1
|
Mourtzi N, Georgakis M, Ntanasi E, Hatzimanolis A, Ramirez A, Heilmann-Heimbach S, Grenier-Boley B, Lambert J, Yannakoulia M, Kosmidis M, Dardiotis E, Hadjigeorgiou G, Sakka P, Scarmeas N. Genetically downregulated Interleukin-6 signalling is associated with a lower risk of frailty. Age Ageing 2023; 52:7008635. [PMID: 36729470 DOI: 10.1093/ageing/afac318] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2021] [Revised: 08/04/2022] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND numerous studies point towards a critical role of Interleukin 6 (IL-6) pathway in frailty pathogenesis yet the causal relationship between the two remains elusive. METHODS we selected genetic variants near the IL-6 receptor locus (IL-6R) associated with reduced C-reactive protein (CRP) levels, a downstream effector of IL-6 pathway, and we used them as genetic proxies of IL-6 signalling downregulation. We then performed a two-sample Mendelian randomisation (MR) to investigate the association with frailty status, as defined by the Frailty Index (FI) in 11,171 individuals from the Hellenic Longitudinal Investigation of Ageing and Diet (HELIAD) study. MR analysis was repeated after excluding depression or cognition-related FI items as well as following age or sex stratification. Association with frailty was also examined using an alternative instrument, weighted on s-IL-6R levels. Replication was attempted in UK Biobank dataset. RESULTS genetic predisposition to IL-6 signalling downregulation, weighted on CRP levels, was associated with lower risk of frailty, inserted either as categorical (odds ratio [95% confidence interval] = 0.15 [-3.39, -0.40], P = 0.013) or continuous variable (beta [se] = -0.09 [0.003], P = 0.0009). Sensitivity analyses revealed similar estimates across different MR methods with no evidence for horizontal pleiotropy or heterogeneity. Results remained robust after exclusion of depression or cognition-related FI items and following sex or age stratification. Genetically increased s-IL-6R levels were negatively correlated with frailty and this finding remained significant in a meta-analysis of UK Biobank and HELIAD cohorts. CONCLUSION our results support a potential causal effect of IL-6 signalling on frailty and further suggest that downregulation of IL-6 levels may reduce frailty risk.
Collapse
Affiliation(s)
- Niki Mourtzi
- 1st Department of Neurology, Aiginition Hospital, National and Kapodistrian University of Athens Medical School, Athens 11528, Greece
| | - Mariosk Georgakis
- Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA 02142, USA.,Program in Medical and Population Genetics, Broad Institute of Harvard and the Massachusetts Institute of Technology, Boston, MA 02142, USA.,Institute for Stroke and Dementia Research (ISD), University Hospital, Ludwig-Maximilians-University (LMU) Munich, Munich 81377, Germany
| | - Eva Ntanasi
- 1st Department of Neurology, Aiginition Hospital, National and Kapodistrian University of Athens Medical School, Athens 11528, Greece.,Department of Nutrition and Dietetics, Harokopio University, Athens 176768, Greece
| | - Alexandros Hatzimanolis
- Department of Psychiatry, National and Kapodistrian University of Athens Medical School, Aiginition Hospital, Athens 11528, Greece.,Neurobiology Research Institute, Theodor-Theohari Cozzika Foundation, Athens 11521, Greece
| | - Alfredo Ramirez
- Medical Faculty, Division of Neurogenetics and Molecular Psychiatry, Department of Psychiatry and Psychotherapy, University of Cologne, Cologne 50923, Germany.,Department of Neurodegenerative Diseases and Geriatric Psychiatry, University Hospital Bonn, Bonn 53127, Germany.,German Center for Neurodegenerative Diseases (DZNE Bonn), Bonn 53127, Germany.,Department of Psychiatry, Glenn Biggs Institute for Alzheimer's and Neurodegenerative Diseases, San Antonio, TX 78229, USA
| | - Stephanie Heilmann-Heimbach
- Institute of Human Genetics, University of Bonn, School of Medicine & University Hospital Bonn, Bonn 53127, Germany
| | | | - Jeanc Lambert
- Univ. Lille, Inserm, CHU Lille, Institut Pasteur de Lille, Lille 59800, France
| | - Mary Yannakoulia
- Department of Nutrition and Dietetics, Harokopio University, Athens 17676, Greece
| | - Mary Kosmidis
- Lab of Cognitive Neuroscience, School of Psychology, Aristotle University of Thessaloniki, Thessaloniki 5412415, Greece
| | - Efthimios Dardiotis
- Department of Neurology, Faculty of Medicine, School of Health Sciences, University Hospital of Larissa, University of Thessaly, Larissa 41110, Greece
| | | | - Paraskevi Sakka
- Athens Association of Alzheimer's Disease and Related Disorders, Marousi 11636, Greece
| | - Nikolaos Scarmeas
- 1st Department of Neurology, Aiginition Hospital, National and Kapodistrian University of Athens Medical School, Athens 11528, Greece.,Department of Neurology, The Gertrude H. Sergievsky Center, Taub Institute for Research in Alzheimer's Disease and the Aging Brain, Columbia University, New York, NY 10032, USA
| |
Collapse
|
2
|
Margioti E, Scarmeas N, Yannakoulia M, Dardiotis E, Hadjigeorgiou G, Sakka P, Ntanasi E, Aretouli E, Kosmidis MH. Subjective Cognitive Decline as a predictor of Frailty in older adults: Hellenic Longitudinal Investigation of Aging and Diet study (HELIAD). J Frailty Aging 2023; 12:198-207. [PMID: 37493380 DOI: 10.14283/jfa.2023.28] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/27/2023]
Abstract
BACKGROUND Subjective cognitive decline (SCD) is a self-evaluation of cognitive impairment, in the absence of observed objective cognitive deficits on a neuropsychological assessment. Frailty refers to a multidimensional syndrome where the individual has poor health including falls, disabilities, hospitalization, and vulnerability. Both terms are associated with cognitive decline and increased incidence of dementia. The present longitudinal study explored whether the detection of SCD can predict the development of frailty over time. METHODS The Hellenic Longitudinal Investigation of Aging and Diet (HELIAD) is an epidemiological, population-based study. From the original testing sample of 1,984 older Greek individuals (≥65 years old), 1,121 remained in the longitudinal analysis. Participants diagnosed with frailty, Mild Cognitive Impairment (MCI), dementia, severe depression, and anxiety, in the baseline assessment were excluded from the analysis (n=146), resulting in a total sample of 975 participants. The average follow-up interval was 3.1 years (SD=0.84 years). SCD was assessed in the baseline assessment with a series of eighteen questions. The questions regarding SCD were categorized according to cognitive domains. Frailty was assessed according to a phenotypic-physiologic (Fried's definition) and a multidomain approach (Frailty Index). Univariate and multivariate Cox regression analyses were used for exploring the role of SCD in developing frailty. RESULTS The proportion of individuals with frailty according to Fried's definition was greater compared to the Frailty Index. At follow-up according to Fried's definition, a greater proportion of cases with frailty was found in those who reported SCD complaints regarding orientation (OD) (HR=3.12 95% CI:1.45-6.73 p<0.004) or in those who reported at least three SCD complaints regarding their memory performance (SMC3) (HR=1.92 95% CI:1.05-3.52 p<0.035) at the baseline assessment. Subjective complaints regarding orientation were predictive of a greater hazard of frailty as defined by the Fried scale (HR=3.12 95% CI:1.45-6.73 p<0.004) and the Frailty Index (HR=3.59 95% CI:1.77-7.25 p<0.001). CONCLUSION Our findings demonstrate that healthy older adults who report SCD complaints regarding orientation or state that they have at least three memory complaints have a higher risk of developing frailty. Additionally, the number of participants with a clinical diagnosis of MCI or dementia, compared to individuals with normal aging, at follow-up was found to be significantly greater in cases with frailty according to both frailty definitions applied (p<0.001). Consequently, it is advisable to use screening questionnaires for SCD covering multiple cognitive domains in clinical practice for identifying and managing frailty, thus, implementing effective interventions to promote healthy aging.
