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Ajibo DN, Orish CN, Ruggieri F, Bocca B, Battistini B, Frazzoli C, Orish FC, Orisakwe OE. An Update Overview on Mechanistic Data and Biomarker Levels in Cobalt and Chromium-Induced Neurodegenerative Diseases. Biol Trace Elem Res 2024; 202:3538-3564. [PMID: 38017235 DOI: 10.1007/s12011-023-03965-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Accepted: 11/12/2023] [Indexed: 11/30/2023]
Abstract
There is increasing evidence that the imbalance of metals as cobalt (Co) and chromium (Cr) may increase the risk of development and progression of neurodegenerative diseases (NDDs). The human exposure to Co and Cr is derived mostly from industry, orthopedic implants, and polluted environments. Neurological effects of Co and Cr include memory deficit, olfactory dysfunction, spatial disorientation, motor neuron disease, and brain cancer. Mechanisms of Co and Cr neurotoxicity included DNA damage and genomic instability, epigenetic changes, mitochondrial disturbance, lipid peroxidation, oxidative stress, inflammation, and apoptosis. This paper seeks to overview the Co and Cr sources, the mechanisms by which these metals induce NDDs, and their levels in fluids of the general population and patients affected by NDDs. To this end, evidence of Co and Cr unbalance in the human body, mechanistic data, and neurological symptoms were collected using in vivo mammalian studies and human samples.
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Affiliation(s)
- Doris Nnena Ajibo
- Department of Experimental Pharmacology & Toxicology, Faculty of Pharmacy, University of Port Harcourt, PMB, 5323, Port Harcourt, Rivers State, Nigeria
| | - Chinna Nneka Orish
- Department of Anatomy, College of Health Sciences University of Port Harcourt, PMB, 5323, Port Harcourt, Rivers State, Nigeria
| | - Flavia Ruggieri
- Department of Environment and Health, Istituto Superiore Di Sanità, Rome, Italy
| | - Beatrice Bocca
- Department of Environment and Health, Istituto Superiore Di Sanità, Rome, Italy
| | - Beatrice Battistini
- Department of Environment and Health, Istituto Superiore Di Sanità, Rome, Italy
| | - Chiara Frazzoli
- Department for Cardiovascular, Endocrine-Metabolic Diseases, and Aging, Istituto Superiore Di Sanità, Rome Viale Regina Elena, 29900161, Rome, Italy
| | | | - Orish E Orisakwe
- Department of Experimental Pharmacology & Toxicology, Faculty of Pharmacy, University of Port Harcourt, PMB, 5323, Port Harcourt, Rivers State, Nigeria.
- African Centre of Excellence for Public Health and Toxicological Research (ACE-PUTOR), University of Port Harcourt, PMB, 5323, Port Harcourt, Rivers State, Nigeria.
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Schroevers JL, Hoevenaar-Blom MP, Busschers WB, Hollander M, Van Gool WA, Richard E, Van Dalen JW, Moll van Charante EP. Antihypertensive medication classes and risk of incident dementia in primary care patients: a longitudinal cohort study in the Netherlands. THE LANCET REGIONAL HEALTH. EUROPE 2024; 42:100927. [PMID: 38800111 PMCID: PMC11126814 DOI: 10.1016/j.lanepe.2024.100927] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/07/2023] [Revised: 04/19/2024] [Accepted: 04/19/2024] [Indexed: 05/29/2024]
Abstract
Background Hypertension is a modifiable risk factor for dementia affecting over 70% of individuals older than 60. Lowering dementia risk through preferential treatment with antihypertensive medication (AHM) classes that are otherwise equivalent in indication could offer a cost-effective, safe, and accessible approach to reducing dementia incidence globally. Certain AHM-classes have been associated with lower dementia risk, potentially attributable to angiotensin-II-receptor (Ang-II) stimulating properties. Previous study results have been inconclusive, possibly due to heterogeneous methodology and limited power. We aimed to comprehensively investigate associations between AHM (sub-)classes and dementia risk using large-scale continuous, real-world prescription and outcome data from primary care. Methods We used data from three Dutch General Practice Registration Networks. Primary endpoints were clinical diagnosis of incident all-cause dementia and mortality. Using Cox regression analysis with time-dependent covariates, we compared the use of angiotensin-converting enzyme inhibitors (ACEi) to angiotensin receptor blockers (ARBs), beta blockers, calcium channel blockers (CCBs), and diuretics; and Ang-II-stimulating- to Ang-II-inhibiting AHM. Findings Of 133,355 AHM-using participants, 5877 (4.4%) developed dementia, and 14,079 (10.6%) died during a median follow-up of 7.6 [interquartile range = 4.1-11.0] years. Compared to ACEi, ARBs [HR = 0.86 (95% CI = 0.80-0.92)], beta blockers [HR = 0.81 (95% CI = 0.75-0.87)], CCBs [HR = 0.77 (95% CI = 0.71-0.84)], and diuretics [HR = 0.65 (95% CI = 0.61-0.70)] were associated with significantly lower dementia risks. Regarding competing risk of death, beta blockers [HR = 1.21 (95% CI = 1.15-1.27)] and diuretics [HR = 1.69 (95% CI = 1.60-1.78)] were associated with higher, CCBs with similar, and ARBs with lower [HR = 0.83 (95% CI = 0.80-0.87)] mortality risk. Dementia [HR = 0.88 (95% CI = 0.82-0.95)] and mortality risk [HR = 0.86 (95% CI = 0.82-0.91)] were lower for Ang-II-stimulating versus Ang-II-inhibiting AHM. There were no interactions with sex, diabetes, cardiovascular disease, and number of AHM used. Interpretation Among patients receiving AHM, ARBs, CCBs, and Ang-II-stimulating AHM were associated with lower dementia risk, without excess mortality explaining these results. Extensive subgroup and sensitivity analyses suggested that confounding by indication did not importantly influence our findings. Dementia risk may be influenced by AHM-classes' angiotensin-II-receptor stimulating properties. An RCT comparing BP treatment with different AHM classes with dementia as outcome is warranted. Funding Netherlands Organisation for Health, Research and Development (ZonMw); Stoffels-Hornstra Foundation.
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Affiliation(s)
- Jakob L. Schroevers
- Department of General Practice, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, the Netherlands
| | - Marieke P. Hoevenaar-Blom
- Department of General Practice, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, the Netherlands
- Department of Public & Occupational Health, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, the Netherlands
| | - Wim B. Busschers
- Department of General Practice, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, the Netherlands
| | - Monika Hollander
- Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Universiteitsweg 100, 3584 CG, Utrecht, the Netherlands
| | - Willem A. Van Gool
- Department of Public & Occupational Health, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, the Netherlands
| | - Edo Richard
- Department of Public & Occupational Health, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, the Netherlands
- Department of Neurology, Donders Institute for Brain, Cognition, and Behaviour, Radboud University Medical Center, Geert Grooteplein Zuid 10, 6525 GA, Nijmegen, the Netherlands
| | - Jan Willem Van Dalen
- Department of Neurology, Donders Institute for Brain, Cognition, and Behaviour, Radboud University Medical Center, Geert Grooteplein Zuid 10, 6525 GA, Nijmegen, the Netherlands
- Department of Neurology, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, the Netherlands
| | - Eric P. Moll van Charante
- Department of General Practice, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, the Netherlands
- Department of Public & Occupational Health, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, the Netherlands
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Gendron WH, Fertan E, Roddick KM, Wong AA, Maliougina M, Hiani YE, Anini Y, Brown RE. Intranasal insulin treatment ameliorates spatial memory, muscular strength, and frailty deficits in 5xFAD mice. Physiol Behav 2024; 281:114583. [PMID: 38750806 DOI: 10.1016/j.physbeh.2024.114583] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Revised: 05/11/2024] [Accepted: 05/13/2024] [Indexed: 05/19/2024]
Abstract
The 5xFAD mouse model shows age-related weight loss as well as cognitive and motor deficits. Metabolic dysregulation, especially impaired insulin signaling, is also present in AD. This study examined whether intranasal delivery of insulin (INI) at low (0.875 U) or high (1.750 U) doses would ameliorate these deficits compared to saline in 10-month-old female 5xFAD and B6SJL wildtype (WT) mice. INI increased forelimb grip strength in the wire hang test in 5xFAD mice in a dose-dependent manner but did not improve the performance of 5xFAD mice on the balance beam. High INI doses reduced frailty scores in 5xFAD mice and improved spatial memory in both acquisition and reversal probe trials in the Morris water maze. INI increased swim speed in 5xFAD mice but had no effect on object recognition memory or working memory in the spontaneous alternation task, nor did it improve memory in the contextual or cued fear memory tasks. High doses of insulin increased the liver, spleen, and kidney weights and reduced brown adipose tissue weights. P-Akt signaling in the hippocampus was increased by insulin in a dose-dependent manner. Altogether, INI increased strength, reduced frailty scores, and improved visual spatial memory. Hypoglycemia was not present after INI, however alterations in tissue and organ weights were present. These results are novel and important as they indicate that intra-nasal insulin can reverse cognitive, motor and frailty deficits found in this mouse model of AD.
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Affiliation(s)
- William H Gendron
- Departments of Psychology and Neuroscience, Dalhousie University, Halifax, Nova Scotia B3H 4R2, Canada
| | - Emre Fertan
- Departments of Psychology and Neuroscience, Dalhousie University, Halifax, Nova Scotia B3H 4R2, Canada
| | - Kyle M Roddick
- Departments of Psychology and Neuroscience, Dalhousie University, Halifax, Nova Scotia B3H 4R2, Canada
| | - Aimée A Wong
- Departments of Psychology and Neuroscience, Dalhousie University, Halifax, Nova Scotia B3H 4R2, Canada
| | - Maria Maliougina
- Departments of Physiology and Biophysics, Dalhousie University, Halifax, Nova Scotia B3H 4R2, Canada
| | - Yassine El Hiani
- Departments of Physiology and Biophysics, Dalhousie University, Halifax, Nova Scotia B3H 4R2, Canada
| | - Younes Anini
- Departments of Physiology and Biophysics, Dalhousie University, Halifax, Nova Scotia B3H 4R2, Canada; Departments of Obstetrics and Gynecology, Dalhousie University, Halifax, Nova Scotia B3H 4R2, Canada
| | - Richard E Brown
- Departments of Psychology and Neuroscience, Dalhousie University, Halifax, Nova Scotia B3H 4R2, Canada; Departments of Physiology and Biophysics, Dalhousie University, Halifax, Nova Scotia B3H 4R2, Canada.
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Cao B, Zeng M, Hao F, Hao Z, Liang X, Zhang Z, Wu Y, Zhang Y, Wang R, Feng W, Zheng X. Cornus officinalis Sieb. Et Zucc. attenuates Aβ 25-35-induced mitochondrial damage and neuroinflammation in mice by modulating the ERK pathway. PHYTOMEDICINE : INTERNATIONAL JOURNAL OF PHYTOTHERAPY AND PHYTOPHARMACOLOGY 2024; 129:155709. [PMID: 38735197 DOI: 10.1016/j.phymed.2024.155709] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Revised: 02/14/2024] [Accepted: 05/02/2024] [Indexed: 05/14/2024]
Abstract
BACKGROUND Cornus officinalis Sieb. Et Zucc. has the efficacy of tonifying the marrow and filling up the essence, breaking up the accumulation and opening up the orifices. Our research team found that CoS extracts were protective against Aβ25-35-induced memory impairment in mice. However, the pharmacodynamic components and mechanisms by which CoS improves AD have yet to be thoroughly explored and investigated. PURPOSE This study focused on exploring the bioactive components and pharmacodynamic mechanisms of CoS aqueous extract underlying mitochondrial damage and neuroinflammation to improve Aβ25-35-induced AD. METHODS AD mouse models were generated using Aβ25-35 brain injections. Different doses of CoS aqueous extract were orally administered to mice for 28 days. The cognitive function, neuronal and synaptic damage, mitochondrial damage (mitochondrial length, mitochondrial fusion fission-related protein expression), neuroglial activation, and immune inflammatory factor and ERK pathway-related protein levels of mice were assessed. The CoS aqueous extracts components were identified using UPLC-TQ/MS and screened for cellular activity. Midivi-1 (Drp1 inhibitor) or PD98059 (ERK inhibitor) was added to Aβ25-35-exposed PC12 cells to assess whether CoS and its active compounds mMorB and CorE regulate mitochondrial fission through ERK/Drp1. PC12-N9 cells were cocultured to investigate whether mMorB and CorE could regulate mitochondrial division through the ERK pathway to modulate neuroinflammation. RESULTS CoS improved exploration and memory in AD mice, reduced synaptic and mitochondrial damage in their hippocampus, and modulated disturbed mitochondrial dynamics. Moreover, CoS inhibited ERK pathway signaling and attenuated abnormal activation of glial cells and secondary immune inflammatory responses. Additionally, in vitro experiments revealed that CoS and its compounds 7β-O-methylmorroniside (mMorB) and Cornusdiridoid E (CorE) ameliorated mitochondrial injury caused by Aβ25-35 in PC12 cells through inhibition of the ERK/Drp1 pathway. Meanwhile, mMorB and CorE ameliorated cellular inflammation by inhibiting the Ras/ERK/CREB signaling pathway. CONCLUSION CoS aqueous extract ameliorates behavioral deficits and brain damage in Aβ25-35-induced AD mice by modulating the ERK pathway to attenuate mitochondrial damage and neuroinflammation, and the compounds mMorB and CorE are the therapeutically active ingredients.
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Affiliation(s)
- Bing Cao
- College of Pharmacy, Henan University of Chinese Medicine, Zhengzhou, China; The Engineering and Technology Center for Chinese Medicine Development of Henan Province, Zhengzhou, China
| | - Mengnan Zeng
- College of Pharmacy, Henan University of Chinese Medicine, Zhengzhou, China; The Engineering and Technology Center for Chinese Medicine Development of Henan Province, Zhengzhou, China
| | - Fengxiao Hao
- College of Pharmacy, Henan University of Chinese Medicine, Zhengzhou, China; The Engineering and Technology Center for Chinese Medicine Development of Henan Province, Zhengzhou, China
| | - Zhiyou Hao
- College of Pharmacy, Henan University of Chinese Medicine, Zhengzhou, China; The Engineering and Technology Center for Chinese Medicine Development of Henan Province, Zhengzhou, China
| | - Xiwen Liang
- College of Pharmacy, Henan University of Chinese Medicine, Zhengzhou, China; The Engineering and Technology Center for Chinese Medicine Development of Henan Province, Zhengzhou, China
| | - Zhenkai Zhang
- College of Pharmacy, Henan University of Chinese Medicine, Zhengzhou, China; The Engineering and Technology Center for Chinese Medicine Development of Henan Province, Zhengzhou, China
| | - Yuanyuan Wu
- College of Pharmacy, Henan University of Chinese Medicine, Zhengzhou, China; The Engineering and Technology Center for Chinese Medicine Development of Henan Province, Zhengzhou, China
| | - Yuhan Zhang
- College of Pharmacy, Henan University of Chinese Medicine, Zhengzhou, China; The Engineering and Technology Center for Chinese Medicine Development of Henan Province, Zhengzhou, China
| | - Ru Wang
- College of Pharmacy, Henan University of Chinese Medicine, Zhengzhou, China; The Engineering and Technology Center for Chinese Medicine Development of Henan Province, Zhengzhou, China
| | - Weisheng Feng
- College of Pharmacy, Henan University of Chinese Medicine, Zhengzhou, China; The Engineering and Technology Center for Chinese Medicine Development of Henan Province, Zhengzhou, China; Co-Construction Collaborative Innovation Center for Chinese Medicine and Respiratory Diseases by Henan & Education Ministry of PR China, China.
| | - Xiaoke Zheng
- College of Pharmacy, Henan University of Chinese Medicine, Zhengzhou, China; The Engineering and Technology Center for Chinese Medicine Development of Henan Province, Zhengzhou, China; Co-Construction Collaborative Innovation Center for Chinese Medicine and Respiratory Diseases by Henan & Education Ministry of PR China, China.
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Anindya K, Zhao Y, Hoang T, Lee JT, Juvekar S, Krishnan A, Mbuma V, Sharma T, Ng N. Interrelationships between physical multimorbidity, depressive symptoms and cognitive function among older adults in China, India and Indonesia: A four-way decomposition analysis. Arch Gerontol Geriatr 2024; 122:105386. [PMID: 38640878 DOI: 10.1016/j.archger.2024.105386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2023] [Revised: 02/07/2024] [Accepted: 02/23/2024] [Indexed: 04/21/2024]
Abstract
OBJECTIVE This paper explores the role of depressive symptoms (mediator/moderator) in the association between physical multimorbidity (exposure) and cognitive function (outcome) among older adults in the three most populous middle-income countries. METHODS This study used cross-sectional data from China (2015 China Health and Retirement Longitudinal Study), India (2017/2018 Longitudinal Ageing Study in India), and Indonesia (2014/2015 Indonesian Family Life Survey), with a total sample of 73,199 respondents aged ≥ 45 years. Three domains of cognitive tests were harmonised across surveys, including time orientation, word recall, and numeracy. The four-way decomposition analysis assessed the mediation and interaction effects between exposure, mediator/moderator, and outcome, adjusted for covariates. RESULTS The mean age of the respondents (in years) was slightly younger in Indonesia (56.0, SD = 8.8) than in China (59.5, SD = 9.3) and India (60.0, SD = 10.5). The proportion of male respondents was 49.3 % in China, 47.3 % in India, and 47.5 % in Indonesia. Respondents in China had the highest mean cognitive function z scores (54.7, SD = 19.9), followed by India (51.1, SD = 20.0) and Indonesia (51.0, SD = 18.4). Physical multimorbidity was associated with lower cognitive function in China and India (p < 0.0001), with 48.4 % and 40.0 % of the association explained by the mediating effect of depressive symptoms ('overall proportion due to mediation'). The association was not found in Indonesia. CONCLUSION Cognitive functions were lower among individuals with physical multimorbidity, and depressive symptoms mainly explained the association. Addressing depressive symptoms among persons with physical multimorbidity is likely to have not only an impact on their mental health but could prevent cognitive decline.
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Affiliation(s)
- Kanya Anindya
- School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
| | - Yang Zhao
- The George Institute for Global Health, Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia; The George Institute for Global Health at Peking University Health Science Center, Beijing, China
| | - Thanh Hoang
- School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - John Tayu Lee
- Nossal Institute for Global Health, The University of Melbourne, Melbourne, Australia; Department of Primary Care and Public Health, School of Public Health, Imperial College London, United Kingdom; College of Health and Medicine, Australian National University, Canberra, Australia
| | - Sanjay Juvekar
- Vadu Rural Health Program, KEM Hospital Research Centre, Pune, India
| | - Anand Krishnan
- Centre for Community Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Vanessa Mbuma
- School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Tarishi Sharma
- School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Nawi Ng
- School of Public Health and Community Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
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Funghi G, Meli C, Cavagna A, Bisoffi L, Zappini F, Papagno C, Dodich A. The Social and Cognitive Online Training (SCOT) project: A digital randomized controlled trial to promote socio-cognitive well-being in older adults. Arch Gerontol Geriatr 2024; 122:105405. [PMID: 38531149 DOI: 10.1016/j.archger.2024.105405] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Revised: 02/28/2024] [Accepted: 03/04/2024] [Indexed: 03/28/2024]
Abstract
OBJECTIVES Effective prevention programs targeting risk factors for cognitive decline in the elderly are recommended given the progressive increase in the aging of the general population. The Social and Cognitive Online Training (SCOT) project is a randomized, controlled, parallel clinical trial designed to prevent the age-related decline in executive and social functions. METHODS The study included 60 cognitively healthy older adults (age = 71.8±5.3, education = 12.3±3.7, MoCA = 25.1±2.4). Participants underwent a baseline clinical and neuropsychological assessment and were then assigned to either an experimental group (SCOT) or a non-specific cognitive training group (CON). Both 8-week digital interventions included two individual cognitive training sessions and one group meeting per week. Post-intervention assessment evaluated the efficacy of the training on specific outcome measures: the Tower of London for executive functioning, the Ekman-60 Faces test, and the Mini-Social cognition & Emotional Assessment battery for social cognition. A measure of loneliness was included as an exploratory outcome. RESULTS Baseline demographic and neuropsychological characteristics were balanced between SCOT (n = 29) and CON (n = 28) groups. Pre-post-intervention analyses showed improvements in executive functioning and social cognition in both groups, without significant interaction effects. Exploratory post-hoc analyses stratifying the SCOT group by training performance showed significant post-training improvements in executive functioning, emotion recognition, and cognitive theory of mind for high-performing participants. DISCUSSION Results provide preliminary evidence for the beneficial effects of SCOT training, particularly for those who performed best during the training. The SCOT training could represent a new intervention to promote socio-cognitive well-being in the context of active ageing and dementia prevention.
