (M.T.), Faculty of Life Sciences, Kumamoto University, Japan
| | - Yasuko Tatewaki
- From the Department of Epidemiology and Public Health (N.H., T.H., J.H., Y.F., M.S., T.O., T.N.), Department of Psychosomatic Medicine (N.H., M.S.), Ito Clinic (N.H.), Center for Cohort Studies (T.H., J.H., M.S., T.N.), Department of Medicine and Clinical Science (J.H., Y.F.), and Department of Neuropsychiatry (T.O.), Graduate School of Medical Sciences, Kyushu University, Fukuoka; Department of Aging Research and Geriatric Medicine (Y. Tatewaki, Y. Taki), Institute of Development, Aging and Cancer, Tohoku University, Sendai; Department of Social Medicine (S.N.), Graduate School of Medicine, Hirosaki University; Division of Neurology and Gerontology (T.M.), Department of Internal Medicine, School of Medicine, Iwate Medical University, Yahaba; Department of Neurology (K.O.), Kanazawa University Graduate School of Medical Sciences, Kanazawa University; Department of Neuropsychiatry (M.M.), Keio University School of Medicine, Tokyo; National Hospital Organization (K.N.), Matsue Medical Center; Department of Neuropsychiatry (J.I.), Ehime University Graduate School of Medicine, Ehime University, Matsuyama; and Department of Neuropsychiatry (M.T.), Faculty of Life Sciences, Kumamoto University, Japan
| | - Yasuyuki Taki
- From the Department of Epidemiology and Public Health (N.H., T.H., J.H., Y.F., M.S., T.O., T.N.), Department of Psychosomatic Medicine (N.H., M.S.), Ito Clinic (N.H.), Center for Cohort Studies (T.H., J.H., M.S., T.N.), Department of Medicine and Clinical Science (J.H., Y.F.), and Department of Neuropsychiatry (T.O.), Graduate School of Medical Sciences, Kyushu University, Fukuoka; Department of Aging Research and Geriatric Medicine (Y. Tatewaki, Y. Taki), Institute of Development, Aging and Cancer, Tohoku University, Sendai; Department of Social Medicine (S.N.), Graduate School of Medicine, Hirosaki University; Division of Neurology and Gerontology (T.M.), Department of Internal Medicine, School of Medicine, Iwate Medical University, Yahaba; Department of Neurology (K.O.), Kanazawa University Graduate School of Medical Sciences, Kanazawa University; Department of Neuropsychiatry (M.M.), Keio University School of Medicine, Tokyo; National Hospital Organization (K.N.), Matsue Medical Center; Department of Neuropsychiatry (J.I.), Ehime University Graduate School of Medicine, Ehime University, Matsuyama; and Department of Neuropsychiatry (M.T.), Faculty of Life Sciences, Kumamoto University, Japan
| | - Shigeyuki Nakaji
- From the Department of Epidemiology and Public Health (N.H., T.H., J.H., Y.F., M.S., T.O., T.N.), Department of Psychosomatic Medicine (N.H., M.S.), Ito Clinic (N.H.), Center for Cohort Studies (T.H., J.H., M.S., T.N.), Department of Medicine and Clinical Science (J.H., Y.F.), and Department of Neuropsychiatry (T.O.), Graduate School of Medical Sciences, Kyushu University, Fukuoka; Department of Aging Research and Geriatric Medicine (Y. Tatewaki, Y. Taki), Institute of Development, Aging and Cancer, Tohoku University, Sendai; Department of Social Medicine (S.N.), Graduate School of Medicine, Hirosaki University; Division of Neurology and Gerontology (T.M.), Department of Internal Medicine, School of Medicine, Iwate Medical University, Yahaba; Department of Neurology (K.O.), Kanazawa University Graduate School of Medical Sciences, Kanazawa University; Department of Neuropsychiatry (M.M.), Keio University School of Medicine, Tokyo; National Hospital Organization (K.N.), Matsue Medical Center; Department of Neuropsychiatry (J.I.), Ehime University Graduate School of Medicine, Ehime University, Matsuyama; and Department of Neuropsychiatry (M.T.), Faculty of Life Sciences, Kumamoto University, Japan
| | - Tetsuya Maeda
- From the Department of Epidemiology and Public Health (N.H., T.H., J.H., Y.F., M.S., T.O., T.N.), Department of Psychosomatic Medicine (N.H., M.S.), Ito Clinic (N.H.), Center for Cohort Studies (T.H., J.H., M.S., T.N.), Department of Medicine and Clinical Science (J.H., Y.F.), and Department of Neuropsychiatry (T.O.), Graduate School of Medical Sciences, Kyushu University, Fukuoka; Department of Aging Research and Geriatric Medicine (Y. Tatewaki, Y. Taki), Institute of Development, Aging and Cancer, Tohoku University, Sendai; Department of Social Medicine (S.N.), Graduate School of Medicine, Hirosaki University; Division of Neurology and Gerontology (T.M.), Department of Internal Medicine, School of Medicine, Iwate Medical University, Yahaba; Department of Neurology (K.O.), Kanazawa University Graduate School of Medical Sciences, Kanazawa University; Department of Neuropsychiatry (M.M.), Keio University School of Medicine, Tokyo; National Hospital Organization (K.N.), Matsue Medical Center; Department of Neuropsychiatry (J.I.), Ehime University Graduate School of Medicine, Ehime University, Matsuyama; and Department of Neuropsychiatry (M.T.), Faculty of Life Sciences, Kumamoto University, Japan
| | - Kenjiro Ono
- From the Department of Epidemiology and Public Health (N.H., T.H., J.H., Y.F., M.S., T.O., T.N.), Department of Psychosomatic Medicine (N.H., M.S.), Ito Clinic (N.H.), Center for Cohort Studies (T.H., J.H., M.S., T.N.), Department of Medicine and Clinical Science (J.H., Y.F.), and Department of Neuropsychiatry (T.O.), Graduate School of Medical Sciences, Kyushu University, Fukuoka; Department of Aging Research and Geriatric Medicine (Y. Tatewaki, Y. Taki), Institute of Development, Aging and Cancer, Tohoku University, Sendai; Department of Social Medicine (S.N.), Graduate School of Medicine, Hirosaki University; Division of Neurology and Gerontology (T.M.), Department of Internal Medicine, School of Medicine, Iwate Medical University, Yahaba; Department of Neurology (K.O.), Kanazawa University Graduate School of Medical Sciences, Kanazawa University; Department of Neuropsychiatry (M.M.), Keio University School of Medicine, Tokyo; National Hospital Organization (K.N.), Matsue Medical Center; Department of Neuropsychiatry (J.I.), Ehime University Graduate School of Medicine, Ehime University, Matsuyama; and Department of Neuropsychiatry (M.T.), Faculty of Life Sciences, Kumamoto University, Japan
| | - Masaru Mimura
- From the Department of Epidemiology and Public Health (N.H., T.H., J.H., Y.F., M.S., T.O., T.N.), Department of Psychosomatic Medicine (N.H., M.S.), Ito Clinic (N.H.), Center for Cohort Studies (T.H., J.H., M.S., T.N.), Department of Medicine and Clinical Science (J.H., Y.F.), and Department of Neuropsychiatry (T.O.), Graduate School of Medical Sciences, Kyushu University, Fukuoka; Department of Aging Research and Geriatric Medicine (Y. Tatewaki, Y. Taki), Institute of Development, Aging and Cancer, Tohoku University, Sendai; Department of Social Medicine (S.N.), Graduate School of Medicine, Hirosaki University; Division of Neurology and Gerontology (T.M.), Department of Internal Medicine, School of Medicine, Iwate Medical University, Yahaba; Department of Neurology (K.O.), Kanazawa University Graduate School of Medical Sciences, Kanazawa University; Department of Neuropsychiatry (M.M.), Keio University School of Medicine, Tokyo; National Hospital Organization (K.N.), Matsue Medical Center; Department of Neuropsychiatry (J.I.), Ehime University Graduate School of Medicine, Ehime University, Matsuyama; and Department of Neuropsychiatry (M.T.), Faculty of Life Sciences, Kumamoto University, Japan
| | - Kenji Nakashima
- From the Department of Epidemiology and Public Health (N.H., T.H., J.H., Y.F., M.S., T.O., T.N.), Department of Psychosomatic Medicine (N.H., M.S.), Ito Clinic (N.H.), Center for Cohort Studies (T.H., J.H., M.S., T.N.), Department of Medicine and Clinical Science (J.H., Y.F.), and Department of Neuropsychiatry (T.O.), Graduate School of Medical Sciences, Kyushu University, Fukuoka; Department of Aging Research and Geriatric Medicine (Y. Tatewaki, Y. Taki), Institute of Development, Aging and Cancer, Tohoku University, Sendai; Department of Social Medicine (S.N.), Graduate School of Medicine, Hirosaki University; Division of Neurology and Gerontology (T.M.), Department of Internal Medicine, School of Medicine, Iwate Medical University, Yahaba; Department of Neurology (K.O.), Kanazawa University Graduate School of Medical Sciences, Kanazawa University; Department of Neuropsychiatry (M.M.), Keio University School of Medicine, Tokyo; National Hospital Organization (K.N.), Matsue Medical Center; Department of Neuropsychiatry (J.I.), Ehime University Graduate School of Medicine, Ehime University, Matsuyama; and Department of Neuropsychiatry (M.T.), Faculty of Life Sciences, Kumamoto University, Japan
| | - Jun-Ichi Iga
- From the Department of Epidemiology and Public Health (N.H., T.H., J.H., Y.F., M.S., T.O., T.N.), Department of Psychosomatic Medicine (N.H., M.S.), Ito Clinic (N.H.), Center for Cohort Studies (T.H., J.H., M.S., T.N.), Department of Medicine and Clinical Science (J.H., Y.F.), and Department of Neuropsychiatry (T.O.), Graduate School of Medical Sciences, Kyushu University, Fukuoka; Department of Aging Research and Geriatric Medicine (Y. Tatewaki, Y. Taki), Institute of Development, Aging and Cancer, Tohoku University, Sendai; Department of Social Medicine (S.N.), Graduate School of Medicine, Hirosaki University; Division of Neurology and Gerontology (T.M.), Department of Internal Medicine, School of Medicine, Iwate Medical University, Yahaba; Department of Neurology (K.O.), Kanazawa University Graduate School of Medical Sciences, Kanazawa University; Department of Neuropsychiatry (M.M.), Keio University School of Medicine, Tokyo; National Hospital Organization (K.N.), Matsue Medical Center; Department of Neuropsychiatry (J.I.), Ehime University Graduate School of Medicine, Ehime University, Matsuyama; and Department of Neuropsychiatry (M.T.), Faculty of Life Sciences, Kumamoto University, Japan
| | - Minoru Takebayashi
- From the Department of Epidemiology and Public Health (N.H., T.H., J.H., Y.F., M.S., T.O., T.N.), Department of Psychosomatic Medicine (N.H., M.S.), Ito Clinic (N.H.), Center for Cohort Studies (T.H., J.H., M.S., T.N.), Department of Medicine and Clinical Science (J.H., Y.F.), and Department of Neuropsychiatry (T.O.), Graduate School of Medical Sciences, Kyushu University, Fukuoka; Department of Aging Research and Geriatric Medicine (Y. Tatewaki, Y. Taki), Institute of Development, Aging and Cancer, Tohoku University, Sendai; Department of Social Medicine (S.N.), Graduate School of Medicine, Hirosaki University; Division of Neurology and Gerontology (T.M.), Department of Internal Medicine, School of Medicine, Iwate Medical University, Yahaba; Department of Neurology (K.O.), Kanazawa University Graduate School of Medical Sciences, Kanazawa University; Department of Neuropsychiatry (M.M.), Keio University School of Medicine, Tokyo; National Hospital Organization (K.N.), Matsue Medical Center; Department of Neuropsychiatry (J.I.), Ehime University Graduate School of Medicine, Ehime University, Matsuyama; and Department of Neuropsychiatry (M.T.), Faculty of Life Sciences, Kumamoto University, Japan
| | - Toshiharu Ninomiya
- From the Department of Epidemiology and Public Health (N.H., T.H., J.H., Y.F., M.S., T.O., T.N.), Department of Psychosomatic Medicine (N.H., M.S.), Ito Clinic (N.H.), Center for Cohort Studies (T.H., J.H., M.S., T.N.), Department of Medicine and Clinical Science (J.H., Y.F.), and Department of Neuropsychiatry (T.O.), Graduate School of Medical Sciences, Kyushu University, Fukuoka; Department of Aging Research and Geriatric Medicine (Y. Tatewaki, Y. Taki), Institute of Development, Aging and Cancer, Tohoku University, Sendai; Department of Social Medicine (S.N.), Graduate School of Medicine, Hirosaki University; Division of Neurology and Gerontology (T.M.), Department of Internal Medicine, School of Medicine, Iwate Medical University, Yahaba; Department of Neurology (K.O.), Kanazawa University Graduate School of Medical Sciences, Kanazawa University; Department of Neuropsychiatry (M.M.), Keio University School of Medicine, Tokyo; National Hospital Organization (K.N.), Matsue Medical Center; Department of Neuropsychiatry (J.I.), Ehime University Graduate School of Medicine, Ehime University, Matsuyama; and Department of Neuropsychiatry (M.T.), Faculty of Life Sciences, Kumamoto University, Japan.
