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Miladitiya A, Juniarto AZ, Nugrohowati AK, Winarni TI. The Role of Body Mass Index, Advanced Age, and Low Educational Attainment in Mild Cognitive Impairment among the Older Adult Population: A Study in a Rural Area in Indonesia. J Nutr Gerontol Geriatr 2023; 42:144-160. [PMID: 37610863 DOI: 10.1080/21551197.2023.2249835] [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: 08/25/2023]
Abstract
This study evaluated the prevalence of mild cognitive impairment (MCI) and factors associated with MCI among older adults in a rural area of Indonesia. This cross-sectional study was conducted in a rural area of East Java, Indonesia. Four hundred and twenty-seven older adults aged ≥60 years were included in the study. MCI was assessed using the Brain Health Test Cognitive Tool. Data related to possible risk factors were obtained using semi-structured questionnaires. The indirect body mass index was determined based on ulnar length. The prevalence of MCI was 12.9%. Being underweight (<18.5 kg/m2) (odds ratio [OR], 2.42; 95% confidence interval [CI], 1.17-4.97; p = 0.016), requiring assistance to manage money or medications (OR, 2.72; 95% CI, 1.02-7.23; p = 0.045), age ≥70 years (OR, 2.50; 95% CI, 1.11-5.60; p = 0.026), and having an educational attainment of ≤6 years (OR, 4.92; 95% CI, 1.92-12.60; p = 0.001) were significantly associated with MCI. In this Indonesian older adult population, underweight people who had an educational attainment of <6 years, those aged ≥70 years, and those who needed assistance to manage money or medications were more likely to have MCI.
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Affiliation(s)
- Aulia Miladitiya
- Magister of Nutrition, Faculty of Medicine, Universitas Diponegoro, Semarang, Central Java, Indonesia
| | - Achmad Zulfa Juniarto
- Department of Biology, Faculty of Medicine, Universitas Diponegoro, Semarang, Central Java, Indonesia
| | - Annta Kern Nugrohowati
- Clinical Nutrition Department, Diponegoro National Hospital, Semarang, Central Java, Indonesia
| | - Tri Indah Winarni
- Department of Anatomy, Faculty of Medicine, Universitas Diponegoro, Semarang, Central Java, Indonesia
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Flores-Cordero JA, Pérez-Pérez A, Jiménez-Cortegana C, Alba G, Flores-Barragán A, Sánchez-Margalet V. Obesity as a Risk Factor for Dementia and Alzheimer's Disease: The Role of Leptin. Int J Mol Sci 2022; 23:5202. [PMID: 35563589 PMCID: PMC9099768 DOI: 10.3390/ijms23095202] [Citation(s) in RCA: 42] [Impact Index Per Article: 21.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2022] [Revised: 05/02/2022] [Accepted: 05/04/2022] [Indexed: 12/12/2022] Open
Abstract
Obesity is a growing worldwide health problem, affecting many people due to excessive saturated fat consumption, lack of exercise, or a sedentary lifestyle. Leptin is an adipokine secreted by adipose tissue that increases in obesity and has central actions not only at the hypothalamic level but also in other regions and nuclei of the central nervous system (CNS) such as the cerebral cortex and hippocampus. These regions express the long form of leptin receptor LepRb, which is the unique leptin receptor capable of transmitting complete leptin signaling, and are the first regions to be affected by chronic neurocognitive deficits, such as mild cognitive impairment (MCI) and Alzheimer's Disease (AD). In this review, we discuss different leptin resistance mechanisms that could be implicated in increasing the risk of developing AD, as leptin resistance is frequently associated with obesity, which is a chronic low-grade inflammatory state, and obesity is considered a risk factor for AD. Key players of leptin resistance are SOCS3, PTP1B, and TCPTP whose signalling is related to inflammation and could be worsened in AD. However, some data are controversial, and it is necessary to further investigate the underlying mechanisms of the AD-causing pathological processes and how altered leptin signalling affects such processes.
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Affiliation(s)
| | | | | | | | | | - Víctor Sánchez-Margalet
- Department of Medical Biochemistry and Molecular Biology and Immunology, Medical School, Virgen Macarena University Hospital, University of Seville, Av. Sánchez Pizjuan 4, 41009 Sevilla, Spain; (J.A.F.-C.); (A.P.-P.); (C.J.-C.); (G.A.); (A.F.-B.)
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Chen MH, Hsu JW, Huang KL, Tsai SJ, Su TP, Li CT, Lin WC, Tu PC, Bai YM. Role of appetite hormone dysregulation in the cognitive function among patients with bipolar disorder and major depressive disorder. World J Biol Psychiatry 2021; 22:428-434. [PMID: 32892683 DOI: 10.1080/15622975.2020.1819566] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
OBJECTIVES The association of appetite hormones with cognitive function in patients with affective disorders remains unknown. METHODS All total, 58 adult patients with bipolar I disorder, 36 with bipolar II disorder, 40 with major depressive disorder were enrolled and age and sex-matched with 40 controls. The levels of appetite hormones leptin, ghrelin, insulin and adiponectin were assessed. Wisconsin Card Sorting Test was used to assess executive function. RESULTS A general linear model, adjusted for demographic data and clinical symptoms, demonstrated the ghrelin levels were higher in patients with bipolar I or II disorder than in those with major depressive disorder and controls (p < 0.001). We also identified a positive correlation of ghrelin level and executive function among patients with bipolar I (p = 0.033) and II (p = 0.027) disorders, but not among those with major depressive disorder and controls. CONCLUSIONS Patients with bipolar I or II disorder were more likely to have high levels of ghrelin than patients with major depressive disorder and controls, which may have a positive correlation on the cognitive function of patients with bipolar I or II disorder.
