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Yin Y, Li X, Zhang X, Yuan X, You X, Wu J. Inhibition of Extracellular Signal-Regulated Kinase Activity Improves Cognitive Function in Mice Subjected to Myocardial Infarction. Cardiovasc Toxicol 2024:10.1007/s12012-024-09877-y. [PMID: 38850470 DOI: 10.1007/s12012-024-09877-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Accepted: 05/28/2024] [Indexed: 06/10/2024]
Abstract
Cognitive impairment is a commonly observed complication following myocardial infarction; however, the underlying mechanisms are still not well understood. The most recent research suggests that extracellular signal-regulated kinase (ERK) plays a critical role in the development and occurrence of cognitive dysfunction-related diseases. This study aims to explore whether the ERK inhibitor U0126 targets the ERK/Signal Transducer and Activator of Transcription 1 (STAT1) pathway to ameliorate cognitive impairment after myocardial infarction. To establish a mouse model of myocardial infarction, we utilized various techniques including Echocardiography, Hematoxylin-eosin (HE) staining, Elisa, Open field test, Elevated plus maze test, and Western blot analysis to assess mouse cardiac function, cognitive function, and signal transduction pathways. For further investigation into the mechanisms of cognitive function and signal transduction, we administered the ERK inhibitor U0126 via intraperitoneal injection. Reduced total distance and activity range were observed in mice subjected to myocardial infarction during the open field test, along with decreased exploration of the open arms in the elevated plus maze test. However, U0126 treatment exhibited a significant improvement in cognitive decline, indicating a protective effect through the inhibition of the ERK/STAT1 signaling pathway. Hence, this study highlights the involvement of the ERK/STAT1 pathway in regulating cognitive dysfunction following myocardial infarction and establishes U0126 as a promising therapeutic target.
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Affiliation(s)
- Yibo Yin
- Department of Anesthesiology, Shanghai Chest Hospital, Shanghai Jiao Tong University, School of Medicine, No. 241 West Huaihai Rd., Shanghai, China
| | - Xin Li
- School of Medical Instrument and Food Engineering USST, University of Shanghai for Science and Technology, Shanghai, China
| | - Xiaoxua Zhang
- School of Medicine, Shanghai University, No. 99 Shangda Road, Baoshan District, Shanghai, 200444, China
| | - Xinru Yuan
- School of Medicine, Shanghai University, No. 99 Shangda Road, Baoshan District, Shanghai, 200444, China
| | - Xingji You
- School of Medicine, Shanghai University, No. 99 Shangda Road, Baoshan District, Shanghai, 200444, China.
| | - Jingxiang Wu
- Department of Anesthesiology, Shanghai Chest Hospital, Shanghai Jiao Tong University, School of Medicine, No. 241 West Huaihai Rd., Shanghai, China.
- School of Medical Instrument and Food Engineering USST, University of Shanghai for Science and Technology, Shanghai, China.
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Poirier SE, Suskin NG, Khaw AV, Thiessen JD, Shoemaker JK, Anazodo UC. Probing Evidence of Cerebral White Matter Microstructural Disruptions in Ischemic Heart Disease Before and Following Cardiac Rehabilitation: A Diffusion Tensor MR Imaging Study. J Magn Reson Imaging 2024; 59:2137-2149. [PMID: 37589418 DOI: 10.1002/jmri.28964] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Revised: 07/31/2023] [Accepted: 08/03/2023] [Indexed: 08/18/2023] Open
Abstract
BACKGROUND Ischemic heart disease (IHD) is linked to brain white matter (WM) breakdown but how age or disease effects WM integrity, and whether it is reversible using cardiac rehabilitation (CR), remains unclear. PURPOSE To assess the effects of brain aging, cardiovascular disease, and CR on WM microstructure in brains of IHD patients following a cardiac event. STUDY TYPE Retrospective. POPULATION Thirty-five IHD patients (9 females; mean age = 59 ± 8 years), 21 age-matched healthy controls (10 females; mean age = 59 ± 8 years), and 25 younger controls (14 females; mean age = 26 ± 4 years). FIELD STRENGTH/SEQUENCE 3 T diffusion-weighted imaging with single-shot echo planar imaging acquired at 3 months and 9 months post-cardiac event. ASSESSMENT Tract-based spatial statistics (TBSS) and tractometry were used to compare fractional anisotropy (FA), mean diffusivity (MD), axial diffusivity (AD), and radial diffusivity (RD) in cerebral WM between: 1) older and younger controls to distinguish age-related from disease-related WM changes; 2) IHD patients at baseline (pre-CR) and age-matched controls to investigate if cardiovascular disease exacerbates age-related WM changes; and 3) IHD patients pre-CR and post-CR to investigate the neuroplastic effect of CR on WM microstructure. STATISTICAL TESTS Two-sample unpaired t-test (age: older vs. younger controls; IHD: IHD pre-CR vs. age-matched controls). One-sample paired t-test (CR: IHD pre- vs. post-CR). Statistical threshold: P < 0.05 (FWE-corrected). RESULTS TBSS and tractometry revealed widespread WM changes in older controls compared to younger controls while WM clusters of decreased FA in the fornix and increased MD in body of corpus callosum were observed in IHD patients pre-CR compared to age-matched controls. Robust WM improvements (increased FA, increased AD) were observed in IHD patients post-CR. DATA CONCLUSION In IHD, both brain aging and cardiovascular disease may contribute to WM disruptions. IHD-related WM disruptions may be favorably modified by CR. LEVEL OF EVIDENCE 3 TECHNICAL EFFICACY: Stage 2.
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Affiliation(s)
- Stefan E Poirier
- Lawson Imaging, Lawson Health Research Institute, London, Ontario, Canada
- Department of Medical Biophysics, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
| | - Neville G Suskin
- Division of Cardiology, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
| | - Alexander V Khaw
- Department of Clinical Neurological Sciences, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
| | - Jonathan D Thiessen
- Lawson Imaging, Lawson Health Research Institute, London, Ontario, Canada
- Department of Medical Biophysics, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
- Department of Medical Imaging, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
| | - Joel K Shoemaker
- School of Kinesiology, Western University, London, Ontario, Canada
| | - Udunna C Anazodo
- Lawson Imaging, Lawson Health Research Institute, London, Ontario, Canada
- Department of Medical Biophysics, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
- Department of Clinical Neurological Sciences, Schulich School of Medicine and Dentistry, Western University, London, Ontario, Canada
- Research Centre for Studies in Aging, McGill University, Montréal, Québec, Canada
- Department of Neurology and Neurosurgery, McGill University, Montréal, Québec, Canada
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Park DY, Jamil Y, Babapour G, Kim J, Campbell G, Akman Z, Kochar A, Sen S, Samsky MD, Sikand NV, Frampton J, Damluji AA, Nanna MG. Association of cardiovascular diseases with cognitive performance in older adults. Am Heart J 2024; 273:10-20. [PMID: 38575050 DOI: 10.1016/j.ahj.2024.03.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2024] [Accepted: 03/30/2024] [Indexed: 04/06/2024]
Abstract
BACKGROUND Cognitive function and cardiovascular disease (CVD) have a bidirectional relationship, but studies on the impact of CVD subtypes and aging spectrum have been scarce. METHODS We assessed older adults aged ≥60 years from the 2011 to 2012 and 2013 to 2014 cycles of the National Health and Nutrition Examination Survey who had coronary heart disease, angina, prior myocardial infarction, congestive heart failure, or prior stroke. We compared CERAD-IR, CERAD-DR, Animal Fluency test, and DSST scores to assess cognitive performance in older adults with and without CVD. RESULTS We included 3,131 older adults, representing 55,479,673 older adults at the national level. Older adults with CVD had lower CERAD-IR (mean difference 1.8, 95% CI 1.4-2.1, P < .001), CERAD-DR (mean difference 0.8, 95% CI 0.6-1.0, P < .001), Animal Fluency test (mean difference 2.1, 95% CI 1.6-2.6, P < .001), and DSST (mean difference 9.5, 95% CI 8.0-10.9, P < .001) scores compared with those without CVD. After adjustment, no difference in CERAD-IR, CERAD-DR, and Animal Fluency test scores was observed, but DSST scores were lower in older adults with CVD (adjusted mean difference 2.9, 95% CI 1.1-4.7, P = .001). Across CVD subtypes, individuals with congestive heart failure had lower performance on the DSST score. The oldest-old cohort of patients ≥80 years old with CVD had lower performance than those without CVD on both the DSST and Animal Fluency test. CONCLUSION Older adults with CVD had lower cognitive performance as measured than those free of CVD, driven by pronounced differences among those with CHF and those ≥80 years old with CVD.
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Affiliation(s)
- Dae Yong Park
- Department of Medicine, Cook County Health, Chicago, IL
| | - Yasser Jamil
- Department of Medicine, Yale New Haven Program, Waterbury, CT
| | - Golsa Babapour
- Section of Cardiovascular Medicine, Yale School of Medicine, New Haven, CT
| | - Junglee Kim
- Department of Medicine, Cook County Health, Chicago, IL
| | - Greta Campbell
- Department of Cardiovascular Medicine, Brigham and Women's Hospital, Boston, MA
| | - Zafer Akman
- Department of Medicine, Yale School of Medicine, New Haven, CT
| | - Ajar Kochar
- Department of Cardiovascular Medicine, Brigham and Women's Hospital, Harvard Medical School, Boston, MA; Richard and Susan Smith Center for Outcomes Research in Cardiology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA
| | - Sounok Sen
- Section of Cardiovascular Medicine, Yale School of Medicine, New Haven, CT
| | - Marc D Samsky
- Section of Cardiovascular Medicine, Yale School of Medicine, New Haven, CT
| | - Nikhil V Sikand
- Section of Cardiovascular Medicine, Yale School of Medicine, New Haven, CT
| | - Jennifer Frampton
- Section of Cardiovascular Medicine, Yale School of Medicine, New Haven, CT
| | - Abdulla Al Damluji
- Inova Center of Outcomes Research, Falls Church, VA; Johns Hopkins University School of Medicine, Baltimore, MD
| | - Michael G Nanna
- Section of Cardiovascular Medicine, Yale School of Medicine, New Haven, CT.
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Shang J, Dong J, Zhu S, Chen Q, Hua J. Trends in cognitive function before and after myocardial infarction: findings from the China Health and Retirement Longitudinal Study. Front Aging Neurosci 2024; 16:1283997. [PMID: 38455665 PMCID: PMC10917921 DOI: 10.3389/fnagi.2024.1283997] [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: 08/27/2023] [Accepted: 02/05/2024] [Indexed: 03/09/2024] Open
Abstract
Objectives Incident stroke was associated with cognitive dysfunction after stroke and even before stroke. However, cognitive trends prior to myocardial infarction (MI) and the timeline of cognitive decline in a few years following incident MI remain unclear, especially among the Chinese population. We aimed to evaluate whether MI was associated with cognitive change both before and after MI in China. Methods This cohort study included 11,287 participants without baseline heart problems or stroke from the China Health and Retirement Longitudinal Study. The exposure was self-reported MI. The outcomes were scores of cognitive functions in five domains, which reflected abilities of episodic memory, visuospatial abilities, orientation, attention and calculation, and global cognition as a summary measure. A Linear mixed model was constructed to explore cognitive function before and after incident MI among the MI participants and the cognitive trends of participants free of MI. Results During the 7-year follow-up, 421 individuals [3.7% of 11,287, mean (SD) age, 60.0 (9.0) years; 59.1% female] experienced MI events. The cognitive scores of participants of both the MI group and the control group without MI declined gradually as time went by. The annual decline rate of the MI group before incident MI was similar to that of the control group during the whole follow-up period. Incident MI was not associated with acute cognitive decline in all five cognitive domains. Moreover, MI did not accelerate the cognitive decline rate after MI compared with the pre-MI cognitive trends. The decline rate of cognitive function after MI was similar to the rate before MI. Conclusions Different from stroke, participants who had an MI did not show steeper cognitive decline before MI. MI was not associated with acute cognitive decline and accelerated decline in several years after MI. Future studies are needed to learn the mechanisms behind the different patterns of cognitive decline between MI and stroke.
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Affiliation(s)
- Jing Shang
- Department of Psychiatry, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China
| | - Jianye Dong
- Department of Obstetrics and Gynecology, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China
| | - Sijia Zhu
- Department of Neurology, The Fourth Affiliated Hospital of Soochow University, Medical Center of Soochow University, Suzhou Dushu Lake Hospital, Suzhou, Jiangsu, China
| | - Qingmei Chen
- Department of Physical Medicine and Rehabilitation, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China
| | - Jianian Hua
- Department of Neurology, The First Affiliated Hospital of Soochow University, Suzhou, Jiangsu, China
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Ijaz N, Jamil Y, Brown CH, Krishnaswami A, Orkaby A, Stimmel MB, Gerstenblith G, Nanna MG, Damluji AA. Role of Cognitive Frailty in Older Adults With Cardiovascular Disease. J Am Heart Assoc 2024; 13:e033594. [PMID: 38353229 PMCID: PMC11010094 DOI: 10.1161/jaha.123.033594] [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: 11/21/2023] [Accepted: 12/19/2023] [Indexed: 02/21/2024]
Abstract
As the older adult population expands, an increasing number of patients affected by geriatric syndromes are seen by cardiovascular clinicians. One such syndrome that has been associated with poor outcomes is cognitive frailty: the simultaneous presence of cognitive impairment, without evidence of dementia, and physical frailty, which results in decreased cognitive reserve. Driven by common pathophysiologic underpinnings (eg, inflammation and neurohormonal dysregulation), cardiovascular disease, cognitive impairment, and frailty also share the following risk factors: hypertension, diabetes, obesity, sedentary behavior, and tobacco use. Cardiovascular disease has been associated with the onset and progression of cognitive frailty, which may be reversible in early stages, making it essential for clinicians to diagnose the condition in a timely manner and prescribe appropriate interventions. Additional research is required to elucidate the mechanisms underlying the development of cognitive frailty, establish preventive and therapeutic strategies to address the needs of older patients with cardiovascular disease at risk for cognitive frailty, and ultimately facilitate targeted intervention studies.
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Affiliation(s)
- Naila Ijaz
- Thomas Jefferson University HospitalPhiladelphiaPAUSA
| | - Yasser Jamil
- Yale University School of MedicineNew HavenCTUSA
| | | | | | - Ariela Orkaby
- New England GRECC, VA Boston Healthcare SystemBostonMAUSA
- Division of AgingBrigham & Women’s Hospital, Harvard Medical SchoolBostonMAUSA
| | | | | | | | - Abdulla A. Damluji
- Johns Hopkins University School of MedicineBaltimoreMDUSA
- The Inova Center of Outcomes ResearchInova Heart and Vascular InstituteFalls ChurchVAUSA
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Liang J, Li C, Gao D, Ma Q, Wang Y, Pan Y, Zhang W, Xie W, Zheng F. Association Between Onset Age of Coronary Heart Disease and Incident Dementia: A Prospective Cohort Study. J Am Heart Assoc 2023; 12:e031407. [PMID: 38018492 PMCID: PMC10727352 DOI: 10.1161/jaha.123.031407] [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: 06/19/2023] [Accepted: 09/20/2023] [Indexed: 11/30/2023]
Abstract
BACKGROUND The association of age at coronary heart disease (CHD) onset with incident dementia remains unexplored. This study aimed to examine whether younger onset age of CHD is associated with a higher risk of incident dementia. METHODS AND RESULTS Data were obtained from the UK Biobank. Information on the diagnosis of CHD and dementia was collected at baseline and follow-ups. Propensity score matching method and Cox proportional hazards models were used to evaluate the association between different ages at CHD onset and incident dementia. A total of 432 667 adults (mean±SD age, 56.9±8.1 years) were included, of whom 11.7% had CHD. Compared with participants without CHD, participants with CHD exhibited higher risks of developing all-cause dementia, Alzheimer's disease, and vascular dementia. More importantly, younger age at CHD onset (per 10-year decrease) was significantly associated with elevated risks of all-cause dementia (hazard ratio [HR], 1.25 [95% CI, 1.20-1.30]; P<0.001), Alzheimer's disease (HR, 1.29 [95% CI, 1.20-1.38]; P<0.001), and vascular dementia (HR, 1.22 [95% CI, 1.13-1.31]; P<0.001). After propensity score matching, patients with CHD had significantly higher risks of all-cause dementia, Alzheimer's disease, and vascular dementia than matched controls among all onset age groups, and the HRs gradually elevated with decreasing age at CHD onset. CONCLUSIONS Younger onset age of CHD is associated with higher risks of incident all-cause dementia, Alzheimer's disease, and vascular dementia, underscoring the necessity to pay attention to the neurocognitive status of individuals diagnosed with CHD at younger age to conduct timely interventions to attenuate subsequent risk of incident dementia.