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Affiliation(s)
- Giulia Funghi
- Center for Mind/Brain Sciences-CIMeC, University of Trento, Rovereto, Italy
| | - Claudia Meli
- Center for Mind/Brain Sciences-CIMeC, University of Trento, Rovereto, Italy
| | - Arianna Cavagna
- Center for Mind/Brain Sciences-CIMeC, University of Trento, Rovereto, Italy
| | - Lisa Bisoffi
- Center for Mind/Brain Sciences-CIMeC, University of Trento, Rovereto, Italy
| | - Francesca Zappini
- Center for Mind/Brain Sciences-CIMeC, University of Trento, Rovereto, Italy
| | - Costanza Papagno
- Center for Mind/Brain Sciences-CIMeC, University of Trento, Rovereto, Italy
| | - Alessandra Dodich
- Center for Mind/Brain Sciences-CIMeC, University of Trento, Rovereto, Italy.
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Hillari L, Frank P, Cadar D. Systemic inflammation, lifestyle behaviours and dementia: A 10-year follow-up investigation. Brain Behav Immun Health 2024; 38:100776. [PMID: 38706574 PMCID: PMC11068506 DOI: 10.1016/j.bbih.2024.100776] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2023] [Revised: 03/17/2024] [Accepted: 04/16/2024] [Indexed: 05/07/2024] Open
Abstract
Objectives Lifestyle behaviours have been linked to dementia incidence, but their cumulative impact on dementia and the underlying mechanisms remain poorly understood. This study investigated the association of co-occurring lifestyle behaviours with dementia incidence and the mediating role of systemic inflammation in this association. Methods The sample comprised 3131 participants (55.2% female) from the English Longitudinal Study of Ageing aged 52-92 years at baseline (2008/09). Self-reported baseline lifestyle behaviours (alcohol intake, fruit and vegetable consumption, smoking, physical activity, sleep duration, social engagement, and cognitive activity) were summed to derive an index of lifestyle behaviours, ranging from 0 to 7, with higher scores denoting a higher number of health-risk behaviours. Incident dementia cases (n = 130, 4.2%) were identified through doctor-diagnosed dementia, informant interviews, and health records between 2014/15 and 2018/19. Systemic inflammation was measured through fasting plasma concentrations of C-reactive protein in 2012/13. Results Binary logistic regression models indicated that the odds of subsequent dementia increased by 1.19 for each additional health-risk behaviour (95% confidence intervals: 1.04, 1.37, p = 0.014) after adjusting for age, sex, ethnicity, wealth, education, marital status, body mass index, coronary heart disease, hypertension, stroke, and depression. However, this association was not mediated by C-reactive protein. Conclusions Co-occurring health-risk behaviours were associated with higher dementia incidence up to 10 years later, underscoring the importance of modifying health-risk behaviours for the prevention of dementia. Systemic inflammation did not explain the association between behaviours and dementia.
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Affiliation(s)
- Leah Hillari
- Behavioural Science and Health, University College London, London, UK
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
| | - Philipp Frank
- Behavioural Science and Health, University College London, London, UK
- UCL Brain Sciences, University College London, London, UK
| | - Dorina Cadar
- Behavioural Science and Health, University College London, London, UK
- Centre for Dementia Studies, Brighton and Sussex Medical School, Brighton, UK
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Wang L, Li M, Liu B, Zheng R, Zhang X, Yu S. miR-30a-5p mediates ferroptosis of hippocampal neurons in chronic cerebral hypoperfusion-induced cognitive dysfunction by modulating the SIRT1/NRF2 pathway. Brain Res Bull 2024; 212:110953. [PMID: 38636610 DOI: 10.1016/j.brainresbull.2024.110953] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2024] [Revised: 04/07/2024] [Accepted: 04/16/2024] [Indexed: 04/20/2024]
Abstract
OBJECTIVE Chronic cerebral hypoperfusion (CCH) is a common cause of brain dysfunction. As a microRNA (also known as miRNAs or miRs), miR-30a-5p participates in neuronal damage and relates to ferroptosis. We explored the in vivo and in vitro effects and functional mechanism of miR-30a-5p in CCH-triggered cognitive impairment through the silent information regulator 1 (SIRT1)/nuclear factor erythroid 2-related factor 2 (NRF2) pathway. METHODS After 1 month of CCH modeling through bilateral common carotid artery stenosis, mice were injected with 2 μL antagomir (also known as anti-miRNAs) miR-30a-5p, with cognitive function evaluated by Morris water maze and novel object recognition tests. In vitro HT-22 cell oxygen glucose deprivation (OGD) model was established, followed by miR-30a-5p inhibitor and/or si-SIRT1 transfections, with Fe2+ concentration, malonaldehyde (MDA) and glutathione (GSH) contents, reactive oxygen species (ROS), miR-30a-5p and SIRT1 and glutathione peroxidase 4 (GPX4) protein levels, NRF2 nuclear translocation, and miR-30a-5p-SIRT1 targeting relationship assessed. RESULTS CCH-induced mice showed obvious cognitive impairment, up-regulated miR-30a-5p, and down-regulated SIRT1. Ferroptosis occurred in hippocampal neurons, manifested by elevated Fe2+ concentration and ROS and MDA levels, mitochondrial atrophy, and diminished GSH content. Antagomir miR-30a-5p or miR-30a-5p inhibitor promoted SIRT1 expression and NRF2 nuclear translocation, increased GPX4, cell viability and GSH content, and reduced Fe2+ concentration and ROS and MDA levels. miR-30a-5p negatively regulated SIRT1. In vitro, miR-30a-5p knockout increased NRF2 nuclear translocation by up-regulating SIRT1, inhibiting OGD-induced ferroptosis in HT-22 cells. CONCLUSION miR-30a-5p induces hippocampal neuronal ferroptosis and exacerbates post-CCH cognitive dysfunction by targeting SIRT1 and reducing NRF2 nuclear translocation.
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Affiliation(s)
- Lihua Wang
- Department of Neurology, The Second Affiliated Hospital of Harbin Medical University, 246 Xuefu Road, Nangang District, Harbin, Heilongjiang 150086, China.
| | - Mingjie Li
- Department of Neurology, The Second Affiliated Hospital of Harbin Medical University, 246 Xuefu Road, Nangang District, Harbin, Heilongjiang 150086, China
| | - Bing Liu
- Department of Neurology, The Second Affiliated Hospital of Harbin Medical University, 246 Xuefu Road, Nangang District, Harbin, Heilongjiang 150086, China
| | - Ruihan Zheng
- Department of Neurology, The Second Affiliated Hospital of Harbin Medical University, 246 Xuefu Road, Nangang District, Harbin, Heilongjiang 150086, China
| | - Xinyi Zhang
- Department of Neurology, The Second Affiliated Hospital of Harbin Medical University, 246 Xuefu Road, Nangang District, Harbin, Heilongjiang 150086, China
| | - Shuoyi Yu
- Department of Neurology, The Second Affiliated Hospital of Harbin Medical University, 246 Xuefu Road, Nangang District, Harbin, Heilongjiang 150086, China
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Frndak S, Deng Z, Ward-Caviness CK, Gorski-Steiner I, Thorpe RJ, Dickerson AS. Risk of dementia due to Co-exposure to air pollution and neighborhood disadvantage. ENVIRONMENTAL RESEARCH 2024; 251:118709. [PMID: 38493859 DOI: 10.1016/j.envres.2024.118709] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/11/2023] [Revised: 03/06/2024] [Accepted: 03/11/2024] [Indexed: 03/19/2024]
Abstract
BACKGROUND Co-exposure to air pollution and neighborhood disadvantage may influence cognition decline. We tested these associations in the context of dementia risk. METHODS We leveraged a cohort of adults ≥65 years (n = 5397) enrolled from 2011 to 2018 in the National Health and Aging Trends Study (NHATS). Particulate matter (PM) ≤ 10 μm in diameter, PM ≤ 2.5 μm in diameter, carbon monoxide, nitric oxide, and nitrogen dioxide - and neighborhood disadvantage were tested for joint associations with dementia risk. Pollutant concentrations at the 2010 census tract level were assigned using the US Environmental Protection Agency's Community Multiscale Air Quality Modeling System. Neighborhood disadvantage was defined using the tract Social Deprivation Index (SDI). Dementia was determined through self- or proxy-report or scores indicative of "probable dementia" according to NHATS screening tools. Joint effects of air pollutants and SDI were tested using quantile g-computation Cox proportional hazards models. We also stratified joint air pollution effects across SDI tertiles. Analyses adjusted for age at enrollment, sex, education, partner status, urbanicity, income, race and ethnicity, years at residence, census segregation, and census region. RESULTS SDI score (aHR = 1.08; 95% CI 0.96, 1.22), joint air pollution (aHR = 1.03, 95% CI 0.92, 1.16) and joint SDI with air pollution (aHR = 1.04, 95% CI 0.89, 1.22) were not associated with dementia risk. After accounting for competing risk of death, joint SDI with air pollution was not associated with dementia risk (aHR = 1.06; 95% CI 0.87, 1.29). In stratified models, joint air pollution was associated with greater risk of dementia at high (aHR = 1.19; 95% CI 0.87, 1.63), but not at medium or low SDI. CONCLUSION Air pollution was associated with greater dementia risk in disadvantaged areas after accounting for competing risks. Air pollution associations with dementia incidence may be attenuated when other risk factors are more prominent in disadvantaged neighborhoods.
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Affiliation(s)
- Seth Frndak
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, USA.
| | - Zhengyi Deng
- Department of Urology, Stanford School of Medicine, USA
| | - Cavin K Ward-Caviness
- Center for Public Health and Environmental Assessment, US Environmental Protection Agency, USA
| | - Irena Gorski-Steiner
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, USA
| | - Roland J Thorpe
- Department of Health, Behavior and Society, Johns Hopkins Bloomberg School of Public Health, USA; Hopkins Center for Health Disparities Solutions, Johns Hopkins Bloomberg School of Public Health, USA; Johns Hopkins Alzheimer's Disease Resource Center for Minority Aging Research, USA
| | - Aisha S Dickerson
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, USA; Hopkins Center for Health Disparities Solutions, Johns Hopkins Bloomberg School of Public Health, USA
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Ren ZL, Zhou HH, Chen CP, He H, Wang DL, Liu Z. Causal relationships between gut microbiota and dementia: A two-sample, bidirectional, Mendelian randomization study. World J Clin Cases 2024; 12:2780-2788. [DOI: 10.12998/wjcc.v12.i16.2780] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2024] [Revised: 03/19/2024] [Accepted: 04/09/2024] [Indexed: 05/29/2024] Open
Abstract
BACKGROUND Existing evidence suggests that gut microbiota represent a significant environmental risk factor for various forms of dementia, including Alzheimer's dementia, vascular dementia, and dementia in other diseases classified elsewhere. However, the exact causal relationships between gut microbiota and the different forms of dementia or their subtypes remain unclear.
AIM To investigate putative causal relationships between gut microbiota and dementia or its subtypes using Mendelian randomization (MR) analysis.
METHODS A bidirectional, two-sample, MR analysis was conducted utilizing publicly available gut microbiota-related genome-wide association study (GWAS) summary data from the MiBioGen consortium alongside GWAS summary statistics for dementia and its subtypes from the FinnGen consortium. Instrumental variables were selected according to the fundamental tenets of MR and their strengths were evaluated using the F-statistic. Five MR methods were employed, and the robustness of our findings was validated. To account for multiple comparisons, we applied the Bonferroni method for P-value adjustment.
RESULTS We identified several gut microbiota taxa exhibiting putative causal relationships with dementia or its subtypes, potentially serving as risk or protective factors for the disease. In addition, reverse MR analysis indicated that the relative abundance of several gut microbiota taxa might be influenced by dementia or its subtypes. An exhaustive sensitivity analysis confirmed the absence of heterogeneity and horizontal pleiotropy. After applying correction for multiple testing, we observed that the order Bacillales (odds ratio: 0.830, 95% confidence interval: 0.740-0.932, P = 0.00155, Padjust = 0.0311) exhibited a strong association with Alzheimer’s disease-related dementia.
CONCLUSION The results suggest that gut microbiota is causally associated with dementia. Our findings provide novel insights into the pathophysiology of dementia and have important implications for its treatment and prevention.
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Affiliation(s)
- Zhao-Lin Ren
- Department of Neurology, The Affiliated Hospital of Guangdong Medical University, Zhanjiang 524000, Guangdong Province, China
| | - Hai-Hong Zhou
- Department of Neurology, The Affiliated Hospital of Guangdong Medical University, Zhanjiang 524000, Guangdong Province, China
| | - Chu-Pei Chen
- Department of Clinical Medicine, Guangdong Medical University, Zhanjiang 524000, Guangdong Province, China
| | - Hao He
- Department of Neurology, The Affiliated Hospital of Guangdong Medical University, Zhanjiang 524000, Guangdong Province, China
| | - Duo-Lao Wang
- Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool L693BX, United Kingdom
| | - Zhou Liu
- Department of Neurology, The Affiliated Hospital of Guangdong Medical University, Zhanjiang 524000, Guangdong Province, China
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11
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Burrell LV, Døhl Ø, Rostoft S, Berggaard N, Antonova I, Johanne Landsjøåsen Bakken I. Disability level and use of long-term care services in Norway: a nation-wide registry study. Scand J Public Health 2024:14034948241251914. [PMID: 38835190 DOI: 10.1177/14034948241251914] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/06/2024]
Abstract
AIMS In Norway, disability level is an important criterion when deciding the type and level of long-term care services. Each care recipient can be scored on 20 different disability level measures. Our aims were to investigate completeness in disability level information in the Norwegian Registry of Primary Health Care (NRPHC), to group disability level measures into meaningful groups, and to study the relationship between grouped disability scores and the type of services received. METHODS We retrieved information on type of care and disability level from the NRPHC on individuals who received long-term care services in 2022. Type of care was divided into hierarchical and mutually exclusive groups, with long-term institutional care as the most complex service group. We used principal components analysis to summarise and visualise the information in the 20 different disability level measures, and to create grouped scores. RESULTS A total of 386,697 persons aged 0-104 years were registered as recipients of long-term care services in Norway on 31 December 2022. Information on disability measures were of high completeness (72.4 % of the population were registered with all 20 measures) but was lower for younger age groups in which the number of recipients was lower. Principal components analyses identified two groups of measures, which we termed physical and cognitive functioning. Physical and cognitive functioning were poorest for individuals receiving the most complex and extensive services. CONCLUSIONS NRPHC disability data are reasonably complete, the 20 measures readily fall into two distinct categories, and seem to reflect real life differences in disability.
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Affiliation(s)
| | - Øystein Døhl
- Department of Finance, Trondheim Municipality, Norway
- Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology, Norway
| | - Siri Rostoft
- Department of Geriatric Medicine, Oslo University Hospital, Norway
- Institute of Clinical Medicine, University of Oslo, Norway
| | - Nina Berggaard
- Division of Health Data and Digitalisation, Norwegian Institute of Public Health, Norway
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12
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Ma BQ, Jia JX, Wang H, Li SJ, Yang ZJ, Wang XX, Yan XS. Cannabidiol improves the cognitive function of SAMP8 AD model mice involving the microbiota-gut-brain axis. JOURNAL OF TOXICOLOGY AND ENVIRONMENTAL HEALTH. PART A 2024; 87:471-479. [PMID: 38590254 DOI: 10.1080/15287394.2024.2338914] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/10/2024]
Abstract
Cannabidiol (CBD), a natural component extracted from Cannabis sativa L. exerts neuroprotective, antioxidant, and anti-inflammatory effects in Alzheimer's disease (AD), a disease characterized by impaired cognition and accumulation of amyloid-B peptides (Aβ). Interactions between the gut and central nervous system (microbiota-gut-brain axis) play a critical role in the pathogenesis of neurodegenerative disorder AD. At present investigations into the mechanisms underlying the neuroprotective action of CBD in AD are not conclusive. The aim of this study was thus to examine the influence of CBD on cognition and involvement of the microbiota-gut-brain axis using a senescence-accelerated mouse prone 8 (SAMP8) model. Data demonstrated that administration of CBD to SAMP8 mice improved cognitive function as evidenced from the Morris water maze test and increased hippocampal activated microglia shift from M1 to M2. In addition, CBD elevated levels of Bacteriodetes associated with a fall in Firmicutes providing morphologically a protective intestinal barrier which subsequently reduced leakage of intestinal toxic metabolites. Further, CBD was found to reduce the levels of hippocampal and colon epithelial cells lipopolysaccharide (LPS), known to be increased in AD leading to impaired gastrointestinal motility, thereby promoting neuroinflammation and subsequent neuronal death. Our findings demonstrated that CBD may be considered a beneficial therapeutic drug to counteract AD-mediated cognitive impairment and restore gut microbial functions associated with the observed neuroprotective mechanisms.
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Affiliation(s)
- Bing-Qian Ma
- Basic Medical and Forensic Medicine, Baotou Medical College, Inner Mongolia, China
| | - Jian-Xin Jia
- Basic Medical and Forensic Medicine, Baotou Medical College, Inner Mongolia, China
- Key Laboratory of Human Anatomy, Education Department of Inner Mongolia Autonomous Region, Inner Mongolia, China
| | - He Wang
- School of Health Sciences, University of Newcastle, Newcastle, Australia
| | - Si-Jia Li
- Teaching and Research Department of Golden Chamber, Liaoning University of Traditional Chinese Medicine, Liaoning, China
| | - Zhan-Jun Yang
- Basic Medical and Forensic Medicine, Baotou Medical College, Inner Mongolia, China
- Key Laboratory of Human Anatomy, Education Department of Inner Mongolia Autonomous Region, Inner Mongolia, China
- Department of Human Anatomy, Chifeng University, Inner Mongolia, China
| | - Xin-Xin Wang
- Basic Medical and Forensic Medicine, Baotou Medical College, Inner Mongolia, China
- Teaching and Research Department of Golden Chamber, Liaoning University of Traditional Chinese Medicine, Liaoning, China
| | - Xu-Sheng Yan
- Basic Medical and Forensic Medicine, Baotou Medical College, Inner Mongolia, China
- Key Laboratory of Human Anatomy, Education Department of Inner Mongolia Autonomous Region, Inner Mongolia, China
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Prince JB, Davis HL, Tan J, Muller-Townsend K, Markovic S, Lewis DMG, Hastie B, Thompson MB, Drummond PD, Fujiyama H, Sohrabi HR. Cognitive and neuroscientific perspectives of healthy ageing. Neurosci Biobehav Rev 2024; 161:105649. [PMID: 38579902 DOI: 10.1016/j.neubiorev.2024.105649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Revised: 03/17/2024] [Accepted: 03/30/2024] [Indexed: 04/07/2024]
Abstract
With dementia incidence projected to escalate significantly within the next 25 years, the United Nations declared 2021-2030 the Decade of Healthy Ageing, emphasising cognition as a crucial element. As a leading discipline in cognition and ageing research, psychology is well-equipped to offer insights for translational research, clinical practice, and policy-making. In this comprehensive review, we discuss the current state of knowledge on age-related changes in cognition and psychological health. We discuss cognitive changes during ageing, including (a) heterogeneity in the rate, trajectory, and characteristics of decline experienced by older adults, (b) the role of cognitive reserve in age-related cognitive decline, and (c) the potential for cognitive training to slow this decline. We also examine ageing and cognition through multiple theoretical perspectives. We highlight critical unresolved issues, such as the disparate implications of subjective versus objective measures of cognitive decline and the insufficient evaluation of cognitive training programs. We suggest future research directions, and emphasise interdisciplinary collaboration to create a more comprehensive understanding of the factors that modulate cognitive ageing.
