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Da Conceicao ARR, Vieira MNN, De Felice FG. Structural changes in the obese brain. Neural Regen Res 2024; 19:2561-2562. [PMID: 38808981 DOI: 10.4103/nrr.nrr-d-23-01123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2023] [Accepted: 02/08/2024] [Indexed: 05/30/2024] Open
Affiliation(s)
- Anna R R Da Conceicao
- D'Or Institute for Research and Education, Rio de Janeiro, Brazil (Da Conceicao ARR, Vieira MNN, De Felice FG)
- Institute of Medical Biochemistry Leopoldo De Meis, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil (Da Conceicao ARR, De Felice FG)
| | - Marcelo N N Vieira
- D'Or Institute for Research and Education, Rio de Janeiro, Brazil (Da Conceicao ARR, Vieira MNN, De Felice FG)
| | - Fernanda G De Felice
- D'Or Institute for Research and Education, Rio de Janeiro, Brazil (Da Conceicao ARR, Vieira MNN, De Felice FG)
- Institute of Medical Biochemistry Leopoldo De Meis, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil (Da Conceicao ARR, De Felice FG)
- Centre for Neuroscience Studies, Department of Biomedical and Molecular Sciences & Department of Psychiatry, Queen's University, Kingston, ON, Canada (De Felice FG)
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2
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Ruiz-Rizzo AL, Finke K, Damoiseaux JS, Bartels C, Buerger K, Cosma NC, Dechent P, Dobisch L, Ewers M, Fliessbach K, Frommann I, Glanz W, Goerss D, Hetzer S, Incesoy EI, Janowitz D, Kilimann I, Laske C, van Lent DM, Munk MHJ, Peters O, Priller J, Ramirez A, Rostamzadeh A, Roy N, Scheffler K, Schneider A, Spottke A, Spruth EJ, Teipel S, Wagner M, Wiltfang J, Yakupov R, Jessen F, Duezel E, Perneczky R, Rauchmann BS. Fornix fractional anisotropy mediates the association between Mediterranean diet adherence and memory four years later in older adults without dementia. Neurobiol Aging 2024; 136:99-110. [PMID: 38340637 DOI: 10.1016/j.neurobiolaging.2024.01.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Revised: 01/24/2024] [Accepted: 01/26/2024] [Indexed: 02/12/2024]
Abstract
Here, we investigated whether fractional anisotropy (FA) of hippocampus-relevant white-matter tracts mediates the association between baseline Mediterranean diet adherence (MeDiAd) and verbal episodic memory over four years. Participants were healthy older adults with and without subjective cognitive decline and patients with amnestic mild cognitive impairment from the DELCODE cohort study (n = 376; age: 71.47 ± 6.09 years; 48.7 % female). MeDiAd and diffusion data were obtained at baseline. Verbal episodic memory was assessed at baseline and four yearly follow-ups. The associations between baseline MeDiAd and white matter, and verbal episodic memory's mean and rate of change over four years were tested with latent growth curve modeling. Baseline MeDiAd was associated with verbal episodic memory four years later (95 % confidence interval, CI [0.01, 0.32]) but not with its rate of change over this period. Baseline Fornix FA mediated - and, thus, explained - that association (95 % CI [0.002, 0.09]). Fornix FA may be an appropriate response biomarker of Mediterranean diet interventions on verbal memory in older adults.
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Affiliation(s)
- Adriana L Ruiz-Rizzo
- Department of Neurology, Jena University Hospital, Jena, Germany; Department of Psychology, General and Experimental Psychology Unit, LMU Munich, Munich, Germany.
| | - Kathrin Finke
- Department of Neurology, Jena University Hospital, Jena, Germany; Department of Psychology, General and Experimental Psychology Unit, LMU Munich, Munich, Germany
| | - Jessica S Damoiseaux
- Department of Psychology, Wayne State University, Detroit, MI, USA; Institute of Gerontology, Wayne State University, Detroit, MI, USA
| | - Claudia Bartels
- Department of Psychiatry and Psychotherapy, University Medical Center Goettingen, University of Goettingen, Goettingen, Germany
| | - Katharina Buerger
- German Center for Neurodegenerative Diseases (DZNE, Munich), Munich, Germany; Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich, Munich, Germany
| | - Nicoleta Carmen Cosma
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin-Institute of Psychiatry and Psychotherapy, Germany
| | - Peter Dechent
- MR-Research in Neurosciences, Department of Cognitive Neurology, Georg-August-University Goettingen, Germany
| | - Laura Dobisch
- German Center for Neurodegenerative Diseases (DZNE), Magdeburg, Germany
| | - Michael Ewers
- German Center for Neurodegenerative Diseases (DZNE, Munich), Munich, Germany; Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich, Munich, Germany
| | - Klaus Fliessbach
- German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany; University of Bonn Medical Center, Dept. of Neurodegenerative Disease and Geriatric Psychiatry/Psychiatry, Bonn, Germany
| | - Ingo Frommann
- German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany; University of Bonn Medical Center, Dept. of Neurodegenerative Disease and Geriatric Psychiatry/Psychiatry, Bonn, Germany
| | - Wenzel Glanz
- German Center for Neurodegenerative Diseases (DZNE), Magdeburg, Germany
| | - Doreen Goerss
- German Center for Neurodegenerative Diseases (DZNE), Rostock, Germany; Department of Psychosomatic Medicine, Rostock University Medical Center, Rostock, Germany
| | - Stefan Hetzer
- Bernstein Center for Computational Neuroscience, Charité - Universitätsmedizin, Berlin, Germany
| | - Enise I Incesoy
- German Center for Neurodegenerative Diseases (DZNE), Magdeburg, Germany; Institute of Cognitive Neurology and Dementia Research (IKND), Otto-von-Guericke University, Magdeburg, Germany; Department for Psychiatry and Psychotherapy, University Clinic Magdeburg, Germany
| | - Daniel Janowitz
- German Center for Neurodegenerative Diseases (DZNE, Munich), Munich, Germany
| | - Ingo Kilimann
- German Center for Neurodegenerative Diseases (DZNE), Rostock, Germany; Department of Psychosomatic Medicine, Rostock University Medical Center, Rostock, Germany
| | - Christoph Laske
- German Center for Neurodegenerative Diseases (DZNE), Tübingen, Germany; Section for Dementia Research, Hertie Institute for Clinical Brain Research and Department of Psychiatry and Psychotherapy, University of Tübingen, Tübingen, Germany
| | - Debora Melo van Lent
- Glenn Biggs Institute for Alzheimer's & Neurodegenerative Diseases, UT Health San Antonio, San Antonio, TX, USA; Department of Neurology, Boston University School of Medicine, Boston, MA, USA; The Framingham Heart Study, Framingham, MA, USA
| | - Matthias H J Munk
- German Center for Neurodegenerative Diseases (DZNE), Tübingen, Germany; Department of Psychiatry and Psychotherapy, University of Tübingen, Tübingen, Germany
| | - Oliver Peters
- Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt-Universität zu Berlin-Institute of Psychiatry and Psychotherapy, Germany; German Center for Neurodegenerative Diseases (DZNE), Berlin, Germany
| | - Josef Priller
- German Center for Neurodegenerative Diseases (DZNE), Berlin, Germany; Department of Psychiatry and Psychotherapy, Charité, Berlin, Germany; School of Medicine, Technical University of Munich; Department of Psychiatry and Psychotherapy, Munich, Germany; University of Edinburgh and UK DRI, Edinburgh, UK
| | - Alfredo Ramirez
- German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany; University of Bonn Medical Center, Dept. of Neurodegenerative Disease and Geriatric Psychiatry/Psychiatry, Bonn, Germany; Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), University of Cologne, Cologne, Germany; Division of Neurogenetics and Molecular Psychiatry, Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany; Department of Psychiatry & Glenn Biggs Institute for Alzheimer's and Neurodegenerative Diseases, San Antonio, TX, USA
| | - Ayda Rostamzadeh
- Department of Psychiatry, University of Cologne, Medical Faculty, Cologne, Germany
| | - Nina Roy
- German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany
| | - Klaus Scheffler
- Department for Biomedical Magnetic Resonance, University of Tübingen, Tübingen, Germany
| | - Anja Schneider
- German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany; University of Bonn Medical Center, Dept. of Neurodegenerative Disease and Geriatric Psychiatry/Psychiatry, Bonn, Germany
| | - Annika Spottke
- German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany; Department of Neurology, University of Bonn, Bonn, Germany
| | - Eike Jakob Spruth
- German Center for Neurodegenerative Diseases (DZNE), Berlin, Germany; Department of Psychiatry and Psychotherapy, Charité, Berlin, Germany
| | - Stefan Teipel
- German Center for Neurodegenerative Diseases (DZNE), Rostock, Germany; Department of Psychosomatic Medicine, Rostock University Medical Center, Rostock, Germany
| | - Michael Wagner
- German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany; University of Bonn Medical Center, Dept. of Neurodegenerative Disease and Geriatric Psychiatry/Psychiatry, Bonn, Germany
| | - Jens Wiltfang
- Department of Psychiatry and Psychotherapy, University Medical Center Goettingen, University of Goettingen, Goettingen, Germany; Neurosciences and Signaling Group, Institute of Biomedicine (iBiMED), Department of Medical Sciences, University of Aveiro, Aveiro, Portugal
| | - Renat Yakupov
- German Center for Neurodegenerative Diseases (DZNE), Magdeburg, Germany
| | - Frank Jessen
- German Center for Neurodegenerative Diseases (DZNE), Bonn, Germany; Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), University of Cologne, Cologne, Germany; Department of Psychiatry, University of Cologne, Medical Faculty, Cologne, Germany
| | - Emrah Duezel
- German Center for Neurodegenerative Diseases (DZNE), Magdeburg, Germany; Institute of Cognitive Neurology and Dementia Research (IKND), Otto-von-Guericke University, Magdeburg, Germany; Department of Psychiatry and Psychotherapy, Otto-von-Guericke University, Magdeburg, Germany; Department of Neurology, Otto-von-Guericke University, Magdeburg, Germany
| | - Robert Perneczky
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Germany; German Center for Neurodegenerative Diseases (DZNE), Munich, Germany; Ageing Epidemiology (AGE) Research Unit, School of Public Health, Imperial College, London, UK; Munich Cluster for Systems Neurology (SyNergy), Munich, Germany; Sheffield Institute for Translational Neuroscience (SITraN), University of Sheffield, Sheffield, UK
| | - Boris-Stephan Rauchmann
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Germany; German Center for Neurodegenerative Diseases (DZNE), Munich, Germany; Sheffield Institute for Translational Neuroscience (SITraN), University of Sheffield, Sheffield, UK; Institute of Neuroradiology, University Hospital, LMU Munich, Germany
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3
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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.
