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Reynolds A, Greenfield EA, Nepomnyaschy L. Disparate benefits of higher childhood socioeconomic status on cognition in young adulthood by intersectional social positions. ADVANCES IN LIFE COURSE RESEARCH 2024; 60:100608. [PMID: 38552532 PMCID: PMC11129928 DOI: 10.1016/j.alcr.2024.100608] [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: 07/12/2023] [Revised: 01/16/2024] [Accepted: 01/16/2024] [Indexed: 04/12/2024]
Abstract
OBJECTIVES Emerging evidence supports the protective effects of higher childhood socioeconomic status (cSES) on cognition over the life course. However, less understood is if higher cSES confers benefits equally across intersecting social positions. Guided by a situational intersectionality perspective and the theory of Minority Diminished Returns (MDR), this study examined the extent to which associations between cSES and cognition in young adulthood are jointly moderated by racialized identity and region of childhood residence. METHODS Using data from the National Longitudinal Study of Adolescent to Adult Health (Add Health), we used multilevel modeling to test associations between cSES and delayed recall and working memory 14 years later when participants were ages 25-34. Further, we examined the influence of racialized identity and region of childhood residence on these associations. RESULTS Higher cSES was associated with higher delayed recall and working memory scores across social positions. However, the strength of the association between higher cSES and working memory differed across racialized subgroups and region of childhood residence. We found a statistically significant three-way interaction between cSES, race and region of childhood residence. Of particular important, a small yet statistically robust association was found in all groups, but was especially strong among White Southerners and especially weak among Black participants from the South. CONCLUSIONS This study contributes to a growing body of research indicating that the protective effects of higher cSES on cognition are not universal across subgroups of intersecting social positions, consistent with the theory of MDR. These findings provide evidence for the importance of considering the role of systemic racism across geographic contexts as part of initiatives to promote equity in life course cognitive aging and brain health.
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Affiliation(s)
- Addam Reynolds
- Andrus Gerontology Center, 3715 McClintock Ave, Los Angeles, CA 90089, USA; Leonard Davis School of Gerontology, University of Southern California, Los Angeles, CA, USA.
| | - Emily A Greenfield
- School of Social Work, Rutgers, The State University of New Jersey, New Brunswick, NJ, USA
| | - Lenna Nepomnyaschy
- School of Social Work, Rutgers, The State University of New Jersey, New Brunswick, NJ, USA
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Patel Y, Woo A, Shi S, Ayoub R, Shin J, Botta A, Ketela T, Sung HK, Lerch J, Nieman B, Paus T, Pausova Z. Obesity and the cerebral cortex: Underlying neurobiology in mice and humans. Brain Behav Immun 2024; 119:637-647. [PMID: 38663773 DOI: 10.1016/j.bbi.2024.04.033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Revised: 04/17/2024] [Accepted: 04/22/2024] [Indexed: 05/01/2024] Open
Abstract
Obesity is a major modifiable risk factor for Alzheimer's disease (AD), characterized by progressive atrophy of the cerebral cortex. The neurobiology of obesity contributions to AD is poorly understood. Here we show with in vivo MRI that diet-induced obesity decreases cortical volume in mice, and that higher body adiposity associates with lower cortical volume in humans. Single-nuclei transcriptomics of the mouse cortex reveals that dietary obesity promotes an array of neuron-adverse transcriptional dysregulations, which are mediated by an interplay of excitatory neurons and glial cells, and which involve microglial activation and lowered neuronal capacity for neuritogenesis and maintenance of membrane potential. The transcriptional dysregulations of microglia, more than of other cell types, are like those in AD, as assessed with single-nuclei cortical transcriptomics in a mouse model of AD and two sets of human donors with the disease. Serial two-photon tomography of microglia demonstrates microgliosis throughout the mouse cortex. The spatial pattern of adiposity-cortical volume associations in human cohorts interrogated together with in silico bulk and single-nucleus transcriptomic data from the human cortex implicated microglia (along with other glial cells and subtypes of excitatory neurons), and it correlated positively with the spatial profile of cortical atrophy in patients with mild cognitive impairment and AD. Thus, multi-cell neuron-adverse dysregulations likely contribute to the loss of cortical tissue in obesity. The dysregulations of microglia may be pivotal to the obesity-related risk of AD.
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Affiliation(s)
- Yash Patel
- The Hospital for Sick Children, Translational Medicine Program, Toronto, ON, Canada; Departments of Physiology and Nutritional Sciences, University of Toronto, Toronto, ON, Canada; Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada
| | - Anita Woo
- The Hospital for Sick Children, Translational Medicine Program, Toronto, ON, Canada; Departments of Physiology and Nutritional Sciences, University of Toronto, Toronto, ON, Canada
| | - Sammy Shi
- The Hospital for Sick Children, Translational Medicine Program, Toronto, ON, Canada; Departments of Physiology and Nutritional Sciences, University of Toronto, Toronto, ON, Canada
| | - Ramy Ayoub
- The Hospital for Sick Children, Translational Medicine Program, Toronto, ON, Canada
| | - Jean Shin
- The Hospital for Sick Children, Translational Medicine Program, Toronto, ON, Canada; Departments of Physiology and Nutritional Sciences, University of Toronto, Toronto, ON, Canada
| | - Amy Botta
- The Hospital for Sick Children, Translational Medicine Program, Toronto, ON, Canada
| | - Troy Ketela
- Princess Margaret Genomics Centre, Toronto, ON, Canada
| | - Hoon-Ki Sung
- The Hospital for Sick Children, Translational Medicine Program, Toronto, ON, Canada
| | - Jason Lerch
- Nuffield Department of Clinical Neurosciences, Oxford University, Oxford, Great Britton
| | - Brian Nieman
- The Hospital for Sick Children, Translational Medicine Program, Toronto, ON, Canada; Department of Medical Biophysics, University of Toronto, Toronto, ON, Canada
| | - Tomas Paus
- Department of Psychiatry and Addictology and Department of Neuroscience, Faculty of Medicine and Centre Hospitalier Universitaire Sainte-Justine, University of Montreal, QC, Canada
| | - Zdenka Pausova
- The Hospital for Sick Children, Translational Medicine Program, Toronto, ON, Canada; Departments of Physiology and Nutritional Sciences, University of Toronto, Toronto, ON, Canada; Department of Pediatrics and Centre Hospitalier Universitaire Sainte-Justine, University of Montreal, QC, Canada.
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Huh J, Arpawong TE, Gruenewald TL, Fisher GG, Prescott CA, Manly JJ, Seblova D, Walters EE, Gatz M. General cognitive ability in high school, attained education, occupational complexity, and dementia risk. Alzheimers Dement 2024; 20:2662-2669. [PMID: 38375960 PMCID: PMC11032536 DOI: 10.1002/alz.13739] [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: 05/17/2023] [Revised: 12/11/2023] [Accepted: 01/20/2024] [Indexed: 02/21/2024]
Abstract
INTRODUCTION We address the extent to which adolescent cognition predicts dementia risk in later life, mediated by educational attainment and occupational complexity. METHODS Using data from Project Talent Aging Study (PTAS), we fitted two structural equation models to test whether adolescent cognition predicts cognitive impairment (CI) and Ascertain Dementia 8 (AD8) status simultaneously (NCognitive Assessment = 2477) and AD8 alone (NQuestionnaire = 6491) 60 years later, mediated by education and occupational complexity. Co-twin control analysis examined 82 discordant pairs for CI/AD8. RESULTS Education partially mediated the effect of adolescent cognition on CI in the cognitive assessment aample and AD8 in the questionnaire sample (Ps < 0.001). Within twin pairs, differences in adolescent cognition were small, but intrapair differences in education predicted CI status. DISCUSSION Adolescent cognition predicted dementia risk 60 years later, partially mediated through education. Educational attainment, but not occupational complexity, contributes to CI risk beyond its role as a mediator of adolescent cognition, further supported by the co-twin analyses. HIGHLIGHTS Project Talent Aging Study follows enrollees from high school for nearly 60 years. General cognitive ability in high school predicts later-life cognitive impairment. Low education is a risk partially due to its association with cognitive ability.
