1
|
Firth W, Pye KR, Weightman Potter PG. Astrocytes at the intersection of ageing, obesity, and neurodegeneration. Clin Sci (Lond) 2024; 138:515-536. [PMID: 38652065 DOI: 10.1042/cs20230148] [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: 11/17/2023] [Revised: 04/05/2024] [Accepted: 04/09/2024] [Indexed: 04/25/2024]
Abstract
Once considered passive cells of the central nervous system (CNS), glia are now known to actively maintain the CNS parenchyma; in recent years, the evidence for glial functions in CNS physiology and pathophysiology has only grown. Astrocytes, a heterogeneous group of glial cells, play key roles in regulating the metabolic and inflammatory landscape of the CNS and have emerged as potential therapeutic targets for a variety of disorders. This review will outline astrocyte functions in the CNS in healthy ageing, obesity, and neurodegeneration, with a focus on the inflammatory responses and mitochondrial function, and will address therapeutic outlooks.
Collapse
Affiliation(s)
- Wyn Firth
- School of Optometry and Vision Sciences, Cardiff University, Cardiff, U.K
| | - Katherine R Pye
- Department of Clinical and Biomedical Sciences, University of Exeter Medical School, Faculty of Health and Life Sciences, University of Exeter, Exeter, U.K
| | - Paul G Weightman Potter
- Department of Clinical and Biomedical Sciences, University of Exeter Medical School, Faculty of Health and Life Sciences, University of Exeter, Exeter, U.K
| |
Collapse
|
2
|
Zhou C, Zhan L, He P, Yuan J, Zha Y. Associations of sarcopenic obesity vs either sarcopenia or obesity alone with cognitive impairment risk in patients requiring maintenance hemodialysis. Nutr Clin Pract 2023; 38:1115-1123. [PMID: 37525570 DOI: 10.1002/ncp.11044] [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: 12/24/2022] [Revised: 06/01/2023] [Accepted: 06/27/2023] [Indexed: 08/02/2023] Open
Abstract
BACKGROUND The association between sarcopenic obesity (SO) and cognitive impairment (CI) risk in patients requiring maintenance hemodialysis (MHD) is not known. In this study, we investigated the prevalence of SO in MHD patients. Furthermore, we would explore and compare the associations between SO, sarcopenia, and obesity with CI risk in this population. METHODS A multicenter, cross-sectional study was conducted. Data from 2743 adult MHD patients were recorded. SO was defined as the co-occurrence of sarcopenia and obesity. Cognitive function was assessed with the Mini-Mental State Examination (MMSE). Multiple logistic regression models, stratified analyses, and interactive analyses were conducted. RESULTS 21.58% of the participants met the criteria for SO. The overall prevalence of CI was 23.3% in our study. Participants in the SO group had the highest CI prevalence (34.6%). The association between SO and CI was weakened but remained statistically significant after adjusting for age, sex, and educational status (odds ratio, 1.47; 95% CI, 1.11-1.96). However, associations between sarcopenia, obesity, and CI disappeared after adjusting for these variables. The additional adjustment did not attenuate the significant association between SO and CI. Subgroup analyses and interactive analyses showed that the associations were similar across subgroups (P > 0.05 for interaction for all). CONCLUSIONS SO and CI are highly prevalent in MHD patients. Participants with SO are at significantly higher risk of CI than those with sarcopenia or obesity alone. Furthermore, this association is consistent across different subgroups.