Collapse
Affiliation(s)
- E Margioti
- Prof. Mary H. Kosmidis, Laboratory of Cognitive Neuroscience, School of Psychology, Aristotle University of Thessaloniki, Thessaloniki, Greece 54124, Τel: +30 2310 997304, fax: +30 2310 995175, E-mail:
| | | | | | | | | | | | | | | | | |
Collapse
|
3
|
Ntanasi E, Charisis S, Yannakoulia M, Georgiadi K, Balomenos V, Kosmidis M, Dardiotis Ε, Hadjigeorgiou G, Sakka P, Maraki M, Scarmeas N. Adherence to the Mediterranean diet and incident frailty: Results from a longitudinal study. Maturitas 2022; 162:44-51. [DOI: 10.1016/j.maturitas.2022.05.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2021] [Revised: 04/21/2022] [Accepted: 05/01/2022] [Indexed: 11/26/2022]
|
4
|
Mourtzi N, Hatzimanolis A, Xiromerisiou G, Ntanasi E, Georgakis MK, Ramirez A, Heilmann-Heimbach S, Grenier-Boley B, Lambert JC, Yannakoulia M, Kosmidis M, Dardiotis E, Hadjigeorgiou G, Sakka P, Scarmeas N. Association between 9p21-23 Locus and Frailty in a Community-Dwelling Greek Population: Results from the Hellenic Longitudinal Investigation of Ageing and Diet. J Prev Alzheimers Dis 2022; 9:77-85. [PMID: 35098976 DOI: 10.14283/jpad.2022.2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
BACKGROUND Frailty is a complex geriatric syndrome arising from a combination of genetic and environmental factors and is associated with adverse health outcomes and mortality. A recent study reported an association between variants of the 9p21-23 locus, associated with a number of age-related disorders, including Alzheimer's disease (AD), and frailty. Frailty has been associated with increased risk of developing AD and it has been proposed that frailty burden may modify AD clinical presentation. In view of the overlapping genetic architecture between the two disorders, it is noteworthy to conduct studies to uncover risk variants that contribute to both AD and frailty. The purpose of this study is to test the reproducibility of the association of 9p21-23 locus with frailty in a population that is ethnically different from previous work and in the context of multidimensional definitions of frailty that will allow us to examine the potential impact to domains pertaining to AD pathology. METHODS We operationalized frailty according two definitions and the corresponding instruments, the Frailty Index (FI) and the Tilburg Frailty Indicator (TFI) and we determined genotypes of eight alleles previously identified as risk increasing for frailty in 1172 community-dwelling older participants (57% females) from the HELIAD study with a mean age of 74 years old. We cross-sectionally investigated the association between risk alleles and frailty, as well as with specific components of each definition using linear regression analyses adjusted for age, sex and years of education. RESULTS Compared to non-carriers, carriers of rs7038172 C risk allele, were associated with a higher FI Score (β=0.089, p=0.002). Similarly, we found a positive association between the presence of at least one rs7038172 C variant and TFI score (β=0.053, p=0.04). Moreover, the rs7038172 variant was associated, irrespectively of dementia status, with the memory and psychological domain of FI and TFI, respectively. CONCLUSION Our study confirms the association of the rs7038172 C allele with the frailty syndrome in a Greek population and in the context of multidimensional definitions of frailty. Furthermore, we report novel associations between this allele and the memory domain of FI and the psychological domain of TFI, that includes memory problems on its components. Given that frailty burden has been shown to modify the AD clinical presentation, it is likely that rs7038172 C allele may accelerate the transition of AD or frailty to dementia Overall, our study corroborates the role of the 9p21-23 region in frailty development and draw potential links with AD pathology.
Collapse
Affiliation(s)
- N Mourtzi
- Scarmeas Nikolaos, MD, MS, PhD, Vasilisis Sofias 72, Athens, Athens, Greece, 115 28, Phone: + 30 2107289310 Fax: + 30 2107289310,
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
5
|
Kalligerou F, Paraskevas G, Zalonis I, Kosmidis MH, Yannakoulia M, Dardiotis E, Hadjigeorgiou G, Sakka P, Scarmeas N. Objective and Subjective Measurements of Motor Function: Results from the HELIAD Study. J Prev Alzheimers Dis 2022; 9:743-751. [PMID: 36281679 DOI: 10.14283/jpad.2022.69] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
BACKGROUND Slow gait speed has recently emerged as a potential prodromal feature of cognitive decline and dementia. Besides objective measurements, subjective motor function (SMF) difficulties might be present prior to the manifestation of gait disorders. OBJECTIVES To examine the association of walking time and the presence of SMF with future cognitive decline in cognitively normal individuals. DESIGN Longitudinal study. SETTINGS Athens and Larissa, Greece. PARTICIPANTS 931 cognitively normal individuals over the age of 64 with longitudinal follow-up from the Hellenic Longitudinal Investigation of Aging and Diet (HELIAD). MEASUREMENTS We used a simple chronometer for recording objective walking time (OWT) and SMF was assessed using a self-reported physical functioning questionnaire. Generalized estimating equations (GEE) models were deployed to explore the associations between baseline OWT and SMF difficulties and the rate of change of performance scores on individual cognitive domains over time. Models were adjusted for age, years of education and sex. RESULTS Each additional second of OWT was associated with 1.1% of a standard deviation more decline per year in the composite z-score, 1.6% in the memory z-score, 1.1% in the executive z-score and 1.8% in the attention-speed z-score. The presence of SMF difficulties was not associated with differential rates of decline in any cognitive domain. CONCLUSION Gait speed can be indicative of future cognitive decline adding credence to the notion that gait speed might serve as a simple and easily accessible clinical tool to identify a larger pool of at risk individuals and improve the detection of prodromal dementia.
