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Castro CB, Costa LM, Dias CB, Chen J, Hillebrandt H, Gardener SL, Brown BM, Loo RL, Garg ML, Rainey-Smith SR, Martins RN, Sohrabi HR. Multi-Domain Interventions for Dementia Prevention - A Systematic Review. J Nutr Health Aging 2023; 27:1271-1280. [PMID: 38151879 DOI: 10.1007/s12603-023-2046-2] [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] [Received: 07/03/2023] [Accepted: 11/10/2023] [Indexed: 12/29/2023]
Abstract
OBJECTIVES There is a growing incidence of cognitive decline and dementia associated with the ageing population. Lifestyle factors such as diet, physical activity, and cognitive activities may individually or collectively be undertaken to increase one's odds of preventing cognitive decline and future dementia. This study will examine whether clinical trials using multidomain lifestyle intervention can significantly decrease the risk of cognitive decline and therefore dementia. DESIGN, SETTING AND PARTICIPANTS This systematic literature review of multidomain lifestyle interventions for the prevention of cognitive decline and dementia followed the PRISMA guidelines. Clinical trials involving multidomain intervention (i.e., diet and physical activity, or without cognitive training) in older adults (≥ 49 years old) at higher risk of dementia were identified through 5 electronic databases (EMBASE, MEDLINE, CINAHL, Cochrane, and Scopus). A comprehensive search was performed to identify and retrieve publications until 15 November 2022. Trials were published in English. RESULTS The included studies (n=15) assessed change in cognition in response to a multidomain lifestyle intervention. However, the cognitive outcome measures used in these studies were heterogeneous. Despite this heterogeneity, two thirds of the studies showed improvement in cognition following a multidomain intervention (n=10 with a total of 9,439 participants). However, five studies reported no improvement in cognition following the multidomain intervention. The most common form of dietary intervention included higher amount of fruit and vegetable intake; whole-grain cereal products instead of refined; low fat options in milk and meat products; and limiting sucrose intake to less than 50 g/day. Most clinical trial studies were powered to examining the effects of multidomain interventions in cognition but were not designed to test the contribution of individual domains (i.e., dietary changes, increased physical activity, or increased cognitive stimulation alone). CONCLUSION This systematic review aimed to determine the effect of multimodal lifestyle interventions on cognitive outcomes in older adults at risk of dementia. We found that participants with conditions that may increase the risk of dementia, (e.g., hypertension, cardiovascular fragility) do benefit from multi-modal lifestyle changes including diet, physical activity, and cognitive training. Two thirds of studies using multidomain lifestyle interventions showed improvements in cognitive function. Trials with a focus on cognitive training, dietary improvement, and physical activity may prevent or delay cognitive decline in older adults including those at risk of developing dementia. Future studies should consider longer follow-up periods and adequate power to be able to examine the effects of each lifestyle component in the context of multimodal interventions.
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Affiliation(s)
- C B Castro
- Professor Hamid R. Sohrabi, Centre for Healthy Ageing, Health Futures Institute, Murdoch University, Perth, Australia, Phone: +61 8 9360 6901, E-mail: ; Professor Ralph N. Martins, Centre of Excellence for Alzheimer's Disease Research and Care, School of Medical and Health Sciences, Edith Cowan University, Perth, Australia, E-mail:
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Goozee K, Chatterjee P, James I, Shen K, Sohrabi HR, Asih PR, Dave P, ManYan C, Taddei K, Ayton SJ, Garg ML, Kwok JB, Bush AI, Chung R, Magnussen JS, Martins RN. Elevated plasma ferritin in elderly individuals with high neocortical amyloid-β load. Mol Psychiatry 2018; 23:1807-1812. [PMID: 28696433 DOI: 10.1038/mp.2017.146] [Citation(s) in RCA: 47] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2017] [Revised: 05/14/2017] [Accepted: 05/26/2017] [Indexed: 12/14/2022]
Abstract
Ferritin, an iron storage and regulation protein, has been associated with Alzheimer's disease (AD); however, it has not been investigated in preclinical AD, detected by neocortical amyloid-β load (NAL), before cognitive impairment. Cross-sectional analyses were carried out for plasma and serum ferritin in participants in the Kerr Anglican Retirement Village Initiative in Aging Health cohort. Subjects were aged 65-90 years and were categorized into high and low NAL groups via positron emission tomography using a standard uptake value ratio cutoff=1.35. Ferritin was significantly elevated in participants with high NAL compared with those with low NAL, adjusted for covariates age, sex, apolipoprotein E ɛ4 carriage and levels of C-reactive protein (an inflammation marker). Ferritin was also observed to correlate positively with NAL. A receiver operating characteristic curve based on a logistic regression of the same covariates, the base model, distinguished high from low NAL (area under the curve (AUC)=0.766), but was outperformed when plasma ferritin was added to the base model (AUC=0.810), such that at 75% sensitivity, the specificity increased from 62 to 71% on adding ferritin to the base model, indicating that ferritin is a statistically significant additional predictor of NAL over and above the base model. However, ferritin's contribution alone is relatively minor compared with the base model. The current findings suggest that impaired iron mobilization is an early event in AD pathogenesis. Observations from the present study highlight ferritin's potential to contribute to a blood biomarker panel for preclinical AD.