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Affiliation(s)
- Jimi Huh
- Department of Population and Public Health SciencesUniversity of Southern CaliforniaLos AngelesCaliforniaUSA
| | - Thalida Em Arpawong
- Leonard Davis School of GerontologyUniversity of Southern CaliforniaLos AngelesCaliforniaUSA
| | | | - Gwenith G. Fisher
- Department of PsychologyColorado State UniversityColorado State UniversityFort CollinsColoradoUSA
| | - Carol A. Prescott
- Department of PsychologyUniversity of Southern CaliforniaLos AngelesCaliforniaUSA
| | | | - Dominika Seblova
- Second Faculty of MedicineCharles University Prague, Second Faculty of Medicine (2. LF UK)PragueCzech Republic
| | - Ellen E. Walters
- Department of PsychologyUniversity of Southern CaliforniaLos AngelesCaliforniaUSA
| | - Margaret Gatz
- Center for Economic and Social Research, University of Southern CaliforniaLos AngelesCaliforniaUSA
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Lv R, Huang Y, Huang S, Wu S, Wang S, Hu G, Ma Y, Song P, Chavarro JE, Subramanian S, Lu C, Li Z, Yuan C. Associations between parental adherence to healthy lifestyles and cognitive performance in offspring: A prospective cohort study in China. Chin Med J (Engl) 2024; 137:683-693. [PMID: 37898876 PMCID: PMC10950188 DOI: 10.1097/cm9.0000000000002861] [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: 03/18/2023] [Indexed: 10/30/2023] Open
Abstract
BACKGROUND Previous studies have reported associations of specific maternal and paternal lifestyle factors with offspring's cognitive development during early childhood. This study aimed to investigate the prospective associations between overall parental lifestyle and offspring's cognitive performance during adolescence and young adulthood in China. METHODS We included 2531 adolescents aged 10-15 years at baseline in 2010 from the China Family Panel Studies. A healthy parental lifestyle score (ranged 0-5) was constructed based on the following five modifiable lifestyle factors: Smoking, drinking, exercise, sleep, and diet. Generalized estimating equation models were used to examine the association between baseline parental healthy lifestyle scores and offspring's fluid and crystallized intelligence in subsequent years (2012, 2014, 2016, and 2018). RESULTS Offspring in the top tertile of parental healthy lifestyle scores performed better in overall fluid intelligence (multivariable-adjusted β = 0.53, 95% confidence interval [CI]: 0.29-0.77) and overall crystallized intelligence (multivariable-adjusted β = 0.35, 95% CI: 0.16-0.54) than those in the bottom tertile of parental healthy lifestyle scores. The results were similar after further adjustment for the offspring's healthy lifestyle scores and persisted across the subgroups of parental socioeconomic status. Additionally, maternal and paternal healthy lifestyle scores were independently associated with better offspring's cognitive performance, with significant contribution observed for paternal never-smoking, weekly exercise, and diversified diet. When both parents and offspring adhered to a healthier lifestyle, we observed the highest level of the offspring's overall crystallized intelligence. CONCLUSIONS Our study indicates that parental adherence to a healthier lifestyle is associated with significantly better offspring's cognitive performance during adolescence and early adulthood, regardless of socioeconomic status. These findings highlight the potential cognitive benefits of promoting healthy lifestyles among parents of adolescents.
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Affiliation(s)
- Rongxia Lv
- School of Public Health, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang 310058, China
| | - Yuhui Huang
- School of Public Health, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang 310058, China
| | - Siyi Huang
- School of Public Health, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang 310058, China
| | - Shiyi Wu
- School of Public Health, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang 310058, China
| | - Siwen Wang
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA
| | - Guangyu Hu
- Institute of Medical Information/Center for Health Policy and Management, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100730, China
| | - Yanan Ma
- Department of Biostatistics and Epidemiology, School of Public Health, China Medical University, Shenyang, Liaoning 110122, China
| | - Peige Song
- School of Public Health, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang 310058, China
| | - Jorge E. Chavarro
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA
| | - S.V. Subramanian
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA
| | - Chunling Lu
- Division of Global Health Equity, Brigham and Women's Hospital, Harvard Medical School, Boston, MA 02115, USA
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA 02115, USA
| | - Zhihui Li
- Vanke School of Public Health, Tsinghua University, Beijing 100084, China
- Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA
| | - Changzheng Yuan
- School of Public Health, the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang 310058, China
- Department of Nutrition, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA
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Backhouse EV, Boardman JP, Wardlaw JM. Cerebral Small Vessel Disease: Early-Life Antecedents and Long-Term Implications for the Brain, Aging, Stroke, and Dementia. Hypertension 2024; 81:54-74. [PMID: 37732415 PMCID: PMC10734792 DOI: 10.1161/hypertensionaha.122.19940] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/22/2023]
Abstract
Cerebral small vessel disease is common in older adults and increases the risk of stroke, cognitive impairment, and dementia. While often attributed to midlife vascular risk factors such as hypertension, factors from earlier in life may contribute to later small vessel disease risk. In this review, we summarize current evidence for early-life effects on small vessel disease, stroke and dementia focusing on prenatal nutrition, and cognitive ability, education, and socioeconomic status in childhood. We discuss possible reasons for these associations, including differences in brain resilience and reserve, access to cognitive, social, and economic resources, and health behaviors, and we consider the extent to which these associations are independent of vascular risk factors. Although early-life factors, particularly education, are major risk factors for Alzheimer disease, they are less established in small vessel disease or vascular cognitive impairment. We discuss current knowledge, gaps in knowledge, targets for future research, clinical practice, and policy change.
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Affiliation(s)
- Ellen V. Backhouse
- Centre for Clinical Brain Sciences (E.V.B., J.P.B., J.M.W.), University of Edinburgh, Scotland, United Kingdom
- MRC UK Dementia Research Institute (E.V.B., J.M.W.), University of Edinburgh, Scotland, United Kingdom
| | - James P. Boardman
- Centre for Clinical Brain Sciences (E.V.B., J.P.B., J.M.W.), University of Edinburgh, Scotland, United Kingdom
- MRC Centre for Reproductive Health (J.P.B.), University of Edinburgh, Scotland, United Kingdom
| | - Joanna M. Wardlaw
- Centre for Clinical Brain Sciences (E.V.B., J.P.B., J.M.W.), University of Edinburgh, Scotland, United Kingdom
- MRC UK Dementia Research Institute (E.V.B., J.M.W.), University of Edinburgh, Scotland, United Kingdom
- Edinburgh Imaging (J.M.W.), University of Edinburgh, Scotland, United Kingdom
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Jia H, Sai X, Si H, Wang J. How do the non-cognitive skills affect retirees' reemployment? Evidence from China. Front Public Health 2023; 11:1128241. [PMID: 38169704 PMCID: PMC10758448 DOI: 10.3389/fpubh.2023.1128241] [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: 12/20/2022] [Accepted: 12/05/2023] [Indexed: 01/05/2024] Open
Abstract
Introduction Promoting the reemployment of retirees is important to effectively recognize the capacity of older adults and to help governments cope with an aging global population. Existing research on the factors that impact reemployment has mainly focused on the role of traditional forms of human capital, like education and experience, while ignoring non-cognitive skills. Methods Based on 3,693 samples, this study examines the impact of non-cognitive skills on the reemployment of Chinese retirees using the Logit model through the lens of human capital theory. Results The results show that non-cognitive skills incentivize retirees to seek reemployment. The incentive effect is greater for retirees who are male, live in a rural household, and are of lower age and education level. Further, the mediation effect model reveals the mediating role of social capital between non-cognitive skills and the reemployment of retirees. Social capital is important to the promotion of retiree reemployment. Discussion This study ultimately sheds light on the relationship between non-cognitive skills and the reemployment of retirees. Findings will help improve governments' understandings of non-cognitive skills so that they may develop better policies on retiree reemployment.