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Affiliation(s)
- Mu-Hong Chen
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan.,Institute of Brain Science, National Yang-Ming University, Taipei, Taiwan.,Division of Psychiatry, School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Ju-Wei Hsu
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan.,Division of Psychiatry, School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Kai-Lin Huang
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan.,Division of Psychiatry, School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Shih-Jen Tsai
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan.,Institute of Brain Science, National Yang-Ming University, Taipei, Taiwan.,Division of Psychiatry, School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Tung-Ping Su
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan.,Institute of Brain Science, National Yang-Ming University, Taipei, Taiwan.,Division of Psychiatry, School of Medicine, National Yang-Ming University, Taipei, Taiwan.,Division of Psychiatry, Faculty of Medicine, National Yang-Ming University, Taipei, Taiwan.,Department of Psychiatry, General Cheng Hsin Hospital, Taipei, Taiwan
| | - Cheng-Ta Li
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan.,Institute of Brain Science, National Yang-Ming University, Taipei, Taiwan.,Division of Psychiatry, School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Wei-Chen Lin
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan.,Institute of Brain Science, National Yang-Ming University, Taipei, Taiwan.,Division of Psychiatry, School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Pei-Chi Tu
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan.,Division of Psychiatry, Faculty of Medicine, National Yang-Ming University, Taipei, Taiwan.,Department of Medical Research, Taipei Veterans General Hospital, Taipei, Taiwan.,Institute of Philosophy of Mind and Cognition, National Yang-Ming University, Taipei, Taiwan
| | - Ya-Mei Bai
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan.,Institute of Brain Science, National Yang-Ming University, Taipei, Taiwan.,Division of Psychiatry, School of Medicine, National Yang-Ming University, Taipei, Taiwan
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Kendig MD, Leigh SJ, Morris MJ. Unravelling the impacts of western-style diets on brain, gut microbiota and cognition. Neurosci Biobehav Rev 2021; 128:233-243. [PMID: 34153343 DOI: 10.1016/j.neubiorev.2021.05.031] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2020] [Revised: 03/23/2021] [Accepted: 05/24/2021] [Indexed: 02/06/2023]
Abstract
The steady rise in the prevalence of obesity has been fostered by modern environments that reduce energy expenditure and encourage consumption of 'western'-style diets high in fat and sugar. Obesity has been consistently associated with impairments in executive function and episodic memory, while emerging evidence indicates that high-fat, high-sugar diets can impair aspects of cognition within days, even when provided intermittently. Here we review the detrimental effects of diet and obesity on cognition and the role of inflammatory and circulating factors, compromised blood-brain barrier integrity and gut microbiome changes. We next evaluate evidence for changing risk profiles across life stages (adolescence and ageing) and other populations at risk (e.g. through maternal obesity). Finally, interventions to ameliorate diet-induced cognitive deficits are discussed, including dietary shifts, exercise, and the emerging field of microbiome-targeted therapies. With evidence that poor diet and obesity impair cognition via multiple mechanisms across the human lifespan, the challenge for future research is to identify effective interventions, in addition to diet and exercise, to prevent and ameliorate adverse effects.
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Leigh SJ, Morris MJ. Diet, inflammation and the gut microbiome: Mechanisms for obesity-associated cognitive impairment. Biochim Biophys Acta Mol Basis Dis 2020; 1866:165767. [PMID: 32171891 DOI: 10.1016/j.bbadis.2020.165767] [Citation(s) in RCA: 100] [Impact Index Per Article: 25.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2019] [Revised: 02/18/2020] [Accepted: 03/09/2020] [Indexed: 12/11/2022]
Abstract
Poor diet and obesity are associated with cognitive impairment throughout adulthood, and increased dementia risk in aging. Here we review the current literature interrogating the mechanisms by which diets high in fat, or fat and sugar lead to cognitive impairment, focusing on changes to gut microbiome composition, inflammatory signalling and blood-brain barrier integrity. Preclinical studies indicate weight gain is not necessary for diet-induced cognitive impairment. Rather, gut microbiome composition, and systemic and central inflammatory processes appear to contribute to diet-induced cognitive impairment. While both obese humans and rodents exhibit reduced blood-brain barrier integrity, cognitive impairments precede these changes, suggesting other mechanisms may underly diet-induced cognitive changes. Other potential candidates include hormone, glucoregulatory and cardiovascular changes. Poor diet and obesity act through multiple mechanisms to affect cognitive health and the challenge for future research is to identify key processes that can be reversed to improve cognition and quality of life.
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