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Bao X, Li W, Liu Y, Li X, Yue L, Xiao S. Impairment of delayed recall as a predictor of amnestic mild cognitive impairment development in normal older adults: a 7-year of longitudinal cohort study in Shanghai. BMC Psychiatry 2023; 23:892. [PMID: 38031039 PMCID: PMC10685709 DOI: 10.1186/s12888-023-05309-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Accepted: 10/25/2023] [Indexed: 12/01/2023] Open
Abstract
BACKGROUND Amnestic mild cognitive impairment (aMCI) is considered a prodromal phase of Alzheimer's disease (AD). However, little is known about the neuropsychological characteristic at pre-MCI stage. This study aimed to investigate which neuropsychological tests could significantly predict aMCI from a seven-year longitudinal cohort study. METHODS The present study included 123 individuals with baseline cognitive normal (NC) diagnosis and a 7-year follow-up visit. All the subjects were from the China Longitudinal Aging Study (CLAS) study. Participants were divided into two groups, non-converter and converter based on whether progression to aMCI at follow-up. All participants underwent standardized comprehensive neuropsychological tests, including the mini-mental state examination (MMSE), Montreal Cognitive Assessment (MoCA), auditory verbal learning test (AVLT), the digital span test, the verbal fluency test, the visual recognition test, the WAIS picture completion task, and WAIS block design. Logistic regression analysis was used to evaluate the predictive power of baseline cognitive performance for the transformation of amnestic mild cognitive impairment. Receiver operating characteristic (ROC) curve was used to test the most sensitive test for distinguishing different groups. RESULTS Between the non-converter group and converter group, there were significant differences in the baseline scores of AVLT-delayed recall (AVLT-DR) (8.70 ± 3.61 vs. 6.81 ± 2.96, p = 0.001) and WAIS block design (29.86 ± 7.07 vs. 26.53 ± 8.29, p = 0.041). After controlling for gender, age, and education level, converter group showed lower baseline AVLT-DR than non-converter group, while no significant difference was found in WAIS block design. Furthermore, converter group had lower AVLT-DR score after controlling for somatic disease. The area under the curve of regression equation model was 0.738 (95%CI:0.635-0.840), with a sensitivity 83.9%, specificity of 63.6%. CONCLUSIONS Our results proved the value of delayed recall of AVLT in predicting conversion to aMCI. Early and careful checking of the cognitive function among older people should be emphasized.
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Affiliation(s)
- Xiaoqian Bao
- Department of Geriatric Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, 200030, China
- Shanghai Huangpu District Mental Health Center, Shanghai, China
| | - Wei Li
- Department of Geriatric Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, 200030, China
- Alzheimer's Disease and Related Disorders Center, Shanghai Jiao Tong University, Shanghai, China
| | - Yuanyuan Liu
- Department of Geriatric Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, 200030, China
- Alzheimer's Disease and Related Disorders Center, Shanghai Jiao Tong University, Shanghai, China
| | - Xia Li
- Department of Geriatric Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, 200030, China.
- Alzheimer's Disease and Related Disorders Center, Shanghai Jiao Tong University, Shanghai, China.
| | - Ling Yue
- Department of Geriatric Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, 200030, China.
- Alzheimer's Disease and Related Disorders Center, Shanghai Jiao Tong University, Shanghai, China.
| | - Shifu Xiao
- Department of Geriatric Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, 200030, China.
- Alzheimer's Disease and Related Disorders Center, Shanghai Jiao Tong University, Shanghai, China.
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Yue L, Chen WG, Liu SC, Chen SB, Xiao SF. An explainable machine learning based prediction model for Alzheimer's disease in China longitudinal aging study. Front Aging Neurosci 2023; 15:1267020. [PMID: 38020780 PMCID: PMC10655104 DOI: 10.3389/fnagi.2023.1267020] [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: 07/25/2023] [Accepted: 10/09/2023] [Indexed: 12/01/2023] Open
Abstract
Alzheimer's disease (AD) is the most common cause of dementia. Accurate prediction and diagnosis of AD and its prodromal stage, i.e., mild cognitive impairment (MCI), is essential for the possible delay and early treatment for the disease. In this paper, we adopt the data from the China Longitudinal Aging Study (CLAS), which was launched in 2011, and includes a joint effort of 15 institutions all over the country. Four thousand four hundred and eleven people who are at least 60 years old participated in the project, where 3,514 people completed the baseline survey. The survey collected data including demographic information, daily lifestyle, medical history, and routine physical examination. In particular, we employ ensemble learning and feature selection methods to develop an explainable prediction model for AD and MCI. Five feature selection methods and nine machine learning classifiers are applied for comparison to find the most dominant features on AD/MCI prediction. The resulting model achieves accuracy of 89.2%, sensitivity of 87.7%, and specificity of 90.7% for MCI prediction, and accuracy of 99.2%, sensitivity of 99.7%, and specificity of 98.7% for AD prediction. We further utilize the SHapley Additive exPlanations (SHAP) algorithm to visualize the specific contribution of each feature to AD/MCI prediction at both global and individual levels. Consequently, our model not only provides the prediction outcome, but also helps to understand the relationship between lifestyle/physical disease history and cognitive function, and enables clinicians to make appropriate recommendations for the elderly. Therefore, our approach provides a new perspective for the design of a computer-aided diagnosis system for AD and MCI, and has potential high clinical application value.
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Affiliation(s)
- Ling Yue
- The Department of Geriatric Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Wu-gang Chen
- School of Computer and Information Engineering and Henan Engineering Research Center of Intelligent Technology and Application, Henan University, Kaifeng, China
| | - Sai-chao Liu
- School of Computer and Information Engineering and Henan Engineering Research Center of Intelligent Technology and Application, Henan University, Kaifeng, China
| | - Sheng-bo Chen
- School of Computer and Information Engineering and Henan Engineering Research Center of Intelligent Technology and Application, Henan University, Kaifeng, China
| | - Shi-fu Xiao
- The Department of Geriatric Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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Liu G, Li Y, Xu Y, Li W. Type 2 diabetes is associated with increased risk of dementia, but not mild cognitive impairment: a cross-sectional study among the elderly in Chinese communities. Front Aging Neurosci 2022; 14:1004954. [PMID: 36185492 PMCID: PMC9524142 DOI: 10.3389/fnagi.2022.1004954] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Accepted: 08/29/2022] [Indexed: 11/13/2022] Open
Abstract
Background: Previous studies have confirmed that diabetes is associated with cognitive impairment, but there is little data on this among older Chinese. Methods: This study included 192 dementia patients, 610 patients with mild cognitive impairment (MCI), and 2,218 normal controls. Their general demographic information (such as gender, age, education, etc.), disease-related information (hypertension), and diabetes information (such as whether you have diabetes, course of the disease, etc) were collected by standardized questionnaires. The mini-mental state examination (MMSE) and Montreal Cognitive Assessment (MoCA) were used to assess their overall cognitive function, Moreover, 84 healthy, randomly selected older adults also underwent brain MRI scans at the same time, and the target brain regions included the hippocampus, the third, fourth, and fifth ventricles. Results: The proportion of type 2 diabetes was significantly higher in the dementia group (25.5%) than that in the normal elderly group (15.6%) and the MCI group (17.7%). By using stepwise multiple logistics regression analysis, we found that type 2 diabetes was associated with dementia (p = 0.005*, OR = 1.805, 95%CI: 1.199–2.761), but not with MCI (p > 0.05). The volume of the fourth ventricle of the healthy elderly with diabetes was significantly larger than that of the healthy elderly without diabetes (p < 0.05), but there was no statistical difference (p > 0.05) in the volume of the hippocampus, the third ventricle, and the fifth ventricle between the two groups. However, we did not find an association between the fourth ventricle and cognitive scores (MMSE and MoCA). Conclusions: In conclusion, type 2 diabetes in elderly Chinese people is associated with dementia, but not MCI. Type 2 diabetes may impair cognitive function by affecting the volume of the fourth ventricle. However, larger longitudinal follow-up studies are needed to confirm these conclusions.
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Affiliation(s)
- Guojun Liu
- Department of Rehabilitation Medicine, The Third People’s Hospital of Lanzhou, Lanzhou, China
| | - Yong Li
- Department of Nephrology, Hubei Provincial Hospital of Traditional Chinese Medicine, Wuhan, China
- Department of Nephrology, Affiliated Hospital of Hubei University of Chinese Medicine, Wuhan, China
- Hubei Provincial Academy of Traditional Chinese Medicine, Wuhan, China
| | - Yuzhen Xu
- Department of Rehabilitation, The Second Affiliated Hospital of Shandong First Medical University, Taian, China
- *Correspondence: Wei Li Yuzhen Xu
| | - Wei Li
- Department of Geriatric Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Alzheimer’s Disease and Related Disorders Center, Shanghai Jiao Tong University, Shanghai, China
- *Correspondence: Wei Li Yuzhen Xu
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Li W, Yue L, Xiao S. Association Between Internet Use, Cognitive Function, and Globus Pallidus Volumes: A Study Among the Elderly in Chinese Communities. Front Public Health 2022; 10:886974. [PMID: 35646776 PMCID: PMC9130581 DOI: 10.3389/fpubh.2022.886974] [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: 03/01/2022] [Accepted: 04/21/2022] [Indexed: 01/15/2023] Open
Abstract
Background Previous studies have linked internet use with several beneficial outcomes for brain health, but there is little data on this among older Chinese. Objective The goal of this study was to explore the association between internet use and cognitive impairment and to explore the possible mechanisms by which internet use prevents cognitive decline. Methods The current study consisted of two cohorts: one from the China Longitudinal Aging Study (CLAS), which included 610 older adults with mild cognitive impairment (MCI), 192 with dementia, and 2,218 healthy older adults; the second cohort included 39 healthy adults from the Shanghai brain health foundation (SHBHF2016001), who underwent T1 cranial magnetic resonance imaging at baseline, from which their volumes of the hippocampus, amygdala, and globus pallidus were calculated. Moreover, they were also followed up for 1 year. Through standardized questionnaires, detailed general demographic information and internet use information was obtained. The cognitive diagnosis of each participant was made by attending psychiatrists at baseline, and their overall cognitive function was assessed by the mini-mental state examination (MMSE) and Montreal Cognitive Assessment (MoCA). Results In cohort 1, after controlling age, gender, smoker, tea drinker, take exercise, diabetes, and hypertension, we found that internet use was associated with MCI (P = 0.015, OR = 0.478, 95% CI: 0.264~0.867), but not for dementia (P = 0.205, OR = 0.393, 95% CI: 0.093~1.665). In cohort 2, we found that the globus pallidus volume of internet users was significantly larger than that of non-users, and the MMSE change score was lower (P < 0.05). The results of partial correlation analysis (controlled for sex, age and education) showed that the change of MMSE value was positively correlated with the volume of left globus pallidus (r = 0.547, P = 0.004). Conclusions Internet use might be a protective factor for mild cognitive impairment among the Chinese elderly, and it may prevent a decline in cognitive decline by affecting the volume of the globus pallidus.