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Yamaguchi S, Murakami T, Satoh M, Komiyama T, Ohi T, Miyoshi Y, Endo K, Hiratsuka T, Hara A, Tatsumi Y, Totsune T, Asayama K, Kikuya M, Nomura K, Hozawa A, Metoki H, Imai Y, Watanabe M, Ohkubo T, Hattori Y. Associations of Dental Health With the Progression of Hippocampal Atrophy in Community-Dwelling Individuals: The Ohasama Study. Neurology 2023; 101:e1056-e1068. [PMID: 37407259 PMCID: PMC10491442 DOI: 10.1212/wnl.0000000000207579] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Accepted: 05/10/2023] [Indexed: 07/07/2023] Open
Abstract
BACKGROUND AND OBJECTIVES Although tooth loss and periodontitis have been considered risk factors of Alzheimer disease, recent longitudinal researches have not found a significant association with hippocampal atrophy. Therefore, this study aimed to clarify a longitudinal association between the number of teeth present (NTP) and hippocampal atrophy dependent on the severity of periodontitis in a late middle-aged and older adult population. METHODS This study included community-dwelling individuals aged 55 years or older who had no cognitive decline and had undergone brain MRI and oral and systemic data collection twice at 4-year intervals. Hippocampal volumes were obtained from MRIs by automated region-of-interest analysis. The mean periodontal probing depth (PD) was used as a measure of periodontitis. Multiple regression analysis was performed with the annual symmetric percentage change (SPC) of the hippocampal volume as the dependent variable and including an interaction term between NTP and mean PD as the independent variable. The interaction details were examined using the Johnson-Neyman technique and simple slope analysis. The 3-way interaction of NTP, mean PD, and time on hippocampal volume was analyzed using a linear mixed-effects model, and the interaction of NTP and time was examined in subgroups divided by the median mean PD. In all models, dropout bias was adjusted by inverse probability weighting. RESULTS Data of 172 participants were analyzed. The qualitative interaction between NTP and the mean PD was significant for the annual SPC in the left hippocampus. The regression coefficient of the NTP on the annual SPC in the left hippocampus was positive (B = 0.038, p = 0.026) at the low-level mean PD (mean -1 SD) and negative (B = -0.054, p = 0.001) at the high-level mean PD (mean +1 SD). Similar results were obtained in the linear mixed-effects model; the interaction of NTP and time was significant in the higher mean PD group. DISCUSSION In a late middle-aged and older cohort, fewer teeth were associated with a faster rate of left hippocampal atrophy in patients with mild periodontitis, whereas having more teeth was associated with a faster rate of atrophy in those with severe periodontitis. The importance of keeping teeth healthy is suggested.
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Affiliation(s)
- Satoshi Yamaguchi
- From the Division of Aging and Geriatric Dentistry (S.Y., T.M., T.K., T. Ohi, Y.M., K.E., T.H., Y.H.), Department of Rehabilitation Dentistry, Tohoku University Graduate School of Dentistry; Division of Public Health, Hygiene and Epidemiology (T.M., M.S., H.M.), Faculty of Medicine, Tohoku Medical and Pharmaceutical University; Department of Preventive Medicine and Epidemiology (T.M., M.S., M.K., A. Hozawa, H.M.), Tohoku Medical Megabank Organization, Tohoku University, Sendai; Japanese Red Cross Ishinomaki Hospital (T. Ohi); Division of Drug Development and Regulatory Science (A. Hara), Faculty of Pharmacy, Keio University; Department of Hygiene and Public Health (Y.T., K.A., M.K., T. Ohkubo), Teikyo University School of Medicine, Tokyo; Department of Neurology (T.T.), National Hospital Organization Sendai Nishitaga Hospital; Department of Aging Research and Geriatric Medicine (T.T.), Institute of Development, Aging and Cancer, Tohoku University; Tohoku Institute for Management of Blood Pressure (K.A., H.M., Y.I., T. Ohkubo), Sendai, Miyagi; Department of Environmental Health Science and Public Health (K.N.), Akita University Graduate School of Medicine; and Research Institute of Living and Environmental Sciences (M.W.), Miyagi Gakuin Women's University, Sendai, Japan.
| | - Takahisa Murakami
- From the Division of Aging and Geriatric Dentistry (S.Y., T.M., T.K., T. Ohi, Y.M., K.E., T.H., Y.H.), Department of Rehabilitation Dentistry, Tohoku University Graduate School of Dentistry; Division of Public Health, Hygiene and Epidemiology (T.M., M.S., H.M.), Faculty of Medicine, Tohoku Medical and Pharmaceutical University; Department of Preventive Medicine and Epidemiology (T.M., M.S., M.K., A. Hozawa, H.M.), Tohoku Medical Megabank Organization, Tohoku University, Sendai; Japanese Red Cross Ishinomaki Hospital (T. Ohi); Division of Drug Development and Regulatory Science (A. Hara), Faculty of Pharmacy, Keio University; Department of Hygiene and Public Health (Y.T., K.A., M.K., T. Ohkubo), Teikyo University School of Medicine, Tokyo; Department of Neurology (T.T.), National Hospital Organization Sendai Nishitaga Hospital; Department of Aging Research and Geriatric Medicine (T.T.), Institute of Development, Aging and Cancer, Tohoku University; Tohoku Institute for Management of Blood Pressure (K.A., H.M., Y.I., T. Ohkubo), Sendai, Miyagi; Department of Environmental Health Science and Public Health (K.N.), Akita University Graduate School of Medicine; and Research Institute of Living and Environmental Sciences (M.W.), Miyagi Gakuin Women's University, Sendai, Japan
| | - Michihiro Satoh
- From the Division of Aging and Geriatric Dentistry (S.Y., T.M., T.K., T. Ohi, Y.M., K.E., T.H., Y.H.), Department of Rehabilitation Dentistry, Tohoku University Graduate School of Dentistry; Division of Public Health, Hygiene and Epidemiology (T.M., M.S., H.M.), Faculty of Medicine, Tohoku Medical and Pharmaceutical University; Department of Preventive Medicine and Epidemiology (T.M., M.S., M.K., A. Hozawa, H.M.), Tohoku Medical Megabank Organization, Tohoku University, Sendai; Japanese Red Cross Ishinomaki Hospital (T. Ohi); Division of Drug Development and Regulatory Science (A. Hara), Faculty of Pharmacy, Keio University; Department of Hygiene and Public Health (Y.T., K.A., M.K., T. Ohkubo), Teikyo University School of Medicine, Tokyo; Department of Neurology (T.T.), National Hospital Organization Sendai Nishitaga Hospital; Department of Aging Research and Geriatric Medicine (T.T.), Institute of Development, Aging and Cancer, Tohoku University; Tohoku Institute for Management of Blood Pressure (K.A., H.M., Y.I., T. Ohkubo), Sendai, Miyagi; Department of Environmental Health Science and Public Health (K.N.), Akita University Graduate School of Medicine; and Research Institute of Living and Environmental Sciences (M.W.), Miyagi Gakuin Women's University, Sendai, Japan
| | - Takamasa Komiyama
- From the Division of Aging and Geriatric Dentistry (S.Y., T.M., T.K., T. Ohi, Y.M., K.E., T.H., Y.H.), Department of Rehabilitation Dentistry, Tohoku University Graduate School of Dentistry; Division of Public Health, Hygiene and Epidemiology (T.M., M.S., H.M.), Faculty of Medicine, Tohoku Medical and Pharmaceutical University; Department of Preventive Medicine and Epidemiology (T.M., M.S., M.K., A. Hozawa, H.M.), Tohoku Medical Megabank Organization, Tohoku University, Sendai; Japanese Red Cross Ishinomaki Hospital (T. Ohi); Division of Drug Development and Regulatory Science (A. Hara), Faculty of Pharmacy, Keio University; Department of Hygiene and Public Health (Y.T., K.A., M.K., T. Ohkubo), Teikyo University School of Medicine, Tokyo; Department of Neurology (T.T.), National Hospital Organization Sendai Nishitaga Hospital; Department of Aging Research and Geriatric Medicine (T.T.), Institute of Development, Aging and Cancer, Tohoku University; Tohoku Institute for Management of Blood Pressure (K.A., H.M., Y.I., T. Ohkubo), Sendai, Miyagi; Department of Environmental Health Science and Public Health (K.N.), Akita University Graduate School of Medicine; and Research Institute of Living and Environmental Sciences (M.W.), Miyagi Gakuin Women's University, Sendai, Japan
| | - Takashi Ohi
- From the Division of Aging and Geriatric Dentistry (S.Y., T.M., T.K., T. Ohi, Y.M., K.E., T.H., Y.H.), Department of Rehabilitation Dentistry, Tohoku University Graduate School of Dentistry; Division of Public Health, Hygiene and Epidemiology (T.M., M.S., H.M.), Faculty of Medicine, Tohoku Medical and Pharmaceutical University; Department of Preventive Medicine and Epidemiology (T.M., M.S., M.K., A. Hozawa, H.M.), Tohoku Medical Megabank Organization, Tohoku University, Sendai; Japanese Red Cross Ishinomaki Hospital (T. Ohi); Division of Drug Development and Regulatory Science (A. Hara), Faculty of Pharmacy, Keio University; Department of Hygiene and Public Health (Y.T., K.A., M.K., T. Ohkubo), Teikyo University School of Medicine, Tokyo; Department of Neurology (T.T.), National Hospital Organization Sendai Nishitaga Hospital; Department of Aging Research and Geriatric Medicine (T.T.), Institute of Development, Aging and Cancer, Tohoku University; Tohoku Institute for Management of Blood Pressure (K.A., H.M., Y.I., T. Ohkubo), Sendai, Miyagi; Department of Environmental Health Science and Public Health (K.N.), Akita University Graduate School of Medicine; and Research Institute of Living and Environmental Sciences (M.W.), Miyagi Gakuin Women's University, Sendai, Japan
| | - Yoshitada Miyoshi
- From the Division of Aging and Geriatric Dentistry (S.Y., T.M., T.K., T. Ohi, Y.M., K.E., T.H., Y.H.), Department of Rehabilitation Dentistry, Tohoku University Graduate School of Dentistry; Division of Public Health, Hygiene and Epidemiology (T.M., M.S., H.M.), Faculty of Medicine, Tohoku Medical and Pharmaceutical University; Department of Preventive Medicine and Epidemiology (T.M., M.S., M.K., A. Hozawa, H.M.), Tohoku Medical Megabank Organization, Tohoku University, Sendai; Japanese Red Cross Ishinomaki Hospital (T. Ohi); Division of Drug Development and Regulatory Science (A. Hara), Faculty of Pharmacy, Keio University; Department of Hygiene and Public Health (Y.T., K.A., M.K., T. Ohkubo), Teikyo University School of Medicine, Tokyo; Department of Neurology (T.T.), National Hospital Organization Sendai Nishitaga Hospital; Department of Aging Research and Geriatric Medicine (T.T.), Institute of Development, Aging and Cancer, Tohoku University; Tohoku Institute for Management of Blood Pressure (K.A., H.M., Y.I., T. Ohkubo), Sendai, Miyagi; Department of Environmental Health Science and Public Health (K.N.), Akita University Graduate School of Medicine; and Research Institute of Living and Environmental Sciences (M.W.), Miyagi Gakuin Women's University, Sendai, Japan