Collapse
Affiliation(s)
- Chaomin Zhou
- Renal Division, Department of Medicine, Guizhou Provincial People's Hospital, Guizhou Provincial Institute of Nephritic and Urinary Disease, Guiyang, China
- Medical College of Guizhou University, Guiyang, China
| | - Lin Zhan
- Central Laboratory of Guizhou Provincial People's Hospital, Guiyang, China
| | - PignHong He
- Renal Division, Department of Medicine, Guizhou Provincial People's Hospital, Guizhou Provincial Institute of Nephritic and Urinary Disease, Guiyang, China
| | - Jing Yuan
- Renal Division, Department of Medicine, Guizhou Provincial People's Hospital, Guizhou Provincial Institute of Nephritic and Urinary Disease, Guiyang, China
| | - Yan Zha
- Renal Division, Department of Medicine, Guizhou Provincial People's Hospital, Guizhou Provincial Institute of Nephritic and Urinary Disease, Guiyang, China
- Medical College of Guizhou University, Guiyang, China
| |
Collapse
|
3
|
Li TC, Li CI, Liu CS, Lin CH, Yang SY, Lin CC. Obesity marker trajectories and cognitive impairment in older adults: a 10-year follow-up in Taichung community health study for elders. BMC Psychiatry 2022; 22:748. [PMID: 36451123 PMCID: PMC9710179 DOI: 10.1186/s12888-022-04420-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2022] [Accepted: 11/24/2022] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Obesity and cognitive impairment prevalence increases as age increases. Recent growing evidence finds links between obesity and cognitive impairment in older adults. However, the association between the two is controversial. This study aims to identify obesity marker trajectory patterns, and to assess whether these patterns are associated with cognitive impairment and cognitive decline during a 10-year follow-up period among community-dwelling older adults. METHODS A total of 626 older adults aged 65 and older were involved in the study, with at least two repeated measurements at baseline, one-year or 10-year follow-up. Cognitive function was measured through the Mini Mental State Examination. Obesity markers included body mass index, waist circumference, waist-to-hip (WHR), fat mass (FM), and abdominal fat (AF) measured by dual-energy X-ray absorptiometry. Multivariate logistic regression analyses were performed to estimate the adjusted odds ratios (ORs) and 95% confidence intervals (CIs) of cognitive impairment and cognitive decline for obesity marker trajectory patterns. RESULTS After a 10-year follow-up, 168 older adults with incident cognitive impairment and 156 with rapid cognitive decline were defined as the top 25th percentile of cognitive decline. Four distinct trajectory groups of obesity markers were identified. In multivariate logistic regression analyses, a low likelihood of cognitive impairment was observed in the consistently high-level group from FM trajectory (ORs = 0.41, 95% CI = 0.20-0.85); the high-level U-shaped group from WHR trajectory (0.43, 0.22-0.84); and the median-level flat inverse U-shaped, consistently high-level, and low-level flat U-shaped groups from AF trajectory (0.44, 0.26-0.77; 0.33, 0.18-0.61; 0.39, 0.18-0.82). In addition, a low likelihood of rapid decline was found in the low-level, slightly increasing trend group from WHR trajectory (0.43, 0.22-0.85). CONCLUSION FM and AF trajectories with consistent high levels and WHR trajectory with high level with U-shaped group are associated with low risks of incident cognitive impairment in older adults. Similarly, WHR trajectory with a low but slowly increasing trend is associated with a decreased risk of cognitive decline.
Collapse
Affiliation(s)
- Tsai-Chung Li
- grid.254145.30000 0001 0083 6092Department of Public Health, College of Public Health, China Medical University, Taichung, Taiwan ,grid.252470.60000 0000 9263 9645Department of Healthcare Administration, College of Medical and Health Science, Asia University, Taichung, Taiwan
| | - Chia-Ing Li
- grid.254145.30000 0001 0083 6092School of Medicine, College of Medicine, China Medical University, No. 100, Sec. 1, Jingmao Rd., Beitun Dist, Taichung, 406040 Taiwan ,grid.411508.90000 0004 0572 9415Department of Medical Research, China Medical University Hospital, Taichung, Taiwan
| | - Chiu-Shong Liu
- grid.254145.30000 0001 0083 6092School of Medicine, College of Medicine, China Medical University, No. 100, Sec. 1, Jingmao Rd., Beitun Dist, Taichung, 406040 Taiwan ,grid.411508.90000 0004 0572 9415Department of Medical Research, China Medical University Hospital, Taichung, Taiwan ,grid.411508.90000 0004 0572 9415Department of Family Medicine, China Medical University Hospital, Taichung, Taiwan
| | - Chih-Hsueh Lin
- grid.254145.30000 0001 0083 6092School of Medicine, College of Medicine, China Medical University, No. 100, Sec. 1, Jingmao Rd., Beitun Dist, Taichung, 406040 Taiwan ,grid.411508.90000 0004 0572 9415Department of Family Medicine, China Medical University Hospital, Taichung, Taiwan
| | - Shing-Yu Yang
- grid.254145.30000 0001 0083 6092Department of Public Health, College of Public Health, China Medical University, Taichung, Taiwan
| | - Cheng-Chieh Lin
- School of Medicine, College of Medicine, China Medical University, No. 100, Sec. 1, Jingmao Rd., Beitun Dist, Taichung, 406040, Taiwan. .,Department of Medical Research, China Medical University Hospital, Taichung, Taiwan. .,Department of Family Medicine, China Medical University Hospital, Taichung, Taiwan.
