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Arenaza‐Urquijo EM, Boyle R, Casaletto K, Anstey KJ, Vila‐Castelar C, Colverson A, Palpatzis E, Eissman JM, Kheng Siang Ng T, Raghavan S, Akinci M, Vonk JMJ, Machado LS, Zanwar PP, Shrestha HL, Wagner M, Tamburin S, Sohrabi HR, Loi S, Bartrés‐Faz D, Dubal DB, Vemuri P, Okonkwo O, Hohman TJ, Ewers M, Buckley RF. Sex and gender differences in cognitive resilience to aging and Alzheimer's disease. Alzheimers Dement 2024; 20:5695-5719. [PMID: 38967222 PMCID: PMC11350140 DOI: 10.1002/alz.13844] [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: 11/08/2023] [Revised: 03/08/2024] [Accepted: 03/21/2024] [Indexed: 07/06/2024]
Abstract
Sex and gender-biological and social constructs-significantly impact the prevalence of protective and risk factors, influencing the burden of Alzheimer's disease (AD; amyloid beta and tau) and other pathologies (e.g., cerebrovascular disease) which ultimately shape cognitive trajectories. Understanding the interplay of these factors is central to understanding resilience and resistance mechanisms explaining maintained cognitive function and reduced pathology accumulation in aging and AD. In this narrative review, the ADDRESS! Special Interest Group (Alzheimer's Association) adopted a multidisciplinary approach to provide the foundations and recommendations for future research into sex- and gender-specific drivers of resilience, including a sex/gender-oriented review of risk factors, genetics, AD and non-AD pathologies, brain structure and function, and animal research. We urge the field to adopt a sex/gender-aware approach to resilience to advance our understanding of the intricate interplay of biological and social determinants and consider sex/gender-specific resilience throughout disease stages. HIGHLIGHTS: Sex differences in resilience to cognitive decline vary by age and cognitive status. Initial evidence supports sex-specific distinctions in brain pathology. Findings suggest sex differences in the impact of pathology on cognition. There is a sex-specific change in resilience in the transition to clinical stages. Gender and sex factors warrant study: modifiable, immune, inflammatory, and vascular.
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Affiliation(s)
- Eider M. Arenaza‐Urquijo
- Environment and Health Over the Life Course Programme, Climate, Air Pollution, Nature and Urban Health ProgrammeBarcelona Institute for Global Health (ISGlobal)BarcelonaSpain
- University of Pompeu FabraBarcelonaBarcelonaSpain
| | - Rory Boyle
- Massachusetts General HospitalHarvard Medical SchoolBostonMassachusettsUSA
| | - Kaitlin Casaletto
- Department of NeurologyMemory and Aging CenterUniversity of California San FranciscoSan FranciscoCaliforniaUSA
| | - Kaarin J. Anstey
- University of New South Wales Ageing Futures InstituteSydneyNew South WalesAustralia
- Neuroscience Research AustraliaSydneyNew South WalesAustralia
- School of Psychology, University of New South WalesSidneyNew South WalesAustralia
| | | | - Aaron Colverson
- University of Florida Center for Arts in Medicine Interdisciplinary Research LabUniversity of Florida, Center of Arts in MedicineGainesvilleFloridaUSA
| | - Eleni Palpatzis
- Environment and Health Over the Life Course Programme, Climate, Air Pollution, Nature and Urban Health ProgrammeBarcelona Institute for Global Health (ISGlobal)BarcelonaSpain
- University of Pompeu FabraBarcelonaBarcelonaSpain
| | - Jaclyn M. Eissman
- Vanderbilt Memory and Alzheimer's Center, Department of NeurologyVanderbilt University Medical CenterNashvilleTennesseeUSA
- Vanderbilt Genetics InstituteVanderbilt University Medical CenterNashvilleTennesseeUSA
| | - Ted Kheng Siang Ng
- Rush Institute for Healthy Aging and Department of Internal MedicineRush University Medical CenterChicagoIllinoisUSA
| | | | - Muge Akinci
- Environment and Health Over the Life Course Programme, Climate, Air Pollution, Nature and Urban Health ProgrammeBarcelona Institute for Global Health (ISGlobal)BarcelonaSpain
- University of Pompeu FabraBarcelonaBarcelonaSpain
| | - Jet M. J. Vonk
- Department of NeurologyMemory and Aging CenterUniversity of California San FranciscoSan FranciscoCaliforniaUSA
| | - Luiza S. Machado
- Graduate Program in Biological Sciences: Biochemistry, Universidade Federal Do Rio Grande Do Sul, FarroupilhaPorto AlegreBrazil
| | - Preeti P. Zanwar
- Jefferson College of Population Health, Thomas Jefferson UniversityPhiladelphiaPennsylvaniaUSA
- The Network on Life Course and Health Dynamics and Disparities, University of Southern CaliforniaLos AngelesCaliforniaUSA
| | | | - Maude Wagner
- Rush Alzheimer's Disease Center, Rush University Medical CenterChicagoIllinoisUSA
| | - Stefano Tamburin
- Department of Neurosciences, Biomedicine and Movement SciencesUniversity of VeronaVeronaItaly
| | - Hamid R. Sohrabi
- Centre for Healthy AgeingHealth Future InstituteMurdoch UniversityMurdochWestern AustraliaAustralia
- School of Psychology, Murdoch UniversityMurdochWestern AustraliaAustralia
| | - Samantha Loi
- Neuropsychiatry Centre, Royal Melbourne HospitalParkvilleVictoriaAustralia
- Department of PsychiatryUniversity of MelbourneParkvilleVictoriaAustralia
| | - David Bartrés‐Faz
- Department of MedicineFaculty of Medicine and Health Sciences & Institut de NeurociènciesUniversity of BarcelonaBarcelonaBarcelonaSpain
- Institut d'Investigacions Biomèdiques (IDIBAPS)BarcelonaBarcelonaSpain
- Institut Guttmann, Institut Universitari de Neurorehabilitació adscrit a la Universitat Autónoma de BarcelonaBadalonaBarcelonaSpain
| | - Dena B. Dubal
- Department of Neurology and Weill Institute of NeurosciencesUniversity of California, San FranciscoSan FranciscoCaliforniaUSA
- Biomedical and Neurosciences Graduate ProgramsUniversity of California, San FranciscoSan FranciscoCaliforniaUSA
| | | | - Ozioma Okonkwo
- Alzheimer's Disease Research Center and Department of MedicineUniversity of Wisconsin School of Medicine and Public HealthMadisonWisconsinUSA
| | - Timothy J. Hohman
- Vanderbilt Memory and Alzheimer's Center, Department of NeurologyVanderbilt University Medical CenterNashvilleTennesseeUSA
- Vanderbilt Genetics InstituteVanderbilt University Medical CenterNashvilleTennesseeUSA
| | - Michael Ewers
- Institute for Stroke and Dementia ResearchKlinikum der Universität MünchenLudwig Maximilians Universität (LMU)MunichGermany
- German Center for Neurodegenerative Diseases (DZNE, Munich)MunichGermany
| | - Rachel F. Buckley
- Massachusetts General HospitalHarvard Medical SchoolBostonMassachusettsUSA
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Turnquist BE, MacIver PH, Katzel LI, Waldstein SR. Interactive Relations of Body Mass Index, Cardiorespiratory Fitness, and Sex to Cognitive Function in Older Adults. Arch Clin Neuropsychol 2024:acae018. [PMID: 38486431 DOI: 10.1093/arclin/acae018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2023] [Revised: 01/29/2024] [Accepted: 02/08/2024] [Indexed: 03/22/2024] Open
Abstract
OBJECTIVE The course of cognitive aging is influenced by multiple health factors. This cross-sectional study investigated the interactive relations between body mass index (BMI), maximum oxygen consumption (VO2max), and sex on neuropsychological outcomes in community-dwelling predominantly older adults. METHODS Participants were 164 healthy adults [M (SD) = 64.6 (12.5) years, 56% men, 87% white] who participated in an investigation of cardiovascular risk factors and brain health. Multivariable regression analysis, adjusted for age, education, ethnicity, smoking, alcohol consumption, and depression, examined the interactive relations of BMI, VO2max, and sex to multiple neuropsychological outcomes. RESULTS Significant BMI*VO2max*sex interactions for Grooved Pegboard dominant (p = .019) and nondominant (p = .005) hands revealed that men with lower VO2max (l/min) displayed worse performance with each hand as BMI increased (p's < .02). A significant BMI*sex interaction for Logical Memory-Delayed Recall (p = .036) (after adjustment for blood glucose) showed that men, but not women, with higher BMI demonstrated worse performance (p = .036). Lastly, significant main effects indicated that lower VO2max was related to poorer logical memory, and higher BMI was associated with poorer Trail Making B and Stroop interference scores (p's < .05). CONCLUSIONS Among men, higher cardiorespiratory fitness may protect against the negative impact of greater BMI on manual dexterity and motor speed, making VO2max a target for intervention. Higher BMI is further associated with poorer executive function and verbal memory (in men), and lower VO2max is associated with poorer verbal memory.