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Affiliation(s)
- Jie Liang
- Department of Clinical Nursing, School of NursingChinese Academy of Medical Sciences & Peking Union Medical CollegeBeijingChina
| | - Chenglong Li
- Heart and Vascular Health Research CenterPeking University Clinical Research Institute, Peking University First HospitalBeijingChina
- Key Laboratory of Epidemiology of Major Diseases (Peking University), Ministry of EducationBeijingChina
| | - Darui Gao
- Heart and Vascular Health Research CenterPeking University Clinical Research Institute, Peking University First HospitalBeijingChina
- Key Laboratory of Epidemiology of Major Diseases (Peking University), Ministry of EducationBeijingChina
| | - Qian Ma
- Department of Cardiology, Beijing Anzhen HospitalCapital Medical UniversityBeijingChina
| | - Yongqian Wang
- Heart and Vascular Health Research CenterPeking University Clinical Research Institute, Peking University First HospitalBeijingChina
- Key Laboratory of Epidemiology of Major Diseases (Peking University), Ministry of EducationBeijingChina
| | - Yang Pan
- Department of Clinical Nursing, School of NursingChinese Academy of Medical Sciences & Peking Union Medical CollegeBeijingChina
| | - Wenya Zhang
- Department of Clinical Nursing, School of NursingChinese Academy of Medical Sciences & Peking Union Medical CollegeBeijingChina
| | - Wuxiang Xie
- Heart and Vascular Health Research CenterPeking University Clinical Research Institute, Peking University First HospitalBeijingChina
- Key Laboratory of Epidemiology of Major Diseases (Peking University), Ministry of EducationBeijingChina
| | - Fanfan Zheng
- Department of Clinical Nursing, School of NursingChinese Academy of Medical Sciences & Peking Union Medical CollegeBeijingChina
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Imahori Y, Vetrano DL, Ljungman P, Laukka EJ, Wu J, Grande G, Rizzuto D, Fratiglioni L, Qiu C. Association of ischemic heart disease with long-term risk of cognitive decline and dementia: A cohort study. Alzheimers Dement 2023; 19:5541-5549. [PMID: 37249150 DOI: 10.1002/alz.13114] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2022] [Revised: 03/30/2023] [Accepted: 04/03/2023] [Indexed: 05/31/2023]
Abstract
INTRODUCTION The independent and joint effect of ischemic heart disease (IHD) and coexisting atrial fibrillation (AF) and heart failure (HF) on dementia risk is largely unknown. METHODS This population-based cohort study included 2568 dementia-free participants (age ≥60 years) in SNAC-K, who were regularly examined from 2001-2004 through 2013-2016. Dementia was diagnosed following the Diagnostic and Statistical Manual of Mental Disorders, 4th edition (DSM-IV) criteria. Global cognitive function was assessed using a global cognitive composite z-score derived from five cognitive domains. Data were analyzed using Cox, Fine-Gray, and linear mixed-effects models. RESULTS Overall, IHD at baseline was associated with multivariable-adjusted hazard ratio (HR) of 1.39 (95% confidence interval = 1.06-1.82) for dementia and multivariable-adjusted β-coefficient of -0.02 (-0.03 to -0.01) for annual changes in global cognitive z-score, independent of AF, HF, and cerebrovascular disease. Coexisting AF or HF did not add further risk to dementia and cognitive decline. DISCUSSION IHD is independently associated with dementia and cognitive decline in older adults, whereas coexisting AF/HF is not associated with an increased risk. HIGHLIGHTS Is a history of ischemic heart disease (IHD) associated with a risk for dementia? How do coexisting heart diseases affect this association? IHD was an independent risk factor for dementia in older adults. This association was independent of coexisting heart and cerebrovascular diseases. The coexistence of heart diseases did not confer additional risk for dementia.
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Affiliation(s)
- Yume Imahori
- Department of Neurobiology, Care Sciences and Society, Aging Research Center, Karolinska Institutet and Stockholm University, Solna, Sweden
| | - Davide L Vetrano
- Department of Neurobiology, Care Sciences and Society, Aging Research Center, Karolinska Institutet and Stockholm University, Solna, Sweden
- Stockholm Gerontology Research Center, Stockholm, Sweden
| | - Petter Ljungman
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
- Department of Cardiology, Danderyd Hospital, Stockholm, Sweden
| | - Erika J Laukka
- Department of Neurobiology, Care Sciences and Society, Aging Research Center, Karolinska Institutet and Stockholm University, Solna, Sweden
- Stockholm Gerontology Research Center, Stockholm, Sweden
| | - Jing Wu
- Department of Neurobiology, Care Sciences and Society, Aging Research Center, Karolinska Institutet and Stockholm University, Solna, Sweden
| | - Giulia Grande
- Department of Neurobiology, Care Sciences and Society, Aging Research Center, Karolinska Institutet and Stockholm University, Solna, Sweden
| | - Debora Rizzuto
- Department of Neurobiology, Care Sciences and Society, Aging Research Center, Karolinska Institutet and Stockholm University, Solna, Sweden
- Stockholm Gerontology Research Center, Stockholm, Sweden
| | - Laura Fratiglioni
- Department of Neurobiology, Care Sciences and Society, Aging Research Center, Karolinska Institutet and Stockholm University, Solna, Sweden
- Stockholm Gerontology Research Center, Stockholm, Sweden
| | - Chengxuan Qiu
- Department of Neurobiology, Care Sciences and Society, Aging Research Center, Karolinska Institutet and Stockholm University, Solna, Sweden
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Mura F, Patron E, Messerotti Benvenuti S, Gentili C, Ponchia A, Del Piccolo F, Palomba D. The moderating role of depressive symptoms in the association between heart rate variability and cognitive performance in cardiac patients. J Affect Disord 2023; 340:139-148. [PMID: 37544481 DOI: 10.1016/j.jad.2023.08.022] [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: 04/21/2023] [Revised: 07/06/2023] [Accepted: 08/03/2023] [Indexed: 08/08/2023]
Abstract
INTRODUCTION Coronary heart disease (CHD) is strongly associated with cognitive impairment, which is a core feature of depression, highly prevalent in patients with CHD. Interestingly, patients with CHD and individuals with depression display reduced heart rate variability (HRV), which proxies a complex network integrating autonomic and attentional systems. This study investigated the moderating role of depressive symptoms in the relation between reduced HRV and cognitive performance in patients with CHD. METHOD The sample included 274 patients with CHD (mean [standard deviation] age = 62 [9.5] years; 13 % women) admitted to cardiac rehabilitation units. Visual attention and task switching were assessed through the Trail Making Test (TMT). Depressive symptoms were assessed with the Beck Depression Inventory-II (BDI-II). Resting electrocardiographic recordings were collected to compute HRV indices. RESULTS Patients with more severe depressive symptoms displayed an inverse association between HRV and cognitive performance (TMT-A: b = -0.08, p = .022; TMTB: b = -0.07, p = .042), whereas patients with milder depressive symptoms showed no significant association (TMT-A: b = -0.00, p = .90; TMTB: b = -0.02, p = .44). CONCLUSIONS Depressive symptoms may strengthen the relation between reduced HRV and poorer cognitive performance in cardiac patients. The presence of depressive symptoms may signal the dysfunction of a network subserving autonomic and cognitive function.
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Affiliation(s)
- Francesca Mura
- Department of General Psychology, University of Padua, Padua, Italy; Padova Neuroscience Center (PNC), University of Padua, Padua, Italy.
| | - Elisabetta Patron
- Department of General Psychology, University of Padua, Padua, Italy; SCUP - Centro di Ateneo Servizi Clinici Universitari Psicologici, University of Padua, Padua, Italy
| | - Simone Messerotti Benvenuti
- Department of General Psychology, University of Padua, Padua, Italy; Padova Neuroscience Center (PNC), University of Padua, Padua, Italy; SCUP - Centro di Ateneo Servizi Clinici Universitari Psicologici, University of Padua, Padua, Italy; Hospital Psychology Unit, Padua University Hospital, Padua, Italy
| | - Claudio Gentili
- Department of General Psychology, University of Padua, Padua, Italy; Padova Neuroscience Center (PNC), University of Padua, Padua, Italy; SCUP - Centro di Ateneo Servizi Clinici Universitari Psicologici, University of Padua, Padua, Italy
| | - Andrea Ponchia
- Unit of Cardiac Rehabilitation, ULSS 6 Euganea, Padua, Italy
| | | | - Daniela Palomba
- Department of General Psychology, University of Padua, Padua, Italy; Padova Neuroscience Center (PNC), University of Padua, Padua, Italy; SCUP - Centro di Ateneo Servizi Clinici Universitari Psicologici, University of Padua, Padua, Italy
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Heger I, van Boxtel M, Deckers K, Bosma H, Verhey F, Köhler S. Socioeconomic position, modifiable dementia risk and cognitive decline: results of 12-year Maastricht Aging Study. Int Psychogeriatr 2023:1-13. [PMID: 37905417 DOI: 10.1017/s1041610223000819] [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] [Indexed: 11/02/2023]
Abstract
OBJECTIVES This study investigated whether the association between modifiable dementia risk and rate of cognitive decline differs across socioeconomic status (SES) strata. DESIGN, SETTING AND PARTICIPANTS Data were used from Maastricht Aging Study, a prospective cohort study with a 12-year follow-up. The baseline sample consisted of 1023 adults over 40 years old. MEASUREMENTS The "LIfestyle for BRAin health" (LIBRA) index was used to assess modifiable dementia risk. Cognitive performance was assessed at baseline, 6 and 12 years, and measured in the domains of information processing speed, executive functioning and verbal memory function. An SES score was calculated from equivalent income and educational level (tertiles). Linear mixed models were used to study the association between LIBRA, SES and their interaction on the rate of cognitive decline. RESULTS Participants in the lowest SES tertile displayed more decline in information processing speed (vs. middle SES: X2 = 7.08, P = 0.029; vs. high SES: X2 = 9.49, P = 0.009) and verbal memory (vs. middle SES: X2 = 9.28, P < 0.001; vs. high SES: X2 = 16.68, P < 0.001) over 6 years compared to their middle- and high-SES counterparts. Higher (unhealthier) LIBRA scores were associated with more decline in information processing speed (X2 = 12.66, P = 0.002) over 12 years and verbal memory (X2 = 4.63, P = 0.032) over 6 years. No consistent effect modification by SES on the association between LIBRA and cognition was found. CONCLUSIONS Results suggest that lifestyle is an important determinant of cognitive decline across SES groups. Yet, people with low SES had a more unfavorable modifiable risk score suggesting more potential for lifestyle-based interventions.
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Affiliation(s)
- Irene Heger
- School for Mental Health and Neuroscience, Department of Psychiatry and Neuropsychology, Maastricht University, Maastricht, The Netherlands
| | - Martin van Boxtel
- School for Mental Health and Neuroscience, Department of Psychiatry and Neuropsychology, Maastricht University, Maastricht, The Netherlands
| | - Kay Deckers
- School for Mental Health and Neuroscience, Department of Psychiatry and Neuropsychology, Maastricht University, Maastricht, The Netherlands
| | - Hans Bosma
- Care and Public Health Research Institute (CAPHRI), Department of Social Medicine, Faculty of Health, Medicine and Life Sciences, Maastricht University, Maastricht, The Netherlands
| | - Frans Verhey
- School for Mental Health and Neuroscience, Department of Psychiatry and Neuropsychology, Maastricht University, Maastricht, The Netherlands
| | - Sebastian Köhler
- School for Mental Health and Neuroscience, Department of Psychiatry and Neuropsychology, Maastricht University, Maastricht, The Netherlands
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Senapati SG, Bhanushali AK, Lahori S, Naagendran MS, Sriram S, Ganguly A, Pusa M, Damani DN, Kulkarni K, Arunachalam SP. Mapping of Neuro-Cardiac Electrophysiology: Interlinking Epilepsy and Arrhythmia. J Cardiovasc Dev Dis 2023; 10:433. [PMID: 37887880 PMCID: PMC10607576 DOI: 10.3390/jcdd10100433] [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: 07/16/2023] [Revised: 08/10/2023] [Accepted: 09/22/2023] [Indexed: 10/28/2023] Open
Abstract
The interplay between neurology and cardiology has gained significant attention in recent years, particularly regarding the shared pathophysiological mechanisms and clinical comorbidities observed in epilepsy and arrhythmias. Neuro-cardiac electrophysiology mapping involves the comprehensive assessment of both neural and cardiac electrical activity, aiming to unravel the intricate connections and potential cross-talk between the brain and the heart. The emergence of artificial intelligence (AI) has revolutionized the field by enabling the analysis of large-scale data sets, complex signal processing, and predictive modeling. AI algorithms have been applied to neuroimaging, electroencephalography (EEG), electrocardiography (ECG), and other diagnostic modalities to identify subtle patterns, classify disease subtypes, predict outcomes, and guide personalized treatment strategies. In this review, we highlight the potential clinical implications of neuro-cardiac mapping and AI in the management of epilepsy and arrhythmias. We address the challenges and limitations associated with these approaches, including data quality, interpretability, and ethical considerations. Further research and collaboration between neurologists, cardiologists, and AI experts are needed to fully unlock the potential of this interdisciplinary field.
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Affiliation(s)
- Sidhartha G. Senapati
- Department of Internal Medicine, Texas Tech University Health and Sciences Center, El Paso, TX 79905, USA; (S.G.S.); (D.N.D.)
| | - Aditi K. Bhanushali
- Department of Radiology, Mayo Clinic, Rochester, MN 55905, USA; (A.K.B.); (S.L.)
| | - Simmy Lahori
- Department of Radiology, Mayo Clinic, Rochester, MN 55905, USA; (A.K.B.); (S.L.)
| | | | - Shreya Sriram
- Division of Gastroenterology & Hepatology, Mayo Clinic, Rochester, MN 55905, USA;
| | - Arghyadeep Ganguly
- Department of Internal Medicine, Western Michigan University Homer Stryker MD School of Medicine, Kalamazoo, MI 49007, USA;
| | - Mounika Pusa
- Mamata Medical College, Khammam 507002, Telangana, India;
| | - Devanshi N. Damani
- Department of Internal Medicine, Texas Tech University Health and Sciences Center, El Paso, TX 79905, USA; (S.G.S.); (D.N.D.)
- Department of Cardiology, Mayo Clinic, Rochester, MN 55905, USA
| | - Kanchan Kulkarni
- IHU-LIRYC, Heart Rhythm Disease Institute, Fondation Bordeaux Université, Pessac, 33600 Bordeaux, France;
- INSERM, Centre de recherche Cardio-Thoracique de Bordeaux, University of Bordeaux, U1045, 33000 Bordeaux, France
| | - Shivaram P. Arunachalam
- Department of Radiology, Mayo Clinic, Rochester, MN 55905, USA; (A.K.B.); (S.L.)
- Division of Gastroenterology & Hepatology, Mayo Clinic, Rochester, MN 55905, USA;
- Department of Medicine, Mayo Clinic, Rochester, MN 55905, USA
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11
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Kootar S, Huque MH, Kiely KM, Anderson CS, Jorm L, Kivipelto M, Lautenschlager NT, Matthews F, Shaw JE, Whitmer RA, Peters R, Anstey KJ. Study protocol for development and validation of a single tool to assess risks of stroke, diabetes mellitus, myocardial infarction and dementia: DemNCD-Risk. BMJ Open 2023; 13:e076860. [PMID: 37739460 PMCID: PMC10533692 DOI: 10.1136/bmjopen-2023-076860] [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: 06/19/2023] [Accepted: 09/05/2023] [Indexed: 09/24/2023] Open
Abstract
INTRODUCTION Current efforts to reduce dementia focus on prevention and risk reduction by targeting modifiable risk factors. As dementia and cardiometabolic non-communicable diseases (NCDs) share risk factors, a single risk-estimating tool for dementia and multiple NCDs could be cost-effective and facilitate concurrent assessments as compared with a conventional single approach. The aim of this study is to develop and validate a new risk tool that estimates an individual's risk of developing dementia and other NCDs including diabetes mellitus, stroke and myocardial infarction. Once validated, it could be used by the public and general practitioners. METHODS AND ANALYSIS Ten high-quality cohort studies from multiple countries were identified, which met eligibility criteria, including large representative samples, long-term follow-up, data on clinical diagnoses of dementia and NCDs, recognised modifiable risk factors for the four NCDs and mortality data. Pooled harmonised data from the cohorts will be used, with 65% randomly allocated for development of the predictive model and 35% for testing. Predictors include sociodemographic characteristics, general health risk factors and lifestyle/behavioural risk factors. A subdistribution hazard model will assess the risk factors' contribution to the outcome, adjusting for competing mortality risks. Point-based scoring algorithms will be built using predictor weights, internally validated and the discriminative ability and calibration of the model will be assessed for the outcomes. Sensitivity analyses will include recalculating risk scores using logistic regression. ETHICS AND DISSEMINATION Ethics approval is provided by the University of New South Wales Human Research Ethics Committee (UNSW HREC; protocol numbers HC200515, HC3413). All data are deidentified and securely stored on servers at Neuroscience Research Australia. Study findings will be presented at conferences and published in peer-reviewed journals. The tool will be accessible as a public health resource. Knowledge translation and implementation work will explore strategies to apply the tool in clinical practice.
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Affiliation(s)
- Scherazad Kootar
- Neuroscience Research Australia, Randwick, New South Wales, Australia
- School of Psychology, University of New South Wales, Sydney, New South Wales, Australia
| | - Md Hamidul Huque
- Neuroscience Research Australia, Randwick, New South Wales, Australia
- School of Psychology, University of New South Wales, Sydney, New South Wales, Australia
| | - Kim M Kiely
- Neuroscience Research Australia, Randwick, New South Wales, Australia
- School of Psychology, University of New South Wales, Sydney, New South Wales, Australia
| | - Craig S Anderson
- The George Institute for Global Health, George Institute for Global Health, Newtown, New South Wales, Australia
- Faculty of Medicine, University of New South Wales, Kensington, NSW, Australia
| | - Louisa Jorm
- Centre for Big Data Research in Health, University of New South Wales, Randwick, New South Wales, Australia
| | - Miia Kivipelto
- Division of Geriatric Epidemiology, Karolinska Institutet, Stockholm, Sweden
| | - Nicola T Lautenschlager
- Academic Unit of Psychiatry of Old Age, Department of Psychiatry, The University of Melbourne, Parkville, Victoria, Australia
- Older Adult Mental Health Program, Royal Melbourne Hospital Mental Health Service, Parkville, Victoria, Australia
| | - Fiona Matthews
- Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK
| | - Jonathan E Shaw
- Clinical and Population Health, Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia
| | | | - Ruth Peters
- University of New South Wales, Sydney, New South Wales, Australia
| | - Kaarin J Anstey
- Neuroscience Research Australia, Randwick, New South Wales, Australia
- School of Psychology, University of New South Wales, Sydney, New South Wales, Australia
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12
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Thong EHE, Quek EJW, Loo JH, Yun CY, Teo YN, Teo YH, Leow AST, Li TYW, Sharma VK, Tan BYQ, Yeo LLL, Chong YF, Chan MY, Sia CH. Acute Myocardial Infarction and Risk of Cognitive Impairment and Dementia: A Review. BIOLOGY 2023; 12:1154. [PMID: 37627038 PMCID: PMC10452707 DOI: 10.3390/biology12081154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Revised: 08/05/2023] [Accepted: 08/16/2023] [Indexed: 08/27/2023]
Abstract
Cognitive impairment (CI) shares common cardiovascular risk factors with acute myocardial infarction (AMI), and is increasingly prevalent in our ageing population. Whilst AMI is associated with increased rates of CI, CI remains underreported and infrequently identified in patients with AMI. In this review, we discuss the evidence surrounding AMI and its links to dementia and CI, including pathophysiology, risk factors, management and interventions. Vascular dysregulation plays a major role in CI, with atherosclerosis, platelet activation, microinfarcts and perivascular inflammation resulting in neurovascular unit dysfunction, disordered homeostasis and a dysfunctional neurohormonal response. This subsequently affects perfusion pressure, resulting in enlarged periventricular spaces and hippocampal sclerosis. The increased platelet activation seen in coronary artery disease (CAD) can also result in inflammation and amyloid-β protein deposition which is associated with Alzheimer's Dementia. Post-AMI, reduced blood pressure and reduced left ventricular ejection fraction can cause chronic cerebral hypoperfusion, cerebral infarction and failure of normal circulatory autoregulatory mechanisms. Patients who undergo coronary revascularization (percutaneous coronary intervention or bypass surgery) are at increased risk for post-procedure cognitive impairment, though whether this is related to the intervention itself or underlying cardiovascular risk factors is debated. Mortality rates are higher in dementia patients with AMI, and post-AMI CI is more prevalent in the elderly and in patients with post-AMI heart failure. Medical management (antiplatelet, statin, renin-angiotensin system inhibitors, cardiac rehabilitation) can reduce the risk of post-AMI CI; however, beta-blockers may be associated with functional decline in patients with existing CI. The early identification of those with dementia or CI who present with AMI is important, as subsequent tailoring of management strategies can potentially improve outcomes as well as guide prognosis.