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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
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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.
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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
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5
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Clifton L, Liu X, Collister JA, Littlejohns TJ, Allen N, Hunter DJ. Assessing the importance of primary care diagnoses in the UK Biobank. Eur J Epidemiol 2024; 39:219-229. [PMID: 38225527 PMCID: PMC10904436 DOI: 10.1007/s10654-023-01095-0] [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: 07/07/2023] [Accepted: 12/24/2023] [Indexed: 01/17/2024]
Abstract
The UK Biobank has made general practitioner (GP) data (censoring date 2016-2017) available for approximately 45% of the cohort, whilst hospital inpatient and death registry (referred to as "HES/Death") data are available cohort-wide through 2018-2022 depending on whether the data comes from England, Wales or Scotland. We assessed the importance of case ascertainment via different data sources in UKB for three diseases that are usually first diagnosed in primary care: Parkinson's disease (PD), type 2 diabetes (T2D), and all-cause dementia. Including GP data at least doubled the number of incident cases in the subset of the cohort with primary care data (e.g. from 619 to 1390 for dementia). Among the 786 dementia cases that were only captured in the GP data before the GP censoring date, only 421 (54%) were subsequently recorded in HES. Therefore, estimates of the absolute incidence or risk-stratified incidence are misleadingly low when based only on the HES/Death data. For incident cases present in both HES/Death and GP data during the full follow-up period (i.e. until the HES censoring date), the median time difference between an incident diagnosis of dementia being recorded in GP and HES/Death was 2.25 years (i.e. recorded 2.25 years earlier in the GP records). Similar lag periods were also observed for PD (median 2.31 years earlier) and T2D (median 2.82 years earlier). For participants with an incident GP diagnosis, only 65.6% of dementia cases, 69.0% of PD cases, and 58.5% of T2D cases had their diagnosis recorded in HES/Death within 7 years since GP diagnosis. The effect estimates (hazard ratios, HR) of established risk factors for the three health outcomes mostly remain in the same direction and with a similar strength of association when cases are ascertained either using HES only or further adding GP data. The confidence intervals of the HR became narrower when adding GP data, due to the increased statistical power from the additional cases. In conclusion, it is desirable to extend both the coverage and follow-up period of GP data to allow researchers to maximise case ascertainment of chronic health conditions in the UK.
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Affiliation(s)
- Lei Clifton
- Nuffield Department of Population Health, University of Oxford, Oxford, UK.
| | - Xiaonan Liu
- Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | | | | | - Naomi Allen
- Nuffield Department of Population Health, University of Oxford, Oxford, UK
- UK Biobank Ltd, Stockport, UK
| | - David J Hunter
- Nuffield Department of Population Health, University of Oxford, Oxford, UK
- Department of Epidemiology, Harvard TH Chan School of Public Health, Boston, MA, USA
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Allen NE, Lacey B, Lawlor DA, Pell JP, Gallacher J, Smeeth L, Elliott P, Matthews PM, Lyons RA, Whetton AD, Lucassen A, Hurles ME, Chapman M, Roddam AW, Fitzpatrick NK, Hansell AL, Hardy R, Marioni RE, O’Donnell VB, Williams J, Lindgren CM, Effingham M, Sellors J, Danesh J, Collins R. Prospective study design and data analysis in UK Biobank. Sci Transl Med 2024; 16:eadf4428. [PMID: 38198570 PMCID: PMC11127744 DOI: 10.1126/scitranslmed.adf4428] [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: 10/24/2022] [Accepted: 12/13/2023] [Indexed: 01/12/2024]
Abstract
Population-based prospective studies, such as UK Biobank, are valuable for generating and testing hypotheses about the potential causes of human disease. We describe how UK Biobank's study design, data access policies, and approaches to statistical analysis can help to minimize error and improve the interpretability of research findings, with implications for other population-based prospective studies being established worldwide.
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Affiliation(s)
- Naomi E Allen
- UK Biobank Ltd, Stockport, UK
- Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Ben Lacey
- UK Biobank Ltd, Stockport, UK
- Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Deborah A Lawlor
- Population Health Science, Bristol Medical School University of Bristol, Bristol, UK
- Medical Research Council Integrative Epidemiology Unit at the University of Bristol, Bristol, UK
| | - Jill P Pell
- School of Health and Wellbeing, University of Glasgow, Scotland
| | - John Gallacher
- Department of Psychiatry, University of Oxford, Oxford, UK
- Dementias Platform UK, Department of Psychiatry, University of Oxford, Oxford, UK
| | - Liam Smeeth
- London School of Hygiene and Tropical Medicine, London, UK
| | - Paul Elliott
- MRC Centre for Environment and Health, School of Public Health, Imperial College London, London, UK
- NIHR Health Protection Research Unit in Chemical Radiation Threats and Hazards, Imperial College London, UK
| | - Paul M Matthews
- UK Dementia Research Centre Institute and Department of Brain Sciences, Imperial College London, London, UK
| | - Ronan A Lyons
- Population Data Science, Swansea University Medical School, Swansea, Wales
| | - Anthony D Whetton
- Veterinary Health Innovation Engine, University of Surrey, Guildford, UK
| | - Anneke Lucassen
- Nuffield Department of Medicine, University of Oxford, Oxford, UK
- Faculty of Medicine, Southampton University, Southampton, UK
| | - Matthew E Hurles
- Wellcome Trust Sanger Institute, Wellcome Genome Campus, Cambridge, UK
| | | | | | | | - Anna L Hansell
- Centre for Environmental Health and Sustainability, University of Leicester, Leicester, UK
| | - Rebecca Hardy
- School of Sport, Exercise and Health Sciences, Loughborough University, Loughborough, UK
| | - Riccardo E Marioni
- Centre for Genomic and Experimental Medicine, University of Edinburgh, Edinburgh, Scotland
| | | | - Julie Williams
- UK Dementia Research Institute, Cardiff University, Cardiff, Wales
| | - Cecilia M Lindgren
- Big Data Institute, Li Ka Shing Centre for Health Information and Discovery, University of Oxford, Oxford, UK
| | | | | | - John Danesh
- British Heart Foundation Cardiovascular Epidemiology Unit, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
- Health Data Research UK Cambridge, Wellcome Genome Campus and University of Cambridge, Cambridge, UK
- National Institute for Health Research Cambridge Biomedical Research Centre, University of Cambridge and Cambridge University Hospitals, Cambridge, UK
| | - Rory Collins
- UK Biobank Ltd, Stockport, UK
- Nuffield Department of Population Health, University of Oxford, Oxford, UK
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7
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Zhang Z, Xu W, Zheng Y, Chen C, Kang X, Chen D, Cheng F, Wang X. Causal relationship between psoriasis vulgaris and dementia: Insights from Mendelian randomization analysis. Exp Dermatol 2024; 33:e14984. [PMID: 37997526 DOI: 10.1111/exd.14984] [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: 07/18/2023] [Revised: 10/26/2023] [Accepted: 11/13/2023] [Indexed: 11/25/2023]
Abstract
Many clinical studies have demonstrated a correlation between psoriasis vulgaris and dementia, yet this correlation remains controversial. Our study employed the Mendelian randomization (MR) method to investigate the causal relationship between psoriasis vulgaris and dementia. Data were obtained from the summary statistics of the genome-wide association studies from IEU-OpenGWAS project database. In univariate Mendelian randomization (UVMR) analysis, psoriasis vulgaris was used as exposure. Alzheimer disease (AD), vascular dementia (VaD), dementia with Lewy bodies (DLB), Parkinson's disease with dementia (PDD) and frontotemporal dementia (FTD) served as the outcomes. In multivariate Mendelian randomization (MVMR) analysis, VaD served as the outcome. The first MVMR analysis used psoriasis vulgaris, mean platelet volume (MPV), platelet distribution width (PDW) and platelet count (PLT) as exposures. The second MVMR analysis used psoriasis vulgaris, vitamin D level and 25 hydroxyvitamin D level as exposures. The main analysis employed the inverse variance weighted method, and the outcomes were evaluated by odds ratio (OR) and 95% confidence interval (95% CI). In UVMR analysis, the results depicted that psoriasis vulgaris was associated with VaD (OR: 0.903, 95% CI: 0.818-0.996, p = 0.041). The results revealed insignificant associations between psoriasis vulgaris and other dementia types. After adjusting the effects of MPV, PDW and PLT in MVMR analysis, the association between psoriasis vulgaris and VaD was no longer significant (p = 0.164). Similarly, after adjusting the effects of vitamin D level and 25 hydroxyvitamin D level in MVMR analysis, the association between psoriasis vulgaris and VaD was also no longer significant (p = 0.533). Our study suggests that psoriasis vulgaris may potentially decrease VaD incidence. However, the causal association between psoriasis vulgaris and VaD may be impeded by platelet-related indices, vitamin D level and 25 hydroxyvitamin D level.