| | - Kosei Endo
- From the Division of Aging and Geriatric Dentistry (S.Y., T.M., T.K., T. Ohi, Y.M., K.E., T.H., Y.H.), Department of Rehabilitation Dentistry, Tohoku University Graduate School of Dentistry; Division of Public Health, Hygiene and Epidemiology (T.M., M.S., H.M.), Faculty of Medicine, Tohoku Medical and Pharmaceutical University; Department of Preventive Medicine and Epidemiology (T.M., M.S., M.K., A. Hozawa, H.M.), Tohoku Medical Megabank Organization, Tohoku University, Sendai; Japanese Red Cross Ishinomaki Hospital (T. Ohi); Division of Drug Development and Regulatory Science (A. Hara), Faculty of Pharmacy, Keio University; Department of Hygiene and Public Health (Y.T., K.A., M.K., T. Ohkubo), Teikyo University School of Medicine, Tokyo; Department of Neurology (T.T.), National Hospital Organization Sendai Nishitaga Hospital; Department of Aging Research and Geriatric Medicine (T.T.), Institute of Development, Aging and Cancer, Tohoku University; Tohoku Institute for Management of Blood Pressure (K.A., H.M., Y.I., T. Ohkubo), Sendai, Miyagi; Department of Environmental Health Science and Public Health (K.N.), Akita University Graduate School of Medicine; and Research Institute of Living and Environmental Sciences (M.W.), Miyagi Gakuin Women's University, Sendai, Japan
| | - Takako Hiratsuka
- From the Division of Aging and Geriatric Dentistry (S.Y., T.M., T.K., T. Ohi, Y.M., K.E., T.H., Y.H.), Department of Rehabilitation Dentistry, Tohoku University Graduate School of Dentistry; Division of Public Health, Hygiene and Epidemiology (T.M., M.S., H.M.), Faculty of Medicine, Tohoku Medical and Pharmaceutical University; Department of Preventive Medicine and Epidemiology (T.M., M.S., M.K., A. Hozawa, H.M.), Tohoku Medical Megabank Organization, Tohoku University, Sendai; Japanese Red Cross Ishinomaki Hospital (T. Ohi); Division of Drug Development and Regulatory Science (A. Hara), Faculty of Pharmacy, Keio University; Department of Hygiene and Public Health (Y.T., K.A., M.K., T. Ohkubo), Teikyo University School of Medicine, Tokyo; Department of Neurology (T.T.), National Hospital Organization Sendai Nishitaga Hospital; Department of Aging Research and Geriatric Medicine (T.T.), Institute of Development, Aging and Cancer, Tohoku University; Tohoku Institute for Management of Blood Pressure (K.A., H.M., Y.I., T. Ohkubo), Sendai, Miyagi; Department of Environmental Health Science and Public Health (K.N.), Akita University Graduate School of Medicine; and Research Institute of Living and Environmental Sciences (M.W.), Miyagi Gakuin Women's University, Sendai, Japan
| | - Azusa Hara
- From the Division of Aging and Geriatric Dentistry (S.Y., T.M., T.K., T. Ohi, Y.M., K.E., T.H., Y.H.), Department of Rehabilitation Dentistry, Tohoku University Graduate School of Dentistry; Division of Public Health, Hygiene and Epidemiology (T.M., M.S., H.M.), Faculty of Medicine, Tohoku Medical and Pharmaceutical University; Department of Preventive Medicine and Epidemiology (T.M., M.S., M.K., A. Hozawa, H.M.), Tohoku Medical Megabank Organization, Tohoku University, Sendai; Japanese Red Cross Ishinomaki Hospital (T. Ohi); Division of Drug Development and Regulatory Science (A. Hara), Faculty of Pharmacy, Keio University; Department of Hygiene and Public Health (Y.T., K.A., M.K., T. Ohkubo), Teikyo University School of Medicine, Tokyo; Department of Neurology (T.T.), National Hospital Organization Sendai Nishitaga Hospital; Department of Aging Research and Geriatric Medicine (T.T.), Institute of Development, Aging and Cancer, Tohoku University; Tohoku Institute for Management of Blood Pressure (K.A., H.M., Y.I., T. Ohkubo), Sendai, Miyagi; Department of Environmental Health Science and Public Health (K.N.), Akita University Graduate School of Medicine; and Research Institute of Living and Environmental Sciences (M.W.), Miyagi Gakuin Women's University, Sendai, Japan
| | - Yukako Tatsumi
- From the Division of Aging and Geriatric Dentistry (S.Y., T.M., T.K., T. Ohi, Y.M., K.E., T.H., Y.H.), Department of Rehabilitation Dentistry, Tohoku University Graduate School of Dentistry; Division of Public Health, Hygiene and Epidemiology (T.M., M.S., H.M.), Faculty of Medicine, Tohoku Medical and Pharmaceutical University; Department of Preventive Medicine and Epidemiology (T.M., M.S., M.K., A. Hozawa, H.M.), Tohoku Medical Megabank Organization, Tohoku University, Sendai; Japanese Red Cross Ishinomaki Hospital (T. Ohi); Division of Drug Development and Regulatory Science (A. Hara), Faculty of Pharmacy, Keio University; Department of Hygiene and Public Health (Y.T., K.A., M.K., T. Ohkubo), Teikyo University School of Medicine, Tokyo; Department of Neurology (T.T.), National Hospital Organization Sendai Nishitaga Hospital; Department of Aging Research and Geriatric Medicine (T.T.), Institute of Development, Aging and Cancer, Tohoku University; Tohoku Institute for Management of Blood Pressure (K.A., H.M., Y.I., T. Ohkubo), Sendai, Miyagi; Department of Environmental Health Science and Public Health (K.N.), Akita University Graduate School of Medicine; and Research Institute of Living and Environmental Sciences (M.W.), Miyagi Gakuin Women's University, Sendai, Japan
| | - Tomoko Totsune
- From the Division of Aging and Geriatric Dentistry (S.Y., T.M., T.K., T. Ohi, Y.M., K.E., T.H., Y.H.), Department of Rehabilitation Dentistry, Tohoku University Graduate School of Dentistry; Division of Public Health, Hygiene and Epidemiology (T.M., M.S., H.M.), Faculty of Medicine, Tohoku Medical and Pharmaceutical University; Department of Preventive Medicine and Epidemiology (T.M., M.S., M.K., A. Hozawa, H.M.), Tohoku Medical Megabank Organization, Tohoku University, Sendai; Japanese Red Cross Ishinomaki Hospital (T. Ohi); Division of Drug Development and Regulatory Science (A. Hara), Faculty of Pharmacy, Keio University; Department of Hygiene and Public Health (Y.T., K.A., M.K., T. Ohkubo), Teikyo University School of Medicine, Tokyo; Department of Neurology (T.T.), National Hospital Organization Sendai Nishitaga Hospital; Department of Aging Research and Geriatric Medicine (T.T.), Institute of Development, Aging and Cancer, Tohoku University; Tohoku Institute for Management of Blood Pressure (K.A., H.M., Y.I., T. Ohkubo), Sendai, Miyagi; Department of Environmental Health Science and Public Health (K.N.), Akita University Graduate School of Medicine; and Research Institute of Living and Environmental Sciences (M.W.), Miyagi Gakuin Women's University, Sendai, Japan
| | - Kei Asayama
- From the Division of Aging and Geriatric Dentistry (S.Y., T.M., T.K., T. Ohi, Y.M., K.E., T.H., Y.H.), Department of Rehabilitation Dentistry, Tohoku University Graduate School of Dentistry; Division of Public Health, Hygiene and Epidemiology (T.M., M.S., H.M.), Faculty of Medicine, Tohoku Medical and Pharmaceutical University; Department of Preventive Medicine and Epidemiology (T.M., M.S., M.K., A. Hozawa, H.M.), Tohoku Medical Megabank Organization, Tohoku University, Sendai; Japanese Red Cross Ishinomaki Hospital (T. Ohi); Division of Drug Development and Regulatory Science (A. Hara), Faculty of Pharmacy, Keio University; Department of Hygiene and Public Health (Y.T., K.A., M.K., T. Ohkubo), Teikyo University School of Medicine, Tokyo; Department of Neurology (T.T.), National Hospital Organization Sendai Nishitaga Hospital; Department of Aging Research and Geriatric Medicine (T.T.), Institute of Development, Aging and Cancer, Tohoku University; Tohoku Institute for Management of Blood Pressure (K.A., H.M., Y.I., T. Ohkubo), Sendai, Miyagi; Department of Environmental Health Science and Public Health (K.N.), Akita University Graduate School of Medicine; and Research Institute of Living and Environmental Sciences (M.W.), Miyagi Gakuin Women's University, Sendai, Japan
| | - Masahiro Kikuya
- From the Division of Aging and Geriatric Dentistry (S.Y., T.M., T.K., T. Ohi, Y.M., K.E., T.H., Y.H.), Department of Rehabilitation Dentistry, Tohoku University Graduate School of Dentistry; Division of Public Health, Hygiene and Epidemiology (T.M., M.S., H.M.), Faculty of Medicine, Tohoku Medical and Pharmaceutical University; Department of Preventive Medicine and Epidemiology (T.M., M.S., M.K., A. Hozawa, H.M.), Tohoku Medical Megabank Organization, Tohoku University, Sendai; Japanese Red Cross Ishinomaki Hospital (T. Ohi); Division of Drug Development and Regulatory Science (A. Hara), Faculty of Pharmacy, Keio University; Department of Hygiene and Public Health (Y.T., K.A., M.K., T. Ohkubo), Teikyo University School of Medicine, Tokyo; Department of Neurology (T.T.), National Hospital Organization Sendai Nishitaga Hospital; Department of Aging Research and Geriatric Medicine (T.T.), Institute of Development, Aging and Cancer, Tohoku University; Tohoku Institute for Management of Blood Pressure (K.A., H.M., Y.I., T. Ohkubo), Sendai, Miyagi; Department of Environmental Health Science and Public Health (K.N.), Akita University Graduate School of Medicine; and Research Institute of Living and Environmental Sciences (M.W.), Miyagi Gakuin Women's University, Sendai, Japan
| | - Kyoko Nomura
