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Marche C, Baourakis G, Fakotakis E, Nieddu A, Errigo A, Pes GM. The impact of nutrition on psycho-affective status in an older Cretan population: a cross-sectional study. Eur J Nutr 2024; 63:2199-2207. [PMID: 38744756 DOI: 10.1007/s00394-024-03395-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Accepted: 04/16/2024] [Indexed: 05/16/2024]
Abstract
BACKGROUND Cognitive and mood status influence both personal and social daily activities, with great impact on life quality, particularly among the elderly population. AIM This cross-sectional study aimed to investigate the psycho-affective status concerning eating habits within an elderly population of the Chania area in Crete, Greece. METHODS Cognitive status was assessed in 101 elderly subjects through the Mini-Mental State Examination (MMSE), and mood was evaluated using the Hospital Anxiety and Depression Scale (HADS). Nutritional status was assessed using a validated food frequency questionnaire. RESULTS Multivariable statistical analysis, after adjustment for age, marital status, education, and comorbidity, highlighted among males a positive association of the MMSE score with vegetable consumption (RR 1.18; 95%CI 1.03‒1.34) and a negative association with potato consumption (RR 0.83; 95%CI 0.72‒0.95). Conversely, among females, no statistically significant association was observed for any food. Further, among males, a protective effect on affective status was identified for chicken meat (RR 0.45; 95%CI 0.27‒0.77), fish (RR 0.41; 95%CI 0.21‒0.82), fruit (RR 0.70; 95%CI 0.52‒0.94), cereals (RR 0.67; 95%CI 0.53‒0.87), and cheese (RR 0.78; 95%CI 0.63‒0.97) consumption. Among females, the adjusted model showed a significant detrimental effect of vegetable consumption (RR 1.33; 95%CI 1.02‒1.73). CONCLUSION A predominantly vegetable-based diet-with the notable exception of fruits and legumes-was associated with better cognitive status in males, albeit not in females. A higher intake of fruit, as well as fish, chicken meat, and cheese among males was associated with a better affective status, indicating that adequate protein supply may play a role in maintaining emotional balance.
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Affiliation(s)
- Chiara Marche
- Department of Biomedical Science, University of Sassari, Viale San Pietro No. 43B, 07100, Sassari, Italy.
| | - George Baourakis
- CIHEAM-Mediterranean Agronomic Institute of Chania, P.O. Box 85, 73100, Chania, Crete, Greece
| | - Eleftherios Fakotakis
- CIHEAM-Mediterranean Agronomic Institute of Chania, P.O. Box 85, 73100, Chania, Crete, Greece
| | - Alessandra Nieddu
- Department of Biomedical Science, University of Sassari, Viale San Pietro No. 43B, 07100, Sassari, Italy
| | - Alessandra Errigo
- Department of Medicine, Surgery and Pharmacy, Viale San Pietro 8, 07100, Sassari, Italy
| | - Giovanni Mario Pes
- Department of Medicine, Surgery and Pharmacy, Viale San Pietro 8, 07100, Sassari, Italy
- Sardinia Blue Zone Longevity Observatory, 08040, Ogliastra, Italy
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Chen Y, Yang K, Huang Y, Wang X, Zhao Y, Ping P, Guan S, Fu S. Associations between lipid profiles and late-life cognitive impairment among oldest-old and centenarian adults. MedComm (Beijing) 2023; 4:e362. [PMID: 37692108 PMCID: PMC10484073 DOI: 10.1002/mco2.362] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Revised: 07/23/2023] [Accepted: 08/06/2023] [Indexed: 09/12/2023] Open
Abstract
Dyslipidemia and cognitive impairment are common among old adults and the occurrence of them rises exponentially with increasing age. Evidences of the relationships between serum lipids and cognitive impairment are inconsistent or equivocal among older adults. This study aimed to investigate the associations between lipid profiles and late-life cognitive impairment among oldest-old and centenarian adults. In this cross-sectional study, serum lipids were biochemically measured among 606 oldest-old adults and 653 centenarians, and cognitive function was evaluated using mini-mental state examination (MMSE). Multivariate linear and logistic regression analyses were performed to explore the associations between serum lipids and cognitive impairment. Results showed participants with cognitive impairment had lower total cholesterol (TC) levels compared with those without cognitive impairment (p < 0.05). TC levels were positively associated with MMSE (p < 0.05). Furthermore, a negative association was observed between TC levels and cognitive impairment (p for trend = 0.002). This negative association remained statistically significant after adjusting for confounders (p for trend = 0.028). These results suggested that older adults with higher TC levels were likely to have better cognitive function. Taking immoderate cholesterol-lowering drugs among older adults is questionable and requires investigation, and cognitive performance of old adults with lower TC levels deserves more attention.
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Affiliation(s)
- Yujian Chen
- Central LaboratoryHainan Hospital of Chinese People's Liberation Army General HospitalSanyaChina
| | - Kaidi Yang
- Oncology DepartmentHainan Hospital of Chinese People's Liberation Army General HospitalSanyaChina
| | - Ya Huang
- Blood Transfusion DepartmentHainan Hospital of Chinese People's Liberation Army General HospitalSanyaChina
| | - Xuejiao Wang
- Pediatric DepartmentHainan Hospital of Chinese People's Liberation Army General HospitalSanyaChina
| | - Yali Zhao
- Central LaboratoryHainan Hospital of Chinese People's Liberation Army General HospitalSanyaChina
| | - Ping Ping
- General Station for Drug and Instrument Supervision and ControlJoint Logistic Support Force of Chinese People's Liberation ArmyBeijingChina
| | - Shasha Guan
- Oncology DepartmentHainan Hospital of Chinese People's Liberation Army General HospitalSanyaChina
| | - Shihui Fu
- Department of CardiologyHainan Hospital of Chinese People's Liberation Army General HospitalSanyaChina
- Department of Geriatric CardiologyChinese People's Liberation Army General HospitalBeijingChina
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Chéour S, Chéour C, Gendreau T, Bouazizi M, Singh KP, Saeidi A, Tao D, Supriya R, Bragazzi NL, Baker JS, Chéour F. Remediation of cognitive and motor functions in Tunisian elderly patients with mild Alzheimer's disease: implications of music therapy and/or physical rehabilitation. Front Aging Neurosci 2023; 15:1216052. [PMID: 37539345 PMCID: PMC10394639 DOI: 10.3389/fnagi.2023.1216052] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Accepted: 07/03/2023] [Indexed: 08/05/2023] Open
Abstract
The purpose of this study was to compare the effects of music therapy (MT) and/or physical rehabilitation (PR) on cognitive and motor function in elderly Tunisian male and female patients with mild Alzheimer's disease (AD). Male patients (N: 16; age: 74.19 ± 4.27 years; weight: 76.71 ± 5.22 kg) and female patients (N: 12; age: 71.46 ± 3.36 years; weight: 67.47 ± 4.31 kg) with mild AD were randomly assigned into 4 groups including control group (Co), PR group participated in physical rehabilitation, MT group received music therapy and MT + PR received both music therapy and physical rehabilitation. Participants were required to engage in the study for four months with three 60-min sessions per week. We found all scores of cognitive (MMSE, ADAS-Cog Total and the ADAS-Cog Memory subscale) and motor functions (step length, walking speed, 6MVT and BBS score) evaluated were the greatest in MT + PR compared to the other groups. Our study also demonstrated that MT has a greater effect on cognitive function, while PR has a more pronounced effect on motor function. Changes in MMSE scores were significantly positively correlated in the PR, MT and MT + PR groups with improvements in all motor functions including step length (r = 0.77), walking speed (r = 0.73), 6MVT (r = 0.75) and BBS scores (r = 0.78) in AD patients. In conclusion, the combination of MT and PR seems to be an appropriate intervention approach that needs consideration as a treatment strategy for elderly male and female patients with mild AD.
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Affiliation(s)
- Sarah Chéour
- High Institute of Sport and Physical Education of Ksar-Saïd, Manouba, Tunisia
| | - Chouaieb Chéour
- High Institute of Sport and Physical Education of Ksar-Saïd, Manouba, Tunisia
| | - Tommy Gendreau
- Physical Education and Sports Pavilion, Laval University, Quebec City, QC, Canada
| | - Majdi Bouazizi
- High Institute of Sport and Physical Education of Gafsa, Gafsa, Tunisia
| | - Kumar Purnendu Singh
- FEBT, School of Environment, Resources and Development, Asian Institute of Technology, Klong Luang, Pathum Thani, Thailand
| | - Ayoub Saeidi
- Department of Physical Education and Sports Sciences, University of Kurdistan, Sanandaj, Iran
| | - Dan Tao
- Department of Government and International Studies, Hong Kong Baptist University, Kowloon Tong, Hong Kong SAR, China
| | - Rashmi Supriya
- Centre for Health and Exercise Science Research, SPEH, Hong Kong Baptist University, Kowloon Tong, Hong Kong SAR, China
| | - Nicola Luigi Bragazzi
- Laboratory for Industrial and Applied Mathematics (LIAM), Department of Mathematics and Statistics, York University, Toronto, ON, Canada
| | - Julien S. Baker
- Centre for Health and Exercise Science Research, SPEH, Hong Kong Baptist University, Kowloon Tong, Hong Kong SAR, China
| | - Foued Chéour
- High Institute of Education and Continuous Training of Tunis, Tunis, Tunisia
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Paramanik V, Kurrey K, Singh P, Tiwari S. Roles of genistein in learning and memory during aging and neurological disorders. Biogerontology 2023; 24:329-346. [PMID: 36828983 DOI: 10.1007/s10522-023-10020-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2022] [Accepted: 01/23/2023] [Indexed: 02/26/2023]
Abstract
Genistein (GEN) is a non-steroidal phytoestrogen that belongs to the isoflavone class. It is abundantly found in soy. Soy and its products are used as food components in many countries including India. The present review is focused to address roles of GEN in brain functions in the context of learning and memory as a function of aging and neurological disorders. Memory decline is one of the most disabling features observed during normal aging and age-associated neurodegenerative disorders namely Alzheimer's disease (AD) and Parkinson's disease (PD), etc. Anatomical, physiological, biochemical and molecular changes in the brain with advancement of age and pathological conditions lead to decline of cognitive functions. GEN is chemically comparable to estradiol and binds to estrogen receptors (ERs). GEN acts through ERs and mimics estrogen action. After binding to ERs, GEN regulates a plethora of brain functions including learning and memory; however detailed study still remains elusive. Due to the neuroprotective, anti-oxidative and anti-inflammatory properties, GEN is used to restore or improve memory functions in different animal models and humans. The present review may be helpful to understand roles of GEN in learning and memory during aging and neurological disorders, its direction of research and therapeutic perspectives.
