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Khaled M, Al-Jamal H, Tajer L, El-Mir R. Alzheimer's Disease in Lebanon: Exploring Genetic and Environmental Risk Factors-A Comprehensive Review. J Alzheimers Dis 2024; 99:21-40. [PMID: 38640157 DOI: 10.3233/jad-231432] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/21/2024]
Abstract
Alzheimer's disease (AD) is a neurodegenerative condition that displays a high prevalence in Lebanon causing a local burden in healthcare and socio-economic sectors. Unfortunately, the lack of prevalence studies and clinical trials in Lebanon minimizes the improvement of AD patient health status. In this review, we include over 155 articles to cover the different aspects of AD ranging from mechanisms to possible treatment and management tools. We highlight some important modifiable and non-modifiable risk factors of the disease including genetics, age, cardiovascular diseases, smoking, etc. Finally, we propose a hypothetical genetic synergy model between APOE4 and TREM2 genes which constitutes a potential early diagnostic tool that helps in reducing the risk of AD based on preventative measures decades before cognitive decline. The studies on AD in Lebanon and the Middle East are scarce. This review points out the importance of genetic mapping in the understanding of disease pathology which is crucial for the emergence of novel diagnostic tools. Hence, we establish a rigid basis for further research to identify the most influential genetic and environmental risk factors for the purpose of using more specific diagnostic tools and possibly adopting a local management protocol.
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Affiliation(s)
| | - Hadi Al-Jamal
- Faculty of Public Health III, Lebanese University, Tripoli, Lebanon
| | - Layla Tajer
- Faculty of Public Health III, Lebanese University, Tripoli, Lebanon
| | - Reem El-Mir
- Faculty of Public Health III, Lebanese University, Tripoli, Lebanon
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Lorenzo-Mora AM, López-Sobaler AM, Bermejo LM, González-Rodríguez LG, Cuadrado-Soto E, Peral-Suárez Á, Salas-González MD, Delgado-Losada ML, Rodríguez-Rojo IC, Barabash A, Maestú-Unturbe F, Aparicio A. Association between Mineral Intake and Cognition Evaluated by Montreal Cognitive Assessment (MoCA): A Cross-Sectional Study. Nutrients 2023; 15:4505. [PMID: 37960158 PMCID: PMC10648921 DOI: 10.3390/nu15214505] [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: 08/15/2023] [Revised: 09/27/2023] [Accepted: 10/20/2023] [Indexed: 11/15/2023] Open
Abstract
BACKGROUND Mineral intake may protect against cognitive impairment (CI) and all-cause dementia, which affects a large number of adults worldwide. The aim of this study was to investigate the association between mineral intake and Montreal Cognitive Assessment (MoCA), which is a sensitive and specific test. METHODS In total, 201 adults were included in a cross-sectional study. They completed a three-day dietary record to estimate their average daily intake of minerals. Contributions to dietary reference intakes (DRIs) were also calculated. The participants were divided into tertiles according to their mineral intake. CI classifications were determined via the MoCA (score < 26). Apolipoprotein E (APOE) genotyping was carried out, and the patients' anthropometric measurements and physical activity, health and personal data were collected. RESULTS The prevalence of CI in this selective sample was 54.2% (34.3% females and 19.9% males). In women, being in the third tertiles of iron and manganese intake was associated with lower odds of having CI (OR [95% CI]: 0.32 [0.11 ± 0.93]; 0.33 [0.12 ± 0.93], p < 0.05). No significant differences were observed for any of the nutrients studied in men. CONCLUSIONS These findings suggest that a low mineral intake, especially low iron and manganese intake in women, is associated with a worse cognition as assessed by MoCA.
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Affiliation(s)
- Ana M. Lorenzo-Mora
- Department of Nutrition and Food Science, Faculty of Pharmacy, Complutense University of Madrid, 28040 Madrid, Spain; (A.M.L.-M.); (A.M.L.-S.); (L.M.B.); (E.C.-S.); (Á.P.-S.); (M.D.S.-G.); (A.A.)
| | - Ana M. López-Sobaler
- Department of Nutrition and Food Science, Faculty of Pharmacy, Complutense University of Madrid, 28040 Madrid, Spain; (A.M.L.-M.); (A.M.L.-S.); (L.M.B.); (E.C.-S.); (Á.P.-S.); (M.D.S.-G.); (A.A.)
