1
|
Luo M, Sun M, Wang T, Wei J, Ruan X, Chen K, Ou J, Chen Y, Qin J. Type 2 diabetes, glycaemic traits, structural brain capacity and cognitive function: A Mendelian randomization analysis. Diabetes Obes Metab 2024; 26:3618-3632. [PMID: 38925590 DOI: 10.1111/dom.15702] [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: 01/30/2024] [Revised: 05/23/2024] [Accepted: 05/23/2024] [Indexed: 06/28/2024]
Abstract
AIM To estimate the causal associations of type 2 diabetes and glycaemic traits with cognitive function, and to determine the potential mediating role of various brain imaging-derived phenotypes (IDPs) using Mendelian randomization (MR) analysis. METHODS Using publicly available summary data, we performed a series of univariable and multivariable MR analysis to infer causality. Two-step MR analysis was then conducted in turn to evaluate the potential mediating role of each brain IDP. RESULTS There was no evidence of causal associations between type 2 diabetes and cognitive function outcomes. Each 1-SD unit higher genetically predicted fasting proinsulin was associated with worse cognitive performance, as evidenced by both univariable (beta: -0.022; 95% confidence interval [CI] -0.038, -0.007) and multivariable MR analysis (beta: -0.027; 95% CI -0.048, -0.005). In addition, the univariable MR analysis identified several causal associations between fasting proinsulin and brain IDPs, and between brain IDPs and cognitive performance. The inverse association of genetically predicted fasting proinsulin with cognitive performance did not attenuate after adjusting for each of the brain IDPs in multivariable MR analysis. CONCLUSIONS The present MR study provided credible evidence for the causal association between genetically predicted fasting proinsulin and cognitive function, informing a potential diagnosis and intervention target for patients with cognitive impairment. No significant brain IDP included in this study was identified as lying on the causal pathway from fasting proinsulin to cognitive performance. Future research involving more specific and granular brain IDP or other brain process is warranted to explore the potential biological mechanism underlying the association.
Collapse
Affiliation(s)
- Manjun Luo
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, China
| | - Mengting Sun
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, China
| | - Tingting Wang
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, China
| | - Jianhui Wei
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, China
| | - Xiaorui Ruan
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, China
| | - Kebin Chen
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, China
| | - Jun Ou
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, China
| | - Yige Chen
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, China
| | - Jiabi Qin
- Department of Epidemiology and Health Statistics, Xiangya School of Public Health, Central South University, Changsha, China
- Hunan Provincial Key Laboratory of Clinical Epidemiology, Central South University, Changsha, China
| |
Collapse
|
2
|
Jain A, Sunder S, Jain N, Yadav N, Saini A, Yadav KS. Study of cognitive functions and their association with depression in type II diabetes mellitus. J Family Med Prim Care 2024; 13:2323-2328. [PMID: 39027822 PMCID: PMC11254044 DOI: 10.4103/jfmpc.jfmpc_1150_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Revised: 12/06/2023] [Accepted: 12/10/2023] [Indexed: 07/20/2024] Open
Abstract
Introduction Individuals with diabetes have higher risk of developing depression, cognitive impairment, and dementia compared to those who do not have diabetes. The present study aims to assess the level of cognitive functions and the presence of depression in diabetes patients and healthy controls. The study also explores the level of cognition among the normal control, diabetes without depression, and diabetes with depression. Methods In the present study, the presence of depression and the level of cognitive functions of 59 cases of diabetes mellitus type-2 were compared with an age- and gender-matched control group of 40 individuals. Clinical and demographic details were recorded on a semi-structured performa. Montreal Cognitive Assessment (MoCA) and Patient Health Questionnaire-9 (PHQ-9) were applied to both diabetes patients and healthy controls to assess the level of cognitive functions and the presence of depression, respectively. Results On applying odds ratio (OR), it was observed in the present study that there were 93.50% more chances [OR 1.935 with 95% confidence interval (CI) being 0.481-7.789] of depression among diabetic cases as compared to the control group. Similarly, the chance of MoCA score being less than 26 was twice among the diabetic group as compared to the control group (OR 2.208 with 95% CI being 0.702-6.946). On application of the Chi-square test, the association of depression was significant with HBA1C level, level of education, and presence of complications. Conclusions Patients with diabetes had almost double the risk of developing depression and poor cognitive functions as compared to the healthy control. High HbA1C level, level of education, and presence of complication in diabetes had a positive statistical association with depression. Thus, it is advisable to investigate patients with diabetes for the presence of depression and cognitive dysfunction by applying simple tools.
Collapse
Affiliation(s)
- Akhilesh Jain
- Department of Psychiatry, ESIC Model Hospital, Jaipur, Rajasthan, India
| | - Shyam Sunder
- Department of Medicine, ESIC Model Hospital, Jaipur, Rajasthan, India
| | - Nitesh Jain
- Department of Medicine, ESIC Model Hospital, Jaipur, Rajasthan, India
| | | | - Ashok Saini
- Department of Psychiatry, ESIC Model Hospital, Jaipur, Rajasthan, India
| | - Kuldeep S. Yadav
- Speciality Doctor, Adult CMHT, Somerest NHS Foundation Trust, United Kingdom
| |
Collapse
|
3
|
Chen S, Ling Y, Zhou F, Qiao X, Reinhardt JD. Trajectories of cognitive function among people aged 45 years and older living with diabetes in China: Results from a nationally representative longitudinal study (2011~2018). PLoS One 2024; 19:e0299316. [PMID: 38787866 PMCID: PMC11125531 DOI: 10.1371/journal.pone.0299316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2023] [Accepted: 02/08/2024] [Indexed: 05/26/2024] Open
Abstract
OBJECTIVES Diabetes is associated with decline of cognitive function. Exploring different trajectories of cognitive function occurring in people with diabetes is important to improved prognosis. This study aimed to investigate differential patterns of trajectories of cognitive function and baseline determinants of trajectory group membership utilizing data from middle-aged and older Chinese adults with diabetes. METHODS Participants of the Chinese Health And Retirement Longitudinal Study (CHARLS) aged 45 years and above received biennial assessments between 2011 and 2018. The primary outcome was overall cognitive function score operationalized as sum of mental intactness and episodic memory scores derived from the Telephone Interview of Cognitive Status (TICS). A weighted growth mixture model was used to estimate cognitive function trajectories of CHARLS participants with diabetes, and baseline factors associated with trajectory group membership were investigated with weighted multinomial logistic regression. RESULTS Data from 1,463 participants with diabetes aged 45 years and above were analyzed, a three-group trajectory model showed the best fit for overall cognitive scores: low baseline, linear declining (22.1%); moderate baseline, linear declining (37.5%) and high-stable (40.3%). Older participants, females, participants with low education, with nighttime sleep <6 h, without daytime napping habits, and with depressive symptoms were at a higher risk of unfavorable cognitive function trajectories. CONCLUSIONS We identified heterogeneous trajectories of cognitive function among middle-aged and older people living with diabetes in China. Socially vulnerable groups including females, rural residents, and those with low education were at a higher risk for unfavorable trajectories. In health programs aimed at preventing and mitigating cognitive decline in individuals with diabetes more attention should be given to vulnerable groups. Reduced nighttime sleep, lack of daytime napping, and depressive symptoms appear to be modifiable risk factors.
Collapse
Affiliation(s)
- Shi Chen
- Institute for Disaster Management and Reconstruction of Sichuan University and Hong Kong Polytechnic University, Sichuan University, Chengdu, China
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Yuewei Ling
- Department of Management Science and Engineering, Stanford University, Stanford, CA, United States of America
| | - Faquan Zhou
- Department of Vascular Surgery, First Affiliated Hospital, Army Medical University (Third Military Medical University), Chongqing, China
| | - Xu Qiao
- Institute for Disaster Management and Reconstruction of Sichuan University and Hong Kong Polytechnic University, Sichuan University, Chengdu, China
- West China School of Public Health and West China Fourth Hospital, Sichuan University, Chengdu, China
| | - Jan D Reinhardt
- Institute for Disaster Management and Reconstruction of Sichuan University and Hong Kong Polytechnic University, Sichuan University, Chengdu, China
- Department of Health Sciences and Medicine, University of Lucerne, Lucerne, Switzerland
- Rehabilitation Medicine Centre, Jiangsu Province Hospital/Nanjing Medical University First Affiliated Hospital, Nanjing, China
| |
Collapse
|
4
|
Feng W, Lv C, Cheng L, Song X, Li X, Xie H, Chen S, Wang X, Xue L, Zhang C, Kou J, Wang L, Zhao H. Targeting ERS-mitophagy in hippocampal neurons to explore the improvement of memory by tea polyphenols in aged type 2 diabetic rats. Free Radic Biol Med 2024; 213:293-308. [PMID: 38286317 DOI: 10.1016/j.freeradbiomed.2024.01.044] [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: 12/30/2023] [Revised: 01/15/2024] [Accepted: 01/26/2024] [Indexed: 01/31/2024]
Abstract
Increasing evidence demonstrated that mitophagy and endoplasmic reticulum stress (ERS) was closely associated with memory decline in elderly type 2 diabetes mellitus (T2DM). Tea polyphenols (TP), an excellent natural antioxidant, has been reported to have neuroprotective properties in aging and diabetes, but the underlying mechanisms are still not fully understood. This study targets ERS-mitophagy in hippocampal neurons to investigate the improvement effect of memory in aged T2DM rats by TP. Rats were randomly divided into the control group, the aged group, the aged T2DM model group, the TP 75, 150, 300 mg/kg groups. TP 300 mg/kg ameliorated mitophagy by decreasing the levels of p-mTOR (S2448), P62 and HSP60 and increasing the levels of PINK1 and Parkin, the ratio of LC3Ⅱ/LC3Ⅰ, co-localization of LC3 and HSP60 and the number of autophagosomes and autolysosomes. TP 300 mg/kg attenuated ERS by downregulating the levels of p-PERK, p-eIF2α, ATF4, GRP78 and restoring the ER structure. To further verify epigallocatechin gallate (EGCG), which is the main active component of TP, enhanced mitophagy by inhibiting ERS, PC12 cells were pretreated with ERS activator tunicamycin (TM) or ERS inhibitor 4-phenylbutyric acid (4-PBA). The results showed that the improvement of mitophagy by EGCG was inhibited by TM and promoted by 4-PBA. Collectively, ERS-mitophagy in hippocampal neurons plays a key role in the improvement of memory by TP in aged T2DM rats. This study will provide a new perspective and strategy for the prevention of memory decline in elderly with T2DM.
Collapse
Affiliation(s)
- Wenjuan Feng
- Department of Nutrition and Food Hygiene, School of Public Health, Shanxi Medical University, Taiyuan, Shanxi, 030001, PR China
| | - Chenhui Lv
- Department of Nutrition and Food Hygiene, School of Public Health, Shanxi Medical University, Taiyuan, Shanxi, 030001, PR China
| | - Le Cheng
- Department of Nutrition and Food Hygiene, School of Public Health, Shanxi Medical University, Taiyuan, Shanxi, 030001, PR China
| | - Xin Song
- Department of Nutrition and Food Hygiene, School of Public Health, Shanxi Medical University, Taiyuan, Shanxi, 030001, PR China
| | - Xuemin Li
- Center for Disease Control and Prevention in Shanxi Province, Taiyuan, Shanxi, 030012, PR China
| | - Haoran Xie
- Department of Nutrition and Food Hygiene, School of Public Health, Shanxi Medical University, Taiyuan, Shanxi, 030001, PR China
| | - Shuangzhi Chen
- Department of Nutrition and Food Hygiene, School of Public Health, Shanxi Medical University, Taiyuan, Shanxi, 030001, PR China
| | - Xi Wang
- Department of Nutrition and Food Hygiene, School of Public Health, Shanxi Medical University, Taiyuan, Shanxi, 030001, PR China
| | - Lushan Xue
- Department of Nutrition and Food Hygiene, School of Public Health, Shanxi Medical University, Taiyuan, Shanxi, 030001, PR China
| | - Cheng Zhang
- Department of Nutrition and Food Hygiene, School of Public Health, Shanxi Medical University, Taiyuan, Shanxi, 030001, PR China
| | - Jie Kou
- Department of Nutrition and Food Hygiene, School of Public Health, Shanxi Medical University, Taiyuan, Shanxi, 030001, PR China
| | - Lili Wang
- Department of Nutrition and Food Hygiene, School of Public Health, Shanxi Medical University, Taiyuan, Shanxi, 030001, PR China
| | - Haifeng Zhao
- Department of Nutrition and Food Hygiene, School of Public Health, Shanxi Medical University, Taiyuan, Shanxi, 030001, PR China; Key Laboratory of Coal Environmental Pathogenicity and Prevention (Shanxi Medical University), Ministry of Education, PR China.
| |
Collapse
|
5
|
Ahn EK, Yoon K, Park JE. Association between sleep hours and changes in cognitive function according to the morningness-eveningness type: A population-based study. J Affect Disord 2024; 345:112-119. [PMID: 37865346 DOI: 10.1016/j.jad.2023.10.122] [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: 05/03/2023] [Revised: 10/16/2023] [Accepted: 10/18/2023] [Indexed: 10/23/2023]
Abstract
OBJECTIVE The aim of this study was to investigate proper sleep hours to reduce the risk of cognitive decrease considering morningness-eveningness type. METHODS The Korean Community Health Survey was used, which includes adults aged over 19 years old. These data were obtained from a cross-sectional study and assessed sleep hours using questionnaire of Pittsburgh Sleep Quality Index. Based on the wake-up time of each participant, they were classified into the morningness, intermediate, eveningness, and none groups. The change in cognitive function was determined by a single question about memory loss experience. RESULTS A total of 224,714 participants were included in the analysis. Of the participants, 55.6 % and 5.0 % of whom had morningness and eveningness, respectively. The risk of cognitive decline was significantly different by sleep hours and morningness-eveningness type. Without considering sleep quality, the intermediate and eveningness groups showed a higher risk of cognitive decline than the morningness group, and the risk was lowest in those with 7-9 sleep hours. However, when sleep quality showing significant effect was included in the analysis, sleep hours showing the lowest risk were different among morningness, intermediate, eveningness groups, and it was the shortest in the morningness type at 5-6 h and the longest in the eveningness type at 7-8 h. CONCLUSION Proper sleep hours to decrease the risk of cognitive decline may be different by morningness-eveningness types. However, when considering sleep quality, sleep duration had little influence on cognitive decline. Future studies investigating healthy sleep hours need to consider sleep quality as well as the habitual sleep schedules. LIMITATIONS The morningness-eveningness types were classified based on wake-up time not morningness-eveningness types. The morningness-eveningness types in this study would be interpreted as habitual sleep schedule rather than chronotype.
Collapse
Affiliation(s)
- Eun Kyoung Ahn
- KM Data Division, Korea Institute of Oriental Medicine, 1672 Yuseokngdaero, Yuseonggu, Daejeon, South Korea
| | - Kyuhyun Yoon
- Institute of Health and Environment, Seoul National University, 1 Gwanak-ro, Gwanak-gu, Seoul, South Korea
| | - Ji-Eun Park
- KM Data Division, Korea Institute of Oriental Medicine, 1672 Yuseokngdaero, Yuseonggu, Daejeon, South Korea.
| |
Collapse
|
6
|
Zou H, Fang J, Han Y, Hu X, Meng J, Huang F, Xu H, Lu C, Wang Y, Zhang L, Dong X, Yu Y, Guo Y, Gu Q, Wang S. Effects and safety of Ginkgo biloba on blood metabolism in type 2 diabetes mellitus: a systematic review and meta-analysis. Front Endocrinol (Lausanne) 2024; 14:1231053. [PMID: 38264278 PMCID: PMC10804948 DOI: 10.3389/fendo.2023.1231053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/01/2023] [Accepted: 11/27/2023] [Indexed: 01/25/2024] Open
Abstract
Background There has existed controversy regarding the use of Ginkgo biloba (GKB) for blood metabolism among type 2 diabetes mellitus(T2DM) patients, and we tried to analyze the effects and safety of GKB on T2DM patients. Methods We conducted a literature search between January 2003 and December 2022 of seven online databases (PubMed, Scopus, Embase, Google Scholar, Web of Sciences, Cochrane Library, and China National Knowledge Infrastructure). A systematic literature review and meta-analysis were performed to compare the effects and safety of GKB among T2DM patients. Four groups of parameters were extracted and analyzed: hemorheology parameters, lipid profile, glycemic control markers, and adverse events. Results In the end, 13 eligible articles with 11 indicators among 1573 patients were included. In the hemorheology parameters section, GKB showed significantly lower plasma viscosity (PV) (SMD=-0.91, 95%CI [-1.45, -0.36], P<0.01) and hematocrit (Hct) (SMD=-0.60, 95%CI [-0.97, -0.24], P<0.01) than the control group. GKB shoed higher velocity of the dorsalis pedis artery (VDPA) (SMD=0.51, 95%CI [0.26, 0.76], P<0.01) and ankle brachial index (ABI) (SMD=0.71, 95%CI [0.32, 1.10], P<0.01) than the control. In both the lipid profile and glycemic control markers sections, we did not find any difference between GKB and control groups, including total cholesterol (TC), triglyceride (TG), low-density lipoprotein (LDL), high-density lipoprotein (HDL), hemoglobin A1c (HbA1c), and fasting serum glucose (FSG). In addition, we saw no difference in adverse events (AE). The sensitivity analysis and funnel plot showed that the results in this research were robust and had no publication bias. Conclusion In conclusion, GKB might safely reduce the risk of peripheral arterial or even systemic cardiovascular disease. However, GKB did not directly improve lipid and blood glucose levels in T2DM patients. Systematic review registration https://inplasy.com/, identifier INPLASY202350096.
