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Ng TKS, Beck T, Liu X, Desai P, Holland T, Dhana K, Krueger K, Wilson RS, Evans DA, Rajan KB. Longitudinal associations between lipid panel and cognitive decline modified by APOE 4 carrier status in biracial community-dwelling older adults: Findings from the Chicago health and aging project. Arch Gerontol Geriatr 2025; 134:105825. [PMID: 40179541 PMCID: PMC12058384 DOI: 10.1016/j.archger.2025.105825] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2024] [Revised: 02/25/2025] [Accepted: 03/08/2025] [Indexed: 04/05/2025]
Abstract
BACKGROUND There have been contradictory findings on the associations between lipids and cognitive decline (CD), which may be attributed to the heterogeneity in the APOE4 carrier status, given APOE's lipid transportation roles. However, extant studies rarely examined the modifying effects of APOE4 carrier status on the associations between lipids and CD. METHODS We analyzed the Chicago Health and Aging Project, a 20-year cohort study comprising older adults with lipid panel assayed, i.e., total cholesterol (TC), triglycerides (TG), high-density lipoprotein (HDL), and low-density lipoprotein (LDL), and longitudinal cognitive tests. We ran adjusted linear mixed-effects models, regressing cognitive test composite on each of the four lipids independently, first with the total sample and subsequently using interaction and stratified subgroup analyses, examining the modifying effects of APOE4 carrier status on the associations. RESULTS 3,496 biracial community-dwelling older adults were recruited from the South side of Chicago (58% African American & 64% women; mean follow-up = 4.6 years). In the total sample, there was a borderline association between TG and CD, estimate (SD, p-value) = 0.0001 (0.0000,0.0565). No associations were detected with other lipids. In the interaction and subgroup analyses, only in ε4 carriers that higher TC levels were significantly associated with accelerated CD, -0.020 (0.009,0.035), whereas higher TG levels were significantly associated with decelerated CD, 0.001 (0.001,0.045). No modifying effects of ε4 carrier status were detected with other lipids. DISCUSSION Specific lipids, i.e., TC and TG, were associated with CD only in the ε4 carriers, highlighting the potential importance of measuring APOE4 status to better inform risk prediction and treatment.
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Affiliation(s)
- Ted K S Ng
- Rush Institute for Healthy Aging, Department of Internal Medicine, Rush University Medical Center, Chicago, IL, USA.
| | - Todd Beck
- Rush Institute for Healthy Aging, Department of Internal Medicine, Rush University Medical Center, Chicago, IL, USA
| | - Xiaoran Liu
- Rush Institute for Healthy Aging, Department of Internal Medicine, Rush University Medical Center, Chicago, IL, USA
| | - Pankaja Desai
- Rush Institute for Healthy Aging, Department of Internal Medicine, Rush University Medical Center, Chicago, IL, USA
| | - Thomas Holland
- Rush University Medical Center, Rush Institute for Healthy Aging & College of Health Sciences, USA
| | - Klodian Dhana
- Rush Institute for Healthy Aging, Department of Internal Medicine, Rush University Medical Center, Chicago, IL, USA
| | - Kristin Krueger
- Rush Institute for Healthy Aging, Department of Internal Medicine, Rush University Medical Center, Chicago, IL, USA
| | - Robert S Wilson
- Rush Alzheimer's Disease Research Center, Department of Internal Medicine, Rush University Medical Center, Chicago, IL, USA
| | - Denis A Evans
- Rush Institute for Healthy Aging, Department of Internal Medicine, Rush University Medical Center, Chicago, IL, USA
| | - Kumar B Rajan
- Rush Institute for Healthy Aging, Department of Internal Medicine, Rush University Medical Center, Chicago, IL, USA; Rush Alzheimer's Disease Research Center, Department of Internal Medicine, Rush University Medical Center, Chicago, IL, USA
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Su Q, Liu Q, Li B, Ma Z, Bai F, Li Y, Yu X, Li M, Li J, Sun D. Exploration of plasma biomarkers for Alzheimer's disease by targeted lipid metabolomics based on nuclear magnetic resonance (NMR) spectroscopy. J Neural Transm (Vienna) 2025; 132:129-138. [PMID: 39382682 DOI: 10.1007/s00702-024-02844-5] [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: 07/09/2024] [Accepted: 10/01/2024] [Indexed: 10/10/2024]
Abstract
Alzheimer's disease (AD) is the most common cause of dementia, but the disease lacks convenient and cost-effective alternative biomarkers currently. We utilized targeted lipid metabolomics based on nuclear magnetic resonance (NMR) spectroscopy to identify plasma biomarkers in AD patients. Our study was a cross-sectional study that enrolled 58 AD patients and 40 matched health controls (HCs). Firstly, we identified plasma lipid metabolites that were significantly different between the two groups based on P < 0.05 and variable importance in the projection (VIP) > 1. Then we examined the correlation between the lipid metabolites and cognitive function using partial correlation analysis and assessed the diagnostic ability of the lipid metabolites using receiver operating characteristic (ROC) curves. Seventeen lipoproteins showed significant differences between AD patients and HCs among 114 lipid metabolites. All 17 lipoproteins were subtypes of low-density lipoprotein (LDL). Among them, LDL-3 particle number, LDL-3 apolipoprotein-B, LDL-3 phospholipids, LDL free cholesterol and LDL phospholipids were significantly correlated with cognitive function. The ROC curves showed that LDL-2 triglycerides (TG) and LDL-3 TG could significantly distinguish AD patients from HCs, with the area under the curve (AUC) above 0.7. In addition, we explored a strategy of combined diagnosis that significantly improved the diagnostic efficacy for AD (AUC = 0.879). Our study provides insight into the lipoprotein alterations associated with AD and potential biomarkers for its diagnosis and cognitive function assessment.
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Affiliation(s)
- Qiao Su
- Tianjin Mental Health Institute, Tianjin Anding Hospital, Mental Health Center of Tianjin Medical University, 13 Liulin Road, Hexi District, Tianjin, 300222, China
| | - Qinghe Liu
- Tianjin Mental Health Institute, Tianjin Anding Hospital, Mental Health Center of Tianjin Medical University, 13 Liulin Road, Hexi District, Tianjin, 300222, China
| | - Baozhu Li
- Tianjin Mental Health Institute, Tianjin Anding Hospital, Mental Health Center of Tianjin Medical University, 13 Liulin Road, Hexi District, Tianjin, 300222, China
| | - Zhonghui Ma
- Tianjin Mental Health Institute, Tianjin Anding Hospital, Mental Health Center of Tianjin Medical University, 13 Liulin Road, Hexi District, Tianjin, 300222, China
| | - Fengfeng Bai
- Tianjin Mental Health Institute, Tianjin Anding Hospital, Mental Health Center of Tianjin Medical University, 13 Liulin Road, Hexi District, Tianjin, 300222, China
| | - Yanzhe Li
- Tianjin Mental Health Institute, Tianjin Anding Hospital, Mental Health Center of Tianjin Medical University, 13 Liulin Road, Hexi District, Tianjin, 300222, China
| | - Xue Yu
- Tianjin Mental Health Institute, Tianjin Anding Hospital, Mental Health Center of Tianjin Medical University, 13 Liulin Road, Hexi District, Tianjin, 300222, China
| | - Meijuan Li
- Tianjin Mental Health Institute, Tianjin Anding Hospital, Mental Health Center of Tianjin Medical University, 13 Liulin Road, Hexi District, Tianjin, 300222, China
| | - Jie Li
- Tianjin Mental Health Institute, Tianjin Anding Hospital, Mental Health Center of Tianjin Medical University, 13 Liulin Road, Hexi District, Tianjin, 300222, China.
| | - Daliang Sun
- Tianjin Mental Health Institute, Tianjin Anding Hospital, Mental Health Center of Tianjin Medical University, 13 Liulin Road, Hexi District, Tianjin, 300222, China.
- Tianjin University, Tianjin, China.
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Rajan KB, Mcaninch EA, Wilson RS, Dhana A, Evans-Lacko S, Evans DA. Statin Initiation and Risk of Incident Alzheimer Disease and Cognitive Decline in Genetically Susceptible Older Adults. Neurology 2024; 102:e209168. [PMID: 38447103 PMCID: PMC11770690 DOI: 10.1212/wnl.0000000000209168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Accepted: 01/08/2024] [Indexed: 03/08/2024] Open
Abstract
BACKGROUND AND OBJECTIVES The association of statin initiation with incident Alzheimer disease (AD) dementia and cognitive decline by the APOE ε4 allele is unknown. Our objective was to examine whether the association of statin initiation with incident AD dementia and cognitive decline differs by the APOE ε4 allele. METHODS This population-based longitudinal cohort study was conducted in 4 urban communities in Chicago, IL, United States, consisting of 4,807 participants. Statin initiation is based on the inspection of medications during home assessments. Clinical diagnosis for incident AD used the NINCDS-ADRDA criteria, and longitudinal measurements of global cognition consisted of episodic memory, perceptual speed, and the Mini-Mental State Examination tests. RESULTS The study participants had a mean age of 72 years, consisting of 63% female individuals and 61% non-Hispanic Black individuals. During the study period, 1,470 (31%) participants reported statin initiation. In a covariate-adjusted competing risk model, statin initiation was associated with a reduced risk of incident clinical AD [hazard ratio (HR) 0.81 (95% CI 0.70-0.94)] compared with nonusers. This association was statistically significantly lower (p interaction = 0.015) among participants with the APOE ε4 allele [HR 0.60 (95% CI 0.49-0.74)] compared with those without the APOE ε4 allele [HR 0.96 (95% CI 0.82-1.12)]. The annual decline in global cognition (β = 0.021, 95% CI 0.007-0.034) and episodic memory (β = 0.020, 95% CI 0.007-0.033) was also substantially slower among participants with the APOE ε4 allele after statin initiation compared with nonusers. However, the association of statin initiation with cognitive decline was not significant among those without the APOE ε4 allele. DISCUSSION Our findings suggest that statins might be associated with a lower risk of incident AD among individuals with the APOE ε4 allele. The benefits of statin therapy need further consideration in randomized clinical trials, especially among those with the APOE ε4 allele. CLASSIFICATION OF EVIDENCE This study provides Class II evidence that among those aged 65 years or older, statin initiation was associated with a reduced risk of Alzheimer disease, especially in the presence of an APOE-e4 allele.
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Affiliation(s)
- Kumar B Rajan
- From the Rush Institute for Healthy Aging (K.B.R., A.D., D.A.E.), Department of Internal Medicine, Rush University Medical Center, Chicago, IL; Division of Endocrinology (E.A.M.), Gerontology and Metabolism, Stanford University Medical Center, CA; Rush Alzheimer's Disease Center (R.S.W.), Rush University Medical Center, Chicago, IL; and Care Policy and Evaluation Centre (S.E.-L.), London School of Economics and Political Science, United Kingdom
| | - Elizabeth A Mcaninch
- From the Rush Institute for Healthy Aging (K.B.R., A.D., D.A.E.), Department of Internal Medicine, Rush University Medical Center, Chicago, IL; Division of Endocrinology (E.A.M.), Gerontology and Metabolism, Stanford University Medical Center, CA; Rush Alzheimer's Disease Center (R.S.W.), Rush University Medical Center, Chicago, IL; and Care Policy and Evaluation Centre (S.E.-L.), London School of Economics and Political Science, United Kingdom
| | - Robert S Wilson
- From the Rush Institute for Healthy Aging (K.B.R., A.D., D.A.E.), Department of Internal Medicine, Rush University Medical Center, Chicago, IL; Division of Endocrinology (E.A.M.), Gerontology and Metabolism, Stanford University Medical Center, CA; Rush Alzheimer's Disease Center (R.S.W.), Rush University Medical Center, Chicago, IL; and Care Policy and Evaluation Centre (S.E.-L.), London School of Economics and Political Science, United Kingdom
| | - Anisa Dhana
- From the Rush Institute for Healthy Aging (K.B.R., A.D., D.A.E.), Department of Internal Medicine, Rush University Medical Center, Chicago, IL; Division of Endocrinology (E.A.M.), Gerontology and Metabolism, Stanford University Medical Center, CA; Rush Alzheimer's Disease Center (R.S.W.), Rush University Medical Center, Chicago, IL; and Care Policy and Evaluation Centre (S.E.-L.), London School of Economics and Political Science, United Kingdom
| | - Sara Evans-Lacko
- From the Rush Institute for Healthy Aging (K.B.R., A.D., D.A.E.), Department of Internal Medicine, Rush University Medical Center, Chicago, IL; Division of Endocrinology (E.A.M.), Gerontology and Metabolism, Stanford University Medical Center, CA; Rush Alzheimer's Disease Center (R.S.W.), Rush University Medical Center, Chicago, IL; and Care Policy and Evaluation Centre (S.E.-L.), London School of Economics and Political Science, United Kingdom
| | - Denis A Evans
- From the Rush Institute for Healthy Aging (K.B.R., A.D., D.A.E.), Department of Internal Medicine, Rush University Medical Center, Chicago, IL; Division of Endocrinology (E.A.M.), Gerontology and Metabolism, Stanford University Medical Center, CA; Rush Alzheimer's Disease Center (R.S.W.), Rush University Medical Center, Chicago, IL; and Care Policy and Evaluation Centre (S.E.-L.), London School of Economics and Political Science, United Kingdom
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Spinedi M, Clark C, Zullo L, Kerksiek A, Pistis G, Castelao E, von Gunten A, Preisig M, Lütjohann D, Popp J. Cholesterol-metabolism, plant sterols, and long-term cognitive decline in older people - Effects of sex and APOEe4. iScience 2024; 27:109013. [PMID: 38327787 PMCID: PMC10847741 DOI: 10.1016/j.isci.2024.109013] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Revised: 12/07/2023] [Accepted: 01/22/2024] [Indexed: 02/09/2024] Open
Abstract
Neurodegenerative, vascular, and dementia diseases are linked to dysregulations in cholesterol metabolism. Dietary plant sterols, or phytosterols, may interfere to neurodegeneration and cognitive decline, and have cholesterol-lowering, anti-inflammatory, and antioxidant qualities. Here, we investigated the potential associations between circulating cholesterol precursors and metabolites, triglycerides, and phytosterols with cognitive decline in older people by performing multivariate analysis on 246 participants engaged in a population-based prospective study. In our analysis we considered the potential effect of sex and APOEe4. We reveal particular dysregulations of diet-derived phytosterols and endogenous cholesterol synthesis and metabolism, and their variations over time linked to cognitive decline in the general population. These results are significant to the development of interventions to avoid cognitive decline in older adults and suggest that levels of circulating sterols should be taken into account when evaluating risk.