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Affiliation(s)
- Haiyan Jia
- School of Public Administration and Policy, Shandong University of Finance and Economics, Jinan, China
| | - Xiaoyu Sai
- School of Sociology and Ethnology, University of Chinese Academy of Social Sciences (UCASS), Beijing, China
| | - Hongyun Si
- School of Public Administration and Policy, Shandong University of Finance and Economics, Jinan, China
| | - Jinming Wang
- School of Public Administration and Policy, Shandong University of Finance and Economics, Jinan, China
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Arzehgar A, Davarinia F, Ferns GA, Hakimi A, Bahrami A. Predicting the Cognitive Ability of Young Women Using a New Feature Selection Algorithm. J Mol Neurosci 2023; 73:678-691. [PMID: 37581703 DOI: 10.1007/s12031-023-02145-8] [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: 02/16/2022] [Accepted: 07/26/2023] [Indexed: 08/16/2023]
Abstract
Cognitive abilities are the capabilities to perform mental processes that include executive function, comprehension, decision-making, work performance, and educational attainment. This study aimed to investigate the relationship between several biomarkers and individuals' cognitive ability using various machine learning methods. A total of 144 young women aged between 18 and 24 years old were recruited into the study. Cognitive performance was assessed using a standard questionnaire. A panel of biochemical, hematological, inflammatory, and oxidative stress biomarkers in serum and urine was measured for all participants. A novel combination of feature selection and feature scoring techniques within a hierarchical ensemble structure has been proposed to identify the most effective features in recognizing the importance of various biomarker signatures in cognitive abilities classification. Multiple feature selection methods were employed in conjunction with different classifiers to construct this model. In this manner, using three filter methods, the scores of each feature were considered. The combination of high-scoring features for each filter method was stored as the primary feature subset. A high-accuracy feature subset was selected by using a wrapper method. The collection of highly scored features from each filter method formed the primary feature subset. A wrapper method was also employed to select a feature subset with high accuracy. To ensure robustness and minimize random variations in the feature subset search process, a repeative tenfold cross-validation was conducted. The most frequently recurring features were determined. This iterative step facilitated the identification of an optimal feature subset, effectively reducing the dimensionality of features while maintaining accuracy. Among the 47 extracted factors, serum level of NOx (nitrite ± nitrate), alkaline phosphatase (ALP), and phosphate as well as blood platelet count (PLT) was entered into the model of cognitive abilities with the highest accuracy of approximately 70.9% using a decision tree classifier. Therefore, the serum levels of NOx, ALP, phosphate, and blood PLT count may be important markers of the cognitive abilities in apparently healthy young women. These factors my provide a simple procedure to identify mental abilities and earlier cognitive decline in healthy adults.
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Affiliation(s)
- Afrooz Arzehgar
- Department of Medical Informatics, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | | | - Gordon A Ferns
- Brighton & Sussex Medical School, Department of Medical Education, Falmer, Brighton, BN1 9PH, Sussex, UK
| | - Ali Hakimi
- Department of Clinical Biochemistry, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
| | - Afsane Bahrami
- Clinical Research Development Unit, Faculty of Medicine, Imam Reza Hospital, Mashhad University of Medical Sciences, Mashhad, Iran.
- Clinical Research Development Unit of Akbar Hospital, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
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Obesity-Related Neuroinflammation: Magnetic Resonance and Microscopy Imaging of the Brain. Int J Mol Sci 2022; 23:ijms23158790. [PMID: 35955925 PMCID: PMC9368789 DOI: 10.3390/ijms23158790] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2022] [Revised: 08/03/2022] [Accepted: 08/06/2022] [Indexed: 12/01/2022] Open
Abstract
Obesity is a major risk factor of Alzheimer’s disease and related dementias. The principal feature of dementia is a loss of neurons and brain atrophy. The mechanistic links between obesity and the neurodegenerative processes of dementias are not fully understood, but recent research suggests that obesity-related systemic inflammation and subsequent neuroinflammation may be involved. Adipose tissues release multiple proinflammatory molecules (fatty acids and cytokines) that impact blood and vessel cells, inducing low-grade systemic inflammation that can transition to tissues, including the brain. Inflammation in the brain—neuroinflammation—is one of key elements of the pathobiology of neurodegenerative disorders; it is characterized by the activation of microglia, the resident immune cells in the brain, and by the structural and functional changes of other cells forming the brain parenchyma, including neurons. Such cellular changes have been shown in animal models with direct methods, such as confocal microscopy. In humans, cellular changes are less tangible, as only indirect methods such as magnetic resonance (MR) imaging are usually used. In these studies, obesity and low-grade systemic inflammation have been associated with lower volumes of the cerebral gray matter, cortex, and hippocampus, as well as altered tissue MR properties (suggesting microstructural variations in cellular and molecular composition). How these structural variations in the human brain observed using MR imaging relate to the cellular variations in the animal brain seen with microscopy is not well understood. This review describes the current understanding of neuroinflammation in the context of obesity-induced systemic inflammation, and it highlights need for the bridge between animal microscopy and human MR imaging studies.
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Schnermann ME, Schulz CA, Ludwig C, Alexy U, Nöthlings U. A lifestyle score in childhood and adolescence was positively associated with subsequently measured fluid intelligence in the DONALD cohort study. Eur J Nutr 2022; 61:3719-3729. [PMID: 35704086 PMCID: PMC9464141 DOI: 10.1007/s00394-022-02921-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Accepted: 05/24/2022] [Indexed: 11/04/2022]
Abstract
PURPOSE Lifestyle scores which combine single factors such as diet, activity, or sleep duration showed associations with cognitive decline in adults. However, the role of a favourable lifestyle in younger age and the build-up of cognitive reserve is less clear, which is why we investigated longitudinal associations between a lifestyle score in childhood and adolescence and fluid intelligence obtained on average 6 years later. METHODS In the DONALD cohort, a lifestyle score of 0 to 4 points including healthy diet and duration of moderate-to-vigorous physical activity, sedentary behaviour and sleep was repeatedly assessed in participants aged 5 and 19 years. Data on fluid intelligence were assessed via a German version of the culture fair intelligence test (CFT), using CFT 1-R in children 8.5 years of age or younger (n = 62) or CFT 20-R in participants older than 8.5 years (n = 192). Multivariable linear regression models were used to investigate prospective associations between the lifestyle score and the fluid intelligence score. RESULTS Mean lifestyle score of all participants was 2.2 (0.7-4) points. A one-point increase in the lifestyle score was associated with a higher fluid intelligence score (4.8 points [0.3-7.3], p = 0.0343) for participants completing the CFT 20-R. Furthermore, each additional hour of sedentary behaviour was associated with a lower fluid intelligence score (- 3.0 points [- 5.7 to - 0.3], p = 0.0313). For younger participants (CFT 1-R), no association was found in any analysis (p > 0.05). CONCLUSION A healthy lifestyle was positively associated with fluid intelligence, whereby sedentary behaviour itself seemed to play a prominent role.
