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Meng L, Jin H, Yulug B, Altay O, Li X, Hanoglu L, Cankaya S, Coskun E, Idil E, Nogaylar R, Ozsimsek A, Shoaie S, Turkez H, Nielsen J, Zhang C, Borén J, Uhlén M, Mardinoglu A. Multi-omics analysis reveals the key factors involved in the severity of the Alzheimer's disease. Alzheimers Res Ther 2024; 16:213. [PMID: 39358810 PMCID: PMC11448018 DOI: 10.1186/s13195-024-01578-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2024] [Accepted: 09/22/2024] [Indexed: 10/04/2024]
Abstract
Alzheimer's disease (AD) is a debilitating neurodegenerative disorder with a global impact, yet its pathogenesis remains poorly understood. While age, metabolic abnormalities, and accumulation of neurotoxic substances are potential risk factors for AD, their effects are confounded by other factors. To address this challenge, we first utilized multi-omics data from 87 well phenotyped AD patients and generated plasma proteomics and metabolomics data, as well as gut and saliva metagenomics data to investigate the molecular-level alterations accounting the host-microbiome interactions. Second, we analyzed individual omics data and identified the key parameters involved in the severity of the dementia in AD patients. Next, we employed Artificial Intelligence (AI) based models to predict AD severity based on the significantly altered features identified in each omics analysis. Based on our integrative analysis, we found the clinical relevance of plasma proteins, including SKAP1 and NEFL, plasma metabolites including homovanillate and glutamate, and Paraprevotella clara in gut microbiome in predicting the AD severity. Finally, we validated the predictive power of our AI based models by generating additional multi-omics data from the same group of AD patients by following up for 3 months. Hence, we observed that these results may have important implications for the development of potential diagnostic and therapeutic approaches for AD patients.
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Affiliation(s)
- Lingqi Meng
- Science for Life Laboratory, KTH - Royal Institute of Technology, Stockholm, Sweden
| | - Han Jin
- Science for Life Laboratory, KTH - Royal Institute of Technology, Stockholm, Sweden
| | - Burak Yulug
- Department of Neurology and Neuroscience, Faculty of Medicine, Alanya Alaaddin Keykubat University, Antalya, Turkey
| | - Ozlem Altay
- Science for Life Laboratory, KTH - Royal Institute of Technology, Stockholm, Sweden
| | - Xiangyu Li
- Science for Life Laboratory, KTH - Royal Institute of Technology, Stockholm, Sweden
| | - Lutfu Hanoglu
- Department of Neurology, Faculty of Medicine, Istanbul Medipol University, Istanbul, Turkey
| | - Seyda Cankaya
- Department of Neurology and Neuroscience, Faculty of Medicine, Alanya Alaaddin Keykubat University, Antalya, Turkey
| | - Ebru Coskun
- Department of Neurology, Faculty of Medicine, Istanbul Medipol University, Istanbul, Turkey
| | - Ezgi Idil
- Department of Neurology and Neuroscience, Faculty of Medicine, Alanya Alaaddin Keykubat University, Antalya, Turkey
| | - Rahim Nogaylar
- Department of Neurology and Neuroscience, Faculty of Medicine, Alanya Alaaddin Keykubat University, Antalya, Turkey
| | - Ahmet Ozsimsek
- Department of Neurology and Neuroscience, Faculty of Medicine, Alanya Alaaddin Keykubat University, Antalya, Turkey
| | - Saeed Shoaie
- Centre for Host-Microbiome Interaction's, Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, London, UK
| | - Hasan Turkez
- Department of Medical Biology, Faculty of Medicine, Atatürk University, Erzurum, Turkey
| | - Jens Nielsen
- Department of Biology and Biological Engineering, Chalmers University of Technology, Gothenburg, Sweden
| | - Cheng Zhang
- Science for Life Laboratory, KTH - Royal Institute of Technology, Stockholm, Sweden
| | - Jan Borén
- Department of Molecular and Clinical Medicine, University of Gothenburg and Sahlgrenska University Hospital, Gothenburg, Sweden
| | - Mathias Uhlén
- Science for Life Laboratory, KTH - Royal Institute of Technology, Stockholm, Sweden.
| | - Adil Mardinoglu
- Science for Life Laboratory, KTH - Royal Institute of Technology, Stockholm, Sweden.
- Centre for Host-Microbiome Interaction's, Faculty of Dentistry, Oral & Craniofacial Sciences, King's College London, London, UK.
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Kocyigit SE, Ates Bulut E, Aydin AE, Dost FS, Kaya D, Isik AT. The relationship between cognitive frailty, physical frailty and malnutrition in Turkish older adults. Nutrition 2024; 126:112504. [PMID: 39142070 DOI: 10.1016/j.nut.2024.112504] [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: 03/14/2024] [Revised: 05/09/2024] [Accepted: 05/26/2024] [Indexed: 08/16/2024]
Abstract
OBJECTIVE The aim of this study was to assess the relationship between cognitive and physical frailty and malnutrition in older adults. METHODS The study was cross-sectional and observational. A total of 992 patients who applied to the geriatric outpatient clinic between January 2018 and December 2022 were included in the study. All patients underwent comprehensive geriatric assessment. Demographic characteristics, geriatric syndromes, comorbidities, and laboratory parameters were recorded. Fried's Frailty Scale was used to determine physical frailty. The Mini Nutritional Assessment Short Form was performed to determine nutritional status. Cognitive frailty was defined as the coexistence of physical frailty and mild cognitive impairment. RESULTS Of 992 patients participating in the study, 66% were female, and the mean age was 73.2 ± 7.4. The rate of physical frailty was 13.4%, and 96 patients were cognitively frail. Malnutrition rates were 18.8%, 12.5%, and 2.2% in the cognitive frailty, physical frailty, and healthy control groups, respectively. The healthy control group had a lower median age, fewer geriatric syndromes (excluding orthostatic hypotension), and lower rates of diabetes and hypertension than the frailty groups. The frequency of malnutrition was similar in the cognitive and physical frailty groups. The cognitive frailty group had higher median age, sarcopenia rate, and Timed Up and Go duration; were less likely to be female; and showed lower albumin, mobility, and functionality scores than the physical frailty group (P < 0.05). After adjusting for demographic characteristics, comorbidities, geriatric syndromes, and laboratory parameters, cognitive frailty showed a stronger relationship with malnutrition (odds ratio 1.96, confidence interval 1.13-5.04, P = 0.04). CONCLUSIONS Cognitive and physical frailty were found to be associated with malnutrition in older adults. Even after accounting for confounding factors, it appears that cognitive frailty is more closely related to nutritional status than physical frailty.
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Affiliation(s)
| | - Esra Ates Bulut
- Department of Geriatric Medicine, Adana City Training and Research Hospital, Adana, Turkey
| | - Ali Ekrem Aydin
- Department of Geriatric Medicine, Ondokuz Mayis University, Samsun, Turkey
| | - Fatma Sena Dost
- Department of Geriatric Medicine, Darica Farabi Training and Research Hospital, Kocaeli, Turkey
| | - Derya Kaya
- Unit for Aging Brain and Dementia, Department of Geriatric Medicine, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey
| | - Ahmet Turan Isik
- Unit for Aging Brain and Dementia, Department of Geriatric Medicine, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey.
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Karam G, Abbas N, El Korh L, Abi Saad A, Nasreddine L, Ouaijan K. The Association of Cognitive Impairment and Depression with Malnutrition among Vulnerable, Community-Dwelling Older Adults: A Large Cross-Sectional Study. Geriatrics (Basel) 2024; 9:122. [PMID: 39311247 PMCID: PMC11417916 DOI: 10.3390/geriatrics9050122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2024] [Revised: 09/05/2024] [Accepted: 09/10/2024] [Indexed: 09/26/2024] Open
Abstract
(1) Background: Mental health issues in older adults, particularly cognitive impairment and depression, can affect nutritional status. This study investigates the prevalence of malnutrition among community-dwelling older adults at risk of social exclusion and dependency in Lebanon and its association with cognitive impairment and depression. (2) Methods: This cross-sectional study used secondary data from the TEC-MED project, involving 1410 older adults aged 60 and above in Beirut. Nutritional status was assessed with the Mini Nutritional Assessment _Short Form (MNA_SF), cognitive impairment with the AD8 Dementia Screening Interview, and depression with the Geriatric Depression Scale (GDS-15). (3) Results: 87.2% of participants were at risk of malnutrition, and 2.5% were malnourished. Cognitive impairment was present in 82.2% of the sample and 45% experienced moderate to severe depression. Malnourished individuals had significantly higher rates of cognitive impairment (96.7% vs. 57.8%) and depression (85.7% vs. 23.2%). Significant associations were found between the risk of malnutrition, decreased food intake, cognitive impairment, and depression; however, no significant association was found with BMI. Logistic regression analysis indicated that older age, cognitive impairment, and depression were significant predictors of malnutrition, while having a caregiver was protective. (4) Conclusions: The high prevalence of risk of malnutrition among vulnerable older adults with cognitive impairment and depression underscores the need for policies integrating nutritional screening into routine health check-ups for older adults.
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Affiliation(s)
- George Karam
- Department of Psychiatry and Clinical Psychology, St. George Hospital University Medical Center, Beirut 11002807, Lebanon; (G.K.)
- Institute for Development, Research, Advocacy and Applied Care (IDRAAC), Beirut 11002110, Lebanon
- Faculty of Medicine, Saint George University of Beirut, Beirut 11002807, Lebanon
| | - Nada Abbas
- Institute for Development, Research, Advocacy and Applied Care (IDRAAC), Beirut 11002110, Lebanon
| | - Lea El Korh
- Institute for Development, Research, Advocacy and Applied Care (IDRAAC), Beirut 11002110, Lebanon
| | - Alexander Abi Saad
- Department of Psychiatry and Clinical Psychology, St. George Hospital University Medical Center, Beirut 11002807, Lebanon; (G.K.)
| | - Lara Nasreddine
- Department of Nutrition and Food Sciences, Faculty of Agriculture and Food Sciences, American University of Beirut, Beirut 11072020, Lebanon
| | - Krystel Ouaijan
- Department of Nutrition and Food Sciences, Faculty of Agriculture and Food Sciences, American University of Beirut, Beirut 11072020, Lebanon
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Levak N, Lehtisalo J, Thunborg C, Westman E, Andersen P, Andrieu S, Broersen LM, Coley N, Hartmann T, Irving GF, Mangialasche F, Ngandu T, Pantel J, Rosenberg A, Sindi S, Soininen H, Solomon A, Wang R, Kivipelto M. Nutrition guidance within a multimodal intervention improves diet quality in prodromal Alzheimer's disease: Multimodal Preventive Trial for Alzheimer's Disease (MIND-AD mini). Alzheimers Res Ther 2024; 16:147. [PMID: 38961421 PMCID: PMC11221015 DOI: 10.1186/s13195-024-01522-8] [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: 03/26/2024] [Accepted: 06/26/2024] [Indexed: 07/05/2024]
Abstract
BACKGROUND Multimodal lifestyle interventions can benefit overall health, including cognition, in populations at-risk for dementia. However, little is known about the effect of lifestyle interventions in patients with prodromal Alzheimer's disease (AD). Even less is known about dietary intake and adherence to dietary recommendations within this population making it difficult to design tailored interventions for them. METHOD A 6-month MIND-ADmini pilot randomized controlled trial (RCT) was conducted among 93 participants with prodromal AD in Sweden, Finland, Germany, and France. Three arms were included in the RCT: 1) multimodal lifestyle intervention (nutritional guidance, exercise, cognitive training, vascular/metabolic risk management, and social stimulation); 2) multimodal lifestyle intervention + medical food product; and 3) regular health advice (control group). Adherence to dietary advice was assessed with a brief food intake questionnaire by using the Healthy Diet Index (HDI) and Mediterranean Diet Adherence Screener (MEDAS). The intake of macro- and micronutrients were analyzed on a subsample using 3-day food records. RESULTS The dietary quality in the intervention groups, pooled together, improved compared to that of the control group at the end of the study, as measured with by HDI (p = 0.026) and MEDAS (p = 0.008). The lifestyle-only group improved significantly more in MEDAS (p = 0.046) and almost significantly in HDI (p = 0.052) compared to the control group, while the lifestyle + medical food group improved in both HDI (p = 0.042) and MEDAS (p = 0.007) during the study. There were no changes in macro- or micronutrient intake for the intervention groups at follow-up; however, the intakes in the control group declined in several vitamins and minerals when adjusted for energy intake. CONCLUSION These results suggest that dietary intervention as part of multimodal lifestyle interventions is feasible and results in improved dietary quality in a population with prodromal AD. Nutrient intakes remained unchanged in the intervention groups while the control group showed a decreasing nutrient density. TRIAL REGISTRATION ClinicalTrials.gov NCT03249688, 2017-07-08.
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Affiliation(s)
- Nicholas Levak
- Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Center for Alzheimer Research QA32, Karolinska Vägen 37 A, 171 64, Solna, Sweden.
- Theme Inflammation and Aging, Karolinska University Hospital, Stockholm, Karolinska Vägen 37 A, 171 64, Solna, Sweden.
| | - Jenni Lehtisalo
- Population Health Unit, Department of Public Health and Welfare, Finnish Institute for Health and Welfare, Helsinki, Finland
- Department of Neurology, Institute of Clinical Medicine, University of Eastern Finland, Yliopistonranta 8, 70210, Kuopio, Finland
| | - Charlotta Thunborg
- Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Center for Alzheimer Research QA32, Karolinska Vägen 37 A, 171 64, Solna, Sweden
- Theme Inflammation and Aging, Karolinska University Hospital, Stockholm, Karolinska Vägen 37 A, 171 64, Solna, Sweden
- Department of Caring Sciences, Faculty of Health and Occupational Studies, University of Gävle, Gävle, Sweden
| | - Eric Westman
- Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Center for Alzheimer Research QA32, Karolinska Vägen 37 A, 171 64, Solna, Sweden
- Department of Neuroimaging, Centre for Neuroimaging Sciences, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, England
| | - Pia Andersen
- Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Center for Alzheimer Research QA32, Karolinska Vägen 37 A, 171 64, Solna, Sweden
- Theme Inflammation and Aging, Karolinska University Hospital, Stockholm, Karolinska Vägen 37 A, 171 64, Solna, Sweden
| | - Sandrine Andrieu
- Department of Clinical Epidemiology and Public Health, UMR 1295, CHU de Toulouse, and Aging Research Team, CERPOP Inserm, Jules Guesde, 31000, Toulouse, France
- IHU HealthAge, Toulouse, 31059, France
| | | | - Nicola Coley
- Department of Clinical Epidemiology and Public Health, UMR 1295, CHU de Toulouse, and Aging Research Team, CERPOP Inserm, Jules Guesde, 31000, Toulouse, France
- IHU HealthAge, Toulouse, 31059, France
| | - Tobias Hartmann
- German Institute for Dementia Prevention (DIDP), Saarland University, 66424, Homburg, Germany
- Department of Experimental Neurology, Medical Faculty, Saarland University, 66424, Homburg, Germany
| | - Gerd Faxén Irving
- Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Center for Alzheimer Research QA32, Karolinska Vägen 37 A, 171 64, Solna, Sweden
| | - Francesca Mangialasche
- Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Center for Alzheimer Research QA32, Karolinska Vägen 37 A, 171 64, Solna, Sweden
| | - Tiia Ngandu
- Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Center for Alzheimer Research QA32, Karolinska Vägen 37 A, 171 64, Solna, Sweden
- Population Health Unit, Department of Public Health and Welfare, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Johannes Pantel
- Institute of General Practice, Goethe University Frankfurt a.M., Frankfurt, Germany
| | - Anna Rosenberg
- Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Center for Alzheimer Research QA32, Karolinska Vägen 37 A, 171 64, Solna, Sweden
- Department of Neurology, Institute of Clinical Medicine, University of Eastern Finland, Yliopistonranta 8, 70210, Kuopio, Finland
| | - Shireen Sindi
- Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Center for Alzheimer Research QA32, Karolinska Vägen 37 A, 171 64, Solna, Sweden
- The Ageing Epidemiology (AGE) Research Unit, School of Public Health, Imperial College London, St Mary's Hospital, Norfolk Place, London, W2 1PG, UK
| | - Hilkka Soininen
- Department of Neurology, Institute of Clinical Medicine, University of Eastern Finland, Yliopistonranta 8, 70210, Kuopio, Finland
| | - Alina Solomon
- Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Center for Alzheimer Research QA32, Karolinska Vägen 37 A, 171 64, Solna, Sweden
- Department of Neurology, Institute of Clinical Medicine, University of Eastern Finland, Yliopistonranta 8, 70210, Kuopio, Finland
- The Ageing Epidemiology (AGE) Research Unit, School of Public Health, Imperial College London, St Mary's Hospital, Norfolk Place, London, W2 1PG, UK
| | - Rui Wang
- Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Center for Alzheimer Research QA32, Karolinska Vägen 37 A, 171 64, Solna, Sweden
- Department of Physical Activity and Health, the Swedish School of Sport and Health Sciences, 114 86, Stockholm, Sweden
- Wisconsin Alzheimer's Disease Research Center, School of Medicine and Public Health, University of Wisconsin, 600 Highland Ave J5/1 Mezzanine, Madison, WI, 53792, USA
| | - Miia Kivipelto
- Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society, Karolinska Institute, Center for Alzheimer Research QA32, Karolinska Vägen 37 A, 171 64, Solna, Sweden
- Theme Inflammation and Aging, Karolinska University Hospital, Stockholm, Karolinska Vägen 37 A, 171 64, Solna, Sweden
- Department of Neurology, Institute of Clinical Medicine, University of Eastern Finland, Yliopistonranta 8, 70210, Kuopio, Finland
- The Ageing Epidemiology (AGE) Research Unit, School of Public Health, Imperial College London, St Mary's Hospital, Norfolk Place, London, W2 1PG, UK
- Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Yliopistonranta 8, 70210, Kuopio, Finland
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Chen Q, Shen J, Gao Y, Wang XX, Jia QY, Li M. Nutritional status of the older adults in nursing homes: A cross-sectional study. J Clin Nurs 2024; 33:2640-2648. [PMID: 38185924 DOI: 10.1111/jocn.16978] [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: 07/29/2023] [Revised: 11/14/2023] [Accepted: 12/07/2023] [Indexed: 01/09/2024]
Abstract
AIM AND OBJECTIVES To investigate the nutritional status of older adults in nursing homes in Chongqing, China, compare and analyse the differences in the physical condition, cognitive function and social-related factors of older adults with different nutritional statuses. BACKGROUND Malnurtition in the older people has become a priority concer, and the incidence and factors associated with malnutrition vary somewhat by healthcare setting. In Chongqing ,China, there is lack of research on malnutrition of the older people in nursing homes. Here, we investigated the incidence of malnutrition and analysed the associated factors. DESIGN A cross-sectional study. METHODS From January to April 2023, a cross-sectional survey was conducted in three nursing homes in Chongqing, China. Participants completed a series of questionnaires, including the Demographic Information Questionnaire which included age, gender, education level, previous occupation, marital status and other information. The survey also included validated non-demographic instruments [Short-Form Mini-Nutritional Assessment (MNA-SF), Barthel Index (BI) and Mini-mental State Examination (MMSE)] to identify related impact factors. The Guidelines for cross-sectional studies were used in this study (Data S1). RESULTS 209 older adults aged 60 and over participated in this study, of whom 121 were women and 88 were men. The average (SD) age of the participants was 84.7 (6.3) years. Of the participants, 46.4% were classified as well nourished. About 39.2% were at risk of malnutrition and 14.4% were malnourished. Compared to those who were well nourished, those who were malnourished or at risk of becoming malnourished were more likely to suffer from comorbidities, polypharmacy, a higher risk of falling, ADL dependence and to receive more nutritional interventions. However, there are no significant differences after adjustment for age, education level, previous occupation, marital status, length of stay, and type of health care payment. CONCLUSION Malnutrition is a common problem among older adults innursing homes in Chongqing, China. There are certain differences in physical conditions and nutritional interventions among older adults withdifferent nutritional status. PUBLIC CONTRIBUTION This study suggests that the problem of malnutrition is very prominent in nursing homes in Chongqing, China. Cognitive impairment, impaired activities of daily living, fall risk and nutritional intervention need to be prevalent in older adults with (risk of) malnutrition.