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Affiliation(s)
- Jon B Prince
- School of Psychology, Murdoch University, WA, Australia; Centre for Healthy Ageing, Health Futures Institute, Murdoch University, WA, Australia.
| | - Helen L Davis
- School of Psychology, Murdoch University, WA, Australia; Centre for Healthy Ageing, Health Futures Institute, Murdoch University, WA, Australia
| | - Jane Tan
- School of Psychology, Murdoch University, WA, Australia; Centre for Healthy Ageing, Health Futures Institute, Murdoch University, WA, Australia
| | - Katrina Muller-Townsend
- School of Psychology, Murdoch University, WA, Australia; Centre for Healthy Ageing, Health Futures Institute, Murdoch University, WA, Australia
| | - Shaun Markovic
- School of Psychology, Murdoch University, WA, Australia; Centre for Healthy Ageing, Health Futures Institute, Murdoch University, WA, Australia; Discipline of Psychology, Counselling and Criminology, Edith Cowan University, WA, Australia
| | - David M G Lewis
- School of Psychology, Murdoch University, WA, Australia; Centre for Healthy Ageing, Health Futures Institute, Murdoch University, WA, Australia
| | | | - Matthew B Thompson
- School of Psychology, Murdoch University, WA, Australia; Centre for Biosecurity and One Health, Harry Butler Institute, Murdoch University, WA, Australia
| | - Peter D Drummond
- School of Psychology, Murdoch University, WA, Australia; Centre for Healthy Ageing, Health Futures Institute, Murdoch University, WA, Australia
| | - Hakuei Fujiyama
- School of Psychology, Murdoch University, WA, Australia; Centre for Healthy Ageing, Health Futures Institute, Murdoch University, WA, Australia; Centre for Molecular Medicine and Innovative Therapeutics, Murdoch University, WA, Australia
| | - Hamid R Sohrabi
- School of Psychology, Murdoch University, WA, Australia; Centre for Healthy Ageing, Health Futures Institute, Murdoch University, WA, Australia; School of Medical and Health Sciences, Edith Cowan University, WA, Australia; Department of Biomedical Sciences, Macquarie University, NSW, Australia.
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14
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Mameno T, Moynihan P, Nakagawa T, Inagaki H, Akema S, Murotani Y, Takeuchi S, Kimura A, Okada Y, Tsujioka Y, Higashi K, Hagino H, Mihara Y, Kosaka T, Takahashi T, Wada M, Gondo Y, Kamide K, Akasaka H, Kabayama M, Ishizaki T, Masui Y, Ikebe K. Exploring the association between number of teeth, food intake, and cognitive function: A 9-year longitudinal study. J Dent 2024; 145:104991. [PMID: 38608831 DOI: 10.1016/j.jdent.2024.104991] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Revised: 03/27/2024] [Accepted: 04/05/2024] [Indexed: 04/14/2024] Open
Abstract
OBJECTIVES This study aimed to investigate the association between the number of teeth, food intake, and cognitive function in Japanese community-dwelling older adults. METHODS This 9-year longitudinal study included a total of 293 analyzable participants who participated in baseline and follow-up surveys. Dental status (number of teeth and periodontal pocket depth), dietary assessment using the brief-type self-administered diet history questionnaire, cognitive function, and the following confounding factors were evaluated: educational level, financial satisfaction, living situation, smoking and drinking habits, history of chronic diseases, apolipoprotein E-ε4 carrier, body mass index, handgrip strength, instrumental activities of daily living, and depressive symptomatology. The Japanese version of the Montreal Cognitive Assessment was used to evaluate cognitive function. A multinomial logistic regression analysis for the intake level of each food categorized into three groups (low, moderate, high), and a generalized estimating equation (GEE) for cognitive function over nine years were performed. RESULTS After controlling for confounding factors, the number of teeth was shown to be associated with the intake of green-yellow vegetables and meat. Furthermore, the GEE indicated that the lowest quartile of intake of green-yellow vegetables significantly associated with lower cognitive function (unstandardized regression coefficient [B] = -0.96, 95 % confidence interval [CI]: -1.72 to -0.20), and the lowest quartile of intake of meat significantly associated with lower cognitive function (B = -1.42, 95 % CI: -2.27 to -0.58). CONCLUSIONS The intake of green and yellow vegetables and meat, which is influenced by the number of teeth, was associated with cognitive function in Japanese community-dwelling older adults. CLINICAL SIGNIFICANCE There are few studies that have examined the association between oral health, food intake, and cognitive function. This 9-year longitudinal study suggests that it is important to maintain natural teeth to enable the functional means to consume green-yellow vegetables and meat, and thereby help maintain cognitive function.
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Affiliation(s)
- Tomoaki Mameno
- Department of Removable Prosthodontics and Gerodontology, Osaka University Graduate School of Dentistry, 1-8 Yamadaoka, Suita, Osaka 565-0871, Japan.
| | - Paula Moynihan
- Adelaide Dental School, Faculty of Health and Medical Sciences, The University of Adelaide, South Australia 5005, Australia
| | - Takeshi Nakagawa
- Research Institute, National Center for Geriatrics and Gerontology, 7-430 Morioka, Obushi, Aichi 474-8511 Japan
| | - Hiroki Inagaki
- Research Team for Promoting Independence and Mental Health, Tokyo Metropolitan Institute of Gerontology, 35-2 Sakae-cho, Itabashi-ku, Tokyo 173-0015, Japan
| | - Suzuna Akema
- Department of Removable Prosthodontics and Gerodontology, Osaka University Graduate School of Dentistry, 1-8 Yamadaoka, Suita, Osaka 565-0871, Japan
| | - Yuki Murotani
- Department of Removable Prosthodontics and Gerodontology, Osaka University Graduate School of Dentistry, 1-8 Yamadaoka, Suita, Osaka 565-0871, Japan
| | - Satoko Takeuchi
- Department of Removable Prosthodontics and Gerodontology, Osaka University Graduate School of Dentistry, 1-8 Yamadaoka, Suita, Osaka 565-0871, Japan
| | - Ayaka Kimura
- Department of Removable Prosthodontics and Gerodontology, Osaka University Graduate School of Dentistry, 1-8 Yamadaoka, Suita, Osaka 565-0871, Japan
| | - Yoshie Okada
- Department of Removable Prosthodontics and Gerodontology, Osaka University Graduate School of Dentistry, 1-8 Yamadaoka, Suita, Osaka 565-0871, Japan
| | - Yoshitaka Tsujioka
- Department of Removable Prosthodontics and Gerodontology, Osaka University Graduate School of Dentistry, 1-8 Yamadaoka, Suita, Osaka 565-0871, Japan
| | - Kotaro Higashi
- Department of Removable Prosthodontics and Gerodontology, Osaka University Graduate School of Dentistry, 1-8 Yamadaoka, Suita, Osaka 565-0871, Japan
| | - Hiromasa Hagino
- Department of Removable Prosthodontics and Gerodontology, Osaka University Graduate School of Dentistry, 1-8 Yamadaoka, Suita, Osaka 565-0871, Japan
| | - Yusuke Mihara
- Department of Removable Prosthodontics and Gerodontology, Osaka University Graduate School of Dentistry, 1-8 Yamadaoka, Suita, Osaka 565-0871, Japan
| | - Takayuki Kosaka
- Department of Removable Prosthodontics and Gerodontology, Osaka University Graduate School of Dentistry, 1-8 Yamadaoka, Suita, Osaka 565-0871, Japan
| | - Toshihito Takahashi
- Department of Removable Prosthodontics and Gerodontology, Osaka University Graduate School of Dentistry, 1-8 Yamadaoka, Suita, Osaka 565-0871, Japan
| | - Masahiro Wada
- Department of Removable Prosthodontics and Gerodontology, Osaka University Graduate School of Dentistry, 1-8 Yamadaoka, Suita, Osaka 565-0871, Japan
| | - Yasuyuki Gondo
- Department of Clinical Thanatology and Geriatric Behavioral Science, Osaka University Graduate School of Human Sciences, 1-2 Yamadaoka, Suita, Osaka 565-0871, Japan
| | - Kei Kamide
- Division of Health Sciences, Osaka University Graduate School of Medicine, 1-7 Yamadaoka, Suita, Osaka 565-0871, Japan
| | - Hiroshi Akasaka
- Department of Geriatric and General Medicine, Osaka University Graduate School of Medicine, 1-7 Yamadaoka, Suita, Osaka 565-0871, Japan
| | - Mai Kabayama
- Division of Health Sciences, Osaka University Graduate School of Medicine, 1-7 Yamadaoka, Suita, Osaka 565-0871, Japan
| | - Tatsuro Ishizaki
- Tokyo Metropolitan Geriatric Hospital and Institute of Gerontology, 35-2 Sakae-cho, Itabashi-ku, Tokyo 173-0015, Japan
| | - Yukie Masui
- Tokyo Metropolitan Geriatric Hospital and Institute of Gerontology, 35-2 Sakae-cho, Itabashi-ku, Tokyo 173-0015, Japan
| | - Kazunori Ikebe
- Department of Removable Prosthodontics and Gerodontology, Osaka University Graduate School of Dentistry, 1-8 Yamadaoka, Suita, Osaka 565-0871, Japan
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Avan A, Feigin VL, Bennett DA, Steinmetz JD, Hachinski V, Stranges S, Owolabi MO, Aali A, Abbasi-Kangevari M, Abbasi-Kangevari Z, Abd-Allah F, Abdollahzade S, Abidi H, Abolhassani H, Abualhasan A, Abu-Gharbieh E, Abu-Rmeileh NME, Abu-Zaid A, Ahmad A, Ahmadi S, Ahmed LA, Ajami M, Al Hamad H, Alanezi FM, Alanzi TM, Alimohamadi Y, Aljunid SM, Al-Raddadi RM, Amiri S, Arabloo J, Arulappan J, Arumugam A, Asadi-Pooya AA, Athar M, Athari SS, Atout MMW, Azadnajafabad S, Azangou-Khyavy M, Azari Jafari A, Azzam AY, Baghcheghi N, Bagherieh S, Baltatu OC, Bazmandegan G, Bhojaraja VS, Bijani A, Bitaraf S, Calina D, Darwish AH, Djalalinia S, Doheim MF, Dorostkar F, Eini E, El Nahas N, El Sayed I, Elhadi M, Elmonem MA, Eskandarieh S, Faghani S, Fallahzadeh A, Farahmand M, Ghafourifard M, Ghamari SH, Gholami A, Ghozy S, Goleij P, Hadei M, Hafezi-Nejad N, Haj-Mirzaian A, Halwani R, Hamidi S, Hasaballah AI, Hassan A, Hedna K, Hegazy MI, Heidari-Soureshjani R, Hosseini MS, Hoveidamanesh S, Jahrami H, Jamshidi E, Javaheri T, Jayapal SK, Kalankesh LR, Kalhor R, Kamiab Z, Keykhaei M, Khader YS, Khan M, Khan MAB, Khatatbeh, Khayat Kashani HR, Khosravi A, Kompani F, Koohestani HR, Larijani B, Lasrado S, Magdy Abd El Razek M, Malekpour MR, Malik AA, Mansournia MA, Mardi P, Maroufi SF, Masoudi S, Mayeli M, Mehrabi Nasab E, Menezes RG, Mirmoeeni S, Mirza-Aghazadeh-Attari M, Mobarakabadi M, Mohammadi E, Mohammadi S, Mohan S, Mokdad AH, Momtazmanesh S, Montazeri F, Moradi Sarabi M, Moraga P, Morovatdar N, Motaghinejad M, Naghavi M, Natto ZS, Nejadghaderi SA, Noroozi N, Okati-Aliabad H, Pazoki Toroudi H, Perna S, Piradov MA, Pourahmadi M, Rafiei A, Rahimi-Movaghar V, Rahmani AM, Rahmani S, Rahmanian V, Rajabpour-Sanati A, Rao CR, Rashidi MM, Rawassizadeh R, Razeghian-Jahromi I, Redwan EMM, Rezaee M, Rezaei N, Rezaei N, Rezaei N, Rezaeian M, Rikhtegar R, Saad AMA, Saddik B, Sadeghi M, Sadeghian S, Saeedi Moghaddam S, Sahebkar A, Salahi S, Salahi S, Samy AM, Sanadgol N, Sarveazad A, Sathian B, Saylan M, Shahbandi A, Shahrokhi S, Shams-Beyranvand M, Shanawaz M, Sharifi-Rad J, Sheikhi RA, Shetty JK, Shobeiri P, Shorofi SA, Siabani S, Tabatabaei SM, Taheri Abkenar Y, Taheri Soodejani M, Temsah MH, Vakilian A, Valadan Tahbaz S, Valizadeh R, Vaziri S, Vo B, Yahyazadeh Jabbari SH, Yesiltepe M, Zaki N, Zare I, Zare Dehnavi A, Zoladl M. The burden of neurological conditions in north Africa and the Middle East, 1990-2019: a systematic analysis of the Global Burden of Disease Study 2019. Lancet Glob Health 2024; 12:e960-e982. [PMID: 38604203 PMCID: PMC11099299 DOI: 10.1016/s2214-109x(24)00093-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2023] [Revised: 01/25/2024] [Accepted: 02/22/2024] [Indexed: 04/13/2024]
Abstract
BACKGROUND The burden of neurological conditions in north Africa and the Middle East is increasing. We aimed to assess the changes in the burden of neurological conditions in this super-region to aid with future decision making. METHODS In this analysis of the Global Burden of Diseases, Injuries, and Risk Factors Study 2019 data, we examined temporal trends of disability-adjusted life-years (DALYs; deaths and disabilities combined), deaths, incident cases, and prevalent cases of 14 major neurological conditions and eight subtypes in 21 countries in the north Africa and the Middle East super-region. Additionally, we assessed neurological DALYs due to 22 potentially modifiable risk factors, within four levels of classification, during the period 1990-2019. We used a Bayesian modelling estimation approach, and generated 95% uncertainty intervals (UIs) for final estimates on the basis of the 2·5th and 97·5th percentiles of 1000 draws from the posterior distribution. FINDINGS In 2019, there were 441·1 thousand (95% UI 347·2-598·4) deaths and 17·6 million (12·5-24·7) neurological DALYs in north Africa and the Middle East. The leading causes of neurological DALYs were stroke, migraine, and Alzheimer's disease and other dementias (hereafter dementias). In north Africa and the Middle East in 2019, 85·8% (82·6-89·1) of stroke and 39·9% (26·4-54·7) of dementia age-standardised DALYs were attributable to modifiable risk factors. North Africa and the Middle East had the highest age-standardised DALY rates per 100 000 population due to dementia (387·0 [172·0-848·5]), Parkinson's disease (84·4 [74·7-103·2]), and migraine (601·4 [107·0-1371·8]) among the global super-regions. Between 1990 and 2019, there was a decrease in the age-standardised DALY rates related to meningitis (-75·8% [-81·1 to -69·5]), tetanus (-88·2% [-93·9 to -76·1]), stroke (-32·0% [-39·1 to -23·3]), intracerebral haemorrhage (-51·7% [-58·2 to -43·8]), idiopathic epilepsy (-26·2% [-43·6 to -1·1]), and subarachnoid haemorrhage (-62·8% [-71·6 to -41·0]), but for all other neurological conditions there was no change. During 1990-2019, the number of DALYs due to dementias, Parkinson's disease, multiple sclerosis, ischaemic stroke, and headache disorder (ie, migraine and tension-type headache) more than doubled in the super-region, and the burden of years lived with disability (YLDs), incidence, and prevalence of multiple sclerosis, motor neuron disease, Parkinson's disease, and ischaemic stroke increased both in age-standardised rate and count. During this period, the absolute burden of YLDs due to head and spinal injuries almost doubled. INTERPRETATION The increasing burden of neurological conditions in north Africa and the Middle East accompanies the increasing ageing population. Stroke and dementia are the primary causes of neurological disability and death, primarily attributable to common modifiable risk factors. Synergistic, systematic, lifetime, and multi-sectoral interventions aimed at preventing or mitigating the burden are needed. FUNDING Bill & Melinda Gates Foundation. TRANSLATIONS For the Persian, Arabic and Turkish translations of the abstract see Supplementary Materials section.
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Stephan BCM, Cochrane L, Kafadar AH, Brain J, Burton E, Myers B, Brayne C, Naheed A, Anstey KJ, Ashor AW, Siervo M. Population attributable fractions of modifiable risk factors for dementia: a systematic review and meta-analysis. THE LANCET. HEALTHY LONGEVITY 2024; 5:e406-e421. [PMID: 38824956 DOI: 10.1016/s2666-7568(24)00061-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Revised: 03/20/2024] [Accepted: 03/25/2024] [Indexed: 06/04/2024] Open
Abstract
BACKGROUND More than 57 million people have dementia worldwide. Evidence indicates a change in dementia prevalence and incidence in high-income countries, which is likely to be due to improved life-course population health. Identifying key modifiable risk factors for dementia is essential for informing risk reduction and prevention strategies. We therefore aimed to estimate the population attributable fraction (PAF) for dementia associated with modifiable risk factors. METHODS In this systematic review and meta-analysis, we searched Embase, MEDLINE, and PsycINFO, via Ovid, from database inception up to June 29, 2023, for population-derived or community-based studies and reviews reporting a PAF value for one or more modifiable risk factor for later-life dementia (prevalent or incident dementia in people aged ≥60 years), with no restrictions on dementia subtype, the sex or baseline age of participants, or the period of study. Articles were independently screened for inclusion by four authors, with disagreements resolved through consensus. Data including unweighted and weighted PAF values (weighted to account for communality or overlap in risk) were independently extracted into a predefined template by two authors and checked by two other authors. When five or more unique studies investigated a given risk factor or combination of the same factors, random-effects meta-analyses were used to calculate a pooled PAF percentage estimate for the factor or combination of factors. The review protocol was registered on PROSPERO, CRD42022323429. FINDINGS 4024 articles were identified, and 74 were included in our narrative synthesis. Overall, PAFs were reported for 61 modifiable risk factors, with sufficient data available for meta-analysis of 12 factors (n=48 studies). In meta-analyses, the highest pooled unweighted PAF values were estimated for low education (17·2% [95% CI 14·4-20·0], p<0·0001), hypertension (15·8% [14·7-17·1], p<0·0001), hearing loss (15·6% [10·3-20·9], p<0·0001), physical inactivity (15·2% [12·8-17·7], p<0·0001), and obesity (9·4% [7·3-11·7], p<0·0001). According to weighted PAF values, low education (9·3% [6·9-11·7], p<0·0001), physical inactivity (7·3% [3·9-11·2], p=0·0021), hearing loss (7·2% [5·2-9·7], p<0·0001), hypertension (7·1% [5·4-8·8], p<0·0001), and obesity (5·3% [3·2-7·4], p=0·0001) had the highest pooled estimates. When low education, midlife hypertension, midlife obesity, smoking, physical inactivity, depression, and diabetes were combined (Barnes and Yaffe seven-factor model; n=9 studies), the pooled unweighted and weighted PAF values were 55·0% (46·5-63·5; p<0·0001) and 32·0% (26·6-37·5; p<0·0001), respectively. The pooled PAF values for most individual risk factors were higher in low-income and middle-income countries (LMICs) versus high-income countries. INTERPRETATION Governments need to invest in a life-course approach to dementia prevention, including policies that enable quality education, health-promoting environments, and improved health. This investment is particularly important in LMICs, where the potential for prevention is high, but resources, infrastructure, budgets, and research focused on ageing and dementia are limited. FUNDING UK Research and Innovation (Medical Research Council).