- From the Division of Aging and Geriatric Dentistry (S.Y., T.M., T.K., T. Ohi, Y.M., K.E., T.H., Y.H.), Department of Rehabilitation Dentistry, Tohoku University Graduate School of Dentistry; Division of Public Health, Hygiene and Epidemiology (T.M., M.S., H.M.), Faculty of Medicine, Tohoku Medical and Pharmaceutical University; Department of Preventive Medicine and Epidemiology (T.M., M.S., M.K., A. Hozawa, H.M.), Tohoku Medical Megabank Organization, Tohoku University, Sendai; Japanese Red Cross Ishinomaki Hospital (T. Ohi); Division of Drug Development and Regulatory Science (A. Hara), Faculty of Pharmacy, Keio University; Department of Hygiene and Public Health (Y.T., K.A., M.K., T. Ohkubo), Teikyo University School of Medicine, Tokyo; Department of Neurology (T.T.), National Hospital Organization Sendai Nishitaga Hospital; Department of Aging Research and Geriatric Medicine (T.T.), Institute of Development, Aging and Cancer, Tohoku University; Tohoku Institute for Management of Blood Pressure (K.A., H.M., Y.I., T. Ohkubo), Sendai, Miyagi; Department of Environmental Health Science and Public Health (K.N.), Akita University Graduate School of Medicine; and Research Institute of Living and Environmental Sciences (M.W.), Miyagi Gakuin Women's University, Sendai, Japan
| | - Atsushi Hozawa
- From the Division of Aging and Geriatric Dentistry (S.Y., T.M., T.K., T. Ohi, Y.M., K.E., T.H., Y.H.), Department of Rehabilitation Dentistry, Tohoku University Graduate School of Dentistry; Division of Public Health, Hygiene and Epidemiology (T.M., M.S., H.M.), Faculty of Medicine, Tohoku Medical and Pharmaceutical University; Department of Preventive Medicine and Epidemiology (T.M., M.S., M.K., A. Hozawa, H.M.), Tohoku Medical Megabank Organization, Tohoku University, Sendai; Japanese Red Cross Ishinomaki Hospital (T. Ohi); Division of Drug Development and Regulatory Science (A. Hara), Faculty of Pharmacy, Keio University; Department of Hygiene and Public Health (Y.T., K.A., M.K., T. Ohkubo), Teikyo University School of Medicine, Tokyo; Department of Neurology (T.T.), National Hospital Organization Sendai Nishitaga Hospital; Department of Aging Research and Geriatric Medicine (T.T.), Institute of Development, Aging and Cancer, Tohoku University; Tohoku Institute for Management of Blood Pressure (K.A., H.M., Y.I., T. Ohkubo), Sendai, Miyagi; Department of Environmental Health Science and Public Health (K.N.), Akita University Graduate School of Medicine; and Research Institute of Living and Environmental Sciences (M.W.), Miyagi Gakuin Women's University, Sendai, Japan
| | - Hirohito Metoki
- From the Division of Aging and Geriatric Dentistry (S.Y., T.M., T.K., T. Ohi, Y.M., K.E., T.H., Y.H.), Department of Rehabilitation Dentistry, Tohoku University Graduate School of Dentistry; Division of Public Health, Hygiene and Epidemiology (T.M., M.S., H.M.), Faculty of Medicine, Tohoku Medical and Pharmaceutical University; Department of Preventive Medicine and Epidemiology (T.M., M.S., M.K., A. Hozawa, H.M.), Tohoku Medical Megabank Organization, Tohoku University, Sendai; Japanese Red Cross Ishinomaki Hospital (T. Ohi); Division of Drug Development and Regulatory Science (A. Hara), Faculty of Pharmacy, Keio University; Department of Hygiene and Public Health (Y.T., K.A., M.K., T. Ohkubo), Teikyo University School of Medicine, Tokyo; Department of Neurology (T.T.), National Hospital Organization Sendai Nishitaga Hospital; Department of Aging Research and Geriatric Medicine (T.T.), Institute of Development, Aging and Cancer, Tohoku University; Tohoku Institute for Management of Blood Pressure (K.A., H.M., Y.I., T. Ohkubo), Sendai, Miyagi; Department of Environmental Health Science and Public Health (K.N.), Akita University Graduate School of Medicine; and Research Institute of Living and Environmental Sciences (M.W.), Miyagi Gakuin Women's University, Sendai, Japan
| | - Yutaka Imai
- From the Division of Aging and Geriatric Dentistry (S.Y., T.M., T.K., T. Ohi, Y.M., K.E., T.H., Y.H.), Department of Rehabilitation Dentistry, Tohoku University Graduate School of Dentistry; Division of Public Health, Hygiene and Epidemiology (T.M., M.S., H.M.), Faculty of Medicine, Tohoku Medical and Pharmaceutical University; Department of Preventive Medicine and Epidemiology (T.M., M.S., M.K., A. Hozawa, H.M.), Tohoku Medical Megabank Organization, Tohoku University, Sendai; Japanese Red Cross Ishinomaki Hospital (T. Ohi); Division of Drug Development and Regulatory Science (A. Hara), Faculty of Pharmacy, Keio University; Department of Hygiene and Public Health (Y.T., K.A., M.K., T. Ohkubo), Teikyo University School of Medicine, Tokyo; Department of Neurology (T.T.), National Hospital Organization Sendai Nishitaga Hospital; Department of Aging Research and Geriatric Medicine (T.T.), Institute of Development, Aging and Cancer, Tohoku University; Tohoku Institute for Management of Blood Pressure (K.A., H.M., Y.I., T. Ohkubo), Sendai, Miyagi; Department of Environmental Health Science and Public Health (K.N.), Akita University Graduate School of Medicine; and Research Institute of Living and Environmental Sciences (M.W.), Miyagi Gakuin Women's University, Sendai, Japan
| | - Makoto Watanabe
- From the Division of Aging and Geriatric Dentistry (S.Y., T.M., T.K., T. Ohi, Y.M., K.E., T.H., Y.H.), Department of Rehabilitation Dentistry, Tohoku University Graduate School of Dentistry; Division of Public Health, Hygiene and Epidemiology (T.M., M.S., H.M.), Faculty of Medicine, Tohoku Medical and Pharmaceutical University; Department of Preventive Medicine and Epidemiology (T.M., M.S., M.K., A. Hozawa, H.M.), Tohoku Medical Megabank Organization, Tohoku University, Sendai; Japanese Red Cross Ishinomaki Hospital (T. Ohi); Division of Drug Development and Regulatory Science (A. Hara), Faculty of Pharmacy, Keio University; Department of Hygiene and Public Health (Y.T., K.A., M.K., T. Ohkubo), Teikyo University School of Medicine, Tokyo; Department of Neurology (T.T.), National Hospital Organization Sendai Nishitaga Hospital; Department of Aging Research and Geriatric Medicine (T.T.), Institute of Development, Aging and Cancer, Tohoku University; Tohoku Institute for Management of Blood Pressure (K.A., H.M., Y.I., T. Ohkubo), Sendai, Miyagi; Department of Environmental Health Science and Public Health (K.N.), Akita University Graduate School of Medicine; and Research Institute of Living and Environmental Sciences (M.W.), Miyagi Gakuin Women's University, Sendai, Japan
| | - Takayoshi Ohkubo
- From the Division of Aging and Geriatric Dentistry (S.Y., T.M., T.K., T. Ohi, Y.M., K.E., T.H., Y.H.), Department of Rehabilitation Dentistry, Tohoku University Graduate School of Dentistry; Division of Public Health, Hygiene and Epidemiology (T.M., M.S., H.M.), Faculty of Medicine, Tohoku Medical and Pharmaceutical University; Department of Preventive Medicine and Epidemiology (T.M., M.S., M.K., A. Hozawa, H.M.), Tohoku Medical Megabank Organization, Tohoku University, Sendai; Japanese Red Cross Ishinomaki Hospital (T. Ohi); Division of Drug Development and Regulatory Science (A. Hara), Faculty of Pharmacy, Keio University; Department of Hygiene and Public Health (Y.T., K.A., M.K., T. Ohkubo), Teikyo University School of Medicine, Tokyo; Department of Neurology (T.T.), National Hospital Organization Sendai Nishitaga Hospital; Department of Aging Research and Geriatric Medicine (T.T.), Institute of Development, Aging and Cancer, Tohoku University; Tohoku Institute for Management of Blood Pressure (K.A., H.M., Y.I., T. Ohkubo), Sendai, Miyagi; Department of Environmental Health Science and Public Health (K.N.), Akita University Graduate School of Medicine; and Research Institute of Living and Environmental Sciences (M.W.), Miyagi Gakuin Women's University, Sendai, Japan
| | - Yoshinori Hattori
- From the Division of Aging and Geriatric Dentistry (S.Y., T.M., T.K., T. Ohi, Y.M., K.E., T.H., Y.H.), Department of Rehabilitation Dentistry, Tohoku University Graduate School of Dentistry; Division of Public Health, Hygiene and Epidemiology (T.M., M.S., H.M.), Faculty of Medicine, Tohoku Medical and Pharmaceutical University; Department of Preventive Medicine and Epidemiology (T.M., M.S., M.K., A. Hozawa, H.M.), Tohoku Medical Megabank Organization, Tohoku University, Sendai; Japanese Red Cross Ishinomaki Hospital (T. Ohi); Division of Drug Development and Regulatory Science (A. Hara), Faculty of Pharmacy, Keio University; Department of Hygiene and Public Health (Y.T., K.A., M.K., T. Ohkubo), Teikyo University School of Medicine, Tokyo; Department of Neurology (T.T.), National Hospital Organization Sendai Nishitaga Hospital; Department of Aging Research and Geriatric Medicine (T.T.), Institute of Development, Aging and Cancer, Tohoku University; Tohoku Institute for Management of Blood Pressure (K.A., H.M., Y.I., T. Ohkubo), Sendai, Miyagi; Department of Environmental Health Science and Public Health (K.N.), Akita University Graduate School of Medicine; and Research Institute of Living and Environmental Sciences (M.W.), Miyagi Gakuin Women's University, Sendai, Japan
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10
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Lin K, Wen W, Lipnicki DM, Mewton L, Chen R, Du J, Wang D, Skoog I, Sterner TR, Najar J, Kim KW, Han JW, Kim JS, Ng TP, Ho R, Chua DQL, Anstey KJ, Cherbuin N, Mortby ME, Brodaty H, Kochan N, Sachdev PS, Jiang J. Risk factors and cognitive correlates of white matter hyperintensities in ethnically diverse populations without dementia: the COSMIC consortium. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2023:2023.08.30.23294876. [PMID: 37693599 PMCID: PMC10491386 DOI: 10.1101/2023.08.30.23294876] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/12/2023]
Abstract
INTRODUCTION White matter hyperintensities (WMH) are an important imaging marker for cerebral small vessel diseases, but their risk factors and cognitive associations have not been well-documented in populations of different ethnicities and/or from different geographical regions. METHOD Magnetic resonance imaging data of five population-based cohorts of non-demented older individuals from Australia, Singapore, South Korea, and Sweden (N = 1,946) were examined for WMH and their associations with vascular risk factors and cognition. RESULT Factors associated with larger whole brain WMH volumes included diabetes, hypertension, stroke, current smoking, body mass index, higher alcohol intake and insufficient physical activity. Participants with moderate or higher physical activity had less WMH than those who never exercised, but the former two groups did not differ. Hypertension and stroke had stronger associations with WMH volumes in the White, compared to Asian subsample. DISCUSSION The current study highlighted the ethnic differences in the contributions of vascular risk factors to WMH.