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Affiliation(s)
- Qiu Chen
- Chongqing Emergency Medical Center, Chongqing University Central Hospital, Chongqing, China
| | - Jun Shen
- The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Ying Gao
- Chongqing Emergency Medical Center, Chongqing University Central Hospital, Chongqing, China
| | - Xin Xia Wang
- University of Wollongong, Wollongong, New South Wales, Australia
| | - Qian Ying Jia
- The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
| | - Miao Li
- Chongqing Medical University, Chongqing, China
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Wang X, Pang Q, Hu J, Luo B, Lu Y, Sun X, Meng S, Jiang Q. Cognitive decline in Sprague-Dawley rats induced by neuroplasticity changes after occlusal support loss. CNS Neurosci Ther 2024; 30:e14750. [PMID: 38898731 PMCID: PMC11187409 DOI: 10.1111/cns.14750] [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: 11/30/2023] [Revised: 02/28/2024] [Accepted: 04/20/2024] [Indexed: 06/21/2024] Open
Abstract
BACKGROUND Tooth loss is closely related to cognitive impairment, especially affecting cognitive functions involving hippocampus. The most well-known function of the hippocampus is learning and memory, and the mechanism behind is neuroplasticity, which strongly depends on the level of brain-derived neurotrophic factor (BDNF). While research has delved into the possible mechanisms behind the loss of teeth leading to cognitive dysfunction, there are few studies on the plasticity of sensory neural pathway after tooth loss, and the changes in related indicators of synaptic plasticity still need to be further explored. METHODS In this study, the bilateral maxillary molars were extracted in Sprague-Dawley rats of two age ranges (young and middle age) to establish occlusal support loss model; then, the spatial cognition was tested by Morris Water Maze (MWM). Quantitative real-time PCR (qPCR) and Western Blotting (WB) were used to detect BDNF, AKT, and functional proteins (viz., PSD95 and NMDAR) of hippocampal synapses. Golgi staining was used to observe changes in ascending nerve pathway. IF was used to confirm the location of BDNF and AKT expressed in hippocampus. RESULTS MWM showed that the spatial cognitive level of rats dropped after occlusal support loss. qPCR, WB, and IF suggested that the BDNF/AKT pathway was down-regulated in the hippocampus. Golgi staining showed the neurons of ascending sensory pathway decreased in numbers. CONCLUSION Occlusal support loss caused plastic changes in ascending nerve pathway and induced cognitive impairment in rats by down-regulating BDNF and synaptic plasticity.
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Affiliation(s)
- Xiaoyu Wang
- School of StomatologyCapital Medical UniversityBeijingChina
| | - Qian Pang
- Department of Prosthodontics, Beijing Stomatological HospitalCapital Medical UniversityBeijingChina
| | - Jiangqi Hu
- Department of Prosthodontics, Beijing Stomatological HospitalCapital Medical UniversityBeijingChina
| | - Bin Luo
- Department of Prosthodontics, Beijing Stomatological HospitalCapital Medical UniversityBeijingChina
| | - Yunping Lu
- Department of Prosthodontics, Beijing Stomatological HospitalCapital Medical UniversityBeijingChina
| | - Xu Sun
- School of StomatologyCapital Medical UniversityBeijingChina
| | - Shixiang Meng
- School of StomatologyCapital Medical UniversityBeijingChina
| | - Qingsong Jiang
- Department of Prosthodontics, Beijing Stomatological HospitalCapital Medical UniversityBeijingChina
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Loda I, D’Angelo E, Marzetti E, Kerminen H. Prevention, Assessment, and Management of Malnutrition in Older Adults with Early Stages of Cognitive Disorders. Nutrients 2024; 16:1566. [PMID: 38892503 PMCID: PMC11173938 DOI: 10.3390/nu16111566] [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: 04/29/2024] [Revised: 05/11/2024] [Accepted: 05/20/2024] [Indexed: 06/21/2024] Open
Abstract
Malnutrition is common in older adults, and its risk is greater in those living with dementia. Relative to cognitively healthy peers, the prevalence of malnutrition is also increased in individuals with early stages of cognitive disorders owing to pathophysiological, cognitive, and psychosocial changes related to cognitive impairment. Malnutrition is associated with adverse health outcomes, including faster cognitive and functional decline. Here, we provide an overview of the prevention, assessment, and management of malnutrition in older adults, with a special focus on the aspects that are important to consider in individuals with early stages of cognitive disorders. Strategies to prevent malnutrition include systematic screening for malnourishment using validated tools to detect those at risk. If the screening reveals an increased risk of malnutrition, a detailed assessment including the individual's nutritional, medical, and functional status as well as dietary intake should be performed. The management of malnutrition in the early stages of cognitive disorders should be based on the findings of a comprehensive assessment and be personalized according to the individual's specific characteristics. In the article, we also provide an overview of the evidence on vitamin supplements and specific dietary patterns to prevent cognitive decline or attenuate its progression.
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Affiliation(s)
- Irene Loda
- Scuola di Specialità in Geriatria, Università degli Studi di Brescia, Viale Europa 11, 25123 Brescia, Italy;
| | - Emanuela D’Angelo
- Fondazione Policlinico Universitario “Agostino Gemelli” IRCCS, Largo A. Gemelli 8, 00168 Rome, Italy
| | - Emanuele Marzetti
- Fondazione Policlinico Universitario “Agostino Gemelli” IRCCS, Largo A. Gemelli 8, 00168 Rome, Italy
- Department of Geriatrics, Orthopedics and Rheumatology, Università Cattolica del Sacro Cuore, Largo F. Vito 1, 00168 Rome, Italy;
| | - Hanna Kerminen
- Department of Geriatrics, Orthopedics and Rheumatology, Università Cattolica del Sacro Cuore, Largo F. Vito 1, 00168 Rome, Italy;
- Faculty of Medicine and Health Technology, The Gerontology Research Center (GEREC), Tampere University, Arvo Ylpön katu 34, 33520 Tampere, Finland
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Zhou J, Liu W, Zhou H, Lau KK, Wong GH, Chan WC, Zhang Q, Knapp M, Wong IC, Luo H. Identifying dementia from cognitive footprints in hospital records among Chinese older adults: a machine-learning study. THE LANCET REGIONAL HEALTH. WESTERN PACIFIC 2024; 46:101060. [PMID: 38638410 PMCID: PMC11025003 DOI: 10.1016/j.lanwpc.2024.101060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Revised: 02/09/2024] [Accepted: 03/25/2024] [Indexed: 04/20/2024]
Abstract
Background By combining theory-driven and data-driven methods, this study aimed to develop dementia predictive algorithms among Chinese older adults guided by the cognitive footprint theory. Methods Electronic medical records from the Clinical Data Analysis and Reporting System in Hong Kong were employed. We included patients with dementia diagnosed at 65+ between 2010 and 2018, and 1:1 matched dementia-free controls. We identified 51 features, comprising exposures to established modifiable factors and other factors before and after 65 years old. The performances of four machine learning models, including LASSO, Multilayer perceptron (MLP), XGBoost, and LightGBM, were compared with logistic regression models, for all patients and subgroups by age. Findings A total of 159,920 individuals (40.5% male; mean age [SD]: 83.97 [7.38]) were included. Compared with the model included established modifiable factors only (area under the curve [AUC] 0.689, 95% CI [0.684, 0.694]), the predictive accuracy substantially improved for models with all factors (0.774, [0.770, 0.778]). Machine learning and logistic regression models performed similarly, with AUC ranged between 0.773 (0.768, 0.777) for LASSO and 0.780 (0.776, 0.784) for MLP. Antipsychotics, education, antidepressants, head injury, and stroke were identified as the most important predictors in the total sample. Age-specific models identified different important features, with cardiovascular and infectious diseases becoming prominent in older ages. Interpretation The models showed satisfactory performances in identifying dementia. These algorithms can be used in clinical practice to assist decision making and allow timely interventions cost-effectively. Funding The Research Grants Council of Hong Kong under the Early Career Scheme 27110519.
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Affiliation(s)
- Jiayi Zhou
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong SAR, China
| | - Wenlong Liu
- Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - Huiquan Zhou
- Department of Psychiatry, The University of Hong Kong, Hong Kong SAR, China
| | - Kui Kai Lau
- Department of Medicine, The University of Hong Kong, Hong Kong SAR, China
| | - Gloria H.Y. Wong
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong SAR, China
| | - Wai Chi Chan
- Department of Psychiatry, The University of Hong Kong, Hong Kong SAR, China
| | - Qingpeng Zhang
- Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
- Musketeers Foundation Institute of Data Science, The University of Hong Kong, Hong Kong SAR, China
| | - Martin Knapp
- Care Policy and Evaluation Centre (CPEC), The London School of Economics and Political Science, London, UK
| | - Ian C.K. Wong
- Centre for Safe Medication Practice and Research, Department of Pharmacology and Pharmacy, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
- Laboratory of Data Discovery for Health (D24H), Hong Kong Science and Technology Park, Sha Tin, Hong Kong SAR, China
- Aston Pharmacy School, Aston University, Birmingham B4 7ET, UK
| | - Hao Luo
- Department of Social Work and Social Administration, The University of Hong Kong, Hong Kong SAR, China
- Department of Computer Science, The University of Hong Kong, Hong Kong SAR, China
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9
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Fukuyama Y, Komiyama T, Ohi T, Hattori Y. Association between oral health and nutritional status among older patients requiring long-term care who received home-visit dental care. J Oral Sci 2024; 66:130-133. [PMID: 38462493 DOI: 10.2334/josnusd.23-0344] [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] [Indexed: 03/12/2024]
Abstract
PURPOSE This study examined the association between oral health and nutritional status among older patients receiving home-visit dental care. METHODS This study enrolled 110 older patients (age ≥65 years) requiring long-term care who received home-visit dental care. The oral health indicators evaluated included number of teeth, occlusal support, number of functional teeth, tongue pressure, tongue coating index (TCI), and rinsing ability. Nutritional indicators included skeletal muscle mass index (SMI) and the mini-nutritional assessment short-form (MNA-SF). A multivariate modified Poisson regression analysis (adjusted for age, sex, medical history, care level, and housing type) was used to calculate prevalence ratios and 95% confidence intervals (CIs). RESULTS The prevalence ratio for low SMI was not significantly higher for patients with ≥20 teeth than for those with 1-19 or no teeth. Number of teeth was not significantly associated with MNA-SF score. A high TCI score (2.15, 95% CI: 1.07-4.32) and poor rinsing ability (2.32, 95% CI: 1.25-4.30) were significantly associated with low SMI. High TCI scores were associated with low scores in MNA-SF categories (1.25, 95% CI: 1.01-1.55). CONCLUSION TCI and rinsing ability, rather than number of teeth, were associated with nutritional status in older patients requiring long-term care.
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Affiliation(s)
- Yutaka Fukuyama
- Division of Aging and Geriatric Dentistry, Department of Rehabilitation Dentistry, Tohoku University Graduate School of Dentistry
| | - Takamasa Komiyama
- Division of Aging and Geriatric Dentistry, Department of Rehabilitation Dentistry, Tohoku University Graduate School of Dentistry
- Faculty of Dentistry, Oral and Craniofacial Sciences, King's College London
| | - Takashi Ohi
- Division of Aging and Geriatric Dentistry, Department of Rehabilitation Dentistry, Tohoku University Graduate School of Dentistry
- Japanese Red Cross Ishinomaki Hospital
| | - Yoshinori Hattori
- Division of Aging and Geriatric Dentistry, Department of Rehabilitation Dentistry, Tohoku University Graduate School of Dentistry
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10
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Wang Y, Zhang G, Shen Y, Zhao P, Sun H, Ji Y, Sun L. Relationship between prognostic nutritional index and post-stroke cognitive impairment. Nutr Neurosci 2024:1-11. [PMID: 38564411 DOI: 10.1080/1028415x.2024.2330786] [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: 04/04/2024]
Abstract
BACKGROUND The Prognostic Nutritional Index (PNI) has been described as a useful screening tool for patient prognosis in several diseases. As a potential diagnostic index, it has attracted the interest of many physicians. However, the correlation between the PNI and post-stroke cognitive impairment (PSCI) remains unclear. METHODS A total of 285 patients with acute ischemic stroke were included. PNI was assessed as serum albumin (g/L) + 5× lymphocyte count (109/L) and was dichotomized according to the prespecified cut-off points 48.43 for the high and low groups. PSCI was defined as Mini-Mental State Examination (MMSE) < 27 at the 6-10 months follow-up. Multiple logistic regression and linear regression analyses were performed to examine the association between PNI and cognitive outcomes. RESULTS A low PNI was independently associated with PSCI after adjusting for age, sex, education, National Institutes of Health Stroke Scale (NIHSS), deep white matter hyperintensity (DWMH), and stroke history (odds ratio [OR]: 2.158; 95% confidence interval [CI]: 1.205-3.863). The PNI scores were significantly associated with MMSE and attention domain (β = 0.113, p = 0.006; β = 0.109, p = 0.041, respectively). The PNI improved the model's discrimination when added to the model with other clinical risk factors. CONCLUSIONS A low PNI was independently associated with the occurrence of PSCI and the PNI scores were specifically associated with the scores of global cognition and attention domain. It can be a promising and straightforward screening indicator to identify the person with impaired immune-nutritional status at higher risk of PSCI.
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Affiliation(s)
- Yongchun Wang
- Department of Neurology and Neuroscience Center, The First Hospital of Jilin University, Jilin University, Changchun, People's Republic of China
- Cognitive Center, Department of Neurology, The First Hospital of Jilin University, Jilin University, Changchun, People's Republic of China
| | - Guimei Zhang
- Department of Neurology and Neuroscience Center, The First Hospital of Jilin University, Jilin University, Changchun, People's Republic of China
- Cognitive Center, Department of Neurology, The First Hospital of Jilin University, Jilin University, Changchun, People's Republic of China
| | - Yanxin Shen
- Department of Neurology and Neuroscience Center, The First Hospital of Jilin University, Jilin University, Changchun, People's Republic of China
- Cognitive Center, Department of Neurology, The First Hospital of Jilin University, Jilin University, Changchun, People's Republic of China
| | - Panpan Zhao
- Department of Neurology and Neuroscience Center, The First Hospital of Jilin University, Jilin University, Changchun, People's Republic of China
- Cognitive Center, Department of Neurology, The First Hospital of Jilin University, Jilin University, Changchun, People's Republic of China
| | - Hui Sun
- Department of Neurology and Neuroscience Center, The First Hospital of Jilin University, Jilin University, Changchun, People's Republic of China
| | - Yingshi Ji
- Department of Pharmacology, Physiology and Cell Biology, College of Basic Medical Sciences, Jilin University, People's Republic of China
| | - Li Sun
- Department of Neurology and Neuroscience Center, The First Hospital of Jilin University, Jilin University, Changchun, People's Republic of China
- Cognitive Center, Department of Neurology, The First Hospital of Jilin University, Jilin University, Changchun, People's Republic of China
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11
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Ishikawa Y, Adachi T, Uchiyama Y. Association of Nutritional Risk With Gait Function and Activities of Daily Living in Older Adult Patients With Hip Fractures. Ann Rehabil Med 2024; 48:115-123. [PMID: 38644638 PMCID: PMC11058366 DOI: 10.5535/arm.230015] [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: 11/02/2023] [Revised: 02/17/2024] [Accepted: 03/12/2024] [Indexed: 04/23/2024] Open
Abstract
OBJECTIVE To investigate the association of nutritional risk with gait function and activities of daily living (ADLs) in older adult patients with hip fractures. METHODS The retrospective data of older adult patients diagnosed with hip fractures who visited the recovery-phase rehabilitation ward between January 2019 and December 2022 were reviewed. Nutritional risk was evaluated using the Geriatric Nutritional Risk Index; gait function and ADLs were assessed using the modified Harris Hip Score subitem and Functional Independence Measure, respectively. Multivariate linear regression and path analysis with structural equation modeling were used to examine the factors associated with ADLs and the associations among the study variables. RESULTS This study included 206 participants (172 females and 34 males; mean age, 85.0±7.3 years). In the multivariate analysis, gait function (β=0.488, p<0.001), cognitive function (β=0.430, p<0.001), and surgery (β=-0.143, p<0.001) were identified as independent factors. Pathway analysis revealed that nutritional risk was not directly correlated with ADLs but was directly associated with gait and cognitive functions. Gait and cognitive functions, in turn, were directly related to ADLs. CONCLUSION Nutritional risk was found to be associated with ADLs through an intermediary of gait and cognitive functions.
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Affiliation(s)
- Yasunobu Ishikawa
- Department of Rehabilitation, Nishio Hospital, Nishio, Japan
- Division of Creative Physical Therapy, Field of Prevention and Rehabilitation Sciences, Graduate School of Medicine, Nagoya University, Nagoya, Japan
| | - Takuji Adachi
- Division of Creative Physical Therapy, Field of Prevention and Rehabilitation Sciences, Graduate School of Medicine, Nagoya University, Nagoya, Japan
| | - Yasushi Uchiyama
- Division of Creative Physical Therapy, Field of Prevention and Rehabilitation Sciences, Graduate School of Medicine, Nagoya University, Nagoya, Japan
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12
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Asher S, Suominen AL, Stephen R, Ngandu T, Koskinen S, Solomon A. Association of tooth location, occlusal support and chewing ability with cognitive decline and incident dementia. J Clin Periodontol 2024. [PMID: 38468379 DOI: 10.1111/jcpe.13970] [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: 09/30/2023] [Revised: 12/28/2023] [Accepted: 02/17/2024] [Indexed: 03/13/2024]
Abstract
AIM Emerging evidence suggests association of tooth loss with impaired cognition. However, the differential effects of anterior versus posterior tooth loss, occlusal support loss and chewing ability are not considered comprehensively. MATERIALS AND METHODS We conducted cross-sectional (N = 4036) and longitudinal analyses (N = 2787) on data from Health 2000 and 2011 Surveys for associations of posterior occlusal support loss, anterior versus posterior tooth loss, and chewing ability with baseline cognition and 11-year cognitive decline. Additionally, 15-year incident dementia risk was investigated (N = 4073). RESULTS After considering relevant confounders and potential reverse causality bias, posterior occlusal support loss significantly increased dementia risk across all categories indicative of posterior occlusal support loss (hazard ratios [HRs] between 1.99 and 2.89). Bilateral inadequate posterior occlusal support was associated with 11-year decline in overall cognition (odds ratio [OR] = 1.48:1.00-2.19), and unilateral inadequate posterior occlusal support with total immediate (OR = 1.62:1.14-2.30) and delayed recall decline (OR = 1.45:1.03-2.05). Moreover, posterior tooth loss was associated with dementia (HR = 2.23:1.27-3.91) and chewing ability with total immediate decline (OR = 1.80:1.04-3.13). CONCLUSIONS Posterior tooth and occlusal support loss significantly increases dementia risk. The impact of posterior occlusal support loss appears to be dose-dependent, and this effect is distinct from that of dentures. Dental healthcare services should be particularly attentive to the state of posterior dentition. Further studies exploring possible mechanisms are warranted.
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Affiliation(s)
- Sam Asher
- Institute of Dentistry, University of Eastern Finland, Kuopio, Finland
| | - Anna Liisa Suominen
- Institute of Dentistry, University of Eastern Finland, Kuopio, Finland
- Oral and Maxillofacial Teaching Unit, Kuopio University Hospital, Kuopio, Finland
- Department of Public Health and Welfare, Finnish Institute for Health and Welfare (THL), Helsinki, Finland
| | - Ruth Stephen
- Department of Public Health and Welfare, Finnish Institute for Health and Welfare (THL), Helsinki, Finland
- Institute of Clinical Medicine/Neurology, University of Eastern Finland, Kuopio, Finland
- Division of Clinical Geriatrics, Karolinska Institute, Stockholm, Sweden
| | - Tiia Ngandu
- Department of Public Health and Welfare, Finnish Institute for Health and Welfare (THL), Helsinki, Finland
- Division of Clinical Geriatrics, Karolinska Institute, Stockholm, Sweden
| | - Seppo Koskinen
- Department of Public Health and Welfare, Finnish Institute for Health and Welfare (THL), Helsinki, Finland
| | - Alina Solomon
- Institute of Clinical Medicine/Neurology, University of Eastern Finland, Kuopio, Finland
- Division of Clinical Geriatrics, Karolinska Institute, Stockholm, Sweden
- Ageing Epidemiology Research Unit, School of Public Health, Imperial College London, London, UK
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13
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He M, Lian T, Liu Z, Li J, Qi J, Li J, Guo P, Zhang Y, Luo D, Guan H, Zhang W, Zheng Z, Yue H, Zhang W, Wang R, Zhang F, Zhang W. An investigation into the potential association between nutrition and Alzheimer's disease. Front Nutr 2024; 11:1306226. [PMID: 38515521 PMCID: PMC10955128 DOI: 10.3389/fnut.2024.1306226] [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: 10/06/2023] [Accepted: 02/23/2024] [Indexed: 03/23/2024] Open
Abstract
Background Malnutrition is the most common nutritional issue in Alzheimer's disease (AD) patients, but there is still a lack of a comprehensive evaluation of the nutritional status in AD patients. This study aimed to determine the potential association of various nutritional indices with AD at different stages. Methods Subjects, including individuals with normal cognition (NC) and patients diagnosed with AD, were consecutively enrolled in this cross-sectional study. Demographics, body composition, dietary patterns, nutritional assessment scales and nutrition-related laboratory variables were collected. Binary logistics regression analyses and receiver operating characteristic (ROC) curves were used to indicate the association between nutrition-related variables and AD at different stages. Results Totals of 266 subjects, including 73 subjects with NC, 72 subjects with mild cognitive impairment due to AD (AD-MCI) and 121 subjects with dementia due to AD (AD-D) were included. There was no significant difference in dietary patterns, including Mediterranean diet and Mediterranean-DASH diet intervention for neurodegenerative delay (MIND) diet between the three groups. Lower BMI value, smaller hip and calf circumferences, lower Mini Nutritional Assessment (MNA) and Geriatric Nutritional Risk Index (GNRI) scores, and lower levels of total protein, albumin, globulin, and apolipoprotein A1 were associated with AD (all p < 0.05). Total protein and albumin levels had the greatest ability to distinguish AD from non-AD (AUC 0.80, 95% CI 0.74-0.84, p < 0.001), increased by combining calf circumference, MNA score and albumin level (AUC 0.83, 95% CI 0.77-0.88, p < 0.001). Albumin level had the greatest ability to distinguish NC from AD-MCI (AUC 0.75, 95% CI 0.67-0.82, p < 0.001), and MNA score greatest ability to distinguish AD-MCI from AD-D (AUC 0.72, 95% CI 0.65-0.78, p < 0.001). Conclusion Nutritional status of AD patients is significantly compromised compared with normal controls, and tends to be worsened with AD progresses. Early identification and intervention of individuals with nutritional risk or malnutrition may be significantly beneficial for reducing the risk, development, and progression of AD.