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Affiliation(s)
- Wei Li
- Department of Geriatric Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Department of Geriatric Psychiatry, Alzheimer's Disease and Related Disorders Center, Shanghai Jiao Tong University, Shanghai, China
| | - Ling Yue
- Department of Geriatric Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Department of Geriatric Psychiatry, Alzheimer's Disease and Related Disorders Center, Shanghai Jiao Tong University, Shanghai, China
| | - Shifu Xiao
- Department of Geriatric Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Department of Geriatric Psychiatry, Alzheimer's Disease and Related Disorders Center, Shanghai Jiao Tong University, Shanghai, China
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Li W, Yue L, Sun L, Xiao S. An Increased Aspartate to Alanine Aminotransferase Ratio Is Associated With a Higher Risk of Cognitive Impairment. Front Med (Lausanne) 2022; 9:780174. [PMID: 35463002 PMCID: PMC9021637 DOI: 10.3389/fmed.2022.780174] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2021] [Accepted: 03/03/2022] [Indexed: 11/13/2022] Open
Abstract
Background Recent Alzheimer's disease (AD) hypotheses implicate that hepatic metabolic disorders might contribute to the disease pathogenesis of AD, but the mechanism remains unclear. Aims To investigate whether the elevated aspartate aminotransferase (AST) and Alanine aminotransferase (ALT) ratio is associated with future cognitive decline, and to explore the possible mechanisms of liver enzymes affecting cognitive function. Methods Three different clinical cohorts were included in the current study, including one cross-sectional study (Cohort 1) and two longitudinal follow-up studies (Cohort 2 and 3). All participants completed a detailed clinical evaluation, neuropsychological tests, and liver enzyme tests. In addition, some of them also underwent structural magnetic resonance imaging (MRI) scans. Results Cohort 1 was derived from the CRC2017ZD02 program, including 135 amnestic mild cognitive impairment (aMCI) patients, 22 AD patients, and 319 normal controls. In this cross-sectional study, we found that the AST/ALT ratio was associated with AD (p = 0.014, OR = 1.848, 95%CI: 1.133∼3.012), but not aMCI; Cohort 2 was derived from the Shanghai Brain Health Program. A total of 260 community elderly people with normal cognitive function were included in the study and followed up for 2 years. In this 2-year longitudinal follow-up study, we found that a higher AST/ALT ratio was a risk factor for future development of aMCI (p = 0.014, HR = 1.848, 95%CI: 1.133∼3.021); Cohort 3 was derived from the China longitudinal aging study (CLAS) Program. A total of 94 community elderly people with normal cognitive function were followed up for 7 years, and all of them completed MRI scans. In this 7-year longitudinal follow-up study, we found that a higher AST/ALT ratio was a risk factor for future development of aMCI (p = 0.006, HR = 2.247, 95%CI: 1.248∼4.049), and the AST/ALT ratio was negatively correlated with right hippocampal volume (r = -0.148, p = 0.043). Conclusion An increased ratio of AST to ALT is associated with a higher risk of cognitive impairment and may impair cognitive function by affecting hippocampal volume.
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Affiliation(s)
- Wei Li
- Department of Geriatric Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Alzheimer's Disease and Related Disorders Center, Shanghai Jiao Tong University, Shanghai, China
| | - Ling Yue
- Department of Geriatric Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Alzheimer's Disease and Related Disorders Center, Shanghai Jiao Tong University, Shanghai, China
| | - Lin Sun
- Department of Geriatric Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Alzheimer's Disease and Related Disorders Center, Shanghai Jiao Tong University, Shanghai, China
| | - Shifu Xiao
- Department of Geriatric Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Alzheimer's Disease and Related Disorders Center, Shanghai Jiao Tong University, Shanghai, China
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Li W, Yue L, Xiao S. Prospective Associations of Tea Consumption With Risk of Cognitive Decline in the Elderly: A 1-Year Follow-Up Study in China. Front Nutr 2022; 9:752833. [PMID: 35265653 PMCID: PMC8899511 DOI: 10.3389/fnut.2022.752833] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Accepted: 01/27/2022] [Indexed: 11/13/2022] Open
Abstract
Background Previous studies show that the consumption of tea is associated with several beneficial outcomes for brain health, but there is little data among the elderly in China. Objective The objective was to explore the longitudinal relationship between tea consumption and the risk of cognitive decline. Methods The current data was obtained from the China Longitudinal Aging Study (CLAS), and a total of 3,246 residents aged 60 years and above were recruited in this study. Some of them (N = 111) underwent a standard T1-weighted magnetic resonance imaging (MRI), from which the volumes of the corpus callosum (CC) and hippocampus were calculated, and detailed tea consumption information was obtained through a standardized questionnaire at baseline. The cognitive diagnosis of each participant was made by attending psychiatrists at baseline and follow-up. Their overall cognitive function was assessed by the Montreal Cognitive Assessment (MoCA), while their associative learning ability was assessed by an associative learning test (ALT). Finally, 1,545 elderly with normal cognitive function completed the baseline and follow-up assessment and were included in the final study. Results After controlling gender, education, smoking, take exercise and hobbies, we found that the elderly with tea consumption habits had a lower incidence rate of cognitive decline (p = 0.002, OR = 0.604, 95%CI:0.437~0.836) and tea consumption was negatively correlated with the change scores of MoCA (r = -0.056, p = 0.029). What's more, the CC_posterior volume of tea drinkers was significantly smaller than that of non-tea drinkers, while the baseline ALT score of tea drinkers was significantly higher than that of non-tea drinkers. The results of correlation analysis showed that the CC_posterior volume was significantly correlated with ALT change score (r = -0.319, p = 0.010). Conclusions The habit of tea consumption is associated with less incidence of cognitive impairment among the Chinese elderly, and it may prevent a decline in memory and associative learning by affecting the volume of the posterior corpus callosum.
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Affiliation(s)
- Wei Li
- Department of Geriatric Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Department of Geriatric Psychiatry, Alzheimer's Disease and Related Disorders Center, Shanghai Jiao Tong University, Shanghai, China
| | - Ling Yue
- Department of Geriatric Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Department of Geriatric Psychiatry, Alzheimer's Disease and Related Disorders Center, Shanghai Jiao Tong University, Shanghai, China
| | - Shifu Xiao
- Department of Geriatric Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Department of Geriatric Psychiatry, Alzheimer's Disease and Related Disorders Center, Shanghai Jiao Tong University, Shanghai, China
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The Effects of Light-to-Moderate Alcohol Consumption on the Cognitive Function of Community Nondemented Male Elderly: A Cohort Study. Behav Neurol 2021; 2021:5681913. [PMID: 33833827 PMCID: PMC8018835 DOI: 10.1155/2021/5681913] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2020] [Revised: 01/23/2021] [Accepted: 02/23/2021] [Indexed: 11/18/2022] Open
Abstract
Aim To investigate the effects of light-to-moderate drinking on the cognitive function of the elderly in a large elderly community cohort. Although heavy drinking is linked with impaired brain functions, the effects of light-to-moderate drinking on the cognitive function of the elderly are still controversial. Methods A total of 1469 nondemented elderly men from 15 research centers in 8 cities and provinces were included and divided into two groups: drinking (531 subjects) and nondrinking (938 subjects). Cognitive functions were assessed by the Beijing version of the Montreal Cognitive Assessment (MoCA) at baseline and one-year follow-up. Results There was no difference in total cognitive scores between the light-to-moderate drinking and nondrinking groups at baseline and follow-up. Nonalcohol users performed better naming and abstraction function at baseline and better naming function at follow-up. There was no difference in cognitive performance decline and new-onset dementia rates at follow-up. Conclusions Light-to-moderate alcohol consumption had no significant impact on the overall cognitive function and the risk of dementia in elderly men.
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Cai H, Su N, Li W, Li X, Xiao S, Sun L. Relationship between afternoon napping and cognitive function in the ageing Chinese population. Gen Psychiatr 2021; 34:e100361. [PMID: 33585792 PMCID: PMC7839842 DOI: 10.1136/gpsych-2020-100361] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Revised: 10/28/2020] [Accepted: 12/09/2020] [Indexed: 12/17/2022] Open
Abstract
Background Several studies have shown that afternoon napping promotes cognitive function in the elderly; on the other hand, some studies have shown opposite results. This current study further examined the relationship between afternoon napping and cognitive function in the ageing Chinese population. Methods A total of 2214 elderly were included (napping group: n=1534; non-napping group: n=680). They all received cognitive evaluations by the Beijing version of the Montreal Cognitive Assessment, the Mini-Mental State Examination, and the Chinese version of the Neuropsychological Test Battery. Among all the subjects, 739 elderly volunteered to take blood lipid tests. Results Significant differences in cognitive function and blood lipids were observed between the napping and the non-napping groups. Afternoon napping was associated with better cognitive function including orientation, language, and memory in the present study. Subjects with the habit of afternoon napping also showed a higher level of triglyceride than the non-napping subjects. Conclusion The results demonstrated that afternoon napping was related to better cognitive function in the Chinese ageing population.
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Affiliation(s)
- Han Cai
- Geriatrics, The Fourth People's Hospital of Wuhu, Wuhu, Anhui, China
| | - Ning Su
- Alzheimer's Disease and Related Disorders Center, Shanghai Mental Health Center, Shanghai, China.,Department of Geriatric Psychiatry, Shanghai Mental Health Center, Shanghai, China
| | - Wei Li
- Alzheimer's Disease and Related Disorders Center, Shanghai Mental Health Center, Shanghai, China.,Department of Geriatric Psychiatry, Shanghai Mental Health Center, Shanghai, China.,School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Xia Li
- Alzheimer's Disease and Related Disorders Center, Shanghai Mental Health Center, Shanghai, China.,Department of Geriatric Psychiatry, Shanghai Mental Health Center, Shanghai, China.,School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Shifu Xiao
- Alzheimer's Disease and Related Disorders Center, Shanghai Mental Health Center, Shanghai, China.,Department of Geriatric Psychiatry, Shanghai Mental Health Center, Shanghai, China.,School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Lin Sun
- Alzheimer's Disease and Related Disorders Center, Shanghai Mental Health Center, Shanghai, China.,Department of Geriatric Psychiatry, Shanghai Mental Health Center, Shanghai, China.,School of Medicine, Shanghai Jiao Tong University, Shanghai, China
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Zhang S, Qiu Q, Qian S, Lin X, Yan F, Sun L, Xiao S, Wang J, Fang Y, Li X. Determining Appropriate Screening Tools and Cutoffs for Cognitive Impairment in the Chinese Elderly. Front Psychiatry 2021; 12:773281. [PMID: 34925100 PMCID: PMC8674928 DOI: 10.3389/fpsyt.2021.773281] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Accepted: 10/13/2021] [Indexed: 12/03/2022] Open
Abstract
Background: The Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA) are the most commonly used tools for cognitive impairment screening. The present study aimed to investigate the ability of the MOCA and MMSE to differentiate between cognitively normal elderly individuals, MCI patients and dementia patients at different ages and education levels and to establish the optimal cutoff scores of the MoCA and MMSE for MCI and dementia in the Chinese elderly. Methods: A total of 2,954 Chinese elderly individuals, including 1,746 normal controls, 599 MCI patients and 249 dementia patients, were consecutively recruited in the study. The optimal cutoffs for MoCA and MMSE were determined using receiver operating characteristic (ROC) analysis among the different age and education levels in the three groups. Furthermore, comparison of ROC curves were made to evaluate the performances of the two tests. Results: The area under the curve(AUC) of the MoCA (0.82) for detecting MCI was significantly higher than that of the MMSE (0.75) (P < 0.001). When the sample was divided according to age and education level, the AUC of the MoCA (0.84) was higher than those of the MMSE (0.71) for MCI (P < 0.001) in the younger and more highly-educated groups. The optimal cutoff scores of the MoCA for the groups aged ≤ 75 years old and education ≤ 6 years, aged > 75 years old and education ≤ 6 years, aged ≤ 75 years old and education > 6 years, aged > 75 years old and education > 6 years in screening for MCI were identified as 19.5, 15.5, 24.5 and 24.5, respectively, and the optimal cutoff scores for dementia were 18.5, 10.5, 18.5 and 20.5, respectively. For MMSE in the above four groups, the cutoff scores to detect MCI were 26.5, 22.5, 28.5 and 26.5, respectively, and the optimal cutoff scores for dementia were 23.5, 19.5, 23.5 and 23.5, respectively. Conclusion: Compared to MMSE, the MoCA is more suitable for discriminating MCI in younger and more highly educated elderly Chinese individuals. However, the MMSE has advantage over MoCA in screening MCI in individuals with lower education levels and the older groups of Chinese elderly.