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Affiliation(s)
- Zehan Zhang
- School of Traditional Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
| | - Wenxiu Xu
- School of Traditional Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
| | - Yuxiao Zheng
- School of Traditional Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
| | - Congai Chen
- School of Traditional Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
| | - Xiangdong Kang
- School of Traditional Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
| | - Dan Chen
- School of Traditional Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
| | - Fafeng Cheng
- School of Traditional Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
| | - Xueqian Wang
- School of Traditional Chinese Medicine, Beijing University of Chinese Medicine, Beijing, China
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8
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Qureshi D, Collister J, Allen NE, Kuźma E, Littlejohns T. Association between metabolic syndrome and risk of incident dementia in UK Biobank. Alzheimers Dement 2024; 20:447-458. [PMID: 37675869 PMCID: PMC10916994 DOI: 10.1002/alz.13439] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Revised: 05/05/2023] [Accepted: 07/29/2023] [Indexed: 09/08/2023]
Abstract
INTRODUCTION The association between metabolic syndrome (MetS) and incident dementia remains inconclusive. METHODS In 176,249 dementia-free UK Biobank participants aged ≥60 years at baseline, Cox proportional-hazards models were used to investigate the association between MetS and incident dementia. MetS was defined as the presence of ≥3 of the following: elevated waist circumference, triglycerides, blood pressure, blood glucose, and reduced high-density lipoprotein cholesterol. RESULTS Over 15 years of follow-up (median = 12.3), 5255 participants developed dementia. MetS was associated with an increased risk of incident dementia (hazard ratio [HR]: 1.12, 95% confidence interval [CI]: 1.06, 1.18). The association remained consistent when restricting to longer follow-up intervals: >5 to 10 years (HR: 1.17, 95% CI: 1.07, 1.27) and >10 years (HR: 1.22, 95% CI: 1.12, 1.32). Stronger associations were observed in those with ≥4 MetS components and in apolipoprotein-E (APOE)-ε4 non-carriers. DISCUSSION In this large population-based prospective cohort, MetS was associated with an increased risk of dementia. HIGHLIGHTS MetS was associated with a 12% increased risk of incident all-cause dementia. Associations remained similar after restricting the analysis to those with longer follow-up. The presence of four or five MetS components was significantly associated with dementia. Stronger associations were observed in those with a low genetic risk for dementia.
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Affiliation(s)
- Danial Qureshi
- Nuffield Department of Population HealthUniversity of OxfordOxfordUK
| | | | - Naomi E. Allen
- Nuffield Department of Population HealthUniversity of OxfordOxfordUK
- UK Biobank LtdStockportUK
| | - Elżbieta Kuźma
- Albertinen Haus Centre for Geriatrics and GerontologyUniversity of HamburgHamburgGermany
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9
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Chen Z, Ho M, Chau PH. Gender-specific moderating role of abdominal obesity in the relationship between handgrip strength and cognitive impairment. Clin Nutr 2023; 42:2546-2553. [PMID: 37931374 DOI: 10.1016/j.clnu.2023.10.027] [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: 04/27/2023] [Revised: 10/26/2023] [Accepted: 10/30/2023] [Indexed: 11/08/2023]
Abstract
BACKGROUND & AIMS Both low handgrip strength (HGS) and abdominal obesity (AO) are associated with cognitive impairment. However, it remains unclear whether low HGS and AO interact to affect cognition, and whether the synergistic effect varies by gender. This study aimed to examine whether the association between low HGS and incident cognitive impairment was moderated by AO among Chinese older men and women. METHODS We used the data of participants (≥60 years) from four waves (2011-2018) of the China Health and Retirement Longitudinal Study. We defined low HGS as the maximal HGS of <28 kg in men and <18 kg in women, and AO as waist circumference of ≥90 cm for men and ≥80 cm for women. Cognitive impairment was defined as a global cognitive score in the lowest 10th percentile. For each gender, we used subdistribution hazards model to estimate subdistribution hazard ratios (SHRs) for the association of low HGS and AO with incident cognitive impairment, treating mortality as the competing event and controlling for other covariates. Multiplicative interaction was assessed through a cross-product interaction term of low HGS and AO in the model. Additive interaction between low HGS and AO was evaluated by calculating the relative excess risk due to interaction (RERI) and attributable proportion due to interaction (AP). RESULTS We included 3704 participants (Mean age: 66.9 ± 5.81; 54.9% male). During the 7-year follow-up, 1133 events of interest occurred (731 cognitive impairments and 402 deaths). Incidence rates of cognitive impairment and mortality were 4.1 (95% CI: 3.8 to 4.4) and 2.2 (95% CI: 2.0 to 2.5) per 100 person-years. There were positive multiplicative (SHR for the product term = 1.974, 95% CI: 1.114 to 3.500) and additive interactions (RERI = 1.056, 95% CI: 0.027 to 2.086, AP = 0.454, 95% CI: 0.158 to 0.750) of low HGS and AO on the risk of cognitive impairment among older men. Male participants with both low HGS and AO showed an increased risk of cognitive impairment (SHR = 2.325, 95% CI: 1.498 to 3.609) compared with those without either. There was no evidence of interaction among older women (SHR for the product term = 1.151, 95% CI: 0.725 to 1.825; RERI = 0.044, 95% CI: -0.524 to 0.613; AP = 0.039, 95% CI: -0.458 to 0.536). CONCLUSIONS Low HGS and AO may interact to synergistically increase the risk of cognitive impairment among Chinese older men. Screening the highest-risk subpopulation, who may benefit most from neurocognitive prevention strategies, may maximize potential public health gains.
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Affiliation(s)
- Zi Chen
- School of Nursing, The University of Hong Kong, Hong Kong, China
| | - Mandy Ho
- School of Nursing, The University of Hong Kong, Hong Kong, China
| | - Pui Hing Chau
- School of Nursing, The University of Hong Kong, Hong Kong, China.
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10
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Wong ATY, Reeves GK, Floud S. Total sleep duration and daytime napping in relation to dementia detection risk: Results from the Million Women Study. Alzheimers Dement 2023; 19:4978-4986. [PMID: 37083147 PMCID: PMC10955772 DOI: 10.1002/alz.13009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Revised: 01/23/2023] [Accepted: 01/24/2023] [Indexed: 04/22/2023]
Abstract
INTRODUCTION There is inconsistent evidence on the associations of sleep duration and daytime napping with dementia risk. METHODS In the Million Women Study, a total of 830,716 women (mean age, 60 years) were asked about sleep duration (<7, 7-8, >8 hours) and daytime napping (rarely/never, sometimes, usually) in median year 2001, and were followed for the first hospital record with any mention of dementia. Cox regression estimated dementia detection risk ratios (RRs) during 17-year follow-up in 5-year intervals. RESULTS With 34,576 dementia cases, there was strong attenuation over follow-up in the RRs related to long sleep duration (>8 vs 7-8 hours) and usually napping (vs rarely/never). Short sleep duration was modestly, positively associated with dementia in the long term (RR = 1.08, 95% confidence interval [CI] 1.04-1.12). DISCUSSION There was little evidence to suggest that long sleep duration and regular napping are associated with long-term dementia risk. Short sleep duration was modestly associated with dementia risk, but residual confounding cannot be excluded. HIGHLIGHTS Long sleep duration was not associated with long-term dementia risk. Daytime napping was not associated with long-term dementia risk. There is some evidence for a small higher risk of dementia related to short sleep.
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Affiliation(s)
- Angel T. Y. Wong
- Cancer Epidemiology UnitNuffield Department of Population HealthUniversity of OxfordOxfordUK
| | - Gillian K. Reeves
- Cancer Epidemiology UnitNuffield Department of Population HealthUniversity of OxfordOxfordUK
| | - Sarah Floud
- Cancer Epidemiology UnitNuffield Department of Population HealthUniversity of OxfordOxfordUK
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11
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Campbell T, Cullen B. Estimating the effect of physical activity on cognitive function within the UK Biobank cohort. Int J Epidemiol 2023; 52:1592-1611. [PMID: 36749099 PMCID: PMC10555922 DOI: 10.1093/ije/dyad009] [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: 05/27/2022] [Accepted: 01/25/2023] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Physical activity (PA) has been associated with benefits for cognitive function (CF), but previous estimates of the strength of this relationship may have been biased due to limitations in statistical modelling practices that are common among observational studies. We aimed to address this by using a rigorously constructed conceptual causal model to guide an empirical analysis estimating the effect of PA on CF in the UK Biobank cohort of middle-aged and older adults. METHODS This study analysed a subsample of 334 227 adults from the UK Biobank prospective cohort study. PA was measured subjectively by self-report and by device using accelerometry, and CF was measured using objective cognitive tests. Composite CF measures were derived to represent general and domain-specific performance. Effect coefficients were estimated using regression models, adjusting for a wide range of confounders specified by the assumed causal model, including genetic risk factors, and relevant health, sociodemographic and behavioural variables from across the lifespan. RESULTS Results indicated very small effect sizes (standardized mean difference estimates all <0.01) of inconsistent direction, for both cross-sectional and longitudinal analyses. CONCLUSIONS The expected protective effect of PA on CF was not observed. This may reflect selection bias within UK Biobank, or the relatively young age of the sample at follow-up.
