1
|
Kontari P, Fife-Schaw C, Smith K. Independent and combined effects of depressive symptoms and cardiometabolic risk factors on dementia incidence: a cross-country comparison in England, the United States and China. Arch Gerontol Geriatr 2025; 136:105889. [PMID: 40403595 DOI: 10.1016/j.archger.2025.105889] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2024] [Revised: 04/17/2025] [Accepted: 05/04/2025] [Indexed: 05/24/2025]
Abstract
BACKGROUND Depression and cardiometabolic conditions are suggested as modifiable risk factors for dementia, yet their combined impact remains unclear. This study assessed the independent and combined effects of depressive symptoms and cardiometabolic conditions on dementia incidence in England, the US and China. METHODS The sample comprised 4472 participants aged 50 and older from the English Longitudinal Study of Ageing (ELSA), 5021 from Health and Retirement Study (HRS), and 8925 from China Health and Retirement Longitudinal Study (CHARLS). Depressive symptoms were assessed using the Center for Epidemiological Studies-Depression scale. Cardiometabolic factors included central obesity, low high-density-lipoprotein (HDL) cholesterol, systolic and diastolic blood pressure (BP), hyperglycemia, diabetes, and inflammation. Dementia incidence was estimated using confounder-adjusted Cox proportional hazards regressions, and pooled estimates were obtained using random-effects meta-analysis. RESULTS A total of 1218 individuals developed dementia over a median of 6.8-12.2 years. Depressive symptoms (ELSA: HR = 1.47 [95 % CI = 1.09-2.00]; HRS: HR = 1.68 [95 % CI = 1.33-2.13]; CHARLS: HR = 1.35 [95 % CI = 1.12-1.64]) and elevated systolic BP (ELSA: HR = 1.51 [95 % CI = 1.17-1.95]; HRS: HR = 1.48 [95 % CI = 1.24-1.79]; CHARLS: HR = 1.26 [95 % CI = 1.05-1.52]) were linked to dementia risk in all countries. While cardiometabolic multimorbidity (≥2 conditions) was not associated with dementia risk, those with the highest cardiometabolic index (≥4 conditions) had a greater risk of dementia in all samples (ELSA: HR = 1.82 [95 % CI = 1.01-3.26]; HRS: HR = 1.85 [95 % CI = 1.02-3.35]; CHARLS: HR = 1.65 [95 % CI = 1.18-2.30]). CONCLUSION Depressive symptoms are independently linked to dementia risk, while having multiple cardiometabolic conditions further increases this risk, especially when co-occurring with depressive symptoms in both Western and Chinese populations.
Collapse
Affiliation(s)
- Panagiota Kontari
- Department of Psychological Sciences, School of Psychology, Faculty of Health and Medicine, University of Surrey, Guildford, UK.
| | - Chris Fife-Schaw
- Department of Psychological Sciences, School of Psychology, Faculty of Health and Medicine, University of Surrey, Guildford, UK
| | - Kimberley Smith
- Department of Psychological Interventions, School of Psychology, Faculty of Health and Medicine, University of Surrey, Guildford, UK
| |
Collapse
|
2
|
Wang J, Zhang J, Zhu Y, Ma X, Wang Y, Liu K, Li Z, Wang J, Liang R, He S, Li J. Association between a healthy lifestyle and dementia in older adults with obesity: A prospective study in the UK biobank. J Affect Disord 2025; 380:421-429. [PMID: 40147612 DOI: 10.1016/j.jad.2025.03.115] [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: 09/19/2024] [Revised: 03/16/2025] [Accepted: 03/19/2025] [Indexed: 03/29/2025]
Abstract
BACKGROUND The impact of adherence to low-risk lifestyle factors on dementia risk in individuals with obesity remains unclear. We aimed to explore the association between healthy lifestyles with dementia in obese participants. METHODS Dementia-free participants from the UK Biobank, aged 50 years or older with obesity (BMI ≥30 kg/m2) at baseline were included. A weighted healthy lifestyle score was calculated incorporating both traditional and emerging lifestyle factors. The primary outcome was all-cause dementia and its subtypes (Alzheimer's disease and Vascular dementia). Cox regression models analyzed the association between healthy lifestyle scores and dementia risk. Restricted cubic splines tested the dose-response. We also examined the effect of lifestyle scores on dementia risk in individuals with normal weight and overweight. RESULTS A total of 54,365 participants were included at baseline. During a median follow-up of 14.4 years, 1271 participants developed all-cause dementia, including 537 cases of Alzheimer's disease and 343 cases of vascular dementia. A 20 % increase in the lifestyle score was associated with a 7 % reduction in dementia risk (HR: 0.93; 95 % CI: 0.91,0.96) and a 4 % reduction in Alzheimer's disease risk (HR: 0.96; 95 % CI: 0.92,1.00). The association was stronger in overweight and obese participants. No significant link was found for vascular dementia. LIMITATIONS Information on lifestyle behaviors was self-reported and might be prone to measurement error. CONCLUSIONS Adherence to a healthy lifestyle may reduce the risk of dementia and Alzheimer's disease in older obese individuals, with a stronger effect observed in those with higher lifestyle scores.
Collapse
Affiliation(s)
- Junru Wang
- Department of Epidemiology and Health Statistics, School of Public Health, Ningxia Medical University, Yinchuan, Ningxia Hui Autonomous Region 750004, China
| | - Jiahui Zhang
- Department of Epidemiology and Health Statistics, School of Public Health, Ningxia Medical University, Yinchuan, Ningxia Hui Autonomous Region 750004, China
| | - Yongbin Zhu
- Department of Epidemiology and Health Statistics, School of Public Health, Ningxia Medical University, Yinchuan, Ningxia Hui Autonomous Region 750004, China
| | - Xiaojun Ma
- Department of Epidemiology and Health Statistics, School of Public Health, Ningxia Medical University, Yinchuan, Ningxia Hui Autonomous Region 750004, China
| | - Yali Wang
- Department of Epidemiology and Health Statistics, School of Public Health, Ningxia Medical University, Yinchuan, Ningxia Hui Autonomous Region 750004, China
| | - Kai Liu
- Department of Epidemiology and Health Statistics, School of Public Health, Ningxia Medical University, Yinchuan, Ningxia Hui Autonomous Region 750004, China
| | - Zhuoyuan Li
- Department of Epidemiology and Health Statistics, School of Public Health, Ningxia Medical University, Yinchuan, Ningxia Hui Autonomous Region 750004, China
| | - Jing Wang
- Department of Epidemiology and Health Statistics, School of Public Health, Ningxia Medical University, Yinchuan, Ningxia Hui Autonomous Region 750004, China
| | - Renzhang Liang
- Department of Pediatric Surgery, Peking University First Hospital Ningxia Women and Children's Hospital (Ningxia Hui Autonomous Region Maternal and Child Health Hospital), China.
| | - Shulan He
- Department of Epidemiology and Health Statistics, School of Public Health, Ningxia Medical University, Yinchuan, Ningxia Hui Autonomous Region 750004, China; Key Laboratory of Environmental Factors and Chronic Disease Control, Ningxia Medical University, Yinchuan, Ningxia Hui Autonomous Region 750004, China.
| | - Jiangping Li
- Department of Epidemiology and Health Statistics, School of Public Health, Ningxia Medical University, Yinchuan, Ningxia Hui Autonomous Region 750004, China; Key Laboratory of Environmental Factors and Chronic Disease Control, Ningxia Medical University, Yinchuan, Ningxia Hui Autonomous Region 750004, China.
| |
Collapse
|
3
|
Zhang L, Wang Q, Wang X, Fu C, Zhang X, Li X, Wang Z, Zhu D. Association of birth weight, midlife obesity, and transition patterns with mild cognitive impairment and brain MRI indices: A prospective population-based study. J Affect Disord 2025; 380:384-393. [PMID: 40154798 DOI: 10.1016/j.jad.2025.03.136] [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: 10/14/2024] [Revised: 03/20/2025] [Accepted: 03/22/2025] [Indexed: 04/01/2025]
Abstract
BACKGROUND To evaluate associations of birth weight, midlife weight, and their transitions with mild cognitive impairment (MCI) and brain MRI indices. METHODS This prospective cohort study included 200,726 UK Biobank participants. Self-reported birth weight and measured midlife anthropometrics were used to classify obesity (waist circumference [WC]/waist-to-hip ratio [WHR]). We constructed nine weight transition patterns from birth to midlife WC, six from birth to midlife WHR. Cox proportional hazards models and linear regression models were used to examine associations of birth weight, midlife body size and their transitions with MCI and brain MRI indices. RESULTS Compared to normal birth weight, low birth weight (HR: 1.29, 95 % CI: 1.16-1.44) and high birth weight (1.11, 1.01-1.22) were both associated with increased risk of MCI, showing a U-shaped relationship. Compared to normal weight at midlife, midlife central obesity [WC (1.25, 1.15-1.37) and WHR (1.27, 1.17-1.37)] were significantly associated with elevated MCI risk. Compared to individuals with normal weight at birth and midlife, those with low birth weight who transition to central obesity at midlife, defined by WC (1.51, 1.27-1.78) or WHR (1.42, 1.22-1.66), showed the highest risk of MCI. Weight transitions were also associated with brain structure, individuals who had low or high birth weight and developed midlife obesity showed significant reductions in total brain volume and grey matter volume, as well as increases in white matter hyperintensity volume. CONCLUSIONS Birth weight exhibited a U-shaped association with MCI risk. Individuals transitioning from low birth weight to midlife central obesity demonstrated the highest MCI susceptibility.
Collapse
Affiliation(s)
- Luyi Zhang
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, China
| | - Qi Wang
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, China
| | - Xiaoyi Wang
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, China
| | - Chunying Fu
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, China
| | - Xiaoyu Zhang
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, China
| | - Xiang Li
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, China
| | - Zhongxuan Wang
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, China
| | - Dongshan Zhu
- Department of Epidemiology, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, China; Center for Clinical Epidemiology and Evidence-based Medicine, Shandong University, Jinan, China.
| |
Collapse
|
4
|
Deng M, Tang F, Zhu Z. Altered cognitive function in obese patients: relationship to gut flora. Mol Cell Biochem 2025; 480:3553-3567. [PMID: 39937394 PMCID: PMC12095350 DOI: 10.1007/s11010-024-05201-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2024] [Accepted: 12/24/2024] [Indexed: 02/13/2025]
Abstract
Obesity is a risk factor for non-communicable diseases such as cardiovascular disease and diabetes, which are leading causes of death and disability. Today, China has the largest number of overweight and obese people, imposing a heavy burden on China's healthcare system. Obesity adversely affects the central nervous system (CNS), especially cognitive functions such as executive power, working memory, learning, and so on. The gradual increase in adult obesity rates has been accompanied by a increase in childhood obesity rates. In the past two decades, the obesity rate among children under 5 years of age has increased from 32 to 42 million. If childhood obesity is not intervened in the early years, it will continue into adulthood and remain there for life. Among the potential causative factors, early lifestyle may influence the composition of the gut flora in childhood obesity, such as the rate and intake of high-energy foods, low levels of physical activity, may persist into adulthood, thus, early lifestyle interventions may improve the composition of the gut flora in obese children. Adipose Axis plays an important role in the development of obesity. Adipose tissue is characterized by increased expression of nucleoside diphosphate-linked molecule X-type motif 2 (NUDT2), amphiphilic protein AMPH genes, which encode proteins that all play important roles in the CNS. NUDT2 is associated with intellectual disability. Furthermore, amphiphysin (AMPH) is involved in glutamatergic signaling, ganglionic synapse development, and maturation, which is associated with mild cognitive impairment (MCI) and Alzheimer's disease (AD). All of the above studies show that obesity is closely related to cognitive decline in patients. Animal experiments have confirmed that obesity causes changes in cognitive function. For example, high-fat diets rich in long- and medium-chain saturated fatty acids may adversely affect cognitive function in obese mice. This process may be attributed to the Short-Chain Fatty Acid (SCFA)-rich high-fat diet (HFD) activating enterocyte TLR signaling, especially TLR-2 and TLR-4, altering the downstream MyD88-4 signaling, thereby impacting the downstream MyD88-NF-κB signaling cascade and up-regulating the levels of pro-inflammatory factors and lipopolysaccharide (LPS). These changes result in the loss of integrity of the intestinal mucosa and cause an imbalance in the internal environment. Obesity may lead to the disruption of the intestinal flora and damage the intestinal barrier function, causing intestinal flora dysbiosis. In recent years, a growing number of studies have investigated the relationship between obesity and the intestinal flora. For example, high-fat and high-sugar diets have been found to lead to the thinning of the mucus layer of the colon, a decrease in the number of tight junction proteins, and an increase in intestinal permeability in mice. Such changes alter the composition of intestinal microorganisms, allow endotoxins into the blood circulation, and induce neuroinflammation and brain damage. Therefore, obesity affects cognitive function and is even hereditary. This paper reviews the obesity-induced cognitive dysfunction, the underlying mechanisms, the research progress of intestinal flora dysregulation in obese patients, the relationship between intestinal flora and cognitive function changes, and the research progress on intestinal flora dysregulation in obese patients. We want to regulate the internal environment of obese patients from the perspective of intestinal flora, improving the cognitive function of obese patients, and prevent obesity-induced changes in related neurological functions.
Collapse
Affiliation(s)
- Mengyuan Deng
- Department of Anesthesiology, Affiliated Hospital of Zunyi Medical University, Zunyi, 563003, China
| | - Fushan Tang
- Department of Clinical Pharmacy, Key Laboratory of Basic Pharmacology of Guizhou Province and School of Pharmacy, Zunyi Medical University, Zunyi, 563006, China
| | | |
Collapse
|
5
|
Wang W, Ren R, Yang H, Jiang J, Ye X, Wang C, Ji X, Li W, Zhao Y, Xia Y, Wang D. Healthy Cardiovascular Status Attenuates the Detrimental Association Between Osteosarcopenic Adiposity and Alzheimer's Disease-Related Dementia: A UK Biobank Cohort Study. J Am Heart Assoc 2025:e041697. [PMID: 40401626 DOI: 10.1161/jaha.125.041697] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/08/2025] [Accepted: 04/28/2025] [Indexed: 05/23/2025]
Abstract
BACKGROUND Body composition abnormalities are associated with the risk of Alzheimer's disease-related dementia (ADRD). However, the specific link between osteosarcopenic adiposity (OSA), cardiovascular health (CVH), and ADRD is underexplored. This study examined the association between OSA and ADRD to determine whether optimal CVH could modify this association. METHODS We analyzed data from 152 028 UK Biobank participants. OSA-related body composition abnormalities include low bone mineral density, low muscle mass/grip strength, and high body fat percentage. CVH was assessed using the Life's Essential 8 questionnaire. High and low CVH corresponded to the lowest and highest cardiovascular disease risks, respectively. The hazard ratios (HRs) and 95% CIs for ADRD were estimated using Cox proportional hazards models. A secondary analysis included 14 750 participants with brain magnetic resonance imaging data to explore the role of brain structure in the association between OSA and the incidence of ADRD. RESULTS After a median follow-up of 14.1 years, 2628 participants (1.73%) developed ADRD. Compared with participants with no body composition abnormalities, the adjusted HRs for ADRD risk for those with 1, 2, and 3 abnormalities were 1.04 (95% CI, 0.95-1.14), 1.17 (95% CI, 1.04-1.31), and 1.46 (95% CI, 1.11-1.92), respectively. We found a significant addictive interaction between CVH and abnormal body components, with a relative excess risk due to interaction (95% CI) of -1.34 (95% CI, -2.11 to -0.57). Gray matter in the hippocampus could mediate these associations, with a mediation proportion of 17.3% (P < 0.001). CONCLUSIONS OSA components are positively associated with the risk of ADRD. Maintaining optimal CVH status may mitigate ADRD risk in individuals with OSA.
Collapse
Affiliation(s)
- Wenxu Wang
- Department of Gerontology and Geriatrics Shengjing Hospital of China Medical University Shenyang China
- Department of Health Statistics, School of Public Health China Medical University Shenyang China
| | - Rui Ren
- Department of Health Statistics, School of Public Health China Medical University Shenyang China
| | - Honghao Yang
- Department of Clinical Epidemiology Shengjing Hospital of China Medical University Shenyang China
- Liaoning Key Laboratory of Precision Medical Research on Major Chronic Disease Shenyang China
| | - Jinguo Jiang
- Department of Clinical Epidemiology Shengjing Hospital of China Medical University Shenyang China
- Liaoning Key Laboratory of Precision Medical Research on Major Chronic Disease Shenyang China
| | - Xingyue Ye
- Department of Health Statistics, School of Public Health China Medical University Shenyang China
| | - Chenying Wang
- Department of Clinical Epidemiology Shengjing Hospital of China Medical University Shenyang China
- Liaoning Key Laboratory of Precision Medical Research on Major Chronic Disease Shenyang China
| | - Xiang Ji
- Department of Clinical Epidemiology Shengjing Hospital of China Medical University Shenyang China
- Liaoning Key Laboratory of Precision Medical Research on Major Chronic Disease Shenyang China
| | - Wen Li
- Department of Clinical Epidemiology Shengjing Hospital of China Medical University Shenyang China
- Liaoning Key Laboratory of Precision Medical Research on Major Chronic Disease Shenyang China
| | - Yuhong Zhao
- Department of Clinical Epidemiology Shengjing Hospital of China Medical University Shenyang China
- Liaoning Key Laboratory of Precision Medical Research on Major Chronic Disease Shenyang China
| | - Yang Xia
- School of Public Health Shenyang Medical College Shenyang China
| | - Difei Wang
- Department of Gerontology and Geriatrics Shengjing Hospital of China Medical University Shenyang China
| |
Collapse
|
6
|
Culver A, Stayrook K, Comerota M, Oblak A, Burris T. Animal models for development of anti-obesity drugs in the age of GLP-1 agents. Expert Opin Drug Discov 2025:1-13. [PMID: 40380806 DOI: 10.1080/17460441.2025.2507766] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2024] [Revised: 04/09/2025] [Accepted: 05/14/2025] [Indexed: 05/19/2025]
Abstract
INTRODUCTION Obesity is a major health crisis globally, with prevalence escalating significantly in recent decades. Obesity is not merely excessive weight but is associated with myriad health complications. Ensuring the translational effectiveness of pre-clinical obesity models is paramount, and the success of GLP-1 therapies has highlighted important benchmarks for guiding drug development. AREAS COVERED The authors discuss the status of various animal models used for the development of anti-obesity drugs, with particular emphasis on rodent models and their validity of preclinical-to-clinical translation. They also highlight innovative animal model integration opportunities between obesity and other associated pathology. The article is based on literature searches using PubMed for content (up until February 2025). EXPERT OPINION The effectiveness of GLP-1 therapies in treating type 2 diabetes and obesity presents an opportunity to evaluate the translational relevance of animal models of obesity. Due to their compelling safety profiles, GLP-1(s) are being tested in a wide range of obesity-associated diseases. Optimization of the mechanistic qualities in this drug class requires the incorporation of new endpoints beyond body weight, including lean mass preservation, cardiovascular health, and anti-inflammatory activities. Finally, we are compelled by the intersection of non-obesity disease models into an obesogenic framework to understand the combinatorial effects of obesity on these other disease indications, including heart failure, neurodegenerative diseases, and cancer.