Collapse
Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | | | - Qing Gu
- Department of Endocrinology, Shidong Hospital, Yangpu District, Shidong Hospital Affiliated to University of Shanghai for Science and Technology, Shanghai, China
| | - Suijun Wang
- Department of Endocrinology, Shidong Hospital, Yangpu District, Shidong Hospital Affiliated to University of Shanghai for Science and Technology, Shanghai, China
| |
Collapse
|
7
|
Reyes Bueno JA, Sánchez-Guijo G, Ráez PD, García-Arnés JA, Garzón-Maldonado FJ, Castro VS, de la Cruz-Cosme C, Alba-Linero C, Gutiérrez-Bedmar M, García-Casares N. Effects of Type 2 Diabetes on the Neuropsychological Profile in Mild Cognitive Impairment. J Alzheimers Dis 2024; 99:887-897. [PMID: 38758998 PMCID: PMC11191518 DOI: 10.3233/jad-230791] [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: 03/27/2024] [Indexed: 05/19/2024]
Abstract
Background Diabetes is one of the main risk factors for developing mild cognitive impairment (MCI) and Alzheimer's disease. Most studies have demonstrated a worse performance in executive function, verbal fluency, and information processing speed in patients with diabetes. Objective To assess the cognitive functioning of persons with type 2 diabetes and amnesic mild cognitive impairment (aMCI-T2DM) compared to persons with aMCI without diabetes and persons without diabetes or aMCI as controls, to understand the role of diabetes in the neuropsychological profile. Methods Cross-sectional study involving a sample of 83 patients, ranging in age from 61 to 85 years and divided into three groups: aMCI-T2DM (27 patients), aMCI (29 patients), Controls (27 individuals). All the participants undertook an exhaustive neuropsychological assessment (auditory-verbal and visual memory, attention, information processing speed, language, executive function, and depression). Results Both groups of aMCI patients performed significantly worse than the controls in all the neuropsychological tests. A significant linear tendency (p trend < 0.05) was found between groups, with the aMCI-T2DM group presenting worse results in global cognition assessed by the Mini-Mental State Examination and Montreal Cognitive Assessment; Rey-Osterrieth Complex Figure Test; Auditory Verbal Learning Test; Trail Making Test A and B, Verbal Fluency Test, and Hamilton Depression Rating Scale. Conclusions aMCI patients with or without diabetes showed worse cognitive function compared to persons without diabetes or aMCI. Additionally, aMCI patients without T2DM presented a different cognitive profile than aMCI patients with T2DM, which tended towards presenting worse cognitive functions such as global cognition, memory, attention, executive function, and language.
Collapse
Affiliation(s)
- José A. Reyes Bueno
- Departamento de Neurología, Hospital Universitario Regional de Málaga, Málaga, Spain
| | | | - Pablo Doblas Ráez
- Departamento de Medicina, Facultad de Medicina, Universidad de Málaga, Málaga, Spain
| | - Juan A. García-Arnés
- Departamento de Medicina, Facultad de Medicina, Universidad de Málaga, Málaga, Spain
| | - Francisco J. Garzón-Maldonado
- Departamento de Neurología, Hospital Universitario Virgen de la Victoria de Málaga, Málaga, Spain
- Instituto de Investigación Biomédica de Málaga y Plataforma en Nanomedicina-IBIMA Plataforma BIONAND, Málaga, Spain
| | - Vicente Serrano Castro
- Departamento de Neurología, Hospital Universitario Virgen de la Victoria de Málaga, Málaga, Spain
| | - Carlos de la Cruz-Cosme
- Departamento de Medicina, Facultad de Medicina, Universidad de Málaga, Málaga, Spain
- Departamento de Neurología, Hospital Universitario Virgen de la Victoria de Málaga, Málaga, Spain
- Instituto de Investigación Biomédica de Málaga y Plataforma en Nanomedicina-IBIMA Plataforma BIONAND, Málaga, Spain
| | - Carmen Alba-Linero
- Departamento de Medicina, Facultad de Medicina, Universidad de Málaga, Málaga, Spain
- Instituto de Investigación Biomédica de Málaga y Plataforma en Nanomedicina-IBIMA Plataforma BIONAND, Málaga, Spain
- Departamento de Oftalmología, Hospital Universitario Virgen de la Victoria de Málaga, Málaga, Spain
| | - Mario Gutiérrez-Bedmar
- Departamento de Medicina, Facultad de Medicina, Universidad de Málaga, Málaga, Spain
- Instituto de Investigación Biomédica de Málaga y Plataforma en Nanomedicina-IBIMA Plataforma BIONAND, Málaga, Spain
- CIBERCV Cardiovascular Diseases, Carlos III Health Institute, Madrid, Spain
| | - Natalia García-Casares
- Departamento de Medicina, Facultad de Medicina, Universidad de Málaga, Málaga, Spain
- Instituto de Investigación Biomédica de Málaga y Plataforma en Nanomedicina-IBIMA Plataforma BIONAND, Málaga, Spain
- Centro de Investigaciones Médico-Sanitarias (CIMES), Spain
| |
Collapse
|
8
|
Lee J, Kim J, Ju HJ, An SJ, Woo B. A Longitudinal Dose-Response Curve Between Leisure-Time Physical Activity and the Prevalence of Diabetes Based on the Different Levels of Cognitive Function Among Older Adults. Am J Alzheimers Dis Other Demen 2024; 39:15333175241241891. [PMID: 38549562 PMCID: PMC11072067 DOI: 10.1177/15333175241241891] [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: 04/02/2024]
Abstract
This study investigated a dose-response relationship between Leisure-Time Physical Activity participation (LTPA) and the risk of diabetes and a comparison of the risk across different cognitive function groups among older adults. The Health and Retirement Study data were used from 2012 to 2020 (n = 18 746). This study conducted a Cox Proportional Hazard Regression to investigate the Dose-Response Curve between the prevalence of diabetes and the covariates following a level of LTPA participation. The result presented that the Odds Ratio continuously decreased as the level of LTPA participation increased. Among the three cognitive function groups, the high group (OR = .43, P < .05) and the mid group (OR = .71, P < .05) had a larger negative slope coefficient than the low group. This study found that LTPA participation reduces the risk of diabetes and gives evidence for the importance of cognitive function in reducing the prevalence of diabetes.
Collapse
Affiliation(s)
- Jungjoo Lee
- School of Health Professions, College of Nursing and Health Professions, University of Southern Mississippi, Hattiesburg, MS, USA
| | - Junhyoung Kim
- Department of Health Behavior, School of Public Health, Texas A&M University, College Station, TX, USA
| | - Hyo Jin Ju
- Department of Medical Humanities, The Convergence Institute of Healthcare and Medical Science, Catholic Kwandong University, Incheon, South Korea
| | - Sang Joon An
- Department of Neurology, The Convergence Institute of Healthcare and Medical Science, International St. Mary’s Hospital, Catholic Kwandong University, Incheon, South Korea
| | - Bomi Woo
- Department of Health Behavior, School of Public Health, Texas A&M University, College Station, TX, USA
| |
Collapse
|
9
|
Aderinto N, Olatunji G, Abdulbasit M, Ashinze P, Faturoti O, Ajagbe A, Ukoaka B, Aboderin G. The impact of diabetes in cognitive impairment: A review of current evidence and prospects for future investigations. Medicine (Baltimore) 2023; 102:e35557. [PMID: 37904406 PMCID: PMC10615478 DOI: 10.1097/md.0000000000035557] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Accepted: 09/18/2023] [Indexed: 11/01/2023] Open
Abstract
Cognitive impairment in individuals with diabetes represents a multifaceted and increasingly prevalent health concern. This review critically examines the current evidence regarding the intricate relationship between diabetes and cognitive decline. It highlights the existing knowledge on the impact of diabetes on cognitive function, spanning from mild cognitive impairment to dementia, including vascular and Alzheimer dementia. The review underscores the need for a standardized diagnostic paradigm and explores research gaps, such as the implications of cognitive impairment in younger populations and various diabetes types. Furthermore, this review emphasizes the relevance of diabetes-related comorbidities, including hypertension and dyslipidemia, in influencing cognitive decline. It advocates for a comprehensive, interdisciplinary approach, integrating insights from neuroscience, endocrinology, and immunology to elucidate the mechanistic underpinnings of diabetes-related cognitive impairment. The second part of this review outlines prospective research directions and opportunities. It advocates for longitudinal studies to understand disease progression better and identifies critical windows of vulnerability. The search for accurate biomarkers and predictive factors is paramount, encompassing genetic and epigenetic considerations. Personalized approaches and tailored interventions are essential in addressing the substantial variability in cognitive outcomes among individuals with diabetes.
Collapse
Affiliation(s)
- Nicholas Aderinto
- Department of Medicine, Ladoke Akintola University of Technology, Ogbomoso, Nigeria
| | - Gbolahan Olatunji
- Department of Medicine and Surgery, University of Ilorin, Kwara State, Nigeria
| | - Muili Abdulbasit
- Department of Medicine, Ladoke Akintola University of Technology, Ogbomoso, Nigeria
| | - Patrick Ashinze
- Saint Francis Catholic Hospital, Okpara Inland, Warri Catholic Diocesan Hospital Commission, Delta State, Nigeria
| | - Olamide Faturoti
- Department of Medicine and Surgery, University of Ilorin, Kwara State, Nigeria
| | - Abayomi Ajagbe
- Department of Anatomy, College of Health Sciences, Nile University of Nigeria, Abuja, Nigeria
| | - Bonaventure Ukoaka
- Department of Internal Medicine, Asokoro District Hospital, Abuja, Nigeria
| | - Gbolahan Aboderin
- Department of Medicine, Ladoke Akintola University of Technology, Ogbomoso, Nigeria
| |
Collapse
|
10
|
An JR, Wang QF, Sun GY, Su JN, Liu JT, Zhang C, Wang L, Teng D, Yang YF, Shi Y. The Role of Iron Overload in Diabetic Cognitive Impairment: A Review. Diabetes Metab Syndr Obes 2023; 16:3235-3247. [PMID: 37872972 PMCID: PMC10590583 DOI: 10.2147/dmso.s432858] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2023] [Accepted: 09/29/2023] [Indexed: 10/25/2023] Open
Abstract
It is well documented that diabetes mellitus (DM) is strongly associated with cognitive decline and structural damage to the brain. Cognitive deficits appear early in DM and continue to worsen as the disease progresses, possibly due to different underlying mechanisms. Normal iron metabolism is necessary to maintain normal physiological functions of the brain, but iron deposition is one of the causes of some neurodegenerative diseases. Increasing evidence shows that iron overload not only increases the risk of DM, but also contributes to the development of cognitive impairment. The current review highlights the role of iron overload in diabetic cognitive impairment (DCI), including the specific location and regulation mechanism of iron deposition in the diabetic brain, the factors that trigger iron deposition, and the consequences of iron deposition. Finally, we also discuss possible therapies to improve DCI and brain iron deposition.
Collapse
Affiliation(s)
- Ji-Ren An
- Liaoning Key Laboratory of Chinese Medicine Combining Disease and Syndrome of Diabetes, Liaoning University of Traditional Chinese Medicine, Shenyang, 110847, People’s Republic of China
- College of Integrative Chinese and Western Medicine, Hebei University of Chinese Medicine, Shijiazhuang, 050200, People’s Republic of China
| | - Qing-Feng Wang
- Liaoning Key Laboratory of Chinese Medicine Combining Disease and Syndrome of Diabetes, Liaoning University of Traditional Chinese Medicine, Shenyang, 110847, People’s Republic of China
| | - Gui-Yan Sun
- Liaoning Key Laboratory of Chinese Medicine Combining Disease and Syndrome of Diabetes, Liaoning University of Traditional Chinese Medicine, Shenyang, 110847, People’s Republic of China
| | - Jia-Nan Su
- Liaoning Key Laboratory of Chinese Medicine Combining Disease and Syndrome of Diabetes, Liaoning University of Traditional Chinese Medicine, Shenyang, 110847, People’s Republic of China
| | - Jun-Tong Liu
- Liaoning Key Laboratory of Chinese Medicine Combining Disease and Syndrome of Diabetes, Liaoning University of Traditional Chinese Medicine, Shenyang, 110847, People’s Republic of China
| | - Chi Zhang
- Liaoning Key Laboratory of Chinese Medicine Combining Disease and Syndrome of Diabetes, Liaoning University of Traditional Chinese Medicine, Shenyang, 110847, People’s Republic of China
| | - Li Wang
- Liaoning Key Laboratory of Chinese Medicine Combining Disease and Syndrome of Diabetes, Liaoning University of Traditional Chinese Medicine, Shenyang, 110847, People’s Republic of China
| | - Dan Teng
- He University, Shenyang, 110163, People’s Republic of China
| | - Yu-Feng Yang
- Liaoning Key Laboratory of Chinese Medicine Combining Disease and Syndrome of Diabetes, Liaoning University of Traditional Chinese Medicine, Shenyang, 110847, People’s Republic of China
| | - Yan Shi
- Liaoning Key Laboratory of Chinese Medicine Combining Disease and Syndrome of Diabetes, Liaoning University of Traditional Chinese Medicine, Shenyang, 110847, People’s Republic of China
| |
Collapse
|
11
|
Lobo E, Lobo A, Gracia-García P, López-Antón R, Saz P, De la Cámara C. Sex Differences in Longitudinal Trajectories of Cognitive Aging in Zaragoza, Spain. Am J Geriatr Psychiatry 2023; 31:796-807. [PMID: 37169710 DOI: 10.1016/j.jagp.2023.04.012] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Revised: 04/19/2023] [Accepted: 04/19/2023] [Indexed: 05/13/2023]
Abstract
OBJECTIVES The objective of this study was to document the longitudinal trajectories of cognitive aging in a sample of cognitively healthy subjects of 55 years or older. The following differences between men and women were hypothesized: 1) in the cognitive loss through aging, 2) in the distinct trajectories identified; and 3) in the predictors associated with the identified trajectories. DESIGN AND SETTING A 4-wave, population-based study in Zaragoza, Spain (1994-2006). PARTICIPANTS A total of 2,403 individuals aged 55+ years, cognitively healthy at baseline. MEASUREMENTS All participants had at least three measurements with the Mini-Mental State Examination (MMSE). Validated Spanish versions of international instruments were used for assessment. Random effects linear panel regression model for analyzing differences by sex in MMSE scores through aging were performed, and growth mixture models (GMM) applied independently for each sex for modeling the longitudinal cognitive trajectories. RESULTS Women showed lower mean MMSE scores in all phases and significantly higher loss in the MMSE from phases 2 to 3 and 3 to 4. The best fitting age-adjusted model of the cognitive trajectories was a 4-class GMM in men and a 3-class in women. Education was a predictor of cognitive trajectories in both men and women. Dependence on iADLs and alcohol status were predictors only for men, and depression and diabetes only for women. CONCLUSIONS The identified differences by sex in cognitive trajectories and their associated factors suggest that men and women may require a different strategy when addressing cognitive aging.