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Affiliation(s)
- Maike Elena Schnermann
- grid.10388.320000 0001 2240 3300Department of Nutrition and Food Sciences, Institute of Nutrition and Food Sciences, Nutritional Epidemiology, University of Bonn, Friedrich-Hirzebruch-Allee 7, 53115 Bonn, Germany
| | - Christina-Alexandra Schulz
- grid.10388.320000 0001 2240 3300Department of Nutrition and Food Sciences, Institute of Nutrition and Food Sciences, Nutritional Epidemiology, University of Bonn, Friedrich-Hirzebruch-Allee 7, 53115 Bonn, Germany
| | - Christine Ludwig
- grid.10388.320000 0001 2240 3300Department of Nutrition and Food Sciences, Institute of Nutrition and Food Sciences, Nutritional Epidemiology, University of Bonn, Friedrich-Hirzebruch-Allee 7, 53115 Bonn, Germany
| | - Ute Alexy
- grid.10388.320000 0001 2240 3300Department of Nutrition and Food Sciences, Institute of Nutrition and Food Sciences, Nutritional Epidemiology, University of Bonn, Friedrich-Hirzebruch-Allee 7, 53115 Bonn, Germany
| | - Ute Nöthlings
- Department of Nutrition and Food Sciences, Institute of Nutrition and Food Sciences, Nutritional Epidemiology, University of Bonn, Friedrich-Hirzebruch-Allee 7, 53115, Bonn, Germany.
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Genetic effects on longitudinal cognitive decline during the early stages of Alzheimer's disease. Sci Rep 2021; 11:19853. [PMID: 34615922 PMCID: PMC8494841 DOI: 10.1038/s41598-021-99310-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2021] [Accepted: 09/22/2021] [Indexed: 11/08/2022] Open
Abstract
Cognitive decline in early-stage Alzheimer's disease (AD) may depend on genetic variability. In the Swedish BioFINDER study, we used polygenic scores (PGS) (for AD, intelligence, and educational attainment) to predict longitudinal cognitive change (measured by mini-mental state examination (MMSE) [primary outcome] and other cognitive tests) over a mean of 4.2 years. We included 260 β-amyloid (Aβ) negative cognitively unimpaired (CU) individuals, 121 Aβ-positive CU (preclinical AD), 50 Aβ-negative mild cognitive impairment (MCI) patients, and 127 Aβ-positive MCI patients (prodromal AD). Statistical significance was determined at Bonferroni corrected p value < 0.05. The PGS for intelligence (beta = 0.1, p = 2.9e-02) was protective against decline in MMSE in CU and MCI participants regardless of Aβ status. The polygenic risk score for AD (beta = - 0.12, p = 9.4e-03) was correlated with the rate of change in MMSE and was partially mediated by Aβ-pathology (mediation effect 20%). There was no effect of education PGS on cognitive measures. Genetic variants associated with intelligence mitigate cognitive decline independent of Aβ-pathology, while effects of genetic variants associated with AD are partly mediated by Aβ-pathology.
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Oveisgharan S, Wilson RS, Yu L, Schneider JA, Bennett DA. Association of Early-Life Cognitive Enrichment With Alzheimer Disease Pathological Changes and Cognitive Decline. JAMA Neurol 2021; 77:1217-1224. [PMID: 32597941 DOI: 10.1001/jamaneurol.2020.1941] [Citation(s) in RCA: 39] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Importance Indicators of early-life cognitive enrichment (ELCE) have been associated with slower cognitive decline and decreased dementia in late life. However, the mechanisms underlying this association have not been elucidated. Objective To examine the association of ELCE with late-life Alzheimer disease (AD) and other common dementia-related pathological changes. Design, Setting, and Participants This clinical-pathological community-based cohort study, the Rush Memory and Aging Project, followed up participants before death for a mean (SD) of 7.0 (3.8) years with annual cognitive and clinical assessments. From January 1, 1997, through June 30, 2019, 2044 participants enrolled, of whom 1018 died. Postmortem data were leveraged from 813 participants. Data were analyzed from April 12, 2019, to February 20, 2020. Exposures Four indicators of ELCE (early-life socioeconomic status, availability of cognitive resources at 12 years of age, frequency of participation in cognitively stimulating activities, and early-life foreign language instruction) were obtained by self-report at the study baseline, from which a composite measure of ELCE was derived. Main Outcomes and Measures A continuous global AD pathology score derived from counts of diffuse plaques, neuritic plaques, and neurofibrillary tangles. Results The 813 participants included in the analysis had a mean (SD) age of 90.1 (6.3) years at the time of death, and 562 (69%) were women. In a linear regression model controlled for age at death, sex, and educational level, a higher level of ELCE was associated with a lower global AD pathology score (estimate, -0.057; standard error, 0.022; P = .01). However, ELCE was not associated with any other dementia-related pathological changes. In addition, a higher level of ELCE was associated with less cognitive decline (mean [SD], -0.13 [0.19] units per year; range, -1.74 to 0.85). An indirect effect through AD pathological changes constituted 20% of the association between ELCE and the rate of late-life cognitive decline, and 80% was a direct association. Conclusions and Relevance These findings suggest that ELCE was associated with better late-life cognitive health, in part through an association with fewer AD pathological changes.
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Affiliation(s)
- Shahram Oveisgharan
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, Illinois.,Department of Neurological Sciences, Rush University Medical Center, Chicago, Illinois
| | - Robert S Wilson
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, Illinois.,Department of Neurological Sciences, Rush University Medical Center, Chicago, Illinois.,Department of Behavioral Sciences, Rush University Medical Center, Chicago, Illinois
| | - Lei Yu
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, Illinois.,Department of Neurological Sciences, Rush University Medical Center, Chicago, Illinois
| | - Julie A Schneider
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, Illinois.,Department of Neurological Sciences, Rush University Medical Center, Chicago, Illinois.,Department of Pathology, Rush University Medical Center, Chicago, Illinois
| | - David A Bennett
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, Illinois.,Department of Neurological Sciences, Rush University Medical Center, Chicago, Illinois
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12
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Deary IJ, Hill WD, Gale CR. Intelligence, health and death. Nat Hum Behav 2021; 5:416-430. [PMID: 33795857 DOI: 10.1038/s41562-021-01078-9] [Citation(s) in RCA: 36] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2019] [Accepted: 02/15/2021] [Indexed: 02/06/2023]
Abstract
The field of cognitive epidemiology studies the prospective associations between cognitive abilities and health outcomes. We review research in this field over the past decade and describe how our understanding of the association between intelligence and all-cause mortality has consolidated with the appearance of new, population-scale data. To try to understand the association better, we discuss how intelligence relates to specific causes of death, diseases/diagnoses and biomarkers of health through the adult life course. We examine the extent to which mortality and health associations with intelligence might be attributable to people's differences in education, other indicators of socioeconomic status, health literacy and adult environments and behaviours. Finally, we discuss whether genetic data provide new tools to understand parts of the intelligence-health associations. Social epidemiologists, differential psychologists and behavioural and statistical geneticists, among others, contribute to cognitive epidemiology; advances will occur by building on a common cross-disciplinary knowledge base.
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Affiliation(s)
- Ian J Deary
- Lothian Birth Cohorts, Department of Psychology, University of Edinburgh, Edinburgh, UK.
| | - W David Hill
- Lothian Birth Cohorts, Department of Psychology, University of Edinburgh, Edinburgh, UK
| | - Catharine R Gale
- Lothian Birth Cohorts, Department of Psychology, University of Edinburgh, Edinburgh, UK.,MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton, UK
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13
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Iso-Markku P, Kaprio J, Lindgren N, Rinne JO, Vuoksimaa E. Middle-age dementia risk scores and old-age cognition: a quasi-experimental population-based twin study with over 20-year follow-up. J Neurol Neurosurg Psychiatry 2021; 92:323-330. [PMID: 33154181 PMCID: PMC7892379 DOI: 10.1136/jnnp-2020-324009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Revised: 08/25/2020] [Accepted: 10/07/2020] [Indexed: 02/02/2023]
Abstract
BACKGROUND Middle-age risk scores predict cognitive impairment, but it is not known if these associations are evident when controlling for shared genetic and environmental factors. Using two risk scores, self-report educational-occupational score and Cardiovascular Risk Factors, Aging and Dementia (CAIDE), we investigated if twins with higher middle-age dementia risk have poorer old-age cognition compared with their co-twins with lower risk. METHODS We used a population-based older Finnish Twin Cohort study with middle-age questionnaire data (n=15 169, mean age=52.0 years, SD=11.8) and old-age cognition measured via telephone interview (mean age=74.1, SD=4.1, n=4302). Between-family and within-family linear regression analyses were performed. RESULTS In between-family analyses (N=2359), higher educational-occupational score was related to better cognition (B=0.76, 95% CI 0.69 to 0.83) and higher CAIDE score was associated with poorer cognition (B=-0.73, 95% CI -0.82 to -0.65). Within twin-pair differences in educational-occupational score were significantly related to within twin-pair differences in cognition in dizygotic (DZ) pairs (B=0.78, 95% CI 0.25 to 1.31; N=338) but not in monozygotic (MZ) pairs (B=0.12, 95% CI -0.44 to 0.68; N=221). Within twin-pair differences in CAIDE score were not related to within twin-pair differences in cognition: DZ B=-0.38 (95% CI -0.90 to 0.14, N=343) and MZ B=-0.05 (95% CI -0.59 to 0.49; N=226). CONCLUSION Middle-age dementia risk scores predicted old-age cognition, but within twin-pair analyses gave little support for associations independent of shared environmental and genetic factors. Understanding genetic underpinnings of risk score-cognition associations is important for early detection of dementia and designing intervention trials.