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Affiliation(s)
- B Eric Turnquist
- Department of Psychology, University of Maryland, Baltimore, MD, USA
- Department of Psychology, American University, Washington, DC, USA
| | - Peter H MacIver
- Department of Psychology, University of Maryland, Baltimore, MD, USA
| | - Leslie I Katzel
- Division of Gerontology, Geriatrics and Palliative Medicine, Department of Medicine, University of Maryland School of Medicine, Baltimore, MD, USA
- Geriatric Research Education and Clinical Center, Baltimore VA Medical Center, Baltimore, MD, USA
| | - Shari R Waldstein
- Department of Psychology, University of Maryland, Baltimore, MD, USA
- Division of Gerontology, Geriatrics and Palliative Medicine, Department of Medicine, University of Maryland School of Medicine, Baltimore, MD, USA
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Yates BA, Armstrong LE, Lee EC, Unverzagt FW, Dadzie E, Lopez V, Williamson K, Vingren JL, Orkaby AR. Effectiveness of a Single Prolonged Aerobic Exercise Session on Executive Function Task Performance in Physically Active Adults (21-70 Years of Age). INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:2802. [PMID: 36833498 PMCID: PMC9957164 DOI: 10.3390/ijerph20042802] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/24/2022] [Revised: 01/31/2023] [Accepted: 02/01/2023] [Indexed: 06/18/2023]
Abstract
We sought to examine the effectiveness of an acute prolonged exercise session on post-exercise executive function in physically active adults and to assess if age or pre-exercise cognitive performance was predictive of the magnitude of change in executive task performance. Self-registered cyclists were recruited prior to participating in a 161-km mass-participation cycling event. Cyclists were excluded if they had not previously participated in a similar endurance event, were young (<18 y), or were cognitively impaired (Mini CogTM < 3 units). Immediately after completing the exercise session, the time taken to complete Trail Making Test Part A and Part B (TMT A + B) was assessed. A faster time to complete the TMT A + B was observed after exercise (+8.5%; p = 0.0003; n = 62; age range = 21-70 y). The magnitude of change in TMT A + B performance (pre vs. post) was influenced by pre-exercise TMT A + B performance (r2 = 0.23, p < 0.0001), not age (r2 =0.002; p = 0.75). Prolonged exercise had a small-to-moderate effect on post-exercise compared to pre-exercise executive function task performance (Cohen's d = 0.38-0.49). These results support the effectiveness of a single prolonged exercise bout to augment executive function in physically active adults, irrespective of age.
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Affiliation(s)
- Brandon A. Yates
- Indiana Center for Musculoskeletal, Indiana University School of Medicine, Indianapolis, IN 46202, USA
- Indiana University Center for Aging Research, Regenstrief Institute, Inc., Indiana University School of Medicine, Indianapolis, IN 46202, USA
| | | | - Elaine C. Lee
- Human Performance Laboratory, University of Connecticut, Storrs, CT 06269, USA
| | - Frederick W. Unverzagt
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN 46202, USA
| | - Ekow Dadzie
- Human Performance Laboratory, University of Connecticut, Storrs, CT 06269, USA
| | - Virgilio Lopez
- Human Performance Laboratory, University of Connecticut, Storrs, CT 06269, USA
| | - Keith Williamson
- Vinson Health Center, Midwestern State University, Wichita Falls, TX 76308, USA
| | - Jakob L. Vingren
- Applied Physiology Laboratory, Department of Kinesiology, Health Promotion, and Recreation, University of North Texas, Denton, TX 76203, USA
- Department of Biological Sciences, University of North Texas, Denton, TX 76203, USA
| | - Ariela R. Orkaby
- New England Geriatric Research, Education, and Clinical Center (GRECC), VA Boston Healthcare System, Boston, MA 02130, USA
- Massachusetts Veterans Epidemiology Research and Information Center (MAVERIC), VA Boston Healthcare System, Boston, MA 02130, USA
- Division of Aging, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA 02115, USA
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Souza MA, Peres Bomfim LG, de Barros VL, Medeiros RC, Ginsicke DC, Colovati MES, Daly T, Zanesco A. The Differential Effect of Schooling and Physical Activity on Dementia in Older Women and Men from Brazil: Implications for Policymaking. J Alzheimers Dis 2022; 90:859-867. [DOI: 10.3233/jad-220517] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background: Modifiable risk factors exert crucial impact on dementia. Objective: We sought to answer the question: do two modifiable risk factors, schooling level and physical activity (PA), affect cognitive function similarly in each sex? Methods: This cross-sectional study was conducted in 2019 and 2021, and the survey was applied to the residents of the metropolitan area of Santos, a seashore of Sao Paulo State. Four hundred and twenty-two participants (women = 254 and men = 168) were eligible. Baecke questionnaire for the elderly was applied for the classification as physically inactive (PI) or active (PA). Cognitive function was assessed by the Mini-Mental State Examination (MMSE) and the Clinical Dementia Rating (CDR). Participants were also stratified by schooling status for both sexes. Results: Higher education had a sex-independent positive influence on MMSE and CDR (p < 0.001). PA influences positively MMSE in older women (PI: 25±5 and PA: 27±3, p < 0.03), but has no effect in older men (26±5 and 25±5, p > 0.05). Concordantly, older women who were PA (1.7 and 0 %) showed a lower prevalence of dementia compared with PI (6.2 and 2.1%), for mild and moderate respectively. Active older women had higher odds of improving the MMSE score (OR: 1.093; 95% CI: 1.008–1.186) than men (OR: 0.97 (95% CI: 0.896–1.051). Conclusion: Education affects cognitive function equally in Brazilian elderly whereas older women are more responsive to the beneficial effects of PA for dementia than men.
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Affiliation(s)
- Melyssa Alves Souza
- Postgraduate Program in Environmental Health, Metropolitan University of Santos (UNIMES), Santos, SP, Brazil
- Department of Biosciences, Institute of Health and Society, Federal University of Sao Paulo (UNIFESP), Santos, SP, Brazil
| | - Larissa Gomes Peres Bomfim
- Postgraduate Program in Environmental Health, Metropolitan University of Santos (UNIMES), Santos, SP, Brazil
| | - Vinicius Lúcio de Barros
- Postgraduate Program in Environmental Health, Metropolitan University of Santos (UNIMES), Santos, SP, Brazil
| | - Ronaldo Coelho Medeiros
- Postgraduate Program in Environmental Health, Metropolitan University of Santos (UNIMES), Santos, SP, Brazil
| | - Danielle Cristine Ginsicke
- Postgraduate Program in Environmental Health, Metropolitan University of Santos (UNIMES), Santos, SP, Brazil
| | | | - Timothy Daly
- Sorbonne Université, Science Norms Democracy, UMR 8011, Paris, France
| | - Angelina Zanesco
- Postgraduate Program in Environmental Health, Metropolitan University of Santos (UNIMES), Santos, SP, Brazil
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Pa J, Aslanyan V, Casaletto KB, Rentería MA, Harrati A, Tom SE, Armstrong N, Rajan K, Avila-Rieger J, Gu Y, Schupf N, Manly JJ, Brickman A, Zahodne L. Effects of Sex, APOE4, and Lifestyle Activities on Cognitive Reserve in Older Adults. Neurology 2022; 99:e789-e798. [PMID: 35858818 PMCID: PMC9484731 DOI: 10.1212/wnl.0000000000200675] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Accepted: 03/18/2022] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND AND OBJECTIVES Lifestyle activities, such as physical activity and cognitive stimulation, may mitigate age-associated cognitive decline, delay dementia onset, and increase cognitive reserve. Whether the association between lifestyle activities and cognitive reserve differs by sex and APOE4 status is an understudied yet critical component for informing targeted prevention strategies. The current study examined interactions between sex and physical or cognitive activities on cognitive reserve for speed and memory in older adults. METHODS Research participants with unimpaired cognition, mild cognitive impairment, or dementia from the Washington Heights-Inwood Columbia Aging Cohort were included in this study. Cognitive reserve scores for speed and memory were calculated by regressing out hippocampal volume, total gray matter volume, and white matter hyperintensity volume from composite cognitive scores for speed and memory, respectively. Self-reported physical activity was assessed using the Godin Leisure Time Exercise Questionnaire, converted to metabolic equivalents (METS). Self-reported cognitive activity (COGACT) was calculated as the sum of 3 yes/no questions. Sex by activity interactions and sex-stratified analyses were conducted using multivariable linear regression models, including a secondary analysis with APOE4 as a moderating factor. RESULTS Seven hundred fifty-eight participants (mean age = 76.11 ± 6.31 years, 62% women) were included in this study. Higher METS was associated with greater speed reserve in women (β = 0.04, CI 0.0-08) but not in men (β = 0.004, CI -0.04 to 0.05). METS was not associated with memory reserve in women or men. More COGACT was associated with greater speed reserve in the cohort (β = 0.13, CI 0.05-0.21). More COGACT had a trend for greater memory reserve in women (β = 0.06, CI -0.02 to 0.14) but not in men (β = -0.04, CI -0.16 to 0.08). Only among women, APOE4 carrier status attenuated relationships between METS and speed reserve (β = -0.09, CI -0.22 to 0.04) and between COGACT and both speed (β = -0.26, CI -0.63 to 0.11) and memory reserves (β = -0.20, CI -0.50.0 to 093). DISCUSSION The associations of self-reported physical and cognitive activities with cognitive reserve are more pronounced in women, although APOE4 attenuates these associations. Future studies are needed to understand the causal relationship among sex, lifestyle activities, and genetic factors on cognitive reserve in older adults to best understand which lifestyle activities may be most beneficial and for whom.