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Affiliation(s)
- Matteo Spinedi
- University Hospital of Psychiatry and University of Zürich, Zürich, Switzerland
| | - Christopher Clark
- University Hospital of Psychiatry and University of Zürich, Zürich, Switzerland
| | - Leonardo Zullo
- Service of Old Age Psychiatry, Department of Psychiatry, University Hospital of Lausanne, Lausanne, Switzerland
| | - Anja Kerksiek
- Institute of Clinical Chemistry and Clinical Pharmacology, University Hospital Bonn, Bonn, Germany
| | - Giorgio Pistis
- Psychiatric Epidemiology and Psychopathology Research Center, Department of Psychiatry, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Enrique Castelao
- Psychiatric Epidemiology and Psychopathology Research Center, Department of Psychiatry, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Armin von Gunten
- Service of Old Age Psychiatry, Department of Psychiatry, University Hospital of Lausanne, Lausanne, Switzerland
| | - Martin Preisig
- Psychiatric Epidemiology and Psychopathology Research Center, Department of Psychiatry, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Dieter Lütjohann
- Institute of Clinical Chemistry and Clinical Pharmacology, University Hospital Bonn, Bonn, Germany
| | - Julius Popp
- University Hospital of Psychiatry and University of Zürich, Zürich, Switzerland
- Service of Old Age Psychiatry, Department of Psychiatry, University Hospital of Lausanne, Lausanne, Switzerland
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Wen J, Hao X, Jia Y, Wang B, Pang J, Liang F. Sex Differences in the Association Between LDL/HDL with Cognitive Decline in Older Adults: National Health and Nutrition Examination Survey. J Alzheimers Dis 2024; 98:1493-1502. [PMID: 38578891 DOI: 10.3233/jad-231195] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/07/2024]
Abstract
Background Lipids have a significant impact on the development and functioning of the nervous system, but the sex differences between the association of LDL/HDL, which reflects lipid metabolic status, and cognitive impairment remains unclear. Objective We aimed to determine if there were sex differences between the association of LDL/HDL and cognitive function in US older adults. Methods This population-based cross-sectional study used data from the National Health and Nutrition Examination Survey (NHANES) 2011-2012 and 2013-2014 cycles. The main outcome was poor cognitive performance defined by the Digit Symbol Substitution Test (DSST) < 34 based on published literature. Results A total of 1,225 participants were included in the study, with a cognitive impairment incidence of 25.6% (314/1,225). Multivariate regression models demonstrated a significant association between cognitive decline and each 1-unit increase in LDL/HDL, after adjusting for all covariates (adjusted odds ratio [OR] = 1.36, 95% confidence interval [CI]: 1.11-1.67). Furthermore, subgroup analysis revealed an interaction between LDL/HDL and cognitive impairment in sex subgroups. Conclusions LDL/HDL was associated with cognitive impairment in the US older adult population in adjusted models, although the significance of this association was not observed in females.
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Affiliation(s)
- Jiaqi Wen
- Department of Neurology, Baotou Central Hospital, Baotou, China
- Inner Mongolia Autonomous Region Clinical Medical Research Center for Neurological Diseases, Baotou, China
| | - Xiwa Hao
- Department of Neurology, Baotou Central Hospital, Baotou, China
- Inner Mongolia Autonomous Region Clinical Medical Research Center for Neurological Diseases, Baotou, China
| | - Yanhong Jia
- Department of Neurology, Baotou Central Hospital, Baotou, China
| | - Baojun Wang
- Department of Neurology, Baotou Central Hospital, Baotou, China
- Inner Mongolia Autonomous Region Clinical Medical Research Center for Neurological Diseases, Baotou, China
| | - Jiangxia Pang
- Department of Neurology, Baotou Central Hospital, Baotou, China
- Inner Mongolia Autonomous Region Clinical Medical Research Center for Neurological Diseases, Baotou, China
| | - Furu Liang
- Department of Neurology, Baotou Central Hospital, Baotou, China
- Inner Mongolia Autonomous Region Clinical Medical Research Center for Neurological Diseases, Baotou, China
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Ding H, Liu C, Li Y, Ang TFA, Devine S, Liu Y, Au R, Doraiswamy PM. Sex-specific blood biomarkers linked to memory changes in middle-aged adults: The Framingham Heart Study. ALZHEIMER'S & DEMENTIA (AMSTERDAM, NETHERLANDS) 2024; 16:e12569. [PMID: 38545543 PMCID: PMC10966919 DOI: 10.1002/dad2.12569] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Revised: 02/02/2024] [Accepted: 02/13/2024] [Indexed: 06/06/2024]
Abstract
The relationship between sex-specific blood biomarkers and memory changes in middle-aged adults remains unclear. We aimed to investigate this relationship using the data from the Framingham Heart Study (FHS). We conducted association analysis, partial correlation analysis, and causal dose-response curves using blood biomarkers and other data from 793 middle-aged participants (≤ 60 years) from the FHS Offspring Cohort. The results revealed associations of adiponectin and fasting blood glucose with midlife memory change, along with a U-shaped relationship of high-density lipoprotein cholesterol with memory change. No significant associations were found for the other blood biomarkers (e.g., amyloid beta protein 42) with memory change. To our knowledge, this is the first sex-specific network analysis of blood biomarkers related to midlife memory change in a prospective cohort study. Our findings highlight the importance of targeting cardiometabolic risks and the need to validate midlife-specific biomarkers that can accelerate the development of primary preventive strategies.
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Affiliation(s)
- Huitong Ding
- Department of Anatomy and NeurobiologyBoston University Chobanian & Avedisian School of MedicineBostonMassachusettsUSA
- Framingham Heart StudyBoston University Chobanian & Avedisian School of MedicineBostonMassachusettsUSA
| | - Chunyu Liu
- Framingham Heart StudyBoston University Chobanian & Avedisian School of MedicineBostonMassachusettsUSA
- Department of BiostatisticsBoston University School of Public HealthBostonMassachusettsUSA
| | - Yi Li
- Department of BiostatisticsBoston University School of Public HealthBostonMassachusettsUSA
| | - Ting Fang Alvin Ang
- Department of Anatomy and NeurobiologyBoston University Chobanian & Avedisian School of MedicineBostonMassachusettsUSA
- Framingham Heart StudyBoston University Chobanian & Avedisian School of MedicineBostonMassachusettsUSA
- Slone Epidemiology CenterBoston University Chobanian & Avedisian School of MedicineBostonMassachusettsUSA
| | - Sherral Devine
- Department of Anatomy and NeurobiologyBoston University Chobanian & Avedisian School of MedicineBostonMassachusettsUSA
- Framingham Heart StudyBoston University Chobanian & Avedisian School of MedicineBostonMassachusettsUSA
| | - Yulin Liu
- Department of Anatomy and NeurobiologyBoston University Chobanian & Avedisian School of MedicineBostonMassachusettsUSA
- Framingham Heart StudyBoston University Chobanian & Avedisian School of MedicineBostonMassachusettsUSA
| | - Rhoda Au
- Department of Anatomy and NeurobiologyBoston University Chobanian & Avedisian School of MedicineBostonMassachusettsUSA
- Framingham Heart StudyBoston University Chobanian & Avedisian School of MedicineBostonMassachusettsUSA
- Slone Epidemiology CenterBoston University Chobanian & Avedisian School of MedicineBostonMassachusettsUSA
- Department of NeurologyBoston University Chobanian & Avedisian School of MedicineBostonMassachusettsUSA
- Department of EpidemiologyBoston University School of Public HealthBostonMassachusettsUSA
| | - P. Murali Doraiswamy
- Neurocognitive Disorders ProgramDepartments of Psychiatry and Medicineand the Duke Institute for Brain SciencesDuke University School of MedicineDurhamNorth CarolinaUSA
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Rudajev V, Novotny J. Cholesterol-dependent amyloid β production: space for multifarious interactions between amyloid precursor protein, secretases, and cholesterol. Cell Biosci 2023; 13:171. [PMID: 37705117 PMCID: PMC10500844 DOI: 10.1186/s13578-023-01127-y] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Accepted: 09/05/2023] [Indexed: 09/15/2023] Open
Abstract
Amyloid β is considered a key player in the development and progression of Alzheimer's disease (AD). Many studies investigating the effect of statins on lowering cholesterol suggest that there may be a link between cholesterol levels and AD pathology. Since cholesterol is one of the most abundant lipid molecules, especially in brain tissue, it affects most membrane-related processes, including the formation of the most dangerous form of amyloid β, Aβ42. The entire Aβ production system, which includes the amyloid precursor protein (APP), β-secretase, and the complex of γ-secretase, is highly dependent on membrane cholesterol content. Moreover, cholesterol can affect amyloidogenesis in many ways. Cholesterol influences the stability and activity of secretases, but also dictates their partitioning into specific cellular compartments and cholesterol-enriched lipid rafts, where the amyloidogenic machinery is predominantly localized. The most complicated relationships have been found in the interaction between cholesterol and APP, where cholesterol affects not only APP localization but also the precise character of APP dimerization and APP processing by γ-secretase, which is important for the production of Aβ of different lengths. In this review, we describe the intricate web of interdependence between cellular cholesterol levels, cholesterol membrane distribution, and cholesterol-dependent production of Aβ, the major player in AD.
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Affiliation(s)
- Vladimir Rudajev
- Department of Physiology, Faculty of Science, Charles University, Prague, Czech Republic
| | - Jiri Novotny
- Department of Physiology, Faculty of Science, Charles University, Prague, Czech Republic
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Moser ED, Manemann SM, Larson NB, St Sauver JL, Takahashi PY, Mielke MM, Rocca WA, Olson JE, Roger VL, Remaley AT, Decker PA, Killian JM, Bielinski SJ. Association Between Fluctuations in Blood Lipid Levels Over Time With Incident Alzheimer Disease and Alzheimer Disease-Related Dementias. Neurology 2023; 101:e1127-e1136. [PMID: 37407257 PMCID: PMC10513892 DOI: 10.1212/wnl.0000000000207595] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Accepted: 05/12/2023] [Indexed: 07/07/2023] Open
Abstract
BACKGROUND AND OBJECTIVES Prevention strategies for Alzheimer disease and Alzheimer disease-related dementias (AD/ADRDs) are urgently needed. Lipid variability, or fluctuations in blood lipid levels at different points in time, has not been examined extensively and may contribute to the risk of AD/ADRD. Lipid panels are a part of routine screening in clinical practice and routinely available in electronic health records (EHR). Thus, in a large geographically defined population-based cohort, we investigated the variation of multiple lipid types and their association to the development of AD/ADRD. METHODS All residents living in Olmsted County, Minnesota on the index date January 1, 2006, aged 60 years or older without an AD/ADRD diagnosis were identified. Persons with ≥3 lipid measurements including total cholesterol, triglycerides, low-density lipoprotein cholesterol (LDL-C), or high-density lipoprotein cholesterol (HDL-C) in the 5 years before index date were included. Lipid variation was defined as any change in individual's lipid levels over time regardless of direction and was measured using variability independent of the mean (VIM). Associations between lipid variation quintiles and incident AD/ADRD were assessed using Cox proportional hazards regression. Participants were followed through 2018 for incident AD/ADRD. RESULTS The final analysis included 11,571 participants (mean age 71 years; 54% female). Median follow-up was 12.9 years with 2,473 incident AD/ADRD cases. After adjustment for confounding variables including sex, race, baseline lipid measurements, education, BMI, and lipid-lowering treatment, participants in the highest quintile of total cholesterol variability had a 19% increased risk of incident AD/ADRD, and those in highest quintile of triglycerides, variability had a 23% increased risk. DISCUSSION In a large EHR derived cohort, those in the highest quintile of variability for total cholesterol and triglyceride levels had an increased risk of incident AD/ADRD. Further studies to identify the mechanisms behind this association are needed.