Collapse
Affiliation(s)
- F Kalligerou
- Nikolaos Scarmeas, M.D., M.Sc., Ph.D. Professor of Neurology, National and Kapodistrian University of Athens, Aiginition Hospital, Leof. Vasilissis Sofias 72, Athens 115 28, Phone: + 30 2107289310,
| | | | | | | | | | | | | | | | | |
Collapse
|
6
|
Geronikola N, Zalonis I, Ntanasi E, Charisis S, Kosmidis M, Anastasiou C, Dardiotis E, Hadjigeorgiou G, Megalou M, Velonakis G, Karavasilis E, Gargalionis A, Patas K, Piperidi A, Chatzipanagiotou S, Sakka P, Paraskevas G, Yannakoulia M, Scarmeas N. Sex Differences in Frailty Incidence in Greek Community-Dwelling Older People: The HELIAD Study. J Frailty Aging 2022; 11:250-255. [DOI: 10.14283/jfa.2022.39] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
|
7
|
Gkotzamanis V, Panagiotakos DB, Yannakoulia M, Kosmidis M, Dardiotis E, Hadjigeorgiou G, Sakka P, Scarmeas N. Sleep Quality and Duration as Determinants of Healthy Aging Trajectories: The HELIAD Study. J Frailty Aging 2022; 12:16-23. [PMID: 36629079 DOI: 10.14283/jfa.2022.37] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
BACKGROUND The aging of global population has increased the scientific interest in the concept of healthy aging and its determinants. AIM The aim of this study was to investigate the association of sleep characteristics with trajectories of healthy aging. DESIGN AND SETTING Prospective observational study conducted in two cities, Maroussi and Larissa. PARTICIPANTS A total of 1226 older adults (≥65 years, 704 women) were selected through random sampling. MEASUREMENTS Sleep quality was assessed with the Sleep Index II, and sleep duration was self-reported. A healthy aging metric was introduced using an Item Response Theory approach based on validated questionnaires that assessed functionality. Four healthy aging trajectories were developed based on whether the healthy aging status of the participants was above (High) or below (Low) the median at baseline and follow-up, i.e., High-High, High-Low, Low-High, and Low-Low. The association of sleep characteristics with the trajectories was investigated using a multinomial logistic regression with the Low-Low group as reference, adjusting for potential confounders. RESULTS 34.3% participants classified to the High-High group, 15.7% to the High-Low, 18.6% to the Low-High, and 31.4% to the Low-Low group. Better sleep quality was associated with the probability of belonging to the High-High group (p-value<0.001); while, long sleep duration was inversely associated with likelihood of being classified in the High-High group (p-value < 0.05). CONCLUSION Poor sleep quality and long sleep duration seem to have a significant negative association with healthy aging. Public health policies are needed to raise awareness about the importance of sleep characteristics on human health.
Collapse
Affiliation(s)
- V Gkotzamanis
- Prof Demosthenes B Panagiotakos, Harokopio University, 70 El. Venizelou St., 176 71 Athens, Greece, Tel. +30 210-9549332,
| | | | | | | | | | | | | | | |
Collapse
|
8
|
Charisis S, Ntanasi E, Yannakoulia M, Anastasiou CA, Kosmidis MH, Dardiotis E, Hadjigeorgiou G, Sakka P, Veskoukis AS, Kouretas D, Scarmeas N. Plasma GSH levels and Alzheimer's disease. A prospective approach.: Results from the HELIAD study. Free Radic Biol Med 2021; 162:274-282. [PMID: 33099001 DOI: 10.1016/j.freeradbiomed.2020.10.027] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2020] [Revised: 10/08/2020] [Accepted: 10/18/2020] [Indexed: 12/11/2022]
Abstract
BACKGROUND Potential links between oxidative stress and the pathophysiology of Alzheimer's disease (AD) have been reported in the existing literature. Biological markers of oxidative stress, such as the reduced form of glutathione (GSH), may have a potential role as predictive biomarkers for AD development. The aim of the present study was to explore the longitudinal associations between plasma GSH and the risk of developing AD or cognitive decline, in a sample of community-dwelling, non-demented older adults. METHODS Participants from the Hellenic Longitudinal Investigation of Aging and Diet (HELIAD) were included in the present prospective study. The sample used in the analyses consisted of 391 non-demented individuals over the age of 64 (mean age = 73.85 years; SD = 5.06), with available baseline GSH measurements and longitudinal follow-up. Plasma GSH was treated both as a continuous variable and as tertiles in our analyses. Cox proportional hazards models were used to evaluate the hazard ratio (HR) for AD incidence as a function of baseline plasma GSH. Generalized estimating equations (GEE) models were deployed to explore the associations between baseline plasma GSH and the rate of change of performance scores on individual cognitive domains over time. Models were adjusted for age, years of education and sex. Supplementary exploratory models were also adjusted for mild cognitive impairment (MCI) at baseline, risk for malnutrition, physical activity and adherence to the Mediterranean dietary pattern. RESULTS A total of 24 incident AD cases occurred during a mean (SD) of 2.99 (0.92) years of follow-up. Individuals in the highest GSH tertile group (highest baseline plasma GSH values) had a 70.1% lower risk for development of AD, compared to those in the lowest one [HR = 0.299 (0.093-0.959); p = 0.042], and also demonstrated a slower rate of decline of their executive functioning over time (5.2% of a standard deviation less decline in the executive composite score for each additional year of follow-up; p = 0.028). The test for trend was also significant suggesting a potential dose-response relationship. CONCLUSION In the present study, higher baseline plasma GSH levels were associated with a decreased risk of developing AD and with a better preservation of executive functioning longitudinally.
Collapse
Affiliation(s)
- S Charisis
- 1st Department of Neurology, Aiginition Hospital, National and Kapodistrian University of Athens Medical School, Greece
| | - E Ntanasi
- 1st Department of Neurology, Aiginition Hospital, National and Kapodistrian University of Athens Medical School, Greece; Department of Nutrition and Dietetics, Harokopio University, Athens, Greece
| | - M Yannakoulia
- Department of Nutrition and Dietetics, Harokopio University, Athens, Greece
| | - C A Anastasiou
- Department of Nutrition and Dietetics, Harokopio University, Athens, Greece
| | - M H Kosmidis
- Lab of Cognitive Neuroscience, School of Psychology, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - E Dardiotis
- School of Medicine, University of Thessaly, Larissa, Greece
| | - G Hadjigeorgiou
- Department of Neurology, Medical School, University of Cyprus, Cyprus
| | - P Sakka
- Athens Association of Alzheimer's Disease and Related Disorders, Athens, Greece
| | - A S Veskoukis
- Department of Biochemistry and Biotechnology, University of Thessaly, Viopolis, Mezourlo, 41500, Larissa, Greece; Department of Nutrition and Dietetics, University of Thessaly, Argonafton 1, 42132, Trikala, Greece
| | - D Kouretas
- Department of Biochemistry and Biotechnology, University of Thessaly, Viopolis, Mezourlo, 41500, Larissa, Greece
| | - N Scarmeas
- 1st Department of Neurology, Aiginition Hospital, National and Kapodistrian University of Athens Medical School, Greece; Taub Institute for Research in Alzheimer's Disease and the Aging Brain, The Gertrude H. Sergievsky Center, Department of Neurology, Columbia University, New York, New York, USA.
| |
Collapse
|
9
|
Mourtzi N, Ntanasi E, Yannakoulia M, Kosmidis M, Anastasiou C, Dardiotis E, Hadjigeorgiou G, Sakka P, Scarmeas N. Apolipoprotein ε4 allele is associated with frailty syndrome: results from the hellenic longitudinal investigation of ageing and diet study. Age Ageing 2019; 48:917-921. [PMID: 31504089 DOI: 10.1093/ageing/afz098] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2019] [Revised: 06/12/2019] [Accepted: 06/21/2019] [Indexed: 12/28/2022] Open
Abstract
Apolipoprotein (APOE) ε4 allele has been associated with a number of age-related diseases but previous studies failed to identify any link with Frailty syndrome. The aim of the present study is to investigate the association between APOE ε4 allele and frailty syndrome. We operationalised Frailty according to the Fried definition, and we determined the APOE genotype in 1234 participants of the hellenic longitudinal investigation of ageing and diet study. Logistic regression analyses were performed to examine the association between APOE ε4 allele and frailty. Models were adjusted for age, education, sex, presence (or absence) of hypertension, diabetes, myocardial infraction, coronary disease, congestive heart failure, arrhythmia or other heart disease, family history of dementia and current smoking. The same models were performed after exclusion of patients with dementia and participants with APOE ε2/ε4 genotype. In the fully adjusted model, carriers of APOE ε4 allele had 2.753 higher odds of frailty relative to non-carriers. After trichotomization of APOE genotype, APOE ε4 heterozygotes had 2.675 higher risk of frailty compared to non-carriers while exclusion of patients with dementia or/and APOE ε2/ε4 genotype did not alter the association. The APOE ε4 allele may be a significant biomarker of frailty with diagnostic and prognostic capacity.