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Affiliation(s)
- Paula Iso-Markku
- Institute for Molecular Medicine Finland, FIMM, Helsinki Institute of Life Sciences, HiLIFE, University of Helsinki, Helsinki, Finland .,HUS Diagnostic Center, Clinical Physiology and Nuclear Medicine, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Jaakko Kaprio
- Institute for Molecular Medicine Finland, FIMM, Helsinki Institute of Life Sciences, HiLIFE, University of Helsinki, Helsinki, Finland.,Clinicum, Department of Public Health, University of Helsinki Faculty of Medicine, Helsinki, Finland
| | | | - Juha O Rinne
- Turku PET Centre, University of Turku, Turku, Finland
| | - Eero Vuoksimaa
- Institute for Molecular Medicine Finland, FIMM, Helsinki Institute of Life Sciences, HiLIFE, University of Helsinki, Helsinki, Finland
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14
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Foverskov E, Glymour MM, Mortensen EL, Osler M, Okholm GT, Lund R. Education and adolescent cognitive ability as predictors of dementia in a cohort of Danish men. PLoS One 2020; 15:e0235781. [PMID: 32760096 PMCID: PMC7410269 DOI: 10.1371/journal.pone.0235781] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2020] [Accepted: 06/22/2020] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND An association between education and dementia is well-established but it is unclear whether education is associated with dementia after accounting for early life cognitive ability and whether there is a joint effect, such that the risk associated with one of the exposures depends on the value of the other. We examined separate and joint associations of adolescent cognitive ability and educational attainment with risk of dementia among Danish men born between 1939 and 1959. METHODS Men (N = 477,421) from the Danish Conscription Database were followed for dementia from the age 60 for up to 17 years via patient and prescription registry linkages. Exposure measures included cognitive ability assessed at the conscript board examination around age 18 and highest educational level (low: 0-10 year, medium: 10-13 years, high: ≥13 years) at age 30 from registry records. Associations with dementia diagnosis were estimated in Cox proportional hazards models adjusted for birth year and age at conscript board examination. Interaction was assessed on the multiplicative scale by including a product term between the two exposure measures and on the additive scale by calculating relative excess risk due to interaction (RERI) between different levels of the exposure measures. RESULTS Compared to men in the high education group hazard ratio [HR] for men in the medium and low group were 1.21 (95% confidence interval [CI]: 1.13, 1.30) and 1.34 (95% CI: 1.24, 1.45), respectively when not adjusting for cognitive ability. Additional adjustment for cognitive ability attenuated the magnitude of the associations, but they remained significant (education medium: HR = 1.10, 95% CI: 1.02, 1.19 and education low: HR = 1.12, 95% CI: 1.02, 1.22). A 10% higher cognitive ability score was associated with a 3.8% lower hazard of dementia (HR = 0.962; 95% CI: 0.957, 0.967), and the magnitude of the association only changed marginally after adjustment for education. Men in the low education group with relatively low cognitive ability were identified as a high-risk subgroup for dementia. The increased risk associated with exposure to both risk factors did, however, not significantly depart from the sum of risk experienced by men only exposed to one of the risk factors (estimates of RERI were not significantly different from 0) and no significant evidence of either additive or multiplicative interactions was found. CONCLUSIONS In conclusion, the results suggest that education and cognitive ability protect against the risk of dementia independently of one another and that increases in educational attainment may at least partially offset dementia risk due to low cognitive ability.
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Affiliation(s)
- Else Foverskov
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark
- Center for Healthy Aging, University of Copenhagen, Copenhagen, Denmark
- * E-mail:
| | - M. Maria Glymour
- Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, California, United States of America
| | - Erik Lykke Mortensen
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark
- Center for Healthy Aging, University of Copenhagen, Copenhagen, Denmark
| | - Merete Osler
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark
- Center for Clinical Research and Prevention, Bispebjerg and Frederiksberg Hospital, Copenhagen, Denmark
| | - Gunhild Tidemann Okholm
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark
- Center for Clinical Research and Prevention, Bispebjerg and Frederiksberg Hospital, Copenhagen, Denmark
| | - Rikke Lund
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark
- Center for Healthy Aging, University of Copenhagen, Copenhagen, Denmark
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15
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Osler M, Okholm GT, Sørensen TIA, Jørgensen TSH. Body mass index in young adulthood and risk of subsequent dementia at different levels of intelligence and education in Danish men. Eur J Epidemiol 2020; 35:843-850. [PMID: 32728913 DOI: 10.1007/s10654-020-00665-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2020] [Accepted: 07/16/2020] [Indexed: 12/15/2022]
Abstract
The risk of dementia seems to be established already early in life, which leads to the question if overweight early in life is an important risk factor for dementia as it appears to be later in life. We examined the association between body mass index (BMI) at entry to adult life and subsequent risk of dementia in men and assessed whether the relationship differed by levels of intelligence and education. The study population consisted of 377,598 Danish men born 1939-1959 with measures of height, weight, intelligence test score (ITS), and educational level (EL) at conscript board examinations around the age of 19 years. Dementia outcomes were obtained from National Patient and Prescription Registries between 1969 and 2016. The association between BMI and dementia was analysed using Cox proportional hazard regression including interactions between BMI and ITS and EL, respectively. During the follow-up through age 77 years, 6144 (1.6%) developed dementia. The frequency was highest in men with lowest BMI, lowest ITS and lowest EL. Young adult BMI below the mean of 21.8 kg/m2 was inversely associated with subsequent dementia, whereas there was no association with higher levels of BMI. Adjustment for young adult ITS and EL attenuated the risk estimates slightly, and interaction analyses showed that the shape of the association between BMI and dementia was unaffected by the levels of ITS and EL. Regardless of levels of ITS and EL, young adult BMI below the mean is inversely associated with subsequent dementia, whereas there is no association with higher levels of BMI.
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Affiliation(s)
- Merete Osler
- Center for Clinical Research and Prevention, Bispebjerg and Frederiksberg Hospital, Nordre Fasanvej 57, 2000, Frederiksberg, Denmark.