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Affiliation(s)
- Ethan D Moser
- From the Department of Quantitative Health Sciences (E.D.M., S.M.M., N.B.L., J.L.S.S., M.M.M., W.A.R., J.E.O., V.L.R., P.A.D., J.M.K., S.J.B.); Division of Community Internal Medicine (P.Y.T.), Department of Medicine, Mayo Clinic; Department of Neurology (M.M.M., W.A.R.), Rochester, MN; Department of Epidemiology and Prevention (M.M.M.), Wake Forest University School of Medicine, Winston-Salem, NC; Mayo Clinic Women's Health Research Center (W.A.R.); Department of Cardiovascular Medicine (V.L.R.), Mayo Clinic, Rochester, MN; Epidemiology and Community Branch (V.L.R.), National Heart, Lung, and Blood Institute, National Institutes of Health; and Lipoprotein Metabolism Laboratory (A.T.R.), Translational Vascular Medicine Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD
| | - Sheila M Manemann
- From the Department of Quantitative Health Sciences (E.D.M., S.M.M., N.B.L., J.L.S.S., M.M.M., W.A.R., J.E.O., V.L.R., P.A.D., J.M.K., S.J.B.); Division of Community Internal Medicine (P.Y.T.), Department of Medicine, Mayo Clinic; Department of Neurology (M.M.M., W.A.R.), Rochester, MN; Department of Epidemiology and Prevention (M.M.M.), Wake Forest University School of Medicine, Winston-Salem, NC; Mayo Clinic Women's Health Research Center (W.A.R.); Department of Cardiovascular Medicine (V.L.R.), Mayo Clinic, Rochester, MN; Epidemiology and Community Branch (V.L.R.), National Heart, Lung, and Blood Institute, National Institutes of Health; and Lipoprotein Metabolism Laboratory (A.T.R.), Translational Vascular Medicine Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD
| | - Nicholas B Larson
- From the Department of Quantitative Health Sciences (E.D.M., S.M.M., N.B.L., J.L.S.S., M.M.M., W.A.R., J.E.O., V.L.R., P.A.D., J.M.K., S.J.B.); Division of Community Internal Medicine (P.Y.T.), Department of Medicine, Mayo Clinic; Department of Neurology (M.M.M., W.A.R.), Rochester, MN; Department of Epidemiology and Prevention (M.M.M.), Wake Forest University School of Medicine, Winston-Salem, NC; Mayo Clinic Women's Health Research Center (W.A.R.); Department of Cardiovascular Medicine (V.L.R.), Mayo Clinic, Rochester, MN; Epidemiology and Community Branch (V.L.R.), National Heart, Lung, and Blood Institute, National Institutes of Health; and Lipoprotein Metabolism Laboratory (A.T.R.), Translational Vascular Medicine Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD
| | - Jennifer L St Sauver
- From the Department of Quantitative Health Sciences (E.D.M., S.M.M., N.B.L., J.L.S.S., M.M.M., W.A.R., J.E.O., V.L.R., P.A.D., J.M.K., S.J.B.); Division of Community Internal Medicine (P.Y.T.), Department of Medicine, Mayo Clinic; Department of Neurology (M.M.M., W.A.R.), Rochester, MN; Department of Epidemiology and Prevention (M.M.M.), Wake Forest University School of Medicine, Winston-Salem, NC; Mayo Clinic Women's Health Research Center (W.A.R.); Department of Cardiovascular Medicine (V.L.R.), Mayo Clinic, Rochester, MN; Epidemiology and Community Branch (V.L.R.), National Heart, Lung, and Blood Institute, National Institutes of Health; and Lipoprotein Metabolism Laboratory (A.T.R.), Translational Vascular Medicine Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD
| | - Paul Y Takahashi
- From the Department of Quantitative Health Sciences (E.D.M., S.M.M., N.B.L., J.L.S.S., M.M.M., W.A.R., J.E.O., V.L.R., P.A.D., J.M.K., S.J.B.); Division of Community Internal Medicine (P.Y.T.), Department of Medicine, Mayo Clinic; Department of Neurology (M.M.M., W.A.R.), Rochester, MN; Department of Epidemiology and Prevention (M.M.M.), Wake Forest University School of Medicine, Winston-Salem, NC; Mayo Clinic Women's Health Research Center (W.A.R.); Department of Cardiovascular Medicine (V.L.R.), Mayo Clinic, Rochester, MN; Epidemiology and Community Branch (V.L.R.), National Heart, Lung, and Blood Institute, National Institutes of Health; and Lipoprotein Metabolism Laboratory (A.T.R.), Translational Vascular Medicine Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD
| | - Michelle M Mielke
- From the Department of Quantitative Health Sciences (E.D.M., S.M.M., N.B.L., J.L.S.S., M.M.M., W.A.R., J.E.O., V.L.R., P.A.D., J.M.K., S.J.B.); Division of Community Internal Medicine (P.Y.T.), Department of Medicine, Mayo Clinic; Department of Neurology (M.M.M., W.A.R.), Rochester, MN; Department of Epidemiology and Prevention (M.M.M.), Wake Forest University School of Medicine, Winston-Salem, NC; Mayo Clinic Women's Health Research Center (W.A.R.); Department of Cardiovascular Medicine (V.L.R.), Mayo Clinic, Rochester, MN; Epidemiology and Community Branch (V.L.R.), National Heart, Lung, and Blood Institute, National Institutes of Health; and Lipoprotein Metabolism Laboratory (A.T.R.), Translational Vascular Medicine Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD
| | - Walter A Rocca
- From the Department of Quantitative Health Sciences (E.D.M., S.M.M., N.B.L., J.L.S.S., M.M.M., W.A.R., J.E.O., V.L.R., P.A.D., J.M.K., S.J.B.); Division of Community Internal Medicine (P.Y.T.), Department of Medicine, Mayo Clinic; Department of Neurology (M.M.M., W.A.R.), Rochester, MN; Department of Epidemiology and Prevention (M.M.M.), Wake Forest University School of Medicine, Winston-Salem, NC; Mayo Clinic Women's Health Research Center (W.A.R.); Department of Cardiovascular Medicine (V.L.R.), Mayo Clinic, Rochester, MN; Epidemiology and Community Branch (V.L.R.), National Heart, Lung, and Blood Institute, National Institutes of Health; and Lipoprotein Metabolism Laboratory (A.T.R.), Translational Vascular Medicine Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD
| | - Janet E Olson
- From the Department of Quantitative Health Sciences (E.D.M., S.M.M., N.B.L., J.L.S.S., M.M.M., W.A.R., J.E.O., V.L.R., P.A.D., J.M.K., S.J.B.); Division of Community Internal Medicine (P.Y.T.), Department of Medicine, Mayo Clinic; Department of Neurology (M.M.M., W.A.R.), Rochester, MN; Department of Epidemiology and Prevention (M.M.M.), Wake Forest University School of Medicine, Winston-Salem, NC; Mayo Clinic Women's Health Research Center (W.A.R.); Department of Cardiovascular Medicine (V.L.R.), Mayo Clinic, Rochester, MN; Epidemiology and Community Branch (V.L.R.), National Heart, Lung, and Blood Institute, National Institutes of Health; and Lipoprotein Metabolism Laboratory (A.T.R.), Translational Vascular Medicine Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD
| | - Véronique L Roger
- From the Department of Quantitative Health Sciences (E.D.M., S.M.M., N.B.L., J.L.S.S., M.M.M., W.A.R., J.E.O., V.L.R., P.A.D., J.M.K., S.J.B.); Division of Community Internal Medicine (P.Y.T.), Department of Medicine, Mayo Clinic; Department of Neurology (M.M.M., W.A.R.), Rochester, MN; Department of Epidemiology and Prevention (M.M.M.), Wake Forest University School of Medicine, Winston-Salem, NC; Mayo Clinic Women's Health Research Center (W.A.R.); Department of Cardiovascular Medicine (V.L.R.), Mayo Clinic, Rochester, MN; Epidemiology and Community Branch (V.L.R.), National Heart, Lung, and Blood Institute, National Institutes of Health; and Lipoprotein Metabolism Laboratory (A.T.R.), Translational Vascular Medicine Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD
| | - Alan T Remaley
- From the Department of Quantitative Health Sciences (E.D.M., S.M.M., N.B.L., J.L.S.S., M.M.M., W.A.R., J.E.O., V.L.R., P.A.D., J.M.K., S.J.B.); Division of Community Internal Medicine (P.Y.T.), Department of Medicine, Mayo Clinic; Department of Neurology (M.M.M., W.A.R.), Rochester, MN; Department of Epidemiology and Prevention (M.M.M.), Wake Forest University School of Medicine, Winston-Salem, NC; Mayo Clinic Women's Health Research Center (W.A.R.); Department of Cardiovascular Medicine (V.L.R.), Mayo Clinic, Rochester, MN; Epidemiology and Community Branch (V.L.R.), National Heart, Lung, and Blood Institute, National Institutes of Health; and Lipoprotein Metabolism Laboratory (A.T.R.), Translational Vascular Medicine Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD
| | - Paul A Decker
- From the Department of Quantitative Health Sciences (E.D.M., S.M.M., N.B.L., J.L.S.S., M.M.M., W.A.R., J.E.O., V.L.R., P.A.D., J.M.K., S.J.B.); Division of Community Internal Medicine (P.Y.T.), Department of Medicine, Mayo Clinic; Department of Neurology (M.M.M., W.A.R.), Rochester, MN; Department of Epidemiology and Prevention (M.M.M.), Wake Forest University School of Medicine, Winston-Salem, NC; Mayo Clinic Women's Health Research Center (W.A.R.); Department of Cardiovascular Medicine (V.L.R.), Mayo Clinic, Rochester, MN; Epidemiology and Community Branch (V.L.R.), National Heart, Lung, and Blood Institute, National Institutes of Health; and Lipoprotein Metabolism Laboratory (A.T.R.), Translational Vascular Medicine Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD
| | - Jill M Killian
- From the Department of Quantitative Health Sciences (E.D.M., S.M.M., N.B.L., J.L.S.S., M.M.M., W.A.R., J.E.O., V.L.R., P.A.D., J.M.K., S.J.B.); Division of Community Internal Medicine (P.Y.T.), Department of Medicine, Mayo Clinic; Department of Neurology (M.M.M., W.A.R.), Rochester, MN; Department of Epidemiology and Prevention (M.M.M.), Wake Forest University School of Medicine, Winston-Salem, NC; Mayo Clinic Women's Health Research Center (W.A.R.); Department of Cardiovascular Medicine (V.L.R.), Mayo Clinic, Rochester, MN; Epidemiology and Community Branch (V.L.R.), National Heart, Lung, and Blood Institute, National Institutes of Health; and Lipoprotein Metabolism Laboratory (A.T.R.), Translational Vascular Medicine Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD
| | - Suzette J Bielinski
- From the Department of Quantitative Health Sciences (E.D.M., S.M.M., N.B.L., J.L.S.S., M.M.M., W.A.R., J.E.O., V.L.R., P.A.D., J.M.K., S.J.B.); Division of Community Internal Medicine (P.Y.T.), Department of Medicine, Mayo Clinic; Department of Neurology (M.M.M., W.A.R.), Rochester, MN; Department of Epidemiology and Prevention (M.M.M.), Wake Forest University School of Medicine, Winston-Salem, NC; Mayo Clinic Women's Health Research Center (W.A.R.); Department of Cardiovascular Medicine (V.L.R.), Mayo Clinic, Rochester, MN; Epidemiology and Community Branch (V.L.R.), National Heart, Lung, and Blood Institute, National Institutes of Health; and Lipoprotein Metabolism Laboratory (A.T.R.), Translational Vascular Medicine Branch, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD.