- VALORNUT Research Group, Complutense University of Madrid, 28040 Madrid, Spain;
- San Carlos Health Research Institute (IdISSC), 28040 Madrid, Spain;
| | - Laura M. Bermejo
- Department of Nutrition and Food Science, Faculty of Pharmacy, Complutense University of Madrid, 28040 Madrid, Spain; (A.M.L.-M.); (A.M.L.-S.); (L.M.B.); (E.C.-S.); (Á.P.-S.); (M.D.S.-G.); (A.A.)
- VALORNUT Research Group, Complutense University of Madrid, 28040 Madrid, Spain;
- San Carlos Health Research Institute (IdISSC), 28040 Madrid, Spain;
| | - Liliana G. González-Rodríguez
- Department of Nutrition and Food Science, Faculty of Pharmacy, Complutense University of Madrid, 28040 Madrid, Spain; (A.M.L.-M.); (A.M.L.-S.); (L.M.B.); (E.C.-S.); (Á.P.-S.); (M.D.S.-G.); (A.A.)
- VALORNUT Research Group, Complutense University of Madrid, 28040 Madrid, Spain;
| | - Esther Cuadrado-Soto
- Department of Nutrition and Food Science, Faculty of Pharmacy, Complutense University of Madrid, 28040 Madrid, Spain; (A.M.L.-M.); (A.M.L.-S.); (L.M.B.); (E.C.-S.); (Á.P.-S.); (M.D.S.-G.); (A.A.)
- VALORNUT Research Group, Complutense University of Madrid, 28040 Madrid, Spain;
| | - África Peral-Suárez
- Department of Nutrition and Food Science, Faculty of Pharmacy, Complutense University of Madrid, 28040 Madrid, Spain; (A.M.L.-M.); (A.M.L.-S.); (L.M.B.); (E.C.-S.); (Á.P.-S.); (M.D.S.-G.); (A.A.)
- School of Sport, Exercise and Health Sciences, Loughborough LE11 3TU, UK
| | - María Dolores Salas-González
- Department of Nutrition and Food Science, Faculty of Pharmacy, Complutense University of Madrid, 28040 Madrid, Spain; (A.M.L.-M.); (A.M.L.-S.); (L.M.B.); (E.C.-S.); (Á.P.-S.); (M.D.S.-G.); (A.A.)
- VALORNUT Research Group, Complutense University of Madrid, 28040 Madrid, Spain;
| | - María Luisa Delgado-Losada
- VALORNUT Research Group, Complutense University of Madrid, 28040 Madrid, Spain;
- San Carlos Health Research Institute (IdISSC), 28040 Madrid, Spain;
- Department of Experimental Psychology, Cognitive Processes and Speech Therapy, Faculty of Psychology, Complutense University of Madrid, 28223 Madrid, Spain
| | - Inmaculada C. Rodríguez-Rojo
- Center for Cognitive and Computational Neuroscience, Complutense University of Madrid, 28223 Madrid, Spain;
- Department of Nursing and Physiotherapy, Faculty of Medicine and Health Sciences, Universidad de Alcalá, 28871 Madrid, Spain
| | - Ana Barabash
- Faculty of Medicine, Department of Medicine, Complutense University of Madrid, 28040 Madrid, Spain;
- Endocrinology and Nutrition Department, Hospital Clínico Universitario San Carlos, Instituto de Investigación Sanitaria del Hospital Clínico San Carlos (IdISSC), 28040 Madrid, Spain
- Centro de Investigación Biomédica en Red de Diabetes y Enfermedades Metabólicas Asociadas (CIBERDEM), 28029 Madrid, Spain
| | - Fernando Maestú-Unturbe
- San Carlos Health Research Institute (IdISSC), 28040 Madrid, Spain;
- Department of Experimental Psychology, Cognitive Processes and Speech Therapy, Faculty of Psychology, Complutense University of Madrid, 28223 Madrid, Spain
- Center for Cognitive and Computational Neuroscience, Complutense University of Madrid, 28223 Madrid, Spain;
| | - Aránzazu Aparicio
- Department of Nutrition and Food Science, Faculty of Pharmacy, Complutense University of Madrid, 28040 Madrid, Spain; (A.M.L.-M.); (A.M.L.-S.); (L.M.B.); (E.C.-S.); (Á.P.-S.); (M.D.S.-G.); (A.A.)