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Affiliation(s)
- Vijay Paramanik
- Cellular and Molecular Neurobiology & Drug Targeting Laboratory, Department of Zoology, Indira Gandhi National Tribal University, Amarkantak, 484 887, MP, India.
| | - Khuleshwari Kurrey
- Department of Psychiatry and Behavioral Sciences, Neurobiology Division, John Hopkins University, School of Medicine, Baltimore, MD, 21287, USA
| | - Padmanabh Singh
- Cellular and Molecular Neurobiology & Drug Targeting Laboratory, Department of Zoology, Indira Gandhi National Tribal University, Amarkantak, 484 887, MP, India
| | - Sneha Tiwari
- Cellular and Molecular Neurobiology & Drug Targeting Laboratory, Department of Zoology, Indira Gandhi National Tribal University, Amarkantak, 484 887, MP, India
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Cohn-Schwartz E, Joshi R, McClure LA. The Associations of Loneliness and Social Support with Cognitive Impairment among Middle-Aged and Older Individuals with Diabetes. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:1885. [PMID: 36767249 PMCID: PMC9914689 DOI: 10.3390/ijerph20031885] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/18/2022] [Revised: 01/13/2023] [Accepted: 01/14/2023] [Indexed: 06/18/2023]
Abstract
Diabetes mellitus is a chronic disease with significant morbidity and mortality and it is associated with poor cognitive performance in later life. This study seeks to determine the relationship between social support and cognitive function among participants with type 2 diabetes mellitus (T2DM). We used data from the Reasons for Geographic and Racial Differences in Stroke (REGARDS) study, including participants with T2DM aged 45 and older (n = 4821). We examined different aspects of perceived social support, measured as structural social support (e.g., marital status), functional social support (having a caregiver in case of sickness or disability), and loneliness. We examined cognitive functioning using a six-item screener. Our results indicate that adults who felt lonely for 5-7 days per week had almost double the odds of cognitive impairment compared to those who didn't feel lonely. These results suggest that among middle-aged and older individuals with T2DM, interventions targeting lonely adults and which aim to reduce loneliness may combat some of the risks of cognitive decline.
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Affiliation(s)
- Ella Cohn-Schwartz
- Department of Epidemiology, Biostatistics, and Community Health Sciences, Faculty of Health Sciences, Ben-Gurion University, Beer-Sheva 8410501, Israel
| | - Rennie Joshi
- Department of Epidemiology and Biostatistics, Drexel University Dornsife School of Public Health, Philadelphia, PA 19104, USA
| | - Leslie A. McClure
- Department of Epidemiology and Biostatistics, Drexel University Dornsife School of Public Health, Philadelphia, PA 19104, USA
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Emami Kazemabad MJ, Asgari Toni S, Tizro N, Dadkhah PA, Amani H, Akhavan Rezayat S, Sheikh Z, Mohammadi M, Alijanzadeh D, Alimohammadi F, Shahrokhi M, Erabi G, Noroozi M, Karimi MA, Honari S, Deravi N. Pharmacotherapeutic potential of pomegranate in age-related neurological disorders. Front Aging Neurosci 2022; 14:955735. [PMID: 36118710 PMCID: PMC9476556 DOI: 10.3389/fnagi.2022.955735] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2022] [Accepted: 07/13/2022] [Indexed: 11/24/2022] Open
Abstract
Age-related neurological disorders [AND] include neurodegenerative diseases [NDDs] such as Alzheimer's disease [AD] and Parkinson's disease [PD], which are the most prevalent types of dementia in the elderly. It also includes other illnesses such as migraine and epilepsy. ANDs are multifactorial, but aging is their major risk factor. The most frequent and vital pathological features of AND are oxidative stress, inflammation, and accumulation of misfolded proteins. As AND brain damage is a significant public health burden and its incidence is increasing, much has been done to overcome it. Pomegranate (Punica granatum L.) is one of the polyphenol-rich fruits that is widely mentioned in medical folklore. Pomegranate is commonly used to treat common disorders such as diarrhea, abdominal pain, wound healing, bleeding, dysentery, acidosis, microbial infections, infectious and noninfectious respiratory diseases, and neurological disorders. In the current review article, we aimed to summarize the data on the pharmacotherapeutic potentials of pomegranate in ANDs.
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Affiliation(s)
| | - Sara Asgari Toni
- Student Research Committee, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Neda Tizro
- School of Medicine, Guilan University of Medical Sciences, Rasht, Iran
| | - Parisa Alsadat Dadkhah
- Student Research Committee, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Hanieh Amani
- Student Research Committee, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Shima Akhavan Rezayat
- Student Research Committee, Faculty of Medicine, Islamic Azad University of Mashhad, Mashhad, Iran
| | - Zahra Sheikh
- Student Research Committee, School of Medicine, Babol University of Medical Sciences, Babol, Iran
| | - Mohammad Mohammadi
- Student Research Committee, School of Medicine, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Dorsa Alijanzadeh
- Student Research Committee, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Farnoosh Alimohammadi
- Student Research Committee, School of Dentistry, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | | | - Gisou Erabi
- Student Research Committee, Urmia University of Medical Sciences, Urmia, Iran
| | - Masoud Noroozi
- Department of Biomedical Engineering, Faculty of Engineering, University of Isfahan, Isfahan, Iran
| | - Mohammad Amin Karimi
- School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Sara Honari
- Student Research Committee, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Niloofar Deravi
- Student Research Committee, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran
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Ren M, Li H, Fu Z, Li Q. Centenarian-Sourced Lactobacillus casei Combined with Dietary Fiber Complex Ameliorates Brain and Gut Function in Aged Mice. Nutrients 2022; 14:324. [PMID: 35057509 PMCID: PMC8781173 DOI: 10.3390/nu14020324] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Revised: 01/04/2022] [Accepted: 01/10/2022] [Indexed: 12/12/2022] Open
Abstract
Dietary intervention could modulate age-related neurological disorders via the gut-brain axis. The potential roles of a probiotic and the dietary fiber complex (DFC) on brain and gut function in aged mice were investigated in this study. Lactobacillus casei LTL1361 and DFC were orally administrated for 12 weeks, and the learning and memory ability, as well as the oxidative parameters, inflammatory markers, gut barrier function and microbial metabolite short-chain fatty acids (SCFAs), were investigated. LTL1361 and DFC supplementation ameliorated cognitive ability, attenuated oxidative stress in brain and inflammation in serum and colon, ameliorated gut barrier function, and increased the SCFA concentrations and gene expression of SCFA receptors. The protective effect was more significantly enhanced in aged mice treated with the combination of LTL1361 and DFC than treated with LTL1361 or DFC alone. These results could be associated with the protected morphology of pyramidal nerve cells in hippocampus of mice brain and the downregulation of apoptosis marker caspase-3 in brain and upregulation of tight junction proteins in small intestine and colon. The results indicated that Lactobacillus casei LTL1361 and DFC alleviated age-related cognitive impairment, as well as protected brain and gut function. Lactobacillus casei LTL1361 and DFC might be used as novel and promising antiaging agents in human.
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Affiliation(s)
| | | | | | - Quanyang Li
- College of Light Industry and Food Engineering, Guangxi University, Nanning 530004, China; (M.R.); (H.L.); (Z.F.)
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Hayashida DY, Jacinto AF, Araújo LMQ, Almada Filho CDM, DI Tommaso AB, Cendoroglo MS. Association between baseline Mini-Mental State Examination score and dementia incidence in a cohort of oldest old. ARQUIVOS DE NEURO-PSIQUIATRIA 2021; 79:1090-1094. [PMID: 34877987 DOI: 10.1590/0004-282x-anp-2020-0543] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/29/2020] [Accepted: 02/15/2021] [Indexed: 11/22/2022]
Abstract
BACKGROUND The Brazilian population has aged rapidly. The oldest old, defined as persons aged 80 years or older, is the fastest growing segment of the Brazilian population. Several instruments have been used to assess the cognitive performance of the older people and predict dementia. One of the most commonly used is the Mini-Mental State Examination (MMSE). OBJECTIVE The aim of this study was to investigate the relationship between baseline MMSE score and the incidence of dementia in a Brazilian cohort of independent oldest old. METHODS Sociodemographic data and serial cognitive assessment of 248 older adults were analyzed. RESULTS Mean follow-up time of subjects was 4.0(±1.9) years, 71.4% were women, and mean MMSE score at entry was 25(±3.5). Mean MMSE scores at baseline were significantly higher (p=0.001) in the cognitively intact group than in those who developed dementia. The logistic regression showed that for a one point increase in MMSE score at baseline there was a 10% reduction in the probability of dementia. CONCLUSIONS In the Brazilian scenario of a rapidly growing population of oldest old, the extensive use of the MMSE gives rise to the need not only to determine its effectiveness for screening dementia, but also to interpret its score in terms of future conversion to dementia.
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Affiliation(s)
- Débora Yumi Hayashida
- Universidade Federal de São Paulo, Escola Paulista de Medicina, Disciplina de Geriatria e Gerontologia, São Paulo SP, Brazil
| | - Alessandro Ferrari Jacinto
- Universidade Federal de São Paulo, Escola Paulista de Medicina, Disciplina de Geriatria e Gerontologia, São Paulo SP, Brazil
| | - Lara Miguel Quirino Araújo
- Universidade Federal de São Paulo, Escola Paulista de Medicina, Disciplina de Geriatria e Gerontologia, São Paulo SP, Brazil
| | - Clineu de Mello Almada Filho
- Universidade Federal de São Paulo, Escola Paulista de Medicina, Disciplina de Geriatria e Gerontologia, São Paulo SP, Brazil
| | - Ana Beatriz DI Tommaso
- Universidade Federal de São Paulo, Escola Paulista de Medicina, Disciplina de Geriatria e Gerontologia, São Paulo SP, Brazil
| | - Maysa Seabra Cendoroglo
- Universidade Federal de São Paulo, Escola Paulista de Medicina, Disciplina de Geriatria e Gerontologia, São Paulo SP, Brazil
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Brumer N, Elkins E, Parada J, Hillyer J, Parbery-Clark A. Examining Delayed Recall in Cochlear Implant Users Using the Montreal Cognitive Assessment, California Verbal Learning Test, Third Edition, and Item Specific Deficit Approach: Preliminary Results. Front Psychol 2021; 12:749045. [PMID: 34803831 PMCID: PMC8599833 DOI: 10.3389/fpsyg.2021.749045] [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: 07/28/2021] [Accepted: 10/04/2021] [Indexed: 11/13/2022] Open
Abstract
Purpose: Recent studies using the Montreal Cognitive Assessment (MoCA) suggest delayed recall is challenging for cochlear implant (CI) users. To better understand the underlying processes associated with delayed recall in CI users, we administered the MoCA and the California Verbal Learning Test, Third Edition (CVLT-3), which provides a more comprehensive assessment of delayed recall ability. Methods: The MoCA and CVLT-3 were administered to 18 high-performing CI users. For the CVLT-3, both the traditional scoring and a newer scoring method, the Item-Specific Deficit Approach (ISDA), were employed. Results: The original MoCA score and MoCA delayed recall subtest score did not relate to performance on any CVLT-3 measures regardless of scoring metric applied (i.e., traditional or ISDA). Encoding performance for both the CVLT-3 and ISDA were related. Consolidation, which is only distinctly defined by the ISDA, related to CVLT-3 cued delay recall performance but not free delay recall performance. Lastly, ISDA retrieval only related to CVLT-3 measures when modified. Conclusion: Performance on the MoCA and CVLT-3 in a high performing CI patient population were not related. We demonstrate that the ISDA can be successfully applied to CI users for the quantification and characterization of delayed recall ability; however, future work addressing lower performing CI users, and comparing to normal hearing controls is needed to determine the extent of potential translational applications. Our work also indicates that a modified ISDA retrieval score may be beneficial for evaluating CI users although additional work addressing the clinical relevance of this is still needed.