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Affiliation(s)
- Blossom C M Stephan
- Dementia Centre of Excellence, Curtin enAble Institute, Faculty of Health Sciences, Curtin University, Perth, WA, Australia; Institute of Mental Health, The University of Nottingham Medical School, Nottingham, UK.
| | - Louie Cochrane
- Institute of Mental Health, The University of Nottingham Medical School, Nottingham, UK
| | | | - Jacob Brain
- Institute of Mental Health, The University of Nottingham Medical School, Nottingham, UK; Freemasons Foundation Centre for Men's Health, Discipline of Medicine, School of Psychology, The University of Adelaide, Adelaide, SA, Australia
| | - Elissa Burton
- Dementia Centre of Excellence, Curtin enAble Institute, Faculty of Health Sciences, Curtin University, Perth, WA, Australia; Curtin School of Allied Health, Faculty of Health Sciences, Curtin University, Perth, WA, Australia
| | - Bronwyn Myers
- Dementia Centre of Excellence, Curtin enAble Institute, Faculty of Health Sciences, Curtin University, Perth, WA, Australia; Mental Health, Alcohol, Substance Use, and Tobacco Research Unit, South African Medical Research Council, Tygerberg, South Africa; Division of Addiction Psychiatry, Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa
| | - Carol Brayne
- Cambridge Public Health, University of Cambridge, Cambridge, UK
| | - Aliya Naheed
- Non-Communicable Diseases, Nutrition Research Division, International Centre for Diarrhoeal Disease Research, Dhaka, Bangladesh
| | - Kaarin J Anstey
- UNSW Ageing Futures Institute, University of New South Wales, Sydney, NSW, Australia; Brain Health and Dementia Centre, Neuroscience Research Australia, Sydney, NSW, Australia
| | - Ammar W Ashor
- Department of Internal Medicine, College of Medicine, Mustansiriyah University, Baghdad, Iraq
| | - Mario Siervo
- Dementia Centre of Excellence, Curtin enAble Institute, Faculty of Health Sciences, Curtin University, Perth, WA, Australia; School of Population Health, Curtin University, Perth, WA, Australia
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Brellenthin AG, Lee DC, Lefferts EC, Lefferts WK, Dougherty RJ, Kim Y. Physical Activity Intensity and Risk of Dementia. Am J Prev Med 2024; 66:948-956. [PMID: 38307157 DOI: 10.1016/j.amepre.2024.01.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Revised: 01/23/2024] [Accepted: 01/23/2024] [Indexed: 02/04/2024]
Abstract
INTRODUCTION Regular participation in aerobic physical activity is associated with a reduced risk of dementia. It is currently unclear whether this association is due to the total volume or intensity of physical activity. METHODS This prospective cohort study analyzed 386,486 adults from the UK Biobank who were free of dementia and self-reported >0 minutes of moderate-to-vigorous intensity physical activity (MVPA) at baseline (2007-2010). Participants were categorized as performing 0%, >0%-30%, or >30% of their total MVPA in vigorous activity (VPA). Cox proportional hazards regression models were used to examine the associations between categories of VPA and incident dementia while adjusting for sociodemographic and lifestyle factors including total MVPA. Analyses were performed in 2022. RESULTS Over an average follow-up of 12.0 (1.7) years, there were 5,177 (1.3%) cases of dementia. Compared to the group reporting 0% VPA, the hazard ratios (95% confidence intervals) of dementia for the groups reporting >0%-30% and >30% VPA were 0.73 (0.68-0.78) and 0.81 (0.75-0.87), respectively, in the fully adjusted model. In a joint analysis, reporting some VPA was associated with a reduced risk of dementia regardless of meeting the aerobic physical activity guidelines (HR=0.78 [0.72-0.85]) or not (HR=0.76 [0.60-0.98]), while meeting the aerobic physical activity guidelines alone without VPA was not associated with incident dementia (HR=0.98 [0.90-1.07]), compared to the group that did not meet the guidelines and reported no VPA. CONCLUSIONS These results suggest that engaging in VPA as part of MVPA is associated with a lower risk of dementia.
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Affiliation(s)
| | - Duck-Chul Lee
- Department of Kinesiology, Iowa State University, Ames, Iowa
| | | | | | - Ryan J Dougherty
- Department of Neurology, Johns Hopkins School of Medicine, Baltimore, Maryland
| | - Youngwon Kim
- University of Hong Kong, Li Ka Shing Faculty of Medicine, School of Public Health, Pokfulam, Hong Kong; University of Cambridge, MRC Epidemiology Unit, Cambridge, United Kingdom.
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Alexandre-Silva V, Cominetti MR. Unraveling the dual role of ADAM10: Bridging the gap between cancer and Alzheimer's disease. Mech Ageing Dev 2024; 219:111928. [PMID: 38513842 DOI: 10.1016/j.mad.2024.111928] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Revised: 03/07/2024] [Accepted: 03/18/2024] [Indexed: 03/23/2024]
Abstract
An inverse association between Alzheimer's disease (AD) and cancer has been proposed. Patients with a cancer history have a decreased risk of developing AD, and AD patients have a reduced cancer incidence, which is not seen in vascular dementia patients. Given this association, common molecular and biological mechanisms that could explain this inverse relationship have been proposed before, such as Peptidylprolyl Cis/Trans Isomerase, NIMA-Interacting 1 (Pin1), Wingless and Int-1 (Wnt), and transformation-related protein 53 (p53)-mediated pathways, along with inflammation and oxidative stress-related proteins. A Disintegrin And Metalloprotease 10 (ADAM10) is a protease responsible for the cleavage of key AD- and cancer-related substrates, and it has inverse roles in those diseases: neuroprotective and disease-promoting, respectively. Thus, herein, we review the relevant literature linking AD and cancer and propose how ADAM10 activity might modulate the inverse association between the diseases. Understanding how this protease mediates those two conditions might raise some considerations in the ADAM10 pharmacological modulation for treating AD and cancer.
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Cotton K, Verghese J. Dementia in Taiwan. Arch Gerontol Geriatr 2024; 121:105415. [PMID: 38503624 DOI: 10.1016/j.archger.2024.105415] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/21/2024]
Affiliation(s)
- Kelly Cotton
- Department of Neurology and Medicine, Albert Einstein College of Medicine, Bronx 10461, NY, USA
| | - Joe Verghese
- Department of Neurology and Medicine, Albert Einstein College of Medicine, Bronx 10461, NY, USA.
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20
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Choi YY, Lee KH. Association Between Subjective Masticatory Function and Mild Cognitive Impairment in Older Adults. Int Dent J 2024; 74:492-499. [PMID: 38584039 PMCID: PMC11123537 DOI: 10.1016/j.identj.2024.03.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Revised: 03/15/2024] [Accepted: 03/20/2024] [Indexed: 04/09/2024] Open
Abstract
AIM This study aimed to examine the effect of subjective masticatory function on the occurrence of mild cognitive impairment (MCI) by analysing the Korean Longitudinal Study of Ageing (KLoSA) data. METHODS The study participants were 2954 KLoSA participants aged 60 years or older in the first wave (2006) who had normal cognitive function. The subjective masticatory function was determined using a survey item, and the responses were grouped into 3 categories, ie, good, moderate, and poor. The occurrence of MCI in the 3 groups was followed up until 2020. Cognitive function was assessed based on the Korean Mini-Mental State Examination score. Age, sex, education level, residence, health insurance type, smoking status, drinking status, and the number of chronic diseases were considered as potential confounders. To examine the occurrence of MCI according to subjective masticatory function, Cox proportional hazard regression analysis was performed. RESULTS Cox proportional hazard regression models adjusted for confounders yielded the following results: in men, the risk of MCI was higher in those whose subjective masticatory function was moderate and poor, as compared to those with good subjective masticatory function (adjusted hazard ratio [aHR], 1.33; 95% confidence interval [CI], 1.12-1.58; aHR, 1.23; 95% CI, 1.04-1.46). In contrast, in women, subjective masticatory function did not significantly influence the occurrence of MCI (aHR, 1.05; 95% CI, 0.89-1.24; aHR, 1.08; 95% CI, 0.92-1.28). CONCLUSIONS This study suggests that poor masticatory function may be a risk factor for MCI in older men.
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Affiliation(s)
- Yoon Young Choi
- Department of Dental Hygiene, College of Bioecological Health, Shinhan University, Uijeongbu, Republic of Korea
| | - Kyeong Hee Lee
- Department of Dental Hygiene, College of Bioecological Health, Shinhan University, Uijeongbu, Republic of Korea.
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21
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Goodwin MV, Hogervorst E, Maidment DW. Hearing difficulties and memory problems: the mediating role of physical health and psychosocial wellbeing. Int J Audiol 2024; 63:439-446. [PMID: 37073645 DOI: 10.1080/14992027.2023.2199443] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2022] [Accepted: 03/30/2023] [Indexed: 04/20/2023]
Abstract
OBJECTIVE To investigate whether the association between hearing difficulties and self-reported memory problems is mediated by physical health and psychosocial wellbeing. DESIGN A cross-sectional study. Path analyses were used to test potential theoretical models (psychosocial-cascade, common cause) of the association between hearing difficulties and memory problems, adjusting for age. STUDY SAMPLE A sample of 479 adults (18-87 years) completed self-reported outcome measures. RESULTS Half the participants reported clinically significant hearing difficulties and 30% self-reported memory problems. In the direct model, reporting hearing difficulties was associated with a greater likelihood of reporting memory problems (β = 0.17, p = 0.007, 95% Confidence Intervals [CI] = 0.00, 0.01). Hearing difficulties were also associated with poorer physical health, but this did not mediate the association with memory. Psychosocial factors, however, fully mediated the relationship between hearing difficulties and memory problems (β = 0.03, p = 0.019, 95% CI = 0.00, 0.01). CONCLUSIONS Adults with hearing difficulties may be more likely to self-report memory problems, irrespective of age. This study supports the psychosocial-cascade model, as the association between self-reported hearing and memory problems was explained entirely by psychosocial factors. Future studies should investigate these associations using behavioural measures, as well as explore whether interventions can reduce the risk of developing memory problems in this population.
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Affiliation(s)
- Maria V Goodwin
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, U.K
| | - Eef Hogervorst
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, U.K
| | - David W Maidment
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, U.K
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Harding E, Sullivan MP, Camic PM, Yong KXX, Stott J, Crutch SJ. Exploring experiential differences in everyday activities - A focused ethnographic study in the homes of people living with memory-led Alzheimer's disease and posterior cortical atrophy. J Aging Stud 2024; 69:101226. [PMID: 38834246 DOI: 10.1016/j.jaging.2024.101226] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Revised: 03/15/2024] [Accepted: 03/24/2024] [Indexed: 06/06/2024]
Abstract
BACKGROUND Supporting ageing in place, quality of life and activity engagement are public health priorities for people living with dementia, but little is known about the needs and experiences of community-dwelling people with rarer forms of dementia with lesser known symptoms. Posterior cortical atrophy (PCA) is a rare form of dementia usually caused by Alzheimer's disease but which is characterised by diminished visual processing (rather than a dominant memory problem), which poses challenges for maintaining independence and accessing appropriate support. METHODS This study used a comparative qualitative design and focussed ethnographic methods to explore experiential differences in activity engagement for 10 people with the most common, memory-led presentation of Alzheimer's disease and 10 people with posterior cortical atrophy within their everyday home environments. RESULTS While the data collection revealed much rich variation in individual and contextual factors, some tentative high-level differences in the experiences of everyday activities could be drawn out, seemingly attributable to the different diagnoses' differing dominant symptoms. These included people with posterior cortical atrophy being less likely to use environmental cues to initiate activities, and more likely to withhold from asking for support because of preserved insight into the impact of this on carers. This lack of initiation of activities could be misinterpreted as apathy. People with posterior cortical atrophy also were discouraged from engaging in activities by disorientation within the home, and difficulties localising, identifying and manipulating objects. People with the more common, memory-led presentation of Alzheimer's disease exhibited more memory-based difficulties with engaging with activities such as forgetting planned activities, where to locate the items required for an activity and the steps involved. Despite these distinct symptom-led challenges, all participants and their family members demonstrated resourcefulness and resilience in making creative adaptations to support continued engagement in everyday activities, supporting the widely reported management strategies of people with dementia of the Alzheimer's type more generally. CONCLUSIONS These findings offer helpful insights into some the differing impacts dementia related visual and memory impairments can have on everyday activity engagement, which will be helpful for others navigating these challenges and the health and social care practitioners working with people affected by these conditions. The findings also highlight the vast individual variation in the multitude of individual and contextual factors involved in everyday activity engagement, and suggest important areas for future work utilising methods which are similarly high in ecological validity and accessibility as the home-based focussed ethnographic methods utilised here.
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Affiliation(s)
- Emma Harding
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, University College London, London, UK.
| | - Mary Pat Sullivan
- School of Social Work, Faculty of Education and Professional Studies, Nipissing University, Nipissing, ON, Canada
| | - Paul M Camic
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, University College London, London, UK
| | - Keir X X Yong
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, University College London, London, UK
| | - Joshua Stott
- Research Department of Clinical, Educational and Health Psychology, Division of Psychology and Language Sciences, University College London, UK
| | - Sebastian J Crutch
- Dementia Research Centre, Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, University College London, London, UK
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Venkatesan D, Muthukumar S, Iyer M, Babu HWS, Gopalakrishnan AV, Yadav MK, Vellingiri B. Heavy metals toxicity on epigenetic modifications in the pathogenesis of Alzheimer's disease (AD). J Biochem Mol Toxicol 2024; 38:e23741. [PMID: 38816991 DOI: 10.1002/jbt.23741] [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: 11/17/2023] [Revised: 03/09/2024] [Accepted: 05/09/2024] [Indexed: 06/01/2024]
Abstract
Alzheimer's disease (AD) is a progressive decline in cognitive ability and behavior which eventually disrupts daily activities. AD has no cure and the progression rate varies unlikely. Among various causative factors, heavy metals are reported to be a significant hazard in AD pathogenesis. Metal-induced neurodegeneration has been focused globally with thorough research to unravel the mechanistic insights in AD. Recently, heavy metals suggested to play an important role in epigenetic alterations which might provide evidential results on AD pathology. Epigenetic modifications are known to play towards novel therapeutic approaches in treating AD. Though many studies focus on epigenetics and heavy metal implications in AD, there is a lack of research on heavy metal influence on epigenetic toxicity in neurological disorders. The current review aims to elucidate the plausible role of cadmium (Cd), iron (Fe), arsenic (As), copper (Cu), and lithium (Li) metals on epigenetic factors and the increase in amyloid beta and tau phosphorylation in AD. Also, the review discusses the common methods of heavy metal detection to implicate in AD pathogenesis. Hence, from this review, we can extend the need for future research on identifying the mechanistic behavior of heavy metals on epigenetic toxicity and to develop diagnostic and therapeutic markers in AD.
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Affiliation(s)
- Dhivya Venkatesan
- Centre for Neuroscience, Department of Biotechnology, Karpagam Academy of Higher Education (Deemed to be University), Coimbatore, India
| | - Sindduja Muthukumar
- Human Cytogenetics and Stem Cell Laboratory, Department of Zoology, School of Basic Sciences, Central University of Punjab, Bathinda, Punjab, India
| | - Mahalaxmi Iyer
- Centre for Neuroscience, Department of Biotechnology, Karpagam Academy of Higher Education (Deemed to be University), Coimbatore, India
- Department of Microbiology, School of Basic Sciences, Central University of Punjab, Bathinda, Punjab, India
| | - Harysh Winster Suresh Babu
- Human Cytogenetics and Stem Cell Laboratory, Department of Zoology, School of Basic Sciences, Central University of Punjab, Bathinda, Punjab, India
| | - Abilash Valsala Gopalakrishnan
- Department of Biomedical Sciences, School of Biosciences and Technology, Vellore Institute of Technology, Vellore, India
| | - Mukesh Kumar Yadav
- Department of Microbiology, School of Basic Sciences, Central University of Punjab, Bathinda, Punjab, India
| | - Balachandar Vellingiri
- Human Cytogenetics and Stem Cell Laboratory, Department of Zoology, School of Basic Sciences, Central University of Punjab, Bathinda, Punjab, India
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24
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van Charante EPM, Hoevenaar-Blom MP, Song M, Andrieu S, Barnes L, Birck C, Brooks R, Coley N, Eggink E, Georges J, Hafdi M, van Gool WA, Handels R, Hou H, Lyu J, Niu Y, Song L, Wang W, Wang Y, Wimo A, Yu Y, Zhang J, Zhang W, Brayne C, Wang W, Richard E. Prevention of dementia using mobile phone applications (PRODEMOS): a multinational, randomised, controlled effectiveness-implementation trial. THE LANCET. HEALTHY LONGEVITY 2024; 5:e431-e442. [PMID: 38763155 DOI: 10.1016/s2666-7568(24)00068-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Revised: 04/11/2024] [Accepted: 04/15/2024] [Indexed: 05/21/2024] Open
Abstract
BACKGROUND The expected increase of dementia prevalence in the coming decades will mainly be in low-income and middle-income countries and in people with low socioeconomic status in high-income countries. This study aims to reduce dementia risk factors in underserved populations at high-risk using a coach-supported mobile health (mHealth) intervention. METHODS This open-label, blinded endpoint, hybrid effectiveness-implementation randomised controlled trial (RCT) investigated whether a coach-supported mHealth intervention can reduce dementia risk in people aged 55-75 years of low socioeconomic status in the UK or from the general population in China with at least two dementia risk factors. The primary effectiveness outcome was change in cardiovascular risk factors, ageing, and incidence of dementia (CAIDE) risk score from baseline to after 12-18 months of intervention. Implementation outcomes were coverage, adoption, sustainability, appropriateness, acceptability, fidelity, feasibility, and costs assessed using a mixed-methods approach. All participants with complete data on the primary outcome, without imputation of missing outcomes were included in the analysis (intention-to-treat principle). This trial is registered with ISRCTN, ISRCTN15986016, and is completed. FINDINGS Between Jan 15, 2021, and April 18, 2023, 1488 people (601 male and 887 female) were randomly assigned (734 to intervention and 754 to control), with 1229 (83%) of 1488 available for analysis of the primary effectiveness outcome. After a mean follow-up of 16 months (SD 2·5), the mean CAIDE score improved 0·16 points in the intervention group versus 0·01 in the control group (mean difference -0·16, 95% CI -0·29 to -0·03). 1533 (10%) invited individuals responded; of the intervention participants, 593 (81%) of 734 adopted the intervention and 367 (50%) of 734 continued active participation throughout the study. Perceived appropriateness (85%), acceptability (81%), and fidelity (79%) were good, with fair overall feasibility (53% of intervention participants and 58% of coaches), at low cost. No differences in adverse events between study arms were found. INTERPRETATION A coach-supported mHealth intervention is modestly effective in reducing dementia risk factors in those with low socioeconomic status in the UK and any socioeconomic status in China. Implementation is challenging in these populations, but those reached actively participated. Whether this intervention will result in less cognitive decline and dementia requires a larger RCT with long follow-up. FUNDING EU Horizon 2020 Research and Innovation Programme and the National Key R&D Programmes of China. TRANSLATION For the Mandarin translation of the abstract see Supplementary Materials section.