- VALORNUT Research Group, Complutense University of Madrid, 28040 Madrid, Spain;
- San Carlos Health Research Institute (IdISSC), 28040 Madrid, Spain;
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Mulgrave VE, Alsayegh AA, Jaldi A, Omire-Mayor DT, James N, Ntekim O, Walters E, Akala EO, Allard JS. Exercise modulates APOE expression in brain cortex of female APOE3 and APOE4 targeted replacement mice. Neuropeptides 2023; 97:102307. [PMID: 36434832 PMCID: PMC9839612 DOI: 10.1016/j.npep.2022.102307] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Revised: 11/02/2022] [Accepted: 11/05/2022] [Indexed: 11/18/2022]
Abstract
Apolipoprotein E (ApoE) is the main cholesterol carrier of the brain and the ε4 gene variant (APOE4) is the most prevalent genetic risk factor for Alzheimer's disease (AD), increasing risk up to 15-fold. Several studies indicate that APOE4 modulates critical factors for neuronal function, including brain-derived neurotrophic factor (BDNF) and peroxisome proliferator-activated receptor γ coactivator 1α (PGC-1α). Both proteins show exercise-induced upregulation, which is presumed to mediate many of the beneficial effects of physical activity including improved cognition; however, there is variability in results between individuals potentially in-part due to genetic variations including APOE isoform. This study aimed to determine if the two most prevalent human APOE isoforms influence adaptive responses to exercise-training. Targeted replacement mice, homozygous for either APOE3 or APOE4 were randomized into exercised and sedentary groups. Baseline locomotor function and voluntary wheel-running behavior was reduced in APOE4 mice. Exercised groups were subjected to daily treadmill running for 8 weeks. ApoE protein in brain cortex was significantly increased by exercise in both genotypes. PGC-1α mRNA levels in brain cortex were significantly lower in APOE4 mice, and only tended to increase with exercise in both genotypes. Hippocampal BDNF protein were similar between genotypes and was not significantly modulated by treadmill running. Behavioral and biochemical variations between APOE3 and APOE4 mice likely contribute to the differential risk for neurological and vascular diseases and the exercise-induced increase in ApoE levels suggests an added feature of the potential efficacy of physical activity as a preventative and therapeutic strategy for neurogenerative processes in both genotypes.
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Affiliation(s)
- Verona E Mulgrave
- Dept. of Nutritional Sciences, College of Nursing and Allied Health Sciences, Howard University, Washington, DC, USA
| | - Abdulrahman A Alsayegh
- Dept. of Nutritional Sciences, College of Nursing and Allied Health Sciences, Howard University, Washington, DC, USA; Department of Clinical Nutrition, College of Applied Medical Sciences, Jazan University, Jazan, Saudi Arabia
| | - Aida Jaldi
- Dept of Physiology & Biophysics, College of Medicine, Howard University, Washington, DC, USA
| | | | - Niaya James
- Dept of Physiology & Biophysics, College of Medicine, Howard University, Washington, DC, USA
| | - Oyonumo Ntekim
- Dept. of Nutritional Sciences, College of Nursing and Allied Health Sciences, Howard University, Washington, DC, USA
| | - Eric Walters
- Dept. of Biochemistry, College of Medicine, Howard University, Washington, DC, USA
| | - Emanuel O Akala
- Dept of Pharmaceutical Sciences, College of Pharmacy, Howard University, Washington, DC, USA
| | - Joanne S Allard
- Dept of Physiology & Biophysics, College of Medicine, Howard University, Washington, DC, USA.
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Guo Y, Wang S, Chao X, Li D, Wang Y, Guo Q, Chen T. Multi-omics studies reveal ameliorating effects of physical exercise on neurodegenerative diseases. Front Aging Neurosci 2022; 14:1026688. [PMID: 36389059 PMCID: PMC9659972 DOI: 10.3389/fnagi.2022.1026688] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Accepted: 09/28/2022] [Indexed: 08/27/2023] Open
Abstract
INTRODUCTION Neurodegenerative diseases such as Alzheimer's disease, Parkinson's disease, amyotrophic lateral sclerosis, and Huntington's disease, are heavy burdens to global health and economic development worldwide. Mounting evidence suggests that exercise, a type of non-invasive intervention, has a positive impact on the life quality of elderly with neurodegenerative diseases. X-omics are powerful tools for mapping global biochemical changes in disease and treatment. METHOD Three major databases were searched related to current studies in exercise intervention on neurodegenerative diseases using omics tools, including metabolomics, metagenomics, genomics, transcriptomics, and proteomics. RESULT We summarized the omics features and potential mechanisms associated with exercise and neurodegenerative diseases in the current studies. Three main mechanisms by which exercise affects neurodegenerative diseases were summed up, including adult neurogenesis, brain-derived neurotrophic factor (BDNF) signaling, and short-chain fatty acids (SCFAs) metabolism. CONCLUSION Overall, there is compelling evidence that exercise intervention is a feasible way of preventing the onset and alleviating the severity of neurodegenerative diseases. These studies highlight the importance of exercise as a complementary approach to the treatment and intervention of neurodegenerative diseases in addition to traditional treatments. More mechanisms on exercise interventions for neurodegenerative diseases, the specification of exercise prescriptions, and differentiated exercise programs should be explored so that they can actually be applied to the clinic.