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Affiliation(s)
- Mingyue He
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Tenghong Lian
- Center for Cognitive Neurology, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Zhan Liu
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Jinghui Li
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Jing Qi
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Jing Li
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Peng Guo
- Center for Cognitive Neurology, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Yanan Zhang
- Department of Blood Transfusion, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Dongmei Luo
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Huiying Guan
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Weijia Zhang
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Zijing Zheng
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Hao Yue
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Wenjing Zhang
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Ruidan Wang
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Fan Zhang
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Wei Zhang
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- Center for Cognitive Neurology, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
- Center of Parkinson’s Disease Institute for Brain Disorders, Beijing, China
- Beijing Key Laboratory on Parkinson Disease, Beijing, China
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14
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Jiang J, Wang A, Shi H, Jiang S, Li W, Jiang T, Wang L, Zhang X, Sun M, Zhao M, Zou X, Xu J. Clinical and neuroimaging association between neuropsychiatric symptoms and nutritional status across the Alzheimer's disease continuum: a longitudinal cohort study. J Nutr Health Aging 2024; 28:100182. [PMID: 38336502 DOI: 10.1016/j.jnha.2024.100182] [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: 10/16/2023] [Revised: 01/24/2024] [Accepted: 01/26/2024] [Indexed: 02/12/2024]
Abstract
OBJECTIVES To investigate the association between neuropsychiatric symptoms (NPS) and nutritional status, and explore their shared regulatory brain regions on the Alzheimer's disease (AD) continuum. DESIGN A longitudinal, observational cohort study. SETTING Data were collected from the Chinese Imaging, Biomarkers, and Lifestyle study between June 1, 2021 and December 31, 2022. PARTICIPANTS Overall, 432 patients on the AD continuum, including amnestic mild cognitive impairment and AD dementia, were assessed at baseline, and only 165 patients completed the (10.37 ± 6.08) months' follow-up. MEASUREMENTS The Mini-Nutritional Assessment (MNA) and Neuropsychiatric Inventory (NPI) were used to evaluate nutritional status and NPS, respectively. The corrected cerebral blood flow (cCBF) measured by pseudo-continuous arterial spin labeling of the dietary nutrition-related brain regions was analyzed. The association between the NPS at baseline and subsequent change in nutritional status and the association between the changes in the severity of NPS and nutritional status were examined using generalized linear mixed models. RESULTS Increased cCBF in the left putamen was associated with malnutrition, general NPS, affective symptoms, and hyperactivity (P < 0.05). The presence of general NPS (β = -1.317, P = 0.003), affective symptoms (β = -1.887, P < 0.001), and appetite/eating disorders (β = -1.714, P < 0.001) at baseline were associated with a decline in the MNA scores during follow-up. The higher scores of general NPI (β = -0.048), affective symptoms (β = -0.181), and appetite/eating disorders (β = -0.416; all P < 0.001) were longitudinally associated with lower MNA scores after adjusting for confounding factors. CONCLUSIONS We found that baseline NPS were predictors of a decline in nutritional status on the AD continuum. The worse the severity of affective symptoms and appetite/eating disorders, the poorer the nutritional status. Furthermore, abnormal perfusion of the putamen may regulate the association between malnutrition and NPS, which suggests their potentially common neural regulatory basis.
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Affiliation(s)
- Jiwei Jiang
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, 100070, China; China National Clinical Research Center for Neurological Diseases, Beijing, 100070, China
| | - Anxin Wang
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, 100070, China; China National Clinical Research Center for Neurological Diseases, Beijing, 100070, China
| | - Hanping Shi
- Department of Gastrointestinal Surgery, Beijing Shijitan Hospital, Capital Medical University, Beijing, 100038, China; Department of Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical University, Beijing, 100038, China; Beijing International Science and Technology Cooperation Base for Cancer Metabolism and Nutrition, Beijing, 100038, China
| | - Shirui Jiang
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, 100070, China; China National Clinical Research Center for Neurological Diseases, Beijing, 100070, China
| | - Wenyi Li
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, 100070, China; China National Clinical Research Center for Neurological Diseases, Beijing, 100070, China
| | - Tianlin Jiang
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, 100070, China; China National Clinical Research Center for Neurological Diseases, Beijing, 100070, China
| | - Linlin Wang
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, 100070, China; China National Clinical Research Center for Neurological Diseases, Beijing, 100070, China
| | - Xiaoli Zhang
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, 100070, China; China National Clinical Research Center for Neurological Diseases, Beijing, 100070, China
| | - Mengfan Sun
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, 100070, China; China National Clinical Research Center for Neurological Diseases, Beijing, 100070, China
| | - Min Zhao
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, 100070, China; China National Clinical Research Center for Neurological Diseases, Beijing, 100070, China
| | - Xinying Zou
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, 100070, China; China National Clinical Research Center for Neurological Diseases, Beijing, 100070, China
| | - Jun Xu
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, 100070, China; China National Clinical Research Center for Neurological Diseases, Beijing, 100070, China.
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15
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Joulaei H, Keshani P, Kashfinejad SM, Foroozanfar Z, Mohsenpour MA, Fararouei M. To assess the contributing factors of nutritional and health status amongst elderlies residing in the nursing homes of fars province, Iran: A cross sectional study. Health Sci Rep 2024; 7:e1940. [PMID: 38455646 PMCID: PMC10918975 DOI: 10.1002/hsr2.1940] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Revised: 12/17/2023] [Accepted: 02/17/2024] [Indexed: 03/09/2024] Open
Abstract
Background and Aims In line with the global trend, the number of elderly is rising in Iran. It should be noted that the nutritional and health needs of these people, especially those living in nursing houses, are extremely significant. The present study aimed to identify the nutritional and health status and uncover their relationship with received care services by elderlies residing in nursing homes. Methods All 373 elderlies living in the nursing homes in Shiraz entered the study, and the requisite data were collected by references to elderlies' files, respective nurses, and elderlies themselves. Results The majority of the elderlies were at risk of malnutrition (62.5% of the total population, 55.4% of females, and approximately 44.6% of males). Elderlies with no insurance coverage mainly fell into the at-risk and malnutrition categories. There was a significant relationship between the needs assessment scores, reflecting the need for physical and psychological actions, and elderlies' malnutrition (odds ratio = 1.87, 95% confidence interval: 1.79-1.95). For each unit increase in the Physical and psychological need score, the odds of exposure to malnutrition (vs. nonmalnourished and at risk of malnutrition) was 1.87 times after adjustment for confounders. Conclusion The results of our study revealed that most of the elderlies living in the nursing homes of Shiraz had some levels of malnutrition such as at-risk for malnutrition (62.5%) and malnourished (18.9%). Based on these results, it is suggested that health policy-makers take practical steps toward promoting the nutritional care of old people and direct extra supervision to nursing homes and all healthcare provisions.
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Affiliation(s)
- Hassan Joulaei
- Health Policy Research Center, Institute of HealthShiraz University of Medical SciencesShirazIran
| | - Parisa Keshani
- Health Policy Research Center, Institute of HealthShiraz University of Medical SciencesShirazIran
| | | | - Zohre Foroozanfar
- HIV/AIDS Research Center, Institute of HealthShiraz University of Medical SciencesShirazIran
| | | | - Mohammad Fararouei
- Department of EpidemiologyShiraz University of Medical SciencesShirazIran
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Arifin H, Chen R, Banda KJ, Kustanti CY, Chang CY, Lin HC, Liu D, Lee TY, Chou KR. Meta-analysis and moderator analysis of the prevalence of malnutrition and malnutrition risk among older adults with dementia. Int J Nurs Stud 2024; 150:104648. [PMID: 38043486 DOI: 10.1016/j.ijnurstu.2023.104648] [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: 06/02/2023] [Revised: 11/06/2023] [Accepted: 11/16/2023] [Indexed: 12/05/2023]
Abstract
BACKGROUND Aging and dementia are common and closely related health problems in older adults, affecting their ability to maintain a healthy diet and ultimately resulting in malnutrition. OBJECTIVE In this study, we estimated the global prevalence of malnutrition and malnutrition risk in older adults with dementia. DESIGN Meta-analysis. DATA SOURCES Embase, Ovid MEDLINE, PubMed, CINAHL, Scopus, and Web of Science were comprehensively searched for articles published from database inception to October 2022. METHODS Pooled prevalence analysis was conducted using a generalized linear mixed model and a random-effects model. I2 and Cochran's Q statistics were used for identifying heterogeneity. Publication bias was evaluated using Peters' regression test and a funnel plot. Moderator analyses were conducted to investigate variations in the prevalence estimates of the included studies. All statistical analyses were conducted using R software. RESULTS A total of 16 studies involving a total of 6513 older adults with dementia were included in the analysis. The results indicated that 32.52 % (95 % confidence interval: 19.55-45.49) of all included older adults with dementia had malnutrition, whereas 46.80 % (95 % confidence interval: 38.90-54.70) had a risk of malnutrition. The prevalence of malnutrition was found to be high among older patients living in institutionalized settings (46.59 %) and those with Alzheimer's disease (12.26 %). The factors moderating the prevalence of malnutrition included adequate vitamin B12 consumption, risk behaviors, medical comorbidities, and certain neuropsychiatric symptoms. The prevalence of malnutrition risk was high among women (29.84 %) and patients with Alzheimer's disease (26.29 %). The factors moderating the prevalence of malnutrition risk included total cholesterol level, vitamin B12 consumption, risk behaviors, medical comorbidities, and certain neuropsychiatric symptoms. CONCLUSIONS Approximately one-third of older adults with dementia are malnourished and nearly half of older adults are at a risk of malnutrition. Encouraging collaboration among health-care professionals and ensuring early assessment and effective management of malnutrition are crucial for maintaining a favorable nutritional status in older adults with dementia. REGISTRATION This study was registered with the International Prospective Register of Systematic Reviews (PROSPERO: CRD42022369329). TWEETABLE ABSTRACT Globally, approximately 32.52 % of older adults with dementia are malnourished and approximately 46.80 % are at a risk of malnutrition.
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Affiliation(s)
- Hidayat Arifin
- School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan; Faculty of Nursing, Universitas Airlangga, Surabaya, Indonesia. https://twitter.com/ha_arifin
| | - Ruey Chen
- School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan; Department of Nursing, Taipei Medical University-Shuang Ho Hospital, New Taipei, Taiwan; Post-Baccalaureate Program in Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan
| | - Kondwani Joseph Banda
- School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan; Endoscopy Unit, Surgery Department, Kamuzu Central Hospital, Lilongwe, Malawi
| | - Christina Yeni Kustanti
- School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan; Sekolah Tinggi Ilmu Kesehatan Bethesda Yakkum, Yogyakarta, Indonesia
| | - Ching-Yi Chang
- School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan
| | - Hui-Chen Lin
- School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan; Research Center in Nursing Clinical Practice, Wan Fang Hospital Taipei Medical University, Taipei, Taiwan
| | - Doresses Liu
- School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan; Research Center in Nursing Clinical Practice, Wan Fang Hospital Taipei Medical University, Taipei, Taiwan; Department of Nursing, Wan Fang Hospital, Taipei Medical University, Taipei, Taiwan
| | - Tso-Ying Lee
- School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan; Nursing Research Center, Department of Nursing, Taipei Medical University Hospital, Taipei, Taiwan
| | - Kuei-Ru Chou
- School of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan; Department of Nursing, Taipei Medical University-Shuang Ho Hospital, New Taipei, Taiwan; Research Center in Nursing Clinical Practice, Wan Fang Hospital Taipei Medical University, Taipei, Taiwan; Psychiatric Research Center, Taipei Medical University Hospital, Taipei, Taiwan; Neuroscience Research Center, Taipei Medical University, Taipei, Taiwan.
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17
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Trinca V, Anderson ND, Fiocco AJ, Ferland G, Laurin D, Keller HH. Nutrition risk and cognitive performance in community-living older adults without cognitive impairment: a cross-sectional analysis of the Canadian Longitudinal Study on Aging. Appl Physiol Nutr Metab 2023; 48:896-906. [PMID: 37590990 DOI: 10.1139/apnm-2023-0211] [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] [Indexed: 08/19/2023]
Abstract
Malnutrition is correlated with poor cognition; however, an understanding of the association between nutrition risk, which precedes malnutrition, and cognition is lacking. This study aimed to determine if nutrition risk measured with the SCREEN-8 tool is associated with cognitive performance among cognitively healthy adults aged 55+, after adjusting for demographic and lifestyle covariates. Sex- and age-stratified analyses were also explored. Baseline data from the Canadian Longitudinal Study on Aging was used. Cognition was determined using a 6-measure composite score based on four executive functions and two memory tasks, taking into account age, sex, and education. Multivariable linear regression was performed while adjusting for body mass index (BMI), lifestyle, and health covariates in the entire sample (n = 11 378) and then stratified by sex and age. Approximately half of participants were female (54.5%) aged 65+ (54.1%). Greater nutrition risk was associated with poorer cognitive performance in the entire sample (F[1, 11 368] = 5.36, p = 0.021) and among participants aged 55-64 (n = 5227; F[1, 5217] = 5.45, p = 0.020). Sex differences in lifestyle and health factors associated with cognition were apparent, but nutrition risk was not associated with cognition in sex-stratified models. Based on this analysis, there may be an association between nutrition risk and cognitive performance in older adults. When screening for either cognitive impairment or nutrition risk, complementary assessments for these conditions is warranted, as early intervention may provide benefit.
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Affiliation(s)
- Vanessa Trinca
- Department of Kinesiology and Health Sciences, University of Waterloo, Waterloo, ON, Canada
| | - Nicole D Anderson
- Rotman Research Institute, Baycrest Academy for Research and Education, Toronto, ON, Canada
- Departments of Psychology & Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Alexandra J Fiocco
- Department of Psychology, Toronto Metropolitan University, Toronto, ON, Canada
| | - Guylaine Ferland
- Département de Nutrition, Université de Montréal, Montreal, QC, Canada
| | - Danielle Laurin
- Centre de recherche du CHU de Québec-Université Laval, VITAM-Centre de recherche en santé durable, CIUSSS-Capitale Nationale and Institut sur le vieillissement et la participation sociale des aînés, Québec, QC, Canada
- Centre d'excellence sur le vieillissement de Québec, Québec, QC, Canada
- Faculté de pharmacie, Université Laval and Institut sur la nutrition et les aliments fonctionnels (INAF) de l'Université Laval, Québec, QC, Canada
| | - Heather H Keller
- Department of Kinesiology and Health Sciences, University of Waterloo, Waterloo, ON, Canada
- Schlegel-UW Research Institute for Aging, Waterloo, ON, Canada
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18
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Amrapala A, Sabé M, Solmi M, Maes M. Neuropsychiatric disturbances in mild cognitive impairment: A scientometric analysis. Ageing Res Rev 2023; 92:102129. [PMID: 37981054 DOI: 10.1016/j.arr.2023.102129] [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: 08/30/2023] [Revised: 11/04/2023] [Accepted: 11/14/2023] [Indexed: 11/21/2023]
Abstract
Behavioral and psychological symptoms of dementia (BPSD) have been extensively studied in dementia than its prodromal stage, known as mild cognitive impairment (MCI). A scientometric study on BPSD in MCI would be valuable in synthesizing the existing body of research and providing insights into the trends, networks, and influencers within this area. We searched for related literature in the Web of Science database and extracted complete text and citation records of each publication. The primary objective was to map the research evolution of BPSD in MCI and highlight dominant research themes. The secondary objective was to identify research network characteristics (authors, journals, countries, and institutions) and abundances. A total of 12,369 studies published between 1980 and 2022 were included in the analysis. We found 51 distinct clusters from the co-cited reference network that were highly credible with significant modularity (Q = 0.856) and silhouette scores (S = 0.932). Five major research domains were identified: symptoms, diagnosis, brain substrates, biochemical pathways, and interventions. In recent years, the research focus in this area has been on gut microbiota, e-health, COVID-19, cognition, and delirium. Collectively, findings from this scientometric analysis can help clarify the scope and direction of future research and clinical practices.
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Affiliation(s)
- Arisara Amrapala
- Department of Psychiatry, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand; Cognitive Fitness and Biopsychiatry Technology Research Unit, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand; Center of Excellence in Digital and AI for Mental Health, Faculty of Engineering, Chulalongkorn University, Bangkok, Thailand.
| | - Michel Sabé
- Division of Adult Psychiatry, Department of Psychiatry, University Hospitals of Geneva, Thonex, Switzerland; Faculty of Medicine, University of Geneva, Geneva, Switzerland.
| | - Marco Solmi
- Department of Psychiatry, University of Ottawa, Ottawa, Ontario, Canada; Department of Mental Health, The Ottawa Hospital, Ottawa, Ontario, Canada; Ottawa Hospital Research Institute (OHRI) Clinical Epidemiology Program University of Ottawa, Ottawa, Ontario, Canada; Department of Child and Adolescent Psychiatry, Charité Universitätsmedizin, Berlin, Germany.
| | - Michael Maes
- Department of Psychiatry, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand; Cognitive Fitness and Biopsychiatry Technology Research Unit, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand; Cognitive Impairment and Dementia Research Unit, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand; Department of Psychiatry, Medical University of Plovdiv and Technological Center for Emergency Medicine, Plovdiv, Bulgaria; Kyung Hee University, Seoul, Republic of Korea; Research Institute, Medical University of Plovdiv, Plovdiv, Bulgaria; Sichuan Provincial Center for Mental Health, Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China; Key Laboratory of Psychosomatic Medicine, Chinese Academy of Medical Sciences, Chengdu, China.
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19
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Jiang J, Liu Y, Wang A, Zhuo Z, Shi H, Zhang X, Li W, Sun M, Jiang S, Wang Y, Zou X, Zhang Y, Jia Z, Xu J. Development and validation of a nutrition-related genetic-clinical-radiological nomogram associated with behavioral and psychological symptoms in Alzheimer's disease. Chin Med J (Engl) 2023:00029330-990000000-00878. [PMID: 38031345 PMCID: PMC11407811 DOI: 10.1097/cm9.0000000000002914] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Indexed: 12/01/2023] Open
Abstract
BACKGROUND Few evidence is available in the early prediction models of behavioral and psychological symptoms of dementia (BPSD) in Alzheimer's disease (AD). This study aimed to develop and validate a novel genetic-clinical-radiological nomogram for evaluating BPSD in patients with AD and explore its underlying nutritional mechanism. METHODS This retrospective study included 165 patients with AD from the Chinese Imaging, Biomarkers, and Lifestyle (CIBL) cohort between June 1, 2021, and March 31, 2022. Data on demoimagedatas, neuropsychological assessments, single-nucleotide polymorphisms of AD risk genes, and regional brain volumes were collected. A multivariate logistic regression model identified BPSD-associated factors, for subsequently constructing a diagnostic nomogram. This nomogram was internally validated through 1000-bootstrap resampling and externally validated using a time-series split based on the CIBL cohort data between June 1, 2022, and February 1, 2023. Area under receiver operating characteristic (ROC) curves, calibration curves, and decision curve analysis (DCA) were used to assess the discrimination, calibration, and clinical applicability of the nomogram. RESULTS Factors independently associated with BPSD were: CETP rs1800775 (odds ratio [OR] = 4.137, 95% confidence interval [CI]: 1.276-13.415, P = 0.018), decreased Mini Nutritional Assessment score (OR = 0.187, 95% CI: 0.086-0.405, P <0.001), increased caregiver burden inventory score (OR = 8.993, 95% CI: 3.830-21.119, P <0.001), and decreased brain stem volume (OR = 0.006, 95% CI: 0.001-0.191, P = 0.004). These variables were incorporated into the nomogram. The area under the ROC curve was 0.925 (95% CI: 0.884-0.967, P <0.001) in the internal validation and 0.791 (95% CI: 0.686-0.895, P <0.001) in the external validation. The calibration plots showed favorable consistency between the prediction of nomogram and actual observations, and the DCA showed that the model was clinically useful in both validations. CONCLUSION A novel nomogram was established and validated based on lipid metabolism-related genes, nutritional status, and brain stem volumes, which may allow patients with AD to benefit from early triage and more intensive monitoring of BPSD. REGISTRATION Chictr.org.cn, ChiCTR2100049131.