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Affiliation(s)
- Eric P Moll van Charante
- Department of General Practice, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands; Department of Public and Occupational Health, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands.
| | - Marieke P Hoevenaar-Blom
- Department of General Practice, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands; Department of Public and Occupational Health, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
| | - Manshu Song
- Beijing Key Laboratory of Clinical Epidemiology, School of Public Health, Capital Medical University, Beijing, China; School of Medical and Health Sciences, Edith Cowan University, Perth, WA, Australia
| | - Sandrine Andrieu
- Aging Research Team, Centre for Epidemiology and Research in Population Health, INSERM-University of Toulouse UPS, Toulouse, France; Department of Epidemiology and Public Health, Toulouse University Hospital, Toulouse, France
| | - Linda Barnes
- Department of Psychiatry, University of Cambridge, Cambridge, UK
| | | | - Rachael Brooks
- Department of Psychiatry, University of Cambridge, Cambridge, UK
| | - Nicola Coley
- Aging Research Team, Centre for Epidemiology and Research in Population Health, INSERM-University of Toulouse UPS, Toulouse, France; Department of Epidemiology and Public Health, Toulouse University Hospital, Toulouse, France
| | - Esmé Eggink
- Department of General Practice, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
| | | | - Melanie Hafdi
- Department of Neurology, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
| | - Willem A van Gool
- Department of Public and Occupational Health, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands
| | - Ron Handels
- Division of Neurogeriatrics, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Solna, Sweden; Faculty of Health, Medicine, and Life Sciences Department of Psychiatry and Neuropsychology, Alzheimer Centre Limburg, School for Mental Health and Neuroscience, Maastricht University, Maastricht, Netherlands
| | - Haifeng Hou
- Centre for Precision Health, Edith Cowan University, Perth, WA, Australia; School of Medical and Health Sciences, Edith Cowan University, Perth, WA, Australia; School of Public Health, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, Shandong, China
| | - Jihui Lyu
- Centre for Cognitive Disorders, Beijing Geriatric Hospital, Beijing, China
| | - Yixuan Niu
- Department of Geriatrics, The Second Medical Centre & National Clinical Research Centre for Geriatric Diseases, Chinese PLA General Hospital, Beijing, China
| | - Libin Song
- Comvee Research Institute, Fuzhou Comvee Network & Technology, Fuzhou, China
| | - Wenzhi Wang
- Department of Neuroepidemiology, Beijing Neurosurgical Institute, Beijing, China
| | - Youxin Wang
- Beijing Key Laboratory of Clinical Epidemiology, School of Public Health, Capital Medical University, Beijing, China; Centre for Precision Health, Edith Cowan University, Perth, WA, Australia; School of Medical and Health Sciences, Edith Cowan University, Perth, WA, Australia
| | - Anders Wimo
- Division of Neurogeriatrics, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Solna, Sweden
| | - Yueyi Yu
- Innovation Centre for Neurological Disorders, Department of Neurology, Xuanwu Hospital, Capital Medical University, Beijing, China
| | - Jinxia Zhang
- Beijing Key Laboratory of Clinical Epidemiology, School of Public Health, Capital Medical University, Beijing, China; Centre for Precision Health, Edith Cowan University, Perth, WA, Australia; School of Medical and Health Sciences, Edith Cowan University, Perth, WA, Australia
| | - Wei Zhang
- Centre for Cognitive Neurology, Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Carol Brayne
- Department of Psychiatry, University of Cambridge, Cambridge, UK
| | - Wei Wang
- Beijing Key Laboratory of Clinical Epidemiology, School of Public Health, Capital Medical University, Beijing, China; Centre for Precision Health, Edith Cowan University, Perth, WA, Australia; School of Medical and Health Sciences, Edith Cowan University, Perth, WA, Australia; School of Public Health, Shandong First Medical University & Shandong Academy of Medical Sciences, Jinan, Shandong, China; Department of Neuroepidemiology, Beijing Neurosurgical Institute, Beijing, China; The First Affiliated Hospital of Shantou University Medical College, Shantou, China
| | - Edo Richard
- Department of Public and Occupational Health, Amsterdam UMC, University of Amsterdam, Amsterdam, Netherlands; Department of Neurology, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, Netherlands
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25
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Smith JR, Deal JA. The need for a more holistic approach to dementia prevention. THE LANCET. HEALTHY LONGEVITY 2024; 5:e382-e383. [PMID: 38824950 DOI: 10.1016/s2666-7568(24)00071-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2024] [Accepted: 04/22/2024] [Indexed: 06/04/2024] Open
Affiliation(s)
- Jason R Smith
- Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, 21205, USA.
| | - Jennifer A Deal
- Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, 21205, USA
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Chiba I, Nakaya N, Kogure M, Hatanaka R, Nakaya K, Tokioka S, Nakamura T, Nagaie S, Fuse N, Obara T, Kotozaki Y, Tanno K, Kuriyama S, Hozawa A. Associations between housing and psychological damage by earthquake and modifiable risk factors for dementia in general older adults: Tohoku Medical Megabank community-based cohort study. Geriatr Gerontol Int 2024; 24:509-516. [PMID: 38700081 DOI: 10.1111/ggi.14867] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Revised: 03/07/2024] [Accepted: 03/22/2024] [Indexed: 05/05/2024]
Abstract
AIM To evaluate the association between housing and psychological damage caused by the Great East Japan Earthquake (GEJE) and modifiable risk factors (MRFs) of dementia for general population of older adults. METHODS This cross-sectional study enrolled 29 039 community-dwelling older adults (mean age 69.1 ± 2.9 years, 55.5% women). We evaluated disaster-related damage (by complete or not complete housing damage) and psychological damage (by post-traumatic stress reaction [PTSR]) after the GEJE using a self-report questionnaire. MRFs encompassed the presence of depression, social isolation, physical inactivity, smoking, and diabetes. We examined the association between disaster-related damage and MRFs using ordinary least squares and modified Poisson regression models adjusted for sociodemographic and health status variables. RESULTS Complete housing damage and PTSR were identified in 2704 (10.0%) and 855 (3.2%) individuals, respectively. The number of MRFs was significantly larger for the individuals with complete housing damage (β = 0.23; 95% confidence interval [CI]: 0.19-0.27) and PTSR (β = 0.60; 95% CI: 0.53-0.67). Prevalence ratios (PRs) for depression and physical inactivity were higher in individuals with complete housing damage. The PRs for all domains of the MRFs were significantly higher in individuals with PTSR. CONCLUSIONS Housing and psychological damage caused by the GEJE were associated with an increased risk factor of dementia. To attenuate the risk of dementia, especially among older victims who have experienced housing and psychological damage after a disaster, multidimensional support across various aspects of MRFs is required. Geriatr Gerontol Int 2024; 24: 509-516.
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Affiliation(s)
- Ippei Chiba
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
- Graduate School of Medicine, Tohoku University, Sendai, Japan
| | - Naoki Nakaya
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
- Graduate School of Medicine, Tohoku University, Sendai, Japan
| | - Mana Kogure
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
- Graduate School of Medicine, Tohoku University, Sendai, Japan
| | - Rieko Hatanaka
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
- Graduate School of Medicine, Tohoku University, Sendai, Japan
| | - Kumi Nakaya
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
- Graduate School of Medicine, Tohoku University, Sendai, Japan
| | - Sayuri Tokioka
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
- Graduate School of Medicine, Tohoku University, Sendai, Japan
| | - Tomohiro Nakamura
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
- Graduate School of Medicine, Tohoku University, Sendai, Japan
- Faculty of Data Science, Kyoto Women's University, Kyoto, Japan
| | - Satoshi Nagaie
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
- Graduate School of Medicine, Tohoku University, Sendai, Japan
| | - Nobuo Fuse
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
- Graduate School of Medicine, Tohoku University, Sendai, Japan
| | - Taku Obara
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
- Graduate School of Medicine, Tohoku University, Sendai, Japan
| | - Yuka Kotozaki
- Division of Clinical Research and Epidemiology, Iwate Tohoku Medical Megabank Organization, Iwate Medical University, Morioka, Japan
- Department of Hygiene and Preventive Medicine, School of Medicine, Iwate Medical University, Morioka, Japan
| | - Kozo Tanno
- Division of Clinical Research and Epidemiology, Iwate Tohoku Medical Megabank Organization, Iwate Medical University, Morioka, Japan
- Department of Hygiene and Preventive Medicine, School of Medicine, Iwate Medical University, Morioka, Japan
| | - Shinichi Kuriyama
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
- Graduate School of Medicine, Tohoku University, Sendai, Japan
| | - Atsushi Hozawa
- Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
- Graduate School of Medicine, Tohoku University, Sendai, Japan
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Quick SM, Lawler K, Shannon MM, Soh SE, McGinley JL, Peiris CL, Snowdon DA, Callisaya ML. Physiotherapy students are underprepared to work with people living with dementia: a qualitative study. Physiotherapy 2024; 123:47-55. [PMID: 38271742 DOI: 10.1016/j.physio.2023.09.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2022] [Revised: 05/08/2023] [Accepted: 09/19/2023] [Indexed: 01/27/2024]
Abstract
OBJECTIVES To 1) explore physiotherapy students' experience in caring for people with dementia; 2) develop a rich understanding of their perceived preparedness to work with people with dementia upon graduation; and 3) identify opportunities to improve dementia education from the perspectives of students. DESIGN A qualitative study comprised of semi-structured interviews via web conferencing software. Thematic analysis was undertaken, with themes/subthemes derived and a qualitative framework generated. SETTING Three Victorian Universities in Australia. PARTICIPANTS Physiotherapy students of entry-to-professional practice education programs (n = 17; mean age 23.7 years, 65% female), having completed at least 15 weeks of clinical placements. RESULTS The overarching theme was that students' experience of providing care for people with dementia was variable. The three sub-themes were: 1) students experience significant challenges when working with people with dementia, 2) students experience a range of emotions when working with people with dementia, and 3) the quality of dementia learning experiences during entry-to-professional practice training is mostly inadequate. Students described the importance of the supervisor during clinical placements, and suggested incorporating 'real-life' scenario training in the classroom to assist them learn to manage the challenging symptoms of dementia. CONCLUSION Physiotherapy students believe that entry-to-practice dementia education is insufficient. These findings have important implications for the future planning and delivery of physiotherapy dementia education. CONTRIBUTION OF THE PAPER.
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Affiliation(s)
- Stephen M Quick
- Peninsula Clinical School, Monash University, Melbourne, Victoria, Australia; National Centre for Healthy Ageing, Melbourne, Victoria, Australia; Academic Unit, Peninsula Health, Melbourne, Victoria, Australia.
| | - Katherine Lawler
- School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Victoria, Australia; Wicking Dementia Research and Education Centre, University of Tasmania, Hobart, Tasmania, Australia.
| | | | - Sze-Ee Soh
- School of Primary and Allied Health Care, Monash University, Melbourne, Victoria, Australia; School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.
| | - Jennifer L McGinley
- Department of Physiotherapy, The University of Melbourne, Melbourne, Victoria, Australia.
| | - Casey L Peiris
- School of Allied Health, Human Services and Sport, La Trobe University, Melbourne, Victoria, Australia.
| | - David A Snowdon
- Peninsula Clinical School, Monash University, Melbourne, Victoria, Australia; National Centre for Healthy Ageing, Melbourne, Victoria, Australia; Academic Unit, Peninsula Health, Melbourne, Victoria, Australia.
| | - Michele L Callisaya
- Peninsula Clinical School, Monash University, Melbourne, Victoria, Australia; National Centre for Healthy Ageing, Melbourne, Victoria, Australia; Academic Unit, Peninsula Health, Melbourne, Victoria, Australia; Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia.
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28
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Sisodiya SM, Gulcebi MI, Fortunato F, Mills JD, Haynes E, Bramon E, Chadwick P, Ciccarelli O, David AS, De Meyer K, Fox NC, Davan Wetton J, Koltzenburg M, Kullmann DM, Kurian MA, Manji H, Maslin MA, Matharu M, Montgomery H, Romanello M, Werring DJ, Zhang L, Friston KJ, Hanna MG. Climate change and disorders of the nervous system. Lancet Neurol 2024; 23:636-648. [PMID: 38760101 DOI: 10.1016/s1474-4422(24)00087-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2023] [Revised: 02/12/2024] [Accepted: 02/27/2024] [Indexed: 05/19/2024]
Abstract
Anthropogenic climate change is affecting people's health, including those with neurological and psychiatric diseases. Currently, making inferences about the effect of climate change on neurological and psychiatric diseases is challenging because of an overall sparsity of data, differing study methods, paucity of detail regarding disease subtypes, little consideration of the effect of individual and population genetics, and widely differing geographical locations with the potential for regional influences. However, evidence suggests that the incidence, prevalence, and severity of many nervous system conditions (eg, stroke, neurological infections, and some mental health disorders) can be affected by climate change. The data show broad and complex adverse effects, especially of temperature extremes to which people are unaccustomed and wide diurnal temperature fluctuations. Protective measures might be possible through local forecasting. Few studies project the future effects of climate change on brain health, hindering policy developments. Robust studies on the threats from changing climate for people who have, or are at risk of developing, disorders of the nervous system are urgently needed.
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Affiliation(s)
- Sanjay M Sisodiya
- Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, University College London, London, UK; Chalfont Centre for Epilepsy, Chalfont-St-Peter, UK.
| | - Medine I Gulcebi
- Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, University College London, London, UK; Chalfont Centre for Epilepsy, Chalfont-St-Peter, UK
| | - Francesco Fortunato
- Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, University College London, London, UK; Chalfont Centre for Epilepsy, Chalfont-St-Peter, UK
| | - James D Mills
- Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, University College London, London, UK; Chalfont Centre for Epilepsy, Chalfont-St-Peter, UK
| | - Ethan Haynes
- Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, University College London, London, UK; Chalfont Centre for Epilepsy, Chalfont-St-Peter, UK
| | - Elvira Bramon
- Division of Psychiatry, University College London, London, UK
| | - Paul Chadwick
- Centre for Behaviour Change, University College London, London, UK
| | - Olga Ciccarelli
- Department of Neuroinflammation, UCL Queen Square Institute of Neurology, University College London, London, UK; National Institute of Health Research University College London Hospitals Biomedical Research Centre, London, UK
| | - Anthony S David
- Division of Psychiatry, University College London, London, UK
| | - Kris De Meyer
- UCL Climate Action Unit, University College London, London, UK
| | - Nick C Fox
- Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, University College London, London, UK; Department of the UK Dementia Research Institute, UCL Queen Square Institute of Neurology, University College London, London, UK
| | | | - Martin Koltzenburg
- Department of Clinical and Movement Neuroscience, UCL Queen Square Institute of Neurology, University College London, London, UK
| | - Dimitri M Kullmann
- Department of Clinical and Experimental Epilepsy, UCL Queen Square Institute of Neurology, University College London, London, UK
| | - Manju A Kurian
- Department of Developmental Neurosciences, Zayed Centre for Research into Rare Disease in Children, UCL Great Ormond Street Institute of Child Health, London, UK
| | - Hadi Manji
- National Hospital for Neurology and Neurosurgery, London, UK
| | - Mark A Maslin
- Department of Geography, University College London, London, UK; Natural History Museum of Denmark, University of Copenhagen, Copenhagen, Denmark
| | - Manjit Matharu
- Headache and Facial Pain Group, UCL Queen Square Institute of Neurology, UCL and the National Hospital for Neurology and Neurosurgery, London, UK
| | - Hugh Montgomery
- Department of Medicine, University College London, London, UK
| | - Marina Romanello
- Institute for Global Health, University College London, London, UK
| | - David J Werring
- Stroke Research Centre, Department of Brain Repair and Rehabilitation, UCL Queen Square Institute of Neurology, University College London, London, UK
| | - Lisa Zhang
- Centre for Behaviour Change, University College London, London, UK
| | - Karl J Friston
- Wellcome Centre for Human Neuroimaging, UCL Queen Square Institute of Neurology, University College London, London, UK
| | - Michael G Hanna
- Centre for Neuromuscular Diseases, Department of Neuromuscular Diseases, UCL Queen Square Institute of Neurology, University College London, London, UK; MRC International Centre for Genomic Medicine in Neuromuscular Diseases, Department of Neuromuscular Diseases, UCL Queen Square Institute of Neurology, University College London, London, UK
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Hirt J, Vetsch J, Weissenfels I, Heinrich S. Nurse-led physical activity interventions for people with dementia in nursing homes: A systematic review on intervention characteristics and implementation facilitators/barriers. Int J Nurs Stud 2024; 154:104756. [PMID: 38552471 DOI: 10.1016/j.ijnurstu.2024.104756] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Revised: 02/29/2024] [Accepted: 03/11/2024] [Indexed: 05/31/2024]
Abstract
BACKGROUND Physical activities are important to maintain and promote physical functioning and activities of daily living in people with dementia. Nurses are in a key position to deliver physical activity interventions in nursing homes. However, synthesized strategies for sustainable implementation of physical activity interventions in nursing homes for people with dementia are lacking. OBJECTIVE We aimed at synthesizing the evidence on nurse-led physical activity interventions and at identifying facilitators and barriers to sustainable implementation of physical activity interventions for people with dementia. DESIGN Systematic review. REVIEW METHODS We performed a comprehensive literature search combining database searches (MEDLINE, CINAHL, CENTRAL, Web of Science Core Collection; last search: September 27, 2023) and supplementary search methods (citation tracking, web searching, clinical guideline database searching). We considered studies on nurse-led physical activity interventions for people with dementia living in nursing homes for eligibility; published as journal articles and related material in English, French, German language, without restrictions on primary study design and publication year. Independently and in duplicate, we assessed the references' eligibility and the quality of the included studies. We used the Mixed Methods Appraisal Tool to appraise quality of included studies. We piloted and double-checked data extractions, and summarized the results narratively and graphically (harvest plot). We prospectively registered our review (PROSPERO CRD42021271833). RESULTS We identified 24 studies (of which eleven were randomized trials) assessing various interventions that we categorized into physical exercise (n = 8), care-integrated physical activity (n = 6), outdoor or walking activity (n = 5), technology-supported physical exercise (n = 3), and dancing (n = 2). Types of outcomes and length of follow-up varied widely. Effects were inconclusive, except for outdoor or walking activities showing an overall positive impact on physical outcomes. For eight interventions, we identified evidence on implementation barriers (b) and facilitators (f), including staff shortage (b), staff time resources (b), or ease of implementation for staff (f) and adaptability of interventions (f) or refusal to participate of people with dementia (b). CONCLUSIONS The results of our review provide a comprehensive overview on types, characteristics and effects of nurse-led physical activity interventions for people with dementia in nursing homes. Based on evidence from a range of study designs and sources, we came to the conclusion that all stakeholders involved considered physical activity interventions for people with dementia as useful and relevant. Outcome measures varied widely and a clear conclusion on effectiveness remains open.
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Affiliation(s)
- Julian Hirt
- Institute of Nursing Science, Department of Health, Eastern Switzerland University of Applied Sciences, St. Gallen, Switzerland; Department of Clinical Research, University Hospital Basel and University of Basel, Basel, Switzerland.
| | - Janine Vetsch
- Institute of Nursing Science, Department of Health, Eastern Switzerland University of Applied Sciences, St. Gallen, Switzerland.
| | - Inga Weissenfels
- Institute of Nursing Science, Department of Health, Eastern Switzerland University of Applied Sciences, St. Gallen, Switzerland.
| | - Steffen Heinrich
- Institute of Nursing Science, Department of Health, Eastern Switzerland University of Applied Sciences, St. Gallen, Switzerland.
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30
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Atya HB, Sharaf NM, Abdelghany RM, El-Helaly SN, Taha H. Autophagy and exosomes; inter-connected maestros in Alzheimer's disease. Inflammopharmacology 2024; 32:2061-2073. [PMID: 38564092 PMCID: PMC11136856 DOI: 10.1007/s10787-024-01466-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2024] [Accepted: 03/17/2024] [Indexed: 04/04/2024]
Abstract
Autophagy is a crucial process involved in the degradation and recycling of cytoplasmic components which are transported to the lysosomal compartment by autophagosomes. Exosomes are an important means of communication and signaling in both normal and diseased states, and they have a significant role in the transmission and propagation of proteins, especially proteins implicated in neurodegenerative disorders. Autophagy may affect exosomal processing, but whether autophagy controls the release of aggregated β-amyloid and tau proteins in exosomes of Alzheimer disease (AD) is unclear. Therefore, our study aimed to investigate how modulating autophagy affects the exosomal release of these proteins in animal models of AD. Isolated exosomes from brain tissues of 48 male albino mice were divided into four groups (Negative control, LPS, rapamycin (RAPA), and chloroquine (CQ). LC3 I and LC3 II as well as Aβ and Tau proteins levels were determined. All mice undergone Neuro-behavioral tests (Morris Water maze test, Y-maze test, and Novel Object Recognition). Both LPS and CQ groups showed reduced expression levels of LC3 II and LC3 II/LC3 I ratio. In contrast, RAPA group showed a significant increase in both LC3-II expression and LC3-II/LC3-I ratio. The levels of both Aβ & Tau in exosomes of CQ & LPS groups were higher. While RAPA group showed a significant diminished levels of tau & Aβ proteins. In conclusion, our findings suggest that autophagy alterations in AD can influence the release of Aβ and tau proteins through exosomes, which may impact the spread of misfolded proteins in AD. These results highlight a potential innovative therapeutic approach for combating AD.
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Affiliation(s)
- Hanaa B Atya
- Biochemistry and Molecular Biology Department, Faculty of Pharmacy, Helwan University, P.O. Box 11795, Cairo, Egypt.
| | - Nadia Mohamed Sharaf
- Department of Pharmacology and Toxicology, Faculty of Pharmacy and Biotechnology, German University in Cairo-(GUC), Cairo, Egypt
| | - Ragwa Mansour Abdelghany
- Department of Pharmacology and Toxicology, Faculty of Pharmacy and Biotechnology, German University in Cairo-(GUC), Cairo, Egypt
| | - Sara Nageeb El-Helaly
- Department of Pharmaceutics and Industrial Pharmacy, Faculty of Pharmacy, Cairo University, Cairo, Egypt
| | - Heba Taha
- Biochemistry and Molecular Biology Department, Faculty of Pharmacy, Helwan University, P.O. Box 11795, Cairo, Egypt
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Giorelli M. Inequalities in the Prevention and Treatment of Alzheimer Disease. Neurol Clin Pract 2024; 14:e200283. [PMID: 38720952 PMCID: PMC11073886 DOI: 10.1212/cpj.0000000000200283] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2023] [Accepted: 01/22/2024] [Indexed: 05/12/2024]
Abstract
Incidence of Alzheimer disease (AD) is going to rise in the next years and to become a health and social emergency. The prevention and the therapeutic management of AD still present unmet needs worldwide. The recent approval of monoclonal antibodies against amyloid β (anti-Aβ mAbs) for AD has increased the level of uncertainty regarding on how such drugs should be administered, to whom, and for how long. Concerns about cost-effectiveness ratios of anti-Aβ mAbs and the need for actual strategies of risk prevention have further dug barriers of inequalities between the national health care systems. Planning research to address questions on the real feasibility of the correct therapeutic management, improving international cooperation on surveillance of risk factors, implementing pathways for timely diagnosis, and effective medical and social support for patients with AD worldwide would be extremely valuable to fight against this upcoming pandemic.