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Affiliation(s)
- Thomas Campbell
- School of Health and Wellbeing, University of Glasgow, Glasgow, UK
- NHS Lanarkshire Neuropsychology Service, Monklands Hospital, Airdrie, UK
| | - Breda Cullen
- School of Health and Wellbeing, University of Glasgow, Glasgow, UK
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12
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Feil K, Fritsch J, Rhodes RE. The intention-behaviour gap in physical activity: a systematic review and meta-analysis of the action control framework. Br J Sports Med 2023; 57:1265-1271. [PMID: 37460164 DOI: 10.1136/bjsports-2022-106640] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/01/2023] [Indexed: 10/06/2023]
Abstract
OBJECTIVE Intention is the proximal antecedent of physical activity in many popular psychological models. Despite the utility of these models, the discrepancy between intention and actual behaviour, known as the intention-behaviour gap, is a central topic of current basic and applied research. The purpose of this meta-analysis was to quantify intention-behaviour profiles and the intention-behaviour gap. DESIGN Systematic review and meta-analysis. DATA SOURCES Literature search was conducted in June 2022 and updated in February 2023 in five databases. ELIGIBILITY CRITERIA FOR SELECTING STUDIES Eligible studies included a measure of physical activity, an assessment of physical activity intention and the employment of the intention-behaviour relationship into profile quadrants. Only papers published in the English language and in peer-reviewed journals were considered. Screening was assisted by the artificial intelligence tool ASReview. RESULTS Twenty-five independent samples were selected from 22 articles including a total of N=29 600. Random-effects meta-analysis revealed that 26.0% of all participants were non-intenders not exceeding their intentions, 4.2% were non-intenders who exceeded their intentions, 33.0% were unsuccessful intenders and 38.7% were successful intenders. Based on the proportion of unsuccessful intenders to all intenders, the overall intention-behaviour gap was 47.6%. CONCLUSION The findings underscore that intention is a necessary, yet insufficient antecedent of physical activity for many. Successful translation of a positive intention into behaviour is nearly at chance. Incorporating mechanisms to overcome the intention-behaviour gap are recommended for clinical practice.
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Affiliation(s)
- Katharina Feil
- Institute of Sports and Sports Science, Karlsruhe Institute of Technology, Karlsruhe, Germany
| | - Julian Fritsch
- Institute of Sports and Sports Science, Karlsruhe Institute of Technology, Karlsruhe, Germany
| | - Ryan E Rhodes
- School of Exercise Science, Physical and Health Education, University of Victoria, Victoria, BC, Canada
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Badji A, Youwakim J, Cooper A, Westman E, Marseglia A. Vascular cognitive impairment - Past, present, and future challenges. Ageing Res Rev 2023; 90:102042. [PMID: 37634888 DOI: 10.1016/j.arr.2023.102042] [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: 01/26/2023] [Revised: 08/22/2023] [Accepted: 08/23/2023] [Indexed: 08/29/2023]
Abstract
Vascular cognitive impairment (VCI) is a lifelong process encompassing a broad spectrum of cognitive disorders, ranging from subtle or mild deficits to prodromal and fully developed dementia, originating from cerebrovascular lesions such as large and small vessel disease. Genetic predisposition and environmental exposure to risk factors such as unhealthy lifestyles, hypertension, cardiovascular disease, and metabolic disorders will synergistically interact, yielding biochemical and structural brain changes, ultimately culminating in VCI. However, little is known about the pathological processes underlying VCI and the temporal dynamics between risk factors and disease mechanisms (biochemical and structural brain changes). This narrative review aims to provide an evidence-based summary of the link between individual vascular risk/disorders and cognitive dysfunction and the potential structural and biochemical pathophysiological processes. We also discuss some key challenges for future research on VCI. There is a need to shift from individual risk factors/disorders to comorbid vascular burden, identifying and integrating imaging and fluid biomarkers, implementing a life-course approach, considering possible neuroprotective influences of positive life exposures, and addressing biological sex at birth and gender differences. Finally, this review highlights the need for future researchers to leverage and integrate multidimensional data to advance our understanding of the mechanisms and pathophysiology of VCI.
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Affiliation(s)
- Atef Badji
- Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden; Theme Inflammation and Aging, Karolinska University Hospital, Stockholm, Sweden
| | - Jessica Youwakim
- Department of Pharmacology and Physiology, Université de Montréal, Montreal, QC, Canada; Centre interdisciplinaire de recherche sur le cerveau et l'apprentissage (CIRCA), Montreal, QC, Canada; Groupe de Recherche sur la Signalisation Neuronal et la Circuiterie (SNC), Montreal, QC, Canada
| | - Alexandra Cooper
- Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden; Unit of Integrative Epidemiology, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Eric Westman
- Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden; Department of Neuroimaging, Centre for Neuroimaging Sciences, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK
| | - Anna Marseglia
- Division of Clinical Geriatrics, Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden.
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Cai S, Huang F, Wang R, Wu M, Liu M, Peng Y, Cao G, Li Y, Liu S, Lu J, Su M, Wei Y, Yiu KH, Chen C. Habitual physical activity improves outcomes among patients with myocardial infarction. Front Cardiovasc Med 2023; 10:1174466. [PMID: 37378408 PMCID: PMC10291190 DOI: 10.3389/fcvm.2023.1174466] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2023] [Accepted: 05/09/2023] [Indexed: 06/29/2023] Open
Abstract
Purpose This study evaluates the association between habitual physical activity (HPA) and the outcomes of patients with myocardial infarction (MI). Methods Patients newly diagnosed with MI were divided into two groups based on whether they engaged in HPA, defined as an aerobic activity with a duration of no less than 150 min/week, before the index admission. The primary outcomes included major adverse cardiovascular events (MACEs), cardiovascular (CV) mortality, and cardiac readmission rate 1 year following the index date of admission. A binary logistic regression model was applied to analyze whether HPA was independently associated with 1-year MACEs, 1-year CV mortality, and 1-year cardiac readmission rate. Results Among the 1,266 patients (mean age 63.4 years, 72% male), 571 (45%) engaged in HPA, and 695 (55%) did not engage in HPA before MI. Patients who participated in HPA were independently associated with a lower Killip class upon admission (OR = 0.48: 95% CI, 0.32-0.71, p < 0.001) and a lower prevalence of 1-year MACEs (OR = 0.74: 95% CI, 0.56-0.98, p = 0.038) and 1-year CV mortality (OR = 0.50: 95% CI, 0.28-0.88, p = 0.017) than those who did not participate in HPA. HPA was not associated with cardiac-related readmission (OR = 0.87: 95% CI, 0.64-1.17, p = 0.35). Conclusions HPA before MI was independently associated with a lower Killip class upon admission, 1-year MACEs, and 1-year CV mortality rate.