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Affiliation(s)
- Shaowei Zhang
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Qi Qiu
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Shixing Qian
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xiang Lin
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Feng Yan
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Lin Sun
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Shifu Xiao
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jinghua Wang
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yuan Fang
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xia Li
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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Yue L, Hu D, Zhang H, Wen J, Wu Y, Li W, Sun L, Li X, Wang J, Li G, Wang T, Shen D, Xiao S. Prediction of 7-year's conversion from subjective cognitive decline to mild cognitive impairment. Hum Brain Mapp 2020; 42:192-203. [PMID: 33030795 PMCID: PMC7721238 DOI: 10.1002/hbm.25216] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Revised: 09/11/2020] [Accepted: 09/14/2020] [Indexed: 11/16/2022] Open
Abstract
Subjective cognitive decline (SCD) is a high‐risk yet less understood status before developing Alzheimer's disease (AD). This work included 76 SCD individuals with two (baseline and 7 years later) neuropsychological evaluations and a baseline T1‐weighted structural MRI. A machine learning‐based model was trained based on 198 baseline neuroimaging (morphometric) features and a battery of 25 clinical measurements to discriminate 24 progressive SCDs who converted to mild cognitive impairment (MCI) at follow‐up from 52 stable SCDs. The SCD progression was satisfactorily predicted with the combined features. A history of stroke, a low education level, a low baseline MoCA score, a shrunk left amygdala, and enlarged white matter at the banks of the right superior temporal sulcus were found to favor the progression. This is to date the largest retrospective study of SCD‐to‐MCI conversion with the longest follow‐up, suggesting predictable far‐future cognitive decline for the risky populations with baseline measures only. These findings provide valuable knowledge to the future neuropathological studies of AD in its prodromal phase.
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Affiliation(s)
- Ling Yue
- Department of Geriatric Psychiatry, Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai, China.,Alzheimer's Disease and Related Disorders Center of Shanghai Jiaotong University, Shanghai, China
| | - Dan Hu
- Department of Radiology and BRIC, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Han Zhang
- Department of Radiology and BRIC, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Junhao Wen
- ARAMIS Lab, ICM, Inserm U1127, Paris, France.,CNRS UMR 7225, Paris, France.,Sorbonne University, Paris, France.,Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Ye Wu
- Department of Radiology and BRIC, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Wei Li
- Department of Geriatric Psychiatry, Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai, China.,Alzheimer's Disease and Related Disorders Center of Shanghai Jiaotong University, Shanghai, China
| | - Lin Sun
- Department of Geriatric Psychiatry, Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai, China.,Alzheimer's Disease and Related Disorders Center of Shanghai Jiaotong University, Shanghai, China
| | - Xia Li
- Department of Geriatric Psychiatry, Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai, China.,Alzheimer's Disease and Related Disorders Center of Shanghai Jiaotong University, Shanghai, China
| | - Jinghua Wang
- Department of Geriatric Psychiatry, Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai, China.,Alzheimer's Disease and Related Disorders Center of Shanghai Jiaotong University, Shanghai, China
| | - Guanjun Li
- Department of Geriatric Psychiatry, Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai, China.,Alzheimer's Disease and Related Disorders Center of Shanghai Jiaotong University, Shanghai, China
| | - Tao Wang
- Department of Geriatric Psychiatry, Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai, China.,Alzheimer's Disease and Related Disorders Center of Shanghai Jiaotong University, Shanghai, China
| | - Dinggang Shen
- Department of Radiology and BRIC, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA.,Department of Brain and Cognitive Engineering, Korea University, Seongbuk-gu, Seoul, Republic of Korea
| | - Shifu Xiao
- Department of Geriatric Psychiatry, Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai, China.,Alzheimer's Disease and Related Disorders Center of Shanghai Jiaotong University, Shanghai, China
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11
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Xu X, Li W, Tao M, Xie Z, Gao X, Yue L, Wang P. Effective and Accurate Diagnosis of Subjective Cognitive Decline Based on Functional Connection and Graph Theory View. Front Neurosci 2020; 14:577887. [PMID: 33132832 PMCID: PMC7550635 DOI: 10.3389/fnins.2020.577887] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Accepted: 09/02/2020] [Indexed: 12/12/2022] Open
Abstract
Subjective cognitive decline (SCD) is considered the earliest preclinical stage of Alzheimer’s disease (AD) that precedes mild cognitive impairment (MCI). Effective and accurate diagnosis of SCD is crucial for early detection of and timely intervention in AD. In this study, brain functional connectome (i.e., functional connections and graph theory metrics) based on the resting-state functional magnetic resonance imaging (rs-fMRI) provided multiple information about brain networks and has been used to distinguish individuals with SCD from normal controls (NCs). The consensus connections and the discriminative nodal graph metrics selected by group least absolute shrinkage and selection operator (LASSO) mainly distributed in the prefrontal and frontal cortices and the subcortical regions corresponded to default mode network (DMN) and frontoparietal task control network. Nodal efficiency and nodal shortest path showed the most significant discriminative ability among the selected nodal graph metrics. Furthermore, the comparison results of topological attributes suggested that the brain network integration function was weakened and network segregation function was enhanced in SCD patients. Moreover, the combination of brain connectome information based on multiple kernel-support vector machine (MK-SVM) achieved the best classification performance with 83.33% accuracy, 90.00% sensitivity, and an area under the curve (AUC) of 0.927. The findings of this study provided a new perspective to combine machine learning methods with exploration of brain pathophysiological mechanisms in SCD and offered potential neuroimaging biomarkers for diagnosis of early-stage AD.
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Affiliation(s)
- Xiaowen Xu
- Department of Medical Imaging, Tongji Hospital, Tongji University School of Medicine, Tongji University, Shanghai, China
| | - Weikai Li
- College of Mathematics and Statistics, Chongqing Jiaotong University, Chongqing, China.,Universal Medical Imaging Diagnostic Center, Shanghai, China
| | - Mengling Tao
- Department of Medical Imaging, Tongji Hospital, Tongji University School of Medicine, Tongji University, Shanghai, China
| | - Zhongfeng Xie
- Department of Medical Imaging, Tongji Hospital, Tongji University School of Medicine, Tongji University, Shanghai, China
| | - Xin Gao
- Universal Medical Imaging Diagnostic Center, Shanghai, China
| | - Ling Yue
- Department of Geriatric Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Alzheimer's Disease and Related Disorders Center, Shanghai Jiao Tong University, Shanghai, China
| | - Peijun Wang
- Department of Medical Imaging, Tongji Hospital, Tongji University School of Medicine, Tongji University, Shanghai, China
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12
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Nie J, Qiu Q, Phillips M, Sun L, Yan F, Lin X, Xiao S, Li X. Early Diagnosis of Mild Cognitive Impairment Based on Eye Movement Parameters in an Aging Chinese Population. Front Aging Neurosci 2020; 12:221. [PMID: 32848703 PMCID: PMC7405864 DOI: 10.3389/fnagi.2020.00221] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2019] [Accepted: 06/22/2020] [Indexed: 01/04/2023] Open
Abstract
Background: The pathogenesis of dementia often starts several years prior to clinical onset during which the individual is asymptomatic. Existing strategies for the accurate diagnosis of early dementia are limited by high cost and the invasive nature of the procedures. Eye movement parameters associated with cognitive functions may be helpful in the early identification of dementia and in the development and evaluation of preventive and therapeutic strategies. Objective: We aimed to assess differences in eye movement parameters between healthy elderly individuals and patients with mild cognitive impairment (MCI). Furthermore, we examined the correlations between eye movement parameters with cognitive functions and specific hemispheric region and neural structures in individuals with MCI. Method: Eighty individuals with MCI without dementia (based on DSM-IV criteria) identified by community screening and 170 healthy controls were administered Chinese versions of MoCA and NTB, and a long (20 min) or short (5 min) version of a visual paired comparison (VPC) task. Two weeks later, 44 MCI patients and 107 healthy controls completed a retest of the VPC task, 44 MCI patients and 43 healthy controls among them administered a MRI. At the end of 1-year follow-up, a subset of 26 individuals with MCI and 57 healthy controls were administered the long version of VPC task and MoCA test again. Eye movement parameters and the relationship of eye movement parameters with cognitive functions and with changes in neural structures were compared between groups. Results: Patients with MCI were older, had less education, and had lower scores on cognitive tests than healthy controls. After adjustment for age and level of education, patients with MCI had lower novelty preference scores on the VPC than healthy controls. Using the logistic regression model, the amount of time that subjects focused on these novel images could predict MCI patients from normal elderly with an out of sample area under the receiver operator characteristic curve of 0.62. Furthermore, the cognition score of subjects whose novelty preference score was low decreased more remarkably in 1 year. For both the patient and control groups, VPC novelty preference was significantly correlated with verbal fluency and delayed and short-term memory function. Novelty preference score was also significantly correlated with the cortical thickness of several structures in the right hemisphere. Conclusion: Eye movement parameters are stable indicators to distinguish patients with MCI and cognitively normal subjects and are not affected by different testing versions and numbers. Additionally, the patients’ cognitive deficits and eye movement indices were correlated. Future longitudinal studies should further explore the clinical utility of eye movement parameters as early markers of MCI.
