1
|
Zhang P, Zhou Y, Chen G, Li J, Wang B, Lu X. Potential association of bone mineral density loss with cognitive impairment and central and peripheral amyloid-β changes: a cross-sectional study. BMC Musculoskelet Disord 2022; 23:626. [PMID: 35773707 PMCID: PMC9245236 DOI: 10.1186/s12891-022-05580-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2021] [Accepted: 06/21/2022] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND There is some evidence in the literature that older adults with cognitive impairments have a higher risk for falls and osteoporotic hip fractures. Currently, the associations between bone health and cognitive health have not been extensively studied. Thus, the present cross-sectional study aims to investigate the relationship between markers of bone loss and cognitive performance in older adults with and without osteopenia as well as older adults with cognitive impairments (i.e., Alzheimer's disease [AD]). METHODS Sixty-two non-osteopenia participants and one hundred three osteopenia participants as the cohort 1 and 33 cognitively normal non-AD participants and 39 AD participants as the cohort 2 were recruited. To assess cognitive and bone health, hip bone mineral density (BMD) and cognitive performance (via Minimal Mental State Examination [MMSE] and/or Auditory Verbal Learning Test-delayed recall [AVLT-DR]) were assessed. Furthermore, in cohort 1, plasma amyloid-β (Aβ) levels, and in cohort 2, cerebrospinal fluid (CSF) Aβ levels were determined. RESULTS We observed that (1) compared with non-osteopenia participants, BMD values (t = - 22.806; 95%CI: - 1.801, - 1.484; p < 0.001), MMSE scores (t = - 5.392; 95%CI: - 3.260, - 1.698; p < 0.001), and AVLT-DR scores (t = - 4.142; 95%CI: - 2.181, - 0.804; p < 0.001), plasma Aβ42 levels (t = - 2.821; 95%CI: - 1.737, - 0.305; p = 0.01), and Aβ42/40 ratio (t = - 2.020; 95%CI: - 0.009, - 0.001; p = 0.04) were significantly lower in osteopenia participants; (2) plasma Aβ42/40 ratio showed a mediate effect for the association between BMD values and the performance of cognitive function in osteopenia participants by mediation analysis, adjusting age, sex, years of education, and body mass index (BMI); (3) BMD values (95%CI: - 1.085, 0.478; p < 0.001) were significantly reduced in AD participants as compared with cognitively normal non-AD participants; (4) in AD participants, the interactive effects of BMD and CSF Aβ42/40 ratio on MMSE scores was found by regression analysis, controlling age, sex, years of education, and BMI; (5) BMD can distinguish AD participants from cognitively normal non-AD participants with AUC of 0.816 and distinguish participants with the cognitive impairment from cognitively normal participants with AUC of 0.794. CONCLUSION Our findings suggest a relationship between bone health and cognitive health. Given the correlations between BMD and important markers of cognitive health (e.g., central and peripheral pathological change of Aβ), BMD might serve as a promising and easy-accessible biomarker. However, more research is needed to further substantiate our findings.
Collapse
Affiliation(s)
- Peng Zhang
- Department of Orthopedics, Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science, No. 136 Jingzhou Street, Xiangcheng District, Xiangyang, 441021, China
| | - Yi Zhou
- Department of Orthopedics, Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science, No. 136 Jingzhou Street, Xiangcheng District, Xiangyang, 441021, China
| | - Gang Chen
- Department of Orthopedics, Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science, No. 136 Jingzhou Street, Xiangcheng District, Xiangyang, 441021, China
| | - Jun Li
- Department of Orthopedics, Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science, No. 136 Jingzhou Street, Xiangcheng District, Xiangyang, 441021, China
| | - Bangjun Wang
- Department of Orthopedics, Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science, No. 136 Jingzhou Street, Xiangcheng District, Xiangyang, 441021, China
| | - Xinyan Lu
- Department of Orthopedics, Xiangyang Central Hospital, Affiliated Hospital of Hubei University of Arts and Science, No. 136 Jingzhou Street, Xiangcheng District, Xiangyang, 441021, China.
