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Buto PT, Wang J, La Joie R, Zimmerman SC, Glymour MM, Ackley SF, Hoffmann TJ, Yaffe K, Zeki Al Hazzouri A, Brenowitz WD. Genetic risk score for Alzheimer's disease predicts brain volume differences in mid and late life in UK biobank participants. Alzheimers Dement 2024; 20:1978-1987. [PMID: 38183377 PMCID: PMC10984491 DOI: 10.1002/alz.13610] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Revised: 10/18/2023] [Accepted: 11/26/2023] [Indexed: 01/08/2024]
Abstract
INTRODUCTION We estimated the ages when associations between Alzheimer's disease (AD) genes and brain volumes begin among middle-aged and older adults. METHODS Among 45,616 dementia-free participants aged 45-80, linear regressions tested whether genetic risk score for AD (AD-GRS) had age-dependent associations with 38 regional brain magnetic resonance imaging volumes. Models were adjusted for sex, assessment center, genetic ancestry, and intracranial volume. RESULTS AD-GRS modified the estimated effect of age (per decade) on the amygdala (-0.41 mm3 [-0.42, -0.40]); hippocampus (-0.45 mm3 [-0.45, -0.44]), nucleus accumbens (-0.55 mm3 [-0.56, -0.54]), thalamus (-0.38 mm3 [-0.39, -0.37]), and medial orbitofrontal cortex (-0.23 mm3 [-0.24, -0.22]). Trends began by age 45 for the nucleus accumbens and thalamus, 48 for the hippocampus, 51 for the amygdala, and 53 for the medial orbitofrontal cortex. An AD-GRS excluding apolipoprotein E (APOE) was additionally associated with entorhinal and middle temporal cortices. DISCUSSION APOE and other genes that increase AD risk predict lower hippocampal and other brain volumes by middle age.
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Affiliation(s)
- Peter T. Buto
- Department of Epidemiology & BiostatisticsUniversity of CaliforniaSan FranciscoCaliforniaUSA
- Department of EpidemiologyBoston University School of Public HealthBostonMassachusettsUSA
| | - Jingxuan Wang
- Department of Epidemiology & BiostatisticsUniversity of CaliforniaSan FranciscoCaliforniaUSA
- Department of EpidemiologyBoston University School of Public HealthBostonMassachusettsUSA
| | - Renaud La Joie
- Memory and Aging CenterUniversity of CaliforniaSan FranciscoCaliforniaUSA
| | - Scott C. Zimmerman
- Department of Epidemiology & BiostatisticsUniversity of CaliforniaSan FranciscoCaliforniaUSA
| | - M. Maria Glymour
- Department of EpidemiologyBoston University School of Public HealthBostonMassachusettsUSA
| | - Sarah F. Ackley
- Department of EpidemiologyBoston University School of Public HealthBostonMassachusettsUSA
| | - Thomas J. Hoffmann
- Department of Epidemiology & BiostatisticsUniversity of CaliforniaSan FranciscoCaliforniaUSA
| | - Kristine Yaffe
- Department of Epidemiology & BiostatisticsUniversity of CaliforniaSan FranciscoCaliforniaUSA
- Departments of Psychiatry and Behavioral SciencesUniversity of CaliforniaSan FranciscoCaliforniaUSA
- Departments of NeurologyUniversity of CaliforniaSan FranciscoUSA
| | - Adina Zeki Al Hazzouri
- Department of EpidemiologyMailman School of Public HealthColumbia UniversityNew YorkNew YorkUSA
| | - Willa D. Brenowitz
- Department of Epidemiology & BiostatisticsUniversity of CaliforniaSan FranciscoCaliforniaUSA
- Kaiser Permanente Center for Health ResearchPortlandOregonUSA
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Hill-Jarrett TG, Choi M, Buto PT, Miramontes S, Thomas MD, Yang Y, Kim MH, Sims KD, Glymour MM. Associations of Everyday and Lifetime Experiences of Discrimination With Willingness to Undergo Alzheimer Disease Predictive Testing. Neurology 2024; 102:e208005. [PMID: 38266219 DOI: 10.1212/wnl.0000000000208005] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Accepted: 10/13/2023] [Indexed: 01/26/2024] Open
Abstract
BACKGROUND AND OBJECTIVES Rapid developments in Alzheimer disease (AD) biomarker research suggest that predictive testing may become widely available. To ensure equal access to AD predictive testing, it is important to understand factors that affect testing interest. Discrimination may influence attitudes toward AD testing, particularly among racially and ethnically minoritized populations, because of structural racism in health care systems. This study examined whether everyday or lifetime discrimination experiences shape interest in AD predictive testing. METHODS In the 2010 and 2012 biennial Health and Retirement Study waves, respondents were randomly selected to complete questions on interest in receiving free testing that could determine whether they would develop AD in the future. The exposures were everyday discrimination (6 items) and lifetime discrimination (7 items); both were transformed into a binary variable. Logistic regression models predicting interest in AD testing were controlled for deciles of propensity scores for each discrimination measure. Odds ratios were re-expressed as risk differences (RDs). RESULTS Our analytic sample included 1,499 respondents. The mean age was 67 (SD = 10.2) years, 57.4% were women, 65.7% were White, and 80% endorsed interest in AD predictive testing. Most of the participants (54.7%) experienced everyday discrimination in at least one domain; 24.1% experienced major lifetime discrimination in at least one domain. Those interested in predictive testing were younger (66 vs 70 years) and more likely to be Black (20% vs 15%) or Latinx (14% vs 8%) than participants uninterested in testing. The probability of wanting an AD test was not associated with discrimination for Black (RD everyday discrimination = -0.026; 95% CI [-0.081 to 0.029]; RD lifetime discrimination = -0.012; 95% CI [-0.085 to 0.063]) or Latinx (RD everyday discrimination = -0.023, 95% CI [-0.082 to 0.039]; RD lifetime discrimination = -0.011; 95% CI [-0.087 to 0.064]) participants. DISCUSSION Despite historical and contemporary experiences of discrimination, Black and Latinx individuals express interest in AD testing. However, Black and Latinx individuals remain underrepresented in AD research, including research on AD testing. Interest in personalized information about dementia risk may be a pathway to enhance their inclusion in research and clinical trials.