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Affiliation(s)
- Jing Nie
- Department of Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Qi Qiu
- Department of Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Michael Phillips
- Department of Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Departments of Psychiatry and Epidemiology, Columbia University, New York, NY, United States
| | - Lin Sun
- Department of Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Feng Yan
- Department of Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xiang Lin
- Department of Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Shifu Xiao
- Department of Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xia Li
- Department of Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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13
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Moodi M, Firoozabadi MD, Kazemi T, Payab M, Ghaemi K, Miri MR, Sharifzadeh G, Fakhrzadeh H, Ebrahimpur M, Arzaghi SM, Zarban A, Mirimoghadam E, Sharifi A, Hosseini MS, Esmaeili A, Mohammadifard M, Ehsanbakhsh A, Ahmadi Z, Yaghoobi GH, Hosseinirad SA, Davari MH, Heydari B, Nikandish M, Norouzpour A, Naseri S, Khorashadizadeh M, Mohtashami S, Mehdizadeh K, Ahmadi G, Soltani H, Khodbakhshi H, Sharifi F, Larijan B. Birjand longitudinal aging study (BLAS): the objectives, study protocol and design (wave I: baseline data gathering). J Diabetes Metab Disord 2020; 19:551-559. [PMID: 32550207 DOI: 10.1007/s40200-020-00504-5] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/26/2019] [Accepted: 02/03/2020] [Indexed: 01/09/2023]
Abstract
Objectives The pace of population aging is growing rapidly around the world. Aging is associated with the emergence of different health status including geriatric syndrome such as frailty, diabetes, cardiovascular diseases, and dementia. These conditions are the most prominent challenges for health care systems and also elderly people. Therefore, understanding these changes can help scientists to prevent and treat significant health issues and also improve the functional ability of older adults. Methods This is a protocol of the first wave of Birjand Longitudinal Aging Study that is an ongoing community-based prospective cohort study with a following up at least 10 years. This study carries out on aged population ≥ 60 years which were residents in Birjand County (urban and rural older subjects). The selection of the participants of this study in urban areas is based on an age group weighted multistage stratified random sample while in the rural region the sample was selected from all ten rural regions of Birjand County by simple random sampling. The rural region sampling was based on the list of the aged population which were under the coverage of the rural health center. Sociodemographic, past medical history, lifestyle, sleep, activities of daily living, cognitive function, quality of life, and social capital were evaluated by interviewing with the participants and one of the informants. Anthropometric measures, electrocardiography, and interpretation of ophthalmologic examination were carried out by experts. Fasting Blood samples were collected and bio-banked in - 80 °C. then finally biochemical and hematologic markers were measured. Results This is the protocol of stage one baseline of Birjand Longitudinal Aging Study (BLAS). The BLAS is an enjoining study, the first phase of its baseline was carried out on a community- dwelling aged population sample ≥ 60 years who were residents in urban and rural regions of Birjand County. This is a community based prospective cohort study with at least 10 years follow up of participants. The data for 65% of older subjects (response rate = 65%) that lived in clusters were collected. Conclusions This study can help scientists to recognize some risk factors related to the aging process and also aware policymakers about the necessity to create heath care services at regional and even national levels.
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Affiliation(s)
- Mitra Moodi
- Social Determinants of Health Research Center, Birjand University of Medical Sciences, Birjand, Iran.,School of Health, Birjand University of Medical Sciences, Birjand, Iran
| | - Mohammad Dehghani Firoozabadi
- Cardiovascular Diseases Research Center, Birjand University of Medical Sciences, Birjand, Iran.,School of Medicine, Birjand University of Medical Sciences, Birjand, Iran
| | - Tooba Kazemi
- Cardiovascular Diseases Research Center, Birjand University of Medical Sciences, Birjand, Iran.,School of Medicine, Birjand University of Medical Sciences, Birjand, Iran
| | - Moloud Payab
- Obesity and Eating Habits Research Center, Endocrinology and Metabolism Molecular-Cellular Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Kazem Ghaemi
- Cardiovascular Diseases Research Center, Birjand University of Medical Sciences, Birjand, Iran.,Cellular and Molecular Research Center, Birjand University of Medical Sciences, Birjand, Iran
| | - Mohammad Reza Miri
- Social Determinants of Health Research Center, Birjand University of Medical Sciences, Birjand, Iran.,School of Health, Birjand University of Medical Sciences, Birjand, Iran
| | - Gholamreza Sharifzadeh
- Social Determinants of Health Research Center, Birjand University of Medical Sciences, Birjand, Iran.,School of Health, Birjand University of Medical Sciences, Birjand, Iran
| | - Hosein Fakhrzadeh
- Elderly Health Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Mahbube Ebrahimpur
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Seyed Masoud Arzaghi
- Elderly Health Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Asghar Zarban
- Cardiovascular Diseases Research Center, Birjand University of Medical Sciences, Birjand, Iran.,School of Medicine, Birjand University of Medical Sciences, Birjand, Iran
| | - Ebrahim Mirimoghadam
- Cardiovascular Diseases Research Center, Birjand University of Medical Sciences, Birjand, Iran.,School of Medicine, Birjand University of Medical Sciences, Birjand, Iran
| | - Ali Sharifi
- Department of Computer Sciences, Shahid Behesthi University, Tehran, Iran
| | - Motahareh Sheikh Hosseini
- Cell Therapy and Regenerative Medicine Research Center, Endocrinology and Metabolism Molecular-Cellular Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Aliakbar Esmaeili
- School of Medicine, Birjand University of Medical Sciences, Birjand, Iran.,Medical Toxicology & Drug Abuse Research Center, Birjand University of Medical Sciences, Birjand, Iran
| | | | - Alireza Ehsanbakhsh
- Social Determinants of Health Research Center, Birjand University of Medical Sciences, Birjand, Iran.,School of Medicine, Birjand University of Medical Sciences, Birjand, Iran
| | - Zahra Ahmadi
- School of Medicine, Birjand University of Medical Sciences, Birjand, Iran
| | - Gholam Hossain Yaghoobi
- Social Determinants of Health Research Center, Birjand University of Medical Sciences, Birjand, Iran.,School of Medicine, Birjand University of Medical Sciences, Birjand, Iran
| | | | - Mohamad Hossein Davari
- Cardiovascular Diseases Research Center, Birjand University of Medical Sciences, Birjand, Iran.,School of Medicine, Birjand University of Medical Sciences, Birjand, Iran
| | - Behroz Heydari
- School of Medicine, Birjand University of Medical Sciences, Birjand, Iran
| | - Malihe Nikandish
- School of Medicine, Birjand University of Medical Sciences, Birjand, Iran
| | - Amir Norouzpour
- School of Medicine, Birjand University of Medical Sciences, Birjand, Iran
| | - Saeed Naseri
- Cellular and Molecular Research Center, Birjand University of Medical Sciences, Birjand, Iran
| | - Masoumeh Khorashadizadeh
- Social Determinants of Health Research Center, Birjand University of Medical Sciences, Birjand, Iran
| | - Somayeh Mohtashami
- Social Determinants of Health Research Center, Birjand University of Medical Sciences, Birjand, Iran
| | - Kambiz Mehdizadeh
- Social Determinants of Health Research Center, Birjand University of Medical Sciences, Birjand, Iran
| | - Galileh Ahmadi
- Social Determinants of Health Research Center, Birjand University of Medical Sciences, Birjand, Iran
| | - Huriye Soltani
- Elderly Health Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Huriye Khodbakhshi
- Social Determinants of Health Research Center, Birjand University of Medical Sciences, Birjand, Iran
| | - Farshad Sharifi
- Elderly Health Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Bagher Larijan
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
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14
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Li W, Sun L, Xiao S. Prevalence, Incidence, Influence Factors, and Cognitive Characteristics of Amnestic Mild Cognitive Impairment Among Older Adult: A 1-Year Follow-Up Study in China. Front Psychiatry 2020; 11:75. [PMID: 32184742 PMCID: PMC7058542 DOI: 10.3389/fpsyt.2020.00075] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2019] [Accepted: 01/30/2020] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND The risk and protective factors of amnestic mild cognitive impairment (aMCI) and its prevalence as well as incidence among old adult in Chinese community are still unclear. METHODS We carried out this 1-year longitudinal study to survey a random sample of 3,246 community elders aged 60 and over in China. All subjects were required to complete a comprehensive clinical assessment, physical examination and several neuropsychological tests at baseline and follow-up. What's more, we also collected their lifestyle information by a standardized questionnaire. RESULTS We found that the prevalence of aMCI was 17.1%, while the incidence of aMCI among Chinese old adult was 70.57 per 1,000 person-years. By using Cox regression analysis, we found that male sex (p = 0.001, OR = 0.489, 95%CI 0.319~0.751) and reading (p = 0.023, OR = 0.533, 95%CI 0.310~0.917) were protective factors for against aMCI. Old adult who developed aMCI in the future showed multiple cognitive impairments (such as immediate memory, associative learning memory and executive function) in their early stage, and Wechsler's Block Design (p = 0.027, OR = 0.969, 95%CL 0.943~0.996) could predict whether subjects would turn into aMCI in the future. CONCLUSIONS The present study suggests that aMCI is a considerable health problem in China. Executive dysfunction may be an indicator of future development of aMCI in the old normal adult.
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Affiliation(s)
- Wei Li
- Department of Geriatric Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Alzheimer's Disease and Related Disorders Center, Shanghai Jiao Tong University, Shanghai, China
| | - Lin Sun
- Department of Geriatric Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Alzheimer's Disease and Related Disorders Center, Shanghai Jiao Tong University, Shanghai, China
| | - Shifu Xiao
- Department of Geriatric Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Alzheimer's Disease and Related Disorders Center, Shanghai Jiao Tong University, Shanghai, China
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15
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Lin S, Yang Y, Qi Q, Wei L, Jing N, Jie Z, Xia L, Shifu X. The Beneficial Effect of Physical Exercise on Cognitive Function in a Non-dementia Aging Chinese Population. Front Aging Neurosci 2019; 11:238. [PMID: 31555125 PMCID: PMC6727612 DOI: 10.3389/fnagi.2019.00238] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2019] [Accepted: 08/16/2019] [Indexed: 11/13/2022] Open
Abstract
Numerous observational studies have shown that physical exercise promotes cognition in the elderly, however, the results from randomized clinical trials (RCTs) are ambiguous. In addition, potential benefits of exercise in an elderly Chinese population have not been comprehensively addressed. In this study, an investigation was launched which focused on the relationship between physical exercise and cognitive function, blood lipid profiles and brain anatomy in a non-dementia aging Chinese population. A total of 2074 non-dementia elderly subjects were included (self-selected exercise n = 1372; self-selected non-exercise n = 702). Amongst the subjects, 689 volunteered to receive blood lipid tests, 141 undergo brain magnetic resonance imaging (MRI), and 1399 receive a 1 year cognitive evaluation follow-up. The Beijing version of the Montreal Cognitive Assessment (MoCA) and the Mini-Mental States Examination (MMSE) were used to assess cognitive function. A significant difference in cognitive function was observed at the baseline and during the 1-year follow-up between the self-selected exercise and self-selected non-exercise groups, however, no significant differences in blood lipids and brain anatomy was evident. Physical exercise has a beneficial effect on cognition, particularly visuospatial function, and decreases the risk of dementia in a Chinese aging cohort.