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Gallant NL, Russill CL, Taylor NC, Nakonechny S, Kohlert A, Ewing K. Time perception among people living with and without dementia: A scoping review. DEMENTIA 2024:14713012241257299. [PMID: 38821887 DOI: 10.1177/14713012241257299] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/02/2024]
Abstract
Dementia often manifests with profound alterations in perception, but it is unclear if and to what extent time perception is altered among people living with dementia compared to those experiencing normal aging. Thus, this scoping review aimed to answer the following research questions: (1) What study designs, participants, time intervals, paradigms, tests, and scores have been employed and in which countries were these methods employed to study time perception in dementia? (2) In which ways do time perception differ across individuals living with and without dementia? (3) In which ways do time perception differ across individuals living with different types of dementia? After deduplication, title and abstract screening, and full-text review, a total of 12 studies were included in this scoping review. Findings generally indicated that people living with dementia perceive time differently than people living without dementia, and that some differences across dementia diagnoses may exist, but the body of literature on time perception in dementia was quite limited. Future research should focus on replicating findings while extending the research to look beyond the dementia versus non-dementia dichotomy as differences across dementia diagnoses may exist. Moreover, if people living with dementia (and, in particular, living with different dementia diagnoses) experience time differently from those experiencing normal aging, we need to begin to address these differences in dementia-friendly initiatives to improve well-being for this population.
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Affiliation(s)
- Natasha L Gallant
- Department of Psychology and Centre on Aging and Health, University of Regina, Canada
| | | | | | | | - Amara Kohlert
- Department of Psychology, University of Regina, Canada
| | - Kyley Ewing
- Department of Philosophy, Cape Breton University, Canada
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Zhu Y, Wang Y, Cui Z, Liu F, Hu J. Identification of pleiotropic and specific therapeutic targets for cardio-cerebral diseases: A large-scale proteome-wide mendelian randomization and colocalization study. PLoS One 2024; 19:e0300500. [PMID: 38820305 PMCID: PMC11142593 DOI: 10.1371/journal.pone.0300500] [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: 11/24/2023] [Accepted: 02/28/2024] [Indexed: 06/02/2024] Open
Abstract
BACKGROUND The cardiac-brain connection has been identified as the basis for multiple cardio-cerebral diseases. However, effective therapeutic targets for these diseases are still limited. Therefore, this study aimed to identify pleiotropic and specific therapeutic targets for cardio-cerebral diseases using Mendelian randomization (MR) and colocalization analyses. METHODS This study included two large protein quantitative trait loci studies with over 4,000 plasma proteins were included in the discovery and replication cohorts, respectively. We initially used MR to estimate the associations between protein and 20 cardio-cerebral diseases. Subsequently, Colocalization analysis was employed to enhance the credibility of the results. Protein target prioritization was based solely on including highly robust significant results from both the discovery and replication phases. Lastly, the Drug-Gene Interaction Database was utilized to investigate protein-gene-drug interactions further. RESULTS A total of 46 target proteins for cardio-cerebral diseases were identified as robust in the discovery and replication phases by MR, comprising 7 pleiotropic therapeutic proteins and 39 specific target proteins. Followed by colocalization analysis and prioritization of evidence grades for target protein, 6 of these protein-disease pairs have achieved the highly recommended level. For instance, the PILRA protein presents a pleiotropic effect on sick sinus syndrome and Alzheimer's disease, whereas GRN exerts specific effects on the latter. APOL3, LRP4, and F11, on the other hand, have specific effects on cardiomyopathy and ischemic stroke, respectively. CONCLUSIONS This study successfully identified important therapeutic targets for cardio-cerebral diseases, which benefits the development of preventive or therapeutic drugs.
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Affiliation(s)
- Yanchen Zhu
- Cardiology Department, Dongfang Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Yahui Wang
- Cardiology Department, Dongfang Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Zhaorui Cui
- Cardiology Department, Dongfang Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Fani Liu
- Cardiology Department, Dongfang Hospital, Beijing University of Chinese Medicine, Beijing, China
| | - Jiqiang Hu
- Cardiology Department, Dongfang Hospital, Beijing University of Chinese Medicine, Beijing, China
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Wang F, Gao C, Wang Y, Li Z, Zheng F, Luo Y. Relationship Between Physical Exercise and Cognitive Function Among Older Adults in China: Cross-Sectional Population-Based Study. JMIR Public Health Surveill 2024; 10:e49790. [PMID: 38815262 DOI: 10.2196/49790] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Revised: 11/25/2023] [Accepted: 03/11/2024] [Indexed: 06/01/2024] Open
Abstract
BACKGROUND The existing literature reveals several significant knowledge gaps that hinder health care providers in formulating exercise prescriptions for cognitive health. OBJECTIVE This study endeavors to elucidate the relationship between the level of physical activity and cognitive function in older adults in China. Moreover, it seeks to explore the associations between distinct exercise behaviors-such as exercise types, the purpose motivating engagement in exercise, the accessibility of exercise fields, and the inclination toward exercise-and cognitive function. METHODS Using data from the China Longitudinal Aging Social Survey (CLASS conducted in 2016, cognitive function was meticulously assessed through the modified Chinese version of the Mini-Mental State Examination, encompassing measures of orientation, memory, and calculation. Using self-report structured questionnaires, a myriad of information about physical activity during leisure time, exercise engagement, exercise intensity, primary exercise types, reasons for exercise participation, availability of sports facilities, and exercise willingness was diligently gathered. Robust ordinary least squares regression models were then used to compute coefficients along with 95% CIs. RESULTS A discernible inverted U-shaped trend in cognitive scores emerged as the level of physical activity surpassed the threshold of 500 metabolic equivalents of task (MET) minutes per week. Notably, individuals with a physical activity level between 500 and 999 MET minutes per week exhibited a coefficient of 0.31 (95% CI 0.09 to 0.54), those with a physical activity level between 1000 and 1499 MET minutes per week displayed a coefficient of 0.75 (95% CI 0.52 to 0.97), and those with a physical activity level above 1500 MET minutes per week demonstrated a coefficient of 0.45 (95% CI 0.23 to 0.68). Older individuals engaging in exercise at specific MET levels showcased superior cognitive function compared to their inactive counterparts. Furthermore, individuals driven by exercise motivations aimed at enhancing physical fitness and health, as well as those using sports facilities or public spaces for exercise, exhibited notably higher cognitive function scores. CONCLUSIONS The findings underscore the potential of exercise as a targeted intervention for the prevention and treatment of dementia or cognitive decline associated with aging in older individuals. Leveraging these insights to formulate informed exercise recommendations holds promise in addressing a significant public health challenge linked to aging populations.
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Affiliation(s)
- Fubaihui Wang
- Social Science of Sport Research Center, China Institute of Sport Science, Beijing, China
| | - Changqing Gao
- Mental Health Center, Kunming Medical University, Kunming, China
| | - Yantao Wang
- Institute for Crime Prevention, Ministry of Justice, Beijing, China
| | - Zhuo Li
- School of Social Sciences, Tsinghua University, Beijing, China
| | - Feiran Zheng
- School of Ethnology and Sociology, Minzu University of China, Beijing, China
| | - Yanan Luo
- Department of Global Health, School of Public Health, Peking University, Beijing, China
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Shang G, Shao Q, Lv K, Xu W, Ji J, Fan S, Kang X, Cheng F, Wang X, Wang Q. Hypercholesterolemia and the Increased Risk of Vascular Dementia: a Cholesterol Perspective. Curr Atheroscler Rep 2024:10.1007/s11883-024-01217-3. [PMID: 38814418 DOI: 10.1007/s11883-024-01217-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/17/2024] [Indexed: 05/31/2024]
Abstract
PURPOSE OF REVIEW Vascular dementia (VaD) is the second most prevalent type of dementia after Alzheimer's disease.Hypercholesterolemia may increase the risk of dementia, but the association between cholesterol and cognitive function is very complex. From the perspective of peripheral and brain cholesterol, we review the relationship between hypercholesterolemia and increased risk of VaD and how the use of lipid-lowering therapies affects cognition. RECENT FINDINGS Epidemiologic studies show since 1980, non-HDL-C levels of individuals has increased rapidly in Asian countries.The study has suggested that vascular risk factors increase the risk of VaD, such as disordered lipid metabolism. Dyslipidemia has been found to interact with chronic cerebral hypoperfusion to promote inflammation resulting in cognitive dysfunction in the brain.Hypercholesterolemia may be a risk factor for VaD. Inflammation could potentially serve as a link between hypercholesterolemia and VaD. Additionally, the potential impact of lipid-lowering therapy on cognitive function is also worth considering. Finding strategies to prevent and treat VaD is critical given the aging of the population to lessen the load on society. Currently, controlling underlying vascular risk factors is considered one of the most effective methods of preventing VaD. Understanding the relationship between abnormal cholesterol levels and VaD, as well as discovering potential serum biomarkers, is important for the early prevention and treatment of VaD.
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Grants
- U21A20400,82205075,81973789 National Natural Science Foundation of China
- U21A20400,82205075,81973789 National Natural Science Foundation of China
- U21A20400,82205075,81973789 National Natural Science Foundation of China
- U21A20400,82205075,81973789 National Natural Science Foundation of China
- U21A20400,82205075,81973789 National Natural Science Foundation of China
- U21A20400,82205075,81973789 National Natural Science Foundation of China
- U21A20400,82205075,81973789 National Natural Science Foundation of China
- U21A20400,82205075,81973789 National Natural Science Foundation of China
- U21A20400,82205075,81973789 National Natural Science Foundation of China
- U21A20400,82205075,81973789 National Natural Science Foundation of China
- (2022-JYB-JBZR-004) Projects of Beijing University of Chinese Medicine
- (2022-JYB-JBZR-004) Projects of Beijing University of Chinese Medicine
- (2022-JYB-JBZR-004) Projects of Beijing University of Chinese Medicine
- (2022-JYB-JBZR-004) Projects of Beijing University of Chinese Medicine
- (2022-JYB-JBZR-004) Projects of Beijing University of Chinese Medicine
- (2022-JYB-JBZR-004) Projects of Beijing University of Chinese Medicine
- (2022-JYB-JBZR-004) Projects of Beijing University of Chinese Medicine
- (2022-JYB-JBZR-004) Projects of Beijing University of Chinese Medicine
- (2022-JYB-JBZR-004) Projects of Beijing University of Chinese Medicine
- (2022-JYB-JBZR-004) Projects of Beijing University of Chinese Medicine
- 7232279 Beijing Natural Science Foundation
- 7232279 Beijing Natural Science Foundation
- 7232279 Beijing Natural Science Foundation
- 7232279 Beijing Natural Science Foundation
- 7232279 Beijing Natural Science Foundation
- 7232279 Beijing Natural Science Foundation
- 7232279 Beijing Natural Science Foundation
- 7232279 Beijing Natural Science Foundation
- 7232279 Beijing Natural Science Foundation
- 7232279 Beijing Natural Science Foundation
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Affiliation(s)
- Guojiao Shang
- School of Traditional Chinese Medicine, Beijing University of Chinese Medicine, No.11 East Beisanhuan Road, Chaoyang District, Beijing, China
| | - Qi Shao
- School of Traditional Chinese Medicine, Beijing University of Chinese Medicine, No.11 East Beisanhuan Road, Chaoyang District, Beijing, China
| | - Kai Lv
- Department of Geratology, The Third Affiliated Hospital of Beijing University of Traditional Chinese Medicine, No.51 Xiaoguan Street, Andingmenwai, Chaoyang District, Beijing, China
| | - Wenxiu Xu
- School of Traditional Chinese Medicine, Beijing University of Chinese Medicine, No.11 East Beisanhuan Road, Chaoyang District, Beijing, China
| | - Jing Ji
- School of Traditional Chinese Medicine, Beijing University of Chinese Medicine, No.11 East Beisanhuan Road, Chaoyang District, Beijing, China
| | - Shuning Fan
- Dongzhimen Hospital of Beijing University of Chinese Medicine, No.5 Haiyuncang, Dongcheng District, Beijing, China
| | - Xiangdong Kang
- School of Traditional Chinese Medicine, Beijing University of Chinese Medicine, No.11 East Beisanhuan Road, Chaoyang District, Beijing, China
| | - Fafeng Cheng
- School of Traditional Chinese Medicine, Beijing University of Chinese Medicine, No.11 East Beisanhuan Road, Chaoyang District, Beijing, China.
| | - Xueqian Wang
- School of Traditional Chinese Medicine, Beijing University of Chinese Medicine, No.11 East Beisanhuan Road, Chaoyang District, Beijing, China.
| | - Qingguo Wang
- School of Traditional Chinese Medicine, Beijing University of Chinese Medicine, No.11 East Beisanhuan Road, Chaoyang District, Beijing, China.
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Nicola L, Loo SJQ, Lyon G, Turknett J, Wood TR. Does resistance training in older adults lead to structural brain changes associated with a lower risk of Alzheimer's dementia? A narrative review. Ageing Res Rev 2024; 98:102356. [PMID: 38823487 DOI: 10.1016/j.arr.2024.102356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2024] [Accepted: 05/27/2024] [Indexed: 06/03/2024]
Abstract
Dementia, particularly Alzheimer's Disease (AD), has links to modifiable risk factors, particularly physical inactivity. However, cognitive benefits are generally attributed to aerobic exercise, with resistance exercise (RE) receiving less attention. This review aims to address this gap by evaluating the impact of RE on brain structures and cognitive deficits associated with AD. Drawing insights from randomized controlled trials (RCTs) utilizing structural neuroimaging, the specific influence of RE on AD-affected brain structures and their correlation with cognitive function are discussed. Preliminary findings suggest that RE induces structural brain changes in older adults that could reduce the risk of AD or mitigate AD progression. Importantly, the impacts of RE appear to follow a dose-response effect, reversing pathological structural changes and improving associated cognitive functions if performed at least twice per week for at least six months, with greatest effects in those already experiencing some element of cognitive decline. While more research is eagerly awaited, this review contributes insights into the potential benefits of RE for cognitive health in the context of AD-related changes in brain structure and function.
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Affiliation(s)
| | | | | | | | - Thomas R Wood
- Department of Pediatrics, University of Washington, Seattle, WA; Institute for Human and Machine Cognition, Pensacola, FL.
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Boucher E, Jell A, Singh S, Davies J, Smith T, Pill A, Varnai K, Woods K, Walliker D, McColl A, Shepperd S, Pendlebury S. Protocol for the Development and Analysis of the Oxford and Reading Cognitive Comorbidity, Frailty and Ageing Research Database-Electronic Patient Records (ORCHARD-EPR). BMJ Open 2024; 14:e085126. [PMID: 38816052 PMCID: PMC11141189 DOI: 10.1136/bmjopen-2024-085126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2024] [Accepted: 05/01/2024] [Indexed: 06/01/2024] Open
Abstract
BACKGROUND Hospital electronic patient records (EPRs) offer the opportunity to exploit large-scale routinely acquired data at relatively low cost and without selection. EPRs provide considerably richer data, and in real-time, than retrospective administrative data sets in which clinical complexity is often poorly captured. With population ageing, a wide range of hospital specialties now manage older people with multimorbidity, frailty and associated poor outcomes. We, therefore, set-up the Oxford and Reading Cognitive Comorbidity, Frailty and Ageing Research Database-Electronic Patient Records (ORCHARD-EPR) to facilitate clinically meaningful research in older hospital patients, including algorithm development, and to aid medical decision-making, implementation of guidelines, and inform policy. METHODS AND ANALYSIS ORCHARD-EPR uses routinely acquired individual patient data on all patients aged ≥65 years with unplanned admission or Same Day Emergency Care unit attendance at four acute general hospitals serving a population of >800 000 (Oxfordshire, UK) with planned extension to the neighbouring Berkshire regional hospitals (>1 000 000). Data fields include diagnosis, comorbidities, nursing risk assessments, frailty, observations, illness acuity, laboratory tests and brain scan images. Importantly, ORCHARD-EPR contains the results from mandatory hospital-wide cognitive screening (≥70 years) comprising the 10-point Abbreviated-Mental-Test and dementia and delirium diagnosis (Confusion Assessment Method-CAM). Outcomes include length of stay, delayed transfers of care, discharge destination, readmissions and death. The rich multimodal data are further enhanced by linkage to secondary care electronic mental health records. Selection of appropriate subgroups or linkage to existing cohorts allows disease-specific studies. Over 200 000 patient episodes are included to date with data collection ongoing of which 129 248 are admissions with a length of stay ≥1 day in 64 641 unique patients. ETHICS AND DISSEMINATION ORCHARD-EPR is approved by the South Central Oxford C Research Ethics Committee (ref: 23/SC/0258). Results will be widely disseminated through peer-reviewed publications and presentations at conferences, and regional meetings to improve hospital data quality and clinical services.
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Affiliation(s)
- Emily Boucher
- Wolfson Centre for Prevention of Stroke and Dementia, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
| | - Aimee Jell
- Informatics Department, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - Sudhir Singh
- Department of Acute General (Internal) Medicine, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
- Department of Geratology, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - Jim Davies
- Department of Computer Science, University of Oxford, Oxford, UK
| | - Tanya Smith
- Research Informatics Team, Research and Development Department, Oxford Health NHS Foundation Trust, Oxford, UK
- NIHR Oxford Health Biomedical Research Centre, Oxford, UK
| | - Adam Pill
- Research Informatics Team, Research and Development Department, Oxford Health NHS Foundation Trust, Oxford, UK
| | - Kinga Varnai
- Research and Development Clinical Informatics, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - Kerrie Woods
- Research and Development Clinical Informatics, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - David Walliker
- Research and Development Clinical Informatics, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - Aubretia McColl
- Department of Acute Medicine, Royal Berkshire NHS Foundation Trust, Reading, UK
- Department of Elderly Care Medicine, Royal Berkshire NHS Hospital Foundation Trust, Reading, UK
| | - Sasha Shepperd
- Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Sarah Pendlebury
- Wolfson Centre for Prevention of Stroke and Dementia, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
- Department of Acute General (Internal) Medicine, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
- Department of Geratology, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
- NIHR Oxford Biomedical Research Centre, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
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38
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Vargas-Barona A, Bernáldez-Sarabia J, Castro-Ceseña AB. Lipid-polymer hybrid nanoparticles loaded with N-acetylcysteine for the modulation of neuroinflammatory biomarkers in human iPSC-derived PSEN2 (N141I) astrocytes as a model of Alzheimer's disease. J Mater Chem B 2024; 12:5085-5097. [PMID: 38713059 DOI: 10.1039/d4tb00521j] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/08/2024]
Abstract
Alzheimer's disease (AD) is a progressive neurodegenerative disease characterized by cognitive impairment associated with the accumulation of beta-amyloid protein (Aβ). Aβ activates glial cells in the brain, increasing the secretion of proinflammatory cytokines, which leads to neuroinflammation and neuronal death. Currently, there are no effective treatments that cure or stop its progression; therefore, AD is considered a global health priority. The main limitations are the low drug bioavailability and impermeability of the blood-brain barrier (BBB). Fortunately, nanomedicine has emerged as a promising field for the development of new nanosystems for the controlled and targeted delivery of drugs to the brain. Therefore, in this work, lipid-polymer hybrid nanoparticles (LPHNPs) conjugated with transferrin (Tf) to facilitate crossing the BBB and loaded with N-acetylcysteine (NAC) for its anti-inflammatory effect were synthesized, and their physicochemical characterization was carried out. Subsequently, an in vitro model involving human astrocytes derived from induced pluripotent stem cells (iPSC) from an AD-diagnosed patient was developed, which was brought to a reactive state by stimulation with lipopolysaccharides (LPSs). The cell culture was treated with either Tf-conjugated LPHNPs loaded with NAC (NAC-Tf-LPHNPs) at 0.25 mg mL-1, or free NAC at 5 mM. The results showed that NAC-Tf-LPHNPs favorably modulated the expression of proinflammatory genes such as interleukin-1β (IL-1β), amyloid precursor protein (APP) and glial fibrillary acidic protein (GFAP). In addition, they reduced the secretion of the proinflammatory cytokines interleukin 6 (IL-6), IL-1β and interferon-gamma (INF-γ). Results for both cases were compared to the group of cells that did not receive any treatment. In contrast, free NAC only had this effect on the expression of IL-1β and the secretion of the cytokines IL-6 and INF-γ. These results indicate the potential of NAC-Tf-LPHNPs for AD treatment.