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Affiliation(s)
- Sidong Cai
- Division of Cardiology, Department of Medicine, The University of Hong Kong-Shenzhen Hospital, Shenzhen, China
| | - Fangmei Huang
- Division of Cardiology, Department of Medicine, The University of Hong Kong-Shenzhen Hospital, Shenzhen, China
| | - Run Wang
- Division of Cardiology, Department of Medicine, The University of Hong Kong-Shenzhen Hospital, Shenzhen, China
| | - Min Wu
- Division of Cardiology, Department of Medicine, The University of Hong Kong-Shenzhen Hospital, Shenzhen, China
| | - Mingya Liu
- Division of Cardiology, Department of Medicine, The University of Hong Kong-Shenzhen Hospital, Shenzhen, China
| | - Yufen Peng
- Division of Cardiology, Department of Medicine, The University of Hong Kong-Shenzhen Hospital, Shenzhen, China
| | - Gaozhen Cao
- Division of Cardiology, Department of Medicine, The University of Hong Kong-Shenzhen Hospital, Shenzhen, China
| | - Yapin Li
- Division of Cardiology, Department of Medicine, The University of Hong Kong-Shenzhen Hospital, Shenzhen, China
| | - Shuhong Liu
- Division of Cardiology, Department of Medicine, The University of Hong Kong-Shenzhen Hospital, Shenzhen, China
| | - Jiena Lu
- Division of Cardiology, Department of Medicine, The University of Hong Kong-Shenzhen Hospital, Shenzhen, China
| | - Mengqi Su
- Division of Cardiology, Department of Medicine, The University of Hong Kong-Shenzhen Hospital, Shenzhen, China
| | - Yinxia Wei
- Division of Cardiology, Department of Medicine, The University of Hong Kong-Shenzhen Hospital, Shenzhen, China
| | - Kai-Hang Yiu
- Division of Cardiology, Department of Medicine, The University of Hong Kong-Shenzhen Hospital, Shenzhen, China
- Division of Cardiology, Department of Medicine, The University of Hong Kong, Queen Mary Hospital, Hong Kong, China
| | - Cong Chen
- Division of Cardiology, Department of Medicine, The University of Hong Kong-Shenzhen Hospital, Shenzhen, China
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Galle SA, Deijen JB, Milders MV, De Greef MHG, Scherder EJA, van Duijn CM, Drent ML. The effects of a moderate physical activity intervention on physical fitness and cognition in healthy elderly with low levels of physical activity: a randomized controlled trial. Alzheimers Res Ther 2023; 15:12. [PMID: 36631905 PMCID: PMC9832427 DOI: 10.1186/s13195-022-01123-3] [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: 01/04/2022] [Accepted: 06/22/2022] [Indexed: 01/13/2023]
Abstract
BACKGROUND Increasing physical activity is one of the most promising and challenging interventions to delay or prevent cognitive decline and dementia. METHODS We conducted a randomized controlled trial to assess the effects of a physical activity intervention, aimed at increasing step count, in elderly with low levels of physical activity on measures of strength, balance, aerobic capacity, and cognition. Participants were assigned to 9 months of exercise counseling or active control. RESULTS The intention-to-treat analyses show that the intervention, compared to control, increases the level of physical activity, but has no significant effect on physical fitness and cognition. Those who increased their physical activity with 35% or more show significant improvements in aerobic capacity, gait speed, verbal memory, executive functioning, and global cognition, compared to those who did not achieve a 35% increase. LIMITATIONS The number of participants that achieved the intended improvement was lower than expected. CONCLUSION Responder analyses suggest an improvement of physical fitness and cognition in those who achieved an increase in physical activity of at least 35%. TRIAL REGISTRATION The trial protocol is registered at the Dutch Trial Register NL5675, August 1, 2016.
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Affiliation(s)
- Sara A. Galle
- grid.12380.380000 0004 1754 9227Department of Clinical, Neuro- and Developmental Psychology, Vrije Universiteit Amsterdam, Van Der Boechorststraat 7, 1081 BT Amsterdam, The Netherlands ,grid.5645.2000000040459992XDepartment of Epidemiology, Erasmus Medical Center, PO Box 2040, 3000 CA Rotterdam, The Netherlands
| | - Jan Berend Deijen
- grid.12380.380000 0004 1754 9227Department of Clinical, Neuro- and Developmental Psychology, Vrije Universiteit Amsterdam, Van Der Boechorststraat 7, 1081 BT Amsterdam, The Netherlands ,Hersencentrum Mental Health Institute, Marnixstraat 364, 1016 XW Amsterdam, The Netherlands
| | - Maarten V. Milders
- grid.12380.380000 0004 1754 9227Department of Clinical, Neuro- and Developmental Psychology, Vrije Universiteit Amsterdam, Van Der Boechorststraat 7, 1081 BT Amsterdam, The Netherlands
| | - Mathieu H. G. De Greef
- grid.4494.d0000 0000 9558 4598Human Movement Sciences, University of Groningen, University Medical Center Groningen, PO Box 196, 9700 AD Groningen, The Netherlands
| | - Erik J. A. Scherder
- grid.12380.380000 0004 1754 9227Department of Clinical, Neuro- and Developmental Psychology, Vrije Universiteit Amsterdam, Van Der Boechorststraat 7, 1081 BT Amsterdam, The Netherlands
| | - Cornelia M. van Duijn
- grid.5645.2000000040459992XDepartment of Epidemiology, Erasmus Medical Center, PO Box 2040, 3000 CA Rotterdam, The Netherlands ,grid.4991.50000 0004 1936 8948Nuffield Department of Population Health, University of Oxford, Old Road Campus, Headington, Oxford, OX3 7LF UK ,Big Data Institute, Li Ka Shing Centre for Health Information and Discovery, Old Road Campus, Headington, Oxford, OX3 7LF UK
| | - Madeleine L. Drent
- grid.12380.380000 0004 1754 9227Department of Clinical, Neuro- and Developmental Psychology, Vrije Universiteit Amsterdam, Van Der Boechorststraat 7, 1081 BT Amsterdam, The Netherlands ,grid.509540.d0000 0004 6880 3010Department of Internal Medicine, Endocrinology Section, Amsterdam University Medical Center, PO Box 7057, 1007 MB Amsterdam, The Netherlands
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Lei Q, Xiao Z, Wu W, Liang X, Zhao Q, Ding D, Deng W. The Joint Effect of Body Mass Index and Serum Lipid Levels on Incident Dementia among Community-Dwelling Older Adults. J Nutr Health Aging 2023; 27:1118-1126. [PMID: 37997734 DOI: 10.1007/s12603-023-2027-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2023] [Accepted: 10/11/2023] [Indexed: 11/25/2023]
Abstract
OBJECTIVES This study aimed to explore the joint effect of body mass index (BMI) and serum lipids levels on incident dementia. METHODS We prospectively followed up with 1,627 dementia-free community residents aged ≥60 for 5.7 years on average. At baseline, weight, and height were measured, and total cholesterol (TC), triglyceride (TG), low-density lipoprotein cholesterol (LDL-C), and high-density lipoprotein cholesterol (HDL-C) were detected in serum. Demographic characteristics were collected through questionnaires. Dementia was based on consensus diagnosis of neurologists and neuropsychologists using DSM-IV criteria. Additive Cox proportional model was used to assess the exposure-response relationship between BMI and serum lipid levels and dementia risk. Interactions and further classifications of BMI and serum lipid levels were further presented by bivariate surface models and decision-tree models. RESULTS The joint effects of TC with BMI, TG with BMI, and LDL-C with BMI on the risk of incident dementia shared a similar pattern, different from their independent exposure-response curves. The joint effect of HDL-C with BMI showed an S-surface but without statistical significance. Participants with TC<5.4 mmol/L and BMI<21 kg/m2 (Hazard Ratio(HR) 1.93, 95% Confidence Interval (CI) 1.05-3.53), TC<5.4 mmol/L and BMI≥21 kg/m2 (HR 1.73, 95% CI 1.09-2.72), and TC≥5.4 mmol/L and BMI<21 kg/m2 (HR 4.02, 95% CI 2.10-7.71) were identified to have the increased risk of incident dementia compared to those with TC≥5.4 mmol/L and BMI≥21 kg/m2. Participants with TG<1.7 mmol/L and BMI<21 kg/m2 had an increased risk of incident dementia compared to those with TG≥1.7 mmol/L and BMI≥21 kg/m2 (HR 1.98, 95%CI 1.17-3.3). Participants with LDL-C≥3.3 mmol/L and BMI<21 kg/m2 were identified to have an increased risk of incident dementia compared to those with LDL-C≥3.3 mmol/L and BMI≥21 kg/m2 (HR 3.33, 95%CI 1.64-6.78). CONCLUSIONS Our study showed that low BMI combined with low or high levels of serum lipids may increase the risk of dementia among older adults. This finding suggests the potential impacts of these two metabolic indexes on the risk of dementia.
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Affiliation(s)
- Q Lei
- Wei Deng, 138 Yixueyuan Rd., Department of Biostatistics, School of Public Health, Fudan University, Shanghai 200032, China, ; Ding Ding, 12 Wulumuqi Zhong Rd., Institute of Neurology, Huashan Hospital, Fudan University, Shanghai 200040, China,
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17
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Chen H, Cao Y, Ma Y, Xu W, Zong G, Yuan C. Age- and sex-specific modifiable risk factor profiles of dementia: evidence from the UK Biobank. Eur J Epidemiol 2023; 38:83-93. [PMID: 36593335 DOI: 10.1007/s10654-022-00952-8] [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: 03/09/2022] [Accepted: 11/27/2022] [Indexed: 01/04/2023]
Abstract
Dementia constitutes a worldwide concern. To characterize the age- and sex-specific modifiable risk factor profiles of dementia, we included 497,401 UK Biobank participants (mean age = 56.5 years) without dementia at baseline (2006-2010) and followed them until March 2021. Cox proportional hazard models were used to estimate the age- and sex-specific hazard ratios (HRs) of incident dementia associated with socioeconomic (less education and high Townsend deprivation index), lifestyle (non-moderate alcohol intake, current smoking, suboptimal diet, physical inactivity, and unhealthy sleep duration), and health condition factors (hypertension, diabetes, cardiovascular diseases, and depressive symptoms). We also calculated the population attributable fractions (PAFs) of these factors. During follow-up (mean = 11.6 years), we identified 6564 dementia cases. HRs for the risk factors were similar between the sexes, while most factors showed stronger associations among younger participants. For example, the HRs of smoking were 1.74 (95% CI: 1.23, 2.47) for individuals aged < 50 years, and 1.18 (1.05, 1.33) for those aged ≥ 65 years. Overall, 46.8% (37.4%, 55.2%) of dementia cases were attributable to the investigated risk factors. The PAFs of the investigated risk factors also decreased with age, but that for health condition risk factors decreased with lower magnitude than socioeconomic and lifestyle risk factors. The stronger associations and greater PAFs of several modifiable risk factors for dementia among younger adults than older participants underscored the importance of dementia prevention from an earlier stage across the adult life course.