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Affiliation(s)
- Elizabeth Hui En Thong
- Internal Medicine Residency, National University Health System, Singapore 119074, Singapore; (E.H.E.T.); (Y.H.T.); (A.S.T.L.)
| | - Ethan J. W. Quek
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117597, Singapore; (E.J.W.Q.); (J.H.L.); (Y.N.T.); (V.K.S.); (B.Y.Q.T.); (L.L.L.Y.); (M.Y.C.)
| | - Jing Hong Loo
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117597, Singapore; (E.J.W.Q.); (J.H.L.); (Y.N.T.); (V.K.S.); (B.Y.Q.T.); (L.L.L.Y.); (M.Y.C.)
| | - Choi-Ying Yun
- Department of Cardiology, National University Heart Centre Singapore, Singapore 119074, Singapore; (C.-Y.Y.); (T.Y.W.L.)
| | - Yao Neng Teo
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117597, Singapore; (E.J.W.Q.); (J.H.L.); (Y.N.T.); (V.K.S.); (B.Y.Q.T.); (L.L.L.Y.); (M.Y.C.)
| | - Yao Hao Teo
- Internal Medicine Residency, National University Health System, Singapore 119074, Singapore; (E.H.E.T.); (Y.H.T.); (A.S.T.L.)
| | - Aloysius S. T. Leow
- Internal Medicine Residency, National University Health System, Singapore 119074, Singapore; (E.H.E.T.); (Y.H.T.); (A.S.T.L.)
| | - Tony Y. W. Li
- Department of Cardiology, National University Heart Centre Singapore, Singapore 119074, Singapore; (C.-Y.Y.); (T.Y.W.L.)
| | - Vijay K. Sharma
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117597, Singapore; (E.J.W.Q.); (J.H.L.); (Y.N.T.); (V.K.S.); (B.Y.Q.T.); (L.L.L.Y.); (M.Y.C.)
- Division of Neurology, Department of Medicine, National University Hospital, Singapore 119074, Singapore;
| | - Benjamin Y. Q. Tan
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117597, Singapore; (E.J.W.Q.); (J.H.L.); (Y.N.T.); (V.K.S.); (B.Y.Q.T.); (L.L.L.Y.); (M.Y.C.)
- Division of Neurology, Department of Medicine, National University Hospital, Singapore 119074, Singapore;
| | - Leonard L. L. Yeo
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117597, Singapore; (E.J.W.Q.); (J.H.L.); (Y.N.T.); (V.K.S.); (B.Y.Q.T.); (L.L.L.Y.); (M.Y.C.)
- Division of Neurology, Department of Medicine, National University Hospital, Singapore 119074, Singapore;
| | - Yao Feng Chong
- Division of Neurology, Department of Medicine, National University Hospital, Singapore 119074, Singapore;
| | - Mark Y. Chan
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117597, Singapore; (E.J.W.Q.); (J.H.L.); (Y.N.T.); (V.K.S.); (B.Y.Q.T.); (L.L.L.Y.); (M.Y.C.)
- Department of Cardiology, National University Heart Centre Singapore, Singapore 119074, Singapore; (C.-Y.Y.); (T.Y.W.L.)
| | - Ching-Hui Sia
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 117597, Singapore; (E.J.W.Q.); (J.H.L.); (Y.N.T.); (V.K.S.); (B.Y.Q.T.); (L.L.L.Y.); (M.Y.C.)
- Department of Cardiology, National University Heart Centre Singapore, Singapore 119074, Singapore; (C.-Y.Y.); (T.Y.W.L.)
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13
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Vishwanath S, Hopper I, Wolfe R, Polekhina G, Reid CM, Tonkin AM, Murray AM, Shah RC, Storey E, Woods RL, McNeil J, Orchard SG, Nelson MR, Steves CJ, Ryan J. Cognitive trajectories and incident dementia after a cardiovascular event in older adults. Alzheimers Dement 2023; 19:3670-3678. [PMID: 36856152 PMCID: PMC10440246 DOI: 10.1002/alz.13006] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2022] [Revised: 01/17/2023] [Accepted: 01/19/2023] [Indexed: 03/02/2023]
Abstract
INTRODUCTION Cardiovascular disease (CVD) is a recognized risk factor for dementia. Here we determined the extent to which an incident CVD event modifies the trajectory of cognitive function and risk of dementia. METHODS 19,114 adults (65+) without CVD or dementia were followed prospectively over 9 years. Incident CVD (fatal coronary heart disease, nonfatal myocardial infarction [MI], stroke, hospitalization for heart failure) and dementia (Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition criteria) were adjudicated by experts. RESULTS Nine hundred twenty-two participants had incident CVD, and 44 developed dementia after CVD (4.9% vs. 4.4% for participants without CVD). Following a CVD event there was a short-term drop in processing speed (-1.97, 95% confidence interval [CI]: -2.57 to -1.41), but there was no significant association with longer-term processing speed. In contrast, faster declines in trajectories of global function (-0.56, 95% CI: -0.76 to -0.36), episodic memory (-0.10, 95% CI: -0.16 to -0.04), and verbal fluency (-0.19, 95% CI: -0.30 to -0.01) were observed. DISCUSSION Findings highlight the importance of monitoring cognition after a CVD event.
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Affiliation(s)
- Swarna Vishwanath
- School of Public Health and Preventive Medicine, Monash University, Victoria, Australia
| | - Ingrid Hopper
- School of Public Health and Preventive Medicine, Monash University, Victoria, Australia
| | - Rory Wolfe
- School of Public Health and Preventive Medicine, Monash University, Victoria, Australia
| | - Galina Polekhina
- School of Public Health and Preventive Medicine, Monash University, Victoria, Australia
| | - Christopher M. Reid
- School of Public Health and Preventive Medicine, Monash University, Victoria, Australia
- School of Public Health, Curtin University, Western Australia, Australia
| | - Andrew M. Tonkin
- School of Public Health and Preventive Medicine, Monash University, Victoria, Australia
| | - Anne M. Murray
- Berman Center for Outcomes & Clinical Research, Hennepin Healthcare Research Institute, Minneapolis, MN, USA
- Department of Medicine, Division of Geriatrics Hennepin Healthcare, University of Minnesota, Minneapolis, MN, USA
| | - Raj C. Shah
- Department of Family Medicine and the Rush Alzheimer’s Disease Centre, Rush University Medical Centre, Chicago, IL, USA
| | - Elsdon Storey
- School of Public Health and Preventive Medicine, Monash University, Victoria, Australia
| | - Robyn L. Woods
- School of Public Health and Preventive Medicine, Monash University, Victoria, Australia
| | - John McNeil
- School of Public Health and Preventive Medicine, Monash University, Victoria, Australia
| | - Suzanne G. Orchard
- School of Public Health and Preventive Medicine, Monash University, Victoria, Australia
| | - Mark R. Nelson
- School of Public Health and Preventive Medicine, Monash University, Victoria, Australia
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Australia
| | - Claire J. Steves
- Department of Twin Research & Genetic Epidemiology, King’s College London, United Kingdom
| | - Joanne Ryan
- School of Public Health and Preventive Medicine, Monash University, Victoria, Australia
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14
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Stone KL, Zhong J, Lyu C, Chodosh J, Blachman NL, Dodson JA. Does Incident Cardiovascular Disease Lead to Greater Odds of Functional and Cognitive Impairment? Insights From the Health and Retirement Study. J Gerontol A Biol Sci Med Sci 2023; 78:1179-1188. [PMID: 36996314 PMCID: PMC10329231 DOI: 10.1093/gerona/glad096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2022] [Indexed: 04/01/2023] Open
Abstract
BACKGROUND Although studies to date have broadly shown that cardiovascular disease (CVD) increases cognitive and physical impairment risk, there is still limited understanding of the magnitude of this risk among relevant CVD subtypes or age cohorts. METHODS We analyzed longitudinal data from 16 679 U.S. Health and Retirement Study participants who were aged ≥65 years at study entry. Primary endpoints were physical impairment (activities of daily living impairment) or cognitive impairment (Langa-Weir Classification of dementia). We compared these endpoints among participants who developed incident CVD versus those who were CVD free, both in the short term (<2-year postdiagnosis) and long term (>5 years), controlling for sociodemographic and health characteristics. We then analyzed the effects by CVD subtype (atrial fibrillation, congestive heart failure, ischemic heart disease, and stroke) and age-at-diagnosis (65-74, 75-84, and ≥85). RESULTS Over a median follow-up of 10 years, 8 750 participants (52%) developed incident CVD. Incident CVD was associated with significantly higher adjusted odds (aOR) of short-term and long-term physical and cognitive impairment. The oldest (≥85) age-at-diagnosis subgroup had the highest risk of short-term physical (aOR 3.01, 95% confidence interval [CI]: 2.40-3.77) and cognitive impairment (aOR 1.96, 95% CI: 1.55-2.48), as well as long-term impairment. All CVD subtypes were associated with higher odds of physical and cognitive impairment, with the highest risk for patients with incident stroke. CONCLUSIONS Incident CVD was associated with an increased risk of physical and cognitive impairment across CVD subtypes. Impairment risk after CVD was highest among the oldest patients (≥85 years) who should therefore remain a target for prevention efforts.
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Affiliation(s)
- Katherine L Stone
- Division of Geriatric Medicine and Palliative Care, Department of Medicine, New York University Langone Medical Center, New York, New York, USA
| | - Judy Zhong
- Division of Biostatistics, Department of Population Health, New York University Langone Medical Center, New York, New York, USA
| | - Chen Lyu
- Division of Biostatistics, Department of Population Health, New York University Langone Medical Center, New York, New York, USA
| | - Joshua Chodosh
- Division of Geriatric Medicine and Palliative Care, Department of Medicine, New York University Langone Medical Center, New York, New York, USA
| | - Nina L Blachman
- Division of Geriatric Medicine and Palliative Care, Department of Medicine, New York University Langone Medical Center, New York, New York, USA
| | - John A Dodson
- Division of Biostatistics, Department of Population Health, New York University Langone Medical Center, New York, New York, USA
- Leon H. Charney Division of Cardiology, Department of Medicine, New York University Langone Medical Center, New York, New York, USA
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15
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Xu S, Liu Y, Wang Q, Liu F, Xu F, Liu Y. Mendelian randomization study reveals a causal relationship between coronary artery disease and cognitive impairment. Front Cardiovasc Med 2023; 10:1150432. [PMID: 37288257 PMCID: PMC10242088 DOI: 10.3389/fcvm.2023.1150432] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Accepted: 05/09/2023] [Indexed: 06/09/2023] Open
Abstract
Background Growing evidence suggests that Coronary artery disease (CAD) is associated with cognitive impairment. However, these results from observational studies was not entirely consistent, with some detecting no such association. And it is necessary to explore the causal relationship between CAD and cognitive impairment. Objective We aimed to explore the potential causal relationship between CAD and cognitive impairment by using bidirectional two-sample mendelian randomization (MR) analyses. Methods Instrument variants were extracted according to strict selection criteria. And we used publicly available summary-level GWAS data. Five different methods of MR [random-effect inverse-variance weighted (IVW), MR Egger, weighted median, weighted mode and Wald ratio] were used to explore the causal relationship between CAD and cognitive impairment. Results There was little evidence to support a causal effect of CAD on cognitive impairment in the forward MR analysis. In the reverse MR analyses, We detect causal effects of fluid intelligence score (IVW: β = -0.12, 95% CI of -0.18 to -0.06, P = 6.8 × 10-5), cognitive performance (IVW: β = -0.18, 95% CI of -0.28 to -0.08, P = 5.8 × 10-4) and dementia with lewy bodies (IVW: OR = 1.07, 95% CI of 1.04-1.10, P = 1.1 × 10-5) on CAD. Conclusion This MR analysis provides evidence of a causal association between cognitive impairment and CAD. Our findings highlight the importance of screening for coronary heart disease in patients of cognitive impairment, which might provide new insight into the prevention of CAD. Moreover, our study provides clues for risk factor identification and early prediction of CAD.
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Affiliation(s)
- Shihan Xu
- The Second Department of Geriatrics, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
- National Clinical Research Center for TCM Cardiology, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Yanfei Liu
- The Second Department of Geriatrics, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
- National Clinical Research Center for TCM Cardiology, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Qing Wang
- The Second Department of Geriatrics, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
- National Clinical Research Center for TCM Cardiology, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Fenglan Liu
- Graduate School of Guangdong Pharmaceutical University, Guangzhou, China
| | - Fengqin Xu
- The Second Department of Geriatrics, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
- National Clinical Research Center for TCM Cardiology, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
| | - Yue Liu
- National Clinical Research Center for TCM Cardiology, Xiyuan Hospital, China Academy of Chinese Medical Sciences, Beijing, China
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16
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Hua R, Li C, Gao D, Zheng F, Xie W. Cognitive decline among older adults with heart diseases before and during the COVID-19 pandemic: A longitudinal cohort study. Front Cardiovasc Med 2023; 9:1077800. [PMID: 36776942 PMCID: PMC9908755 DOI: 10.3389/fcvm.2022.1077800] [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: 10/23/2022] [Accepted: 12/29/2022] [Indexed: 01/27/2023] Open
Abstract
Background Little is known about the impact induced by the COVID-19 pandemic on the cognitive function of older adults with heart diseases. This study aimed to examine whether older adults with heart diseases suffered larger cognitive deterioration during the COVID-19 pandemic. Methods This study leveraged longitudinal data from the Health and Retirement Study (HRS), a nationally representative U.S. aging cohort with objective cognitive assessments measured before and during the pandemic. The interval from HRS waves 13 to 14 (April 2016 to June 2019) was defined as the pre-pandemic period to control the pre-existed cognitive difference between participants with and without heart diseases, and the interval from waves 14 to 15 (June 2019 to June 2021) was defined as the pandemic period. The HRS wave 14 survey was considered the baseline. The heart disease status was defined by a self-reported diagnosis. Linear mixed models were performed to evaluate and compare the cognitive differences during different periods. Results A total of 9,304 participants (women: 5,655, 60.8%; mean age: 65.8 ± 10.8 years) were included, and 2,119 (22.8%) had heart diseases. During the pre-pandemic period, there was no significant difference (-0.03, 95% CI: -0.22 to 0.15, P = 0.716) in the changes in global cognitive scores between participants with and without heart disease. During the pandemic period, a larger decreased change in the global cognitive score was observed in the heart disease group compared with the non-heart disease group (-0.37, 95% CI: -0.55 to -0.19, P < 0.001). An enlarged difference in global cognitive score was observed during the pandemic period (-0.33, 95% CI: -0.65 to -0.02, P = 0.036). Conclusion The findings demonstrated that the population with heart diseases suffered more cognitive decline related to the pandemic, underscoring the necessity to provide immediate cognitive monitoring and interventions for the population with heart diseases.
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Affiliation(s)
- Rong Hua
- Peking University Clinical Research Institute, Peking University First Hospital, Beijing, China
- Peking University Clinical Research Institute Heart and Vascular Health Research Center at Peking University Shougang Hospital, Beijing, China
| | - Chenglong Li
- Peking University Clinical Research Institute, Peking University First Hospital, Beijing, China
- Peking University Clinical Research Institute Heart and Vascular Health Research Center at Peking University Shougang Hospital, Beijing, China
| | - Darui Gao
- Peking University Clinical Research Institute, Peking University First Hospital, Beijing, China
- Peking University Clinical Research Institute Heart and Vascular Health Research Center at Peking University Shougang Hospital, Beijing, China
| | - Fanfan Zheng
- School of Nursing, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, China
| | - Wuxiang Xie
- Peking University Clinical Research Institute, Peking University First Hospital, Beijing, China
- Peking University Clinical Research Institute Heart and Vascular Health Research Center at Peking University Shougang Hospital, Beijing, China
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17
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Köhler S, Soons LM, Tange H, Deckers K, van Boxtel MP. Sleep Quality and Cognitive Decline Across the Adult Age Range: Findings from the Maastricht Aging Study (MAAS). J Alzheimers Dis 2023; 96:1041-1049. [PMID: 38007668 PMCID: PMC10741338 DOI: 10.3233/jad-230213] [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] [Accepted: 09/11/2023] [Indexed: 11/27/2023]
Abstract
BACKGROUND Sleep disturbances have been linked with cognitive decline and a higher risk of dementia. However, there is a lack of studies with sufficient follow-up duration, a detailed neuropsychological assessment and adequate control of main confounders. OBJECTIVE To investigate the relation between self-reported sleep quality and cognitive decline over 12 years in cognitively healthy individuals from the general population. METHODS We used data from the Maastricht Aging Study (MAAS), a Dutch population-based prospective cohort study of 1,823 community-dwelling adults aged 24 to 82 years at baseline. Cognitive performance was measured at baseline, 6 and 12 years on verbal memory, executive functions, and information processing speed. Sleep quality was assessed at baseline using the sleep subscale score of the 90-item Symptom Checklist (SCL-90). Additional modifiable dementia risk factors were summarized in the LIfestyle for BRAin health (LIBRA) risk score. Weighted linear mixed models tested the association between continuous scores and tertiles of subjective sleep quality and change in cognitive performances over time. Models were adjusted for age, gender, educational level, LIBRA, and use of hypnotic (sleep) medication. RESULTS Worse sleep quality was associated with faster decline in processing speed. At older age (≥65 years), it was also associated with faster decline in verbal memory. Association were independent of other modifiable dementia risk factors and use of hypnotic medication. Directionally similar but non-significant associations were found between worse sleep quality and executive functions. CONCLUSIONS In this population-based study across the adult age range, poor self-reported sleep was associated with accelerated cognitive decline.