- Department of Public Health, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
| | - Gunhild Tidemann Okholm
- Center for Clinical Research and Prevention, Bispebjerg and Frederiksberg Hospital, Nordre Fasanvej 57, 2000, Frederiksberg, Denmark
- Department of Public Health, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Thorkild I A Sørensen
- Department of Public Health, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Terese Sara Høj Jørgensen
- Center for Clinical Research and Prevention, Bispebjerg and Frederiksberg Hospital, Nordre Fasanvej 57, 2000, Frederiksberg, Denmark
- Department of Public Health, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
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16
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Jørgensen TSH, Okholm GT, Christensen K, Sørensen TI, Osler M. Body height in young adult men and risk of dementia later in adult life. eLife 2020; 9:51168. [PMID: 32041683 PMCID: PMC7012597 DOI: 10.7554/elife.51168] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2019] [Accepted: 01/16/2020] [Indexed: 12/24/2022] Open
Abstract
This study examined the relationship between body height and dementia and explored the impact of intelligence level, educational attainment, early life environment and familial factors. A total of 666,333 men, 70,608 brothers, and 7388 twin brothers born 1939-1959 and examined at the conscript board were followed in Danish nationwide registers (1969-2016). Cox regression models were applied to analyze the association between body height and dementia. Within-brothers and within-twin pair analyses were conducted to explore the role of shared familial factors including partly shared genetics. In total, 10,599 men were diagnosed with dementia. The association between one z-score difference in body height and dementia (HR: 0.90, 95% CI: 0.89;0.90) was inverse and weakened slightly after adjustment for intelligence test scores and educational level. The associations persisted in within-brother analysis and revealed a stronger, but less precise, point estimate than the cohort analysis of brothers. The twin analysis showed similar, but imprecise estimates.
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Affiliation(s)
- Terese Sara Høj Jørgensen
- Center for Clinical Research and Prevention, Bispebjerg and Frederiksberg Hospital, Copenhagen, Denmark.,Department of Public Health, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Gunhild Tidemann Okholm
- Center for Clinical Research and Prevention, Bispebjerg and Frederiksberg Hospital, Copenhagen, Denmark.,Department of Public Health, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Kaare Christensen
- Danish Aging Research Center, Department of Public Health, University of Southern Denmark, Copenhagen, Denmark
| | - Thorkild Ia Sørensen
- Department of Public Health, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.,Novo Nordisk Foundation Center for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Merere Osler
- Center for Clinical Research and Prevention, Bispebjerg and Frederiksberg Hospital, Copenhagen, Denmark.,Department of Public Health, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
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17
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Rodriguez FS, Lachmann T. Systematic Review on the Impact of Intelligence on Cognitive Decline and Dementia Risk. Front Psychiatry 2020; 11:658. [PMID: 32765312 PMCID: PMC7378785 DOI: 10.3389/fpsyt.2020.00658] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Accepted: 06/24/2020] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Previous studies have shown that an intellectually stimulating lifestyle is associated with a lower risk for cognitive decline and Alzheimer's disease and related dementia (ADRD). It is unclear so far whether higher intelligence may protect against this. The aim of this study was to conduct a systematic review on the association between intelligence and cognitive decline and ADRD risk. METHODS We searched the PubMed, web of science, and Scopus databases following the Preferred Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) and Population, Intervention, Comparison, and Outcome (PICO) criteria. Quality of evidence was assessed using Critical Appraisal Skills Programme (CASP) checklists. RESULTS From an initial n=8,371 search hits, n= 14 studies met the inclusion criteria and had sufficient quality. Evidence indicates that cognitive decline in old age is not significantly associated with childhood intelligence (n=9). Evidence with regard to ADRD risk is inconclusive (n=5) with some studies showing no effects and other studies with significant effects having limitations in their design. CONCLUSIONS Even though the majority of the studies show no significant association, we cannot exclude a possible effect that might be moderated by other, so far unknown factors. Further studies are necessary to systematically assess the influence of intelligence on ADRD risk and what factors moderate this association.
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Affiliation(s)
- Francisca S Rodriguez
- RG Psychosocial Epidemiology and Public Health, German Center for Neurodegenerative Diseases (DZNE), Greifswald, Germany.,Center for Cognitive Science, University of Kaiserslautern, Kaiserslautern, Germany.,Institute of Social Medicine, Occupational Health and Public Health (ISAP), University of Leipzig, Leipzig, Germany
| | - Thomas Lachmann
- Center for Cognitive Science, University of Kaiserslautern, Kaiserslautern, Germany.,Facultad de Lenguas y Educación, Universidad Nebrija, Madrid, Spain
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18
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Osler M, Rozing MP, Eliasen MH, Christensen K, Mortensen EL. Traumatic brain injury and risk of dementia at different levels of cognitive ability and education. Eur J Neurol 2019; 27:399-405. [PMID: 31571318 DOI: 10.1111/ene.14095] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2019] [Accepted: 09/27/2019] [Indexed: 11/30/2022]
Abstract
BACKGROUND AND PURPOSE The effect of cognitive resources on the risk of dementia following traumatic brain injury (TBI) has hardly been investigated. The aim of this study was to examine the influence of cognitive ability and education in young adulthood on the association between TBI and dementia in men. METHOD A cohort of 658 447 Danish men, born between 1939 and 1959, who had been cognitively assessed at conscription were followed in the Danish National Patient Registry and the National Prescription Registry from 1977 through 2016 for incident TBI and dementia. The association between TBI and dementia was analysed using Cox proportional regression. RESULTS During follow-up, 29 781(4.5%) men experienced TBI and 10 971(1.7%) developed dementia. TBI was associated with a higher risk of subsequent dementia after adjustment for cognitive ability, education and psychiatric comorbidity. The risk estimate was higher for early-onset dementia (hazard ratio 5.49, 95% confidence interval 4.97-6.06) than for dementia diagnosed after age 60 years (hazard ratio 2.85, 95% confidence interval 2.63-3.10). The association was slightly stronger in men with the highest cognitive scores or education than amongst those at lower levels. CONCLUSION Young adult cognitive ability did not explain a relatively strong association between TBI and dementia, and no evidence was found that cognitive ability or education was protective.
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Affiliation(s)
- M Osler
- Center for Clinical Research and Prevention, Bispebjerg and Frederiksberg Hospital, Frederiksberg, Denmark.,Department of Public Health, University of Copenhagen, Copenhagen, Denmark.,Danish Aging Research Center, Institute of Public Health, University of Southern Denmark, Odense, Denmark
| | - M P Rozing
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark.,Center for Healthy Aging, University of Copenhagen, Copenhagen, Denmark.,Research Unit for General Practice and Section of General Practice, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - M H Eliasen
- Center for Clinical Research and Prevention, Bispebjerg and Frederiksberg Hospital, Frederiksberg, Denmark
| | - K Christensen
- Danish Aging Research Center, Institute of Public Health, University of Southern Denmark, Odense, Denmark.,Department of Clinical Genetics and Department of Clinical Biochemistry and Pharmacology, Odense University Hospital, Odense, Denmark
| | - E L Mortensen
- Department of Public Health, University of Copenhagen, Copenhagen, Denmark.,Danish Aging Research Center, Institute of Public Health, University of Southern Denmark, Odense, Denmark.,Center for Healthy Aging, University of Copenhagen, Copenhagen, Denmark
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19
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Abstract
The Danish Twin Registry (DTR) was established in the 1950s, when twins born from 1870 to 1910 were ascertained, and has since been extended to include twins from birth cohorts until 2009. The DTR currently comprises of more than 175,000 twins from the 140 birth cohorts. This makes the DTR the oldest nationwide twin register and among the largest in the world. The combination of data from several surveys, including biological samples and repeated measurements on the same individuals, and data from Danish national registers provides a unique resource for a wide range of twin studies. This article provides an updated overview of the data in the DTR: First, we provide a summary of the establishment of the register, the different ascertainment methods and the twins included; then follows an overview of major surveys conducted in the DTR since 1994 and a description of the DTR biobank, including a description of the molecular data created so far; finally, a short description is given of the linkage to Danish national registers at Statistics Denmark and some recent examples of studies using the various data resources in the DTR are highlighted.