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Cummings J, Hahn-Pedersen JH, Eichinger CS, Freeman C, Clark A, Tarazona LRS, Lanctôt K. Exploring the relationship between patient-relevant outcomes and Alzheimer's disease progression assessed using the clinical dementia rating scale: a systematic literature review. Front Neurol 2023; 14:1208802. [PMID: 37669257 PMCID: PMC10470645 DOI: 10.3389/fneur.2023.1208802] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2023] [Accepted: 07/21/2023] [Indexed: 09/07/2023] Open
Abstract
Background People with Alzheimer's disease (AD) have difficulties in performing activities of daily living (ADLs) as the disease progresses, commonly experience neuropsychiatric symptoms (NPS), and often have comorbidities such as cardiovascular disease. These factors all contribute to a requirement for care and considerable healthcare costs in AD. The Clinical Dementia Rating (CDR) scale is a widely used measure of dementia staging, but the correlations between scores on this scale and patient-/care partner-relevant outcomes have not been characterized fully. We conducted a systematic literature review to address this evidence gap. Methods Embase, MEDLINE, and the Cochrane Library were searched September 13, 2022, to identify published studies (no restriction by date or country) in populations with mild cognitive impairment due to AD or AD dementia. Studies of interest reported data on the relationships between CDR Global or CDR-Sum of Boxes (CDR-SB) scores and outcomes including NPS, comorbidities, ADLs, nursing home placement, healthcare costs, and resource use. Results Overall, 58 studies met the inclusion criteria (42 focusing on comorbidities, 14 on ADLs or dependence, five on nursing home placement, and six on economic outcomes). CDR/CDR-SB scores were correlated with the frequency of multiple NPS and with total scores on the Neuropsychiatric Inventory. For cardiovascular comorbidities, no single risk factor was consistently linked to AD progression. Increasing CDR/CDR-SB scores were correlated with decline in multiple different measures of ADLs and were also associated with nursing home placement and increasing costs of care. Conclusion NPS, ADLs, and costs of care are clearly linked to AD progression, as measured using CDR Global or CDR-SB scores, from the earliest stages of disease. This indicates that scores derived from the CDR are a meaningful way to describe the severity and burden of AD for patients and care partners across disease stages.
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Affiliation(s)
- Jeffrey Cummings
- Chambers-Grundy Center for Transformative Neuroscience, Department of Brain Health, School of Integrated Health Sciences, University of Nevada, Las Vegas, NV, United States
| | | | | | | | | | | | - Krista Lanctôt
- Hurvitz Brain Sciences Program, Sunnybrook Research Institute, Toronto, ON, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
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10
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Oliveira FFD. Looking Behind the Curtain: Patient Stratification According to Genetic or Demographic Factors May Yield Unexpected Results in Studies of Neurodegenerative Diseases. J Alzheimers Dis 2023:JAD230561. [PMID: 37393510 DOI: 10.3233/jad-230561] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/03/2023]
Abstract
Amyloid-PET studies of neurodegenerative diseases may yield inconclusive findings due to lacking stratification according to genetic or demographic variants. APOEɛ4 alleles are the major variants to increase disease susceptibility and cause earlier onset and more behavioral features in patients with late-onset Alzheimer's disease, but have no linear effects on cognitive or functional decline; thus, sample stratification according to APOEɛ4 carrier status may be the best option. Interactions among APOEɛ4 alleles, sex, and age on amyloid-β deposition may reveal even more innovative findings with sufficiently large samples, suggesting variable genomic effects of cognitive reserve, sex differences, and cerebrovascular risk on neurodegeneration.
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Nasab AS, Noorani F, Paeizi Z, Khani L, Banaei S, Sadeghi M, Shafeghat M, Shafie M, Mayeli M, Initiative (ADNI) TADN. A Comprehensive Investigation of the Potential Role of Lipoproteins and Metabolite Profile as Biomarkers of Alzheimer's Disease Compared to the Known CSF Biomarkers. Int J Alzheimers Dis 2023; 2023:3540020. [PMID: 36936136 PMCID: PMC10019964 DOI: 10.1155/2023/3540020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2022] [Revised: 12/22/2022] [Accepted: 01/30/2023] [Indexed: 03/14/2023] Open
Abstract
Introduction While cerebrospinal fluid (CSF) core biomarkers have been considered diagnostic biomarkers for a long time, special attention has been recently dedicated to lipoproteins and metabolites that could be potentially associated with Alzheimer's disease (AD) neurodegeneration. Herein, we aimed to investigate the relationship between the levels of CSF core biomarkers including Aβ-42, TAU, and P-TAU and plasma lipoproteins and metabolites of patients with AD from the baseline cohort of the Alzheimer's Disease Neuroimaging Initiative (ADNI) database. Method Using the ADNI database, fourteen subclasses of lipoproteins as well as a number of lipids and fatty acids and low-molecular metabolites including amino acids, ketone bodies, and glycolysis-related metabolites in blood samples were measured as potential noninvasive markers, and their association with the CSF core biomarkers was statistically investigated controlling for age and gender. Results A total number of 251 AD subjects were included, among whom 71 subjects were negative for the Apo-E ε4 allele and 150 were positive. There was no significant difference between the two groups regarding cognitive assessments, CSF core biomarkers, and lipoproteins and metabolites except the level of Aβ-42 (p < 0.001) and phenylalanine (p = 0.049), which were higher in the negative group. CSF TAU and P-TAU were significantly correlated with medium and small HDL in the negative group, and with extremely large VLDL in the positive group. Our results also indicated significant correlations of metabolites including unsaturated fatty acids, glycerol, and leucine with CSF core biomarkers. Conclusion Based on our findings, a number of lipoproteins and metabolites were associated with CSF core biomarkers of AD. These correlations showed some differences in Apo-E ε4 positive and negative groups, which reminds the role of Apo-E gene status in the pathophysiology of AD development. However, further research is warranted to explore the exact association of lipoproteins and other metabolites with AD core biomarkers and pathology.
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Affiliation(s)
- Azam Sajjadi Nasab
- 1NeuroTRACT Association, Students' Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Fatemeh Noorani
- 1NeuroTRACT Association, Students' Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Zahra Paeizi
- 1NeuroTRACT Association, Students' Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Leila Khani
- 1NeuroTRACT Association, Students' Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Saba Banaei
- 1NeuroTRACT Association, Students' Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammad Sadeghi
- 1NeuroTRACT Association, Students' Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Melika Shafeghat
- 1NeuroTRACT Association, Students' Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran
- 2School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Mahan Shafie
- 1NeuroTRACT Association, Students' Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran
- 2School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Mahsa Mayeli
- 1NeuroTRACT Association, Students' Scientific Research Center, Tehran University of Medical Sciences, Tehran, Iran
- 2School of Medicine, Tehran University of Medical Sciences, Tehran, Iran
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12
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Cachide M, Carvalho L, Rosa IM, Wiltfang J, Henriques AG, da Cruz e Silva OAB. BIN1 rs744373 SNP and APOE alleles specifically associate to common diseases. FRONTIERS IN DEMENTIA 2022; 1:1001113. [PMID: 39081475 PMCID: PMC11285651 DOI: 10.3389/frdem.2022.1001113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Accepted: 10/12/2022] [Indexed: 08/02/2024]
Abstract
APOE ε4 and BIN1 are the two main genetic risk factors for sporadic Alzheimer's Disease (AD). Among several BIN1 variants, the rs744373 is frequently associated with AD risk by contributing to tau pathology and poor cognitive performance. This study addressed the association of APOE and BIN1 rs744373 to specific characteristics in a Portuguese primary care-based study group, denoted pcb-Cohort. The study included 590 participants from five primary care health centers in the Aveiro district of Portugal. Individuals were evaluated and scored for cognitive and clinical characteristics, and blood samples were collected from the volunteers meeting the inclusion and exclusion criteria (N = 505). APOE and BIN1 genotypes were determined, and their association with cognitive characteristics and other diseases that might contribute to cognitive deficits, namely depression, hypertension, type 2 diabetes, dyslipidemia, osteoarticular diseases, gastrointestinal diseases, cardiovascular and respiratory diseases, was assessed. The diseases attributed to the study group were those previously diagnosed and confirmed by specialists. The results generated through multivariate analysis show that APOE ε4 carriers significantly associated with poorer cognitive performance (OR = 2.527; p = 0.031). Additionally, there was a significant risk of dyslipidemia for APOE ε4 carriers (OR = 1.804; p = 0.036), whereas BIN1 rs744373 risk-allele carriers were at a significantly lower risk of having dyslipidemia (OR = 0.558; p = 0.006). Correlations were evident for respiratory diseases in which APOE ε4 showed a protective tendency (OR = 0.515; p = 0.088), and BIN1 had a significative protective profile (OR = 0.556; p = 0.026). Not of statistical significance, APOE ε2 showed a trend to protect against type 2 diabetes (OR = 0.342; p = 0.093), in contrast BIN1 rs744373 risk-allele carriers were more likely to exhibit the disease (OR = 1.491; p = 0.099). The data here presented clearly show, for the first time, that the two top genetic risk factors for sporadic AD impact a similar group of common diseases, namely dyslipidemia, respiratory diseases, and type 2 diabetes.
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Affiliation(s)
- Maria Cachide
- Neurosciences and Signalling Group, Medical Sciences Department, Institute of Biomedicine - iBiMED, University of Aveiro, Aveiro, Portugal
| | - Liliana Carvalho
- Neurosciences and Signalling Group, Medical Sciences Department, Institute of Biomedicine - iBiMED, University of Aveiro, Aveiro, Portugal
| | - Ilka Martins Rosa
- Neurosciences and Signalling Group, Medical Sciences Department, Institute of Biomedicine - iBiMED, University of Aveiro, Aveiro, Portugal
| | - Jens Wiltfang
- Neurosciences and Signalling Group, Medical Sciences Department, Institute of Biomedicine - iBiMED, University of Aveiro, Aveiro, Portugal
- Department of Psychiatry and Psychotherapy, University Medical Centre Goettingen (UMG), Georg-August University, Goettingen, Germany
- German Centre for Neurodegenerative Diseases (DZNE), Goettingen, Germany
| | - Ana Gabriela Henriques
- Neurosciences and Signalling Group, Medical Sciences Department, Institute of Biomedicine - iBiMED, University of Aveiro, Aveiro, Portugal
| | - Odete A. B. da Cruz e Silva
- Neurosciences and Signalling Group, Medical Sciences Department, Institute of Biomedicine - iBiMED, University of Aveiro, Aveiro, Portugal
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Rudajev V, Novotny J. Cholesterol as a key player in amyloid β-mediated toxicity in Alzheimer’s disease. Front Mol Neurosci 2022; 15:937056. [PMID: 36090253 PMCID: PMC9453481 DOI: 10.3389/fnmol.2022.937056] [Citation(s) in RCA: 40] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Accepted: 07/27/2022] [Indexed: 11/13/2022] Open
Abstract
Alzheimer’s disease (AD) is a neurodegenerative disorder that is one of the most devastating and widespread diseases worldwide, mainly affecting the aging population. One of the key factors contributing to AD-related neurotoxicity is the production and aggregation of amyloid β (Aβ). Many studies have shown the ability of Aβ to bind to the cell membrane and disrupt its structure, leading to cell death. Because amyloid damage affects different parts of the brain differently, it seems likely that not only Aβ but also the nature of the membrane interface with which the amyloid interacts, helps determine the final neurotoxic effect. Because cholesterol is the dominant component of the plasma membrane, it plays an important role in Aβ-induced toxicity. Elevated cholesterol levels and their regulation by statins have been shown to be important factors influencing the progression of neurodegeneration. However, data from many studies have shown that cholesterol has both neuroprotective and aggravating effects in relation to the development of AD. In this review, we attempt to summarize recent findings on the role of cholesterol in Aβ toxicity mediated by membrane binding in the pathogenesis of AD and to consider it in the broader context of the lipid composition of cell membranes.
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López-Gambero AJ, Pacheco-Sánchez B, Rosell-Valle C, Medina-Vera D, Navarro JA, Fernández-Arjona MDM, de Ceglia M, Sanjuan C, Simon V, Cota D, Rivera P, Rodríguez de Fonseca F, Suárez J. Dietary administration of D-chiro-inositol attenuates sex-specific metabolic imbalances in the 5xFAD mouse model of Alzheimer's disease. Biomed Pharmacother 2022; 150:112994. [PMID: 35483188 DOI: 10.1016/j.biopha.2022.112994] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Revised: 04/13/2022] [Accepted: 04/17/2022] [Indexed: 11/02/2022] Open
Abstract
Increasing evidence shows that hypothalamic dysfunction, insulin resistance, and weight loss precede and progress along with the cognitive decline in sporadic Alzheimer's Disease (AD) with sex differences. This study aimed to determine the effect of oral dietary administration of D-Chiro-inositol (DCI), an inositol used against insulin resistance associated with polycystic ovary, on the occurrence of metabolic disorders in the transgenic 5xFAD mouse model of AD (FAD: Family Alzheimer's Disease). DCI was administered from 6 to 10 months of age to male and female 5xFAD mice and control (non-Tg) littermates. Energy balance and multiple metabolic and inflammatory parameters in the hypothalamus, liver and plasma were evaluated to assess the central and peripheral effects of DCI. Results indicated that weight loss and reduced food intake in 5xFAD mice were associated with decreased neuropeptides controlling food intake and the appearance of a pro-inflammatory state in the hypothalamus. Oral administration of DCI partially restored energy balance and hypothalamic parameters, highlighting an increased expression of Npy and Agrp and female-specific downregulation of Gfap and Igf1. DCI also partially normalized impaired insulin signaling and circulating insulin, GLP-1, and GIP deficiencies in 5xFAD mice. Principal component analysis of metabolic parameters indicated the presence of a female-specific fatty liver in 5xFAD mice: DCI administration reversed hepatic fat accumulation, β-oxidation, inflammation and increased GOT and GPT levels. Our study depicts that metabolic impairment along with the cognitive decline in a mouse model of AD, which is exacerbated in females, can be ameliorated by oral supplementation with insulin-sensitizing DCI.