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Affiliation(s)
- Judy Pa
- From the Alzheimer's Disease Cooperative Study (J.P.), Department of Neurosciences, School of Medicine, UCSD Health, San Diego, CA; Mark and Mary Stevens Neuroimaging and Informatics Institute (J.P., V.A.), USC Alzheimer Disease Research Center, Department of Neurology, University of Southern California, Los Angeles; Department of Population and Public Health Sciences (V.A.), Keck School of Medicine, University of Southern California, Los Angeles; Memory and Aging Center (K.B.C.), Department of Neurology, University of California, San Francisco; Taub Institute for Research on Alzheimer's Disease and the Aging Brain (M.A.R., J.A.-R., Y.G., N.S., J.J.M., A.B.), Department of Neurology, Columbia University, New York City; Center for Population Health Sciences (A.H.), Department of Primary Care and Population Health, Stanford University, CA; Department of Neurology (S.E.T.), Vagelos College of Physicians and Surgeons and Department of Epidemiology, Mailman School of Public Health, Columbia University, New York City; Laboratory of Behavioral Neuroscience (N.A.), National Institute on Aging, Bethesda, MD; Department of Psychiatry and Human Behavior (N.A.), Warren Alpert Medical School of Brown University, Providence, RI; Department of Public Health Sciences (K.R.), University of California, Davis; and Department of Psychology (L.Z.), University of Michigan, Ann Arbor.
| | - Vahan Aslanyan
- From the Alzheimer's Disease Cooperative Study (J.P.), Department of Neurosciences, School of Medicine, UCSD Health, San Diego, CA; Mark and Mary Stevens Neuroimaging and Informatics Institute (J.P., V.A.), USC Alzheimer Disease Research Center, Department of Neurology, University of Southern California, Los Angeles; Department of Population and Public Health Sciences (V.A.), Keck School of Medicine, University of Southern California, Los Angeles; Memory and Aging Center (K.B.C.), Department of Neurology, University of California, San Francisco; Taub Institute for Research on Alzheimer's Disease and the Aging Brain (M.A.R., J.A.-R., Y.G., N.S., J.J.M., A.B.), Department of Neurology, Columbia University, New York City; Center for Population Health Sciences (A.H.), Department of Primary Care and Population Health, Stanford University, CA; Department of Neurology (S.E.T.), Vagelos College of Physicians and Surgeons and Department of Epidemiology, Mailman School of Public Health, Columbia University, New York City; Laboratory of Behavioral Neuroscience (N.A.), National Institute on Aging, Bethesda, MD; Department of Psychiatry and Human Behavior (N.A.), Warren Alpert Medical School of Brown University, Providence, RI; Department of Public Health Sciences (K.R.), University of California, Davis; and Department of Psychology (L.Z.), University of Michigan, Ann Arbor
| | - Kaitlin B Casaletto
- From the Alzheimer's Disease Cooperative Study (J.P.), Department of Neurosciences, School of Medicine, UCSD Health, San Diego, CA; Mark and Mary Stevens Neuroimaging and Informatics Institute (J.P., V.A.), USC Alzheimer Disease Research Center, Department of Neurology, University of Southern California, Los Angeles; Department of Population and Public Health Sciences (V.A.), Keck School of Medicine, University of Southern California, Los Angeles; Memory and Aging Center (K.B.C.), Department of Neurology, University of California, San Francisco; Taub Institute for Research on Alzheimer's Disease and the Aging Brain (M.A.R., J.A.-R., Y.G., N.S., J.J.M., A.B.), Department of Neurology, Columbia University, New York City; Center for Population Health Sciences (A.H.), Department of Primary Care and Population Health, Stanford University, CA; Department of Neurology (S.E.T.), Vagelos College of Physicians and Surgeons and Department of Epidemiology, Mailman School of Public Health, Columbia University, New York City; Laboratory of Behavioral Neuroscience (N.A.), National Institute on Aging, Bethesda, MD; Department of Psychiatry and Human Behavior (N.A.), Warren Alpert Medical School of Brown University, Providence, RI; Department of Public Health Sciences (K.R.), University of California, Davis; and Department of Psychology (L.Z.), University of Michigan, Ann Arbor
| | - Miguel Arce Rentería
- From the Alzheimer's Disease Cooperative Study (J.P.), Department of Neurosciences, School of Medicine, UCSD Health, San Diego, CA; Mark and Mary Stevens Neuroimaging and Informatics Institute (J.P., V.A.), USC Alzheimer Disease Research Center, Department of Neurology, University of Southern California, Los Angeles; Department of Population and Public Health Sciences (V.A.), Keck School of Medicine, University of Southern California, Los Angeles; Memory and Aging Center (K.B.C.), Department of Neurology, University of California, San Francisco; Taub Institute for Research on Alzheimer's Disease and the Aging Brain (M.A.R., J.A.-R., Y.G., N.S., J.J.M., A.B.), Department of Neurology, Columbia University, New York City; Center for Population Health Sciences (A.H.), Department of Primary Care and Population Health, Stanford University, CA; Department of Neurology (S.E.T.), Vagelos College of Physicians and Surgeons and Department of Epidemiology, Mailman School of Public Health, Columbia University, New York City; Laboratory of Behavioral Neuroscience (N.A.), National Institute on Aging, Bethesda, MD; Department of Psychiatry and Human Behavior (N.A.), Warren Alpert Medical School of Brown University, Providence, RI; Department of Public Health Sciences (K.R.), University of California, Davis; and Department of Psychology (L.Z.), University of Michigan, Ann Arbor
| | - Amal Harrati
- From the Alzheimer's Disease Cooperative Study (J.P.), Department of Neurosciences, School of Medicine, UCSD Health, San Diego, CA; Mark and Mary Stevens Neuroimaging and Informatics Institute (J.P., V.A.), USC Alzheimer Disease Research Center, Department of Neurology, University of Southern California, Los Angeles; Department of Population and Public Health Sciences (V.A.), Keck School of Medicine, University of Southern California, Los Angeles; Memory and Aging Center (K.B.C.), Department of Neurology, University of California, San Francisco; Taub Institute for Research on Alzheimer's Disease and the Aging Brain (M.A.R., J.A.-R., Y.G., N.S., J.J.M., A.B.), Department of Neurology, Columbia University, New York City; Center for Population Health Sciences (A.H.), Department of Primary Care and Population Health, Stanford University, CA; Department of Neurology (S.E.T.), Vagelos College of Physicians and Surgeons and Department of Epidemiology, Mailman School of Public Health, Columbia University, New York City; Laboratory of Behavioral Neuroscience (N.A.), National Institute on Aging, Bethesda, MD; Department of Psychiatry and Human Behavior (N.A.), Warren Alpert Medical School of Brown University, Providence, RI; Department of Public Health Sciences (K.R.), University of California, Davis; and Department of Psychology (L.Z.), University of Michigan, Ann Arbor
| | - Sarah E Tom
- From the Alzheimer's Disease Cooperative Study (J.P.), Department of Neurosciences, School of Medicine, UCSD Health, San Diego, CA; Mark and Mary Stevens Neuroimaging and Informatics Institute (J.P., V.A.), USC Alzheimer Disease Research Center, Department of Neurology, University of Southern California, Los Angeles; Department of Population and Public Health Sciences (V.A.), Keck School of Medicine, University of Southern California, Los Angeles; Memory and Aging Center (K.B.C.), Department of Neurology, University of California, San Francisco; Taub Institute for Research on Alzheimer's Disease and the Aging Brain (M.A.R., J.A.-R., Y.G., N.S., J.J.M., A.B.), Department of Neurology, Columbia University, New York City; Center for Population Health Sciences (A.H.), Department of Primary Care and Population Health, Stanford University, CA; Department of Neurology (S.E.T.), Vagelos College of Physicians and Surgeons and Department of Epidemiology, Mailman School of Public Health, Columbia University, New York City; Laboratory of Behavioral Neuroscience (N.A.), National Institute on Aging, Bethesda, MD; Department of Psychiatry and Human Behavior (N.A.), Warren Alpert Medical School of Brown University, Providence, RI; Department of Public Health Sciences (K.R.), University of California, Davis; and Department of Psychology (L.Z.), University of Michigan, Ann Arbor
| | - Nicole Armstrong