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Affiliation(s)
- Jiwei Jiang
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China
- National Clinical Research Center for Neurological Diseases, Beijing 100070, China
| | - Yaou Liu
- National Clinical Research Center for Neurological Diseases, Beijing 100070, China
- Department of Radiology, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China
| | - Anxin Wang
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China
- National Clinical Research Center for Neurological Diseases, Beijing 100070, China
| | - Zhizheng Zhuo
- National Clinical Research Center for Neurological Diseases, Beijing 100070, China
- Department of Radiology, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China
| | - Hanping Shi
- Department of Gastrointestinal Surgery, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China
- Department of Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical University, Beijing 100038, China
- Beijing International Science and Technology Cooperation Base for Cancer Metabolism and Nutrition, Beijing 100081, China
| | - Xiaoli Zhang
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China
- National Clinical Research Center for Neurological Diseases, Beijing 100070, China
| | - Wenyi Li
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China
- National Clinical Research Center for Neurological Diseases, Beijing 100070, China
| | - Mengfan Sun
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China
- National Clinical Research Center for Neurological Diseases, Beijing 100070, China
| | - Shirui Jiang
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China
- National Clinical Research Center for Neurological Diseases, Beijing 100070, China
| | - Yanli Wang
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China
- National Clinical Research Center for Neurological Diseases, Beijing 100070, China
| | - Xinying Zou
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China
- National Clinical Research Center for Neurological Diseases, Beijing 100070, China
| | - Yuan Zhang
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China
- National Clinical Research Center for Neurological Diseases, Beijing 100070, China
| | - Ziyan Jia
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China
- National Clinical Research Center for Neurological Diseases, Beijing 100070, China
| | - Jun Xu
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing 100070, China
- National Clinical Research Center for Neurological Diseases, Beijing 100070, China
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20
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Boquete-Pumar C, Álvarez-Salvago F, Martínez-Amat A, Molina-García C, De Diego-Moreno M, Jiménez-García JD. Influence of Nutritional Status and Physical Fitness on Cognitive Domains among Older Adults: A Cross-Sectional Study. Healthcare (Basel) 2023; 11:2963. [PMID: 37998454 PMCID: PMC10671636 DOI: 10.3390/healthcare11222963] [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: 10/05/2023] [Revised: 10/25/2023] [Accepted: 11/13/2023] [Indexed: 11/25/2023] Open
Abstract
BACKGROUND The health issues presented by the aging population can result in reduced muscle mass, poorer physical function, and cognitive impairment. The goal of this study was to determine how nutritional status and physical fitness relate to cognitive impairment in older adults. METHODS A cross-sectional descriptive and analytical study involving 100 participants was carried out to analyze the impact of nutritional status and physical fitness on cognitive impairment. Nutritional status was assessed with the Eating Assessment Tool (EAT-10) and The Mini Nutritional Assessment-Short Form (MNA-SF); physical fitness via the implementation of manual grip evaluation, the 4-m walking test (4-MWT), and the Timed Up and Go (TUG) test; and cognitive impairment evaluation was conducted using the Mini-Mental State Examination (MMSE), the Boston Naming Test (BNT) and the Controlled Oral Word Association Test (COWAT). RESULTS Data analysis revealed that higher malnutrition status was associated with fewer correct responses in the COWAT (R2 = 0.421), while a correlation between higher MMSE and BNT scores, faster completion times for the 4-m walking and TUG tests, and an increase in handgrip strength load was also observed. CONCLUSION The analysis of the data revealed that those individuals with superior nutritional status and greater levels of physical fitness outperformed others on the cognitive evaluation.
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Affiliation(s)
- Carmen Boquete-Pumar
- Department of Health Sciences, Faculty of Health Sciences, University of Jaén, 23071 Jaén, Spain; (C.B.-P.); (A.M.-A.); (M.D.D.-M.); (J.D.J.-G.)
| | - Francisco Álvarez-Salvago
- Department of Health Sciences, Faculty of Health Sciences, University of Jaén, 23071 Jaén, Spain; (C.B.-P.); (A.M.-A.); (M.D.D.-M.); (J.D.J.-G.)
- Department of Physiotherapy, Faculty of Health Sciences, European University of Valencia, 46010 Valencia, Spain
| | - Antonio Martínez-Amat
- Department of Health Sciences, Faculty of Health Sciences, University of Jaén, 23071 Jaén, Spain; (C.B.-P.); (A.M.-A.); (M.D.D.-M.); (J.D.J.-G.)
| | - Cristina Molina-García
- Health Sciences PhD Program, Universidad Católica de Murcia UCAM, Campus de los Jerónimos nº135, 30107 Guadalupe, Spain;
| | - Manuel De Diego-Moreno
- Department of Health Sciences, Faculty of Health Sciences, University of Jaén, 23071 Jaén, Spain; (C.B.-P.); (A.M.-A.); (M.D.D.-M.); (J.D.J.-G.)
| | - José Daniel Jiménez-García
- Department of Health Sciences, Faculty of Health Sciences, University of Jaén, 23071 Jaén, Spain; (C.B.-P.); (A.M.-A.); (M.D.D.-M.); (J.D.J.-G.)
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21
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Kauzor K, Drewel M, Gonzalez H, Rattinger GB, Hammond AG, Wengreen H, Lyketsos CG, Tschanz JT. Malnutrition and neuropsychiatric symptoms in dementia: the Cache County Dementia Progression Study. Int Psychogeriatr 2023; 35:653-663. [PMID: 37246509 PMCID: PMC10592578 DOI: 10.1017/s1041610223000467] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
OBJECTIVES Among people with dementia, poor nutritional status has been associated with worse cognitive and functional decline, but few studies have examined its association with neuropsychiatric symptoms (NPS). We examined this topic in a population-based sample of persons with dementia. DESIGN Longitudinal, observational cohort study. SETTING Community. PARTICIPANTS Two hundred ninety-two persons with dementia (71.9% Alzheimer's disease, 56.2% women) were followed up to 6 years. MEASUREMENTS We used a modified Mini-Nutritional Assessment (mMNA) and the Neuropsychiatric Inventory (NPI) to evaluate nutritional status and NPS, respectively. Individual linear mixed effects models examined the associations between time-varying mMNA total score or clinical categories (malnourishment, risk for malnourishment, or well-nourished) and NPI total score (excluding appetite domain) or NPI individual domain or cluster (e.g. psychosis) scores. Covariates tested were dementia onset age, type, and duration, medical comorbidities, sex, apolipoprotein E (APOE) genotype, and education. RESULTS Compared to the well-nourished, those at risk for malnourishment and those malnourished had higher total NPI scores [b (95% CI) = 1.76 (0.04, 3.48) or 3.20 (0.62, 5.78), respectively], controlling for significant covariates. Higher mMNA total score (better nutritional status) was associated with lower total NPI [b (95% CI) = -0.58 (-0.86, -0.29)] and lower domain scores for psychosis [b (95% CI) = -0.08 (-0.16, .004)], depression [b (95% CI = -0.11 (-0.16, -0.05], and apathy [b (95% CI = -0.19 (-0.28, -0.11)]. CONCLUSIONS Worse nutritional status is associated with more severe NPS. Dietary or behavioral interventions to prevent malnutrition may be beneficial for persons with dementia.
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Affiliation(s)
- Kaitlyn Kauzor
- Department of Psychology, Utah State University, 2810 Old Main Hill, Logan, UT 84321-2810, USA
| | - Mikaela Drewel
- Department of Psychology, Utah State University, 2810 Old Main Hill, Logan, UT 84321-2810, USA
| | - Hector Gonzalez
- Department of Psychology, Utah State University, 2810 Old Main Hill, Logan, UT 84321-2810, USA
| | - Gail B Rattinger
- School of Pharmacy and Pharmaceutical Sciences, Binghamton University, P.O. Box 6000. Binghamton, NY 13902-6000, USA
| | - Alexandra G Hammond
- Department of Psychology, Utah State University, 2810 Old Main Hill, Logan, UT 84321-2810, USA
| | - Heidi Wengreen
- Nutrition Dietetics and Food Sciences, Utah State University, 8710 Old Main Hill, Logan, UT 84322-8710, USA
| | - Constantine G Lyketsos
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine and Johns Hopkins Bayview Medical Center, 5300 Alpha Commons Drive, 4th Floor, Baltimore, MD 21224, USA
| | - JoAnn T Tschanz
- Department of Psychology, Utah State University, 2810 Old Main Hill, Logan, UT 84321-2810, USA
- Alzheimer's Disease and Dementia Research Center, Utah State University, 6405 Old Main Hill, Logan, UT, 84322-6405, USA
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Unsal P, Guner M, Ozsurekci C, Balli N, Bas AO, Ozturk Y, Dikmeer A, Burkuk S, Koca M, Balci C, Dogu BB, Cankurtaran M, Halil M. Prevalence of nutrition disorders and nutrition-related conditions in older patients with Alzheimer's disease. Nutr Clin Pract 2023; 38:1142-1153. [PMID: 37076942 DOI: 10.1002/ncp.10995] [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: 12/06/2022] [Revised: 02/26/2023] [Accepted: 03/19/2023] [Indexed: 04/21/2023] Open
Abstract
BACKGROUNDS Alzheimer's disease is frequently encountered with nutrition-related conditions such as malnutrition, sarcopenia, frailty, overnutrition, and micronutrient abnormalities in older patients. In this study, we aimed to evaluate the prevalence of nutrition disorders and nutrition-related conditions in the same patient group. METHODS A total of 253 older patients with Alzheimer's disease underwent comprehensive geriatric assessment, which included nutrition-related disorders, malnutrition via the Mini Nutritional Assessment-Short Form (MNA-SF), frailty via the Clinical Frailty Scale (CFS), and sarcopenia was diagnosed according to European Working Group on Sarcopenia in Older People-2 criteria. RESULTS The patients' mean age was 79.8 ± 6.5 years, and 58.1% were women. In our patients, 64.8% had malnutrition or were at risk of malnutrition; 38.3% had sarcopenia; 19.8% were prefrail; and 80.2% were frail. Malnutrition, frailty, and sarcopenia prevalence increased as the Alzheimer's disease stage progressed. Malnutrition was found to be significantly related with frailty scores via CFS (odds ratio [OR], 1.397; P = 0.0049) and muscle mass via fat-free mass index (FFMI) (OR, 0.793; P = 0.001). In logistic regression analysis, age, MNA-SF, and CFS were included in the model to detect the independent correlates of probable and confirmed sarcopenia. CFS was independently associated with probable and confirmed sarcopenia (OR, 1.822; P = 0.013; OR, 2.671; P = 0.001, respectively). Frailty was similarly related with FFMI (OR, 0.836; P = 0.031). Obesity was independently related with FFMI (OR, 0.688; P < 0.001). CONCLUSION In conclusion, nutrition disorders and nutrition-related conditions can present concurrently in patients with all stages of Alzheimer's disease; therefore, these frequent problems should be screened and diagnosed accordingly.
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Affiliation(s)
- Pelin Unsal
- Department of Internal Medicine, Division of Geriatric Medicine, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Merve Guner
- Department of Internal Medicine, Division of Geriatric Medicine, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Cemile Ozsurekci
- Department of Internal Medicine, Division of Geriatric Medicine, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Nisa Balli
- Department of Clinical Pharmacy, Hacettepe University Faculty of Pharmacy, Ankara, Turkey
| | - Arzu Okyar Bas
- Department of Internal Medicine, Division of Geriatric Medicine, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Yelda Ozturk
- Department of Internal Medicine, Division of Geriatric Medicine, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Ayse Dikmeer
- Department of Internal Medicine, Division of Geriatric Medicine, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Suna Burkuk
- Department of Internal Medicine, Division of Geriatric Medicine, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Meltem Koca
- Department of Internal Medicine, Division of Geriatric Medicine, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Cafer Balci
- Department of Internal Medicine, Division of Geriatric Medicine, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Burcu Balam Dogu
- Department of Internal Medicine, Division of Geriatric Medicine, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Mustafa Cankurtaran
- Department of Internal Medicine, Division of Geriatric Medicine, Hacettepe University Faculty of Medicine, Ankara, Turkey
| | - Meltem Halil
- Department of Internal Medicine, Division of Geriatric Medicine, Hacettepe University Faculty of Medicine, Ankara, Turkey
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23
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Jiang J, Shi H, Jiang S, Wang A, Zou X, Wang Y, Li W, Zhang Y, Sun M, Ren Q, Xu J. Nutrition in Alzheimer's disease: a review of an underappreciated pathophysiological mechanism. SCIENCE CHINA. LIFE SCIENCES 2023; 66:2257-2279. [PMID: 37058185 DOI: 10.1007/s11427-022-2276-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/30/2022] [Accepted: 02/16/2023] [Indexed: 04/15/2023]
Abstract
Alzheimer's disease (AD) is the leading cause of dementia in older individuals and is an escalating challenge to global public health. Pharmacy therapy of AD is one of the well-funded areas; however, little progress has been made due to the complex pathogenesis. Recent evidence has demonstrated that modifying risk factors and lifestyle may prevent or delay the incidence of AD by 40%, which suggests that the management should pivot from single pharmacotherapy toward a multipronged approach because AD is a complex and multifaceted disease. Recently, the gut-microbiota-brain axis has gained tremendous traction in the pathogenesis of AD through bidirectional communication with multiple neural, immune, and metabolic pathways, providing new insights into novel therapeutic strategies. Dietary nutrition is an important and profound environmental factor that influences the composition and function of the microbiota. The Nutrition for Dementia Prevention Working Group recently found that dietary nutrition can affect cognition in AD-related dementia directly or indirectly through complex interactions of behavioral, genetic, systemic, and brain factors. Thus, considering the multiple etiologies of AD, nutrition represents a multidimensional factor that has a profound effect on AD onset and development. However, mechanistically, the effect of nutrition on AD is uncertain; therefore, optimal strategies or the timing of nutritional intervention to prevent or treat AD has not been established.Thus, this review summarizes the current state of knowledge concerning nutritional disorders, AD patient and caregiver burden, and the roles of nutrition in the pathophysiology of AD. We aim to emphasize knowledge gaps to provide direction for future research and to establish optimal nutrition-based intervention strategies for AD.
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Affiliation(s)
- Jiwei Jiang
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, 100070, China
- China National Clinical Research Center for Neurological Diseases, Beijing, 100070, China
| | - Hanping Shi
- Department of Gastrointestinal Surgery, Beijing Shijitan Hospital, Capital Medical University, Beijing, 100038, China
- Department of Clinical Nutrition, Beijing Shijitan Hospital, Capital Medical University, Beijing, 100038, China
- Beijing International Science and Technology Cooperation Base for Cancer Metabolism and Nutrition, Beijing, 100038, China
| | - Shirui Jiang
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, 100070, China
- China National Clinical Research Center for Neurological Diseases, Beijing, 100070, China
| | - Anxin Wang
- China National Clinical Research Center for Neurological Diseases, Beijing, 100070, China
| | - Xinying Zou
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, 100070, China
- China National Clinical Research Center for Neurological Diseases, Beijing, 100070, China
| | - Yanli Wang
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, 100070, China
- China National Clinical Research Center for Neurological Diseases, Beijing, 100070, China
| | - Wenyi Li
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, 100070, China
- China National Clinical Research Center for Neurological Diseases, Beijing, 100070, China
| | - Yuan Zhang
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, 100070, China
- China National Clinical Research Center for Neurological Diseases, Beijing, 100070, China
| | - Mengfan Sun
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, 100070, China
- China National Clinical Research Center for Neurological Diseases, Beijing, 100070, China
| | - Qiwei Ren
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, 100070, China
- China National Clinical Research Center for Neurological Diseases, Beijing, 100070, China
| | - Jun Xu
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, 100070, China.
- China National Clinical Research Center for Neurological Diseases, Beijing, 100070, China.
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Wiese LAK, Gibson A, Guest MA, Nelson AR, Weaver R, Gupta A, Carmichael O, Lewis JP, Lindauer A, Loi S, Peterson R, Radford K, Rhodus EK, Wong CG, Zuelsdorff M, Saidi LG, Valdivieso-Mora E, Franzen S, Pope CN, Killian TS, Shrestha HL, Heyn PC, Ng TKS, Prusaczyk B, John S, Kulshreshtha A, Sheffler JL, Besser L, Daniel V, Tolea MI, Miller J, Musyimi C, Corkey J, Yank V, Williams CL, Rahemi Z, Park J, Magzamen S, Newton RL, Harrington C, Flatt JD, Arora S, Walter S, Griffin P, Babulal GM. Global rural health disparities in Alzheimer's disease and related dementias: State of the science. Alzheimers Dement 2023; 19:4204-4225. [PMID: 37218539 PMCID: PMC10524180 DOI: 10.1002/alz.13104] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Revised: 03/23/2023] [Accepted: 03/23/2023] [Indexed: 05/24/2023]
Abstract
INTRODUCTION Individuals living in rural communities are at heightened risk for Alzheimer's disease and related dementias (ADRD), which parallels other persistent place-based health disparities. Identifying multiple potentially modifiable risk factors specific to rural areas that contribute to ADRD is an essential first step in understanding the complex interplay between various barriers and facilitators. METHODS An interdisciplinary, international group of ADRD researchers convened to address the overarching question of: "What can be done to begin minimizing the rural health disparities that contribute uniquely to ADRD?" In this state of the science appraisal, we explore what is known about the biological, behavioral, sociocultural, and environmental influences on ADRD disparities in rural settings. RESULTS A range of individual, interpersonal, and community factors were identified, including strengths of rural residents in facilitating healthy aging lifestyle interventions. DISCUSSION A location dynamics model and ADRD-focused future directions are offered for guiding rural practitioners, researchers, and policymakers in mitigating rural disparities. HIGHLIGHTS Rural residents face heightened Alzheimer's disease and related dementia (ADRD) risks and burdens due to health disparities. Defining the unique rural barriers and facilitators to cognitive health yields insight. The strengths and resilience of rural residents can mitigate ADRD-related challenges. A novel "location dynamics" model guides assessment of rural-specific ADRD issues.