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Affiliation(s)
- Keshuo Lin
- Centre for Healthy Brain Ageing, School of Clinical Medicine, University of New South Wales, Sydney, NSW 2052, Australia
| | - Wei Wen
- Centre for Healthy Brain Ageing, School of Clinical Medicine, University of New South Wales, Sydney, NSW 2052, Australia
| | - Darren M. Lipnicki
- Centre for Healthy Brain Ageing, School of Clinical Medicine, University of New South Wales, Sydney, NSW 2052, Australia
| | - Louise Mewton
- Centre for Healthy Brain Ageing, School of Clinical Medicine, University of New South Wales, Sydney, NSW 2052, Australia
| | - Rory Chen
- Centre for Healthy Brain Ageing, School of Clinical Medicine, University of New South Wales, Sydney, NSW 2052, Australia
| | - Jing Du
- Centre for Healthy Brain Ageing, School of Clinical Medicine, University of New South Wales, Sydney, NSW 2052, Australia
| | - Dadong Wang
- CSIRO Informatics and Statistics, Locked Bag 17, North Ryde, NSW 1670, Australia
| | - Ingmar Skoog
- Neuropsychiatric Epidemiology Unit, Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, Box 100, 405 30, at the University of Gothenburg, Sweden
- Centre for Ageing and Health (AGECAP) at the University of Gothenburg, Box 100, 405 30, Sweden
- Region Västra Götaland, Sahlgrenska University Hospital, Psychiatry, Cognition and Old Age Psychiatry Clinic, Gothenburg, Box 100, Goeteborg, Vaestra Goetaland 405 30, Sweden
| | - Therese Rydberg Sterner
- Neuropsychiatric Epidemiology Unit, Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, Box 100, 405 30, at the University of Gothenburg, Sweden
- Centre for Ageing and Health (AGECAP) at the University of Gothenburg, Box 100, 405 30, Sweden
- Aging Research Center, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet and Stockholm University, Nobels väg 6, 171 77 Stockholm, Sweden
| | - Jenna Najar
- Neuropsychiatric Epidemiology Unit, Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy, Box 100, 405 30, at the University of Gothenburg, Sweden
- Centre for Ageing and Health (AGECAP) at the University of Gothenburg, Box 100, 405 30, Sweden
- Section Genomics of Neurodegenerative Diseases and Aging, Department of Human Genetics, Amsterdam Universitair Medische Centra, PO Box 7057, 1007 MB, Amsterdam, the Netherlands
| | - Ki Woong Kim
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Gyeonggi-do 13620, Seongnam, Korea
- Department of Psychiatry, Seoul National University College of Medicine, Seoul 03080, Korea
- Department of Brain and Cognitive Sciences, Seoul National University College of Natural Sciences, Seoul 03080, Korea
| | - Ji Won Han
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Gyeonggi-do 13620, Seongnam, Korea
- Department of Psychiatry, Seoul National University College of Medicine, Seoul 03080, Korea
| | - Jun Sung Kim
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Gyeonggi-do 13620, Seongnam, Korea
| | - Tze Pin Ng
- Khoo Teck Puat Hospital, 768828, Singapore
- Geriatric Education and Research Institute, Ministry of Health, 768024, Singapore
| | - Roger Ho
- Institute for Health Innovation and Technology (iHealthtech), National University of Singapore, 119077, Singapore
| | - Denise Qian Ling Chua
- Department of Psychological Medicine, National University of Singapore, 119077, Singapore
| | - Kaarin J. Anstey
- School of Psychology, University of New South Wales, NSW 2052,Australia
- Neuroscience Research Australia, NSW 2031, Australia
- Ageing Futures Institute, University of New South Wales, NSW 2052,Australia
| | - Nicolas Cherbuin
- National Centre for Epidemiology and Population Health, College of Health and Medicine, Australian National University, ACT 2600, Canberra, Australia
| | - Moyra E. Mortby
- School of Psychology, University of New South Wales, NSW 2052,Australia
- Neuroscience Research Australia, NSW 2031, Australia
- Ageing Futures Institute, University of New South Wales, NSW 2052,Australia
| | - Henry Brodaty
- Centre for Healthy Brain Ageing, School of Clinical Medicine, University of New South Wales, Sydney, NSW 2052, Australia
| | - Nicole Kochan
- Centre for Healthy Brain Ageing, School of Clinical Medicine, University of New South Wales, Sydney, NSW 2052, Australia
| | - Perminder S. Sachdev
- Centre for Healthy Brain Ageing, School of Clinical Medicine, University of New South Wales, Sydney, NSW 2052, Australia
- Neuropsychiatric Institute, The Prince of Wales Hospital, Sydney, NSW 2031, Australia
| | - Jiyang Jiang
- Centre for Healthy Brain Ageing, School of Clinical Medicine, University of New South Wales, Sydney, NSW 2052, Australia
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11
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Li Z, Wang W, Sang F, Zhang Z, Li X. White matter changes underlie hypertension-related cognitive decline in older adults. Neuroimage Clin 2023; 38:103389. [PMID: 37004321 PMCID: PMC10102561 DOI: 10.1016/j.nicl.2023.103389] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Revised: 03/18/2023] [Accepted: 03/25/2023] [Indexed: 03/31/2023]
Abstract
Hypertension has been well recognized as a risk factor for cognitive impairment and dementia. Although the underlying mechanisms of hypertension-affected cognitive deterioration are not fully understood, white matter changes (WMCs) seem to play an important role. WMCs include low microstructural integrity and subsequent white matter macrostructural lesions, which are common on brain imaging in hypertensive patients and are critical for multiple cognitive domains. This article provides an overview of the impact of hypertension on white matter microstructural and macrostructural changes and its link to cognitive dysfunction. Hypertension may induce microstructural changes in white matter, especially for the long-range fibers such as anterior thalamic radiation (ATR) and inferior fronto-occipital fasciculus (IFOF), and then macrostructural abnormalities affecting different lobes, especially the periventricular area. Different regions' WMCs would further exert different effects to specific cognitive domains and accelerate brain aging. As a modifiable risk factor, hypertension might provide a new perspective for alleviating and delaying cognitive impairment.
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Affiliation(s)
- Zilin Li
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing 100875, China; Beijing Aging Brain Rejuvenation Initiative Centre, Beijing Normal University, Beijing 100875, China
| | - Wenxiao Wang
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing 100875, China; Beijing Aging Brain Rejuvenation Initiative Centre, Beijing Normal University, Beijing 100875, China
| | - Feng Sang
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing 100875, China; Beijing Aging Brain Rejuvenation Initiative Centre, Beijing Normal University, Beijing 100875, China
| | - Zhanjun Zhang
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing 100875, China; Beijing Aging Brain Rejuvenation Initiative Centre, Beijing Normal University, Beijing 100875, China
| | - Xin Li
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing 100875, China; Beijing Aging Brain Rejuvenation Initiative Centre, Beijing Normal University, Beijing 100875, China.
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12
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Cho MH, Han K, Lee S, Jeong SM, Yoo JE, Kim S, Lee J, Chun S, Shin DW. Blood pressure and dementia risk by physical frailty in the elderly: a nationwide cohort study. Alzheimers Res Ther 2023; 15:56. [PMID: 36941727 PMCID: PMC10026431 DOI: 10.1186/s13195-023-01211-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2022] [Accepted: 03/13/2023] [Indexed: 03/23/2023]
Abstract
BACKGROUND Midlife hypertension has been recognized as a modifiable risk factor for dementia, but association between blood pressure (BP) in late life and dementia has been inconclusive. In addition, few studies have investigated effects of BP control on dementia incidence in the frail elderly. Thus, this study aimed to investigate the association of BP and dementia incidence with concomitant consideration of physical frailty in the young elderly population. METHODS Using the Korean National Health Information Database, we identified 804,024 subjects without history of dementia at age 66. Dementia diagnosis was defined with prescription records of anti-dementia drugs and dementia-related diagnostic codes. Physical frailty was measured using the Timed Up and Go test. Association of BP and dementia incidence with concomitant consideration of physical frailty was investigated using Cox hazards analyses. RESULTS The risks of Alzheimer's and vascular dementia increased from systolic BP ≥ 160 and 130-139 mmHg, respectively; a significant association of dementia incidence with low BP was not observed. In the analyses stratified by the physical frailty status, low BP was not associated with increased risks of dementia within the groups both with and without physical frailty. CONCLUSIONS High BP was associated with increased risks of dementia, especially for vascular dementia, while low BP was not associated with increased risks of any type of dementia in young elderly people, even in those with physical frailty. This study suggests the need for tight BP control in young elderly people, irrespective of frailty status, to prevent dementia and supports the current clinical guidelines of hypertension treatment.