- From the Alzheimer's Disease Cooperative Study (J.P.), Department of Neurosciences, School of Medicine, UCSD Health, San Diego, CA; Mark and Mary Stevens Neuroimaging and Informatics Institute (J.P., V.A.), USC Alzheimer Disease Research Center, Department of Neurology, University of Southern California, Los Angeles; Department of Population and Public Health Sciences (V.A.), Keck School of Medicine, University of Southern California, Los Angeles; Memory and Aging Center (K.B.C.), Department of Neurology, University of California, San Francisco; Taub Institute for Research on Alzheimer's Disease and the Aging Brain (M.A.R., J.A.-R., Y.G., N.S., J.J.M., A.B.), Department of Neurology, Columbia University, New York City; Center for Population Health Sciences (A.H.), Department of Primary Care and Population Health, Stanford University, CA; Department of Neurology (S.E.T.), Vagelos College of Physicians and Surgeons and Department of Epidemiology, Mailman School of Public Health, Columbia University, New York City; Laboratory of Behavioral Neuroscience (N.A.), National Institute on Aging, Bethesda, MD; Department of Psychiatry and Human Behavior (N.A.), Warren Alpert Medical School of Brown University, Providence, RI; Department of Public Health Sciences (K.R.), University of California, Davis; and Department of Psychology (L.Z.), University of Michigan, Ann Arbor
| | - Kumar Rajan
- From the Alzheimer's Disease Cooperative Study (J.P.), Department of Neurosciences, School of Medicine, UCSD Health, San Diego, CA; Mark and Mary Stevens Neuroimaging and Informatics Institute (J.P., V.A.), USC Alzheimer Disease Research Center, Department of Neurology, University of Southern California, Los Angeles; Department of Population and Public Health Sciences (V.A.), Keck School of Medicine, University of Southern California, Los Angeles; Memory and Aging Center (K.B.C.), Department of Neurology, University of California, San Francisco; Taub Institute for Research on Alzheimer's Disease and the Aging Brain (M.A.R., J.A.-R., Y.G., N.S., J.J.M., A.B.), Department of Neurology, Columbia University, New York City; Center for Population Health Sciences (A.H.), Department of Primary Care and Population Health, Stanford University, CA; Department of Neurology (S.E.T.), Vagelos College of Physicians and Surgeons and Department of Epidemiology, Mailman School of Public Health, Columbia University, New York City; Laboratory of Behavioral Neuroscience (N.A.), National Institute on Aging, Bethesda, MD; Department of Psychiatry and Human Behavior (N.A.), Warren Alpert Medical School of Brown University, Providence, RI; Department of Public Health Sciences (K.R.), University of California, Davis; and Department of Psychology (L.Z.), University of Michigan, Ann Arbor
| | - Justina Avila-Rieger
- From the Alzheimer's Disease Cooperative Study (J.P.), Department of Neurosciences, School of Medicine, UCSD Health, San Diego, CA; Mark and Mary Stevens Neuroimaging and Informatics Institute (J.P., V.A.), USC Alzheimer Disease Research Center, Department of Neurology, University of Southern California, Los Angeles; Department of Population and Public Health Sciences (V.A.), Keck School of Medicine, University of Southern California, Los Angeles; Memory and Aging Center (K.B.C.), Department of Neurology, University of California, San Francisco; Taub Institute for Research on Alzheimer's Disease and the Aging Brain (M.A.R., J.A.-R., Y.G., N.S., J.J.M., A.B.), Department of Neurology, Columbia University, New York City; Center for Population Health Sciences (A.H.), Department of Primary Care and Population Health, Stanford University, CA; Department of Neurology (S.E.T.), Vagelos College of Physicians and Surgeons and Department of Epidemiology, Mailman School of Public Health, Columbia University, New York City; Laboratory of Behavioral Neuroscience (N.A.), National Institute on Aging, Bethesda, MD; Department of Psychiatry and Human Behavior (N.A.), Warren Alpert Medical School of Brown University, Providence, RI; Department of Public Health Sciences (K.R.), University of California, Davis; and Department of Psychology (L.Z.), University of Michigan, Ann Arbor
| | - Yian Gu
- From the Alzheimer's Disease Cooperative Study (J.P.), Department of Neurosciences, School of Medicine, UCSD Health, San Diego, CA; Mark and Mary Stevens Neuroimaging and Informatics Institute (J.P., V.A.), USC Alzheimer Disease Research Center, Department of Neurology, University of Southern California, Los Angeles; Department of Population and Public Health Sciences (V.A.), Keck School of Medicine, University of Southern California, Los Angeles; Memory and Aging Center (K.B.C.), Department of Neurology, University of California, San Francisco; Taub Institute for Research on Alzheimer's Disease and the Aging Brain (M.A.R., J.A.-R., Y.G., N.S., J.J.M., A.B.), Department of Neurology, Columbia University, New York City; Center for Population Health Sciences (A.H.), Department of Primary Care and Population Health, Stanford University, CA; Department of Neurology (S.E.T.), Vagelos College of Physicians and Surgeons and Department of Epidemiology, Mailman School of Public Health, Columbia University, New York City; Laboratory of Behavioral Neuroscience (N.A.), National Institute on Aging, Bethesda, MD; Department of Psychiatry and Human Behavior (N.A.), Warren Alpert Medical School of Brown University, Providence, RI; Department of Public Health Sciences (K.R.), University of California, Davis; and Department of Psychology (L.Z.), University of Michigan, Ann Arbor
| | - Nicole Schupf
- From the Alzheimer's Disease Cooperative Study (J.P.), Department of Neurosciences, School of Medicine, UCSD Health, San Diego, CA; Mark and Mary Stevens Neuroimaging and Informatics Institute (J.P., V.A.), USC Alzheimer Disease Research Center, Department of Neurology, University of Southern California, Los Angeles; Department of Population and Public Health Sciences (V.A.), Keck School of Medicine, University of Southern California, Los Angeles; Memory and Aging Center (K.B.C.), Department of Neurology, University of California, San Francisco; Taub Institute for Research on Alzheimer's Disease and the Aging Brain (M.A.R., J.A.-R., Y.G., N.S., J.J.M., A.B.), Department of Neurology, Columbia University, New York City; Center for Population Health Sciences (A.H.), Department of Primary Care and Population Health, Stanford University, CA; Department of Neurology (S.E.T.), Vagelos College of Physicians and Surgeons and Department of Epidemiology, Mailman School of Public Health, Columbia University, New York City; Laboratory of Behavioral Neuroscience (N.A.), National Institute on Aging, Bethesda, MD; Department of Psychiatry and Human Behavior (N.A.), Warren Alpert Medical School of Brown University, Providence, RI; Department of Public Health Sciences (K.R.), University of California, Davis; and Department of Psychology (L.Z.), University of Michigan, Ann Arbor
| | - Jennifer J Manly
- From the Alzheimer's Disease Cooperative Study (J.P.), Department of Neurosciences, School of Medicine, UCSD Health, San Diego, CA; Mark and Mary Stevens Neuroimaging and Informatics Institute (J.P., V.A.), USC Alzheimer Disease Research Center, Department of Neurology, University of Southern California, Los Angeles; Department of Population and Public Health Sciences (V.A.), Keck School of Medicine, University of Southern California, Los Angeles; Memory and Aging Center (K.B.C.), Department of Neurology, University of California, San Francisco; Taub Institute for Research on Alzheimer's Disease and the Aging Brain (M.A.R., J.A.-R., Y.G., N.S., J.J.M., A.B.), Department of Neurology, Columbia University, New York City; Center for Population Health Sciences (A.H.), Department of Primary Care and Population Health, Stanford University, CA; Department of Neurology (S.E.T.), Vagelos College of Physicians and Surgeons and Department of Epidemiology, Mailman School of Public Health, Columbia University, New York City; Laboratory of Behavioral Neuroscience (N.A.), National Institute on Aging, Bethesda, MD; Department of Psychiatry and Human Behavior (N.A.), Warren Alpert Medical School of Brown University, Providence, RI; Department of Public Health Sciences (K.R.), University of California, Davis; and Department of Psychology (L.Z.), University of Michigan, Ann Arbor
| | - Adam Brickman
- From the Alzheimer's Disease Cooperative Study (J.P.), Department of Neurosciences, School of Medicine, UCSD Health, San Diego, CA; Mark and Mary Stevens Neuroimaging and Informatics Institute (J.P., V.A.), USC Alzheimer Disease Research Center, Department of Neurology, University of Southern California, Los Angeles; Department of Population and Public Health Sciences (V.A.), Keck School of Medicine, University of Southern California, Los Angeles; Memory and Aging Center (K.B.C.), Department of Neurology, University of California, San Francisco; Taub Institute for Research on Alzheimer's Disease and the Aging Brain (M.A.R., J.A.-R., Y.G., N.S., J.J.M., A.B.), Department of Neurology, Columbia University, New York City; Center for Population Health Sciences (A.H.), Department of Primary Care and Population Health, Stanford University, CA; Department of Neurology (S.E.T.), Vagelos College of Physicians and Surgeons and Department of Epidemiology, Mailman School of Public Health, Columbia University, New York City; Laboratory of Behavioral Neuroscience (N.A.), National Institute on Aging, Bethesda, MD; Department of Psychiatry and Human Behavior (N.A.), Warren Alpert Medical School of Brown University, Providence, RI; Department of Public Health Sciences (K.R.), University of California, Davis; and Department of Psychology (L.Z.), University of Michigan, Ann Arbor
