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Zuliani G, Brombo G, Polastri M, Romagnoli T, Mola G, Riccetti R, Seripa D, Trentini A, Cervellati C. High plasma homocysteine levels predict the progression from mild cognitive impairment to dementia. Neurochem Int 2024; 177:105763. [PMID: 38723899 DOI: 10.1016/j.neuint.2024.105763] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Revised: 04/29/2024] [Accepted: 05/06/2024] [Indexed: 05/12/2024]
Abstract
High levels of blood homocysteine (HCy), a well-known cardiovascular risk factor and promoter of oxidative stress, have been associated with the incidence of cognitive impairment and dementia. Nonetheless, contrasting data are still present on its involvement in the progression from Mild Cognitive Impairment (MCI) to overt dementia. In this study we aimed to observe whether blood HCy level are associated with the evolution from MCI, divided into amnestic MCI (aMCI) and non-amnestic MCI (naMCI), to dementia. Blood HCy was measured in 311 MCI subjects (aMCI: 64%, naMCI: 36%) followed-up for a median of 33 months (range 10-155 months). At follow-up, 137 individuals converted to dementia (naMCI, n = 34; aMCI, n = 103). Based on HCy distribution, subjects in the highest tertile had a greater risk to convert to dementia compared to tertile I (Hazard Ratio (95% confidence interval): 2.25 (1.05-4.86); p = 0.04). aMCI subjects did not show increased risk to convert to dementia with increasing HCy concentration, but was significant in naMCI (p = 0.04). We observed a non-significant increase in the risk of progression to dementia from naMCI/low HCy (reference group, HCy cutoff value = 16 μmol/L) to naMCI/high HCy, but it was significant from aMCI/low HCy (HR: 2.73; 95%CI: 1.06-7.0; p:0.03), to aMCI/high HCy (HR: 3.24; 95%CI: 1.17-8.47; p:0.02). Our results suggest that HCy levels are associated with the progression from MCI to dementia. This association seems significant only for the naMCI group, indirectly supporting the notion that hyperhomocysteinemia damages the nervous system through its role as a vascular risk factor.
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Affiliation(s)
- Giovanni Zuliani
- Department of Translational Medicine and for Romagna, University of Ferrara, 44121, Ferrara, Italy
| | - Gloria Brombo
- Department of Translational Medicine and for Romagna, University of Ferrara, 44121, Ferrara, Italy
| | - Michele Polastri
- Department of Translational Medicine and for Romagna, University of Ferrara, 44121, Ferrara, Italy
| | - Tommaso Romagnoli
- Department of Translational Medicine and for Romagna, University of Ferrara, 44121, Ferrara, Italy
| | - Gianmarco Mola
- Department of Translational Medicine and for Romagna, University of Ferrara, 44121, Ferrara, Italy
| | - Raffaella Riccetti
- Department of Translational Medicine and for Romagna, University of Ferrara, 44121, Ferrara, Italy
| | - Davide Seripa
- Research Laboratory, Complex Structure of Geriatrics, Department of Medical Sciences, Fondazione IRCCS Casa Sollievo Della Sofferenza, Viale Cappuccini 1, 71013, San Giovanni Rotondo, Italy
| | - Alessandro Trentini
- Department of Environmental and Prevention Sciences, University of Ferrara, 44121, Ferrara, Italy.
| | - Carlo Cervellati
- Department of Translational Medicine and for Romagna, University of Ferrara, 44121, Ferrara, Italy
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Hung L, Park J, Levine H, Call D, Celeste D, Lacativa D, Riley B, Riley N, Zhao Y. Technology-based group exercise interventions for people living with dementia or mild cognitive impairment: A scoping review. PLoS One 2024; 19:e0305266. [PMID: 38870211 PMCID: PMC11175425 DOI: 10.1371/journal.pone.0305266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2024] [Accepted: 05/28/2024] [Indexed: 06/15/2024] Open
Abstract
Older people living with dementia or mild cognitive impairment (MCI) are more vulnerable to experiencing social isolation and loneliness due to their cognitive and physical impairments. Increasingly integrating technology into group exercises contributed to the improved resilience and well-being of older adults living with dementia and MCI. The purpose of this scoping review was to identify the various types, feasibility, outcome measures, and impacts of technology-based group exercise interventions for people with dementia or MCI. We utilized the Joanna Briggs Institute approach, a three-step process. A comprehensive literature search on five databases-CINAHL, MEDLINE, Embase, Web of Science, and PsycInfo-until January 2024 yielded 1,585 publications; the final review included 14 publications that recruited a total of 379 participants, with mean age of 69 (SD = 4.21) years to 87.07 (SD = 3.92) years. Analysis of data showed three types of technology-based group exercise interventions for people with dementia or MCI: (a) exergames, (b) virtual cycling or kayak paddling, and (c) video-conferencing platforms. In addition, we identified three key impacts: (a) feasibility and accessibility; (b) physical, psychosocial, and cognitive benefits; and (c) adaptations necessary for persons with dementia or MCI. Our study suggests that technology-based group exercise interventions are feasible and acceptable to persons with dementia or MCI. Future studies should involve individuals with dementia and their caregivers in the design and implementation of technology-based group exercise programs.
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Affiliation(s)
- Lillian Hung
- School of Nursing, University of British Columbia, Vancouver, British Columbia, Canada
- IDEA Lab, University of British Columbia, Vancouver, British Columbia, Canada
| | - Juyong Park
- Phyllis & Harvey Sandler School of Social Work, College of Social Work & Criminal Justice, Florida Atlantic University, Boca Raton, Florida, United States of America
| | - Hannah Levine
- Charles E. Schmidt College of Medicine, Marcus Institute of Integrative Health at FAU Medicine, Florida Atlantic University, Boca Raton, Florida, United States of America
| | - David Call
- Independent Patient Partner, Panama, Florida, United States of America
| | - Diane Celeste
- Independent Family Partner, Panama, Florida, United States of America
| | - Dierdre Lacativa
- Independent Family Partner, Panama, Florida, United States of America
| | - Betty Riley
- Independent Family Partner, Panama, Florida, United States of America
| | - Nathanul Riley
- Independent Patient Partner, Panama, Florida, United States of America
| | - Yong Zhao
- IDEA Lab, University of British Columbia, Vancouver, British Columbia, Canada
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Ferreira S, Raimundo A, Pozo-Cruz JD, Bernardino A, Leite N, Yoshida HM, Marmeleira J. Effects of Multimodal Exercise With Augmented Reality on Cognition in Community-Dwelling Older Adults. J Am Med Dir Assoc 2024; 25:104954. [PMID: 38428831 DOI: 10.1016/j.jamda.2024.01.023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Revised: 01/26/2024] [Accepted: 01/28/2024] [Indexed: 03/03/2024]
Abstract
OBJECTIVES This study aims to investigate the effects of an exercise intervention using multimodal exercise with augmented reality and multimodal exercise-only on cognitive function in older adults living in a community dwelling. DESIGN Quasi-experimental research study. SETTING AND PARTICIPANTS In this control study, 78 participants were divided into 2 experimental groups (with sessions 3 times a week for 12 weeks) and a control group (CG). METHODS EG1 participated in a multimodal exercise-only intervention program, EG2 participated in a multimodal exercise program with augmented reality exergames, and CG continued its usual activities. Participants were assessed at baseline and postintervention after 12 weeks. RESULTS Comparison between baseline and postintervention at 12 weeks showed significant improvements in executive functions, verbal fluency, choice reaction time, and dual task in EG1, whereas there were improvements in general cognition, executive functions, verbal fluency, discrimination reaction time, and depression in EG2 (P ≤ .05). The clinical effect sizes of the interventions were large for overall cognition, executive functions, and reaction time on single- and dual-task reaction time in EG1 and for overall cognition, executive functions, and verbal fluency in EG2. CONCLUSION AND IMPLICATIONS The intervention programs showed significant improvements in several cognitive domains. The multimodal exercise-only showed improvements in more variables than the multimodal exercise with augmented reality, but the augmented reality group showed greater changes between baseline and postintervention.
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Affiliation(s)
- Soraia Ferreira
- Departamento de Desporto e Saúde, Escola de Saúde e Desenvolvimento Humano, Universidade de Évora, Évora, Portugal; Comprehensive Health Research Centre (CHRC), Palácio do Vimioso, Évora, Portugal.
| | - Armando Raimundo
- Departamento de Desporto e Saúde, Escola de Saúde e Desenvolvimento Humano, Universidade de Évora, Évora, Portugal; Comprehensive Health Research Centre (CHRC), Palácio do Vimioso, Évora, Portugal
| | - Jesus Del Pozo-Cruz
- Department of Physical Education and Sports, University of Seville, Sevilla, Spain; Epidemiology of Physical Activity and Fitness across Lifespan Research Group (EPAFit), University of Seville, Sevilla, Spain
| | | | - Nilton Leite
- Departamento de Desporto e Saúde, Escola de Saúde e Desenvolvimento Humano, Universidade de Évora, Évora, Portugal; Comprehensive Health Research Centre (CHRC), Palácio do Vimioso, Évora, Portugal
| | - Hélio Mamoru Yoshida
- Grupo de Estudos em Psicologia do Esporte e Neurociências (GEPEN - FEF/UNICAMP), Instituto de Ciências da Saúde, Universidade Federal do Triângulo Mineiro, Uberaba, Brazil
| | - José Marmeleira
- Departamento de Desporto e Saúde, Escola de Saúde e Desenvolvimento Humano, Universidade de Évora, Évora, Portugal; Comprehensive Health Research Centre (CHRC), Palácio do Vimioso, Évora, Portugal
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Lee J, Lim BO, Yong BJ, Ryul S. Effects of participation in an eight-week, online video body-weight resistance training on cognitive function and physical fitness in older adults: A randomized control trial. Geriatr Nurs 2024; 58:98-103. [PMID: 38788559 DOI: 10.1016/j.gerinurse.2024.05.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2024] [Revised: 04/14/2024] [Accepted: 05/03/2024] [Indexed: 05/26/2024]
Abstract
The purpose of this study was to investigate the effects of an eight-week online video bodyweight resistance training on cognitive function and physical fitness in older adults. A total of 30 older adults was randomly assigned into either an exercise group or a control group. The exercise group participated in the exercise and the control group was required to maintain daily living. Mini mental status examination (MMSE) and senior fit-ness tests (SFT) were measured pre- and post-eight weeks of intervention. Participating in the exercise experienced increases in cognitive functions of attention (p < 0.05) and calculation (p < 0.05), recall (p < 0.05), and repetition (p < 0.05) from the MMSE. Also, older adults in the exercise group demonstrated improved two-minute walk (p < 0.05), chair sit tests (p < 0.05), and results of the SFT. The online video resistance training may help to increase cognitive function and fitness in older adults.
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Affiliation(s)
- Junga Lee
- Graduate School of Sport Science, Kyung Hee University, 1732 Deogyeong daero, Giheung-gu, Yongin-si, Gyeonggi-do 446-701, Republic of Korea.
| | - Bee-Oh Lim
- Graduate School of Sport Science, Kyung Hee University, 1732 Deogyeong daero, Giheung-gu, Yongin-si, Gyeonggi-do 446-701, Republic of Korea
| | - Byeon Ji Yong
- Graduate School of Sport Science, Kyung Hee University, 1732 Deogyeong daero, Giheung-gu, Yongin-si, Gyeonggi-do 446-701, Republic of Korea
| | - Seok Ryul
- Graduate School of Sport Science, Kyung Hee University, 1732 Deogyeong daero, Giheung-gu, Yongin-si, Gyeonggi-do 446-701, Republic of Korea
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Holleman J, Daniilidou M, Kåreholt I, Aspö M, Hagman G, Udeh-Momoh CT, Spulber G, Kivipelto M, Solomon A, Matton A, Sindi S. Diurnal cortisol, neuroinflammation, and neuroimaging visual rating scales in memory clinic patients. Brain Behav Immun 2024; 118:499-509. [PMID: 38503394 DOI: 10.1016/j.bbi.2024.03.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Revised: 02/18/2024] [Accepted: 03/16/2024] [Indexed: 03/21/2024] Open
Abstract
BACKGROUND Neuroinflammation is a hallmark of the Alzheimer's disease (AD) pathogenic process. Cortisol dysregulation may increase AD risk and is related to brain atrophy. This cross-sectional study aims to examine interactions of cortisol patterns and neuroinflammation markers in their association with neuroimaging correlates. METHOD 134 participants were recruited from the Karolinska University Hospital memory clinic (Stockholm, Sweden). Four visual rating scales were applied to magnetic resonance imaging or computed tomography scans: medial temporal lobe atrophy (MTA), global cortical atrophy (GCA), white matter lesions (WML), and posterior atrophy. Participants provided saliva samples for assessment of diurnal cortisol patterns, and underwent lumbar punctures for cerebrospinal fluid (CSF) sampling. Three cortisol measures were used: the cortisol awakening response, total daily output, and the ratio of awakening to bedtime levels. Nineteen CSF neuroinflammation markers were categorized into five composite scores: proinflammatory cytokines, other cytokines, angiogenesis markers, vascular injury markers, and glial activation markers. Ordinal logistic regressions were conducted to assess associations between cortisol patterns, neuroinflammation scores, and visual rating scales, and interactions between cortisol patterns and neuroinflammation scores in relation to visual rating scales. RESULT Higher levels of angiogenesis markers were associated with more severe WML. Some evidence was found for interactions between dysregulated diurnal cortisol patterns and greater neuroinflammation-related biomarkers in relation to more severe GCA and WML. No associations were found between cortisol patterns and visual rating scales. CONCLUSION This study suggests an interplay between diurnal cortisol patterns and neuroinflammation in relation to brain structure. While this cross-sectional study does not provide information on causality or temporality, these findings suggest that neuroinflammation may be involved in the relationship between HPA-axis functioning and AD.
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Affiliation(s)
- Jasper Holleman
- Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences, and Society, Karolinska Institutet, Karolinska Vägen 37A - QA32, 171 64 Solna, Stockholm, Sweden.
| | - Makrina Daniilidou
- Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences, and Society, Karolinska Institutet, Karolinska Vägen 37A - QA32, 171 64 Solna, Stockholm, Sweden; Division of Neurogeriatrics, Department of Neurobiology, Care Sciences, and Society, Karolinska Institutet, Stockholm, Sweden
| | - Ingemar Kåreholt
- Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences, and Society, Karolinska Institutet, Karolinska Vägen 37A - QA32, 171 64 Solna, Stockholm, Sweden; Aging Research Center, Karolinska Institutet and Stockholm University, Stockholm, Sweden; Institute of Gerontology, School of Health and Welfare, Jönköping University, Jönköping, Sweden
| | - Malin Aspö
- Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences, and Society, Karolinska Institutet, Karolinska Vägen 37A - QA32, 171 64 Solna, Stockholm, Sweden; Theme Inflammation and Aging. Karolinska University Hospital, Stockholm, Sweden
| | - Göran Hagman
- Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences, and Society, Karolinska Institutet, Karolinska Vägen 37A - QA32, 171 64 Solna, Stockholm, Sweden; Theme Inflammation and Aging. Karolinska University Hospital, Stockholm, Sweden
| | - Chinedu T Udeh-Momoh
- Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences, and Society, Karolinska Institutet, Karolinska Vägen 37A - QA32, 171 64 Solna, Stockholm, Sweden; Ageing Epidemiology Research Unit (AGE), School of Public Health, Faculty of Medicine, Imperial College London, UK; Division of Public Health Sciences, Wake Forest University School of Medicine, North Carolina, USA; Brain and Mind Institute, Aga Khan University, Nairobi, Kenya
| | - Gabriela Spulber
- Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences, and Society, Karolinska Institutet, Karolinska Vägen 37A - QA32, 171 64 Solna, Stockholm, Sweden; Theme Inflammation and Aging. Karolinska University Hospital, Stockholm, Sweden
| | - Miia Kivipelto
- Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences, and Society, Karolinska Institutet, Karolinska Vägen 37A - QA32, 171 64 Solna, Stockholm, Sweden; Theme Inflammation and Aging. Karolinska University Hospital, Stockholm, Sweden; Ageing Epidemiology Research Unit (AGE), School of Public Health, Faculty of Medicine, Imperial College London, UK; Institute of Public Health and Clinical Nutrition, University of Eastern Finland, Kuopio, Finland
| | - Alina Solomon
- Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences, and Society, Karolinska Institutet, Karolinska Vägen 37A - QA32, 171 64 Solna, Stockholm, Sweden; Theme Inflammation and Aging. Karolinska University Hospital, Stockholm, Sweden; Ageing Epidemiology Research Unit (AGE), School of Public Health, Faculty of Medicine, Imperial College London, UK; Institute of Clinical Medicine, Neurology, University of Eastern Finland, Kuopio, Finland
| | - Anna Matton
- Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences, and Society, Karolinska Institutet, Karolinska Vägen 37A - QA32, 171 64 Solna, Stockholm, Sweden; Division of Neurogeriatrics, Department of Neurobiology, Care Sciences, and Society, Karolinska Institutet, Stockholm, Sweden; Ageing Epidemiology Research Unit (AGE), School of Public Health, Faculty of Medicine, Imperial College London, UK
| | - Shireen Sindi
- Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences, and Society, Karolinska Institutet, Karolinska Vägen 37A - QA32, 171 64 Solna, Stockholm, Sweden; Ageing Epidemiology Research Unit (AGE), School of Public Health, Faculty of Medicine, Imperial College London, UK
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Ksinan AJ, Dalecká A, Court T, Pikhart H, Bobák M. Pulmonary function and trajectories of cognitive decline in aging population. Exp Gerontol 2024; 189:112386. [PMID: 38428543 DOI: 10.1016/j.exger.2024.112386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Revised: 02/21/2024] [Accepted: 02/23/2024] [Indexed: 03/03/2024]
Abstract
BACKGROUND The number of older people with cognitive impairment is increasing worldwide. Impaired lung function might be associated with cognitive decline in older age; however, results from large longitudinal studies are lacking. In this study, we examined the longitudinal associations between pulmonary function and the trajectories of cognitive decline using prospective population-based SHARE data from 14 countries. METHODS The analytic sample included N = 32,049 older adults (Mean age at baseline = 64.76 years). The dependent variable was cognitive performance, measured repeatedly across six waves in three domains: verbal fluency, memory, and numeracy. The main predictor of interest was peak expiratory flow (PEF). The data were analyzed in a multilevel accelerated longitudinal design, with models adjusted for a variety of covariates. RESULTS A lower PEF score was associated with lower cognitive performance for each domain as well as a lower global cognitive score. These associations remained statistically significant after adjusting for all covariates Q4 vs Q1 verbal fluency: unstandardized coefficient B = -3.15; numeracy: B = -0.52; memory: B = -0.64; global cognitive score B = -2.65, all p < .001). However, the PEF score was not found to be associated with the rate of decline for either of the cognitive outcomes. CONCLUSIONS In this large multi-national longitudinal study, the PEF score was independently associated with lower levels of cognitive functions, but it did not predict a future decline. The results suggest that pre-existing differences in lung functions are responsible for variability in cognitive functions and that these differences remained stable across aging.
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Affiliation(s)
- Albert J Ksinan
- RECETOX, Faculty of Science, Masaryk University, Brno, Czech Republic.
| | - Andrea Dalecká
- RECETOX, Faculty of Science, Masaryk University, Brno, Czech Republic
| | - Tatyana Court
- RECETOX, Faculty of Science, Masaryk University, Brno, Czech Republic
| | - Hynek Pikhart
- RECETOX, Faculty of Science, Masaryk University, Brno, Czech Republic; Department of Epidemiology & Public Health, University College London, Institute of Epidemiology and Health Care, London, UK
| | - Martin Bobák
- RECETOX, Faculty of Science, Masaryk University, Brno, Czech Republic; Department of Epidemiology & Public Health, University College London, Institute of Epidemiology and Health Care, London, UK
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Chen CYA, Chiu CC, Huang CY, Cheng YC, Huang MC, Kuo PH, Chen WY. Cluster analysis dissecting cognitive deficits in older adults with major depressive disorder and the association with neurofilament light chain. BMC Geriatr 2024; 24:344. [PMID: 38627748 PMCID: PMC11020442 DOI: 10.1186/s12877-024-04960-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2023] [Accepted: 04/09/2024] [Indexed: 04/19/2024] Open
Abstract
BACKGROUND Cognitive impairment is a growing problem with increasing burden in global aging. Older adults with major depressive disorder (MDD) have higher risk of dementia. Neurofilament light chain (NfL) has been proven as a potential biomarker in neurodegenerative disease, including dementia. We aimed to investigate the association between cognitive deficits and NfL levels in older adults with MDD. METHODS In this cross-sectional study, we enrolled 39 MDD patients and 15 individuals with mild neurocognitive disorder or major neurocognitive disorder, Alzheimer's type, as controls, from a tertiary psychiatric hospital. Both groups were over age 65 and with matched Mini-Mental State Examination (MMSE) score. Demographic data, clinical variables, and plasma NfL levels were obtained. We used cluster analysis according to their cognitive profile and estimated the correlation between plasma NfL levels and each cognitive domain. RESULTS In the MDD group, participants had higher rate of family psychiatry history and current alcohol use habit compared with controls. Control group of neurocognitive disorders showed significantly lower score in total MMSE and higher plasma NfL levels. Part of the MDD patients presented cognitive deficits clustered with that of neurocognitive disorders (cluster A). In cluster A, the total MMSE score (r=-0.58277, p=0.0287) and the comprehension domain (r=-0.71717, p=0.0039) were negatively correlated to NfL levels after adjusting for age, while the associations had not been observed in the other cluster. CONCLUSIONS We noted the negative correlation between NfL levels and cognition in MDD patients clustered with neurodegenerative disorder, Alzheimer's type. NfL could be a promising candidate as a biomarker to predict subtype of patients in MDD to develop cognitive decline. Further longitudinal studies and within MDD cluster analysis are required to validate our findings for clinical implications.