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Affiliation(s)
- Sebastian Köhler
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience (MHeNs), Maastricht University, Maastricht, The Netherlands
- Alzheimer Center Limburg, Maastricht University Medical Center+, Maastricht, The Netherlands
| | - Lion M. Soons
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience (MHeNs), Maastricht University, Maastricht, The Netherlands
- Alzheimer Center Limburg, Maastricht University Medical Center+, Maastricht, The Netherlands
| | - Huibert Tange
- Department of Family Medicine, Care and Public Health Research Institute (CAPHRI), Maastricht University, Maastricht, The Netherlands
| | - Kay Deckers
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience (MHeNs), Maastricht University, Maastricht, The Netherlands
- Alzheimer Center Limburg, Maastricht University Medical Center+, Maastricht, The Netherlands
| | - Martin P.J. van Boxtel
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience (MHeNs), Maastricht University, Maastricht, The Netherlands
- Alzheimer Center Limburg, Maastricht University Medical Center+, Maastricht, The Netherlands
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18
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Dion C, Tanner JJ, Libon DJ, Price CC. Contributions of Cardiovascular Burden, Peripheral Inflammation, and Brain Integrity on Digital Clock Drawing Performance in Non-Demented Older Adults. J Alzheimers Dis 2023; 95:453-467. [PMID: 37545230 PMCID: PMC10870342 DOI: 10.3233/jad-221011] [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] [Indexed: 08/08/2023]
Abstract
BACKGROUND Greater cardiovascular burden and peripheral inflammation are associated with dysexecutive neuropsychological profiles and a higher likelihood of conversion to vascular dementia. The digital clock drawing test (dCDT) is useful in identifying neuropsychological dysfunction related to vascular etiology. However, the specific cognitive implications of the combination of cardiovascular risk, peripheral inflammation, and brain integrity remain unknown. OBJECTIVE We aimed to examine the role of cardiovascular burden, inflammation, and MRI-defined brain integrity on dCDT latency and graphomotor metrics in older adults. METHODS 184 non-demented older adults (age 69±6, 16±3 education years, 46% female, 94% white) completed dCDT, vascular assessment, blood draw, and brain MRI. dCDT variables of interest: total completion time (TCT), pre-first hand latency, digit misplacement, hour hand distance from center, and clock face area. Cardiovascular burden was calculated using the Framingham Stroke Risk Profile (FSRP-10). Peripheral inflammation markers included interleukin (IL)-6, IL-8, IL-10, tumor necrosis factor-alpha, and high sensitivity C-reactive protein. Brain integrity included bilateral entorhinal cortex volume, lateral ventricular volume, and whole brain leukoaraiosis. RESULTS FSRP-10, peripheral inflammation, and brain integrity explained an additional 14.6% of the variance in command TCT, where FSRP-10 was the main predictor. FSRP-10, inflammatory markers, and brain integrity explained an additional 17.0% in command digit misplacement variance, with findings largely driven by FSRP-10. CONCLUSION Subtle graphomotor behavior operationalized using dCDT metrics (i.e., TCT and digit misplacement) is partly explained by cardiovascular burden, peripheral inflammation, and brain integrity and may indicate vulnerability to a disease process.
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Affiliation(s)
- Catherine Dion
- Clinical and Health Psychology, University of Florida, Gainesville, FL, USA
| | - Jared J. Tanner
- Clinical and Health Psychology, University of Florida, Gainesville, FL, USA
| | - David J. Libon
- Department of Geriatrics and Gerontology, New Jersey Institute for Successful Aging, School of Osteopathic Medicine, Rowan University, Glassboro, NJ, USA
- Department of Psychology, Rowan University, Glassboro, NJ, USA
| | - Catherine C. Price
- Clinical and Health Psychology, University of Florida, Gainesville, FL, USA
- Department of Anesthesiology, University of Florida, Gainesville, FL, USA
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19
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High Throughput Fabrication of Flexible Top-Driven Sensing Probe. Polymers (Basel) 2022; 14:polym14235124. [PMID: 36501518 PMCID: PMC9738077 DOI: 10.3390/polym14235124] [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: 10/10/2022] [Revised: 11/20/2022] [Accepted: 11/21/2022] [Indexed: 11/27/2022] Open
Abstract
In this work, considering the current status of conservative and complicated traditional thrombosis treatment methods, a kind of flexible intelligent probe (FIP) with a top-driven sensing strategy is proposed to realize the expected function of thrombosis accurate localization in a liquid flow environment. After throughput fabrication, we find that the FIP has excellent electrical conductivity and mechanical properties. Notable, our FIP with the principle of piezo-resistive sensing has a quasi-linear sensitivity (approx. 0.325 L per minute) to flow sensing in the low flow velocity range (0-1 L per minute). Via the well-designed magnetically driven method, our FIP has a maximum deflection output force of 443.264 mN, a maximum deflection angle of 43°, and a maximum axial force of 54.176 mN. We demonstrate that the FIP is capable of completing the specified command actions relatively accurately and has a good response to real-time sensing feedback performance, which has broad application prospects in thrombus localization detection.
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20
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Shang S, Liu Z, Gao J, Wang J, Lu W, Fei Y, Zhang B, Mi B, Li P, Ma L, Jiang Y, Chen C, Dang L, Liu J, Qu Q. The Relationship Between Pre-existing Coronary Heart Disease and Cognitive Impairment Is Partly Explained by Reduced Left Ventricular Ejection Fraction in the Subjects Without Clinical Heart Failure: A Cross-Sectional Study. Front Hum Neurosci 2022; 16:835900. [PMID: 35634203 PMCID: PMC9130859 DOI: 10.3389/fnhum.2022.835900] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Accepted: 04/01/2022] [Indexed: 11/13/2022] Open
Abstract
Background Coronary heart disease (CHD) is closely associated with cognitive impairment, especially in severe cases of heart failure. However, it is unclear whether cardiac systolic function plays a role in the relationship between pre-existing CHD and cognitive impairment in subjects without clinical heart failure. Methods In total, 208 subjects from the First Affiliated Hospital of Xi’an Jiaotong University were recruited from June 2014 to January 2015, and were divided into CHD (n = 118) and non-CHD (n = 90) groups according to the inclusion and exclusion criteria. The global cognitive function of all subjects was assessed by the Mini-Mental State Examination (MMSE) and cognitive impairment was defined as the score lower than the cutoff value. Left ventricular ejection fraction (LVEF) was measured using transthoracic echocardiograms. The relationship among pre-existing CHD, LVEF, and cognitive impairment was analyzed by multivariate logistic regression. Results In total, 34 subjects met the criteria of cognitive impairment. Univariate analysis showed that the cognitive impairment prevalence in the CHD group was significantly higher than that in the non-CHD group (22.0 vs. 8.9%, p = 0.011). Multivariate logistic analysis revealed that CHD was significantly associated with a higher risk of cognitive impairment (odds ratio [OR] = 3.284 [95% CI, 1.032–10.450], p = 0.044) after adjusting for confounds except for LVEF. However, the OR of CHD decreased (OR = 2.127 [95% CI, 0.624–7.254], p = 0.228) when LVEF was further corrected as a continuous variable, and LVEF was negatively associated with the risk of cognitive impairment (OR = 0.928 [95% CI, 0.882–0.976], p = 0.004). Conclusion Pre-existing CHD is associated with a higher risk of cognitive impairment, and such an association can be considerably explained by reduced LVEF. An impaired cardiac systolic function may play a key role in the relationship between CHD and cognitive impairment among patients with pre-heart failure conditions.
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Affiliation(s)
- Suhang Shang
- Department of Neurology, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
| | - Ziyu Liu
- Department of Neurology, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
| | - Jinying Gao
- Department of Neurology, The People’s Hospital of Ankang, Ankang, China
| | - Jin Wang
- Department of Neurology, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
| | - Wenhui Lu
- Department of Neurology, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
| | - Yulang Fei
- Medical College, Xijing University, Xi’an, China
| | - Binyan Zhang
- Department of Epidemiology and Health Statistics, School of Public Health, Xi’an Jiaotong University Health Science Center, Xi’an, China
| | - Baibing Mi
- Department of Epidemiology and Health Statistics, School of Public Health, Xi’an Jiaotong University Health Science Center, Xi’an, China
| | - Pei Li
- The Assisted Reproductive Technology Center, Northwest Women’s and Children’s Hospital, Xi’an, China
| | - Louyan Ma
- The Second Department of Geriatrics, Xi’an No 9 Hospital, Xi’an, China
| | - Yu Jiang
- Department of Neurology, The Second Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
| | - Chen Chen
- Department of Neurology, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
| | - Liangjun Dang
- Department of Neurology, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
| | - Jie Liu
- Department of Neurology, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
| | - Qiumin Qu
- Department of Neurology, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, China
- *Correspondence: Qiumin Qu,
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21
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Zhang L, Hill SK, Guo B, Wu B, Alliey-Rodriguez N, Eum S, Lizano P, Ivleva EI, Reilly JL, Keefe RSE, Keedy SK, Tamminga CA, Pearlson GD, Clementz BA, Keshavan MS, Gershon ES, Sweeney JA, Bishop JR. Impact of polygenic risk for coronary artery disease and cardiovascular medication burden on cognitive impairment in psychotic disorders. Prog Neuropsychopharmacol Biol Psychiatry 2022; 113:110464. [PMID: 34756932 PMCID: PMC8932335 DOI: 10.1016/j.pnpbp.2021.110464] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Revised: 10/13/2021] [Accepted: 10/25/2021] [Indexed: 12/12/2022]
Abstract
BACKGROUND Cognitive impairment is a core deficit across psychotic disorders, the causes and therapeutics of which remain unclear. Epidemiological observations have suggested associations between cognitive dysfunction in psychotic disorders and cardiovascular risk factors, but an underlying etiology has not been established. METHODS Neuropsychological performance using the Brief Assessment of Cognition in Schizophrenia (BACS) was assessed in 616 individuals of European ancestry (403 psychosis, 213 controls). Polygenic risk scores for coronary artery disease (PRSCAD) were quantified for each participant across 13 p-value thresholds (PT 0.5-5e-8). Cardiovascular and psychotropic medications were categorized for association analyses. Each PRSCAD was examined in relation to the BACS and the optimized PT was confirmed with five-fold cross-validation and independent validation. Functional enrichment analyses were used to identify biological mechanisms linked to PRSCAD-cognition associations. Multiple regression analyses examined PRSCAD under the optimal PT and medication burden in relation to the BACS composite and subtest scores. RESULTS Higher PRSCAD was associated with lower BACS composite scores (p = 0.001) in the psychosis group, primarily driven by the Verbal Memory subtest (p < 0.001). Genes linked to multiple nervous system related processes and pathways were significantly enriched in PRSCAD. After controlling for PRSCAD, a greater number of cardiovascular medications was also correlated with worse BACS performance in patients with psychotic disorders (p = 0.029). CONCLUSIONS Higher PRSCAD and taking more cardiovascular medications were both significantly associated with cognitive impairment in psychosis. These findings indicate that cardiovascular factors may increase the risk for cognitive dysfunction and related functional outcomes among individuals with psychotic disorders.
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Affiliation(s)
- Lusi Zhang
- Department of Experimental and Clinical Pharmacology, College of Pharmacy, University of Minnesota, Minneapolis, MN, United States of America
| | - Scot Kristian Hill
- Department of Psychology, Rosalind Franklin University of Medicine and Science, North Chicago, IL, United States of America
| | - Bin Guo
- Division of Biostatistics, School of Public Health, University of Minnesota, Minneapolis, MN, United States of America
| | - Baolin Wu
- Division of Biostatistics, School of Public Health, University of Minnesota, Minneapolis, MN, United States of America
| | - Ney Alliey-Rodriguez
- Department of Psychiatry and Behavioral Neuroscience, University of Chicago, Chicago, IL, United States of America
| | - Seenae Eum
- Department of Pharmacogenomics, School of Pharmacy, Shenandoah University, Fairfax, VA, United States of America
| | - Paulo Lizano
- Department of Psychiatry, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, United States of America
| | - Elena I Ivleva
- Department of Psychiatry, Southwestern Medical Center, University of Texas, Dallas, TX, United States of America
| | - James L Reilly
- Department of Psychiatry and Behavioral Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States of America
| | - Richard S E Keefe
- Departments of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, NC, United States of America
| | - Sarah K Keedy
- Department of Psychiatry and Behavioral Neuroscience, University of Chicago, Chicago, IL, United States of America
| | - Carol A Tamminga
- Department of Psychiatry, Southwestern Medical Center, University of Texas, Dallas, TX, United States of America
| | - Godfrey D Pearlson
- Departments of Psychiatry and Neurobiology, School of Medicine, Yale University, New Haven, CT, United States of America
| | - Brett A Clementz
- Department of Psychology and Neuroscience, University of Georgia, Athens, GA, United States of America
| | - Matcheri S Keshavan
- Department of Psychiatry, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, United States of America
| | - Elliot S Gershon
- Department of Psychiatry and Behavioral Neuroscience, University of Chicago, Chicago, IL, United States of America
| | - John A Sweeney
- Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati, Cincinnati, OH, United States of America
| | - Jeffrey R Bishop
- Department of Experimental and Clinical Pharmacology, College of Pharmacy, University of Minnesota, Minneapolis, MN, United States of America; Department of Psychiatry and Behavioral Sciences, University of Minnesota Medical School, Minneapolis, MN, United States of America.
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22
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Scalco A, Moro N, Mongillo M, Zaglia T. Neurohumoral Cardiac Regulation: Optogenetics Gets Into the Groove. Front Physiol 2021; 12:726895. [PMID: 34531763 PMCID: PMC8438220 DOI: 10.3389/fphys.2021.726895] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Accepted: 07/27/2021] [Indexed: 12/25/2022] Open
Abstract
The cardiac autonomic nervous system (ANS) is the main modulator of heart function, adapting contraction force, and rate to the continuous variations of intrinsic and extrinsic environmental conditions. While the parasympathetic branch dominates during rest-and-digest sympathetic neuron (SN) activation ensures the rapid, efficient, and repeatable increase of heart performance, e.g., during the "fight-or-flight response." Although the key role of the nervous system in cardiac homeostasis was evident to the eyes of physiologists and cardiologists, the degree of cardiac innervation, and the complexity of its circuits has remained underestimated for too long. In addition, the mechanisms allowing elevated efficiency and precision of neurogenic control of heart function have somehow lingered in the dark. This can be ascribed to the absence of methods adequate to study complex cardiac electric circuits in the unceasingly moving heart. An increasing number of studies adds to the scenario the evidence of an intracardiac neuron system, which, together with the autonomic components, define a little brain inside the heart, in fervent dialogue with the central nervous system (CNS). The advent of optogenetics, allowing control the activity of excitable cells with cell specificity, spatial selectivity, and temporal resolution, has allowed to shed light on basic neuro-cardiology. This review describes how optogenetics, which has extensively been used to interrogate the circuits of the CNS, has been applied to untangle the knots of heart innervation, unveiling the cellular mechanisms of neurogenic control of heart function, in physiology and pathology, as well as those participating to brain-heart communication, back and forth. We discuss existing literature, providing a comprehensive view of the advancement in the understanding of the mechanisms of neurogenic heart control. In addition, we weigh the limits and potential of optogenetics in basic and applied research in neuro-cardiology.
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Affiliation(s)
- Arianna Scalco
- Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, Padova, Italy
- Veneto Institute of Molecular Medicine, Padova, Italy
| | - Nicola Moro
- Department of Cardiac, Thoracic, Vascular Sciences and Public Health, University of Padova, Padova, Italy
- Veneto Institute of Molecular Medicine, Padova, Italy
| | - Marco Mongillo
- Veneto Institute of Molecular Medicine, Padova, Italy
- Department of Biomedical Sciences, University of Padova, Padova, Italy
| | - Tania Zaglia
- Veneto Institute of Molecular Medicine, Padova, Italy
- Department of Biomedical Sciences, University of Padova, Padova, Italy
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23
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Moazzami K, Garcia M, Young A, Almuwaqqat Z, Lima BB, Martini A, Alkhalaf M, Shah AJ, Goldstein FC, Hajjar I, Levey AI, Bremner JD, Quyyumi AA, Vaccarino V. Association between symptoms of psychological distress and cognitive functioning among adults with coronary artery disease. Stress Health 2021; 37:538-546. [PMID: 33319483 PMCID: PMC8395370 DOI: 10.1002/smi.3018] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Revised: 12/09/2020] [Accepted: 12/11/2020] [Indexed: 12/14/2022]
Abstract
Greater psychological distress is associated with cognitive impairment in healthy adults. Whether such associations also exist in patients with coronary artery disease (CAD) is uncertain. We assessed cognitive function in 496 individuals with CAD using the verbal and visual memory subtests of the Wechsler Memory Scale and executive functioning measured by the Trail Making Test Parts A and B. We used a composite score of psychological distress derived through summation of Z-transformed psychological distress symptom scales (depression, posttraumatic stress, anxiety, anger, hostility and perceived stress) and scores for each individual psychological scale. Multivariable linear regression models were used to determine the association between memory scores (as outcomes) and the psychological distress scores (both composite score and individual scales). After adjusting for demographic and cardiovascular risk factors, a higher psychological distress score was independently associated with worse memory and executive functioning. Each standard deviation increase in psychological distress score was associated with 3% (95% confidence interval [CI], 1%-5%) to 5% (95% CI, 3-7%) worse cognitive performance (higher Trail A and Trail B, and lower verbal and visual memory scores). Among individuals with CAD, a higher level of psychological distress is independently associated with worse cognitive performance. These findings suggest that psychological risk factors play a role in cognitive trajectories of persons with CAD.