Collapse
Affiliation(s)
- Niki Mourtzi
- 1st Department of Neurology, Aiginition Hospital, National and Kapodistrian University of Athens Medical School, Athens, Greece
| | - Eva Ntanasi
- 1st Department of Neurology, Aiginition Hospital, National and Kapodistrian University of Athens Medical School, Athens, Greece
- Department of Nutrition and Dietetics, Harokopio University, Athens, Greece
- Department of Neurology, Medical School, University of Cyprus, Nicosia, Cyprus
| | - Mary Yannakoulia
- Department of Nutrition and Dietetics, Harokopio University, Athens, Greece
| | - Mary Kosmidis
- Lab of Cognitive Neuroscience, School of Psychology, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Costas Anastasiou
- 1st Department of Neurology, Aiginition Hospital, National and Kapodistrian University of Athens Medical School, Athens, Greece
- Department of Nutrition and Dietetics, Harokopio University, Athens, Greece
| | | | | | - Paraskevi Sakka
- Athens Association of Alzheimer’s Disease and Related Disorders, Marousi, Greece
| | - Nikolaos Scarmeas
- 1st Department of Neurology, Aiginition Hospital, National and Kapodistrian University of Athens Medical School, Athens, Greece
- Department of Neurology, The Gertrude H. Sergievsky Center, Taub Institute for Research in Alzheimer’s Disease and the Aging Brain, Columbia University, New York, NY, USA
| |
Collapse
|
10
|
Ntanasi E, Scarmeas N, Mamalaki E, Kosmidis MH, Anastasiou CA, Dardiotis E, Hadjigeorgiou G, Megalou M, Voskou P, Sakka P, Yannakoulia M. Food Consumption and Frailty Syndrome: Results From the Hellenic Longitudinal Investigation of Aging and Diet Study. J Am Med Dir Assoc 2019; 20:640-642. [PMID: 30745176 DOI: 10.1016/j.jamda.2018.12.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2018] [Accepted: 12/18/2018] [Indexed: 12/01/2022]
Affiliation(s)
- Eva Ntanasi
- Department of Nutrition and Dietetics, Harokopio University, Athens, Greece; Eginition Hospital, 1(st) Neurology Clinic, Department of Social Medicine, Psychiatry and Neurology, National and Kapodistrian University of Athens, Athens, Greece
| | - Nikolaos Scarmeas
- 1st Department of Neurology, Aiginition Hospital, National and Kapodistrian University of Athens Medical School, Athens, Greece; Taub Institute for Research in Alzheimer's Disease and the Aging Brain, The Gertrude H. Sergievsky Center, Department of Neurology, Columbia University, New York, NY
| | - Eirini Mamalaki
- Department of Nutrition and Dietetics, Harokopio University, Athens, Greece
| | - Mary-Helen Kosmidis
- Laboratory of Cognitive Neuroscience, School of Psychology, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Costas A Anastasiou
- Department of Nutrition and Dietetics, Harokopio University, Athens, Greece; Eginition Hospital, 1(st) Neurology Clinic, Department of Social Medicine, Psychiatry and Neurology, National and Kapodistrian University of Athens, Athens, Greece
| | | | | | | | - Panagiota Voskou
- Eginition Hospital, 1(st) Neurology clinic, Department of Social Medicine, Psychiatry and Neurology, National and Kapodistrian University of Athens, Athens, Greece
| | - Paraskevi Sakka
- Athens Association of Alzheimer's Disease and Related Disorders, Athens, Greece
| | - Mary Yannakoulia
- Department of Nutrition and Dietetics, Harokopio University, Athens, Greece
| |
Collapse
|
11
|
Anastasiou CA, Yannakoulia M, Kontogianni MD, Kosmidis MH, Mamalaki E, Dardiotis E, Hadjigeorgiou G, Sakka P, Tsapanou A, Lykou A, Scarmeas N. Mediterranean Lifestyle in Relation to Cognitive Health: Results from the HELIAD Study. Nutrients 2018; 10:nu10101557. [PMID: 30347812 PMCID: PMC6213445 DOI: 10.3390/nu10101557] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2018] [Revised: 10/11/2018] [Accepted: 10/16/2018] [Indexed: 01/06/2023] Open
Abstract
Many lifestyle factors have been linked to cognitive function but little is known about their combined effect. An overall lifestyle pattern for people living in the Mediterranean basin has been proposed, including diet, but also physical activity, sleep and daily living activities with social/intellectual aspects. We aimed to examine the associations between a combination of these lifestyle factors and detailed cognitive performance. A total of 1716 participants from the Hellenic Longitudinal Investigation of Ageing and Diet (HELIAD), a population-based study of participants ≥65 years, were included in this analysis. Lifestyle factors were evaluated using standard, validated questionnaires and a Total Lifestyle Index (TLI) was constructed. Cognitive outcomes included mild cognitive impairment (MCI) diagnosis, a composite z-score (either continuous or with a threshold at the 25th percentile) and z-scores for five cognitive domains. A higher TLI was associated with 65% reduced odds for MCI in the non-demented individuals and 43% reduced odds for low global cognition when MCI participants were excluded, a risk reduction equivalent to 9 and 2.7 fewer years of ageing, respectively. Each lifestyle factor was differentially associated with domain-specific cognitive performance. Our results suggest that a TLI, more so than single lifestyle parameters, may be related to cognitive performance.
Collapse
Affiliation(s)
- Costas A Anastasiou
- Department of Neurology, Aiginition Hospital, National and Kapodistrian University of Athens Medical School, 11528 Athens, Greece.
- Department of Nutrition and Dietetics, Harokopio University, 17671 Athens, Greece.
| | - Mary Yannakoulia
- Department of Nutrition and Dietetics, Harokopio University, 17671 Athens, Greece.
| | - Meropi D Kontogianni
- Department of Nutrition and Dietetics, Harokopio University, 17671 Athens, Greece.
| | - Mary H Kosmidis
- Laboratory of Cognitive Neuroscience, School of Psychology, Aristotle University of Thessaloniki, 54124 Thessaloniki, Greece.
| | - Eirini Mamalaki
- Department of Nutrition and Dietetics, Harokopio University, 17671 Athens, Greece.
| | - Efthimios Dardiotis
- Department of Neurology, Faculty of Medicine, University of Thessaly, 41500 Larissa, Greece.
| | - Giorgos Hadjigeorgiou
- Department of Neurology, Faculty of Medicine, University of Thessaly, 41500 Larissa, Greece.
- Department of Neurology, Medical School, University of Cyprus, 2408 Nicosia, Cyprus.
| | - Paraskevi Sakka
- Athens Association of Alzheimer's Disease and Related Disorders, 11636 Marousi, Greece.
| | - Angeliki Tsapanou
- Department of Neurology, Aiginition Hospital, National and Kapodistrian University of Athens Medical School, 11528 Athens, Greece.