Collapse
Affiliation(s)
- Elena Lobo
- Department of Preventive Medicine and Public Health (EL), Universidad de Zaragoza, Zaragoza, Spain; Instituto de Investigación Sanitaria de Aragón (IIS Aragón) (EL, AL, RLA, PS, PGG, CDC) Zaragoza, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM) (EL PGG, RLA, CDC), Ministry of Science and Innovation, Madrid, Spain
| | - Antonio Lobo
- Instituto de Investigación Sanitaria de Aragón (IIS Aragón) (EL, AL, RLA, PS, PGG, CDC) Zaragoza, Spain; Department of Medicine and Psychiatry (AL, PGG, PS, CDC), Universidad de Zaragoza, Zaragoza, Spain.
| | - Patricia Gracia-García
- Instituto de Investigación Sanitaria de Aragón (IIS Aragón) (EL, AL, RLA, PS, PGG, CDC) Zaragoza, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM) (EL PGG, RLA, CDC), Ministry of Science and Innovation, Madrid, Spain; Department of Medicine and Psychiatry (AL, PGG, PS, CDC), Universidad de Zaragoza, Zaragoza, Spain; Psychiatry Service (PGG), Hospital Universitario Miguel Servet, Zaragoza, Spain
| | - Raúl López-Antón
- Instituto de Investigación Sanitaria de Aragón (IIS Aragón) (EL, AL, RLA, PS, PGG, CDC) Zaragoza, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM) (EL PGG, RLA, CDC), Ministry of Science and Innovation, Madrid, Spain; Department of Sociology and Psychology (RLA), Universidad de Zaragoza, Zaragoza, Spain
| | - Pedro Saz
- Instituto de Investigación Sanitaria de Aragón (IIS Aragón) (EL, AL, RLA, PS, PGG, CDC) Zaragoza, Spain; Department of Medicine and Psychiatry (AL, PGG, PS, CDC), Universidad de Zaragoza, Zaragoza, Spain
| | - Concepción De la Cámara
- Instituto de Investigación Sanitaria de Aragón (IIS Aragón) (EL, AL, RLA, PS, PGG, CDC) Zaragoza, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM) (EL PGG, RLA, CDC), Ministry of Science and Innovation, Madrid, Spain; Department of Medicine and Psychiatry (AL, PGG, PS, CDC), Universidad de Zaragoza, Zaragoza, Spain; Psychiatry Service (CDC), Hospital Clínico Universitario, Zaragoza, Spain
| |
Collapse
|
12
|
Tang X, Chen Y, Tan H, Fang J, Yu D, Chen C, Li X, Hu Z, Ding L, Zhang Y. Micro- and macro-changes in early-stage type 2 diabetes mellitus without cognitive impairment: a diffusion tensor imaging (DTI) and surface-based morphometry (SBM) study. Front Neurol 2023; 14:1115634. [PMID: 37475732 PMCID: PMC10354865 DOI: 10.3389/fneur.2023.1115634] [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: 12/04/2022] [Accepted: 05/26/2023] [Indexed: 07/22/2023] Open
Abstract
Introduction Brain structure and function changes are considered major brain damages in type 2 diabetes mellitus (T2DM), which likely has a close relationship with cognitive impairment. Many previous studies have shown by using brain structural and functional magnetic resonance imaging (MRI) methods that brain white and gray matter are damaged in T2DM, leading to cognitive impairment. Researches neglected patients of T2DM without cognitive dysfunction might also have brain changes. Methods In this study, subjects with early stage T2DM with no cognitive dysfunction were enrolled to detect brain damages using the tract-based spatial statistics analysis (TBSS) method to demonstrate white matter (WM) micro changes and surface-based morphometry (SBM) method to assess cerebral cortex macro changes. Results The whole-brain TBSS analysis revealed that there were no statistically significant changes in fractional anisotropy (FA) and mean diffusivity (MD), but the FA declined in some area of cerebral WM (p < 0.1). The SBM results showed no changes in cortical thickness (CT), cortical volume (CV), surface area (SA), and cortical sulcal curve (CSC) between these two groups, but pial local gyration index (LGI) was decreased in the precuneus (-log10, p = -3.327). Discussion In conclusion, early stage T2DM patients without cognitive impairment had brain micro and macro structural damages, suggesting the potential use of MRI as an imaging marker to detect brain changes in early stage T2DM, which could not be observed and assessed clinically.
Collapse
Affiliation(s)
- Xiangyong Tang
- Department of Medical Imaging, Affiliated Longhua People's Hospital, Southern Medical University, Shenzhen, China
| | - Yanzi Chen
- Department of Medical Imaging, Affiliated Longhua People's Hospital, Southern Medical University, Shenzhen, China
| | - Hui Tan
- Department of Medical Imaging, Second Affiliated Hospital, Shantou University Medical College, Shantou, China
| | - Jinzhi Fang
- Department of Medical Imaging, Affiliated Longhua People's Hospital, Southern Medical University, Shenzhen, China
| | - Dafei Yu
- Department of Medical Imaging, Affiliated Longhua People's Hospital, Southern Medical University, Shenzhen, China
| | - Cuimei Chen
- Department of Medical Imaging, Affiliated Longhua People's Hospital, Southern Medical University, Shenzhen, China
| | - Xiao Li
- Department of Medical Imaging, Affiliated Longhua People's Hospital, Southern Medical University, Shenzhen, China
| | - Ziqi Hu
- Department of Medical Imaging, Affiliated Longhua People's Hospital, Southern Medical University, Shenzhen, China
| | - Ling Ding
- Department of Medical Imaging, Affiliated Longhua People's Hospital, Southern Medical University, Shenzhen, China
| | - Yuzhong Zhang
- Department of Medical Imaging, Affiliated Longhua People's Hospital, Southern Medical University, Shenzhen, China
| |
Collapse
|
13
|
Wang L, Yu H, Hao L, Ju M, Feng W, Xiao R. The Interaction Effect of 27-Hydroxycholesterol Metabolism Disorder and CYP27A1 Single Nucleotide Polymorphisms in Mild Cognitive Impairment: Evidence from a Case-Control Study. Mol Nutr Food Res 2023; 67:e2200576. [PMID: 36811281 DOI: 10.1002/mnfr.202200576] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Revised: 01/02/2023] [Indexed: 02/24/2023]
Abstract
SCOPE The aim of the study is to investigate the relationship between 27-hydroxycholesterol (27-OHC), 27-hydroxylase (CYP27A1) polymorphisms, and Alzheimer's disease (AD). METHODS AND RESULTS A case-control study based on EMCOA study includes 220 healthy cognition and mild cognitive impairment (MCI) subjects respectively, matched by sex, age, and education. The level of 27-OHC and its related metabolites are examined by high performance liquid chromatography-mass spectrometry (HPLC-MS). The results show that 27-OHC level is positively associated with risk of MCI (p < 0.001), negatively associated with specific domain of cognitive function. Serum 27-OHC is positively associated with 7a-hydroxy-3-oxo-4-cholestenoic acid (7-HOCA) in cognitive healthy subjects, while positively associated with 3β-hydroxy-5-cholestenoic acid (27-CA) in MCI subjects (p < 0.001). CYP27A1 and Apolipoprotein E (ApoE) single nucleotide polymorphisms (SNPs) genotyping are determined. The global cognitive function is significant higher in Del-carrier of rs10713583, compared with AA genotype (p = 0.007). Stroop Color-Word Test Interference Trial (SCWT-IT) is significant higher in G-carrier genotype (p = 0.042), compared with TT genotype in rs12614206. CONCLUSIONS The results show that 27-OHC metabolic disorder is associated with MCI and multi-domain cognitive function. CYP27A1 SNPs is correlated to cognitive function, while the interaction between 27-OHC and CYP27A1 SNPs need further study.
Collapse
Affiliation(s)
- Lijing Wang
- School of Public Health, Beijing Key Laboratory of Environmental Toxicology, Capital Medical University, Beijing, 100069, China
| | - Huiyan Yu
- School of Public Health, Beijing Key Laboratory of Environmental Toxicology, Capital Medical University, Beijing, 100069, China
| | - Ling Hao
- School of Public Health, Beijing Key Laboratory of Environmental Toxicology, Capital Medical University, Beijing, 100069, China
| | - Mengwei Ju
- School of Public Health, Beijing Key Laboratory of Environmental Toxicology, Capital Medical University, Beijing, 100069, China
| | - Wenjing Feng
- School of Public Health, Beijing Key Laboratory of Environmental Toxicology, Capital Medical University, Beijing, 100069, China
| | - Rong Xiao
- School of Public Health, Beijing Key Laboratory of Environmental Toxicology, Capital Medical University, Beijing, 100069, China
| |
Collapse
|
14
|
Al-Sayyar A, Hammad MM, Williams MR, Al-Onaizi M, Abubaker J, Alzaid F. Neurotransmitters in Type 2 Diabetes and the Control of Systemic and Central Energy Balance. Metabolites 2023; 13:384. [PMID: 36984824 PMCID: PMC10058084 DOI: 10.3390/metabo13030384] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2023] [Revised: 02/10/2023] [Accepted: 02/13/2023] [Indexed: 03/08/2023] Open
Abstract
Efficient signal transduction is important in maintaining the function of the nervous system across tissues. An intact neurotransmission process can regulate energy balance through proper communication between neurons and peripheral organs. This ensures that the right neural circuits are activated in the brain to modulate cellular energy homeostasis and systemic metabolic function. Alterations in neurotransmitters secretion can lead to imbalances in appetite, glucose metabolism, sleep, and thermogenesis. Dysregulation in dietary intake is also associated with disruption in neurotransmission and can trigger the onset of type 2 diabetes (T2D) and obesity. In this review, we highlight the various roles of neurotransmitters in regulating energy balance at the systemic level and in the central nervous system. We also address the link between neurotransmission imbalance and the development of T2D as well as perspectives across the fields of neuroscience and metabolism research.
Collapse
Affiliation(s)
| | | | | | - Mohammed Al-Onaizi
- Dasman Diabetes Institute, Kuwait City 15462, Kuwait
- Department of Anatomy, Faculty of Medicine, Kuwait University, Kuwait City 13110, Kuwait
| | | | - Fawaz Alzaid
- Dasman Diabetes Institute, Kuwait City 15462, Kuwait
- Institut Necker Enfants Malades-INEM, Université Paris Cité, CNRS, INSERM, F-75015 Paris, France
| |
Collapse
|
15
|
Xu T, Ye X, Lu X, Lan G, Xie M, Huang Z, Wang T, Wu J, Zhan Z, Xie X. Association between solid cooking fuel and cognitive decline: Three nationwide cohort studies in middle-aged and older population. ENVIRONMENT INTERNATIONAL 2023; 173:107803. [PMID: 36805161 DOI: 10.1016/j.envint.2023.107803] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Revised: 01/07/2023] [Accepted: 02/02/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND Household solid-fuel burning contributes to indoor air pollution and is linked to poor cognitive function, but how solid cooking fuel use leads to cognitive decline over time is not well elaborated. OBJECTIVE We examine the associations of solid cooking fuel with cognitive function among three nationally representative cohorts. METHODS This study uses data from the 2010-2018 China Family Panel Studies (CFPS), the 2011-2018 China Health and Retirement Longitudinal Study (CHARLS) and the 2003-2015 Mexican Health and Aging Study (MHAS) in adults over the age of 50. Time varying Cox model was conducted to measure the association between cooking fuel types and cognitive decline. Mediation analysis was used to estimate the potential mediation effects on the associations of cooking fuel types with cognitive decline risk. RESULTS Respondents in CFPS, CHARLS, and MHAS relied on solid cooking fuel at baseline approximately 56 %, 51 %, and 12 %, respectively. Using solid fuel was consistently associated with higher risk of cognitive decline in three cohorts (CFPS: HR = 1.300 [95 % CI: 1.201, 1.407], CHARLS: HR = 1.179 [95 % CI: 1.059, 1.312], MHAS: HR = 1.237 [95 % CI: 1.123, 1.362]). Compared to those with persistent solid fuel, persistent clean fuel and change from solid fuel to clean fuel were associated with a lower risk of cognitive decline. Hypertension, diabetes, physical activity, dyslipidemia and high-density lipoprotein cholesterol (HDL-C) may partially mediate the cognitive decline caused by solid fuel use. Of the cognitive decline burden, 18.23 % (95 % CI: 12.21 %, 24.73 %) in CFPS, 8.90 % (95 % CI: 2.93 %, 15.52 %) in CHARLS and 2.92 % (95 % CI: 1.52 %, 4.46 %) in MHAS of cognitive decline cases attributable to solid cooking fuel use. CONCLUSION The use of solid cooking fuel is associated with a higher risk of cognitive decline. It is essential to promote the expanded use of clean fuel to protect cognitive health.
Collapse
Affiliation(s)
- Tingting Xu
- Department of Epidemiology and Health Statistics, School of Public Health, Fujian Medical University, Fuzhou, China
| | - Xiaoying Ye
- Department of Epidemiology and Health Statistics, School of Public Health, Fujian Medical University, Fuzhou, China
| | - Xiaoli Lu
- Department of Epidemiology and Health Statistics, School of Public Health, Fujian Medical University, Fuzhou, China
| | - Guohui Lan
- Department of Epidemiology and Health Statistics, School of Public Health, Fujian Medical University, Fuzhou, China
| | - Mengying Xie
- The Second Clinical Medical School, Nanchang University, Nanchang, China
| | - Zelin Huang
- Department of Epidemiology and Health Statistics, School of Public Health, Fujian Medical University, Fuzhou, China
| | - Tinggui Wang
- Department of Epidemiology and Health Statistics, School of Public Health, Fujian Medical University, Fuzhou, China
| | - Jieyu Wu
- Department of Epidemiology and Health Statistics, School of Public Health, Fujian Medical University, Fuzhou, China
| | - Zhiying Zhan
- Department of Epidemiology and Health Statistics, School of Public Health, Fujian Medical University, Fuzhou, China
| | - Xiaoxu Xie
- Department of Epidemiology and Health Statistics, School of Public Health, Fujian Medical University, Fuzhou, China; Clinical Research Unit, The Second Affiliated Hospital, Fujian Medical University, Quanzhou, China.
| |
Collapse
|
16
|
Mirahmad M, Mohseni S, Tabatabaei-Malazy O, Esmaeili F, Alatab S, Bahramsoltani R, Ejtahed HS, Qulami H, Bitarafan Z, Arjmand B, Nazeri E. Antioxidative hypoglycemic herbal medicines with in vivo and in vitro activity against C-reactive protein; a systematic review. PHYTOMEDICINE : INTERNATIONAL JOURNAL OF PHYTOTHERAPY AND PHYTOPHARMACOLOGY 2023; 109:154615. [PMID: 36610136 DOI: 10.1016/j.phymed.2022.154615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/01/2022] [Revised: 11/16/2022] [Accepted: 12/17/2022] [Indexed: 06/17/2023]
Abstract
BACKGROUND Inflammation is a double-edged sword in the pathophysiology of chronic diseases, such as type 2 diabetes mellitus (T2DM). The global rise in the prevalence of T2DM in one hand, and poor disease control with currently-available treatments on the other hand, along with an increased tendency towards the use of natural products make scientists seek herbal medicines for the management of diabetes and its complications by reducing C-reactive protein (CRP) as an inflammatory marker. PURPOSE To systematically review the literature to identify the efficacy of various medicinal plants with antioxidative and anti-inflammatory properties considering their effect on CRP in animal models of T2DM. STUDY DESIGN systematic review. METHODS Electronic databases including PubMed, Scopus, Web of Science and Cochran Library were searched using the search terms "herbal medicine", "diabetes", "c-reactive protein", "antioxidants" till August 2021. The quality of evidence was assessed using the Systematic Review Centre for Laboratory animal Experimentation (SYRCLE's) tool. The study protocol was registered in PROSPERO with an ID number CRD42020207190. A manual search to detect any articles not found in the databases was also made. The identified studies were then critically reviewed and relevant data were extracted and summarized. RESULTS Among total of 9904 primarily-retrieved articles, twenty-three experimental studies were finally included. Our data indicated that numerous herbal medicines, compared to placebo or hypoglycemic medications, are effective in treatment of diabetes and its complications through decreasing CRP concentrations and oxidative stresses levels. Medicinal plants including Psidium guajava L., Punica granatum L., Ginkgo biloba L., Punica granatum L., Dianthus superbusn L.. Moreover, Eichhornia crassipes (Mart.) Solms, Curcuma longa L., Azadirachta indica A. Juss., Morus alba L., and Ficus racemosa L. demonstrated potential neuroprotective effects in animal models of diabetes. CONCLUSION Hypoglycemic medicinal plants discussed in this review seem to be promising regulators of CRP, and oxidative stress. Thus, these plants are suitable candidates for management of diabetes' complications. Nevertheless, further high-quality in vivo studies and clinical trials are required to confirm these effects.
Collapse
Affiliation(s)
- Maryam Mirahmad
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Shahrzad Mohseni
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Ozra Tabatabaei-Malazy
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.
| | - Fataneh Esmaeili
- Department of Clinical Biochemistry, Faculty of Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Sudabeh Alatab
- Digestive Disease Research Center, Digestive Disease Research Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Roodabeh Bahramsoltani
- Department of Traditional Pharmacy, School of Persian Medicine, Tehran University of Medical Sciences, Tehran, Iran; PhytoPharmacology Interest Group (PPIG), Universal Scientific Education and Research Network (USERN), Tehran, Iran
| | - Hanieh-Sadat Ejtahed
- Obesity and Eating Habits Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Husseyn Qulami
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Zahra Bitarafan
- Division of Biotechnology and Plant Health, Norwegian Institute of Bioeconomy Research, Høgskoleveien 7, As 1433, Norway
| | - Babak Arjmand
- Cell Therapy and Regenerative Medicine Research Center, Endocrinology and Metabolism Molecular-Cellular Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Elahe Nazeri
- Genetics Department, Breast Cancer Research Center, Motamed Cancer Institute, ACECR, Tehran, Iran
| |
Collapse
|
17
|
Davidson S, Allenback G, Decourt B, Sabbagh MN. Type 2 Diabetes Comorbidity and Cognitive Decline in Patients with Alzheimer's Disease. J Alzheimers Dis 2023; 95:1573-1584. [PMID: 37718812 DOI: 10.3233/jad-230489] [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] [Indexed: 09/19/2023]
Abstract
BACKGROUND Although insulin dysregulation and resistance likely participate in Alzheimer's disease (AD) etiologies, little is known about the correlation between type 2 diabetes mellitus (T2DM) and the progression of cognitive decline in patients with AD. OBJECTIVE To determine whether AD patients with T2DM experience more rapid cognitive decline than those without T2DM. METHODS All cognitive performance data and the presence or absence of T2DM comorbidity in patients with AD were derived from the US National Alzheimer's Coordinating Center's (NACC) Uniform Data Set (UDS). A search of the UDS identified 3,055 participants with AD who had more than one epoch completed. The data set culled clinically diagnosed AD dementia patients who were assessed for diabetes type identified during at least 1 visit. These patients were divided into 2 groups based on whether they had a diagnosis of T2DM. The data from these groups were then analyzed for differences in cognitive decline based on neuropsychological test battery scores and a Clinician Dementia Rating using a general linear model. RESULTS Comparisons of the mean scores for 16 selected tests from the neuropsychological test battery showed no significant differences in baseline scores and scores at subsequent visits between the T2DM and nondiabetic groups. CONCLUSIONS The results revealed no differences in cognitive decline metrics over the course of 5 visits in either study group. These data indicate that the presence of T2DM does not increase the rate of cognitive decline in AD. This finding contradicts expected disease burden and will need to be explored further.