Collapse
Affiliation(s)
- Alexander Culver
- Pelagos Pharmaceuticals, Inc, Houston, TX, USA
- Monument Biosciences, Indianapolis, IN, USA
| | | | | | - Adrian Oblak
- Stark Neurosciences Research Institute, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Thomas Burris
- College of Pharmacy, University of Florida, Gainesville, FL, USA
| |
Collapse
|
7
|
Tsuda T. Preventive effects against cognitive decline and obesity via the combination of dietary factors and exercise: can dietary factors replace or complement the beneficial effects of exercise? Food Funct 2025; 16:3243-3254. [PMID: 40197497 DOI: 10.1039/d4fo06349j] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/10/2025]
Abstract
Regular exercise is known to have positive effects on a variety of health outcomes, including the prevention of obesity and cognitive decline. Several recent reports have suggested that combining exercise with dietary factors such as flavonoids can amplify health functions. While the addition of dietary factors synergistically or additively enhances the beneficial effects of exercise, the addition of exercise may also reduce the amount of dietary factors needed to obtain their beneficial effects. This review describes (1) the exercise-induced improvement of health functions focusing on cognitive function, (2) several studies that investigated the effects that combining flavonoids with exercise has on obesity and cognitive function, and (3) the synergistic effect of inducing beige adipocyte formation to potentially explain the mechanism of the preventive effects of combining dietary factors and exercise on obesity, including new findings on lactate obtained through these studies. Finally, we summarize the following challenges and issues in research on developing the combination of dietary factors and exercise: clarifying the appropriate types and intensities of exercise and appropriate intake of dietary factors for obtaining the optimal combined effect, accumulating results of human interventional studies, and examining the benefits of this combination in improving the memory and learning ability of young adults and children. As scientists studying functional foods, we should focus more on exercise-replacement and exercise-complementing dietary factors in our research. This journal will play an important role in elucidating the molecular mechanisms underlying the combined effects of dietary factors and exercise.
Collapse
Affiliation(s)
- Takanori Tsuda
- School of Bioscience and Biotechnology and Graduate School of Bioscience and Biotechnology, Chubu University, Kasugai, Aichi 487-8501, Japan.
| |
Collapse
|
8
|
Wei J, Zhu X, Liu J, Gao Y, Liu X, Wang K, Zheng X. Estimating global prevalence of mild cognitive impairment and dementia in elderly with overweight, obesity, and central obesity: A systematic review and meta-analysis. Obes Rev 2025; 26:e13882. [PMID: 39647849 DOI: 10.1111/obr.13882] [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: 01/04/2024] [Revised: 11/26/2024] [Accepted: 11/28/2024] [Indexed: 12/10/2024]
Abstract
BACKGROUND AND AIM Previous studies have demonstrated that adiposity, particularly obesity during midlife, may have a detrimental effect on cognitive function. This study aims to estimate the global prevalence of mild cognitive impairment (MCI) and dementia in elderly aged 60 years or above with overweight, obesity, and central obesity. METHODS We searched PubMed, Embase, Web of Science, and Cochrane Library from inception to November 2023. DerSimonian-Laird random-effects model with Logit transformation was used. Sensitivity analysis, meta-regression, and subgroup analysis were employed to investigate determinants of the prevalence of MCI and dementia. RESULTS A total of 72 studies involving 2,980,947 elderly with distinct adiposity status were included. Pooled prevalence of MCI and dementia in elderly with overweight and obesity was 32.54% and 9.47%, respectively. Univariate meta-regression analysis indicated that the heterogeneity in dementia prevalence was attributable to variations in study size (R2 = 0.01, p < 0.05), while the multivariable analysis underscored that the income of country or area had the most significant predictive importance (60.3% and 90.3%) for both MCI and dementia prevalence. Subgroup analysis revealed regional disparities and diagnostic technique variations contributing to heterogeneity. Based on currently available but inadequate epidemiological data, the pooled prevalence of MCI and dementia in elderly with central obesity was calculated as 10.18% and 9.75%, respectively. CONCLUSION Strategies to address adiposity-associated cognitive impairment should consider multifaceted interventions beyond simple weight reduction. Macro-level initiatives such as improvement of income levels and micro-level interventions including the adoption of accurate diagnostic techniques also represent equally pivotal components.
Collapse
Affiliation(s)
- Junlun Wei
- Department of Endocrinology and Metabolism, Research Center for Islet Transplantation, West China Hospital, Sichuan University, Chengdu, China
| | - Xinyue Zhu
- Department of Endocrinology and Metabolism, Research Center for Islet Transplantation, West China Hospital, Sichuan University, Chengdu, China
| | - Jiaye Liu
- Division of Thyroid Surgery, Department of General Surgery, West China Hospital, Sichuan University, Chengdu, China
- Laboratory of Thyroid and Parathyroid Diseases, Frontiers Science Center for Disease-Related Molecular Network, West China Hospital, Sichuan University, Chengdu, China
- Department of Respiratory and Critical Care Medicine, Frontiers Science Center for Disease-related Molecular Network, Center of Precision Medicine, Precision Medicine Key Laboratory of Sichuan Province, West China Hospital, Sichuan University, Chengdu, China
| | - Yun Gao
- Department of Endocrinology and Metabolism, Research Center for Islet Transplantation, West China Hospital, Sichuan University, Chengdu, China
| | - Xinjun Liu
- Department of Vascular Surgery, University Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Ke Wang
- Department of Vascular Surgery, University Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China
| | - Xiaofeng Zheng
- Department of Endocrinology and Metabolism, Research Center for Islet Transplantation, West China Hospital, Sichuan University, Chengdu, China
| |
Collapse
|
9
|
Qiu SD, Zhang DD, Ma LY, Li QY, Wang LY, Wang YD, Wang YC, Xiong SY, Tan L. Associations of metabolic syndrome with risks of dementia and cognitive impairment: A systematic review and meta-analysis. J Alzheimers Dis 2025; 105:15-27. [PMID: 40111916 DOI: 10.1177/13872877251326553] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/22/2025]
Abstract
BackgroundPrevious studies have linked metabolic syndrome (MetS) to dementia risk.ObjectiveWe conducted a systematic review and meta-analysis to assess the association between MetS and dementia as well as cognitive impairment, with additional focus on individual MetS components.MethodsWe systematically searched the PubMed, Embase, and Cochrane Library databases from inception through July 2024. We used random-effects models to calculate relative risks (RRs) and odds ratios (ORs) with 95% confidence intervals (CIs). Publication bias was evaluated using the Egger's test, while potential sources of heterogeneity were investigated through meta-regression, subgroup, and sensitivity analyses.ResultsOur analysis included 21 studies with a total of 411,810 participants. MetS was associated with increased risks of all-cause dementia (RR = 1.33, 95% CI = 1.03-1.71, I² = 85.8%) and vascular dementia (RR = 2.07, 95% CI = 1.32-3.24, I² = 10.1%), but not Alzheimer's disease (RR = 1.10, 95% CI = 0.64-1.91, I² = 81.8%). Regarding cognitive impairment, longitudinal studies showed an increased risk (OR = 1.38, 95% CI = 1.24-1.53, I² = 3.3%), with similar findings in cross-sectional studies (OR = 1.65, 95% CI = 1.19-2.28, I² = 85.3%).ConclusionsThis study found that MetS is significantly associated with increased risks of dementia and cognitive impairment, with each component potentially being a modifiable factor. These findings may help guide clinicians in recommending lifestyle interventions to prevent cognitive decline and promote brain health.
Collapse
Affiliation(s)
- Shu-Dong Qiu
- Department of Neurology, Qingdao Municipal Hospital, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Dan-Dan Zhang
- Department of Neurology, Qingdao Municipal Hospital, Qingdao University, Qingdao, Shandong, China
| | - Li-Yun Ma
- Department of Neurology and Psychiatry, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| | - Qiong-Yao Li
- Department of Neurology, Qingdao Municipal Hospital, Qingdao University, Qingdao, Shandong, China
| | - Lan-Yang Wang
- Department of Neurology, Qingdao Municipal Hospital, Nanjing Medical University, Nanjing, Jiangsu, China
| | - Yu-Dong Wang
- School of Clinical Medicine, Shandong Second Medical University, Weifang, Shandong, China
| | - Yong-Chang Wang
- Department of Neurology, Qingdao Municipal Hospital, Qingdao University, Qingdao, Shandong, China
| | - Shi-Yin Xiong
- Department of Neurology, Qingdao Municipal Hospital, Qingdao University, Qingdao, Shandong, China
| | - Lan Tan
- Department of Neurology, Qingdao Municipal Hospital, Nanjing Medical University, Nanjing, Jiangsu, China
- Department of Neurology, Qingdao Municipal Hospital, Qingdao University, Qingdao, Shandong, China
- Department of Neurology and Psychiatry, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, China
| |
Collapse
|
10
|
Liu T, Liu Y, Shi H, Yue G, Dai X, Zhang Y, Wang S, Shen J, Xu T, Yin J, Zhang J, Zhang Y, Wang L, Zhou G, Zhang D. Sijunzi decoction improves lipid metabolism via regulation of Wnt/β-catenin signaling pathway in diabetic mice and 3T3-L1 cells. JOURNAL OF ETHNOPHARMACOLOGY 2025; 346:119672. [PMID: 40139576 DOI: 10.1016/j.jep.2025.119672] [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: 09/30/2024] [Revised: 12/20/2024] [Accepted: 03/21/2025] [Indexed: 03/29/2025]
Abstract
ETHNOPHARMACOLOGICAL RELEVANCE Sijunzi decoction (SJZD), a traditional Chinese medicinal formula with the functions of invigorating the Spleen and replenishing Qi, has been clinically used for the management of diabetes, but its actions and underlying mechanisms on diabetic lipid metabolism remain largely unknown. AIM OF THE STUDY To explore the effects of SJZD on lipid metabolism disorders and its association with the Wnt/β-catenin pathway in the white adipose tissue of diabetic mice and 3T3-L1 cells. MATERIALS AND METHODS The diabetic lipid metabolism disorders models were established by high-fat diet/streptozotocin in mice and palmitic acid in 3T3-L1 cells, respectively. The effects of SJZD on total cholesterol (TC), triglyceride (TG), low-density lipoprotein cholesterol (LDL), high-density lipoprotein cholesterol (HDL), and glucose consumption were determined by biochemical assay. Hematoxylin-eosin (H&E) staining was used to examine pathological alterations in adipose tissues. Oil red O staining was used to evaluate the differentiation of lipid droplets in 3T3-L1 adipocytes. The expression levels of Wnt10b, β-catenin, CCAAT enhancer binding protein α (C/EBP-α), sterol regulatory element-binding protein 1 (SREBP-1c), acetyl-CoA carboxylase-1 (ACC1), peroxisome proliferator-activated receptor γ (PPAR-γ), fatty acid synthase (FASN), adipose triglyceride lipase (ATGL) were examined by Western blot and/or qRT-PCR. In addition, the main components of SJZD and SJZD-containing serum (SCS) were identified by UPLC-Q-TOF-MS/MS. RESULTS SJZD reduces the body fat ratio, fasting blood glucose levels, adipose tissue index and serum levels of TC, TG, and LDL, and increases the body weight, lean ratio, and serum HDL levels, as well as prevents the adipocytes hypertrophy in diabetic mice. In addition, SJZD, SCS and its ingredients (Ginsenoside Rb1 and Glycyrrhetinic acid) inhibit lipid synthesis, TG levels and promote glucose consumption in diabetic mice and 3T3-L1 adipocytes. These interventions decrease the expressions of PPAR-γ, SREBP-1c, C/EBP-α, FASN, ACC1 and P-β-catenin, and increase the expressions of ATGL, Wnt10b and β-catenin. CONCLUSION SJZD regulates the Wnt/β-catenin signaling pathway to preserve lipid metabolism homeostasis in diabetes. GRb and Gac may constitute the material basis of SJZD in attenuation of diabetic lipid metabolism disorders. These findings highlight a novel strategy for the treatment of diabetes.
Collapse
Affiliation(s)
- Tianyuan Liu
- Diabetes Research Center, School of Traditional Chinese Medicine, Beijing University of Chinese Medicine, Beijing, 100029, PR China
| | - Yage Liu
- Diabetes Research Center, School of Traditional Chinese Medicine, Beijing University of Chinese Medicine, Beijing, 100029, PR China; Food and Pharmacy College, Xuchang University, Xuchang, Henan, 461000, PR China
| | - Hanfen Shi
- Diabetes Research Center, School of Traditional Chinese Medicine, Beijing University of Chinese Medicine, Beijing, 100029, PR China
| | - Gaiyue Yue
- Diabetes Research Center, School of Traditional Chinese Medicine, Beijing University of Chinese Medicine, Beijing, 100029, PR China
| | - Xuan Dai
- Diabetes Research Center, School of Traditional Chinese Medicine, Beijing University of Chinese Medicine, Beijing, 100029, PR China
| | - Yueyi Zhang
- Diabetes Research Center, School of Traditional Chinese Medicine, Beijing University of Chinese Medicine, Beijing, 100029, PR China
| | - Shan Wang
- Diabetes Research Center, School of Traditional Chinese Medicine, Beijing University of Chinese Medicine, Beijing, 100029, PR China
| | - Jin Shen
- Diabetes Research Center, School of Traditional Chinese Medicine, Beijing University of Chinese Medicine, Beijing, 100029, PR China
| | - Tianshu Xu
- Diabetes Research Center, School of Traditional Chinese Medicine, Beijing University of Chinese Medicine, Beijing, 100029, PR China
| | - Jiyuan Yin
- Diabetes Research Center, School of Traditional Chinese Medicine, Beijing University of Chinese Medicine, Beijing, 100029, PR China
| | - Jianglan Zhang
- Department of Pathology, School of Chinese Medicine, Beijing University of Chinese Medicine, Beijing, 102488, PR China
| | - Yanfei Zhang
- Department of Anatomy, School of Chinese Medicine, Beijing University of Chinese Medicine, Beijing, 102488, PR China
| | - Lili Wang
- Department of TCM Pharmacology, Chinese Material Medica School, Beijing University of Chinese Medicine, Beijing, 102488, PR China
| | - Gang Zhou
- Center for Drug Evaluation, National Medical Products Administration, Beijing, 100076, PR China
| | - Dongwei Zhang
- Diabetes Research Center, School of Traditional Chinese Medicine, Beijing University of Chinese Medicine, Beijing, 100029, PR China.
| |
Collapse
|
11
|
Zeng M, Chen Y, Lobanov-Rostovsky S, Liu Y, Steptoe A, Brunner EJ, Liao J. Adiposity and dementia among Chinese adults: longitudinal study in the China Health and Retirement Longitudinal Study (CHARLS). Int J Obes (Lond) 2025; 49:706-714. [PMID: 39695279 PMCID: PMC11999862 DOI: 10.1038/s41366-024-01698-x] [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: 05/26/2024] [Revised: 11/16/2024] [Accepted: 11/27/2024] [Indexed: 12/20/2024]
Abstract
BACKGROUND Evidence on the age-dependent association between adiposity and risk of dementia in the Chinese population is unclear. We aim to disentangle the association of mid- and late- life adiposity with subsequent dementia risk in Chinese adults and compare ageing trajectories of adiposity between those with/out dementia. METHODS Dementia was ascertained based on cognitive batteries and the Activity of Daily Living Scale in the China Health and Retirement Longitudinal Study (CHARLS). Adiposity was measured by body mass index (BMI), waist circumference (WC), and waist-to-height ratio (WtHR). We estimated hazard ratio (HR) of adiposity for incident dementia by age groups (i.e. 50-64, and ≥65). Age trajectories of adiposity measures were fitted using a mixed-effect model in a case-control design. The interaction terms of age and dementia were included to examine the difference between cases and controls. RESULTS Hazard ratios (HRs) for incident dementia in two age groups (50-64 and ≥65) were estimated in 13,355 participants. Raised mid-life BMI was associated with incident dementia (HR (95% CI): overweight 1.33 (1.03 to 1.73), obesity 1.63 (1.17 to 2.28)). Mid-life abdominal obesity was associated with incident dementia (WC 1.45 (1.15 to 1.84), WtHR 1.44 (1.08 to 1.94)), accounting for ≤24.2% of dementia cases. Among participants developing dementia, adiposity measures were higher in mid-life and declined faster with age, compared to those remaining dementia-free. Late-life adiposity was not associated with dementia risk. CONCLUSION Mid-life but not late-life adiposity was associated with dementia incidence in China. Accelerated weight loss in prodromal dementia is likely to explain the mixed evidence on adiposity and dementia risk in the Chinese population. Rapid decline in adiposity in later life may be an early sign. Reducing mid-life adiposity in the population may mitigate the future dementia burden.
Collapse
Affiliation(s)
- Minrui Zeng
- Department of Medical Statistics, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, P. R. China
| | - Yuntao Chen
- Department of Epidemiology & Public Health, University College London, London, UK
| | | | - Yuyang Liu
- Department of Medical Statistics, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, P. R. China
- Guangming District Center for Disease Control and Prevention, Shenzhen, China
| | - Andrew Steptoe
- Department of Behavioural Science and Health, University College London, London, UK
| | - Eric John Brunner
- Department of Epidemiology & Public Health, University College London, London, UK
| | - Jing Liao
- Department of Medical Statistics, School of Public Health, Sun Yat-sen University, Guangzhou, Guangdong, P. R. China.
- Sun Yat-sen Global Health Institute, Institute of State Governance, Sun Yat-sen University, Guangzhou, China.
| |
Collapse
|
12
|
Tian Q, Dong Q, Su Z, Liu Y, Ma L, Dong H, Xu Y, Ma Z, Chen X, Ma X. Association of body weight and serum uric acid with Alzheimer's disease biomarkers and cognitive impairment. J Alzheimers Dis 2025; 104:255-268. [PMID: 39924832 DOI: 10.1177/13872877251315011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/11/2025]
Abstract
BackgroundGiven the limited effective treatments for Alzheimer's disease (AD), obesity and serum uric acid (SUA) levels which are considered modifiable risk factors for dementia are of interest. However, research indicates conflicting results.ObjectiveWe aimed to further investigate the association of body weight (BW) and SUA with AD biomarkers and cognitive impairment.MethodsClinical data were collected from 139 adults (mean age 66.9 years) with chronic cognitive impairment. Cerebrospinal fluid (CSF) biomarkers and PET imaging were used to assess amyloid-β (A) and Tau (T) tangles load, classifying participants into AT profiles based on the results. The association of BW and SUA with AT profiles was evaluated using multivariable logistic regression, and their relationship with cognitive function (Mini-Mental State Examination (MMSE) scores) were analyzed using multivariable linear regression.ResultsLower BW levels significantly influenced the presence of Aβ positive state (A+) (p = 0.007), while SUA levels did not (p = 0.263). Higher dementia proportion (p = 0.021), lighter BW (p = 0.019), and lower mean arterial pressure (MAP) levels (p = 0.025) were associated with AD pathological progress (A-T-→A+T-→A+T+), but SUA was not observed statistically significant. Among all participants regardless of Aβ state, high education levels (p < 0.001), high BW (p = 0.010), and high SUA (p=0.036) were associated with high MMSE scores, and high serum creatinine (p = 0.003) was associated with low MMSE scores.ConclusionsLower BW may accelerate AD pathology and cause cognitive impairment, while SUA is not linked to AD pathological progression but protects cognitive function.