| |
Collapse
|
4
|
Correlation between Body Mass Index (BMI) and Performance on the Montreal Cognitive Assessment (MoCA) in a Cohort of Adult Women in South Africa. Behav Neurol 2022; 2022:8994793. [PMID: 35154508 PMCID: PMC8828333 DOI: 10.1155/2022/8994793] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2021] [Revised: 01/04/2022] [Accepted: 01/07/2022] [Indexed: 11/17/2022] Open
Abstract
Objective. Recent evidence suggests that obesity is increasing worldwide and may negatively impact neurocognition. Local studies on the association of weight status with neurocognitive function are sparse. This study is aimed at examining the association between body mass index (BMI) and neurocognitive functioning scores in a cohort of adult women. Methods. A convenience sample of 175 women aged 18 to 59 years (
) recruited in a community-based quantitative study completed the Montreal Cognitive Assessment (MoCA). The BMI metric was used to measure body fat based on weight and height and was stratified as high BMI (overweight or obese) or low BMI (normal weight). The Beck Depression Inventory (BDI) was used to assess depression. Pearson’s correlation analysis and the student’s
-test analysis were performed. Results. We observed a significant inverse association between BMI and performance on MoCA (
,
). Performance on subtest of attention, memory, constructive abstraction, and executive functions significantly and inversely correlated with BMI. Significantly lower scores on the MoCA were found in women with a high BMI compared to women with a low BMI (
vs.
),
,
). Conclusions. BMI and MoCA were inversely associated on both global and domain-specific neurocognitive test of attention, memory, and executive function; key neurocognitive control; and regulatory functions underlying behavior and decision-making. The findings provide a rationale for further research into the long-term effects of BMI on neurocognition.
Collapse
|
5
|
Ren Z, Li Y, Li X, Shi H, Zhao H, He M, Zha S, Qiao S, Pu Y, Liu H, Zhang X. Associations of body mass index, waist circumference and waist-to-height ratio with cognitive impairment among Chinese older adults: Based on the CLHLS. J Affect Disord 2021; 295:463-470. [PMID: 34507227 DOI: 10.1016/j.jad.2021.08.093] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Revised: 08/27/2021] [Accepted: 08/30/2021] [Indexed: 01/11/2023]
Abstract
BACKGROUND Few studies have been conducted on the associations of body mass index (BMI), waist circumference (WC), and waist-to-height ratio (WHtR) with cognitive impairment among Chinese older adults through a prospective design. OBJECTIVE This study was aimed to evaluate the associations of BMI, WC, and WHtR with cognitive impairment. METHODS We included participants aged 65 years and older in 2014 at baseline and 2018 follow-up surveys of the Chinese Longitudinal Healthy Longevity Survey (CLHLS). BMI, WC, and WHtR were calculated from measured weight, height, and waist circumference. Mini-Mental State Examination was utilized to assess cognitive impairment. Modified Poisson regression was used for calculating prevalence ratios, risk ratios, and 95% confidence intervals. RESULTS A total of 5156 participants were included in 2014 at baseline. The prevalence of cognitive impairment was 42.5%, 26.7%, and 21.2% in underweight, normal-weight, and overweight/obesity participants defined by BMI categories, respectively, and 24.1% and 26.8% in central obesity participants defined by WC and WHtR cutoffs, respectively. Prospectively, participants with underweight were more likely to suffer from cognitive impairment (RR = 1.258, 95% CI: [1.016, 1.559]), but no risk was found among participants with overweight/obesity after adjustment. Regardless of whether covariates were adjusted or not, no effect on cognitive impairment was found in participants with WC and WHtR groups in the follow-up survey. CONCLUSIONS Underweight may be a significant risk factor for the cognitive impairment of Chinese older adults. Weight management programs targeting older adults should attach importance to achieving and maintaining optimal body weight and improving cognitive function.