Collapse
Affiliation(s)
- Skylar Davidson
- Kirk Kerkorian School of Medicine at the University of Nevada, Las Vegas, Las Vegas, NV, USA
| | - Gayle Allenback
- Kirk Kerkorian School of Medicine at the University of Nevada, Las Vegas, Las Vegas, NV, USA
| | - Boris Decourt
- Translational Neurodegenerative Research Lab, Roseman University, Las Vegas, NV, USA
- Department of Pharmacology and Neuroscience, Texas Tech University Health Science Center, School of Medicine, Lubbock, TX, USA
| | - Marwan N Sabbagh
- Department of Neurology, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Phoenix, AZ, USA
| |
Collapse
|
18
|
Chanti-Ketterl M, Stebbins RC, Obhi HK, Belsky DW, Plassman BL, Yang YC. Sex Differences in the Association Between Metabolic Dysregulation and Cognitive Aging: The Health and Retirement Study. J Gerontol A Biol Sci Med Sci 2022; 77:1827-1835. [PMID: 34606593 PMCID: PMC9757032 DOI: 10.1093/gerona/glab285] [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: 04/23/2021] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Dysregulation of some metabolic factors increases the risk of dementia. It remains unclear if overall metabolic dysregulation, or only certain components, contribute to cognitive aging and if these associations are sex specific. METHODS Data from the 2006-2016 waves of the Health and Retirement Study (HRS) was used to analyze 7 103 participants aged 65 and older at baseline (58% women). We created a metabolic-dysregulation risk score (MDRS) composed of blood pressure/hypertension status, glycosylated hemoglobin (HbA1c)/diabetes status, total cholesterol (TC), high-density lipoprotein cholesterol (HDL-C), and waist circumference, and assessed cognitive trajectories from repeated measures of the HRS-Telephone Interview for Cognitive Status (HRS-TICS) over 10 years of follow-up. Linear mixed-effects models estimated associations between MDRS or individual metabolic factors (biomarkers) with mean and change in HRS-TICS scores and assessed sex-modification of these associations. RESULTS Participants with higher MDRSs had lower mean HRS-TICS scores, but there were no statistically significant differences in rate of decline. Sex stratification showed this association was present for women only. MDRS biomarkers revealed heterogeneity in the strength and direction of associations with HRS-TICS. Lower HRS-TICS levels were associated with hypertension, higher HbA1c/diabetes, and lower HDL-C and TC, whereas faster rate of cognitive decline was associated with hypertension, higher HbA1c/diabetes, and higher TC. Participants with higher HbA1c/diabetes presented worse cognitive trajectories. Sex differences indicated that women with higher HbA1c/diabetes to have lower HRS-TICS levels, whereas hypertensive males presented better cognitive trajectory. CONCLUSIONS Our results demonstrate that metabolic dysregulation is more strongly associated with cognition in women compared with men, though sex differences vary by individual biomarker.
Collapse
Affiliation(s)
- Marianne Chanti-Ketterl
- Department of Psychiatry and Behavioral Science, Duke University, Durham, North Carolina, USA
| | - Rebecca C Stebbins
- Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Hardeep K Obhi
- Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - Daniel W Belsky
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, New York, USA
- Butler Columbia Aging Center, Columbia University, New York, New York, USA
| | - Brenda L Plassman
- Department of Psychiatry and Behavioral Science, Duke University, Durham, North Carolina, USA
| | - Yang Claire Yang
- Department of Sociology, Carolina Population Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
- Lineberger Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| |
Collapse
|
19
|
Manzali SB, Yu E, Ravona-Springer R, Livny A, Golan S, Ouyang Y, Lesman-Segev O, Liu L, Ganmore I, Alkelai A, Gan-Or Z, Lin HM, Heymann A, Schnaider Beeri M, Greenbaum L. Alzheimer’s Disease Polygenic Risk Score Is Not Associated With Cognitive Decline Among Older Adults With Type 2 Diabetes. Front Aging Neurosci 2022; 14:853695. [PMID: 36110429 PMCID: PMC9468264 DOI: 10.3389/fnagi.2022.853695] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Accepted: 06/06/2022] [Indexed: 11/13/2022] Open
Abstract
ObjectivesMultiple risk loci for late-onset Alzheimer’s disease (LOAD) have been identified. Type 2 diabetes (T2D) is a risk factor for cognitive decline, dementia and Alzheimer’s disease (AD). We investigated the association of polygenic risk score (PRS) for LOAD with overall cognitive functioning and longitudinal decline, among older adults with T2D.MethodsThe study included 1046 Jewish participants from the Israel Diabetes and Cognitive Decline (IDCD) study, aged ≥ 65 years, diagnosed with T2D, and cognitively normal at baseline. The PRS included variants from 26 LOAD associated loci (at genome-wide significance level), and was calculated with and without APOE. Outcome measures, assessed in 18 months intervals, were global cognition and the specific domains of episodic memory, attention/working memory, executive functions, and language/semantic categorization. Random coefficient models were used for analysis, adjusting for demographic variables, T2D-related characteristics, and cardiovascular factors. Additionally, in a subsample of 202 individuals, we analyzed the association of PRS with the volumes of total gray matter, frontal lobe, hippocampus, amygdala, and white matter hyperintensities. Last, the association of PRS with amyloid beta (Aβ) burden was examined in 44 participants who underwent an 18F-flutemetamol PET scan.ResultsThe PRS was not significantly associated with overall functioning or decline in global cognition or any of the specific cognitive domains. Similarly, following correction for multiple testing, there was no association with Aβ burden and other brain imaging phenotypes.ConclusionOur results suggest that the cumulative effect of LOAD susceptibility loci is not associated with a greater rate of cognitive decline in older adults with T2D, and other pathways may underlie this link.
Collapse
Affiliation(s)
- Sigalit B. Manzali
- Department of Pathology, Sheba Medical Center, Tel Hashomer, Israel
- The Joseph Sagol Neuroscience Center, Sheba Medical Center, Tel Hashomer, Israel
| | - Eric Yu
- Department of Human Genetics, McGill University, Montréal, QC, Canada
- Montreal Neurological Institute, McGill University, Montréal, QC, Canada
| | - Ramit Ravona-Springer
- The Joseph Sagol Neuroscience Center, Sheba Medical Center, Tel Hashomer, Israel
- Memory Clinic, Sheba Medical Center, Tel Hashomer, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Abigail Livny
- The Joseph Sagol Neuroscience Center, Sheba Medical Center, Tel Hashomer, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Department of Diagnostic Imaging, Sheba Medical Center, Tel Hashomer, Israel
| | - Sapir Golan
- The Joseph Sagol Neuroscience Center, Sheba Medical Center, Tel Hashomer, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Yuxia Ouyang
- Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Orit Lesman-Segev
- The Joseph Sagol Neuroscience Center, Sheba Medical Center, Tel Hashomer, Israel
- Department of Diagnostic Imaging, Sheba Medical Center, Tel Hashomer, Israel
| | - Lang Liu
- Department of Human Genetics, McGill University, Montréal, QC, Canada
- Montreal Neurological Institute, McGill University, Montréal, QC, Canada
| | - Ithamar Ganmore
- The Joseph Sagol Neuroscience Center, Sheba Medical Center, Tel Hashomer, Israel
- Memory Clinic, Sheba Medical Center, Tel Hashomer, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Anna Alkelai
- Institute for Genomic Medicine, Columbia University Medical Center, New York, NY, United States
| | - Ziv Gan-Or
- Department of Human Genetics, McGill University, Montréal, QC, Canada
- Montreal Neurological Institute, McGill University, Montréal, QC, Canada
- Department of Neurology and Neurosurgery, McGill University, Montréal, QC, Canada
| | - Hung-Mo Lin
- Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Anthony Heymann
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- Maccabi Healthcare Services, Tel Aviv, Israel
| | - Michal Schnaider Beeri
- The Joseph Sagol Neuroscience Center, Sheba Medical Center, Tel Hashomer, Israel
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Lior Greenbaum
- The Joseph Sagol Neuroscience Center, Sheba Medical Center, Tel Hashomer, Israel
- Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel
- The Danek Gertner Institute of Human Genetics, Sheba Medical Center, Tel Hashomer, Israel
- *Correspondence: Lior Greenbaum,
| |
Collapse
|
20
|
Identification and Experimental Validation of Marker Genes between Diabetes and Alzheimer’s Disease. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2022; 2022:8122532. [PMID: 35996379 PMCID: PMC9391608 DOI: 10.1155/2022/8122532] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/17/2022] [Revised: 06/15/2022] [Accepted: 08/01/2022] [Indexed: 11/21/2022]
Abstract
Currently, Alzheimer's disease (AD) and type 2 diabetes mellitus (T2DM) are widely prevalent in the elderly population, and accumulating evidence implies a strong link between them. For example, patients with T2DM have a higher risk of developing neurocognitive disorders, including AD, but the exact mechanisms are still unclear. This time, by combining bioinformatics analysis and in vivo experimental validation, we attempted to find a common biological link between AD and T2DM. We firstly downloaded the gene expression profiling (AD: GSE122063; T2DM: GSE161355) derived from the temporal cortex. To find the associations, differentially expressed genes (DEGs) of the two datasets were filtered and intersected. Based on them, enrichment analysis was carried out, and the least absolute shrinkage and selection operator (LASSO) logistic regression and support vector machine-recursive feature elimination (SVM-RFE) algorithms were used to identify the specific genes. After verifying in the external dataset and in the samples from the AD and type 2 diabetes animals, the shared targets of the two diseases were finally determined. Based on them, the ceRNA networks were constructed. Besides, the logistic regression and single-sample gene set enrichment analysis (ssGSEA) were performed. As a result, 62 DEGs were totally identified between AD and T2DM, and the enrichment analysis indicated that they were much related to the function of synaptic vesicle and MAPK signaling pathway. Based on the evidence from external dataset and RT-qPCR, CARTPT, EPHA5, and SERPINA3 were identified as the marker genes in both diseases, and their clinical significance and biological functions were further analyzed. In conclusion, discovering and exploring the marker genes that are dysregulated in both 2 diseases could help us better comprehend the intrinsic relationship between T2DM and AD, which may inspire us to develop new strategies for facing the dilemmas of clinical or basic research in cognitive dysfunction.
Collapse
|
21
|
Yang J, Xu H, Li J, Zhao Y, Guan S, Fu Y, Bao R, Liu Z. The association between undiagnosed diabetes and cognitive function: findings from the China health and retirement longitudinal study. BMC Endocr Disord 2022; 22:151. [PMID: 35658946 PMCID: PMC9167534 DOI: 10.1186/s12902-022-01055-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2021] [Accepted: 05/20/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The cognitive function of people with diabetes has gained an increasing interest in recent years, and this study focuses on exploring the relationship between undiagnosed diabetes and cognitive function among the middle-aged and elderly people in China. METHODS The data came from the China Health and Retirement Longitudinal Study (CHARLS) which was conducted between July and October 2015. 9855 subjects were enrolled in the study. Executive function and episodic memory were used to assess cognitive function. The subjects were divided into three groups: no diabetes, diagnosed diabetes, and undiagnosed diabetes, and weighted multiple linear regression models were established to evaluate the association of undiagnosed diabetes with cognitive function. RESULTS After controlling for covariates, undiagnosed diabetes was statistically associated with executive function (β = -0.215, P < 0.01). In the age group of ≥65 years, undiagnosed diabetes was statistically associated with executive function (β = -0.358, P < 0.01) and episodic memory (β = -0.356, P < 0.01). When adjusting for confounders, no statistically significant associations were found between diagnosed diabetes and cognitive function except in 45-54 age group (β = 0.374, P < 0.05). CONCLUSIONS The cross-sectional study suggested that undiagnosed diabetes was linked to poor cognitive function, especially in the elderly population. Timely diagnosis and active treatment of diabetes are important to reduce the occurrence of cognitive impairment. Further prospective cohort studies are required to articulate the association between undiagnosed diabetes and cognitive function.
Collapse
Affiliation(s)
- Jiafei Yang
- Department of Epidemiology and Health Statistics, School of Public Health and Management, Ningxia Medical University, Yinchuan, 750004, Ningxia Hui Autonomous Region, China
- Research Center of Health Big Data, Key Laboratory of Environmental Factors and Chronic Disease Control, Yinchuan, 750004, Ningxia Hui Autonomous Region, China
| | - Haiming Xu
- Research Center of Health Big Data, Key Laboratory of Environmental Factors and Chronic Disease Control, Yinchuan, 750004, Ningxia Hui Autonomous Region, China
- Department of Occupational and Environmental Health, School of Public Health and Management, Ningxia Medical University, Yinchuan, 750004, China
| | - Jiangping Li
- Department of Epidemiology and Health Statistics, School of Public Health and Management, Ningxia Medical University, Yinchuan, 750004, Ningxia Hui Autonomous Region, China
- Research Center of Health Big Data, Key Laboratory of Environmental Factors and Chronic Disease Control, Yinchuan, 750004, Ningxia Hui Autonomous Region, China
| | - Yu Zhao
- Department of Epidemiology and Health Statistics, School of Public Health and Management, Ningxia Medical University, Yinchuan, 750004, Ningxia Hui Autonomous Region, China
- Research Center of Health Big Data, Key Laboratory of Environmental Factors and Chronic Disease Control, Yinchuan, 750004, Ningxia Hui Autonomous Region, China
| | - Suzhen Guan
- Research Center of Health Big Data, Key Laboratory of Environmental Factors and Chronic Disease Control, Yinchuan, 750004, Ningxia Hui Autonomous Region, China
- Department of Occupational and Environmental Health, School of Public Health and Management, Ningxia Medical University, Yinchuan, 750004, China
| | - Youjuan Fu
- Department of Occupational and Environmental Health, School of Public Health and Management, Ningxia Medical University, Yinchuan, 750004, China
| | - Rui Bao
- Department of Occupational and Environmental Health, School of Public Health and Management, Ningxia Medical University, Yinchuan, 750004, China
| | - Zhihong Liu
- Research Center of Health Big Data, Key Laboratory of Environmental Factors and Chronic Disease Control, Yinchuan, 750004, Ningxia Hui Autonomous Region, China.
- Department of Occupational and Environmental Health, School of Public Health and Management, Ningxia Medical University, Yinchuan, 750004, China.
| |
Collapse
|
22
|
Fan S, Song R. Beneficial Effects of Tofacitinib in Long-Standing Diabetes-Induced Cognitive Impairment in Rats through BDNF-TNF-α-Nrf2 Signalling Pathway. INT J PHARMACOL 2022. [DOI: 10.3923/ijp.2022.856.863] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
|
23
|
Faaitiiti KL, Jupiter DC. Diabetes-Specific Dementia: A Structured Literature Review of Cognitive Assessment Methods. J Foot Ankle Surg 2022; 61:401-409. [PMID: 34893425 PMCID: PMC8936078 DOI: 10.1053/j.jfas.2021.11.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Accepted: 11/08/2021] [Indexed: 02/03/2023]
Abstract
Diabetes mellitus is a known risk factor for the development of multiple subtypes of dementia and mild cognitive impairment. Recent research identifies a cause-specific diabetes-related dementia with a unique set of characteristics. Currently, there is no standard cognitive assessment battery recommended to specifically assess dementia that is a direct consequence of chronic diabetes, and some evaluations have been used for decades with minimal revisions, regardless of appropriateness. We performed a systematic review of the dementia/cognition evaluation methods most commonly used in the literature for assessing diabetic patients and identified which cognitive domains are typically assessed in this setting, and whether cognitive changes were more reflective of a vascular pathology, Alzheimer's pathology, or something else entirely. Search results yielded 1089 articles. After screening for appropriateness, a total of 11 full-text articles were assessed. In general, subjects in the reviewed studies were assessed using a variety of testing methods, examining different combinations of cognitive domains. A standard, clear definition of which cognitive domains are the most important to assess in diabetic patients is needed in order to determine what combination of assessment tools are most pertinent. Given the growing subset of the US population, careful reconsideration of cognitive assessment methods is needed to create self-care plans that take into account a specific collection of cognitive challenges for those with diabetes.