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Affiliation(s)
- Tanisha G Hill-Jarrett
- From the Department of Neurology (T.G.H.-.J), Memory and Aging Center; Department of Epidemiology and Biostatistics (M.C., P.T.B.); Bakar Computational Health Sciences Institute (S.M.); Department of Psychiatry and Behavioral Sciences (M.D.T.), Weill Institute for Neurosciences; Department of Epidemiology and Biostatistics (Y.Y., K.D.S., M.M.G.); and Institute for Health Policy Studies (M.H.K.), University of California San Francisco
| | - Minhyuk Choi
- From the Department of Neurology (T.G.H.-.J), Memory and Aging Center; Department of Epidemiology and Biostatistics (M.C., P.T.B.); Bakar Computational Health Sciences Institute (S.M.); Department of Psychiatry and Behavioral Sciences (M.D.T.), Weill Institute for Neurosciences; Department of Epidemiology and Biostatistics (Y.Y., K.D.S., M.M.G.); and Institute for Health Policy Studies (M.H.K.), University of California San Francisco
| | - Peter T Buto
- From the Department of Neurology (T.G.H.-.J), Memory and Aging Center; Department of Epidemiology and Biostatistics (M.C., P.T.B.); Bakar Computational Health Sciences Institute (S.M.); Department of Psychiatry and Behavioral Sciences (M.D.T.), Weill Institute for Neurosciences; Department of Epidemiology and Biostatistics (Y.Y., K.D.S., M.M.G.); and Institute for Health Policy Studies (M.H.K.), University of California San Francisco
| | - Silvia Miramontes
- From the Department of Neurology (T.G.H.-.J), Memory and Aging Center; Department of Epidemiology and Biostatistics (M.C., P.T.B.); Bakar Computational Health Sciences Institute (S.M.); Department of Psychiatry and Behavioral Sciences (M.D.T.), Weill Institute for Neurosciences; Department of Epidemiology and Biostatistics (Y.Y., K.D.S., M.M.G.); and Institute for Health Policy Studies (M.H.K.), University of California San Francisco
| | - Marilyn D Thomas
- From the Department of Neurology (T.G.H.-.J), Memory and Aging Center; Department of Epidemiology and Biostatistics (M.C., P.T.B.); Bakar Computational Health Sciences Institute (S.M.); Department of Psychiatry and Behavioral Sciences (M.D.T.), Weill Institute for Neurosciences; Department of Epidemiology and Biostatistics (Y.Y., K.D.S., M.M.G.); and Institute for Health Policy Studies (M.H.K.), University of California San Francisco
| | - Yulin Yang
- From the Department of Neurology (T.G.H.-.J), Memory and Aging Center; Department of Epidemiology and Biostatistics (M.C., P.T.B.); Bakar Computational Health Sciences Institute (S.M.); Department of Psychiatry and Behavioral Sciences (M.D.T.), Weill Institute for Neurosciences; Department of Epidemiology and Biostatistics (Y.Y., K.D.S., M.M.G.); and Institute for Health Policy Studies (M.H.K.), University of California San Francisco
| | - Min Hee Kim
- From the Department of Neurology (T.G.H.-.J), Memory and Aging Center; Department of Epidemiology and Biostatistics (M.C., P.T.B.); Bakar Computational Health Sciences Institute (S.M.); Department of Psychiatry and Behavioral Sciences (M.D.T.), Weill Institute for Neurosciences; Department of Epidemiology and Biostatistics (Y.Y., K.D.S., M.M.G.); and Institute for Health Policy Studies (M.H.K.), University of California San Francisco
| | - Kendra D Sims
- From the Department of Neurology (T.G.H.-.J), Memory and Aging Center; Department of Epidemiology and Biostatistics (M.C., P.T.B.); Bakar Computational Health Sciences Institute (S.M.); Department of Psychiatry and Behavioral Sciences (M.D.T.), Weill Institute for Neurosciences; Department of Epidemiology and Biostatistics (Y.Y., K.D.S., M.M.G.); and Institute for Health Policy Studies (M.H.K.), University of California San Francisco
| | - M Maria Glymour
- From the Department of Neurology (T.G.H.-.J), Memory and Aging Center; Department of Epidemiology and Biostatistics (M.C., P.T.B.); Bakar Computational Health Sciences Institute (S.M.); Department of Psychiatry and Behavioral Sciences (M.D.T.), Weill Institute for Neurosciences; Department of Epidemiology and Biostatistics (Y.Y., K.D.S., M.M.G.); and Institute for Health Policy Studies (M.H.K.), University of California San Francisco
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Buto PT, Shah A, Pearce BD, Lima BB, Almuwaqqat Z, Martini A, Al-Abboud O, Tarlapally N, Sullivan S, Sun YV, Murrah NV, Driggers E, Shallenberger L, Lewis TT, Elon L, Bremner JD, Raggi P, Quyyumi A, Vaccarino V. Association of systemic inflammation with posttraumatic stress disorder after a myocardial infarction. Brain Behav Immun Health 2023; 30:100629. [PMID: 37396337 PMCID: PMC10308211 DOI: 10.1016/j.bbih.2023.100629] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2023] [Accepted: 04/21/2023] [Indexed: 07/04/2023] Open