Collapse
Affiliation(s)
- Qing Tian
- Department of Neurology, Mental and Neurological Diseases Research Center, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, Guangdong, China
| | - Qing Dong
- Department of Neurology, Mental and Neurological Diseases Research Center, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, Guangdong, China
| | - Zhumin Su
- Department of Neurology, Mental and Neurological Diseases Research Center, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, Guangdong, China
| | - Yingying Liu
- Department of Neurology, Mental and Neurological Diseases Research Center, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, Guangdong, China
| | - Lili Ma
- Department of Neurology, Mental and Neurological Diseases Research Center, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, Guangdong, China
| | - Huimin Dong
- Department of Clinical Laboratory, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, Guangdong, China
| | - Yiru Xu
- School of Foreign Languages, Sun Yat-sen University, Guangzhou, Guangdong, China
| | - Zhan Ma
- Department of Neurology, Mental and Neurological Diseases Research Center, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, Guangdong, China
| | - Xiaohong Chen
- Department of Neurology, Mental and Neurological Diseases Research Center, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, Guangdong, China
| | - Xiaomeng Ma
- Department of Neurology, Mental and Neurological Diseases Research Center, The Third Affiliated Hospital of Sun Yat-Sen University, Guangzhou, Guangdong, China
| |
Collapse
|
13
|
Nakashima Y, Hibi T, Urakami M, Hoshino M, Morii T, Sugawa H, Katsuta N, Tominaga Y, Takahashi H, Otomo A, Hadano S, Yasuda S, Hokamura A, Imai S, Kinoshita H. Soymilk yogurt prepared using Pediococcus pentosaceus TOKAI 759m ameliorates cognitive function through gut microbiota modulation in high-fat diet mice. Curr Res Food Sci 2025; 10:100993. [PMID: 40026903 PMCID: PMC11869912 DOI: 10.1016/j.crfs.2025.100993] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2024] [Revised: 01/15/2025] [Accepted: 01/29/2025] [Indexed: 03/05/2025] Open
Abstract
Recent studies have confirmed that obesity leads to neuroinflammation and cognitive decline. This study aimed to examine whether soymilk yogurt prepared using Pediococcus pentosaceus TOKAI 759m could prevent cognitive decline and neuroinflammation progression in mice fed a high-fat diet (HFD). C57BL/6NJcl male mice were grouped according to the following dietary interventions and monitored for 15 weeks: (1) normal control diet, (2) HFD, (3) HFD with soymilk (SM), (4) HFD with soymilk yogurt (SY), and (5) HFD with bacterial cells of the starter strain (BC). The levels of inflammatory cytokines in serum and hippocampus were measured. Compared to the HFD group, the SY group scored higher in the novel object recognition test and exhibited lower levels of Interleukin-6 (IL-6) and Tumor Necrosis Factor (TNF)-α in the hippocampus. However, the SM and BC groups did not show these significant changes. Proteomic analysis of the hippocampus revealed three enriched protein clusters in the SY group: synaptic proteins, glycolysis, and mitochondrial ATP formation. Fecal samples were also collected to measure the proportion of gut microbiota using 16S rRNA analysis. Interestingly, the proportion of butyrate-producing bacteria, such as Clostridium and Akkermansia, tended to be higher in the SY group than in the HFD group. An additional in vitro study revealed that the components of SY, such as daidzein, genistein, and adenine, could decrease inflammatory cytokine levels in microglial cells. In conclusion, soymilk yogurt prepared using P. pentosaceus TOKAI 759m may modulate gut microbiota and prevent neuroinflammation, thereby leading to a possible improvement in cognitive function.
Collapse
Affiliation(s)
- Yuki Nakashima
- Graduate School of Bioscience, Tokai University, 871-12 Sugido, Mashiki-machi, Kamimashiki-gun, Kumamoto, Japan
- JSPS Research Fellowship for Young Scientists, Tokyo, 102-0083, Japan
| | - Tomoyuki Hibi
- Graduate School of Bioscience, Tokai University, 871-12 Sugido, Mashiki-machi, Kamimashiki-gun, Kumamoto, Japan
- Research Institute of Agriculture, Tokai University, Kumamoto, 862-8652, Japan
| | - Masafumi Urakami
- School of Agriculture, Tokai University, 871-12 Sugido, Mashiki-machi, Kamimashiki-gun, Kumamoto, Japan
| | - Maki Hoshino
- Graduate School of Agriculture, Tokai University, 871-12 Sugido, Mashiki-machi, Kamimashiki-gun, Kumamoto, Japan
| | - Taiki Morii
- School of Agriculture, Tokai University, 871-12 Sugido, Mashiki-machi, Kamimashiki-gun, Kumamoto, Japan
| | - Hikari Sugawa
- Graduate School of Agriculture, Tokai University, 871-12 Sugido, Mashiki-machi, Kamimashiki-gun, Kumamoto, Japan
| | - Nana Katsuta
- Research Institute of Agriculture, Tokai University, Kumamoto, 862-8652, Japan
| | - Yuki Tominaga
- Graduate School of Agriculture, Tokai University, 871-12 Sugido, Mashiki-machi, Kamimashiki-gun, Kumamoto, Japan
| | - Himeno Takahashi
- Graduate School of Bioscience, Tokai University, 871-12 Sugido, Mashiki-machi, Kamimashiki-gun, Kumamoto, Japan
- Research Institute of Agriculture, Tokai University, Kumamoto, 862-8652, Japan
| | - Asako Otomo
- Molecular Neuropathobiology Laboratory, Department of Physiology, Tokai University School of Medicine, Isehara, Kanagawa, 259- 1193, Japan
| | - Shinji Hadano
- Molecular Neuropathobiology Laboratory, Department of Physiology, Tokai University School of Medicine, Isehara, Kanagawa, 259- 1193, Japan
| | - Shin Yasuda
- Graduate School of Bioscience, Tokai University, 871-12 Sugido, Mashiki-machi, Kamimashiki-gun, Kumamoto, Japan
- School of Agriculture, Tokai University, 871-12 Sugido, Mashiki-machi, Kamimashiki-gun, Kumamoto, Japan
- Graduate School of Agriculture, Tokai University, 871-12 Sugido, Mashiki-machi, Kamimashiki-gun, Kumamoto, Japan
| | - Ayaka Hokamura
- Graduate School of Agriculture, Tokai University, 871-12 Sugido, Mashiki-machi, Kamimashiki-gun, Kumamoto, Japan
| | - Saki Imai
- Research Institute of Agriculture, Tokai University, Kumamoto, 862-8652, Japan
- Graduate School of Agriculture, Tokai University, 871-12 Sugido, Mashiki-machi, Kamimashiki-gun, Kumamoto, Japan
| | - Hideki Kinoshita
- Graduate School of Bioscience, Tokai University, 871-12 Sugido, Mashiki-machi, Kamimashiki-gun, Kumamoto, Japan
- Research Institute of Agriculture, Tokai University, Kumamoto, 862-8652, Japan
- School of Agriculture, Tokai University, 871-12 Sugido, Mashiki-machi, Kamimashiki-gun, Kumamoto, Japan
- Graduate School of Agriculture, Tokai University, 871-12 Sugido, Mashiki-machi, Kamimashiki-gun, Kumamoto, Japan
- Probio Co., Ltd., 1330-1 Futa, Nishihara-mura, Aso-gun, Kumamoto, Japan
| |
Collapse
|
14
|
Feng S, Wang T, Su Y, Yan J, Wang Y, Zhang Z, Yin C, Zhai H. Global burden, risk factors, and projections of early-onset dementia: Insights from the Global Burden of Disease Study 2021. Ageing Res Rev 2025; 104:102644. [PMID: 39701185 DOI: 10.1016/j.arr.2024.102644] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2024] [Revised: 12/16/2024] [Accepted: 12/16/2024] [Indexed: 12/21/2024]
Abstract
BACKGROUND Despite increasing global awareness of dementia, reliable estimates of the disease burden associated with Early-Onset Dementia (EOD) remain insufficiently quantified. This study aims to estimate the disease burden of EOD, analyze the burden attributable to risk factors from 1990 to 2021, and project these trends to 2050 at global, regional, and national levels, providing essential data to inform public health policy. METHODS By utilising data from the GBD 2021 database, this study analysed metrics such as age-standardized prevalence (ASPR), mortality (ASMR), and disability-adjusted life years (AS-DALYs) for EOD. Joinpoint Regression analysis was used to calculated average annual percent changes (AAPCs) of ASPR, ASMR, and AS-DALYs. Then, the disease burden attributable to high fasting plasma glucose (FPG), high body-mass index (BMI), and tobacco were also reported. Finally, the Bayesian age-period-cohort (BAPC) model was employed to project global ASPR, ASMR and AS-DALYs, as well as ASMR and AS-DALYs attributed to the three risk factors from 2022 to 2050. RESULTS In 2021, the global case numbers of prevalence, mortality and DALYs for EOD were 7.75 (95 %UI: 5.82, 10.08) million, 73,386 (14,059, 232,169), and 3.77 (1.69, 8.88) million. Despite large increases in case numbers, AAPCs of ASR (0.08 % [0.02, 0.14], 0.07 % [0.05, 0.1], and 0.08 % [0.05, 0.1]) kept stable. Females exhibited higher case numbers and ASR across all disease burden indicators than males. Region- and country-level geographical heterogeneities were evident. Furthermore, global ASMR and AS-DALYs associated with high BMI and high FPG showed a steady increase, while the growth in ASMR and AS-DALYs attributable to tobacco has declined. To 2050, global case numbers of prevalence, mortality and DALYs for EOD will continue to rise, but ASRs won't change considerably. Females are anticipated to remain at a higher risk. The disease burden associated with high BMI and high FPG are expected to persist in their upward trends, whereas that related to tobacco are projected to decline. CONCLUSION The increasing burden of EOD underscores the critical need for tailored public health strategies and policies, a unique challenge underrecognized before.
Collapse
Affiliation(s)
- Shixing Feng
- School of Chinese Materia Medica, Beijing University of Chinese Medicine, Beijing 100026, China; Institut International de Médecine Intégrative, Centre France Chine de la Médecine Chinoise, Selles sur Cher 41130, France.
| | - Tianyi Wang
- Institut International de Médecine Intégrative, Centre France Chine de la Médecine Chinoise, Selles sur Cher 41130, France.
| | - Yang Su
- Département d'informatique, École Normale Supérieure - PSL, Paris 75005, France
| | - Jinlong Yan
- Department of Geography and Spatial Information Techniques, Ningbo University, Ningbo 315211, China
| | - Yiheng Wang
- Research Center for Eco-Environmental Sciences, Chinese Academy of Sciences, Beijing 100085, China
| | - Zhenqiang Zhang
- Henan Engineering Research Center for Prevention and Treatment of Major Chronic Diseases with Chinese Medicine, Academy of Chinese Medical Sciences, Henan University of Chinese Medicine, Zhengzhou 450046, China
| | - Chaohui Yin
- School of Resource and Environment, Henan Agricultural University, Zhengzhou 450046, China.
| | - Huaqiang Zhai
- School of Chinese Materia Medica, Beijing University of Chinese Medicine, Beijing 100026, China.
| |
Collapse
|
15
|
Liang Z, Qin H, Su B, Bao Y, Vitiello MV, Hu G, Wang Y. Trajectories of general and central obesity beyond middle age in relation to late-life cognitive decline and dementia. Obesity (Silver Spring) 2025; 33:405-415. [PMID: 39873393 PMCID: PMC11774005 DOI: 10.1002/oby.24208] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2024] [Revised: 10/24/2024] [Accepted: 10/28/2024] [Indexed: 01/30/2025]
Abstract
OBJECTIVE The objective was to evaluate the longitudinal patterns of central and general obesity, identify their genetic and behavioral risk determinants, and investigate the association of distinct obesity trajectories beyond middle age with subsequent cognitive decline and the risk of developing dementia in late life. METHODS Using a nationally representative, longitudinal, community-based cohort, we examined trajectory patterns of obesity over a 14-year span beyond middle age employing latent mixture modeling. We then evaluated their relationship with subsequent cognitive decline through linear mixed models and with the risk of developing dementia using Cox models, adjusting for confounding variables. RESULTS Among the 4751 eligible participants (mean age, 58.7 [SD 8.1] years; 57% female), our analysis identified five distinct BMI trajectories and four WC trajectories spanning a 14-year period. In comparison with individuals in the low-stable BMI group, characterized by a consistent and healthy body weight (range, 22.8-22.9 kg/m2), those in the high-stable group, maintaining a stable obesity status (range, 34.3-35.4 kg/m2), exhibited an elevated risk of developing dementia (odds ratio [OR], 1.43; 95% CI: 1.02 to 2.00) and experienced a more accelerated cognitive decline over 6 years (difference in 6-year decline, -0.11 SD [95% CI: -0.18 to -0.03]). Similarly, when compared with participants in the low-stable WC group, indicating a stable and healthy WC (range, 76-79 cm), those in the high-increasing WC group, showing an increasing trend (range, 115-122 cm), demonstrated an increased risk of developing dementia (OR, 1.57, 95% CI: 1.01 to 2.49) and experienced a swifter cognitive decline (OR: -0.18 [95% CI: -0.28 to -0.07]). CONCLUSIONS General and central obesity trajectories beyond midlife with persistently high or increasing patterns were significantly associated with an increased risk of developing cognitive decline and dementia in late life. Longitudinal obesity patterns may assist in precise identification of older adults at risk of developing cognitive impairment for targeted intervention.
Collapse
Affiliation(s)
- Zhengting Liang
- School of Traditional Chinese MedicineXinjiang Medical UniversityUrumqiChina
| | - Huibo Qin
- Quality Control Department of Liaocheng People's HospitalShandongChina
| | - Binbin Su
- School of Population Medicine and Public HealthChinese Academy of Medical Sciences/Peking Union Medical CollegeBeijingChina
| | - Yanping Bao
- National Institute on Drug DependencePeking UniversityBeijingChina
- School of Public HealthPeking UniversityBeijingChina
| | - Michael V. Vitiello
- Department of Psychiatry and Behavioral SciencesUniversity of WashingtonSeattleWashingtonUSA
| | - Gang Hu
- School of Health ManagementXinjiang Medical UniversityUrumqiChina
- Health Management Center of the First Affiliated Hospital of Xinjiang Medical UniversityUrumqiChina
| | - Yunhe Wang
- Nuffield Department of Population HealthUniversity of OxfordOxfordUK
| |
Collapse
|
16
|
Li Y, Sanjay AB, Manchella M, Mishra A, Logan PE, Kim HJ, Risacher SL, Gao S, Apostolova LG. Effect of genetic and vascular risk factors on rates of cognitive decline in early-onset and late-onset Alzheimer's disease. J Alzheimers Dis 2025; 103:920-930. [PMID: 39801136 PMCID: PMC12001323 DOI: 10.1177/13872877241307321] [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: 01/23/2025]
Abstract
BACKGROUND Although previous studies have shown that cognitive decline in Alzheimer's disease (AD) is associated with various risk factors, they primarily focused on late-onset AD (LOAD). OBJECTIVE We aim to evaluate the differential impact of risk factors on the cognitive decline between early-onset AD (EOAD, onset < 65 years) and LOAD (onset ≥ 65 years) and explore the longitudinal effect of Apolipoprotein E allele 4 (APOE ε4) on cortical atrophy in both cohorts. METHODS Using data from 212 EOAD and 1101 LOAD participants in the Alzheimer's Disease Neuroimaging Initiative (ADNI), we conducted multivariable mixed-effect models to evaluate the impact of APOE ε4, education, hypertension, diabetes, dyslipidemia, and body mass index on cognitive performance. Preprocessed MRI data were utilized for longitudinal parametric mapping. RESULTS APOE ε4 carriers in both groups showed significantly accelerated declines in language, verbal memory, executive function, and general cognition. By controlling other significant risk factors, APOE ε4 carriers showed faster declines in language and verbal memory in both groups. Females exhibited accelerated declines in Language and verbal memory in the EOAD and LOAD cohorts respectively. LOAD individuals with hypertension showed faster declines while overweight and obese participants displayed slower declines in both cohorts across all domains except visuospatial. Notably, APOE ε4 status was associated with longitudinal cortical atrophy in the LOAD cohort but not in the EOAD cohort. CONCLUSIONS Known risk factors for AD were associated with cognitive decline in both EOAD and LOAD cohorts.
Collapse
Affiliation(s)
- Yunyi Li
- Department of Biostatistics and Health Data Science, Indiana University School of Medicine, Indianapolis, IN, USA
| | | | - Mohit Manchella
- Department of Chemistry, University of Southern Indiana, Evansville, IN, USA
| | - Aryan Mishra
- Department of Medical Sciences, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Paige E Logan
- Department of Neurology, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Hee Jin Kim
- Department of Neurology, Indiana University School of Medicine, Indianapolis, IN, USA
- Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Shannon L Risacher
- Indiana Alzheimer’s Disease Research Center, Indianapolis, IN, USA
- Department of Radiology and Imaging Sciences, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Sujuan Gao
- Department of Biostatistics and Health Data Science, Indiana University School of Medicine, Indianapolis, IN, USA
- Indiana Alzheimer’s Disease Research Center, Indianapolis, IN, USA
| | - Liana G Apostolova
- Department of Neurology, Indiana University School of Medicine, Indianapolis, IN, USA
- Indiana Alzheimer’s Disease Research Center, Indianapolis, IN, USA
| |
Collapse
|
17
|
Vitali F, Wiegand JP, Parker-Halstead L, Tucker A, Diaz Brinton R. Weight trajectories in aging humanized APOE mice with translational validity to human Alzheimer's risk population: A retrospective analysis. PLoS One 2025; 20:e0314097. [PMID: 39854369 PMCID: PMC11760569 DOI: 10.1371/journal.pone.0314097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2024] [Accepted: 11/06/2024] [Indexed: 01/26/2025] Open
Abstract
Translational validity of mouse models of Alzheimer's disease (AD) is variable. Because change in weight is a well-documented precursor of AD, we investigated whether diversity of human AD risk weight phenotypes was evident in a longitudinally characterized cohort of 1,196 female and male humanized APOE (hAPOE) mice, monitored up to 28 months of age which is equivalent to 81 human years. Autoregressive Hidden Markov Model (AHMM) incorporating age, sex, and APOE genotype was employed to identify emergent weight trajectories and phenotypes. In the hAPOE-AD mouse cohort, five distinct weight trajectories emerged: three trajectories were associated with a weight loss phenotype (36% of mice, n = 426), one with weight gain (13% of mice, n = 152), and one trajectory of no change in weight (34% of mice, n = 403). The AHMM model findings were validated with post-hoc survival analyses, revealing differences in survival rates across the five identified phenotypes. Further validation was performed using body composition and plasma β-amyloid data from mice within the identified gain, loss and stable weight trajectories. Weight gain trajectory was associated with elevated plasma β-amyloid levels, higher body fat composition, lower survival rates and a greater proportion of APOE4/4 carriers. In contrast, weight loss was associated with greater proportion of hAPOE3/4 carriers, better survival rates and was predominantly male. The association between weight change and AD risk observed in humans was mirrored in the hAPOE-AD mouse model. Weight trajectories of APOE3/3 mice were equally distributed across weight gain, loss and stability. Surprisingly, despite genetic uniformity, comparable housing, diet and handling, distinct weight trajectories and divergence points emerged for subpopulations. These data are consistent with the heterogeneity observed in the human population for change in body weight during aging and highlight the importance of longitudinal phenotypic characterization of mouse aging to advance the translational validity of preclinical AD mouse models.