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Affiliation(s)
- Sun Lin
- Alzheimer's Disease and Related Disorders Center, Department of Geriatric Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yang Yang
- Shanghai I-Zhaohu Senior Care Services Co., Ltd., Shanghai, China
| | - Qiu Qi
- Alzheimer's Disease and Related Disorders Center, Department of Geriatric Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Li Wei
- Alzheimer's Disease and Related Disorders Center, Department of Geriatric Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Nie Jing
- Alzheimer's Disease and Related Disorders Center, Department of Geriatric Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Zhang Jie
- Key Laboratory of Arrhythmias, Ministry of Education, Shanghai East Hospital, Tong Ji University School of Medicine, Shanghai, China
| | - Li Xia
- Alzheimer's Disease and Related Disorders Center, Department of Geriatric Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xiao Shifu
- Alzheimer's Disease and Related Disorders Center, Department of Geriatric Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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16
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Li W, Sun L, Li G, Xiao S. Prevalence, Influence Factors and Cognitive Characteristics of Mild Cognitive Impairment in Type 2 Diabetes Mellitus. Front Aging Neurosci 2019; 11:180. [PMID: 31417393 PMCID: PMC6682644 DOI: 10.3389/fnagi.2019.00180] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2019] [Accepted: 07/03/2019] [Indexed: 12/19/2022] Open
Abstract
Background: Type 2 diabetes mellitus (T2DM) is considered as an independent risk factor for mild cognitive impairment (MCI). This study was performed to investigate the prevalence, influencing factors and cognitive characteristics of MCI in elderly patients with T2DM in China. Methods: In the cross-sectional study, we performed cluster random sampling of 3,246 people age 60 years and older across the country. All participants were interviewed and screened for T2DM and MCI. A total of 341 subjects were diagnosed of MCI according to the criteria of Petersen, and a total of 256 subjects were diagnosed of T2DM by using the American Diabetes Association criteria Among the 256 T2DM people, 56 were also diagnosed with MCI. Logistic regression analyses were performed to evaluate risk and protective factor for MCI with T2DM. We also assessed their cognitive function by using the Mini-mental State Examination (MMSE), Montreal Cognitive Assessment (MoCA), Digit span, Associative Learning Test (ALT), Visual Identification Test (VIT), Verbal Fluency (VF), Wechsler Adult Intelligence Scale (WAIS)-III Block Design, WAIS-III picture completion and Auditory Verbal Learning Test (AVLT). Results: Among the 256 T2DM patients, 56 were diagnosed with MCI, and the prevalence of MCI in T2DM was 21.8%. Multivariate logistic regression analyses showed that depression (p = 0.002, OR = 6.220, 95% CI: 2.005–19.290) was a risk factor for MCI among T2DM patients, while education (p < 0.001, OR = 0.869, 95% CI: 0.805–0.983) was a protective one. All the scores of neuropsychological tests (except for MMSE) in T2DM patients with MCI were lower than those without MCI (p < 0.05), but there was no statistical difference (p > 0.05) in neuropsychological tests between T2DM-MCI group and No-T2DM-MCI group. Linear regression analysis showed that the drug treatment of diabetes was positively correlated (t = 2.263, p = 0.025) with the total score of auditory word tests. Conclusions: The present study suggests a high prevalence of MCI among Chinese T2DM patients. Depression is a risk factor for MCI, while education is a protective one. T2DM patients with MCI often show comprehensive cognitive impairment, and the drug treatment of diabetes might help to improve cognitive function.
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Affiliation(s)
- Wei Li
- Department of Geriatric Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Lin Sun
- Department of Geriatric Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Guanjun Li
- Department of Geriatric Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Shifu Xiao
- Department of Geriatric Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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17
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Qiu Q, Lin X, Sun L, Zhu MJ, Wang T, Wang JH, Li GJ, Xiao SF, Li X. Cognitive decline is related to high blood glucose levels in older Chinese adults with the ApoE ε3/ε3 genotype. Transl Neurodegener 2019; 8:12. [PMID: 30984391 PMCID: PMC6446313 DOI: 10.1186/s40035-019-0151-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2018] [Accepted: 03/18/2019] [Indexed: 12/17/2022] Open
Abstract
Background Few studies have investigated the effects of blood glucose (BG) on cognitive function in community-dwelling elderly individuals carrying the apolipoprotein E (APOE) ε3 allele. Objective To explore the effect of high BG levels on cognitive function in APOE ε3-carrying, non-demented, community-dwelling older adults, as compared to their counterparts carrying the APOE ε4 or APOE ε2 alleles. Methods Within the China Longitudinal Ageing Study, we recruited 282 elderly adults without dementia. Data collected included demographic information; psychological measures; laboratory test results, including BG and plasma lipid levels; and APOE genotypes. We divided the participants into APOE ε2(ε2/ε2, ε2/ε3), ε3(ε3/ε3), and ε4(ε3/ε4, ε4/ε4) groups. Partial correlation analyses and multivariate linear regression analyses were utilized to compare the cognitive function and laboratory data between the APOE groups. White matter hyperintensity (WMH) was measured on magnetic resonance images in 77 participants. Results With adjustment for age, sex, education, and diabetes, higher BG in non-demented community-dwelling older adults was associated with cognitive decline in immediate memory and executive function. In the APOE ε3 group, elevated BG was associated with cognitive decline in immediate memory, executive function, and perceptual reasoning. In the APOE ε4 group, higher BG was also correlated with a decline in abstract reasoning. There was a trend for association between higher BG and more severe WMHs. Conclusion Worse cognitive function was correlated withApoEε3/ε3 genotype carriers with higher BG in community-dwelling older adults.
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Affiliation(s)
- Qi Qiu
- Department of Psychogeriatrics, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, South WanPing Road 600, Shanghai, 200030 China
| | - Xiang Lin
- Department of Psychogeriatrics, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, South WanPing Road 600, Shanghai, 200030 China
| | - Lin Sun
- Department of Psychogeriatrics, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, South WanPing Road 600, Shanghai, 200030 China
| | - Min-Jie Zhu
- Department of Psychogeriatrics, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, South WanPing Road 600, Shanghai, 200030 China
| | - Tao Wang
- Department of Psychogeriatrics, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, South WanPing Road 600, Shanghai, 200030 China
| | - Jing-Hua Wang
- Department of Psychogeriatrics, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, South WanPing Road 600, Shanghai, 200030 China
| | - Guan-Jun Li
- Department of Psychogeriatrics, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, South WanPing Road 600, Shanghai, 200030 China
| | - Shi-Fu Xiao
- Department of Psychogeriatrics, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, South WanPing Road 600, Shanghai, 200030 China
| | - Xia Li
- Department of Psychogeriatrics, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, South WanPing Road 600, Shanghai, 200030 China
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18
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Li W, Sun L, Yue L, Li G, Xiao S. The Association Between Eating Green Vegetables Every Day And Mild Cognitive Impairment: A Community-Based Cross-Sectional Study In Shanghai. Neuropsychiatr Dis Treat 2019; 15:3213-3218. [PMID: 31819449 PMCID: PMC6875499 DOI: 10.2147/ndt.s221074] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/27/2019] [Accepted: 10/28/2019] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Emerging evidence has suggested that green vegetables may prevent cognitive decline. METHODS We examined the cross-sectional association between green vegetables intake and mild cognitive impairment (MCI) using data from 525 participants aged 55 years and above from the China Longitudinal Aging Study (CLAS) in Shanghai. RESULTS Compared with participants who did not eat green vegetables every day, those who had consumed green vegetables every day had a significantly lower risk of mild cognitive impairment (MCI) (OR = 0.218, 95% CI, 0.116-0.411, p < 0.001), and this association was independent of age, education, having hobbies, surfing the Internet, sleep time per night (youth), long-term residency and consumption of specific red food, such as meat, bread, bean curd, and ginger. CONCLUSION In summary, using community-based data in Shanghai, we found out that subjects who eat green vegetables every day have significantly lower odds of MCI than those who do not eat every day. Based on current evidence, we propose that eating green vegetables every day might be a potential preventive measure to slow cognitive decline and neurodegeneration in the elderly.
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Affiliation(s)
- Wei Li
- Department of Geriatric Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China.,Alzheimer's Disease and Related Disorders Center, Shanghai Jiao Tong University, Shanghai, People's Republic of China
| | - Lin Sun
- Department of Geriatric Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China.,Alzheimer's Disease and Related Disorders Center, Shanghai Jiao Tong University, Shanghai, People's Republic of China
| | - Ling Yue
- Department of Geriatric Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China.,Alzheimer's Disease and Related Disorders Center, Shanghai Jiao Tong University, Shanghai, People's Republic of China
| | - Guanjun Li
- Department of Geriatric Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China.,Alzheimer's Disease and Related Disorders Center, Shanghai Jiao Tong University, Shanghai, People's Republic of China
| | - Shifu Xiao
- Department of Geriatric Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China.,Alzheimer's Disease and Related Disorders Center, Shanghai Jiao Tong University, Shanghai, People's Republic of China
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Li W, Qiu Q, Sun L, Li X, Xiao S. Short-term adverse effects of the apolipoprotein E ε4 allele over language function and executive function in healthy older adults. Neuropsychiatr Dis Treat 2019; 15:1855-1861. [PMID: 31371959 PMCID: PMC6628858 DOI: 10.2147/ndt.s183064] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2018] [Accepted: 06/10/2019] [Indexed: 01/14/2023] Open
Abstract
Background: The 4 allele of the apolipoprotein E (APOE) gene is known as a risk factor for cognitive impairment. How APOE ε polymorphism affects the language and executive functions of healthy aging subjects remains less clear. Purpose: In this follow-up study, the relationship between APOE status and cognitive performance across various cognitive domains in healthy individuals (without dementia or mild cognitive impairment (MCI)) over 60 years old was investigated. Patients and methods: Based on multiplex amplification refractory mutation system polymerase chain reaction (PCR), 228 subjects (n=228; mean age: 70.59±8.07 years old; male %=40.8%) were divided into three groups, e2 (ε2/ε2 and ε2/ε3, n=35), e3 (ε3/ε3, n=152), and e4 (ε2/ε4, ε3/ε4, and ε4/ε4, n=41). Results: There was no statistical difference (p>0.05) in the general demographic data and neuropsychological tests among the three groups on the baseline; however, e4 group showed a greater drop rate (p<0.05) versus non-carriers on verbal fluency (e2: -0.043±0.221; e3: -0.081±0.239; e4: 0.069±0.329) and Webster picture completion (e2: 0.055±0.281; e3: 0.083±0.428; e4: 0.438±1.280) over the subsequent one year. Conclusion: The findings suggest that possession of the APOE ε4 allele predicted a higher decline on tasks of language function and executive function in healthy elderly. And further research is required to determine whether strengthening the training of language function and executive function will delay the occurrence of cognitive impairment.
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Affiliation(s)
- Wei Li
- Department of Geriatric Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Alzheimer's Disease and Related Disorders Center, Shanghai Jiao Tong University, Shanghai, China
| | - Qi Qiu
- Department of Geriatric Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Alzheimer's Disease and Related Disorders Center, Shanghai Jiao Tong University, Shanghai, China
| | - Lin Sun
- Department of Geriatric Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Alzheimer's Disease and Related Disorders Center, Shanghai Jiao Tong University, Shanghai, China
| | - Xia Li
- Department of Geriatric Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Alzheimer's Disease and Related Disorders Center, Shanghai Jiao Tong University, Shanghai, China
| | - Shifu Xiao
- Department of Geriatric Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Alzheimer's Disease and Related Disorders Center, Shanghai Jiao Tong University, Shanghai, China
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Li W, Li Y, Qiu Q, Sun L, Yue L, Li X, Xiao S. Associations Between the Apolipoprotein E ε4 Allele and Reduced Serum Levels of High Density Lipoprotein a Cognitively Normal Aging Han Chinese Population. Front Endocrinol (Lausanne) 2019; 10:827. [PMID: 31866940 PMCID: PMC6906139 DOI: 10.3389/fendo.2019.00827] [Citation(s) in RCA: 5] [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: 09/06/2019] [Accepted: 11/12/2019] [Indexed: 11/13/2022] Open
Abstract
Background: Previous studies have confirmed that APOE genotype is associated with lipid metabolism, but related studies are inconsistent. Therefore, we conducted this cross-sectional study to explore the associations between apolipoprotein E (APOE) genotypes and serum levels of fasting blood sugar, triglycerides, total cholesterol, high density lipoprotein, and low density lipoprotein in a cognitively normal aging Han Chinese population. Methods: One hundred sixty-nine community elders with normal cognitive function were included in the study. Based on multiplex amplification refractory mutation system polymerase chain reaction (PCR), these subjects were divided into three groups: (1) E2/2 or E2/3 (APOE E2); (2) E3/3 (APOE E3); and (3) E2/4, E3/4, or E4/4 (APOE E4). Correlations of serum levels of fasting blood sugar, triglycerides, total cholesterol, high density lipoprotein, and low density lipoprotein with APOE genotypes were assessed. Results: The results of Mann-Whitney analysis showed that the concentration of high density lipoprotein (HDL) in APOE E2 and E3 groups was higher than that in E4 groups (p < 0.05). Logistic regression analysis also suggested that a lower level of high density lipoprotein was associated with the E4 allele (adjusted odds ratio 0.164, 95% confidence interval 0.031~ 0.876, P = 0.034). Conclusion: APOE E4 is associated with decreased serum high density lipoprotein concentration in healthy elderly. However, the above conclusions need to be further verified.