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20
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Christensen GT, Skogstad S, Nissen LR, Osler M. Data Resource Profile: Danish Conscription Registry Data (DCRD). Int J Epidemiol 2019; 47:1023-1024e. [PMID: 29659845 DOI: 10.1093/ije/dyy048] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/14/2018] [Indexed: 12/15/2022] Open
Affiliation(s)
- Gunhild Tidemann Christensen
- Danish Aging Research Center, Department of Public Health, University of Southern Denmark, Odense, Denmark.,Section for Epidemiology, Center for Clinical Research and Disease Prevention, Bispebjerg and Frederiksberg Hospital, Capital Region, Copenhagen, Denmark.,Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Sissel Skogstad
- Section for Epidemiology, Center for Clinical Research and Disease Prevention, Bispebjerg and Frederiksberg Hospital, Capital Region, Copenhagen, Denmark.,Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Lars Ravnborg Nissen
- Research and Knowledge Center, Veteran Center, Danish Defence Personnel Organisation, Ballerup, Denmark
| | - Merete Osler
- Danish Aging Research Center, Department of Public Health, University of Southern Denmark, Odense, Denmark.,Section for Epidemiology, Center for Clinical Research and Disease Prevention, Bispebjerg and Frederiksberg Hospital, Capital Region, Copenhagen, Denmark.,Department of Public Health, University of Copenhagen, Copenhagen, Denmark
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21
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Influence of young adult cognitive ability and additional education on later-life cognition. Proc Natl Acad Sci U S A 2019; 116:2021-2026. [PMID: 30670647 PMCID: PMC6369818 DOI: 10.1073/pnas.1811537116] [Citation(s) in RCA: 66] [Impact Index Per Article: 13.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
Abstract
How and when education improves cognitive capacity is an issue of profound societal importance. Education and later-life education-related factors, such as occupational complexity and engagement in cognitive-intellectual activities, are frequently considered indices of cognitive reserve, but whether their effects are truly causal remains unclear. In this study, after accounting for general cognitive ability (GCA) at an average age of 20 y, additional education, occupational complexity, or engagement in cognitive-intellectual activities accounted for little variance in late midlife cognitive functioning in men age 56-66 (n = 1009). Age 20 GCA accounted for 40% of variance in the same measure in late midlife and approximately 10% of variance in each of seven cognitive domains. The other factors each accounted for <1% of the variance in cognitive outcomes. The impact of these other factors likely reflects reverse causation-namely, downstream effects of early adult GCA. Supporting that idea, age 20 GCA, but not education, was associated with late midlife cortical surface area (n = 367). In our view, the most parsimonious explanation of our results, a meta-analysis of the impact of education, and epidemiologic studies of the Flynn effect is that intellectual capacity gains due to education plateau in late adolescence/early adulthood. Longitudinal studies with multiple cognitive assessments before completion of education would be needed to confirm this speculation. If cognitive gains reach an asymptote by early adulthood, then strengthening cognitive reserve and reducing later-life cognitive decline and dementia risk may really begin with improving educational quality and access in childhood and adolescence.
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22
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Huang AR, Strombotne KL, Horner EM, Lapham SJ. Adolescent Cognitive Aptitudes and Later-in-Life Alzheimer Disease and Related Disorders. JAMA Netw Open 2018; 1:e181726. [PMID: 30646141 PMCID: PMC6324501 DOI: 10.1001/jamanetworkopen.2018.1726] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
IMPORTANCE Low early-life cognitive ability is a potential early marker of dementia risk in later life. Previous studies use only global measures of general intelligence and/or study this relationship in gender-specific samples. The contribution of early-life performance on specific cognitive abilities, such as language, reasoning, and visualization aptitudes, to indicating future dementia risk is unknown. OBJECTIVES To investigate the association between adolescent cognitive ability and Medicare-recorded Alzheimer disease and related disorders (ADRD) using both general and specific measures of cognitive ability and to explore these associations separately in men and women. DESIGN, SETTING, AND PARTICIPANTS Population-based cohort study from the Project Talent-Medicare linked data set, a linkage of adolescent sociobehavioral data collected from high school students in 1960 to participants' 2012 to 2013 Medicare Claims and expenditures data. The association between adolescent cognitive ability and risk of ADRD in later life was assessed in a diverse sample of 43 014 men and 42 749 women aged 66 to 73 years using a series of logistic regressions stratified by sex, accounting for demographic characteristics, adolescent socioeconomic status, and regional effects. Data analysis was conducted from November 2017 to March 2018. MAIN OUTCOMES AND MEASURES Presence of Medicare-reported ADRD. RESULTS Overall, 1239 men (2.9%) and 1416 women (3.3%) developed ADRD. Lower mechanical reasoning was associated with increased odds of ADRD in men (odds ratio, 1.17; 95% CI, 1.05-1.29), and lower memory for words in adolescence was associated with increased odds of ADRD in women (odds ratio, 1.16; 95% CI, 1.05-1.28). Lower performance on several other language, reasoning, visualization, and mathematic aptitudes in adolescence showed prominent, but weaker, associations with odds of ADRD. CONCLUSIONS AND RELEVANCE This work contributes to the understanding of early-life origins of ADRD risk. The results suggest specific measures of cognitive ability may contribute to very early identification of at-risk subgroups who may benefit from prevention or intervention efforts.
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Anderson E, Cochrane A, Golding J, Nowicki S. Locus of control as a modifiable risk factor for cognitive function in midlife. Aging (Albany NY) 2018; 10:1542-1555. [PMID: 30001219 PMCID: PMC6075438 DOI: 10.18632/aging.101490] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2018] [Accepted: 06/21/2018] [Indexed: 11/25/2022]
Abstract
Few modifiable risk factors for cognitive decline have been identified. Despite an external locus of control (LoC) being adversely associated with many psychological and physical health outcomes, few studies have examined whether it is related to cognitive function in adulthood. In 1178 women from the Avon Longitudinal Study of Parents and Children, we examined whether LoC, and change in LoC over time, is associated with cognitive function in midlife. LoC was prospectively measured at mean ages 30 and 48 years using the validated Nowicki-Strickland scale. Cognitive function was examined at mean age 51 years. At both time points, greater externality was associated with lower cognitive function. For example, the group of women classified as being external at mean age 48 years had, on average, a 0.18 lower cognitive function score (95% CI: (0.11 to 0.25) than the group classified as being internal (p<0.001). Participants who changed from external to internal over time, on average, had better cognitive function than those who remained external or changed to become external. In summary, an external LoC may be detrimental to cognitive function. Thus, interventions to increase internality may help to minimise the adverse consequences on cognitive health later in life.