| | - Laura Zahodne
- From the Alzheimer's Disease Cooperative Study (J.P.), Department of Neurosciences, School of Medicine, UCSD Health, San Diego, CA; Mark and Mary Stevens Neuroimaging and Informatics Institute (J.P., V.A.), USC Alzheimer Disease Research Center, Department of Neurology, University of Southern California, Los Angeles; Department of Population and Public Health Sciences (V.A.), Keck School of Medicine, University of Southern California, Los Angeles; Memory and Aging Center (K.B.C.), Department of Neurology, University of California, San Francisco; Taub Institute for Research on Alzheimer's Disease and the Aging Brain (M.A.R., J.A.-R., Y.G., N.S., J.J.M., A.B.), Department of Neurology, Columbia University, New York City; Center for Population Health Sciences (A.H.), Department of Primary Care and Population Health, Stanford University, CA; Department of Neurology (S.E.T.), Vagelos College of Physicians and Surgeons and Department of Epidemiology, Mailman School of Public Health, Columbia University, New York City; Laboratory of Behavioral Neuroscience (N.A.), National Institute on Aging, Bethesda, MD; Department of Psychiatry and Human Behavior (N.A.), Warren Alpert Medical School of Brown University, Providence, RI; Department of Public Health Sciences (K.R.), University of California, Davis; and Department of Psychology (L.Z.), University of Michigan, Ann Arbor
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6
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Eubank JM, Oberlin DJ, Alto A, Sahyoun NR, Asongwed E, Monroe-Lord L, Harrison EA. Effects of Lifestyle Factors on Cognition in Minority Population of Older Adults: A Review. Front Nutr 2022; 9:841070. [PMID: 35369047 PMCID: PMC8966895 DOI: 10.3389/fnut.2022.841070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2021] [Accepted: 02/14/2022] [Indexed: 11/16/2022] Open
Abstract
The onset of dementia and Alzheimer's disease (AD) is projected to expand over the next several decades in the United States as the population ages. However, the cognitive health burden is not equally distributed among the population, as Hispanics and African Americans are at higher risk of AD when compared with Non-Hispanic Whites. There is some evidence to indicate that cognitive decline may be associated with lifestyle factors and that interventions in these domains may prevent or delay this decline. These lifestyle factors include social engagement, physical activity, both aerobic and strength training, dietary intake, sleep and stress. This review summarizes, in general, what is known about the relationship between risk factors and cognition and, in particular what is known about this relationship in minority populations. The results show that the relationship between these risk factors and cognitive decline is stronger for some of the factors such as physical activity and dietary intake and weaker for the other factors depending on what is measured and in what populations. It does appear, however, that the studies in minority populations is limited and warrants more targeted research and interventions.
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Affiliation(s)
- Jacob M. Eubank
- Lehman College, City University of New York, New York, NY, United States
- *Correspondence: Jacob M. Eubank ; orcid.org/0000-0003-1806-9308
| | - Douglas J. Oberlin
- Lehman College, City University of New York, New York, NY, United States
| | - Andrew Alto
- Lehman College, City University of New York, New York, NY, United States
| | - Nadine R. Sahyoun
- Department of Nutrition and Food Science, University of Maryland College Park, College Park, MD, United States
| | - Elmira Asongwed
- College of Agriculture, Urban Sustainability and Environmental Sciences, University of the District of Columbia, Washington, DC, United States
| | - Lillie Monroe-Lord
- College of Agriculture, Urban Sustainability and Environmental Sciences, University of the District of Columbia, Washington, DC, United States
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7
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Khandekar P, Shenoy S, Sathe A. Prefrontal cortex hemodynamic response to acute high intensity intermittent exercise during executive function processing. The Journal of General Psychology 2022:1-28. [PMID: 35289723 DOI: 10.1080/00221309.2022.2048785] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
We investigated prefrontal cortex (PFC) hemodynamic response, through functional near infrared spectroscopy (fNIRS) during executive function (EF) processing in response to acute high intensity intermittent exercise (HIIE) in young adults. We also assessed the associated sex differences in the cognitive scores and related PFC hemodynamic functions in response to HIIE. 49 young healthy adult participants (32 women, 17 men) were randomly assigned to either control or HIIE intervention groups. HIIE group participants performed 4 × 4 minutes of HIIE on cycle ergometer with 3 minutes of active recovery between the bouts; control group relaxed for the time equivalent to intervention. fNIRS data was collected during the performance of the EF tests including Color Word Stroop Test (CWST) and Trail Making Test (TMT) in pre and post sessions in both the groups. Results indicated a significant change in the hemodynamic response in the form of increased oxygenated and decreased deoxygenated hemoglobin in the PFC areas specific to the EF tasks, with improved CWST and TMT scores in response to HIIE intervention. PFC activation was different in men and women in response to HIIE, however similar scores of task performance were observed in men and women during the performance of executive functions in response to HIIE. The study concludes that an acute HIIE session improves executive function which is associated with an increase activation of PFC. Sex differences exist in the activation of PFC in response to HIIE during EF processing. Our study adds to the current evidence regarding exercise and cognition.
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Chappel-Farley MG, Mander BA, Neikrug AB, Stehli A, Nan B, Grill JD, Yassa MA, Benca RM. Symptoms of obstructive sleep apnea are associated with less frequent exercise and worse subjective cognitive function across adulthood. Sleep 2022; 45:zsab240. [PMID: 34604910 PMCID: PMC8919199 DOI: 10.1093/sleep/zsab240] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Revised: 08/15/2021] [Indexed: 02/07/2023] Open
Abstract
STUDY OBJECTIVES To determine whether subjective measures of exercise and sleep are associated with cognitive complaints and whether exercise effects are mediated by sleep. METHODS This study analyzed questionnaire data from adults (18-89) enrolled in a recruitment registry. The Cognitive Function Instrument (CFI) assessed cognitive complaints. Medical Outcomes Study Sleep Scale (MOS-SS) subscales and factor scores assessed sleep quality, daytime sleepiness, nighttime disturbance, and insomnia and obstructive sleep apnea (OSA)-like symptoms. Exercise frequency was defined as the weekly number of exercise sessions. Exercise frequency, MOS-SS subscales, and factor scores were examined as predictors of CFI score, adjusting for age, body mass index, education, sex, cancer diagnosis, antidepressant usage, psychiatric conditions, and medical comorbidities. Analyses of covariance examined the relationship between sleep duration groups (short, mid-range, and long) and CFI score, adjusting for covariates. Mediation by sleep in the exercise-CFI score relationship was tested. RESULTS Data from 2106 adults were analyzed. Exercise and MOS-SS subscales and factor scores were associated with CFI score. Higher Sleep Adequacy scores were associated with fewer cognitive complaints, whereas higher Sleep Somnolence, Sleep Disturbance, Sleep Problems Index I, Sleep Problems Index II, and factor scores were associated with more cognitive complaints. MOS-SS subscales and factor scores, except Sleep Disturbance and the insomnia factor score, mediated the association between exercise and cognitive complaints. CONCLUSIONS The relationship between exercise frequency and subjective cognitive performance is mediated by sleep. In particular, the mediation effect appears to be driven by symptoms possibly suggestive of OSA which are negatively associated with exercise engagement, sleep quality, daytime sleepiness, and subjective cognitive performance.