Collapse
Affiliation(s)
- Zheng Ren
- Department of Social Medicine and Health Management, School of Public Health, Jilin University, Changchun, China
| | - Yuyu Li
- Department of Social Medicine and Health Management, School of Public Health, Jilin University, Changchun, China
| | - Xiangrong Li
- Department of Social Medicine and Health Management, School of Public Health, Jilin University, Changchun, China
| | - Hong Shi
- Department of Social Medicine and Health Management, School of Public Health, Jilin University, Changchun, China
| | - Hanfang Zhao
- Department of Social Medicine and Health Management, School of Public Health, Jilin University, Changchun, China
| | - Minfu He
- Department of Social Medicine and Health Management, School of Public Health, Jilin University, Changchun, China
| | - Shuang Zha
- Department of Social Medicine and Health Management, School of Public Health, Jilin University, Changchun, China
| | - Shuyin Qiao
- Department of Social Medicine and Health Management, School of Public Health, Jilin University, Changchun, China
| | - Yajiao Pu
- Department of Social Medicine and Health Management, School of Public Health, Jilin University, Changchun, China
| | - Hongjian Liu
- Department of Epidemiology and Biostatistics, School of Public Health, Jilin University, Changchun, China
| | - Xiumin Zhang
- Department of Social Medicine and Health Management, School of Public Health, Jilin University, Changchun, China.
| |
Collapse
|
6
|
Karunathilaka N, Rathnayake S. Screening for mild cognitive impairment in people with obesity: a systematic review. BMC Endocr Disord 2021; 21:230. [PMID: 34789218 PMCID: PMC8600927 DOI: 10.1186/s12902-021-00898-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Accepted: 11/05/2021] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVE Recent evidence demonstrates that obesity is associated with developing cognitive impairment. However, evidence related to the assessment of mild cognitive impairment (MCI) in people with obesity is limited. Therefore, this systematic review aimed to examine evidence concerning the screening of MCI in people with obesity from the general population. METHOD We conducted a systematic search of CINHAL, EMBASE, MEDLINE, PsycINFO and PubMed electronic databases for observational studies to assess MCI in people with obesity from the general population. PRISMA guideline was followed. The articles published from January 2011 to July 2021 were included. RESULTS Database search found 3104 sources. After the screening process, two articles from China and Egypt were included. The main age groups assessed were middle-aged adulthood and older adulthood. There were no studies undertaken in young adults or across the life span. Obesity was assessed by body mass index. MCI was assessed by cognitive screening tools; Mini-mental State Examination and Addenbrooke's Cognitive Examination. The prevalence of MCI in people with obesity was 18.5 % and 42.9 % in Chinese and Egyptian studies, respectively. Only one study supported a positive association between MCI and obesity. CONCLUSIONS Limited studies were found on screening MCI in people with obesity in the general population. The available evidence was not adequate to explain the overall prevalence, possible associations, and the best tool for assessing MCI in people with obesity. Expanding screening studies for MCI in people with obesity in the general population is essential.