Collapse
Affiliation(s)
- Kelli L Faaitiiti
- Medical Student, School of Medicine, The University of Texas Medical Branch, Galveston, TX
| | - Daniel C Jupiter
- Associate Professor, Department of Preventive Medicine and Population Health, The University of Texas Medical Branch, Galveston, TX; Associate Professor, Department of Orthopaedic Surgery and Rehabilitation, The University of Texas Medical Branch, Galveston, TX.
| |
Collapse
|
24
|
Shen J, Li J, Hua Y, Ding B, Zhou C, Yu H, Xiao R, Ma W. Association between the Erythrocyte Membrane Fatty Acid Profile and Cognitive Function in the Overweight and Obese Population Aged from 45 to 75 Years Old. Nutrients 2022; 14:nu14040914. [PMID: 35215564 PMCID: PMC8878599 DOI: 10.3390/nu14040914] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Revised: 02/11/2022] [Accepted: 02/13/2022] [Indexed: 12/21/2022] Open
Abstract
Dietary fatty acid intake is closely related to the cognitive function of the overweight and obese population. However, few studies have specified the correlation between exact fatty acids and cognitive functions in different body mass index (BMI) groups. We aimed to explain these relationships and reference guiding principles for the fatty acid intake of the overweight and obese population. Normal weight, overweight, and obese participants were recruited to receive a cognitive function assessment and dietary survey, dietary fatty acids intake was calculated, and the erythrocyte membrane fatty acid profile was tested by performing a gas chromatography analysis. The percentages of saturated fatty acids (SFAs) in the obese group were higher, while monounsaturated fatty acids (MUFAs) and polyunsaturated fatty acids (PUFAs) were lower than in the normal weight and overweight groups. In the erythrocyte membrane, the increase of n-3 PUFAs was accompanied by cognitive decline in the overweight group, which could be a protective factor for cognitive function in the obese group. High n-6 PUFAs intake could exacerbate the cognitive decline in the obese population. Dietary fatty acid intake had different effects on the cognitive function of overweight and obese people, especially the protective effect of n-3 PUFAs; more precise dietary advice is needed to prevent cognitive impairment.
Collapse
Affiliation(s)
- Jingyi Shen
- School of Public Health, Beijing Key Laboratory of Environmental Toxicology, Capital Medical University, Beijing 100069, China; (J.S.); (J.L.); (Y.H.); (C.Z.); (H.Y.); (R.X.)
| | - Jinchen Li
- School of Public Health, Beijing Key Laboratory of Environmental Toxicology, Capital Medical University, Beijing 100069, China; (J.S.); (J.L.); (Y.H.); (C.Z.); (H.Y.); (R.X.)
| | - Yinan Hua
- School of Public Health, Beijing Key Laboratory of Environmental Toxicology, Capital Medical University, Beijing 100069, China; (J.S.); (J.L.); (Y.H.); (C.Z.); (H.Y.); (R.X.)
| | - Bingjie Ding
- Department of Clinical Nutrition, Beijing Friendship Hospital, Capital Medical University, Beijing 100050, China;
| | - Cui Zhou
- School of Public Health, Beijing Key Laboratory of Environmental Toxicology, Capital Medical University, Beijing 100069, China; (J.S.); (J.L.); (Y.H.); (C.Z.); (H.Y.); (R.X.)
| | - Huiyan Yu
- School of Public Health, Beijing Key Laboratory of Environmental Toxicology, Capital Medical University, Beijing 100069, China; (J.S.); (J.L.); (Y.H.); (C.Z.); (H.Y.); (R.X.)
| | - Rong Xiao
- School of Public Health, Beijing Key Laboratory of Environmental Toxicology, Capital Medical University, Beijing 100069, China; (J.S.); (J.L.); (Y.H.); (C.Z.); (H.Y.); (R.X.)
| | - Weiwei Ma
- School of Public Health, Beijing Key Laboratory of Environmental Toxicology, Capital Medical University, Beijing 100069, China; (J.S.); (J.L.); (Y.H.); (C.Z.); (H.Y.); (R.X.)
- Correspondence:
| |
Collapse
|
25
|
Kan J, Cheng J, Hu C, Chen L, Liu S, Venzon D, Murray M, Li S, Du J. A Botanical Product Containing Cistanche and Ginkgo Extracts Potentially Improves Chronic Fatigue Syndrome Symptoms in Adults: A Randomized, Double-Blind, and Placebo-Controlled Study. Front Nutr 2021; 8:658630. [PMID: 34901100 PMCID: PMC8662561 DOI: 10.3389/fnut.2021.658630] [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] [Received: 01/26/2021] [Accepted: 11/04/2021] [Indexed: 11/13/2022] Open
Abstract
Dietary therapy may be beneficial in alleviating symptoms of chronic fatigue syndrome (CFS), a disorder that is characterized by extreme fatigue and other symptoms, but the cause of which remains unclear. The aim of this study was to evaluate the protective effect of a botanical product containing cistanche (Cistanche tubulosa [Schenk] Wight) and ginkgo (Ginkgo biloba L.) extracts on adults with CFS in a randomized, double-blind, placebo-controlled clinical trial. A total of 190 subjects (35-60 years old, non-obese) with CFS were randomized to receive one tablet of a low dose (120-mg ginkgo and 300-mg cistanche), a high dose (180-mg ginkgo and 450-mg cistanche) or a placebo once daily for 60 days. Blood samples and responses on the Chalder fatigue scale (CFQ 11), the World Health Organization's quality of life questionnaire (WHOQOL), and the sexual life quality questionnaire (SLQQ) were collected at baseline and post-intervention. CFS symptoms of impaired memory or concentration, physical fatigue, unrefreshing sleep, and post-exertional malaise were significantly improved (p < 0.001) in both of the treatment groups. The botanical intervention significantly decreased physical and mental fatigue scores of CFQ 11 and improved WHOQOL and SLQQ scores of the subjects (p < 0.01). Levels of blood ammonia and lactic acid in the treatment groups were significantly lower than those of the placebo group (low-dose: p < 0.05; high-dose: p < 0.01). In addition, the change in lactic acid concentration was negatively associated with the severity of CFS symptoms (p = 0.0108) and was correlated with the change in total physical fatigue score of the CFQ (p = 0.0302). Considering the trivial effect size, the results may lack clinical significance. In conclusion, this botanical product showed promising effects in ameliorating the symptoms of CFS. Clinical trials with improved assessment tools, an expanded sample size, and an extended follow-up period are warranted to further validate the findings. Clinical Trial Registration: https://clinicaltrials.gov/, identifier: NCT02807649.
Collapse
Affiliation(s)
- Juntao Kan
- Nutrilite Health Institute, Shanghai, China
| | - Junrui Cheng
- Nutrilite Health Institute, Shanghai, China
- Plants for Human Health Institute, North Carolina State University, Kannapolis, NC, United States
| | - Chun Hu
- Nutrilite Health Institute, Buena Park, CA, United States
| | - Liang Chen
- Nutrilite Health Institute, Shanghai, China
| | - Siyu Liu
- Nutrilite Health Institute, Shanghai, China
| | - Dawna Venzon
- Nutrilite Health Institute, Buena Park, CA, United States
| | - Mary Murray
- Nutrilite Health Institute, Buena Park, CA, United States
| | - Shuguang Li
- School of Public Health, Fudan University, Shanghai, China
| | - Jun Du
- Nutrilite Health Institute, Shanghai, China
| |
Collapse
|
26
|
Fu X, Wang J, Zhang P, Du H, Wu S, Zhang H, Xiong W. Diagnosis of TCM symptoms and analysis of risk factors of mild cognitive impairment in patients with type 2 diabetes mellitus. Am J Transl Res 2021; 13:12980-12987. [PMID: 34956514 PMCID: PMC8661213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Accepted: 09/13/2021] [Indexed: 06/14/2023]
Abstract
OBJECTIVE To explore the diagnosis of traditional Chinese medicine (TCM) syndrome and analyze the risk factors of mild cognitive impairment (MCI) in patients with type 2 diabetes mellitus (T2DM). METHODS 141 T2DM patients, who were hospitalized in department of endocrinology of our hospital from February 2020 to December 2020, were chosen as research subjects. The patients were divided into an observation group (n=65, T2DM with MCI) and a control group (n=76, T2DM with normal cognitive function) according to the Montreal Cognitive Assessment (MoCA) score and diagnostic criteria of MCI. Pearson correlation analysis was used to study the correlation between MoCA score and influencing factors, and multiple logistic regression analyses were applied to analyze the risk factors of T2DM patients. RESULTS Deficiency of kidney essence (34/65, 52.31%) and phlegm obstructing orifices (16/65, 2.62%) were common in T2DM patients with MCI. The observation group had apparently lower MoCA scores than the control group (23.46±3.12 points vs. 27.39±2.56 points, t=8.2150, P=0.0000). According to the results of multivariate logistic regression analysis, age, course of diabetes, homocysteine (HCY) and glycosylated hemoglobin (HbAlc) were the independent risk factors of MCI, and the education level was a protective factor. CONCLUSION Mental deficiency and phlegm obstruction are common in T2DM patients complicated with MCI. The factors such as age, diabetes course, education degree, HCY and HbAlc are closely related to MCI. The occurrence of MCI in T2DM patients can be prevented by improving the education degree of patients, effective control of blood glucose and reduction of HCY level.
Collapse
Affiliation(s)
- Xudong Fu
- Department of Health Medicine, Liaocheng People’s HospitalLiaocheng 252000, Shandong, China
| | - Jiajia Wang
- Department of Endocrinology, Gaotang County People’s HospitalGaotang 252800, Shandong, China
| | - Ping Zhang
- Department of Gynecology, Zhangqiu District People’s HospitalJinan 252200, Shandong, China
| | - Hongquan Du
- Department of Endocrinology, Liaocheng People’s HospitalLiaocheng 252000, Shandong, China
| | - Suqin Wu
- Department of Endocrinology, Heze City Chinese Medicine HospitalHeze 274000, Shandong, China
| | - Haiqing Zhang
- Department of Endocrinology, Shandong First Medical University Affiliated Provincial Hospital, Shandong University Affiliated Provincial HospitalJinan 250021, Shandong, China
| | - Wen Xiong
- Endocrine and Metabolic Diseases Hospital of Shandong First Medical University, Shandong First Medical University & Shandong Academy of Medical SciencesJinan 250062, Shandong, China
| |
Collapse
|
27
|
Roh M, Dan H, Kim O. Influencing Factors of Subjective Cognitive Impairment in Middle-Aged and Older Adults. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph182111488. [PMID: 34770002 PMCID: PMC8583411 DOI: 10.3390/ijerph182111488] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Revised: 10/28/2021] [Accepted: 10/29/2021] [Indexed: 11/25/2022]
Abstract
The purpose of this study was to identify the factors affecting subjective cognitive impairment. We analyzed data from the 2019 Korea Community Health Survey and enrolled 68,546 middle-aged adults, aged 50 to 64 years, and 74,547 older adults, aged 65 years and older, in this study. Multiple logistic regression analysis was performed to identify factors influencing subjective cognitive impairment. Of the participants, 11,926 (17.4%) middle-aged and 21,880 (29.4%) older adults living in the community reported subjective cognitive impairment. Major factors that influenced subjective cognitive impairment in both middle-aged and older adults were gender, subjective stress, depressive symptoms, and alcohol drinking. In contrast to middle-aged adults, the marital status of older adults affected subjective cognitive impairment. Therefore, the factors affecting subjective cognitive impairment in middle-aged and older adults need to be considered for screening and management to prevent cognitive impairment and dementia. In particular, it is necessary to evaluate and manage stress and depressive symptoms from middle age to prevent subjective cognitive impairment.
Collapse
Affiliation(s)
| | | | - Oksoo Kim
- Correspondence: ; Tel.: +82-02-3277-3703
| |
Collapse
|
28
|
Abstract
Diabetes is one of the most common disease states in older adults and there are significant risks to the use of antidiabetic medications. The older adult population varies greatly in functional ability, independence, and cognition. These factors, along with increased risk of hypoglycemia, falls, and other comorbidities, add to the complexity of creating medication regimens to treat diabetes in older adults. In the current review, a person-centered approach to diabetes care in older adults is described to aid clinician decision making. By keeping the patient and their individual factors in the center of the decision, risks of over- or under-treating diabetes can be minimized. The review will discuss person-centered goal setting, practical approaches to diabetes medication management, and specific considerations for choosing medication classes based on patient characteristics. [Journal of Gerontological Nursing, 47(10), 7-13.].
Collapse
|
29
|
Komici K, Femminella GD, Bencivenga L, Rengo G, Pagano G. Diabetes Mellitus and Parkinson's Disease: A Systematic Review and Meta-Analyses. JOURNAL OF PARKINSONS DISEASE 2021; 11:1585-1596. [PMID: 34486987 DOI: 10.3233/jpd-212725] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
BACKGROUND A link between diabetes mellitus (DM) and Parkinson's disease (PD) have been proposed but evidence are sparse and inconsistent. OBJECTIVE Perform a systematic review of all evidence that link DM and PD characterising the prevalence of DM in PD patients, the risk of developing PD in DM patients and the influence of DM on PD severity and progression. METHODS MEDLINE, Scopus, and Cochrane Library from inception to June 30, 2021 were searched. Studies reporting prevalence, incidence, severity and disease progression of DM and PD were included. Prevalence of DM in PD and incidence of PD in DM patients, and characteristics of PD. RESULTS A total of 21 studies (n = 11,396) included data on DM prevalence in PD patients, 12 studies (n = 17,797,221) included data on incidence of PD in DM patients, and 10 studies (n = 2,482) included data on DM impact on PD severity and disease progression. The prevalence of DM in PD patients was 10.02 %, (95%C.I. 7.88 -12.16), DM patients showed a higher risk of developing PD (OR: 1.34 95%CI 1.26-1.43 p < 0.0001) compared to non-DM, and PD patients with DM showed a greater severity of motor symptoms, with higher Hoehn and Yahr stage (SMD: 0.36 95%CI 0.12-0.60; p < 0.001) and higher UPDRS (SMD 0.60 95%CI 0.28-0.92; p < 0.001) compared with PD patients without DM. CONCLUSION Although the prevalence of DM in PD patients is similar to the general population, patients with DM have a higher risk of developing PD, and the presence of DM is associated with greater PD severity and faster progression, which suggests that DM may be a facilitating factor of neurodegeneration.
Collapse
Affiliation(s)
- Klara Komici
- Department of Medicine and Health Sciences, University of Molise, Campobasso, Italy
| | | | - Leonardo Bencivenga
- Department of Translational Medical Sciences, University of Naples "Federico II", Naples, Italy.,Department of Advanced Biomedical Sciences, University of Naples "Federico II", Naples, Italy
| | - Giuseppe Rengo
- Department of Translational Medical Sciences, University of Naples "Federico II", Naples, Italy.,Istituti Clinici Scientifici Maugeri SpA Società Benefit (ICS Maugeri SpA SB), Scientific Institute of Telese Terme, Telese Terme (BN), Italy
| | - Gennaro Pagano
- King's College London, London, UK.,Roche Pharma Research and Early Development (pRED), Neuroscience and Rare Diseases Discovery and Translational Area, Roche Innovation Center, Basel, Switzerland
| |
Collapse
|
30
|
Bi T, Feng R, Zhan L, Ren W, Lu X. ZiBuPiYin Recipe Prevented and Treated Cognitive Decline in ZDF Rats With Diabetes-Associated Cognitive Decline via Microbiota-Gut-Brain Axis Dialogue. Front Cell Dev Biol 2021; 9:651517. [PMID: 34485269 PMCID: PMC8416319 DOI: 10.3389/fcell.2021.651517] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2021] [Accepted: 07/07/2021] [Indexed: 11/13/2022] Open
Abstract
Gut microbiota is becoming one of the key determinants in human health and disease. Shifts in gut microbiota composition affect cognitive function and provide new insights for the prevention and treatment of neurological diseases. Diabetes-associated cognitive decline (DACD) is one of the central nervous system complications of type 2 diabetes mellitus (T2DM). ZiBuPiYin recipe (ZBPYR), a traditional Chinese medicine (TCM) formula, has long been used for the treatment of T2DM and prevention of DACD. However, the contribution of ZBPYR treatment to the interaction between the gut microbiota and metabolism for preventing and treating DACD remains to be clarified. Here, we investigate whether the gut microbiota plays a key role in ZBPYR-mediated prevention of DACD and treatment of T2DM via incorporating microbiomics and metabolomics, and investigate the links between the microbiota-gut-brain axis interaction and the efficacy of ZBPYR in ZDF rats. In the current study, we found that ZBPYR treatment produced lasting changes in gut microbiota community and metabolites and remotely affected hippocampus metabolic changes, thereby improving memory deficits and reversing β-amyloid deposition and insulin resistance in the brain of ZDF rats from T2DM to DACD. This may be related to a series of metabolic changes affected by gut microbiota, including alanine, aspartic acid, and glutamic acid metabolism; branched-chain amino acid metabolism; short-chain fatty acid metabolism; and linoleic acid/unsaturated fatty acid metabolism. In summary, this study demonstrates that prevention and treatment of DACD by ZBPYR partly depends on the gut microbiota, and the regulatory effects of bacteria-derived metabolites and microbiota-gut-brain axis are important protective mechanisms of ZBPYR.