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Affiliation(s)
- K Goozee
- Department of Biomedical Sciences, Macquarie University, Sydney, NSW, Australia.,Anglicare, Sydney, NSW, Australia.,School of Psychiatry and Clinical Neurosciences, University of Western Australia, Perth, WA, Australia.,School of Medical Health and Sciences, Edith Cowan University, Perth, WA, Australia.,McCusker Alzheimer Research Foundation, Perth, WA, Australia.,KaRa Institute of Neurological Disease, Sydney, NSW, Australia.,The Cooperative Research Centre for Mental Health, Carlton, VIC, Australia
| | - P Chatterjee
- Department of Biomedical Sciences, Macquarie University, Sydney, NSW, Australia.,School of Medical Health and Sciences, Edith Cowan University, Perth, WA, Australia.,KaRa Institute of Neurological Disease, Sydney, NSW, Australia
| | - I James
- Institute for Immunology and Infectious Diseases, Murdoch University, Perth, WA, Australia
| | - K Shen
- Australian eHealth Research Centre, CSIRO, Floreat, WA, Australia
| | - H R Sohrabi
- Department of Biomedical Sciences, Macquarie University, Sydney, NSW, Australia.,School of Medical Health and Sciences, Edith Cowan University, Perth, WA, Australia.,McCusker Alzheimer Research Foundation, Perth, WA, Australia.,The Cooperative Research Centre for Mental Health, Carlton, VIC, Australia
| | - P R Asih
- KaRa Institute of Neurological Disease, Sydney, NSW, Australia.,School of Medical Sciences, University of New South Wales, Sydney, NSW, Australia
| | - P Dave
- Department of Biomedical Sciences, Macquarie University, Sydney, NSW, Australia.,Anglicare, Sydney, NSW, Australia
| | - C ManYan
- Anglicare, Sydney, NSW, Australia
| | - K Taddei
- School of Medical Health and Sciences, Edith Cowan University, Perth, WA, Australia.,McCusker Alzheimer Research Foundation, Perth, WA, Australia
| | - S J Ayton
- Florey Department of Neuroscience and Mental Health, University of Melbourne University, Melbourne, VIC, Australia
| | - M L Garg
- Nutraceuticals Research Program, School of Biomedical Sciences and Pharmacy, University of Newcastle, Callaghan, NSW, Australia
| | - J B Kwok
- School of Medical Sciences, University of New South Wales, Sydney, NSW, Australia.,Neuroscience Research Australia, Sydney, NSW, Australia
| | - A I Bush
- The Cooperative Research Centre for Mental Health, Carlton, VIC, Australia.,Florey Department of Neuroscience and Mental Health, University of Melbourne University, Melbourne, VIC, Australia
| | - R Chung
- Department of Biomedical Sciences, Macquarie University, Sydney, NSW, Australia
| | - J S Magnussen
- Department of Clinical Medicine, Macquarie University, Sydney, NSW, Australia
| | - R N Martins
- Department of Biomedical Sciences, Macquarie University, Sydney, NSW, Australia. .,School of Psychiatry and Clinical Neurosciences, University of Western Australia, Perth, WA, Australia. .,School of Medical Health and Sciences, Edith Cowan University, Perth, WA, Australia. .,McCusker Alzheimer Research Foundation, Perth, WA, Australia. .,KaRa Institute of Neurological Disease, Sydney, NSW, Australia. .,The Cooperative Research Centre for Mental Health, Carlton, VIC, Australia.