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Affiliation(s)
- Nadav Brumer
- Auditory Research Laboratory, Center for Hearing and Skull Base Surgery, Swedish Neuroscience Institute, Seattle, WA, United States
| | - Elizabeth Elkins
- Auditory Research Laboratory, Center for Hearing and Skull Base Surgery, Swedish Neuroscience Institute, Seattle, WA, United States
| | - Jennifer Parada
- Department of Psychology, Bellevue College, Bellevue, WA, United States
| | - Jake Hillyer
- College of Medicine, University of Arizona, Phoenix, AZ, United States
| | - Alexandra Parbery-Clark
- Auditory Research Laboratory, Center for Hearing and Skull Base Surgery, Swedish Neuroscience Institute, Seattle, WA, United States
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Cardona MI, Afi A, Lakicevic N, Thyrian JR. Physical Activity Interventions and Their Effects on Cognitive Function in People with Dementia: A Systematic Review and Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18168753. [PMID: 34444501 PMCID: PMC8394441 DOI: 10.3390/ijerph18168753] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Revised: 08/16/2021] [Accepted: 08/17/2021] [Indexed: 11/16/2022]
Abstract
BACKGROUND Physical activity (PA) has emerged as an alternative nonpharmacological approach to effectively address the effects of dementia. The primary aim was to identify and summarize PA interventions and their effects on cognitive function among persons with dementia (PwD). METHODS A systematic review was conducted with a meta-analysis using different electronic databases, such as PubMed, Embase, APA PsycNET, and the Web of Science. The identified and selected studies were randomized controlled trials (RCTs) that were written in English, published between 2000 and 2020, and implemented among PwD who received a PA intervention and whose cognitive function was measured at baseline and during a follow-up. RESULTS Twenty-two PA intervention studies met the eligibility criteria and showed a medium-size effect on the cognitive function of PwD, 0.4803 (95% CI = 0.1901-0.7704), with a high percentage of heterogeneity (I2 = 86%, p ≤ 0.0001). Moreover, this review complements other reviews by including eight studies that have not previously been considered. Overall, studies have methodological limitations. However, six studies implemented in the past five years have shown more robust methodological designs, including larger sample sizes and more comprehensive measurement tools. CONCLUSION It is not yet possible to draw a conclusion on the ideal PA intervention for this population due to the high proportion of heterogeneity within the included studies. More emphasis is needed on the intensity of PA monitoring and adherence to such programs.
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Affiliation(s)
- Maria Isabel Cardona
- Deutsches Zentrum für Neurodegenerative Erkrankungen (DZNE), Site Rostock/Greifswald, Ellernholzstr. 1–2, 17489 Greifswald, Germany; (A.A.); (J.R.T.)
- Correspondence: ; Tel.: +49-383-486-7593; Fax: +49-383-4861-9551
| | - Adel Afi
- Deutsches Zentrum für Neurodegenerative Erkrankungen (DZNE), Site Rostock/Greifswald, Ellernholzstr. 1–2, 17489 Greifswald, Germany; (A.A.); (J.R.T.)
| | - Nemanja Lakicevic
- Sport and Exercise Sciences Research Unit, University of Palermo, 90133 Palermo, Italy;
| | - Jochen René Thyrian
- Deutsches Zentrum für Neurodegenerative Erkrankungen (DZNE), Site Rostock/Greifswald, Ellernholzstr. 1–2, 17489 Greifswald, Germany; (A.A.); (J.R.T.)
- Institute for Community Medicine, University Medicine Greifswald, Ellernholzstraße 1–2, 17489 Greifswald, Germany
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11
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Nicoli C, Galbussera AA, Bosetti C, Franchi C, Gallus S, Mandelli S, Marcon G, Quadri P, Riso P, Riva E, Lucca U, Tettamanti M. The role of diet on the risk of dementia in the oldest old: The Monzino 80-plus population-based study. Clin Nutr 2021; 40:4783-4791. [PMID: 34242918 DOI: 10.1016/j.clnu.2021.06.016] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2020] [Revised: 06/08/2021] [Accepted: 06/10/2021] [Indexed: 11/18/2022]
Abstract
BACKGROUND & AIMS Longevity also carries its dark side of age-related chronic diseases, dementia being one of the worst and the most prevalent. Since dementia lacks effective treatments, preventing or delaying it is highly desirable. Dietary habits and nutrition have been found to be important modifiable risk factors for many chronic diseases, but evidence on the role of diet on the risk of dementia is still limited, particularly among the very old. Aim of the present work is to study the association of the Mediterranean diet and its components with prevalent and incident dementia in the oldest-old. METHODS We analyzed data from the Monzino 80-plus study, a population-based study in subjects 80 years or older in the Varese province, Italy. A validated food frequency questionnaire was used to collect information on 23 different foods consumed in the previous year. A Mediterranean diet score was calculated and its components were classified into tertiles. Multivariable models for dementia prevalence and incidence were adjusted for demographic and clinical characteristics. RESULTS Information on nutrition was available for 1390 subjects in the cross-sectional study and 512 subjects in the longitudinal study, mean respective ages 93 and 92. Greater adherence to Mediterranean diet, greater consumption of eggs, fruits and vegetables, carbohydrates, and greater food intake were associated with a lower prevalence of dementia. Increasing number of portions per week and consumption of legumes significantly decreased the incidence of dementia during the 3.6 year mean follow-up: corresponding hazard ratios of highest vs. lowest tertiles (95% confidence intervals) were 0.66 (0.46-0.95) and 0.68 (0.47-0.97), respectively. CONCLUSION Oldest-old eating less and having diets with less variety and nutrient density were more frequent among subjects with dementia. The longitudinal analysis confirmed oldest-old subjects who eat more portions, as well as those who have a higher intake of legumes, are at decreased risk of developing dementia even though reverse causality cannot be completely ruled out.
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Affiliation(s)
- Cristina Nicoli
- Department of Food, Environmental and Nutritional Sciences, Division of Human Nutrition, Università degli Studi di Milano, Via Celoria 2, 20133, Milano, (MI), Italy.
| | - Alessia Antonella Galbussera
- Laboratory of Geriatric Neuropsychiatry, Department of Neuroscience, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Via Mario Negri 2, 20156, Milano, (MI), Italy.
| | - Cristina Bosetti
- Laboratory of Methodology for Clinical Research, Department of Oncology, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Via Mario Negri 2, 20156, Milano, (MI), Italy.
| | - Carlotta Franchi
- Laboratory of Quality Assessment of Geriatric Therapies and Services, Department of Neuroscience, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Via Mario Negri 2, 20156, Milano, (MI), Italy; Italian Institute for Planetary Health, Via Mario Negri 2, 20156, Milano, (MI), Italy.
| | - Silvano Gallus
- Laboratory of Lifestyle Epidemiology, Department of Environmental Health Sciences, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Via Mario Negri 2, 20156, Milano, (MI), Italy.
| | - Sara Mandelli
- Laboratory of Geriatric Neuropsychiatry, Department of Neuroscience, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Via Mario Negri 2, 20156, Milano, (MI), Italy.
| | - Gabriella Marcon
- Department of Medical Science, University of Trieste, Piazzale Europa 1, 34127, Trieste, (TS), Italy; Azienda Sanitaria Universitaria Giuliano Isontina (ASUGI), Via Costantino Costantinides 2, 34128, Trieste, (TS), Italy; DAME, University of Udine, Via Palladio 8, 33100, Udine, (UD), Italy.
| | - Pierluigi Quadri
- Ospedale Della Beata Vergine, Ente Ospedaliero Cantonale, Ospedale Regionale di Mendrisio, Via Turconi 23, 6850, Mendrisio, Switzerland.
| | - Patrizia Riso
- Department of Food, Environmental and Nutritional Sciences, Division of Human Nutrition, Università degli Studi di Milano, Via Celoria 2, 20133, Milano, (MI), Italy.
| | - Emma Riva
- Laboratory of Geriatric Neuropsychiatry, Department of Neuroscience, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Via Mario Negri 2, 20156, Milano, (MI), Italy.
| | - Ugo Lucca
- Laboratory of Geriatric Neuropsychiatry, Department of Neuroscience, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Via Mario Negri 2, 20156, Milano, (MI), Italy.
| | - Mauro Tettamanti
- Laboratory of Geriatric Neuropsychiatry, Department of Neuroscience, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Via Mario Negri 2, 20156, Milano, (MI), Italy.