Collapse
Affiliation(s)
- Francesca Vitali
- Center for Innovation in Brain Science, University of Arizona Health Sciences, Tucson, Arizona, United States of America
- Department of Neurology, College of Medicine Tucson, University of Arizona, Tucson, Arizona, United States of America
- BIO5 Institute, University of Arizona, Tucson, Arizona, United States of America
- Center for Biomedical Informatics and Biostatistics, Tucson, Arizona, United States of America
| | - Jean-Paul Wiegand
- Center for Innovation in Brain Science, University of Arizona Health Sciences, Tucson, Arizona, United States of America
| | - Lillian Parker-Halstead
- Center for Innovation in Brain Science, University of Arizona Health Sciences, Tucson, Arizona, United States of America
| | - Allan Tucker
- Department of Computer Science, Brunel University London, Uxbridge, United Kingdom
| | - Roberta Diaz Brinton
- Center for Innovation in Brain Science, University of Arizona Health Sciences, Tucson, Arizona, United States of America
- Department of Neurology, College of Medicine Tucson, University of Arizona, Tucson, Arizona, United States of America
- BIO5 Institute, University of Arizona, Tucson, Arizona, United States of America
- Center for Biomedical Informatics and Biostatistics, Tucson, Arizona, United States of America
- Department of Pharmacology, College of Medicine Tucson, University of Arizona, Tucson, Arizona, United States of America
| |
Collapse
|
18
|
Gan L, Wang C, Liu X. Proteomics-based mortality prediction modeling in type 2 diabetes: new promise for personalized treatment and prevention. BMC Med 2025; 23:17. [PMID: 39838408 PMCID: PMC11752623 DOI: 10.1186/s12916-024-03803-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2024] [Accepted: 11/28/2024] [Indexed: 01/23/2025] Open
Affiliation(s)
- Lu Gan
- Neurology Department, Shanghai TCM-Integrated Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, 200082, People's Republic of China
| | - Changde Wang
- Neurology Department, Shanghai TCM-Integrated Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, 200082, People's Republic of China
| | - Xiaoying Liu
- Neurology Department, Shanghai TCM-Integrated Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, 200082, People's Republic of China.
| |
Collapse
|
19
|
Dhungel O, Sharma P, Sapkota N. Risk Factors Profile in Dementia Patients at a Tertiary Care Hospital in Nepal: A Cross-Sectional Study. Am J Alzheimers Dis Other Demen 2025; 40:15333175251328472. [PMID: 40122775 PMCID: PMC11938857 DOI: 10.1177/15333175251328472] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2024] [Revised: 02/21/2025] [Accepted: 03/03/2025] [Indexed: 03/25/2025]
Abstract
Dementia is attributable to 12 known risk factors in 40% cases. This study aimed to assess the prevalence of defined risk factors among people living with dementia. 174 patients with dementia and caregivers were interviewed using semi-structured pro forma, risk factors provided by the Lancet Commission on Dementia (2020), and Dementia Severity Rating Scale (DSRS). The prevalence of 11 known risk factors and associations between the risk factors and dementia severity were assessed. The mean age of the participants was 73.9 years (SD = 8.34 years). The education below intermediate level was 83.3%, 17.8% had hearing loss, 37.9% had hypertension, 24.1% had diabetes, 25.9% and 55.2% had alcohol and nicotine harmful use respectively and 8% had a history of traumatic brain injury and obesity each. There is a substantial prevalence of risk factors among people living with dementia in Nepal but no associations between any of the risk factors and dementia severity.
Collapse
Affiliation(s)
- Omkar Dhungel
- Department of Psychiatry, Nepalese Army Institute of Health Sciences, Kathmandu, Nepal
| | - Pawan Sharma
- Department of Psychiatry, Institute of Medicine, Patan Academy of Health Sciences, Lalitpur, Nepal
| | - Nidesh Sapkota
- Department of Psychiatry, Institute of Medicine, Patan Academy of Health Sciences, Lalitpur, Nepal
| |
Collapse
|
20
|
Roy B, Thedim M, Liew C, Kumar R, Vacas S. Distinct brain and neurocognitive transformations after bariatric surgery: a pilot study. Front Neurosci 2024; 18:1454284. [PMID: 39564525 PMCID: PMC11573770 DOI: 10.3389/fnins.2024.1454284] [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: 06/24/2024] [Accepted: 10/16/2024] [Indexed: 11/21/2024] Open
Abstract
Background Obese patients have worse outcomes after surgery and are at increased risk for perioperative neurocognitive disorders (PND). Our aim was to detail the cognitive trajectories of patients undergoing bariatric surgery (BS) and map distinct structural brain changes using magnetic resonance imaging (MRI) to better understand the association between the vulnerable brain, surgery, and the arc of PND. Methods Prospective pilot study with longitudinal comprehensive cognitive assessments and MRI were performed on obese patients scheduled for BS. We analyzed baseline cognitive function and high-resolution T1-/T2-weighted brain images on 19 obese patients [age, 54 (9) years, BMI, 40 (36, 42) kg m-2] and compared with 50 healthy control subjects [age, 52 (6) years; BMI, 25 (24, 27) kg m-2]. Patients were evaluated within five days of BS (baseline), immediately after (within 48h), and follow up at six months. Results At baseline, obese patients had significant brain tissue changes seen in MRI and decreased cognitive scores compared to controls (MoCA 26 vs 28, P = 0.017). Surgery induced further gray matter volume and brain tissue changes along with reduced cognitive scores within the immediate postoperative period (MoCA 26 vs 24, P < 0.001). At six months, we observed reversal of brain alterations for most patients and a concomitant rebound of cognitive scores to patient's baseline status. Conclusions Bariatric surgery resulted in worsening of preexisting brain structural integrity and lower cognitive function for obese patients compared to baseline. These distinct brain lesions are consistent with specific domains of cognition. Most of these changes reverted to patient's baseline condition within six months after surgery.
Collapse
Affiliation(s)
- Bhaswati Roy
- Department of Anesthesiology and Perioperative Medicine, University of California, Los Angeles, Los Angeles, CA, United States
| | - Mariana Thedim
- Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States
| | - Chiewlin Liew
- Department of Anesthesiology and Perioperative Medicine, University of California, Los Angeles, Los Angeles, CA, United States
| | - Rajesh Kumar
- Department of Anesthesiology and Perioperative Medicine, University of California, Los Angeles, Los Angeles, CA, United States
- Department of Radiology, University of California, Los Angeles, Los Angeles, CA, United States
- Department of Bioengineering, University of California, Los Angeles, Los Angeles, CA, United States
| | - Susana Vacas
- Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, United States
| |
Collapse
|
21
|
Mackey-Alfonso SE, Butler MJ, Taylor AM, Williams-Medina AR, Muscat SM, Fu H, Barrientos RM. Short-term high fat diet impairs memory, exacerbates the neuroimmune response, and evokes synaptic degradation via a complement-dependent mechanism in a mouse model of Alzheimer's disease. Brain Behav Immun 2024; 121:56-69. [PMID: 39043341 DOI: 10.1016/j.bbi.2024.07.021] [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: 04/01/2024] [Revised: 07/17/2024] [Accepted: 07/19/2024] [Indexed: 07/25/2024] Open
Abstract
Alzheimer's Disease (AD) is a neurodegenerative disease characterized by profound memory impairments, synaptic loss, neuroinflammation, and hallmark pathological markers. High-fat diet (HFD) consumption increases the risk of developing AD even after controlling for metabolic syndrome, pointing to a role of the diet itself in increasing risk. In AD, the complement system, an arm of the immune system which normally tags redundant or damaged synapses for pruning, becomes pathologically overactivated leading to tagging of healthy synapses. While the unhealthy diet to AD link is strong, the underlying mechanisms are not well understood in part due to confounding variables associated with long-term HFD which can independently influence the brain. Therefore, we experimented with a short-term diet regimen to isolate the diet's impact on brain function without causing obesity. This project investigated the effect of short-term HFD on 1) memory, 2) neuroinflammation including complement, 3) AD pathology markers, 4) synaptic markers, and 5) in vitro microglial synaptic phagocytosis in the 3xTg-AD mouse model. Following the consumption of either standard chow or HFD, 3xTg-AD and non-Tg mice were tested for memory impairments. In a separate cohort of mice, levels of hippocampal inflammatory markers, complement proteins, AD pathology markers, and synaptic markers were measured. For the last set of experiments, BV2 microglial phagocytosis of synapses was evaluated. Synaptoneurosomes isolated from the hippocampus of 3xTg-AD mice fed chow or HFD were incubated with equal numbers of BV2 microglia. The number of BV2 microglia that phagocytosed synaptoneurosomes was tracked over time with a live-cell imaging assay. Finally, we incubated BV2 microglia with a complement receptor inhibitor (NIF) and repeated the assay. Behavioral analysis showed 3xTg-AD mice had significantly impaired long-term contextual and cued fear memory compared to non-Tg mice that was further impaired by HFD. HFD significantly increased inflammatory markers and complement expression while decreasing synaptic marker expression only in 3xTg-AD mice, without altering AD pathology markers. Synaptoneurosomes from HFD-fed 3xTg-AD mice were phagocytosed at a significantly higher rate than those from chow-fed mice, suggesting the synapses were altered by HFD. The complement receptor inhibitor blocked this effect in a dose-dependent manner, demonstrating the HFD-mediated increase in phagocytosis was complement dependent. This study indicates HFD consumption increases neuroinflammation and over-activates the complement cascade in 3xTg-AD mice, resulting in poorer memory. The in vitro data point to complement as a potential mechanistic culprit and therapeutic target underlying HFD's influence in increasing cognitive vulnerability to AD.
Collapse
Affiliation(s)
- Sabrina E Mackey-Alfonso
- Medical Scientist Training Program, The Ohio State University, Columbus, OH, USA; Neuroscience Graduate Program, The Ohio State University, Columbus, OH, USA; Institute for Behavioral Medicine Research, Ohio State University, Columbus, OH, USA
| | - Michael J Butler
- Institute for Behavioral Medicine Research, Ohio State University, Columbus, OH, USA; Department of Psychiatry and Behavioral Health, Ohio State University, Columbus, OH, USA
| | - Ashton M Taylor
- Institute for Behavioral Medicine Research, Ohio State University, Columbus, OH, USA
| | | | - Stephanie M Muscat
- Institute for Behavioral Medicine Research, Ohio State University, Columbus, OH, USA
| | - Hongjun Fu
- Department of Neuroscience, The Ohio State University, Columbus, OH, USA; Chronic Brain Injury Program, The Ohio State University, Columbus, OH, USA
| | - Ruth M Barrientos
- Institute for Behavioral Medicine Research, Ohio State University, Columbus, OH, USA; Department of Psychiatry and Behavioral Health, Ohio State University, Columbus, OH, USA; Department of Neuroscience, The Ohio State University, Columbus, OH, USA; Chronic Brain Injury Program, The Ohio State University, Columbus, OH, USA.
| |
Collapse
|
22
|
Booranasuksakul U, Tsintzas K, Macdonald I, Stephan BC, Siervo M. Application of a new definition of sarcopenic obesity in middle-aged and older adults and association with cognitive function: Findings from the National Health and Nutrition Examination Survey 1999-2002. Clin Nutr ESPEN 2024; 63:919-928. [PMID: 39181532 DOI: 10.1016/j.clnesp.2024.08.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2024] [Revised: 08/07/2024] [Accepted: 08/19/2024] [Indexed: 08/27/2024]
Abstract
BACKGROUND & AIMS The role of sarcopenic obesity (SO) in impaired cognitive function has been investigated in several observational studies, but results have been mixed. This study applied the proposed European Society for Clinical Nutrition and Metabolism (ESPEN)-European Association for the Study of Obesity (EASO) definition of SO to a representative population aged ≥50 years to identify the association between SO and cognitive function. METHODS Data from the National Health and Nutrition Examination Survey 1999-2002 waves were used. At the screening phase, body mass index or waist circumference were used to evaluate obesity; sarcopenia was identified using the SARC-F questionnaire. At the diagnostic phase I and II, sarcopenia was assessed using knee extensor isometric strength and appendicular lean mass, and fat mass percent was used to assess obesity. Cognitive function in older participants (60-85 years) was assessed using the Digit Symbol Substitution Test. A self-reported memory question was used in middle-aged individuals (50-59 years). RESULTS The sample included 2356 participants (men, 44.7%). The prevalence of SO was 32.3%, 21.2% and 15.0% at the screening, diagnosis I, and diagnosis II, respectively. Significant associations between SO and cognitive impairment were observed in individuals aged 60-85 at diagnosis I (OR: 2.3, 95%CI 1.4-3.8, P = 0.007) and diagnosis II (OR: 2.7, 95%CI 1.5-4.9, P = 0.004). CONCLUSION The new ESPEN-EASO definition of SO identified a high prevalence of SO cases. A significant association between SO and poor cognitive function in older individuals was observed.
Collapse
Affiliation(s)
- Uraiporn Booranasuksakul
- MRC Versus Arthritis Centre for Musculoskeletal Ageing Research, School of Life Sciences, The University of Nottingham Medical School, Queen's Medical Centre, Nottingham, NG7 2UH, UK.
| | - Kostas Tsintzas
- MRC Versus Arthritis Centre for Musculoskeletal Ageing Research, School of Life Sciences, The University of Nottingham Medical School, Queen's Medical Centre, Nottingham, NG7 2UH, UK
| | - Ian Macdonald
- MRC Versus Arthritis Centre for Musculoskeletal Ageing Research, School of Life Sciences, The University of Nottingham Medical School, Queen's Medical Centre, Nottingham, NG7 2UH, UK
| | - Blossom Cm Stephan
- Institute of Mental Health, The University of Nottingham Medical School, Nottingham, UK; Curtin enAble Institute, Faculty of Health Sciences, Curtin University, Kent Street, Bentley, WA, Australia; Dementia Centre of Excellence, enAble Institute, Faculty of Health Sciences, Curtin University, Kent Street, Bentley, WA, Australia
| | - Mario Siervo
- Dementia Centre of Excellence, enAble Institute, Faculty of Health Sciences, Curtin University, Kent Street, Bentley, WA, Australia; Curtin School of Population Health, Faculty of Health Sciences, Curtin University, Bentley WA, Australia; Vascular and Metabolic Disorders Group, Curtin Health Innovation Research Institute (CHIRI), Australia
| |
Collapse
|
23
|
O'Keefe P, Muniz-Terrera G, Voll S, Mann FD, Clouston S, Wanström L, Rodgers JL, Hofer S. Inter-cohort shifts in chronic disease, dementia, and mortality. BIODEMOGRAPHY AND SOCIAL BIOLOGY 2024; 69:203-217. [PMID: 39541238 DOI: 10.1080/19485565.2024.2419518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2024]
Abstract
Previous work using U.S. data has identified generational shifts, reflected in inter-cohort changes, in the incidence and prevalence of diseases in older ages. This study extends previous findings to England by examining similar results in memory complaints, heart conditions, stroke, diabetes, lung disease, and cancer using data from the English Longitudinal Study of Ageing (ELSA). We fit Cox proportional hazard models to the first eight waves (2002-2016) of the ELSA sample (n = 18,528). In addition to exploring shifts in disease incidence we also examine shifts in disease mortality. Both general and sex-related differences are examined. Disease incidence has increased for later-born cohorts in England, replicating similar trends in the U.S. Not all diseases showed differences between men and women, but when differences were identified, women had lower risks for disease. In comparison to the U.S. sample, disease trends in England are more negative (i.e. accelerated failure times) for more recently born cohorts. These results showing increasing incidence of disease among the later-born cohorts suggest the possibility of increased disease burden in coming years.
Collapse
Affiliation(s)
- Patrick O'Keefe
- Department of Neurology, Oregon Health and Sciences University ,Portland, OR, USA
| | | | - Stacey Voll
- Department of Psychology, University of Victoria, Victoria, BC, USA
| | - Frank D Mann
- Department of Medicine, Program in Public health, School of Medicine, Health Sciences Center, Stony Brook University, Stony Brook, NY, USA
| | - Sean Clouston
- Department of Medicine, Program in Public health, School of Medicine, Health Sciences Center, Stony Brook University, Stony Brook, NY, USA
| | - Linda Wanström
- Department of Information and computer Science, Linköping University, Linköping, Sweden
| | - Joseph L Rodgers
- Departmetnt of Psychology and Human Development, Peabody College, Vanderbilt University, Nashville, TN, USA
| | - Scott Hofer
- Pacific Health Research and Education Institute, Honolulu, HI, USA
| |
Collapse
|
24
|
Ju RH, Al Snih S. The role of dynapenia and obesity on cognitive function in older adults. Clin Nutr ESPEN 2024; 63:191-196. [PMID: 38963765 PMCID: PMC11424253 DOI: 10.1016/j.clnesp.2024.06.039] [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: 06/17/2024] [Accepted: 06/24/2024] [Indexed: 07/06/2024]
Abstract
BACKGROUND & AIMS Dynapenia and obesity have been independently associated with cognitive decline in older adults, but their co-occurring effects has not been well-studied. The study objective is to examine the relationship between dynapenic-obesity and cognitive impairment in older adults 75 years and older with normal or high cognitive function at baseline over 12 years of follow-up. We hypothesize that those with dynapenic obesity will have greater odds of cognitive function impairment than those with dynapenia only, obesity only, or no dynapenia no obesity (reference group). METHODS A total of 761 participants with a mean age of 81.5 and Mini-Mental State Examination (MMSE) > 21 at baseline were divided into four groups: no dynapenia no obesity (n = 316), obesity only (n = 142), dynapenia only (n = 217), and dynapenic obesity (n = 86). Measures included socio-demographics, medical conditions, body mass index, depressive symptoms, handgrip strength, and limitations in activities of daily living. We performed a mixed models estimate for cognitive decline for these groups over a 12-year period. Handgrip strength (HGS) was measured with a handgrip dynamometer and cognitive function was assessed with MMSE. RESULTS Participants in the dynapenia-obesity group experienced a greater (β = - 1.29, Standard Error = 0.60, p-value = 0.0316) cognitive decline over time compared to those in the no dynapenia and no obesity group, after controlling for all covariates. CONCLUSION Older adults with dynapenic-obesity were at high risk of cognitive decline over time. These findings highlight the need for interventions that target both conditions in this population to help maintain cognitive health. Community-based strength training programs and educational initiatives on nutrition and diet can help older adults reduce their risk of age-related cognitive decline.