Abstract
Background Adverse mental health conditions including depression, posttraumatic stress disorder (PTSD), and anxiety are prevalent among patients who survive myocardial infarctions (MI) and are associated with adverse outcomes. The mechanisms underlying these associations, however, are not well understood. Inflammatory pathways may mediate the cardiovascular outcomes of patients with mental health disorders. We examined the bidirectional association between PTSD symptoms and inflammatory biomarkers in a young/middle-aged post MI population. We further examined how this association may differ between women and men as well as between Black and non-Black individuals. Methods Participants included individuals with early onset MI between the ages 25 and 60. Mental health scores for depression, PTSD, perceived stress, and anxiety as well as inflammatory biomarkers, interleukin-6 (IL-6) and high sensitivity C-reactive protein (hsCRP), were collected at baseline and at six-month follow up. We examined the bidirectional changes in mental health symptoms and inflammatory biomarkers between baseline and follow-up. Results Among 244 patients in the study (mean age: 50.8, 48.4% female, 64.3% Black), the geometric means for IL-6 level and hsCRP at rest were 1.7 pg/mL and 2.76 mg/L, respectively. Mental health scores at baseline did not consistently predict changes in inflammatory biomarkers at follow-up. However, baseline levels of both IL-6 and hsCRP were robustly associated with an increase in re-experiencing PTSD symptoms at 6 months: in adjusted linear mixed models, there was a 1.58-point increase in re-experiencing PTSD symptoms per unit of baseline hsCRP (p = 0.01) and 2.59-point increase per unit of baseline IL-6 (p = 0.02). Once the analysis was stratified by race, the association was only noted in Black individuals. Baseline inflammation was not associated with change in any of the other mental health symptom scores. Conclusion Markers of inflammation are associated with an increase in post-event PTSD symptoms in younger or middle-aged patients who experienced an MI, especially Black patients. These results suggest a mechanistic link between inflammation and the development of PTSD among individuals with cardiovascular disease.
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Affiliation(s)
- Peter T. Buto
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Amit Shah
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
- Department of Medicine, Division of Cardiology, Emory University School of Medicine, Atlanta, GA, USA
- Atlanta VA Health Care System, Decatur, GA, USA
| | - Brad D. Pearce
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Bruno B. Lima
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
- Department of Medicine, Division of Cardiology, Emory University School of Medicine, Atlanta, GA, USA
| | - Zakaria Almuwaqqat
- Department of Medicine, Division of Cardiology, Emory University School of Medicine, Atlanta, GA, USA
| | - Afif Martini
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Omar Al-Abboud
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Nitya Tarlapally
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Samaah Sullivan
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
- Department of Epidemiology, Human Genetics and Environmental Sciences, University of Texas Health Science Center, Houston, TX, USA
| | - Yan V. Sun
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
- Atlanta VA Health Care System, Decatur, GA, USA
| | - Nancy V. Murrah
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Emily Driggers
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Lucy Shallenberger
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Tené T. Lewis
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Lisa Elon
- Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - J. Douglas Bremner
- Atlanta VA Health Care System, Decatur, GA, USA
- Departments of Psychiatry and Behavioral Sciences and Radiology, Emory University School of Medicine, USA
| | - Paolo Raggi
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
- Mazankowski Alberta Heart Institute, University of Alberta, Edmonton, Alberta, Canada
| | - Arshed Quyyumi
- Department of Medicine, Division of Cardiology, Emory University School of Medicine, Atlanta, GA, USA
| | - Viola Vaccarino
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
- Department of Medicine, Division of Cardiology, Emory University School of Medicine, Atlanta, GA, USA
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