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Affiliation(s)
- Mi Hee Cho
- Samsung C&T Medical Clinic, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Kyungdo Han
- Department of Statistics and Actuarial Science, Soongsil University, Seoul, Republic of Korea
| | - Seungwoo Lee
- Department of Medical Statistics, College of Medicine, Catholic University of Korea, Seoul, Republic of Korea
| | - Su-Min Jeong
- Department of Medicine, Seoul National University College of Medicine, Seoul , Republic of Korea
| | - Jung Eun Yoo
- Department of Family Medicine, Health System Gangnam Center, Seoul National University Hospital, Seoul, Republic of Korea
| | - SangYun Kim
- Department of Neurology, Seoul National University Bundang Hospital & Seoul National University College of Medicine, Seongnam, Republic of Korea
| | - Jinkook Lee
- Department of Economics & Center for Economic & Social Research, University of Southern California, Los Angeles, CA, USA
| | - Sohyun Chun
- International Healthcare Center, Samsung Medical Center, 81 Irwon-Ro, Gangnam-Gu, Seoul, Republic of Korea.
| | - Dong Wook Shin
- Department of Family Medicine/Supportive Care Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea.
- Department of Clinical Research Design & Evaluation, Samsung Advanced Institute for Health Science & Technology (SAIHST), Sungkyunkwan University, 81 Irwon-Ro, Gangnam-Gu, Seoul, 06351, Republic of Korea.
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13
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Alateeq K, Walsh EI, Cherbuin N. Dietary magnesium intake is related to larger brain volumes and lower white matter lesions with notable sex differences. Eur J Nutr 2023:10.1007/s00394-023-03123-x. [PMID: 36899275 DOI: 10.1007/s00394-023-03123-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Accepted: 02/14/2023] [Indexed: 03/12/2023]
Abstract
PURPOSE To examine the association between dietary magnesium (Mg) intake and brain volumes and white matter lesions (WMLs) in middle to early old age. METHODS Participants (aged 40-73 years) from UK Biobank (n = 6001) were included and stratified by sex. Dietary Mg was measured using an online computerised 24 h recall questionnaire to estimate daily Mg intake. Latent class analysis and hierarchical linear regression models were performed to investigate the association between baseline dietary Mg, Mg trajectories, and brain volumes and WMLs. Associations between baseline Mg, and baseline blood pressure (BP) measures, and baseline Mg, Mg trajectories and BP changes (between baseline and wave 2) were also investigated to assess whether BP mediates the link between Mg intake and brain health. All analyses controlled for health and socio-demographic covariates. Possible interactions between menopausal status and Mg trajectories in predicting brain volumes and WMLs were also investigated. RESULTS On average, higher baseline dietary Mg intake was associated with larger brain volumes (gray matter [GM]: 0.001% [SE = 0.0003]; left hippocampus [LHC]: 0.0013% [SE = 0.0006]; and right hippocampus [RHC]: 0.0023% [SE = 0.0006]) in both men and women. Latent class analysis of Mg intake revealed three classes: "high-decreasing" (men = 3.2%, women = 1.9%), "low-increasing" (men = 1.09%, women = 1.62%), and "stable normal" (men = 95.71%, women = 96.51%). In women, only the "high-decreasing" trajectory was significantly associated with larger brain volumes (GM: 1.17%, [SE = 0.58]; and RHC: 2.79% [SE = 1.11]) compared to the "normal-stable", the "low-increasing" trajectory was associated with smaller brain volumes (GM: - 1.67%, [SE = 0.30]; white matter [WM]: - 0.85% [SE = 0.42]; LHC: - 2.43% [SE = 0.59]; and RHC: - 1.50% [SE = 0.57]) and larger WMLs (1.6% [SE = 0.53]). Associations between Mg and BP measures were mostly non-significant. Furthermore, the observed neuroprotective effect of higher dietary Mg intake in the "high-decreasing" trajectory appears to be greater in post-menopausal than pre-menopausal women. CONCLUSIONS Higher dietary Mg intake is related to better brain health in the general population, and particularly in women.
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Affiliation(s)
- Khawlah Alateeq
- National Centre for Epidemiology and Population Health, College of Health and Medicine, Australian National University, 54 Mills Road, Canberra, ACT, 2601, Australia. .,Radiological Science, College of Applied Medical Science, King Saud University, Riyadh, 11451, Saudi Arabia.
| | - Erin I Walsh
- National Centre for Epidemiology and Population Health, College of Health and Medicine, Australian National University, 54 Mills Road, Canberra, ACT, 2601, Australia.,Population Health Exchange, National Centre for Epidemiology and Population Health, Australian National University, Canberra, Australia
| | - Nicolas Cherbuin
- National Centre for Epidemiology and Population Health, College of Health and Medicine, Australian National University, 54 Mills Road, Canberra, ACT, 2601, Australia
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14
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Adamo D, Canfora F, Calabria E, Coppola N, Sansone M, Spagnuolo G, Pecoraro G, Aria M, D’Aniello L, Mignogna MD, Leuci S. Burning Mouth Syndrome and Hypertension: Prevalence, Gender Differences and Association with Pain and Psycho-Social Characteristics-A Case Control Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:2040. [PMID: 36767407 PMCID: PMC9916056 DOI: 10.3390/ijerph20032040] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/20/2022] [Revised: 01/14/2023] [Accepted: 01/19/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND To assess the prevalence of hypertension (HTN) in burning mouth syndrome (BMS) patients and to investigate its relationship with sociodemographic factors, pain and the psychological profile. METHODS A case-control study was conducted by enrolling 242 BMS patients and 242 controls matched for age and gender. Sociodemographic and clinical characteristics were recorded, and all participants completed numeric rating scale (NRS), the short-form of the McGill pain questionnaire (SF-MPQ), the Hamilton rating scale for anxiety and depression (HAM-A, HAM-D), the Pittsburgh sleep quality index (PSQI) and the Epworth sleepiness scale (ESS). RESULTS The BMS patients presented with a statistically significant higher prevalence of HTN compared to that in the controls (55% versus 33.5%; p-value: <0.001) and higher median scores of the NRS, SF-MPQ, HAM-A, HAM-D, PSQI and ESS (p < 0.001). Multivariate regression analysis in the BMS patients indicated positive correlations between HTN and age, systemic diseases, drug consumption and anxiety (p-value: <0.001) and these predictors were responsible for 11.3% of the HTN variance in the BMS patients, when considered together. CONCLUSIONS The prevalence of HTN was significantly higher in the BMS patients, since ageing, the presence of comorbidities, drug consumption and anxiety were potential predictors. Further studies are needed to better investigate the relationship between BMS and HTN.
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Affiliation(s)
- Daniela Adamo
- Department of Neuroscience, Reproductive Sciences and Odontostomatology, University of Naples Federico II, 80138 Naples, Italy
| | - Federica Canfora
- Department of Neuroscience, Reproductive Sciences and Odontostomatology, University of Naples Federico II, 80138 Naples, Italy
| | - Elena Calabria
- Department of Health Sciences, School of Dentistry, University Magna Graecia of Catanzaro, 88100 Catanzaro, Italy
| | - Noemi Coppola
- Department of Neuroscience, Reproductive Sciences and Odontostomatology, University of Naples Federico II, 80138 Naples, Italy
| | - Mattia Sansone
- Department of Neuroscience, Reproductive Sciences and Odontostomatology, University of Naples Federico II, 80138 Naples, Italy
| | - Gianrico Spagnuolo
- Department of Neuroscience, Reproductive Sciences and Odontostomatology, University of Naples Federico II, 80138 Naples, Italy
- Therapeutic Dentistry Department, Institute for Dentistry, Sechenov University, Moscow 119991, Russia
| | - Giuseppe Pecoraro
- Department of Neuroscience, Reproductive Sciences and Odontostomatology, University of Naples Federico II, 80138 Naples, Italy
| | - Massimo Aria
- Department of Economics and Statistics, University Federico II of Naples, 80138 Naples, Italy
| | - Luca D’Aniello
- Department of Social Sciences, University Federico II of Naples, 80138 Naples, Italy
| | - Michele Davide Mignogna
- Department of Neuroscience, Reproductive Sciences and Odontostomatology, University of Naples Federico II, 80138 Naples, Italy
| | - Stefania Leuci
- Department of Neuroscience, Reproductive Sciences and Odontostomatology, University of Naples Federico II, 80138 Naples, Italy
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15
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Canfora F, Calabria E, Pecoraro G, Leuci S, Coppola N, Mazzaccara C, Spirito F, Aria M, D'Aniello L, Mignogna MD, Adamo D. Prevalence of hypertension and correlation with mental health in women with burning mouth syndrome: A case-control study. Front Cardiovasc Med 2023; 9:969148. [PMID: 36741839 PMCID: PMC9894887 DOI: 10.3389/fcvm.2022.969148] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Accepted: 12/27/2022] [Indexed: 01/21/2023] Open
Abstract
Background The relationship between hypertension (HTN) and chronic pain is still a matter of debate, and its prevalence in patients with burning mouth syndrome (BMS) has never been evaluated. This study aimed to assess the prevalence of HTN in women with BMS and to evaluate its relationship with potential predictors such as risk factors for cardiovascular diseases, pain, and mental health status analyzing differences with healthy women. Methods In total, 250 women with BMS (WBMS) were prospectively recruited and compared with an equal number of healthy women (HW) matched for age. Education, body mass index, smoke and alcohol consumption, intensity and quality of pain, and psychological profile were further investigated to identify the potential predictors of HTN. Specifically, pain assessment [the Numeric Rating Scale (NRS) and Short-Form McGill Pain Questionnaire (SF-MPQ)] and psychological assessment [Hamilton Rating Scale for Depression and Anxiety (HAM-D and HAM-A), Pittsburgh Sleep Quality Index (PSQI), and Epworth Sleepiness Scale (ESS)] was carried out for the participants. Results HTN was found in 128 (51.2%) WBMS and 76 (30.4%) HW (p < 0.001**). The scores of the NRS, SF-MPQ, HAM-D, HAM-A, and PSQI were statistically significantly higher in the WBMS than in the HW (p < 0.001**). A strongly linear correlation between HTN and employment status, systemic diseases, and education level (p < 0.001**) was found in WBMS, while a strong correlation between HTN and employment status, hypercholesterolemia, systemic diseases, and drug consumption was found in HW (p < 0.001**). No statistically significant correlation was found between HTN and pain, anxiety, depression, and sleep disturbances. Conclusion These results suggest that WBMS showed a higher prevalence of HTN compared with controls. Unemployed WBMS with lower education and other systemic comorbidities are at an increased risk of developing HTN. HTN is associated with alteration in the vascular structure and function of the brain, and these processes accelerate brain aging, which contributes to a reduction in intracortical connectivity, thus affecting the modulatory system of control of pain in patients with BMS, independently of their mental health assessment. Predictors that may underlie this association remain unclear, taking into account the differences found in HW, and should be further elucidated.