Collapse
Affiliation(s)
- Tingting Bi
- School of Traditional Chinese Medicine and School of Integrated Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing, China.,Jiangsu Collaborative Innovation Center of Chinese Medicinal Resources Industrialization, Nanjing University of Chinese Medicine, Nanjing, China
| | - Ruiqi Feng
- School of Traditional Chinese Medicine and School of Integrated Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing, China
| | - Libin Zhan
- School of Traditional Chinese Medicine and School of Integrated Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing, China.,Jiangsu Collaborative Innovation Center of Chinese Medicinal Resources Industrialization, Nanjing University of Chinese Medicine, Nanjing, China
| | - Weiming Ren
- School of Traditional Chinese Medicine and School of Integrated Chinese and Western Medicine, Nanjing University of Chinese Medicine, Nanjing, China
| | - Xiaoguang Lu
- Department of Emergency Medicine, Zhongshan Hospital, Dalian University, Dalian, China
| |
Collapse
|
31
|
Zhu Y, Fang C, Zhang Q, Lu Y, Zhang R, Wang A, Bu X, Zhang J, Ju Z, Zhang Y, Xu T, Zhong C. Soluble ST2 and risk of cognitive impairment after acute ischemic stroke: a prospective observational study. BMC Geriatr 2021; 21:330. [PMID: 34030636 PMCID: PMC8142507 DOI: 10.1186/s12877-021-02288-6] [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: 02/01/2021] [Accepted: 05/10/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Soluble suppression of tumorigenesis-2 (sST2) was reported to be associated with cognitive performance and risk of incident stroke. However, the impact of sST2 on cognitive function after ischemic stroke is unclear. We aimed to assess the association of sST2 and cognitive impairment at 3 months in acute ischemic stroke patients. METHODS Baseline plasma sST2 levels were measured in 619 ischemic stroke patients (mean age: 60.0 ± 10.5 years) from 7 participating hospitals of the China Antihypertensive Trial in Acute Ischemic Stroke. Montreal Cognitive Assessment (MoCA) and Mini-Mental State Examination (MMSE) were used to assess cognitive status. Cognitive impairment was defined as a MoCA score < 23 or MMSE score < 27. The association between sST2 and cognitive impairment was evaluated by logistic regression analysis. RESULTS 325 (52.5%) or 323 (52.2%) participants developed cognitive impairment according to MoCA or MMSE. After adjustment for age, sex, education, and other covariates, the odds ratio for the highest vs lowest quartile of sST2 was 2.38 (95% CI, 1.42-4.00) and 1.82 (95% CI 1.09-3.03) risk of cognitive impairment defined by MoCA and MMSE score, respectively. Incorporation sST2 into a model containing conventional risk factors significantly improved reclassification. CONCLUSIONS Elevated plasma sST2 levels were significantly associated with post-stroke cognitive impairment.
Collapse
Affiliation(s)
- Yinwei Zhu
- Department of Epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Medical College of Soochow University, 199 Renai Road, Industrial Park District, Suzhou, 215123, Jiangsu Province, China
| | - Chongquan Fang
- Department of Epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Medical College of Soochow University, 199 Renai Road, Industrial Park District, Suzhou, 215123, Jiangsu Province, China
| | - Qi Zhang
- Department of Epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Medical College of Soochow University, 199 Renai Road, Industrial Park District, Suzhou, 215123, Jiangsu Province, China
| | - Yaling Lu
- Department of Epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Medical College of Soochow University, 199 Renai Road, Industrial Park District, Suzhou, 215123, Jiangsu Province, China
| | - Rui Zhang
- Department of Epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Medical College of Soochow University, 199 Renai Road, Industrial Park District, Suzhou, 215123, Jiangsu Province, China
| | - Aili Wang
- Department of Epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Medical College of Soochow University, 199 Renai Road, Industrial Park District, Suzhou, 215123, Jiangsu Province, China
| | - Xiaoqing Bu
- Department of Epidemiology, School of Public Health, Chongqing Medical University, Chongqing, China
| | - Jintao Zhang
- Department of Neurology, The 88th Hospital of PLA, Taian, Shandong, China
| | - Zhong Ju
- Department of Neurology, Kerqin District First People's Hospital of Tongliao City, Tongliao, Inner Mongolia, China
| | - Yonghong Zhang
- Department of Epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Medical College of Soochow University, 199 Renai Road, Industrial Park District, Suzhou, 215123, Jiangsu Province, China
| | - Tan Xu
- Department of Epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Medical College of Soochow University, 199 Renai Road, Industrial Park District, Suzhou, 215123, Jiangsu Province, China.
| | - Chongke Zhong
- Department of Epidemiology, School of Public Health and Jiangsu Key Laboratory of Preventive and Translational Medicine for Geriatric Diseases, Medical College of Soochow University, 199 Renai Road, Industrial Park District, Suzhou, 215123, Jiangsu Province, China.
| |
Collapse
|
32
|
De La Garza R, Rodrigo H, Fernandez F, Roy U. The Increase of HIV-1 Infection, Neurocognitive Impairment, and Type 2 Diabetes in The Rio Grande Valley. Curr HIV Res 2021; 17:377-387. [PMID: 31663481 DOI: 10.2174/1570162x17666191029162235] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2019] [Revised: 10/17/2019] [Accepted: 10/26/2019] [Indexed: 12/15/2022]
Abstract
The Human Immunodeficiency Virus (HIV-1) infection remains a persistent predicament for the State of Texas, ranking seventh among the most documented HIV cases in the United States. In this regard, the Rio Grande Valley (RGV) in South Texas is considered as one of the least investigated areas of the state with respect to HIV infection and HIV associated comorbidities. Considering the 115% increase in average HIV incidence rates per 100,000 within the RGV from 2007-2015, it is worth characterizing this population with respect to their HIV-1 infection, HIV-1 Associated Neurocognitive Disorders (HAND), and the association of treatment with combined antiretroviral therapy (cART). Moreover, the increased rate of Type-2 Diabetes (T2D) in the RGV population is intertwined with that of HIV-1 infection facing challenges due to the lack of knowledge about prevention to inadequate access to healthcare. Hence, the role of T2D in the development of HAND among the people living with HIV (PLWH) in the RGV will be reviewed to establish a closer link between T2D and HAND in cART-treated patients of the RGV.
Collapse
Affiliation(s)
- Roberto De La Garza
- Department of Health and Biomedical Sciences, University of Texas Rio Grande Valley, Brownsville, Texas, United States
| | - Hansapani Rodrigo
- School of Mathematical and Statistical Sciences, University of Texas Rio Grande Valley, Edinburg, Texas, United States
| | - Francisco Fernandez
- Department of Psychiatry, School of Medicine, University of Texas Rio Grande Valley, Harlingen, Texas, United States
| | - Upal Roy
- Department of Health and Biomedical Sciences, University of Texas Rio Grande Valley, Brownsville, Texas, United States
| |
Collapse
|
33
|
Domergue H, Regueme SC, Zafra OL, Manaz-Rodriguez L, Sinclair A, Bourdel-Marchasson I. Gait Speed and Evolution of Verbal Fluencies in Frail or Prefrail Older People with Type 2 Diabetes. A Pilot Study. J Nutr Health Aging 2021; 25:802-807. [PMID: 34179937 DOI: 10.1007/s12603-021-1636-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
OBJECTIVES Type 2 diabetes (T2D) is a risk factor of frailty and cognitive impairment. Impaired gait in older people is associated with incident vascular dementia. We aimed to assess whether in frail or prefrail older subjects with T2D, lower gait speed can be associated with faster cognitive decline. DESIGN Case-control study nested in a large randomized control trial (RCT, MID-frail); post hoc analysis. SETTING AND PARTICIPANTS Older frail and prefrail subjects (>70y) with T2D and with no history of cognitive problems were enrolled in a single recruiting center. Participants were divided into two groups depending on their walking speed - above (fast walkers) or below (slow walkers) using a cut off of 1 m/sec. MEASURE Cognitive function was assessed at baseline and during follow-up with the MMSE, category and letter fluencies at 15 sec (initiation) and 15-60 sec (late). RESULTS 48 subjects were included, 22 were fast walkers, 26 were slow walkers. The mean follow-up was 60.9 (SD 17.5) weeks. The baseline 0-15 sec letter fluency was higher in fast walkers (p=0.008). There was no difference at baseline with MMSE scores and category fluency. The MID-Frail intervention did not change the evolution of any cognitive changes. Comparisons were adjusted for age, sex and baseline performance, and showed a steeper decline of category fluency score in slow walkers (fast walkers +0.04 (-1.49 to1.56) compared with -0.89 (-2.15 to 0.38), p=0.049) with a moderate effect size. CONCLUSION In frail or prefrail older adults with diabetes, we observed a decline in category fluency in those with low gait speed.
Collapse
Affiliation(s)
- H Domergue
- Professor Isabelle Bourdel-Marchasson, Centre Henri Choussat, Hôpital Xavier Arnozan, 33604 Pessac cedex, France, tel: 33 (0)5 57 65 65 71, fax 33 (0)5 57 65 62 26,
| | | | | | | | | | | |
Collapse
|
34
|
Krivanek TJ, Gale SA, McFeeley BM, Nicastri CM, Daffner KR. Promoting Successful Cognitive Aging: A Ten-Year Update. J Alzheimers Dis 2021; 81:871-920. [PMID: 33935078 PMCID: PMC8293659 DOI: 10.3233/jad-201462] [Citation(s) in RCA: 59] [Impact Index Per Article: 19.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/18/2021] [Indexed: 02/07/2023]
Abstract
A decade has passed since we published a comprehensive review in this journal addressing the topic of promoting successful cognitive aging, making this a good time to take stock of the field. Because there have been limited large-scale, randomized controlled trials, especially following individuals from middle age to late life, some experts have questioned whether recommendations can be legitimately offered about reducing the risk of cognitive decline and dementia. Despite uncertainties, clinicians often need to at least make provisional recommendations to patients based on the highest quality data available. Converging lines of evidence from epidemiological/cohort studies, animal/basic science studies, human proof-of-concept studies, and human intervention studies can provide guidance, highlighting strategies for enhancing cognitive reserve and preventing loss of cognitive capacity. Many of the suggestions made in 2010 have been supported by additional research. Importantly, there is a growing consensus among major health organizations about recommendations to mitigate cognitive decline and promote healthy cognitive aging. Regular physical activity and treatment of cardiovascular risk factors have been supported by all of these organizations. Most organizations have also embraced cognitively stimulating activities, a heart-healthy diet, smoking cessation, and countering metabolic syndrome. Other behaviors like regular social engagement, limiting alcohol use, stress management, getting adequate sleep, avoiding anticholinergic medications, addressing sensory deficits, and protecting the brain against physical and toxic damage also have been endorsed, although less consistently. In this update, we review the evidence for each of these recommendations and offer practical advice about behavior-change techniques to help patients adopt brain-healthy behaviors.
Collapse
Affiliation(s)
- Taylor J. Krivanek
- Center for Brain/Mind Medicine, Department of Neurology, Brigham and Women’s Hospital, Harvard Medical School, Hale Building for Transformative Medicine, Boston, MA, USA
| | - Seth A. Gale
- Center for Brain/Mind Medicine, Department of Neurology, Brigham and Women’s Hospital, Harvard Medical School, Hale Building for Transformative Medicine, Boston, MA, USA
| | - Brittany M. McFeeley
- Center for Brain/Mind Medicine, Department of Neurology, Brigham and Women’s Hospital, Harvard Medical School, Hale Building for Transformative Medicine, Boston, MA, USA
| | - Casey M. Nicastri
- Center for Brain/Mind Medicine, Department of Neurology, Brigham and Women’s Hospital, Harvard Medical School, Hale Building for Transformative Medicine, Boston, MA, USA
| | - Kirk R. Daffner
- Center for Brain/Mind Medicine, Department of Neurology, Brigham and Women’s Hospital, Harvard Medical School, Hale Building for Transformative Medicine, Boston, MA, USA
| |
Collapse
|
35
|
Shi L, Zhang R, Li T, Han X, Yuan N, Jiang L, Zhou H, Xu S. Decreased miR-132 plays a crucial role in diabetic encephalopathy by regulating the GSK-3β/Tau pathway. Aging (Albany NY) 2020; 13:4590-4604. [PMID: 33406505 PMCID: PMC7906212 DOI: 10.18632/aging.202418] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Accepted: 11/10/2020] [Indexed: 12/12/2022]
Abstract
Diabetic encephalopathy (DE) is a global concern and Gordian knot worldwide. miRNA-132 (miR-132) is a class of negative gene regulators that promote diabetic pathologic mechanisms and its complications. However, the molecular mechanisms of miR-132 in DE are elusive, thus an alternative therapeutic strategy is urgently in demand. The present study explored the protective effect and the underlying mechanism of miR-132 on DE via the GSK-β/Tau signaling pathway. Experimentally, a type 2 DM rat model was developed by incorporating a high-fat diet and streptozotocin injection. Further, the DE model was screened via the Morris Water Maze test. Primary hippocampal neurons and HT-22 cells were used for in vitro analysis. We found that hyperglycemia exacerbates cognitive impairment in T2DM rats. When we isolated the primary hippocampus neurons, the expression of miR-132 RNA was low in both the DE hippocampus and primary neurons. GSK-3β and Tau 404 were highly expressed in injured HT-22 cells and diabetic hippocampal tissues. miR-132 downregulated the expression of GSK-3β. Besides, a binding and colocalized relationship between GSK3β and Tau was also reported. These findings suggest that miR-132 exerts protective effects from DE injury by repressing GSK-3β expression and alleviating Tau hyperphosphorylation in HT-22 cells and hippocampus tissues.
Collapse
Affiliation(s)
- Li Shi
- Department of Endocrinology, The First Hospital of Hebei Medical University, Shijiazhuang 050000, China.,Central Laboratory, The First Hospital of Hebei Medical University, Shijiazhuang 050000, China.,Department of Endocrinology, The First Affiliated Hospital of Hebei North University, Zhangjiakou 075000, China
| | - Rui Zhang
- Central Laboratory, The First Hospital of Hebei Medical University, Shijiazhuang 050000, China.,Hebei Key Laboratory of Brain Science and Psychiatric-Psychologic Disease, Shijiazhuang 075000, China.,Hebei International Joint Research Center for Brain Science, Shijiazhuang 075000, China
| | - Tian Li
- School of Basic Medicine, The Fourth Military Medical University, Xi'an 710032, China
| | - Xue Han
- Department of General Practice, Xingtai People's Hospital, Xingtai 054000, China
| | - Nannan Yuan
- Central Laboratory, The First Hospital of Hebei Medical University, Shijiazhuang 050000, China.,Hebei Key Laboratory of Brain Science and Psychiatric-Psychologic Disease, Shijiazhuang 075000, China.,Hebei International Joint Research Center for Brain Science, Shijiazhuang 075000, China
| | - Lei Jiang
- Central Laboratory, The First Hospital of Hebei Medical University, Shijiazhuang 050000, China.,Hebei Key Laboratory of Brain Science and Psychiatric-Psychologic Disease, Shijiazhuang 075000, China.,Hebei International Joint Research Center for Brain Science, Shijiazhuang 075000, China
| | - Huimin Zhou
- Department of Endocrinology, The First Hospital of Hebei Medical University, Shijiazhuang 050000, China.,Hebei Key Laboratory of Brain Science and Psychiatric-Psychologic Disease, Shijiazhuang 075000, China.,Hebei International Joint Research Center for Brain Science, Shijiazhuang 075000, China
| | - Shunjiang Xu
- Central Laboratory, The First Hospital of Hebei Medical University, Shijiazhuang 050000, China.,Hebei Key Laboratory of Brain Science and Psychiatric-Psychologic Disease, Shijiazhuang 075000, China.,Hebei International Joint Research Center for Brain Science, Shijiazhuang 075000, China
| |
Collapse
|
36
|
Naguib R, Soliman ES, Neimatallah FM, AlKhudhairy NS, ALGhamdi AM, Almosa RS, Aldashash KA, Alkhalifah BY, Elmorshedy H. Cognitive impairment among patients with diabetes in Saudi Arabia: a cross-sectional study. MIDDLE EAST CURRENT PSYCHIATRY 2020. [DOI: 10.1186/s43045-020-00058-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
The incidence of cognitive impairment (CI) is higher in patients with diabetes mellitus (DM). The association between DM and CI and the risk factors for CI need to be addressed to estimate the prevalence of cognitive impairment in patients with DM and to identify the potential risk factors. The study is a cross-sectional study using a convenient sample of 269 subjects. Sociodemographic diabetes-related variables including biochemical markers were collected. CI and diabetes-related distress (DRD) were assessed using the Arabic version of Montreal Cognitive Assessment scale (MoCA) and the Diabetes Distress Screening Scale respectively.
Results
Overall, 80.3% had cognitive impairment while 33.8% had severe impairment. Older age, female gender, low level of education, and low income were associated with CI; duration of diabetes and DRD were associated with CI while ophthalmic complications were associated with severe CI. Duration of diabetes was inversely associated with CI. Level of HbA1c was significantly higher in patients with severe CI, and the probability of CI increased as the level of HbA1c increased. Low level of education was associated with severe CI, and CI was two times more likely among patients with DRD.
Conclusion
CI was higher than worldwide figures. Elderly females with low educational level, long duration of DM, and low socioeconomic status are at more risk. The probability of severe CI increased with increased level of HbA1c. Screening for CI in patients with diabetes along with intervention programs while considering the DRD and the level of HbA1c is crucial.