| |
Collapse
|
2
|
Wang Q, Shi Y, Qi X, Qi L, Chen X, Shi J, Xie C, Zhang Z. Platelet-Derived Amyloid-β Protein Precursor as a Biomarker of Alzheimer's Disease. J Alzheimers Dis 2022; 88:589-599. [PMID: 35662121 DOI: 10.3233/jad-220122] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Platelet proteins may be associated with Alzheimer's disease (AD) pathology. OBJECTIVE To investigate the relationship between platelet proteins and cerebrospinal fluid (CSF) biomarkers of AD and cognition in individuals with memory decline to identify effective screening methods for detecting the early stages of the disease. METHODS We classified 68 participants with subjective memory decline according to the ATN framework determined by CSF amyloid-β (A), CSF p-tau (T), and t-tau (N). All participants underwent Mini-Mental State Examination (MMSE) and platelet-related protein content testing. RESULTS Eighteen participants had normal AD biomarkers (NCs), 24 subjects had non-AD pathologic changes (non-AD), and 26 subjects fell within the Alzheimer's continuum (AD). The platelet amyloid-β protein precursor (AβPP) ratio in the AD group was significantly lower than in the non-AD and NCs groups, and positively correlated with MMSE scores and CSF amyloid-β42 level, which could affect MMSE scores through CSF amyloid-β42. Levels of platelet phosphorylated-tau 231 and ser396/404 phosphorylated tau were elevated in both AD and non-AD compared to NCs. Additionally, the receiver operating characteristic analysis demonstrated that the platelet AβPP ratio was a sensitive identifier for differentiating the AD from NCs (AUC = 0.846) and non-AD (AUC = 0.768). And ser396/404 phosphorylated tau could distinguish AD from NCs. CONCLUSION Our study was the first to find an association between platelet AβPP ratio and CSF biomarkers of AD, which contribute to the understanding of the peripheral changes in AD. These findings may help to discover potential feasible and effective screening tools for AD.
Collapse
Affiliation(s)
- Qing Wang
- Department of Neurology, The Affiliated ZhongDa Hospital, School of Medicine, Institution of Neuropsychiatry, Southeast University, Nanjing, China
| | - Yachen Shi
- Department of Neurology, The Affiliated ZhongDa Hospital, School of Medicine, Institution of Neuropsychiatry, Southeast University, Nanjing, China
| | - Xinyang Qi
- Department of Neurology, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Lingyu Qi
- Department of Neurology, The Affiliated ZhongDa Hospital, School of Medicine, Institution of Neuropsychiatry, Southeast University, Nanjing, China
| | - Xiang Chen
- Department of Neurology, The Affiliated ZhongDa Hospital, School of Medicine, Institution of Neuropsychiatry, Southeast University, Nanjing, China
| | - Jingping Shi
- Department of Neurology, The Affiliated Brain Hospital of Nanjing Medical University, Nanjing, China
| | - Chunming Xie
- Department of Neurology, The Affiliated ZhongDa Hospital, School of Medicine, Institution of Neuropsychiatry, Southeast University, Nanjing, China.,The Key Laboratory of Developmental Genes and Human Disease, Southeast University, Nanjing, China
| | - Zhijun Zhang
- Department of Neurology, The Affiliated ZhongDa Hospital, School of Medicine, Institution of Neuropsychiatry, Southeast University, Nanjing, China.,The Key Laboratory of Developmental Genes and Human Disease, Southeast University, Nanjing, China.,The Shenzhen Institute of Advanced Technology, Chinese Academy of Sciences, Shenzhen, China
| |
Collapse
|
3
|
Shen H, Han C, Yang Y, Guo L, Sheng Y, Wang J, Li W, Zhai L, Wang G, Guan Q. Pyroptosis executive protein GSDMD as a biomarker for diagnosis and identification of Alzheimer's disease. Brain Behav 2021; 11:e02063. [PMID: 33587329 PMCID: PMC8035446 DOI: 10.1002/brb3.2063] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Revised: 12/01/2020] [Accepted: 01/17/2021] [Indexed: 01/01/2023] Open