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Affiliation(s)
- Miranda G Chappel-Farley
- Department of Neurobiology and Behavior, University of California, Irvine, Irvine, CA, USA
- Center for the Neurobiology of Learning and Memory, University of California, Irvine, Irvine, CA, USA
| | - Bryce A Mander
- Center for the Neurobiology of Learning and Memory, University of California, Irvine, Irvine, CA, USA
- Department of Psychiatry and Human Behavior, University of California, Irvine, Irvine, CA, USA
- Institute for Memory Impairments and Neurological Disorders, University of California, Irvine, Irvine, CA, USA
- Department of Cognitive Sciences, University of California Irvine, Irvine, CA, USA
| | - Ariel B Neikrug
- Department of Psychiatry and Human Behavior, University of California, Irvine, Irvine, CA, USA
| | - Annamarie Stehli
- Department of Psychiatry and Human Behavior, University of California, Irvine, Irvine, CA, USA
| | - Bin Nan
- Center for the Neurobiology of Learning and Memory, University of California, Irvine, Irvine, CA, USA
- Institute for Memory Impairments and Neurological Disorders, University of California, Irvine, Irvine, CA, USA
- Department of Statistics, University of California, Irvine, Irvine, CA, USA
| | - Joshua D Grill
- Department of Neurobiology and Behavior, University of California, Irvine, Irvine, CA, USA
- Department of Psychiatry and Human Behavior, University of California, Irvine, Irvine, CA, USA
- Institute for Memory Impairments and Neurological Disorders, University of California, Irvine, Irvine, CA, USA
| | - Michael A Yassa
- Department of Neurobiology and Behavior, University of California, Irvine, Irvine, CA, USA
- Center for the Neurobiology of Learning and Memory, University of California, Irvine, Irvine, CA, USA
- Department of Psychiatry and Human Behavior, University of California, Irvine, Irvine, CA, USA
- Institute for Memory Impairments and Neurological Disorders, University of California, Irvine, Irvine, CA, USA
| | - Ruth M Benca
- Department of Neurobiology and Behavior, University of California, Irvine, Irvine, CA, USA
- Center for the Neurobiology of Learning and Memory, University of California, Irvine, Irvine, CA, USA
- Department of Psychiatry and Human Behavior, University of California, Irvine, Irvine, CA, USA
- Institute for Memory Impairments and Neurological Disorders, University of California, Irvine, Irvine, CA, USA
- Department of Psychiatry and Behavioral Medicine, Wake Forest University, Winston-Salem, NC, USA
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9
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Predovan D, Gazes Y, Lee S, Li P, Sloan RP, Stern Y. Effect of Aerobic Exercise on White Matter Tract Microstructure in Young and Middle-Aged Healthy Adults. Front Hum Neurosci 2021; 15:681634. [PMID: 34276329 PMCID: PMC8283503 DOI: 10.3389/fnhum.2021.681634] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2021] [Accepted: 05/10/2021] [Indexed: 11/13/2022] Open
Abstract
Recent evidence suggests that being physically active can mitigate age-related white matter (WM) changes. In a randomized clinical trial, the effect of 6-month aerobic exercise (AE) or stretching/toning interventions on measures of WM microstructure (WMM) was assessed in a sample of 74 adults aged 20-67 years. Major WM pathways were reconstructed. No significant group-level change in WM tract microstructure following an AE training was observed. Without adjustment for multiple comparisons, an increase in fractional anisotropy (FA) and a decrease in mean diffusivity (MD) of the uncinate fasciculus were observed post-intervention in the AE group in comparison with the stretching group. In the AE group, a significant increase in cardiorespiratory fitness was measured but did not correlate with FA and MD change. The present results of this study are in accordance with similar studies in healthy adults that did not show significant benefit on WMM after participating in an AE program. Clinical Trial Registration: Clinicaltrials.gov identifier, NCT01179958.
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Affiliation(s)
- David Predovan
- Cognitive Neuroscience Division, The Taub Institute for Research on Aging and Alzheimer's Disease, Columbia University, New York, NY, United States
| | - Yunglin Gazes
- Cognitive Neuroscience Division, The Taub Institute for Research on Aging and Alzheimer's Disease, Columbia University, New York, NY, United States
| | - Seonjoo Lee
- Department of Biostatistics, Columbia University, New York, NY, United States.,Mental Health Data Science, New York State Psychiatric Institute, New York, NY, United States
| | - Peipei Li
- Cognitive Neuroscience Division, The Taub Institute for Research on Aging and Alzheimer's Disease, Columbia University, New York, NY, United States
| | - Richard P Sloan
- Division of Behavioral Medicine, Department of Psychiatry, Columbia University, New York, NY, United States
| | - Yaakov Stern
- Cognitive Neuroscience Division, The Taub Institute for Research on Aging and Alzheimer's Disease, Columbia University, New York, NY, United States
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10
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Krüger RL, Clark CM, Dyck AM, Anderson TJ, Clement F, Hanly PJ, Hanson HM, Hill MD, Hogan DB, Holroyd-Leduc J, Longman RS, McDonough M, Pike GB, Rawling JM, Sajobi T, Poulin MJ. The Brain in Motion II Study: study protocol for a randomized controlled trial of an aerobic exercise intervention for older adults at increased risk of dementia. Trials 2021; 22:394. [PMID: 34127029 PMCID: PMC8201462 DOI: 10.1186/s13063-021-05336-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2020] [Accepted: 05/21/2021] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND There remains no effective intervention capable of reversing most cases of dementia. Current research is focused on prevention by addressing risk factors that are shared between cardiovascular disease and dementia (e.g., hypertension) before the cognitive, functional, and behavioural symptoms of dementia manifest. A promising preventive treatment is exercise. This study describes the methods of a randomized controlled trial (RCT) that assesses the effects of aerobic exercise and behavioural support interventions in older adults at increased risk of dementia due to genetic and/or cardiovascular risk factors. The specific aims are to determine the effect of aerobic exercise on cognitive performance, explore the biological mechanisms that influence cognitive performance after exercise training, and determine if changes in cerebrovascular physiology and function persist 1 year after a 6-month aerobic exercise intervention followed by a 1-year behavioural support programme (at 18 months). METHODS We will recruit 264 participants (aged 50-80 years) at elevated risk of dementia. Participants will be randomly allocated into one of four treatment arms: (1) aerobic exercise and health behaviour support, (2) aerobic exercise and no health behaviour support, (3) stretching-toning and health behaviour support, and (4) stretching-toning and no health behaviour support. The aerobic exercise intervention will consist of three supervised walking/jogging sessions per week for 6 months, whereas the stretching-toning control intervention will consist of three supervised stretching-toning sessions per week also for 6 months. Following the exercise interventions, participants will receive either 1 year of ongoing telephone behavioural support or no telephone support. The primary aim is to determine the independent effect of aerobic exercise on a cognitive composite score in participants allocated to this intervention compared to participants allocated to the stretching-toning group. The secondary aims are to examine the effects of aerobic exercise on a number of secondary outcomes and determine whether aerobic exercise-related changes persist after a 1-year behavioural support programme (at 18 months). DISCUSSION This study will address knowledge gaps regarding the underlying mechanisms of the pro-cognitive effects of exercise by examining the potential mediating factors, including cerebrovascular/physiological, neuroimaging, sleep, and genetic factors that will provide novel biologic evidence on how aerobic exercise can prevent declines in cognition with ageing. TRIAL REGISTRATION ClinicalTrials.gov NCT03035851 . Registered on 30 January 2017.