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Affiliation(s)
- Cynthia Yi-An Chen
- Department of Psychiatry, Wan-Fang Hospital, Taipei Medical University, Taipei, Taiwan
| | - Chih-Chiang Chiu
- Department of Psychiatry, Taipei City Psychiatric Center, Songde branch, Taipei City Hospital, Taipei, Taiwan
- Department of Psychiatry, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Cho-Yin Huang
- Department of Psychiatry, Taipei City Psychiatric Center, Songde branch, Taipei City Hospital, Taipei, Taiwan
| | - Ying-Chih Cheng
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan
- Department of Psychiatry, China Medical University Hsinchu Hospital, China Medical University, Hsinchu, Taiwan
| | - Ming-Chyi Huang
- Department of Psychiatry, Taipei City Psychiatric Center, Songde branch, Taipei City Hospital, Taipei, Taiwan
- Department of Psychiatry, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
| | - Po-Hsiu Kuo
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan
- Department of Public Health, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - Wen-Yin Chen
- Department of Psychiatry, Taipei City Psychiatric Center, Songde branch, Taipei City Hospital, Taipei, Taiwan.
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan.
- School of Medicine, College of Medicine, Fu Jen Catholic University, New Taipei, Taiwan.
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Pinyopornpanish K, Buawangpong N, Soontornpun A, Thaikla K, Pateekhum C, Nantsupawat N, Wiwatkunupakarn N, Jiraporncharoen W, Angkurawaranon C. A household survey of the prevalence of subjective cognitive decline and mild cognitive impairment among urban community-dwelling adults aged 30 to 65. Sci Rep 2024; 14:7783. [PMID: 38565884 PMCID: PMC10987517 DOI: 10.1038/s41598-024-58150-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2023] [Accepted: 03/26/2024] [Indexed: 04/04/2024] Open
Abstract
While it is possible to detect cognitive decline before the age of 60, and there is a report indicating that certain cognitive abilities peak in one's 30s, the evidence regarding cognitive problems in populations younger than 65 years is scarce. This study aims to (1) determine the proportion of community-dwelling adults with different cognitive status, and (2) determine the prevalence of neuropsychiatric behaviors. A population-based survey was conducted in Chiang Mai, Thailand. Individuals aged 30 to 65 were recruited and assessed for demographic data, memory complaints, cognitive performance, and neuropsychiatric symptoms using self-reported questionnaires. In a total of 539 participants, 33.95% had mild cognitive impairment (MCI), 7.05% had subjective cognitive decline (SCD), and 52.50% had neuropsychiatric symptoms. The risk of MCI increased with age, and neuropsychiatric symptoms were significantly higher in those with MCI or SCD than in those without (p < 0.001). The most common complaints were sleep problems, anxiety, and irritability. Screening for MCI in adults aged < 65 years might be useful. However, further investigation on the appropriate age to screen and the program's cost-effectiveness is suggested.
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Affiliation(s)
- Kanokporn Pinyopornpanish
- Department of Family Medicine, Faculty of Medicine, Chiang Mai University, 110 Inthawarorot Rd., Sriphum, Muang, Chiang Mai, 50200, Thailand
- Global Health and Chronic Conditions Research Group, Chiang Mai University, Chiang Mai, 50200, Thailand
| | - Nida Buawangpong
- Department of Family Medicine, Faculty of Medicine, Chiang Mai University, 110 Inthawarorot Rd., Sriphum, Muang, Chiang Mai, 50200, Thailand
- Global Health and Chronic Conditions Research Group, Chiang Mai University, Chiang Mai, 50200, Thailand
| | - Atiwat Soontornpun
- Division of Neurology, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, 50200, Thailand
| | - Kanittha Thaikla
- Research Institute for Health Sciences, Chiang Mai University, Chiang Mai, 50200, Thailand
| | - Chanapat Pateekhum
- Department of Family Medicine, Faculty of Medicine, Chiang Mai University, 110 Inthawarorot Rd., Sriphum, Muang, Chiang Mai, 50200, Thailand
| | - Nopakoon Nantsupawat
- Department of Family Medicine, Faculty of Medicine, Chiang Mai University, 110 Inthawarorot Rd., Sriphum, Muang, Chiang Mai, 50200, Thailand
- Global Health and Chronic Conditions Research Group, Chiang Mai University, Chiang Mai, 50200, Thailand
| | - Nutchar Wiwatkunupakarn
- Department of Family Medicine, Faculty of Medicine, Chiang Mai University, 110 Inthawarorot Rd., Sriphum, Muang, Chiang Mai, 50200, Thailand
- Global Health and Chronic Conditions Research Group, Chiang Mai University, Chiang Mai, 50200, Thailand
| | - Wichuda Jiraporncharoen
- Department of Family Medicine, Faculty of Medicine, Chiang Mai University, 110 Inthawarorot Rd., Sriphum, Muang, Chiang Mai, 50200, Thailand
- Global Health and Chronic Conditions Research Group, Chiang Mai University, Chiang Mai, 50200, Thailand
| | - Chaisiri Angkurawaranon
- Department of Family Medicine, Faculty of Medicine, Chiang Mai University, 110 Inthawarorot Rd., Sriphum, Muang, Chiang Mai, 50200, Thailand.
- Global Health and Chronic Conditions Research Group, Chiang Mai University, Chiang Mai, 50200, Thailand.
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Abayomi SN, Sritharan P, Yan E, Saripella A, Alhamdah Y, Englesakis M, Tartaglia MC, He D, Chung F. The diagnostic accuracy of the Mini-Cog screening tool for the detection of cognitive impairment-A systematic review and meta-analysis. PLoS One 2024; 19:e0298686. [PMID: 38483857 PMCID: PMC10939258 DOI: 10.1371/journal.pone.0298686] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2023] [Accepted: 01/30/2024] [Indexed: 03/17/2024] Open
Abstract
BACKGROUND The Mini-Cog is a rapid screening tool that can be administered to older adults to detect cognitive impairment (CI); however, the accuracy of the Mini-Cog to detect CI for older patients in various healthcare settings is unclear. OBJECTIVES To evaluate the diagnostic accuracy of the Mini-Cog to screen for cognitive impairment in older patients across different healthcare settings. METHODS/DESIGN We searched nine electronic databases (including MEDLINE, Embase) from inception to January 2023. We included studies with patients ≥60 years old undergoing screening for cognitive impairment using the Mini-Cog across all healthcare settings. A cut-off of ≤ 2/5 was used to classify dementia, mild cognitive impairment (MCI), and cognitive impairment (defined as either MCI or dementia) across various settings. The diagnostic accuracy of the Mini-Cog was assessed against gold standard references such as the Diagnostic and Statistical Manual of Mental Disorders (DSM). A bivariate random-effects model was used to estimate accuracy and diagnostic ability. The risk of bias was assessed using QUADAS-2 criteria. RESULTS The systematic search resulted in 4,265 articles and 14 studies were included for analysis. To detect dementia (six studies, n = 4772), the Mini-Cog showed 76% sensitivity and 83% specificity. To detect MCI (two studies, n = 270), it showed 84% sensitivity and 79% specificity. To detect CI (eight studies, n = 2152), it had 67% sensitivity and 83% specificity. In the primary care setting, to detect either MCI, dementia, or CI (eight studies, n = 5620), the Mini-Cog demonstrated 73% sensitivity and 84% specificity. Within the secondary care setting (seven studies, n = 1499), the Mini-Cog to detect MCI, dementia or CI demonstrated 73% sensitivity and 76% specificity. A high or unclear risk of bias persisted in the patient selection and timing domain. CONCLUSIONS The Mini-Cog is a quick and freely available screening tool and has high sensitivity and specificity to screen for CI in older adults across various healthcare settings. It is a practical screening tool for use in time-sensitive and resource-limited healthcare settings.
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Affiliation(s)
| | - Praveen Sritharan
- Michael G DeGroote School of Medicine, McMaster University, Hamilton, Ontario, Canada
| | - Ellene Yan
- Temerty Faculty of Medicine, Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada
- Department of Anesthesia and Pain Management, Toronto Western Hospital, University Health Network, Toronto, Ontario, Canada
| | - Aparna Saripella
- Department of Anesthesia and Pain Management, Toronto Western Hospital, University Health Network, Toronto, Ontario, Canada
| | - Yasmin Alhamdah
- Temerty Faculty of Medicine, Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada
- Department of Anesthesia and Pain Management, Toronto Western Hospital, University Health Network, Toronto, Ontario, Canada
| | - Marina Englesakis
- Library & Information Services, University Health Network, Toronto, Ontario, Canada
| | - Maria Carmela Tartaglia
- Temerty Faculty of Medicine, Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada
- Temerty Faculty of Medicine, Division of Neurology, University of Toronto, Toronto, Ontario, Canada
| | - David He
- Department of Anesthesiology and Pain Medicine, Mount Sinai Hospital, University of Toronto, Toronto, Ontario, Canada
| | - Frances Chung
- Temerty Faculty of Medicine, Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada
- Department of Anesthesia and Pain Management, Toronto Western Hospital, University Health Network, Toronto, Ontario, Canada
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10
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Zhao E, Lowres N, Bloomfield J, Weddell J, Tofler G, Gallagher R. Current Practices and Attitudes of Cardiac Nurses Regarding Cognitive Screening in Patients With Acute Coronary Syndrome. Heart Lung Circ 2024:S1443-9506(24)00047-7. [PMID: 38462415 DOI: 10.1016/j.hlc.2024.01.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Revised: 12/21/2023] [Accepted: 01/11/2024] [Indexed: 03/12/2024]
Abstract
BACKGROUND Cognitive impairment (CI) is common in patients with acute coronary syndrome (ACS) but is often undetected and may affect recovery and secondary prevention uptake. Nurses play a crucial role providing care for patients with ACS and promoting secondary prevention. AIM This study aimed to explore current nursing practices and barriers regarding CI screening in patients with ACS. METHODS Cardiac nurses were recruited from three metropolitan teaching hospitals and two professional associations in Australia and undertook a 38-question purpose-built survey. RESULTS A total of 95 nurses participated (mean age 38±13 years; 78% [n=74] female): 69 were registered nurses, and 48% had received CI training. Only 16% of nurses in our sample reported that they regularly screen for CI, and 23% reported that they never screen; however, 59% believed screening should be part of everyday practice. Nurses mostly screened when ward policy required admission/daily cognitive screening (34%) or when they suspected cognitive problems or decline (39%). Nurses in acute settings (vs non-acute) were nine times more likely to screen when adjusting for confounders. The typically used screening instruments assessed delirium/confusion and dementia but not milder CI. Common barriers to screening included communication difficulties, patients too unstable/unwell, time constraints requiring clinical care prioritisation, and being unaware of patients' normal cognition status. CONCLUSIONS Screening practices for CI in the context of ACS were found to be suboptimal, with only 16% of nurses in our sample reporting regularly screening. The most used methods focus on screening for delirium. Given current practice, many CI cases will be missed, especially mild CI, which will negatively affect secondary prevention efforts. Further research is required to identify appropriate methods to implement routine screening within the nursing clinical workflow and establish a suitable screening tool.
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Affiliation(s)
- Emma Zhao
- Charles Perkins Centre & Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia; Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia.
| | - Nicole Lowres
- Charles Perkins Centre & Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia; Heart Research Institute, Sydney, NSW, Australia
| | | | - Joseph Weddell
- Charles Perkins Centre & Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia; Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
| | - Geoffrey Tofler
- Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia; Department of Cardiology, Royal North Shore Hospital, Sydney, NSW, Australia
| | - Robyn Gallagher
- Charles Perkins Centre & Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia; Faculty of Medicine and Health, University of Sydney, Sydney, NSW, Australia
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11
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Cermelli A, Roveta F, Giorgis L, Boschi S, Grassini A, Ferrandes F, Lombardo C, Marcinnò A, Rubino E, Rainero I. Is headache a risk factor for dementia? A systematic review and meta-analysis. Neurol Sci 2024; 45:1017-1030. [PMID: 37721571 PMCID: PMC10858119 DOI: 10.1007/s10072-023-07069-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Accepted: 09/09/2023] [Indexed: 09/19/2023]
Abstract
OBJECTIVE In this systematic review and meta-analysis, we critically evaluate available evidence regarding the association between primary headaches and subsequent decline of cognitive function and dementia. BACKGROUND Recent studies suggested that headache disorders may increase the risk for dementia. However, available studies are conflicting. METHODS To identify qualifying studies, we searched scientific databases, including Pubmed, Scopus, Web of Science, Science Direct and BMC, screening for relevant papers. In order to reduce the heterogeneity between different studies, the analyses were further subdivided according to the clinical diagnoses and the study methodologies. RESULTS We identified 23 studies investigating the association between primary headaches and the risk of dementia. Of these, 18 met our inclusion criteria for meta-analysis (covering 924.140 individuals). Overall effect-size shows that primary headaches were associated with a small increase in dementia risk (OR = 1,15; CI 95%: 1,03-1,28; p = 0,02). Analyzing subgroups, we found that migraine was associated with both a moderate increased risk of all-cause dementia (OR = 1,26; p = 0,00; 95% CI: 1,13-1,40) as well as a moderate increased risk of Alzheimer's disease (OR = 2,00; p = 0,00; 95% CI: 1,46-2,75). This association was significant in both case-control and retrospective cohort studies but not in prospective studies. CONCLUSIONS Our study supports the presence of a link between primary headaches and dementia. However, in the subgroup analysis, only patients with migraine showed a moderate increase risk for all-cause dementia and for Alzheimer's disease. Additional rigorous studies are needed to elucidate the possible role of primary headaches on the risk of developing cognitive impairment and dementia.
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Affiliation(s)
- Aurora Cermelli
- Headache Center, Department of Neuroscience, ''Rita Levi Montalcini'', University of Torino, Via Cherasco 15, 10126, Turin, Italy
| | - Fausto Roveta
- Headache Center, Department of Neuroscience, ''Rita Levi Montalcini'', University of Torino, Via Cherasco 15, 10126, Turin, Italy
| | - Lia Giorgis
- Headache Center, Department of Neuroscience, ''Rita Levi Montalcini'', University of Torino, Via Cherasco 15, 10126, Turin, Italy
| | - Silvia Boschi
- Headache Center, Department of Neuroscience, ''Rita Levi Montalcini'', University of Torino, Via Cherasco 15, 10126, Turin, Italy
| | - Alberto Grassini
- Headache Center, Department of Neuroscience, ''Rita Levi Montalcini'', University of Torino, Via Cherasco 15, 10126, Turin, Italy
| | - Fabio Ferrandes
- Headache Center, Department of Neuroscience, ''Rita Levi Montalcini'', University of Torino, Via Cherasco 15, 10126, Turin, Italy
| | - Chiara Lombardo
- Headache Center, Department of Neuroscience, ''Rita Levi Montalcini'', University of Torino, Via Cherasco 15, 10126, Turin, Italy
| | - Andrea Marcinnò
- Headache Center, Department of Neuroscience, ''Rita Levi Montalcini'', University of Torino, Via Cherasco 15, 10126, Turin, Italy
| | - Elisa Rubino
- Headache Center, Department of Neuroscience, ''Rita Levi Montalcini'', University of Torino, Via Cherasco 15, 10126, Turin, Italy
- Department of Neuroscience and Mental Health, Città della Salute e della Scienza, Corso Bramante 88, Turin, Italy
| | - Innocenzo Rainero
- Headache Center, Department of Neuroscience, ''Rita Levi Montalcini'', University of Torino, Via Cherasco 15, 10126, Turin, Italy.
- Department of Neuroscience and Mental Health, Città della Salute e della Scienza, Corso Bramante 88, Turin, Italy.
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12
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Lee J, Kim J, Valdivia DS. The longitudinal relationship between levels of cognitively stimulating leisure activity and positive and negative affect among older adults with MCI. Psychogeriatrics 2024; 24:369-381. [PMID: 38296267 DOI: 10.1111/psyg.13083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Revised: 12/19/2023] [Accepted: 01/16/2024] [Indexed: 03/04/2024]
Abstract
BACKGROUND The purpose of this study was to investigate the longitudinal relationship between different levels of cognitively stimulating leisure activity (CSLA) participation and different levels of positive and negative affect among older adults with mild cognitive impairment (MCI). METHODS Using a repeated-measured multivariate analysis of covariance (RM-MANCOVA), this study analyzed the Health and Retirement Study (HRS) data from 2012 to 2020 (N = 5932). RESULTS The results presented the following. (a) The high CSLA group showed higher positive affect and lower negative affect than the mid and low groups. Also, the mid-CSLA group presented higher positive affect and lower negative affect than the low CSLA group. (b) Both positive and negative affect showed significant differences between years and indicated a continuously declining slope year by year without exceptions. (c) The high CSLA group not only presented higher positive affect and lower negative affect during the period but also solely showed a rebounding feature in the declining slope on both emotions. CONCLUSIONS The findings of this study provide valuable support for the design and implementation of CSLA participation programs and clinical guidelines for older adults with MCI. The results highlight the importance of determining the optimal level of CSLA engagement that is required to promote emotional health and cognitive function in this population. Healthcare professionals and clinical practitioners can leverage the insights gained from this study to develop and deliver effective CSLA interventions tailored to the specific needs and capacities of older adults with MCI.
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Affiliation(s)
- Jungjoo Lee
- School of Health Professions, College of Nursing and Health Professions, University of Southern Mississippi, Hattiesburg, Mississippi, USA
| | - Junhyoung Kim
- Department of Health Behavior, School of Public Health, Texas A&M University, College Station, Texas, USA
| | - Dubravka Svetina Valdivia
- Department of Counseling and Educational Psychology, School of Education, Indiana University, Bloomington, Indiana, USA
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13
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Wang XH, He Y, Zhou H, Xiao T, Du R, Zhang X. Risk factors for cognitive impairment in patients with chronic kidney disease. World J Psychiatry 2024; 14:308-314. [PMID: 38464766 PMCID: PMC10921279 DOI: 10.5498/wjp.v14.i2.308] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Revised: 12/01/2023] [Accepted: 01/05/2024] [Indexed: 02/06/2024] Open
Abstract
BACKGROUND Chronic kidney disease (CKD) patients have been found to be at risk of concurrent cognitive dysfunction in previous studies, which has now become an important public health issue of widespread concern. AIM To investigate the risk factors for concurrent cognitive dysfunction in patients with CKD. METHODS This is a prospective cohort study conducted among patients with CKD between October 2021 and March 2023. A questionnaire was formulated by literature review and expert consultation and included questions about age, sex, education level, per capita monthly household income, marital status, living condition, payment method, and hypertension. RESULTS Logistic regression analysis showed that patients aged 60-79 years [odds ratio (OR) = 1.561, P = 0.015] and ≥ 80 years (OR = 1.760, P = 0.013), participants with middle to high school education (OR = 0.820, P = 0.027), divorced or widowed individuals (OR = 1.37, P = 0.032), self-funded patients (OR = 2.368, P = 0.008), and patients with hypertension (OR = 2.011, P = 0.041) had a higher risk of cognitive impairment. The risk of cognitive impairment was lower for those with a college degree (OR = 0.435, P = 0.034) and married individuals. CONCLUSION The risk factors affecting cognitive dysfunction are age, 60-79 years and ≥ 80 years; education, primary school education or less; marital status, divorced or widowed; payment method, self-funded; hypertension; and CKD.
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Affiliation(s)
- Xiao-Hui Wang
- Department of Nephrology, The Fifth Hospital of Wuhan, Wuhan 430050, Hubei Province, China
| | - Yong He
- Department of Nephrology, The Fifth Hospital of Wuhan, Wuhan 430050, Hubei Province, China
| | - Huan Zhou
- Department of Nephrology, The Fifth Hospital of Wuhan, Wuhan 430050, Hubei Province, China
| | - Ting Xiao
- Department of Nephrology, The Fifth Hospital of Wuhan, Wuhan 430050, Hubei Province, China
| | - Ran Du
- Department of Nephrology, The Central Hospital of Enshi Tujia and Miao Autonomous Prefecture, Enshi 445000, Hubei Province, China
| | - Xin Zhang
- Department of Nephrology, The Fifth Hospital of Wuhan, Wuhan 430050, Hubei Province, China
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14
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Garcia MJ, Leadley R, Ross J, Bozeat S, Redhead G, Hansson O, Iwatsubo T, Villain N, Cummings J. Prognostic and Predictive Factors in Early Alzheimer's Disease: A Systematic Review. J Alzheimers Dis Rep 2024; 8:203-240. [PMID: 38405341 PMCID: PMC10894607 DOI: 10.3233/adr-230045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Accepted: 12/24/2023] [Indexed: 02/27/2024] Open
Abstract
Background Alzheimer's disease (AD) causes progressive decline of cognition and function. There is a lack of systematic literature reviews on prognostic and predictive factors in its early clinical stages (eAD), i.e., mild cognitive impairment due to AD and mild AD dementia. Objective To identify prognostic factors affecting eAD progression and predictive factors for treatment efficacy and safety of approved and/or under late-stage development disease-modifying treatments. Methods Databases were searched (August 2022) for studies reporting prognostic factors associated with eAD progression and predictive factors for treatment response. The Quality in Prognostic Factor Studies tool or the Cochrane risk of bias tool were used to assess risk of bias. Two reviewers independently screened the records. A single reviewer performed data extraction and quality assessment. A second performed a 20% check. Content experts reviewed and interpreted the data collected. Results Sixty-one studies were included. Self-reporting, diagnosis definition, and missing data led to high risk of bias. Population size ranged from 110 to 11,451. Analyses found data indicating that older age was and depression may be associated with progression. Greater baseline cognitive impairment was associated with progression. APOE4 may be a prognostic factor, a predictive factor for treatment efficacy and predicts an adverse response (ARIA). Elevated biomarkers (CSF/plasma p-tau, CSF t-tau, and plasma neurofilament light) were associated with disease progression. Conclusions Age was the strongest risk factor for progression. Biomarkers were associated with progression, supporting their use in trial selection and aiding diagnosis. Baseline cognitive impairment was a prognostic factor. APOE4 predicted ARIA, aligning with emerging evidence and relevant to treatment initiation/monitoring.