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Affiliation(s)
- Antonio J López-Gambero
- Instituto de investigación Biomédica de Málaga-IBIMA, 29010 Málaga, Spain; UGC Salud Mental, Hospital Regional Universitario de Málaga, 29010 Málaga, Spain; Universidad de Málaga, Andalucia Tech, Departamento de Biología Celular, Genética y Fisiología, Campus de Teatinos s/n, 29071 Málaga, Spain.
| | | | | | - Dina Medina-Vera
- Instituto de investigación Biomédica de Málaga-IBIMA, 29010 Málaga, Spain; Universidad de Málaga, Andalucia Tech, Departamento de Biología Celular, Genética y Fisiología, Campus de Teatinos s/n, 29071 Málaga, Spain; Universidad de Málaga, Andalucia Tech, Facultad de Medicina, Campus de Teatinos s/n, 29071 Málaga, Spain; UGC Corazón, Hospital Universitario Virgen de la Victoria, 29010 Málaga, Spain.
| | - Juan Antonio Navarro
- Instituto de investigación Biomédica de Málaga-IBIMA, 29010 Málaga, Spain; UGC Salud Mental, Hospital Regional Universitario de Málaga, 29010 Málaga, Spain; Universidad de Málaga, Andalucia Tech, Facultad de Medicina, Campus de Teatinos s/n, 29071 Málaga, Spain.
| | - María Del Mar Fernández-Arjona
- Instituto de investigación Biomédica de Málaga-IBIMA, 29010 Málaga, Spain; UGC Salud Mental, Hospital Regional Universitario de Málaga, 29010 Málaga, Spain.
| | - Marialuisa de Ceglia
- Instituto de investigación Biomédica de Málaga-IBIMA, 29010 Málaga, Spain; UGC Salud Mental, Hospital Regional Universitario de Málaga, 29010 Málaga, Spain.
| | - Carlos Sanjuan
- EURONUTRA S.L, Parque Tecnológico de Andalucía, Campanillas, 29590, Spain.
| | - Vincent Simon
- University of Bordeaux, INSERM, Neurocentre Magendie, U1215, 33000 Bordeaux, France.
| | - Daniela Cota
- University of Bordeaux, INSERM, Neurocentre Magendie, U1215, 33000 Bordeaux, France.
| | - Patricia Rivera
- Instituto de investigación Biomédica de Málaga-IBIMA, 29010 Málaga, Spain; UGC Salud Mental, Hospital Regional Universitario de Málaga, 29010 Málaga, Spain.
| | - Fernando Rodríguez de Fonseca
- Instituto de investigación Biomédica de Málaga-IBIMA, 29010 Málaga, Spain; UGC Salud Mental, Hospital Regional Universitario de Málaga, 29010 Málaga, Spain.
| | - Juan Suárez
- Instituto de investigación Biomédica de Málaga-IBIMA, 29010 Málaga, Spain; Universidad de Málaga, Andalucia Tech, Facultad de Medicina, Campus de Teatinos s/n, 29071 Málaga, Spain; Departamento de Anatomía Humana, Medicina Legal e Historia de la Ciencia, Universidad de Málaga, 29071 Málaga, Spain.
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15
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Fu J, Huang Y, Bao T, Ou R, Wei Q, Chen Y, Yang J, Chen X, Shang H. Effects of Sex on the Relationship Between Apolipoprotein E Gene and Serum Lipid Profiles in Alzheimer’s Disease. Front Aging Neurosci 2022; 14:844066. [PMID: 35707700 PMCID: PMC9190463 DOI: 10.3389/fnagi.2022.844066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2021] [Accepted: 04/08/2022] [Indexed: 11/13/2022] Open
Abstract
Background Sex is an important factor in studying the relationship between the APOE gene, lipid profiles, and AD. However, few studies have focused on the effect of sex on lipids in AD and normal controls with different APOE genes. Materials and Methods A total of 549 participants, including 298 AD patients and 251 body mass index (BMI)-matched healthy controls (HCs), were enrolled. Lipid profiles and APOE genes in both AD patients and HCs were determined. Results (1) TC and LDL were higher in AD patients than in HCs, only in APOEε4 carrying populations, but not in non-carrying populations. (2) TC and LDL were higher in APOEε4 allele carriers than in non-carriers, only in AD populations, but not in HCs. (3) The TC of APOEε2 carriers was lower than that of non-carriers in the male AD population, but not in the female AD population, female HCs, and male HCs. (4) The increased LDL level may increase the risk of AD in female people carrying APOEε4. Conclusion The TC and LDL levels of APOEε4 carriers were higher than those of non-carriers, and the effect was more significant in the female AD population. The TC levels in APOEε2 carriers were lower than those in non-carriers, which was more significant in the male AD population.
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Affiliation(s)
- Jiajia Fu
- Laboratory of Neurodegenerative Disorders, National Clinical Research Center for Geriatrics, Department of Neurology, West China Hospital, Sichuan University, Chengdu, China
| | - Yan Huang
- Health Management Center, West China Hospital, Sichuan University, Chengdu, China
| | - Ting Bao
- Health Management Center, West China Hospital, Sichuan University, Chengdu, China
| | - Ruwei Ou
- Laboratory of Neurodegenerative Disorders, National Clinical Research Center for Geriatrics, Department of Neurology, West China Hospital, Sichuan University, Chengdu, China
| | - Qianqian Wei
- Laboratory of Neurodegenerative Disorders, National Clinical Research Center for Geriatrics, Department of Neurology, West China Hospital, Sichuan University, Chengdu, China
| | - Yongping Chen
- Laboratory of Neurodegenerative Disorders, National Clinical Research Center for Geriatrics, Department of Neurology, West China Hospital, Sichuan University, Chengdu, China
| | - Jing Yang
- Laboratory of Neurodegenerative Disorders, National Clinical Research Center for Geriatrics, Department of Neurology, West China Hospital, Sichuan University, Chengdu, China
| | - Xueping Chen
- Laboratory of Neurodegenerative Disorders, National Clinical Research Center for Geriatrics, Department of Neurology, West China Hospital, Sichuan University, Chengdu, China
- *Correspondence: Xueping Chen,
| | - Huifang Shang
- Laboratory of Neurodegenerative Disorders, National Clinical Research Center for Geriatrics, Department of Neurology, West China Hospital, Sichuan University, Chengdu, China
- Huifang Shang,
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16
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Silva NCBS, Bracko O, Nelson AR, de Oliveira FF, Robison LS, Shaaban CE, Hainsworth AH, Price BR. Vascular cognitive impairment and dementia: An early career researcher perspective. ALZHEIMER'S & DEMENTIA (AMSTERDAM, NETHERLANDS) 2022; 14:e12310. [PMID: 35496373 PMCID: PMC9043906 DOI: 10.1002/dad2.12310] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Revised: 03/16/2022] [Accepted: 03/22/2022] [Indexed: 01/07/2023]
Abstract
The field of vascular contributions to cognitive impairment and dementia (VCID) is evolving rapidly. Research in VCID encompasses topics aiming to understand, prevent, and treat the detrimental effects of vascular disease burden in the human brain. In this perspective piece, early career researchers (ECRs) in the field provide an overview of VCID, discuss past and present efforts, and highlight priorities for future research. We emphasize the following critical points as the field progresses: (a) consolidate existing neuroimaging and fluid biomarkers, and establish their utility for pharmacological and non-pharmacological interventions; (b) develop new biomarkers, and new non-clinical models that better recapitulate vascular pathologies; (c) amplify access to emerging biomarker and imaging techniques; (d) validate findings from previous investigations in diverse populations, including those at higher risk of cognitive impairment (e.g., Black, Hispanic, and Indigenous populations); and (e) conduct randomized controlled trials within diverse populations with well-characterized vascular pathologies emphasizing clinically meaningful outcomes.
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Affiliation(s)
- Nárlon C. Boa Sorte Silva
- Djavad Mowafaghian Centre for Brain HealthDepartment of Physical TherapyFaculty of MedicineThe University of British ColumbiaVancouverBritish ColumbiaCanada
| | - Oliver Bracko
- Department of BiologyThe University of MiamiCoral GablesFloridaUSA
| | - Amy R. Nelson
- Department of Physiology and Cell BiologyUniversity of South AlabamaMobileAlabamaUSA
| | | | - Lisa S. Robison
- Department of Psychology and NeuroscienceNova Southeastern UniversityFort LauderdaleFloridaUSA
| | | | - Atticus H. Hainsworth
- Molecular & Clinical Sciences Research InstituteSt George's University of London, UKDepartment of NeurologySt George's University Hospitals NHS Foundation Trust LondonLondonUK
| | - Brittani R. Price
- Department of NeuroscienceTufts University School of MedicineBostonMassachusettsUSA
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17
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de Oliveira FF, Bertolucci PHF, Chen ES, Smith MC. Pharmacogenetic Analyses of Therapeutic Effects of Lipophilic Statins on Cognitive and Functional Changes in Alzheimer’s Disease. J Alzheimers Dis 2022; 87:359-372. [DOI: 10.3233/jad-215735] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Background: Pharmacogenetic effects of statins on clinical changes in Alzheimer’s disease (AD) could be mediated by epistatic interactions among relevant genetic variants involved in cholesterol metabolism. Objective: To investigate associations of HMGCR (rs3846662), NR1H2 (rs2695121), or CETP (rs5882&rs708272) with cognitive and functional changes in AD, with stratification according to APOE ɛ4 carrier status and lipid-lowering treatment with lipophilic statins. Methods: Consecutive outpatients with late-onset AD were screened with cognitive tests, while caregivers scored functionality and global ratings, with prospective neurotranslational associations documented for one year. Results: Considering n = 190:142 had hypercholesterolemia, 139 used lipophilic statins; minor allele frequencies were 0.379 (rs2695121-T:46.3% heterozygotes), 0.368 (rs5882-G:49.5% heterozygotes), and 0.371 (rs708272-A:53.2% heterozygotes), all in Hardy-Weinberg equilibrium. For APOE ɛ4 carriers: rs5882-GG protected from cognitive decline; rs5882-AA caused faster cognitive decline; carriers of rs2695121-CC or rs5882-AA were more susceptible to harmful cognitive effects of lipophilic statins; carriers of rs5882-GG or rs708272-AG had functional benefits when using lipophilic statins. APOE ɛ4 non-carriers resisted any cognitive or functional effects of lipophilic statins, while invariability of rs3846662 (all AA) prevented the assessment of HMGCR effects. When assessing CETP haplotypes only: rs5882-GG protected from cognitive and functional decline, regardless of lipophilic statin therapy; lipophilic statins usually caused cognitive and functional harm to carriers of rs5882-A and/or rs708272-A; lipophilic statins benefitted cognition and functionality of carriers of rs5882-G and/or rs708272-G. Conclusion: Reportedly protective variants of CETP and NR1H2 also slowed cognitive and functional decline particularly for APOE ɛ4 carriers, and regardless of cholesterol variations, while therapy with lipophilic statins might affect carriers of specific genetic variants.