Collapse
Affiliation(s)
- Rylie H Ju
- John Sealy School of Medicine, The University of Texas Medical Branch, 301 University Boulevard Galveston, TX 77555, USA.
| | - Soham Al Snih
- Department of Population Health and Health Disparities, School of Public and Population Health, The University of Texas Medical Branch, 301 University Boulevard Galveston, TX 77555, USA; Division of Geriatrics & Palliative Medicine, Department of Internal Medicine, The University of Texas Medical Branch, 301 University Boulevard Galveston, TX 77555, USA; Sealy Center on Aging, The University of Texas Medical Branch, 301 University Boulevard Galveston, TX 77555, USA.
| |
Collapse
|
25
|
Zhang S, Lu J, Jin Z, Xu H, Zhang D, Chen J, Wang J. Gut microbiota metabolites: potential therapeutic targets for Alzheimer's disease? Front Pharmacol 2024; 15:1459655. [PMID: 39355779 PMCID: PMC11442227 DOI: 10.3389/fphar.2024.1459655] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2024] [Accepted: 09/05/2024] [Indexed: 10/03/2024] Open
Abstract
Background Alzheimer's disease (AD) is a neurodegenerative disease characterized by progressive decline in cognitive function, which significantly increases pain and social burden. However, few therapeutic interventions are effective in preventing or mitigating the progression of AD. An increasing number of recent studies support the hypothesis that the gut microbiome and its metabolites may be associated with upstream regulators of AD pathology. Methods In this review, we comprehensively explore the potential mechanisms and currently available interventions targeting the microbiome for the improvement of AD. Our discussion is structured around modern research advancements in AD, the bidirectional communication between the gut and brain, the multi-target regulatory effects of microbial metabolites on AD, and therapeutic strategies aimed at modulating gut microbiota to manage AD. Results The gut microbiota plays a crucial role in the pathogenesis of AD through continuous bidirectional communication via the microbiota-gut-brain axis. Among these, microbial metabolites such as lipids, amino acids, bile acids and neurotransmitters, especially sphingolipids and phospholipids, may serve as central components of the gut-brain axis, regulating AD-related pathogenic mechanisms including β-amyloid metabolism, Tau protein phosphorylation, and neuroinflammation. Additionally, interventions such as probiotic administration, fecal microbiota transplantation, and antibiotic use have also provided evidence supporting the association between gut microbiota and AD. At the same time, we propose an innovative strategy for treating AD: a healthy lifestyle combined with targeted probiotics and other potential therapeutic interventions, aiming to restore intestinal ecology and microbiota balance. Conclusion Despite previous efforts, the molecular mechanisms by which gut microbes act on AD have yet to be fully described. However, intestinal microorganisms may become an essential target for connecting the gut-brain axis and improving the symptoms of AD. At the same time, it requires joint exploration by multiple centers and multiple disciplines.
Collapse
Affiliation(s)
- Shanshan Zhang
- The School to Changchun University of Chinese Medicine, Changchun, China
| | - Jing Lu
- Research Center of Traditional Chinese Medicine, The Affiliated Hospital to Changchun University of Chinese Medicine, Changchun, China
| | - Ziqi Jin
- The School to Changchun University of Chinese Medicine, Changchun, China
| | - Hanying Xu
- Department of Encephalopathy, The Affiliated Hospital to Changchun University of Chinese Medicine, Changchun, China
| | - Dongmei Zhang
- Research Center of Traditional Chinese Medicine, The Affiliated Hospital to Changchun University of Chinese Medicine, Changchun, China
| | - Jianan Chen
- The School to Changchun University of Chinese Medicine, Changchun, China
| | - Jian Wang
- Department of Encephalopathy, The Affiliated Hospital to Changchun University of Chinese Medicine, Changchun, China
| |
Collapse
|
26
|
Wang MB, Rahmani F, Benzinger TLS, Raji CA. Edge Density Imaging Identifies White Matter Biomarkers of Late-Life Obesity and Cognition. Aging Dis 2024; 15:1899-1912. [PMID: 37196133 PMCID: PMC11272213 DOI: 10.14336/ad.2022.1210] [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: 08/13/2022] [Accepted: 12/10/2022] [Indexed: 05/19/2023] Open
Abstract
Alzheimer disease (AD) and obesity are related to disruptions in the white matter (WM) connectome. We examined the link between the WM connectome and obesity and AD through edge-density imaging/index (EDI), a tractography-based method that characterizes the anatomical embedding of tractography connections. A total of 60 participants, 30 known to convert from normal cognition or mild-cognitive impairment to AD within a minimum of 24 months of follow up, were selected from the Alzheimer disease Neuroimaging Initiative (ADNI). Diffusion-weighted MR images from the baseline scans were used to extract fractional anisotropy (FA) and EDI maps that were subsequently averaged using deterministic WM tractography based on the Desikan-Killiany atlas. Multiple linear and logistic regression analysis were used to identify the weighted sum of tract-specific FA or EDI indices that maximized correlation to body-mass-index (BMI) or conversion to AD. Participants from the Open Access Series of Imaging Studies (OASIS) were used as an independent validation for the BMI findings. The edge-density rich, periventricular, commissural and projection fibers were among the most important WM tracts linking BMI to FA as well as to EDI. WM fibers that contributed significantly to the regression model related to BMI overlapped with those that predicted conversion; specifically in the frontopontine, corticostriatal, and optic radiation pathways. These results were replicated by testing the tract-specific coefficients found using ADNI in the OASIS-4 dataset. WM mapping with EDI enables identification of an abnormal connectome implicated in both obesity and conversion to AD.
Collapse
Affiliation(s)
- Maxwell Bond Wang
- Machine Learning Department, Carnegie Mellon University, Pittsburgh, PA, USA.
- Neuroscience Institute, Carnegie Mellon University, Pittsburgh, PA, USA.
- Medical Scientist Training Program, University of Pittsburgh/Carnegie Mellon University, Pittsburgh, PA, USA.
| | - Farzaneh Rahmani
- Mallinckrodt Institute of Radiology, Division of Neuroradiology, Washington University in St. Louis, St. Louis, MO, USA.
- Charles F. and Joanne Knight Alzheimer Disease Research Center (Knight ADRC), Washington University, St. Louis, Missouri, USA.
| | - Tammie L. S Benzinger
- Mallinckrodt Institute of Radiology, Division of Neuroradiology, Washington University in St. Louis, St. Louis, MO, USA.
- Charles F. and Joanne Knight Alzheimer Disease Research Center (Knight ADRC), Washington University, St. Louis, Missouri, USA.
| | - Cyrus A Raji
- Mallinckrodt Institute of Radiology, Division of Neuroradiology, Washington University in St. Louis, St. Louis, MO, USA.
- Charles F. and Joanne Knight Alzheimer Disease Research Center (Knight ADRC), Washington University, St. Louis, Missouri, USA.
- Department of Neurology, Washington University in Saint Louis, St. Louis, Missouri, USA
| |
Collapse
|
27
|
Kompella P, Wang G, Durrett RE, Lai Y, Marin C, Liu Y, Habib SL, DiGiovanni J, Vasquez KM. Obesity increases genomic instability at DNA repeat-mediated endogenous mutation hotspots. Nat Commun 2024; 15:6213. [PMID: 39043652 PMCID: PMC11266421 DOI: 10.1038/s41467-024-50006-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2023] [Accepted: 06/26/2024] [Indexed: 07/25/2024] Open
Abstract
Obesity is associated with increased cancer risk, yet the underlying mechanisms remain elusive. Obesity-associated cancers involve disruptions in metabolic and cellular pathways, which can lead to genomic instability. Repetitive DNA sequences capable of adopting alternative DNA structures (e.g., H-DNA) stimulate mutations and are enriched at mutation hotspots in human cancer genomes. However, it is not known if obesity impacts DNA repeat-mediated endogenous mutation hotspots. We address this gap by measuring mutation frequencies in obese and normal-weight transgenic reporter mice carrying either a control human B-DNA- or an H-DNA-forming sequence (from a translocation hotspot in c-MYC in Burkitt lymphoma). Here, we discover that H-DNA-induced DNA damage and mutations are elevated in a tissue-specific manner, and DNA repair efficiency is reduced in obese mice compared to those on the control diet. These findings elucidate the impact of obesity on cancer-associated endogenous mutation hotspots, providing mechanistic insight into the link between obesity and cancer.
Collapse
Affiliation(s)
- Pallavi Kompella
- Division of Pharmacology and Toxicology, College of Pharmacy, The University of Texas at Austin, Dell Pediatric Research Institute, Austin, TX, USA
| | - Guliang Wang
- Division of Pharmacology and Toxicology, College of Pharmacy, The University of Texas at Austin, Dell Pediatric Research Institute, Austin, TX, USA
| | - Russell E Durrett
- Department of Molecular Biosciences, The University of Texas at Austin, Austin, TX, USA
| | - Yanhao Lai
- Department of Chemistry and Biochemistry, Florida International University, Miami, FL, USA
| | - Celeste Marin
- Department of Chemistry and Biochemistry, Florida International University, Miami, FL, USA
| | - Yuan Liu
- Department of Chemistry and Biochemistry, Florida International University, Miami, FL, USA
| | - Samy L Habib
- South Texas Veterans Health Care System, San Antonio, TX, USA
| | - John DiGiovanni
- Division of Pharmacology and Toxicology, College of Pharmacy, The University of Texas at Austin, Dell Pediatric Research Institute, Austin, TX, USA
| | - Karen M Vasquez
- Division of Pharmacology and Toxicology, College of Pharmacy, The University of Texas at Austin, Dell Pediatric Research Institute, Austin, TX, USA.
| |
Collapse
|
28
|
Tripathi PN, Lodhi A, Rai SN, Nandi NK, Dumoga S, Yadav P, Tiwari AK, Singh SK, El-Shorbagi ANA, Chaudhary S. Review of Pharmacotherapeutic Targets in Alzheimer's Disease and Its Management Using Traditional Medicinal Plants. Degener Neurol Neuromuscul Dis 2024; 14:47-74. [PMID: 38784601 PMCID: PMC11114142 DOI: 10.2147/dnnd.s452009] [Citation(s) in RCA: 42] [Impact Index Per Article: 42.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Accepted: 05/03/2024] [Indexed: 05/25/2024] Open
Abstract
Alzheimer's disease (AD) is a progressive neurodegenerative disorder characterized by cognitive decline, memory loss, and impaired daily functioning. While there is currently no cure for AD, several pharmacotherapeutic targets and management strategies have been explored. Additionally, traditional medicinal plants have gained attention for their potential role in AD management. Pharmacotherapeutic targets in AD include amyloid-beta (Aβ) aggregation, tau protein hyperphosphorylation, neuroinflammation, oxidative stress, and cholinergic dysfunction. Traditional medicinal plants, such as Ginkgo biloba, Huperzia serrata, Curcuma longa (turmeric), and Panax ginseng, have demonstrated the ability to modulate these targets through their bioactive compounds. Ginkgo biloba, for instance, contains flavonoids and terpenoids that exhibit neuroprotective effects by reducing Aβ deposition and enhancing cerebral blood flow. Huperzia serrata, a natural source of huperzine A, has acetylcholinesterase-inhibiting properties, thus improving cholinergic function. Curcuma longa, enriched with curcumin, exhibits anti-inflammatory and antioxidant effects, potentially mitigating neuroinflammation and oxidative stress. Panax ginseng's ginsenosides have shown neuroprotective and anti-amyloidogenic properties. The investigation of traditional medicinal plants as a complementary approach to AD management offers several advantages, including a lower risk of adverse effects and potential multi-target interactions. Furthermore, the cultural knowledge and utilization of these plants provide a rich source of information for the development of new therapies. However, further research is necessary to elucidate the precise mechanisms of action, standardize preparations, and assess the safety and efficacy of these natural remedies. Integrating traditional medicinal-plant-based therapies with modern pharmacotherapies may hold the key to a more comprehensive and effective approach to AD treatment. This review aims to explore the pharmacotherapeutic targets in AD and assess the potential of traditional medicinal plants in its management.
Collapse
Affiliation(s)
- Prabhash Nath Tripathi
- Department of Pharmaceutical Technology, Meerut Institute of Engineering and Technology, Meerut, Uttar Pradesh, India
| | - Ankit Lodhi
- Department of Pharmaceutical Technology, Meerut Institute of Engineering and Technology, Meerut, Uttar Pradesh, India
| | - Sachchida Nand Rai
- Center of Experimental Medicine and Surgery, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India
| | - Nilay Kumar Nandi
- Department of Pharmaceutical Technology, Meerut Institute of Engineering and Technology, Meerut, Uttar Pradesh, India
| | - Shweta Dumoga
- Department of Pharmaceutical Technology, Meerut Institute of Engineering and Technology, Meerut, Uttar Pradesh, India
| | - Pooja Yadav
- Department of Pharmaceutical Technology, Meerut Institute of Engineering and Technology, Meerut, Uttar Pradesh, India
| | - Amit Kumar Tiwari
- Department of Pharmaceutical Sciences, College of Pharmacy, University of Arkansas for Medical Sciences, Little Rock, AR, 72205, USA
| | - Santosh Kumar Singh
- Center of Experimental Medicine and Surgery, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India
| | - Abdel-Nasser A El-Shorbagi
- Department of Medicinal Chemistry, College of Pharmacy, University of Sharjah, Sharjah, United Arab Emirates
| | - Sachin Chaudhary
- Department of Medicinal Chemistry, College of Pharmacy, University of Sharjah, Sharjah, United Arab Emirates
| |
Collapse
|
29
|
Valli H, Tindale A, Butt H, Beattie CJ, Adasuriya G, Warraich M, Ahmad M, Banerjee A, Providencia R, Haldar S. Weight reduction interventions for the management of atrial fibrillation in overweight and obese people. Cochrane Database Syst Rev 2024; 5:CD014768. [PMID: 39908074 PMCID: PMC11091950 DOI: 10.1002/14651858.cd014768] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2025]
Abstract
OBJECTIVES This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To evaluate the efficacy of weight loss interventions as adjunctive treatment for reducing atrial fibrillation burden.
Collapse
Affiliation(s)
- Haseeb Valli
- Department of Cardiology, Royal Brompton & Harefield NHS Foundation Trust, London, UK
| | | | - Haroun Butt
- Royal Brompton and Harefield NHS Foundation Trust, London, UK
| | | | | | - Mazhar Warraich
- Department of Internal Medicine, The Royal Wolverhampton Hospitals NHS Trust, Wolverhampton, UK
| | - Mahmood Ahmad
- Department of Cardiology, Royal Free Hospital, Royal Free London NHS Foundation Trust, London, UK
| | - Amitava Banerjee
- Institute of Health Informatics Research, University College London, London, UK
| | - Rui Providencia
- Barts Heart Centre, St Bartholomew's Hospital, Barts Health NHS Trust, London, UK
| | - Shouvik Haldar
- Royal Brompton and Harefield NHS Foundation Trust, London, UK
| |
Collapse
|
30
|
Patel V, Edison P. Cardiometabolic risk factors and neurodegeneration: a review of the mechanisms underlying diabetes, obesity and hypertension in Alzheimer's disease. J Neurol Neurosurg Psychiatry 2024; 95:581-589. [PMID: 38290839 PMCID: PMC11103343 DOI: 10.1136/jnnp-2023-332661] [Citation(s) in RCA: 22] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Accepted: 01/09/2024] [Indexed: 02/01/2024]
Abstract
A growing body of evidence suggests that cardiometabolic risk factors play a significant role in Alzheimer's disease (AD). Diabetes, obesity and hypertension are highly prevalent and can accelerate neurodegeneration and perpetuate the burden of AD. Insulin resistance and enzymes including insulin degrading enzymes are implicated in AD where breakdown of insulin is prioritised over amyloid-β. Leptin resistance and inflammation demonstrated by higher plasma and central nervous system levels of interleukin-6 (IL-6), IL-1β and tumour necrosis factor-α, are mechanisms connecting obesity and diabetes with AD. Leptin has been shown to ameliorate AD pathology and enhance long-term potentiation and hippocampal-dependent cognitive function. The renin-aldosterone angiotensin system, involved in hypertension, has been associated with AD pathology and neurotoxic reactive oxygen species, where angiotensin binds to specific angiotensin-1 receptors in the hippocampus and cerebral cortex. This review aims to consolidate the evidence behind putative processes stimulated by obesity, diabetes and hypertension, which leads to increased AD risk. We focus on how novel knowledge can be applied clinically to facilitate recognition of efficacious treatment strategies for AD.
Collapse
Affiliation(s)
- Vijay Patel
- Department of Brain Sciences, Imperial College London, London, UK
| | - Paul Edison
- Department of Brain Sciences, Imperial College London, London, UK
- Cardiff University, Cardiff, UK
| |
Collapse
|
31
|
Veneziani I, Grimaldi A, Marra A, Morini E, Culicetto L, Marino S, Quartarone A, Maresca G. Towards a Deeper Understanding: Utilizing Machine Learning to Investigate the Association between Obesity and Cognitive Decline-A Systematic Review. J Clin Med 2024; 13:2307. [PMID: 38673581 PMCID: PMC11051247 DOI: 10.3390/jcm13082307] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2024] [Revised: 04/09/2024] [Accepted: 04/13/2024] [Indexed: 04/28/2024] Open
Abstract
Background/Objectives: Several studies have shown a relation between obesity and cognitive decline, highlighting a significant global health challenge. In recent years, artificial intelligence (AI) and machine learning (ML) have been integrated into clinical practice for analyzing datasets to identify new risk factors, build predictive models, and develop personalized interventions, thereby providing useful information to healthcare professionals. This systematic review aims to evaluate the potential of AI and ML techniques in addressing the relationship between obesity, its associated health consequences, and cognitive decline. Methods: Systematic searches were performed in PubMed, Cochrane, Web of Science, Scopus, Embase, and PsycInfo databases, which yielded eight studies. After reading the full text of the selected studies and applying predefined inclusion criteria, eight studies were included based on pertinence and relevance to the topic. Results: The findings underscore the utility of AI and ML in assessing risk and predicting cognitive decline in obese patients. Furthermore, these new technology models identified key risk factors and predictive biomarkers, paving the way for tailored prevention strategies and treatment plans. Conclusions: The early detection, prevention, and personalized interventions facilitated by these technologies can significantly reduce costs and time. Future research should assess ethical considerations, data privacy, and equitable access for all.