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Affiliation(s)
| | - Regina Leadley
- Mtech Access Ltd, IT Centre, Innovation Way, Heslington, York, UK
| | - Janine Ross
- Mtech Access Ltd, IT Centre, Innovation Way, Heslington, York, UK
| | | | | | - Oskar Hansson
- Clinical Memory Research Unit, Department of Clinical Sciences Malmö, Faculty of Medicine, Lund University, Lund, Sweden
- Memory Clinic, Skåne University Hospital, Lund, Sweden
| | | | - Nicolas Villain
- AP-HP Sorbonne Université, Pitié-Salpêtrière Hospital, Department of Neurology, Institute of Memory and Alzheimer’s Disease, Paris, France
- Sorbonne Université, INSERM U1127, CNRS 7225, Institut du Cerveau –ICM, Paris, France
| | - Jeffrey Cummings
- Chambers-Grundy Center for TransformativeNeuroscience, Department of Brain Health, School of IntegratedHealth Sciences, University of Nevada Las Vegas, Las Vegas, NV, USA
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15
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Zhao R, Yue T, Xu Z, Zhang Y, Wu Y, Bai Y, Ni G, Ming D. Electroencephalogram-based objective assessment of cognitive function level associated with age-related hearing loss. GeroScience 2024; 46:431-446. [PMID: 37273160 PMCID: PMC10828275 DOI: 10.1007/s11357-023-00847-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Accepted: 05/29/2023] [Indexed: 06/06/2023] Open
Abstract
Age-Related Hearing Loss (ARHL) is a common problem in aging. Numerous longitudinal cohort studies have revealed that ARHL is closely related to cognitive function, leading to a significant risk of cognitive decline and dementia. This risk gradually increases with the severity of hearing loss. We designed dual auditory Oddball and cognitive task paradigms for the ARHL subjects, then obtained the Montreal Cognitive Assessment (MoCA) scale evaluation results for all the subjects. Multi-dimensional EEG characteristics helped explore potential biomarkers to evaluate the cognitive level of the ARHL group, having a significantly lower P300 peak amplitude coupled with a prolonged latency. Moreover, visual memory, auditory memory, and logical calculation were investigated during the cognitive task paradigm. In the ARHL groups, the alpha-to-beta rhythm energy ratio in the visual and auditory memory retention period and the wavelet packet entropy value within the logical calculation period were significantly reduced. Correlation analysis between the above specificity indicators and the subjective scale results of the ARHL group revealed that the auditory P300 component characteristics could assess attention resources and information processing speed. The alpha and beta rhythm energy ratio and wavelet packet entropy can become potential indicators to determine working memory and logical cognitive computation-related cognitive ability.
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Affiliation(s)
- Ran Zhao
- Academy of Medical Engineering and Translational Medicine, Tianjin University, No. 92, Weijin Road, Nankai District, Tianjin, China
- Tianjin Key Laboratory of Brain Science and Neuroengineering, Tianjin, 300072, China
- Haihe Laboratory of Brain-Computer Interaction and Human-Machine Integration, Tianjin, 300392, China
| | - Tao Yue
- Academy of Medical Engineering and Translational Medicine, Tianjin University, No. 92, Weijin Road, Nankai District, Tianjin, China
| | - Zihao Xu
- Academy of Medical Engineering and Translational Medicine, Tianjin University, No. 92, Weijin Road, Nankai District, Tianjin, China
| | - Yunqi Zhang
- School of Education, Tianjin University, Tianjin, China
| | - Yubo Wu
- Academy of Medical Engineering and Translational Medicine, Tianjin University, No. 92, Weijin Road, Nankai District, Tianjin, China
| | - Yanru Bai
- Academy of Medical Engineering and Translational Medicine, Tianjin University, No. 92, Weijin Road, Nankai District, Tianjin, China.
- Tianjin Key Laboratory of Brain Science and Neuroengineering, Tianjin, 300072, China.
- Haihe Laboratory of Brain-Computer Interaction and Human-Machine Integration, Tianjin, 300392, China.
| | - Guangjian Ni
- Academy of Medical Engineering and Translational Medicine, Tianjin University, No. 92, Weijin Road, Nankai District, Tianjin, China.
- Tianjin Key Laboratory of Brain Science and Neuroengineering, Tianjin, 300072, China.
- Haihe Laboratory of Brain-Computer Interaction and Human-Machine Integration, Tianjin, 300392, China.
| | - Dong Ming
- Academy of Medical Engineering and Translational Medicine, Tianjin University, No. 92, Weijin Road, Nankai District, Tianjin, China
- Tianjin Key Laboratory of Brain Science and Neuroengineering, Tianjin, 300072, China
- Haihe Laboratory of Brain-Computer Interaction and Human-Machine Integration, Tianjin, 300392, China
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16
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Martin J, Reid N, Ward DD, King S, Hubbard RE, Gordon EH. Investigating Sex Differences in Risk and Protective Factors in the Progression of Mild Cognitive Impairment to Dementia: A Systematic Review. J Alzheimers Dis 2024; 97:101-119. [PMID: 38143350 DOI: 10.3233/jad-230700] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2023]
Abstract
BACKGROUND Developing effective strategies for reducing dementia risk requires a detailed understanding of the risk and protective factors associated with the progression of mild cognitive impairment (MCI) to dementia. OBJECTIVE We aimed to systematically review the evidence for sex differences in these factors. METHODS Five online databases (PubMed/CINAHL/EMBASE/PsycINFO/Cochrane) were searched from inception until 17 October 2022 for cohort studies that focused on sex differences in risk and protective factors in the progression of MCI to dementia. RESULTS A total of 2,972 studies were identified, of which 12 studies from five countries were included in the systematic review. There was substantial variability in study designs, study populations and outcome measures. Sex differences were present in the associations of sociodemographic, health, psychological factors, genetic and other biomarkers with the progression of MCI to dementia. APOE ɛ4 status and depression appeared to increase the risk of progression for females, whereas history of stroke, MRI markers and cerebrospinal fluid biomarkers appeared to increase the risk of progression for males. APOE ɛ2 status and marital status (unmarried) were observed to reduce risk of progression in males and females, respectively. CONCLUSIONS The ability of studies to accurately detail risk factors for dementia are likely limited when solely controlling for the effects of sex. Although the heterogeneity and underpowered nature of the studies made it difficult to synthesize the findings for each risk factor, this study highlights the apparent need for further research examining risk factors for dementia in males and females with MCI separately.
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Affiliation(s)
- Jissa Martin
- Centre for Health Services Research, Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia
| | - Natasha Reid
- Centre for Health Services Research, Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia
| | - David D Ward
- Centre for Health Services Research, Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia
| | - Shannon King
- Busselton Hospital, WA Country Health Service, Western Australia, Australia
| | - Ruth E Hubbard
- Centre for Health Services Research, Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia
- Princess Alexandra Hospital, Metro South Hospital and Health Service, Queensland, Australia
| | - Emily H Gordon
- Centre for Health Services Research, Faculty of Medicine, The University of Queensland, Brisbane, Queensland, Australia
- Princess Alexandra Hospital, Metro South Hospital and Health Service, Queensland, Australia
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17
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McLaren AMR, Kawaja MD. Olfactory Dysfunction and Alzheimer's Disease: A Review. J Alzheimers Dis 2024; 99:811-827. [PMID: 38728185 DOI: 10.3233/jad-231377] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/12/2024]
Abstract
Alzheimer's disease is the most common cause of dementia, and it is one of the leading causes of death globally. Identification and validation of biomarkers that herald the onset and progression of Alzheimer's disease is of paramount importance for early reliable diagnosis and effective pharmacological therapy commencement. A substantial body of evidence has emerged demonstrating that olfactory dysfunction is a preclinical symptom of neurodegenerative diseases including Alzheimer's disease. While a correlation between olfactory dysfunction and Alzheimer's disease onset and progression in humans exists, the mechanism underlying this relationship remains unknown. The aim of this article is to review the current state of knowledge regarding the range of potential factors that may contribute to the development of Alzheimer's disease-related olfactory dysfunction. This review predominantly focuses on genetic mutations associated with Alzheimer's disease including amyloid-β protein precursor, presenilin 1 and 2, and apolipoprotein E mutations, that may (in varying ways) drive the cellular events that lead to and sustain olfactory dysfunction.
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Affiliation(s)
| | - Michael D Kawaja
- Centre for Neuroscience Studies, Queen's University, Kingston, Ontario, ON, Canada
- Department of Biomedical and Molecular Sciences, Queen's University, Kingston, Ontario, ON, Canada
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18
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Xie XY, Huang LY, Cheng GR, Liu D, Hu FF, Zhang JJ, Han GB, Liu XC, Wang JY, Zhou J, Zeng DY, Liu J, Nie QQ, Song D, Yu YF, Hu CL, Fu YD, Li SY, Cai C, Cui YY, Cai WY, Li YQ, Fan RJ, Wan H, Xu L, Ou YM, Chen XX, Zhou YL, Chen YS, Li JQ, Wei Z, Wu Q, Mei YF, Tan W, Song SJ, Zeng Y. Association Between Long-Term Exposure to Ambient Air Pollution and the Risk of Mild Cognitive Impairment in a Chinese Urban Area: A Case-Control Study. J Alzheimers Dis 2024; 98:941-955. [PMID: 38489185 DOI: 10.3233/jad-231186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/17/2024]
Abstract
Background As a prodromal stage of dementia, significant emphasis has been placed on the identification of modifiable risks of mild cognitive impairment (MCI). Research has indicated a correlation between exposure to air pollution and cognitive function in older adults. However, few studies have examined such an association among the MCI population inChina. Objective We aimed to explore the association between air pollution exposure and MCI risk from the Hubei Memory and Aging Cohort Study. Methods We measured four pollutants from 2015 to 2018, 3 years before the cognitive assessment of the participants. Logistic regression models were employed to calculate odds ratios (ORs) to assess the relationship between air pollutants and MCI risk. Results Among 4,205 older participants, the adjusted ORs of MCI risk for the highest quartile of PM2.5, PM10, O3, and SO2 were 1.90 (1.39, 2.62), 1.77 (1.28, 2.47), 0.56 (0.42, 0.75), and 1.18 (0.87, 1.61) respectively, compared with the lowest quartile. Stratified analyses indicated that such associations were found in both males and females, but were more significant in older participants. Conclusions Our findings are consistent with the growing evidence suggesting that air pollution increases the risk of mild cognitive decline, which has considerable guiding significance for early intervention of dementia in the older population. Further studies in other populations and broader geographical areas are warranted to validate these findings.
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Affiliation(s)
- Xin-Yan Xie
- Brain Science and Advanced Technology Institute, Wuhan University of Science and Technology, Wuhan, China
- Geriatric Hospital Affiliated to Wuhan University of Science and Technology, Wuhan, China
- School of Public Health, Wuhan University of Science and Technology, Wuhan, China
| | - Lin-Ya Huang
- Brain Science and Advanced Technology Institute, Wuhan University of Science and Technology, Wuhan, China
| | - Gui-Rong Cheng
- Brain Science and Advanced Technology Institute, Wuhan University of Science and Technology, Wuhan, China
- Geriatric Hospital Affiliated to Wuhan University of Science and Technology, Wuhan, China
- School of Public Health, Wuhan University of Science and Technology, Wuhan, China
| | - Dan Liu
- Brain Science and Advanced Technology Institute, Wuhan University of Science and Technology, Wuhan, China
- Geriatric Hospital Affiliated to Wuhan University of Science and Technology, Wuhan, China
- School of Public Health, Wuhan University of Science and Technology, Wuhan, China
| | - Fei-Fei Hu
- Brain Science and Advanced Technology Institute, Wuhan University of Science and Technology, Wuhan, China
- Geriatric Hospital Affiliated to Wuhan University of Science and Technology, Wuhan, China
| | - Jing-Jing Zhang
- Brain Science and Advanced Technology Institute, Wuhan University of Science and Technology, Wuhan, China
| | - Gang-Bin Han
- Brain Science and Advanced Technology Institute, Wuhan University of Science and Technology, Wuhan, China
| | - Xiao-Chang Liu
- Brain Science and Advanced Technology Institute, Wuhan University of Science and Technology, Wuhan, China
| | - Jun-Yi Wang
- Brain Science and Advanced Technology Institute, Wuhan University of Science and Technology, Wuhan, China
| | - Juan Zhou
- Brain Science and Advanced Technology Institute, Wuhan University of Science and Technology, Wuhan, China
| | - De-Yang Zeng
- Brain Science and Advanced Technology Institute, Wuhan University of Science and Technology, Wuhan, China
| | - Jing Liu
- Brain Science and Advanced Technology Institute, Wuhan University of Science and Technology, Wuhan, China
| | - Qian-Qian Nie
- Brain Science and Advanced Technology Institute, Wuhan University of Science and Technology, Wuhan, China
| | - Dan Song
- Brain Science and Advanced Technology Institute, Wuhan University of Science and Technology, Wuhan, China
| | - Ya-Fu Yu
- Brain Science and Advanced Technology Institute, Wuhan University of Science and Technology, Wuhan, China
| | - Chen-Lu Hu
- Brain Science and Advanced Technology Institute, Wuhan University of Science and Technology, Wuhan, China
| | - Yi-Di Fu
- Brain Science and Advanced Technology Institute, Wuhan University of Science and Technology, Wuhan, China
| | - Shi-Yue Li
- Brain Science and Advanced Technology Institute, Wuhan University of Science and Technology, Wuhan, China
| | - Cheng Cai
- Brain Science and Advanced Technology Institute, Wuhan University of Science and Technology, Wuhan, China
| | - Yu-Yang Cui
- Brain Science and Advanced Technology Institute, Wuhan University of Science and Technology, Wuhan, China
| | - Wan-Ying Cai
- Brain Science and Advanced Technology Institute, Wuhan University of Science and Technology, Wuhan, China
| | - Yi-Qing Li
- Brain Science and Advanced Technology Institute, Wuhan University of Science and Technology, Wuhan, China
| | - Ren-Jia Fan
- Brain Science and Advanced Technology Institute, Wuhan University of Science and Technology, Wuhan, China
| | - Hong Wan
- Brain Science and Advanced Technology Institute, Wuhan University of Science and Technology, Wuhan, China
| | - Lang Xu
- Brain Science and Advanced Technology Institute, Wuhan University of Science and Technology, Wuhan, China
- Geriatric Hospital Affiliated to Wuhan University of Science and Technology, Wuhan, China
- School of Public Health, Wuhan University of Science and Technology, Wuhan, China
| | - Yang-Ming Ou
- Brain Science and Advanced Technology Institute, Wuhan University of Science and Technology, Wuhan, China
- Geriatric Hospital Affiliated to Wuhan University of Science and Technology, Wuhan, China
- School of Public Health, Wuhan University of Science and Technology, Wuhan, China
| | - Xing-Xing Chen
- Brain Science and Advanced Technology Institute, Wuhan University of Science and Technology, Wuhan, China
- Geriatric Hospital Affiliated to Wuhan University of Science and Technology, Wuhan, China
| | - Yan-Ling Zhou
- Brain Science and Advanced Technology Institute, Wuhan University of Science and Technology, Wuhan, China
- Geriatric Hospital Affiliated to Wuhan University of Science and Technology, Wuhan, China
| | - Yu-Shan Chen
- Brain Science and Advanced Technology Institute, Wuhan University of Science and Technology, Wuhan, China
- School of Public Health, Wuhan University of Science and Technology, Wuhan, China
| | - Jin-Quan Li
- Brain Science and Advanced Technology Institute, Wuhan University of Science and Technology, Wuhan, China
- Geriatric Hospital Affiliated to Wuhan University of Science and Technology, Wuhan, China
- School of Public Health, Wuhan University of Science and Technology, Wuhan, China
| | - Zhen Wei
- Brain Science and Advanced Technology Institute, Wuhan University of Science and Technology, Wuhan, China
- School of Public Health, Wuhan University of Science and Technology, Wuhan, China
| | - Qiong Wu
- Brain Science and Advanced Technology Institute, Wuhan University of Science and Technology, Wuhan, China
- Geriatric Hospital Affiliated to Wuhan University of Science and Technology, Wuhan, China
| | - Yu-Fei Mei
- Brain Science and Advanced Technology Institute, Wuhan University of Science and Technology, Wuhan, China
- Geriatric Hospital Affiliated to Wuhan University of Science and Technology, Wuhan, China
| | - Wei Tan
- Geriatric Hospital Affiliated to Wuhan University of Science and Technology, Wuhan, China
| | - Shao-Jun Song
- Reproductive Medicine Center, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - Yan Zeng
- Brain Science and Advanced Technology Institute, Wuhan University of Science and Technology, Wuhan, China
- Geriatric Hospital Affiliated to Wuhan University of Science and Technology, Wuhan, China
- School of Public Health, Wuhan University of Science and Technology, Wuhan, China
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19
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Hasegawa S, Mizokami F, Mizuno T, Yabu T, Kameya Y, Hayakawa Y, Arai H. Investigation of geriatric syndromes associated with medication in Japan using insurance claims data. Geriatr Gerontol Int 2024; 24:61-67. [PMID: 38084388 DOI: 10.1111/ggi.14755] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2023] [Revised: 10/25/2023] [Accepted: 11/12/2023] [Indexed: 01/05/2024]
Abstract
AIM Multiple risk factors are involved in geriatric syndrome (GS) occurring in older adults. Although drug therapy often contributes to GS, the specific causes among older adults in Japan remain unclear. In this study, we examined the possible prescribing cascade rate among older outpatients eligible for Late-stage Elderly Health Insurance and elucidated the differences between GS and GS associated with medication (GSAM) trends. METHODS This retrospective study enrolled patients from health insurance claims data in Japan between October 2018 and March 2019; hospitalized patients were excluded. Two groups were identified among the participants with GS: GS (no use of GS-causing medications) and possible-GSAM (p-GSAM; use of GS-causing medications). The collected data were analyzed using the Bell Curve for Excel, and statistical significance was set at P < 0.05. RESULTS In total, 137 781 outpatients were enrolled. Of the 32 259 outpatients who did not use GS-causing medications, 7342 were classified into the GS group. Among 105 522 outpatients who used GS-causing medications, 8347 were classified as having p-GSAM. The mean number of prescriptions was significantly higher in the p-GSAM group than in the GS group (P < 0.01). Furthermore, all GS symptoms showed significant differences, with impaired appetite being the most prevalent in the p-GSAM group than in the GS group (P < 0.01). A possible prescribing cascade was suspected in 2826 (33.9%) of 8347 outpatients in the p-GSAM group. CONCLUSION Impaired appetite in patients taking GS-causing medications might lead to prescribing cascades. Further studies are needed to prevent such prescribing cascades. Geriatr Gerontol Int 2024; 24: 61-67.
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Affiliation(s)
- Sho Hasegawa
- Department of Pharmacotherapeutics and Informatics, Fujita Health University, Toyoake, Japan
- Department of Education and Innovation Training for Pharmacy, National Center for Geriatrics and Gerontology, Obu, Japan
| | - Fumihiro Mizokami
- Department of Education and Innovation Training for Pharmacy, National Center for Geriatrics and Gerontology, Obu, Japan
- Department of Pharmacy, National Center for Geriatrics and Gerontology, Obu, Japan
| | - Tomohiro Mizuno
- Department of Pharmacotherapeutics and Informatics, Fujita Health University, Toyoake, Japan
| | | | - Yoshitaka Kameya
- Faculty of Information Engineering, Meijo University, Nagoya, Japan
| | - Yuji Hayakawa
- Department of Education and Innovation Training for Pharmacy, National Center for Geriatrics and Gerontology, Obu, Japan
- Department of Pharmacy, National Hospital Organization, Nagoya Medical Center, Nagoya, Japan
| | - Hidenori Arai
- National Center for Geriatrics and Gerontology, Obu, Japan
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20
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Angarita-Rodríguez A, González-Giraldo Y, Rubio-Mesa JJ, Aristizábal AF, Pinzón A, González J. Control Theory and Systems Biology: Potential Applications in Neurodegeneration and Search for Therapeutic Targets. Int J Mol Sci 2023; 25:365. [PMID: 38203536 PMCID: PMC10778851 DOI: 10.3390/ijms25010365] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2023] [Revised: 12/01/2023] [Accepted: 12/19/2023] [Indexed: 01/12/2024] Open
Abstract
Control theory, a well-established discipline in engineering and mathematics, has found novel applications in systems biology. This interdisciplinary approach leverages the principles of feedback control and regulation to gain insights into the complex dynamics of cellular and molecular networks underlying chronic diseases, including neurodegeneration. By modeling and analyzing these intricate systems, control theory provides a framework to understand the pathophysiology and identify potential therapeutic targets. Therefore, this review examines the most widely used control methods in conjunction with genomic-scale metabolic models in the steady state of the multi-omics type. According to our research, this approach involves integrating experimental data, mathematical modeling, and computational analyses to simulate and control complex biological systems. In this review, we find that the most significant application of this methodology is associated with cancer, leaving a lack of knowledge in neurodegenerative models. However, this methodology, mainly associated with the Minimal Dominant Set (MDS), has provided a starting point for identifying therapeutic targets for drug development and personalized treatment strategies, paving the way for more effective therapies.
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Affiliation(s)
- Andrea Angarita-Rodríguez
- Departamento de Nutrición y Bioquímica, Facultad de Ciencias, Pontificia Universidad Javeriana, Edf. Carlos Ortiz, Oficina 107, Cra. 7 40-62, Bogotá 110231, Colombia; (A.A.-R.); (Y.G.-G.); (A.F.A.)
- Laboratorio de Bioinformática y Biología de Sistemas, Universidad Nacional de Colombia, Bogotá 111321, Colombia;
| | - Yeimy González-Giraldo
- Departamento de Nutrición y Bioquímica, Facultad de Ciencias, Pontificia Universidad Javeriana, Edf. Carlos Ortiz, Oficina 107, Cra. 7 40-62, Bogotá 110231, Colombia; (A.A.-R.); (Y.G.-G.); (A.F.A.)
| | - Juan J. Rubio-Mesa
- Departamento de Estadística, Facultad de Ciencias, Universidad Nacional de Colombia, Bogotá 111321, Colombia;
| | - Andrés Felipe Aristizábal
- Departamento de Nutrición y Bioquímica, Facultad de Ciencias, Pontificia Universidad Javeriana, Edf. Carlos Ortiz, Oficina 107, Cra. 7 40-62, Bogotá 110231, Colombia; (A.A.-R.); (Y.G.-G.); (A.F.A.)
| | - Andrés Pinzón
- Laboratorio de Bioinformática y Biología de Sistemas, Universidad Nacional de Colombia, Bogotá 111321, Colombia;
| | - Janneth González
- Departamento de Nutrición y Bioquímica, Facultad de Ciencias, Pontificia Universidad Javeriana, Edf. Carlos Ortiz, Oficina 107, Cra. 7 40-62, Bogotá 110231, Colombia; (A.A.-R.); (Y.G.-G.); (A.F.A.)