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Affiliation(s)
- Alondra Vargas-Barona
- Departamento de Innovación Biomédica, Centro de Investigación Científica y de Educación Superior de Ensenada, Baja California (CICESE), Carretera Ensenada- Tijuana No. 3918, Zona Playitas, C.P. 22860, Ensenada, Baja California, Mexico.
| | - Johanna Bernáldez-Sarabia
- Departamento de Innovación Biomédica, Centro de Investigación Científica y de Educación Superior de Ensenada, Baja California (CICESE), Carretera Ensenada- Tijuana No. 3918, Zona Playitas, C.P. 22860, Ensenada, Baja California, Mexico.
| | - Ana B Castro-Ceseña
- Departamento de Innovación Biomédica, Centro de Investigación Científica y de Educación Superior de Ensenada, Baja California (CICESE), Carretera Ensenada- Tijuana No. 3918, Zona Playitas, C.P. 22860, Ensenada, Baja California, Mexico.
- CONAHCYT-Departamento de Innovación Biomédica, Centro de Investigación Científica y de Educación Superior de Ensenada, Baja California (CICESE), Carretera Ensenada-Tijuana No. 3918, Zona Playitas, C.P. 22860, Ensenada, Baja California, Mexico
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39
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Şener M, Küçükgüçlü Ö, Akyol MA. Does having a family member with dementia affect health beliefs about changing lifestyle and health behaviour for dementia risk reduction? Psychogeriatrics 2024. [PMID: 38811353 DOI: 10.1111/psyg.13134] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2024] [Revised: 04/26/2024] [Accepted: 05/11/2024] [Indexed: 05/31/2024]
Abstract
BACKGROUND Dementia is a worldwide public health concern. Implementing lifestyle changes that target modifiable risk factors is crucial for reducing the risk of dementia. The aim of this study was to investigate the effect of having family members with dementia on individuals' health beliefs and tendencies towards adopting healthier lifestyles and behaviours. METHODS A cross-sectional, comparative study was conducted with 338 people aged 40 years and older, of whom 168 have the experience of having family members with dementia, and 170 have no such experience. Data were collected using a characteristics form, the Motivation to Change Lifestyle and Health Behaviours for Dementia Risk Reduction scale, and the modified Charlson comorbidity index. Descriptive statistics, Pearson's chi-square and independent t-tests, were used. RESULTS Those with family members with dementia were more likely to have greater motivation to modify their lifestyle (perceived susceptibility, severity, benefits, and cues to action) to reduce their risk of developing dementia. Additionally, they had greater perceived barriers to gain by adopting a healthy lifestyle, in contrast to those without such family members. CONCLUSION The presence of family members with dementia could be an important factor to consider when designing initiatives targeting health beliefs related to dementia prevention behaviours and lifestyle changes.
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Affiliation(s)
- Melek Şener
- SBU Izmir Bozyaka Education and Research Hospital, Karabaglar, Turkiye
| | - Özlem Küçükgüçlü
- Department of Internal Medicine Nursing, Dokuz Eylul University Faculty of Nursing, Inciralti, Turkiye
| | - Merve Aliye Akyol
- Department of Internal Medicine Nursing, Dokuz Eylul University Faculty of Nursing, Inciralti, Turkiye
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40
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Jiang B, Liu Q, Li JP, Lin SN, Wan HJ, Yu ZW, Wang J, Zhuang W, Tang JH, Chen CH, Li FY, Bi M, Xiao NA, Zheng KM. Prevalence and risk factors for dementia and mild cognitive impairment among older people in Southeast China: a community-based study. BMC Geriatr 2024; 24:466. [PMID: 38807058 PMCID: PMC11134668 DOI: 10.1186/s12877-024-05054-6] [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: 01/29/2024] [Accepted: 05/08/2024] [Indexed: 05/30/2024] Open
Abstract
BACKGROUND With the aging population, the number of individuals with dementia in China is increasing rapidly. This community-based study aimed to investigate the prevalence and risk factors for dementia and mild cognitive impairment (MCI) among older adults in China. METHODS In this study, 20,070 individuals aged ≥ 65 were recruited between January 1, 2022, and February 1, 2023, from ten communities in Xiamen City, China. We collected data on age, sex, level of education, and medical history, as well as global cognition and functional status. The prevalence of dementia and MCI was examined, and the risk factors for different groups were assessed. RESULTS The overall prevalence of dementia and MCI was approximately 5.4% (95% confidence interval [CI], 5.1-5.7) and 7.7% (95% CI, 7.4-8.1), respectively. The results also indicated that dementia and MCI share similar risk factors, including older age, female sex, hypertension, and diabetes mellitus. Compared with individuals with no formal education, those with > 6 years of education had an odds ratio for MCI of 1.83 (95% CI, 1.49-2.25). We also found that only 5.5% of the positive participants chose to be referred to the hospital for further diagnosis and treatment during follow-up visits. CONCLUSIONS This study estimated the prevalence and risk factors for dementia and MCI among individuals aged ≥ 65 years in Southeast China. These findings are crucial for preventing and managing dementia and MCI in China.
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Affiliation(s)
- Bin Jiang
- Department of Neurology and Department of Neuroscience, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China
- The School of Clinical Medicine, Fujian Medical University, Fuzhou, China
- Xiamen Key Laboratory of Brain Center, Xiamen, China
| | - Qi Liu
- Department of Neurology and Department of Neuroscience, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China
- The School of Clinical Medicine, Fujian Medical University, Fuzhou, China
- Xiamen Key Laboratory of Brain Center, Xiamen, China
| | - Jian-Peng Li
- Department of Neurology and Department of Neuroscience, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China
- The School of Clinical Medicine, Fujian Medical University, Fuzhou, China
- Xiamen Key Laboratory of Brain Center, Xiamen, China
| | - Si-Ning Lin
- Department of Neurology and Department of Neuroscience, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China
- The School of Clinical Medicine, Fujian Medical University, Fuzhou, China
| | - Hui-Juan Wan
- Department of Neurology and Department of Neuroscience, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China
- The School of Clinical Medicine, Fujian Medical University, Fuzhou, China
- Xiamen Key Laboratory of Brain Center, Xiamen, China
| | - Zi-Wen Yu
- Department of Neurology and Department of Neuroscience, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China
- The School of Clinical Medicine, Fujian Medical University, Fuzhou, China
- Xiamen Key Laboratory of Brain Center, Xiamen, China
| | - Jing Wang
- Department of Neurology and Department of Neuroscience, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China
- The School of Clinical Medicine, Fujian Medical University, Fuzhou, China
- Xiamen Key Laboratory of Brain Center, Xiamen, China
| | - Wei Zhuang
- Department of Neurology, Nanjing County Hospital, Zhangzhou, China
| | - Jia-Hui Tang
- Department of Neurology and Department of Neuroscience, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China
- The School of Clinical Medicine, Fujian Medical University, Fuzhou, China
- Xiamen Key Laboratory of Brain Center, Xiamen, China
| | - Cai-Hong Chen
- Department of Neurology and Department of Neuroscience, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China
- The School of Clinical Medicine, Fujian Medical University, Fuzhou, China
- Xiamen Key Laboratory of Brain Center, Xiamen, China
| | - Fa-Yin Li
- Department of Neurology and Department of Neuroscience, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China
- The School of Clinical Medicine, Fujian Medical University, Fuzhou, China
- Xiamen Key Laboratory of Brain Center, Xiamen, China
| | - Min Bi
- Department of Neurology and Department of Neuroscience, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China.
- The School of Clinical Medicine, Fujian Medical University, Fuzhou, China.
- Xiamen Key Laboratory of Brain Center, Xiamen, China.
| | - Nai-An Xiao
- Department of Neurology and Department of Neuroscience, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China.
- The School of Clinical Medicine, Fujian Medical University, Fuzhou, China.
- Department of Neurology, The Third Hospital of Xiamen, Xiamen, China.
| | - Kun-Mu Zheng
- Department of Neurology and Department of Neuroscience, The First Affiliated Hospital of Xiamen University, School of Medicine, Xiamen University, Xiamen, China.
- The School of Clinical Medicine, Fujian Medical University, Fuzhou, China.
- Xiamen Key Laboratory of Brain Center, Xiamen, China.
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Kakinen A, Jiang Y, Davis TP, Teesalu T, Saarma M. Brain Targeting Nanomedicines: Pitfalls and Promise. Int J Nanomedicine 2024; 19:4857-4875. [PMID: 38828195 PMCID: PMC11143448 DOI: 10.2147/ijn.s454553] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Accepted: 04/15/2024] [Indexed: 06/05/2024] Open
Abstract
Brain diseases are the most devastating problem among the world's increasingly aging population, and the number of patients with neurological diseases is expected to increase in the future. Although methods for delivering drugs to the brain have advanced significantly, none of these approaches provide satisfactory results for the treatment of brain diseases. This remains a challenge due to the unique anatomy and physiology of the brain, including tight regulation and limited access of substances across the blood-brain barrier. Nanoparticles are considered an ideal drug delivery system to hard-to-reach organs such as the brain. The development of new drugs and new nanomaterial-based brain treatments has opened various opportunities for scientists to develop brain-specific delivery systems that could improve treatment outcomes for patients with brain disorders such as Alzheimer's disease, Parkinson's disease, stroke and brain tumors. In this review, we discuss noteworthy literature that examines recent developments in brain-targeted nanomedicines used in the treatment of neurological diseases.
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Affiliation(s)
- Aleksandr Kakinen
- Institute of Biotechnology, HiLIFE, University of Helsinki, Helsinki, Finland
- Australian Institute for Bioengineering and Nanotechnology, University of Queensland, Brisbane, QLD, Australia
| | - Yuhao Jiang
- Australian Institute for Bioengineering and Nanotechnology, University of Queensland, Brisbane, QLD, Australia
| | - Thomas Paul Davis
- Australian Institute for Bioengineering and Nanotechnology, University of Queensland, Brisbane, QLD, Australia
| | - Tambet Teesalu
- Institute of Biomedicine and Translational Medicine, Faculty of Medicine, University of Tartu, Tartu, Estonia
- Materials Research Laboratory, University of California Santa Barbara, Santa Barbara, CA, USA
| | - Mart Saarma
- Institute of Biotechnology, HiLIFE, University of Helsinki, Helsinki, Finland
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42
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Collins-Pisano C, Leggett AN, Gambee D, Fortuna KL. Usability, Acceptability, and Preliminary Effectiveness of a Peer-Delivered and Technology-Supported Mental Health Intervention for Family Caregivers of People With Dementia: Field Usability Study. JMIR Hum Factors 2024; 11:e41202. [PMID: 38801660 DOI: 10.2196/41202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Revised: 01/02/2023] [Accepted: 04/13/2023] [Indexed: 05/29/2024] Open
Abstract
BACKGROUND Family caregivers of people with dementia are critical to the quality of life of care recipients and the sustainability of health care systems but face an increased risk of emotional distress and negative physical and mental health outcomes. OBJECTIVE The purpose of this study was to examine the usability, acceptability, and preliminary effectiveness of a technology-based and caregiver-delivered peer support program, the Caregiver Remote Education and Support (CARES) smartphone or tablet app. METHODS A total of 9 adult family caregivers of people with dementia received the CARES intervention, and 3 former family caregivers of people with dementia were trained to deliver it. Quantitative data were collected at baseline and at the end of the 2-week field usability study. Qualitative data were also collected at the end of the 2-week field usability study. RESULTS The field usability study demonstrated that a 2-week peer-delivered and technology-supported mental health intervention designed to improve burden, stress, and strain levels was experienced by former and current family caregivers of people with dementia as acceptable. Current family caregivers rated CARES as above average in usability, whereas the caregiver peer supporters rated CARES as marginally usable. CARES was associated with non-statistically significant improvements in burden, stress, and strain levels. CONCLUSIONS This field usability study demonstrated that it is possible to train former family caregivers of people with dementia to use technology to deliver a mental health intervention to current family caregivers of people with dementia. Future studies would benefit from a longer trial; a larger sample size; a randomized controlled design; and a control of covariables such as stages of dementia, years providing care, and severity of dementia symptoms.
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Affiliation(s)
- Caroline Collins-Pisano
- Department of Psychological and Brain Sciences, Dartmouth College, Hanover, NH, United States
- Department of Psychology, University of Colorado, Colorado Springs, Colorado Springs, CO, United States
| | - Amanda N Leggett
- Institute of Gerontology, Wayne State University, Detroit, MI, United States
| | - David Gambee
- Department of Psychiatry, Dartmouth College, Hanover, NH, United States
| | - Karen L Fortuna
- Department of Psychiatry, Dartmouth College, Hanover, NH, United States
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43
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Arslan B, Zetterberg H, Ashton NJ. Blood-based biomarkers in Alzheimer's disease - moving towards a new era of diagnostics. Clin Chem Lab Med 2024; 62:1063-1069. [PMID: 38253262 DOI: 10.1515/cclm-2023-1434] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Accepted: 01/05/2024] [Indexed: 01/24/2024]
Abstract
Alzheimer's disease (AD), a primary cause of dementia globally, is traditionally diagnosed via cerebrospinal fluid (CSF) measures and positron emission tomography (PET). The invasiveness, cost, and limited accessibility of these methods have led to exploring blood-based biomarkers as a promising alternative for AD diagnosis and monitoring. Recent advancements in sensitive immunoassays have identified potential blood-based biomarkers, such as Aβ42/Aβ40 ratios and phosphorylated tau (p-tau) species. This paper briefly evaluates the clinical utility and reliability of these biomarkers across various AD stages, highlighting challenges like refining plasma Aβ42/Aβ40 assays and enhancing the precision of p-tau, particularly p-tau181, p-tau217, and p-tau231. The discussion also covers other plasma biomarkers like neurofilament light (NfL), glial fibrillary acidic protein (GFAP), and synaptic biomarkers, assessing their significance in AD diagnostics. The need for ongoing research and development of robust assays to match the performance of CSF and PET biomarkers is underscored. In summary, blood-based biomarkers are increasingly crucial in AD diagnosis, follow-up, prognostication, treatment response evaluation, and population screening, particularly in primary care settings. These developments are set to revolutionize AD diagnostics, offering earlier and more accessible detection and management options.
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Affiliation(s)
- Burak Arslan
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden
- Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden
| | - Henrik Zetterberg
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden
- Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden
- Wisconsin Alzheimer's Disease Research Center, School of Medicine and Public Health, University of Wisconsin-Madison, Madison, WI, USA
- Department of Neurodegenerative Disease, UCL Institute of Neurology, London, UK
- UK Dementia Research Institute at UCL, London, UK
- Hong Kong Center for Neurodegenerative Diseases, Clear Water Bay, Hong Kong, P.R. China
| | - Nicholas J Ashton
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at the University of Gothenburg, Mölndal, Sweden
- Department of Old Age Psychiatry, Psychology & Neuroscience, King's College London, Institute of Psychiatry, London, UK
- King's College London, Institute of Psychiatry, Psychology and Neuroscience, Maurice Wohl Institute Clinical Neuroscience Institute, London, UK
- NIHR Biomedical Research Centre for Mental Health & Biomedical Research Unit for Dementia at South London & Maudsley, NHS Foundation, London, UK
- Centre for Age-Related Medicine, Stavanger University Hospital, Stavanger, Norway
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Duodu PA, Dey NEY, Okyere J, Simkhada B, Barker C, Gillibrand W, Simkhada P. Gendered differences in the prevalence and associated factors of dementia in Ghana: a cross-sectional survey. BMC Psychiatry 2024; 24:397. [PMID: 38802813 PMCID: PMC11131303 DOI: 10.1186/s12888-024-05856-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/08/2023] [Accepted: 05/17/2024] [Indexed: 05/29/2024] Open
Abstract
BACKGROUND Dementia as a global phenomenon has received significant attention in research due to the adverse effects it has on the daily functioning of its victims. Despite studies conducted in relation to the prevalence and associated factors of dementia in Ghana, not much attention has been paid to the influence of gender. The study, therefore, focused on estimating gender differences in the prevalence and associated factors of dementia in the Ashanti Region of Ghana. METHODS This study adopted a cross-sectional design with surveys to recruit 800 participants who were 45 years or older. The data was obtained using the standardized Rowland Universal Dementia Assessment Scale (RUDAS) together with information on the various associated factors. A series of logistic models comprising of the total sample model, male sample model, and female sample model were estimated to analyse the data. All data analyses were completed in Stata version 14. RESULTS The overall prevalence of dementia was 23.38% [95% CI:20.44, 26.31]. More females 24.56% [95% CI:20.81, 28.31] compared to males 21.31% [95% CI:16.57, 26.04] were at risk of dementia. Younger age, attaining formal education, and belonging to richer households were negatively associated with the risk of dementia. In the total sample model, younger age and attaining formal education were negatively associated with dementia risk. In the male-female stratified models, education and household wealth index were negatively associated with dementia risk in the male sample while age and education were negatively related to dementia risk in the female sample. CONCLUSION The study concludes that there are gendered differences in the prevalence and factors associated with the risk of dementia in Ghana. As such, interventions and programmes to identify dementia cases must be gender sensitive. Specifically, when addressing dementia risk in males, interventions should be directed towards those with lower wealth status. Likewise, when developing programmes to mitigate dementia risk in women, particular attention should be given to women in the oldest age category.
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Grants
- HHS013-01 Strategic Research Investment Seed Funding, School of Human and Health Sciences, University of Huddersfield
- HHS013-01 Strategic Research Investment Seed Funding, School of Human and Health Sciences, University of Huddersfield
- HHS013-01 Strategic Research Investment Seed Funding, School of Human and Health Sciences, University of Huddersfield
- HHS013-01 Strategic Research Investment Seed Funding, School of Human and Health Sciences, University of Huddersfield
- HHS013-01 Strategic Research Investment Seed Funding, School of Human and Health Sciences, University of Huddersfield
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Affiliation(s)
- Precious Adade Duodu
- Department of Nursing, School of Human and Health Sciences, University of Huddersfield, Queensgate, Huddersfield, England, UK
| | | | - Joshua Okyere
- Department of Population and Health, University of Cape Coast, Cape Coast, Ghana.
- School of Nursing and Midwifery, College of Health Sciences, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.
| | - Bibha Simkhada
- Department of Nursing, School of Human and Health Sciences, University of Huddersfield, Queensgate, Huddersfield, England, UK
| | - Caroline Barker
- Department of Nursing, School of Human and Health Sciences, University of Huddersfield, Queensgate, Huddersfield, England, UK
| | - Warren Gillibrand
- Department of Nursing, School of Human and Health Sciences, University of Huddersfield, Queensgate, Huddersfield, England, UK
| | - Padam Simkhada
- School of Human and Health Sciences, University of Huddersfield, Queensgate, Huddersfield, England, UK
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Kumar N, Jangid K, Kumar V, Yadav RP, Mishra J, Upadhayay S, Kumar V, Devi B, Kumar V, Dwivedi AR, Kumar P, Baranwal S, Bhatti JS, Kumar V. In Vitro and In Vivo Investigations of Chromone Derivatives as Potential Multitarget-Directed Ligands: Cognitive Amelioration Utilizing a Scopolamine-Induced Zebrafish Model. ACS Chem Neurosci 2024. [PMID: 38795037 DOI: 10.1021/acschemneuro.4c00007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/27/2024] Open
Abstract
Alzheimer's disease is a complex neurological disorder linked with multiple pathological hallmarks. The interrelation of therapeutic targets assists in the enhancement of cognitive decline through interference with overall neuronal transmission. We have synthesized and screened various chromone derivatives as potential multitarget-directed ligands for the effective treatment of Alzheimer's disease. The synthesized compounds exhibited multipotent activity against AChE, BuChE, MAO-B, and amyloid β aggregation. Three potent compounds, i.e., VN-3, VN-14, and VN-19 were identified that displayed remarkable activities against different targets. These compounds displayed IC50 values of 80 nM, 2.52 μM, and 140 nM against the AChE enzyme, respectively, and IC50 values of 2.07 μM, 70 nM, and 450 nM against the MAO-B isoform, respectively. VN-3 displayed potent activity against self-induced Aβ1-42 aggregation with inhibition of 58.3%. In the ROS inhibition studies, the most potent compounds reduced the intracellular ROS levels up to 80% in SH-SY5Y cells at 25 μM concentration. The compounds were found to be neuroprotective and noncytotoxic even at a concentration of 25 μM against SH-SY5Y cells. In silico studies showed that the compounds were nicely accommodated in the active sites of the receptors along with thermodynamically stable orientations. Compound VN-19 exhibited a balanced multitargeting profile against AChE, BuChE, MAO-B, and Aβ1-42 enzymes and was further evaluated for in vivo activities on the scopolamine-induced zebrafish model. VN-19 was found to ameliorate the cognitive decline in zebrafish brains by protecting them against scopolamine-induced neurodegeneration. Thus, VN-3, VN-14, and VN-19 were identified as potent multitarget-directed ligands with a balanced activity profile against different targets and can be developed as therapeutics for AD.