Collapse
Affiliation(s)
- Isabella Veneziani
- Department of Nervous System and Behavioural Sciences, Psychology Section, University of Pavia, Piazza Botta, 11, 27100 Pavia, Italy (A.G.)
| | - Alessandro Grimaldi
- Department of Nervous System and Behavioural Sciences, Psychology Section, University of Pavia, Piazza Botta, 11, 27100 Pavia, Italy (A.G.)
| | - Angela Marra
- IRCCS Centro Neurolesi “Bonino-Pulejo”, S.S. 113 Via Palermo C. da Casazza, 98124 Messina, Italy; (A.M.); (E.M.); (S.M.); (A.Q.); (G.M.)
| | - Elisabetta Morini
- IRCCS Centro Neurolesi “Bonino-Pulejo”, S.S. 113 Via Palermo C. da Casazza, 98124 Messina, Italy; (A.M.); (E.M.); (S.M.); (A.Q.); (G.M.)
| | - Laura Culicetto
- IRCCS Centro Neurolesi “Bonino-Pulejo”, S.S. 113 Via Palermo C. da Casazza, 98124 Messina, Italy; (A.M.); (E.M.); (S.M.); (A.Q.); (G.M.)
| | - Silvia Marino
- IRCCS Centro Neurolesi “Bonino-Pulejo”, S.S. 113 Via Palermo C. da Casazza, 98124 Messina, Italy; (A.M.); (E.M.); (S.M.); (A.Q.); (G.M.)
| | - Angelo Quartarone
- IRCCS Centro Neurolesi “Bonino-Pulejo”, S.S. 113 Via Palermo C. da Casazza, 98124 Messina, Italy; (A.M.); (E.M.); (S.M.); (A.Q.); (G.M.)
| | - Giuseppa Maresca
- IRCCS Centro Neurolesi “Bonino-Pulejo”, S.S. 113 Via Palermo C. da Casazza, 98124 Messina, Italy; (A.M.); (E.M.); (S.M.); (A.Q.); (G.M.)
| |
Collapse
|
32
|
Morgan AE, Mc Auley MT. Vascular dementia: From pathobiology to emerging perspectives. Ageing Res Rev 2024; 96:102278. [PMID: 38513772 DOI: 10.1016/j.arr.2024.102278] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2024] [Revised: 03/16/2024] [Accepted: 03/17/2024] [Indexed: 03/23/2024]
Abstract
Vascular dementia (VaD) is the second most common type of dementia. VaD is synonymous with ageing, and its symptoms place a significant burden on the health and wellbeing of older people. Despite the identification of a substantial number of risk factors for VaD, the pathological mechanisms underpinning this disease remain to be fully elucidated. Consequently, a biogerontological imperative exists to highlight the modifiable lifestyle factors which can mitigate against the risk of developing VaD. This review will critically examine some of the factors which have been revealed to modulate VaD risk. The survey commences by providing an overview of the putative mechanisms which are associated with the pathobiology of VaD. Next, the factors which influence the risk of developing VaD are examined. Finally, emerging treatment avenues including epigenetics, the gut microbiome, and pro-longevity pharmaceuticals are discussed. By drawing this key evidence together, it is our hope that it can be used to inform future experimental investigations in this field.
Collapse
Affiliation(s)
- Amy Elizabeth Morgan
- School of Health and Sports Sciences, Hope Park, Liverpool Hope University, Liverpool L16 9JD, United Kingdom.
| | - Mark Tomás Mc Auley
- School of Science, Engineering and Environment, University of Salford Manchester, Salford M5 4NT, United Kingdom
| |
Collapse
|
33
|
Wu Z, Owen A, Woods RL, Cribb L, Alharbi T, Zhou Z, Chong TTJ, Orchard SG, Shah RC, Wolfe R, Torres D, McNeil JJ, Sheets KM, Murray AM, Ryan J. Associations of body habitus and its changes with incident dementia in older adults. J Am Geriatr Soc 2024; 72:1023-1034. [PMID: 38243627 PMCID: PMC11018504 DOI: 10.1111/jgs.18757] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Revised: 11/29/2023] [Accepted: 12/07/2023] [Indexed: 01/21/2024]
Abstract
BACKGROUND This study examined the associations of body mass index (BMI) and waist circumference (WC), as well as their short- and long-term changes over time, with incident dementia in older individuals. METHODS Data came from 18,837 community-dwelling individuals aged 65+ years from Australia and the United States, who were relatively healthy without major cognitive impairment at enrolment. Anthropometric measures were prospectively assessed at baseline, as well as change and variability from baseline to year two (three time-points). In a subgroup (n = 11,176), self-reported weight at age 18 and 70+ years was investigated. Dementia cases satisfied DSM-IV criteria. Cox regression was used to examine the associations between anthropometric measures and incident risk of dementia. RESULTS Compared to normal weight, an overweight (HR: 0.67, 95%CI: 0.57-0.79, p < 0.001) or obese BMI (HR: 0.73, 95%CI: 0.60-0.89, p = 0.002), or a larger WC (elevated, HR: 0.71, 95%CI: 0.58-0.86, p < 0.001; highly elevated, HR: 0.65, 95%CI: 0.55-0.78, p < 0.001; relative to low) at baseline was associated with lower dementia risk. In contrast, substantial increases in BMI (>5%) over 2 years after baseline were associated with higher dementia risk (HR: 1.49, 95% CI: 1.17-1.91, p = 0.001). Increased dementia risk was also seen with an underweight BMI at baseline and a 2-year BMI decrease (>5%), but these associations appeared only in the first 4 years of follow-up. Compared to normal weight at both age 18 and 70+ years, being obese at both times was associated with increased dementia risk (HR: 2.27, 95%CI: 1.22-4.24, p = 0.01), while obesity only at age 70+ years was associated with decreased risk (HR: 0.70, 95%CI: 0.51-0.95, p = 0.02). CONCLUSIONS Our findings suggest that long-term obesity and weight gain in later life may be risk factors for dementia. Being underweight or having substantial weight loss in old age may be early markers of pre-clinical dementia.
Collapse
Affiliation(s)
- Zimu Wu
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia, 3004
| | - Alice Owen
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia, 3004
| | - Robyn L. Woods
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia, 3004
| | - Lachlan Cribb
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia, 3004
| | - Tagrid Alharbi
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia, 3004
| | - Zhen Zhou
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia, 3004
| | - Trevor T.-J. Chong
- Turner Institute for Brain and Mental Health, Monash University, Melbourne, VIC, Australia, 3800
- Department of Neurology, Alfred Health, Melbourne, VIC, Australia, 3181
- Department of Clinical Neurosciences, St Vincent’s Hospital, Melbourne, VIC, Australia, 3065
| | - Suzanne G. Orchard
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia, 3004
| | - Raj C. Shah
- Department of Family & Preventive Medicine and the Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, IL USA 60612
| | - Rory Wolfe
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia, 3004
| | - Daniel Torres
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia, 3004
| | - John J. McNeil
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia, 3004
| | - Kerry M. Sheets
- Division of Geriatric and Palliative Medicine, Department of Medicine, Hennepin Healthcare, Minneapolis, MN, USA, 55415
| | - Anne M. Murray
- Berman Center for Outcomes and Clinical Research, Minneapolis, MN, USA, 55404
| | - Joanne Ryan
- School of Public Health and Preventive Medicine, Monash University, Melbourne, VIC, Australia, 3004
| |
Collapse
|
34
|
Lynch MA. A case for seeking sex-specific treatments in Alzheimer's disease. Front Aging Neurosci 2024; 16:1346621. [PMID: 38414633 PMCID: PMC10897030 DOI: 10.3389/fnagi.2024.1346621] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Accepted: 01/15/2024] [Indexed: 02/29/2024] Open
Abstract
There is no satisfactory explanation for the sex-related differences in the incidence of many diseases and this is also true of Alzheimer's disease (AD), where females have a higher lifetime risk of developing the disease and make up about two thirds of the AD patient population. The importance of understanding the cause(s) that account for this disproportionate distribution cannot be overestimated, and is likely to be a significant factor in the search for therapeutic strategies that will combat the disease and, furthermore, potentially point to a sex-targeted approach to treatment. This review considers the literature in the context of what is known about the impact of sex on processes targeted by drugs that are in clinical trial for AD, and existing knowledge on differing responses of males and females to these drugs. Current knowledge strongly supports the view that trials should make assessing sex-related difference in responses a priority with a focus on exploring the sex-stratified treatments.
Collapse
|
35
|
Lin S, Jiang L, Wei K, Yang J, Cao X, Li C. Sex-Specific Association of Body Mass Index with Hippocampal Subfield Volume and Cognitive Function in Non-Demented Chinese Older Adults. Brain Sci 2024; 14:170. [PMID: 38391744 PMCID: PMC10887390 DOI: 10.3390/brainsci14020170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2024] [Revised: 01/28/2024] [Accepted: 02/01/2024] [Indexed: 02/24/2024] Open
Abstract
Recent research suggests a possible association between midlife obesity and an increased risk of dementia in later life. However, the underlying mechanisms remain unclear. Little is known about the relationship between body mass index (BMI) and hippocampal subfield atrophy. In this study, we aimed to explore the associations between BMI and hippocampal subfield volumes and cognitive function in non-demented Chinese older adults. Hippocampal volumes were assessed using structural magnetic resonance imaging. Cognitive function was evaluated using the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS). A total of 66 participants were included in the final analysis, with 35 females and 31 males. We observed a significant correlation between BMI and the hippocampal fissure volume in older females. In addition, there was a negative association between BMI and the RBANS total scale score, the coding score, and the story recall score, whereas no significant correlations were observed in older males. In conclusion, our findings revealed sex-specific associations between BMI and hippocampal subfield volumes and cognitive performance, providing valuable insights into the development of effective interventions for the early prevention of cognitive decline.
Collapse
Affiliation(s)
- Shaohui Lin
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China
- Department of Geriatrics, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, China
| | - Lijuan Jiang
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China
| | - Kai Wei
- Department of Traditional Chinese Medicine, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 201108, China
- Shanghai Institute of Traditional Chinese Medicine for Mental Health, Shanghai 201108, China
| | - Junjie Yang
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China
| | - Xinyi Cao
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China
- Clinical Neurocognitive Research Center, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China
| | - Chunbo Li
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai 200030, China
- Institute of Psychology and Behavioral Science, Shanghai Jiao Tong University, Shanghai 200030, China
- CAS Center for Excellence in Brain Science and Intelligence Technology (CEBSIT), Chinese Academy of Sciences, Shanghai 200030, China
| |
Collapse
|
36
|
Kawade N, Yamanaka K. Novel insights into brain lipid metabolism in Alzheimer's disease: Oligodendrocytes and white matter abnormalities. FEBS Open Bio 2024; 14:194-216. [PMID: 37330425 PMCID: PMC10839347 DOI: 10.1002/2211-5463.13661] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Revised: 06/07/2023] [Accepted: 06/14/2023] [Indexed: 06/19/2023] Open
Abstract
Alzheimer's disease (AD) is the most common cause of dementia. A genome-wide association study has shown that several AD risk genes are involved in lipid metabolism. Additionally, epidemiological studies have indicated that the levels of several lipid species are altered in the AD brain. Therefore, lipid metabolism is likely changed in the AD brain, and these alterations might be associated with an exacerbation of AD pathology. Oligodendrocytes are glial cells that produce the myelin sheath, which is a lipid-rich insulator. Dysfunctions of the myelin sheath have been linked to white matter abnormalities observed in the AD brain. Here, we review the lipid composition and metabolism in the brain and myelin and the association between lipidic alterations and AD pathology. We also present the abnormalities in oligodendrocyte lineage cells and white matter observed in AD. Additionally, we discuss metabolic disorders, including obesity, as AD risk factors and the effects of obesity and dietary intake of lipids on the brain.
Collapse
Affiliation(s)
- Noe Kawade
- Department of Neuroscience and Pathobiology, Research Institute of Environmental MedicineNagoya UniversityJapan
- Department of Neuroscience and Pathobiology, Nagoya University Graduate School of MedicineNagoya UniversityJapan
| | - Koji Yamanaka
- Department of Neuroscience and Pathobiology, Research Institute of Environmental MedicineNagoya UniversityJapan
- Department of Neuroscience and Pathobiology, Nagoya University Graduate School of MedicineNagoya UniversityJapan
- Institute for Glyco‐core Research (iGCORE)Nagoya UniversityJapan
- Center for One Medicine Innovative Translational Research (COMIT)Nagoya UniversityJapan
| |
Collapse
|
37
|
O'Hara L, Neville C, Marr C, McAlinden M, Kee F, Weir D, McGuinness B. Investigating the prevalence of cognitive impairment and dementia in the Northern Ireland Cohort for the Longitudinal Study of Ageing (NICOLA): the Harmonised Cognitive Assessment Protocol (HCAP) cross-sectional substudy. BMJ Open 2024; 14:e075672. [PMID: 38296305 PMCID: PMC10831431 DOI: 10.1136/bmjopen-2023-075672] [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: 05/15/2023] [Accepted: 01/17/2024] [Indexed: 02/03/2024] Open
Abstract
INTRODUCTION The Northern Ireland Cohort for the Longitudinal Study of Ageing (NICOLA) study is the largest study of ageing in Northern Ireland (NI). The Harmonised Cognitive Assessment Protocol (HCAP) is a substudy of NICOLA designed to assess cognitive impairment and dementia in individuals aged 65 and over. The NICOLA-HCAP substudy is funded by the National Institute on Aging as part of a network for enhancing cross-national research within a worldwide group of population-based, longitudinal studies of ageing, all of which are centred around the US-based Health and Retirement Study. METHODS AND ANALYSIS The NICOLA-HCAP study will draw on the main NICOLA cohort (of 8283 participants) and randomly sample 1000 participants aged 65 and over to take part in the substudy. Participants will complete a series of cognitive tests (n=19) via a computer-assisted personal interview administered in their home (or alternatively within the research centre) and will be asked to nominate a family member or friend to complete an additional interview of validated instruments to provide information on respondent's prior and current cognitive and physical functioning and whether the individual requires help with daily activities. The objectives of the study are: to investigate the prevalence of dementia and cognitive impairment in NICOLA; harmonise scoring of the NICOLA-HCAP data to the HCAP studies conducted in Ireland, the USA and England; to explore the validity of dementia estimates; and investigate the risk factors for dementia and cognitive impairment. ETHICS AND DISSEMINATION The study received ethical approval from the Faculty of Medicine, Health and Life Sciences Research Ethics Committee, Queen's University Belfast. We will provide data from the Northern Irish HCAP to the research community via data repositories such as the Dementias Platform UK and Gateway to Global Aging to complement existing public data resources and support epidemiological research by others. Findings will also be disseminated through peer-reviewed publications and at international conferences.
Collapse
Affiliation(s)
- Leeanne O'Hara
- Centre for Public Health, Queen's University Belfast, Belfast, UK
| | | | - Calum Marr
- Centre for Public Health, Queen's University Belfast, Belfast, UK
| | | | - Frank Kee
- Centre for Public Health, Queen's University Belfast, Belfast, UK
| | - David Weir
- University of Michigan, Ann Arbor, Michigan, USA
| | | |
Collapse
|
38
|
Wiese LK, Pratt BA, Heinze K, Besser L, Ifill A(A, Williams CL. Community-Based Strategies to Reduce Alzheimer's Disease and Related Dementia Incidence Among Rural, Racially/Ethnically Diverse Older Adults. CURRENT GERIATRICS REPORTS 2023; 12:205-219. [PMID: 38223294 PMCID: PMC10783445 DOI: 10.1007/s13670-023-00400-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/20/2023] [Indexed: 01/16/2024]
Abstract
Purpose of Review The purpose of this paper was to address the research question "What recent advances in Alzheimer's Disease and Related Dementias (ADRD) risk reduction strategies can be tailored for rural, racially/ethnically diverse populations?" A rural resident's life story that grounded the work is shared. Next, a brief description is provided regarding ADRD risk factors of importance in rural, multicultural settings. Gaps in U.S.-based research are highlighted. Policy actions and interventions that may make a difference in alleviating rural, ADRD-related disparities are offered. Recent Findings More than a dozen factors, including lack of built environment, periodontitis, poor air quality, and sensory loss, were identified that are of particular relevance to rural groups. Evidence of importance to underserved residents has also emerged regarding the harmful effects of ultra-processed foods on brain health, benefits of even minimal physical activity, and importance of social engagement, on brain health. Summary Resident-led initiatives will be key to creating change at the community level. Health providers are also called to assist in identifying and adapting culturally specific upstream approaches, in partnership with community stakeholders. These mechanisms are vital for decreasing ADRD burdens in underserved communities facing the largest disparities in preventive care.
Collapse
Affiliation(s)
- Lisa Kirk Wiese
- C. E. Lynn College of Nursing, Florida Atlantic University, 777 Glades Road, Mail Code #84, Boca Raton FL 33431, USA
| | - Beth A. Pratt
- C. E. Lynn College of Nursing, Florida Atlantic University, 777 Glades Road, Mail Code #84, Boca Raton FL 33431, USA
| | - Katherine Heinze
- C. E. Lynn College of Nursing, Florida Atlantic University, 777 Glades Road, Mail Code #84, Boca Raton FL 33431, USA
| | - Lilah Besser
- Comprehensive Center for Brain Health, University of Miami Miller School of Medicine, Boca Raton, FL, USA
| | - Antoinita (Annie) Ifill
- Palm Health Foundation/Community Partners of South Florida, 491 E. Main Street Suite 5A, Pahokee FL 33476, USA
| | - Christine L. Williams
- C. E. Lynn College of Nursing, Florida Atlantic University, 777 Glades Road, Mail Code #84, Boca Raton FL 33431, USA
| |
Collapse
|
39
|
Kim DR, Moon E, Shin MJ, Yang YA, Park JH. Effect of Individual Virtual Reality Cognitive Training Programs on Cognitive Function and Depression in Middle-Aged Women: Randomized Controlled Trial. JMIR Ment Health 2023; 10:e48912. [PMID: 37878378 PMCID: PMC10632914 DOI: 10.2196/48912] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Revised: 09/04/2023] [Accepted: 09/12/2023] [Indexed: 10/26/2023] Open
Abstract
BACKGROUND Given the increasing incidence of early-onset Alzheimer disease, strategies for early diagnosis and swift treatment interventions are crucial for mitigating cognitive problems in women and middle-aged individuals who face a high risk of cognitive impairment. OBJECTIVE This study aimed to assess the effectiveness of individual cognitive training programs based on virtual reality (VR), a nonpharmacological intervention, on cognitive function and depression in middle-aged women at risk of cognitive impairment. It used VR technology, which has recently been recognized as a promising tool. METHODS We administered a VR-based cognitive training program for 30 minutes daily, twice a week, for 12 weeks (24 sessions). This study included middle-aged women residing in older adults' welfare facilities in G-gu, Busan, from May to August 2021. A total of 60 participants were randomly divided into the training (n=30) and control (n=30) groups. Cognitive and depressive functions were assessed using the Korean versions of the Montreal Cognitive Assessment (K-MoCA), Digit Span Test (DST), Korean-Color Word Stroop Test (K-CWST), and Short Form of the Geriatric Depression Scale (SGDS-K) before the intervention. The training group underwent a VR-based cognitive training program, whereas the control group was educated to maintain regular daily activities. The same assessments were performed 12 weeks after treatment. RESULTS A comparison of the mean scores before and after K-MoCA in the training group revealed a significant increase from 24.87 (SD 2.62) to 27.50 (SD 1.70; P<.01), indicating substantial cognitive improvement. Similarly, the mean DST forward scores increased significantly from 6.97 (SD 1.10) to 7.90 (SD 1.18; P<.01), suggesting enhanced short-term auditory memory and attention. The mean DST backward scores also showed a significant improvement from 4.10 (SD 0.71) to 4.77 (SD 1.2; P=.01). Notably, the mean SGDS-K scores decreased significantly from 3.97 (SD 2.51) to 2.13 (SD 1.87; P<.01), indicating a reduction in depression within the training group. CONCLUSIONS The VR-based cognitive training programs significantly enhanced cognitive function and reduced depression in middle-aged women. Consequently, these programs are considered beneficial nonpharmacological cognitive training interventions for middle-aged women at high risk of cognitive impairment. TRIAL REGISTRATION UMIN Clinical Trials Registry UMIN000049752; https://tinyurl.com/z5du989z.