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21
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Wang GHM, Chen WH, Chang SH, Zhang T, Shao H, Guo J, Lo-Ciganic WH. Association between first-line antidepressant use and risk of dementia in older adults: a retrospective cohort study. BMC Geriatr 2023; 23:825. [PMID: 38066473 PMCID: PMC10709864 DOI: 10.1186/s12877-023-04475-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2023] [Accepted: 11/09/2023] [Indexed: 12/18/2023] Open
Abstract
BACKGROUND Prior studies suggested that antidepressant use is associated with an increased risk of dementia compared to no use, which is subject to confounding by indication. We aimed to compare the dementia risk among older adults with depression receiving first-line antidepressants (i.e., SSRI/SNRI) versus psychotherapy, which is also considered the first-line therapy for depression. METHODS This retrospective cohort study was conducted using the US Medical Expenditure Panel Survey from 2010 to 2019. We included adults aged ≥ 50 years diagnosed with depression who initiated SSRI/SNRI or psychotherapy. We excluded patients with a dementia diagnosis before the first record of SSRI/SNRI use or psychotherapy. The exposure was the patient's receipt of SSRI/SNRI (identified from self-report questionnaires) or psychotherapy (identified from the Outpatient Visits or Office-Based Medical Provider Visits files). The outcome was a new diagnosis of dementia within 2 years (i.e., survey panel period) identified using ICD-9/ICD-10 codes from the Medical Conditions file. Using a multivariable logistic regression model, we reported adjusted odds ratios (aORs) with 95% confidence intervals (CIs). We also conducted subgroup analyses by patient sex, age group, race/ethnicity, severity of depression, combined use of other non-SSRI/SNRI antidepressants, and presence of underlying cognitive impairment. RESULTS Among 2,710 eligible patients (mean age = 61 ± 8, female = 69%, White = 84%), 89% used SSRIs/SNRIs, and 11% received psychotherapy. The SSRI/SNRI users had a higher crude incidence of dementia than the psychotherapy group (16.4% vs. 11.8%), with an aOR of 1.36 (95% CI = 1.06-1.74). Subgroup analyses yielded similar findings as the main analyses, except no significant association for patients who were aged < 65 years (1.23, 95% CI = 0.93-1.62), male (1.34, 95% CI = 0.95-1.90), Black (0.76, 95% CI = 0.48-1.19), had a higher PHQ-2 (1.39, 95% CI = 0.90-2.15), and had underlying cognitive impairment (1.06, 95% CI = 0.80-1.42). CONCLUSIONS Our findings suggested that older adults with depression receiving SSRIs/SNRIs were associated with an increased dementia risk compared to those receiving psychotherapy.
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Affiliation(s)
- Grace Hsin-Min Wang
- Department of Pharmaceutical Outcomes & Policy, College of Pharmacy, University of Florida, 1225 Center Drive, HPNP 3338, Gainesville, FL, 32610, USA
| | - Wei-Han Chen
- Department of Pharmaceutical Outcomes & Policy, College of Pharmacy, University of Florida, 1225 Center Drive, HPNP 3338, Gainesville, FL, 32610, USA
| | - Shao-Hsuan Chang
- Department of Pharmaceutical Outcomes & Policy, College of Pharmacy, University of Florida, 1225 Center Drive, HPNP 3338, Gainesville, FL, 32610, USA
| | - Tianxiao Zhang
- Department of Pharmaceutical Outcomes & Policy, College of Pharmacy, University of Florida, 1225 Center Drive, HPNP 3338, Gainesville, FL, 32610, USA
| | - Hui Shao
- Hubert Department of Global Health, Rollin School of Public Health, Emory University, Atlanta, GA, USA
| | - Jingchuan Guo
- Department of Pharmaceutical Outcomes & Policy, College of Pharmacy, University of Florida, 1225 Center Drive, HPNP 3338, Gainesville, FL, 32610, USA
| | - Wei-Hsuan Lo-Ciganic
- Center for Pharmaceutical Policy and Prescribing, Health Policy Institute, University of Pittsburgh, Pittsburgh, PA, USA.
- North Florida/South Georgia Veterans Health System, Geriatric Research Education and Clinical Center, Gainesville, FL, USA.
- Division of General Internal Medicine, School of Medicine, University of Pittsburgh, Pittsburgh, PA, USA.
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22
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Trinca V, Anderson ND, Fiocco AJ, Ferland G, Laurin D, Keller HH. Nutrition risk and cognitive performance in community-living older adults without cognitive impairment: a cross-sectional analysis of the Canadian Longitudinal Study on Aging. Appl Physiol Nutr Metab 2023; 48:896-906. [PMID: 37590990 DOI: 10.1139/apnm-2023-0211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/19/2023]
Abstract
Malnutrition is correlated with poor cognition; however, an understanding of the association between nutrition risk, which precedes malnutrition, and cognition is lacking. This study aimed to determine if nutrition risk measured with the SCREEN-8 tool is associated with cognitive performance among cognitively healthy adults aged 55+, after adjusting for demographic and lifestyle covariates. Sex- and age-stratified analyses were also explored. Baseline data from the Canadian Longitudinal Study on Aging was used. Cognition was determined using a 6-measure composite score based on four executive functions and two memory tasks, taking into account age, sex, and education. Multivariable linear regression was performed while adjusting for body mass index (BMI), lifestyle, and health covariates in the entire sample (n = 11 378) and then stratified by sex and age. Approximately half of participants were female (54.5%) aged 65+ (54.1%). Greater nutrition risk was associated with poorer cognitive performance in the entire sample (F[1, 11 368] = 5.36, p = 0.021) and among participants aged 55-64 (n = 5227; F[1, 5217] = 5.45, p = 0.020). Sex differences in lifestyle and health factors associated with cognition were apparent, but nutrition risk was not associated with cognition in sex-stratified models. Based on this analysis, there may be an association between nutrition risk and cognitive performance in older adults. When screening for either cognitive impairment or nutrition risk, complementary assessments for these conditions is warranted, as early intervention may provide benefit.
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Affiliation(s)
- Vanessa Trinca
- Department of Kinesiology and Health Sciences, University of Waterloo, Waterloo, ON, Canada
| | - Nicole D Anderson
- Rotman Research Institute, Baycrest Academy for Research and Education, Toronto, ON, Canada
- Departments of Psychology & Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Alexandra J Fiocco
- Department of Psychology, Toronto Metropolitan University, Toronto, ON, Canada
| | - Guylaine Ferland
- Département de Nutrition, Université de Montréal, Montreal, QC, Canada
| | - Danielle Laurin
- Centre de recherche du CHU de Québec-Université Laval, VITAM-Centre de recherche en santé durable, CIUSSS-Capitale Nationale and Institut sur le vieillissement et la participation sociale des aînés, Québec, QC, Canada
- Centre d'excellence sur le vieillissement de Québec, Québec, QC, Canada
- Faculté de pharmacie, Université Laval and Institut sur la nutrition et les aliments fonctionnels (INAF) de l'Université Laval, Québec, QC, Canada
| | - Heather H Keller
- Department of Kinesiology and Health Sciences, University of Waterloo, Waterloo, ON, Canada
- Schlegel-UW Research Institute for Aging, Waterloo, ON, Canada
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23
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Jin S, Li C, Miao J, Sun J, Yang Z, Cao X, Sun K, Liu X, Ma L, Xu X, Liu Z. Sociodemographic Factors Predict Incident Mild Cognitive Impairment: A Brief Review and Empirical Study. J Am Med Dir Assoc 2023; 24:1959-1966.e7. [PMID: 37716705 DOI: 10.1016/j.jamda.2023.08.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2023] [Revised: 08/15/2023] [Accepted: 08/17/2023] [Indexed: 09/18/2023]
Abstract
OBJECTIVES Mild cognitive impairment (MCI) is a transitional stage between normal cognitive aging and dementia that increases the risk of progressive cognitive decline. Early prediction of MCI could be beneficial for identifying vulnerable individuals in the community and planning primary and secondary prevention to reduce the incidence of MCI. DESIGN A narrative review and cohort study. SETTING AND PARTICIPANTS We review the MCI prediction based on the assessment of sociodemographic factors. We included participants from 3 surveys: 8915 from wave 2011/2012 of the China Health and Retirement Longitudinal Study (CHARLS), 9765 from the 2011 Chinese Longitudinal Healthy Longevity Survey (CLHLS), and 1823 from the 2014 Rugao Longevity and Ageing Study (RuLAS). METHODS We searched in PubMed, Embase, and Web of Science Core Collection between January 1, 2019, and December 30, 2022. To construct the composite risk score, a multivariate Cox proportional hazards regression model was used. The performance of the score was assessed using receiver operating characteristic (ROC) curves. Furthermore, the composite risk score was validated in 2 longitudinal cohorts, CLHLS and RuLAS. RESULTS We concluded on 20 articles from 892 available. The results suggested that the previous models suffered from several defects, including overreliance on cross-sectional data, low predictive utility, inconvenient measurement, and inapplicability to developing countries. Our empirical work suggested that the area under the curve for a 5-year MCI prediction was 0.861 in CHARLS, 0.797 in CLHLS, and 0.823 in RuLAS. We designed a publicly available online tool for this composite risk score. CONCLUSIONS AND IMPLICATIONS Attention to these sociodemographic factors related to the incidence of MCI can be beneficially incorporated into the current work, which will set the stage for better early prediction of MCI before its incidence and for reducing the burden of the disease.
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Affiliation(s)
- Shuyi Jin
- Institute of Wenzhou, Second Affiliated Hospital, and School of Public Health, the Key Laboratory of Intelligent Preventive Medicine of Zhejiang Province, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | - Chenxi Li
- Institute of Wenzhou, Second Affiliated Hospital, and School of Public Health, the Key Laboratory of Intelligent Preventive Medicine of Zhejiang Province, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | - Jiani Miao
- Institute of Wenzhou, Second Affiliated Hospital, and School of Public Health, the Key Laboratory of Intelligent Preventive Medicine of Zhejiang Province, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | - Jingyi Sun
- Institute of Wenzhou, Second Affiliated Hospital, and School of Public Health, the Key Laboratory of Intelligent Preventive Medicine of Zhejiang Province, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | - Zhenqing Yang
- Institute of Wenzhou, Second Affiliated Hospital, and School of Public Health, the Key Laboratory of Intelligent Preventive Medicine of Zhejiang Province, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | - Xingqi Cao
- Institute of Wenzhou, Second Affiliated Hospital, and School of Public Health, the Key Laboratory of Intelligent Preventive Medicine of Zhejiang Province, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | - Kaili Sun
- Institute of Wenzhou, Second Affiliated Hospital, and School of Public Health, the Key Laboratory of Intelligent Preventive Medicine of Zhejiang Province, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China
| | - Xiaoting Liu
- School of Public Affairs, Zhejiang University, Hangzhou, Zhejiang, China
| | - Lina Ma
- Department of Geriatrics, Xuanwu Hospital Capital Medical University, National Clinical Research Center for Geriatric Diseases, Beijing, China
| | - Xin Xu
- Department of Big Data in Health Science School of Public Health, and Center for Clinical Big Data and Analytics of the Second Affiliated Hospital, School of Medicine, Zhejiang University, China.
| | - Zuyun Liu
- Institute of Wenzhou, Second Affiliated Hospital, and School of Public Health, the Key Laboratory of Intelligent Preventive Medicine of Zhejiang Province, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, China.
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24
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Palimariciuc M, Oprea DC, Cristofor AC, Florea T, Dobrin RP, Dobrin I, Gireadă B, Gavril R, Mawas I, Bejenariu AC, Knieling A, Ciobica A, Chiriță R. The Effects of Transcranial Direct Current Stimulation in Patients with Mild Cognitive Impairment. Neurol Int 2023; 15:1423-1442. [PMID: 38132971 PMCID: PMC10745513 DOI: 10.3390/neurolint15040092] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Revised: 11/20/2023] [Accepted: 11/21/2023] [Indexed: 12/23/2023] Open
Abstract
Transcranial direct current stimulation (tDCS) came into consideration in recent years as a promising, non-invasive form of neuromodulation for individuals suffering from mild cognitive impairment (MCI). MCI represents a transitional stage between normal cognitive aging and more severe cognitive decline, which appears in neurodegenerative diseases, such as Alzheimer's disease. Numerous studies have shown that tDCS can have several useful effects in patients with MCI. It is believed to enhance cognitive functions, including memory and attention, potentially slowing down the progression of neurodegeneration and cognitive decline. tDCS is believed to work by modulating neuronal activity and promoting synaptic plasticity in the brain regions associated with cognition. Moreover, tDCS is generally considered safe and well-tolerated, making it an attractive option for long-term therapeutic use in MCI. However, further research is needed to determine the optimal stimulation parameters and long-term effects of tDCS in this population, as well as its potential to serve as a complementary therapy alongside other interventions for MCI. In this review, we included 16 randomized clinical trials containing patients with MCI who were treated with tDCS. We aim to provide important evidence for the cognitive enhancement using tDCS in patients with MCI, summarizing the effects and conclusions found in several clinical trials, and discuss its main mechanisms.
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Affiliation(s)
- Matei Palimariciuc
- Department of Medicine III, Faculty of Medicine, Grigore T. Popa University of Medicine and Pharmacy of Iasi, 700115 Iasi, Romania; (M.P.); (D.C.O.); (A.C.C.); (T.F.); (I.D.); (B.G.); (R.G.); (I.M.); (A.C.B.); (R.C.)
- Institute of Psychiatry “Socola”, 36 Bucium Street, 700282 Iasi, Romania
| | - Dan Cătălin Oprea
- Department of Medicine III, Faculty of Medicine, Grigore T. Popa University of Medicine and Pharmacy of Iasi, 700115 Iasi, Romania; (M.P.); (D.C.O.); (A.C.C.); (T.F.); (I.D.); (B.G.); (R.G.); (I.M.); (A.C.B.); (R.C.)
- Institute of Psychiatry “Socola”, 36 Bucium Street, 700282 Iasi, Romania
| | - Ana Caterina Cristofor
- Department of Medicine III, Faculty of Medicine, Grigore T. Popa University of Medicine and Pharmacy of Iasi, 700115 Iasi, Romania; (M.P.); (D.C.O.); (A.C.C.); (T.F.); (I.D.); (B.G.); (R.G.); (I.M.); (A.C.B.); (R.C.)
- Institute of Psychiatry “Socola”, 36 Bucium Street, 700282 Iasi, Romania
| | - Tudor Florea
- Department of Medicine III, Faculty of Medicine, Grigore T. Popa University of Medicine and Pharmacy of Iasi, 700115 Iasi, Romania; (M.P.); (D.C.O.); (A.C.C.); (T.F.); (I.D.); (B.G.); (R.G.); (I.M.); (A.C.B.); (R.C.)
- Institute of Psychiatry “Socola”, 36 Bucium Street, 700282 Iasi, Romania
| | - Romeo Petru Dobrin
- Department of Medicine III, Faculty of Medicine, Grigore T. Popa University of Medicine and Pharmacy of Iasi, 700115 Iasi, Romania; (M.P.); (D.C.O.); (A.C.C.); (T.F.); (I.D.); (B.G.); (R.G.); (I.M.); (A.C.B.); (R.C.)
- Institute of Psychiatry “Socola”, 36 Bucium Street, 700282 Iasi, Romania
| | - Irina Dobrin
- Department of Medicine III, Faculty of Medicine, Grigore T. Popa University of Medicine and Pharmacy of Iasi, 700115 Iasi, Romania; (M.P.); (D.C.O.); (A.C.C.); (T.F.); (I.D.); (B.G.); (R.G.); (I.M.); (A.C.B.); (R.C.)
- Institute of Psychiatry “Socola”, 36 Bucium Street, 700282 Iasi, Romania
| | - Bogdan Gireadă
- Department of Medicine III, Faculty of Medicine, Grigore T. Popa University of Medicine and Pharmacy of Iasi, 700115 Iasi, Romania; (M.P.); (D.C.O.); (A.C.C.); (T.F.); (I.D.); (B.G.); (R.G.); (I.M.); (A.C.B.); (R.C.)
- Institute of Psychiatry “Socola”, 36 Bucium Street, 700282 Iasi, Romania
| | - Radu Gavril
- Department of Medicine III, Faculty of Medicine, Grigore T. Popa University of Medicine and Pharmacy of Iasi, 700115 Iasi, Romania; (M.P.); (D.C.O.); (A.C.C.); (T.F.); (I.D.); (B.G.); (R.G.); (I.M.); (A.C.B.); (R.C.)
- Institute of Psychiatry “Socola”, 36 Bucium Street, 700282 Iasi, Romania
| | - Iasmin Mawas
- Department of Medicine III, Faculty of Medicine, Grigore T. Popa University of Medicine and Pharmacy of Iasi, 700115 Iasi, Romania; (M.P.); (D.C.O.); (A.C.C.); (T.F.); (I.D.); (B.G.); (R.G.); (I.M.); (A.C.B.); (R.C.)
| | - Andreea Cristina Bejenariu
- Department of Medicine III, Faculty of Medicine, Grigore T. Popa University of Medicine and Pharmacy of Iasi, 700115 Iasi, Romania; (M.P.); (D.C.O.); (A.C.C.); (T.F.); (I.D.); (B.G.); (R.G.); (I.M.); (A.C.B.); (R.C.)
- Institute of Psychiatry “Socola”, 36 Bucium Street, 700282 Iasi, Romania
| | - Anton Knieling
- Institute of Forensic Medicine, 700455 Iași, Romania;
- Forensic Science Department, Faculty of Medicine, Grigore T. Popa University of Medicine and Pharmacy of Iasi, 700115 Iasi, Romania
| | - Alin Ciobica
- Department of Biology, Faculty of Biology, Alexandru Ioan Cuza University, B-dul Carol I No. 11, 700506 Iasi, Romania;
- Academy of Romanian Scientists, Splaiul Independentei Nr. 54, Sector 5, 050094 Bucuresti, Romania
- Centre of Biomedical Research, Romanian Academy, B-dul Carol I No. 8, 700506 Iasi, Romania
- Preclinical Department, Apollonia University, Păcurari Street 11, 700511 Iași, Romania
| | - Roxana Chiriță
- Department of Medicine III, Faculty of Medicine, Grigore T. Popa University of Medicine and Pharmacy of Iasi, 700115 Iasi, Romania; (M.P.); (D.C.O.); (A.C.C.); (T.F.); (I.D.); (B.G.); (R.G.); (I.M.); (A.C.B.); (R.C.)
- Institute of Psychiatry “Socola”, 36 Bucium Street, 700282 Iasi, Romania
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Adrián JA, Bermúdez-Llusá G, Caramés JM, Rodríguez-Parra MJ, Arango-Lasprilla JC. The NeuroBel: A Screening Test for Verbal Language Impairment in Spanish-Speaking Elderly People With Cognitive Decline. AMERICAN JOURNAL OF SPEECH-LANGUAGE PATHOLOGY 2023; 32:2615-2629. [PMID: 37656140 DOI: 10.1044/2023_ajslp-23-00071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/02/2023]
Abstract
PURPOSE The NeuroBel is a short test that can detect cognitive decline using language tasks. This study replicated previous research using larger clinical samples from three Spanish-speaking countries. METHOD Eight tasks were used to analyze verbal language functioning using a psycholinguistic approach. A total of 232 elderly, monolingual Spanish speakers from Spain, Cuba, and Colombia participated in this study. Of these, 76 had Alzheimer's disease (AD) in the initial phase, 75 had mild cognitive impairment (MCI), and 81 did not exhibit cognitive impairment (healthy controls). RESULTS Significant differences were observed among the three clinical groups. The participants with AD and the participants with MCI had significantly lower NeuroBel scores than the control group on most of the tasks. However, repetition (in AD vs. MCI) and auditory lexical decision (in MCI vs. control) tasks were not significant in Tukey's post hoc tests. Discriminant analysis showed that 80.6% of the participants were correctly classified into the original groups and revealed the tasks that were the best and worst for differentiating among groups. The receiver-operating characteristic curves showed high sensitivity for AD and MCI. The area under the curve was .97 in the contrast of AD versus MCI + controls, .96 in the determination of overall cognitive decline (AD + MCI vs. controls), and .93 in the contrast of MCI and control groups. CONCLUSION This study confirmed that the NeuroBel is a suitable test for detecting cognitive decline based on language impairment in Spanish-speaking elderly people.
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Affiliation(s)
- José A Adrián
- Department of Psychology and Speech-Language Pathology, University of Málaga, Spain
| | - Geidy Bermúdez-Llusá
- Department of Psychology and Speech-Language Pathology, University of Málaga, Spain
| | - José M Caramés
- Department of Psychology and Speech-Language Pathology, University of Málaga, Spain
| | - María J Rodríguez-Parra
- Department of Personality, Evaluation and Psychological Treatment, University of Granada, Spain
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Cao E, Ma D, Nayak S, Duong TQ. Deep learning combining FDG-PET and neurocognitive data accurately predicts MCI conversion to Alzheimer's dementia 3-year post MCI diagnosis. Neurobiol Dis 2023; 187:106310. [PMID: 37769746 DOI: 10.1016/j.nbd.2023.106310] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2023] [Revised: 09/20/2023] [Accepted: 09/25/2023] [Indexed: 10/03/2023] Open
Abstract
INTRODUCTION This study reports a novel deep learning approach to predict mild cognitive impairment (MCI) conversion to Alzheimer's dementia (AD) within three years using whole-brain fluorodeoxyglucose (FDG) positron emission tomography (PET) and cognitive scores (CS). METHODS This analysis consisted of 150 normal controls (CN), 257 MCI, and 205 AD subjects from ADNI. FDG-PET and CS were obtained at MCI diagnosis to predict AD conversion within three years of MCI diagnosis using convolutional neural networks. RESULTS Neurocognitive scores predicted better than FDG-PET per se, but the best model was a combination of FDG-PET, age, and neurocognitive data, yielding an AUC of 0.785 ± 0.096 and a balanced accuracy of 0.733 ± 0.098. Saliency maps highlighted putamen, thalamus, inferior frontal gyrus, parietal operculum, precuneus cortices, calcarine cortices, temporal gyrus, and planum temporale to be important for prediction. DISCUSSION Deep learning accurately predicts MCI conversion to AD and provides neural correlates of brain regions associated with AD conversion.