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12
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Shaughnessy KA, Hackney KJ, Clark BC, Kraemer WJ, Terbizan DJ, Bailey RR, McGrath R. A Narrative Review of Handgrip Strength and Cognitive Functioning: Bringing a New Characteristic to Muscle Memory. J Alzheimers Dis 2021; 73:1265-1278. [PMID: 31929158 DOI: 10.3233/jad-190856] [Citation(s) in RCA: 39] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND Measures of handgrip strength have not only emerged as a clinically viable screening tool for determining risk for morbidity, functional disability, and early mortality, but also for helping to identify cognitive deficits. However, the phenomena that links low handgrip strength with cognitive decline remains unclear. The role of the muscular and neural systems, and their adaptations to muscle strengthening activities over the life course, may provide important information for how age-related changes to muscle mass, strength, and neural capacity influence cognition. Moreover, disentangling how handgrip strength and cognitive function are associated may help to inform healthcare providers working with aging adults and guide targeted interventions aiming to preserve muscle and cognitive functioning. OBJECTIVE To 1) highlight and summarize evidence examining the associations of handgrip strength and cognitive functioning, and 2) provide directions for future research in this area. METHODS Articles from the PubMed database were searched from November 2018-May 2019. The search term algorithm, inclusion and exclusion criteria were pre-specified by investigators. RESULTS Several cross-sectional and longitudinal studies have revealed that measures of handgrip strength were associated with cognitive declines regardless of age demographics and the presence of comorbidities. CONCLUSION Handgrip strength can be used in clinical and epidemiological settings for helping to determine the onset and progression of cognitive impairment. Future research should continue to examine how handgrip strength and cognitive function are linked.
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Affiliation(s)
- Keith A Shaughnessy
- Department of Health, Nutrition, and Exercise Sciences, North Dakota State University, Fargo, ND, USA
| | - Kyle J Hackney
- Department of Health, Nutrition, and Exercise Sciences, North Dakota State University, Fargo, ND, USA
| | - Brian C Clark
- Ohio Musculoskeletal and Neurological Institute, Ohio University, Athens, OH, USA.,Department of Biomedical Sciences, Ohio University, Athens, OH, USA.,Division of Geriatric Medicine, Ohio University, Athens, OH, USA
| | - William J Kraemer
- Department of Human Sciences, The Ohio State University, Columbus, OH, USA
| | - Donna J Terbizan
- Department of Health, Nutrition, and Exercise Sciences, North Dakota State University, Fargo, ND, USA
| | - Ryan R Bailey
- Brown School of Social Work, Washington University in St. Louis, St. Louis, MO, USA
| | - Ryan McGrath
- Department of Health, Nutrition, and Exercise Sciences, North Dakota State University, Fargo, ND, USA
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13
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Masika GM, Yu DSF, Li PWC, Wong A, Lin RSY. Psychometrics and diagnostic properties of the Montreal Cognitive Assessment 5-min protocol in screening for Mild Cognitive Impairment and dementia among older adults in Tanzania: A validation study. Int J Older People Nurs 2020; 16:e12348. [PMID: 32920984 DOI: 10.1111/opn.12348] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2019] [Revised: 08/02/2020] [Accepted: 08/18/2020] [Indexed: 12/14/2022]
Abstract
BACKGROUND The prevalence of dementia in Tanzania, as in other developing countries, is progressively increasing. Yet international screening instruments for mild cognitive impairment are lacking. OBJECTIVES The aim of this study was to determine the psychometrics and the diagnostic ability of the Montreal Cognitive Assessment 5 minutes protocol (MoCA-5-min) among older adults in the rural Tanzania. METHODS The MoCA-5-min and the Identification and Intervention for Dementia in Elderly Africans (IDEA) cognitive screening were concurrently administered through face to face to 202 community-dwelling older adults in Chamwino district. Exploratory factor analysis (EFA) using principal component method and oblique rotation was performed to determine the underlying factor structure of the scale. The concurrent and construct as well as predictive validities of the MoCA-5-min were examined by comparing its score with IDEA cognitive screening and psychiatrist's diagnosis using DSM-V criteria, respectively. RESULTS The EFA found that all the MoCA-5-min items highly loaded into one component, with factor loading ranging from 0.550 to 0.879. The intraclass correlation coefficient for 6 weeks test-retest reliability was 0.85. Its strong significant correlation with the IDEA screening (Pearson's r = 0.614, p < 0.001) demonstrated a good concurrent validity. Using the psychiatrist's rating as the gold standard, MoCA-5-min demonstrated the optimal cut-off score for MCI at 22, which yielded the sensitivity of 80% and specificity of 74%; and dementia at score of 16 giving a sensitivity of 90% and specificity of 80%. Upon stratifying the sample into different age groups, the optimal cut-off scores tended to decrease with the increase in age. CONCLUSION The MoCA-5-min is reliable and provides a valid and accurate measure of cognitive decline among older population in the rural settings of Tanzania. The use of varying cut-off scores across age groups may ensure more precise discriminatory power of the MoCA-5-min. IMPLICATIONS FOR PRACTICE Availability of the MoCA-5-min in Tanzania will facilitate clinicians to timely detect dementia at both pre-clinical and clinical stages. Its availability will also encourage further research and international collaborations in dementia prevention programs.
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Affiliation(s)
- Golden M Masika
- The Nethersole School of Nursing, Chinese University of Hong Kong, New Territories, Hong Kong.,Department of Nursing and Midwifery, College of Health Sciences, University of Dodoma, Dodoma, Tanzania
| | - Doris S F Yu
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong
| | - Polly W C Li
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong
| | - Adrian Wong
- Department of Medicine and Therapeutics, Therese Pei Fong Chow Research Centre for Prevention of Dementia, Lui Che Woo Institute of Innovative Medicine, Chinese University of Hong Kong, New Territories, Hong Kong
| | - Rose S Y Lin
- School of Nursing, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, Hong Kong
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14
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Rosa G, Giannotti C, Martella L, Massa F, Serafini G, Pardini M, Nobili FM, Monacelli F. Brain Aging, Cardiovascular Diseases, Mixed Dementia, and Frailty in the Oldest Old: From Brain Phenotype to Clinical Expression. J Alzheimers Dis 2020; 75:1083-1103. [DOI: 10.3233/jad-191075] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Affiliation(s)
- Gianmarco Rosa
- Department of Internal Medicine and Medical Specialties, DIMI, Section of Cardiovascular Diseases, University of Genoa, Genoa, Italy
- IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Chiara Giannotti
- Department of Internal Medicine and Medical Specialties, DIMI, Section of Geriatrics, Genoa, Italy
- IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Lucia Martella
- Department of Internal Medicine and Medical Specialties, DIMI, Section of Geriatrics, Genoa, Italy
- IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Federico Massa
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health DINOGMI, Section of Psychiatry, University of Genoa, Genoa, Italy
- IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Gianluca Serafini
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health DINOGMI, Section of Psychiatry, University of Genoa, Genoa, Italy
- IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Matteo Pardini
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health DINOGMI, Section of Psychiatry, University of Genoa, Genoa, Italy
- IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Flavio Mariano Nobili
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health DINOGMI, Section of Psychiatry, University of Genoa, Genoa, Italy
- IRCCS Ospedale Policlinico San Martino, Genoa, Italy
| | - Fiammetta Monacelli
- Department of Internal Medicine and Medical Specialties, DIMI, Section of Geriatrics, Genoa, Italy
- IRCCS Ospedale Policlinico San Martino, Genoa, Italy
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15
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Chen TB, Weng SC, Chou YY, Lee YS, Liang CK, Lin CS, Lan TH, Lin SY, Lin YT. Predictors of Mortality in the Oldest Old Patients with Newly Diagnosed Alzheimer Disease in a Residential Aged Care Facility. Dement Geriatr Cogn Disord 2020; 48:93-104. [PMID: 31600747 DOI: 10.1159/000503059] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2019] [Accepted: 09/01/2019] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND In Taiwan, the causes of death and related factors in the oldest old people with Alzheimer disease (AD) are not well characterized. We investigated the factors associated with mortality in the oldest old patients with newly diagnosed AD admitted to a long-stay residential facility. METHODS We performed a prospective study of newly diagnosed AD patients at a veterans' home between 2012 and 2016. At admission, all eligible participants received a comprehensive geriatric assessment, including demographic variables, lifestyle habits, cognitive evaluations, medical conditions (comorbidities, Age-Adjusted Charlson Comorbidity Index score, and polypharmacy), nutritional status evaluated by the Mini Nutritional Assessment-Short Form and body mass index (BMI), and global functional status. A Cox proportional hazards model was used to evaluate the predictive values of clinical parameters for all-cause mortality. RESULTS The cohort comprised 84 newly diagnosed AD patients (mean age 86.6 ± 3.9 years) with a mean follow-up period of 2.1 ± 1.2 years. The overall median survival was 3.5 years from the time of AD diagnosis (95% confidence interval, 3.1-3.9 years). BMI was significantly lower in the deceased group than in the alive group (20.7 ± 2.9 vs. 22.6 ± 3.4, p = 0.023). Logistic regression demonstrated that the clinical parameters significantly associated with mortality were high global comorbidity, low nutritional status (malnutrition and underweight), and impaired physical function at the time of AD diagnosis. CONCLUSION Comorbidity burden, nutritional status, and physical functional status at the time of dementia diagnosis are important contributors to poor outcome in the oldest old. Efforts to control concurrent chronic disorders, nutritional interventions, and physical independency as a long-term care strategy for dementia may provide survival benefit.
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Affiliation(s)
- Ting-Bin Chen
- Department of Neurology, Neurological Institute, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Shuo-Chun Weng
- Center for Geriatrics and Gerontology, Taichung Veterans General Hospital, Taichung, Taiwan.,Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan.,Division of Nephrology, Department of Internal Medicine, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Yi-Yin Chou
- Center for Geriatrics and Gerontology, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Yu-Shan Lee
- Center for Geriatrics and Gerontology, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Chih-Kaung Liang
- Center for Geriatrics and Gerontology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
| | - Chu-Sheng Lin
- Center for Geriatrics and Gerontology, Taichung Veterans General Hospital, Taichung, Taiwan.,Department of Family Medicine, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Tsuo-Hung Lan
- Department of Psychiatry, Taichung Veterans General Hospital, Taichung, Taiwan.,Department of Psychiatry, School of Medicine, National Yang-Ming University, Taipei, Taiwan.,Center for Neuropsychiatric Research, National Health Research Institutes, Zhunan, Taiwan
| | - Shih-Yi Lin
- Center for Geriatrics and Gerontology, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Yu-Te Lin
- Center for Geriatrics and Gerontology, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan,
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16
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Verma M, Grover S, Singh T, Dahiya N, Nehra R. Screening for cognitive impairment among the elderly attending the noncommunicable diseases clinics in a rural area of Punjab, North India. Asian J Psychiatr 2020; 50:102001. [PMID: 32248085 DOI: 10.1016/j.ajp.2020.102001] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2019] [Revised: 02/13/2020] [Accepted: 03/15/2020] [Indexed: 12/24/2022]
Abstract
BACKGROUND Amongst all the ailments among the elderly persons, cognitive impairment has significant impact on the quality of life. Non-communicable diseases (NCDs) like diabetes and hypertension increase the risk of cognitive impairment and dementia. Little is known about the prevalence and correlates of cognitive impairment in elderly with NCDs. AIM The present study aimed to evaluate the prevalence and correlates of cognitive impairment among elderly patients living with NCDs. METHODOLOGY 297 patients attending the chronic disease clinic of two Community Health Centres were evaluated using Hindi mini-mental scale (HMSE), University of California Los Angeles Loneliness Scale (UCLA LS), Geriatric Depression Scale, Generalized Anxiety Disorder (GAD-7 scale) and Vulnerability to Abuse Screening Scale. RESULTS More than one-fourth (27.3 %) of participants had cognitive impairment as per the HMSE scores. The mean HMSE score was lowest (23.90+6.61) among patients with hypertension followed by patients with diabetes alone (26.90+4.46). People with hypertension had lower mean scores on all the domains of HMSE. Multivariable binary logistic regression depicted younger age, high education status, per capita income, long duration of diseases, loneliness, and hypertension emerged as the significant risk factors associated with cognitive impairment. CONCLUSION Older adults with non-communicable diseases have high prevalence of cognitive impairment. Physicians should make the patients and their family members aware about the association of non-communicable diseases with cognitive impairments and should encourage these persons to use remedial measures to reduce the risk of future development of dementia.