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Affiliation(s)
- Kasra Moazzami
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA.,Division of Cardiology, Department of Medicine, Emory Clinical Cardiovascular Research Institute, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Mariana Garcia
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA.,Division of Cardiology, Department of Medicine, Emory Clinical Cardiovascular Research Institute, Emory University School of Medicine, Atlanta, Georgia, USA
| | - An Young
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA.,Division of Cardiology, Department of Medicine, Emory Clinical Cardiovascular Research Institute, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Zakaria Almuwaqqat
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA.,Division of Cardiology, Department of Medicine, Emory Clinical Cardiovascular Research Institute, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Bruno B Lima
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA.,Division of Cardiology, Department of Medicine, Emory Clinical Cardiovascular Research Institute, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Afif Martini
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
| | - Mhmtjamil Alkhalaf
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
| | - Amit J Shah
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA.,Division of Cardiology, Department of Medicine, Emory Clinical Cardiovascular Research Institute, Emory University School of Medicine, Atlanta, Georgia, USA.,Atlanta VA Medical Center, Decatur, Georgia, USA
| | - Felicia C Goldstein
- Department of Neurology, Emory University School of Medicine, Emory University, Atlanta, Georgia, USA.,Goizuetta Alzheimer's Disease Research Center, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Ihab Hajjar
- Department of Neurology, Emory University School of Medicine, Emory University, Atlanta, Georgia, USA.,Goizuetta Alzheimer's Disease Research Center, Emory University School of Medicine, Atlanta, Georgia, USA.,Division of General Internal Medicine and Geriatrics, Department of Medicine, Emory University, Atlanta, Georgia, USA
| | - Allan I Levey
- Department of Neurology, Emory University School of Medicine, Emory University, Atlanta, Georgia, USA.,Goizuetta Alzheimer's Disease Research Center, Emory University School of Medicine, Atlanta, Georgia, USA
| | - J Douglas Bremner
- Atlanta VA Medical Center, Decatur, Georgia, USA.,Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, Georgia, USA.,Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Arshed A Quyyumi
- Division of Cardiology, Department of Medicine, Emory Clinical Cardiovascular Research Institute, Emory University School of Medicine, Atlanta, Georgia, USA
| | - Viola Vaccarino
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA.,Division of Cardiology, Department of Medicine, Emory Clinical Cardiovascular Research Institute, Emory University School of Medicine, Atlanta, Georgia, USA
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24
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Frey A, Homola GA, Henneges C, Mühlbauer L, Sell R, Kraft P, Franke M, Morbach C, Vogt M, Müllges W, Ertl G, Solymosi L, Pirpamer L, Schmidt R, Pham M, Störk S, Stoll G. Temporal changes in total and hippocampal brain volume and cognitive function in patients with chronic heart failure-the COGNITION.MATTERS-HF cohort study. Eur Heart J 2021; 42:1569-1578. [PMID: 33496311 PMCID: PMC8060058 DOI: 10.1093/eurheartj/ehab003] [Citation(s) in RCA: 32] [Impact Index Per Article: 10.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Revised: 09/22/2020] [Accepted: 01/04/2021] [Indexed: 12/17/2022] Open
Abstract
Aims We quantified the concurring dynamics affecting total and hippocampal brain volume and cognitive function in patients with chronic heart failure (HF) over a period of three years. Methods and results A total of 148 patients with mild stable HF entered this monocentric prospective cohort study: mean age 64.5 (10.8) years; 16.2% female; 77% in New York Heart Association functional classes I–II; 128 and 105 patients attended follow-up visits after 1 and 3 years, respectively. The assessment included cardiological, neurological, psychological work-up, and brain magnetic resonance imaging. Total and regional brain volumes were quantified using an operator-independent fully automated approach and reported normalized to the mean estimated intracranial volume. At baseline, the mean hippocampal volume was ∼13% lower than expected. However, the 3-year progressive hippocampal volume loss was small: −62 mm3 [95% confidence interval (CI) −81 to −42, P < 0.0001). This corresponded to a relative change of −1.8% (95% CI −2.3 to −1.2), which was similar in magnitude as observed with physiological aging. Moreover, the load of white matter hypointensities increased within the limits of normal aging. Cognitive function during the 3-year observation period remained stable, with ‘intensity of attention’ as the only domain declining (LSmean −1.82 points, 95% CI −3.05 to −0.58, P = 0.004). After 3 years, performance in all domains of cognition remained associated with hippocampal volume (r ≥ 0.29). Conclusion In patients with predominantly mild HF, the markedly reduced hippocampal volume observed at baseline was associated with impaired cognitive function, but no accelerated deterioration in cognition and brain atrophy became evident over a mid-term period of three years.
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Affiliation(s)
- Anna Frey
- Comprehensive Heart Failure Center Würzburg, University and University Hospital Würzburg, Am Schwarzenberg 15, 97078 Würzburg, Germany.,Department of Medicine I, University Hospital Würzburg, Josef-Schneider-Straße 11, Würzburg 97080, Germany
| | - György A Homola
- Comprehensive Heart Failure Center Würzburg, University and University Hospital Würzburg, Am Schwarzenberg 15, 97078 Würzburg, Germany.,Department of Neuroradiology, University Hospital Würzburg, Josef-Schneider-Straße 11, Würzburg 97080, Germany
| | - Carsten Henneges
- Comprehensive Heart Failure Center Würzburg, University and University Hospital Würzburg, Am Schwarzenberg 15, 97078 Würzburg, Germany
| | - Larissa Mühlbauer
- Comprehensive Heart Failure Center Würzburg, University and University Hospital Würzburg, Am Schwarzenberg 15, 97078 Würzburg, Germany.,Department of Psychiatry, Psychosomatics and Psychotherapy, University Hospital Würzburg, Josef-Schneider-Straße 11, Würzburg 97080, Germany
| | - Roxane Sell
- Comprehensive Heart Failure Center Würzburg, University and University Hospital Würzburg, Am Schwarzenberg 15, 97078 Würzburg, Germany.,Department of Psychiatry, Psychosomatics and Psychotherapy, University Hospital Würzburg, Josef-Schneider-Straße 11, Würzburg 97080, Germany
| | - Peter Kraft
- Comprehensive Heart Failure Center Würzburg, University and University Hospital Würzburg, Am Schwarzenberg 15, 97078 Würzburg, Germany.,Department of Neurology, University Hospital Würzburg, Josef-Schneider-Straße 11, Würzburg 97080, Germany.,Department of Neurology, Hospital Main-Spessart, Grafen-von-Rieneck-Straße 5, 97816 Lohr a. Main, Germany
| | - Maximilian Franke
- Comprehensive Heart Failure Center Würzburg, University and University Hospital Würzburg, Am Schwarzenberg 15, 97078 Würzburg, Germany.,Department of Neurology, University Hospital Würzburg, Josef-Schneider-Straße 11, Würzburg 97080, Germany
| | - Caroline Morbach
- Comprehensive Heart Failure Center Würzburg, University and University Hospital Würzburg, Am Schwarzenberg 15, 97078 Würzburg, Germany.,Department of Medicine I, University Hospital Würzburg, Josef-Schneider-Straße 11, Würzburg 97080, Germany
| | - Marius Vogt
- Department of Neuroradiology, University Hospital Würzburg, Josef-Schneider-Straße 11, Würzburg 97080, Germany
| | - Wolfgang Müllges
- Comprehensive Heart Failure Center Würzburg, University and University Hospital Würzburg, Am Schwarzenberg 15, 97078 Würzburg, Germany.,Department of Neurology, University Hospital Würzburg, Josef-Schneider-Straße 11, Würzburg 97080, Germany
| | - Georg Ertl
- Comprehensive Heart Failure Center Würzburg, University and University Hospital Würzburg, Am Schwarzenberg 15, 97078 Würzburg, Germany.,Department of Medicine I, University Hospital Würzburg, Josef-Schneider-Straße 11, Würzburg 97080, Germany
| | - László Solymosi
- Comprehensive Heart Failure Center Würzburg, University and University Hospital Würzburg, Am Schwarzenberg 15, 97078 Würzburg, Germany.,Department of Neuroradiology, University Hospital Würzburg, Josef-Schneider-Straße 11, Würzburg 97080, Germany
| | - Lukas Pirpamer
- Department of Neurology, Medical University of Graz, Auenbruggerpl. 22, 8036 Graz, Austria
| | - Reinhold Schmidt
- Department of Neurology, Medical University of Graz, Auenbruggerpl. 22, 8036 Graz, Austria
| | - Mirko Pham
- Comprehensive Heart Failure Center Würzburg, University and University Hospital Würzburg, Am Schwarzenberg 15, 97078 Würzburg, Germany.,Department of Neuroradiology, University Hospital Würzburg, Josef-Schneider-Straße 11, Würzburg 97080, Germany
| | - Stefan Störk
- Comprehensive Heart Failure Center Würzburg, University and University Hospital Würzburg, Am Schwarzenberg 15, 97078 Würzburg, Germany.,Department of Medicine I, University Hospital Würzburg, Josef-Schneider-Straße 11, Würzburg 97080, Germany
| | - Guido Stoll
- Comprehensive Heart Failure Center Würzburg, University and University Hospital Würzburg, Am Schwarzenberg 15, 97078 Würzburg, Germany.,Department of Neurology, University Hospital Würzburg, Josef-Schneider-Straße 11, Würzburg 97080, Germany
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25
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Rundek T, Gardener H, Dias Saporta AS, Loewenstein DA, Duara R, Wright CB, Dong C, Levin B, Elkind MSV, Sacco RL. Global Vascular Risk Score and CAIDE Dementia Risk Score Predict Cognitive Function in the Northern Manhattan Study. J Alzheimers Dis 2021; 73:1221-1231. [PMID: 31884476 DOI: 10.3233/jad-190925] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Modifiable vascular risk factors (VRF) have been implicated in cognitive impairment. OBJECTIVE We compared the prediction of cognitive performance between the Cardiovascular Risk Factors, Aging, and Incidence of Dementia (CAIDE) dementia risk score, a validated tool to estimate dementia risk using VRF, and the Northern Manhattan Study (NOMAS) global vascular risk score (GVRS), created to predict vascular events. METHODS The CAIDE and GVRS scores were calculated based on baseline VRF among 1,290 stroke-free participants in the prospective population-based NOMAS MRI cohort (mean age 64±8 years, 60% women; 66% Hispanic, 17% Black, 15% White; 46% completed high school). Domain-specific Z-scores were derived for episodic and semantic memory, executive function, and processing speed, and averaged to calculate global cognition. RESULTS The CAIDE score was associated with worse global cognition at initial assessment (Beta per SD = -0.347, p < 0.0001), and with greater decline over time (Beta per SD = -0.033, p = 0.02). These associations were largely due to age and education, and the association with cognitive decline was not significant after adjusting for age, sex, and education. The GVRS was inversely associated with global cognition at initial testing (Beta per SD = -0.247, p < 0.0001) and greater decline over time (Beta per SD = -0.127, p < 0.0001), which persisted after adjusting for sociodemographics. The associations for both scores with initial cognitive performance were driven by executive function and processing speed, and the GVRS was associated with decline in episodic memory and processing speed. CONCLUSIONS The GVRS was a stronger predictor of cognitive decline than the CAIDE in a multi-ethnic urban cohort. The inclusion of glucose and smoking in the GVRS, which are absent in CAIDE, likely explains the better performance of the GVRS.
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Affiliation(s)
- Tatjana Rundek
- Department of Neurology, University of Miami Miller School of Medicine, Miami, FL, USA.,Evelyn F McKnight Brain Institute, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Hannah Gardener
- Department of Neurology, University of Miami Miller School of Medicine, Miami, FL, USA.,Evelyn F McKnight Brain Institute, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Anita Seixas Dias Saporta
- Department of Neurology, University of Miami Miller School of Medicine, Miami, FL, USA.,Evelyn F McKnight Brain Institute, University of Miami Miller School of Medicine, Miami, FL, USA
| | - David A Loewenstein
- Department of Neurology, University of Miami Miller School of Medicine, Miami, FL, USA.,Evelyn F McKnight Brain Institute, University of Miami Miller School of Medicine, Miami, FL, USA
| | | | - Clinton B Wright
- National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, MD, USA
| | - Chuanhui Dong
- Department of Neurology, University of Miami Miller School of Medicine, Miami, FL, USA.,Evelyn F McKnight Brain Institute, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Bonnie Levin
- Department of Neurology, University of Miami Miller School of Medicine, Miami, FL, USA.,Evelyn F McKnight Brain Institute, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Mitchell S V Elkind
- Department of Neurology, Columbia University College of Physicians and Surgeons, New York, NY, USA
| | - Ralph L Sacco
- Department of Neurology, University of Miami Miller School of Medicine, Miami, FL, USA.,Evelyn F McKnight Brain Institute, University of Miami Miller School of Medicine, Miami, FL, USA
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26
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Covello AL, Horwitz LI, Singhal S, Blaum CS, Li Y, Dodson JA. Cardiovascular disease and cumulative incidence of cognitive impairment in the Health and Retirement Study. BMC Geriatr 2021; 21:274. [PMID: 33902466 PMCID: PMC8074515 DOI: 10.1186/s12877-021-02191-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2020] [Accepted: 03/30/2021] [Indexed: 11/30/2022] Open
Abstract
Background We sought to examine whether people with a diagnosis of cardiovascular disease (CVD) experienced a greater incidence of subsequent cognitive impairment (CI) compared to people without CVD, as suggested by prior studies, using a large longitudinal cohort. Methods We employed Health and Retirement Study (HRS) data collected biennially from 1998 to 2014 in 1305 U.S. adults age ≥ 65 newly diagnosed with CVD vs. 2610 age- and gender-matched controls. Diagnosis of CVD was adjudicated with an established HRS methodology and included self-reported coronary heart disease, angina, heart failure, myocardial infarction, or other heart conditions. CI was defined as a score < 11 on the 27-point modified Telephone Interview for Cognitive Status. We examined incidence of CI over an 8-year period using a cumulative incidence function accounting for the competing risk of death. Results Mean age at study entry was 73 years, 55% were female, and 13% were non-white. Cognitive impairment developed in 1029 participants over 8 years. The probability of death over the study period was greater in the CVD group (19.8% vs. 13.8%, absolute difference 6.0, 95% confidence interval 2.2 to 9.7%). The cumulative incidence analysis, which adjusted for the competing risk of death, showed no significant difference in likelihood of cognitive impairment between the CVD and control groups (29.7% vs. 30.6%, absolute difference − 0.9, 95% confidence interval − 5.6 to 3.7%). This finding did not change after adjusting for relevant demographic and clinical characteristics using a proportional subdistribution hazard regression model. Conclusions Overall, we found no increased risk of subsequent CI among participants with CVD (compared with no CVD), despite previous studies indicating that incident CVD accelerates cognitive decline. Supplementary Information The online version contains supplementary material available at 10.1186/s12877-021-02191-0.
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Affiliation(s)
- Allyson L Covello
- New York University Grossman School of Medicine, 550 First Avenue, New York, NY, USA.
| | - Leora I Horwitz
- Division of Healthcare Delivery Science, Department of Population Health, NYU Grossman School of Medicine, New York, NY, USA
| | - Shreya Singhal
- NYU Steinhardt School of Culture, Education, and Human Development, New York, NY, USA
| | | | - Yi Li
- Division of Biostatistics, Department of Population Health, NYU Grossman School of Medicine, New York, NY, USA
| | - John A Dodson
- Division of Healthcare Delivery Science, Department of Population Health, NYU Grossman School of Medicine, New York, NY, USA.,Leon H. Charney Division of Cardiology, Department of Medicine, NYU Grossman School of Medicine, New York, NY, USA
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Luksiene D, Sapranaviciute-Zabazlajeva L, Tamosiunas A, Radisauskas R, Bobak M. Lowered cognitive function and the risk of the first events of cardiovascular diseases: findings from a cohort study in Lithuania. BMC Public Health 2021; 21:792. [PMID: 33894765 PMCID: PMC8070287 DOI: 10.1186/s12889-021-10843-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2021] [Accepted: 04/12/2021] [Indexed: 11/10/2022] Open
Abstract
Background The purpose of this prospective cohort study was to examine whether the level of cognitive function at the baseline expressed as a cognitive function composite score and score of specific domains predict the risk of first cardiovascular disease (CVD) events in middle-aged and older populations. Methods Seven thousand eighty-seven participants, men and women aged 45–72 years, were assessed in the baseline survey of the Health Alcohol Psychosocial Factors in Eastern Europe (HAPIEE) study in 2006–2008 in the city of Kaunas, Lithuania. During 10 years of follow-up, the risk of first non-fatal events of CVD and death from CVD (excluding those participants with a documented history of CVD and/or ischemic heart disease (IHD) diagnosed at the baseline survey) was evaluated. Cox proportional hazards regression models were applied to examine how cognitive function predicts the first events of CVD. Results During the follow-up, there were 156 deaths from CVD (49 women and 107 men) and 464 first non-fatal CVD events (195 women and 269 men) registered. The total number of first CVD events was 620 (11.5%). After adjustment for sociodemographic factors, biological and lifestyle risk factors and illnesses, a decrease per 1 standard deviation in different cognitive function scores significantly increased the risk of a first event of CVD (immediate verbal recall score - by 17% in men and 32% in women; delayed verbal recall score – by 17% in men and 24% in women; and a composite score of cognitive function – by 15% in men and 29% in women). Kaplan-Meier survival curves for the probability of a first cardiovascular event according to the categories of a composite score of cognitive function, revealed that a lowered cognitive function predicts a higher probability of the events compared to normal cognitive function (p < 0.05). Conclusions The findings of this follow-up study suggest that men and women with lower cognitive functions have an increased risk for a first event of CVD compared to participants with a higher level of cognitive functions.