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Affiliation(s)
- Eric Cao
- Department of Radiology, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY 10467, United States
| | - Da Ma
- Department of Internal Medicine Section of Gerontology and Geriatric Medicine, Wake Forest, University School of Medicine, Winston-Salam, NC 27109, United States
| | - Siddharth Nayak
- Department of Radiology, Weill Cornell Medicine, New York, 10065, United States
| | - Tim Q Duong
- Department of Radiology, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY 10467, United States.
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Blanco K, Salcidua S, Orellana P, Sauma-Pérez T, León T, Steinmetz LCL, Ibañez A, Duran-Aniotz C, de la Cruz R. Systematic review: fluid biomarkers and machine learning methods to improve the diagnosis from mild cognitive impairment to Alzheimer's disease. Alzheimers Res Ther 2023; 15:176. [PMID: 37838690 PMCID: PMC10576366 DOI: 10.1186/s13195-023-01304-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/02/2023] [Accepted: 09/15/2023] [Indexed: 10/16/2023]
Abstract
Mild cognitive impairment (MCI) is often considered an early stage of dementia, with estimated rates of progression to dementia up to 80-90% after approximately 6 years from the initial diagnosis. Diagnosis of cognitive impairment in dementia is typically based on clinical evaluation, neuropsychological assessments, cerebrospinal fluid (CSF) biomarkers, and neuroimaging. The main goal of diagnosing MCI is to determine its cause, particularly whether it is due to Alzheimer's disease (AD). However, only a limited percentage of the population has access to etiological confirmation, which has led to the emergence of peripheral fluid biomarkers as a diagnostic tool for dementias, including MCI due to AD. Recent advances in biofluid assays have enabled the use of sophisticated statistical models and multimodal machine learning (ML) algorithms for the diagnosis of MCI based on fluid biomarkers from CSF, peripheral blood, and saliva, among others. This approach has shown promise for identifying specific causes of MCI, including AD. After a PRISMA analysis, 29 articles revealed a trend towards using multimodal algorithms that incorporate additional biomarkers such as neuroimaging, neuropsychological tests, and genetic information. Particularly, neuroimaging is commonly used in conjunction with fluid biomarkers for both cross-sectional and longitudinal studies. Our systematic review suggests that cost-effective longitudinal multimodal monitoring data, representative of diverse cultural populations and utilizing white-box ML algorithms, could be a valuable contribution to the development of diagnostic models for AD due to MCI. Clinical assessment and biomarkers, together with ML techniques, could prove pivotal in improving diagnostic tools for MCI due to AD.
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Affiliation(s)
- Kevin Blanco
- Center for Social and Cognitive Neuroscience (CSCN), School of Psychology, Universidad Adolfo Ibanez, Diagonal Las Torres 2640, Peñalolén, Santiago, Chile
| | - Stefanny Salcidua
- Latin American Institute for Brain Health (BrainLat), Universidad Adolfo Ibáñez, Santiago, Chile
- Faculty of Engineering and Sciences, Universidad Adolfo Ibáñez, Diagonal Las Torres 2700, Building D, Peñalolén, Santiago, Chile
| | - Paulina Orellana
- Center for Social and Cognitive Neuroscience (CSCN), School of Psychology, Universidad Adolfo Ibanez, Diagonal Las Torres 2640, Peñalolén, Santiago, Chile
- Latin American Institute for Brain Health (BrainLat), Universidad Adolfo Ibáñez, Santiago, Chile
| | - Tania Sauma-Pérez
- Latin American Institute for Brain Health (BrainLat), Universidad Adolfo Ibáñez, Santiago, Chile
| | - Tomás León
- Global Brain Health Institute, Trinity College, Dublin, Ireland
- Memory and Neuropsychiatric Center (CMYN) Neurology Department, Hospital del Salvador and Faculty of Medicine, University of Chile, Santiago, Chile
| | - Lorena Cecilia López Steinmetz
- Latin American Institute for Brain Health (BrainLat), Universidad Adolfo Ibáñez, Santiago, Chile
- Technische Universität Berlin, Berlin, Deutschland
- Instituto de Investigaciones Psicológicas (IIPsi), Universidad Nacional de Córdoba (UNC) y Consejo Nacional de Investigaciones Científicas y Técnicas (CONICET), Córdoba, Argentina
| | - Agustín Ibañez
- Latin American Institute for Brain Health (BrainLat), Universidad Adolfo Ibáñez, Santiago, Chile
- Global Brain Health Institute, Trinity College, Dublin, Ireland
- Global Brain Health Institute, University of California San Francisco (UCSF), San Francisco, CA, USA
- Cognitive Neuroscience Center (CNC), Universidad de San Andrés, & National Scientific and Technical Research Council (CONICET), Buenos Aires, Argentina
| | - Claudia Duran-Aniotz
- Center for Social and Cognitive Neuroscience (CSCN), School of Psychology, Universidad Adolfo Ibanez, Diagonal Las Torres 2640, Peñalolén, Santiago, Chile.
- Latin American Institute for Brain Health (BrainLat), Universidad Adolfo Ibáñez, Santiago, Chile.
| | - Rolando de la Cruz
- Latin American Institute for Brain Health (BrainLat), Universidad Adolfo Ibáñez, Santiago, Chile.
- Faculty of Engineering and Sciences, Universidad Adolfo Ibáñez, Diagonal Las Torres 2700, Building D, Peñalolén, Santiago, Chile.
- Data Observatory Foundation, ANID Technology Center No. DO210001, Santiago, Chile.
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Chung PC, Chan TC. Digital oral health biomarkers for early detection of cognitive decline. BMC Public Health 2023; 23:1952. [PMID: 37814231 PMCID: PMC10561400 DOI: 10.1186/s12889-023-16897-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2023] [Accepted: 10/04/2023] [Indexed: 10/11/2023] Open
Abstract
BACKGROUND Oral health could influence cognitive function by stimulating brain activity and blood flow. The quantified oral status from oral inflammation, frailty and masticatory performance were rarely applied to the cognitive function screening. We aimed to adopt non-invasive digital biomarkers to quantify oral health and employ machine learning algorithms to detect cognitive decline in the community. METHODS We conducted a prospective case-control study to recruit 196 participants between 50 and 80 years old from Puzi Hospital (Chiayi County, Taiwan) between December 01, 2021, and December 31, 2022, including 163 with normal cognitive function and 33 with cognitive decline. Demographics, daily interactions, electronically stored medical records, masticatory ability, plaque index, oral diadochokinesis (ODK), periodontal status, and digital oral health indicators were collected. Cognitive function was classified, and confirmed mild cognitive impairment diagnoses were used for sensitivity analysis. RESULTS The cognitive decline group significantly differed in ODK rate (P = 0.003) and acidity from SILL-Ha (P = 0.04). Younger age, increased social interactions, fewer cariogenic bacteria, high leukocytes, and high buffering capacity led to lower risk of cognitive decline. Patients with slow ODK, high plaque index, variance of hue (VOH) from bicolor chewing gum, and acidity had increased risk of cognitive decline. The prediction model area under the curve was 0.86 and was 0.99 for the sensitivity analysis. CONCLUSIONS A digital oral health biomarker approach is feasible for tracing cognitive function. When maintaining oral hygiene and oral health, cognitive status can be assessed simultaneously and early monitoring of cognitive status can prevent disease burden in the future.
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Affiliation(s)
- Ping-Chen Chung
- Department of Dentistry, Puzi Hospital, Ministry of Health and Welfare, Chiayi, Taiwan
| | - Ta-Chien Chan
- Research Center for Humanities and Social Sciences, Academia Sinica, 128 Academia Road, Section 2, Nankang, Taipei, 115, Taiwan.
- Institute of Public Health, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.
- Department of Public Health, College of Public Health, China Medical University, Taichung campus, Taichung City, Taiwan.
- School of Medicine, College of Medicine, National Sun Yat-sen University, Kaohsiung, Taiwan.
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Chung J, Byun S. Motoric Cognitive Risk and Incident Dementia in Older Adults. JAMA Netw Open 2023; 6:e2338534. [PMID: 37856120 PMCID: PMC10587785 DOI: 10.1001/jamanetworkopen.2023.38534] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Accepted: 09/06/2023] [Indexed: 10/20/2023] Open
Abstract
Importance Motoric cognitive risk (MCR) is a novel predementia syndrome; however, whether it can estimate dementia in a nationwide population or has additive estimation validity over cognitive or motoric components alone remains unknown. Objective To examine whether modified MCR, which incorporates the timed-up-and-go and one-leg-standing tests, improves estimation validity for incident dementia over using cognitive or motoric components alone. Design, Setting, and Participants This nationwide cohort study evaluated data from individuals aged 66 years who participated in the National Screening Program for Transitional Ages in Korea from January 1, 2009, to December 31, 2013, and examined the association between MCR and incident dementia using Cox proportional hazards regression analysis. Data were collected from the index date (the date on which the participant had the screening) until dementia onset, death, or the end of the follow-up period, whichever came first. The 2 subtypes were defined as subjective cognitive declines with timed-up-and-go impairment or one-leg-standing impairment. The data set was generated with permission from the Korean National Health Insurance Service, and data analysis was conducted from August 2, 2021, to January 31, 2022. Individuals diagnosed with dementia or psychotic disorders or those who had a documented history of dementia medication use before the index date were excluded. Main Outcomes and Measures The main outcome was incidence of dementia, defined as an individual receiving their first dementia medication with the relevant International Statistical Classification of Diseases and Related Health Problems, Tenth Revision, codes after the index date. Results Among the 1 137 530 participants (53.7% women), 15 380 (1.4%) met the MCR criteria for the timed-up-and-go subtype, and 32 910 (2.9%) met the criteria for the one-leg-standing subtype. The mean (SD) follow-up period was 7.02 (1.38) years. Participants with MCR demonstrated an approximately 2-fold higher risk of incident dementia than those without MCR (timed-up-and-go subtype, adjusted hazard ratio, 2.03; 95% CI, 1.94-2.13; one-leg-standing subtype, adjusted hazard ratio, 2.05; 95% CI, 1.98-2.12). Conclusions and Relevance In this cohort study of participants aged 66 years of the National Screening Program for Transitional Ages, modified motoric cognitive risk had higher adjusted hazard ratios of incident dementia than individual cognitive or motoric components. Motoric cognitive risk may be a practical screening tool for estimating dementia among individuals in their mid-60s ; however, further investigation of the clinical and neurobiological aspects is necessary.
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Affiliation(s)
- Jeehae Chung
- Industry-Academic Cooperation Foundation, The Catholic University of Korea, Seoul, Korea
| | - Seonjeong Byun
- Department of Neuropsychiatry, Uijeongbu St Mary’s Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
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Sarwal A, Boucher RE, Abraham N, Singh R, Ye X, Moghaddam FA, Hartsell SE, Wei G, Beddhu S. Associations of Hyponatremia with Cognition Function and All-Cause Mortality: Post Hoc Analysis of the Systolic BP Intervention Trial. KIDNEY360 2023; 4:1362-1370. [PMID: 37612818 PMCID: PMC10615374 DOI: 10.34067/kid.0000000000000224] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Accepted: 07/13/2023] [Indexed: 08/25/2023]
Abstract
Key Points Incident hyponatremia is associated with probable dementia. Incident hyponatremia does not seem to be associated with mild cognitive impairment or death. Background Acute neurologic effects of severe hyponatremia are well-known. However, the long-term association of hyponatremia with cognitive impairment is unclear. Methods In this post hoc analysis of the Systolic Blood Pressure Intervention Trial, we examined whether incident hyponatremia is a risk factor of mild cognitive impairment (MCI) or probable dementia (PD). In those with baseline serum sodium level ≥130 mmol/L, we defined incident hyponatremia in the first 6 months as a Systolic Blood Pressure Intervention Trial safety alert for serum sodium level <130 mmol/L from randomization to the 6-month visit. In multivariate Cox regression models adjusted for baseline cognitive function and other variables, we related incident hyponatremia in the first 6 months with subsequent MCI or PD in 8540 participants with cognitive outcomes data and with all-cause mortality (ACM) in 9135 participants with mortality data. Results Incident hyponatremia in the first 6 months was noted in 116 participants (1.4%). Older age, female sex, non-Black race, lower body mass index, and randomization to intensive systolic BP control were associated with incident hyponatremia. Compared with those without hyponatremia, those with incident hyponatremia had higher risk of PD (2.1 versus 0.9 events/100 person-years; hazard ratio [HR], 3.08; 95% confidence interval [CI], 1.48 to 6.41) but not MCI (3.1 versus 3.6 events/100 person-years; HR, 0.95; 95% CI, 0.54 to 1.68) and the composite of MCI/PD (5.0 versus 4.2 events/100 person-years; HR, 1.28; 95% CI, 0.82 to 2.0). There were no significant differences in ACM (HR, 1.84; 95% CI, 0.90 to 3.73). Conclusions Biologic plausibility for the association of incident hyponatremia with PD but not MCI or death is unclear. The association of incident hyponatremia with PD could reflect a chance finding or noncausal biologic association or causal relationship.
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Affiliation(s)
- Amara Sarwal
- Division of Nephrology & Hypertension, University of Utah School of Medicine, Salt Lake City, Utah
| | - Robert E. Boucher
- Division of Nephrology & Hypertension, University of Utah School of Medicine, Salt Lake City, Utah
| | - Nikita Abraham
- Division of Nephrology & Hypertension, University of Utah School of Medicine, Salt Lake City, Utah
| | - Ravinder Singh
- Division of Nephrology & Hypertension, University of Utah School of Medicine, Salt Lake City, Utah
| | - Xiangyang Ye
- Division of Nephrology & Hypertension, University of Utah School of Medicine, Salt Lake City, Utah
| | - Farahnaz A. Moghaddam
- Division of Nephrology & Hypertension, University of Utah School of Medicine, Salt Lake City, Utah
| | - Sydney E. Hartsell
- Division of Nephrology & Hypertension, University of Utah School of Medicine, Salt Lake City, Utah
| | - Guo Wei
- Division of Nephrology & Hypertension, University of Utah School of Medicine, Salt Lake City, Utah
| | - Srinivasan Beddhu
- Division of Nephrology & Hypertension, University of Utah School of Medicine, Salt Lake City, Utah
- Medical Service, Veterans Affairs Salt Lake City Health Care System, Salt Lake City, Utah
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Steiner‐Lim GZ, Bensoussan A, Andrews‐Marney ER, Al‐Dabbas MA, Cave AE, Chiu CL, Christofides K, De Blasio FM, Dewsbury LS, Fagan NL, Fogarty JS, Hattom LC, Hohenberg MI, Jafar D, Karamacoska D, Lim CK, Liu J, Metri N, Oxenham DV, Ratajec H, Roy N, Shipton DG, Varjabedian D, Chang DH. A randomized, double-blind, placebo-controlled, parallel-group 12-week pilot phase II trial of SaiLuoTong (SLT) for cognitive function in older adults with mild cognitive impairment. ALZHEIMER'S & DEMENTIA (NEW YORK, N. Y.) 2023; 9:e12420. [PMID: 37830013 PMCID: PMC10565903 DOI: 10.1002/trc2.12420] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/09/2023] [Revised: 07/26/2023] [Accepted: 08/14/2023] [Indexed: 10/14/2023]
Abstract
INTRODUCTION This study primarily aimed to evaluate the efficacy and safety of SaiLuoTong (SLT) on cognition in mild cognitive impairment (MCI). METHODS Community-dwelling people with MCI aged ≥60 years were randomly assigned to 180 mg/day SLT or placebo for 12 weeks. RESULTS Thirty-nine participants were randomized to each group (N = 78); 65 were included in the final analysis. After 12 weeks, the between-groups difference in Logical Memory delayed recall scores was 1.40 (95% confidence interval [CI]: 0.22 to 2.58; P = 0.010); Delis-Kaplan Executive Function System Trail Making Test Condition 4 switching and contrast scaled scores were 1.42 (95% CI: -0.15 to 2.99; P = 0.038) and 1.56 (95% CI: -0.09 to 3.20; P = 0.032), respectively; Rey Auditory Verbal Learning Test delayed recall was 1.37 (95% CI: -0.10 to 2.84; P = 0.034); and Functional Activities Questionnaire was 1.21 (95% CI: -0.21 to 2.63; P = 0.047; P < 0.001 after controlling for baseline scores). DISCUSSION SLT is well tolerated and may be useful in supporting aspects of memory retrieval and executive function in people with MCI. Highlights SaiLuoTong (SLT) improves delayed memory retrieval and executive function in people with mild cognitive impairment (MCI).SLT is well tolerated in people ≥ 60 years.The sample of community dwellers with MCI was well characterized and homogeneous.
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Affiliation(s)
- Genevieve Z. Steiner‐Lim
- NICM Health Research InstituteWestern Sydney UniversityPenrithNew South WalesAustralia
- Translational Health Research Institute (THRI)Western Sydney UniversityPenrithNew South WalesAustralia
| | - Alan Bensoussan
- NICM Health Research InstituteWestern Sydney UniversityPenrithNew South WalesAustralia
| | | | - Mahmoud A. Al‐Dabbas
- NICM Health Research InstituteWestern Sydney UniversityPenrithNew South WalesAustralia
| | - Adele E. Cave
- NICM Health Research InstituteWestern Sydney UniversityPenrithNew South WalesAustralia
| | - Christine L. Chiu
- Macquarie Medical SchoolMacquarie UniversityMacquarie ParkNew South WalesAustralia
| | - Katerina Christofides
- NICM Health Research InstituteWestern Sydney UniversityPenrithNew South WalesAustralia
| | - Frances M. De Blasio
- NICM Health Research InstituteWestern Sydney UniversityPenrithNew South WalesAustralia
| | - Lauren S. Dewsbury
- NICM Health Research InstituteWestern Sydney UniversityPenrithNew South WalesAustralia
| | - Naomi L. Fagan
- NICM Health Research InstituteWestern Sydney UniversityPenrithNew South WalesAustralia
| | - Jack S. Fogarty
- Science of Learning in Education CentreNational Institute of EducationNanyang Technological UniversitySingapore
| | - Lena C. Hattom
- NICM Health Research InstituteWestern Sydney UniversityPenrithNew South WalesAustralia
| | - Mark I. Hohenberg
- School of MedicineWestern Sydney UniversityPenrithNew South WalesAustralia
| | - Deyyan Jafar
- NICM Health Research InstituteWestern Sydney UniversityPenrithNew South WalesAustralia
- Macquarie Medical SchoolMacquarie UniversityMacquarie ParkNew South WalesAustralia
| | - Diana Karamacoska
- NICM Health Research InstituteWestern Sydney UniversityPenrithNew South WalesAustralia
- Translational Health Research Institute (THRI)Western Sydney UniversityPenrithNew South WalesAustralia
| | - Chai K. Lim
- Macquarie Medical SchoolMacquarie UniversityMacquarie ParkNew South WalesAustralia
| | - Jianxun Liu
- Xiyuan HospitalChina Academy of Chinese Medical SciencesBeijingPR China
| | - Najwa‐Joelle Metri
- NICM Health Research InstituteWestern Sydney UniversityPenrithNew South WalesAustralia
| | - D. Vincent Oxenham
- Neuropsychology DepartmentRoyal North Shore HospitalSt. LeonardsNew South WalesAustralia
- School of Psychological Sciences, Faculty of Medicine, Health and Human SciencesMacquarie UniversityMacquarie ParkNew South WalesAustralia
| | - Holly Ratajec
- NICM Health Research InstituteWestern Sydney UniversityPenrithNew South WalesAustralia
| | - Nikita Roy
- NICM Health Research InstituteWestern Sydney UniversityPenrithNew South WalesAustralia
| | - Danielle G. Shipton
- NICM Health Research InstituteWestern Sydney UniversityPenrithNew South WalesAustralia
| | - David Varjabedian
- NICM Health Research InstituteWestern Sydney UniversityPenrithNew South WalesAustralia
- School of MedicineWestern Sydney UniversityPenrithNew South WalesAustralia
| | - Dennis H. Chang
- NICM Health Research InstituteWestern Sydney UniversityPenrithNew South WalesAustralia
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Cho K. Neutrophil-Mediated Progression of Mild Cognitive Impairment to Dementia. Int J Mol Sci 2023; 24:14795. [PMID: 37834242 PMCID: PMC10572848 DOI: 10.3390/ijms241914795] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 09/26/2023] [Accepted: 09/29/2023] [Indexed: 10/15/2023] Open
Abstract
Cognitive impairment is a serious condition that begins with amnesia and progresses to cognitive decline, behavioral dysfunction, and neuropsychiatric impairment. In the final stage, dysphagia and incontinence occur. There are numerous studies and developed drugs for cognitive dysfunction in neurodegenerative diseases, such as Alzheimer's disease (AD); however, their clinical effectiveness remains equivocal. To date, attempts have been made to overcome cognitive dysfunction and understand and delay the aging processes that lead to degenerative and chronic diseases. Cognitive dysfunction is involved in aging and the disruption of inflammation and innate immunity. Recent reports have indicated that the innate immune system is prevalent in patients with AD, and that peripheral neutrophil markers can predict a decline in executive function in patients with mild cognitive impairment (MCI). Furthermore, altered levels of pro-inflammatory interleukins have been reported in MCI, which have been suggested to play a role in the peripheral immune system during the process from early MCI to dementia. Neutrophils are the first responders of the innate immune system. Neutrophils eliminate harmful cellular debris via phagocytosis, secrete inflammatory factors to activate host defense systems, stimulate cytokine production, kill pathogens, and regulate extracellular proteases and inhibitors. This review investigated and summarized the regulation of neutrophil function during cognitive impairment caused by various degenerative diseases. In addition, this work elucidates the cellular mechanism of neutrophils in cognitive impairment and what is currently known about the effects of activated neutrophils on cognitive decline.