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Affiliation(s)
- Yuhuai Guo
- School of Kinesiology, Shanghai University of Sport, Shanghai, China
- Center for Translational Medicine and Shanghai Key Laboratory of Diabetes Mellitus, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Shanghai, China
| | - Shouli Wang
- Center for Translational Medicine and Shanghai Key Laboratory of Diabetes Mellitus, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Shanghai, China
| | - Xiaowen Chao
- Center for Translational Medicine and Shanghai Key Laboratory of Diabetes Mellitus, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Shanghai, China
| | - Ding Li
- Department of Gerontology, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Shanghai, China
| | - Ying Wang
- Department of Gerontology, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Shanghai, China
| | - Qihao Guo
- Department of Gerontology, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Shanghai, China
| | - Tianlu Chen
- Center for Translational Medicine and Shanghai Key Laboratory of Diabetes Mellitus, Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, Shanghai, China
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Fassier P, Kang JH, Lee IM, Grodstein F, Vercambre MN. Vigorous Physical Activity and Cognitive Trajectory Later in Life: Prospective Association and Interaction by Apolipoprotein E e4 in the Nurses' Health Study. J Gerontol A Biol Sci Med Sci 2022; 77:817-825. [PMID: 34125204 PMCID: PMC8974346 DOI: 10.1093/gerona/glab169] [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: 01/05/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND The apolipoprotein E (APOE) e4 allele is a well-established genetic risk factor of brain aging. Vigorous physical activity may be particularly important in APOE-e4 carriers, but data have been inconsistent, likely due to differences in the timing of the physical activity assessment, definition of cognitive decline, and/or sample size. METHODS We prospectively evaluated the association between vigorous physical activity and cognition assessed at least 9 years later, according to APOE-e4 carrier status. Biennially from 1986, Nurses' Health Study participants reported their leisure-time physical activities. Starting in 1995-2001 and through 2008, participants (aged 70+ years) underwent up to 4 repeated cognitive telephone assessments (6 tasks averaged together using z-scores). RESULTS Among 7252 women, latent process mixed models identified 3 major patterns of cognitive change over 6 years: high-stable, medium-stable, and decline. Taking the high-stable cognitive trajectory as the outcome reference in multinomial logistic regressions, highest tertile of vigorous physical activity (≥5.9 metabolic-equivalent [MET]-hours/wk) compared to lowest tertile (≤0.9 MET-hours/wk) was significantly associated with subsequent lower likelihood of the medium-stable trajectory in the global score (odds ratio [OR] [95% CI] = 0.72 [0.63, 0.82]), verbal memory (OR [95% CI] = 0.78 [0.68-0.89]), and telephone interview of cognitive status score (OR [95% CI] = 0.81 [0.70-0.94]). Vigorous physical activity was also associated with lower likelihood of decline in category fluency (OR [95% CI] = 0.72 [0.56, 0.92]). We observed some evidence (p-interaction = .07 for the global score) that the association was stronger among APOE-e4 carriers than noncarriers (OR [95% CI] = 0.60 [0.39, 0.92] vs 0.82 [0.59, 1.16]). CONCLUSION Midlife vigorous physical activity was associated with better cognitive trajectories in women in their seventies, with suggestions of stronger associations among APOE-e4 carriers.