Abstract
OBJECTIVE This study was mainly conducted to explore the expression changes of GSDMD and conventional markers (including T-Tau, Tau181p, and Aβ1-42 ) in the cerebrospinal fluid among patients with Alzheimer's disease (AD) and vascular dementia (VD), followed by determination of role of GSDMD in diagnosing and identifying AD and VD. METHODS In this study, 60 patients with VD, 60 patients with AD, and 50 healthy controls were enrolled. Lumbar puncture was performed to collect cerebrospinal fluid samples. Patients with VD and patients with AD were evaluated using the Mini-Mental State Examination (MMSE) scale, Montreal Cognitive Assessment (MoCA) scale, Clinical Dementia Rating (CDR) scale, Activity of Daily Living (ADL) scale, and Neuropsychiatric Inventory (NPI) questionnaire, aiming to determine the behavioral ability of patients. ELISA kit was purchased to determine the levels of GSDMD, T-Tau, Tau181p, and Aβ1-42 in cerebrospinal fluid, and the expression of inflammatory factors, IL-1β and IL-6, was also detected. RESULTS (1) The levels of GSDMD, T-Tau, and Tau181p in the cerebrospinal fluid were higher in patients with AD than those of patients with VD and healthy controls, while the levels of Aβ1-42 in the cerebrospinal fluid were lower in patients with AD than that in healthy controls and patients with VD. (2) GSDMD had good diagnostic accuracy in AD. Additionally, GSDMD, T-Tau, Tau181p, and Aβ1-42 had good discrimination accuracy in distinguishing AD and VD. (3) The expression levels of inflammatory factors (IL-1β and IL-6) in cerebrospinal fluid were higher in patients with AD than those of healthy controls and patients with VD, which were positively correlated with GSDMD expression. CONCLUSION The expression of GSDMD was increased in patients with AD, which could be used as a biomarker for AD diagnosis and identification from VD.
Collapse
Affiliation(s)
- Heping Shen
- Department of Neurology, The Second Affiliated Hospital of Jiaxing University, Jiaxing, China
| | - Chenyang Han
- Department of Pharmacy, The Second Affiliated Hospital of Jiaxing University, Jiaxing, China
| | - Yi Yang
- Department of Pharmacy, The Second Affiliated Hospital of Jiaxing University, Jiaxing, China
| | - Li Guo
- Department of Center Laboratory, The Second Affiliated Hospital of Jiaxing University, Jiaxing, China
| | - Yongjia Sheng
- Department of Pharmacy, The Second Affiliated Hospital of Jiaxing University, Jiaxing, China
| | - Jin Wang
- Department of Pharmacy, The Second Affiliated Hospital of Jiaxing University, Jiaxing, China
| | - Wenyan Li
- Department of Pharmacy, The Second Affiliated Hospital of Jiaxing University, Jiaxing, China
| | - Liping Zhai
- Department of Neurology, The Second Affiliated Hospital of Jiaxing University, Jiaxing, China
| | - Genghuan Wang
- Department of Neurology, The Second Affiliated Hospital of Jiaxing University, Jiaxing, China
| | - Qiaobing Guan
- Department of Neurology, The Second Affiliated Hospital of Jiaxing University, Jiaxing, China
| |
Collapse
|
4
|
Davis KAS, Bishara D, Perera G, Molokhia M, Rajendran L, Stewart RJ. Benefits and Harms of Statins in People with Dementia: A Systematic Review and Meta-Analysis. J Am Geriatr Soc 2020; 68:650-658. [PMID: 32039479 DOI: 10.1111/jgs.16342] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2019] [Revised: 12/22/2019] [Accepted: 12/30/2019] [Indexed: 12/14/2022]
Abstract