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Affiliation(s)
- Wei Li
- Department of Geriatric Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Alzheimer's Disease and Related Disorders Center, Shanghai Jiao Tong University, Shanghai, China
| | - Yong Li
- Department of Psychiatry, Hubei Provincial Hospital of TCM, Wuhan, China
| | - Qi Qiu
- Department of Geriatric Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Alzheimer's Disease and Related Disorders Center, Shanghai Jiao Tong University, Shanghai, China
| | - Lin Sun
- Department of Geriatric Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Alzheimer's Disease and Related Disorders Center, Shanghai Jiao Tong University, Shanghai, China
| | - Ling Yue
- Department of Geriatric Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Alzheimer's Disease and Related Disorders Center, Shanghai Jiao Tong University, Shanghai, China
| | - Xia Li
- Department of Geriatric Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Alzheimer's Disease and Related Disorders Center, Shanghai Jiao Tong University, Shanghai, China
- *Correspondence: Xia Li
| | - Shifu Xiao
- Department of Geriatric Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Alzheimer's Disease and Related Disorders Center, Shanghai Jiao Tong University, Shanghai, China
- Shifu Xiao
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Xu H, Wang Y, Yuan Y, Zhang X, Zuo X, Cui L, Liu Y, Chen W, Su N, Wang H, Yan F, Li X, Wang T, Xiao S. Gender differences in the protective effects of green tea against amnestic mild cognitive impairment in the elderly Han population. Neuropsychiatr Dis Treat 2018; 14:1795-1801. [PMID: 30022828 PMCID: PMC6044798 DOI: 10.2147/ndt.s165618] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND Gender differences may contribute to variances in the potential protective effects of tea against cognitive impairment in the elderly. OBJECTIVE To examine the association between different types of tea consumption and the risk of amnestic mild cognitive impairment (aMCI) along gender lines. METHODS A cross-sectional study was conducted with reference to 20 communities in China. The sample population included elderly participants aged 60 years or older. A standardized questionnaire was used to collect each participant's general demographic information. Trained psychologists administrated the Mini-Mental State Examination (MMSE) and the Montreal Cognitive Assessment (MoCA) to assess participants' cognitive function. An attending psychiatrist evaluated each participant's cognitive function. Finally, data from 2,131 participants were analyzed to assess the association. RESULTS With regard to male participants, the percentage of green tea consumption was higher in the normal control group than in the aMCI group (X2=4.64, P=0.031). Logistic regression analysis showed that green tea consumption reduced the risk of aMCI in male participants (OR=0.657, P=0.019), and this finding was highly significant in males aged under 70 years (OR=0.376, P=0.002). Regarding female participants across every age group, the results indicated that tea consumption failed to significantly decrease the risk of aMCI (P>0.05). Unlike green tea, black tea and oolong tea were not correlated with a reduced risk of aMCI in terms of gender or age group. Multiple linear regression analysis also revealed that age, years of education, and green tea consumption (B=0.996, P=0.000) were associated with MoCA and MMSE scores, though only in male participants. CONCLUSION Green tea consumption showed a protective effect against aMCI in males but not in females, particularly in males aged <70 years. However, black tea and oolong tea failed to show any protective effect in either males or females.
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Affiliation(s)
- Hua Xu
- Department of Geriatric Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China, ;
- Alzheimer's Disease and Related Disorders Center, Shanghai Jiao Tong University, Shanghai, China, ;
| | - Yaping Wang
- Department of Psychology and Psychiatry, The Second Affiliated Hospital of Xi'an Jiao Tong University School of Medicine, Xi'an, Shaanxi Province, China
| | - Yefeng Yuan
- Department of Psychiatry, The First Affiliated Hospital of Nanchang University, Nanchang, Jiangxi Province, China
| | - Xulai Zhang
- Department of Geriatric Psychiatry, The Fourth People's Hospital of Hefei City, Hefei, Anhui Province, China
| | - Xiaoyun Zuo
- Department of Geriatrics, The Third People's Hospital of Jian City, Jian, Jiangxi Province, China
| | - Lijuan Cui
- Department of Applied Psychology, East China Normal University, Shanghai, China
| | - Ying Liu
- Department of Psychiatry, The First Affiliated Hospital of the China Medical University, Shenyang, Liaoning Province, China
| | - Wei Chen
- Department of Psychiatry, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang Province, China
| | - Ning Su
- Department of Geriatric Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China, ;
- Alzheimer's Disease and Related Disorders Center, Shanghai Jiao Tong University, Shanghai, China, ;
| | - Haihong Wang
- Department of Geriatric Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China, ;
- Alzheimer's Disease and Related Disorders Center, Shanghai Jiao Tong University, Shanghai, China, ;
| | - Feng Yan
- Department of Geriatric Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China, ;
- Alzheimer's Disease and Related Disorders Center, Shanghai Jiao Tong University, Shanghai, China, ;
| | - Xia Li
- Department of Geriatric Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China, ;
- Alzheimer's Disease and Related Disorders Center, Shanghai Jiao Tong University, Shanghai, China, ;
| | - Tao Wang
- Department of Geriatric Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China, ;
- Alzheimer's Disease and Related Disorders Center, Shanghai Jiao Tong University, Shanghai, China, ;
| | - Shifu Xiao
- Department of Geriatric Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China, ;
- Alzheimer's Disease and Related Disorders Center, Shanghai Jiao Tong University, Shanghai, China, ;
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Sun L, Xu H, Zhang J, Li W, Nie J, Qiu Q, Liu Y, Fang Y, Yang Z, Li X, Xiao S. Alcohol Consumption and Subclinical Findings on Cognitive Function, Biochemical Indexes, and Cortical Anatomy in Cognitively Normal Aging Han Chinese Population. Front Aging Neurosci 2018; 10:182. [PMID: 29970998 PMCID: PMC6018200 DOI: 10.3389/fnagi.2018.00182] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2018] [Accepted: 05/29/2018] [Indexed: 12/23/2022] Open
Abstract
Background: Binge drinking of alcohol is associated with brain damage, but less is known about relationship of light-to-moderate alcohol consumption with cognitive function, biochemical indexes, and cortical anatomy. Previous findings have debated on whether light-to-moderate drinking has any health benefits. We investigated cortical thickness and its association with alcohol consumption and cognitive functions in a non-dementia aging Han Chinese population. Methods: 940 non-dementia aging subjects were included in our study (alcohol n = 149; non-alcohol n = 791). Among them, 572 received blood biochemical tests including liver function and lipid metabolism (alcohol n = 100; non-alcohol n = 472) and 141 had brain magnetic resonance imaging (alcohol n = 27; non-alcohol n = 114). The Beijing version of the Montreal Cognitive Assessment and the Chinese version of the neuropsychological test battery were used to assess cognitive functions. Results: There was no significant difference in cognitive functions between alcohol and non-alcohol groups in the overall database. Similarly, there was no significant difference in liver function and lipid metabolism between two groups in the sub-database. The left superiortemporal gyrus was one of age sensitive regions and alcohol consumption was significantly associated with thinner cortex of the left superiotemporal cluster in the sub-database. Conclusion: Alcohol consumption was not significantly associated with better or worse cognitive function and biochemical indexes abnormality, however, significantly associated with thinner cortex of the left superiortemporal gyrus in cognitively normal aging Han Chinese population.
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Affiliation(s)
- Lin Sun
- Alzheimer's Disease and Related Disorders Center, Department of Geriatric Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Hua Xu
- Alzheimer's Disease and Related Disorders Center, Department of Geriatric Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jie Zhang
- Shanghai East Hospital, Key Laboratory of Arrhythmias, Ministry of Education, Tong Ji University School of Medicine, Shanghai, China
| | - Wei Li
- Alzheimer's Disease and Related Disorders Center, Department of Geriatric Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jing Nie
- Alzheimer's Disease and Related Disorders Center, Department of Geriatric Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Qi Qiu
- Alzheimer's Disease and Related Disorders Center, Department of Geriatric Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yuanyuan Liu
- Alzheimer's Disease and Related Disorders Center, Department of Geriatric Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yuan Fang
- Alzheimer's Disease and Related Disorders Center, Department of Geriatric Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Zhi Yang
- Alzheimer's Disease and Related Disorders Center, Department of Geriatric Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xia Li
- Alzheimer's Disease and Related Disorders Center, Department of Geriatric Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Shifu Xiao
- Alzheimer's Disease and Related Disorders Center, Department of Geriatric Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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Yue L, Wang T, Wang J, Li G, Wang J, Li X, Li W, Hu M, Xiao S. Asymmetry of Hippocampus and Amygdala Defect in Subjective Cognitive Decline Among the Community Dwelling Chinese. Front Psychiatry 2018; 9:226. [PMID: 29942265 PMCID: PMC6004397 DOI: 10.3389/fpsyt.2018.00226] [Citation(s) in RCA: 57] [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: 12/05/2017] [Accepted: 05/08/2018] [Indexed: 01/16/2023] Open
Abstract
Background: Subjective cognitive decline (SCD) may be the first clinical sign of Alzheimer's disease (AD). SCD individuals with normal cognition may already have significant medial temporal lobe atrophy. However, few studies have been devoted to exploring the alteration of left-right asymmetry with hippocampus and amygdala in SCD. The aim of this study was to compare SCD individuals with amnestic mild cognitive impairment (MCI) patients and the normal population for volume and asymmetry of hippocampus, amygdala and temporal horn, and to assess their relationship with cognitive function in elderly population living in China. Methods: 111 SCD, 30 MCI, and 67 healthy controls (HC) underwent a standard T1-weighted MRI, from which the volumes of the hippocampus and amygdala were calculated and compared. Then we evaluated the pattern and extent of asymmetry in hippocampus and amygdala of these samples. Furthermore, we also investigated the relationship between the altered brain regions and cognitive function. Results: Among the three groups, SCD showed more depressive symptoms (p < 0.001) and higher percentage of heart disease (16.4% vs. 35.1%, p = 0.007) than controls. In terms of brain data, significant differences were found in the volume and asymmetry of both hippocampus and amygdala among the three groups (P < 0.05). In logistic analysis controlled by age, gender, education level, depression symptoms, anxiety symptom, somatic disease and lifestyle in terms of smoking, both SCD and MCI individuals showed significant decreased right hippocampal and amygdala volume than controls. For asymmetry pattern, a ladder-shaped difference of left-larger-than-right asymmetry was found in amygdala with MCI>SCD>HC, and an opposite asymmetry of left-less-than-right pattern was found with HC>SCD>MCI in hippocampus. Furthermore, correlation was shown between the volume of right hippocampus and right amygdala with MMSE and MoCA in SCD group. Conclusion: Our results supported that SCD individuals are biologically distinguishable from HC, and this may relate to cognitive impairment, although more longitudinal studies are need to investigate this further.Moreover, different levels of asymmetry in hippocampus and amygdala might be a potential dividing factor to differentiate clinical diagnosis.