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Affiliation(s)
| | - Jae Hee Kang
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - I-Min Lee
- Division of Preventive Medicine, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Francine Grodstein
- Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, Illinois, USA
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Medina R, Bouhaben J, de Ramón I, Cuesta P, Antón-Toro L, Pacios J, Quintero J, Quiroga AR, Maestú F. Alfa band power increases in posterior brain regions in attention deficit hyperactivity disorder after digital cognitive stimulation treatment. Brain Commun 2022; 4:fcac038. [PMID: 35402910 PMCID: PMC8984701 DOI: 10.1093/braincomms/fcac038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Revised: 10/11/2021] [Accepted: 02/15/2022] [Indexed: 11/15/2022] Open
Abstract
Abstract
The changes triggered by pharmacological treatments in resting-state alpha-band (8–14 Hz) oscillations have been widely studied in attention deficit hyperactivity disorder. However, to date, there has been no evidence regarding the possible changes in cognitive stimulation treatments on these oscillations. This paper sets out to verify whether cognitive stimulation treatments based on progressive increases in cognitive load can be effective in triggering changes in alpha-band power in attention deficit hyperactivity disorder. With this objective, we compared a cognitive stimulation treatment (n = 13) to placebo treatment (n = 13) for 12 weeks (36 sessions of 15 min) in child patients (8–11 years old) with attention deficit hyperactivity disorder. Two magnetoencephalographic recordings were acquired for all the participants. In order to extract the areas with changes in alpha power between both magnetoencephalographic recordings, the differences in the power ratio (pre/post-condition) were calculated using an Analysis of Covariance test adjusted for the age variable. The results show an increase in the post-treatment power ratio in the experimental group versus the placebo group (P < 0.01) in posterior regions and the default mode network. In addition, these alpha changes were related to measures of attention, working memory and cognitive flexibility. The results seem to indicate that cognitive stimulation treatment based on progressive increases in cognitive load triggers alpha-band power changes in child attention deficit hyperactivity disorder patients in the direction of their peers without this disorder.
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Affiliation(s)
| | | | - Ignacio de Ramón
- Sincrolab, Ltd., Madrid 28033, Spain
- Laboratory of Cognitive and Computational Neuroscience, Centre for Biomedical Technology (CTB), Technical University of Madrid, Madrid 28660, Spain
| | - Pablo Cuesta
- Laboratory of Cognitive and Computational Neuroscience, Centre for Biomedical Technology (CTB), Technical University of Madrid, Madrid 28660, Spain
| | - Luis Antón-Toro
- Laboratory of Cognitive and Computational Neuroscience, Centre for Biomedical Technology (CTB), Technical University of Madrid, Madrid 28660, Spain
- Department of Experimental Psychology, Complutense University of Madrid, Madrid 28223, Spain
| | - Javier Pacios
- Laboratory of Cognitive and Computational Neuroscience, Centre for Biomedical Technology (CTB), Technical University of Madrid, Madrid 28660, Spain
- Department of Experimental Psychology, Complutense University of Madrid, Madrid 28223, Spain
| | - Javier Quintero
- Department of Psychiatry, University Hospital Infanta Leonor, Madrid 28031, Spain
| | | | - Fernando Maestú
- Laboratory of Cognitive and Computational Neuroscience, Centre for Biomedical Technology (CTB), Technical University of Madrid, Madrid 28660, Spain
- Department of Experimental Psychology, Complutense University of Madrid, Madrid 28223, Spain
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Pearce AM, Marr C, Dewar M, Gow AJ. Apolipoprotein E Genotype Moderation of the Association Between Physical Activity and Brain Health. A Systematic Review and Meta-Analysis. Front Aging Neurosci 2022; 13:815439. [PMID: 35153725 PMCID: PMC8833849 DOI: 10.3389/fnagi.2021.815439] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2021] [Accepted: 12/17/2021] [Indexed: 12/12/2022] Open
Abstract
Introduction Possession of one or two e4 alleles of the apolipoprotein E (APOE) gene is associated with cognitive decline and dementia risk. Some evidence suggests that physical activity may benefit carriers of the e4 allele differently. Method We conducted a systematic review and meta-analysis of studies which assessed APOE differences in the association between physical activity and: lipid profile, Alzheimer's disease pathology, brain structure and brain function in healthy adults. Searches were carried out in PubMed, SCOPUS, Web of Science and PsycInfo. Results Thirty studies were included from 4,896 papers screened. Carriers of the e4 allele gained the same benefit from physical activity as non-carriers on most outcomes. For brain activation, e4 carriers appeared to gain a greater benefit from physical activity on task-related and resting-state activation and resting-state functional connectivity compared to non-carriers. Post-hoc analysis identified possible compensatory mechanisms allowing e4 carriers to maintain cognitive function. Discussion Though there is evidence suggesting physical activity may benefit e4 carriers differently compared to non-carriers, this may vary by the specific brain health outcome, perhaps limited to brain activation. Further research is required to confirm these findings and elucidate the mechanisms.
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