Collapse
Affiliation(s)
- Nimantha Karunathilaka
- Department of Nursing and Midwifery, Faculty of Allied Health Sciences, General Sir John Kotelawala Defence University, Ratmalana, Sri Lanka
| | - Sarath Rathnayake
- Department of Nursing, Faculty of Allied Health Sciences, University of Peradeniya, Peradeniya, Sri Lanka
| |
Collapse
|
7
|
Setyaningsih I, Leksono ABB, Muhrodji P, Edyanto AS, Vidyanti AN. Adolescents with Internet Gaming Disorder are more likely to have Lower Score of Cognitive Function: A Cross-sectional Study among Junior High School Students in Yogyakarta, Indonesia. Open Access Maced J Med Sci 2021. [DOI: 10.3889/oamjms.2021.6858] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
BACKGROUND: Internet Gaming Disorder (IGD) has emerged as a rapidly rising public health problem mostly affecting children and adolescent worldwide, as a result of massive growth of technology and internet usage in recent years. Adolescents are the most vulnerable age group to problematic internet gaming use due to lack of cognitive control.
AIM: This study aims to investigate the association between IGD and cognitive function among junior high school- students in Indonesia.
METHODS: The subjects of this cross-sectional study were students at two randomly selected junior high schools in Yogyakarta, Indonesia. The Game Addiction Scale-7 Indonesian version and the Modified Mini Mental State Examination for Children-Indonesian version were used to assess IGD and cognitive function, respectively. Multivariate analysis with linear regression was used to determine the relationship between IGD and cognitive function.
RESULTS: There were 142 subjects with a mean age of 14 years. Students with IGD significantly had lower score of cognitive function, particularly for domains of attention (p = 0.000), recall memory (p = 0.000), and language (p = 0.002), compared with the counterpart group. Furthermore, multivariate analysis showed that students with IGD were more likely to have lower cognitive function score by 1.40 points than those without IGD (B = –1.40, 95% CI -2.51–-0.29, R2 = 0.469).
CONCLUSIONS: IGD was negatively associated with cognitive function. Junior high school students with IGD in Indonesia had lower score of cognitive function compared with students without IGD, particularly in the domains of attention, recall memory, and language. Clinicians, teachers, and parents should be more aware of the detrimental effect of IGD. Further study with larger sample size, diverse subjects, and wider age range is still needed.
Collapse
|
8
|
Tou NX, Wee SL, Pang BWJ, Lau LK, Jabbar KA, Seah WT, Chen KK, Ng TP. Associations of fat mass and muscle function but not lean mass with cognitive impairment: The Yishun Study. PLoS One 2021; 16:e0256702. [PMID: 34437646 PMCID: PMC8389410 DOI: 10.1371/journal.pone.0256702] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Accepted: 08/12/2021] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Sarcopenia and obesity are reportedly associated with risk of cognitive decline, and sarcopenic obesity (SO) heightens the risk, but the evidence is sparse and inconclusive. This study aimed to examine the association between SO and cognitive impairment. METHODS A total of 542 community-dwelling adults aged between 21 and 90 years were recruited. All participants were assessed for body composition (dual X-ray absorptiometry), handgrip strength (HGS), gait speed (GS), and cognitive function (Repeatable Battery for the Assessment of Neuropsychological Status). Sarcopenia was defined by the presence of low appendicular lean mass index (ALMI) and low HGS or low GS according to the 2019 Asian Working Group for Sarcopenia criteria, and obesity was defined based on the upper two quintiles of fat mass index (FMI). RESULTS Sarcopenia alone or in combination with obesity were not significantly associated with cognitive impairment after controlling for confounding variables. Obesity on its own was significantly associated with greater odds of impaired attention (OR: 2.05, 95%CI 1.12-3.82). Low ALMI was not associated, but low HGS, slow GS, and high FMI were individually associated with cognitive impairment: low HGS and immediate memory (OR: 1.91, 95% CI 1.04-3.49); low GS and immediate memory (OR: 2.17, 95% CI 1.26-3.72); high FMI and attention (OR: 2.06, 95% CI 1.22-3.51). Co-occurring high FMI with either low HGS or slow GS exacerbated the observed odds of global and domain-specific (attention, visuospatial) cognitive impairment. CONCLUSIONS Lean mass is not relevant, whereas muscle strength and physical performance or adiposity are relevant in defining sarcopenia or sarcopenic obesity in terms of their cognitive impacts.