- Taub Institute for Research in Alzheimer's Disease and the Aging Brain, The Gertrude H. Sergievsky Center, Department of Neurology, Columbia University, New York, NY 10032, USA.
| | | | - Nikolaos Scarmeas
- Department of Neurology, Aiginition Hospital, National and Kapodistrian University of Athens Medical School, 11528 Athens, Greece.
- Taub Institute for Research in Alzheimer's Disease and the Aging Brain, The Gertrude H. Sergievsky Center, Department of Neurology, Columbia University, New York, NY 10032, USA.
| |
Collapse
|
12
|
Bakirtzis C, Konstantinopoulou E, Langdon DW, Grigoriadou E, Minti F, Nikolaidis I, Boziki MK, Tatsi T, Ioannidis P, Karapanayiotides T, Afrantou T, Hadjigeorgiou G, Grigoriadis N. Long-term effects of prolonged-release fampridine in cognitive function, fatigue, mood and quality of life of MS patients: The IGNITE study. J Neurol Sci 2018; 395:106-112. [PMID: 30308444 DOI: 10.1016/j.jns.2018.10.004] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2018] [Revised: 09/13/2018] [Accepted: 10/02/2018] [Indexed: 10/28/2022]
Abstract
BACKGROUND Studies have reported conflicting results regarding the potential benefit of prolonged release (PR) fampridine in other domains besides walking. Moreover, only a small number of studies have explored long- term effects of PR fampridine. The aim of this study was to assess cognitive function, quality of life, mood and fatigue in MS patients treated with fampridine after 6 and 12 months of treatment. METHODS IGNITE was an observational, open label study. Subjects were examined with the timed 25-ft walk (T25FW) and the BICAMS battery and were asked to complete the Multiple Sclerosis Impact Scale (MSIS-29), Modified Fatigue Impact Scale (MFIS), Beck Depression Inventory-II (BDI-II) and MS International Quality-of-Life questionnaire (MUSIQOL) at baseline and at weeks 24 and 48. Patients were sub-grouped into responders (n:40) and non-responders (n:20) according to T25FW performance after 2 weeks on treatment. RESULTS After 6 months, statistically significant improvement was observed on T25FW (p < .001), SDMT (p < .001) and MSIS29 (p < .001), for responders. After 1 year on treatment, statistically significant improvement was observed in T25FW (p < .001), MSIS29 (p = .004), SDMT (p < .001) and MUSIQOL (p = .03) for responders. There were no statistically significant improvements for the non-responders. CONCLUSIONS PR Fampridine may have a beneficial effect on information processing speed though not on memory. Study data provide some evidence that fampridine treatment may reduce the impact of MS on daily activities and improve quality of life but has no effect on subjective fatigue and mood.
Collapse
Affiliation(s)
- C Bakirtzis
- The Multiple Sclerosis Center, 2nd Department of Neurology, AHEPA University Hospital, Aristotle University of Thessaloniki, Greece.
| | - E Konstantinopoulou
- Lab of Cognitive Neuroscience, School of Psychology, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - D W Langdon
- Royal Holloway, University of London, London, UK
| | - E Grigoriadou
- The Multiple Sclerosis Center, 2nd Department of Neurology, AHEPA University Hospital, Aristotle University of Thessaloniki, Greece
| | - F Minti
- The Multiple Sclerosis Center, 2nd Department of Neurology, AHEPA University Hospital, Aristotle University of Thessaloniki, Greece
| | - I Nikolaidis
- The Multiple Sclerosis Center, 2nd Department of Neurology, AHEPA University Hospital, Aristotle University of Thessaloniki, Greece
| | - M K Boziki
- The Multiple Sclerosis Center, 2nd Department of Neurology, AHEPA University Hospital, Aristotle University of Thessaloniki, Greece
| | - T Tatsi
- The Multiple Sclerosis Center, 2nd Department of Neurology, AHEPA University Hospital, Aristotle University of Thessaloniki, Greece
| | - P Ioannidis
- The Multiple Sclerosis Center, 2nd Department of Neurology, AHEPA University Hospital, Aristotle University of Thessaloniki, Greece
| | - T Karapanayiotides
- The Multiple Sclerosis Center, 2nd Department of Neurology, AHEPA University Hospital, Aristotle University of Thessaloniki, Greece
| | - T Afrantou
- The Multiple Sclerosis Center, 2nd Department of Neurology, AHEPA University Hospital, Aristotle University of Thessaloniki, Greece
| | - G Hadjigeorgiou
- Department of Neurology, Medical School, University of Cyprus, Cyprus
| | - N Grigoriadis
- The Multiple Sclerosis Center, 2nd Department of Neurology, AHEPA University Hospital, Aristotle University of Thessaloniki, Greece
| |
Collapse
|
13
|
Ntanasi E, Yannakoulia M, Mourtzi N, Vlachos GS, Kosmidis MH, Anastasiou CA, Dardiotis E, Hadjigeorgiou G, Megalou M, Sakka P, Scarmeas N. Prevalence and Risk Factors of Frailty in a Community-Dwelling Population: The HELIAD Study. J Aging Health 2018; 32:14-24. [PMID: 30246620 DOI: 10.1177/0898264318801735] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Objective: To estimate the prevalence of frailty using five different instruments in a cohort of older adults and explore the association between frailty and various risk factors. Method: 1,867 participants aged 65 years and above were included in the current retrospective cross-sectional study. Frailty was operationalized according to the Fried definition, the FRAIL Scale, the Frailty Index (FI), the Tilburg Frailty Indicator (TFI), and the Groningen Frailty Index (GFI). We explored the role of various frailty risk factors using logistic regression analyses. Results: The prevalence of frailty varied depending on the definition used (Fried definition = 4.1%, FRAIL Scale = 1.5%, FI = 19.7%, TFI = 24.5%, and GFI = 30.2%). The only risk factors consistently associated with frailty irrespectively of definition were education and age. Conclusion: The frailty prevalence reported in our study is similar or lower to that reported in other population studies. Qualitative differences between frailty definitions were observed.
Collapse
Affiliation(s)
- E Ntanasi
- Harokopio University, Athens, Greece.,Eginition Hospital, Athens, Greece.,Athens Association of Alzheimer's Disease and Related Disorders, Athens, Greece
| | | | | | | | | | - C A Anastasiou
- Harokopio University, Athens, Greece.,Eginition Hospital, Athens, Greece
| | | | | | - M Megalou
- Biomedicine Diagnostic Laboratory, Athens, Greece
| | - P Sakka
- Athens Association of Alzheimer's Disease and Related Disorders, Athens, Greece
| | - N Scarmeas
- Eginition Hospital, Athens, Greece.,Columbia University, New York, NY, USA
| |
Collapse
|
14
|
Mamalaki E, Anastasiou C, Kosmidis M, Dardiotis E, Hadjigeorgiou G, Sakka P, Scarmeas N, Yannakoulia M. Associations between the Mediterranean diet and sleep in the elderly. Clin Nutr ESPEN 2018. [DOI: 10.1016/j.clnesp.2018.01.051] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
|
15
|
Tsapanou A, Gu Y, O'Shea DM, Yannakoulia M, Kosmidis MH, Dardiotis E, Hadjigeorgiou G, Sakka P, Stern Y, Scarmeas N. Dataset on the associations between sleep quality/duration and cognitive performance in cognitively healthy older adults. Data Brief 2017; 14:720-723. [PMID: 28932777 PMCID: PMC5596325 DOI: 10.1016/j.dib.2017.08.028] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2017] [Revised: 07/18/2017] [Accepted: 08/24/2017] [Indexed: 11/28/2022] Open
Abstract
In the present data, we provide the details of the cross-sectional study examining the associations between sleep quality/sleep duration and cognitive performance. Data are from the Hellenic Longitudinal Investigation of Aging and Diet (HELIAD). A total of 1484 older adults (65 y.o. or older) took part in the study. Sleep measurements were drawn from the sleep scale of the Medical Outcomes Study (MOS). Cognition was used as a z-score drawn by different tests. The domains examined were: executive function, visuo-spatial ability, language, attention- speed of processing, as well as the composite z-score of all the cognitive domains (including memory). Linear regression models were conducted to investigate the associations between sleep quality and cognition, and sleep duration and cognition as well. We also conducted linear regression analyses for the associations between sleep quality/duration and cognitive domains/composite cognitive score based on the status of the Apolipoprotein E-ε4 (ApoE-ε4) genotype. Analyses were performed excluding both the demented and the Mild Cognitive Impairment (MCI) participants. Adjustments conducted for multiple covariates. For further analyses and enhanced discussion, see original article: "Sleep quality and duration in relation to memory in the elderly: initial results from the Hellenic Longitudinal Investigation of Aging and Diet" by Tsapanou et al. [1].