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Affiliation(s)
- Hui Chen
- School of Public Health, The Second Affiliated Hospital, Zhejiang University School of Medicine, 866 Yuhangtang Road, Xihu District, Hangzhou, 310058, China
| | - Yaying Cao
- CAS Key Laboratory of Nutrition, Metabolism and Food Safety, Shanghai Institute of Nutrition and Health, University of Chinese Academy of Sciences, Chinese Academy of Sciences, Shanghai, 200031, China
| | - Yuan Ma
- Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA, USA
| | - Weili Xu
- Department of Neurobiology, Care Sciences and Society, Aging Research Centre, Karolinska Institutet and Stockholm University, Stockholm, Sweden
- Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Geng Zong
- CAS Key Laboratory of Nutrition, Metabolism and Food Safety, Shanghai Institute of Nutrition and Health, University of Chinese Academy of Sciences, Chinese Academy of Sciences, Shanghai, 200031, China.
| | - Changzheng Yuan
- School of Public Health, The Second Affiliated Hospital, Zhejiang University School of Medicine, 866 Yuhangtang Road, Xihu District, Hangzhou, 310058, China.
- Department of Nutrition, Harvard T. H. Chan School of Public Health, Boston, MA, USA.
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Galle SA, Liu J, Bonnechère B, Amin N, Milders MM, Deijen JB, Scherder EJA, Drent ML, Voortman T, Ikram MA, van Duijn CM. The long-term relation between physical activity and executive function in the Rotterdam Study. Eur J Epidemiol 2023; 38:71-81. [PMID: 36166135 DOI: 10.1007/s10654-022-00902-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Accepted: 07/24/2022] [Indexed: 01/27/2023]
Abstract
BACKGROUND Research on the association between physical inactivity and cognitive decline and dementia is dominated by studies with short-term follow-up, that might be biased by reverse causality. OBJECTIVE Investigate the long-term association between physical activity, cognition, and the rate of age-associated cognitive decline. METHODS We investigated the association between late-life physical activity and executive functioning and rate of decline of executive abilities during follow-up of up to 16 years, in 3553 participants of the prospective Rotterdam Study cohort. Measurement took place in 1997-1999, 2002-2004, 2009-2011, and 2014-2015. RESULTS At baseline (age ± 72 years), higher levels of physical activity were associated with higher levels of executive functioning (adjusted mean difference = 0.03, 95% CI: 0.00 ; 0.06, p = 0.03). This difference remained intact up to 16 years of follow-up. The level of physical activity at baseline was unrelated to the rate of decline of executive abilities over time, in the whole group (adjusted mean difference in changetime*physical activity = 0.00, 95% CI: -0.00 ; 0.01, p = 0.31). However, stratification by APOE genotype showed that the accelerated decline of executive abilities observed in those with the ApoE-ε4 allele might be attenuated by higher levels of physical activity in late adulthood (ApoE-ε4 carriers: Btime*physical activity = 0.01, 95% CI: 0.00 ; 0.01, p = 0.03). CONCLUSION Higher levels of physical activity in late adulthood are related to higher levels of executive functioning, up to 16 years of follow-up. Accelerated decline of executive abilities observed in those with the ApoE-ε4 allele might be mitigated by higher levels of physical activity.
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Affiliation(s)
- Sara A Galle
- Department of Clinical, Neuro- and Developmental Psychology, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands.
- Department of Epidemiology, Erasmus MC, University Medical Centre, Rotterdam, The Netherlands.
| | - Jun Liu
- Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Bruno Bonnechère
- REVAL Rehabilitation Research Centre, Faculty of Rehabilitation Sciences, Hasselt University, Hasselt, Belgium
- Technology-Supported and Data-Driven Rehabilitation, Data Sciences Institute, Hasselt University, Diepenbeek, Belgium
| | - Najaf Amin
- Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Maarten M Milders
- Department of Clinical, Neuro- and Developmental Psychology, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Jan Berend Deijen
- Department of Clinical, Neuro- and Developmental Psychology, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Hersencentrum Mental Health Institute, Amsterdam, The Netherlands
| | - Erik J A Scherder
- Department of Clinical, Neuro- and Developmental Psychology, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Madeleine L Drent
- Department of Clinical, Neuro- and Developmental Psychology, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Department of Internal Medicine, Endocrinology Section, Amsterdam University Medical Centre, Amsterdam, The Netherlands
| | - Trudy Voortman
- Department of Epidemiology, Erasmus MC, University Medical Centre, Rotterdam, The Netherlands
| | - M Arfan Ikram
- Department of Epidemiology, Erasmus MC, University Medical Centre, Rotterdam, The Netherlands
| | - Cornelia M van Duijn
- Department of Epidemiology, Erasmus MC, University Medical Centre, Rotterdam, The Netherlands
- Nuffield Department of Population Health, University of Oxford, Oxford, UK
- Li Ka Shing Centre for Health Information and Discovery, Big Data Institute, Oxford, UK
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Su S, Shi L, Zheng Y, Sun Y, Huang X, Zhang A, Que J, Sun X, Shi J, Bao Y, Deng J, Lu L. Leisure Activities and the Risk of Dementia: A Systematic Review and Meta-analysis. Neurology 2022; 99:e1651-e1663. [PMID: 35948447 PMCID: PMC9559944 DOI: 10.1212/wnl.0000000000200929] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2021] [Accepted: 05/19/2022] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Leisure activities are major components of modifiable and healthy lifestyles and are proposed to help prevent the development of dementia. This study aimed to assess the effects of different types of leisure activities, including cognitive, physical, and social activities, on the incidence of all-cause dementia (ACD), Alzheimer disease (AD), and vascular dementia (VD). METHODS We performed a systematic review and meta-analysis of the Cochrane, PubMed, Embase, and Web of Science databases to identify longitudinal studies that examined associations between leisure activities and dementia. Relative risks (RRs) and 95% CIs were pooled using random-effects meta-analysis. Subgroup analyses were used to estimate potential effect modifiers. The study was registered with PROSPERO (CRD42019116857). RESULTS A total of 38 longitudinal studies, with 2,154,818 participants at baseline, 74,700 ACD cases, 2,848 AD cases, and 1,423 VD cases during follow-up, were included in the meta-analysis. The subgroup analyses showed that physical (RR 0.83, 95% CI 0.78-0.88), cognitive (RR 0.77; 95% CI 0.68-0.87), and social (RR 0.93; 95% CI 0.87-0.99) activities were associated with a decreased incidence of ACD. In addition, physical (RR 0.87; 95% CI 0.78-0.96) and cognitive (RR 0.66; 95% CI 0.52-0.85) activities were related to a reduced risk of AD. Physical activity (RR 0.67; 95% CI 0.53-0.85) was associated with a lower incidence of VD. DISCUSSION Our findings suggest that leisure activities are inversely associated with a risk of ACD, AD, and VD.
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Affiliation(s)
- Sizhen Su
- From the Peking University Sixth Hospital (S.S., L.S., Y.S., X.H., A.Z., J.Q., X.S., J.D., L.L.), Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital); Peking-Tsinghua Center for Life Sciences and PKU-IDG/McGovern Institute for Brain Research (Y.Z., L.L.), Peking University, Beijing; and National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence (J.S., Y.B.), Peking University, China
| | - Le Shi
- From the Peking University Sixth Hospital (S.S., L.S., Y.S., X.H., A.Z., J.Q., X.S., J.D., L.L.), Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital); Peking-Tsinghua Center for Life Sciences and PKU-IDG/McGovern Institute for Brain Research (Y.Z., L.L.), Peking University, Beijing; and National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence (J.S., Y.B.), Peking University, China
| | - Yongbo Zheng
- From the Peking University Sixth Hospital (S.S., L.S., Y.S., X.H., A.Z., J.Q., X.S., J.D., L.L.), Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital); Peking-Tsinghua Center for Life Sciences and PKU-IDG/McGovern Institute for Brain Research (Y.Z., L.L.), Peking University, Beijing; and National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence (J.S., Y.B.), Peking University, China
| | - Yankun Sun
- From the Peking University Sixth Hospital (S.S., L.S., Y.S., X.H., A.Z., J.Q., X.S., J.D., L.L.), Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital); Peking-Tsinghua Center for Life Sciences and PKU-IDG/McGovern Institute for Brain Research (Y.Z., L.L.), Peking University, Beijing; and National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence (J.S., Y.B.), Peking University, China
| | - Xiaolin Huang
- From the Peking University Sixth Hospital (S.S., L.S., Y.S., X.H., A.Z., J.Q., X.S., J.D., L.L.), Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital); Peking-Tsinghua Center for Life Sciences and PKU-IDG/McGovern Institute for Brain Research (Y.Z., L.L.), Peking University, Beijing; and National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence (J.S., Y.B.), Peking University, China
| | - Anyi Zhang
- From the Peking University Sixth Hospital (S.S., L.S., Y.S., X.H., A.Z., J.Q., X.S., J.D., L.L.), Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital); Peking-Tsinghua Center for Life Sciences and PKU-IDG/McGovern Institute for Brain Research (Y.Z., L.L.), Peking University, Beijing; and National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence (J.S., Y.B.), Peking University, China
| | - Jianyu Que
- From the Peking University Sixth Hospital (S.S., L.S., Y.S., X.H., A.Z., J.Q., X.S., J.D., L.L.), Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital); Peking-Tsinghua Center for Life Sciences and PKU-IDG/McGovern Institute for Brain Research (Y.Z., L.L.), Peking University, Beijing; and National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence (J.S., Y.B.), Peking University, China
| | - Xinyu Sun
- From the Peking University Sixth Hospital (S.S., L.S., Y.S., X.H., A.Z., J.Q., X.S., J.D., L.L.), Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital); Peking-Tsinghua Center for Life Sciences and PKU-IDG/McGovern Institute for Brain Research (Y.Z., L.L.), Peking University, Beijing; and National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence (J.S., Y.B.), Peking University, China
| | - Jie Shi
- From the Peking University Sixth Hospital (S.S., L.S., Y.S., X.H., A.Z., J.Q., X.S., J.D., L.L.), Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital); Peking-Tsinghua Center for Life Sciences and PKU-IDG/McGovern Institute for Brain Research (Y.Z., L.L.), Peking University, Beijing; and National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence (J.S., Y.B.), Peking University, China
| | - Yanping Bao
- From the Peking University Sixth Hospital (S.S., L.S., Y.S., X.H., A.Z., J.Q., X.S., J.D., L.L.), Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital); Peking-Tsinghua Center for Life Sciences and PKU-IDG/McGovern Institute for Brain Research (Y.Z., L.L.), Peking University, Beijing; and National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence (J.S., Y.B.), Peking University, China.