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Jayakody DMP, Friedland PL, Eikelboom RH, Martins RN, Sohrabi HR. A novel study on association between untreated hearing loss and cognitive functions of older adults: Baseline non-verbal cognitive assessment results. Clin Otolaryngol 2017; 43:182-191. [PMID: 28710824 DOI: 10.1111/coa.12937] [Citation(s) in RCA: 47] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/09/2017] [Indexed: 11/30/2022]
Abstract
BACKGROUND Age-related hearing loss (ARHL) is highly prevalent in older adults, and more than two-thirds above age of 70 years suffer from ARHL. Recent studies have established a link between ARHL and cognitive impairment; however, most of the studies have used verbally loaded cognitive measures to investigate the association between ARHL and cognition. It is possible that due to hearing impairment, the elderly may experience difficulty in following verbal instructions or completing tasks that heavily rely on hearing during cognitive assessments. This may result in overestimation of cognitive impairment in such individuals. This baseline cross-sectional study investigated the associations between untreated hearing loss and a number of cognitive functions using a battery of non-verbal cognitive tests. Further, association between hearing loss and psychological status of older adults was examined. STUDY DESIGN Prospective case-controlled study. METHODS A total of 119 participants (54 males, M=66.33±10.50 years; 65 females M=61.51±11.46 years) were recruited. All participants completed a hearing assessment, a computerised test battery of non-verbal cognitive functions and the depression, anxiety and stress scale. RESULTS Hierarchical multiple regression analysis results revealed that hearing thresholds significantly associated with the working memory (P<0.05), paired associative learning scores (P<0.05), depression (P<0.001), and anxiety (P<0.001) and stress (P<0.001) scores. Analysis of covariance results revealed that participants with moderately-severe hearing loss performed significantly poorer in paired associative learning and working memory tasks and psychological function tests compared to those with normal hearing. CONCLUSION Results of the current study suggest a significant relationship between ARHL and both cognition and psychological status. Our results also have some implications for using non-verbal cognitive tests to evaluate cognitive functions in post-lingually hearing impaired ageing adults, at least for those with more than moderately-severe levels of hearing loss.
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Affiliation(s)
- D M P Jayakody
- Ear Science Institute Australia, Subiaco, WA, Australia.,Ear Sciences Centre, School of Surgery, The University of Western Australia, Crawley, WA, Australia
| | - P L Friedland
- Ear Science Institute Australia, Subiaco, WA, Australia.,Ear Sciences Centre, School of Surgery, The University of Western Australia, Crawley, WA, Australia.,Department of Otolaryngology Head Neck Skull Base Surgery, Sir Charles Gairdner Hospital, Nedlands, WA, Australia
| | - R H Eikelboom
- Ear Science Institute Australia, Subiaco, WA, Australia.,Ear Sciences Centre, School of Surgery, The University of Western Australia, Crawley, WA, Australia.,Department of Speech-Language Pathology and Audiology, University of Pretoria, Pretoria, South Africa
| | - R N Martins
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA, Australia
| | - H R Sohrabi
- School of Medical and Health Sciences, Edith Cowan University, Joondalup, WA, Australia
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Sutton TA, Sohrabi HR, Rainey-Smith SR, Bird SM, Weinborn M, Martins RN. The role of APOE-ɛ4 and beta amyloid in the differential rate of recovery from ECT: a review. Transl Psychiatry 2015; 5:e539. [PMID: 25826114 PMCID: PMC4429172 DOI: 10.1038/tp.2015.39] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2014] [Revised: 01/27/2015] [Accepted: 02/23/2015] [Indexed: 12/29/2022] Open
Abstract
Individual biological differences may contribute to the variability of outcomes, including cognitive effects, observed following electroconvulsive treatment (ECT). A narrative review of the research literature on carriage of the apolipoprotein E ɛ4 allele (APOE-ɛ4) and the protein biomarker beta amyloid (Aβ) with ECT cognitive outcome was undertaken. ECT induces repeated brain seizures and there is debate as to whether this causes brain injury and long-term cognitive disruption. The majority of ECT is administered to the elderly (over age 65 years) with drug-resistant depression. Depression in the elderly may be a symptom of the prodromal stage of Alzheimer's disease (AD). Carriage of the APOE-ɛ4 allele and raised cerebral Aβ are consistently