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Affiliation(s)
- Federica Canfora
- Department of Neuroscience, Reproductive Sciences and Dentistry, University of Naples Federico II, Naples, Italy
| | - Elena Calabria
- Department of Neuroscience, Reproductive Sciences and Dentistry, University of Naples Federico II, Naples, Italy,*Correspondence: Elena Calabria ✉
| | - Giuseppe Pecoraro
- Department of Neuroscience, Reproductive Sciences and Dentistry, University of Naples Federico II, Naples, Italy
| | - Stefania Leuci
- Department of Neuroscience, Reproductive Sciences and Dentistry, University of Naples Federico II, Naples, Italy
| | - Noemi Coppola
- Department of Neuroscience, Reproductive Sciences and Dentistry, University of Naples Federico II, Naples, Italy
| | - Cristina Mazzaccara
- Department of Molecular Medicine and Medical Biotechnology, University of Naples Federico II, Naples, Italy,CEINGE Advanced Biotechnologies, Naples, Italy
| | - Francesca Spirito
- Department of Clinical and Experimental Medicine, University of Foggia, Foggia, Italy
| | - Massimo Aria
- Department of Economics and Statistics, University of Naples Federico II, Naples, Italy
| | - Luca D'Aniello
- Department of Social Sciences, University of Naples Federico II, Naples, Italy
| | - Michele Davide Mignogna
- Department of Neuroscience, Reproductive Sciences and Dentistry, University of Naples Federico II, Naples, Italy
| | - Daniela Adamo
- Department of Neuroscience, Reproductive Sciences and Dentistry, University of Naples Federico II, Naples, Italy
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16
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García-García I, Michaud A, Jurado MÁ, Dagher A, Morys F. Mechanisms linking obesity and its metabolic comorbidities with cerebral grey and white matter changes. Rev Endocr Metab Disord 2022; 23:833-843. [PMID: 35059979 DOI: 10.1007/s11154-021-09706-5] [Citation(s) in RCA: 20] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/14/2021] [Indexed: 02/07/2023]
Abstract
Obesity is a preventable risk factor for cerebrovascular disorders and it is associated with cerebral grey and white matter changes. Specifically, individuals with obesity show diminished grey matter volume and thickness, which seems to be more prominent among fronto-temporal regions in the brain. At the same time, obesity is associated with lower microstructural white matter integrity, and it has been found to precede increases in white matter hyperintensity load. To date, however, it is unclear whether these findings can be attributed solely to obesity or whether they are a consequence of cardiometabolic complications that often co-exist with obesity, such as low-grade systemic inflammation, hypertension, insulin resistance, or dyslipidemia. In this narrative review we aim to provide a comprehensive overview of the potential impact of obesity and a number of its cardiometabolic consequences on brain integrity, both separately and in synergy with each other. We also identify current gaps in knowledge and outline recommendations for future research.
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Affiliation(s)
- Isabel García-García
- Department of Clinical Psychology and Psychobiology, Universitat de Barcelona, Barcelona, Spain.
- Institut de Neurociències, Universitat de Barcelona, Barcelona, Spain.
| | | | - María Ángeles Jurado
- Department of Clinical Psychology and Psychobiology, Universitat de Barcelona, Barcelona, Spain
- Institut de Neurociències, Universitat de Barcelona, Barcelona, Spain
- Institut de Recerca Sant Joan de Déu, Hospital Sant Joan de Déu, Esplugues de Llobregat, Spain
| | - Alain Dagher
- Department of Neurology and Neurosurgery, McGill University, Montreal, Canada
| | - Filip Morys
- Department of Neurology and Neurosurgery, McGill University, Montreal, Canada
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17
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Effects of Higher Normal Blood Pressure on Brain Are Detectable before Middle-Age and Differ by Sex. J Clin Med 2022; 11:jcm11113127. [PMID: 35683516 PMCID: PMC9181456 DOI: 10.3390/jcm11113127] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2022] [Revised: 05/19/2022] [Accepted: 05/19/2022] [Indexed: 11/21/2022] Open
Abstract
Background: To quantify the association between blood pressure (BP) across its full range, brain volumes and white matter lesions (WMLs) while investigating the effects of age, sex, body mass index (BMI), and antihypertensive medication. Methods: UK Biobank participants (n = 36,260) aged (40−70) years were included and stratified by sex and four age groups (age ≤ 45, 46−55, 56−65 and > 65 years). Multi-level regression analyses were used to assess the association between mean arterial pressure (MAP), systolic BP (SBP), diastolic BP (DBP), and brain volumes segmented using the FreeSufer software (gray matter volume [GMV], white matter volume [WMV], left [LHCV] and right hippocampal volume [RHCV]) and WMLs. Interaction effects between body mass index (BMI), antihypertensive medication and BP in predicting brain volumes and WMLs were also investigated. Results: Every 10 mmHg higher DBP was associated with lower brain volumes (GMV: −0.19%−−0.40%) [SE = 47.7−62.4]; WMV: −0.20−−0.23% [SE = 34.66−53.03]; LHCV: −0.40−−0.59% [SE = 0.44−0.57]; RHCV: −0.17−−0.57% [SE = 0.32−0.95]) across all age groups. A similar pattern was detected in both sexes, although it was weaker in men. Every 10 mmHg higher MAP was associated with larger WMLs across all age groups but peaked >65 years (1.19−1.23% [SE = 0.002]). Both lower BMI and anti-hypertensive medication appeared to afford a protective effect. Conclusion: Higher BP is associated with worse cerebral health across the full BP range from middle adulthood and into old age.
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18
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Peters R, Xu Y, Eramudugolla R, Sachdev PS, Cherbuin N, Tully PJ, Mortby ME, Anstey KJ. Diastolic Blood Pressure Variability in Later Life May Be a Key Risk Marker for Cognitive Decline. Hypertension 2022; 79:1037-1044. [PMID: 35176867 DOI: 10.1161/hypertensionaha.121.18799] [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] [Indexed: 11/16/2022]
Abstract
BACKGROUND There is an increasing awareness of the need to understand the interaction between long-term blood pressure patterns and their impact on the brain and cognition. METHODS Our aim was to investigate the relationship between repeated blood pressure measures and change in cognitive performance over 12 years and imaging data at 12 years using a longitudinal population study. The data consisted of 2 cohorts, one midlife and one later life. Using linear regression, we examined the relationship between blood pressure (systolic, diastolic, change in blood pressure between visits, and visit-to-visit variability), change in cognitive performance and imaging at 12 years. RESULTS Data on cognitive change were available in 1054 at midlife, baseline age 42.7 (SD 1.5) and 1233 in later life, 62.5 (1.5) years. Imaging data were available in 168 and 233, respectively. After adjustment for multiple comparisons greater diastolic blood pressure variability in later life was associated with a -1.95 point decline (95% CI, -2.89 to -1.01) on an attention-based task and a -0.42 point (95% CI, -0.68 to -0.15) decline in performance on a psychomotor task. A higher SD in diastolic pressure across follow-up was associated with greater white matter hyperintensity volume (%increase per 10 mm Hg increase in the SD [1.50 (95% CI, 1.16-1.94]). CONCLUSIONS In a largely normotensive/mildly hypertensive population, our analyses reported no relationships between blood pressure and cognition in midlife but a potential role for diastolic blood pressure variability in later life as a risk marker for cognitive decline. This may indicate an at-risk period or a means to identify an at-risk population at the age where diastolic pressure is starting to decline.
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Affiliation(s)
- Ruth Peters
- Neuroscience Research Australia, NSW (R.P., Y.X., R.E., M.E.M., K.J.A.).,School of Psychology, University of New South Wales, Australia. (R.P., Y.X., R.E., M.E.M., K.J.A.)
| | - Ying Xu
- Neuroscience Research Australia, NSW (R.P., Y.X., R.E., M.E.M., K.J.A.).,School of Psychology, University of New South Wales, Australia. (R.P., Y.X., R.E., M.E.M., K.J.A.)
| | - Ranmalee Eramudugolla
- Neuroscience Research Australia, NSW (R.P., Y.X., R.E., M.E.M., K.J.A.).,School of Psychology, University of New South Wales, Australia. (R.P., Y.X., R.E., M.E.M., K.J.A.)
| | - Perminder S Sachdev
- Centre for Healthy Brain Ageing (CHeBA), School of Psychiatry, University of New South Wales, Australia. (P.S.S.).,Neuropsychiatric Institute, the Prince of Wales Hospital, Sydney, Australia (P.S.S.)
| | | | | | - Moyra E Mortby
- Neuroscience Research Australia, NSW (R.P., Y.X., R.E., M.E.M., K.J.A.).,School of Psychology, University of New South Wales, Australia. (R.P., Y.X., R.E., M.E.M., K.J.A.)
| | - Kaarin J Anstey
- Neuroscience Research Australia, NSW (R.P., Y.X., R.E., M.E.M., K.J.A.).,School of Psychology, University of New South Wales, Australia. (R.P., Y.X., R.E., M.E.M., K.J.A.)
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Hughes TM, Lockhart SN, Suerken CK, Jung Y, Whitlow CT, Bateman JR, Williams BJ, Espeland MA, Sachs BC, Williamson J, Cleveland M, Yang M, Rogers S, Hayden KM, Baker LD, Craft S. Hypertensive Aspects of Cardiometabolic Disorders Are Associated with Lower Brain Microstructure, Perfusion, and Cognition. J Alzheimers Dis 2022; 90:1589-1599. [PMID: 36314205 PMCID: PMC9764872 DOI: 10.3233/jad-220646] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
BACKGROUND Cardiometabolic disorders (hypertension, diabetes) are key modifiable risk factors for Alzheimer's disease and related disorders. They often co-occur; yet, the extent to which they independently affect brain structure and function is unclear. OBJECTIVE We hypothesized their combined effect is greater in associations with cognitive function and neuroimaging biomarkers of white matter (WM) health and cerebral perfusion in a diverse older adult cohort. METHODS Participants aged 50-85 years received: clinical evaluation, oral glucose tolerance testing, neuroimaging, cognitive testing, and adjudication. Neuroimaging included: T1 (gray [GM]/WM segmentation, regional volumes/thicknesses); FLAIR (WM hyperintensity volume [WMHv]; arterial spin labeling (cerebral blood flow); diffusion tensor imaging (fractional anisotropy [FA]); and neurite orientation dispersion and density imaging (Free Water). Hypertension (HTN) and impaired glucose tolerance (IGT) were staged and cardiometabolic status was categorized (HTN only, IGT only, IGT+HTN, neither). Multivariable linear regression modeled associations with cognitive and neuroimaging measures (covariates: age, gender, race). RESULTS MRI was available for 478 participants (35% mild cognitive impairment, 10% dementia) with mean age 70±8 years, 74% with HTN, 61% with IGT, and 15% self-identified as Black/African-American. IGT+HTN was significantly associated with cognitive impairment, higher WM Free Water and WMHv, lower FA, and lower GM perfusion compared to neither factor. HTN alone was associated with poorer cognition and lower GM perfusion. Cardiometabolic factors were not associated with GM macrostructure (volumes, temporal lobe cortical thickness) or cognitive status. CONCLUSION HTN and its co-occurrence with IGT (HTN+IGT) were associated with lower global cognitive performance and reduced GM perfusion and impaired WM microstructure.