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Affiliation(s)
- Emma Anderson
- MRC Integrative Epidemiology Unit at the University of Bristol, Bristol BS8 2BN, UK
| | - Alice Cochrane
- MRC Integrative Epidemiology Unit at the University of Bristol, Bristol BS8 2BN, UK
| | - Jean Golding
- Centre for Child and Adolescent Health, Bristol Medical School, University of Bristol, Oakfield House, Oakfield Grove, Bristol BS8 2BN, UK
| | - Stephen Nowicki
- Department of Psychology, PAIS Building, Emory University, Atlanta, GA 30322, USA
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24
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Mosing MA, Lundholm C, Cnattingius S, Gatz M, Pedersen NL. Associations between birth characteristics and age-related cognitive impairment and dementia: A registry-based cohort study. PLoS Med 2018; 15:e1002609. [PMID: 30020924 PMCID: PMC6051563 DOI: 10.1371/journal.pmed.1002609] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2017] [Accepted: 06/13/2018] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND There is evidence for long-lasting effects of birth characteristics on cognitive ability in childhood and adulthood. Further, low cognitive ability throughout the lifetime has been linked to age-related cognitive decline and dementia risk. However, little is known about the effects of birth characteristics on cognitive dysfunction late in life. Here we explore potential associations between birth characteristics (weight, head circumference, length, and gestational age), adjusted and not adjusted for gestational age, and cognitive impairment and dementia late in life. METHODS AND FINDINGS Data from twins in the Swedish Twin Registry born 1926-1960 were merged with information from the Swedish birth, patient, and cause of death registries, resulting in a sample of 35,191 individuals. A subsample of 4,000 twins aged 65 years and older also participated in a telephone cognitive screening in 1998-2002. Associations of birth characteristics with registry-based dementia diagnoses and on telephone-assessed cognitive impairment were investigated in the full sample and subsample, respectively. The full sample contained 907 (2.6%) individuals with a dementia diagnosis (an incidence rate of 5.9% per 100,000 person-years), 803 (2.4%) individuals born small for gestational age, and 929 (2.8%) individuals born with a small head for gestational age. The subsample contained 569 (14.2%) individuals with cognitive impairment. Low birth weight for gestational age and being born with a small head for gestational age were significant risk factors for cognitive dysfunction late in life, with an up to 2-fold risk increase (p < 0.001) compared to infants with normal growth and head size, even after controlling for familial factors, childhood socioeconomic status, and education in adulthood. In line with this, each additional 100 g birth weight and each additional millimeter head circumference significantly reduced the risk for dementia (hazard ratio 0.98, 95% confidence interval 0.97 to 0.99, p = 0.004) and cognitive impairment (odds ratio 0.99, 95% confidence interval 0.99 to 1.00, p = 0.004), respectively. Within-pair analyses of identical twins, though hampered by small sample size, suggested that the observed associations between birth characteristics and dementia are likely not due to underlying shared genetic or environmental etiology. A limitation of the present study is that registry-based dementia diagnoses likely miss some of the true dementia cases in the population. Further, a more precise measure of cognitive reserve early in life as well as a date of onset for the cognitive impairment measure in the subsample would have been favorable. CONCLUSIONS In this study, we found that infants of smaller birth size (i.e., low birth weight or small head circumference adjusted and unadjusted for gestational age) have a significantly higher risk of age-related cognitive dysfunction compared to those with normal growth, highlighting the importance of closely monitoring the cognitive development of such infants and evaluating the potential of early life interventions targeted at enhancing cognitive reserve.
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Affiliation(s)
- Miriam A. Mosing
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
- Department of Neuroscience, Karolinska Institutet, Stockholm, Sweden
- * E-mail:
| | - Cecilia Lundholm
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Sven Cnattingius
- Clinical Epidemiology Unit, Department of Medicine, Solna, Karolinska Institute, Stockholm, Sweden
| | - Margaret Gatz
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
- Center for Economic and Social Research, University of Southern California, Los Angeles, California, United States of America
| | - Nancy L. Pedersen
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
- Department of Psychology, University of Southern California, Los Angeles, California, United States of America
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Abstract
BACKGROUND Electroconvulsive therapy (ECT) is the most effective treatment for severe episodes of mood disorders. Temporary memory loss is a common side-effect, but ongoing discussions exist regarding potential long-term adverse cognitive outcomes. Only a few studies have examined the frequency of dementia in patients after ECT. The aim of this study was to examine the association between ECT and risk of subsequent dementia in patients with a first-time hospital diagnosis of affective disorder. METHODS We did a cohort study of patients aged 10 years and older in Denmark with a first-time hospital contact for an affective disorder from Jan 1, 2005, through Dec 31, 2015, identified in the Danish National Patient Registry with ICD-10 codes F30.0 to F39.9. From the registry we retrieved information on all ECTs registered for patients and followed up patients for incidental dementia (defined by hospital discharge diagnoses or acetylcholinesterase inhibitor use) until Oct 31, 2016. We examined the association between ECT and dementia using Cox regression analyses with multiple adjustments and propensity-score matching on sociodemographic and clinical variables. FINDINGS Of 168 015 patients included in the study, 5901 (3·5%) patients had at least one ECT. During the median follow-up of 4·9 years (IQR 2·4-7·8) and 872 874 person years, the number of patients who developed dementia was 111 (0·1%) of 99 045 patients aged 10-49 years, 965 (2·7%) of 35 945 aged 50-69 years, and 4128 (12·5%) of 33 025 aged 70-108 years. 217 (3·6%) of the 5901 patients treated with ECT developed dementia, whereas of 162 114 patients not treated with ECT 4987 (3·1%) developed dementia. The corresponding incidences were 70·4 cases per 10 000 person-years (95% CI 61·6-80·5) and 59·2 per 10 000 person-years (57·6-60·8). In patients younger than 50 years and 50-69 years, ECT was not associated with a risk of dementia compared with age-matched patients who were not given ECT (age-adjusted hazard ratio [HR] 1·51, 95% CI 0·67-3·46, p=0·32; and 1·15, 0·91-1·47, p=0·22, respectively). In patients aged 70 years and older, ECT was associated with a decreased rate of dementia (0·68, 95% CI 0·58-0·80; p<0·0001), but in the propensity-score matched sample the HR was attenuated (0·77, 0·59-1·00; p=0·062). 31 754 patients (17·6%) died during follow-up (mortality rate per 1000 person-years 35·7, 95% CI 35·3-36·2) and supplementary analyses suggested that the risk of dementia, taking the competing mortality risk into account, was not significantly associated with ECT (subdistribution HR 0·98, 95% CI 0·76-1·26; p=0·24). INTERPRETATION ECT was not associated with risk of incidental dementia in patients with affective disorders after correcting for the potential effect of patient selection or competing mortality. The findings from this study support the continued use of ECT in patients with severe episodes of mood disorders, including those who are elderly. FUNDING Danish Council for Independent Research, Danish Medical Research Council, the Velux Foundation, the Jascha Foundation, and the Doctor Sofus Carl Emil Friis and Olga Doris Friis grant.
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Hoeijmakers L, Lesuis SL, Krugers H, Lucassen PJ, Korosi A. A preclinical perspective on the enhanced vulnerability to Alzheimer's disease after early-life stress. Neurobiol Stress 2018; 8:172-185. [PMID: 29888312 PMCID: PMC5991337 DOI: 10.1016/j.ynstr.2018.02.003] [Citation(s) in RCA: 39] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2017] [Revised: 02/17/2018] [Accepted: 02/20/2018] [Indexed: 12/13/2022] Open
Abstract
Stress experienced early in life (ES), in the form of childhood maltreatment, maternal neglect or trauma, enhances the risk for cognitive decline in later life. Several epidemiological studies have now shown that environmental and adult life style factors influence AD incidence or age-of-onset and early-life environmental conditions have attracted attention in this respect. There is now emerging interest in understanding whether ES impacts the risk to develop age-related neurodegenerative disorders, and their severity, such as in Alzheimer's disease (AD), which is characterized by cognitive decline and extensive (hippocampal) neuropathology. While this might be relevant for the identification of individuals at risk and preventive strategies, this topic and its possible underlying mechanisms have been poorly studied to date. In this review, we discuss the role of ES in modulating AD risk and progression, primarily from a preclinical perspective. We focus on the possible involvement of stress-related, neuro-inflammatory and metabolic factors in mediating ES-induced effects on later neuropathology and the associated impairments in neuroplasticity. The available studies suggest that the age of onset and progression of AD-related neuropathology and cognitive decline can be affected by ES, and may aggravate the progression of AD neuropathology. These relevant changes in AD pathology after ES exposure in animal models call for future clinical studies to elucidate whether stress exposure during the early-life period in humans modulates later vulnerability for AD.
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Affiliation(s)
| | | | | | | | - Aniko Korosi
- Brain Plasticity Group, Center for Neuroscience, Swammerdam Institute for Life Sciences, University of Amsterdam, Science Park 904, Amsterdam, The Netherlands
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Khachaturian AS. Letter. ALZHEIMER'S & DEMENTIA: DIAGNOSIS, ASSESSMENT & DISEASE MONITORING 2017; 9:84-87. [PMID: 29255790 PMCID: PMC5725207 DOI: 10.1016/j.dadm.2017.11.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Affiliation(s)
- Ara S. Khachaturian
- Corresponding author. Tel.: 301-309-6730; Fax: (844) 309-6730. http://www.alzheimersanddementia.orghttp://adj.edmgr.com
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