Collapse
|
37
|
Doucet J, Verny C, Bordier L, Rekik A, Zulfiqar AA, Bezerra CB, Bauduceau B. Evolution in geriatric syndromes and association with survival over 5 years in the GERODIAB cohort of older French diabetic patients. Eur Geriatr Med 2020; 12:619-625. [PMID: 33225383 DOI: 10.1007/s41999-020-00425-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Accepted: 10/20/2020] [Indexed: 12/16/2022]
Abstract
PURPOSE Although one in three patients with diabetes in Western countries is over 70 years-old, geriatric syndromes and their relationship with survival remain seldom studied. The present aim of the GERODIAB study was to examine the evolution of geriatric disorders and their relationship with survival in older type 2 patients with diabetes with initial sufficient autonomy. METHODS We performed a prospective, observational study over 5 years in patients with diabetes aged 70 years or above. A total of 987 consecutive type 2 patients with diabetes (mean age 77 years, range 70-94 years, 65.2% were 75 years and above, 52.1% women) were included from 56 French diabetic centres. Individual characteristics, diabetes parameters and geriatric parameters (autonomy, nutrition, cognitive alteration, depression, orthostatic hypotension, falls) were annually recorded. Survival was analysed using the Kaplan-Meier method and proportional hazards regression models. RESULTS Institutional living, impaired activity and difficulties in instrumental daily activity, cognitive disorders, malnutrition, depression, orthostatic hypotension and hypoglycaemia strongly increased during the follow-up. Institutional living, impaired activity and difficulties in instrumental daily activity, cognitive disorders and hypoglycaemia were strongly associated with reduced survival, but not falls. In hazard ratio models, living in an institution (HR = 2.39; CI = 1.77-3.24; p < 0.0001) and impaired Activity of Daily Living scale score were the most significant and independent predictors of death (HR = 1.59; CI = 1.19-2.13; p = 0.0016), associated with HbA1c ≥ 70 mmol/mol (HR = 1.62; CI = 1.12-2.36; p = 0.011). CONCLUSION Our findings show the considerable alteration of geriatric parameters and their relationship with decreased survival after a 5-year follow-up in type 2 patients with diabetes, independent of HbA1c and age. They, therefore, confirm the prognostic interest of using yearly geriatric markers in older diabetic patient management, especially the ADL, IADL and MMSE scales. Taking into account these prognostic parameters should contribute to target appropriate HbA1c goals. TRIAL REGISTRATION Registered at clinicaltrials.gov (21/01/2011): NCT01282060.
Collapse
Affiliation(s)
- J Doucet
- Service de Médecine Interne Polyvalente, Hôpital Saint Julien, CHU de Rouen - Normandy University, 76031, Rouen cedex, France.
| | - Ch Verny
- Service de Gérontologie, CHU de Bicêtre, 12 rue Séverine, 94276, Le Kremlin Bicêtre cedex, France
| | - L Bordier
- Service D'Endocrinologie, Hôpital Bégin, 69 avenue de Paris, 94160, Saint Mandé, France
| | - A Rekik
- Service de Médecine Interne Polyvalente, Hôpital Saint Julien, CHU de Rouen - Normandy University, 76031, Rouen cedex, France
| | - A A Zulfiqar
- Service de Médecine Gériatrique, Hôpital Saint Julien, CHU de Rouen - Normandy University, 76031, Rouen cedex, France
| | - C Bandeira Bezerra
- School of Medicine, University of Fortaleza - Unifor, Fortaleza, Ceara, Brazil
| | - B Bauduceau
- Service D'Endocrinologie, Hôpital Bégin, 69 avenue de Paris, 94160, Saint Mandé, France
| |
Collapse
|
38
|
Cochar-Soares N, de Carvalho DHT, de Andrade FB, Castro-Costa E, de Oliveira C, Lima-Costa MF, Alexandre TDS. Does undiagnosed diabetes mitigate the association between diabetes and cognitive impairment? Findings from the ELSI-Brazil study. J Diabetes 2020; 12:834-843. [PMID: 32478972 DOI: 10.1111/1753-0407.13074] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2019] [Revised: 05/04/2020] [Accepted: 05/25/2020] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Type 2 diabetes mellitus (T2DM) is associated with cognitive impairment. However, most of the evidence has been based on self-reported T2DM, and undiagnosed diabetes has not been considered as a separate category. We aimed to examine the extent to which undiagnosed diabetes modifies the association between diabetes and cognitive impairment in a representative sample of Brazilian adults aged 50 years and older. METHODS We analyzed baseline data from 1944 participants of the Brazilian Longitudinal Study of Aging (ELSI-Brazil) conducted from 2015 to 2016. Diabetes was evaluated based on self-reported doctor diagnosis and glycosylated hemoglobin levels. Participants were classified as diabetics (D), undiagnosed diabetics (UDD), or nondiabetics (ND). Cognitive function was assessed by word list learning and verbal fluency tests. Three multiple logistic regression models were used to evaluate the changes in the strength of the associations. RESULTS Participants with diabetes had 49% greater odds of exhibiting impaired memory than nondiabetics (odds ratio [OR] = 1.49; 95% CI: 1.01-2.20). By combining UDD and ND, the association between diabetes and impaired memory was attenuated by 2.0%, losing its statistical significance (OR = 1.46; 95% CI: 0.98-2.17). By combining UDD and D, the association was attenuated by 7.4% (OR = 1.38; 95% CI: 1.01-1.90). No significant association was found between T2DM and impaired verbal fluency. CONCLUSION This study found an association between T2DM and impaired memory but not with impaired verbal fluency. When UDD individuals are considered diabetics, this association is attenuated; when UDD individuals are considered as ND, this association is attenuated to the extent that it loses its statistical significance, affecting thus the clinical interpretation.
Collapse
Affiliation(s)
- Natália Cochar-Soares
- Department of Gerontology, Graduate Program in Gerontology, Federal University of Sao Carlos, Brazil
| | - Danilo H T de Carvalho
- Department of Physical Therapy, Graduate Program in Physical Therapy, Federal University of Sao Carlos, Brazil
| | | | - Erico Castro-Costa
- René Rachou Research Center, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
| | - Cesar de Oliveira
- Department of Epidemiology and Public Health, University College London, London, UK
| | - Maria F Lima-Costa
- René Rachou Research Center, Oswaldo Cruz Foundation, Rio de Janeiro, Brazil
| | - Tiago da S Alexandre
- Department of Gerontology, Graduate Program in Gerontology, Federal University of Sao Carlos, Brazil
- Department of Physical Therapy, Graduate Program in Physical Therapy, Federal University of Sao Carlos, Brazil
- Department of Epidemiology and Public Health, University College London, London, UK
| |
Collapse
|
39
|
Hua W, Hou J, Jiang T, Su B, Fu J, Sun R, Chang B, Xia W, Wu H, Zhang T, Guo C, Wang W. The Longitudinal Association Between Cardiovascular Risk and Cognitive Function in Middle-Aged and Older Adults in China: A Nationally Representative Cohort Study. Front Cardiovasc Med 2020; 7:560947. [PMID: 33195454 PMCID: PMC7604338 DOI: 10.3389/fcvm.2020.560947] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Accepted: 09/11/2020] [Indexed: 11/13/2022] Open
Abstract
Objective: China has the largest population living with dementia, causing a tremendous burden on the aging society. Cardiovascular disease (CVD) may trigger a cascade of pathologies associated with cognitive aging. We aim to investigate the association between cardiovascular risk (CVR) factors and cognitive function in the nationally representative cohort in China. Methods: Participants were recruited from 150 counties in 28 provinces via a four-stage sampling method. The outcomes included several cognitive tasks. The independent variable was a composite score of cardiovascular risk calculated from sex-specific equations. We fitted the time-lagged regression to model the association between CVR and cognition. Besides, we performed cross-group analyses to test for model invariance across sex and age. We thus constrained path coefficients to be equal across each grouping variable (e.g., sex) and compared the fit of this constrained model with an unconstrained model in which the path coefficients were allowed to vary by group. Results: A total of 3,799 participants were included in the final analyses. We found that the CVR had a negative linear association with global cognition (β = -0.1, p < 0.01). Additionally, CVR had inverse linear associations with domain-specific measurements of memory and learning, calculation, orientation, and visual-spatial ability (all values of p < 0.01). Regarding sex and age moderation, males had a more pronounced association between higher CVR and worse general cognition, immediate recall, orientation, calculation, and visual-spatial ability (all values of p < 0.0001). In contrast, females exhibited a slightly larger negative association in delayed recall. Older participants (>65 years old) had a more pronounced association between higher CVR and worse calculation ability (p = 0.003). Conclusion: CVD are risk factors for lower global cognition and cognitive subdomains in middle-aged and older adults in China.
Collapse
Affiliation(s)
- Wei Hua
- Center for Infectious Diseases, Beijing Youan Hospital, Capital Medical University, Beijing, China
| | - Jianhua Hou
- Center for Infectious Diseases, Beijing Youan Hospital, Capital Medical University, Beijing, China
- Beijing Key Laboratory for HIV/AIDS Research, Beijing, China
| | - Taiyi Jiang
- Center for Infectious Diseases, Beijing Youan Hospital, Capital Medical University, Beijing, China
| | - Bin Su
- Center for Infectious Diseases, Beijing Youan Hospital, Capital Medical University, Beijing, China
- Beijing Key Laboratory for HIV/AIDS Research, Beijing, China
| | - Jiangning Fu
- Institute of Psychology, Chinese Academy of Sciences, Beijing, China
| | - Runsong Sun
- State Key Laboratory of Cognitive Neuroscience and Learning, Beijing Normal University, Beijing, China
| | - Biru Chang
- Department of Psychology, Research Institute for International and Comparative Education, Shanghai Normal University, Shanghai, China
| | - Wei Xia
- Center for Infectious Diseases, Beijing Youan Hospital, Capital Medical University, Beijing, China
| | - Hao Wu
- Center for Infectious Diseases, Beijing Youan Hospital, Capital Medical University, Beijing, China
- Beijing Key Laboratory for HIV/AIDS Research, Beijing, China
| | - Tong Zhang
- Center for Infectious Diseases, Beijing Youan Hospital, Capital Medical University, Beijing, China
- Beijing Key Laboratory for HIV/AIDS Research, Beijing, China
| | - Caiping Guo
- Center for Infectious Diseases, Beijing Youan Hospital, Capital Medical University, Beijing, China
| | - Wen Wang
- Center for Infectious Diseases, Beijing Youan Hospital, Capital Medical University, Beijing, China
| |
Collapse
|
40
|
Andrews RM, Shpitser I, Lopez O, Longstreth WT, Chaves PHM, Kuller L, Carlson MC. Examining the causal mediating role of brain pathology on the relationship between diabetes and cognitive impairment: the Cardiovascular Health Study. JOURNAL OF THE ROYAL STATISTICAL SOCIETY. SERIES A, (STATISTICS IN SOCIETY) 2020; 183:1705-1726. [PMID: 34321718 PMCID: PMC8314961 DOI: 10.1111/rssa.12570] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
The paper examines whether diabetes mellitus leads to incident mild cognitive impairment and dementia through brain hypoperfusion and white matter disease. We performed inverse odds ratio weighted causal mediation analyses to decompose the effect of diabetes on cognitive impairment into direct and indirect effects, and we found that approximately a third of the total effect of diabetes is mediated through vascular-related brain pathology. Our findings lend support for a common aetiological hypothesis regarding incident cognitive impairment, which is that diabetes increases the risk of clinical cognitive impairment in part by impacting the vasculature of the brain.
Collapse
Affiliation(s)
- Ryan M Andrews
- Johns Hopkins University, Baltimore, USA, and Leibniz Institute for Prevention Research and Epidemiology-BIPS, Bremen, Germany
| | | | - Oscar Lopez
- University of Pittsburgh School of Medicine, USA
| | | | | | | | - Michelle C Carlson
- Johns Hopkins University, Baltimore, and Johns Hopkins Center on Aging and Health, Baltimore, USA
| |
Collapse
|
41
|
Abstract
Dementia incidence continues to rise in the United States and around the world. Although age is the single biggest risk factor for the development of dementia, it is not considered normal sequelae of aging. Although there has been little to no progress made in the past couple of decades in the treatment or cure of Alzheimer disease, there has been significant progress made in prevention. Single factors, such as hearing loss or cardiovascular risk factors, may increase the risk for cognitive decline. The opportunity to mitigate these risk factors provides an exciting new healthy aging approach to dementia prevention.
Collapse
Affiliation(s)
- Maryjo L Cleveland
- Department of Geriatrics and Gerontology, Healthy Aging and Brain Wellness Program, Wake Forest Baptist Health, Sticht Center, Medical Center Boulevard, Winston-Salem, NC 27157, USA.
| |
Collapse
|
42
|
Guo M, Kang K, Wang A, Jia J, Zhang J, Wang Y, Wang D, Chen S, Zhao X. Association of diabetes status with cognitive impairment in two Chinese rural communities. J Neurol Sci 2020; 415:116894. [PMID: 32446011 DOI: 10.1016/j.jns.2020.116894] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2019] [Revised: 04/20/2020] [Accepted: 05/07/2020] [Indexed: 01/21/2023]
Abstract
BACKGROUND AND PURPOSE Diabetes may be one of the risk factors of cognitive impairment. In this study, we aimed to investigate the relationship between diabetes status and cognitive impairment among the middle-aged and elderly population (≥40 years) in Chinese rural communities. METHODS A sample of 3392 participants aged 40 years or older from the China National Stroke Prevention Project (CSPP) between 2015 and 2017 were enrolled in this study. Cognitive function was assessed by the Beijing edition of the Montreal cognitive assessment (MoCA) scale. Cognitive impairment was diagnosed as a MoCA score < 26. Diabetes status was divided into three groups------Normal: fasting plasma glucose (FPG) ≤ 5.5 mmol/L, Prediabetes: 5.6 ≤ FPG ≤ 6.9 mmol/L, Diabetes: FPG ≥ 7.0 mmol/L or with a history of diabetes. Multivariate logistic regression was used to analyze the association between diabetes status and cognitive impairment. RESULTS Out of the 3392 enrolled participants, 2023(59.6%) had cognitive impairment, 1586(46.8%) had abnormal fasting plasma glucose including 867(25.6%) prediabetes and 719(21.2%) diabetes. After adjusting for potential risk factors, we found prediabetes (OR: 1.22, 95%CI: 1.03-1.45) and diabetes (OR: 1.28, 95%CI: 1.06-1.55) are all associated with cognitive impairment, especially in the domains of language (prediabetes: OR: 1.14, 95%CI: 1.05-1.25; diabetes: OR:1.13, 95%CI: 1.03-1.24), visuospatial/executive functions (diabetes: OR: 1.50, 95%CI: 1.22-1.84) and attention (diabetes: OR: 1.15, 95%CI: 1.02-1.31). CONCLUSIONS In this large community-based study, we found diabetes status may be an independent risk factor for cognitive impairment, particularly in domains of language, visuospatial/executive functions, and attention.
Collapse
Affiliation(s)
- Mengyi Guo
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China; China National Clinical Research Center for Neurological Diseases, Beijing, China; Center of Stroke, Beijing Institute for Brain Disorders, Beijing, China; Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, Beijing, China
| | - Kaijiang Kang
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China; China National Clinical Research Center for Neurological Diseases, Beijing, China; Center of Stroke, Beijing Institute for Brain Disorders, Beijing, China; Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, Beijing, China
| | - Anxin Wang
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China; China National Clinical Research Center for Neurological Diseases, Beijing Tiantan Hospital, Capital Medical University, Beijing, China
| | - Jiaokun Jia
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China; China National Clinical Research Center for Neurological Diseases, Beijing, China; Center of Stroke, Beijing Institute for Brain Disorders, Beijing, China; Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, Beijing, China
| | - Jia Zhang
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China; China National Clinical Research Center for Neurological Diseases, Beijing, China; Center of Stroke, Beijing Institute for Brain Disorders, Beijing, China; Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, Beijing, China
| | - Yu Wang
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China; China National Clinical Research Center for Neurological Diseases, Beijing, China; Center of Stroke, Beijing Institute for Brain Disorders, Beijing, China; Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, Beijing, China
| | - Dandan Wang
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China; China National Clinical Research Center for Neurological Diseases, Beijing, China; Center of Stroke, Beijing Institute for Brain Disorders, Beijing, China; Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, Beijing, China
| | - Shengyun Chen
- Department of Neurology, Beijing Sanbo Brain Hospital, Capital Medical University, Beijing, China.
| | - Xingquan Zhao
- Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China; China National Clinical Research Center for Neurological Diseases, Beijing, China; Center of Stroke, Beijing Institute for Brain Disorders, Beijing, China; Beijing Key Laboratory of Translational Medicine for Cerebrovascular Disease, Beijing, China.
| |
Collapse
|
43
|
Zhang L, Ma Q, Zhou Y. Strawberry Leaf Extract Treatment Alleviates Cognitive Impairment by Activating Nrf2/HO-1 Signaling in Rats With Streptozotocin-Induced Diabetes. Front Aging Neurosci 2020; 12:201. [PMID: 32792939 PMCID: PMC7390916 DOI: 10.3389/fnagi.2020.00201] [Citation(s) in RCA: 20] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2020] [Accepted: 06/10/2020] [Indexed: 12/19/2022] Open
Abstract
Diabetes-associated cognitive impairment (DACI) is a common complication of diabetes mellitus (DM) that affects the central nervous system. Cognitive impairment, such as learning and memory impairment, and even dementia, is the main clinical manifestation of DACI. Unfortunately, there is no effective means by which to delay the cognitive symptoms of DM. Evidence has shown that strawberry leaf extract could alleviate cognitive decline, suppress oxidative stress, and reduce inflammatory responses in rats. In the present study, we evaluated the effect of strawberry leaf extract on cognitive function in a rat model of streptozotocin (STZ)-induced diabetes. After the continuous administration of strawberry leaf extract for 4 weeks, the Morris Water Maze (MWM) test results showed that the cognitive impairment of the rats was alleviated. Moreover, strawberry leaf extract significantly reduced the level of reactive oxygen species (ROS), decreased the level of malondialdehyde (MDA), improved the activity of superoxide dismutase (SOD) and catalase (CAT), decreased the mRNA expression of interleukin-6 (IL-6) and tumor necrosis factor-α (TNF-α) and decreased the protein expression of caspase-3 and caspase-9 in the hippocampus of DM rats. Also, transcription factor nuclear factor erythroid 2 (NF-E2)-related factor 2 (Nrf2)/hemeoxygenase-1(HO-1) signaling was activated by the administration of strawberry leaf extract. Our findings indicate that strawberry leaf extract may be a potential drug candidate for the treatment of DACI and may be used as a basis for further research on the development of drugs for cognitive impairment in diabetes.