Collapse
Affiliation(s)
- Nien Xiang Tou
- Geriatric Education and Research Institute, Singapore, Singapore
| | - Shiou-Liang Wee
- Geriatric Education and Research Institute, Singapore, Singapore
- Health and Social Sciences Cluster, Singapore Institute of Technology, Singapore, Singapore
- Program of Health Services and System Research, Duke-National University of Singapore Medical School, Singapore, Singapore
- * E-mail:
| | | | - Lay Khoon Lau
- Geriatric Education and Research Institute, Singapore, Singapore
| | | | - Wei Ting Seah
- Geriatric Education and Research Institute, Singapore, Singapore
| | | | - Tze Pin Ng
- Geriatric Education and Research Institute, Singapore, Singapore
- Department of Psychological Medicine, National University of Singapore, Singapore, Singapore
| |
Collapse
|
9
|
Guo D, Zhang X, Zhan C, Lin Q, Liu J, Yang Q, Tu J, Ning X, Wang J, Song Y. Sex Differences in the Association Between Obesity and Cognitive Impairment in a Low-Income Elderly Population in Rural China: A Population-Based Cross-Sectional Study. Front Neurol 2021; 12:669174. [PMID: 34305783 PMCID: PMC8299782 DOI: 10.3389/fneur.2021.669174] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2021] [Accepted: 06/10/2021] [Indexed: 02/02/2023] Open
Abstract
Background: Obesity is a potentially modifiable risk factor for cognitive impairment. However, sex-specific relationships between obesity and cognitive impairment in late life remain unclear. Objective: We aimed to assess sex differences in the association between various obesity parameters and cognitive impairment in a low-income elderly population in rural China. Methods: A population-based cross-sectional study was conducted to collect basic information from elderly residents aged 60 years and older from April 2014 to August 2014 in rural areas of Tianjin, China. Obesity parameters, including body mass index (BMI) and waist circumference (WC), and Mini Mental State Examination scores were measured, and the relationships between these variables were assessed. Results: A total of 1,081 residents with a mean age of 67.70 years were enrolled in this study. After adjusting for age, educational attainment, smoking status, drinking status, physical exercise participation, and the presence of diabetes and hyperlipidemia, blood pressure group; a high BMI was found to be associated with an increased prevalence of cognitive impairment in elderly women. Each 1-unit increase in BMI was associated with a 5.9% increase in the prevalence of cognitive impairment. WC was related to the prevalence of cognitive impairment in elderly men, and each 1-cm increase in WC was associated with a 4.0% decrease in the prevalence of cognitive impairment. However, there were no significant associations between WC and cognitive function in women or between BMI and cognitive impairment in men. Conclusion: A greater WC was positively associated with better cognitive function in low-income elderly men in rural China, whereas a higher BMI was associated with an increased risk of cognitive impairment in elderly women, independent of sociodemographic, lifestyle, and health-related comorbid factors. Our results suggest weight management of elderly women in rural China may have cognitive benefits. However, randomized controlled trials would be needed to confirm causality.