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Affiliation(s)
- Dalia Luksiene
- Laboratory of Population Studies of the Institute of Cardiology, Medical Academy, Lithuanian University of Health Sciences, LT-50162, Kaunas, Lithuania. .,Department of Environmental and Occupational Medicine, Faculty of Public Health, Medical Academy, Lithuanian University of Health Sciences, LT-47181, Kaunas, Lithuania.
| | | | - Abdonas Tamosiunas
- Laboratory of Population Studies of the Institute of Cardiology, Medical Academy, Lithuanian University of Health Sciences, LT-50162, Kaunas, Lithuania.,Department of Preventive Medicine, Faculty of Public Health, Medical Academy, Lithuanian University of Health Sciences, LT-47181, Kaunas, Lithuania
| | - Ricardas Radisauskas
- Laboratory of Population Studies of the Institute of Cardiology, Medical Academy, Lithuanian University of Health Sciences, LT-50162, Kaunas, Lithuania.,Department of Environmental and Occupational Medicine, Faculty of Public Health, Medical Academy, Lithuanian University of Health Sciences, LT-47181, Kaunas, Lithuania
| | - Martin Bobak
- Department of Epidemiology and Public Health, University College London, London, WC1E 6BT, UK
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van Zutphen EM, Rijnhart JJM, Rhebergen D, Muller M, Huisman M, Beekman A, Kok A, Appelman Y. Do Cardiovascular Risk Factors and Cardiovascular Disease Explain Sex Differences in Cognitive Functioning in Old Age? J Alzheimers Dis 2021; 80:1643-1655. [PMID: 33720886 PMCID: PMC8150475 DOI: 10.3233/jad-201173] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background: Sex differences in cognitive functioning in old age are known to exist yet are still poorly understood. Objective: This study examines to what extent differences in cardiovascular risk factors and cardiovascular disease between men and women explain sex differences in cognitive functioning. Methods: Data from 2,724 older adults from the Longitudinal Aging Study Amsterdam were used. Information processing speed and episodic memory, measured three times during six years of follow-up, served as outcomes. The mediating role of cardiovascular risk factors and cardiovascular disease was examined in single and multiple mediator models. Determinant-mediator effects were estimated using linear or logistic regression, and determinant-outcome and mediator-outcome effects were estimated using linear mixed models. Indirect effects were estimated using the product-of-coefficients estimator. Results: Women scored 1.58 points higher on information processing speed and 1.53 points higher on episodic memory. Several cardiovascular risk factors had small mediating effects. The sex difference in information processing speed was mediated by smoking, depressive symptoms, obesity, and systolic blood pressure. The sex difference in episodic memory was mediated by smoking, physical activity, and depressive symptoms. Effects of smoking, LDL cholesterol, and diabetes mellitus on information processing speed differed between men and women. Conclusion: Differences in cardiovascular risk factors between women and men partially explained why women had better cognitive functioning. A healthy cardiovascular lifestyle seems beneficial for cognition and sex-specific strategies may be important to preserve cognitive functioning at older age.
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Affiliation(s)
- Elisabeth Maria van Zutphen
- Amsterdam UMC, Vrije Universiteit Amsterdam, Psychiatry, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands.,GGZ inGeest Specialized Mental Health Care, Amsterdam, The Netherlands.,Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Epidemiology and Data Science, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Judith Johanna Maria Rijnhart
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Epidemiology and Data Science, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Didericke Rhebergen
- Amsterdam UMC, Vrije Universiteit Amsterdam, Psychiatry, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands.,GGZ inGeest Specialized Mental Health Care, Amsterdam, The Netherlands.,Mental Health Care Institute GGZ Centraal, Amersfoort, The Netherlands
| | - Majon Muller
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Internal Medicine, Amsterdam, The Netherlands
| | - Martijn Huisman
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Epidemiology and Data Science, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands.,Department of Sociology, Vrije Universiteit, Amsterdam, The Netherlands
| | - Aartjan Beekman
- Amsterdam UMC, Vrije Universiteit Amsterdam, Psychiatry, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands.,GGZ inGeest Specialized Mental Health Care, Amsterdam, The Netherlands
| | - Almar Kok
- Amsterdam UMC, Vrije Universiteit Amsterdam, Psychiatry, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands.,GGZ inGeest Specialized Mental Health Care, Amsterdam, The Netherlands.,Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Epidemiology and Data Science, Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Yolande Appelman
- Amsterdam UMC, Vrije Universiteit Amsterdam, Department of Cardiology, Amsterdam, The Netherlands
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29
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Moazzami K, Wittbrodt MT, Lima BB, Kim JH, Almuwaqqat Z, Shah AJ, Hajjar I, Goldstein FC, Levey AI, Nye JA, Bremner JD, Vaccarino V, Quyyumi AA. Neurobiological Pathways Linking Acute Mental Stress to Impairments in Executive Function in Individuals with Coronary Artery Disease. J Alzheimers Dis Rep 2021; 5:99-109. [PMID: 33782663 PMCID: PMC7990469 DOI: 10.3233/adr-200287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Individuals with coronary artery disease (CAD) have worse executive function compared to the general population but the mechanisms are unknown. OBJECTIVE To investigate the role of acute mental stress (MS) on the executive function of patients with CAD. METHODS Participants with stable CAD underwent acute MS testing with simultaneous peripheral vascular function measurements and brain imaging using high resolution-positron emission tomography. Digital pulse wave amplitude was continuously measured using peripheral artery tonometry (PAT, Itamar Inc). Stress/rest PAT ratio (sPAT) of pulse wave amplitude during MS/baseline was calculated as a measure of microvascular constriction during MS. Plasma levels of catecholamine and interleukin-6 were assessed at baseline and after MS. Executive function was assessed both at baseline and at 2 years follow-up using the Trail Making Test parts A and B. RESULTS We studied 389 individuals with brain data available for 148 participants. Of this population follow-up cognitive assessments were performed in 226 individuals (121 with brain imaging). After multivariable adjustment for baseline demographics, risk factors, and medication use, a lower sPAT, indicating greater vasoconstriction, a higher inferior frontal lobe activation with MS, and increases in norepinephrine and IL-6 levels with MS were all independently associated with greater time to complete Trail B test.-38.4pt. CONCLUSION In response to acute MS, greater peripheral vasoconstriction, higher inferior frontal lobe brain activation, and increases in the levels of norepinephrine and IL-6 are associated with worse executive function.
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Affiliation(s)
- Kasra Moazzami
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA,
Emory Clinical Cardiovascular Research Institute, Department of Medicine, Division of Cardiology, Emory University School of Medicine, Atlanta, GA, USA
| | - Matthew T. Wittbrodt
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA
| | - Bruno B. Lima
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA,
Emory Clinical Cardiovascular Research Institute, Department of Medicine, Division of Cardiology, Emory University School of Medicine, Atlanta, GA, USA
| | - Jeong Hwan Kim
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA,
Emory Clinical Cardiovascular Research Institute, Department of Medicine, Division of Cardiology, Emory University School of Medicine, Atlanta, GA, USA
| | - Zakaria Almuwaqqat
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA,
Emory Clinical Cardiovascular Research Institute, Department of Medicine, Division of Cardiology, Emory University School of Medicine, Atlanta, GA, USA
| | - Amit J. Shah
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA,
Emory Clinical Cardiovascular Research Institute, Department of Medicine, Division of Cardiology, Emory University School of Medicine, Atlanta, GA, USA,Atlanta VA Medical Center, Decatur, GA, USA
| | - Ihab Hajjar
- Department of Neurology, Emory University School of Medicine, Emory University, Atlanta, GA, USA,
Goizuetta Alzheimer’s Disease Research Center, Emory University School of Medicine, Atlanta, GA, USA,Division of General Internal Medicine and Geriatrics, Department of Medicine, Emory University, Atlanta, GA, USA
| | - Felicia C. Goldstein
- Department of Neurology, Emory University School of Medicine, Emory University, Atlanta, GA, USA,
Goizuetta Alzheimer’s Disease Research Center, Emory University School of Medicine, Atlanta, GA, USA
| | - Allan I. Levey
- Department of Neurology, Emory University School of Medicine, Emory University, Atlanta, GA, USA,
Goizuetta Alzheimer’s Disease Research Center, Emory University School of Medicine, Atlanta, GA, USA
| | - Jonathon A. Nye
- Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, GA, USA
| | - J. Douglas Bremner
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA,Division of General Internal Medicine and Geriatrics, Department of Medicine, Emory University, Atlanta, GA, USA,
Department of Radiology and Imaging Sciences, Emory University School of Medicine, Atlanta, GA, USA
| | - Viola Vaccarino
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA,
Emory Clinical Cardiovascular Research Institute, Department of Medicine, Division of Cardiology, Emory University School of Medicine, Atlanta, GA, USA
| | - Arshed A. Quyyumi
- Emory Clinical Cardiovascular Research Institute, Department of Medicine, Division of Cardiology, Emory University School of Medicine, Atlanta, GA, USA,Correspondence to: Arshed A. Quyyumi, MD, Emory Clinical Cardiovascular Research Institute, Emory University School of Medicine, 1462 Clifton Road N.E. Suite 507, Atlanta, GA 30322, USA. Tel.: +1 404 727 3655; Fax: +1 404 712 8785; E-mail:
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30
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Moazzami K, Sullivan S, Lima BB, Kim JH, Hammadah M, Almuwaqqat Z, Shah AJ, Hajjar I, Goldstein FC, Levey AI, Bremner JD, Quyyumi AA, Vaccarino V. Mental stress-induced myocardial ischemia and cognitive impairment in coronary atherosclerosis. J Psychosom Res 2021; 141:110342. [PMID: 33360843 PMCID: PMC7857648 DOI: 10.1016/j.jpsychores.2020.110342] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Revised: 12/10/2020] [Accepted: 12/10/2020] [Indexed: 10/22/2022]
Abstract
OBJECTIVE To understand if presence of mental stress-induced myocardial ischemia (MSIMI) is associated with higher prevalence of cognitive impairment at baseline and its decline over time. METHODS A cohort of participants with stable coronary atherosclerosis underwent acute mental stress testing using a series of standardized speech/arithmetic stressors. The stress/rest digital vasomotor response to mental stress (sPAT) was assessed to measure microvascular constriction during mental stress. Patients received 99mTc-sestamibi myocardial perfusion imaging at rest, with mental stress and with conventional (exercise/pharmacological) stress. Cognitive function was assessed both at baseline and at a 2 year follow-up using the Trail Making Test parts A and B and the verbal and visual memory subtests of the Wechsler Memory Scale. RESULTS We studied 486 individuals (72% male, 32.1% Black, 62 ± 9 (mean ± SD) years old). After multivariable adjustment for baseline demographics, risk factors, and medication use, presence of MSIMI was associated with 21% and 20% slower completion of Trail-A and Trail-B, respectively (p for all <0.01). After a 2-year follow-up period, presence of MSIMI was associated with a 33% slower completion of Trail-B, denoting cognitive decline (B = 0.33, 95% CI, 0.04, 0.62). A lower sPAT, indicating greater vasoconstriction, mediated the association between MSIMI and worsening Trail-B performance by 18.2%. Ischemia with a conventional stress test was not associated with any of the cognitive tests over time. CONCLUSION MSIMI is associated with slower visuomotor processing and worse executive function at baseline and with greater decline in these abilities over time.
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Affiliation(s)
- Kasra Moazzami
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, United States of America,Emory Clinical Cardiovascular Research Institute, Department of Medicine, Division of Cardiology, Emory University School of Medicine, Atlanta, GA, United States of America
| | - Samaah Sullivan
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, United States of America
| | - Bruno B. Lima
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, United States of America,Emory Clinical Cardiovascular Research Institute, Department of Medicine, Division of Cardiology, Emory University School of Medicine, Atlanta, GA, United States of America
| | - Jeong Hwan Kim
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, United States of America,Emory Clinical Cardiovascular Research Institute, Department of Medicine, Division of Cardiology, Emory University School of Medicine, Atlanta, GA, United States of America
| | - Muhammad Hammadah
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, United States of America,Emory Clinical Cardiovascular Research Institute, Department of Medicine, Division of Cardiology, Emory University School of Medicine, Atlanta, GA, United States of America
| | - Zakaria Almuwaqqat
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, United States of America,Emory Clinical Cardiovascular Research Institute, Department of Medicine, Division of Cardiology, Emory University School of Medicine, Atlanta, GA, United States of America
| | - Amit J. Shah
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, United States of America,Emory Clinical Cardiovascular Research Institute, Department of Medicine, Division of Cardiology, Emory University School of Medicine, Atlanta, GA, United States of America
| | - Ihab Hajjar
- Department of Neurology, Emory University School of Medicine, Emory University, Atlanta, GA, United States of America,Goizuetta Alzheimer’s Disease Research Center, Emory University School of Medicine, Atlanta, GA, United States of America,Division of General Internal Medicine and Geriatrics, Department of Medicine, Emory University, Atlanta, GA, United States of America
| | - Felicia C. Goldstein
- Department of Neurology, Emory University School of Medicine, Emory University, Atlanta, GA, United States of America,Goizuetta Alzheimer’s Disease Research Center, Emory University School of Medicine, Atlanta, GA, United States of America
| | - Allan I. Levey
- Department of Neurology, Emory University School of Medicine, Emory University, Atlanta, GA, United States of America,Goizuetta Alzheimer’s Disease Research Center, Emory University School of Medicine, Atlanta, GA, United States of America
| | - J. Douglas Bremner
- Atlanta VA Medical Center, Decatur, GA, United States of America,Department of Radiology and Imaging Sciences, Emory University School of Medicine, United States of America,Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, United States of America
| | - Arshed A. Quyyumi
- Emory Clinical Cardiovascular Research Institute, Department of Medicine, Division of Cardiology, Emory University School of Medicine, Atlanta, GA, United States of America
| | - Viola Vaccarino
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, United States of America; Emory Clinical Cardiovascular Research Institute, Department of Medicine, Division of Cardiology, Emory University School of Medicine, Atlanta, GA, United States of America.
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Halloway S, Schoeny ME, Barnes LL, Arvanitakis Z, Pressler SJ, Braun LT, Volgman AS, Gamboa C, Wilbur J. A study protocol for MindMoves: A lifestyle physical activity and cognitive training intervention to prevent cognitive impairment in older women with cardiovascular disease. Contemp Clin Trials 2021; 101:106254. [PMID: 33383230 PMCID: PMC7954878 DOI: 10.1016/j.cct.2020.106254] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2020] [Revised: 11/13/2020] [Accepted: 12/15/2020] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Cognitive impairment (CI) and cardiovascular disease (CVD) disproportionately affect women compared to men, and CVD increases risk of CI. Physical activity and cognitive training can improve cognition in older adults and may have additive or synergistic effects. However, no combined intervention has targeted women with CVD or utilized a sustainable lifestyle approach. The purpose of the trial is to evaluate efficacy of MindMoves, a 24-week multimodal physical activity and cognitive training intervention, on cognition and serum biomarkers in older women with CVD. Three serum biomarkers (brain-derived neurotrophic factor [BDNF], vascular endothelial growth factor [VEGF], and insulin-like growth factor 1 [IGF-1]) were selected as a priori hypothesized indicators of the effects of physical activity and/or cognitive training on cognition. METHODS The study design is a randomized controlled trial with a 2 × 2 factorial design, to determine independent and combined efficacies of Mind (tablet-based cognitive training) and Move (lifestyle physical activity with goal-setting and group meetings) on change in cognition (primary outcome) and serum biomarkers (secondary outcomes). We will recruit 254 women aged ≥65 years with CVD and without CI from cardiology clinics. Women will be randomized to one of four conditions: (1) Mind, (2) Move, (3) MindMoves, or (4) usual care. Data will be obtained from participants at baseline, 24, 48, and 72 weeks. DISCUSSION This study will test efficacy of a lifestyle-focused intervention to prevent or delay cognitive impairment in older women with CVD and may identify relevant serum biomarkers that could be used as early indicators of intervention response.
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Affiliation(s)
- Shannon Halloway
- Rush University, College of Nursing, 600 S. Paulina, Suite 1080, Chicago, IL 60612, USA.
| | - Michael E Schoeny
- Rush University, College of Nursing, 600 S. Paulina, Suite 1080, Chicago, IL 60612, USA.
| | - Lisa L Barnes
- Rush Alzheimer's Disease Center, 1750 W. Harrison, Chicago, IL 60612, USA.
| | - Zoe Arvanitakis
- Rush Alzheimer's Disease Center, 1750 W. Harrison, Chicago, IL 60612, USA; Rush Medical College, 600 S. Paulina Street, Suite 524, Chicago, IL 60612, USA.
| | - Susan J Pressler
- Indiana University, School of Nursing, 600 Barnhill Drive, Indianapolis, IN 46202, USA.
| | - Lynne T Braun
- Rush University, College of Nursing, 600 S. Paulina, Suite 1080, Chicago, IL 60612, USA.
| | | | - Charlene Gamboa
- Rush University, College of Nursing, 600 S. Paulina, Suite 1080, Chicago, IL 60612, USA.
| | - JoEllen Wilbur
- Rush University, College of Nursing, 600 S. Paulina, Suite 1080, Chicago, IL 60612, USA.