Collapse
Affiliation(s)
- Li Zhang
- Department of Nursing, The People's Hospital of Suzhou New District, Suzhou, China
| | - Qinghua Ma
- Department of Prevention and Health Protection, The 3rd People's Hospital of Xiangcheng District, Suzhou, China
| | - Yanling Zhou
- Department of Operation, The Second Affiliated Hospital of Soochow University, Suzhou, China
| |
Collapse
|
44
|
Yu F, Han W, Zhan G, Li S, Xiang S, Zhu B, Jiang X, Yang L, Luo A, Hua F, Yang C. Abnormal gut microbiota composition contributes to cognitive dysfunction in streptozotocin-induced diabetic mice. Aging (Albany NY) 2020; 11:3262-3279. [PMID: 31123221 PMCID: PMC6555457 DOI: 10.18632/aging.101978] [Citation(s) in RCA: 45] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2019] [Accepted: 05/12/2019] [Indexed: 02/07/2023]
Abstract
Both diabetes and Alzheimer’s disease are age-related disorders, and numerous studies have demonstrated that patients with diabetes are at an increased risk of cognitive dysfunction (CD) and Alzheimer’s disease, suggesting shared or interacting pathomechanisms. The present study investigated the role of abnormal gut microbiota in diabetes-induced CD and the potential underlying mechanisms. An intraperitoneal injection of streptozotocin administered for 5 consecutive days was used for establishing a diabetic animal model. Hierarchical cluster analysis of Morris water maze (MWM) performance indices (escape latency and target quadrant crossing) was adopted to classify the diabetic model mice into CD and Non-CD phenotypes. Both β-diversity and relative abundance of several gut bacteria significantly differed between the CD and Non-CD groups. Further, fecal bacteria transplantation from Non-CD mice, but not from CD mice, into the gut of pseudo-germ-free mice significantly improved host MWM performance, an effect associated with alterations in β-diversity and relative abundance of host gut bacteria. Collectively, these findings suggest that abnormal gut microbiota composition contributes to the onset of diabetes-induced CD and that improving gut microbiota composition is a potential therapeutic strategy for diabetes and related comorbidities.
Collapse
Affiliation(s)
- Fan Yu
- Department of Endocrinology, The Third Affiliated Hospital of Soochow University, Changzhou 213003, China
| | - Wei Han
- Department of Neurosurgery, The Third Affiliated Hospital of Soochow University, Changzhou 213003, China
| | - Gaofeng Zhan
- Department of Anesthesiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Shan Li
- Department of Anesthesiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Shoukui Xiang
- Department of Endocrinology, The Third Affiliated Hospital of Soochow University, Changzhou 213003, China
| | - Bin Zhu
- Department of Critical Care Medicine, The Third Affiliated Hospital of Soochow University, Changzhou 213003, China
| | - Xiaohong Jiang
- Department of Endocrinology, The Third Affiliated Hospital of Soochow University, Changzhou 213003, China
| | - Ling Yang
- Department of Cardiology, The Third Affiliated Hospital of Soochow University, Changzhou 213003, China
| | - Ailin Luo
- Department of Anesthesiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| | - Fei Hua
- Department of Endocrinology, The Third Affiliated Hospital of Soochow University, Changzhou 213003, China
| | - Chun Yang
- Department of Anesthesiology, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430030, China
| |
Collapse
|
45
|
|
46
|
Wen XH, Guo QL, Guo JC. Effect of 9 - PAHSA on cognitive dysfunction in diabetic mice and its possible mechanism. Biochem Biophys Res Commun 2020; 524:525-532. [PMID: 32014256 DOI: 10.1016/j.bbrc.2020.01.071] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2019] [Accepted: 01/13/2020] [Indexed: 01/19/2023]
Abstract
Diabetes mellitus (DM) is currently a major global health problem, which is associated with the development of cognitive dysfunction. However, although numerous clinical drugs for hyperglycemia have been used at present, safer and more effective therapeutic intervention strategies for diabetic cognitive impairments are still a huge challenge. Recently, several studies have indicated that a novel class of branched palmitic acid esters of hydroxyl stearic acids (PAHSAs) may have anti-diabetes and anti-inflammatory effects in insulin-resistant mice. Herein, whether the 9-PAHSA that one of the PAHSAs can attenuates DM-associated cognitive impairment in a mouse model of type 2 diabetes has been investigated. Our results showed that 9-PAHSA mildly prevented deficits of spatial working memory in Y-maze test while reversed the preference bias toward novel mice in Social choice test. Furthermore, the effect of REST on cognitive impairment of diabetes was explored for the first time. It was found that the expression of REST in diabetic mice increased, and the expression of target protein BDNF (Brain-derived neurotrophic factor) was decreased. After administration of 9-PAHSA, the situation was reversed. In summary, we conclude that exogenous supplement of 9-PAHSA can improve DM-related cognitive impairment to some extent, and the protective effect may be associated with decreased REST/NRSF (repressor element-1 silencing transcription factor/neuron-restrictive silence factor) and upregulated BDNF expression in frontal cortex.
Collapse
Affiliation(s)
- Xiao-Hong Wen
- State Key Laboratory of Medical Neurobiology & Institutes of Brain Science, Fudan University, Shanghai, China.
| | - Qi-Lin Guo
- State Key Laboratory of Medical Neurobiology & Institutes of Brain Science, Fudan University, Shanghai, China
| | - Jing-Chun Guo
- State Key Laboratory of Medical Neurobiology & Institutes of Brain Science, Fudan University, Shanghai, China
| |
Collapse
|
47
|
Cui L, Chen W, Yu X, Ju C. The relationship between cognitive function and having diabetes in patients treated with hemodialysis. Int J Nurs Sci 2020; 7:60-65. [PMID: 32099861 PMCID: PMC7031115 DOI: 10.1016/j.ijnss.2019.12.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2019] [Revised: 11/27/2019] [Accepted: 12/09/2019] [Indexed: 12/21/2022] Open
Abstract
PURPOSE Patients undergoing maintenance hemodialysis (MHD) have a higher prevalence of cognitive impairment and inferior cognitive performance than the general population, and those with cognitive impairment are at higher risk of death than those without cognitive impairment. Having diabetes has been associated with an increased risk of cognitive decline in end-stage kidney disease patients treated with peritoneal dialysis or kidney transplant. However, these findings may not extend to the hemodialysis population. Thus, we aim to investigate the relationship between having diabetes and cognitive function in MHD patients. METHODS This was a cross-sectional study. A total of 203 patients treated with MHD from two blood purification centers were enrolled as subjects. The Chinese version of the Montreal Cognitive Assessment (MoCA) was utilized to assess cognitive function. RESULTS MHD patients with diabetes had a significantly higher prevalence of global cognitive impairment and inferior performance in global cognition, visuospatial/executive function, naming, language, abstraction and orientation tasks compared with those without diabetes. According to the multiple linear analyses, having diabetes was significantly associated with lower global cognitive function, naming, and language scores, with β coefficients and 95% CIs of -1.30 [ -2.59, -0.01], -0.25 [-0.47, -0.02], and -0.32 [-0.58, -0.07], respectively (all P < 0.05). Having diabetes could not independently predict an increased risk of global cognitive impairment. CONCLUSIONS In MHD patients, having diabetes is significantly associated with lower cognitive function scores. Medical staff should evaluate early and focus on the decline of cognitive function in MHD patients with diabetes, in order to achieve early diagnosis and early intervention.
Collapse
Affiliation(s)
- Lei Cui
- Medical School, Southeast University, Nanjing, Jiangsu, China
- Nursing Department, Zhongda Hospital, Nanjing, Jiangsu, China
| | - Weixia Chen
- Medical School, Southeast University, Nanjing, Jiangsu, China
- Nursing Department, Zhongda Hospital, Nanjing, Jiangsu, China
| | - Xingxing Yu
- Medical School, Southeast University, Nanjing, Jiangsu, China
- Nursing Department, Zhongda Hospital, Nanjing, Jiangsu, China
| | - Changping Ju
- Medical School, Southeast University, Nanjing, Jiangsu, China
- Nursing Department, Zhongda Hospital Lishui Branch, Nanjing, Jiangsu, China
| |
Collapse
|
48
|
Titova OE, Lindberg E, Tan X, Elmståhl S, Lind L, Schiöth HB, Benedict C. Association between sleep duration and executive function differs between diabetic and non-diabetic middle-aged and older adults. Psychoneuroendocrinology 2020; 111:104472. [PMID: 31610410 DOI: 10.1016/j.psyneuen.2019.104472] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2019] [Revised: 10/02/2019] [Accepted: 10/02/2019] [Indexed: 01/26/2023]
Abstract
Executive function is defined as a set of cognitive skills that are necessary to plan, monitor, and execute a sequence of goal-directed complex actions. Executive function is influenced by a variety of factors, including habitual sleep duration and diabetes. In the present study, we investigated in 18,769 Swedish adults (mean age: 61 y) the association between executive function, diabetes, and self-reported sleep duration. We observed a significant interaction between diabetes and sleep duration for the Trail Making Test (TMT) ratio (P < 0.01). This ratio is a measure of executive function where higher values indicate worse performance. Among diabetic participants (n = 1,523), long (defined as ≥9 h per day) vs. normal sleep duration (defined as 7-8 hours per day) was associated with a higher TMT ratio (P < 0.05). Similar significant results were observed in diabetic individuals without pharmacological treatment for diabetes (n = 1,062). Among non-diabetic participants (n = 17,246), no association between long sleep duration and the TMT ratio was observed (P > 0.05). Instead, short (defined as <7 h per day) vs. normal sleep duration was linked to a higher TMT ratio (P < 0.05). These findings suggest that the association between sleep duration and executive function differs between diabetic and non-diabetic middle-aged and older adults. Based on the cross-sectional design of the study, no firm conclusions can be drawn on the causality of the relations.
Collapse
Affiliation(s)
- Olga E Titova
- Department of Neuroscience, Uppsala University, Uppsala, Sweden; Department of Surgical Sciences, Section of Orthopedics, Uppsala University, Uppsala, Sweden.
| | - Eva Lindberg
- Department of Medical Sciences, Respiratory, Allergy and Sleep Research, Uppsala University, Uppsala, Sweden
| | - Xiao Tan
- Department of Neuroscience, Uppsala University, Uppsala, Sweden
| | - Sölve Elmståhl
- Division of Geriatric Medicine, Department of Health Sciences, Clinical Research Centre (CRC), Lund University, Skåne University Hospital, Malmö, Sweden
| | - Lars Lind
- Department of Medical Sciences, Cardiovascular Epidemiology, Uppsala University, Uppsala, Sweden
| | - Helgi B Schiöth
- Department of Neuroscience, Uppsala University, Uppsala, Sweden; Institute for Translational Medicine and Biotechnology, Sechenov First Moscow State Medical University, Moscow, Russia
| | | |
Collapse
|
49
|
Peña-González P, Mondragón-Maya A, Silva-Pereyra J, Roa-Rojas P. Cognitive Reserve and Executive Functions in Adults with Type 2 Diabetes. J Diabetes Res 2020; 2020:7941543. [PMID: 33083496 PMCID: PMC7557905 DOI: 10.1155/2020/7941543] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2020] [Revised: 06/22/2020] [Accepted: 08/29/2020] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND Adults with type two diabetes mellitus (DM2) show cognitive deficits within the executive function domain. The detrimental effects of DM2 over executive function (EF) performance may be mediated by factors such as cognitive reserve (CR). CR mediates cognitive performance by delaying the appearance of clinical symptoms from subjacent brain pathology or attenuating the severity of such symptoms. Our main goal was to study the effects of CR on executive functions of adults with DM2. METHODS Data from a total of 1,034 adults were included (362 women, 672 men). Subjects were categorized into four groups: subjects with DM2 and high CR (n = 235), control subjects with high CR (n = 265), subjects with DM2 and low CR (n = 298), and control subjects with low CR (n = 236). CR was quantified through 3 proxies: education, occupational complexity, and leisure activities. Executive functions were evaluated through visual scanning, verbal fluency, and backwards counting tasks. First, a series of four one-way ANOVAs was performed where group was included as a between-subject factor and executive function as a dependent variable. Second, a hierarchical multiple regression analysis was conducted to assess the weight of each CR proxy on EF performance. RESULTS CR level significantly affected all executive function scores independently of the diabetes status. Hierarchical regression analyses indicated that years of education accounted for most of the variance in the model for executive function performance. In this study, we found that there is a significant effect of CR on executive function performance of DM2 subjects and education is the most important CR proxy.
Collapse
Affiliation(s)
| | - Alejandra Mondragón-Maya
- Carrera de Psicología, Facultad de Estudios Superiores Iztacala, Universidad Nacional Autónoma de México, Tlalnepantla, Estado de México, Mexico
| | - Juan Silva-Pereyra
- Proyecto de Neurociencias, Facultad de Estudios Superiores Iztacala, Universidad Nacional Autónoma de México, Tlalnepantla, Estado de México, Mexico
| | - Paloma Roa-Rojas
- Dirección de Investigación, Instituto Nacional de Geriatría, Mexico
| |
Collapse
|
50
|
Grigolon RB, Brietzke E, Mansur RB, Idzikowski MA, Gerchman F, De Felice FG, McIntyre RS. Association between diabetes and mood disorders and the potential use of anti-hyperglycemic agents as antidepressants. Prog Neuropsychopharmacol Biol Psychiatry 2019; 95:109720. [PMID: 31352032 DOI: 10.1016/j.pnpbp.2019.109720] [Citation(s) in RCA: 29] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2019] [Revised: 07/08/2019] [Accepted: 07/25/2019] [Indexed: 12/13/2022]
Abstract
Epidemiological and mechanistic studies support the association between Diabetes Mellitus and mood disorders, such as Major Depressive Disorder and Bipolar Disorder. This association is especially relevant in specific domains of depressive psychopathology, such as disturbances in reward systems and cognitive functions. Several anti-hyperglycemic agents have demonstrated effects on depressive symptoms and cognitive decline and this efficacy is probably the result of an action in shared brain targets between these two groups of conditions. These medications include subcutaneous insulin, intranasal insulin, metformin, and liraglutide. The study of the mechanisms involved in the relationship between Diabetes Mellitus and mood disorders offers a new avenue of investigation, and this understanding can be applied when examining whether antidiabetic agents can be repurposed as antidepressants and mood stabilizers. The objective of this narrative review is to critically appraise the literature surrounding drugs commonly used as anti-hyperglycemic agents and their effects on the brain, while discussing their potential as a new treatment for mental illnesses, and specifically, mood disorders.
Collapse
Affiliation(s)
- Ruth B Grigolon
- Post-Graduation Program in Psychiatry and Medical Psychology, Universidade Federal de São Paulo (Unifesp), São Paulo, SP, Brazil; Research Group in Molecular and Behavioral Neuroscience of Mood Disorders, Universidade Federal de São Paulo (Unifesp), São Paulo, SP, Brazil
| | - Elisa Brietzke
- Post-Graduation Program in Psychiatry and Medical Psychology, Universidade Federal de São Paulo (Unifesp), São Paulo, SP, Brazil; Research Group in Molecular and Behavioral Neuroscience of Mood Disorders, Universidade Federal de São Paulo (Unifesp), São Paulo, SP, Brazil; Department of Psychiatry, Queen's University School of Medicine, Kingston, ON, Canada.
| | - Rodrigo B Mansur
- Mood Disorders Psychopharmacology Unit (MDPU), Toronto Western Hospital, University Health Network (UHN), Toronto, ON, Canada; Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Maia A Idzikowski
- Department of Psychiatry, Queen's University School of Medicine, Kingston, ON, Canada
| | - Fernando Gerchman
- Department of Internal Medicine, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil; Unit of Endocrinology and Metabolism, Hospital de Clinicas de Porto Alegre, Porto Alegre, RS, Brazil
| | - Fernanda G De Felice
- Institute of Medical Biochemistry Leopoldo de Meis, Federal University of Rio de Janeiro, Rio de Janeiro, RJ, Brazil; Department of Psychiatry and Centre for Neuroscience Studies, Queen's University, Kingston, ON, Canada
| | - Roger S McIntyre
- Mood Disorders Psychopharmacology Unit (MDPU), Toronto Western Hospital, University Health Network (UHN), Toronto, ON, Canada; Brain and Cognition Discovery Foundation (BCDF), Toronto, ON, Canada
| |
Collapse
|