Collapse
Affiliation(s)
- Du-Ri Kim
- Health Convergence Medicine Laboratory, Biomedical Research Institute, Pusan National University Hospital, Busan, Republic of Korea
- Department of Rehabilitation Science, Graduate School, Inje University, Gimhae, Republic of Korea
| | - EunSoo Moon
- Health Convergence Medicine Laboratory, Biomedical Research Institute, Pusan National University Hospital, Busan, Republic of Korea
- Department of Psychiatry, Pusan National University School of Medicine, Yangsan, Republic of Korea
- Department of Psychiatry, Pusan National University Hospital, Busan, Republic of Korea
| | - Myung-Jun Shin
- Health Convergence Medicine Laboratory, Biomedical Research Institute, Pusan National University Hospital, Busan, Republic of Korea
- Department of Rehabilitation Medicine, Pusan National University School of Medicine, Yangsan, Republic of Korea
- Department of Rehabilitation Medicine, Pusan National University Hospital, Busan, Republic of Korea
| | - Yeong-Ae Yang
- Department of Occupational Therapy, College of Biomedical Science and Engineering, Inje University, Gimhae, Republic of Korea
- Institute of Aged Life Redesign, Inje University, Gimhae, Republic of Korea
| | - Jong-Hwan Park
- Health Convergence Medicine Laboratory, Biomedical Research Institute, Pusan National University Hospital, Busan, Republic of Korea
| |
Collapse
|
40
|
Zhang Y, Shen Y, Liufu N, Liu L, Li W, Shi Z, Zheng H, Mei X, Chen CY, Jiang Z, Abtahi S, Dong Y, Liang F, Shi Y, Cheng LL, Yang G, Kang JX, Wilkinson JE, Xie Z. Transmission of Alzheimer's disease-associated microbiota dysbiosis and its impact on cognitive function: evidence from mice and patients. Mol Psychiatry 2023; 28:4421-4437. [PMID: 37604976 PMCID: PMC11733706 DOI: 10.1038/s41380-023-02216-7] [Citation(s) in RCA: 26] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2023] [Revised: 06/26/2023] [Accepted: 08/03/2023] [Indexed: 08/23/2023]
Abstract
Spouses of Alzheimer's disease (AD) patients are at a higher risk of developing incidental dementia. However, the causes and underlying mechanism of this clinical observation remain largely unknown. One possible explanation is linked to microbiota dysbiosis, a condition that has been associated with AD. However, it remains unclear whether gut microbiota dysbiosis can be transmitted from AD individuals to non-AD individuals and contribute to the development of AD pathogenesis and cognitive impairment. We, therefore, set out to perform both animal studies and clinical investigation by co-housing wild-type mice and AD transgenic mice, analyzing microbiota via 16S rRNA gene sequencing, measuring short-chain fatty acid amounts, and employing behavioral test, mass spectrometry, site-mutations and other methods. The present study revealed that co-housing between wild-type mice and AD transgenic mice or administrating feces of AD transgenic mice to wild-type mice resulted in AD-associated gut microbiota dysbiosis, Tau phosphorylation, and cognitive impairment in the wild-type mice. Gavage with Lactobacillus and Bifidobacterium restored these changes in the wild-type mice. The oral and gut microbiota of AD patient partners resembled that of AD patients but differed from healthy controls, indicating the transmission of microbiota. The underlying mechanism of these findings includes that the butyric acid-mediated acetylation of GSK3β at lysine 15 regulated its phosphorylation at serine 9, consequently impacting Tau phosphorylation. Pending confirmative studies, these results provide insight into a potential link between the transmission of AD-associated microbiota dysbiosis and development of cognitive impairment, which underscore the need for further research in this area.
Collapse
Affiliation(s)
- Yiying Zhang
- Geriatric Anesthesia Research Unit, Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital and Harvard Medical School, Charlestown, MA, 02129, USA.
| | - Yuan Shen
- Geriatric Anesthesia Research Unit, Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital and Harvard Medical School, Charlestown, MA, 02129, USA
- Anesthesia and Brain Research Institute, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, 200072, PR China
- Mental Health Center affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, 200030, PR China
| | - Ning Liufu
- Geriatric Anesthesia Research Unit, Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital and Harvard Medical School, Charlestown, MA, 02129, USA
- Department of Anesthesiology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, Guangdong Province, 510120, PR China
| | - Ling Liu
- Geriatric Anesthesia Research Unit, Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital and Harvard Medical School, Charlestown, MA, 02129, USA
- Department of Anesthesiology, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, Guangdong Province, 510120, PR China
| | - Wei Li
- Geriatric Anesthesia Research Unit, Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital and Harvard Medical School, Charlestown, MA, 02129, USA
| | - Zhongyong Shi
- Geriatric Anesthesia Research Unit, Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital and Harvard Medical School, Charlestown, MA, 02129, USA
- Anesthesia and Brain Research Institute, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, 200072, PR China
- Mental Health Center affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, 200030, PR China
| | - Hailin Zheng
- Anesthesia and Brain Research Institute, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, 200072, PR China
| | - Xinchun Mei
- Geriatric Anesthesia Research Unit, Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital and Harvard Medical School, Charlestown, MA, 02129, USA
- Anesthesia and Brain Research Institute, Shanghai Tenth People's Hospital, Tongji University School of Medicine, Shanghai, 200072, PR China
- Mental Health Center affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, 200030, PR China
| | - Chih-Yu Chen
- Laboratory for Lipid Medicine and Technology, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Charlestown, MA, 02129, USA
| | - Zengliang Jiang
- Laboratory for Lipid Medicine and Technology, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Charlestown, MA, 02129, USA
- Key Laboratory of Growth Regulation and Translational Research of Zhejiang Province, School of Life Sciences, Westlake University, Hangzhou, PR China
| | - Shabnamsadat Abtahi
- Biostatistics Department and Department of Immunology and Infectious Diseases, Harvard School of Public Health, Boston, MA, 02115, USA
| | - Yuanlin Dong
- Geriatric Anesthesia Research Unit, Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital and Harvard Medical School, Charlestown, MA, 02129, USA
| | - Feng Liang
- Geriatric Anesthesia Research Unit, Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital and Harvard Medical School, Charlestown, MA, 02129, USA
| | - Yujiang Shi
- Shanghai Key Laboratory of Medical Epigenetics, Institutes of Biomedical Sciences, Zhongshan Hospital, Fudan University, Shanghai, 200032, PR China
| | - Leo L Cheng
- Departments of Radiology and Pathology, Massachusetts General Hospital and Harvard Medical School, Charlestown, MA, 02129, USA
| | - Guang Yang
- Department of Anesthesiology, Columbia University Medical Center, New York, NY, 10032, USA
| | - Jing X Kang
- Laboratory for Lipid Medicine and Technology, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Charlestown, MA, 02129, USA
| | - Jeremy E Wilkinson
- Biostatistics Department and Department of Immunology and Infectious Diseases, Harvard School of Public Health, Boston, MA, 02115, USA
| | - Zhongcong Xie
- Geriatric Anesthesia Research Unit, Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital and Harvard Medical School, Charlestown, MA, 02129, USA.
| |
Collapse
|
41
|
Tashiro M, Yasuda N, Inoue M, Yamagishi K, Tsugane S, Sawada N. Body mass index, weight change in midlife, and dementia incidence: the Japan Public Health Center-based Prospective Study. ALZHEIMER'S & DEMENTIA (AMSTERDAM, NETHERLANDS) 2023; 15:e12507. [PMID: 38026757 PMCID: PMC10668007 DOI: 10.1002/dad2.12507] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Revised: 10/12/2023] [Accepted: 10/27/2023] [Indexed: 12/01/2023]
Abstract
INTRODUCTION Insufficient evidence exists on the sex-specific associations of body mass index (BMI) and weight change through midlife with dementia incidence, especially in Asian populations. METHODS For 37,414 Japanese residents aged 40 to 59 years, BMIs at baseline (year 1990 or 1993) and 10-year follow-ups were obtained. Weight changes between baseline and 10-year follow-ups were determined. Disabling dementia incidence from 2006 to 2016 was ascertained using long-term care insurance (LTCI) certifications. Hazard ratios (HRs) were computed. RESULTS Increased dementia risk was observed with obesity at baseline and with underweight at 10-year follow-ups. Weight loss after baseline was at greater risk than weight gain. No sex difference was observed. DISCUSSION In both sexes, obesity in midlife increased the risk of developing dementia with increasing impacts of weight loss after midlife. A healthy body weight throughout adulthood is beneficial for dementia prevention. Highlights Obesity in midlife is a risk factor for incident dementia.Weight loss is a bigger risk factor than weight gain in later midlife.Association of BMI and weight change in midlife with dementia does not vary by sex.
Collapse
Affiliation(s)
- Miwa Tashiro
- Department of Public HealthKochi University Medical SchoolNankoku‐shiKochiJapan
| | - Nobufumi Yasuda
- Department of Public HealthKochi University Medical SchoolNankoku‐shiKochiJapan
| | - Manami Inoue
- Division of PreventionNational Cancer Center Institute for Cancer ControlChuou‐kuTokyoJapan
| | - Kazumasa Yamagishi
- Department of Public Health MedicineInstitute of Medicineand Health Services Research and Development CenterUniversity of TsukubaTsukuba‐shiIbarakiJapan
| | - Shoichiro Tsugane
- National Institute of Health and NutritionNational Institutes of Biomedical InnovationHealth and NutritionShinjyuku‐kuTokyoJapan
- Division of Cohort ResearchNational Cancer Center Institute for Cancer ControlChuou‐kuTokyoJapan
| | - Norie Sawada
- Division of Cohort ResearchNational Cancer Center Institute for Cancer ControlChuou‐kuTokyoJapan
| |
Collapse
|
42
|
Shinohara M, Gheni G, Hitomi J, Bu G, Sato N. APOE genotypes modify the obesity paradox in dementia. J Neurol Neurosurg Psychiatry 2023; 94:670-680. [PMID: 37414536 PMCID: PMC10695687 DOI: 10.1136/jnnp-2022-331034] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Accepted: 06/05/2023] [Indexed: 07/08/2023]
Abstract
BACKGROUND While obesity in midlife is a risk factor for dementia, several studies suggested that obesity also protected against dementia, hence so-called obesity paradox. The current study aims to address the relationship between apolipoprotein E (APOE) genotype and obesity in dementia. METHODS Clinical and neuropathological records of the National Alzheimer's Coordinating Center (NACC) in the USA, which longitudinally followed approximately 20 000 subjects with different cognitive statues, APOE genotype and obesity states, were reviewed. RESULTS Obesity was associated with cognitive decline in early elderly cognitively normal individuals without APOE4, especially those with APOE2. Neuropathological analyses adjusted for dementia status showed that APOE2 carriers tended to have more microinfarcts and haemorrhages due to obesity. On the other hand, obesity was associated with a lower frequency of dementia and less cognitive impairment in individuals with mild cognitive impairment or dementia. Such trends were particularly strong in APOE4 carriers. Obesity was associated with fewer Alzheimer's pathologies in individuals with dementia. CONCLUSIONS Obesity may accelerate cognitive decline in middle to early elderly cognitive normal individuals without APOE4 likely by provoking vascular impairments. On the other hand, obesity may ease cognitive impairment in both individuals with dementia and individuals at the predementia stage, especially those with APOE4, through protecting against Alzheimer's pathologies. These results support that APOE genotype modifies the obesity paradox in dementia.
Collapse
Affiliation(s)
- Mitsuru Shinohara
- Department of Aging Neurobiology, National Center for Geriatrics and Gerontology, Obu, Aichi, Japan
- Department of Neuroscience, Mayo Clinic, Jacksonville, Florida, USA
- Department of Aging Neurobiology, Osaka University, Suita, Osaka, Japan
| | - Ghupurjan Gheni
- Department of Aging Neurobiology, National Center for Geriatrics and Gerontology, Obu, Aichi, Japan
| | - Junichi Hitomi
- Department of Aging Neurobiology, National Center for Geriatrics and Gerontology, Obu, Aichi, Japan
| | - Guojun Bu
- Department of Neuroscience, Mayo Clinic, Jacksonville, Florida, USA
| | - Naoyuki Sato
- Department of Aging Neurobiology, National Center for Geriatrics and Gerontology, Obu, Aichi, Japan
- Department of Aging Neurobiology, Osaka University, Suita, Osaka, Japan
| |
Collapse
|
43
|
Qi M, Janssen I, Barinas-Mitchell E, Budoff M, Brooks MM, Karlamangla AS, Derby CA, Chang CCH, Shields KJ, El Khoudary SR. The quantity and quality of cardiovascular fat at mid-life and future cognitive performance among women: The SWAN cardiovascular fat ancillary study. Alzheimers Dement 2023; 19:4073-4083. [PMID: 37212597 PMCID: PMC11221406 DOI: 10.1002/alz.13133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2023] [Revised: 04/10/2023] [Accepted: 04/12/2023] [Indexed: 05/23/2023]
Abstract
INTRODUCTION Cardiovascular fat is a novel risk factor that may link to dementia. Fat volume and radiodensity are measurements of fat quantity and quality, respectively. Importantly, high fat radiodensity could indicate healthy or adverse metabolic processes. METHODS The associations of cardiovascular fat (including epicardial, paracardial, and thoracic perivascular adipose tissue [PVAT]) quantity and quality assessed at mean age of 51 with subsequent cognitive performance measured repeatedly over 16 years of follow-up were examined using mixed models among 531 women. RESULTS Higher thoracic PVAT volume was associated with a higher future episodic memory (β[standard error (SE)] = 0.08 [0.04], P = 0.033), while higher thoracic PVAT radiodensity with lower future episodic (β[SE] = -0.06 [0.03], P = 0.045) and working (β[SE] = -0.24 [0.08], P = 0.003) memories. The latter association is prominent at higher volume of thoracic PVAT. DISCUSSION Mid-life thoracic PVAT may have a distinct contribution to future cognition possibly due to its distinct adipose tissue type (brown fat) and anatomical proximity to the brain circulation. HIGHLIGHTS Higher mid-life thoracic perivascular adipose tissue (thoracic PVAT) volume is related to a better future episodic memory in women. Higher mid-life thoracic PVAT radiodensity is related to worse future working and episodic memories. Negative association of high thoracic PVAT radiodensity with working memory is prominent at higher thoracic PVAT volume. Mid-life thoracic PVAT is linked to future memory loss, an early sign of Alzheimer's disease. Mid-life women's epicardial and paracardial fat are not related to future cognition.
Collapse
Affiliation(s)
- Meiyuzhen Qi
- University of Pittsburgh School of Public Health, Department of Epidemiology, Pittsburgh, PA, 15261, USA
| | - Imke Janssen
- Rush University Rush Medical Center, Department of Preventive Medicine, Chicago, IL, 60612, USA
| | - Emma Barinas-Mitchell
- University of Pittsburgh School of Public Health, Department of Epidemiology, Pittsburgh, PA, 15261, USA
| | - Matthew Budoff
- Harbor-UCLA Medical Center, Lundquist Institute, Torrance, CA, 90509, USA
| | - Maria M. Brooks
- University of Pittsburgh School of Public Health, Department of Epidemiology, Pittsburgh, PA, 15261, USA
| | - Arun S. Karlamangla
- University of California Los Angeles David Geffen School of Medicine, Los Angeles, CA, 90095, USA
| | - Carol A. Derby
- Albert Einstein College of Medicine Department of Neurology and Department of Epidemiology & Public Health, Bronx, NY, 10461, USA
| | - Chung-Chou H. Chang
- University of Pittsburgh School of Public Health, Department of Epidemiology, Pittsburgh, PA, 15261, USA
| | | | - Samar R. El Khoudary
- University of Pittsburgh School of Public Health, Department of Epidemiology, Pittsburgh, PA, 15261, USA
| |
Collapse
|
44
|
Ramírez-Carreto RJ, Rodríguez-Cortés YM, Torres-Guerrero H, Chavarría A. Possible Implications of Obesity-Primed Microglia that Could Contribute to Stroke-Associated Damage. Cell Mol Neurobiol 2023; 43:2473-2490. [PMID: 36935429 PMCID: PMC10025068 DOI: 10.1007/s10571-023-01329-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2022] [Accepted: 02/14/2023] [Indexed: 03/21/2023]
Abstract
Microglia, the resident macrophages of the central nervous system, are essential players during physiological and pathological processes. Although they participate in synaptic pruning and maintenance of neuronal circuits, microglia are mainly studied by their activity modulating inflammatory environment and adapting their phenotype and mechanisms to insults detected in the brain parenchyma. Changes in microglial phenotypes are reflected in their morphology, membrane markers, and secreted substances, stimulating neighbor glia and leading their responses to control stimuli. Understanding how microglia react in various microenvironments, such as chronic inflammation, made it possible to establish therapeutic windows and identify synergic interactions with acute damage events like stroke. Obesity is a low-grade chronic inflammatory state that gradually affects the central nervous system, promoting neuroinflammation development. Obese patients have the worst prognosis when they suffer a cerebral infarction due to basal neuroinflammation, then obesity-induced neuroinflammation could promote the priming of microglial cells and favor its neurotoxic response, potentially worsening patients' prognosis. This review discusses the main microglia findings in the obesity context during the course and resolution of cerebral infarction, involving the temporality of the phenotype changes and balance of pro- and anti-inflammatory responses, which is lost in the swollen brain of an obese subject. Obesity enhances proinflammatory responses during a stroke. Obesity-induced systemic inflammation promotes microglial M1 polarization and priming, which enhances stroke-associated damage, increasing M1 and decreasing M2 responses.