| | - Jiahui Deng
- From the Peking University Sixth Hospital (S.S., L.S., Y.S., X.H., A.Z., J.Q., X.S., J.D., L.L.), Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital); Peking-Tsinghua Center for Life Sciences and PKU-IDG/McGovern Institute for Brain Research (Y.Z., L.L.), Peking University, Beijing; and National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence (J.S., Y.B.), Peking University, China
| | - Lin Lu
- From the Peking University Sixth Hospital (S.S., L.S., Y.S., X.H., A.Z., J.Q., X.S., J.D., L.L.), Peking University Institute of Mental Health, NHC Key Laboratory of Mental Health (Peking University), National Clinical Research Center for Mental Disorders (Peking University Sixth Hospital); Peking-Tsinghua Center for Life Sciences and PKU-IDG/McGovern Institute for Brain Research (Y.Z., L.L.), Peking University, Beijing; and National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence (J.S., Y.B.), Peking University, China
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20
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Huang SY, Li YZ, Zhang YR, Huang YY, Wu BS, Zhang W, Deng YT, Chen SD, He XY, Chen SF, Dong Q, Zhang C, Chen RJ, Suckling J, Rolls ET, Feng JF, Cheng W, Yu JT. Sleep, physical activity, sedentary behavior, and risk of incident dementia: a prospective cohort study of 431,924 UK Biobank participants. Mol Psychiatry 2022; 27:4343-4354. [PMID: 35701596 DOI: 10.1038/s41380-022-01655-y] [Citation(s) in RCA: 28] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2022] [Revised: 05/17/2022] [Accepted: 05/31/2022] [Indexed: 02/07/2023]
Abstract
Although sleep, physical activity and sedentary behavior have been found to be associated with dementia risk, findings are inconsistent and their joint relationship remains unclear. This study aimed to investigate independent and joint associations of these three modifiable behaviors with dementia risks. A total of 431,924 participants (median follow-up 9.0 years) without dementia from UK Biobank were included. Multiple Cox regressions were used to estimate adjusted hazard ratios (HRs) and 95% confidence intervals (CIs). Models fitted with restricted cubic spline were conducted to test for linear and nonlinear shapes of each association. Sleep duration, leisure-time physical activity (LTPA), and screen-based sedentary behavior individually associated with dementia risks in different non-linear patterns. Sleep duration associated with dementia in a U-shape with a nadir at 7 h/day. LTPA revealed a curvilinear relationship with dementia in diminishing tendency, while sedentary behavior revealed a J-shaped relationship. The dementia risk was 17% lower in the high LTPA group (HR[95%CI]: 0.83[0.76-0.91]) and 22% higher in the high sedentary behavior group (1.22[1.10-1.35]) compared to the corresponding low-level group, respectively. A combination of seven-hour/day sleep, moderate-to-high LTPA, and low-to-moderate sedentary behavior showed the lowest dementia risk (0.59[0.50-0.69]) compared to the referent group (longer or shorter sleep/low LTPA/high sedentary behavior). Notably, each behavior was non-linearly associated with brain structures in a pattern similar to its association with dementia, suggesting they may affect dementia risk by affecting brain structures. Our findings highlight the potential to change these three daily behaviors individually and simultaneously to reduce the risk of dementia.
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Affiliation(s)
- Shu-Yi Huang
- Department of Neurology and Institute of Neurology, Huashan Hospital, State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Shanghai Medical College, Fudan University, Shanghai, China
| | - Yu-Zhu Li
- Institute of Science and Technology for Brain-Inspired Intelligence, Fudan University, Shanghai, China
- Key Laboratory of Computational Neuroscience and Brain-Inspired Intelligence, Fudan University, Ministry of Education, Shanghai, China
| | - Ya-Ru Zhang
- Department of Neurology and Institute of Neurology, Huashan Hospital, State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Shanghai Medical College, Fudan University, Shanghai, China
| | - Yu-Yuan Huang
- Department of Neurology and Institute of Neurology, Huashan Hospital, State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Shanghai Medical College, Fudan University, Shanghai, China
| | - Bang-Sheng Wu
- Department of Neurology and Institute of Neurology, Huashan Hospital, State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Shanghai Medical College, Fudan University, Shanghai, China
| | - Wei Zhang
- Institute of Science and Technology for Brain-Inspired Intelligence, Fudan University, Shanghai, China
- Key Laboratory of Computational Neuroscience and Brain-Inspired Intelligence, Fudan University, Ministry of Education, Shanghai, China
| | - Yue-Ting Deng
- Department of Neurology and Institute of Neurology, Huashan Hospital, State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Shanghai Medical College, Fudan University, Shanghai, China
| | - Shi-Dong Chen
- Department of Neurology and Institute of Neurology, Huashan Hospital, State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Shanghai Medical College, Fudan University, Shanghai, China
| | - Xiao-Yu He
- Department of Neurology and Institute of Neurology, Huashan Hospital, State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Shanghai Medical College, Fudan University, Shanghai, China
| | - Shu-Fen Chen
- Department of Neurology and Institute of Neurology, Huashan Hospital, State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Shanghai Medical College, Fudan University, Shanghai, China
| | - Qiang Dong
- Department of Neurology and Institute of Neurology, Huashan Hospital, State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Shanghai Medical College, Fudan University, Shanghai, China
| | - Can Zhang
- Genetics and Aging Research Unit, McCance Center for Brain Health, Mass General Institute for Neurodegenerative Diseases (MIND), Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Charlestown, MA, USA
| | - Ren-Jie Chen
- School of Public Health, Key Lab of Public Health Safety of the Ministry of Education and Key Lab of Health Technology Assessment of the Ministry of Health, Fudan University, Shanghai, China
| | - John Suckling
- Department of Psychiatry, University of Cambridge, Cambridge, UK
| | - Edmund T Rolls
- Institute of Science and Technology for Brain-Inspired Intelligence, Fudan University, Shanghai, China
- Oxford Centre for Computational Neuroscience, Oxford, UK
- Department of Computer Science, University of Warwick, Coventry, UK
| | - Jian-Feng Feng
- Institute of Science and Technology for Brain-Inspired Intelligence, Fudan University, Shanghai, China
- Key Laboratory of Computational Neuroscience and Brain-Inspired Intelligence, Fudan University, Ministry of Education, Shanghai, China
| | - Wei Cheng
- Institute of Science and Technology for Brain-Inspired Intelligence, Fudan University, Shanghai, China.
- Key Laboratory of Computational Neuroscience and Brain-Inspired Intelligence, Fudan University, Ministry of Education, Shanghai, China.
- Fudan ISTBI-ZJNU Algorithm Centre for Brain-Inspired Intelligence, Zhejiang Normal University, Jinhua, China.
- Shanghai Medical College and Zhongshan Hospital Immunotherapy Technology Transfer Center, Shanghai, China.
| | - Jin-Tai Yu
- Department of Neurology and Institute of Neurology, Huashan Hospital, State Key Laboratory of Medical Neurobiology and MOE Frontiers Center for Brain Science, Shanghai Medical College, Fudan University, Shanghai, China.
- Institute of Science and Technology for Brain-Inspired Intelligence, Fudan University, Shanghai, China.
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21
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van der Veere P, Hammami I, Buck G, Greenland M, Offer A, Nunn M, Whiteley W, Bulbulia R, Collins R, Armitage J, Mafham M, Parish S. Weight loss in a cardiovascular trial population identifies people at future risk of dementia. ALZHEIMER'S & DEMENTIA (AMSTERDAM, NETHERLANDS) 2022; 14:e12352. [PMID: 36092692 PMCID: PMC9428278 DOI: 10.1002/dad2.12352] [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: 05/25/2022] [Accepted: 07/11/2022] [Indexed: 11/09/2022]
Abstract
Introduction Populations at increased risk of dementia need to be identified for well-powered trials of preventive interventions. Weight loss, which often occurs in pre-clinical dementia, could identify a population at sufficiently high dementia risk. Methods In 12,975 survivors in the Heart Protection Study statin trial of people with, or at high risk of, cardiovascular disease, the association of weight change over 5 years during the trial with post-trial dementia recorded in electronic hospital admission and death records (n = 784) was assessed, after adjustment for age, sex, treatment allocation, and deprivation measures. Results Among the 60% without substantial weight gain (≤2 kg weight gain), each 1 kg weight loss was associated with a risk ratio for dementia of 1.04 (95% confidence interval, 1.02-1.07). Weight loss ≥4 kg and cognitive function below the mean identified participants aged ≥67 years with a 13% 10-year dementia risk. Discussion The combination of weight loss and high vascular risk identified individuals at high risk of dementia who could be recruited to dementia prevention trials.