Collapse
Affiliation(s)
- A Tsapanou
- Department of Social Medicine, Psychiatry and Neurology, National and Kapodistrian University of Athens, Athens, Greece.,Cognitive Neuroscience Division, Department of Neurology and The Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Columbia University Medical Center, New York, NY, USA
| | - Y Gu
- Cognitive Neuroscience Division, Department of Neurology and The Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Columbia University Medical Center, New York, NY, USA
| | - D M O'Shea
- Department of Clinical and Health Psychology, University of Florida, FL, USA
| | - M Yannakoulia
- Department of Nutrition and Diabetics, Harokopio University, Athens, Greece
| | - M H Kosmidis
- Department of Psychology, Aristotle University of Thessaloniki, Greece
| | - E Dardiotis
- Department of Neurology, Faculty of Medicine, University of Thessaly, Larissa, Greece
| | - G Hadjigeorgiou
- Department of Neurology, Faculty of Medicine, University of Thessaly, Larissa, Greece
| | - P Sakka
- Athens Association of Alzheimer's Disease and Related Disorders, Athens, Greece
| | - Y Stern
- Cognitive Neuroscience Division, Department of Neurology and The Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Columbia University Medical Center, New York, NY, USA
| | - N Scarmeas
- Department of Social Medicine, Psychiatry and Neurology, National and Kapodistrian University of Athens, Athens, Greece.,Cognitive Neuroscience Division, Department of Neurology and The Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Columbia University Medical Center, New York, NY, USA
| |
Collapse
|
16
|
Tsapanou A, Gu Y, O'Shea DM, Yannakoulia M, Kosmidis M, Dardiotis E, Hadjigeorgiou G, Sakka P, Stern Y, Scarmeas N. Sleep quality and duration in relation to memory in the elderly: Initial results from the Hellenic Longitudinal Investigation of Aging and Diet. Neurobiol Learn Mem 2017; 141:217-225. [PMID: 28455107 DOI: 10.1016/j.nlm.2017.04.011] [Citation(s) in RCA: 43] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2016] [Revised: 04/10/2017] [Accepted: 04/24/2017] [Indexed: 02/02/2023]
Abstract
BACKGROUND Sleep is crucial for cognition, particularly for memory, given its complex association with neurodegenerative processes. The aim of the present study was to examine the association between sleep quality as well as sleep duration and memory performance in a Greek elderly population. SETTING Cross-sectional design in the Hellenic Longitudinal Investigation of Aging and Diet (HELIAD), a population representative study of Greek elderly (65years or older). METHODS Data from 1589 participants free of sleep medication were included. Sleep quality was estimated by using the Sleep Scale from the Medical Outcomes Study. An extensive neuropsychological assessment examining memory was administered to each participant. Linear regression analyses were used to examine whether sleep quality (higher score, poor quality) and/or sleep duration were associated with memory expressed in the form of a z-score. Age, sex, education, and body mass index were included as covariates. The main analyses were conducted first on the total sample, then with the exclusion of demented participants, and finally with the exclusion of both demented and participants with Mild Cognitive Impairment (MCI). We then conducted further analyses on the non-demented, non-MCI group, initially stratified by Apolipoprotein E-ε4 gene. We further examined the role of co-morbidities, as well as the association between sleep duration groups and memory. We also explored any interaction effect between sex and sleep quality/duration on memory. We then examined the associations between components of sleep measures and memory scores. Lastly, we examined the associations between sleep quality/duration and verbal/non-verbal memory separately. RESULTS In the total sample, we noted significant associations between sleep duration and memory (B=-0.001, p≤0.0001), but not for sleep quality and memory (B=-0.038, p=0.121). After excluding the demented participants, the associations were significant for: sleep quality and memory (B=-0.054, p=0.023), and sleep duration and memory (B=-0.001, p≤0.0001). After excluding both the MCI and the demented subjects, the associations between sleep quality and memory (B=-0.065, p=0.006), and sleep duration and memory (B=-0.001, p=0.003) were still significant. The association between the sleep duration groups and memory function was also significant, such that poor memory performance was associated with the longer sleep duration group. The results remained significant even after controlling for the co-morbidities, as well as after adding in the model anxiety and depression as covariates. Associations between sleep quality and memory, and sleep duration and memory were present in the ApoE-ε4 non-carriers. The individual sleep questions that were probably shown to be driving the associations between sleep and memory were: time to fall asleep, sleep not quiet, getting enough sleep to feel rested upon waking in the morning, and getting the amount of sleep needed. Sleep duration was associated with both verbal and non-verbal memory, while sleep quality was only associated with verbal memory. CONCLUSION Poor sleep quality and longer sleep duration were linked to low memory performance, independent of demographic and clinical factors, in a large sample of cognitively healthy older Greek adults. Other parameters than sleep and memory measurements could play an important role on the association. Levels of melatonin, or circadian rhythms dysregulation might play a crucial role in the above associations.
Collapse
Affiliation(s)
- A Tsapanou
- Department of Social Medicine, Psychiatry and Neurology, National and Kapodistrian University of Athens, Athens, Greece; Cognitive Neuroscience Division, Department of Neurology and The Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Columbia University Medical Center, New York, NY, USA.