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Affiliation(s)
- Lisa Ann Kirk Wiese
- C.E. Lynn College of Nursing, Florida Atlantic University, Boca Raton, Florida, USA
| | - Allison Gibson
- University of Kentucky College of Social Work, University of Kentucky, Lexington, Kentucky, USA
- Sanders-Brown Center on Aging, University of Kentucky, Lexington, Kentucky, USA
| | - Marc Aaron Guest
- Center for Innovation in Healthy and Resilient Aging, Edson College of Nursing and Health Innovation, Arizona State University, Phoenix, Arizona, USA
| | - Amy R Nelson
- Frederick P. Whiddon College of Medicine, Department of Physiology & Cell Biology, University of South Alabama, Mobile, Alabama, USA
| | - Raven Weaver
- Department of Human Development, Washington State University, Pullman, Washington, USA
| | - Aditi Gupta
- Division of Nephrology and Hypertension, Department of Internal Medicine, Neurology, Alzheimer's Disease Research Center, University of Kansas, Kansas City, Kansas, USA
| | - Owen Carmichael
- Pennington Biomedical Research Center, Baton Rouge, Louisiana, USA
| | - Jordan P Lewis
- Memory Keepers Medical Discovery Team, University of Minnesota Medical School, Duluth, Minnesota, USA
| | - Allison Lindauer
- Oregon Alzheimer's Disease Research Center, Oregon Health & Science University, Portland, Oregon, USA
| | - Samantha Loi
- Neuropsychiatry, Royal Melbourne Hospital, Parkville, Victoria, Australia
- Department of Psychiatry, University of Melbourne, Parkville, Victoria, Australia
| | - Rachel Peterson
- University of Montana School of Public and Community Health Sciences, Missoula, Montana, USA
| | - Kylie Radford
- School of Psychology, University of New South Wales, Sydney, Australia
| | - Elizabeth K Rhodus
- University of Kentucky College of Social Work, University of Kentucky, Lexington, Kentucky, USA
- Sanders-Brown Center on Aging, University of Kentucky, Lexington, Kentucky, USA
- University of Kentucky Alzheimer's Disease Research Center, University of Kentucky, Lexington, Kentucky, USA
- University of Kentucky College of Medicine, for Health Equity Transformation, University of Kentucky, Lexington, Kentucky, USA
| | - Christina G Wong
- Cleveland Clinic Lou Ruvo Center for Brain Health, Las Vegas, Nevada, USA
| | - Megan Zuelsdorff
- School of Nursing, University of Wisconsin-Madison, Madison, Wisconsin, USA
- Wisconsin Alzheimer's Disease Research Center, University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA
| | - Ladan Ghazi Saidi
- Department of Communication Disorders, Center for Brain Biology and Behavior (CB3), University of Nebraska at Kearney, and Lincoln, Nebraska, USA
| | - Esmeralda Valdivieso-Mora
- Department of Psychology and Public Health, Universidad Centroamericana José Simeón Cañas, El Salvador, El Salvador
| | - Sanne Franzen
- Department of Neurology and Alzheimer Center, Erasmus MC University Medical Center, Rotterdam, the Netherlands
| | - Caitlin N Pope
- Department of Health, Behavior, & Society, University of Kentucky, Lexington, Kentucky, USA
| | - Timothy S Killian
- Human Development and Family Sciences, University of Arkansas, Fayetteville, Arkansas, USA
| | - Hom L Shrestha
- School of Kinesiology and Health Sciences, Laurentian University, Sudbury, Ontario, Canada
| | - Patricia C Heyn
- Center for Optimal Aging, Department of Physical Therapy, Marymount University, Arlington, Virginia, USA
| | - Ted Kheng Siang Ng
- Department of Psychology, Arizona State University, Phoenix, Arizona, USA
| | - Beth Prusaczyk
- Institute for Informatics (I2), Center for Population Health Informatics at I2, Washington University in St. Louis School of Medicine, St. Louis, Missouri, USA
| | - Samantha John
- Department of Brain Health, School of Integrated Health Sciences, University of Nevada, Las Vegas, Nevada, USA
| | - Ambar Kulshreshtha
- Department of Family and Preventive Medicine, Division of Hospital Medicine, Emory University School of Medicine, Atlanta, Georgia, USA
- Department of Epidemiology, Division of Hospital Medicine, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Julia L Sheffler
- Center for Translational Behavioral Science, Florida State University College of Medicine, Tallahassee, Florida, USA
| | - Lilah Besser
- Comprehensive Center for Brain Health, University of Miami Miller School of Medicine, Boca Raton, Florida, USA
| | - Valerie Daniel
- Comprehensive Center for Brain Health, University of Miami Miller School of Medicine, Boca Raton, Florida, USA
| | - Magdalena I Tolea
- Comprehensive Center for Brain Health, University of Miami Miller School of Medicine, Boca Raton, Florida, USA
| | - Justin Miller
- Cleveland Clinic Lou Ruvo Center for Brain Health, Las Vegas, Nevada, USA
| | - Christine Musyimi
- Africa Mental Health Research and Training Foundation, Nairobi, Kenya
| | | | - Veronica Yank
- Department of Medicine, University of California, San Francisco, USA
| | - Christine L Williams
- C.E. Lynn College of Nursing, Florida Atlantic University, Boca Raton, Florida, USA
| | - Zahra Rahemi
- Clemson School of Nursing, Clemson University, Clemson, South Carolina, USA
| | - JuYoung Park
- Sandler School of Social Work, College of Social Work and Criminal Justice, Florida Atlantic University, Boca Raton, Florida, USA
| | - Sheryl Magzamen
- Department of Environmental and Radiological Health Sciences, Colorado State University, Fort Collins, Colorado, USA
| | - Robert L Newton
- Pennington Biomedical Research Center, Baton Rouge, Louisiana, USA
| | | | - Jason D Flatt
- School of Public Health, Department of Social & Behavioral Health, University of Nevada, Las Vegas, USA
| | - Sonakshi Arora
- Cleveland Clinic Lou Ruvo Center for Brain Health, Las Vegas, Nevada, USA
| | - Sarah Walter
- Department of Clinical Research and Leadership, The George Washington University School of Medicine and Health Sciences, Washington, District of Columbia, USA
| | - Percy Griffin
- Alzheimer's Therapeutic Research Institute, Alzheimer's Clinical Trials Consortium, University of Southern California, San Diego, California, USA
| | - Ganesh M Babulal
- Scientific Engagement, Medical & Scientific Relations, Alzheimer's Association, Chicago, Illinois, USA
- Department of Neurology, Washington University School of Medicine, St. Louis, Missouri, USA
- Department of Psychology, University of Johannesburg, Johannesburg, South Africa
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25
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Popp D, Nia A, Biedermann G, Schmoelz L, Silvaieh S, Tiefenboeck TM, Hajdu S, Widhalm HK. Predictive Validity of Mortality after Surgically Treated Proximal Femur Fractures Based on Four Nutrition Scores-A Retrospective Data Analysis. Nutrients 2023; 15:3357. [PMID: 37571292 PMCID: PMC10420813 DOI: 10.3390/nu15153357] [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: 06/30/2023] [Revised: 07/22/2023] [Accepted: 07/24/2023] [Indexed: 08/13/2023] Open
Abstract
BACKGROUND Hip fractures are becoming a growing concern due to an aging population. The high costs to the healthcare system and far-reaching consequences for those affected, including a loss of independence and increased mortality rates, make this issue important. Poor nutritional status is a common problem among geriatric patients and is associated with a worse prognosis. Nutritional screening tools can help identify high-risk patients and enable individualized care to improve survival rates. MATERIAL AND METHODS This retrospective study investigates four nutritional scores and laboratory parameters' predictive significance concerning postoperative mortality after surgical treatment of proximal femur fractures at 1, 3, 6, and 12 month/s for patients over 60 years using the chi-square test, Cox regression analysis, and receiver operating characteristics (ROC). The European Society for Clinical Nutrition and Metabolism (ESPEN) guidelines were used as part of the screening of the respective nutritional status of the patients, in particular to filter out malnutrition. RESULTS A total of 1080 patients were included in this study, whereas 8.05% suffered from malnutrition, defined as a body mass index (BMI) below 18.5 kg/m2. The Mini Nutritional Assessment (MNA) screening tool identified the highest proportion of malnourished patients at 14.54%. A total of 36.39% of patients were at risk of malnutrition according to three nutrition scores, with MNA providing the most significant proportion at 41.20%. Patients identified as malnourished had a higher mortality rate, and MNA screening was the only tool to show a significant correlation with postoperative mortality in all survey intervals. The MNA presented the best predictive significance among the screening tools, with a maximum area under the curve (AUC) of 0.7 at 12 month postoperatively. CONCLUSIONS MNA screening has a solid correlation and predictive significance regarding postoperative mortality-therefore routine implementation of this screening in orthopedic/traumatology wards is recommended. Moreover, nutritional substitution therapy can offer a relatively inexpensive and easy-to-implement measure. The Graz malnutrition screening (GMS) shows moderate predictive power and could be considered as an alternative for patients under 60 years of age. A higher albumin level is associated with improved survival probability, but cannot be indicative of nutritional status.
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Affiliation(s)
- Domenik Popp
- Clinical Division of Traumatology, Department of Orthopedics and Trauma Surgery, Medical University of Vienna, 1090 Vienna, Austria; (D.P.); (A.N.); (G.B.); (L.S.); (T.M.T.); (S.H.)
| | - Arastoo Nia
- Clinical Division of Traumatology, Department of Orthopedics and Trauma Surgery, Medical University of Vienna, 1090 Vienna, Austria; (D.P.); (A.N.); (G.B.); (L.S.); (T.M.T.); (S.H.)
| | - Gregor Biedermann
- Clinical Division of Traumatology, Department of Orthopedics and Trauma Surgery, Medical University of Vienna, 1090 Vienna, Austria; (D.P.); (A.N.); (G.B.); (L.S.); (T.M.T.); (S.H.)
| | - Lukas Schmoelz
- Clinical Division of Traumatology, Department of Orthopedics and Trauma Surgery, Medical University of Vienna, 1090 Vienna, Austria; (D.P.); (A.N.); (G.B.); (L.S.); (T.M.T.); (S.H.)
| | - Sara Silvaieh
- Department of Neurology, Medical University of Vienna, 1090 Vienna, Austria;
| | - Thomas M. Tiefenboeck
- Clinical Division of Traumatology, Department of Orthopedics and Trauma Surgery, Medical University of Vienna, 1090 Vienna, Austria; (D.P.); (A.N.); (G.B.); (L.S.); (T.M.T.); (S.H.)
| | - Stefan Hajdu
- Clinical Division of Traumatology, Department of Orthopedics and Trauma Surgery, Medical University of Vienna, 1090 Vienna, Austria; (D.P.); (A.N.); (G.B.); (L.S.); (T.M.T.); (S.H.)
| | - Harald K. Widhalm
- Clinical Division of Traumatology, Department of Orthopedics and Trauma Surgery, Medical University of Vienna, 1090 Vienna, Austria; (D.P.); (A.N.); (G.B.); (L.S.); (T.M.T.); (S.H.)
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26
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Doroszkiewicz J, Mroczko J, Rutkowski P, Mroczko B. Molecular Aspects of a Diet as a New Pathway in the Prevention and Treatment of Alzheimer's Disease. Int J Mol Sci 2023; 24:10751. [PMID: 37445928 PMCID: PMC10341644 DOI: 10.3390/ijms241310751] [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: 05/22/2023] [Revised: 06/19/2023] [Accepted: 06/26/2023] [Indexed: 07/15/2023] Open
Abstract
Alzheimer's disease is the most common cause of dementia in the world. Lack of an established pathology makes it difficult to develop suitable approaches and treatment for the disease. Besides known hallmarks, including amyloid β peptides cumulating in plaques and hyperphosphorylated tau forming NFTs, inflammation also plays an important role, with known connections to the diet. In AD, adhering to reasonable nutrition according to age-related principles is recommended. The diet should be high in neuroprotective foods, such as polyunsaturated fatty acids, antioxidants, and B vitamins. In addition, foods capable of rising BDNF should be considered because of the known profitable results of this molecule in AD. Adhering to beneficial diets might result in improvements in memory, cognition, and biomarkers and might even reduce the risk of developing AD. In this review, we discuss the effects of various diets, foods, and nutrients on brain health and possible connections to Alzheimer's disease.
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Affiliation(s)
- Julia Doroszkiewicz
- Department of Neurodegeneration Diagnostics, Medical University of Bialystok, 15-089 Bialystok, Poland; (J.M.); (B.M.)
| | - Jan Mroczko
- Department of Neurodegeneration Diagnostics, Medical University of Bialystok, 15-089 Bialystok, Poland; (J.M.); (B.M.)
| | | | - Barbara Mroczko
- Department of Neurodegeneration Diagnostics, Medical University of Bialystok, 15-089 Bialystok, Poland; (J.M.); (B.M.)
- Department of Biochemical Diagnostics, Medical University of Białystok, 15-089 Bialystok, Poland
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27
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Jiang M, Jang SE, Zeng L. The Effects of Extrinsic and Intrinsic Factors on Neurogenesis. Cells 2023; 12:cells12091285. [PMID: 37174685 PMCID: PMC10177620 DOI: 10.3390/cells12091285] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2023] [Revised: 04/18/2023] [Accepted: 04/25/2023] [Indexed: 05/15/2023] Open
Abstract
In the mammalian brain, neurogenesis is maintained throughout adulthood primarily in two typical niches, the subgranular zone (SGZ) of the dentate gyrus and the subventricular zone (SVZ) of the lateral ventricles and in other nonclassic neurogenic areas (e.g., the amygdala and striatum). During prenatal and early postnatal development, neural stem cells (NSCs) differentiate into neurons and migrate to appropriate areas such as the olfactory bulb where they integrate into existing neural networks; these phenomena constitute the multistep process of neurogenesis. Alterations in any of these processes impair neurogenesis and may even lead to brain dysfunction, including cognitive impairment and neurodegeneration. Here, we first summarize the main properties of mammalian neurogenic niches to describe the cellular and molecular mechanisms of neurogenesis. Accumulating evidence indicates that neurogenesis plays an integral role in neuronal plasticity in the brain and cognition in the postnatal period. Given that neurogenesis can be highly modulated by a number of extrinsic and intrinsic factors, we discuss the impact of extrinsic (e.g., alcohol) and intrinsic (e.g., hormones) modulators on neurogenesis. Additionally, we provide an overview of the contribution of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection to persistent neurological sequelae such as neurodegeneration, neurogenic defects and accelerated neuronal cell death. Together, our review provides a link between extrinsic/intrinsic factors and neurogenesis and explains the possible mechanisms of abnormal neurogenesis underlying neurological disorders.
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Affiliation(s)
- Mei Jiang
- Department of Human Anatomy, Dongguan Key Laboratory of Stem Cell and Regenerative Tissue Engineering, Dongguan Campus, Guangdong Medical University, Dongguan 523808, China
| | - Se Eun Jang
- Neural Stem Cell Research Lab, Research Department, National Neuroscience Institute, Singapore 308433, Singapore
| | - Li Zeng
- Neural Stem Cell Research Lab, Research Department, National Neuroscience Institute, Singapore 308433, Singapore
- Neuroscience and Behavioral Disorders Program, DUKE-NUS Graduate Medical School, Singapore 169857, Singapore
- Lee Kong Chian School of Medicine, Nanyang Technology University, Novena Campus, 11 Mandalay Road, Singapore 308232, Singapore
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28
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Krzysztoforska K, Piechal A, Wojnar E, Blecharz-Klin K, Pyrzanowska J, Joniec-Maciejak I, Krzysztoforski J, Widy-Tyszkiewicz E. Protocatechuic Acid Prevents Some of the Memory-Related Behavioural and Neurotransmitter Changes in a Pyrithiamine-Induced Thiamine Deficiency Model of Wernicke-Korsakoff Syndrome in Rats. Nutrients 2023; 15:nu15030625. [PMID: 36771332 PMCID: PMC9921060 DOI: 10.3390/nu15030625] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Revised: 01/21/2023] [Accepted: 01/23/2023] [Indexed: 01/27/2023] Open
Abstract
The purpose of this research was to investigate the effects of protocatechuic acid (PCA) at doses of 50 and 100 mg/kg on the development of unfavourable changes in cognitive processes in a pyrithiamine-induced thiamine deficiency (PTD) model of the Wernicke-Korsakoff syndrome (WKS) in rats. The effects of PCA were assessed at the behavioural and biochemical levels. Behavioural analysis was conducted using the Foot Fault test (FF), Bar test, Open Field test, Novel Object Recognition test (NOR), Hole-Board test and Morris Water Maze test (MWM). Biochemical analysis consisting of determination of concentration and turnover of neurotransmitters in selected structures of the rat CNS was carried out using high-performance liquid chromatography. PTD caused catalepsy (Bar test) and significantly impaired motor functions, leading to increased ladder crossing time and multiplied errors due to foot misplacement (FF). Rats with experimentally induced WKS showed impaired consolidation and recall of spatial reference memory in the MWM test, while episodic memory related to object recognition in the NOR was unimpaired. Compared to the control group, rats with WKS showed reduced serotonin levels in the prefrontal cortex and changes in dopamine and/or norepinephrine metabolites in the prefrontal cortex, medulla oblongata and spinal cord. PTD was also found to affect alanine, serine, glutamate, and threonine levels in certain areas of the rat brain. PCA alleviated PTD-induced cataleptic symptoms in rats, also improving their performance in the Foot Fault test. In the MWM, PCA at 50 and 100 mg/kg b.w. improved memory consolidation and the ability to retrieve acquired information in rats, thereby preventing unfavourable changes caused by PTD. PCA at both tested doses was also shown to have a beneficial effect on normalising PTD-disrupted alanine and glutamate concentrations in the medulla oblongata. These findings demonstrate that certain cognitive deficits in spatial memory and abnormalities in neurotransmitter levels persist in rats that have experienced an acute episode of PTD, despite restoration of thiamine supply and long-term recovery. PCA supplementation largely had a preventive effect on the development of these deficits, to some extent also normalising neurotransmitter concentrations in the brain.
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Affiliation(s)
- Kinga Krzysztoforska
- Department of Experimental and Clinical Pharmacology, Centre for Preclinical Research and Technology CePT, Medical University of Warsaw, Banacha 1b, 02-097 Warsaw, Poland
- Correspondence:
| | - Agnieszka Piechal
- Department of Experimental and Clinical Pharmacology, Centre for Preclinical Research and Technology CePT, Medical University of Warsaw, Banacha 1b, 02-097 Warsaw, Poland
| | - Ewa Wojnar
- Department of Experimental and Clinical Pharmacology, Centre for Preclinical Research and Technology CePT, Medical University of Warsaw, Banacha 1b, 02-097 Warsaw, Poland
| | - Kamilla Blecharz-Klin
- Department of Experimental and Clinical Pharmacology, Centre for Preclinical Research and Technology CePT, Medical University of Warsaw, Banacha 1b, 02-097 Warsaw, Poland
| | - Justyna Pyrzanowska
- Department of Experimental and Clinical Pharmacology, Centre for Preclinical Research and Technology CePT, Medical University of Warsaw, Banacha 1b, 02-097 Warsaw, Poland
| | - Ilona Joniec-Maciejak
- Department of Experimental and Clinical Pharmacology, Centre for Preclinical Research and Technology CePT, Medical University of Warsaw, Banacha 1b, 02-097 Warsaw, Poland
| | - Jan Krzysztoforski
- Faculty of Chemical and Process Engineering, Warsaw University of Technology, Waryńskiego 1, 00-645 Warsaw, Poland
| | - Ewa Widy-Tyszkiewicz
- Department of Experimental and Clinical Pharmacology, Centre for Preclinical Research and Technology CePT, Medical University of Warsaw, Banacha 1b, 02-097 Warsaw, Poland
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29
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Warren A. An integrative approach to dementia care. FRONTIERS IN AGING 2023; 4:1143408. [PMID: 36873742 PMCID: PMC9978191 DOI: 10.3389/fragi.2023.1143408] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Accepted: 02/08/2023] [Indexed: 02/18/2023]
Abstract
As the aging population continues to increase, Alzheimer's disease and related dementias are becoming a global health crisis. The burdens experienced by the person living with dementia, their caregivers, healthcare, and society persist unabated. Persons with dementia represent an important population in need of a tenable care plan. Caregivers need the tools with which to properly care for these persons and to mitigate their own stress response. A viable healthcare model utilizing integrated approaches to care for persons with dementia is in overwhelming demand. While much research is focused on a cure, it is equally important to address the difficulties faced by those currently affected. One approach is to incorporate interventions to increase quality of life within the caregiver-patient dyad via a comprehensive integrative model. Improving daily life of the persons with dementia, along with their caregivers and loved ones may aid in attenuating the pervasive psychological and physical impacts of this disease. A focus on interventions that provide neural and physical stimulation may facilitate quality of life in this regard. The subjective experience of this disease is challenging to capture. The relationship between neurocognitive stimulation and quality of life is at least, in part, therefore still uncertain. This narrative review aims to explore the efficacy and evidence-base of an integrative approach to dementia care in facilitating optimal cognition and quality of life outcomes. These approaches will be reviewed alongside person-centered care that is fundamental to integrative medicine, including exercise; music; art and creativity; nutrition; psychosocial engagement; memory training; and acupuncture.
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Affiliation(s)
- Alison Warren
- DAOM, MSHS (Master of science in health sciences), Department of Clinical Research and Leadership, George Washington University School of Medicine and Health Sciences, Washington, DC, United States
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30
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Jiang J, Hong Y, Li W, Wang A, Jiang S, Jiang T, Wang Y, Wang L, Yang S, Ren Q, Zou X, Xu J. Chain Mediation Analysis of the Effects of Nutrition and Cognition on the Association of Apolipoprotein E ɛ4 with Neuropsychiatric Symptoms in Alzheimer's Disease. J Alzheimers Dis 2023; 96:669-681. [PMID: 37840496 DOI: 10.3233/jad-230577] [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] [Indexed: 10/17/2023]
Abstract
BACKGROUND Apolipoprotein E (APOE) is the most recognized risk gene for cognitive decline and clinical progression of late-onset Alzheimer's disease (AD); nonetheless, its association with neuropsychiatric symptoms (NPSs) remains inconclusive. OBJECTIVE To investigate the association of APOE ɛ4 with NPSs and explore nutritional status and cognition as joint mediators of this association. METHODS Between June 2021 and October 2022, patients with amnestic mild cognitive impairment (aMCI) or AD were recruited from the Chinese Imaging, Biomarkers, and Lifestyle Study. NPSs were assessed using the Neuropsychiatric Inventory, while global cognition and nutritional status were evaluated using the Mini-Mental State Examination (MMSE) and Mini-Nutritional Assessment (MNA), respectively. Simple mediation and multiple chain mediation models were developed to examine the mediating effects of the MNA and MMSE scores on the relationship between APOE ɛ4 and specific neuropsychiatric symptom. RESULTS Among 310 patients, 229 (73.87%) had NPSs, and 110 (35.48%) carried APOE ɛ4. Patients with APOE ɛ4 were more likely to have hallucinations (p = 0.014), apathy (p = 0.008), and aberrant motor activity (p = 0.018). MNA and MMSE scores mediated the association between APOE ɛ4 and hallucinations (17.97% and 37.13%, respectively), APOE ɛ4 and apathy (30.73% and 57.72%, respectively), and APOE ɛ4 and aberrant motor activity (17.82% and 34.24%), respectively. Chain-mediating effects of MNA and MMSE scores on the association of APOE ɛ4 with hallucinations, apathy, and aberrant motor activity after adjusting for confounding factors were 6.84%, 11.54%, and 6.19%, respectively. CONCLUSION Nutritional status and cognition jointly mediate the association between APOE ɛ4 and neuropsychiatric symptoms in patients with aMCI or AD.