OBJECTIVES More people with dementia also fall into the category of high vascular risk, for which a statin is usually prescribed. However, these recommendations are based on studies in people without dementia. We aimed to evaluate the evidence for the long-term effectiveness and harm of statin therapy in patients with dementia. DESIGN Systematic review of randomized controlled trials and observational research. SETTING Publications from developed countries indexed in the PubMed, Web of Science, and Cochrane trial database between 2007 and 2019. PARTICIPANTS Trials including people with all types of dementia with a mean age older than 65 years. INTERVENTION Treatment with a statin for 6 months or longer. MEASUREMENTS Major adverse cardiovascular events, dementia progression, and general health at 2 years, or medication adverse events (AEs) at any time. Each article was assessed for bias using the Newcastle-Ottawa or Cochrane Collaboration tools. A narrative synthesis and pooled analyses are reported. RESULTS Five articles met the inclusion criteria. They reported only on dementia of the Alzheimer's type. There was no evidence regarding cardiovascular events or general health. We made a very low confidence finding that statins reduce dementia progression based on three cohort studies of heterogeneous design. We made a very low confidence finding of no significant difference in AEs based on two randomized controlled trials of 18 months: odds ratios of any AE = 1.21 (95% confidence interval [CI] = .83-1.77), serious AE = 1.03 (95% CI = .76-1.87), and death = 1.69 (95% CI = .79-3.62). CONCLUSION Evidence was insufficient to fully evaluate the efficacy of statins in people with dementia. We found that statins may have a small benefit delaying progression in Alzheimer's dementia, although this conflicted with previous findings from shorter randomized trials. For safety, the trial data lacked power to show clinically important differences between the groups. We recommend that clinical data be leveraged for further observational studies to inform prescribing decisions. J Am Geriatr Soc 68:650-658, 2020.
Collapse
Affiliation(s)
- Katrina A S Davis
- King's College London (KCL) Institute of Psychiatry, Psychology and Neuroscience, London, UK.,South London and Maudsley NHS Foundation Trust, London, UK
| | - Delia Bishara
- King's College London (KCL) Institute of Psychiatry, Psychology and Neuroscience, London, UK.,South London and Maudsley NHS Foundation Trust, London, UK
| | - Gayan Perera
- King's College London (KCL) Institute of Psychiatry, Psychology and Neuroscience, London, UK.,South London and Maudsley NHS Foundation Trust, London, UK
| | - Mariam Molokhia
- King's College London (KCL) School of Population Health and Environmental Sciences, London, UK
| | - Lawrence Rajendran
- King's College London (KCL) Institute of Psychiatry, Psychology and Neuroscience, London, UK.,UK Dementia Research Institute, multisite, UK
| | - Robert J Stewart
- King's College London (KCL) Institute of Psychiatry, Psychology and Neuroscience, London, UK.,South London and Maudsley NHS Foundation Trust, London, UK
| |
Collapse
|
5
|
Whelan CD, Mattsson N, Nagle MW, Vijayaraghavan S, Hyde C, Janelidze S, Stomrud E, Lee J, Fitz L, Samad TA, Ramaswamy G, Margolin RA, Malarstig A, Hansson O. Multiplex proteomics identifies novel CSF and plasma biomarkers of early Alzheimer's disease. Acta Neuropathol Commun 2019; 7:169. [PMID: 31694701 PMCID: PMC6836495 DOI: 10.1186/s40478-019-0795-2] [Citation(s) in RCA: 126] [Impact Index Per Article: 25.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2019] [Accepted: 08/24/2019] [Indexed: 12/13/2022] Open
Abstract
To date, the development of disease-modifying therapies for Alzheimer’s disease (AD) has largely focused on the removal of amyloid beta Aβ fragments from the CNS. Proteomic profiling of patient fluids may help identify novel therapeutic targets and biomarkers associated with AD pathology. Here, we applied the Olink™ ProSeek immunoassay to measure 270 CSF and plasma proteins across 415 Aβ- negative cognitively normal individuals (Aβ- CN), 142 Aβ-positive CN (Aβ+ CN), 50 Aβ- mild cognitive impairment (MCI) patients, 75 Aβ+ MCI patients, and 161 Aβ+ AD patients from the Swedish BioFINDER