| | - Y Gu
- Cognitive Neuroscience Division, Department of Neurology and The Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Columbia University Medical Center, New York, NY, USA
| | - D M O'Shea
- Department of Clinical and Health Psychology, University of Florida, FL, USA
| | - M Yannakoulia
- Department of Nutrition and Diabetics, Harokopio University, Athens, Greece
| | - M Kosmidis
- Department of Psychology, Aristotle University of Thessaloniki, Greece
| | - E Dardiotis
- Department of Neurology, Faculty of Medicine, University of Thessaly, Larissa, Greece
| | - G Hadjigeorgiou
- Department of Neurology, Faculty of Medicine, University of Thessaly, Larissa, Greece
| | - P Sakka
- Athens Association of Alzheimer's Disease and Related Disorders, Athens, Greece
| | - Y Stern
- Cognitive Neuroscience Division, Department of Neurology and The Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Columbia University Medical Center, New York, NY, USA
| | - N Scarmeas
- Department of Social Medicine, Psychiatry and Neurology, National and Kapodistrian University of Athens, Athens, Greece; Cognitive Neuroscience Division, Department of Neurology and The Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Columbia University Medical Center, New York, NY, USA
| |
Collapse
|
17
|
Scalco R, Quinlivan R, Martin R, Baruch N, Martin M, Navarra C, Martinuzzi A, Bruno C, Laforet P, Sperber K, Sacconi S, Wakelin A, Hadjigeorgiou G, Vissing J, Vorgerd M, Haller R, Oflazer Z, Pouget J, Lucia A, Andreu T, Toscano A, Musumeci O. G.P.245. Neuromuscul Disord 2014. [DOI: 10.1016/j.nmd.2014.06.321] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
|
18
|
Almpanidou P, Hadjigeorgiou G, Gourgoulianis K, Papadimitriou A. Association of tumor necrosis factor-α gene polymorphism (-308) and obstructive sleep apnea-hypopnea syndrome. Hippokratia 2012; 16:217-220. [PMID: 23935286 PMCID: PMC3738726] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2023]
Abstract
BACKGROUND AND AIM Elevated serum tumor necrosis factor-α (TNF-α) concentra-tion and a polymorphism of the TNF-α gene at the position -308 in the promoter region are associated with obstructive sleep apnea-hypopnea syndrome (OSAHS). We aimed to determine the association of this polymorphism with OSAHS in Greek patients. PATIENTS AND METHODS A blood sample was obtained from 220 patients clinicaly diagnosed with OSAHS and 319 normal controls. TNF-α genotype was determined from nucleus-containing cells from whole blood using a PCR method. RESULTS The results demonstrated that the distribution of alleles was significantly dif-ferent when comparing the OSAHS patients group to the healthy controls. The appearance of AA (p=0.04) and AG (p<0.001) genotypes was significantly greater in OSAHS patients (8.6% and 32.7%, respectively) compared to the healthy control group (4.4% and 26.3%, respectively). Correspondingly, the appearance of the GG genotype was significantly lower in OSAHS patients compared to healthy controls (53.6% vs 69.3%). The A and G allele appeared at a frequency of 27.5% and 72.5% respectively in the OSAHS groups, and 17.6% and 82.4% in the control group respectively. CONCLUSIONS The distribution of genotypes and alleles of the single nucleotide polymorphism of TNF-α (-308) of OSAHS patients varies from healthy controls.
Collapse
Affiliation(s)
- P Almpanidou
- Neurogenetics Unit, Dept of Neurology, University Hospital of Larissa, Medical School, University of Thessaly
| | | | | | | |
Collapse
|
19
|
Spiliotis J, Vaxevanidou A, Halkia E, Hadjigeorgiou G, Datsis A. Reoperation combining re-cytoreductive surgery and re-HIPEC for recurrent peritoneal carcinomatosis. J BUON 2012; 17:522-525. [PMID: 23033293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
PURPOSE Cytoreductive surgery (CS) and hyperthermic intraperitoneal chemotherapy (HIPEC) is the proper treatment for resectable peritoneal carcinomatosis (PC). The aim of this study was to evaluate the postoperative course and long-term outcome of repeat CS (reCS) plus repeat HIPEC (reHIPEC) in patients with recurrent disease, after primary CS plus primary HIPEC. METHODS From 2004 to 2012 85 patients were subjected to primary CS + HIPEC. Fourteen of those patients developed recurrent PC and were subjected to reCS+reHIPEC during the same time period. Eligibility criteria included limited extent of the peritoneal disease, and interval of more than 12 months from the primary CS+HIPEC. The origins of the tumors were ovarian cancer (n=7) colorectal cancer (n=3), pseudomyxoma peritonei (n=3), and uterine sarcoma (n=1). RESULTS At second laparotomy, mean peritoneal cancer index (PCI) was 5.3 + 2.8. Among the 14 procedures, HIPEC was used in all patients. The postoperative mortality was 0% and grade 3-4 postoperative complications occurred in 4 patients. The overall 1-, 2- and 3- year overall survival rate was 90, 40 and 30%, respectively. CONCLUSION ReCS+reHIPEC is feasible and yields an accepted survival in highly selected patients.
Collapse
Affiliation(s)
- J Spiliotis
- Department of Surgery, "Metaxa" Cancer Hospital, Piraeus, Greece
| | | | | | | | | |
Collapse
|
20
|
Karathanou A, Paterakis K, Pakopoulou M, Tasiou A, Hadjigeorgiou G, Chovas A, Paraforos G, Fountas K, Komnos A. Biochemical markers analyzed using microdialysis and traumatic brain injury outcomes. J Neurosurg Sci 2011; 55:173-177. [PMID: 21968581] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
AIM Traumatic brain injury is a leading cause of disability and mortality among young people. Multiparametric cerebral bedside monitoring is a safe and promising technique for preventing secondary brain damage. The objective of this study was to investigate the usefulness of cerebral microdialysis in predicting the outcomes of patients with traumatic brain injury. METHODS Thirty-eight patients (33 males) were included in the study. The GCS on admission was ≤8. The outcome was assessed using the GOS over six months of follow-up. RESULTS Among the patients included, 18 had a favorable outcome (GOS=4.5) and the remaining 20 had an unfavorable outcome. L/P ratio and glycerol concentration were statistically significantly higher in the patients with unfavorable prognosis. CONCLUSION Biochemical parameters analysed using microdialysis could serve as predictor indexes of clinical outcome several months after the injury.
Collapse
Affiliation(s)
- A Karathanou
- Intensive Care Unit, Achillopoulio General Hospital, Volos, Greece
| | | | | | | | | | | | | | | | | |
Collapse
|
21
|
Dimitroulias A, Tsironi E, Hadjigeorgiou G, Scarmeas N, Rountas C, Zibis A, Malizos K. White Matter Lesions in Femoral Head Osteonecrosis patients: Manifestation of vascular disease or not? Hippokratia 2011; 15:265-268. [PMID: 22435027 PMCID: PMC3306036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
BACKGROUND Osteonecrosis has been associated with the presence of white matter lesions. The objective of this study was to investigate the association between macro- and micro- vascular disease and white matter lesions. METHODS Sixty-four patients with femoral head osteonecrosis were assessed during a cross sectional study in our university-based hospital. A vascular 'profile' was obtained for each patient and included measurement of plasma lipids, fundoscopic examination and common carotid artery triplex ultrasonography. All patients had brain MRI to assess for presence of white matter lesions. The two groups formed, with and without white matter lesions, were compared in order to define the association between white matter lesions and vascular disease. RESULTS Patients without white matter lesions had more frequently corticosteroid induced osteonecrosis. There was no difference in the two groups with respect to intima media thickness and ApoB/ApoA1 ratio. Only one of our patients demonstrated retinopathy. CONCLUSIONS There is no evidence of concurrent macro- and micro- vascular pathology in young patients with white matter lesions and femoral head osteonecrosis. Cortisone appears to have a 'protective' effect against occurrence of white matter lesions.