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Affiliation(s)
- Madhur Verma
- Department of Community and Family Medicine, All India Institute of Medical Sciences Bathinda, Punjab, India; Department of Community Medicine, School of Public Health, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
| | - Sandeep Grover
- Department of Psychiatry, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
| | - Tarundeep Singh
- Department of Community Medicine, School of Public Health, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
| | - Neha Dahiya
- Department of Community Medicine, School of Public Health, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
| | - Ritu Nehra
- Department of Psychiatry, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
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17
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The puzzle of preserved cognition in the oldest old. Neurol Sci 2019; 41:441-447. [PMID: 31713754 DOI: 10.1007/s10072-019-04111-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2019] [Accepted: 10/15/2019] [Indexed: 02/07/2023]
Abstract
Although epidemiological studies predict an exponential increase in the prevalence of dementia with age, recent studies have demonstrated that the oldest old are actually less frequently affected by dementia than the younger elderly. To explain this, I suggest a parallel between brain ageing and Alzheimer's disease (AD) and assume that theories concerning the brain's vulnerability to AD and its individual variability may also explain why some of the oldest old remain cognitively efficient. Some theories argue that AD is due to the continuing presence of the immature neurones vulnerable to amyloid beta protein (Aß) that are normally involved in brain development and then removed as a result of cell selection by the proteins associated with both brain development and AD. If a dysfunction in cell selection allows these immature neurones to survive, they degenerate early as a result of the neurotoxic action of Aß accumulation, which their mature counterparts can withstand. Consequently, age at the time of onset of AD and its clinical presentations depend on the number and location of such immature cells. I speculate that the same mechanism is responsible for the variability of normal brain ageing: the oldest old with well-preserved cognitive function are people genetically programmed for extreme ageing who have benefited from better cell selection during prenatal and neonatal life and therefore have fewer surviving neurones vulnerable to amyloid-promoted degeneration, whereas the process of early life cell selection was less successful in the oldest old who develop dementia.
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18
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Xu X, Zhao Y, Xia S, Zhang X. Investigation of multi-scale spatio-temporal pattern of oldest-old clusters in China on the basis of spatial scan statistics. PLoS One 2019; 14:e0219695. [PMID: 31348778 PMCID: PMC6660084 DOI: 10.1371/journal.pone.0219695] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/15/2019] [Accepted: 06/29/2019] [Indexed: 11/18/2022] Open
Abstract
Background Ageing is becoming a considerable public health burden in China, which produces great societal development challenges. Healthy and active longevity could ease the ageing burden on families and communities. To date, most studies of the oldest-old distribution are focused on a simple scale from spatial perspective, and the multi-scale spatio-temporal clusters trend in the oldest-old population has not yet been determined. Thus, the objective in present study is to use a new method to evaluate the spatio-temporal pattern and detect the risk clusters in the oldest-old population from three scales. Methods Individuals aged 65 years or older and individuals aged 80 years or older on three scales in China from 2000 to 2010 were used. The exploratory spatial data analysis was performed using Moran’s I statistic, and the pattern of the oldest-old clusters among humans was examined by using the spatial scan statistical method. Then, spatial stratified heterogeneity was used to explore the factors affecting the spatial heterogeneity of the oldest-old population. Results The oldest-old index in the southeast coastal areas is higher than that in the northwest inland areas in China. A three-ladder terrain distribution of the oldest-old index from west to east is obvious. The overall pattern of the oldest-old index evolves from a “concave” shape to an “east-west uplift, and northern collapse” shape. Space-time analysis revealed that high-risk areas were concentrated in five regions: the Yangtze River Delta, the Pearl River Delta, the Southeast Coast, Sichuan and Chongqing, and the Central Plains. The oldest-old cluster at different scales shows a similar pattern, but local differences exist. The risk at the prefecture scale and county scale is greater than at the interprovincial scale; the sublevel can identify clusters that have not been identified at the previous level, especially the bordering areas of prefectures and counties; and more risk units and greater relative risk are found in urban areas than in rural areas. Conclusions The results emphasized that spatial scan statistics can be used to estimate the spatial clusters of the oldest-old people. The detection of these clusters might be highly useful in the surveillance of the ageing phenomenon, thus helping local public health authorities measure the population burden at all locations, identifying geographical areas that require more attention, and evaluating the impacts of intervention programs.
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Affiliation(s)
- Xin Xu
- School of Geographic Science, Nanjing Normal University, Nanjing, China
- Jiangsu Center for Collaborative Innovation in Geographical Information Resource Development and Application, Nanjing, China
- Key Laboratory of Virtual Geographic Environment (Nanjing Normal University), Ministry of Education, Nanjing, China
| | - Yuan Zhao
- School of Geographic Science, Nanjing Normal University, Nanjing, China
- Jiangsu Center for Collaborative Innovation in Geographical Information Resource Development and Application, Nanjing, China
- Key Laboratory of Virtual Geographic Environment (Nanjing Normal University), Ministry of Education, Nanjing, China
- Ginling College, Nanjing Normal University, Nanjing, China
- International Center for Aging and Health Studies (Nanjing Normal University), Nanjing, China
- * E-mail:
| | - Siyou Xia
- School of Geographic Science, Nanjing Normal University, Nanjing, China
- Jiangsu Center for Collaborative Innovation in Geographical Information Resource Development and Application, Nanjing, China
- Key Laboratory of Virtual Geographic Environment (Nanjing Normal University), Ministry of Education, Nanjing, China
| | - Xinlin Zhang
- School of Geographic Science, Nanjing Normal University, Nanjing, China
- Jiangsu Center for Collaborative Innovation in Geographical Information Resource Development and Application, Nanjing, China
- Key Laboratory of Virtual Geographic Environment (Nanjing Normal University), Ministry of Education, Nanjing, China
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Gómez-Gómez ME, Zapico SC. Frailty, Cognitive Decline, Neurodegenerative Diseases and Nutrition Interventions. Int J Mol Sci 2019; 20:ijms20112842. [PMID: 31212645 PMCID: PMC6600148 DOI: 10.3390/ijms20112842] [Citation(s) in RCA: 87] [Impact Index Per Article: 17.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2019] [Revised: 06/01/2019] [Accepted: 06/05/2019] [Indexed: 12/12/2022] Open
Abstract
Currently the human population is aging faster. This leads to higher dependency rates and the transformation of health and social care to adapt to this aged population. Among the changes developed by this population is frailty. It is defined as a clinically detectable syndrome, related to the aging of multiple physiological systems, which prompts a situation of vulnerability. The etiology of frailty seems to be multifactorial and its pathophysiology is influenced by the interaction of numerous factors. Morley et al. propose four main mechanisms triggering the frailty: atherosclerosis, sarcopenia, cognitive deterioration and malnutrition, with their respective metabolic alterations. Malnutrition is associated with cognitive impairment or functional loss, but it is also known that an inadequate nutritional status predisposes to cognitive frailty. Additionally, nutritional factors that may influence vascular risk factors will potentially have an effect on dementia decline among patients with cognitive frailty. This review aims to describe the nutritional factors that have been researched so far which may lead to the development of frailty, and especially cognitive decline.
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Affiliation(s)
| | - Sara C Zapico
- International Forensic Research Institute and Chemistry Department, Florida International University, 11200 SW 8 St., CP323, Miami, FL 33199, USA.
- Anthropology Department, Smithsonian Institution, NMNH, MRC 112, 10th and Constitution Ave, NW, PO Box 37012, Washington, DC 20560, USA.