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Affiliation(s)
- Fabricio Ferreira de Oliveira
- Department of Morphology and Genetics and Neurosurgery, Escola Paulista de Medicina, Federal University of São Paulo (UNIFESP), São Paulo, SP, Brazil
| | | | - Elizabeth Suchi Chen
- Department of Morphology and Genetics and Neurosurgery, Escola Paulista de Medicina, Federal University of São Paulo (UNIFESP), São Paulo, SP, Brazil
| | - Marilia Cardoso Smith
- Department of Morphology and Genetics and Neurosurgery, Escola Paulista de Medicina, Federal University of São Paulo (UNIFESP), São Paulo, SP, Brazil
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18
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Jansson D, Wang M, Thomas RG, Erickson MA, Peskind ER, Li G, Iliff J. Markers of Cerebrovascular Injury, Inflammation, and Plasma Lipids Are Associated with Alzheimer's Disease Cerebrospinal Fluid Biomarkers in Cognitively Normal Persons. J Alzheimers Dis 2022; 86:813-826. [PMID: 35124650 PMCID: PMC10010435 DOI: 10.3233/jad-215400] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
BACKGROUND Alzheimer's disease (AD) is a multifactorial process that takes years to manifest clinically. We propose that brain-derived indicators of cerebrovascular dysfunction and inflammation would inform on AD-related pathological processes early in, and perhaps prior to neurodegenerative disease development. OBJECTIVE Define the relationship between cerebrospinal fluid (CSF) markers of cerebrovascular dysfunction and neuroinflammation with AD CSF biomarkers in cognitively normal individuals. METHODS Analytes were measured from CSF and plasma collected at baseline from two randomized control trials. We performed Pearson correlation analysis (adjusting for age, sex, APOE haplotype, and education) between markers of central nervous system (CNS) barrier disruption, cerebrovascular dysfunction, CSF inflammatory cytokines and chemokines, and plasma lipid levels. We then developed a statistical prediction model using machine learning to test the ability of measured CSF analytes and blood lipid profiles to predict CSF AD biomarkers (total tau, phospho-tau (181), Aβ42) in this clinical population. RESULTS Our analysis revealed a significant association between markers of CNS barrier dysfunction and markers of cerebrovascular dysfunction, acute inflammatory responses, and CSF inflammatory cytokines. There was a significant association of blood lipid profiles with cerebrovascular injury markers, and CSF inflammatory cytokine levels. Using machine learning, we show that combinations of blood lipid profiles, CSF markers of CNS barrier disruption, cerebrovascular dysfunction and CSF inflammatory cytokines predict CSF total tau, p-tau, and, to a lesser extent, Aβ42 in cognitively normal subjects. CONCLUSION This suggests that these parallel pathological processes may contribute to the development of AD-related neuropathology in the absence of clinical manifestations.
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Affiliation(s)
- Deidre Jansson
- VA Northwest Mental Illness Research, Education, and Clinical Center (MIRECC), VA Puget Sound Health Care System, Seattle, WA, USA.,Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, WA, USA
| | - Marie Wang
- VA Northwest Mental Illness Research, Education, and Clinical Center (MIRECC), VA Puget Sound Health Care System, Seattle, WA, USA.,Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, WA, USA
| | - Ronald G Thomas
- Department of Family Medicine and Public Health, University of California, San Diego, San Diego, CA, USA
| | - Michelle A Erickson
- Geriatrics Research Education and Clinical Center (GRECC), VA Puget Sound Healthcare System, Seattle, WA, USA.,Division of Gerontology and Geriatric Medicine, Department of Medicine, University of Washington School of Medicine, Seattle, WA, USA
| | - Elaine R Peskind
- VA Northwest Mental Illness Research, Education, and Clinical Center (MIRECC), VA Puget Sound Health Care System, Seattle, WA, USA.,Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, WA, USA
| | - Ge Li
- VA Northwest Mental Illness Research, Education, and Clinical Center (MIRECC), VA Puget Sound Health Care System, Seattle, WA, USA.,Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, WA, USA.,Geriatrics Research Education and Clinical Center (GRECC), VA Puget Sound Healthcare System, Seattle, WA, USA
| | - Jeffrey Iliff
- VA Northwest Mental Illness Research, Education, and Clinical Center (MIRECC), VA Puget Sound Health Care System, Seattle, WA, USA.,Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, WA, USA.,Department of Neurology, University of Washington School of Medicine, Seattle, WA, USA
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19
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Bakeberg MC, Gorecki AM, Kenna JE, Jefferson A, Byrnes M, Ghosh S, Horne MK, McGregor S, Stell R, Walters S, Mastaglia FL, Anderton RS. Elevated HDL Levels Linked to Poorer Cognitive Ability in Females With Parkinson's Disease. Front Aging Neurosci 2021; 13:656623. [PMID: 34177552 PMCID: PMC8226251 DOI: 10.3389/fnagi.2021.656623] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Accepted: 05/10/2021] [Indexed: 11/13/2022] Open
Abstract
Introduction Cholesterol levels have been associated with age-related cognitive decline, however, such an association has not been comprehensively explored in people with Parkinson's disease (PD). To address this uncertainty, the current cross-sectional study examined the cholesterol profile and cognitive performance in a cohort of PD patients. Methods Cognitive function was evaluated using two validated assessments (ACE-R and SCOPA-COG) in 182 people with PD from the Australian Parkinson's Disease Registry. Total cholesterol (TC), high-density lipoprotein (HDL), low-density lipoprotein (LDL), and Triglyceride (TRG) levels were examined within this cohort. The influence of individual lipid subfractions on domain-specific cognitive performance was investigated using covariate-adjusted generalised linear models. Results Females with PD exhibited significantly higher lipid subfraction levels (TC, HDL, and LDL) when compared to male counterparts. While accounting for covariates, HDL levels were strongly associated with poorer performance across multiple cognitive domains in females but not males. Conversely, TC and LDL levels were not associated with cognitive status in people with PD. Conclusion Higher serum HDL associates with poorer cognitive function in females with PD and presents a sex-specific biomarker for cognitive impairment in PD.
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Affiliation(s)
- Megan C Bakeberg
- Perron Institute for Neurological and Translational Science, Nedlands, WA, Australia.,Centre for Neuromuscular and Neurological Disorders, The University of Western Australia, Perth, WA, Australia
| | - Anastazja M Gorecki
- Perron Institute for Neurological and Translational Science, Nedlands, WA, Australia.,School of Biological Sciences, The University of Western Australia, Perth, WA, Australia
| | - Jade E Kenna
- Perron Institute for Neurological and Translational Science, Nedlands, WA, Australia.,Centre for Neuromuscular and Neurological Disorders, The University of Western Australia, Perth, WA, Australia
| | - Alexa Jefferson
- Perron Institute for Neurological and Translational Science, Nedlands, WA, Australia
| | - Michelle Byrnes
- Perron Institute for Neurological and Translational Science, Nedlands, WA, Australia.,Centre for Neuromuscular and Neurological Disorders, The University of Western Australia, Perth, WA, Australia
| | - Soumya Ghosh
- Perron Institute for Neurological and Translational Science, Nedlands, WA, Australia.,Centre for Neuromuscular and Neurological Disorders, The University of Western Australia, Perth, WA, Australia
| | - Malcolm K Horne
- The Florey Institute of Neuroscience and Mental Health, University of Melbourne, Parkville, VIC, Australia.,Centre for Clinical Neurosciences and Neurological Research, St Vincent's Hospital Melbourne, Fitzroy, VIC, Australia
| | - Sarah McGregor
- Centre for Clinical Neurosciences and Neurological Research, St Vincent's Hospital Melbourne, Fitzroy, VIC, Australia
| | - Rick Stell
- Perron Institute for Neurological and Translational Science, Nedlands, WA, Australia.,Centre for Neuromuscular and Neurological Disorders, The University of Western Australia, Perth, WA, Australia
| | - Sue Walters
- Perron Institute for Neurological and Translational Science, Nedlands, WA, Australia
| | - Frank L Mastaglia
- Perron Institute for Neurological and Translational Science, Nedlands, WA, Australia.,Centre for Neuromuscular and Neurological Disorders, The University of Western Australia, Perth, WA, Australia
| | - Ryan S Anderton
- Perron Institute for Neurological and Translational Science, Nedlands, WA, Australia.,Centre for Neuromuscular and Neurological Disorders, The University of Western Australia, Perth, WA, Australia.,School of Health Sciences, Institute for Health Research, The University of Notre Dame Australia, Fremantle, WA, Australia
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20
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A Negative Energy Balance Is Associated with Metabolic Dysfunctions in the Hypothalamus of a Humanized Preclinical Model of Alzheimer's Disease, the 5XFAD Mouse. Int J Mol Sci 2021; 22:ijms22105365. [PMID: 34065168 PMCID: PMC8161294 DOI: 10.3390/ijms22105365] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Revised: 05/15/2021] [Accepted: 05/16/2021] [Indexed: 12/19/2022] Open
Abstract
Increasing evidence links metabolic disorders with neurodegenerative processes including Alzheimer’s disease (AD). Late AD is associated with amyloid (Aβ) plaque accumulation, neuroinflammation, and central insulin resistance. Here, a humanized AD model, the 5xFAD mouse model, was used to further explore food intake, energy expenditure, neuroinflammation, and neuroendocrine signaling in the hypothalamus. Experiments were performed on 6-month-old male and female full transgenic (Tg5xFAD/5xFAD), heterozygous (Tg5xFAD/-), and non-transgenic (Non-Tg) littermates. Although histological analysis showed absence of Aβ plaques in the hypothalamus of 5xFAD mice, this brain region displayed increased protein levels of GFAP and IBA1 in both Tg5xFAD/- and Tg5xFAD/5xFAD mice and increased expression of IL-1β in Tg5xFAD/5xFAD mice, suggesting neuroinflammation. This condition was accompanied by decreased body weight, food intake, and energy expenditure in both Tg5xFAD/- and Tg5xFAD/5xFAD mice. Negative energy balance was associated with altered circulating levels of insulin, GLP-1, GIP, ghrelin, and resistin; decreased insulin and leptin hypothalamic signaling; dysregulation in main metabolic sensors (phosphorylated IRS1, STAT5, AMPK, mTOR, ERK2); and neuropeptides controlling energy balance (NPY, AgRP, orexin, MCH). These results suggest that glial activation and metabolic dysfunctions in the hypothalamus of a mouse model of AD likely result in negative energy balance, which may contribute to AD pathogenesis development.
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21
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Xuan K, Zhao T, Qu G, Liu H, Chen X, Sun Y. The efficacy of statins in the treatment of Alzheimer's disease: a meta-analysis of randomized controlled trial. Neurol Sci 2020; 41:1391-1404. [PMID: 31930449 DOI: 10.1007/s10072-020-04243-6] [Citation(s) in RCA: 25] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2019] [Accepted: 01/07/2020] [Indexed: 10/25/2022]
Abstract
OBJECTIVE Alzheimer's disease (AD) is a common type of dementia, which has caused heavy global economic and health burden, and the using of statins to treat AD has caused widely debated. The purpose of this meta-analysis is to explore the effect of statins in the treatment of Alzheimer's disease. METHODS Studies were retrieved by searching PubMed, Embase, Cochrane library, OvisdSP, Web of Science, Chinese Nation Knowledge Infrastructure (CNKI) and Chinese Biomedical Database (CBM) databases before March 31, 2019. We extracted the Mini-Mental State Examination (MMSE), Alzheimer's Disease Assessment Scale-cognitive (ADAS-Cog), Neuropsychiatric Inventory (NPI), Activities of Daily Living (ADL) scale score, and other information. The pooled Weighted Mean Difference (WMD) and their 95% confidence intervals (95% CI) were calculated with random effect model or fixed random effect model. RESULTS A total of nine randomized controlled trials were included that contained 1489 patients; of them, 742 patients in the statins group, 747 patients in the control group. There were nine studies used the MMSE scale, five studies used the ADAS-Cog scale, four studies used the NPI scale, and six studies used the ADL scale. Meta-analysis of the nine studies that reported the MMSE scale scores indicated that there is no significant effect of statins as compared with control group (the pooled WMD = 1.09, 95% CI, - 0.00, 2.18, p = 0.05, I2 = 87.9%). Meta-analysis of the five studies that reported the ADAS-Cog scale scores also indicated that there is no significant effect of statins as compared with control group (the pooled WMD = - 0.16, 95% CI, - 2.67, 2.36, p = 0.90, I2 = 80.1%). Meta-analysis of the four studies that reported the NPI scale scores indicated that treatment with statins could slow the rise in the NPI scale scores (the pooled WMD = - 1.16, 95% CI, - 1.88, - 0.44, p = 0.002, I2 = 45.4%). Meta-analysis of the six studies that reported the ADL scale scores indicated that treatment with statins could improve patients' daily living ability (the pooled WMD = - 4.06, 95% CI, - 6.88, - 1.24, p = 0.005, I2 = 86.7%). Results of subgroup analysis indicated that the use of statins in the short term (≤ 12 months) associated with the change of the MMSE scale scores (the pooled WMD = 1.78, 95% CI, 0.53, 3.04, p = 0.005, I2 = 79.6%). Sensitivity analysis and publication bias test were both negative, and the results were relatively reliable and stable. CONCLUSION Statins used in AD patients had beneficial effects on the scores of MMSE scale in the short term (≤ 12 months), and statins could slow the deterioration of neuropsychiatric status and significantly improve activities of daily living ability in AD patients, but statins did not show an advantage in the change of the ADAS-Cog scale scores.
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Affiliation(s)
- Kun Xuan
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Tianming Zhao
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Guangbo Qu
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Haixia Liu
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Xin Chen
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei, 230032, Anhui, China
| | - Yehuan Sun
- Department of Epidemiology and Health Statistics, School of Public Health, Anhui Medical University, No. 81 Meishan Road, Hefei, 230032, Anhui, China.