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Affiliation(s)
- KyoungJoo Cho
- Department of Life Science, Kyonggi University, Suwon 16227, Republic of Korea
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Ren Y, Qu S. Constituent isoflavones of Puerariae radix as a potential neuroprotector in cognitive impairment: Evidence from preclinical studies. Ageing Res Rev 2023; 90:102040. [PMID: 37619620 DOI: 10.1016/j.arr.2023.102040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2023] [Revised: 08/21/2023] [Accepted: 08/21/2023] [Indexed: 08/26/2023]
Abstract
With the increasing aging population worldwide, the incidence of senile cognitive impairment (CI) is increasing, posing a serious threat to the health of elderly persons. Despite developing new drugs aimed at improving CI, progress in this regard has been insufficient. Natural preparations derived from plants have become an unparalleled resource for developing new drugs. Puerariae radix (PR) has a long history as Chinese herbal medicine. PR is rich in various chemical components such as isoflavones, triterpenes, and saponins. The isoflavones (puerarin, daidzein, formononetin, and genistein) exhibit potential therapeutic effects on CI through multiple mechanisms. Relevant literature was organized from major scientific databases such as PubMed, Elsevier, SpringerLink, ScienceDirect, and Web of Science. Using "Puerariae radix," "Pueraria lobata," "isoflavones," "puerarin," "antioxidant," "daidzein," "formononetin," "genistein," "Alzheimer"s disease," and "vascular cognitive impairment" as keywords, the relevant literature was extracted from the databases mentioned above. We found that isoflavones from PR have neuroprotective effects on multiple models of CI via multiple targets and mechanisms. These isoflavones prevent Aβ aggregation, inhibit tau hyperphosphorylation, increase cholinergic neurotransmitter levels, reduce neuroinflammation and oxidative stress, improve synaptic plasticity, promote nerve regeneration, and prevent apoptosis. PR has been used as traditional Chinese herbal medicine for a long time, and its constituent isoflavones exert significant therapeutic effects on CI through various neuroprotective mechanisms. This review will contribute to the future development of isoflavones present in PR as novel drug candidates for the clinical treatment of CI.
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Affiliation(s)
- Yaoyao Ren
- Department of Otolaryngology Head and Neck Surgery, Shengjing Hospital of China Medical University, 36 Sanhao Street, Heping District, 110004 Shenyang, Liaoning, PR China
| | - Shengtao Qu
- Department of Neurosurgery, Shengjing Hospital of China Medical University, No. 36 Sanhao St, Shenyang 110004, PR China.
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Asher S, Suominen AL, Stephen R, Ngandu T, Koskinen S, Solomon A. Association of tooth count with cognitive decline and dementia in the Finnish adult population. J Clin Periodontol 2023; 50:1154-1166. [PMID: 37461219 DOI: 10.1111/jcpe.13851] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Revised: 06/16/2023] [Accepted: 06/29/2023] [Indexed: 08/18/2023]
Abstract
AIM To evaluate whether tooth loss is associated with cognitive decline and incident dementia. MATERIALS AND METHODS We analysed data from the Finnish population-based Health 2000 and follow-up Health 2011 surveys (participants aged ≥30 years and without dementia at baseline; N = 5506 at baseline and 3426 at 11-year follow-up). Dementia diagnoses until 2015 were ascertained from national registers (N = 5542). Tooth count was dichotomized as adequate (≥20) versus tooth loss (<20). Tooth loss was further stratified into 10-19 teeth, 1-9 teeth and edentulism. Upper and lower jaws were also considered separately. Baseline cognitive test scores were dichotomized by median as high versus low, and 11-year change as decline versus no decline. RESULTS Tooth loss (<20) was associated with lower baseline overall cognition (odds ratio [OR] = 1.21, 95% confidence interval [CI] = 1.03-1.43), 11-year cognitive decline (OR = 1.30, 95% CI = 1.05-1.70) and higher 15-year dementia risk (hazard ratio = 1.52, 95% CI = 1.15-2.02) after adjusting for multiple confounders. After adjustment for dentures, associations became non-significant, except for 10-19 teeth remaining and dementia. Results were similar after considering reverse causality bias; however, 10-19 teeth remaining was significantly associated with 11-year cognitive decline even after adjustment for dentures. No jaw-specific differences were observed. CONCLUSIONS Tooth loss adversely impacts the risk of cognitive decline and dementia. The role of dentures should be further explored.
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Affiliation(s)
- Sam Asher
- Institute of Dentistry, University of Eastern Finland, Kuopio, Finland
| | - Anna Liisa Suominen
- Institute of Dentistry, University of Eastern Finland, Kuopio, Finland
- Oral Health Teaching Clinic, Kuopio University Hospital, Kuopio, Finland
- Department of Public Health and Welfare, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Ruth Stephen
- Department of Public Health and Welfare, Finnish Institute for Health and Welfare, Helsinki, Finland
- Institute of Clinical Medicine/Neurology, University of Eastern Finland, Kuopio, Finland
- Division of Clinical Geriatrics, Center for Alzheimer Research, Karolinska Institute, Stockholm, Sweden
| | - Tiia Ngandu
- Department of Public Health and Welfare, Finnish Institute for Health and Welfare, Helsinki, Finland
- Division of Clinical Geriatrics, Center for Alzheimer Research, Karolinska Institute, Stockholm, Sweden
| | - Seppo Koskinen
- Department of Public Health and Welfare, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Alina Solomon
- Institute of Clinical Medicine/Neurology, University of Eastern Finland, Kuopio, Finland
- Division of Clinical Geriatrics, Center for Alzheimer Research, Karolinska Institute, Stockholm, Sweden
- Ageing Epidemiology Research Unit, School of Public Health, Imperial College London, London, UK
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Abramova O, Zorkina Y, Ushakova V, Gryadunov D, Ikonnikova A, Fedoseeva E, Emelyanova M, Ochneva A, Morozova I, Pavlov K, Syunyakov T, Andryushchenko A, Savilov V, Kurmishev M, Andreuyk D, Shport S, Gurina O, Chekhonin V, Kostyuk G, Morozova A. Alteration of Blood Immune Biomarkers in MCI Patients with Different APOE Genotypes after Cognitive Training: A 1 Year Follow-Up Cohort Study. Int J Mol Sci 2023; 24:13395. [PMID: 37686198 PMCID: PMC10488004 DOI: 10.3390/ijms241713395] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2023] [Revised: 08/22/2023] [Accepted: 08/24/2023] [Indexed: 09/10/2023] Open
Abstract
Many studies aim to detect the early phase of dementia. One of the major ways to achieve this is to identify corresponding biomarkers, particularly immune blood biomarkers. The objective of this study was to identify such biomarkers in patients with mild cognitive impairment (MCI) in an experiment that included cognitive training. A group of patients with MCI diagnoses over the age of 65 participated in the study (n = 136). Measurements of cognitive functions (using the Mini-Mental State Examination scale and Montreal Cognitive Assessment) and determination of 27 serum biomarkers were performed twice: on the first visit and on the second visit, one year after the cognitive training. APOE genotypes were also determined. Concentrations of EGF (F = 17; p = 0.00007), Eotaxin (F = 7.17; p = 0.008), GRO (F = 13.42; p = 0.0004), IL-8 (F = 8.16; p = 0.005), MCP-1 (F = 13.46; p = 0.0001) and MDC (F = 5.93; p = 0.016) increased after the cognitive training in MCI patients. All these parameters except IL-8 demonstrated a weak correlation with other immune parameters and were poorly represented in the principal component analysis. Differences in concentrations of IP-10, FGF-2, TGFa and VEGF in patients with MCI were associated with APOE genotype. Therefore, the study identified several immune blood biomarkers that could potentially be associated with changes in cognitive function.
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Affiliation(s)
- Olga Abramova
- Mental-Health Clinic No. 1 Named after N.A. Alekseev, Zagorodnoe Highway 2, 115191 Moscow, Russia; (O.A.); (Y.Z.); (V.U.); (A.O.); (I.M.)
- Department of Basic and Applied Neurobiology, V. Serbsky Federal Medical Research Centre of Psychiatry and Narcology, Kropotkinsky per. 23, 119034 Moscow, Russia
| | - Yana Zorkina
- Mental-Health Clinic No. 1 Named after N.A. Alekseev, Zagorodnoe Highway 2, 115191 Moscow, Russia; (O.A.); (Y.Z.); (V.U.); (A.O.); (I.M.)
- Department of Basic and Applied Neurobiology, V. Serbsky Federal Medical Research Centre of Psychiatry and Narcology, Kropotkinsky per. 23, 119034 Moscow, Russia
| | - Valeriya Ushakova
- Mental-Health Clinic No. 1 Named after N.A. Alekseev, Zagorodnoe Highway 2, 115191 Moscow, Russia; (O.A.); (Y.Z.); (V.U.); (A.O.); (I.M.)
- Department of Basic and Applied Neurobiology, V. Serbsky Federal Medical Research Centre of Psychiatry and Narcology, Kropotkinsky per. 23, 119034 Moscow, Russia
- Biological Faculty, M.V. Lomonosov Moscow State University, 119991 Moscow, Russia
| | - Dmitry Gryadunov
- Center for Precision Genome Editing and Genetic Technologies for Biomedicine, Engelhardt Institute of Molecular Biology, Russian Academy of Sciences, 119991 Moscow, Russia
| | - Anna Ikonnikova
- Center for Precision Genome Editing and Genetic Technologies for Biomedicine, Engelhardt Institute of Molecular Biology, Russian Academy of Sciences, 119991 Moscow, Russia
| | - Elena Fedoseeva
- Center for Precision Genome Editing and Genetic Technologies for Biomedicine, Engelhardt Institute of Molecular Biology, Russian Academy of Sciences, 119991 Moscow, Russia
| | - Marina Emelyanova
- Center for Precision Genome Editing and Genetic Technologies for Biomedicine, Engelhardt Institute of Molecular Biology, Russian Academy of Sciences, 119991 Moscow, Russia
| | - Aleksandra Ochneva
- Mental-Health Clinic No. 1 Named after N.A. Alekseev, Zagorodnoe Highway 2, 115191 Moscow, Russia; (O.A.); (Y.Z.); (V.U.); (A.O.); (I.M.)
- Department of Basic and Applied Neurobiology, V. Serbsky Federal Medical Research Centre of Psychiatry and Narcology, Kropotkinsky per. 23, 119034 Moscow, Russia
| | - Irina Morozova
- Mental-Health Clinic No. 1 Named after N.A. Alekseev, Zagorodnoe Highway 2, 115191 Moscow, Russia; (O.A.); (Y.Z.); (V.U.); (A.O.); (I.M.)
| | - Konstantin Pavlov
- Mental-Health Clinic No. 1 Named after N.A. Alekseev, Zagorodnoe Highway 2, 115191 Moscow, Russia; (O.A.); (Y.Z.); (V.U.); (A.O.); (I.M.)
- Department of Basic and Applied Neurobiology, V. Serbsky Federal Medical Research Centre of Psychiatry and Narcology, Kropotkinsky per. 23, 119034 Moscow, Russia
| | - Timur Syunyakov
- Mental-Health Clinic No. 1 Named after N.A. Alekseev, Zagorodnoe Highway 2, 115191 Moscow, Russia; (O.A.); (Y.Z.); (V.U.); (A.O.); (I.M.)
- International Centre for Education and Research in Neuropsychiatry (ICERN), Samara State Medical University, 443016 Samara, Russia
| | - Alisa Andryushchenko
- Mental-Health Clinic No. 1 Named after N.A. Alekseev, Zagorodnoe Highway 2, 115191 Moscow, Russia; (O.A.); (Y.Z.); (V.U.); (A.O.); (I.M.)
| | - Victor Savilov
- Mental-Health Clinic No. 1 Named after N.A. Alekseev, Zagorodnoe Highway 2, 115191 Moscow, Russia; (O.A.); (Y.Z.); (V.U.); (A.O.); (I.M.)
| | - Marat Kurmishev
- Mental-Health Clinic No. 1 Named after N.A. Alekseev, Zagorodnoe Highway 2, 115191 Moscow, Russia; (O.A.); (Y.Z.); (V.U.); (A.O.); (I.M.)
| | - Denis Andreuyk
- Mental-Health Clinic No. 1 Named after N.A. Alekseev, Zagorodnoe Highway 2, 115191 Moscow, Russia; (O.A.); (Y.Z.); (V.U.); (A.O.); (I.M.)
- Biological Faculty, M.V. Lomonosov Moscow State University, 119991 Moscow, Russia
| | - Svetlana Shport
- Department of Basic and Applied Neurobiology, V. Serbsky Federal Medical Research Centre of Psychiatry and Narcology, Kropotkinsky per. 23, 119034 Moscow, Russia
| | - Olga Gurina
- Department of Basic and Applied Neurobiology, V. Serbsky Federal Medical Research Centre of Psychiatry and Narcology, Kropotkinsky per. 23, 119034 Moscow, Russia
| | - Vladimir Chekhonin
- Department of Basic and Applied Neurobiology, V. Serbsky Federal Medical Research Centre of Psychiatry and Narcology, Kropotkinsky per. 23, 119034 Moscow, Russia
- Department of Medical Nanobiotechnology, Pirogov Russian National Research Medical University, 117997 Moscow, Russia
| | - Georgy Kostyuk
- Mental-Health Clinic No. 1 Named after N.A. Alekseev, Zagorodnoe Highway 2, 115191 Moscow, Russia; (O.A.); (Y.Z.); (V.U.); (A.O.); (I.M.)
- Department of Psychiatry, Federal State Budgetary Educational Institution of Higher Education “Moscow State University of Food Production”, Volokolamskoye Highway 11, 125080 Moscow, Russia
| | - Anna Morozova
- Mental-Health Clinic No. 1 Named after N.A. Alekseev, Zagorodnoe Highway 2, 115191 Moscow, Russia; (O.A.); (Y.Z.); (V.U.); (A.O.); (I.M.)
- Department of Basic and Applied Neurobiology, V. Serbsky Federal Medical Research Centre of Psychiatry and Narcology, Kropotkinsky per. 23, 119034 Moscow, Russia
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Brandt A, Kromm F, Hernández-Arriaga A, Martínez Sánchez I, Bozkir HÖ, Staltner R, Baumann A, Camarinha-Silva A, Heijtz RD, Bergheim I. Cognitive Alterations in Old Mice Are Associated with Intestinal Barrier Dysfunction and Induced Toll-like Receptor 2 and 4 Signaling in Different Brain Regions. Cells 2023; 12:2153. [PMID: 37681885 PMCID: PMC10486476 DOI: 10.3390/cells12172153] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2023] [Revised: 08/24/2023] [Accepted: 08/25/2023] [Indexed: 09/09/2023] Open
Abstract
Emerging evidence implicate the 'microbiota-gut-brain axis' in cognitive aging and neuroinflammation; however, underlying mechanisms still remain to be elucidated. Here, we assessed if potential alterations in intestinal barrier function and microbiota composition as well as levels of two key pattern-recognition receptors namely Toll-like receptor (TLR) 2 and TLR4, in blood and different brain regions, and depending signaling cascades are paralleling aging associated alterations of cognition in healthy aging mice. Cognitive function was assessed in the Y-maze and intestinal and brain tissue and blood were collected in young (4 months old) and old (24 months old) male C57BL/6 mice to determine intestinal microbiota composition by Illumina amplicon sequencing, the concentration of TLR2 and TLR4 ligands in plasma and brain tissue as well as to determine markers of intestinal barrier function, senescence and TLR2 and TLR4 signaling. Cognitive function was significantly impaired in old mice. Also, in old mice, intestinal microbiota composition was significantly altered, while the relative abundance of Gram-negative or Gram-positive bacteria in the small and large intestines at different ages was not altered. Moreover, intestinal barrier function was impaired in small intestine of old mice, and the levels of TLR2 and TLR4 ligands were also significantly higher in both portal and peripheral blood. Furthermore, levels of TLR2 and TLR4 ligands, and downstream markers of TLR signaling were higher in the hippocampal and prefrontal cortex of old mice compared to young animals. Taken together, our results suggest that even in 'healthy' aging, cognitive function is impaired in mice going along with an increased intestinal translocation of TLR ligands and alterations of TLR signaling in several brain regions.
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Affiliation(s)
- Annette Brandt
- Department of Nutritional Sciences, Molecular Nutritional Science, University of Vienna, 1090 Vienna, Austria
| | - Franziska Kromm
- Department of Nutritional Sciences, Molecular Nutritional Science, University of Vienna, 1090 Vienna, Austria
| | - Angélica Hernández-Arriaga
- Animal Nutrition Department, Institute of Animal Science, University of Hohenheim, 70593 Stuttgart, Germany
| | - Inés Martínez Sánchez
- Department of Neuroscience, Karolinska Institute, Biomedicum, 17177 Stockholm, Sweden
| | - Haktan Övül Bozkir
- Department of Nutritional Sciences, Molecular Nutritional Science, University of Vienna, 1090 Vienna, Austria
| | - Raphaela Staltner
- Department of Nutritional Sciences, Molecular Nutritional Science, University of Vienna, 1090 Vienna, Austria
| | - Anja Baumann
- Department of Nutritional Sciences, Molecular Nutritional Science, University of Vienna, 1090 Vienna, Austria
| | - Amélia Camarinha-Silva
- Animal Nutrition Department, Institute of Animal Science, University of Hohenheim, 70593 Stuttgart, Germany
| | - Rochellys Diaz Heijtz
- Department of Neuroscience, Karolinska Institute, Biomedicum, 17177 Stockholm, Sweden
| | - Ina Bergheim
- Department of Nutritional Sciences, Molecular Nutritional Science, University of Vienna, 1090 Vienna, Austria
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Jackson-Cowan L, Silverberg JI. Longitudinal course of cognitive impairment in patients with atopic dermatitis. Arch Dermatol Res 2023; 315:1553-1560. [PMID: 36708375 DOI: 10.1007/s00403-023-02536-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Revised: 01/10/2023] [Accepted: 01/13/2023] [Indexed: 01/29/2023]
Abstract
Atopic dermatitis (AD) is a common inflammatory skin disease. Cognitive dysfunction was recently demonstrated to be increased in adults and children with AD. However, little is known about the longitudinal course of cognitive impairment in AD and its relationship with pruritus. To investigate the longitudinal course and predictors of cognitive impairment in AD a prospective dermatology practice-based study was performed using questionnaires and evaluation by a dermatologist (n = 210). Patients with ≥ 2 visits were included (mean follow-up time: 318 days). Cognitive function was assessed using the Patient-Reported Outcomes Measurement Information System (PROMIS) Cognitive Function 8-item Short-Form. At baseline, 20.85% of patients had PROMIS T scores ≤ 45, indicating cognitive impairment (CI). Among patients with CI at baseline, 34.09% had persistent CI, 47.72% had a fluctuating course, and 18.18% had sustained improvement of cognitive function. In repeated-measures regression models, cognitive function scores declined overtime in patients with worse AD severity [SCORing Atopic Dermatitis (SCORAD): p = 0.01, Atopic Dermatitis Severity Index: p = 0.001], increased itch (p = 0.01), skin pain (p = 0.001), and sleep disturbance (p = 0.001). In multivariable logistic regression models, persistent CI was associated with female gender and depressive symptoms [moderate-to-severe Patient Health Questionnaire-9 score (PHQ9)]. Latent class analysis identified two classes of cognitive dysfunction: normal cognition (77.23%), moderate dysfunction (16.21%) and severe impairment (6.55%). Black/African-American race (p = 0.02), moderate-to-severe SCORAD (p = 0.03), dermatology life quality index (p < 0.0001), PHQ9 (p < 0.0001), itch (p = 0.02) and skin pain (p < 0.0001) were more likely to experience moderate dysfunction or severe cognitive impairment. AD is associated with a heterogeneous longitudinal course of cognitive function in adults, with some patients experiencing persistent CI over time.
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Affiliation(s)
- Ladonya Jackson-Cowan
- AU/UGA Medical Partnership, The Medical College of Georgia at Augusta University, Athens, GA, USA
| | - Jonathan I Silverberg
- Department of Dermatology, The George Washington University School of Medicine and Health Sciences, Suite 2B-425, 2150 Pennsylvania Avenue, Washington, DC, 20037, USA.
- Department of Dermatology, Northwestern University Feinberg School of Medicine, Chicago, USA.
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Ferrari S, Galla R, Mulè S, Rosso G, Brovero A, Macchi V, Ruga S, Uberti F. The Role of Bifidobacterium bifidum novaBBF7, Bifidobacterium longum novaBLG2 and Lactobacillus paracasei TJB8 to Improve Mechanisms Linked to Neuronal Cells Protection against Oxidative Condition in a Gut-Brain Axis Model. Int J Mol Sci 2023; 24:12281. [PMID: 37569657 PMCID: PMC10419296 DOI: 10.3390/ijms241512281] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Revised: 07/27/2023] [Accepted: 07/29/2023] [Indexed: 08/13/2023] Open
Abstract
Despite the identification of several innovative targets for avoiding cognitive decline, there has yet to be a widely accepted approach that deals with minimising the deterioration of cognitive function. In this light, recent studies suggest that regulating the gut-brain axis with probiotics is a potential therapeutic strategy to support brain health. For this reason, in vitro models were used to examine the efficacy of different probiotic combinations to enhance intestinal homeostasis and positively affect the brain. Therefore, the new formulation has been evaluated for its capacity to modify intestinal barrier functions in a 3D in vitro model without any adverse effects and directly impact the mechanisms underlying cognitive function in a gut-brain axis model. According to our findings, B. bifidum novaBBF7 10 mg/mL, B. longum novaBLG2 5 mg/mL and L. paracasei TJB8 10 mg/mL may successfully modify the intestinal barrier and improve SCFA production. Successively, the probiotics studied caused no harm at the neuronal level, as demonstrated by iNOS, mitochondrial potential, and cell viability tests, confirming their safety features and enhancing antioxidant mechanisms and antineuroinflammation activity. Additionally, the damage caused by oxidative stress was also healed, and critical pathways that result in cognitive impairment were changed by synergetic action, supporting the hypothesis that brain ageing and neurodegeneration are slowed down. All these findings demonstrate the ability of probiotics to affect cognitive processes and their ability to sustain the mechanisms underlying cognitive function by acting on intestinal function.