Collapse
Affiliation(s)
- Ricardo Jair Ramírez-Carreto
- Unidad de Investigación en Medicina Experimental, Facultad de Medicina, Universidad Nacional Autónoma de México, Mexico City, Mexico
| | - Yesica María Rodríguez-Cortés
- Unidad de Investigación en Medicina Experimental, Facultad de Medicina, Universidad Nacional Autónoma de México, Mexico City, Mexico
| | - Haydee Torres-Guerrero
- Unidad de Investigación en Medicina Experimental, Facultad de Medicina, Universidad Nacional Autónoma de México, Mexico City, Mexico.
| | - Anahí Chavarría
- Unidad de Investigación en Medicina Experimental, Facultad de Medicina, Universidad Nacional Autónoma de México, Mexico City, Mexico.
| |
Collapse
|
45
|
Charisis S, Lin H, Ray R, Joehanes R, Beiser AS, Levy D, Seshadri S, Sargurupremraj M, Satizabal CL. Obesity impacts the expression of Alzheimer's disease-related genes: The Framingham Heart Study. Alzheimers Dement 2023; 19:3496-3505. [PMID: 36811231 PMCID: PMC10435662 DOI: 10.1002/alz.12954] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2022] [Revised: 12/01/2022] [Accepted: 12/12/2022] [Indexed: 02/24/2023]
Abstract
INTRODUCTION We investigated associations of obesity with the expression of Alzheimer's disease (AD)-related genes in a large community-based cohort. METHODS The sample consisted of 5619 participants from the Framingham Heart Study. Obesity metrics included body mass index (BMI) and waist-to-hip ratio (WHR). Gene expression was measured for a set of 74 AD-related genes, derived by integrating genome-wide association study results with functional genomics data. RESULTS Obesity metrics were associated with the expression of 21 AD-related genes. The strongest associations were observed with CLU, CD2AP, KLC3, and FCER1G. Unique associations were noted with TSPAN14, SLC24A4 for BMI, and ZSCAN21, BCKDK for WHR. After adjustment for cardiovascular risk factors, 13 associations remained significant for BMI and 8 for WHR. Dichotomous obesity metrics exhibited unique associations with EPHX2 for BMI, and with TSPAN14 for WHR. DISCUSSION Obesity was associated with AD-related gene expression; these findings shed light on the molecular pathways linking obesity to AD.
Collapse
Affiliation(s)
- Sokratis Charisis
- Glenn Biggs Institute for Alzheimer’s and Neurodegenerative Diseases, UT Health San Antonio, San Antonio, TX, USA
| | - Honghuang Lin
- Boston University School of Medicine, Department of Neurology, Boston, MA, USA
- The Framingham Heart Study, Framingham, MA, USA
- University of Massachusetts Chan Medical School, Worcester, MA, USA
| | - Roshni Ray
- Long School of Medicine, UT Health San Antonio, San Antonio, TX, USA
| | - Roby Joehanes
- The Framingham Heart Study, Framingham, MA, USA
- Population Sciences Branch, National Heart, Lung and Blood Institutes of Health, Bethesda, MD, USA
| | - Alexa S Beiser
- Boston University School of Medicine, Department of Neurology, Boston, MA, USA
- The Framingham Heart Study, Framingham, MA, USA
- Boston University School of Public Health, Department of Biostatistics, Boston, MA, USA
| | - Daniel Levy
- The Framingham Heart Study, Framingham, MA, USA
- Population Sciences Branch, National Heart, Lung and Blood Institutes of Health, Bethesda, MD, USA
| | - Sudha Seshadri
- Glenn Biggs Institute for Alzheimer’s and Neurodegenerative Diseases, UT Health San Antonio, San Antonio, TX, USA
- Boston University School of Medicine, Department of Neurology, Boston, MA, USA
- The Framingham Heart Study, Framingham, MA, USA
| | - Muralidharan Sargurupremraj
- Glenn Biggs Institute for Alzheimer’s and Neurodegenerative Diseases, UT Health San Antonio, San Antonio, TX, USA
| | - Claudia L Satizabal
- Glenn Biggs Institute for Alzheimer’s and Neurodegenerative Diseases, UT Health San Antonio, San Antonio, TX, USA
- Boston University School of Medicine, Department of Neurology, Boston, MA, USA
- The Framingham Heart Study, Framingham, MA, USA
| |
Collapse
|
46
|
Escobar AP, Bonansco C, Cruz G, Dagnino-Subiabre A, Fuenzalida M, Negrón I, Sotomayor-Zárate R, Martínez-Pinto J, Jorquera G. Central and Peripheral Inflammation: A Common Factor Causing Addictive and Neurological Disorders and Aging-Related Pathologies. Int J Mol Sci 2023; 24:10083. [PMID: 37373230 PMCID: PMC10298583 DOI: 10.3390/ijms241210083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2023] [Revised: 06/08/2023] [Accepted: 06/09/2023] [Indexed: 06/29/2023] Open
Abstract
Many diseases and degenerative processes affecting the nervous system and peripheral organs trigger the activation of inflammatory cascades. Inflammation can be triggered by different environmental conditions or risk factors, including drug and food addiction, stress, and aging, among others. Several pieces of evidence show that the modern lifestyle and, more recently, the confinement associated with the COVID-19 pandemic have contributed to increasing the incidence of addictive and neuropsychiatric disorders, plus cardiometabolic diseases. Here, we gather evidence on how some of these risk factors are implicated in activating central and peripheral inflammation contributing to some neuropathologies and behaviors associated with poor health. We discuss the current understanding of the cellular and molecular mechanisms involved in the generation of inflammation and how these processes occur in different cells and tissues to promote ill health and diseases. Concomitantly, we discuss how some pathology-associated and addictive behaviors contribute to worsening these inflammation mechanisms, leading to a vicious cycle that promotes disease progression. Finally, we list some drugs targeting inflammation-related pathways that may have beneficial effects on the pathological processes associated with addictive, mental, and cardiometabolic illnesses.
Collapse
Affiliation(s)
- Angélica P. Escobar
- Centro de Neurobiología y Fisiopatología Integrativa (CENFI), Instituto de Fisiología, Facultad de Ciencias, Universidad de Valparaíso, Valparaíso 2360102, Chile; (A.P.E.); (C.B.); (G.C.); (M.F.); (I.N.); (R.S.-Z.)
| | - Christian Bonansco
- Centro de Neurobiología y Fisiopatología Integrativa (CENFI), Instituto de Fisiología, Facultad de Ciencias, Universidad de Valparaíso, Valparaíso 2360102, Chile; (A.P.E.); (C.B.); (G.C.); (M.F.); (I.N.); (R.S.-Z.)
| | - Gonzalo Cruz
- Centro de Neurobiología y Fisiopatología Integrativa (CENFI), Instituto de Fisiología, Facultad de Ciencias, Universidad de Valparaíso, Valparaíso 2360102, Chile; (A.P.E.); (C.B.); (G.C.); (M.F.); (I.N.); (R.S.-Z.)
| | - Alexies Dagnino-Subiabre
- Centro de Neurobiología y Fisiopatología Integrativa (CENFI), Instituto de Fisiología, Facultad de Ciencias, Universidad de Valparaíso, Valparaíso 2360102, Chile; (A.P.E.); (C.B.); (G.C.); (M.F.); (I.N.); (R.S.-Z.)
| | - Marco Fuenzalida
- Centro de Neurobiología y Fisiopatología Integrativa (CENFI), Instituto de Fisiología, Facultad de Ciencias, Universidad de Valparaíso, Valparaíso 2360102, Chile; (A.P.E.); (C.B.); (G.C.); (M.F.); (I.N.); (R.S.-Z.)
| | - Ignacio Negrón
- Centro de Neurobiología y Fisiopatología Integrativa (CENFI), Instituto de Fisiología, Facultad de Ciencias, Universidad de Valparaíso, Valparaíso 2360102, Chile; (A.P.E.); (C.B.); (G.C.); (M.F.); (I.N.); (R.S.-Z.)
| | - Ramón Sotomayor-Zárate
- Centro de Neurobiología y Fisiopatología Integrativa (CENFI), Instituto de Fisiología, Facultad de Ciencias, Universidad de Valparaíso, Valparaíso 2360102, Chile; (A.P.E.); (C.B.); (G.C.); (M.F.); (I.N.); (R.S.-Z.)
| | - Jonathan Martínez-Pinto
- Centro de Neurobiología y Fisiopatología Integrativa (CENFI), Instituto de Fisiología, Facultad de Ciencias, Universidad de Valparaíso, Valparaíso 2360102, Chile; (A.P.E.); (C.B.); (G.C.); (M.F.); (I.N.); (R.S.-Z.)
- Stark Neurosciences Research Institute, Indiana University School of Medicine, Indianapolis, IN 46202, USA
- Department of Anatomy, Cell Biology and Physiology, Indiana University School of Medicine, Indianapolis, IN 46202, USA
| | - Gonzalo Jorquera
- Centro de Neurobiología y Fisiopatología Integrativa (CENFI), Instituto de Fisiología, Facultad de Ciencias, Universidad de Valparaíso, Valparaíso 2360102, Chile; (A.P.E.); (C.B.); (G.C.); (M.F.); (I.N.); (R.S.-Z.)
- Instituto de Nutrición y Tecnología de los Alimentos (INTA), Universidad de Chile, Santiago 7830490, Chile
| |
Collapse
|
47
|
Naomi R, Teoh SH, Rusli RNM, Embong H, Bahari H, Kumar J. Elateriospermum tapos Yoghurt as a Therapeutic Intervention for Obesity-Associated Cognitive Impairments and Anxiety-like Behaviour in a High Fat Diet Maternal Obese Rat Model. Nutrients 2023; 15:nu15102312. [PMID: 37242195 DOI: 10.3390/nu15102312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Revised: 05/10/2023] [Accepted: 05/12/2023] [Indexed: 05/28/2023] Open
Abstract
Maternal obesity can be considered an intergenerational cycle and is also an important indicator of cognitive impairments. It is thought that using natural products is the best and safest way to combat maternal obesity and associated complications. Recent studies have shown that Elateriospermum tapos (E. tapos) contains bioactive compounds with anti-obesity effects, and yoghurt is a convenient medium for supplementing obese maternal rats with E. tapos extract. Thus, the aim of this study is to investigate the impact of E. tapos in yoghurt on maternally obese rats' cognitive function supplemented with a high-fat diet (HFD). In this study, 48 female Sprague-Dawley rats were used. The rats were fed HFD for a period of 16 weeks to induce obesity, after which they were allowed to mate. Upon confirmation of pregnancy, obese rats were given varying doses of E. tapos (5, 50, and 500 mg/kg) in yoghurt until postnatal (PND) day 21. On PND 21, the dams' body mass index (BMI), Lee index, abdominal circumference, oxidative status, and metabolic profile were measured. The behavioral tests (open field, place, and object recognition) were conducted on PND 21 to access memory. The results show that the 50 and 500 mg/kg E. tapos in yoghurt supplemented groups had similar BMI, Lee index, abdominal circumference, lipid profile, FBG, insulin, FRAP, and GSH levels, as well as a similar recognition index, in comparison with the control group supplemented with saline. In conclusion, the results of this study indicate that the newly formulated E. tapos in yogurt can act as an anti-obesity agent in maternal obesity, alleviate anxiety, and enhance hippocampal-dependent memory.
Collapse
Affiliation(s)
- Ruth Naomi
- Department of Human Anatomy, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang 43400, Malaysia
| | - Soo Huat Teoh
- Advanced Medical and Dental Institute, Universiti Sains Malaysia, Penang 13200, Malaysia
| | - Rusydatul Nabila Mahmad Rusli
- Department of Human Anatomy, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang 43400, Malaysia
| | - Hashim Embong
- Department of Emergency Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur 56000, Malaysia
| | - Hasnah Bahari
- Department of Human Anatomy, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang 43400, Malaysia
| | - Jaya Kumar
- Department of Physiology, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur 56000, Malaysia
| |
Collapse
|
48
|
Naomi R, Teoh SH, Embong H, Balan SS, Othman F, Bahari H, Yazid MD. The Role of Oxidative Stress and Inflammation in Obesity and Its Impact on Cognitive Impairments-A Narrative Review. Antioxidants (Basel) 2023; 12:antiox12051071. [PMID: 37237937 DOI: 10.3390/antiox12051071] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2023] [Revised: 04/26/2023] [Accepted: 04/28/2023] [Indexed: 05/28/2023] Open
Abstract
Obesity is a chronic low-grade inflammatory condition that induces the generation of oxidative stress and inflammation. This oxidative stress and inflammation stimulate brain atrophy and some morphological changes in the brain that eventually result in cognitive impairments. However, there is no exact study that has summarized the role of oxidative stress and inflammation in obesity and its impact on cognitive impairments. Thus, the objective of this review is to recapitulate the current role of oxidative stress and inflammation in cognitive decline based on in vivo evidence. A comprehensive search was performed in Nature, Medline and Ovid, ScienceDirect, and PubMed, and the search was limited to the past 10 years of publication. From the search, we identified 27 articles to be further reviewed. The outcome of this study indicates that a greater amount of fat stored in individual adipocytes in obesity induces the formation of reactive oxygen species and inflammation. This will lead to the generation of oxidative stress, which may cause morphological changes in the brain, suppress the endogenous antioxidant system, and promote neuroinflammation and, eventually, neuronal apoptosis. This will impair the normal function of the brain and specific regions that are involved in learning, as well as memory. This shows that obesity has a strong positive correlation with cognitive impairments. Hence, this review summarizes the mechanism of oxidative stress and inflammation that induce memory loss based on animal model evidence. In conclusion, this review may serve as an insight into therapeutic development focusing on oxidative stress and inflammatory pathways to manage an obesity-induced cognitive decline in the future.
Collapse
Affiliation(s)
- Ruth Naomi
- Department of Human Anatomy, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang 43400, Malaysia
| | - Soo Huat Teoh
- Advanced Medical and Dental Institute, Universiti Sains Malaysia, Kepala Batas 13200, Malaysia
| | - Hashim Embong
- Department of Emergency Medicine, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur 56000, Malaysia
| | - Santhra Segaran Balan
- Department of Diagnostic and Allied Health Sciences, Faculty of Health and Life Sciences, Management and Science University, Shah Alam 40100, Malaysia
| | - Fezah Othman
- Department of Biomedical Sciences, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang 43400, Malaysia
| | - Hasnah Bahari
- Department of Human Anatomy, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang 43400, Malaysia
| | - Muhammad Dain Yazid
- Centre for Tissue Engineering and Regenerative Medicine (CTERM), Universiti Kebangsaan Malaysia, Kuala Lumpur 56000, Malaysia
| |
Collapse
|
49
|
Zhang Y, Shen Y, Liufu N, Liu L, Li W, Shi Z, Zheng H, Mei X, Chen CY, Jiang Z, Abtahi S, Dong Y, Liang F, Shi Y, Cheng L, Yang G, Kang JX, Wilkinson J, Xie Z. Transmission of Alzheimer's Disease-Associated Microbiota Dysbiosis and its Impact on Cognitive Function: Evidence from Mouse Models and Human Patients. RESEARCH SQUARE 2023:rs.3.rs-2790988. [PMID: 37162940 PMCID: PMC10168447 DOI: 10.21203/rs.3.rs-2790988/v1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
Spouses of Alzheimer's disease (AD) patients are at higher risk of developing AD dementia, but the reasons and underlying mechanism are unknown. One potential factor is gut microbiota dysbiosis, which has been associated with AD. However, it remains unclear whether the gut microbiota dysbiosis can be transmitted to non-AD individuals and contribute to the development of AD pathogenesis and cognitive impairment. The present study found that co-housing wild-type mice with AD transgenic mice or giving them AD transgenic mice feces caused AD-associated gut microbiota dysbiosis, Tau phosphorylation, and cognitive impairment. Gavage with Lactobacillus and Bifidobacterium restored these changes. The oral and gut microbiota of AD patient partners resembled that of AD patients but differed from healthy controls, indicating the transmission of oral and gut microbiota and its impact on cognitive function. The underlying mechanism of these findings includes that the butyric acid-mediated acetylation of GSK3β at lysine 15 regulated its phosphorylation at serine 9, consequently impacting Tau phosphorylation. These results provide insight into a potential link between gut microbiota dysbiosis and AD and underscore the need for further research in this area.
Collapse
Affiliation(s)
| | - Yuan Shen
- Tenth People's Hospital of Tongji University
| | | | | | - Wei Li
- Massachusetts General Hospital
| | | | | | | | | | | | | | - Yuanlin Dong
- Geriatric Anesthesia Research Unit, Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital and Harvard Medical School
| | | | | | | | - Guang Yang
- Department of Anesthesiology, Columbia University
| | | | | | | |
Collapse
|
50
|
Zhao D, Luo J, Li J, Gao T, Fu P, Wang Y, Zhou C. Tooth loss, body mass index and cognitive function among middle-aged and older adults in China: Does gender matter? J Affect Disord 2023; 333:517-523. [PMID: 37086810 DOI: 10.1016/j.jad.2023.04.021] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2023] [Revised: 03/20/2023] [Accepted: 04/14/2023] [Indexed: 04/24/2023]
Abstract
BACKGROUND Previous studies have shown a longitudinal association between tooth loss and cognitive function. Body mass index (BMI) is an essential applicable indicator of health status screening. However, the underlying mechanism among these factors remains unclear. This study aimed to determine the mediating role of BMI in the tooth loss-cognition relationship by gender among Chinese middle-aged and older adults. METHODS This is a prospective and cohort study. We used three waves of follow-up data (2011, 2013, and 2015) from the China Health and Retirement Longitudinal Survey, including 10,013 participants aged 45 years or above. Cognitive function was evaluated by Telephone Interview of Cognitive Status, words recall, and figure drawing. The cross-lagged panel model was applied to test the hypothesized model. RESULTS Tooth loss is associated with higher BMI and lower level of cognitive function. We found significant total effects (B = -0.017, P = 0.008), direct effect (B = -0.015, P = 0.022) and indirect effects (B = -0.002, P = 0.010) of tooth loss on cognition mediated through BMI only among middle-aged and older men. For middle-aged and older women, the total effect (B = -0.010, P = 0.125) and direct effect (B = -0.007, P = 0.249) were no more significant. CONCLUSIONS The longitudinal association between tooth loss and cognition was primarily indirect through BMI among middle-aged Chinese males but not women. Public health authorities should remind middle-aged and older males with tooth loss and high BMI to participate in timely medical checkups for improving cognition.
Collapse
Affiliation(s)
- Dan Zhao
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, China
| | - Jingjing Luo
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, China
| | - Jie Li
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, China
| | - Tingting Gao
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, China
| | - Peipei Fu
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, China
| | - Yi Wang
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, China
| | - Chengchao Zhou
- Centre for Health Management and Policy Research, School of Public Health, Cheeloo College of Medicine, Shandong University, Jinan 250012, China; NHC Key Lab of Health Economics and Policy Research (Shandong University), Jinan 250012, China; Institute of Health and Elderly Care, Shandong University, Jinan 250012, China.
| |
Collapse
|