- Center for Evidence-Based Practice, Anhui Medical University, Hefei, Anhui, China.
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22
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Selected LDLR and APOE Polymorphisms Affect Cognitive and Functional Response to Lipophilic Statins in Alzheimer's Disease. J Mol Neurosci 2020; 70:1574-1588. [PMID: 32474901 DOI: 10.1007/s12031-020-01588-7] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2020] [Accepted: 05/13/2020] [Indexed: 12/14/2022]
Abstract
Effects of statins over clinical changes in Alzheimer's disease (AD) are usually non-significant, but epistatic interactions between genetic variants involved in cholesterol metabolism could be important for such effects. We aimed to investigate whether LDLR single-nucleotide polymorphisms rs11669576 (LDLR8), rs5930 (LDLR10), and rs5925 (LDLR13) are associated with cognitive and functional changes in AD, while also considering APOE haplotypes and lipid-lowering treatment with lipophilic statins for stratification. Consecutive outpatients with late-onset AD were screened with cognitive tests, while caregivers scored functionality and caregiver burden, with prospective neurotranslational correlations documented for 1 year. For 179 patients, minor allele frequencies were 0.078 for rs11669576-A (14.5% heterozygotes), 0.346 for rs5930-A (42.5% heterozygotes), and 0.444 for rs5925-C (56.4% heterozygotes), all in Hardy-Weinberg equilibrium; 134 patients had hypercholesterolemia, and 133 used lipophilic statins. Carriers of rs11669576-G had faster cognitive decline, while functional decline was slower for carriers of rs11669576-A who used lipophilic statins. APOE-ε4 carriers who also carried rs5930-AA had improved caregiver burden, while carriers of haplotypes that included rs5930-AG had worse cognitive and functional outcomes, though carriers of the A allele of rs5930 had better cognitive and functional response to lipophilic statins. APOE-ε4 non-carriers who carried rs5925-TT had slower cognitive decline, while lipophilic statins protected carriers of the other genotypes. We preliminarily conclude that reportedly protective variants of LDLR and APOE against risk of AD also slowed cognitive decline, regardless of cholesterol variations, while therapy with lipophilic statins might benefit carriers of specific genetic variants.
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23
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de Oliveira FF, Berretta JM, de Almeida Junior GV, de Almeida SS, Chen ES, Smith MC, Bertolucci PHF. Pharmacogenetic analyses of variations of measures of cardiovascular risk in Alzheimer's dementia. Indian J Med Res 2020; 150:261-271. [PMID: 31719297 PMCID: PMC6886147 DOI: 10.4103/ijmr.ijmr_1209_17] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
Background & objectives: Neurodegeneration affects blood pressure variations, while renal function and cerebral perfusion are impaired by vascular risk factors. This study was aimed to estimate variations of measures of cardiovascular risk in Alzheimer's dementia by pharmacogenetic analyses of the effects of angiotensin-converting enzyme (ACE) inhibitors and statins. Methods: Consecutive patients were prospectively followed to study variations of creatinine clearance and blood pressure for one year, estimated by correlating the effects of ACE inhibitors with the ACE Alu I/D polymorphism and genotypes or haplotypes of rs1800764 or rs4291, and the effects of statins with LDLR (low-density lipoprotein receptor) genotypes or haplotypes of rs11669576 (exon 8) or rs5930 (exon 10), or genotypes of rs2695121 (liver X receptor β gene). Variations of the coronary heart disease (CHD) risk according to these cardiovascular measures were also explored. Results: All polymorphisms of the 193 patients were in Hardy-Weinberg equilibrium. Genetic determinants of cardiovascular effects affected the individual variability of the response to ACE inhibitors and statins. ACE inhibitors, but not statins, reduced blood pressure for all patients. ACE inhibitors protected carriers of alleles that supposedly decrease serum ACE levels (rs1800764-T, rs4291-A, Alu II) regarding creatinine clearance variations (P<0.005), but carriers of Alu DD (P<0.02), rs1800764-C (P<0.05), or rs4291-AT (P<0.04) showed better blood pressure lowering effects. The presence of rs2695121-T (P=0.007) or rs5930-A (P=0.039) was associated with systolic blood pressure lowering, whereas rs5930-AA was protective against decrease in creatinine clearance (P=0.019). Statins lowered creatinine clearance for carriers of rs2695121-CT (P=0.026). Interpretation & conclusions: Pharmacological response of blood pressure and creatinine clearance to ACE inhibitors and statins may be genetically mediated.
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Affiliation(s)
- Fabricio Ferreira de Oliveira
- Department of Neurology & Neurosurgery, Escola Paulista de Medicina, Federal University of São Paulo, São Paulo, Brazil
| | - Juliana Marília Berretta
- Department of Medicine, Escola Paulista de Medicina, Federal University of São Paulo, São Paulo, Brazil
| | | | - Sandro Soares de Almeida
- Department of Biophysics, Escola Paulista de Medicina, Federal University of São Paulo, São Paulo, Brazil
| | - Elizabeth Suchi Chen
- Department of Morphology & Genetics, Escola Paulista de Medicina, Federal University of São Paulo, São Paulo, Brazil
| | - Marilia Cardoso Smith
- Department of Morphology & Genetics, Escola Paulista de Medicina, Federal University of São Paulo, São Paulo, Brazil
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24
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Kridawati A, Hardinsyah H, Sulaeman A, Rahardjo TBW, Hogervorst E. Tempe, Tofu, and Amyloid-β 1-40 Serum Levels in Ovariectomized Rats. J Alzheimers Dis 2020; 76:159-163. [PMID: 32444549 DOI: 10.3233/jad-200220] [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] [Indexed: 11/15/2022]
Abstract
BACKGROUND Estrogens have been found to reduce amyloid-β (Aβ) levels, a risk factor associated with dementia. We hypothesized that phytoestrogenic soybean products such as tempe and tofu might show similar effects. OBJECTIVE The aim of this study were to analyze the effect of tempe and tofu flour on Aβ1-40 serum levels in ovariectomized rats. METHODS This research was conducted on female Sprague Dawley rats, aged 12 months. Before the intervention rats underwent ovariectomy (OVx) and were grouped into 5 intervention groups which were given tempe flour, tofu flour, estradiol, or casein as an active control. There was also a non-OVx control group which was fed a normal diet. RESULTS The intake of tempe and tofu flour decreased Aβ serum levels in all estrogen and phytoestrogenic treatment groups, offsetting effects of OVx (but not in the casein group, where Aβ levels rise). CONCLUSION The tempe flour group showed the strongest decrease in serum Aβ levels compared to the other groups. Future studies should investigate whether tempe can reduce Aβ levels in patients with dementia.
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Affiliation(s)
- Atik Kridawati
- Public Health Science Graduate Program, Universitas Respati Indonesia, Jakarta Timur, Indonesia.,Centre for Family and Ageing Studies, Universitas Respati Indonesia, Jakarta Timur, Indonesia
| | - Hardinsyah Hardinsyah
- Department of Community Nutrition, Faculty of Human Ecology, Bogor Agricultural University, Bogor, Indonesia
| | - Ahmad Sulaeman
- Department of Community Nutrition, Faculty of Human Ecology, Bogor Agricultural University, Bogor, Indonesia
| | - Tri Budi W Rahardjo
- Centre for Family and Ageing Studies, Universitas Respati Indonesia, Jakarta Timur, Indonesia
| | - Eef Hogervorst
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
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25
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de Oliveira FF, de Almeida SS, Chen ES, Smith MC, Naffah-Mazzacoratti MDG, Bertolucci PHF. Lifetime Risk Factors for Functional and Cognitive Outcomes in Patients with Alzheimer's Disease. J Alzheimers Dis 2019; 65:1283-1299. [PMID: 30149448 DOI: 10.3233/jad-180303] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Lifetime risk factors for cognitive and functional decline in Alzheimer's disease (AD) are not fully understood, and were prospectively evaluated in patients with low mean schooling from São Paulo, Brazil. Consecutive outpatients with late-onset AD were assessed for APOE haplotypes and the following potential baseline predictors: gender, schooling, age at dementia onset, lifetime urban living and sanitary conditions, occupational complexity, cognitive and physical activities, cerebrovascular risk factors (obesity, lifetime alcohol use and smoking, length of arterial hypertension, diabetes mellitus, and a dyslipidemic profile), use of a pacemaker, creatinine clearance, body mass index, waist circumference, head traumas with unconsciousness, treated systemic bacterial infections, amount of surgical procedures under general anesthesia, and family history of AD. Participants were followed from October 2010 to May 2017 for baseline risk factor associations with time since dementia onset for Clinical Dementia Rating and Mini-Mental State Examination score changes. For 227 patients (154 women, 119 APOE ε 4 carriers), later AD onset (mean 73.60±6.4 years-old, earlier for APOE ε 4/ε 4 carriers, p < 0.001) was the only variable hastening all endpoints, baseline creatinine clearance and lifetime alcohol use were hazardous for earlier cognitive and functional endpoints, women had earlier cognitive endpoints only, and schooling had a cumulative protective effect over later cognitive endpoints, particularly for carriers of APOE ε 4. Exclusively for carriers of APOE ε 4, head traumas with unconsciousness were hazardous for earlier cognitive endpoints, while lifetime sanitary conditions were protective regarding later cognitive endpoints. Functional and cognitive outcomes in AD represent probable interactions between effects of brain reserve and cerebral perfusion over neurodegeneration.
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Affiliation(s)
- Fabricio Ferreira de Oliveira
- Department of Neurology and Neurosurgery, Escola Paulista de Medicina, Federal University of São Paulo (UNIFESP), São Paulo, SP, Brazil
| | - Sandro Soares de Almeida
- Department of Biophysics, Escola Paulista de Medicina, Federal University of São Paulo (UNIFESP), São Paulo, SP, Brazil
| | - Elizabeth Suchi Chen
- Department of Morphology and Genetics, Escola Paulista de Medicina, Federal University of São Paulo (UNIFESP), São Paulo, SP, Brazil
| | - Marilia Cardoso Smith
- Department of Morphology and Genetics, Escola Paulista de Medicina, Federal University of São Paulo (UNIFESP), São Paulo, SP, Brazil
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26
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Petek B, Villa-Lopez M, Loera-Valencia R, Gerenu G, Winblad B, Kramberger MG, Ismail MAM, Eriksdotter M, Garcia-Ptacek S. Connecting the brain cholesterol and renin-angiotensin systems: potential role of statins and RAS-modifying medications in dementia. J Intern Med 2018; 284:620-642. [PMID: 30264910 DOI: 10.1111/joim.12838] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
Millions of people worldwide receive agents targeting the renin-angiotensin system (RAS) to treat hypertension or statins to lower cholesterol. The RAS and cholesterol metabolic pathways in the brain are autonomous from their systemic counterparts and are interrelated through the cholesterol metabolite 27-hydroxycholesterol (27-OHC). These systems contribute to memory and dementia pathogenesis through interference in the amyloid-beta cascade, vascular mechanisms, glucose metabolism, apoptosis, neuroinflammation and oxidative stress. Previous studies examining the relationship between these treatments and cognition and dementia risk have produced inconsistent results. Defining the blood-brain barrier penetration of these medications has been challenging, and the mechanisms of action on cognition are not clearly established. Potential biases are apparent in epidemiological and clinical studies, such as reverse epidemiology, indication bias, problems defining medication exposure, uncertain and changing doses, and inappropriate grouping of outcomes and medications. This review summarizes current knowledge of the brain cholesterol and RAS metabolism and the mechanisms by which these pathways affect neurodegeneration. The putative mechanisms of action of statins and medications inhibiting the RAS will be examined, together with prior clinical and animal studies on their effects on cognition. We review prior epidemiological studies, analysing their strengths and biases, and identify areas for future research. Understanding the pathophysiology of the brain cholesterol system and RAS and their links to neurodegeneration has enormous potential. In future, well-designed epidemiological studies could identify potential treatments for Alzheimer's disease (AD) amongst medications that are already in use for other indications.