Collapse
|
22
|
Protogerou G, Ralli S, Tsougos I, Patramani I, Hadjigeorgiou G, Fezoulidis I, Kapsalaki EZ. T2 FLAIR Increased Signal Intensity at the Posterior Limb of the Internal Capsule: Clinical Significance in ALS Patients. Neuroradiol J 2011; 24:226-34. [PMID: 24059612 DOI: 10.1177/197140091102400210] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2011] [Accepted: 03/02/2011] [Indexed: 11/15/2022] Open
Abstract
Amyotrophic lateral sclerosis (ALS) is characterized by progressive upper and lower motor neuron degeneration. A hyperintense signal on T2-weighted images along the corticospinal tract has been reported in patients with confirmed ALS. However, the specificity of this finding is under consideration, since it is also identified in healthy controls. Moreover, the correlation of this finding with disease progression has not yet been established. The purpose of our study is to evaluate the frequency with which this high signal appears in the posterior limb of the internal capsule (PLIC), compare visual with quantitative measurements, and correlate these with the progression of the disease. Our prospective clinical study included 24 patients and 51 healthy volunteers. In the ALS patient group, the diagnosis was established according to the criteria of El Escorial in the revised form of Airlee House. All patients were neurologically examined and underwent diagnostic procedures to exclude other diseases resembling ALS. The initial MRI was performed six months to two years after the onset of symptomatology. All ALS patients were clinically examined regarding their symptoms from the upper and lower motor neurons. Follow-up MRIs were performed in nine out of 24 patients over a period of six months. Signal changes in the PLIC are visually evaluated on FLAIR images, and are classified as distinct, mild or no signal change. Fractional anisotropy (FA) measurements are performed by placing a region of interest (ROI) in the PLIC bilaterally. Both findings are being compared. Mild signal changes were visualized in the PLIC in ten volunteers and seven patients. Distinct T2 FLAIR signal changes were visualized in the PLIC in seven ALS patients. No distinct signal change was visualized in the controls. Moreover this increased T2 FLAIR signal change became more accentuated with disease progress. FA measurements in patients were lower than in age-matched healthy subjects, with a further decrease with disease progression. Our findings indicate that although mild hyperintensity of the PLIC is not pathognomonic for ALS, detection of a distinct PLIC hyperintensity that gradually accentuates might actually be a sign of progressive ALS. This finding is supported by the progressively decreasing FA measurements. Larger numbers of patients need to be included and re-evaluated to obtain statistically significant results.
Collapse
Affiliation(s)
- G Protogerou
- Department of Radiology, University Hospital of Larissa, University of Thessaly, School of Medicine; Larissa, Greece -
| | | | | | | | | | | | | |
Collapse
|
23
|
Skriapas K, Konstantinidis C, Tzortzis V, Hadjigeorgiou G, Samarinas M, Aggelakis K, Poulakis V, Melekos M. MP-07.12: Sexual dysfunction in women with newly diagnosed multiple sclerosis. Urology 2007. [DOI: 10.1016/j.urology.2007.06.296] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
|
24
|
Tzortzis V, Skriapas K, Hadjigeorgiou G, Mitsogiannis I, Aggelakis K, Gravas S, Poulakis V, Melekos MD. Sexual dysfunction in newly diagnosed multiple sclerosis women. Mult Scler 2007. [DOI: 10.1177/1352458507084596] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
|
25
|
Winkelmann J, Lichtner P, Kemlink D, Polo O, Montagna P, Högl B, Stiasny-Kolster K, Hadjigeorgiou G, Pütz B, Trenkwalder C, Strom T, Meitinger T, Müller-Myhsok B. New loci for restless legs syndrome map to chromosome 4q and 17p. Akt Neurol 2006. [DOI: 10.1055/s-2006-952980] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
|
26
|
Scarmeas N, Albert M, Brandt J, Blacker D, Hadjigeorgiou G, Papadimitriou A, Dubois B, Sarazin M, Wegesin D, Marder K, Bell K, Honig L, Stern Y. Motor signs predict poor outcomes in Alzheimer disease. Neurology 2006; 64:1696-703. [PMID: 15911793 PMCID: PMC3028937 DOI: 10.1212/01.wnl.0000162054.15428.e9] [Citation(s) in RCA: 130] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To examine whether the presence of motor signs has predictive value for important outcomes in Alzheimer disease (AD). METHODS A total of 533 patients with AD at early stages (mean Folstein Mini-Mental State Examination [MMSE] 21/30 at entry) were recruited and followed semiannually for up to 13.1 years (mean 3) in five University-based AD centers in the United States and European Union. Four outcomes, assessed every 6 months, were used in Cox models: cognitive endpoint (Columbia Mini-Mental State Examination < or = 20/57 [ approximately MMSE < or = 10/30]), functional endpoint (Blessed Dementia Rating Scale > or = 10), institutionalization equivalent index, and death. Using a standardized portion of the Unified PD Rating Scale (administered every 6 months for a total of 3,149 visit-assessments, average 5.9 per patient), the presence of motor signs, as well as of individual motor sign domains, was examined as time-dependent predictor. The models controlled for cohort, recruitment center, sex, age, education, a comorbidity index, and baseline cognitive and functional performance. RESULTS A total of 39% of the patients reached the cognitive, 41% the functional, 54% the institutionalization, and 47% the mortality endpoint. Motor signs were noted for 14% of patients at baseline and for 45% at any evaluation. Their presence was associated with increased risk for cognitive decline (RR, 1.72; 95% CI, 1.24 to 2.38), functional decline (1.80 [1.33 to 2.45]), institutionalization (1.68 [1.26 to 2.25]), and death (1.38 [1.05 to 1.82]). Tremor was associated with increased risk for reaching the cognitive and bradykinesia for reaching the functional endpoints. Postural-gait abnormalities carried increased risk for institutionalization and mortality. Faster rates of motor sign accumulation were associated with increased risk for all outcomes. CONCLUSIONS Motor signs predict cognitive and functional decline, institutionalization, and mortality in Alzheimer disease. Different motor sign domains predict different outcomes.
Collapse
Affiliation(s)
- N Scarmeas
- Cognitive Neuroscience Division of the Taub Institute for Research in Alzheimer's Disease and the Aging Brain, Columbia University Medical Center, New York, NY 10032, USA.
| | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
27
|
Sue CM, Tanji K, Hadjigeorgiou G, Andreu AL, Nishino I, Krishna S, Bruno C, Hirano M, Shanske S, Bonilla E, Fischel-Ghodsian N, DiMauro S, Friedman R. Maternally inherited hearing loss in a large kindred with a novel T7511C mutation in the mitochondrial DNA tRNA(Ser(UCN)) gene. Neurology 1999; 52:1905-8. [PMID: 10371545 DOI: 10.1212/wnl.52.9.1905] [Citation(s) in RCA: 130] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Thirty-six of 43 maternally related members of a large African American family experienced hearing loss. A muscle biopsy specimen from the proband showed cytochrome c oxidase (COX)-deficient fibers but no ragged-red fibers; biochemical analysis showed marked reduction of COX activity. A novel T7511C point mutation in the tRNA(Ser(UCN)) gene was present in almost homoplasmic levels (>95%) in the blood of 18 of 20 family members, and was also found in lower abundance in the other two. Single-fiber PCR showed that the mutational load was greater in COX-deficient muscle fibers. The tRNA(ser(UCN)) gene may be a "hot spot" for mutations associated with maternally transmitted hearing loss.
Collapse
Affiliation(s)
- C M Sue
- Department of Neurology, Columbia University College of Physicians and Surgeons, New York, NY 10032, USA
| | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
28
|
Papadimitriou A, Chroni E, Anastasopoulos I, Avramidis T, Hadjigeorgiou G, Koutroumanidis M. Continuous muscle fiber activity associated with morphea (localized scleroderma). Neurology 1998; 51:1763-4. [PMID: 9855545 DOI: 10.1212/wnl.51.6.1763] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
- A Papadimitriou
- University of Thessalia, Department of Neurology, Red Cross Hospital, Athens, Greece
| | | | | | | | | | | |
Collapse
|