Collapse
Affiliation(s)
- Dandan Guo
- Department of Neurology, Tianjin Medical University General Hospital, Tianjin, China
| | - Xin Zhang
- Department of Neurology, Tianjin Medical University General Hospital, Tianjin, China
| | - Changqing Zhan
- Department of Neurology, Tianjin Medical University General Hospital, Tianjin, China.,Department of Neurology, Wuhu No.2 People's Hospital, Wuhu, China
| | - Qiuxing Lin
- Department of Neurology, Tianjin Medical University General Hospital, Tianjin, China.,Laboratory of Epidemiology, Tianjin Neurological Institute, Tianjin, China.,Key Laboratory of Post-neuroinjury Neuro-Repair and Regeneration in Central Nervous System, Tianjin Neurological Institute, Ministry of Education, Tianjin, China
| | - Jie Liu
- Department of Neurology, Tianjin Medical University General Hospital, Tianjin, China.,Laboratory of Epidemiology, Tianjin Neurological Institute, Tianjin, China.,Key Laboratory of Post-neuroinjury Neuro-Repair and Regeneration in Central Nervous System, Tianjin Neurological Institute, Ministry of Education, Tianjin, China
| | - Qiaoxia Yang
- Department of Cardiology, Tianjin Medical University General Hospital, Tianjin, China
| | - Jun Tu
- Department of Neurology, Tianjin Medical University General Hospital, Tianjin, China.,Laboratory of Epidemiology, Tianjin Neurological Institute, Tianjin, China.,Key Laboratory of Post-neuroinjury Neuro-Repair and Regeneration in Central Nervous System, Tianjin Neurological Institute, Ministry of Education, Tianjin, China
| | - Xianjia Ning
- Department of Neurology, Tianjin Medical University General Hospital, Tianjin, China.,Laboratory of Epidemiology, Tianjin Neurological Institute, Tianjin, China.,Key Laboratory of Post-neuroinjury Neuro-Repair and Regeneration in Central Nervous System, Tianjin Neurological Institute, Ministry of Education, Tianjin, China
| | - Jinghua Wang
- Department of Neurology, Tianjin Medical University General Hospital, Tianjin, China.,Laboratory of Epidemiology, Tianjin Neurological Institute, Tianjin, China.,Key Laboratory of Post-neuroinjury Neuro-Repair and Regeneration in Central Nervous System, Tianjin Neurological Institute, Ministry of Education, Tianjin, China
| | - Yijun Song
- Department of General Medicine, Tianjin Medical University General Hospital, Tianjin, China
| |
Collapse
|
10
|
Fu J, Liu Q, Du Y, Zhu Y, Sun C, Lin H, Jin M, Ma F, Li W, Liu H, Zhang X, Chen Y, Sun Z, Wang G, Huang G. Age- and Sex-Specific Prevalence and Modifiable Risk Factors of Mild Cognitive Impairment Among Older Adults in China: A Population-Based Observational Study. Front Aging Neurosci 2020; 12:578742. [PMID: 33192471 PMCID: PMC7662098 DOI: 10.3389/fnagi.2020.578742] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Accepted: 09/23/2020] [Indexed: 12/11/2022] Open
Abstract
Background Minimal data are available on the prevalence of mild cognitive impairment (MCI) in older Chinese adults. Moreover, the current information on MCI shows important geographical variations. Objective We aimed to assess the prevalence and risk factors for MCI by age and sex among older adults in a North Chinese population. Methods In this population-based cross-sectional study, we enrolled a random sample of 4,943 adults aged ≥ 60 years between March 2018 and June 2019 in Tianjin, China. Of these, 312 individuals were excluded due to a lack of data (e.g., fasting blood test). As a result, 4,631 subjects were assessed. Individuals with MCI were identified using neuropsychological assessments, including the Mini-Mental State Examination and Activities of Daily Living scale, based on a modified version of the Petersen’s criteria. Results The mean (SD) age of the 4,631 participants was 67.6 (4.89) years, and 2,579 (55.7%) were female. The overall age- and sex-standardized prevalence of MCI in our study population was 10.7%. There were significant associations of MCI with age [65–69 vs. 60–64 years, OR = 0.74; 95% confidence interval (CI): 0.58, 0.96], physical activity (≥23.0 vs. <23.0 MET-hours/week, OR = 0.79; 95% CI: 0.64, 0.96), body mass index (BMI) (OR = 0.92; 95% CI: 0.89, 0.95), grip strength (OR = 0.50; 95% CI: 0.38, 0.67), hypertension (yes vs. no, OR = 1.44; 95% CI: 1.18, 1.77), higher levels of sleepiness (OR = 1.80; 95% CI: 1.36, 2.37), and longer sleep duration (OR = 1.40; 95% CI: 1.14, 1.72). The inverse association between BMI and MCI was stronger in older age groups (P for heterogeneity = 0.003). Moreover, the magnitude of association between triglycerides and MCI was different between the sexes (P for heterogeneity = 0.029). Conclusion The age- and sex-standardized prevalence of MCI was 10.7% in the study sample. Physical activity, BMI, grip strength, sleepiness, sleep duration, and hypertension were associated with the prevalence of MCI. Additionally, triglycerides and BMI might be differently associated with the presence of MCI for different sexes and age stages, respectively.