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Affiliation(s)
- B Petek
- Division of Neurogeriatrics, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.,Department of Neurology, University Medical Centre, Ljubljana, Slovenia.,University of Ljubljana, Ljubljana, Slovenia
| | - M Villa-Lopez
- Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | - R Loera-Valencia
- Center for Alzheimer Research, Division of Neurogeriatrics, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | - G Gerenu
- Division of Neurogeriatrics, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.,Department of Neurosciences, Biodonostia Health Research Institute, San Sebastian, Spain.,Center for Networked Biomedical Research in Neurodegenerative Diseases, CIBERNED, Health Institute Carlos III, Ministry of Economy and Competitiveness, Madrid, Spain
| | - B Winblad
- Division of Neurogeriatrics, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.,Department of Geriatric Medicine, Karolinska University Hospital, Stockholm, Sweden
| | - M G Kramberger
- Division of Neurogeriatrics, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.,Department of Neurology, University Medical Centre, Ljubljana, Slovenia.,University of Ljubljana, Ljubljana, Slovenia
| | - M-A-M Ismail
- Center for Alzheimer Research, Division of Neurogeriatrics, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.,Theme Neuro, Diseases of the Nervous System patient flow, Karolinska University Hospital, Huddinge, Sweden
| | - M Eriksdotter
- Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.,Department of Geriatric Medicine, Karolinska University Hospital, Stockholm, Sweden
| | - S Garcia-Ptacek
- Division of Clinical Geriatrics, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.,Department of Internal Medicine, Neurology Section, Södersjukhuset, Stockholm, Sweden
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27
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Lee CY, Yoon JH, Park JH, Hong JY, Sunwoo MK, Kang SY. Uric acid level may not be reduced in essential tremor. Int J Neurosci 2018; 128:1163-1167. [PMID: 29936882 DOI: 10.1080/00207454.2018.1492574] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
BACKGROUND Essential tremor is very common, but characterization is difficult because of its heterogeneity. Neuropathology is important to elucidate the characteristics of neurological disorders. However, pathological findings in essential tremor have been inconsistent among studies. Uric acid is a strong antioxidant and might be a biomarker in neurodegenerative process. We hypothesized that uric acid level would be reduced if essential tremor is a neurodegenerative disease. Our aim was to compare uric acid level between essential tremor patients and healthy individuals. METHODS This was a prospective, case-control, multicenter study with 92 essential tremor patients and 77 healthy subjects. For homogeneity, the essential tremor group was subdivided into two groups (hereditary and sporadic). Clinical and laboratory findings were compared among the essential tremor and healthy groups. RESULTS The demographic characteristics were comparable among the groups. The uric acid level was lower in the essential tremor group than in healthy subjects, but the difference did not reach statistical significance. There was a negative correlation between uric acid level and disease duration in the hereditary group (p = .046) and between uric acid level and age at onset in the sporadic group (p = .012). The mean values of total cholesterol were significantly lower in the sporadic group than in the other groups (p = .011). Total cholesterol was positively correlated with age at onset in the hereditary essential tremor group (p = .010). CONCLUSIONS We did not find any evidence that uric acid levels suggested essential tremor is a neurodegenerative disease. However, further research with more patients might be needed given the negative correlations of disease duration and age at onset with uric acid level.
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Affiliation(s)
- Chae Young Lee
- a Department of Neurology Dongtan Sacred Heart Hospital , Hallym University College of Medicine , Hwaseong , Republic of Korea
| | - Jung Han Yoon
- b Department of Neurology , Ajou University School of Medicine , Suwon , Republic of Korea
| | - Jeong-Ho Park
- c Department of Neurology, College of Medicine , Soonchunhyang University Bucheon Hospital , Bucheon , Republic of Korea
| | - Jin Yong Hong
- d Department of Neurology , Yonsei University Wonju College of Medicine , Wonju , Republic of Korea
| | - Mun Kyung Sunwoo
- e Department of Neurology , Bundang Jesaeng General Hospital , Seongnam , Republic of Korea
| | - Suk Yun Kang
- a Department of Neurology Dongtan Sacred Heart Hospital , Hallym University College of Medicine , Hwaseong , Republic of Korea
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28
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Cañete-Massé C, Peró-Cebollero M, Gudayol-Ferré E, Guàrdia-Olmos J. Longitudinal Estimation of the Clinically Significant Change in the Treatment of Major Depression Disorder. Front Psychol 2018; 9:1406. [PMID: 30127761 PMCID: PMC6088288 DOI: 10.3389/fpsyg.2018.01406] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2018] [Accepted: 07/19/2018] [Indexed: 11/13/2022] Open
Abstract
Background: Although major depressive disorder is usually treated with antidepressants, only 50-70% of the patients respond to this treatment. This study applied Jacobson and Truax's (1991) methodology (reliable change index, RCI) to a sample of depressive patients being treated with one of two antidepressants to evaluate their functioning and the effect of certain variables such as severity and age. Method: Seventy-three depressive patients medicated with Escitalopram (n = 37) or Duloxetine (n = 36) were assessed using the Hamilton depression rating scale over a 24-week period. Results: They indicate that the RCI stabilizes in an absolute way starting in week 16, and it is not until week 24 that all of the patients become part of the functional population. We found limited statistical significance with respect to the RCI and the external variables. Conclusion: Our study suggests the need to accompany the traditional statistical methodology with some other clinical estimation systems capable of going beyond a simple subtraction between pre and posttreatment values. Hence, it is concluded that RCI estimations could be stronger and more stable than the classical statistical techniques.
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Affiliation(s)
| | - Maribel Peró-Cebollero
- Facultat de Psicologia, Universitat de Barcelona, Barcelona, Spain
- Institute of Neuroscience (UB), The UB Institute of Complex Systems (UBICS), Barcelona, Spain
| | - Esteve Gudayol-Ferré
- Facultad de Psicología, Universidad Michoacana de San Nicolás de Hidalgo, Michoacan, Mexico
| | - Joan Guàrdia-Olmos
- Facultat de Psicologia, Universitat de Barcelona, Barcelona, Spain
- Institute of Neuroscience (UB), The UB Institute of Complex Systems (UBICS), Barcelona, Spain
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29
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Li R, Wang TJ, Lyu PY, Liu Y, Chen WH, Fan MY, Xu J. Effects of Plasma Lipids and Statins on Cognitive Function. Chin Med J (Engl) 2018; 131:471-476. [PMID: 29451153 PMCID: PMC5830833 DOI: 10.4103/0366-6999.225062] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2017] [Indexed: 01/09/2023] Open
Abstract
OBJECTIVE: Dementia is the fourth most common cause of death in developed countries. The relationship between plasma lipids and cognitive function is complex and controversial. Due to the increasing life expectancy of the population, there is an urgent need to control vascular risk factors and to identify therapies to prevent and treat both cognitive impairment and dementia. Here, we reviewed the effects of plasma lipids and statins on cognitive function. DATA SOURCES: We searched the PubMed database for research articles published through November 2017 with key words including "plasma lipids," "hyperlipidemia," "hypercholesterolemia," "statins," and "cognition function." STUDY SELECTION: Articles were retrieved and reviewed to analyze the effects of plasma lipids and statins on cognitive function and the mechanisms underlying these effects. RESULTS: Many studies have examined the relationship between plasma lipids and cognitive function, but no definitive conclusions can be drawn. The mechanisms involved may include blood-brain barrier injury, the influence on small blood vessels in the brain, the influence on amyloid deposition, and a neuroprotective effect. To date, most studies of statins and cognition have been observational, with few randomized controlled trials. Therefore, firm conclusions regarding whether mid- or long-term statin use affects cognition function and dementia remain elusive. However, increasing concern exists that statins may be a causative factor for cognitive problems. These adverse effects appear to be rare and likely represent a yet-to-be-defined vulnerability in susceptible individuals. CONCLUSIONS: The association between plasma lipids and cognition, the mechanism of the influence of plasma lipids on cognitive function, and the association between statins and cognitive function are complex issues and currently not fully understood. Future research aimed at identifying the mechanisms that underlie the effects of plasma lipids and statins on cognition will not only provide important insight into the causes and interdependencies of cognitive impairment and dementia, but also inspire novel strategies for treating and preventing these cognitive disorders.
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Affiliation(s)
- Rui Li
- Graduate School, Hebei Medical University, Shijiazhuang, Hebei 050017, China
| | - Tian-Jun Wang
- Department of Neurology, Hebei General Hospital, Shijiazhuang, Hebei 050051, China
| | - Pei-Yuan Lyu
- Graduate School, Hebei Medical University, Shijiazhuang, Hebei 050017, China
- Department of Neurology, Hebei General Hospital, Shijiazhuang, Hebei 050051, China
| | - Yang Liu
- Graduate School, Hebei Medical University, Shijiazhuang, Hebei 050017, China
| | - Wei-Hong Chen
- Graduate School, Hebei Medical University, Shijiazhuang, Hebei 050017, China
| | - Ming-Yue Fan
- Department of Neurology, Hebei General Hospital, Shijiazhuang, Hebei 050051, China
| | - Jing Xu
- Department of Neurology, Hebei General Hospital, Shijiazhuang, Hebei 050051, China
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30
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Alfaro FJ, Gavrieli A, Saade-Lemus P, Lioutas VA, Upadhyay J, Novak V. White matter microstructure and cognitive decline in metabolic syndrome: a review of diffusion tensor imaging. Metabolism 2018; 78:52-68. [PMID: 28920863 PMCID: PMC5732847 DOI: 10.1016/j.metabol.2017.08.009] [Citation(s) in RCA: 85] [Impact Index Per Article: 12.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2017] [Revised: 08/18/2017] [Accepted: 08/22/2017] [Indexed: 12/13/2022]
Abstract
Metabolic syndrome is a cluster of cardiovascular risk factors defined by the presence of abdominal obesity, glucose intolerance, hypertension and/or dyslipidemia. It is a major public health epidemic worldwide, and a known risk factor for the development of cognitive dysfunction and dementia. Several studies have demonstrated a positive association between the presence of metabolic syndrome and worse cognitive outcomes, however, evidence of brain structure pathology is limited. Diffusion tensor imaging has offered new opportunities to detect microstructural white matter changes in metabolic syndrome, and a possibility to detect associations between functional and structural abnormalities. This review analyzes the impact of metabolic syndrome on white matter microstructural integrity, brain structure abnormalities and their relationship to cognitive function. Each of the metabolic syndrome components exerts a specific signature of white matter microstructural abnormalities. Metabolic syndrome and its components exert both additive/synergistic, as well as, independent effects on brain microstructure thus accelerating brain aging and cognitive decline.
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Affiliation(s)
- Freddy J Alfaro
- Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, 185 Pilgrim Road, Palmer 127, Boston, MA 02215, USA.
| | - Anna Gavrieli
- Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, 185 Pilgrim Road, Palmer 127, Boston, MA 02215, USA.
| | - Patricia Saade-Lemus
- Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, 185 Pilgrim Road, Palmer 127, Boston, MA 02215, USA.
| | - Vasileios-Arsenios Lioutas
- Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, 185 Pilgrim Road, Palmer 127, Boston, MA 02215, USA.
| | - Jagriti Upadhyay
- Department of Endocrinology, Beth Israel Deaconess Medical Center, Harvard Medical School, 330 Brookline Ave, Boston, MA 02215,USA.
| | - Vera Novak
- Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, 185 Pilgrim Road, Palmer 127, Boston, MA 02215, USA.
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31
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de Oliveira FF, Pereira FV, Pivi GAK, Smith MC, Bertolucci PHF. Effects of APOE haplotypes and measures of cardiovascular risk over gender-dependent cognitive and functional changes in one year in Alzheimer's disease. Int J Neurosci 2017; 128:472-476. [DOI: 10.1080/00207454.2017.1396986] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Fabricio Ferreira de Oliveira
- Department of Neurology and Neurosurgery, Escola Paulista de Medicina, Federal University of São Paulo (UNIFESP), São Paulo, Brazil
| | - Fernando Vieira Pereira
- Department of Neurology and Neurosurgery, Escola Paulista de Medicina, Federal University of São Paulo (UNIFESP), São Paulo, Brazil
| | - Glaucia Akiko Kamikado Pivi
- Department of Neurology and Neurosurgery, Escola Paulista de Medicina, Federal University of São Paulo (UNIFESP), São Paulo, Brazil
| | - Marilia Cardoso Smith
- Department of Morphology and Genetics, Escola Paulista de Medicina, Federal University of São Paulo (UNIFESP), São Paulo, Brazil
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32
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Cognitive behavioral therapy (CBT) for preventing Alzheimer's disease. Behav Brain Res 2017; 334:163-177. [PMID: 28743599 DOI: 10.1016/j.bbr.2017.07.024] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2017] [Revised: 07/15/2017] [Accepted: 07/18/2017] [Indexed: 12/13/2022]
Abstract
This review provides the rationale for implementing cognitive behavioral therapy (CBT) for the prevention of Alzheimer's disease (AD). There are known risk factors associated with the development of AD, some of which may be ameliorated with CBT. We posit that treating the risk factors of inactivity, poor diet, hyposmia and anosmia, sleep disorders and lack of regularly engaged challenging cognitive activity will modify the physiology of the brain sufficiently to avoid the accumulation of excess proteins, including amyloid beta, causal events in the development of AD. Further, the successful treatment of the listed risk factors is well within our technology to do so and, even further, it is cost effective. Also, there is considerable scientific literature to support the proposition that, if implemented by well-established practices, CBT will be effective and will be engaged by those of retirement age. That is, we present a biologically informed CBT for the prevention of the development of AD, i.e., an aspect of applied behavioral neuroscience.
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