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20
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Nelson PT, Dickson DW, Trojanowski JQ, Jack CR, Boyle PA, Arfanakis K, Rademakers R, Alafuzoff I, Attems J, Brayne C, Coyle-Gilchrist ITS, Chui HC, Fardo DW, Flanagan ME, Halliday G, Hokkanen SRK, Hunter S, Jicha GA, Katsumata Y, Kawas CH, Keene CD, Kovacs GG, Kukull WA, Levey AI, Makkinejad N, Montine TJ, Murayama S, Murray ME, Nag S, Rissman RA, Seeley WW, Sperling RA, White III CL, Yu L, Schneider JA. Limbic-predominant age-related TDP-43 encephalopathy (LATE): consensus working group report. Brain 2019; 142:1503-1527. [PMID: 31039256 PMCID: PMC6536849 DOI: 10.1093/brain/awz099] [Citation(s) in RCA: 824] [Impact Index Per Article: 164.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2019] [Revised: 02/10/2019] [Accepted: 02/25/2019] [Indexed: 12/18/2022] Open
Abstract
We describe a recently recognized disease entity, limbic-predominant age-related TDP-43 encephalopathy (LATE). LATE neuropathological change (LATE-NC) is defined by a stereotypical TDP-43 proteinopathy in older adults, with or without coexisting hippocampal sclerosis pathology. LATE-NC is a common TDP-43 proteinopathy, associated with an amnestic dementia syndrome that mimicked Alzheimer's-type dementia in retrospective autopsy studies. LATE is distinguished from frontotemporal lobar degeneration with TDP-43 pathology based on its epidemiology (LATE generally affects older subjects), and relatively restricted neuroanatomical distribution of TDP-43 proteinopathy. In community-based autopsy cohorts, ∼25% of brains had sufficient burden of LATE-NC to be associated with discernible cognitive impairment. Many subjects with LATE-NC have comorbid brain pathologies, often including amyloid-β plaques and tauopathy. Given that the 'oldest-old' are at greatest risk for LATE-NC, and subjects of advanced age constitute a rapidly growing demographic group in many countries, LATE has an expanding but under-recognized impact on public health. For these reasons, a working group was convened to develop diagnostic criteria for LATE, aiming both to stimulate research and to promote awareness of this pathway to dementia. We report consensus-based recommendations including guidelines for diagnosis and staging of LATE-NC. For routine autopsy workup of LATE-NC, an anatomically-based preliminary staging scheme is proposed with TDP-43 immunohistochemistry on tissue from three brain areas, reflecting a hierarchical pattern of brain involvement: amygdala, hippocampus, and middle frontal gyrus. LATE-NC appears to affect the medial temporal lobe structures preferentially, but other areas also are impacted. Neuroimaging studies demonstrated that subjects with LATE-NC also had atrophy in the medial temporal lobes, frontal cortex, and other brain regions. Genetic studies have thus far indicated five genes with risk alleles for LATE-NC: GRN, TMEM106B, ABCC9, KCNMB2, and APOE. The discovery of these genetic risk variants indicate that LATE shares pathogenetic mechanisms with both frontotemporal lobar degeneration and Alzheimer's disease, but also suggests disease-specific underlying mechanisms. Large gaps remain in our understanding of LATE. For advances in prevention, diagnosis, and treatment, there is an urgent need for research focused on LATE, including in vitro and animal models. An obstacle to clinical progress is lack of diagnostic tools, such as biofluid or neuroimaging biomarkers, for ante-mortem detection of LATE. Development of a disease biomarker would augment observational studies seeking to further define the risk factors, natural history, and clinical features of LATE, as well as eventual subject recruitment for targeted therapies in clinical trials.
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Affiliation(s)
| | | | | | | | | | - Konstantinos Arfanakis
- Rush University Medical Center, Chicago, IL, USA
- Illinois Institute of Technology, Chicago, IL, USA
| | | | | | | | | | | | - Helena C Chui
- University of Southern California, Los Angeles, CA, USA
| | | | | | - Glenda Halliday
- The University of Sydney Brain and Mind Centre and Central Clinical School Faculty of Medicine and Health, Sydney, Australia
| | | | | | | | | | | | | | - Gabor G Kovacs
- Institute of Neurology Medical University of Vienna, Vienna, Austria
| | | | | | | | | | - Shigeo Murayama
- Tokyo Metropolitan Geriatric Hospital and Institute of Gerontology, Tokyo, Japan
| | | | - Sukriti Nag
- Rush University Medical Center, Chicago, IL, USA
| | | | | | | | | | - Lei Yu
- Rush University Medical Center, Chicago, IL, USA
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Durongbhan P, Zhao Y, Chen L, Zis P, De Marco M, Unwin ZC, Venneri A, He X, Li S, Zhao Y, Blackburn DJ, Sarrigiannis PG. A Dementia Classification Framework Using Frequency and Time-Frequency Features Based on EEG Signals. IEEE Trans Neural Syst Rehabil Eng 2019; 27:826-835. [DOI: 10.1109/tnsre.2019.2909100] [Citation(s) in RCA: 48] [Impact Index Per Article: 9.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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Uddin MS, Mamun AA, Takeda S, Sarwar MS, Begum MM. Analyzing the chance of developing dementia among geriatric people: a cross-sectional pilot study in Bangladesh. Psychogeriatrics 2019; 19:87-94. [PMID: 30221441 DOI: 10.1111/psyg.12368] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2018] [Revised: 07/02/2018] [Accepted: 07/31/2018] [Indexed: 12/12/2022]
Abstract
AIM Alzheimer's disease is the most common form of dementia, representing 60-80% of cases, and ageing is the primary risk factor for the development of Alzheimer's disease. The objective of this study was to examine the chance of developing dementia (i.e. mild cognitive impairment (MCI), Alzheimer's disease) among geriatric people in Bangladesh. METHODS This study included 390 adult citizens of Bangladesh (age range: 60-70 years). The Takeda Three Colors Combination (TTCC) test was used to detect the prevalence of MCI and mild dementia among the subjects, and then the Clinical Dementia Rating was used to determine the level of dementia. RESULTS The subjects who were aged 60-65 years included 154 with MCI, 76 with mild dementia, 1 with moderate dementia, 4 with severe dementia, and 29 without dementia. The subjects who were aged 66-70 years included 75 with MCI, 36 with mild dementia, 0 with moderate dementia, 2 with severe dementia, and 13 without dementia. The sensitivity of the TTCC was 75% and 58% for the mild dementia and MCI groups, respectively, and the specificity was 52%. The odds ratio of incorrect responses to the TTCC was 3.42 (95% confidence interval: 1.63-7.21) for subjects with mild dementia compared those without dementia. However, the TTCC outcomes revealed no significant differences between the MCI and non-dementia groups. The results showed no significant associations between cognitive decline/developing dementia and social status/occupation. CONCLUSION The outcomes of this study indicated that most of the subjects had MCI or mild dementia and were farmers aged 60-65 years.
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Affiliation(s)
- Md Sahab Uddin
- Department of Pharmacy, Southeast University, Dhaka, Bangladesh
| | | | - Shinya Takeda
- Department of Clinical Psychology, Tottori University Graduate School of Medical Sciences, Tottori, Japan
| | - Md Shahid Sarwar
- Department of Pharmacy, Noakhali Science and Technology University, Noakhali, Bangladesh
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Litwin H, Schwartz E, Damri N. Cognitively Stimulating Leisure Activity and Subsequent Cognitive Function: A SHARE-based Analysis. THE GERONTOLOGIST 2018; 57:940-948. [PMID: 27117305 DOI: 10.1093/geront/gnw084] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2015] [Accepted: 03/25/2016] [Indexed: 01/24/2023] Open
Abstract
Purpose of the Study The aim of the inquiry was to examine whether cognitively stimulating leisure activity (CSLA) can delay or reduce cognitive decline in late life and whether its effect is moderated by education, age, or activity pattern. Design and Methods Employing secondary analysis of data on respondents aged 65 and older from the 4th and 5th waves of the Survey of Health, Ageing and Retirement in Europe (N = 16,572), the inquiry regressed cognitive function (memory, numeracy, and fluency) at Time 2 on frequency of engagement in CSLA at baseline, controlling for cognitive function scores at baseline and a range of confounders. The study also considered education by CSLA and age by CSLA interactions, as well as the effect of CSLA patterns. Results CSLA frequency was found to be positively related to subsequent cognitive functioning on all measures, 2 years later. The effect of CSLA on memory and fluency was stronger among those with lower education, whereas the age by CSLA interaction was not significant. Respondents who started CSLA after baseline showed better cognitive functioning at Time 2 than those who did not engage in CSLA at all and those who had engaged in such activity at baseline but stopped. Implications The study documents that CSLAs constitute a potential source for the delay or reduction of cognitive decline, regardless of one's age. As such, practitioners should recognize the value of this medium and encourage its greater use in appropriate settings.
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Affiliation(s)
- Howard Litwin
- Israel Gerontological Data Center, Paul Baerwald School of Social Work and Social Welfare, The Hebrew University of Jerusalem, Israel
| | - Ella Schwartz
- Israel Gerontological Data Center, Paul Baerwald School of Social Work and Social Welfare, The Hebrew University of Jerusalem, Israel
| | - Noam Damri
- Israel Gerontological Data Center, Paul Baerwald School of Social Work and Social Welfare, The Hebrew University of Jerusalem, Israel
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Paolacci L, Giannandrea D, Mecocci P, Parnetti L. Biomarkers for Early Diagnosis of Alzheimer's Disease in the Oldest Old: Yes or No? J Alzheimers Dis 2018; 58:323-335. [PMID: 28436390 DOI: 10.3233/jad-161127] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
In recent years, many efforts have been spent to identify sensitive biomarkers able to improve the accuracy of Alzheimer's disease (AD) diagnosis. Two different workgroups (NIA-AA and IWG) included cerebrospinal fluid (CSF) and neuroimaging findings in their sets of criteria in order to improve diagnostic accuracy as well as early diagnosis. The number of subjects with cognitive impairment increases with aging but the oldest old (≥85 years of age), the fastest growing age group, is still the most unknown from a biological point of view. For this reason, the aim of our narrative mini-review is to evaluate the pertinence of the new criteria for AD diagnosis in the oldest old. Moreover, since different subgroups of oldest old have been described in scientific literature (escapers, delayers, survivors), we want to outline the clinical profile of the oldest old who could really benefit from the use of biomarkers for early diagnosis. Reviewing the literature on biomarkers included in the diagnostic criteria, we did not find a high degree of evidence for their use in the oldest old, although CSF biomarkers seem to be still the most useful for excluding AD diagnosis in the "fit" subgroup of oldest old subjects, due to the high negative predictive value maintained in this age group.
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Affiliation(s)
- Lucia Paolacci
- Department of Medicine, Section of Gerontologyand Geriatrics, University of Perugia, Perugia, Italy
| | - David Giannandrea
- Department of Medicine, Section of Neurology, Center for Memory Disturbances-Lab of Clinical Neurochemistry, University of Perugia, Perugia, Italy.,Neurology Unit, Presidio Ospedaliero Alto Chiascio, USL 1 Umbria, Italy
| | - Patrizia Mecocci
- Department of Medicine, Section of Gerontologyand Geriatrics, University of Perugia, Perugia, Italy
| | - Lucilla Parnetti
- Department of Medicine, Section of Neurology, Center for Memory Disturbances-Lab of Clinical Neurochemistry, University of Perugia, Perugia, Italy
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Kesler SR, Rao V, Ray WJ, Rao A. Probability of Alzheimer's disease in breast cancer survivors based on gray-matter structural network efficiency. ALZHEIMER'S & DEMENTIA: DIAGNOSIS, ASSESSMENT & DISEASE MONITORING 2017; 9:67-75. [PMID: 29201992 PMCID: PMC5700833 DOI: 10.1016/j.dadm.2017.10.002] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Introduction Breast cancer chemotherapy is associated with accelerated aging and potentially increased risk for Alzheimer's disease (AD). Methods We calculated the probability of AD diagnosis from brain network and demographic and genetic data obtained from 47 female AD converters and 47 matched healthy controls. We then applied this algorithm to data from 78 breast cancer survivors. Results The classifier discriminated between AD and healthy controls with 86% accuracy (P < .0001). Chemotherapy-treated breast cancer survivors demonstrated significantly higher probability of AD compared to healthy controls (P < .0001) and chemotherapy-naïve survivors (P = .007), even after stratifying for apolipoprotein e4 genotype. Chemotherapy-naïve survivors also showed higher AD probability compared to healthy controls (P = .014). Discussion Chemotherapy-treated breast cancer survivors who have a particular profile of brain structure may have a higher risk for AD, especially those who are older and have lower cognitive reserve.