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Lüscher TF. The heart and the brain: cardiovascular risk factors, atrial fibrillation, and dementia. Eur Heart J 2020; 40:2271-2275. [PMID: 33215642 DOI: 10.1093/eurheartj/ehz508] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Affiliation(s)
- Thomas F Lüscher
- Imperial College and Director of Research, Education & Development, Royal Brompton and Harefield Hospitals London, UK.,Center for Molecular Cardiology, University of Zurich, Switzerland.,Editor-in-Chief, EHJ Editorial Office, Zurich Heart House, Hottingerstreet 14, Zurich, Switzerland
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Kuan PF, Clouston S, Yang X, Kotov R, Bromet E, Luft BJ. Molecular linkage between post-traumatic stress disorder and cognitive impairment: a targeted proteomics study of World Trade Center responders. Transl Psychiatry 2020; 10:269. [PMID: 32753605 PMCID: PMC7403297 DOI: 10.1038/s41398-020-00958-4] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Revised: 07/10/2020] [Accepted: 07/15/2020] [Indexed: 12/16/2022] Open
Abstract
Existing work on proteomics has found common biomarkers that are altered in individuals with post-traumatic stress disorder (PTSD) and mild cognitive impairment (MCI). The current study expands our understanding of these biomarkers by profiling 276 plasma proteins with known involvement in neurobiological processes using the Olink Proseek Multiplex Platform in individuals with both PTSD and MCI compared to either disorder alone and with unaffected controls. Participants were World Trade Center (WTC) responders recruited through the Stony Brook WTC Health Program. PTSD and MCI were measured with the PTSD Checklist (PCL) and the Montreal Cognitive Assessment, respectively. Compared with unaffected controls, we identified 16 proteins associated with comorbid PTSD-MCI at P < 0.05 (six at FDR < 0.1), 20 proteins associated with PTSD only (two at FDR < 0.1), and 24 proteins associated with MCI only (one at FDR < 0.1), for a total of 50 proteins. The multiprotein composite score achieved AUCs of 0.84, 0.77, and 0.83 for PTSD-MCI, PTSD only, and MCI only versus unaffected controls, respectively. To our knowledge, the current study is the largest to profile a large set of proteins involved in neurobiological processes. The significant associations across the three case-group analyses suggest that shared biological mechanisms may be involved in the two disorders. If findings from the multiprotein composite score are replicated in independent samples, it has the potential to add a new tool to help classify both PTSD and MCI.
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Affiliation(s)
- Pei-Fen Kuan
- Department of Applied Mathematics and Statistics, Stony Brook University, Stony Brook, NY, USA
| | - Sean Clouston
- Department of Family and Preventive Medicine, Stony Book University, Stony Brook, NY, USA
| | - Xiaohua Yang
- Department of Medicine, Stony Brook University, Stony Brook, NY, USA
| | - Roman Kotov
- Department of Psychiatry, Stony Book University, Stony Brook, NY, USA
| | - Evelyn Bromet
- Department of Psychiatry, Stony Book University, Stony Brook, NY, USA
| | - Benjamin J Luft
- Department of Medicine, Stony Brook University, Stony Brook, NY, USA.
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Wang MC, Li TC, Li CI, Liu CS, Lin CH, Lin WY, Yang CW, Yang SY, Lin CC. Cognitive function and its transitions in predicting all-cause mortality among urban community-dwelling older adults. BMC Psychiatry 2020; 20:203. [PMID: 32375731 PMCID: PMC7201694 DOI: 10.1186/s12888-020-02618-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2019] [Accepted: 04/23/2020] [Indexed: 12/15/2022] Open
Abstract
BACKGROUND Cognitive impairment is accompanied with high rates of comorbid conditions, leading ultimately to death. Few studies examine the relation between cognitive transition and mortality, especially in Asian population. This study evaluated baseline cognition and cognitive transition in relation to all-cause mortality among community-dwelling older adults. METHODS We conducted a community-based prospective cohort study among 921 participants of Taichung Community Health Study for Elders in 2009. Cognitive function was evaluated by the Mini-Mental State Examination. Cognitive impairment was considered if the total score is less than 27, 24, and 21 for a participant's educational level of more than 6 years, equal or less than 6 years, and illiteracy, respectively. One-year transition in cognitive function was obtained among 517 individuals who were assessed in both 2009 and 2010. Mortality was followed up until 2016. Cox proportional hazards models were applied to estimate the adjusted hazard ratios of mortality for baseline cognitive impairment and one-year transition in cognitive status. RESULTS After a follow-up of 6.62 years, 160 deaths were recorded. The multivariate adjusted hazard ratio (95% confidence interval) for baseline cognitive impairment was 2.08 (1.43, 3.01). Significantly increased mortality risk was observed for cognitively impaired-normal and impaired-impaired subgroups over 1 year as compared with those who remained normal [2.87 (1.25, 6.56) and 3.79 (1.64, 8.73), respectively]. The area under the receiver operating characteristic curves demonstrated that baseline cognition and one-year cognitive transition had no differential predictive ability for mortality. Besides, there was an interaction of cognitive impairment and frailty, with an additive mortality risk [5.41 (3.14, 9.35)] for the elders who presented with both. CONCLUSION Baseline cognitive impairment rather than one-year progression is associated with mortality in a six-year follow-up on older adults.
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Affiliation(s)
- Mu-Cyun Wang
- grid.411508.90000 0004 0572 9415Department of Family Medicine, China Medical University Hospital, Taichung, Taiwan ,grid.254145.30000 0001 0083 6092School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan
| | - Tsai-Chung Li
- grid.254145.30000 0001 0083 6092Department of Public Health, College of Public Health, China Medical University, Taichung, Taiwan
| | - Chia-Ing Li
- grid.254145.30000 0001 0083 6092School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan ,grid.411508.90000 0004 0572 9415Department of Medical Research, China Medical University Hospital, Taichung, Taiwan
| | - Chiu-Shong Liu
- grid.411508.90000 0004 0572 9415Department of Family Medicine, China Medical University Hospital, Taichung, Taiwan ,grid.254145.30000 0001 0083 6092School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan ,grid.411508.90000 0004 0572 9415Department of Medical Research, China Medical University Hospital, Taichung, Taiwan
| | - Chih-Hsueh Lin
- grid.411508.90000 0004 0572 9415Department of Family Medicine, China Medical University Hospital, Taichung, Taiwan ,grid.254145.30000 0001 0083 6092School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan
| | - Wen-Yuan Lin
- grid.411508.90000 0004 0572 9415Department of Family Medicine, China Medical University Hospital, Taichung, Taiwan ,grid.254145.30000 0001 0083 6092School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan
| | - Chuan-Wei Yang
- grid.411508.90000 0004 0572 9415Department of Medical Research, China Medical University Hospital, Taichung, Taiwan
| | - Shing-Yu Yang
- grid.254145.30000 0001 0083 6092Department of Public Health, College of Public Health, China Medical University, Taichung, Taiwan
| | - Cheng-Chieh Lin
- Department of Family Medicine, China Medical University Hospital, Taichung, Taiwan. .,School of Medicine, College of Medicine, China Medical University, Taichung, Taiwan. .,Department of Healthcare Administration, College of Medical and Health Science, Asia University, Taichung, Taiwan.
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de la Torre J. The Vascular Hypothesis of Alzheimer's Disease: A Key to Preclinical Prediction of Dementia Using Neuroimaging. J Alzheimers Dis 2019; 63:35-52. [PMID: 29614675 DOI: 10.3233/jad-180004] [Citation(s) in RCA: 67] [Impact Index Per Article: 13.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
The vascular hypothesis of Alzheimer's disease (VHAD) was proposed 24 years ago from observations made in our laboratory using aging rats subjected to chronic brain hypoperfusion. In recent years, VHAD has become a mother-lode to numerous neuroimaging studies targeting cerebral hemodynamic changes, particularly brain hypoperfusion in elderly patients at risk of developing Alzheimer's disease (AD). There is a growing consensus among neuroradiologists that brain hypoperfusion is likely involved in the pathogenesis of AD and that disturbed cerebral blood flow (CBF) can serve as a key biomarker for predicting conversion of mild cognitive impairment to AD. The use of cerebral hypoperfusion as a preclinical predictor of AD is becoming decisive in stratifying low and high risk patients that may develop cognitive decline and for assessing the effectiveness of therapeutic interventions. There is currently an international research drive from neuroimaging groups to seek new perspectives that can broaden our understanding of AD and improve lifestyle. Diverse neuroimaging methods are currently being used to monitor normal and dyscognitive brain activity. Some techniques are very powerful and can detect, diagnose, quantify, prognose, and predict cognitive decline before AD onset, even from a healthy cognitive state. Multimodal imaging offers new insights in the treatment and prevention of cognitive decline during advanced aging and better understanding of the functional and structural organization of the human brain. This review discusses the impact the VHAD and CBF are having on the neuroimaging technology that can usher practical strategies to help prevent AD.
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Affiliation(s)
- Jack de la Torre
- Department of Psychology, University of Texas, Austin, Austin, TX, USA
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Lipnicki DM, Makkar SR, Crawford JD, Thalamuthu A, Kochan NA, Lima-Costa MF, Castro-Costa E, Ferri CP, Brayne C, Stephan B, Llibre-Rodriguez JJ, Llibre-Guerra JJ, Valhuerdi-Cepero AJ, Lipton RB, Katz MJ, Derby CA, Ritchie K, Ancelin ML, Carrière I, Scarmeas N, Yannakoulia M, Hadjigeorgiou GM, Lam L, Chan WC, Fung A, Guaita A, Vaccaro R, Davin A, Kim KW, Han JW, Suh SW, Riedel-Heller SG, Roehr S, Pabst A, van Boxtel M, Köhler S, Deckers K, Ganguli M, Jacobsen EP, Hughes TF, Anstey KJ, Cherbuin N, Haan MN, Aiello AE, Dang K, Kumagai S, Chen T, Narazaki K, Ng TP, Gao Q, Nyunt MSZ, Scazufca M, Brodaty H, Numbers K, Trollor JN, Meguro K, Yamaguchi S, Ishii H, Lobo A, Lopez-Anton R, Santabárbara J, Leung Y, Lo JW, Popovic G, Sachdev PS. Determinants of cognitive performance and decline in 20 diverse ethno-regional groups: A COSMIC collaboration cohort study. PLoS Med 2019; 16:e1002853. [PMID: 31335910 PMCID: PMC6650056 DOI: 10.1371/journal.pmed.1002853] [Citation(s) in RCA: 74] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2019] [Accepted: 06/14/2019] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND With no effective treatments for cognitive decline or dementia, improving the evidence base for modifiable risk factors is a research priority. This study investigated associations between risk factors and late-life cognitive decline on a global scale, including comparisons between ethno-regional groups. METHODS AND FINDINGS We harmonized longitudinal data from 20 population-based cohorts from 15 countries over 5 continents, including 48,522 individuals (58.4% women) aged 54-105 (mean = 72.7) years and without dementia at baseline. Studies had 2-15 years of follow-up. The risk factors investigated were age, sex, education, alcohol consumption, anxiety, apolipoprotein E ε4 allele (APOE*4) status, atrial fibrillation, blood pressure and pulse pressure, body mass index, cardiovascular disease, depression, diabetes, self-rated health, high cholesterol, hypertension, peripheral vascular disease, physical activity, smoking, and history of stroke. Associations with risk factors were determined for a global cognitive composite outcome (memory, language, processing speed, and executive functioning tests) and Mini-Mental State Examination score. Individual participant data meta-analyses of multivariable linear mixed model results pooled across cohorts revealed that for at least 1 cognitive outcome, age (B = -0.1, SE = 0.01), APOE*4 carriage (B = -0.31, SE = 0.11), depression (B = -0.11, SE = 0.06), diabetes (B = -0.23, SE = 0.10), current smoking (B = -0.20, SE = 0.08), and history of stroke (B = -0.22, SE = 0.09) were independently associated with poorer cognitive performance (p < 0.05 for all), and higher levels of education (B = 0.12, SE = 0.02) and vigorous physical activity (B = 0.17, SE = 0.06) were associated with better performance (p < 0.01 for both). Age (B = -0.07, SE = 0.01), APOE*4 carriage (B = -0.41, SE = 0.18), and diabetes (B = -0.18, SE = 0.10) were independently associated with faster cognitive decline (p < 0.05 for all). Different effects between Asian people and white people included stronger associations for Asian people between ever smoking and poorer cognition (group by risk factor interaction: B = -0.24, SE = 0.12), and between diabetes and cognitive decline (B = -0.66, SE = 0.27; p < 0.05 for both). Limitations of our study include a loss or distortion of risk factor data with harmonization, and not investigating factors at midlife. CONCLUSIONS These results suggest that education, smoking, physical activity, diabetes, and stroke are all modifiable factors associated with cognitive decline. If these factors are determined to be causal, controlling them could minimize worldwide levels of cognitive decline. However, any global prevention strategy may need to consider ethno-regional differences.
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Affiliation(s)
- Darren M. Lipnicki
- Centre for Healthy Brain Ageing, University of New South Wales, Sydney, New South Wales, Australia
| | - Steve R. Makkar
- Centre for Healthy Brain Ageing, University of New South Wales, Sydney, New South Wales, Australia
| | - John D. Crawford
- Centre for Healthy Brain Ageing, University of New South Wales, Sydney, New South Wales, Australia
| | - Anbupalam Thalamuthu
- Centre for Healthy Brain Ageing, University of New South Wales, Sydney, New South Wales, Australia
| | - Nicole A. Kochan
- Centre for Healthy Brain Ageing, University of New South Wales, Sydney, New South Wales, Australia
| | | | | | | | - Carol Brayne
- Department of Public Health and Primary Care, Cambridge University, Cambridge, United Kingdom
| | - Blossom Stephan
- Institute of Health and Society, Newcastle University, Newcastle upon Tyne, United Kingdom
| | | | - Jorge J. Llibre-Guerra
- Institute of Neurology and Neurosurgery, Havana, Cuba
- Memory and Aging Center, University of California, San Francisco, San Francisco, California, United States of America
| | | | - Richard B. Lipton
- Saul R. Korey Department of Neurology, Albert Einstein College of Medicine, Yeshiva University, New York, New York, United States of America
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Yeshiva University, New York, New York, United States of America
- Department of Psychiatry and Behavioral Medicine, Albert Einstein College of Medicine, Yeshiva University, New York, New York, United States of America
| | - Mindy J. Katz
- Saul R. Korey Department of Neurology, Albert Einstein College of Medicine, Yeshiva University, New York, New York, United States of America
| | - Carol A. Derby
- Saul R. Korey Department of Neurology, Albert Einstein College of Medicine, Yeshiva University, New York, New York, United States of America
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, Yeshiva University, New York, New York, United States of America
| | - Karen Ritchie
- Inserm, U1061 Neuropsychiatry: Epidemiological and Clinical Research, La Colombière Hospital, Montpellier, France
- Université de Montpellier, Montpellier, France
- Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, United Kingdom
| | - Marie-Laure Ancelin
- Inserm, U1061 Neuropsychiatry: Epidemiological and Clinical Research, La Colombière Hospital, Montpellier, France
- Université de Montpellier, Montpellier, France
| | - Isabelle Carrière
- Inserm, U1061 Neuropsychiatry: Epidemiological and Clinical Research, La Colombière Hospital, Montpellier, France
- Université de Montpellier, Montpellier, France
| | - Nikolaos Scarmeas
- 1st Department of Neurology, Aiginition Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
- Taub Institute for Research on Alzheimer’s Disease and the Aging Brain, Gertrude H. Sergievsky Center, Department of Neurology, Columbia University, New York, New York, United States of America
| | - Mary Yannakoulia
- Department of Nutrition and Dietetics, Harokopio University, Athens, Greece
| | - Georgios M. Hadjigeorgiou
- University of Thessaly, Larissa, Greece
- Department of Neurology, Medical School, University of Cyprus, Nicosia, Cyprus
| | - Linda Lam
- Department of Psychiatry, Chinese University of Hong Kong, Hong Kong SAR, China
| | - Wai-chi Chan
- Department of Psychiatry, University of Hong Kong, Hong Kong SAR, China
| | - Ada Fung
- Department of Applied Social Sciences, Hong Kong Polytechnic University, Hong Kong SAR, China
| | | | | | | | - Ki Woong Kim
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, Korea
- Department of Psychiatry, College of Medicine, Seoul National University, Seoul, Korea
- Department of Brain and Cognitive Science, College of Natural Sciences, Seoul National University, Seoul, Korea
| | - Ji Won Han
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Seung Wan Suh
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Steffi G. Riedel-Heller
- Institute of Social Medicine, Occupational Health and Public Health, Medical Faculty, University of Leipzig, Leipzig, Germany
| | - Susanne Roehr
- Institute of Social Medicine, Occupational Health and Public Health, Medical Faculty, University of Leipzig, Leipzig, Germany
| | - Alexander Pabst
- Institute of Social Medicine, Occupational Health and Public Health, Medical Faculty, University of Leipzig, Leipzig, Germany
| | - Martin van Boxtel
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Sebastian Köhler
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Kay Deckers
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Mary Ganguli
- Department of Psychiatry, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America
- Department of Neurology, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America
- Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America
| | - Erin P. Jacobsen
- Department of Psychiatry, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, United States of America
| | - Tiffany F. Hughes
- Department of Sociology, Anthropology, and Gerontology, Youngstown State University, Youngstown, Ohio, United States of America
| | - Kaarin J. Anstey
- School of Psychology, University of New South Wales, Sydney, New South Wales, Australia
- Neuroscience Research Australia, Sydney, New South Wales, Australia
- Centre for Research on Ageing, Health and Wellbeing, Australian National University, Canberra, Australian Capital Territory, Australia
| | - Nicolas Cherbuin
- Centre for Research on Ageing, Health and Wellbeing, Australian National University, Canberra, Australian Capital Territory, Australia
| | - Mary N. Haan
- Department of Epidemiology and Biostatistics, School of Medicine, University of California, San Francisco, San Francisco, California, United States of America
| | - Allison E. Aiello
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
- Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States of America
| | - Kristina Dang
- Department of Epidemiology and Biostatistics, School of Medicine, University of California, San Francisco, San Francisco, California, United States of America
| | - Shuzo Kumagai
- Center for Health Science and Counseling, Kyushu University, Kasuga, Japan
| | - Tao Chen
- Center for Health Science and Counseling, Kyushu University, Kasuga, Japan
| | - Kenji Narazaki
- Faculty of Socio-Environmental Studies, Fukuoka Institute of Technology, Fukuoka, Japan
| | - Tze Pin Ng
- Gerontology Research Programme, Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Qi Gao
- Gerontology Research Programme, Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Ma Shwe Zin Nyunt
- Department of Psychological Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - Marcia Scazufca
- Instituto de Psiquiatria e LIM-23, Hospital da Clínicas, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil
| | - Henry Brodaty
- Centre for Healthy Brain Ageing, University of New South Wales, Sydney, New South Wales, Australia
- Dementia Collaborative Research Centre, University of New South Wales, Sydney, New South Wales, Australia
| | - Katya Numbers
- Centre for Healthy Brain Ageing, University of New South Wales, Sydney, New South Wales, Australia
| | - Julian N. Trollor
- Centre for Healthy Brain Ageing, University of New South Wales, Sydney, New South Wales, Australia
- Department of Developmental Disability Neuropsychiatry, School of Psychiatry, University of New South Wales, Sydney, New South Wales, Australia
| | - Kenichi Meguro
- Geriatric Behavioral Neurology, Tohoku University, Sendai, Japan
| | | | - Hiroshi Ishii
- Geriatric Behavioral Neurology, Tohoku University, Sendai, Japan
| | - Antonio Lobo
- Department of Medicine and Psychiatry, Universidad de Zaragoza, Zaragoza, Spain
- Instituto de Investigación Sanitaria Aragón, Zaragoza, Spain
- Centro de Investigación Biomédica en Red de Salud Mental, Ministry of Science and Innovation, Madrid, Spain
| | - Raul Lopez-Anton
- Instituto de Investigación Sanitaria Aragón, Zaragoza, Spain
- Centro de Investigación Biomédica en Red de Salud Mental, Ministry of Science and Innovation, Madrid, Spain
- Department of Psychology and Sociology, Universidad de Zaragoza, Zaragoza, Spain
| | - Javier Santabárbara
- Instituto de Investigación Sanitaria Aragón, Zaragoza, Spain
- Centro de Investigación Biomédica en Red de Salud Mental, Ministry of Science and Innovation, Madrid, Spain
- Department of Microbiology, Preventive Medicine and Public Health, Universidad de Zaragoza, Zaragoza, Spain
| | - Yvonne Leung
- Centre for Healthy Brain Ageing, University of New South Wales, Sydney, New South Wales, Australia
| | - Jessica W. Lo
- Centre for Healthy Brain Ageing, University of New South Wales, Sydney, New South Wales, Australia
| | - Gordana Popovic
- Centre for Healthy Brain Ageing, University of New South Wales, Sydney, New South Wales, Australia
- School of Mathematics and Statistics, University of New South Wales, Sydney, New South Wales, Australia
| | - Perminder S. Sachdev
- Centre for Healthy Brain Ageing, University of New South Wales, Sydney, New South Wales, Australia
- Dementia Collaborative Research Centre, University of New South Wales, Sydney, New South Wales, Australia
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Halloway S, Wilbur J, Schoeny ME, Braun LT, Aggarwal NT, Miller AM, Crane MM, Volgman AS. Feasibility of a Lifestyle Physical Activity Intervention to Prevent Memory Loss in Older Women With Cardiovascular Disease: A Mixed-Methods Approach. Can J Nurs Res 2019; 52:278-289. [PMID: 31256633 DOI: 10.1177/0844562119856233] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
BACKGROUND Memory loss in older age affects women more than men and cardiovascular disease is a leading risk factor. Physical activity can improve memory in healthy older adults; however, few physical activity interventions have targeted women with cardiovascular disease, and none utilized lifestyle approaches. PURPOSE The purpose of this study was to examine feasibility, acceptability, and preliminary effects of a 24-week lifestyle physical activity intervention (physical activity prescription, five group meetings, and nine motivational interviewing calls). METHODS A sequential mixed-methods approach was used. Participants were 18 sedentary women ≥65 years with cardiovascular disease and without cognitive impairment recruited in August 2017. Feasibility, acceptability, self-reported health, accelerometer-assessed physical activity, and neurocognitive memory tests were measured using a pre-post test design. Two post-intervention focus groups (n = 8) were conducted in June 2018. Concept analysis was used to identify barriers/motivators of intervention participation. RESULTS Meeting attendance was >72% and retention was 94%. Participants rated the program with high satisfaction. There were significant improvements at 24 weeks in self-rated physical health, objective daily steps, and estimated cardiorespiratory fitness (d = .30-.64). Focus group themes generated recommendations for modifying the intervention. CONCLUSION Findings support adapting the intervention further for women with cardiovascular disease and testing it in an efficacy trial.