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Affiliation(s)
- Ling Yue
- Department of Geriatric Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Alzheimer's Disease and Related Disorders Center, Shanghai Jiao Tong University, Shanghai, China
| | - Tao Wang
- Department of Geriatric Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Alzheimer's Disease and Related Disorders Center, Shanghai Jiao Tong University, Shanghai, China
| | - Jingyi Wang
- Division of Psychiatry, University of College London, London, United Kingdom
| | - Guanjun Li
- Department of Geriatric Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Alzheimer's Disease and Related Disorders Center, Shanghai Jiao Tong University, Shanghai, China
| | - Jinghua Wang
- Department of Geriatric Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Alzheimer's Disease and Related Disorders Center, Shanghai Jiao Tong University, Shanghai, China
| | - Xia Li
- Department of Geriatric Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Alzheimer's Disease and Related Disorders Center, Shanghai Jiao Tong University, Shanghai, China
| | - Wei Li
- Department of Geriatric Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Alzheimer's Disease and Related Disorders Center, Shanghai Jiao Tong University, Shanghai, China
| | - Mingxing Hu
- Department of Computer Science, University of College London, London, United Kingdom
| | - Shifu Xiao
- Department of Geriatric Psychiatry, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China.,Alzheimer's Disease and Related Disorders Center, Shanghai Jiao Tong University, Shanghai, China
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Su N, Li W, Li X, Wang T, Zhu M, Liu Y, Shi Y, Xiao S. The Relationship between the Lifestyle of the Elderly in Shanghai Communities and Mild Cognitive Impairment. SHANGHAI ARCHIVES OF PSYCHIATRY 2017; 29:352-357. [PMID: 29719346 PMCID: PMC5925586 DOI: 10.11919/j.issn.1002-0829.217059] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background Those with mild cognitive impairment (MCI) are ten times more like to develop Alzheimer’s disease (AD) than the general population. MCI diagnosis and early intervention are helpful for the diagnosis and treatment of AD in its early stages, thus delaying its development and improving the quality of life for those with MCI. Aims To analyze the relationship between the lifestyle of the elderly in Shanghai communities and mild cognitive impairment and to look for preventative lifestyle measures for the elderly with mild cognitive impairment. Methods 1005 elderly persons were randomly selected from the community in Shanghai. Study participants were 265 people with an MCI diagnosis and 607 non-MCI elderly persons. The demographic and lifestyle data of these elderly people were collected for univariate and multivariate analysis to search for statistically significant indicators. Results The univariate analysis revealed that smoking (χ2= 10.808, p=0.001), tea drinking (χ2=11.74, p= 0.001), having hobbies (χ2= 20.815, p<0.001), reading (χ2=28.670, p= 0.001), surfing the internet (χ2=12.623, p= 0.001), and photography (χ2=4.470, p= 0.034) were protective factors for MCI. The binary logistic regression, a multivariate analysis, revealed that smoking, reading, and surfing the internet had statistical significance. Their OR values were 0.562 (0.358-0.883), 0.428 (0.253-0.726), and 0.238 (0.071-0.797) respectively. Thus, smoking, reading, and surfing the internet were protective factors for MCI. Conclusions Lifestyle is associated with the onset of MCI. Good life habits and behaviors are significant in the prevention of MCI developing into Alzheimer’s.
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Affiliation(s)
- Ning Su
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Wei Li
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xia Li
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Tao Wang
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Minjie Zhu
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yuanyuan Liu
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yanchen Shi
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Shifu Xiao
- Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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25
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Heidari Z, Feizi A. The Isfahan Comprehensive Elderly Study: Objectives, research design, methodology, and preliminary results. JOURNAL OF RESEARCH IN MEDICAL SCIENCES 2017; 22:85. [PMID: 28919912 PMCID: PMC5553243 DOI: 10.4103/jrms.jrms_309_17] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/09/2017] [Revised: 04/29/2017] [Accepted: 04/30/2017] [Indexed: 11/04/2022]
Abstract
BACKGROUND This paper presents the objectives, research design, methodology, and primary findings of the Isfahan Comprehensive Elderly Study (ICES). MATERIALS AND METHODS In this cross-sectional study, 603 elderly persons (aged 60 and over) were selected by multistage cluster sampling method from Isfahan, Iran, in 2016 comprehensive questionnaires along with a detailed interview were used to collect information on personal, family, socioeconomic, health and social services characteristics, life styles, physical illnesses and chronic diseases, mental, emotional and cognition disorders, quality of life, disabilities, sleep quality, social supports, life satisfaction, self-efficacy, and of participants. RESULTS The mean ± standard deviation (SD) age of participants was 69.66 ± 6.31 years, consisting of 50.75% females. About 23% of elderly persons were at the risk of malnutrition and 4.5% were current smoker. Severe and mild depression were documented in 9.3% and 30.2% among included study subjects, respectively. About half of the participants had hypertension, and 26.8% suffered from cardiovascular disease. The mean ± SD of total score of Geriatric Depression Scale, Perceived Stress Scale, Older People's Quality of Life, Physical Activity Scale for the Elderly and Pittsburg Sleep Quality Index was 8.84 ± 6.79, 14.76 ± 5.92, 133.99 ± 10.55, 142.04 ± 120.53, and 6.17 ± 3.44, respectively. Elderly males had significantly higher life satisfaction and self-efficacy and better cognitive function than females (P < 0.01). CONCLUSION The findings of current study provided a comprehensive overview of the current health status and lifestyle of older adults in Isfahan city. The ICES could help policy makers to design appropriate prevention and interventional programs and policies to cover the specific needs of the elderly population.
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Affiliation(s)
- Zahra Heidari
- Department of Biostatistics and Epidemiology and Student Research Center, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Awat Feizi
- Department of Biostatistics and Epidemiology, School of Health, Isfahan University of Medical Sciences, Isfahan, Iran.,Endocrinology and Metabolism Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.,Cardiac Rehabilitation Research Center, Isfahan Cardiovascular Research Institute, Isfahan University of Medical Sciences, Isfahan, Iran
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26
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Li W, Qiu Q, Sun L, Yue L, Wang T, Li X, Xiao S. Sex differences in obesity and cognitive function in a cognitively normal aging Chinese Han population. Neuropsychiatr Dis Treat 2017; 13:2405-2410. [PMID: 29066899 PMCID: PMC5604567 DOI: 10.2147/ndt.s145245] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND Sex differences in Alzheimer's disease and mild cognitive impairment have been well recognized. However, sex differences in cognitive function and obesity in cognitively normal aging Chinese Han population have not attracted much attention. OBJECTIVE The aim of this study was to investigate the relationship between sex, obesity, and cognitive function in an elderly Chinese population with normal cognitive function. SUBJECTS AND METHODS A total of 228 cognitively normal aging participants (males/females =93/135) entered this study. Their general demographic information (sex, age, and education) was collected by standardized questionnaire. Apolipoprotein E (APOE) genotype and serum lipid levels were measured. The Montreal Cognitive Assessment (MoCA) was used to assess participants' cognitive function. RESULTS The prevalence of obesity in elderly women (18/133, 13.5%) was significantly higher than that in men (5/92, 5.4%, P=0.009). Regression analyses showed that obesity was associated with drinking alcohol (OR =13.695, P=0.045) and triglyceride (OR =1.436, P=0.048) in women and limited to low-density lipoprotein (OR =11.829, P=0.023) in men. Women performed worse on the naming score for MoCA than men (P<0.01). Stepwise linear regression analysis showed that education (t=3.689, P<0.001) and smoking (t=2.031, P=0.045) were related to the score of naming in female, while high-density lipoprotein (t=-2.077, P=0.041) was related to the score of naming in male; however, no correlation was found between body mass index and cognitive function in both male and female (P>0.05). CONCLUSION Our finding suggests that there are significant sex differences in obesity and specific cognitive domains in aging Chinese Han population with normal cognitive function.
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Affiliation(s)
- Wei Li
- Alzheimer's Disease and Related Disorders Center, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China
| | - Qi Qiu
- Alzheimer's Disease and Related Disorders Center, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China
| | - Lin Sun
- Alzheimer's Disease and Related Disorders Center, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China
| | - Ling Yue
- Alzheimer's Disease and Related Disorders Center, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China
| | - Tao Wang
- Alzheimer's Disease and Related Disorders Center, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China
| | - Xia Li
- Alzheimer's Disease and Related Disorders Center, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China
| | - Shifu Xiao
- Alzheimer's Disease and Related Disorders Center, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, People's Republic of China
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Ban CX, Zhong L, Wang T, Zhu MJ, Wang JH, Zhang ZL, Wang Z, Su N, Liu YY, Shi YC, Xiao SF, Li X. Enhanced Diabetes Susceptibility in Community Dwelling Han Elders Carrying the Apolipoprotein E 3/3 Genotype. PLoS One 2016; 11:e0151336. [PMID: 26998902 PMCID: PMC4801405 DOI: 10.1371/journal.pone.0151336] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2015] [Accepted: 02/26/2016] [Indexed: 11/30/2022] Open
Abstract
Despite Apolipoprotein E (ApoE) being one of the main apolipoproteins in the blood, the association between its genotype and the high cholesterol or blood glucose levels commonly seen in clinical practice is inconclusive. Such research is also lacking in the Han population. The aim of this study was to investigate the association between APOE genotype, diabetes, and plasma glucose and lipid levels. We included 243 community-dwelling elderly residents in this study. Participant APOE genotypes were assessed and were simultaneously tested for weight, height, blood glucose, triglycerides, cholesterol, and high- and low-density lipoprotein. In addition, gender, age, years of education, cognitive function, and medical history was recorded. Subjects were divided into 3 groups based on APOE genotype: APOE ε2 group (ε2/ε2 and ε2/ε3), APOE ε3 group (ε3/ε3), and APOE ε4 group (ε2/ε4, ε3/ε4 and ε4/ε4). Comparisons between groups were conducted for the incidence of diabetes, high blood pressure, and dementia, as well as for differences in body-mass index, fasting plasma glucose, and blood lipids. The APOE ε3/ε3 genotype exhibited the highest frequency (70.4%) among the subjects. Participants in the APOE ε3 group demonstrated significantly higher levels of fasting plasma glucose than those in the APOE ε2 and APOE ε4 groups (P<0.05). The APOE ε3 group had slightly higher abnormal fasting plasma glucose values than did the APOE ε2 group (P = 0.065). Furthermore, the APOE3 genotype was significantly correlated with both fasting plasma glucose level and glucose abnormality (P< 0.05) and trended toward statistically significant correlation with diabetes (P = 0.082). The correlation between APOE2 and low low-density lipoprotein levels also approached statistical significance (P = 0.052). Thus, elderly community dwelling residents of Han ethnicity carrying the APOE ε3/ε3 genotype might have higher plasma glucose levels and a higher occurrence of diabetes.