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Affiliation(s)
- Shelli R. Kesler
- Department of Neuro-oncology, University of Texas MD Anderson Cancer Center, Houston, TX, USA
- Corresponding author. Tel.: +713-792-8296; Fax: +713-794-4999.
| | - Vikram Rao
- Department of Neuro-oncology, University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - William J. Ray
- The Neurodegeneration Consortium at the Institute of Applied Cancer Science, University of Texas MD Anderson Cancer Center, Houston, TX, USA
| | - Arvind Rao
- Department of Bioinformatics and Computational Biology, University of Texas MD Anderson Cancer Center, Houston, TX, USA
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26
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Thomson RS, Auduong P, Miller AT, Gurgel RK. Hearing loss as a risk factor for dementia: A systematic review. Laryngoscope Investig Otolaryngol 2017; 2:69-79. [PMID: 28894825 PMCID: PMC5527366 DOI: 10.1002/lio2.65] [Citation(s) in RCA: 180] [Impact Index Per Article: 25.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2016] [Revised: 11/12/2016] [Accepted: 12/19/2016] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVES To review evidence of hearing loss as a risk factor for dementia. Data Sources: PubMed Review methods: A systematic review was conducted using the PubMed database using the search terms (hearing loss OR presbycusis) AND (dementia OR cognitive decline). Initially, 488 articles were obtained. Only those studies evaluating an association between hearing loss and incident dementia or cognitive decline were included in the analysis. This resulted in 17 articles which were thoroughly evaluated with consideration for study design, method for determining hearing loss and cognitive status, relevant covariates and confounding factors, and key findings. RESULTS All of the 17 articles meeting inclusion criteria indicate that hearing loss is associated with dementia or cognitive decline. The methods used among the studies for ascertaining hearing loss and dementia were notably varied. For hearing loss, peripheral auditory function was tested far more than central auditory function. For peripheral audition, pure tone audiometry was the most commonly reported method for defining hearing loss. Only a few studies measured central auditory function by using the Synthetic Sentence Identification with Ipsilateral Competing Message test (SSI-ICM) and the Staggered Spondaic Word Test (SSW). Dementia was most often defined using the Mini Mental State Exam (MMSE). However, many studies used extensive batteries of tests to define cognitive status, often including a neuropsychologist. Confounding variables such as cardiovascular risk factors were measured in 17 studies and family history of dementia was only evaluated in 1 study. Overall, the methods used by studies to ascertain hearing loss, cognitive status and other variables are valid, making their evaluation appear reliable. CONCLUSION While each of the studies included in this study utilized slightly different methods for evaluating participants, each of them demonstrated that hearing loss is associated with higher incidence of dementia in older adults. LEVEL OF EVIDENCE Level V, systematic review.
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Affiliation(s)
- Rhett S Thomson
- Department of Surgery University of Utah Salt Lake City Utah U.S.A.,Division of Otolaryngology University of Utah Salt Lake City Utah U.S.A
| | - Priscilla Auduong
- Department of Surgery University of Utah Salt Lake City Utah U.S.A.,Division of Otolaryngology University of Utah Salt Lake City Utah U.S.A
| | - Alexander T Miller
- Department of Surgery University of Utah Salt Lake City Utah U.S.A.,Division of Otolaryngology University of Utah Salt Lake City Utah U.S.A
| | - Richard K Gurgel
- Department of Surgery University of Utah Salt Lake City Utah U.S.A.,Division of Otolaryngology University of Utah Salt Lake City Utah U.S.A
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de Pedro-Cuesta J, Martínez-Martín P, Rábano A, Alcalde-Cabero E, José García López F, Almazán-Isla J, Ruiz-Tovar M, Medrano MJ, Avellanal F, Calero O, Calero M. Drivers: A Biologically Contextualized, Cross-Inferential View of the Epidemiology of Neurodegenerative Disorders. J Alzheimers Dis 2016; 51:1003-22. [PMID: 26923014 PMCID: PMC4927850 DOI: 10.3233/jad-150884] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Background: Sutherland et al. (2011) suggested that, instead of risk factors for single neurodegenerative disorders (NDDs), there was a need to identify specific “drivers”, i.e., risk factors with impact on specific deposits, such as amyloid-β, tau, or α-synuclein, acting across entities. Objectives and Methods: Redefining drivers as “neither protein/gene- nor entity-specific features identifiable in the clinical and general epidemiology of conformational NDDs (CNDDs) as potential footprints of templating/spread/transfer mechanisms”, we conducted an analysis of the epidemiology of ten CNDDs, searching for patterns. Results: We identified seven potential drivers, each of which was shared by at least two CNDDs: 1) an age-at-exposure-related susceptibility to Creutzfeldt-Jakob disease (CJD) and several late-life CNDDs; 2) a relationship between age at onset, survival, and incidence; 3) shared genetic risk factors for CJD and late-life CNNDs; 4) partly shared personal (diagnostic, educational, behavioral, and social risk factors) predating clinical onset of late-life CNDDs; 5) two environmental risk factors, namely, surgery for sporadic CJD and amyotrophic lateral sclerosis, and Bordetella pertussis infection for Parkinson’s disease; 6) reticulo-endothelial system stressors or general drivers (andropause or premenopausal estrogen deficiency, APOEɛ4, and vascular risk factors) for late-life CNDDs such as dementia/Alzheimer’s disease, type-2 diabetes mellitus, and some sporadic cardiac and vascular degenerative diseases; and 7) a high, invariant incidence ratio of sporadic to genetic forms of mid- and late-life CNDDs, and type-2 diabetes mellitus. Conclusion: There might be a systematic epidemiologic pattern induced by specific proteins (PrP, TDP-43, SOD1, α-synuclein, amyloid-β, tau, Langerhans islet peptide, and transthyretin) or established combinations of these.
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Affiliation(s)
- Jesús de Pedro-Cuesta
- Department of Applied Epidemiology, National Center for Epidemiology, Carlos III Institute of Health, Madrid, Spain.,Consortium for Biomedical Research in Neurodegenerative Diseases (CIBERNED), Madrid, Spain
| | - Pablo Martínez-Martín
- Department of Applied Epidemiology, National Center for Epidemiology, Carlos III Institute of Health, Madrid, Spain.,Consortium for Biomedical Research in Neurodegenerative Diseases (CIBERNED), Madrid, Spain
| | - Alberto Rábano
- Consortium for Biomedical Research in Neurodegenerative Diseases (CIBERNED), Madrid, Spain.,Alzheimer Disease Research Unit, CIEN Foundation, Queen Sofia Foundation Alzheimer Center, Madrid, Spain
| | - Enrique Alcalde-Cabero
- Department of Applied Epidemiology, National Center for Epidemiology, Carlos III Institute of Health, Madrid, Spain.,Consortium for Biomedical Research in Neurodegenerative Diseases (CIBERNED), Madrid, Spain
| | - Fernando José García López
- Department of Applied Epidemiology, National Center for Epidemiology, Carlos III Institute of Health, Madrid, Spain.,Consortium for Biomedical Research in Neurodegenerative Diseases (CIBERNED), Madrid, Spain
| | - Javier Almazán-Isla
- Department of Applied Epidemiology, National Center for Epidemiology, Carlos III Institute of Health, Madrid, Spain.,Consortium for Biomedical Research in Neurodegenerative Diseases (CIBERNED), Madrid, Spain
| | - María Ruiz-Tovar
- Department of Applied Epidemiology, National Center for Epidemiology, Carlos III Institute of Health, Madrid, Spain.,Consortium for Biomedical Research in Neurodegenerative Diseases (CIBERNED), Madrid, Spain
| | - Maria-José Medrano
- Department of Applied Epidemiology, National Center for Epidemiology, Carlos III Institute of Health, Madrid, Spain
| | - Fuencisla Avellanal
- Department of Applied Epidemiology, National Center for Epidemiology, Carlos III Institute of Health, Madrid, Spain.,Consortium for Biomedical Research in Neurodegenerative Diseases (CIBERNED), Madrid, Spain
| | - Olga Calero
- Consortium for Biomedical Research in Neurodegenerative Diseases (CIBERNED), Madrid, Spain.,Chronic Disease Programme, Carlos III Institute of Health, Madrid, Spain
| | - Miguel Calero
- Consortium for Biomedical Research in Neurodegenerative Diseases (CIBERNED), Madrid, Spain.,Alzheimer Disease Research Unit, CIEN Foundation, Queen Sofia Foundation Alzheimer Center, Madrid, Spain.,Chronic Disease Programme, Carlos III Institute of Health, Madrid, Spain
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Abstract
Background Rising life expectancy means an increase in the number of elderly people with hearing loss in the population. Many elderly people live in nursing homes, with varying care needs. A substantial proportion of these people will need help with their hearing aids and other hearing devices. Objective The objective of the study has been to assess the knowledge, experience, skills, competence, and need for information of staff at nursing homes in relation to residents’ hearing loss and hearing aids. Materials and methods One hundred and ninety-five employees at seven nursing homes participated in the study. The main approach was a descriptive study, using questionnaires. Results The main findings are that 73% of informants found that many residents need help with their hearing aids. Only one-tenth report that they know enough about the residents’ hearing aids. Almost four out of five informants find that the residents become socially isolated as a result of hearing loss. Seventy-eight percent agree to some extent that more residents would benefit from hearing aids. Conclusion Staff at nursing homes have insufficient knowledge about hearing loss and hearing aids. Increased focus on the elderly with hearing impairment in nursing homes is needed. Contact between nursing homes and audiological specialists should be improved to best followup hearing loss and hearing aids.