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Affiliation(s)
- Shannon Halloway
- Department of Community, Systems and Mental Health Nursing, Rush University, Chicago, IL, USA
| | - JoEllen Wilbur
- Department of Women, Children and Family Nursing, Rush University, Chicago, IL, USA
| | - Michael E Schoeny
- Department of Community, Systems and Mental Health Nursing, Rush University, Chicago, IL, USA
| | - Lynne T Braun
- Department of Adult Health and Gerontological Nursing, Rush University, Chicago, IL, USA.,Department of Internal Medicine, Rush Medical College; Rush Heart Center for Women, Rush University Medical Center, Chicago, IL, USA
| | - Neelum T Aggarwal
- Department of Neurological Sciences, Rush Medical College; Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, USA
| | - Arlene M Miller
- Department of Community, Systems and Mental Health Nursing, Rush University, Chicago, IL, USA
| | - Melissa M Crane
- Department of Preventive Medicine, Rush University Medical Center, Chicago, IL, USA
| | - Annabelle S Volgman
- Department of Internal Medicine, Rush Medical College; Rush Heart Center for Women, Rush University Medical Center, Chicago, IL, USA
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Heger I, Deckers K, van Boxtel M, de Vugt M, Hajema K, Verhey F, Köhler S. Dementia awareness and risk perception in middle-aged and older individuals: baseline results of the MijnBreincoach survey on the association between lifestyle and brain health. BMC Public Health 2019; 19:678. [PMID: 31159779 PMCID: PMC6545627 DOI: 10.1186/s12889-019-7010-z] [Citation(s) in RCA: 51] [Impact Index Per Article: 10.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2018] [Accepted: 05/20/2019] [Indexed: 01/19/2023] Open
Abstract
Background The total number of people with dementia is increasing worldwide, due to our aging society. Without a disease-modifying drug available, risk reduction strategies are to date the only promising way to reduce dementia incidence in the future. Substantial evidence exists that lifestyle factors contribute to the risk of dementia, such as physical exercise, mental activity and (non-)smoking. Still, most people seem unaware of a relationship between lifestyle and brain health. This paper investigates dementia literacy and knowledge of modifiable risk and protective factors of dementia in a Dutch population-based sample. Methods An online-survey was carried out among 590 community-dwelling people between 40 and 75 years old in the Province of Limburg, the Netherlands. The total group comprises both of a provincial sample (n = 381) and a sample of three specific districts within the province (n = 209). Dementia awareness and knowledge about 12 risk and protective factors was assessed with items derived from the British Social Attitudes (BSA) survey, supplemented with custom items developed by the research team. Results The majority of participants (56%) were unaware of a relationship between lifestyle and dementia risk. Most individuals identified low cognitive activity, physical inactivity and unhealthy diet as dementia risk factors. Particular gaps in knowledge existed with regard to major cardiovascular risk factors such as hypertension, hypercholesterolemia and coronary heart disease. Although the level of awareness varied by age and level of education, most people (70%) were eager to learn more about the topic of brain health, and indicated to be interested in using eHealth (54%) to measure or improve brain health. Conclusions Most people still are unaware of the relation between lifestyle and brain health, indicating the need for public health campaigns. Increasing awareness in the general population about the presence of modifiable dementia risk and protective factors is a crucial first step prior to implementation of preventative measures. Targeting specific subgroups, such as individuals with low socioeconomic status and low health literacy, is essential for the reach and effect of a prevention campaign. Outcome of this study was the rationale for an awareness campaign in The Netherlands, called “MijnBreincoach” (“MyBraincoach”). Electronic supplementary material The online version of this article (10.1186/s12889-019-7010-z) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Irene Heger
- Alzheimer Centrum Limburg, School for Mental Health and Neuroscience, Department of Psychiatry and Neuropsychology, Maastricht University, Dr. Tanslaan 12, 6229 ET, Maastricht, The Netherlands.
| | - Kay Deckers
- Alzheimer Centrum Limburg, School for Mental Health and Neuroscience, Department of Psychiatry and Neuropsychology, Maastricht University, Dr. Tanslaan 12, 6229 ET, Maastricht, The Netherlands
| | - Martin van Boxtel
- Alzheimer Centrum Limburg, School for Mental Health and Neuroscience, Department of Psychiatry and Neuropsychology, Maastricht University, Dr. Tanslaan 12, 6229 ET, Maastricht, The Netherlands
| | - Marjolein de Vugt
- Alzheimer Centrum Limburg, School for Mental Health and Neuroscience, Department of Psychiatry and Neuropsychology, Maastricht University, Dr. Tanslaan 12, 6229 ET, Maastricht, The Netherlands
| | - KlaasJan Hajema
- GGD Zuid-Limburg, Postbus 33, 6400 AA, Heerlen, The Netherlands
| | - Frans Verhey
- Alzheimer Centrum Limburg, School for Mental Health and Neuroscience, Department of Psychiatry and Neuropsychology, Maastricht University, Dr. Tanslaan 12, 6229 ET, Maastricht, The Netherlands
| | - Sebastian Köhler
- Alzheimer Centrum Limburg, School for Mental Health and Neuroscience, Department of Psychiatry and Neuropsychology, Maastricht University, Dr. Tanslaan 12, 6229 ET, Maastricht, The Netherlands.
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Cognitive Decline Before and After Incident Coronary Events. J Am Coll Cardiol 2019; 73:3041-3050. [DOI: 10.1016/j.jacc.2019.04.019] [Citation(s) in RCA: 111] [Impact Index Per Article: 22.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2019] [Revised: 03/28/2019] [Accepted: 04/02/2019] [Indexed: 12/29/2022]
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Olin JW, Narula J. Is Spontaneous Rupture of Aortic Plaques Truly More Common Than Believed? J Am Coll Cardiol 2018; 71:2903-2905. [PMID: 29929613 DOI: 10.1016/j.jacc.2018.05.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2018] [Accepted: 05/09/2018] [Indexed: 12/25/2022]
Affiliation(s)
- Jeffrey W Olin
- Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, New York.
| | - Jagat Narula
- Zena and Michael A. Wiener Cardiovascular Institute, Icahn School of Medicine at Mount Sinai, New York, New York
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Ma H, Yang J, Xie H, Liu J, Wang F, Xu X, Bai W, Lin K. Regional myocardial motion in patients with mild cognitive impairment: a pilot study. BMC Cardiovasc Disord 2018; 18:79. [PMID: 29720085 PMCID: PMC5932804 DOI: 10.1186/s12872-018-0824-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2018] [Accepted: 04/26/2018] [Indexed: 01/15/2023] Open
Abstract
Background Cardiovascular disease (CVD) is a risk factor for cognitive impairment in the elderly. Manifestations of subclinical CVDs can be found in patients with cognitive impairment. The aim of the present study was to test the hypothesis that patients with mild cognitive impairment (MCI) have different magnetic resonance imaging (MRI)-derived regional myocardial motion indices compared with healthy controls. Methods Eleven MCI patients (age, 65.5 years ±5.9; range, 55–81 years old) and 11 sex−/age-matched healthy volunteers were enrolled. All of the participants underwent a head MRI and cardiac MRI. Global cortical atrophy (GCA) was graded on the head MRI. The left ventricular ejection fraction (LVEF) and regional strain, strain rate, displacement and velocity were measured on cine images. The GCA scores, global cardiac function and regional myocardial motion indices were compared between MCI patients and healthy controls using the t-test. Results MCI patients had a higher GCA score than healthy controls (p = 0.048). However, there was no significant difference in LVEF between MCI patients and controls. Compared to healthy controls, MCI patients had a lower peak radial strain (29.1% ± 24.1% vs. 46.4% ± 43.4%, p < 0.001), lower peak diastolic radial strain rate (3.2 ± 2.4 s− 1 vs. 6.0 ± 3.0 s− 1, p < 0.001), lower peak diastolic circumferential strain rate (2.5 ± 2.1 s− 1 vs. 3.2 ± 2.1 s− 1, p = 0.002), lower peak systolic radial displacement (4.2 ± 2.2 mm vs. 5.2 ± 3.3 mm, p = 0.002), lower peak diastolic radial velocity (31 ± 18 mm/s vs. 45 ± 33 mm/s, p < 0.001), and lower peak diastolic circumferential velocity (178 ± 124 degree/s vs. 217 ± 131 degree/s, p = 0.005). Conclusion MRI-derived regional myocardial strain, strain rate and velocity were found to be different between MCI patients and healthy controls. Regional myocardial motion indices have the potential to become novel quantitative imaging biomarkers for representing the risk of neurodegenerative disorders, such as Alzheimer’s disease (AD). Electronic supplementary material The online version of this article (10.1186/s12872-018-0824-2) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Heng Ma
- Department of Radiology, Yuhuangding Hospital, Qingdao University School of Medicine, 20 E Yuhuangding Rd, Yantai, 264000, Shandong, China.,Department of Radiology, Northwestern University Feinberg School of Medicine, 737 N Michigan Ave, Ste 1600, Chicago, IL, 60611, USA
| | - Jun Yang
- Department of Radiology, Yuhuangding Hospital, Qingdao University School of Medicine, 20 E Yuhuangding Rd, Yantai, 264000, Shandong, China
| | - Haizhu Xie
- Department of Radiology, Yuhuangding Hospital, Qingdao University School of Medicine, 20 E Yuhuangding Rd, Yantai, 264000, Shandong, China
| | - Jing Liu
- Department of Radiology, Yuhuangding Hospital, Qingdao University School of Medicine, 20 E Yuhuangding Rd, Yantai, 264000, Shandong, China
| | - Fang Wang
- Department of Radiology, Yuhuangding Hospital, Qingdao University School of Medicine, 20 E Yuhuangding Rd, Yantai, 264000, Shandong, China
| | - Xiao Xu
- Department of Radiology, Yuhuangding Hospital, Qingdao University School of Medicine, 20 E Yuhuangding Rd, Yantai, 264000, Shandong, China
| | - Wei Bai
- Department of Radiology, Yuhuangding Hospital, Qingdao University School of Medicine, 20 E Yuhuangding Rd, Yantai, 264000, Shandong, China
| | - Kai Lin
- Department of Radiology, Northwestern University Feinberg School of Medicine, 737 N Michigan Ave, Ste 1600, Chicago, IL, 60611, USA.
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Cacabelos R, Meyyazhagan A, Carril JC, Cacabelos P, Teijido Ó. Pharmacogenetics of Vascular Risk Factors in Alzheimer's Disease. J Pers Med 2018; 8:jpm8010003. [PMID: 29301387 PMCID: PMC5872077 DOI: 10.3390/jpm8010003] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2017] [Revised: 12/19/2017] [Accepted: 12/27/2017] [Indexed: 12/19/2022] Open
Abstract
Alzheimer’s disease (AD) is a polygenic/complex disorder in which genomic, epigenomic, cerebrovascular, metabolic, and environmental factors converge to define a progressive neurodegenerative phenotype. Pharmacogenetics is a major determinant of therapeutic outcome in AD. Different categories of genes are potentially involved in the pharmacogenetic network responsible for drug efficacy and safety, including pathogenic, mechanistic, metabolic, transporter, and pleiotropic genes. However, most drugs exert pleiotropic effects that are promiscuously regulated for different gene products. Only 20% of the Caucasian population are extensive metabolizers for tetragenic haplotypes integrating CYP2D6-CYP2C19-CYP2C9-CYP3A4/5 variants. Patients harboring CYP-related poor (PM) and/or ultra-rapid (UM) geno-phenotypes display more irregular profiles in drug metabolism than extensive (EM) or intermediate (IM) metabolizers. Among 111 pentagenic (APOE-APOB-APOC3-CETP-LPL) haplotypes associated with lipid metabolism, carriers of the H26 haplotype (23-TT-CG-AG-CC) exhibit the lowest cholesterol levels, and patients with the H104 haplotype (44-CC-CC-AA-CC) are severely hypercholesterolemic. Furthermore, APOE, NOS3, ACE, AGT, and CYP variants influence the therapeutic response to hypotensive drugs in AD patients with hypertension. Consequently, the implementation of pharmacogenetic procedures may optimize therapeutics in AD patients under polypharmacy regimes for the treatment of concomitant vascular disorders.
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Affiliation(s)
- Ramón Cacabelos
- EuroEspes Biomedical Research Center, Institute of Medical Science and Genomic Medicine, Bergondo, 15165 La Coruña, Spain.
| | - Arun Meyyazhagan
- EuroEspes Biomedical Research Center, Institute of Medical Science and Genomic Medicine, Bergondo, 15165 La Coruña, Spain.
- Chair of Genomic Medicine, Continental University Medical School, Huancayo 12000, Peru.
| | - Juan C Carril
- EuroEspes Biomedical Research Center, Institute of Medical Science and Genomic Medicine, Bergondo, 15165 La Coruña, Spain.
- Chair of Genomic Medicine, Continental University Medical School, Huancayo 12000, Peru.
| | - Pablo Cacabelos
- EuroEspes Biomedical Research Center, Institute of Medical Science and Genomic Medicine, Bergondo, 15165 La Coruña, Spain.
- Chair of Genomic Medicine, Continental University Medical School, Huancayo 12000, Peru.
| | - Óscar Teijido
- EuroEspes Biomedical Research Center, Institute of Medical Science and Genomic Medicine, Bergondo, 15165 La Coruña, Spain.
- Chair of Genomic Medicine, Continental University Medical School, Huancayo 12000, Peru.
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