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Affiliation(s)
- Renata L. Krüger
- Department of Physiology & Pharmacology, Cumming School of Medicine, University of Calgary, Calgary, Alberta T2N 4N1 Canada
- Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Calgary, Alberta T2N 4N1 Canada
| | - Cameron M. Clark
- Department of Physiology & Pharmacology, Cumming School of Medicine, University of Calgary, Calgary, Alberta, T2N 4N1, Canada, Calgary, Alberta Canada
| | - Adrienna M. Dyck
- Department of Physiology & Pharmacology, Cumming School of Medicine, University of Calgary, Calgary, Alberta T2N 4N1 Canada
- Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Calgary, Alberta T2N 4N1 Canada
| | - Todd J. Anderson
- Department of Cardiac Sciences at the University of Calgary, Calgary, Alberta T2N 4N1 Canada
- Libin Cardiovascular Institute of Alberta, Cumming School of Medicine, University of Calgary, Calgary, Alberta T2N 4N1 Canada
| | - Fiona Clement
- Department of Community Health Sciences at the University of Calgary, Calgary, Alberta T2N 4N1 Canada
- O’Brien Institute for Public Health, Cumming School of Medicine, University of Calgary, Calgary, Alberta T2N 4N1 Canada
| | - Patrick J. Hanly
- Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Calgary, Alberta T2N 4N1 Canada
- Sleep Centre, Foothills Medical Centre, University of Calgary, Calgary, Alberta T2N 4N1 Canada
| | - Heather M. Hanson
- Department of Community Health Sciences at the University of Calgary, Calgary, Alberta T2N 4N1 Canada
- Seniors Health Strategic Clinical Network™, Alberta Health Services, Edmonton, Alberta Canada
| | - Michael D. Hill
- Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Calgary, Alberta T2N 4N1 Canada
- Department of Community Health Sciences at the University of Calgary, Calgary, Alberta T2N 4N1 Canada
- Department of Clinical Neurosciences at the University of Calgary, Calgary, Alberta T2N 4N1 Canada
- Department of Medicine at the University of Calgary, T2N 4 N1, Calgary, Alberta Canada
- Department of Radiology at the University of Calgary, Calgary, Alberta T2N 4N1 Canada
| | - David B. Hogan
- Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Calgary, Alberta T2N 4N1 Canada
- Department of Community Health Sciences at the University of Calgary, Calgary, Alberta T2N 4N1 Canada
- O’Brien Institute for Public Health, Cumming School of Medicine, University of Calgary, Calgary, Alberta T2N 4N1 Canada
- Seniors Health Strategic Clinical Network™, Alberta Health Services, Edmonton, Alberta Canada
- Department of Medicine at the University of Calgary, T2N 4 N1, Calgary, Alberta Canada
| | - Jayna Holroyd-Leduc
- Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Calgary, Alberta T2N 4N1 Canada
- Department of Community Health Sciences at the University of Calgary, Calgary, Alberta T2N 4N1 Canada
- O’Brien Institute for Public Health, Cumming School of Medicine, University of Calgary, Calgary, Alberta T2N 4N1 Canada
- Seniors Health Strategic Clinical Network™, Alberta Health Services, Edmonton, Alberta Canada
- Department of Medicine at the University of Calgary, T2N 4 N1, Calgary, Alberta Canada
| | - R. Stewart Longman
- Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Calgary, Alberta T2N 4N1 Canada
- Sleep Centre, Foothills Medical Centre, University of Calgary, Calgary, Alberta T2N 4N1 Canada
| | - Meghan McDonough
- O’Brien Institute for Public Health, Cumming School of Medicine, University of Calgary, Calgary, Alberta T2N 4N1 Canada
- Faculty of Kinesiology, University of Calgary, Calgary, Alberta T2N 4N1 Canada
| | - G. Bruce Pike
- Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Calgary, Alberta T2N 4N1 Canada
- Department of Clinical Neurosciences at the University of Calgary, Calgary, Alberta T2N 4N1 Canada
- Department of Radiology at the University of Calgary, Calgary, Alberta T2N 4N1 Canada
- CAIP Chair in Healthy Brain Aging, Calgary, Canada
| | - Jean M. Rawling
- Department of Family Medicine at the University of Calgary, Calgary, Alberta T2N 4N1 Canada
| | - Tolulope Sajobi
- Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Calgary, Alberta T2N 4N1 Canada
- Department of Community Health Sciences at the University of Calgary, Calgary, Alberta T2N 4N1 Canada
- O’Brien Institute for Public Health, Cumming School of Medicine, University of Calgary, Calgary, Alberta T2N 4N1 Canada
| | - Marc J. Poulin
- Department of Physiology & Pharmacology, Cumming School of Medicine, University of Calgary, Calgary, Alberta T2N 4N1 Canada
- Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Calgary, Alberta T2N 4N1 Canada
- Libin Cardiovascular Institute of Alberta, Cumming School of Medicine, University of Calgary, Calgary, Alberta T2N 4N1 Canada
- O’Brien Institute for Public Health, Cumming School of Medicine, University of Calgary, Calgary, Alberta T2N 4N1 Canada
- Department of Clinical Neurosciences at the University of Calgary, Calgary, Alberta T2N 4N1 Canada
- Faculty of Kinesiology, University of Calgary, Calgary, Alberta T2N 4N1 Canada
- Brenda Strafford Foundation Chair in Alzheimer Research, Calgary, Alberta Canada
- Heritage Medical Research Building, Room 210, 3330 Hospital Drive NW, Calgary, Alberta T2N 4N1 Canada
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Lazar RM, Howard VJ, Kernan WN, Aparicio HJ, Levine DA, Viera AJ, Jordan LC, Nyenhuis DL, Possin KL, Sorond FA, White CL. A Primary Care Agenda for Brain Health: A Scientific Statement From the American Heart Association. Stroke 2021; 52:e295-e308. [PMID: 33719523 PMCID: PMC8995075 DOI: 10.1161/str.0000000000000367] [Citation(s) in RCA: 37] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
A healthy brain is critical for living a longer and fuller life. The projected aging of the population, however, raises new challenges in maintaining quality of life. As we age, there is increasing compromise of neuronal activity that affects functions such as cognition, also making the brain vulnerable to disease. Once pathology-induced decline begins, few therapeutic options are available. Prevention is therefore paramount, and primary care can play a critical role. The purpose of this American Heart Association scientific statement is to provide an up-to-date summary for primary care providers in the assessment and modification of risk factors at the individual level that maintain brain health and prevent cognitive impairment. Building on the 2017 American Heart Association/American Stroke Association presidential advisory on defining brain health that included "Life's Simple 7," we describe here modifiable risk factors for cognitive decline, including depression, hypertension, physical inactivity, diabetes, obesity, hyperlipidemia, poor diet, smoking, social isolation, excessive alcohol use, sleep disorders, and hearing loss. These risk factors include behaviors, conditions, and lifestyles that can emerge before adulthood and can be routinely identified and managed by primary care clinicians.
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12
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Roeh A, Schoenfeld J, Raab R, Landes V, Papazova I, Haller B, Strube W, Halle M, Falkai P, Hasan A, Scherr J. Effects of Marathon Running on Cognition and Retinal Vascularization: A Longitudinal Observational Study. Med Sci Sports Exerc 2021; 53:2207-2214. [PMID: 34033620 DOI: 10.1249/mss.0000000000002699] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
INTRODUCTION Physical activity has beneficial effects on both cardiovascular and neurocognitive parameters, and these 2 modalities are known to interact at rest. However, findings on their interaction during exercise are inconclusive. PURPOSE Therefore, this longitudinal study aimed to investigate the effects of different forms of exercise (training period, marathon race, recovery period) on both parameters and their interaction. METHODS We included 100 marathon runners (MA) (mean [SD] age: 43.6 [10.0] years, 80 male) and 46 age- and sex-matched sedentary controls (SC, for baseline comparison). Over the 6-month study period with 6 visits (12 and 2 weeks before the marathon; immediately, 24 hours, 72 hours and 12 weeks after the marathon), we assessed cognitive parameters by evaluating 1-to 3-back d prime, the d2 task, and the Trail Making Test A (TMTA) and B (TMTB); retinal vessel parameters by assessing arteriolar-to-venular ratio (AVR), central retinal arteriolar and venular equivalents (CRAE/CRVE). RESULTS In the long-term analysis, 3-back d prime correlated positively with AVR (P = 0.024, B = 1.86,SE = 0.824) and negatively with CRVE (P = 0.05,B = -0.006,SE = 0.003) and TMTB correlated negatively with CRAE (P = 0.025,B = -0.155,SE = 0.069), even after correcting for age and systolic blood pressure as possible confounders. Acute effects were inconsistent with maximal cognitive improvement 24 hours after the marathon. AVR was significantly smaller in SC compared to MA. CONCLUSION Chronic exercise seems to prime the central nervous system for acute, intensive bouts of exercise. Our findings indicate a possible relationship between cognitive performance in high-demand tasks and retinal vasculature and support the idea of a neuroplastic effect of exercise.