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Affiliation(s)
- Jorunn Solheim
- Department of Ear, Nose and Throat, Lovisenberg Diakonale Hospital
| | - Olga Shiryaeva
- Department of Ear, Nose and Throat, Lovisenberg Diakonale Hospital
| | - Kari J Kvaerner
- C3 Centre for Connected Care, Oslo University Hospital, Oslo, Norway
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Miller IN, Himali JJ, Beiser AS, Murabito JM, Seshadri S, Wolf PA, Au R. Normative Data for the Cognitively Intact Oldest-Old: The Framingham Heart Study. Exp Aging Res 2016. [PMID: 26214098 DOI: 10.1080/0361073x.2015.1053755] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
UNLABELLED BACKGROUND/STUDY CONTEXT: The number of individuals who reach extreme age is quickly increasing. Much of the current literature focuses on impaired cognition in extreme age, and debate continues regarding what constitutes "normal" cognition in extreme age. This study aimed to provide oldest-old normative data and to compare cognitive performances of cognitively intact elderly individuals from the Framingham Heart Study. METHODS A total of 1302 individuals aged 65+ years from the Framingham Heart Study were separated into 5-year age bands and compared on cognitive tests. Multivariate linear regression analyses were conducted, adjusting for gender, the Wide Range Achievement Test-Third Edition (WRAT-III) Reading score, and cohort. Analyses also included comparisons between 418 individuals aged 80+ and 884 individuals aged 65-79, and comparisons within oldest-old age bands. RESULTS Normative data for all participants are presented. Significant differences were found on most tests between age groups in the overall analysis between young-old and oldest-old, and analysis of oldest-old age bands also revealed select significant differences (all ps <.05). CONCLUSION As aging increases, significant cognitive differences and increased variability in performances are evident. These results support the use of age-appropriate normative data for oldest-old individuals.
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Affiliation(s)
- Ivy N Miller
- a Department of Psychology , Minneapolis VA Healthcare System , Minneapolis , Minnesota , USA
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Comparative Incidence of Conformational, Neurodegenerative Disorders. PLoS One 2015; 10:e0137342. [PMID: 26335347 PMCID: PMC4559310 DOI: 10.1371/journal.pone.0137342] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2015] [Accepted: 08/14/2015] [Indexed: 12/12/2022] Open
Abstract
Background The purpose of this study was to identify incidence and survival patterns in conformational neurodegenerative disorders (CNDDs). Methods We identified 2563 reports on the incidence of eight conditions representing sporadic, acquired and genetic, protein-associated, i.e., conformational, NDD groups and age-related macular degeneration (AMD). We selected 245 papers for full-text examination and application of quality criteria. Additionally, data-collection was completed with detailed information from British, Swedish, and Spanish registries on Creutzfeldt-Jakob disease (CJD) forms, amyotrophic lateral sclerosis (ALS), and sporadic rapidly progressing neurodegenerative dementia (sRPNDd). For each condition, age-specific incidence curves, age-adjusted figures, and reported or calculated median survival were plotted and examined. Findings Based on 51 valid reported and seven new incidence data sets, nine out of eleven conditions shared specific features. Age-adjusted incidence per million person-years increased from ≤1.5 for sRPNDd, different CJD forms and Huntington's disease (HD), to 1589 and 2589 for AMD and Alzheimer's disease (AD) respectively. Age-specific profiles varied from (a) symmetrical, inverted V-shaped curves for low incidences to (b) those increasing with age for late-life sporadic CNDDs and for sRPNDd, with (c) a suggested, intermediate, non-symmetrical inverted V-shape for fronto-temporal dementia and Parkinson's disease. Frequently, peak age-specific incidences from 20–24 to ≥90 years increased with age at onset and survival. Distinct patterns were seen: for HD, with a low incidence, levelling off at middle age, and long median survival, 20 years; and for sRPNDd which displayed the lowest incidence, increasing with age, and a short median disease duration. Interpretation These results call for a unified population view of NDDs, with an age-at-onset-related pattern for acquired and sporadic CNDDs. The pattern linking age at onset to incidence magnitude and survival might be explained by differential pathophysiological mechanisms associated with specific misfolded protein deposits.
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Antunes HKM, Santos-Galduroz RF, De Aquino Lemos V, Bueno OFA, Rzezak P, de Santana MG, De Mello MT. The influence of physical exercise and leisure activity on neuropsychological functioning in older adults. AGE (DORDRECHT, NETHERLANDS) 2015; 37:9815. [PMID: 26169946 PMCID: PMC4501327 DOI: 10.1007/s11357-015-9815-8] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/13/2015] [Accepted: 07/06/2015] [Indexed: 06/01/2023]
Abstract
It has been suggested that leisure activity and physical exercise can be a protective factor for neuropsychological functions and are associated with a reduced risk of dementia. Thus, the purpose of this study was to investigate the influence of physical exercise and leisure on the neuropsychological functions of healthy older adults. The sample was composed of 51 sedentary female volunteers who were 60-70 years old and were distributed into three groups: A-control, B-leisure, and C-training. Volunteers were submitted to a physical and neuropsychological assessment at baseline and after 6 months. Groups A and B were monitored longitudinally three times a week. Group C improved their neuropsychological functioning and oxygen consumption compared to groups A and B (p = <0.05). The neuropsychological functions of groups A and B were significantly worse after 6 months of monitoring (p = <0.05). The data suggest that physical exercise improves neuropsychological functioning, although leisure activities may also improve this functioning. Thus, an aerobic physical fitness program can partially serve as a non-medication alternative for maintaining and improving these functions in older adults; however, leisure activities should also be considered.
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Affiliation(s)
- Hanna Karen Moreira Antunes
- Departamento de Biociências, Universidade Federal de São Paulo (UNIFESP), Campus Baixada Santista, Rua Silva Jardim, 136, Térreo Vila Mathias, Santos, São Paulo, 11015-020, Brazil,
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Castiglione A, Benatti A, Girasoli L, Caserta E, Montino S, Pagliaro M, Bovo R, Martini A. Cochlear implantation outcomes in older adults. HEARING BALANCE AND COMMUNICATION 2015. [DOI: 10.3109/13625187.2015.1030885] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Marcelo A, Bix G. The potential role of perlecan domain V as novel therapy in vascular dementia. Metab Brain Dis 2015; 30:1-5. [PMID: 24964971 DOI: 10.1007/s11011-014-9576-6] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/17/2014] [Accepted: 06/13/2014] [Indexed: 10/25/2022]
Abstract
Vascular dementia (VaD) is the second most common cause of dementia and leads to a decline in cognitive thinking via conditions that lead to blockage or reduced blood flow to the brain. It is a poorly understood disease, and the changes that occur are often linked to other types of dementia such as Alzheimer's disease. To date, there are no approved therapies or drugs to treat the symptoms of VaD, even though there is some evidence of drugs approved for Alzheimer's that might have some benefit in patients diagnosed with VaD. The altered blood flow that precedes VaD may result in compensatory mechanisms, such as angiogenesis, to increase blood flow in the brain. Angiogenesis, the process of new blood vessel formations from pre-existing ones, involves several pro-angiogenic factors such as vascular endothelial growth factor (VEGF) and is regulated by a variety of growth factors from neurons, astrocytes, and pericytes in the brain as well the extracellular matrix (ECM). The ECM highly regulates angiogenesis and other processes in the brain. One such ECM component is the heparan sulfate proteoglycan perlecan and its bioactive region, Domain V (DV). Here we discuss the potential role of DV as a novel therapy to treat VaD.
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Affiliation(s)
- Aileen Marcelo
- Sanders-Brown Center on Aging, Department of Anatomy and Neurobiology and Department of Neurology, University of Kentucky, 430 Sanders Brown Building, 800 S. Limestone Street, Lexington, KY, 40536-0230, USA
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Kesler SR. Default mode network as a potential biomarker of chemotherapy-related brain injury. Neurobiol Aging 2014; 35 Suppl 2:S11-9. [PMID: 24913897 PMCID: PMC4120757 DOI: 10.1016/j.neurobiolaging.2014.03.036] [Citation(s) in RCA: 70] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2013] [Revised: 03/11/2014] [Accepted: 03/14/2014] [Indexed: 01/01/2023]
Abstract
Chronic medical conditions and/or their treatments may interact with aging to alter or even accelerate brain senescence. Adult onset cancer, for example, is a disease associated with advanced aging and emerging evidence suggests a profile of subtle but diffuse brain injury following cancer chemotherapy. Breast cancer is currently the primary model for studying these "chemobrain" effects. Given the widespread changes to brain structure and function as well as the common impairment of integrated cognitive skills observed following breast cancer chemotherapy, it is likely that large-scale brain networks are involved. Default mode network (DMN) is a strong candidate considering its preferential vulnerability to aging and sensitivity to toxicity and disease states. Additionally, chemotherapy is associated with several physiological effects including increased inflammation and oxidative stress that are believed to elevate toxicity in the DMN. Biomarkers of DMN connectivity could aid in the development of treatments for chemotherapy-related cognitive decline.
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Affiliation(s)
- Shelli R Kesler
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA.
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Wang H. Establishment of an animal model of vascular dementia. Exp Ther Med 2014; 8:1599-1603. [PMID: 25289066 PMCID: PMC4186350 DOI: 10.3892/etm.2014.1926] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2014] [Accepted: 05/20/2014] [Indexed: 02/01/2023] Open
Abstract
The aim of this study was to establish a mouse model of vascular dementia (VaD) in order to overcome the shortcomings of rat models of VaD, which include high production costs, difficult surgery, surgical trauma and high mortality. In this study, repeated ischemia-reperfusion of the total bilateral carotid artery in mice, combined with a reduction of blood pressure, was used to establish an animal model of VaD. A total of 40 Kunming mice (clean grade) were randomly divided into a sham group and a model group. Behavioral tests were performed for each group following the surgery, and the morphology of the hippocampus was analyzed. The results of the step-down avoidance test, water maze test and microscopy examinations confirmed that following surgery, learning and memory dysfunction was significantly increased in the model group. The results of the morphological observations showed that the number of hippocampal CA1 neurons was significantly decreased in the model group compared with that in the sham surgery group (P<0.01). In the present study, a mouse model of VaD was successfully established, which was simple, effective and reliable, and may be used in the future to investigate VaD.
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Affiliation(s)
- Hao Wang
- Department of Traditional Chinese Internal Medicine, China-Japan Friendship Hospital, Beijing 100029, P.R. China
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Small vessel disease and memory loss: what the clinician needs to know to preserve patients' brain health. Curr Cardiol Rep 2014; 15:427. [PMID: 24105643 DOI: 10.1007/s11886-013-0427-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
Small vessel disease (SVD) in the brain manifests in the periventricular and deep white matter and radiographically is described as "leukoaraiosis". It is increasingly recognized as a cause of morbidity from middle age onward and this clinical relevance has paralleled advances in the field of neuroradiology. Overall, SVD is a heterogenous group of vascular disorders that may be asymptomatic, or a harbinger of many conditions that jeopardize brain health. Management and prevention focuses on blood pressure control, lifestyle modification, and symptomatic treatment.
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