implicated in AD, but inconsistently implicated in brain injury (and related syndromes) recovery rates. A paucity of brain-related recovery, genetic and biomarker research in ECT responses in the elderly was found: three studies have examined the effect of APOE-ɛ4 allele carriage on cognition in the depressed elderly receiving ECT, and two have examined Aβ changes after ECT, with contradictory findings. Cognitive changes in all studies of ECT effects were measured by a variety of psychological tests, making comparisons of such changes between studies problematic. Further, psychological test data-validity measures were not routinely administered, counter to current testing recommendations. The methodological issues of the currently available literature as well as the need for well-designed, hypothesis driven, longitudinal studies are discussed.
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Affiliation(s)
- T A Sutton
- School of Psychiatry and Clinical Neurosciences, University of Western Australia, Crawley, WA, Australia
| | - H R Sohrabi
- School of Psychiatry and Clinical Neurosciences, University of Western Australia, Crawley, WA, Australia,Centre of Excellence for Alzheimer's Disease Research and Care, School of Medical Sciences, Edith Cowan University, Joondalup, WA, Australia,Sir James McCusker Alzheimer's Disease Research Unit, Hollywood Private Centre, Nedlands, WA, Australia
| | - S R Rainey-Smith
- Centre of Excellence for Alzheimer's Disease Research and Care, School of Medical Sciences, Edith Cowan University, Joondalup, WA, Australia,Sir James McCusker Alzheimer's Disease Research Unit, Hollywood Private Centre, Nedlands, WA, Australia
| | - S M Bird
- School of Psychiatry and Clinical Neurosciences, University of Western Australia, Crawley, WA, Australia,Centre of Excellence for Alzheimer's Disease Research and Care, School of Medical Sciences, Edith Cowan University, Joondalup, WA, Australia,Sir James McCusker Alzheimer's Disease Research Unit, Hollywood Private Centre, Nedlands, WA, Australia
| | - M Weinborn
- Centre of Excellence for Alzheimer's Disease Research and Care, School of Medical Sciences, Edith Cowan University, Joondalup, WA, Australia,Sir James McCusker Alzheimer's Disease Research Unit, Hollywood Private Centre, Nedlands, WA, Australia,School of Psychology, University of Western Australia, Hollywood Private Hospital, Nedlands, WA, Australia
| | - R N Martins
- School of Psychiatry and Clinical Neurosciences, University of Western Australia, Crawley, WA, Australia,Centre of Excellence for Alzheimer's Disease Research and Care, School of Medical Sciences, Edith Cowan University, Joondalup, WA, Australia,Sir James McCusker Alzheimer's Disease Research Unit, Hollywood Private Centre, Nedlands, WA, Australia,Sir James McCusker Alzheimer's Disease Research Unit, Suite 22, Hollywood Medical Centre, 85 Monash Avenue, Nedlands, WA 6009, Australia. E-mail:
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Sohrabi HR, Bates KA, Weinborn MG, Johnston ANB, Bahramian A, Taddei K, Laws SM, Rodrigues M, Morici M, Howard M, Martins G, Mackay-Sim A, Gandy SE, Martins RN. Olfactory discrimination predicts cognitive decline among community-dwelling older adults. Transl Psychiatry 2012; 2:e118. [PMID: 22832962 PMCID: PMC3365262 DOI: 10.1038/tp.2012.43] [Citation(s) in RCA: 74] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
The presence of olfactory dysfunction in individuals at higher risk of Alzheimer's disease has significant diagnostic and screening implications for preventive and ameliorative drug trials. Olfactory threshold, discrimination and identification can be reliably recorded in the early stages of neurodegenerative diseases. The current study has examined the ability of various olfactory functions in predicting cognitive decline in a community-dwelling sample. A group of 308 participants, aged 46-86 years old, were recruited for this study. After 3 years of follow-up, participants were divided into cognitively declined and non-declined groups based on their performance on a neuropsychological battery. Assessment of olfactory functions using the Sniffin' Sticks battery indicated that, contrary to previous findings, olfactory discrimination, but not olfactory identification, significantly predicted subsequent cognitive decline (odds ratio = 0.869; P<0.05; 95% confidence interval = 0.764-0.988). The current study findings confirm previously reported associations between olfactory and cognitive functions, and indicate that impairment in olfactory discrimination can predict future cognitive decline. These findings further our current understanding of the association between cognition and olfaction, and support olfactory assessment in screening those at higher risk of dementia.