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Affiliation(s)
- Sara Ferrari
- Laboratory of Physiology, Department of Translational Medicine, University of Piemonte Orientale, Via Solaroli 17, 28100 Novara, Italy
| | - Rebecca Galla
- Laboratory of Physiology, Department of Translational Medicine, University of Piemonte Orientale, Via Solaroli 17, 28100 Novara, Italy
- Noivita Srls, Spin Off, University of Piemonte Orientale, Via Solaroli 17, 28100 Novara, Italy
| | - Simone Mulè
- Laboratory of Physiology, Department of Translational Medicine, University of Piemonte Orientale, Via Solaroli 17, 28100 Novara, Italy
| | - Giorgia Rosso
- Laboratory of Physiology, Department of Translational Medicine, University of Piemonte Orientale, Via Solaroli 17, 28100 Novara, Italy
| | - Arianna Brovero
- Laboratory of Physiology, Department of Translational Medicine, University of Piemonte Orientale, Via Solaroli 17, 28100 Novara, Italy
| | - Valentina Macchi
- Laboratory of Physiology, Department of Translational Medicine, University of Piemonte Orientale, Via Solaroli 17, 28100 Novara, Italy
| | - Sara Ruga
- Noivita Srls, Spin Off, University of Piemonte Orientale, Via Solaroli 17, 28100 Novara, Italy
| | - Francesca Uberti
- Laboratory of Physiology, Department of Translational Medicine, University of Piemonte Orientale, Via Solaroli 17, 28100 Novara, Italy
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Lawson L, Mc Ardle R, Wilson S, Beswick E, Karimi R, Slight SP. Digital Endpoints for Assessing Instrumental Activities of Daily Living in Mild Cognitive Impairment: Systematic Review. J Med Internet Res 2023; 25:e45658. [PMID: 37490331 PMCID: PMC10410386 DOI: 10.2196/45658] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2023] [Revised: 04/05/2023] [Accepted: 04/19/2023] [Indexed: 07/26/2023] Open
Abstract
BACKGROUND Subtle impairments in instrumental activities of daily living (IADLs) can be a key predictor of disease progression and are considered central to functional independence. Mild cognitive impairment (MCI) is a syndrome associated with significant changes in cognitive function and mild impairment in complex functional abilities. The early detection of functional decline through the identification of IADL impairments can aid early intervention strategies. Digital health technology is an objective method of capturing IADL-related behaviors. However, it is unclear how these IADL-related behaviors have been digitally assessed in the literature and what differences can be observed between MCI and normal aging. OBJECTIVE This review aimed to identify the digital methods and metrics used to assess IADL-related behaviors in people with MCI and report any statistically significant differences in digital endpoints between MCI and normal aging and how these digital endpoints change over time. METHODS A total of 16,099 articles were identified from 8 databases (CINAHL, Embase, MEDLINE, ProQuest, PsycINFO, PubMed, Web of Science, and Scopus), out of which 15 were included in this review. The included studies must have used continuous remote digital measures to assess IADL-related behaviors in adults characterized as having MCI by clinical diagnosis or assessment. This review was conducted in accordance with the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. RESULTS Ambient technology was the most commonly used digital method to assess IADL-related behaviors in the included studies (14/15, 93%), with passive infrared motion sensors (5/15, 33%) and contact sensors (5/15, 33%) being the most prevalent types of methods. Digital technologies were used to assess IADL-related behaviors across 5 domains: activities outside of the home, everyday technology use, household and personal management, medication management, and orientation. Other recognized domains-culturally specific tasks and socialization and communication-were not assessed. Of the 79 metrics recorded among 11 types of technologies, 65 (82%) were used only once. There were inconsistent findings around differences in digital IADL endpoints across the cognitive spectrum, with limited longitudinal assessment of how they changed over time. CONCLUSIONS Despite the broad range of metrics and methods used to digitally assess IADL-related behaviors in people with MCI, several IADLs relevant to functional decline were not studied. Measuring multiple IADL-related digital endpoints could offer more value than the measurement of discrete IADL outcomes alone to observe functional decline. Key recommendations include the development of suitable core metrics relevant to IADL-related behaviors that are based on clinically meaningful outcomes to aid the standardization and further validation of digital technologies against existing IADL measures. Increased longitudinal monitoring is necessary to capture changes in digital IADL endpoints over time in people with MCI. TRIAL REGISTRATION PROSPERO International Prospective Register of Systematic Reviews CRD42022326861; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=326861.
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Affiliation(s)
- Lauren Lawson
- School of Pharmacy, Population Health Sciences Institute, Newcastle University, Newcastle Upon Tyne, United Kingdom
| | - Ríona Mc Ardle
- School of Pharmacy, Population Health Sciences Institute, Newcastle University, Newcastle Upon Tyne, United Kingdom
| | - Sarah Wilson
- School of Pharmacy, Population Health Sciences Institute, Newcastle University, Newcastle Upon Tyne, United Kingdom
| | - Emily Beswick
- School of Pharmacy, Population Health Sciences Institute, Newcastle University, Newcastle Upon Tyne, United Kingdom
| | - Radin Karimi
- School of Pharmacy, Population Health Sciences Institute, Newcastle University, Newcastle Upon Tyne, United Kingdom
| | - Sarah P Slight
- School of Pharmacy, Population Health Sciences Institute, Newcastle University, Newcastle Upon Tyne, United Kingdom
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Salis F, Puxeddu B, Piras V, Belfiori M, Marongiu G, Capone A, Mandas A. Orthogeriatric Assessment of the Elderly Patient with Fragility Hip Fracture: Preliminary Results of a Prospective Study. J Pers Med 2023; 13:1138. [PMID: 37511751 PMCID: PMC10381970 DOI: 10.3390/jpm13071138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Revised: 07/08/2023] [Accepted: 07/12/2023] [Indexed: 07/30/2023] Open
Abstract
Nowadays, more studies deal with "OrthoGeriatrics", for the co-management of elderly patients suffering fractures, from the admission to the discharge and beyond. For the first time at Cagliari University Hospital, we introduced an orthogeriatric service, in which trained geriatricians stay in orthopedic unit alongside trained orthopedics. The primary aim of the study was to analyze the rate of death and rehospitalization in elderly femur-fractured people of 65 or more years of age, identifying possible predictive factors. The secondary aim of the study was to analyze the recovery of daily living autonomies during the months following surgery. To reach the aim, we designed a prospective study, which is currently ongoing. We evaluated femur-fractured patients aged 65 years or more with a comprehensive geriatric assessment before surgery. The most common fractures were lateral hip ones, treated with osteosynthesis. Cognitive-affective, functional, and nutritional status, mood, and comorbidities were less impaired than in the outpatient service of the same hospital devoted to frail elderly. Pain control was excellent. A significantly low delirium incidence was found. More than a third of the sample were recognized as frail (according to the Survey of Health, Ageing and Retirement in Europe-Frailty Instrument (SHARE-FI)), and over a third of the sample were identified as a moderate-high risk of hospitalization and death (according to Multidimensional Prognostic Index (MPI)). Overall mortality rate was 13.87%, and rehospitalization rate was 11.84%. Frail people were more likely to die than non-frail (HR: 5.64), and pre-frail ones (HR: 3.97); similarly, high-risk patients were more likely to die than low-risk (HR: 8.04), and moderate-risk ones (HR: 5.46). Conversely, neither SHARE-FI nor MPI predicted rehospitalization. Creatinine (OR: 2.66, p = 0.003) and folate (OR: 0.75, p = 0.03) levels were independently associated with death and rehospitalization, respectively. Finally, the patients did recover the lost autonomies later, 6 months after surgery. Our study demonstrated that SHARE-FI and MPI are reliable tools to predict mortality in an orthogeriatric setting, and that creatinine and folate levels should also be measured given their independent association with negative outcomes.
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Affiliation(s)
- Francesco Salis
- Department of Medical Sciences, and Public Health, University of Cagliari, 09100 Cagliari, Italy
| | - Benedetta Puxeddu
- Department of Medical Sciences, and Public Health, University of Cagliari, 09100 Cagliari, Italy
| | - Veronica Piras
- Department of Medicine, Surgery, and Pharmacy, University of Sassari, 07100 Sassari, Italy
| | - Maristella Belfiori
- Department of Medical Sciences, and Public Health, University of Cagliari, 09100 Cagliari, Italy
| | - Giuseppe Marongiu
- University Hospital "Azienda Ospedaliero-Universitaria" of Cagliari, 09042 Monserrato, Italy
- Department of Surgical Sciences, University of Cagliari, 09100 Cagliari, Italy
| | - Antonio Capone
- University Hospital "Azienda Ospedaliero-Universitaria" of Cagliari, 09042 Monserrato, Italy
- Department of Surgical Sciences, University of Cagliari, 09100 Cagliari, Italy
| | - Antonella Mandas
- Department of Medical Sciences, and Public Health, University of Cagliari, 09100 Cagliari, Italy
- University Hospital "Azienda Ospedaliero-Universitaria" of Cagliari, 09042 Monserrato, Italy
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Vipin A, Kumar D, Soo SA, Zailan FZ, Leow YJ, Koh CL, Ng ASL, Ng KP, Kandiah N. APOE4 carrier status determines association between white matter disease and grey matter atrophy in early-stage dementia. Alzheimers Res Ther 2023; 15:103. [PMID: 37270543 DOI: 10.1186/s13195-023-01251-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Accepted: 05/29/2023] [Indexed: 06/05/2023]
Abstract
BACKGROUND White matter hyperintensities, a neuroimaging marker of small-vessel cerebrovascular disease and apolipoprotein ε4 (APOE4) allele, are important dementia risk factors. However, APOE4 as a key effect modifier in the relationship between white matter hyperintensities and grey matter volume needs further exploration. METHODS One hundred ninety-two early-stage dementia (including mild cognitive impairment and mild dementia) and 259 cognitively unimpaired participants from a neurocognitive research cohort with neuroimaging data, APOE genotyping, and neuropsychological assessments were studied. We investigated independent and interactive effects of white matter hyperintensities and APOE4 on whole-brain voxel-wise grey matter volume using voxel-based morphometry (uncorrected p < 0.001; minimum cluster size = 100 voxels). We further assessed interactive effects between APOE4 and white matter hyperintensities on global cognition, memory, and executive function in early-stage dementia and cognitively unimpaired participants. RESULTS Independent of APOE4 status, higher white matter hyperintensity load was associated with greater grey matter atrophy across frontal, parietal, temporal, and occipital lobes in cognitively unimpaired and early-stage dementia subjects. However, interaction analyses and independent sample analyses revealed that APOE4 non-carriers demonstrated greater white matter hyperintensity-associated grey matter atrophy compared to APOE4 carriers in both cognitively unimpaired and early-stage dementia groups. Additional confirmatory analyses among APOE4 non-carriers demonstrated that white matter hyperintensities resulted in widespread grey matter loss. Analyses of cognitive function demonstrated that higher white matter hyperintensity load was associated with worse global (Mini-Mental State Examination, Montreal Cognitive Assessment) and executive function (Color Trails 2) in APOE4 non-carriers compared to APOE4 carriers in early-stage dementia but not cognitively unimpaired participants. CONCLUSIONS The association between white matter hyperintensities and grey matter loss is more pronounced in APOE4 non-carriers than APOE4 carriers in the cognitively unimpaired and early-stage dementia stages. Furthermore, white matter hyperintensity presence results in poorer executive function in APOE4 non-carriers compared to APOE4 carriers. This finding may have significant impact on the design of clinical trials with disease modifying therapies.
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Grants
- MOE AcRF Tier 3 Award MOE2017-T3-1-002 Ministry of Education - Singapore
- MOE AcRF Tier 3 Award MOE2017-T3-1-002 Ministry of Education - Singapore
- MOE AcRF Tier 3 Award MOE2017-T3-1-002 Ministry of Education - Singapore
- MOE AcRF Tier 3 Award MOE2017-T3-1-002 Ministry of Education - Singapore
- MOE AcRF Tier 3 Award MOE2017-T3-1-002 Ministry of Education - Singapore
- MOE AcRF Tier 3 Award MOE2017-T3-1-002 Ministry of Education - Singapore
- NMRC/CIRG/1415/2015, NMRC/CSA/063/2014, MOH-CSAINV18nov-0007, NMRC/CIRG/14MAY025 National Medical Research Council
- NMRC/CIRG/1415/2015, NMRC/CSA/063/2014, MOH-CSAINV18nov-0007, NMRC/CIRG/14MAY025 National Medical Research Council
- NMRC/CIRG/1415/2015, NMRC/CSA/063/2014, MOH-CSAINV18nov-0007, NMRC/CIRG/14MAY025 National Medical Research Council
- NMRC/CIRG/1415/2015, NMRC/CSA/063/2014, MOH-CSAINV18nov-0007, NMRC/CIRG/14MAY025 National Medical Research Council
- NMRC/CIRG/1415/2015, NMRC/CSA/063/2014, MOH-CSAINV18nov-0007, NMRC/CIRG/14MAY025 National Medical Research Council
- NMRC/CIRG/1415/2015, NMRC/CSA/063/2014, MOH-CSAINV18nov-0007, NMRC/CIRG/14MAY025 National Medical Research Council
- Reference Number: 991016 National Neuroscience Institute-Health Research Endowment Fund (NNI-HREF), Singapore
- Reference Number: 991016 National Neuroscience Institute-Health Research Endowment Fund (NNI-HREF), Singapore
- Reference Number: 991016 National Neuroscience Institute-Health Research Endowment Fund (NNI-HREF), Singapore
- Reference Number: 991016 National Neuroscience Institute-Health Research Endowment Fund (NNI-HREF), Singapore
- Reference Number: 991016 National Neuroscience Institute-Health Research Endowment Fund (NNI-HREF), Singapore
- Reference Number: 991016 National Neuroscience Institute-Health Research Endowment Fund (NNI-HREF), Singapore
- Reference Number: 991016 National Neuroscience Institute-Health Research Endowment Fund (NNI-HREF), Singapore
- Reference Number: 991016 National Neuroscience Institute-Health Research Endowment Fund (NNI-HREF), Singapore
- Reference Number: 991016 National Neuroscience Institute-Health Research Endowment Fund (NNI-HREF), Singapore
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Affiliation(s)
- Ashwati Vipin
- Dementia Research Centre - Lee Kong Chian School of Medicine, Nanyang Technology University, 11 Mandalay Road, Singapore, 308232, Singapore
- National Neuroscience Institute, Singapore, Singapore
| | - Dilip Kumar
- Dementia Research Centre - Lee Kong Chian School of Medicine, Nanyang Technology University, 11 Mandalay Road, Singapore, 308232, Singapore
- National Neuroscience Institute, Singapore, Singapore
| | - See Ann Soo
- Dementia Research Centre - Lee Kong Chian School of Medicine, Nanyang Technology University, 11 Mandalay Road, Singapore, 308232, Singapore
- National Neuroscience Institute, Singapore, Singapore
| | - Fatin Zahra Zailan
- Dementia Research Centre - Lee Kong Chian School of Medicine, Nanyang Technology University, 11 Mandalay Road, Singapore, 308232, Singapore
- National Neuroscience Institute, Singapore, Singapore
| | - Yi Jin Leow
- Dementia Research Centre - Lee Kong Chian School of Medicine, Nanyang Technology University, 11 Mandalay Road, Singapore, 308232, Singapore
- National Neuroscience Institute, Singapore, Singapore
| | - Chen Ling Koh
- National Neuroscience Institute, Singapore, Singapore
| | - Adeline Su Lyn Ng
- National Neuroscience Institute, Singapore, Singapore
- Duke-NUS Medical School, Singapore, Singapore
| | - Kok Pin Ng
- Dementia Research Centre - Lee Kong Chian School of Medicine, Nanyang Technology University, 11 Mandalay Road, Singapore, 308232, Singapore
- National Neuroscience Institute, Singapore, Singapore
- Duke-NUS Medical School, Singapore, Singapore
| | - Nagaendran Kandiah
- Dementia Research Centre - Lee Kong Chian School of Medicine, Nanyang Technology University, 11 Mandalay Road, Singapore, 308232, Singapore.
- National Neuroscience Institute, Singapore, Singapore.
- Duke-NUS Medical School, Singapore, Singapore.
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Chad Chew EY, Prem P, Jasmine K, Nav V, Arthi B. Comparison of DBFS with MoCA and MMSE tools for MCI screening. Bioinformation 2023; 19:522-524. [PMID: 37886151 PMCID: PMC10599673 DOI: 10.6026/97320630019522] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Revised: 05/31/2023] [Accepted: 05/31/2023] [Indexed: 10/28/2023] Open
Abstract
Mild cognitive impairment (MCI) has been associated with many diseases. The MCI could be a marker for the early diagnosis of certain diseases. Early detection of MCI could be beneficial for restoration of cognitive reserves. One hundred and five subjects were included in the study, underwent the Digital Brain Function Screen (DBFS) test as well as the Montreal Cognitive Assessment (MoCA) test and 73 subjects took the Mini-Mental State Examination (MMSE) test. DBFS test and retest was taken by 16 subjects. The test scores of DBFS tool showed significant positive correlation with MoCA and MMSE test scores. In conclusion, the DBFS tool could be an effective digital tool which can overcome the disadvantages of traditional tools of screening MCI like MoCA and MMSE.
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Affiliation(s)
| | - Pillay Prem
- Neurowyzr Pte. Ltd., 6 Raffles Quay, 11-07, Singapore-048580
| | - Kuah Jasmine
- Neurowyzr Pte. Ltd., 6 Raffles Quay, 11-07, Singapore-048580
| | - Vij Nav
- Neurowyzr Pte. Ltd., 6 Raffles Quay, 11-07, Singapore-048580
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Karamacoska D, Butt A, Leung IHK, Childs RL, Metri NJ, Uruthiran V, Tan T, Sabag A, Steiner-Lim GZ. Brain function effects of exercise interventions for cognitive decline: a systematic review and meta-analysis. Front Neurosci 2023; 17:1127065. [PMID: 37260849 PMCID: PMC10228832 DOI: 10.3389/fnins.2023.1127065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Accepted: 04/21/2023] [Indexed: 06/02/2023] Open
Abstract
Introduction Exercise is recognized as a modifiable lifestyle factor that can mitigate cognitive decline and dementia risk. While the benefits of exercise on cognitive aging have been reported on extensively, neuronal effects in adults experiencing cognitive decline have not been systematically synthesized. The aim of this systematic review was to assess the effects of exercise on cognition and brain function in people with cognitive decline associated with dementia risk. Method A systematic search was conducted for randomized controlled trials of ≥ 4 weeks exercise (aerobic, resistance, or mind-body) that assessed cognition and brain function using neuroimaging and neurophysiological measures in people with subjective or objective cognitive decline. Study characteristics and brain function effects were narratively synthesized, while domain-specific cognitive performance was subjected to meta-analysis. Study quality was also assessed. Results 5,204 records were identified and 12 unique trials met the eligibility criteria, representing 646 adults classified with cognitive frailty, mild or vascular cognitive impairment. Most interventions involved 40-minute sessions conducted 3 times/week. Exercise improved global cognition (g = -0.417, 95% CI, -0.694 to -0.140, p = 0.003, I2 = 43.56%), executive function (g = -0.391, 95% CI, -0.651 to -0.131, p = 0.003, I2 = 13.28%), but not processing speed or general short-term memory (both p >0.05). Across fMRI and ERP studies, significant neuronal adaptations were found with exercise cf. control throughout the brain and were linked with improved global cognition, memory, and executive function. Cerebral blood flow was also found to improve with 24 weeks of exercise, but was not linked with cognitive changes. Discussion The cognitive improvements associated with exercise are likely driven by increased metabolic activity, cerebrovascular mechanisms, and neuroplasticity throughout the brain. Our paper shows the promise in, and need for, high-quality trials integrating cognitive and brain function measures to elucidate the functional relationship between exercise and brain health in populations with a high risk of dementia. Systematic review registration PROSPERO, identifier: CRD42022291843.
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Affiliation(s)
- Diana Karamacoska
- NICM Health Research Institute, Western Sydney University, Penrith, NSW, Australia
- Translational Health Research Institute (THRI), Western Sydney University, Penrith, NSW, Australia
| | - Ali Butt
- NICM Health Research Institute, Western Sydney University, Penrith, NSW, Australia
| | - Isabella H. K. Leung
- NICM Health Research Institute, Western Sydney University, Penrith, NSW, Australia
- School of Health Sciences, Western Sydney University, Campbelltown, NSW, Australia
| | - Ryan L. Childs
- NICM Health Research Institute, Western Sydney University, Penrith, NSW, Australia
| | - Najwa-Joelle Metri
- NICM Health Research Institute, Western Sydney University, Penrith, NSW, Australia
| | - Vithya Uruthiran
- School of Health Sciences, Western Sydney University, Campbelltown, NSW, Australia
| | - Tiffany Tan
- School of Medicine, Western Sydney University, Penrith, NSW, Australia
| | - Angelo Sabag
- NICM Health Research Institute, Western Sydney University, Penrith, NSW, Australia
- Discipline of Exercise and Sport Science, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - Genevieve Z. Steiner-Lim
- NICM Health Research Institute, Western Sydney University, Penrith, NSW, Australia
- Translational Health Research Institute (THRI), Western Sydney University, Penrith, NSW, Australia
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Yuan A, Halabicky O, Rao H, Liu J. Lifetime air pollution exposure, cognitive deficits, and brain imaging outcomes: A systematic review. Neurotoxicology 2023; 96:69-80. [PMID: 37001821 PMCID: PMC10963081 DOI: 10.1016/j.neuro.2023.03.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Revised: 03/21/2023] [Accepted: 03/28/2023] [Indexed: 03/31/2023]
Abstract
As the amount of air pollution and human exposure has increased, the effects on human health have become an important public health issue. A field of growing interest is how air pollution exposure affects brain structure and function underlying cognitive deficits and if structural and connectivity changes mediate the relationship between the two. We conducted a systematic review to examine the literature on air pollution, brain structure and connectivity, and cognition studies. Eleven studies matched our inclusion criteria and were included in the qualitative analysis. Results suggest significant associations between air pollution and decreased volumes of specific brain structures, cortical thickness and surface area such as in the prefrontal cortex and temporal lobe, as well as the weakening of functional connectivity pathways, largely the Default Mode (DMN) and Frontal Parietal (FPN) networks, as detected by fMRI. Associations between air pollution and cognitive outcomes were found in most of the studies (n = 9), though some studies showed stronger associations than others. For children & adolescents, these deficiencies largely involved heavy reasoning, problem solving, and logic. For young and middle-aged adults, the associations were mostly seen for executive function and visuospatial cognitive domains. To our knowledge, this is the first systematic review to consolidate findings on the associations among air pollution, brain structure, and cognitive function. In the future, it will be important to conduct further longitudinal studies that follow children who have been exposed at a young age and examine associations with brain structure and cognition throughout adulthood.