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Affiliation(s)
- Jiwei Jiang
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Fengtai District, Beijing, China
- National Clinical Research Center for Neurological Diseases, Fengtai District, Beijing, China
| | - Yin Hong
- Department of Health Management, Beijing Tian Tan Hospital, Capital Medical University, Fengtai District, Beijing, China
| | - Wenyi Li
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Fengtai District, Beijing, China
- National Clinical Research Center for Neurological Diseases, Fengtai District, Beijing, China
| | - Anxin Wang
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Fengtai District, Beijing, China
- National Clinical Research Center for Neurological Diseases, Fengtai District, Beijing, China
| | - Shirui Jiang
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Fengtai District, Beijing, China
- National Clinical Research Center for Neurological Diseases, Fengtai District, Beijing, China
| | - Tianlin Jiang
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Fengtai District, Beijing, China
- National Clinical Research Center for Neurological Diseases, Fengtai District, Beijing, China
| | - Yanli Wang
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Fengtai District, Beijing, China
- National Clinical Research Center for Neurological Diseases, Fengtai District, Beijing, China
| | - Linlin Wang
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Fengtai District, Beijing, China
- National Clinical Research Center for Neurological Diseases, Fengtai District, Beijing, China
| | - Shiyi Yang
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Fengtai District, Beijing, China
- National Clinical Research Center for Neurological Diseases, Fengtai District, Beijing, China
| | - Qiwei Ren
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Fengtai District, Beijing, China
- National Clinical Research Center for Neurological Diseases, Fengtai District, Beijing, China
| | - Xinying Zou
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Fengtai District, Beijing, China
- National Clinical Research Center for Neurological Diseases, Fengtai District, Beijing, China
| | - Jun Xu
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Fengtai District, Beijing, China
- National Clinical Research Center for Neurological Diseases, Fengtai District, Beijing, China
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Fernandes MS, Pedroza AA, de Andrade Silva SC, de Lemos MDT, Bernardo EM, Pereira AR, Dos Santos TM, Lagranha C. Undernutrition during development modulates endoplasmic reticulum stress genes in the hippocampus of juvenile rats: Involvement of oxidative stress. Brain Res 2022; 1797:148098. [PMID: 36162496 DOI: 10.1016/j.brainres.2022.148098] [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: 05/16/2022] [Revised: 08/24/2022] [Accepted: 09/20/2022] [Indexed: 11/26/2022]
Abstract
To evaluate whether exercise training mitigates the deleterious effects of undernutrition during the developmental period in juvenile Wistar rats. Pregnant Wistar rats were fed with a diet containing 17 % or 8 % casein during pregnancy and lactation. At 30 days of life, male offspring were divided into 4 groups: Low-Protein non-trained (LS), Low-Protein Trained (LT), Normoprotein non-trained (NS), and Normoprotein Trained (NT). Trained rats performed aerobic exercise training (AET) for 4 weeks, 5 days a week, 1 h a day. 24 h from the last day of training, the animals were sacrificed. The tissues were removed to analyze indicators of mitochondrial metabolism, oxidative stress, and gene expression of GRP78, PERK, ATF6 ER stress markers, and BDNF. The results showed that undernutrition during development promotes deleterious effects on mitochondrial oxidative metabolism and induces reticulum stress in the hippocampus of juvenile rats. On the other hand, AET improves mitochondrial function and increases enzymatic and non-enzymatic antioxidant capacity, as well as declines ER stress. AET at moderate intensity for 4 weeks in male juvenile Wistar rats acts as a lifestyle intervention opposing the negative effects induced by a protein-restricted maternal diet.
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Affiliation(s)
- Matheus Santos Fernandes
- Graduate Program in Neuropsychiatry and Behavioral Sciences, Federal University of Pernambuco, Recife, PE, Brazil; Laboratory of Biochemistry and Exercise Biochemistry / CAV, Federal University of Pernambuco, Vitoria de Santo Antão, PE, Brazil; Physical Education and Sport Department, Federal University of Pernambuco, Recife, PE, Brazil
| | - Anderson Apolônio Pedroza
- Graduate Program in Biochemistry and Physiology, Federal University of Pernambuco, Recife, PE, Brazil; Laboratory of Biochemistry and Exercise Biochemistry / CAV, Federal University of Pernambuco, Vitoria de Santo Antão, PE, Brazil
| | - Severina Cássia de Andrade Silva
- Graduate Program in Neuropsychiatry and Behavioral Sciences, Federal University of Pernambuco, Recife, PE, Brazil; Laboratory of Biochemistry and Exercise Biochemistry / CAV, Federal University of Pernambuco, Vitoria de Santo Antão, PE, Brazil
| | - Maria Daniele Teixeira de Lemos
- Graduate Program in Biochemistry and Physiology, Federal University of Pernambuco, Recife, PE, Brazil; Laboratory of Biochemistry and Exercise Biochemistry / CAV, Federal University of Pernambuco, Vitoria de Santo Antão, PE, Brazil
| | - Elenilson M Bernardo
- Graduate Program in Biochemistry and Physiology, Federal University of Pernambuco, Recife, PE, Brazil; Laboratory of Biochemistry and Exercise Biochemistry / CAV, Federal University of Pernambuco, Vitoria de Santo Antão, PE, Brazil
| | - Allifer R Pereira
- Laboratory of Biochemistry and Exercise Biochemistry / CAV, Federal University of Pernambuco, Vitoria de Santo Antão, PE, Brazil
| | - Tony Meireles Dos Santos
- Graduate Program in Neuropsychiatry and Behavioral Sciences, Federal University of Pernambuco, Recife, PE, Brazil; Physical Education and Sport Department, Federal University of Pernambuco, Recife, PE, Brazil
| | - Claudia Lagranha
- Graduate Program in Neuropsychiatry and Behavioral Sciences, Federal University of Pernambuco, Recife, PE, Brazil; Graduate Program in Biochemistry and Physiology, Federal University of Pernambuco, Recife, PE, Brazil; Laboratory of Biochemistry and Exercise Biochemistry / CAV, Federal University of Pernambuco, Vitoria de Santo Antão, PE, Brazil.
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Geng R, Zhang Y, Liu M, Deng S, Ding J, Zhong H, Tu Q. Elevated serum uric acid is associated with cognitive improvement in older American adults: A large, population-based-analysis of the NHANES database. Front Aging Neurosci 2022; 14:1024415. [PMID: 36570535 PMCID: PMC9772611 DOI: 10.3389/fnagi.2022.1024415] [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: 08/21/2022] [Accepted: 11/15/2022] [Indexed: 12/14/2022] Open
Abstract
Background The many studies revealing a connection between serum uric acid (SUA) and dementia have reported conflicting results. This study sought to investigate the relations between SUA and cognitive function in older adults. Materials and methods The sample was 2,767 American adults aged ≥60 years from the National Health and Nutrition Examination Survey 2011-2014. Cognitive performance was evaluated by the Consortium to Establish a Registry for Alzheimer's Disease test, animal fluency test, digit symbol substitution test, and composite z-score. Multivariate linear regression analyses were conducted to estimate the association between SUA and cognitive function. Results SUA level and cognitive function were significantly, positively correlated. Age significantly correlated with the association between SUA and cognitive function. Conclusion These findings support a connection between SUA and cognition, showing a positive link between SUA and cognitive scores among older American adults. We contend that a slight rise in uric acid within the normal range is advantageous for enhanced cognition. To confirm the precise dose-time-response relation, more tests will be needed.
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Taghadosi Z, Zarifkar A, Razban V, Aligholi H. The effect of chronic stress and its preconditioning on spatial memory as well as hippocampal LRP1 and RAGE expression in a streptozotocin-induced rat model of Alzheimer's disease. Metab Brain Dis 2022; 37:2699-2710. [PMID: 35930096 DOI: 10.1007/s11011-022-01044-y] [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: 01/13/2022] [Accepted: 06/26/2022] [Indexed: 10/16/2022]
Abstract
According to available evidence, prolonged or chronic exposure to stress is detrimental to various brain structures, including the hippocampus. The current study examined the expression of two critical blood-brain barrier receptors required for amyloid-beta clearance to understand better the mechanism by which chronic stress impairs learning and memory in patients with Alzheimer's disease (AD). Rats were randomly assigned to one of two groups in this study: experiment 1 and experiment 2. Each main group was then divided into four subgroups. Rats were bilaterally injected with streptozotocin (STZ, 3 mg/kg, twice) using the intracerebroventricular (ICV) technique to induce the Alzheimer's model. Additionally, they were subjected to foot shock (1 mA, 1 Hz) for 10 s every 60 s (1 h/day) for ten consecutive days prior to and following STZ injection. The Morris Water Maze (MWM) test was used to assess spatial learning and memory. Real-time PCR was used to determine Low-density lipoprotein receptor-related protein-1 (LRP1) and receptor for advanced glycation end-products (RAGE) mRNA levels in the hippocampus. Moreover, the animals' body weights were determined as physiological parameters in all groups. The results indicated that 10-day chronic electric foot shock stress reduced body weight, impaired spatial learning and memory, decreased hippocampal LRP1 mRNA expression, and increased hippocampal RAGE mRNA expression in a rat AD model. It can be concluded that chronic stress in conjunction with AD alters the expression of LRP1 and RAGE in the hippocampus. The findings pave the way for scientists to develop novel treatment strategies for AD.
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Affiliation(s)
- Zohreh Taghadosi
- Department of Neuroscience, School of Advanced Medical Sciences and Technologies, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Asadollah Zarifkar
- Department of Neuroscience, School of Advanced Medical Sciences and Technologies, Shiraz University of Medical Sciences, Shiraz, Iran
- Shiraz Neuroscience Research Center, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Vahid Razban
- Department of Molecular Medicine, School of Advanced Medical Sciences and Technologies, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Hadi Aligholi
- Department of Neuroscience, School of Advanced Medical Sciences and Technologies, Shiraz University of Medical Sciences, Shiraz, Iran.
- Epilepsy Research Center, Shiraz University of Medical Sciences, Shiraz, Iran.
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Prevention and management of behavioural and psychological symptoms in patients with dementia in acute care: a best practice implementation project. JBI Evid Implement 2022; 20:289-300. [PMID: 36375022 PMCID: PMC9794137 DOI: 10.1097/xeb.0000000000000329] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
INTRODUCTION Behavioural and psychological symptoms of dementia are very common in acute care. Agitation and aggressive behaviours are the most common symptoms and are challenging to manage. Early detection and a nonpharmacological approach are recommended. OBJECTIVES To implement evidence-based recommendations for the prevention and management of aggression/agitation in patients with dementia in an acute geriatric care unit. METHODS The project used the JBI Practical Application of Clinical Evidence System and Getting Research into Practice audit and feedback tool. A baseline audit was conducted with seven audit criteria based on evidence summaries. It was followed by the implementation of an action plan and a follow-up audit. RESULTS Results showed moderate improvements in compliance with best practice recommendations. The second audit indicated an improvement up to 46% with the identification of factors/triggers that precipitate aggression/agitation and completion of a risk assessment. The highest improvement was the training of the nursing team (79%). Compliance with the involvement of patients and their families in the care planning improved slightly (14%). The lowest improvement was for the development and implementation of individualized care plans (10%). CONCLUSION The project implementation achieved some positive changes. A formalized process for preventing aggression/agitation is in place. The interprofessional collaboration, the support given to the nursing team and the basket of nonpharmacological interventions were strengthened. The electronic documentation and a limited collaboration of the nursing team were challenging. As further strategies were implemented, further audit would be required to assess achievement in change and/or demonstration of improved care provided for this vulnerable population.
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Otsuka R. Diet, nutrition, and cognitive function: A narrative review of Japanese longitudinal studies. Geriatr Gerontol Int 2022; 22:825-831. [PMID: 36002912 PMCID: PMC9805113 DOI: 10.1111/ggi.14463] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Revised: 04/19/2022] [Accepted: 07/20/2022] [Indexed: 01/09/2023]
Abstract
In aging societies, the number of older people with cognitive decline and dementia is increasing. Proper nutrition is a key factor that can help in the prevention of these age-related impairments. This narrative review of longitudinal studies in Japan outlines the relationship between nutrition and the brain and focuses on Japanese nutritional epidemiologic studies. The results of Japanese cohort studies suggest that rather than a single food or nutrient, a nutritionally balanced diet that integrates a variety of foods and nutrients can contribute to the maintenance of brain function and be effective in preventing dementia. In addition, this review considers a nutritional approach to reducing the severity of cognitive decline in individuals with mild cognitive impairment and dementia, and suggests lifelong strategies for the prevention of cognitive decline. It is important that we consider the practice of eating not only as a way to obtain nutrients, but also as an important lifestyle habit to maintain our physical and mental health. Geriatr Gerontol Int 2022; 22: 825-831.
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Affiliation(s)
- Rei Otsuka
- Department of Epidemiology of Aging, Center for Gerontology and Social Science, Research InstituteNational Center for Geriatrics and GerontologyAichiJapan
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36
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Zhang X, Meng Y, Zhang W, Shi L, Liu X, Zhang L, Liu Q. Diagnostic Values of Advanced Glycation End Products and Homocysteine in Patients with Alzheimer's Disease and Sarcopenia. COMPUTATIONAL AND MATHEMATICAL METHODS IN MEDICINE 2022; 2022:8949048. [PMID: 36118832 PMCID: PMC9481380 DOI: 10.1155/2022/8949048] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Revised: 08/14/2022] [Accepted: 08/23/2022] [Indexed: 11/17/2022]
Abstract
This study is aimed at exploring the diagnostic value of advanced glycation end products (AGEs) and homocysteine (Hcy) in Alzheimer's disease (AD) complicated with sarcopenia (SP) and to analyze the risk factors related to AD complicated with SP. A total of 168 patients admitted to our hospital from November 2019 to December 2021 were enrolled. Patients were divided into the NC (no SP and AD) group with 29 cases, the AD group with 39 cases, the AD+SP group with 35 cases, and the SP group with 65 cases. The general information, Mini-Mental State Examination (MMSE) scores, and serum levels of AGEs and Hcy among the four groups were compared. Unordered logistic regression was used to analyze the influencing factors of SP patients complicated with dementia. The AGE level was higher in the AD or AD+SP group than the NC or SP group (P < 0.05). There was no significant difference between the SP group and the NC group or between the AD group and the AD+SP group (P > 0.05). The Hcy level was higher in the SP or AD group than the NC group (P < 0.05). There were no significant differences between the AD group and NC group or between the SP group and AD+SP group (P > 0.05). The ROC curve of serum AGEs and Hcy for the diagnosis of AD showed that the area under curve (AUC) was 0.887, P < 0.05 (95% CI: 0.821-0.954, sensitivity: 80.95%, specificity: 73.81%) and 0.7423, P < 0.05 (95% CI: 0.6382-0.8465, sensitivity: 60.42%, specificity: 57.59%), respectively. The ROC curve of serum AGEs and Hcy for the diagnosis of SP showed that the AUC was 0.5533, P > 0.05 (95% CI: 0.4294-0.6771) and 0.8744, P < 0.05 (95% CI: 0.8006-0.9483). Age (P < 0.001), depression (P = 0.001), malnutrition (P = 0.002), and BMI (P < 0.001) were independent influencing factors of SP complicated with AD in elderly inpatients. In conclusion, combined serum AGEs and Hcy had a good diagnostic value for AD combined with SP, which may be helpful for early detection of patient condition.
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Affiliation(s)
- Xuelian Zhang
- Geriatrics Department, The First People's Hospital of Lianyungang, Xuzhou Medical University Affiliated Hospital of Lianyungang, The First Affiliated Hospital of Kangda College of Nangjing Medical University, Jiangsu 222002, Jiangsu, China
| | - Yunxia Meng
- Geriatrics Department, The First People's Hospital of Lianyungang, Xuzhou Medical University Affiliated Hospital of Lianyungang, The First Affiliated Hospital of Kangda College of Nangjing Medical University, Jiangsu 222002, Jiangsu, China
| | - Weiwei Zhang
- Geriatrics Department, The First People's Hospital of Lianyungang, Xuzhou Medical University Affiliated Hospital of Lianyungang, The First Affiliated Hospital of Kangda College of Nangjing Medical University, Jiangsu 222002, Jiangsu, China
| | - Luhang Shi
- Geriatrics Department, The First People's Hospital of Lianyungang, Xuzhou Medical University Affiliated Hospital of Lianyungang, The First Affiliated Hospital of Kangda College of Nangjing Medical University, Jiangsu 222002, Jiangsu, China
| | - Xia Liu
- Geriatrics Department, The First People's Hospital of Lianyungang, Xuzhou Medical University Affiliated Hospital of Lianyungang, The First Affiliated Hospital of Kangda College of Nangjing Medical University, Jiangsu 222002, Jiangsu, China
| | - Lijuan Zhang
- Geriatrics Department, The First People's Hospital of Lianyungang, Xuzhou Medical University Affiliated Hospital of Lianyungang, The First Affiliated Hospital of Kangda College of Nangjing Medical University, Jiangsu 222002, Jiangsu, China
| | - Qiaoling Liu
- Geriatrics Department, The First People's Hospital of Lianyungang, Xuzhou Medical University Affiliated Hospital of Lianyungang, The First Affiliated Hospital of Kangda College of Nangjing Medical University, Jiangsu 222002, Jiangsu, China
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Mao Y, Wu J, Liu G, Yu Y, Chen B, Liu J, Wang J, Yu P, Zhang C, Wu J. Chinese expert consensus on prevention and intervention for the elderly with malnutrition (2022). Aging Med (Milton) 2022; 5:191-203. [PMID: 36247340 PMCID: PMC9549312 DOI: 10.1002/agm2.12226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2022] [Revised: 09/06/2022] [Accepted: 09/06/2022] [Indexed: 11/12/2022] Open
Abstract
Malnutrition is a state of altered body composition and body cell mass due to inadequate intake or utilization of energy or nutrients, leading to physical and mental dysfunction and impaired clinical outcomes. As one of the most common geriatric syndromes, malnutrition in the elderly is a significant risk factor for poor clinical outcomes, causing a massive burden on medical resources and society. The risk factors for malnutrition in the elderly are diverse and include demographics, chronic diseases, and psychosocial factors. Presently, recommendations for the prevention and intervention of malnutrition in the elderly are not clear or consistent in China. This consensus is based on the latest global evidence and multiregional clinical experience in China, which aims to standardize the prevention and intervention of malnutrition in the elderly in China and improve the efficacy of clinical practice and the prognosis of elderly patients.
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Affiliation(s)
- Yongjun Mao
- Department of Geriatric Medicinethe Affiliated Hospital of Qingdao UniversityQingdaoChina
| | - Jianqing Wu
- Department of GeriatricsJiangsu Province HospitalThe First Affiliated Hospital of Nanjing Medical UniversityNanjingChina
| | - Gongxiang Liu
- Center of Gerontology and GeriatricsWest China HospitalSichuan UniversityChina National Clinical Research Center for Geriatric MedicineChengduChina
| | - Yao Yu
- Department of Geriatric Medicinethe Affiliated Hospital of Qingdao UniversityQingdaoChina
| | - Bo Chen
- Department of GeriatricsJiangsu Province HospitalThe First Affiliated Hospital of Nanjing Medical UniversityNanjingChina
| | - Jia Liu
- Department of Geriatric Medicinethe Affiliated Hospital of Qingdao UniversityQingdaoChina
| | - Jianye Wang
- Beijing HospitalNational Center of GerontologyInstitute of Geriatric MedicineChinese Academy of Medical SciencesBeijingChina
| | - Pulin Yu
- Beijing HospitalNational Center of GerontologyInstitute of Geriatric MedicineChinese Academy of Medical SciencesBeijingChina
| | - Cuntai Zhang
- Institute of Aging, Department of Geriatrics, Tongji Hospital, Tongji Medical CollegeHuazhong University of Science and TechnologyWuhanChina
| | - Jinhui Wu
- Center of Gerontology and GeriatricsWest China HospitalSichuan UniversityChina National Clinical Research Center for Geriatric MedicineChengduChina
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Kuroda Y, Sugimoto T, Satoh K, Suemoto CK, Matsumoto N, Uchida K, Kishino Y, Sakurai T. Factors Associated with Behavioral and Psychological Symptoms of Dementia during COVID-19. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:10094. [PMID: 36011727 PMCID: PMC9407936 DOI: 10.3390/ijerph191610094] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/20/2022] [Revised: 08/05/2022] [Accepted: 08/10/2022] [Indexed: 06/15/2023]
Abstract
(1) Background: Preventive measures to control the spread of COVID-19 are essential, but they often cause social isolation and diminish the physical and mental health of older adults. In cognitively impaired individuals, the pandemic has worsened behavioral and psychological symptoms of dementia (BPSD). Here, we explored the factors contributing to the worsening of BPSD during the COVID-19 pandemic. (2) Methods: Potential patients were identified at a memory clinic in Japan between June 2017 and June 2021. Eligible patients had a diagnosis of mild cognitive impairment (MCI) or dementia during the study period. The outcome was BPSD, as assessed by using the Dementia Behavioral Disorders Scale. Information on patients' lifestyle habits and use of care services was obtained for use as primary explanatory variables; multiple regression analysis was performed to examine the relationship between BPSD and care services use or lifestyle habits. The model was adjusted for sociodemographic factors, and the interaction terms of the pandemic period with lifestyle and service use were included to evaluate the effects of COVID-19. (3) Results: We identified 977 participants with MCI and 1380 with dementia (MCI group: 69.8% age 75 years or older, 54.2% female; dementia group: 79.8% age 75 years or older, 64.8% female). After adjustment for possible confounders, significantly worse BPSD was demonstrated in those who used daycare services during COVID-19 (both MCI and dementia patients; p = 0.007 and p = 0.025 respectively) and in those with poor nutritional function (dementia patients; p = 0.040). (4) Conclusions and Implications: During COVID-19, poor nutritional status and use of daycare services were associated with BPSD in those with cognitive decline. These findings indicate the need to fully examine the quantity and quality of care services for people with cognitive decline during emergencies and to continue to provide effective services.