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Affiliation(s)
- Naveen Kumar
- Laboratory of Organic and Medicinal Chemistry, Department of Chemistry, Central University of Punjab, Bathinda, Punjab 151401, India
| | - Kailash Jangid
- Laboratory of Organic and Medicinal Chemistry, Department of Chemistry, Central University of Punjab, Bathinda, Punjab 151401, India
- Department of Pharmaceutical Sciences and Natural Products, Central University of Punjab, Bathinda, Punjab 151401, India
| | - Vishal Kumar
- Department of Pharmacology, Central University of Punjab, Bathinda, Punjab 151401, India
| | - Ravi Prakash Yadav
- Gastrointestinal Disease Lab, Department of Microbiology, Central University of Punjab, Bathinda, Punjab 151401, India
| | - Jayapriya Mishra
- Laboratory of Translational Medicine and Nanotherapeutics, Department of Human Genetics and Molecular Medicine, Central University of Punjab, Bathinda, Punjab 151401, India
| | - Shubham Upadhayay
- Department of Pharmacology, Central University of Punjab, Bathinda, Punjab 151401, India
| | - Vinay Kumar
- Laboratory of Organic and Medicinal Chemistry, Department of Chemistry, Central University of Punjab, Bathinda, Punjab 151401, India
| | - Bharti Devi
- Laboratory of Organic and Medicinal Chemistry, Department of Chemistry, Central University of Punjab, Bathinda, Punjab 151401, India
| | - Vijay Kumar
- Laboratory of Organic and Medicinal Chemistry, Department of Chemistry, Central University of Punjab, Bathinda, Punjab 151401, India
| | - Ashish Ranjan Dwivedi
- Department of Pharmaceutical Sciences and Natural Products, Central University of Punjab, Bathinda, Punjab 151401, India
- Gitam School of Pharmacy, Hyderabad, Telangana 502329, India
| | - Puneet Kumar
- Department of Pharmacology, Central University of Punjab, Bathinda, Punjab 151401, India
| | - Somesh Baranwal
- Gastrointestinal Disease Lab, Department of Microbiology, Central University of Punjab, Bathinda, Punjab 151401, India
| | - Jasvinder Singh Bhatti
- Laboratory of Translational Medicine and Nanotherapeutics, Department of Human Genetics and Molecular Medicine, Central University of Punjab, Bathinda, Punjab 151401, India
| | - Vinod Kumar
- Laboratory of Organic and Medicinal Chemistry, Department of Chemistry, Central University of Punjab, Bathinda, Punjab 151401, India
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Zahr NM. Alcohol Use Disorder and Dementia: A Review. Alcohol Res 2024; 44:03. [PMID: 38812709 PMCID: PMC11135165 DOI: 10.35946/arcr.v44.1.03] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2024] Open
Abstract
PURPOSE By 2040, 21.6% of Americans will be over age 65, and the population of those older than age 85 is estimated to reach 14.4 million. Although not causative, older age is a risk factor for dementia: every 5 years beyond age 65, the risk doubles; approximately one-third of those older than age 85 are diagnosed with dementia. As current alcohol consumption among older adults is significantly higher compared to previous generations, a pressing question is whether drinking alcohol increases the risk for Alzheimer's disease or other forms of dementia. SEARCH METHODS Databases explored included PubMed, Web of Science, and ScienceDirect. To accomplish this narrative review on the effects of alcohol consumption on dementia risk, the literature covered included clinical diagnoses, epidemiology, neuropsychology, postmortem pathology, neuroimaging and other biomarkers, and translational studies. Searches conducted between January 12 and August 1, 2023, included the following terms and combinations: "aging," "alcoholism," "alcohol use disorder (AUD)," "brain," "CNS," "dementia," "Wernicke," "Korsakoff," "Alzheimer," "vascular," "frontotemporal," "Lewy body," "clinical," "diagnosis," "epidemiology," "pathology," "autopsy," "postmortem," "histology," "cognitive," "motor," "neuropsychological," "magnetic resonance," "imaging," "PET," "ligand," "degeneration," "atrophy," "translational," "rodent," "rat," "mouse," "model," "amyloid," "neurofibrillary tangles," "α-synuclein," or "presenilin." When relevant, "species" (i.e., "humans" or "other animals") was selected as an additional filter. Review articles were avoided when possible. SEARCH RESULTS The two terms "alcoholism" and "aging" retrieved about 1,350 papers; adding phrases-for example, "postmortem" or "magnetic resonance"-limited the number to fewer than 100 papers. Using the traditional term, "alcoholism" with "dementia" resulted in 876 citations, but using the currently accepted term "alcohol use disorder (AUD)" with "dementia" produced only 87 papers. Similarly, whereas the terms "Alzheimer's" and "alcoholism" yielded 318 results, "Alzheimer's" and "alcohol use disorder (AUD)" returned only 40 citations. As pertinent postmortem pathology papers were published in the 1950s and recent animal models of Alzheimer's disease were created in the early 2000s, articles referenced span the years 1957 to 2024. In total, more than 5,000 articles were considered; about 400 are herein referenced. DISCUSSION AND CONCLUSIONS Chronic alcohol misuse accelerates brain aging and contributes to cognitive impairments, including those in the mnemonic domain. The consensus among studies from multiple disciplines, however, is that alcohol misuse can increase the risk for dementia, but not necessarily Alzheimer's disease. Key issues to consider include the reversibility of brain damage following abstinence from chronic alcohol misuse compared to the degenerative and progressive course of Alzheimer's disease, and the characteristic presence of protein inclusions in the brains of people with Alzheimer's disease, which are absent in the brains of those with AUD.
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Affiliation(s)
- Natalie M Zahr
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, California. Center for Health Sciences, SRI International, Menlo Park, California
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47
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Ilyas K, Iqbal H, Akash MSH, Rehman K, Hussain A. Heavy metal exposure and metabolomics analysis: an emerging frontier in environmental health. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2024:10.1007/s11356-024-33735-7. [PMID: 38780845 DOI: 10.1007/s11356-024-33735-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/07/2024] [Accepted: 05/16/2024] [Indexed: 05/25/2024]
Abstract
Exposure to heavy metals in various populations can lead to extensive damage to different organs, as these metals infiltrate and bioaccumulate in the human body, causing metabolic disruptions in various organs. To comprehensively understand the metal homeostasis, inter-organ "traffic," and extensive metabolic alterations resulting from heavy metal exposure, employing complementary analytical methods is crucial. Metabolomics is pivotal in unraveling the intricacies of disease vulnerability by furnishing thorough understandings of metabolic changes linked to different metabolic diseases. This field offers exciting prospects for enhancing the disease prevention, early detection, and tailoring treatment approaches to individual needs. This article consolidates the existing knowledge on disease-linked metabolic pathways affected by the exposure of diverse heavy metals providing concise overview of the underlying impact mechanisms. The main aim is to investigate the connection between the altered metabolic pathways and long-term complex health conditions induced by heavy metals such as diabetes mellitus, cardiovascular diseases, renal disorders, inflammation, neurodegenerative diseases, reproductive risks, and organ damage. Further exploration of common pathways may unveil the shared targets for treating associated pathological conditions. In this article, the role of metabolomics in disease susceptibility is emphasized that metabolomics is expected to be routinely utilized for the diagnosis and monitoring of diseases and practical value of biomarkers derived from metabolomics, as well as determining their appropriate integration into extensive clinical settings.
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Affiliation(s)
- Kainat Ilyas
- Department of Pharmaceutical Chemistry, Government College University, Faisalabad, Pakistan
| | - Hajra Iqbal
- Department of Pharmaceutical Chemistry, Government College University, Faisalabad, Pakistan
| | | | - Kanwal Rehman
- Department of Pharmacy, The Women University, Multan, Pakistan
| | - Amjad Hussain
- Institute of Chemistry, University of Okara, Okara, Pakistan
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48
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Sadeghi MA, Stevens D, Kundu S, Sanghera R, Dagher R, Yedavalli V, Jones C, Sair H, Luna LP. Detecting Alzheimer's Disease Stages and Frontotemporal Dementia in Time Courses of Resting-State fMRI Data Using a Machine Learning Approach. JOURNAL OF IMAGING INFORMATICS IN MEDICINE 2024:10.1007/s10278-024-01101-1. [PMID: 38780666 DOI: 10.1007/s10278-024-01101-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/28/2023] [Revised: 03/20/2024] [Accepted: 03/22/2024] [Indexed: 05/25/2024]
Abstract
Early, accurate diagnosis of neurodegenerative dementia subtypes such as Alzheimer's disease (AD) and frontotemporal dementia (FTD) is crucial for the effectiveness of their treatments. However, distinguishing these conditions becomes challenging when symptoms overlap or the conditions present atypically. Resting-state fMRI (rs-fMRI) studies have demonstrated condition-specific alterations in AD, FTD, and mild cognitive impairment (MCI) compared to healthy controls (HC). Here, we used machine learning to build a diagnostic classification model based on these alterations. We curated all rs-fMRIs and their corresponding clinical information from the ADNI and FTLDNI databases. Imaging data underwent preprocessing, time course extraction, and feature extraction in preparation for the analyses. The imaging features data and clinical variables were fed into gradient-boosted decision trees with fivefold nested cross-validation to build models that classified four groups: AD, FTD, HC, and MCI. The mean and 95% confidence intervals for model performance metrics were calculated using the unseen test sets in the cross-validation rounds. The model built using only imaging features achieved 74.4% mean balanced accuracy, 0.94 mean macro-averaged AUC, and 0.73 mean macro-averaged F1 score. It accurately classified FTD (F1 = 0.99), HC (F1 = 0.99), and MCI (F1 = 0.86) fMRIs but mostly misclassified AD scans as MCI (F1 = 0.08). Adding clinical variables to model inputs raised balanced accuracy to 91.1%, macro-averaged AUC to 0.99, macro-averaged F1 score to 0.92, and improved AD classification accuracy (F1 = 0.74). In conclusion, a multimodal model based on rs-fMRI and clinical data accurately differentiates AD-MCI vs. FTD vs. HC.
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Affiliation(s)
- Mohammad Amin Sadeghi
- Division of Neuroradiology, Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins Medicine, 600 N Wolfe St, Phipps B100F, Baltimore, MD, 21287, USA
| | - Daniel Stevens
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Shinjini Kundu
- Division of Neuroradiology, Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins Medicine, 600 N Wolfe St, Phipps B100F, Baltimore, MD, 21287, USA
| | - Rohan Sanghera
- University of Cambridge, School of Clinical Medicine, Cambridge, UK
| | - Richard Dagher
- Division of Neuroradiology, Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins Medicine, 600 N Wolfe St, Phipps B100F, Baltimore, MD, 21287, USA
| | - Vivek Yedavalli
- Division of Neuroradiology, Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins Medicine, 600 N Wolfe St, Phipps B100F, Baltimore, MD, 21287, USA
| | - Craig Jones
- Division of Neuroradiology, Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins Medicine, 600 N Wolfe St, Phipps B100F, Baltimore, MD, 21287, USA
- Department of Computer Science, Johns Hopkins University, Baltimore, MD, USA
- The Malone Center for Engineering in Healthcare, The Whiting School of Engineering, Johns Hopkins University, Baltimore, MD, USA
| | - Haris Sair
- Division of Neuroradiology, Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins Medicine, 600 N Wolfe St, Phipps B100F, Baltimore, MD, 21287, USA
- The Malone Center for Engineering in Healthcare, The Whiting School of Engineering, Johns Hopkins University, Baltimore, MD, USA
| | - Licia P Luna
- Division of Neuroradiology, Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins Medicine, 600 N Wolfe St, Phipps B100F, Baltimore, MD, 21287, USA.
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49
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Dicarlo M, Pignataro P, Zecca C, Dell'Abate MT, Urso D, Gnoni V, Giugno A, Borlizzi F, Zerlotin R, Oranger A, Colaianni G, Colucci S, Logroscino G, Grano M. Irisin Levels in Cerebrospinal Fluid Correlate with Biomarkers and Clinical Dementia Scores in Alzheimer Disease. Ann Neurol 2024. [PMID: 38780366 DOI: 10.1002/ana.26946] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Revised: 04/19/2024] [Accepted: 04/23/2024] [Indexed: 05/25/2024]
Abstract
OBJECTIVE Irisin, released by muscles during exercise, was recently identified as a neuroprotective factor in mouse models of Alzheimer disease (AD). In a cohort of AD patients, we studied cerebrospinal fluid (CSF) and plasma irisin levels, sex interactions, and correlations with disease biomarkers. METHODS Correlations between CSF and plasma irisin levels and AD biomarkers (amyloid β 1-42, hyperphosphorylated tau, and total tau [t-tau]) and Clinical Dementia Rating Scale Sum of Boxes (CDR-SOB) were analyzed in a cohort of patients with Alzheimer dementia (n = 82), mild cognitive impairment (n = 44), and subjective memory complaint (n = 20) biologically characterized according to the recent amyloid/tau/neurodegeneration classification. RESULTS CSF irisin was reduced in Alzheimer dementia patients (p < 0.0001), with lower levels in female patients. Moreover, CSF irisin correlated positively with Aβ42 in both female (r = 0.379, p < 0.001) and male (r = 0.262, p < 0.05) patients, and negatively with CDR-SOB (r = -0.234, p < 0.05) only in female patients. A negative trend was also observed between CSF irisin and t-tau levels in all patients (r = -0.144, p = 0.082) and in the female subgroup (r = -0.189, p = 0.084). INTERPRETATION The results highlight the relationship between irisin and biomarkers of AD pathology, especially in females. Our findings also offer perspectives toward the use of irisin as a marker of the AD continuum. ANN NEUROL 2024.
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Affiliation(s)
- Manuela Dicarlo
- Department of Precision and Regenerative Medicine and Ionian Area, University of Bari "A. Moro", Bari, Italy
| | - Patrizia Pignataro
- Department of Precision and Regenerative Medicine and Ionian Area, University of Bari "A. Moro", Bari, Italy
- Department of Translational Biomedicine and Neuroscience, University of Bari "A. Moro", Bari, Italy
| | - Chiara Zecca
- Center for Neurodegenerative Diseases and the Aging Brain, University of Bari "A. Moro" at "Pia Fondazione Card G. Panico" Hospital, Tricase, Italy
| | - Maria Teresa Dell'Abate
- Center for Neurodegenerative Diseases and the Aging Brain, University of Bari "A. Moro" at "Pia Fondazione Card G. Panico" Hospital, Tricase, Italy
| | - Daniele Urso
- Center for Neurodegenerative Diseases and the Aging Brain, University of Bari "A. Moro" at "Pia Fondazione Card G. Panico" Hospital, Tricase, Italy
| | - Valentina Gnoni
- Center for Neurodegenerative Diseases and the Aging Brain, University of Bari "A. Moro" at "Pia Fondazione Card G. Panico" Hospital, Tricase, Italy
| | - Alessia Giugno
- Center for Neurodegenerative Diseases and the Aging Brain, University of Bari "A. Moro" at "Pia Fondazione Card G. Panico" Hospital, Tricase, Italy
| | - Francesco Borlizzi
- Center for Neurodegenerative Diseases and the Aging Brain, University of Bari "A. Moro" at "Pia Fondazione Card G. Panico" Hospital, Tricase, Italy
| | - Roberta Zerlotin
- Department of Precision and Regenerative Medicine and Ionian Area, University of Bari "A. Moro", Bari, Italy
| | - Angela Oranger
- Department of Precision and Regenerative Medicine and Ionian Area, University of Bari "A. Moro", Bari, Italy
| | - Graziana Colaianni
- Department of Precision and Regenerative Medicine and Ionian Area, University of Bari "A. Moro", Bari, Italy
| | - Silvia Colucci
- Department of Translational Biomedicine and Neuroscience, University of Bari "A. Moro", Bari, Italy
| | - Giancarlo Logroscino
- Center for Neurodegenerative Diseases and the Aging Brain, University of Bari "A. Moro" at "Pia Fondazione Card G. Panico" Hospital, Tricase, Italy
| | - Maria Grano
- Department of Precision and Regenerative Medicine and Ionian Area, University of Bari "A. Moro", Bari, Italy
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50
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Lindhout JE, Richard E, Hafdi M, Perry M, Moll van Charante E, van Gool WA. The Association of Ancillary Diagnostic Tests With Outcome in Dementia. J Am Med Dir Assoc 2024; 25:105040. [PMID: 38796169 DOI: 10.1016/j.jamda.2024.105040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Revised: 04/12/2024] [Accepted: 04/14/2024] [Indexed: 05/28/2024]
Abstract
OBJECTIVES Dementia is a clinical diagnosis without curative treatment. It is uncertain whether ancillary testing is beneficial for patients. This study investigates the association between use of diagnostic tests and time to poor outcome and health care costs. DESIGN Nationwide register-based cohort study using health care reimbursement data in the Netherlands. SETTING AND PARTICIPANTS All Dutch hospitals, including 13,312 patients diagnosed with dementia in 2018. METHODS Diagnostic testing included computed tomography or magnetic resonance imaging (CT/MRI), neuropsychological examination (NPE), nuclear imaging (PET/SPECT), electroencephalography (EEG), and cerebrospinal fluid (CSF) testing. We compared time to poor outcome (institutionalization or death) and costs per month from 2018 to 2021 between those who underwent a specific diagnostic test in previous years to controls, propensity score matched for age, sex, type of hospital, and comorbidity. RESULTS Time to poor outcome in those who underwent CT/MRI, EEG, or CSF testing was similar to those who did not, but was longer for those who underwent NPE. Time to poor outcome was shorter in patients who underwent PET/SPECT. Patients who underwent CSF testing or PET/SPECT had higher mean total health care costs as compared to controls (CSF €248, 95% CI 64-433; PET/SPECT: €315, 95% CI 179-451). NPE during the diagnostic trajectory was associated with lower total health care cost (-€127, 95% CI -62, -193). CONCLUSION AND IMPLICATIONS NPE was associated with longer time to poor outcome and lower health care costs, potentially due to confounding by indication. Patients who underwent neuroimaging (CT, MRI, SPECT/PET), CSF testing, or EEG for dementia diagnostics did not experience a longer time to poor outcome or lower health care costs. This emphasizes the importance of clinical examination as anchor for the diagnosis of dementia.
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Affiliation(s)
- Josephine E Lindhout
- Department of Neurology, Radboud University Medical Center, Donders Institute for Brain, Cognition, and Behavior, Nijmegen, The Netherlands; Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam University Medical Center, University of Amsterdam, Amsterdam, The Netherlands.
| | - Edo Richard
- Department of Neurology, Radboud University Medical Center, Donders Institute for Brain, Cognition, and Behavior, Nijmegen, The Netherlands; Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam University Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Melanie Hafdi
- Department of Neurology, Amsterdam University Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Marieke Perry
- Radboudumc Alzheimer Center, Radboud University Medical Center, Nijmegen, The Netherlands; Department of Primary and Community Care, Donders Institute for Brain, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Eric Moll van Charante
- Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam University Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Willem A van Gool
- Department of Neurology, Radboud University Medical Center, Donders Institute for Brain, Cognition, and Behavior, Nijmegen, The Netherlands; Department of Public and Occupational Health, Amsterdam Public Health Research Institute, Amsterdam University Medical Center, University of Amsterdam, Amsterdam, The Netherlands
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