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Affiliation(s)
- Aurora Yuan
- University of Pennsylvania, College of Arts & Sciences, 249 S 36th St, Philadelphia, PA 19104, United States
| | - Olivia Halabicky
- University of Michigan, School of Public Health, 1415 Washington Heights, Ann Arbor, MI 48109, United States
| | - Hengyi Rao
- University of Pennsylvania, Perelman School of Medicine, 3400 Civic Center Blvd, Philadelphia, PA 19104, United States
| | - Jianghong Liu
- University of Pennsylvania, School of Nursing, 418 Curie Blvd, Philadelphia, PA 19104, United States.
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Ghazi L, Shen J, Ying J, Derington CG, Cohen JB, Marcum ZA, Herrick JS, King JB, Cheung AK, Williamson JD, Pajewski NM, Bryan N, Supiano M, Sonnen J, Weintraub WS, Greene TH, Bress AP. Identifying Patients for Intensive Blood Pressure Treatment Based on Cognitive Benefit: A Secondary Analysis of the SPRINT Randomized Clinical Trial. JAMA Netw Open 2023; 6:e2314443. [PMID: 37204788 PMCID: PMC10199351 DOI: 10.1001/jamanetworkopen.2023.14443] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Accepted: 03/25/2023] [Indexed: 05/20/2023] Open
Abstract
Importance Intensive vs standard treatment to lower systolic blood pressure (SBP) reduces risk of mild cognitive impairment (MCI) or dementia; however, the magnitude of cognitive benefit likely varies among patients. Objective To estimate the magnitude of cognitive benefit of intensive vs standard systolic BP (SBP) treatment. Design, Setting, and Participants In this ad hoc secondary analysis of the Systolic Blood Pressure Intervention Trial (SPRINT), 9361 randomized clinical trial participants 50 years or older with high cardiovascular risk but without a history of diabetes, stroke, or dementia were followed up. The SPRINT trial was conducted between November 1, 2010, and August 31, 2016, and the present analysis was completed on October 31, 2022. Intervention Systolic blood pressure treatment to an intensive (<120 mm Hg) vs standard (<140 mm Hg) target. Main Outcomes and Measures The primary outcome was a composite of adjudicated probable dementia or amnestic MCI. Results A total of 7918 SPRINT participants were included in the analysis; 3989 were in the intensive treatment group (mean [SD] age, 67.9 [9.2] years; 2570 [64.4%] men; 1212 [30.4%] non-Hispanic Black) and 3929 were in the standard treatment group (mean [SD] age, 67.9 [9.4] years; 2570 [65.4%] men; 1249 [31.8%] non-Hispanic Black). Over a median follow-up of 4.13 (IQR, 3.50-5.88) years, there were 765 and 828 primary outcome events in the intensive treatment group and standard treatment group, respectively. Older age (hazard ratio [HR] per 1 SD, 1.87 [95% CI, 1.78-1.96]), Medicare enrollment (HR per 1 SD, 1.42 [95% CI, 1.35-1.49]), and higher baseline serum creatinine level (HR per 1 SD, 1.24 [95% CI, 1.19-1.29]) were associated with higher risk of the primary outcome, while better baseline cognitive functioning (HR per 1 SD, 0.43 [95% CI, 0.41-0.44]) and active employment status (HR per 1 SD, 0.44 [95% CI, 0.42-0.46]) were associated with lower risk of the primary outcome. Risk of the primary outcome by treatment goal was estimated accurately based on similar projected and observed absolute risk differences (C statistic = 0.79). Higher baseline risk for the primary outcome was associated with greater benefit (ie, larger absolute reduction of probable dementia or amnestic MCI) of intensive vs standard treatment across the full range of estimated baseline risk. Conclusions and Relevance In this secondary analysis of the SPRINT trial, participants with higher baseline projected risk of probable dementia or amnestic MCI gained greater absolute cognitive benefit from intensive vs standard SBP treatment in a monotonic fashion. Trial Registration ClinicalTrials.gov Identifier: NCT01206062.
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Affiliation(s)
- Lama Ghazi
- Department of Epidemiology, School of Public Health, University of Alabama at Birmingham
| | - Jincheng Shen
- Department of Family and Preventive Medicine, University of Utah, Salt Lake City
| | - Jian Ying
- Department of Internal Medicine, Spencer Fox Eccles School of Medicine, University of Utah, Salt Lake City
| | - Catherine G. Derington
- Intermountain Healthcare Department of Population Health Sciences, Spencer Fox Eccles School of Medicine, University of Utah, Salt Lake City
| | - Jordana B. Cohen
- Department of Medicine, Renal-Electrolyte and Hypertension Division, Perelman School of Medicine at the University of Pennsylvania, Philadelphia
- Department of Biostatistics, Epidemiology, and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia
| | - Zachary A. Marcum
- Department of Pharmacy, University of Washington School of Pharmacy, Seattle
| | - Jennifer S. Herrick
- Intermountain Healthcare Department of Population Health Sciences, Spencer Fox Eccles School of Medicine, University of Utah, Salt Lake City
- George E. Wahlen Department of Veterans Affairs Medical Center, Salt Lake City, Utah
| | - Jordan B. King
- Intermountain Healthcare Department of Population Health Sciences, Spencer Fox Eccles School of Medicine, University of Utah, Salt Lake City
- Institute for Health Research, Kaiser Permanente Colorado, Aurora
| | - Alfred K. Cheung
- Department of Internal Medicine, Spencer Fox Eccles School of Medicine, University of Utah, Salt Lake City
- George E. Wahlen Department of Veterans Affairs Medical Center, Salt Lake City, Utah
| | - Jeff D. Williamson
- The Sticht Center for Healthy Aging and Alzheimer’s Prevention, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Nicholas M. Pajewski
- Department of Biostatistics and Data Science, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Nick Bryan
- Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia
| | - Mark Supiano
- Division of Geriatrics, University of Utah School of Medicine, and The Center on Aging, University of Utah, Salt Lake City
| | - Josh Sonnen
- Department of Pathology and Neurology and Neurosurgery, McGill University School of Medicine, Montreal, Quebec, Canada
| | | | - Tom H. Greene
- Intermountain Healthcare Department of Population Health Sciences, Spencer Fox Eccles School of Medicine, University of Utah, Salt Lake City
| | - Adam P. Bress
- Intermountain Healthcare Department of Population Health Sciences, Spencer Fox Eccles School of Medicine, University of Utah, Salt Lake City
- George E. Wahlen Department of Veterans Affairs Medical Center, Salt Lake City, Utah
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Wang Y, Crowe M, Knibbs LD, Fuller-Tyszkiewicz M, Mygind L, Kerr JA, Wake M, Olsson CA, Enticott PG, Peters RL, Daraganova G, Mavoa S, Lycett K. Greenness modifies the association between ambient air pollution and cognitive function in Australian adolescents, but not in mid-life adults. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2023; 324:121329. [PMID: 36822308 DOI: 10.1016/j.envpol.2023.121329] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Revised: 01/31/2023] [Accepted: 02/19/2023] [Indexed: 06/18/2023]
Abstract
UNLABELLED Exposure to ambient air pollution has been associated with reduced cognitive function in childhood and later life, with too few mid-life studies to draw conclusions. In contrast, residential greenness has been associated with enhanced cognitive function throughout the lifecourse. Here we examine the extent to which (1) ambient air pollution and residential greenness predict later cognitive function in adolescence and mid-life, and (2) greenness modifies air pollution-cognitive function associations. PARTICIPANTS 6220 adolescents (51% male) and 2623 mid-life adults (96% mothers) from the Longitudinal Study of Australian Children. MEASURES Exposures: Annual average particulate matter <2.5 μm (PM2.5), nitrogen dioxide (NO2) and greenness (Normalised Difference Vegetation Index) for residential addresses from validated land-use regression models over a 10-13-year period. OUTCOMES Cognitive function from CogState tests of attention, working memory and executive function, dichotomised into poorer (worst quartile) versus not poor. ANALYSES Adjusted mixed-effects generalised linear models with residential greenness assessed as an effect modifier (high vs. low divided at median). The annual mean for PM2.5 and NO2 across exposure windows was 6.3-6.8 μg/m3, and 5.5-7.1 ppb, respectively. For adolescents, an IQR increment of NO2 was associated with 19-24% increased odds of having poorer executive function across all time windows, while associations weren't observed between air pollution and other outcomes. For adults, high NO2 predicted poorer cognitive function across all outcomes, while high PM2.5 predicted poorer attention only. There was little evidence of associations between greenness and cognitive function in adjusted models for both generations. Interactions were found between residential greenness, air pollutants and cognitive function in adolescents, but not adults. The magnitude of effects was similar across generations and exposure windows. Findings highlight the potential benefits of cognitive health associated with the regulation of air pollution and urban planning strategies for increasing green spaces and vegetation.
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Affiliation(s)
- Yichao Wang
- Centre for Social and Early Emotional Development, School of Psychology, Deakin University, Geelong, VIC, 3220, Australia; Department of Paediatrics, University of Melbourne, Parkville, VIC, 3010, Australia; Population Health Theme, Murdoch Children's Research Institute, Parkville, VIC, 3052, Australia.
| | - Mallery Crowe
- Centre for Social and Early Emotional Development, School of Psychology, Deakin University, Geelong, VIC, 3220, Australia
| | - Luke D Knibbs
- School of Public Health, University of Sydney, Sydney, NSW, 2006, Australia; Public Health Unit, Sydney Local Health District, Camperdown, NSW, 2050, Australia
| | - Matthew Fuller-Tyszkiewicz
- Centre for Social and Early Emotional Development, School of Psychology, Deakin University, Geelong, VIC, 3220, Australia
| | - Lærke Mygind
- Cognitive Neuroscience Unit, School of Psychology, Deakin University, Burwood, VIC, 3125, Australia; Unit of Medical Psychology, University of Copenhagen, Copenhagen, 1353, Denmark; Center for Clinical Research and Prevention, Copenhagen University Hospital - Bispebjerg and Frederiksberg, The Capital Region of Denmark, Copenhagen, 2000, Denmark
| | - Jessica A Kerr
- Department of Paediatrics, University of Melbourne, Parkville, VIC, 3010, Australia; Population Health Theme, Murdoch Children's Research Institute, Parkville, VIC, 3052, Australia; Department of Psychological Medicine, University of Otago Christchurch, New Zealand
| | - Melissa Wake
- Department of Paediatrics, University of Melbourne, Parkville, VIC, 3010, Australia; Population Health Theme, Murdoch Children's Research Institute, Parkville, VIC, 3052, Australia; Liggins Institute, University of Auckland, New Zealand
| | - Craig A Olsson
- Centre for Social and Early Emotional Development, School of Psychology, Deakin University, Geelong, VIC, 3220, Australia; Population Health Theme, Murdoch Children's Research Institute, Parkville, VIC, 3052, Australia; Psychological Sciences, University of Melbourne, Parkville, VIC, 3010, Australia
| | - Peter G Enticott
- Cognitive Neuroscience Unit, School of Psychology, Deakin University, Burwood, VIC, 3125, Australia
| | - Rachel L Peters
- Department of Paediatrics, University of Melbourne, Parkville, VIC, 3010, Australia; Population Health Theme, Murdoch Children's Research Institute, Parkville, VIC, 3052, Australia
| | - Galina Daraganova
- Psychological Sciences, University of Melbourne, Parkville, VIC, 3010, Australia; Business Intelligence, South Eastern Melbourne Primary Health Network, Melbourne, VIC, 3202, Australia
| | - Suzanne Mavoa
- Population Health Theme, Murdoch Children's Research Institute, Parkville, VIC, 3052, Australia; Environmental Public Health Branch, Environment Protection Authority Victoria, Melbourne, VIC, 3001, Australia; Melbourne School of Population and Global Health, University of Melbourne, Parkville, VIC, 3010, Australia
| | - Kate Lycett
- Centre for Social and Early Emotional Development, School of Psychology, Deakin University, Geelong, VIC, 3220, Australia; Population Health Theme, Murdoch Children's Research Institute, Parkville, VIC, 3052, Australia
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Katabathula S, Davis PB, Xu R. Comorbidity-driven multi-modal subtype analysis in mild cognitive impairment of Alzheimer's disease. Alzheimers Dement 2023; 19:1428-1439. [PMID: 36166485 PMCID: PMC10040466 DOI: 10.1002/alz.12792] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
BACKGROUND Mild cognitive impairment (MCI) is a heterogeneous condition with high individual variabilities in clinical outcomes driven by patient demographics, genetics, brain structure features, blood biomarkers, and comorbidities. Multi-modality data-driven approaches have been used to discover MCI subtypes; however, disease comorbidities have not been included as a modality though multiple diseases including hypertension are well-known risk factors for Alzheimer's disease (AD). The aim of this study was to examine MCI heterogeneity in the context of AD-related comorbidities along with other AD-relevant features and biomarkers. METHODS A total of 325 MCI subjects with 32 AD-relevant comorbidities and features were considered. Mixed-data clustering is applied to discover and compare MCI subtypes with and without including AD-related comorbidities. Finally, the relevance of each comorbidity-driven subtype was determined by examining their MCI to AD disease prognosis, descriptive statistics, and conversion rates. RESULTS We identified four (five) MCI subtypes: poor-, average-, good-, and best-AD prognosis by including comorbidities (without including comorbidities). We demonstrated that comorbidity-driven MCI subtypes differed from those identified without comorbidity information. We further demonstrated the clinical relevance of comorbidity-driven MCI subtypes. Among the four comorbidity-driven MCI subtypes there were substantial differences in the proportions of participants who reverted to normal function, remained stable, or converted to AD. The groups showed different behaviors, having significantly different MCI to AD prognosis, significantly different means for cognitive test-related and plasma features, and by the proportion of comorbidities. CONCLUSIONS Our study indicates that AD comorbidities should be considered along with other diverse AD-relevant characteristics to better understand MCI heterogeneity.
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Affiliation(s)
- Sreevani Katabathula
- Center for Artificial Intelligence in Drug Discovery, Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | - Pamela B Davis
- Center for Community Health Integration, Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | - Rong Xu
- Center for Artificial Intelligence in Drug Discovery, Case Western Reserve University School of Medicine, Cleveland, OH, USA
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Lee D, Park JY, Kim WJ. Altered functional connectivity of the default mode and dorsal attention network in subjective cognitive decline. J Psychiatr Res 2023; 159:165-171. [PMID: 36738647 DOI: 10.1016/j.jpsychires.2023.01.040] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/25/2022] [Revised: 12/23/2022] [Accepted: 01/26/2023] [Indexed: 01/31/2023]
Abstract
Subjective cognitive decline (SCD) is a clinical condition in which performance on standardized cognitive tests does not indicate impairment like mild cognitive impairment (MCI), but self-experienced cognitive capacity persistently declines. We aimed to explore the functional connectivity (FC) characteristics of SCD subjects compared to healthy controls and MCI patients. Resting-state functional MRI was performed on 152 elderly subjects: 65 normal controls, 62 SCD subjects, and 25 MCI patients. A seed-based FC analysis was performed to compare groups. The major brain regions of the default mode network (DMN) and dorsal attention network (DAN), large-scale brain networks disrupted in patients with dementia, were selected as seed regions. As a result, the SCD group showed stronger FC than the MCI group between DMN seeds and the supramarginal gyrus. Both the SCD and MCI groups showed stronger FC between the left lateral parietal cortex and right dorsolateral prefrontal cortex. In the FC analysis centred on DAN seeds, both the SCD and MCI groups showed weaker FC of the right posterior intraparietal sulcus in the left anterior cingulate cortex and the left insula, compared to those in the control group. Within the SCD group, hyperconnectivity between the right lateral parietal cortex and left supramarginal gyrus was significantly correlated with better performance on the Controlled Oral Word Association Test. In conclusion, the SCD group showed several DMN- and DAN-related FC alterations, similar to the MCI group, but with distinct hyperconnectivity between DMN seeds and the supramarginal gyrus. In particular, SCD has DMN-related FC patterns distinct from those of MCI that are associated with verbal fluency retention.
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Affiliation(s)
- Deokjong Lee
- Department of Psychiatry, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin, South Korea; Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, South Korea
| | - Jin Young Park
- Department of Psychiatry, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin, South Korea; Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, South Korea; Center for Digital Health, Yongin Severance Hospital, Yonsei University Health System, Yongin, South Korea.
| | - Woo Jung Kim
- Department of Psychiatry, Yongin Severance Hospital, Yonsei University College of Medicine, Yongin, South Korea; Institute of Behavioral Science in Medicine, Yonsei University College of Medicine, Seoul, South Korea.
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Chan RNF, Tang Z, Chan VTT, Chan RNC, Cheng ETW, Ng NCY, Cheung CY. The cross-sectional and longitudinal relationship of diabetic retinopathy to cognitive impairment: a systematic review and meta-analysis. Eye (Lond) 2023; 37:220-227. [PMID: 35501601 PMCID: PMC9873601 DOI: 10.1038/s41433-022-02033-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2021] [Revised: 02/07/2022] [Accepted: 03/14/2022] [Indexed: 01/28/2023] Open
Abstract
OBJECTIVES To establish a potential relationship between diabetic retinopathy (DR) and different stages of cognitive impairment METHODS: Literature searches were conducted on PubMed and EMBASE, with keywords "diabetic retinopathy" and "cognitive impairment". Inclusion criteria were original human studies, and English language. Quality of studies was assessed by the Newcastle-Ottawa Quality Assessment (NOSGEN). The register number of this study on the International Prospective Register of Systematic Reviews (PROSPERO) is CRD42021236747. The main outcome measures were odds ratios (OR) and risk ratios (RR) for cross-sectional and longitudinal studies, respectively. Meta-regression was performed to evaluate the effects of potential moderator variables, including, age, onset age of diabetes mellitus (DM), duration of DM, and HbA1c. RESULTS Twenty-five studies (17 cross-sectional and 8 longitudinal studies) with a total of 1,963,914 subjects, were included. Among the cross-sectional studies, the pooled ORs of any cognitive impairment, early stage of cognitive impairment and dementia in subjects with DR (95% confidence interval) were 1.48 (1.08-2.02), 1.59 (1.01-2.51), and 1.13 (0.86-1.50), respectively. Among the longitudinal studies, the pooled RRs of any cognitive impairment, early stage of cognitive impairment, and dementia in subjects with DR (95% confidence interval) were 1.35 (1.12-1.65), 1.50 (1.06-2.12), and 1.31 (1.03-1.66), respectively. Meta-regression showed age, onset age of DM, duration of DM, and glycated hemoglobin (HbA1c) were not statistically associated with the outcomes. CONCLUSIONS The presence of DR in DM patients indicates both higher odds of prevalent cognitive impairment and escalated risks of developing cognitive impairment in the future.
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Affiliation(s)
- Robert N F Chan
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, Hong Kong, China
| | - Ziqi Tang
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, Hong Kong, China
| | - Victor T T Chan
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, Hong Kong, China
- Department of Ophthalmology and Visual Sciences, Prince of Wales Hospital, Hong Kong Special Administrative Region, Hong Kong, China
| | - Raymond N C Chan
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, Hong Kong, China
| | - Esther T W Cheng
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, Hong Kong, China
| | - Natalie C Y Ng
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, Hong Kong, China
| | - Carol Y Cheung
- Department of Ophthalmology and Visual Sciences, The Chinese University of Hong Kong, Hong Kong Special Administrative Region, Hong Kong, China.
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50
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Yang X, Xi L, Guo Z, Liu L, Ping Z. The relationship between cadmium and cognition in the elderly: a systematic review. Ann Hum Biol 2023; 50:15-25. [PMID: 36645404 DOI: 10.1080/03014460.2023.2168755] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023]
Abstract
Context: The relationship between cadmium (Cd) and the cognition of the elderly is indistinct.Objective: To summarise the studies on the relationship between the cognition of the elderly and Cd.Methods: Literatures were searched in PubMed, Web of Science, China National Knowledge Infrastructure (CNKI), and Wan fang database on April 25, 2022. The entries in the STROBE statement were used to evaluate the literature quality; all the quantitative studies that met the requirements were systematically summarised.Results: Blood Cd was negatively correlated with the cognitive ability of the elderly, corresponding to different cognitive ability assessment methods, the regression coefficients were: -0.11 (-0.20, -0.03), -0.46 (-0.71, -0.21), -0.54 (-0.90, -0.17), -0.19 (-0.37, -0.01), and -2.29 (-3.41, -1.16). The regression coefficients between urinary Cd level and cognition score were -1.42 (-2.38, -0.46), and 0.76 (-1.28, -0.23). When dietary Cd increased by 1 μg/kg, the composite z-score decreased by 3.64 (p = 0.001). There was no significant correlation between drinking water Cd, fingernail Cd and cognition (p > 0.05).Conclusion: We concluded that blood Cd (including whole blood and plasma), urine Cd and dietary Cd were negatively correlated with the cognition of the elderly, but the relationship between Cd in drinking water and fingernails and cognition was not statistically significant.
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Affiliation(s)
- Xueke Yang
- College of Public Health, Zhengzhou University, Zhengzhou, China
| | - Lijing Xi
- College of Public Health, Zhengzhou University, Zhengzhou, China
| | - Zhaoyan Guo
- College of Public Health, Zhengzhou University, Zhengzhou, China
| | - Li Liu
- School of Basic Medical Sciences, Zhengzhou University, Zhengzhou, China
| | - Zhiguang Ping
- College of Public Health, Zhengzhou University, Zhengzhou, China
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