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Affiliation(s)
- Chun-xia Ban
- Department of Psychogeriatrics, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Li Zhong
- Fujian Provincial Key Laboratory of Neurodegenerative Disease and Aging Research, Institute of Neuroscience, Medical College, Xiamen University, Xiamen, China
| | - Tao Wang
- Department of Psychogeriatrics, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Min-jie Zhu
- Department of Psychogeriatrics, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jing-hua Wang
- Department of Psychogeriatrics, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Zhen-lian Zhang
- Fujian Provincial Key Laboratory of Neurodegenerative Disease and Aging Research, Institute of Neuroscience, Medical College, Xiamen University, Xiamen, China
| | - Zhe Wang
- Fujian Provincial Key Laboratory of Neurodegenerative Disease and Aging Research, Institute of Neuroscience, Medical College, Xiamen University, Xiamen, China
| | - Ning Su
- Department of Psychogeriatrics, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yuan-yuan Liu
- Department of Psychogeriatrics, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yan-chen Shi
- Department of Psychogeriatrics, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Shi-fu Xiao
- Department of Psychogeriatrics, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xia Li
- Department of Psychogeriatrics, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
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28
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The influence of education on Chinese version of Montreal cognitive assessment in detecting amnesic mild cognitive impairment among older people in a Beijing rural community. ScientificWorldJournal 2014; 2014:689456. [PMID: 24982978 PMCID: PMC4058117 DOI: 10.1155/2014/689456] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2014] [Accepted: 04/26/2014] [Indexed: 11/17/2022] Open
Abstract
To assess the influence of education on the performance of Chinese version of Montreal cognitive assessment (C-MoCA) in relation to the mini-mental state examination (MMSE) in detecting amnesic mild cognitive impairment (aMCI) among rural-dwelling older people C-MoCA and MMSE was administered and diagnostic interviews were conducted among community-dwelling elderly in two villages in Beijing. The performance of C-MoCA and MMSE in detecting aMCI was evaluated by the area under the ROC curve (AUC). Effect size of education on variations in C-MoCA scores was estimated with general linear model. Among 172 study participants (24 cases of aMCI and 148 normal controls), the AUC of C-MoCA was 0.72 (95% CI = 0.62–0.81, cutoff = 20/21), compared to AUC of MMSE of 0.74 (95% CI = 0.64–0.84, cutoff = 26/27). The performance of both C-MoCA and MMSE was especially poorer among those with low (0–6 years) education. After controlling for gender and age, education (η2 = 0.204) had a surpassing effect over aMCI diagnosis (η2 = 0.052) on variations in C-MoCA scores. Among rural older people, the MoCA showed modest accuracy and was no better than MMSE in detecting aMCI, especially in those with low education, due to the overwhelming effect of education relative to aMCI diagnosis on variations in C-MoCA performance.
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29
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Sachdev PS, Lipnicki DM, Kochan NA, Crawford JD, Rockwood K, Xiao S, Li J, Li X, Brayne C, Matthews FE, Stephan BCM, Lipton RB, Katz MJ, Ritchie K, Carrière I, Ancelin ML, Seshadri S, Au R, Beiser AS, Lam LCW, Wong CHY, Fung AWT, Kim KW, Han JW, Kim TH, Petersen RC, Roberts RO, Mielke MM, Ganguli M, Dodge HH, Hughes T, Anstey KJ, Cherbuin N, Butterworth P, Ng TP, Gao Q, Reppermund S, Brodaty H, Meguro K, Schupf N, Manly J, Stern Y, Lobo A, Lopez-Anton R, Santabárbara J. COSMIC (Cohort Studies of Memory in an International Consortium): an international consortium to identify risk and protective factors and biomarkers of cognitive ageing and dementia in diverse ethnic and sociocultural groups. BMC Neurol 2013; 13:165. [PMID: 24195705 PMCID: PMC3827845 DOI: 10.1186/1471-2377-13-165] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2013] [Accepted: 10/31/2013] [Indexed: 12/25/2022] Open
Abstract
BACKGROUND A large number of longitudinal studies of population-based ageing cohorts are in progress internationally, but the insights from these studies into the risk and protective factors for cognitive ageing and conditions like mild cognitive impairment and dementia have been inconsistent. Some of the problems confounding this research can be reduced by harmonising and pooling data across studies. COSMIC (Cohort Studies of Memory in an International Consortium) aims to harmonise data from international cohort studies of cognitive ageing, in order to better understand the determinants of cognitive ageing and neurocognitive disorders. METHODS/DESIGN Longitudinal studies of cognitive ageing and dementia with at least 500 individuals aged 60 years or over are eligible and invited to be members of COSMIC. There are currently 17 member studies, from regions that include Asia, Australia, Europe, and North America. A Research Steering Committee has been established, two meetings of study leaders held, and a website developed. The initial attempts at harmonising key variables like neuropsychological test scores are in progress. DISCUSSION The challenges of international consortia like COSMIC include efficient communication among members, extended use of resources, and data harmonisation. Successful harmonisation will facilitate projects investigating rates of cognitive decline, risk and protective factors for mild cognitive impairment, and biomarkers of mild cognitive impairment and dementia. Extended implications of COSMIC could include standardised ways of collecting and reporting data, and a rich cognitive ageing database being made available to other researchers. COSMIC could potentially transform our understanding of the epidemiology of cognitive ageing, and have a world-wide impact on promoting successful ageing.
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Affiliation(s)
- Perminder S Sachdev
- Centre for Healthy Brain Ageing, University of New South Wales, Sydney, Australia
- Dementia Collaborative Research Centre, University of New South Wales, Sydney, Australia
| | - Darren M Lipnicki
- Centre for Healthy Brain Ageing, University of New South Wales, Sydney, Australia
| | - Nicole A Kochan
- Centre for Healthy Brain Ageing, University of New South Wales, Sydney, Australia
| | - John D Crawford
- Centre for Healthy Brain Ageing, University of New South Wales, Sydney, Australia
| | - Kenneth Rockwood
- Department of Medicine (Geriatric Medicine & Neurology), Dalhousie University, Halifax, NS, Canada
| | - Shifu Xiao
- Department of Geriatric Psychiatry, Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Juan Li
- Institute of Psychology, Chinese Academy of Sciences, Beijing, China
| | - Xia Li
- Department of Geriatric Psychiatry, Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Carol Brayne
- Department of Public Health and Primary Care, Cambridge University, Cambridge, UK
| | - Fiona E Matthews
- MRC Biostatistics Unit, Institute of Public Health, Cambridge, UK
| | - Blossom CM Stephan
- Institute of Health and Society, Newcastle University, Newcastle upon Tyne, UK
| | - Richard B Lipton
- Saul B. Korey Department of Neurology; Albert Einstein College of Medicine, Yeshiva University, New York, NY, USA
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Yeshiva University, New York, NY, USA
| | - Mindy J Katz
- Saul B. Korey Department of Neurology; Albert Einstein College of Medicine, Yeshiva University, New York, NY, USA
| | - Karen Ritchie
- Inserm, U1061 Nervous System Pathologies: Epidemiological and Clinical Research, La Colombière Hospital, Montpellier Cedex 5, France
- Université de Montpellier 1, Montpellier, France
- Faculty of Medicine, Imperial College, St Mary’s Hospital, London, UK
| | - Isabelle Carrière
- Inserm, U1061 Nervous System Pathologies: Epidemiological and Clinical Research, La Colombière Hospital, Montpellier Cedex 5, France
- Université de Montpellier 1, Montpellier, France
| | - Marie-Laure Ancelin
- Inserm, U1061 Nervous System Pathologies: Epidemiological and Clinical Research, La Colombière Hospital, Montpellier Cedex 5, France
- Université de Montpellier 1, Montpellier, France
| | - Sudha Seshadri
- Department of Neurology, Boston University School of Medicine, Boston, MA, USA
| | - Rhoda Au
- Department of Neurology, Boston University School of Medicine, Boston, MA, USA
| | - Alexa S Beiser
- Department of Biostatistics, Boston University School of Public Health, Boston, MA, USA
| | - Linda CW Lam
- Department of Psychiatry, The Chinese University of Hong Kong, Hong Kong, SAR, China
| | - Candy HY Wong
- Department of Psychiatry, Tai Po Hospital, Hong Kong, SAR, China
| | - Ada WT Fung
- Department of Psychiatry, The Chinese University of Hong Kong, Hong Kong, SAR, China
| | - Ki Woong Kim
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, Korea
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, Korea
- Department of Brain and Cognitive Sciences, Seoul National University College of Natural Sciences, Seoul, Korea
| | - Ji Won Han
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Tae Hui Kim
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, Korea
| | | | | | | | - Mary Ganguli
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
- Department of Neurology, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
- Department of Epidemiology, University of Pittsburgh Graduate School of Public Health, Pittsburgh, PA, USA
| | - Hiroko H Dodge
- Department of Neurology, Oregon Health and Science University, Portland, OR, USA
- Department of Neurology, University of Michigan, Ann Arbor, MI, USA
| | - Tiffany Hughes
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Kaarin J Anstey
- Centre for Research on Ageing, Health and Wellbeing, College of Medicine, Biology and Environment, The Australian National University, Canberra, Australia
| | - Nicolas Cherbuin
- Centre for Research on Ageing, Health and Wellbeing, College of Medicine, Biology and Environment, The Australian National University, Canberra, Australia
| | - Peter Butterworth
- Centre for Research on Ageing, Health and Wellbeing, College of Medicine, Biology and Environment, The Australian National University, Canberra, Australia
| | - Tze Pin Ng
- Gerontology Research Programme, Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Qi Gao
- Gerontology Research Programme, Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Simone Reppermund
- Centre for Healthy Brain Ageing, University of New South Wales, Sydney, Australia
| | - Henry Brodaty
- Centre for Healthy Brain Ageing, University of New South Wales, Sydney, Australia
- Dementia Collaborative Research Centre, University of New South Wales, Sydney, Australia
| | - Kenichi Meguro
- Department of Geriatric Behavioral Neurology, Tohoku University Graduate School of Medicine, Sendai, Japan
| | - Nicole Schupf
- The Taub Institute for Research in Alzheimer’s Disease and the Aging Brain, Columbia University, New York, NY, USA
- The Gertrude H. Sergievsky Center, Columbia University, New York, NY, USA
- The Division of Epidemiology, Joseph P. Mailman School of Public Health, Columbia University, New York, NY, USA
| | - Jennifer Manly
- The Taub Institute for Research in Alzheimer’s Disease and the Aging Brain, Columbia University, New York, NY, USA
- The Gertrude H. Sergievsky Center, Columbia University, New York, NY, USA
- The Department of Neurology, Columbia University, New York, NY, USA
| | - Yaakov Stern
- The Taub Institute for Research in Alzheimer’s Disease and the Aging Brain, Columbia University, New York, NY, USA
- The Gertrude H. Sergievsky Center, Columbia University, New York, NY, USA
- The Department of Neurology, Columbia University, New York, NY, USA
| | - Antonio Lobo
- Department of Medicine and Psychiatry, Universidad de Zaragoza, Zaragoza, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Ministry of Science and Innovation, Madrid, Spain
- Instituto de Investigación Sanitaria de Aragón (IIS Aragón), Zaragoza, Spain
| | - Raúl Lopez-Anton
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Ministry of Science and Innovation, Madrid, Spain
- Department of Psychology and Sociology, Universidad de Zaragoza, Zaragoza, Spain
| | - Javier Santabárbara
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Ministry of Science and Innovation, Madrid, Spain
- Department of Preventive Medicine and Public Health, Universidad de Zaragoza, Zaragoza, Spain
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