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Affiliation(s)
- Timothy M. Hughes
- Department of Internal Medicine, Section on Gerontology and Geriatric Medicine, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Samuel N. Lockhart
- Department of Internal Medicine, Section on Gerontology and Geriatric Medicine, Wake Forest School of Medicine, Winston-Salem, NC, USA,Correspondence to: Samuel N. Lockhart, PhD, Wake Forest School of Medicine, Medical Center Blvd. Winston-Salem, NC 27157, USA. Tel.: +1 336 716 8145;
| | - Cynthia K. Suerken
- Department of Biostatistics and Data Science, Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Youngkyoo Jung
- Department of Radiology, School of Medicine, University of California, Davis, CA, USA
| | | | - James R. Bateman
- Department of Neurology, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | | | - Mark A. Espeland
- Department of Internal Medicine, Section on Gerontology and Geriatric Medicine, Wake Forest School of Medicine, Winston-Salem, NC, USA,Department of Biostatistics and Data Science, Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Bonnie C. Sachs
- Department of Internal Medicine, Section on Gerontology and Geriatric Medicine, Wake Forest School of Medicine, Winston-Salem, NC, USA,Department of Neurology, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Jeff Williamson
- Department of Internal Medicine, Section on Gerontology and Geriatric Medicine, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Maryjo Cleveland
- Department of Internal Medicine, Section on Gerontology and Geriatric Medicine, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Mia Yang
- Department of Internal Medicine, Section on Gerontology and Geriatric Medicine, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Samantha Rogers
- Department of Internal Medicine, Section on Gerontology and Geriatric Medicine, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Kathleen M. Hayden
- Department of Social Sciences and Health Policy, Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Laura D. Baker
- Department of Internal Medicine, Section on Gerontology and Geriatric Medicine, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Suzanne Craft
- Department of Internal Medicine, Section on Gerontology and Geriatric Medicine, Wake Forest School of Medicine, Winston-Salem, NC, USA
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20
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The Effect of Hearing Aid Use on the Association Between Hearing Loss and Brain Structure in Older Adults. Ear Hear 2021; 43:933-940. [PMID: 34711744 DOI: 10.1097/aud.0000000000001148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
OBJECTIVES Recent studies have shown an association between poorer hearing thresholds and smaller brain tissue volumes in older adults. Several underlying causal mechanisms have been opted, with a sensory deprivation hypothesis as one of the most prominent. If hearing deprivation would lead to less brain volume, hearing aids could be hypothesized to moderate this pathway by restoration of hearing. This study aims to investigate whether such a moderating effect of hearing aids exists. DESIGN The authors conducted a cross-sectional study involving aging participants of the population-based Rotterdam Study. Hearing aid use was assessed by interview and hearing loss was quantified using pure-tone audiometry. Total brain volume, gray matter and white matter volume and white matter integrity [fractional anisotropy (FA) and mean diffusivity] were measured using magnetic resonance imaging. Only participants with a pure tone average at 1, 2, and 4 kHz (PTA1,2,4) of ≥35 dB HL were included. Associations of hearing loss with brain volume and global measures of white matter integrity were analyzed using linear regression, with hearing aid use and interaction between hearing aid use and PTA1,2,4 included as independent variables. Models were adjusted for age, sex, time between audiometry and magnetic resonance imaging, level of education, and cardiovascular risk factors. RESULTS Out of 459 included participants with mean age (range) 70.4 (52 to 92) 41% were female. Distributions of age and sex among hearing aid users (n = 172) did not significantly differ from those without hearing aids. PTA1,2,4 was associated with lower FA, but not with a difference in total brain volume, gray matter volume, white matter volume, or mean diffusivity. Interaction between hearing aid use and PTA1,2,4 was not associated with FA or any of the other outcome measures. Additional analysis revealed that interaction between hearing aid use and age was associated with lower FA. CONCLUSIONS We found no evidence for a moderating effect of hearing aids on the relationship between hearing loss and brain structure in a population of older adults. However, use of hearing aids did appear as an effect modifier in the association between age and white matter integrity. Future longitudinal research is needed to clarify these results.
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Cherbuin N, Walsh EI, Shaw M, Luders E, Anstey KJ, Sachdev PS, Abhayaratna WP, Gaser C. Optimal Blood Pressure Keeps Our Brains Younger. Front Aging Neurosci 2021; 13:694982. [PMID: 34675795 PMCID: PMC8523821 DOI: 10.3389/fnagi.2021.694982] [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: 04/14/2021] [Accepted: 07/23/2021] [Indexed: 11/13/2022] Open
Abstract
Background: Elevated blood pressure (BP) is a major health risk factor and the leading global cause of premature death. Hypertension is also a risk factor for cognitive decline and dementia. However, when elevated blood pressure starts impacting cerebral health is less clear. We addressed this gap by estimating how a validated measure of brain health relates to changes in BP over a period of 12 years. Methods: Middle-age (44-46 years at baseline, n = 335, 52% female) and older-age (60-64 years, n = 351, 46% female) cognitively intact individuals underwent up to four brain scans. Brain health was assessed using a machine learning approach to produce an estimate of "observed" age (BrainAGE), which can be contrasted with chronological age. Longitudinal associations between blood pressures and BrainAGE were assessed with linear mixed-effects models. Results: A progressive increase in BP was observed over the follow up (MAP = 0.8 mmHg/year, SD = 0.92; SBP = 1.41 mmHg/year, SD = 1.49; DBP = 0.61 mmHg/year, SD = 0.78). In fully adjusted models, every additional 10 mmHg increase in blood pressure (above 90 for mean, 114 for systolic, and 74 for diastolic blood pressure) was associated with a higher BrainAGE by 65.7 days for mean, and 51.1 days for systolic/diastolic blood pressure. These effects occurred across the blood pressure range and were not exclusively driven by hypertension. Conclusion: Increasing blood pressure is associated with poorer brain health. Compared to a person becoming hypertensive, somebody with an ideal BP is predicted to have a brain that appears more than 6 months younger at midlife.
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Affiliation(s)
- Nicolas Cherbuin
- Centre for Research on Ageing, Health and Wellbeing, Australian National University, Canberra, ACT, Australia
| | - Erin I Walsh
- Centre for Research on Ageing, Health and Wellbeing, Australian National University, Canberra, ACT, Australia
| | - Marnie Shaw
- College of Engineering & Computer Science, Australian National University, Canberra, ACT, Australia
| | - Eileen Luders
- Centre for Research on Ageing, Health and Wellbeing, Australian National University, Canberra, ACT, Australia.,School of Psychology, University of Auckland, Auckland, New Zealand
| | - Kaarin J Anstey
- Neuroscience Research Australia, Sydney, NSW, Australia.,School of Psychiatry, University of New South Wales, Sydney, NSW, Australia
| | - Perminder S Sachdev
- Centre for Healthy Brain Ageing (CHeBA), School of Psychiatry, University of New South Wales, Sydney, NSW, Australia
| | | | - Christian Gaser
- Department of Neurology, Jena University Hospital, Jena, Germany.,Department of Psychiatry and Psychotherapy, Jena University Hospital, Jena, Germany
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Masoli JAH, Delgado J. Blood pressure, frailty and dementia. Exp Gerontol 2021; 155:111557. [PMID: 34537278 DOI: 10.1016/j.exger.2021.111557] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2021] [Revised: 09/09/2021] [Accepted: 09/13/2021] [Indexed: 10/20/2022]
Abstract
High blood pressure (BP) affects 75% of people aged over 70. Ageing alters BP homeostasis, resulting in postural hypotension and increased BP variability. Co-morbidity and frailty add complexity to understanding BP changes in later life. Longitudinal BP declines are likely driven by accumulating co-morbidity and are accelerated in both frailty and dementia. This narrative review summarises what is known about the association between BP and frailty, the clinical management of BP in frailty and the association between BP, cognitive decline and dementia.
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Affiliation(s)
- Jane A H Masoli
- Epidemiology and Public Health, College of Medicine and Health, University of Exeter, Exeter, UK; Healthcare for Older People Department, Royal Devon and Exeter NHS Foundation Trust, Exeter, UK.
| | - João Delgado
- Epidemiology and Public Health, College of Medicine and Health, University of Exeter, Exeter, UK
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Jacków-Nowicka J, Podgórski P, Bladowska J, Szcześniak D, Rymaszewska J, Zatońska K, Połtyn-Zaradna K, Szuba A, Sa Siadek M, Zimny A. The Impact of Common Epidemiological Factors on Gray and White Matter Volumes in Magnetic Resonance Imaging-Is Prevention of Brain Degeneration Possible? Front Neurol 2021; 12:633619. [PMID: 34326804 PMCID: PMC8315783 DOI: 10.3389/fneur.2021.633619] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Accepted: 06/07/2021] [Indexed: 11/13/2022] Open
Abstract
Introduction: The aim of the study was to evaluate the impact of multiple risk factors (age, diabetes, hypertension, hyperlipidemia, BMI, smoking, alcohol) on the gray and white matter volumes as well as on the burden of white matter hyperintensities (WMH). Material and Methods: The study group consisted of 554 subjects (age range: 50–69 yrs, F/M: 367/187) recruited from the larger cohort of the Polish fraction of the Prospective Urban Rural Epidemiological (PURE) study. The participants answered questionnaires about their lifestyle, underwent physical and psychological examination (MoCA test), laboratory blood tests followed by brain MRI. Volumetric measurements of the total gray matter (GMvol), total white matter (WMvol) and WHM (WMHvol) normalized to the total intracranial volume were performed using the Computational Anatomy Toolbox 12 (CAT12) and Statistical Parametric Maps 12 (SPM12) based on 3D T1-weighted sequence. The influence of risk factors was assessed using multiple regression analysis before and after correction for multiple comparisons. Results: Older age was associated with lower GMvol and WMvol, and higher WMHvol (p < 0.001). Smaller GMvol volume was associated with higher WMHvol (p < 0.001). Higher WMHvol was associated with hypertension (p = 0.01) and less significantly with hyperlipidemia (only before correction p = 0.03). Diabetes, abnormal BMI, smoking and alcohol intake did not have any significant impact on GMvol, WMvol or WMHvol (p > 0.05). MoCA score was not influenced by any of the factors. Conclusions: Gray matter loss is strongly associated with the accumulation of WMH which seems to be potentially preventable by maintaining normal blood pressure and cholesterol levels.
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Affiliation(s)
- Jagoda Jacków-Nowicka
- Department of General and Interventional Radiology and Neuroradiology, Wroclaw Medical University, Wrocław, Poland
| | - Przemysław Podgórski
- Department of General and Interventional Radiology and Neuroradiology, Wroclaw Medical University, Wrocław, Poland
| | - Joanna Bladowska
- Department of General and Interventional Radiology and Neuroradiology, Wroclaw Medical University, Wrocław, Poland
| | - Dorota Szcześniak
- Department of Psychiatry, Wroclaw Medical University, Wrocław, Poland
| | | | - Katarzyna Zatońska
- Department of Social Medicine, Wroclaw Medical University, Wrocław, Poland
| | | | - Andrzej Szuba
- Department of Angiology, Hypertension and Diabetology, Wroclaw Medical University, Wrocław, Poland
| | - Marek Sa Siadek
- Department of General and Interventional Radiology and Neuroradiology, Wroclaw Medical University, Wrocław, Poland
| | - Anna Zimny
- Department of General and Interventional Radiology and Neuroradiology, Wroclaw Medical University, Wrocław, Poland
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