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Affiliation(s)
- H R Sohrabi
- The School of Medical Sciences, Edith Cowan University, Joondalup, WA, Australia,The McCusker Alzheimer's Research Foundation, Hollywood Private Hospital, Nedlands, WA, Australia,The Centre of Excellence for Alzheimer's Disease Research and Care, Edith Cowan University, Joondalup, WA, Australia
| | - K A Bates
- The McCusker Alzheimer's Research Foundation, Hollywood Private Hospital, Nedlands, WA, Australia,The Centre of Excellence for Alzheimer's Disease Research and Care, Edith Cowan University, Joondalup, WA, Australia,The School of Animal Biology, University of Western Australia, Crawley, WA, Australia
| | - M G Weinborn
- The School of Psychology, University of Western Australia, Crawley, WA, Australia
| | - A N B Johnston
- Eskitis Institute for Cell and Molecular Therapies, Griffith University, Nathan, Queensland, Australia
| | - A Bahramian
- The McCusker Alzheimer's Research Foundation, Hollywood Private Hospital, Nedlands, WA, Australia
| | - K Taddei
- The School of Medical Sciences, Edith Cowan University, Joondalup, WA, Australia,The McCusker Alzheimer's Research Foundation, Hollywood Private Hospital, Nedlands, WA, Australia,The Centre of Excellence for Alzheimer's Disease Research and Care, Edith Cowan University, Joondalup, WA, Australia
| | - S M Laws
- The School of Medical Sciences, Edith Cowan University, Joondalup, WA, Australia,The McCusker Alzheimer's Research Foundation, Hollywood Private Hospital, Nedlands, WA, Australia,The Centre of Excellence for Alzheimer's Disease Research and Care, Edith Cowan University, Joondalup, WA, Australia
| | - M Rodrigues
- The School of Medical Sciences, Edith Cowan University, Joondalup, WA, Australia,The McCusker Alzheimer's Research Foundation, Hollywood Private Hospital, Nedlands, WA, Australia
| | - M Morici
- The School of Medical Sciences, Edith Cowan University, Joondalup, WA, Australia
| | - M Howard
- The School of Medical Sciences, Edith Cowan University, Joondalup, WA, Australia
| | - G Martins
- The School of Medical Sciences, Edith Cowan University, Joondalup, WA, Australia,The McCusker Alzheimer's Research Foundation, Hollywood Private Hospital, Nedlands, WA, Australia
| | - A Mackay-Sim
- Eskitis Institute for Cell and Molecular Therapies, Griffith University, Nathan, Queensland, Australia
| | - S E Gandy
- Mount Sinai School of Medicine, New York, NY, USA
| | - R N Martins
- The School of Medical Sciences, Edith Cowan University, Joondalup, WA, Australia,The McCusker Alzheimer's Research Foundation, Hollywood Private Hospital, Nedlands, WA, Australia,The Centre of Excellence for Alzheimer's Disease Research and Care, Edith Cowan University, Joondalup, WA, Australia,The School of Psychiatry and Clinical Neuroscience, University of Western Australia, Crawley, WA, Australia,The School of Medical Sciences, Edith Cowan University, 270 Joondalup Dr, Joondalup, WA 6027, Australia. E-mail:
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