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Affiliation(s)
- Astrid Roeh
- Department of Psychiatry and Psychotherapy, Klinikum der Universität München, Ludwig-Maximilians University Munich, Munich, Germany Department of Prevention and Sports Medicine, Klinikum rechts der Isar, Technische Universitaet Muenchen, Munich, Germany Deutsches Zentrum für Herz- und Kreislauf-Forschung (DZHK) e.V. (German Center for Cardiovascular Research), Partner Site Munich Heart Alliance, Munich, Germany Institute of Medical Informatics, Statistics and Epidemiology, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany Department of Psychiatry, Psychotherapy and Psychosomatics of the University Augsburg, Bezirkskrankenhaus Augsburg, Medical Faculty, University of Augsburg, Augsburg, Germany University Center for Preventive and Sports Medicine, Balgrist University Hospital, University of Zurick, Zurich, Switzerland
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Krell-Roesch J, Syrjanen JA, Bezold J, Trautwein S, Barisch-Fritz B, Boes K, Woll A, Forzani E, Kremers WK, Machulda MM, Mielke MM, Knopman DS, Petersen RC, Vassilaki M, Geda YE. Physical Activity and Trajectory of Cognitive Change in Older Persons: Mayo Clinic Study of Aging. J Alzheimers Dis 2021; 79:377-388. [PMID: 33216032 PMCID: PMC7839815 DOI: 10.3233/jad-200959] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/21/2020] [Indexed: 01/03/2023]
Abstract
BACKGROUND Little is known about the association between physical activity (PA) and cognitive trajectories in older adults. OBJECTIVE To examine the association between PA and change in memory, language, attention, visuospatial skills, and global cognition, and a potential impact of sex or Apolipoprotein E (APOE) ɛ4 status. METHODS Longitudinal study derived from the population-based Mayo Clinic Study of Aging, including 2,060 cognitively unimpaired males and females aged ≥70 years. Engagement in midlife (ages 50-65) and late-life (last year) PA was assessed using a questionnaire. Neuropsychological testing was done every 15 months (mean follow-up 5.8 years). We ran linear mixed-effect models to examine whether mid- or late-life PA at three intensities (mild, moderate, vigorous) was associated with cognitive z-scores. RESULTS Light intensity midlife PA was associated with less decline in memory function compared to the no-PA reference group (time x light PA; estimate [standard error] 0.047 [0.016], p = 0.004). Vigorous late-life PA was associated with less decline in language (0.033 [0.015], p = 0.030), attention (0.032 [0.017], p = 0.050), and global cognition (0.039 [0.016], p = 0.012). Females who were physically inactive in midlife experienced more pronounced cognitive decline than females physically active in midlife and males regardless of PA (p-values for time interaction terms with midlife PA levels and sex were all p < 0.05 for global cognition). APOE ɛ4 carriership did not moderate the association between PA and cognition. CONCLUSION Engaging in PA, particularly of vigorous intensity in late-life, was associated with less pronounced decline in global and domain-specific cognition. This association may differ by sex.
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Affiliation(s)
- Janina Krell-Roesch
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
- Institute of Sports and Sports Science, Karlsruhe Institute of Technology, Karlsruhe, Germany
| | | | - Jelena Bezold
- Institute of Sports and Sports Science, Karlsruhe Institute of Technology, Karlsruhe, Germany
| | - Sandra Trautwein
- Institute of Sports and Sports Science, Karlsruhe Institute of Technology, Karlsruhe, Germany
| | - Bettina Barisch-Fritz
- Institute of Sports and Sports Science, Karlsruhe Institute of Technology, Karlsruhe, Germany
| | - Klaus Boes
- Institute of Sports and Sports Science, Karlsruhe Institute of Technology, Karlsruhe, Germany
| | - Alexander Woll
- Institute of Sports and Sports Science, Karlsruhe Institute of Technology, Karlsruhe, Germany
| | - Erica Forzani
- Biodesign Institute, Arizona State University, Tempe, AZ, USA
| | - Walter K. Kremers
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
| | - Mary M. Machulda
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA
| | - Michelle M. Mielke
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
- Department of Neurology, Mayo Clinic, Rochester, MN, USA
| | | | - Ronald C. Petersen
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
- Department of Neurology, Mayo Clinic, Rochester, MN, USA
| | - Maria Vassilaki
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
| | - Yonas E. Geda
- Biodesign Institute, Arizona State University, Tempe, AZ, USA
- Department of Neurology, Barrow Neurological Institute, Phoenix, AZ, USA
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Gu Y, Beato JM, Amarante E, Chesebro AG, Manly JJ, Schupf N, Mayeux RP, Brickman AM. Assessment of Leisure Time Physical Activity and Brain Health in a Multiethnic Cohort of Older Adults. JAMA Netw Open 2020; 3:e2026506. [PMID: 33211111 PMCID: PMC7677758 DOI: 10.1001/jamanetworkopen.2020.26506] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
IMPORTANCE Results from longitudinal studies suggest that regular leisure time physical activity (LTPA) is associated with reduced risk of dementia or Alzheimer disease. Data on the association between LTPA and brain magnetic resonance imaging (MRI) measures remain scarce and inconsistent. OBJECTIVE To examine the association of LTPA and MRI-assessed brain aging measures in a multiethnic elderly population. DESIGN, SETTING, AND PARTICIPANTS This cross-sectional study included 1443 older (≥65 years) adults without dementia who were participants of the Washington/Hamilton Heights-Inwood Columbia Aging Project study. LTPA, from self-reported questionnaire, was calculated as metabolic equivalent of energy expenditure. Both moderate to vigorous LTPA, assessed as meeting Physical Activity Guidelines for Americans (≥150 minutes/week) or not, and light-intensity LTPA were also examined. EXPOSURES LTPA. MAIN OUTCOMES AND MEASURES Primary outcomes included total brain volume (TBV), cortical thickness, and white matter hyperintensity volume, all derived from MRI scans with established methods and adjusted for intracranial volume when necessary. We examined the association of LTPA with these imaging markers using regression models adjusted for demographic, clinical, and vascular risk factors. RESULTS The 1443 participants of the study had a mean (SD) age of 77.2 (6.4) years; 921 (63.8%) were women; 27.0%, 34.4%, and 36.3% were non-Hispanic White, non-Hispanic African American, and Hispanic individuals, respectively; and 27.3% carried the apolipoprotein E (APOE) ɛ4 allele. Compared with the LTPA of nonactive older adults, those with the most LTPA had larger (in cm3) TBV (β [SE], 13.17 [4.42] cm3; P = .003; P for trend = .006) and greater cortical thickness (β [SE], 0.016 [0.008] mm; P = .05; P for trend = .03). The effect size comparing the highest LTPA level with the nonactive group was equivalent to approximately 3 to 4 years of aging (β for 1 year older, -3.06 and -0.005 for TBV and cortical thickness, respectively). A dose-response association was found and even the lowest LTPA level had benefits (eg, TBV: β [SE], 9.03 [4.26] cm3; P = .03) compared with the nonactive group. Meeting Physical Activity Guidelines for Americans (TBV: β [SE], 18.82 [5.14] cm3; P < .001) and light-intensity LTPA (TBV: β [SE], 9.26 [4.29] cm3; P = .03) were also associated with larger brain measures. The association between LTPA and TBV was moderated by race/ethnicity, sex, and APOE status, but generally existed in all subgroups. The results remained similar after excluding participants with mild cognitive impairment. CONCLUSIONS AND RELEVANCE In this study, more physical activity was associated with larger brain volume in older adults. Longitudinal studies are warranted to explore the potential role of physical activity in brain health among older individuals.
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Affiliation(s)
- Yian Gu
- Taub Institute for Research in Alzheimer’s Disease and the Aging Brain, Columbia University, New York, New York
- Department of Neurology, Columbia University, New York, New York
- Gertrude H. Sergievsky Center, Columbia University, New York, New York
- Joseph P. Mailman School of Public Health, Department of Epidemiology, Columbia University, New York, New York
| | - Juliet M. Beato
- Taub Institute for Research in Alzheimer’s Disease and the Aging Brain, Columbia University, New York, New York
| | - Erica Amarante
- Taub Institute for Research in Alzheimer’s Disease and the Aging Brain, Columbia University, New York, New York
| | - Anthony G. Chesebro
- Taub Institute for Research in Alzheimer’s Disease and the Aging Brain, Columbia University, New York, New York
| | - Jennifer J. Manly
- Taub Institute for Research in Alzheimer’s Disease and the Aging Brain, Columbia University, New York, New York
- Department of Neurology, Columbia University, New York, New York
- Gertrude H. Sergievsky Center, Columbia University, New York, New York
| | - Nicole Schupf
- Taub Institute for Research in Alzheimer’s Disease and the Aging Brain, Columbia University, New York, New York
- Department of Neurology, Columbia University, New York, New York
- Joseph P. Mailman School of Public Health, Department of Epidemiology, Columbia University, New York, New York
| | - Richard P. Mayeux
- Taub Institute for Research in Alzheimer’s Disease and the Aging Brain, Columbia University, New York, New York
- Department of Neurology, Columbia University, New York, New York
- Gertrude H. Sergievsky Center, Columbia University, New York, New York
- Joseph P. Mailman School of Public Health, Department of Epidemiology, Columbia University, New York, New York
| | - Adam M. Brickman
- Taub Institute for Research in Alzheimer’s Disease and the Aging Brain, Columbia University, New York, New York
- Department of Neurology, Columbia University, New York, New York
- Gertrude H. Sergievsky Center, Columbia University, New York, New York
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