Collapse
Affiliation(s)
- Jingzhu Fu
- Department of Nutrition and Food Science, School of Public Health, Tianjin Medical University, Tianjin, China.,Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin, China
| | - Qian Liu
- Department of Nutrition and Food Science, School of Public Health, Tianjin Medical University, Tianjin, China.,Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin, China
| | - Yue Du
- Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin, China.,Department of Social Medicine and Health Management, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Yun Zhu
- Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin, China.,Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Changqing Sun
- Neurosurgical Department of Baodi Clinical College of Tianjin Medical University, Tianjin, China
| | - Hongyan Lin
- Department of Nutrition and Food Science, School of Public Health, Tianjin Medical University, Tianjin, China.,Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin, China
| | - Mengdi Jin
- Department of Nutrition and Food Science, School of Public Health, Tianjin Medical University, Tianjin, China.,Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin, China
| | - Fei Ma
- Department of Nutrition and Food Science, School of Public Health, Tianjin Medical University, Tianjin, China.,Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin, China
| | - Wen Li
- Department of Nutrition and Food Science, School of Public Health, Tianjin Medical University, Tianjin, China.,Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin, China
| | - Huan Liu
- Department of Nutrition and Food Science, School of Public Health, Tianjin Medical University, Tianjin, China.,Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin, China
| | - Xumei Zhang
- Department of Nutrition and Food Science, School of Public Health, Tianjin Medical University, Tianjin, China.,Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin, China
| | - Yongjie Chen
- Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin, China.,Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Zhuoyu Sun
- Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin, China.,Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Guangshun Wang
- Department of Tumor, Baodi Clinical College of Tianjin Medical University, Tianjin, China
| | - Guowei Huang
- Department of Nutrition and Food Science, School of Public Health, Tianjin Medical University, Tianjin, China.,Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin, China
| |
Collapse
|
11
|
Higher level of acute serum VEGF and larger infarct volume are more frequently associated with post-stroke cognitive impairment. PLoS One 2020; 15:e0239370. [PMID: 33017430 PMCID: PMC7535035 DOI: 10.1371/journal.pone.0239370] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Accepted: 09/07/2020] [Indexed: 01/01/2023] Open
Abstract
Background Serum vascular endothelial growth factor (VEGF) and infarct volume detected by brain imaging have been associated with stroke outcome. However, the relationship of these two variables with post-stroke cognitive impairment (PSCI) remains unclear. We aimed to investigate the association between acute serum VEGF levels and infarct volume with PSCI in ischemic stroke patients. Methods Fifty-six first-ever ischemic stroke patients who were hospitalized in Dr. Sardjito General Hospital Yogyakarta, Indonesia were prospectively recruited. Serum VEGF level was taken on day 5 of stroke onset and measured by ELISA. Infarct volume was calculated manually from head CT scan by expert radiologist. PSCI was assessed after 3 months follow up by using Montreal Cognitive Assessment-Indonesian version (MoCA-INA). We performed a ROC curve analysis to determine the cut-off point of VEGF level and infarct volume. Multivariate logistic regression analysis was performed to measure the contribution of VEGF level and infarct volume to PSCI after controlling covariates (demographic and clinical data). Results The mean age of PSCI and non-PSCI patients was 61.63% ± 8.47 years and 58.67% ± 9.01 years, respectively (p = 0.221). No differences observed for vascular risk factors, infarct location, and NIHSS in both groups. Multivariate logistic regression showed that patients with higher VEGF level alone (≥519.8 pg/ml) were 4.99 times more likely to have PSCI than those with lower VEGF level (OR = 4.99, 95% CI = 1.01–24.7, p = 0.048). In addition, patients with larger infarct volume alone (≥0.054 ml) were also more frequently associated with PSCI (OR = 7.71, 95% CI = 1.39–42.91, p = 0.019). Conclusions Acute ischemic stroke patients with higher serum VEGF level (≥519.8 pg/ml) and larger infarct volume (≥0.054 ml) were more likely to have PSCI 3 months after stroke. These findings may contribute to predict PSCI earlier and thus better prevention strategy could be made.
Collapse
|