study. A validation cohort included 59 Aβ- CN, 23 Aβ- + CN, 44 Aβ- MCI and 53 Aβ+ MCI. To compare protein concentrations in patients versus controls, we applied multiple linear regressions adjusting for age, gender, medications, smoking and mean subject-level protein concentration, and corrected findings for false discovery rate (FDR, q < 0.05). We identified, and replicated, altered levels of ten CSF proteins in Aβ+ individuals, including CHIT1, SMOC2, MMP-10, LDLR, CD200, EIF4EBP1, ALCAM, RGMB, tPA and STAMBP (− 0.14 < d < 1.16; q < 0.05). We also identified and replicated alterations of six plasma proteins in Aβ+ individuals OSM, MMP-9, HAGH, CD200, AXIN1, and uPA (− 0.77 < d < 1.28; q < 0.05). Multiple analytes associated with cognitive performance and cortical thickness (q < 0.05). Plasma biomarkers could distinguish AD dementia (AUC = 0.94, 95% CI = 0.87–0.98) and prodromal AD (AUC = 0.78, 95% CI = 0.68–0.87) from CN. These findings reemphasize the contributions of immune markers, phospholipids, angiogenic proteins and other biomarkers downstream of, and potentially orthogonal to, Aβ- and tau in AD, and identify candidate biomarkers for earlier detection of neurodegeneration.
Collapse
|
6
|
Xie H, Wang Y, Tao S, Huang S, Zhang C, Lv Z. Wearable Sensor-Based Daily Life Walking Assessment of Gait for Distinguishing Individuals With Amnestic Mild Cognitive Impairment. Front Aging Neurosci 2019; 11:285. [PMID: 31695605 PMCID: PMC6817674 DOI: 10.3389/fnagi.2019.00285] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2019] [Accepted: 10/03/2019] [Indexed: 11/15/2022] Open
Abstract
Objectives: To characterize gait disorders in patients with amnestic mild cognitive impairment (aMCIs) and determine the association between the performance of the gait function and cognition. Methodology: In this study, we enrolled 38 patients with aMCI and 30 cognitively normal individuals normal controls (NC). Neuropsychological assessments included tests of memory, executive function, language, and attention. Using an inertial-sensor-based wearable instrument, we collected the gait data dynamically for at least 1 h/day for 2 weeks. The gait parameters included walking velocity, stride length, stride time, cadence, and stride time variability. Results: The aMCI patients had reduced walking velocity and stride length and increased stride time variability compared with the NCs. The total number of steps, stride time, and cadence did not differ between the two groups. For all the subjects, walking velocity and stride length was positively associated with memory and executive function. Stride time variability was negatively correlated with the cognitive domains including memory, executive function and attention. Conclusion: This study suggested that cognitive impairment-related gait disorders occur (reduced gait speed, gait length, and gait stability) in daily life walking among the aMCI patients. A sensor-based wearable device for gait measurement may be an alternative and convenient tool for screening cognitive impairment.
Collapse
Affiliation(s)
- Haiqun Xie
- Department of Neurology, First People's Hospital of Foshan, Foshan, China
| | - Yukai Wang
- Department of Neurology, First People's Hospital of Foshan, Foshan, China
| | - Shuai Tao
- Dalian Key Laboratory of Smart Medical and Health, Dalian University, Dalian, China
| | - Shuyun Huang
- Department of Neurology, First People's Hospital of Foshan, Foshan, China
| | - Chengguo Zhang
- Department of Neurology, First People's Hospital of Foshan, Foshan, China
| | - Zeping Lv
- National Research Center for Rehabilitation Technical Aids, Rehabilitation Hospital, Beijing Key Laboratory of Rehabilitation Technical Aids for Old-Age Disability, Key Laboratory of Intelligent Control and Rehabilitation Technology of the Ministry of Civil Affairs, Beijing, China
| |
Collapse
|