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Affiliation(s)
- Yujiro Kuroda
- Department of Prevention and Care Science, Center for Development of Advanced Medicine for Dementia, National Center for Geriatrics and Gerontology, Obu 474-8511, Japan
| | - Taiki Sugimoto
- Department of Prevention and Care Science, Center for Development of Advanced Medicine for Dementia, National Center for Geriatrics and Gerontology, Obu 474-8511, Japan
| | - Kenichi Satoh
- Faculty of Data Science, Shiga University, Hikone 522-8522, Japan
| | - Claudia K. Suemoto
- Division of Geriatrics, University of Sao Paulo, Sao Paulo 01246-903, Brazil
| | - Nanae Matsumoto
- Department of Prevention and Care Science, Center for Development of Advanced Medicine for Dementia, National Center for Geriatrics and Gerontology, Obu 474-8511, Japan
| | - Kazuaki Uchida
- Department of Prevention and Care Science, Center for Development of Advanced Medicine for Dementia, National Center for Geriatrics and Gerontology, Obu 474-8511, Japan
| | - Yoshinobu Kishino
- Center for Comprehensive Care and Research on Memory Disorders, National Center for Geriatrics and Gerontology, Obu 474-8511, Japan
- Department of Cognition and Behavior Science, Nagoya University Graduate School of Medicine, Nagoya 464-8601, Japan
| | - Takashi Sakurai
- Department of Prevention and Care Science, Center for Development of Advanced Medicine for Dementia, National Center for Geriatrics and Gerontology, Obu 474-8511, Japan
- Center for Comprehensive Care and Research on Memory Disorders, National Center for Geriatrics and Gerontology, Obu 474-8511, Japan
- Department of Cognition and Behavior Science, Nagoya University Graduate School of Medicine, Nagoya 464-8601, Japan
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Kishino Y, Sugimoto T, Kimura A, Kuroda Y, Uchida K, Matsumoto N, Saji N, Niida S, Sakurai T. Longitudinal association between nutritional status and behavioral and psychological symptoms of dementia in older women with mild cognitive impairment and early-stage Alzheimer’s disease. Clin Nutr 2022; 41:1906-1912. [DOI: 10.1016/j.clnu.2022.06.035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Revised: 06/22/2022] [Accepted: 06/24/2022] [Indexed: 11/29/2022]
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Feng L, Chu Z, Quan X, Zhang Y, Yuan W, Yao Y, Zhao Y, Fu S. Malnutrition is positively associated with cognitive decline in centenarians and oldest-old adults: A cross-sectional study. EClinicalMedicine 2022; 47:101336. [PMID: 35497066 PMCID: PMC9046105 DOI: 10.1016/j.eclinm.2022.101336] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2021] [Revised: 01/23/2022] [Accepted: 02/18/2022] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Cognitive decline is a growing public health concern. However, presently, only a few large-scale studies are available on the prevalence of cognitive decline worldwide, and the relationship between nutrition and cognitive decline remains unclear and requires further investigation, especially among Chinese centenarians and oldest-old adults. This study aimed to assess the prevalence of cognitive decline among Chinese centenarians and oldest-old adults, its associated factors, and explore a possible connection with nutrition, to provide new directions for the prevention of cognitive decline in Chinese centenarians and oldest-old adults. METHODS Based on the China Hainan Centenarian Cohort Study (CHCCS), a household survey was conducted among all the centenarians and oldest-old adults residing in 16 cities and counties of Hainan province from June 2014 to June 2016. This study included 946 centenarians and oldest-old adults (412 and 534, respectively). Cognitive function was measured using the mini-mental state examination (MMSE). FINDINGS The total prevalence of cognitive decline was 76·6% (725 participants). Centenarians had a significantly higher prevalence of cognitive decline compared to oldest-old adults [359 centenarians (87·1%) vs. 366 oldest-old adults (68·5%)]. Centenarians and oldest-old adults with cognitive decline had significantly lower prognostic nutritional index (PNI) and mini nutrition assessment-short form (MNA-SF) than those without cognitive decline (P < 0·05). Multivariate logistic regression analyses showed that participants with higher PNI and MNA-SF were less likely to have cognitive decline. Multivariate linear regression analyses showed that PNI and MNA-SF were positively associated with MMSE (P < 0·05). INTERPRETATION Malnutrition was positively associated with cognitive decline among Chinese centenarians and oldest-old adults. It is therefore important for clinicians and community health workers to pay attention to malnutrition in these populations and provide supplemental nutrients to prevent cognitive decline. FUNDING This work was supported by grants from the National Natural Science Foundation of China (81900357, 81903392, 81941021, 81901252, 82001476, 81802804, 81801251), the Military Medical Science and Technology Youth Incubation Program (20QNPY110, 19QNP060), the Excellent Youth Incubation Program of Chinese People's Liberation Army General Hospital (2020-YQPY-007), the Military Medicine Youth Program of Chinese People's Liberation Army General Hospital (QNF19069, QNF19068), the National Key R&D Program of China (2018YFC2000400), the National S&D Resource Sharing Service Platform Project of China (YCZYPT[2018]07), the Innovation Platform for Academinicians of Hainan Province, the Hainan Major Scientific and Technological Cooperation Project (2016KJHZ0039), the China Postdoctoral Science Foundation funded project (2019M650359, 2020M682816, 2021T140298), the Medical Big Data R&D Project of Chinese People's Liberation Army General Hospital (MBD2018030), the National Geriatric Disease Clinical Medicine Research centre Project (NCRCG-PLAGH-2017-014), the Central Health Care Scientific Research Project (W2017BJ12), the Hainan Medical and Health Research Project (16A200057), the Sanya Medical and Health Science and Technology Innovation Project (2016YW21, 2017YW22, 2018YW11), and the Clinical Scientific Research Supporting Fund of Chinese People's Liberation Army General Hospital (2017FC-CXYY-3009).
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Affiliation(s)
- Long Feng
- Department of Anesthesiology, Hainan Hospital of Chinese People's Liberation Army General Hospital, Sanya, China
| | - Zhixiang Chu
- Emergency Department, Hainan Hospital of Chinese People's Liberation Army General Hospital, Sanya, China
| | - Xiaojiao Quan
- Intensive Care Unit, Hainan Hospital of Chinese People's Liberation Army General Hospital, Sanya, China
| | - Yujie Zhang
- Department of Epidemiology, School of Public Health, Southern Medical University, Guangzhou, China
| | - Weixiu Yuan
- Department of Anesthesiology, Hainan Hospital of Chinese People's Liberation Army General Hospital, Sanya, China
- Corresponding authors at: Hainan Hospital of Chinese People's Liberation Army General Hospital, Sanya, China.
| | - Yao Yao
- China Center for Health Development Studies, Peking University, Beijing, China
- Center for Healthy Aging and Development Studies, National School of Development, Peking University, Beijing, China
- Corresponding author at: China Center for Health Development Studies, Peking University, Beijing, China.
| | - Yali Zhao
- Central Laboratory, Hainan Hospital of Chinese People's Liberation Army General Hospital, Sanya, China
- Corresponding authors at: Hainan Hospital of Chinese People's Liberation Army General Hospital, Sanya, China.
| | - Shihui Fu
- Department of Cardiology, Hainan Hospital of Chinese People's Liberation Army General Hospital, Sanya, China
- Corresponding authors at: Hainan Hospital of Chinese People's Liberation Army General Hospital, Sanya, China.
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Zhang T, Zhang Y, Lv Z, Xiang J. Sarcopenia and motoric cognitive risk syndrome: a moderated mediation model. BMC Geriatr 2022; 22:141. [PMID: 35183116 PMCID: PMC8857782 DOI: 10.1186/s12877-022-02802-4] [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: 10/24/2021] [Accepted: 01/27/2022] [Indexed: 02/07/2023] Open
Abstract
Background Sarcopenia has been identified as a risk factor for cognitive impairment, and motoric cognitive risk syndrome (MCR) is a recently defined pre-dementia syndrome. It is not known whether they are related. We aimed to investigate the association and potential pathways between sarcopenia and MCR in the community elderly by establishing a moderated mediation model. Methods 846 community residents aged ≥ 60 years were recruited from May 2021 to September 2021 and had a comprehensive geriatric evaluation. The diagnosis of sarcopenia followed the criteria issued by the Asian Working Group for Sarcopenia in 2019. MCR was defined as subjective cognitive decline and slow gait. Apathy symptoms and physical activity were assessed by the Apathy Evaluation Scale (AES) and the International Physical Activity Questionnaire (IPAQ). Logistic regression and moderated mediation analyses were conducted to explore the association between the four. Results 60 (7.1%) had MCR among 846 participants. After full adjustment, sarcopenia (odds ratio [OR] = 3.81, 95% confidence interval [CI] = 1.69–8.60, P = 0.001), AES score (OR = 1.09, 95% CI = 1.04–1.14, P < 0.001), and IPAQ level (OR = 0.43, 95% CI = 0.28–0.66, P < 0.001) were associated with MCR. Apathy partially mediated the relationship between sarcopenia and MCR. Physical activity played a moderation role in the indirect pathway of the mediation model. The increase in physical activity can alleviate the indirect effect of sarcopenia on MCR. Conclusion We established a moderated mediation model to uncover the underlying association mechanism of sarcopenia and MCR preliminarily. These findings suggest that attention should be paid to the management of apathy and physical activity in the context of sarcopenia to prevent early dementia actively. Further validation is needed in future longitudinal studies.
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Van Wymelbeke-Delannoy V, Maître I, Salle A, Lesourd B, Bailly N, Sulmont-Rossé C. Prevalence of malnutrition risk among older French adults with culinary dependence. Age Ageing 2022; 51:6406696. [PMID: 34673917 DOI: 10.1093/ageing/afab208] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Revised: 07/06/2021] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVE The term 'culinary dependence' denotes a situation in which someone delegates all or part of their daily meal-related activities to a third party. The present study aimed to explore nutritional risk among older people (≥65 years) with culinary dependence. METHOD The first survey included 559 people either living at home without help, with help unrelated to food activities, with help related to food activities or living in nursing home. The second survey included 319 people with food help provided by a caregiver, by meals-on-wheels or by a nursing home. Nutritional status was assessed with the Mini-Nutritional Assessment. Sociological background and wellness variables (health, cognitive and mental status) were collected. RESULTS The first survey found a strong association between culinary dependence and nutritional risk. About half of the people who delegated their food-related activities were malnourished or at risk of malnutrition compared with only 4% for people with no help and 12% for people with help unrelated to food activity. According to the second survey, this prevalence varied slightly depending on who the tasks were delegated to (46% for those who had the support of a caregiver; 60% for those who used a meals-on-wheels service; 69% for those living in nursing home). According to multivariate analyses, dependence categories, depressive symptoms and cognitive status were identified as independent determinants of malnutrition. CONCLUSION Without inferring a causal relationship between dependence and malnutrition, there is a strong need for care structures to take into account the issue of malnutrition when developing services targeting older people.
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Affiliation(s)
- Virginie Van Wymelbeke-Delannoy
- CHU Dijon Bourgogne F Mitterrand, Unité du Pôle Personnes Âgées, F-21000 Dijon, France
- Centre des Sciences du Goût et de l'Alimentation, AgroSup Dijon, CNRS, INRAE, Université Bourgogne Franche-Comté, F-21000 Dijon, France
| | - Isabelle Maître
- Ecole Supérieure d’Agricultures (ESA), USC 1422 GRAPPE, INRAE, SFR 4207, QUASAV, Angers, France
| | - Agnès Salle
- CHU, Service d’endocrinologie, diabétologie et nutrition, Angers, France
| | - Bruno Lesourd
- Département de Gériatrie CHU, Clermont-Ferrand, France
| | - Nathalie Bailly
- University of Tours, E.A. 2114. « Psychologie des Ages de la Vie et Adaptation », Department of Psychology, Tours, France
| | - Claire Sulmont-Rossé
- Centre des Sciences du Goût et de l'Alimentation, AgroSup Dijon, CNRS, INRAE, Université Bourgogne Franche-Comté, F-21000 Dijon, France
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Chao YT, Kuo FH, Lee YS, Huang YH, Weng SC, Chou YY, Lin CS, Lin SY. Characteristics and Outcome Determinants of Hospitalized Older Patients with Cognitive Dysfunction. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19010584. [PMID: 35010842 PMCID: PMC8744733 DOI: 10.3390/ijerph19010584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 11/29/2021] [Revised: 01/01/2022] [Accepted: 01/01/2022] [Indexed: 12/10/2022]
Abstract
Cognitive dysfunction commonly occurs among older patients during admission and is associated with adverse prognosis. This study evaluated clinical characteristics and outcome determinants in hospitalized older patients with cognitive disorders. The main outcomes were length of stay, readmission within 30 days, Barthel index (BI) score at discharge, BI score change (discharge BI score minus BI score), and proportion of positive BI score change to indicate change of activities of daily living (ADL) change during hospitalization. A total of 642 inpatients with a mean age of 79.47 years (76–103 years) were categorized into three groups according to the medical history of dementia, and Mini-Mental State Examination (MMSE) scores at admission. Among them, 74 had dementia diagnosis (DD), 310 had cognitive impairment (CI), and 258 had normal MMSE scores. Patients with DD and CI generally had a higher risk of many geriatric syndromes, such as multimorbidities, polypharmacy, delirium, incontinence, visual and auditory impairment, fall history, physical frailty. They had less BI score, BI score change, and proportion of positive BI score change ADL at discharge. (DD 70.0%, CI 79.0%), suggesting less ADL change during hospitalization compared with those with normal MMSE scores (92.9%; p < 0.001). Using multiple regression analysis, we found that among patients with DD and CI, age (p = 0.008) and walking speed (p = 0.023) were predictors of discharge BI score. In addition, age (p = 0.047) and education level were associated with dichotomized BI score change (positive vs. non-positive) during hospitalization. Furthermore, the number and severity of comorbidities predicted LOS (p < 0.001) and readmission (p = 0.001) in patients with cognitive disorders. It is suggested that appropriate strategies are required to improve clinical outcomes in these patients.
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Affiliation(s)
- Yi-Ting Chao
- Center for Geriatrics & Gerontology, Taichung Veterans General Hospital, Taichung 407219, Taiwan; (Y.-T.C.); (F.-H.K.); (Y.-S.L.); (Y.-H.H.); (S.-C.W.); (Y.-Y.C.); (C.-S.L.)
- Division of Neurology, Taichung Veterans General Hospital, Taichung 407219, Taiwan
| | - Fu-Hsuan Kuo
- Center for Geriatrics & Gerontology, Taichung Veterans General Hospital, Taichung 407219, Taiwan; (Y.-T.C.); (F.-H.K.); (Y.-S.L.); (Y.-H.H.); (S.-C.W.); (Y.-Y.C.); (C.-S.L.)
- Division of Neurology, Taichung Veterans General Hospital, Taichung 407219, Taiwan
| | - Yu-Shan Lee
- Center for Geriatrics & Gerontology, Taichung Veterans General Hospital, Taichung 407219, Taiwan; (Y.-T.C.); (F.-H.K.); (Y.-S.L.); (Y.-H.H.); (S.-C.W.); (Y.-Y.C.); (C.-S.L.)
- Division of Neurology, Taichung Veterans General Hospital, Taichung 407219, Taiwan
| | - Yu-Hui Huang
- Center for Geriatrics & Gerontology, Taichung Veterans General Hospital, Taichung 407219, Taiwan; (Y.-T.C.); (F.-H.K.); (Y.-S.L.); (Y.-H.H.); (S.-C.W.); (Y.-Y.C.); (C.-S.L.)
- Department of Nursing, Taichung Veterans General Hospital, Taichung 407219, Taiwan
| | - Shuo-Chun Weng
- Center for Geriatrics & Gerontology, Taichung Veterans General Hospital, Taichung 407219, Taiwan; (Y.-T.C.); (F.-H.K.); (Y.-S.L.); (Y.-H.H.); (S.-C.W.); (Y.-Y.C.); (C.-S.L.)
- Division of Nephrology, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung 407219, Taiwan
- Institute of Clinical Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taipei 112201, Taiwan
| | - Yin-Yi Chou
- Center for Geriatrics & Gerontology, Taichung Veterans General Hospital, Taichung 407219, Taiwan; (Y.-T.C.); (F.-H.K.); (Y.-S.L.); (Y.-H.H.); (S.-C.W.); (Y.-Y.C.); (C.-S.L.)
- Division of Allergy, Immunology and Rheumatology, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung 407219, Taiwan
| | - Chu-Sheng Lin
- Center for Geriatrics & Gerontology, Taichung Veterans General Hospital, Taichung 407219, Taiwan; (Y.-T.C.); (F.-H.K.); (Y.-S.L.); (Y.-H.H.); (S.-C.W.); (Y.-Y.C.); (C.-S.L.)
- Department of Family Medicine, Taichung Veterans General Hospital, Taichung 407219, Taiwan
| | - Shih-Yi Lin
- Center for Geriatrics & Gerontology, Taichung Veterans General Hospital, Taichung 407219, Taiwan; (Y.-T.C.); (F.-H.K.); (Y.-S.L.); (Y.-H.H.); (S.-C.W.); (Y.-Y.C.); (C.-S.L.)
- Institute of Clinical Medicine, College of Medicine, National Yang Ming Chiao Tung University, Taipei 112201, Taiwan
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung 407219, Taiwan
- Correspondence:
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Kuroda Y, Sugimoto T, Matsumoto N, Uchida K, Kishino Y, Suemoto CK, Sakurai T. Prevalence of Behavioral and Psychological Symptoms in Patients With Cognitive Decline Before and During the COVID-19 Pandemic. Front Psychiatry 2022; 13:839683. [PMID: 35321225 PMCID: PMC8934776 DOI: 10.3389/fpsyt.2022.839683] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Accepted: 02/09/2022] [Indexed: 01/10/2023] Open
Abstract
OBJECTIVE Preventive measures to limit the spread of COVID-19 are essential, but often cause social isolation, affecting the physical and mental health of older adults. Patients with dementia are likely to have worsening behavioral and psychological symptoms of dementia (BPSD) owing to pandemic restrictions. To examine this, we described BPSD before and during the COVID-19 pandemic. METHODS We identified patients at a memory clinic in Japan between October 2018 and December 2019 (15 months before the pandemic began, n = 1,384) and between April 2020 and June 2021 (15 months after the State of Emergency was declared; n = 675 patients). A propensity score was used to match 576 patients from each group. The Mini-Mental State Exam was used to classify cognitive function into mild and moderate/severe. Dementia Behavioral Disturbance Scale was used to evaluate BPSD. The association between BPSD before and during the pandemic was evaluated using binomial logistic regression models. RESULTS The levels of frequent night waking were higher in individuals before the pandemic than in those evaluated during the pandemic in both the mild group [adjusted odds ratio (AOR) = 1.82, 95% CI 1.02-3.23] and the moderate/severe group (AOR = 1.96, 95% CI 1.19-3.23). During the pandemic, physical attacks were higher in the mild group (AOR = 4.25, 95% CI 1.12-16.07), while night wandering was higher in the moderate/severe group (AOR = 2.22, 95% CI 1.03-4.81). CONCLUSION In patients with cognitive impairment, some BPSD were more prevalent during the pandemic, depending on dementia severity. The findings pertaining to the higher frequency of sleep disturbance and aggressiveness during COVID-19 should be used to guide BPSD screening in patients with dementia and to provide evidence-based interventions.
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Affiliation(s)
- Yujiro Kuroda
- Department of Prevention and Care Science, Center for Development of Advanced Medicine for Dementia, National Center for Geriatrics and Gerontology, Obu, Japan
| | - Taiki Sugimoto
- Department of Prevention and Care Science, Center for Development of Advanced Medicine for Dementia, National Center for Geriatrics and Gerontology, Obu, Japan.,Center for Comprehensive Care and Research on Memory Disorders, National Center for Geriatrics and Gerontology, Obu, Japan
| | - Nanae Matsumoto
- Center for Comprehensive Care and Research on Memory Disorders, National Center for Geriatrics and Gerontology, Obu, Japan
| | - Kazuaki Uchida
- Center for Comprehensive Care and Research on Memory Disorders, National Center for Geriatrics and Gerontology, Obu, Japan.,Department of Public Health, Graduate School of Health Sciences, Kobe University, Kobe, Japan
| | - Yoshinobu Kishino
- Center for Comprehensive Care and Research on Memory Disorders, National Center for Geriatrics and Gerontology, Obu, Japan.,Department of Cognitive and Behavioral Science, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | | | - Takashi Sakurai
- Department of Prevention and Care Science, Center for Development of Advanced Medicine for Dementia, National Center for Geriatrics and Gerontology, Obu, Japan.,Center for Comprehensive Care and Research on Memory Disorders, National Center for Geriatrics and Gerontology, Obu, Japan.,Department of Cognitive and Behavioral Science, Nagoya University Graduate School of Medicine, Nagoya, Japan
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Wang T, Chen Y, Zou Y, Pang Y, He X, Chen Y, Liu Y, Feng W, Zhang Y, Li Q, Shi J, Ding F, Marshall C, Gao J, Xiao M. Locomotor Hyperactivity in the Early-Stage Alzheimer’s Disease-like Pathology of APP/PS1 Mice: Associated with Impaired Polarization of Astrocyte Aquaporin 4. Aging Dis 2022; 13:1504-1522. [PMID: 36186142 PMCID: PMC9466968 DOI: 10.14336/ad.2022.0219] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2021] [Accepted: 02/19/2022] [Indexed: 12/21/2022] Open
Abstract
Non-cognitive behavioral and psychological symptoms often occur in Alzheimer's disease (AD) patients and mouse models, although the exact neuropathological mechanism remains elusive. Here, we report hyperactivity with significant inter-individual variability in 4-month-old APP/PS1 mice. Pathological analysis revealed that intraneuronal accumulation of amyloid-β (Aβ), c-Fos expression in glutamatergic neurons and activation of astrocytes were more evident in the frontal motor cortex of hyperactive APP/PS1 mice, compared to those with normal activity. Moreover, the hyperactive phenotype was associated with mislocalization of perivascular aquaporin 4 (AQP4) and glymphatic transport impairment. Deletion of the AQP4 gene increased hyperactivity, intraneuronal Aβ load and glutamatergic neuron activation, but did not influence working memory or anxiety-like behaviors of 4-month-old APP/PS1 mice. Together, these results demonstrate that AQP4 mislocalization or deficiency leads to increased intraneuronal Aβ load and neuronal hyperactivity in the motor cortex, which in turn causes locomotor over-activity during the early pathophysiology of APP/PS1 mice. Therefore, improving AQP4 mediated glymphatic clearance may offer a new strategy for early intervention of hyperactivity in the prodromal phase of AD.
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Affiliation(s)
- Tianqi Wang
- Jiangsu Province Key Laboratory of Neurodegeneration, Center for Global Health, Nanjing Medical University, Nanjing, 211166, China.
- Brain Institute, the Affiliated Nanjing Brain Hospital of Nanjing Medical University, Nanjing, 210029, China.
| | - Yan Chen
- Jiangsu Province Key Laboratory of Neurodegeneration, Center for Global Health, Nanjing Medical University, Nanjing, 211166, China.
- Brain Institute, the Affiliated Nanjing Brain Hospital of Nanjing Medical University, Nanjing, 210029, China.
| | - Ying Zou
- Jiangsu Province Key Laboratory of Neurodegeneration, Center for Global Health, Nanjing Medical University, Nanjing, 211166, China.
| | - Yingting Pang
- Jiangsu Province Key Laboratory of Neurodegeneration, Center for Global Health, Nanjing Medical University, Nanjing, 211166, China.
| | - Xiaoxin He
- Jiangsu Province Key Laboratory of Neurodegeneration, Center for Global Health, Nanjing Medical University, Nanjing, 211166, China.
- Brain Institute, the Affiliated Nanjing Brain Hospital of Nanjing Medical University, Nanjing, 210029, China.
| | - Yali Chen
- Jiangsu Province Key Laboratory of Neurodegeneration, Center for Global Health, Nanjing Medical University, Nanjing, 211166, China.
- Department of Human Anatomy and Histoembryology, Nanjing University of Chinese Medicine, Nanjing, 210023, China.
| | - Yun Liu
- Jiangsu Province Key Laboratory of Neurodegeneration, Center for Global Health, Nanjing Medical University, Nanjing, 211166, China.
| | - Weixi Feng
- Jiangsu Province Key Laboratory of Neurodegeneration, Center for Global Health, Nanjing Medical University, Nanjing, 211166, China.
- Brain Institute, the Affiliated Nanjing Brain Hospital of Nanjing Medical University, Nanjing, 210029, China.
| | - Yanli Zhang
- Jiangsu Province Key Laboratory of Neurodegeneration, Center for Global Health, Nanjing Medical University, Nanjing, 211166, China.
| | - Qian Li
- Jiangsu Province Key Laboratory of Neurodegeneration, Center for Global Health, Nanjing Medical University, Nanjing, 211166, China.
- Brain Institute, the Affiliated Nanjing Brain Hospital of Nanjing Medical University, Nanjing, 210029, China.
| | - Jingping Shi
- Department of Neurology, the Affiliated Nanjing Brain Hospital of Nanjing Medical University, Nanjing, 210029, China.
| | - Fengfei Ding
- Department of Pharmacology, Shanghai Medical College, Fudan University, Shanghai, 200032, China.
| | - Charles Marshall
- College of Health Sciences, University of Kentucky Center of Excellence in Rural Health, Hazard, KY 41701, USA
| | - Junying Gao
- Jiangsu Province Key Laboratory of Neurodegeneration, Center for Global Health, Nanjing Medical University, Nanjing, 211166, China.
- Correspondence should be addressed to: Dr. Ming Xiao (E-mail: ) or Dr. Junying Gao (), Jiangsu Province Key Laboratory of Neurodegeneration, Nanjing Medical University, Nanjing, China
| | - Ming Xiao
- Jiangsu Province Key Laboratory of Neurodegeneration, Center for Global Health, Nanjing Medical University, Nanjing, 211166, China.
- Brain Institute, the Affiliated Nanjing Brain Hospital of Nanjing Medical University, Nanjing, 210029, China.
- Correspondence should be addressed to: Dr. Ming Xiao (E-mail: ) or Dr. Junying Gao (), Jiangsu Province Key Laboratory of Neurodegeneration, Nanjing Medical University, Nanjing, China
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Smith L, Shin JI, Oh H, Carmichael C, Jacob L, Stefanac S, Lindsay RK, Soysal P, Veronese N, Tully MA, Butler L, Barnett Y, Koyanagi A. Body Mass Index and Mild Cognitive Impairment Among Middle-Aged and Older Adults from Low- and Middle-Income Countries. J Alzheimers Dis 2021; 85:1095-1105. [PMID: 34897093 DOI: 10.3233/jad-215345] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
BACKGROUND The effect of weight modification on future dementia risk is currently a subject of debate and may be modified by age. OBJECTIVE The aim of the present study was to investigate the association between body mass index (BMI) status with mild cognitive impairment (MCI) (a preclinical stage of dementia) in middle-aged and older adults residing in six low- and middle-income countries using nationally representative data. METHODS Cross-sectional data from the Study on Global Ageing and Adult Health (SAGE) were analyzed. MCI was defined using the National Institute on Aging-Alzheimer's Association criteria. BMI (kg/m2) was based on measured weight and height and categorized as: underweight (<18.5), normal (18.5-24.9), overweight (25.0-29.9), and obese (≥30.0). Multivariable logistic regression analysis and meta-analysis were conducted to assess associations. RESULTS Data on 32,715 individuals aged ≥50 years with preservation in functional abilities were analyzed [mean (SD) age 62.1 (15.6) years; 51.7% females]. Among those aged 50-64 years, compared to normal weight, underweight (OR = 1.44; 95% CI = 1.14-1.81), overweight (OR = 1.17; 95% CI = 1.002-1.37), and obesity (OR = 1.46; 95% CI = 1.09-1.94) were all significantly associated with higher odds for MCI. In those aged ≥65 years, underweight (OR = 0.71; 95% CI = 0.54-0.95) and overweight (OR = 0.72; 95% CI = 0.55-0.94) were associated with significantly lower odds for MCI, while obesity was not significantly associated with MCI. CONCLUSION The results of the study suggest that the association between BMI and MCI is likely moderated by age. Future longitudinal studies are required to confirm or refute the present findings before recommendations for policy and practice can be made.
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Affiliation(s)
- Lee Smith
- Centre for Health, Performance and Wellbeing, Anglia Ruskin University, Cambridge, UK
| | - Jae Il Shin
- Department of Pediatrics, Yonsei University College of Medicine, Seoul, South Korea
| | - Hans Oh
- Suzanne Dworak Peck School of Social Work, University of Southern California, Los Angeles, CA, USA
| | - Christina Carmichael
- Centre for Health, Performance and Wellbeing, Anglia Ruskin University, Cambridge, UK
| | - Louis Jacob
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, CIBERSAM, Dr.Antoni Pujadas, Barcelona, Spain.,Faculty of Medicine, University of Versailles Saint-Quentin-en-Yvelines, Montigny-le-Bretonneux, France
| | - Sinisa Stefanac
- Institute of Outcomes Research, Centre for Medical Statistics, Informatics and Intelligent Systems, Medical University of Vienna, Vienna, Austria
| | - Rosie K Lindsay
- Vision and Hearing Sciences, Anglia Ruskin University, Cambridge, UK
| | - Pinar Soysal
- Department of Geriatric Medicine, Faculty of Medicine, Bezmialem Vakif University, Fatih, İstanbul, Turkey
| | - Nicola Veronese
- Geriatric Unit, Department of Internal Medicine and Geriatrics, University of Palermo, Palermo, Italy
| | - Mark A Tully
- School of Health Sciences, Institute of Mental Health Sciences, Ulster University, Newtownabbey, Northern Ireland
| | - Laurie Butler
- Centre for Health, Performance and Wellbeing, Anglia Ruskin University, Cambridge, UK
| | - Yvonne Barnett
- Centre for Health, Performance and Wellbeing, Anglia Ruskin University, Cambridge, UK
| | - Ai Koyanagi
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, CIBERSAM, Dr.Antoni Pujadas, Barcelona, Spain.,ICREA, Pg, Barcelona, Spain
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Sun B, Zhao Y, Lu W, Chen Y. The Relationship of Malnutrition With Cognitive Function in the Older Chinese Population: Evidence From the Chinese Longitudinal Healthy Longevity Survey Study. Front Aging Neurosci 2021; 13:766159. [PMID: 34880747 PMCID: PMC8645828 DOI: 10.3389/fnagi.2021.766159] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2021] [Accepted: 10/13/2021] [Indexed: 01/01/2023] Open
Abstract
Background and Objective: Few studies have explored the relationship between malnutrition measured by the Geriatric Nutritional Risk Index (GNRI) and cognitive performance. This study aimed to investigate the association of malnutrition with cognitive function in the Chinese population. Methods: It was a prospective longitudinal study and used three waves of the Chinese Longitudinal Healthy Longevity Survey (CLHLS) data in 2011–2012, 2014, and 2017–2018. Participants aged 60 years or older without mental illness and cerebrovascular diseases were eligible. The GNRI was used to assess nutritional status as follows: normal nutrition (a GNRI > 98), mild malnutrition (92 ≤ a GNRI ≤ 98), and moderate-to-severe malnutrition (a GNRI < 92). Cognitive performance was evaluated by the Mini-Mental State Examination (MMSE) scores. The relationship between the GNRI and cognitive function was analyzed using a linear mixed-effects model. Results: A total of 1,632 subjects were analyzed, including 741 males and 891 females. Of these, 65.0, 19.4, and 15.6% of subjects were at normal nutritional status, mild, and moderate-to-severe malnutrition, respectively. After adjusting for potential confounders, participants under mild and moderate-to-severe malnutrition status have a lower MMSE score [β (95% CI): –0.95 (–1.60, –0.25) and –1.39 (–2.21, –0.57), respectively], compared with those having normal nutrition. Also, there was a linear trend in the association of malnutrition risk with cognitive function in the total population [β (95% CI): –0.74 (–1.13, –0.35)]. However, a significant association of malnutrition with cognitive function was observed only among illiterate females aged above 90 years. Conclusion: This study suggested that there was a significant relationship between the GNRI and cognitive function in the Chinese elderly. Furthermore, subjects with more serious malnutrition have a worse cognitive function, especially in the oldest illiterate females. Clinicians should put more emphasis on assessing the nutritional and cognitive status of the elderly to timely intervene and prevent cognitive impairment.
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Affiliation(s)
- Boran Sun
- Department of Epidemiology and Statistics, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Yihao Zhao
- Department of Epidemiology and Statistics, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Wenli Lu
- Department of Epidemiology and Statistics, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Yongjie Chen
- Department of Epidemiology and Statistics, School of Public Health, Tianjin Medical University, Tianjin, China
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Delibaş DH, Eşkut N, İlhan B, Erdoğan E, Top Kartı D, Yılmaz Küsbeci Ö, Bahat G. Clarifying the relationship between sarcopenia and depression in geriatric outpatients. Aging Male 2021; 24:29-36. [PMID: 34151708 DOI: 10.1080/13685538.2021.1936482] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
OBJECTIVE We investigate the relationship between sarcopenia components and depression in geriatric outpatients, considering the effects of potential confounding factors. METHODS Adults ≥60 years of age were selected from outpatient clinics. Muscle strength was assessed using handgrip strength (HGS) measured using a hydraulic hand dynamometer and chair stand test (CSST). Physical performance was evaluated by usual gait speed (UGS), nutritional status, and frailty were screened by mini-nutritional assessment (MNA) questionnaire and FRAIL scale. Depression was diagnosed through a psychiatric interview and the administration of the Geriatric Depression Scale (GDS). RESULTS Participants with depression were similar to participants without depression regarding age (p = .055), education (p = .095), frailty (p = .857), and HGS scores (p = .053). The group with depression had longer CSST duration (p = .023), slower UGS (p = .027), and more malnutrition (p = .001). Multivariate regression analysis revealed that only the malnutrition was independently associated factor with depression after adjusting for confounding factors. CONCLUSIONS Depression is associated with malnutrition and some components of sarcopenia in geriatric outpatients. Our results revealed that sarcopenia might be associated with depression through malnutrition. If malnutrition lasts for a long time, sarcopenia may become evident in the later stages of depression.
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Affiliation(s)
- Dursun Hakan Delibaş
- Department of Psychiatry, Izmir Bozyaka Training and Research Hospital, University of Health Sciences, Izmir, Turkey
| | - Neslihan Eşkut
- Department of Neurology, Izmir Bozyaka Training and Research Hospital, University of Health Sciences, Izmir, Turkey
| | - Birkan İlhan
- Department of Internal Medicine, Division of Geriatrics, Şişli Hamidiye Etfal Training and Research Hospital, University of Health Sciences, Istanbul, Turkey
| | - Esin Erdoğan
- Department of Psychiatry, Izmir Bozyaka Training and Research Hospital, University of Health Sciences, Izmir, Turkey
| | - Dilek Top Kartı
- Department of Neurology, Izmir Bozyaka Training and Research Hospital, University of Health Sciences, Izmir, Turkey
| | - Özge Yılmaz Küsbeci
- Department of Neurology, Izmir Medicalpark Hospital, Izmir University of Economics, Izmir, Turkey
| | - Gülistan Bahat
- Department of Internal Medicine, Division of Geriatrics, Istanbul Medical School, Istanbul University, Istanbul, Turkey
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Kawaguchi Y, Akaike H, Shoda K, Furuya S, Hosomura N, Amemiya H, Kawaida H, Kono H, Ichikawa D. Is surgery the best treatment for elderly gastric cancer patients? World J Gastrointest Surg 2021; 13:1351-1360. [PMID: 34950425 PMCID: PMC8649569 DOI: 10.4240/wjgs.v13.i11.1351] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2021] [Revised: 07/27/2021] [Accepted: 08/25/2021] [Indexed: 02/06/2023] Open
Abstract
As the elderly population increases, the number of patients with gastric cancer has also been increasing. Elderly people have various preoperative problems such as malnutrition, high frequency of comorbidities, decreased performance status, and dementia. Furthermore, when surgery is performed, high postoperative complication rates and death from other diseases are also concerns. The goal of surgery in the elderly is that short-term outcomes are comparable to those in nonelderly, and long-term outcomes reach life expectancy. Perioperative problems in the elderly include: (1) Poor perioperative nutritional status; (2) Postoperative pneumonia; and (3) Psychological problems (dementia and postoperative delirium). Malnutrition in the elderly has been reported to be associated with increased postoperative complications and dementia, pointing out the importance of nutritional management. In addition, multidisciplinary team efforts, including perioperative respiratory rehabilitation, preoperative oral care, and early postoperative mobilization programs, are effective in preventing postoperative pneumonia. Furthermore, there are many reports on the usefulness of laparoscopic surgery for the elderly, and we considered that minimally invasive surgery would be the optimal treatment after assessing preoperative risk.
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Affiliation(s)
- Yoshihiko Kawaguchi
- First Department of Surgery, Faculty of Medicine, University of Yamanashi, Yamanashi 409-3898, Japan
| | - Hidenori Akaike
- First Department of Surgery, Faculty of Medicine, University of Yamanashi, Yamanashi 409-3898, Japan
| | - Katsutoshi Shoda
- First Department of Surgery, Faculty of Medicine, University of Yamanashi, Yamanashi 409-3898, Japan
| | - Shinji Furuya
- First Department of Surgery, Faculty of Medicine, University of Yamanashi, Yamanashi 409-3898, Japan
| | - Naohiro Hosomura
- First Department of Surgery, Faculty of Medicine, University of Yamanashi, Yamanashi 409-3898, Japan
| | - Hidetake Amemiya
- First Department of Surgery, Faculty of Medicine, University of Yamanashi, Yamanashi 409-3898, Japan
| | - Hiromichi Kawaida
- First Department of Surgery, Faculty of Medicine, University of Yamanashi, Yamanashi 409-3898, Japan
| | - Hiroshi Kono
- First Department of Surgery, Faculty of Medicine, University of Yamanashi, Yamanashi 409-3898, Japan
| | - Daisuke Ichikawa
- First Department of Surgery, Faculty of Medicine, University of Yamanashi, Yamanashi 409-3898, Japan
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Factors associated with unintentional weight loss among older adults in a geriatric outpatient clinic of university hospital. PLoS One 2021; 16:e0260233. [PMID: 34793549 PMCID: PMC8601429 DOI: 10.1371/journal.pone.0260233] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Accepted: 11/04/2021] [Indexed: 12/28/2022] Open
Abstract
Background Unintentional weight loss (UWL) is defined as unintentional reduction of more than 5% of baseline body weight over 6 to 12 months. UWL is a common problem in the older adults, resulting in increased rate of morbidity and mortality. With specific reference to Thailand, no information on factors associated with UWL in older adults could be traced. The aims of this research were to identify the factors associated with UWL and to assess the common causes of UWL among older adults in the geriatric outpatient clinic of university hospital. Methods A case-control study was conducted from June 1st, 2020 to December 31st, 2020. Eighty older adults aged 60 years or older were enrolled in the UWL group while the non-UWL group consisted of 160 participants. Data collection was performed by structural questionnaire including baseline characteristics, psychosocial factors, health information, lifestyle behaviors, and medications. The factors associated with UWL were analyzed by using univariate and multivariate logistic regression analysis. Causes of UWL were recorded from electronic medical records. Results The mean age of the 240 participants was 79.6 years (SD 7.4). Most patients were female (79.2%) and had fewer than 12 years of education (62.6%). The three common causes of UWL were reduced appetite (20.1%), dementia and behavioral and psychological symptoms of dementia (13.7%) and medications (11.0%). Multivariate logistic regression analysis showed that a Charlson Comorbidity Index (CCI) score of >1 (OR 2.55, 95% CI 1.37–4.73; P = 0.003), vitamin D deficiency (OR 4.01, 95% CI 1.62–9.97; P = 0.003), and hemoglobin level of <12 g/dL (OR 2.47, 95% CI 1.32–4.63; P = 0.005) were factors significantly associated with UWL. Conclusions Factors associated with UWL were CCI score >1, vitamin D deficiency, and hemoglobin level of <12 g/dl. The early detection of these associated factors, reduced appetite, dementia and polypharmacy may be important in UWL prevention in older adults.
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