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Affiliation(s)
- Pieter van der Veere
- Clinical Trial Service Unit and Epidemiological Studies UnitNuffield Department of Population HealthUniversity of OxfordOxfordUK
| | - Imen Hammami
- Clinical Trial Service Unit and Epidemiological Studies UnitNuffield Department of Population HealthUniversity of OxfordOxfordUK
| | - Georgina Buck
- Clinical Trial Service Unit and Epidemiological Studies UnitNuffield Department of Population HealthUniversity of OxfordOxfordUK
| | - Melanie Greenland
- Clinical Trial Service Unit and Epidemiological Studies UnitNuffield Department of Population HealthUniversity of OxfordOxfordUK
| | - Alison Offer
- Clinical Trial Service Unit and Epidemiological Studies UnitNuffield Department of Population HealthUniversity of OxfordOxfordUK
| | - Michelle Nunn
- Clinical Trial Service Unit and Epidemiological Studies UnitNuffield Department of Population HealthUniversity of OxfordOxfordUK
| | - William Whiteley
- Clinical Trial Service Unit and Epidemiological Studies UnitNuffield Department of Population HealthUniversity of OxfordOxfordUK,Centre for Clinical Brain SciencesUniversity of EdinburghUK
| | - Richard Bulbulia
- Clinical Trial Service Unit and Epidemiological Studies UnitNuffield Department of Population HealthUniversity of OxfordOxfordUK
| | - Rory Collins
- Clinical Trial Service Unit and Epidemiological Studies UnitNuffield Department of Population HealthUniversity of OxfordOxfordUK
| | - Jane Armitage
- Clinical Trial Service Unit and Epidemiological Studies UnitNuffield Department of Population HealthUniversity of OxfordOxfordUK,MRC Population Health Research UnitNuffield Department of Population HealthUniversity of OxfordOxfordUK
| | - Marion Mafham
- Clinical Trial Service Unit and Epidemiological Studies UnitNuffield Department of Population HealthUniversity of OxfordOxfordUK
| | - Sarah Parish
- Clinical Trial Service Unit and Epidemiological Studies UnitNuffield Department of Population HealthUniversity of OxfordOxfordUK,MRC Population Health Research UnitNuffield Department of Population HealthUniversity of OxfordOxfordUK
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22
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McGrath ER, Beiser AS, O'Donnell A, Himali JJ, Pase MP, Satizabal CL, Seshadri S. Determining Vascular Risk Factors for Dementia and Dementia Risk Prediction Across Mid- to Later Life: The Framingham Heart Study. Neurology 2022; 99:e142-e153. [PMID: 35584926 PMCID: PMC9280997 DOI: 10.1212/wnl.0000000000200521] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Accepted: 02/28/2022] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND AND OBJECTIVES The association between vascular risk factors and dementia varies with age, making generalizability of dementia risk prediction rules to individuals of different ages challenging. We determined the most important vascular risk factors for inclusion in age-specific dementia risk scores. METHODS Framingham Heart Study Original and Offspring cohort participants with available data on the Framingham Stroke Risk Profile (FSRP) at midlife (age 55; n = 4,899, 57% women), late life (ages 65 or 70), or later life (ages 75 or 80 [n = 2,386, 62% women]) were followed for 10-year incident dementia risk from ages 65, 70, 75, and 80. RESULTS Age- and sex-adjusted midlife risk factors associated with 10-year risk of dementia from age 65 included FSRP (hazard ratio [HR] 1.16, 95% CI 1.06-1.26, per 1 SD increment in log-transformed score), diabetes mellitus (DM; HR 4.31, 95% CI 1.97-9.43), and systolic blood pressure (SBP; HR 1.12, 95% CI 1.02-1.24, per 10 mm Hg increment). Late-life risk factors associated with 10-year incident dementia from ages 65 or 70 included FSRP (age 65 only: HR 1.06, 95% CI 1.02-1.10), antihypertensive use (age 65 reported: HR 1.66, 95% CI 1.12-2.46), DM (age 65 reported: HR 1.96, 95% CI 1.09-3.52), atrial fibrillation (age 65 reported: HR 2.30, 95% CI 1.00-5.27), nonstroke cardiovascular disease (nsCVD; age 65 reported: HR 1.95, 95% CI 1.24-3.07), and stroke (age 70 only: HR 3.61, 95% CI 2.21-5.92). Later-life risk factors associated with 10-year incident dementia from ages 75 or 80 included antihypertensive use (age 80 only: HR 0.74, 95% CI 0.62-0.89), DM (age 80 reported: HR 1.40, 95% CI 1.04-1.89), atrial fibrillation (age 80 reported: HR 1.43, 95% CI 1.07-1.92), and stroke (age 80 reported: HR 1.63, 95% CI 1.13-2.35). In stepwise models, SBP and DM at age 55, nsCVD at age 65, DM and stroke at ages 70 and 75, and DM, stroke, and use of antihypertensives (protective) at age 80 were the most important vascular risk factors for dementia. DISCUSSION Our findings support the use of age-specific dementia risk scores, which should prioritize including, at age 55, SBP and DM; at age 65, nsCVD; at ages 70 and 75, DM and stroke; and at age 80, DM, stroke, and antihypertensive use.
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Affiliation(s)
- Emer R McGrath
- From the HRB Clinical Research Facility (E.R.M.) and School of Medicine, National University of Ireland Galway; The Framingham Heart Study (E.R.M., A.S.B., A.O., J.J.H., M.P.P., C.L.S., S.S.); Boston University School of Public Health (A.S.B., A.O., J.J.H.); Boston University School of Medicine (A.S.B., J.J.H., S.S.), MA; Glenn Biggs Institute for Alzheimer's & Neurodegenerative Diseases (J.J.H., C.L.S., S.S.), University of Texas Health Sciences Center, San Antonio; The Turner Institute for Brain and Mental Health (M.P.P.), Monash University, Victoria, Australia; and Harvard T.H. Chan School of Public Health (M.P.P.), Boston, MA.
| | - Alexa S Beiser
- From the HRB Clinical Research Facility (E.R.M.) and School of Medicine, National University of Ireland Galway; The Framingham Heart Study (E.R.M., A.S.B., A.O., J.J.H., M.P.P., C.L.S., S.S.); Boston University School of Public Health (A.S.B., A.O., J.J.H.); Boston University School of Medicine (A.S.B., J.J.H., S.S.), MA; Glenn Biggs Institute for Alzheimer's & Neurodegenerative Diseases (J.J.H., C.L.S., S.S.), University of Texas Health Sciences Center, San Antonio; The Turner Institute for Brain and Mental Health (M.P.P.), Monash University, Victoria, Australia; and Harvard T.H. Chan School of Public Health (M.P.P.), Boston, MA
| | - Adrienne O'Donnell
- From the HRB Clinical Research Facility (E.R.M.) and School of Medicine, National University of Ireland Galway; The Framingham Heart Study (E.R.M., A.S.B., A.O., J.J.H., M.P.P., C.L.S., S.S.); Boston University School of Public Health (A.S.B., A.O., J.J.H.); Boston University School of Medicine (A.S.B., J.J.H., S.S.), MA; Glenn Biggs Institute for Alzheimer's & Neurodegenerative Diseases (J.J.H., C.L.S., S.S.), University of Texas Health Sciences Center, San Antonio; The Turner Institute for Brain and Mental Health (M.P.P.), Monash University, Victoria, Australia; and Harvard T.H. Chan School of Public Health (M.P.P.), Boston, MA
| | - Jayandra J Himali
- From the HRB Clinical Research Facility (E.R.M.) and School of Medicine, National University of Ireland Galway; The Framingham Heart Study (E.R.M., A.S.B., A.O., J.J.H., M.P.P., C.L.S., S.S.); Boston University School of Public Health (A.S.B., A.O., J.J.H.); Boston University School of Medicine (A.S.B., J.J.H., S.S.), MA; Glenn Biggs Institute for Alzheimer's & Neurodegenerative Diseases (J.J.H., C.L.S., S.S.), University of Texas Health Sciences Center, San Antonio; The Turner Institute for Brain and Mental Health (M.P.P.), Monash University, Victoria, Australia; and Harvard T.H. Chan School of Public Health (M.P.P.), Boston, MA
| | - Matthew P Pase
- From the HRB Clinical Research Facility (E.R.M.) and School of Medicine, National University of Ireland Galway; The Framingham Heart Study (E.R.M., A.S.B., A.O., J.J.H., M.P.P., C.L.S., S.S.); Boston University School of Public Health (A.S.B., A.O., J.J.H.); Boston University School of Medicine (A.S.B., J.J.H., S.S.), MA; Glenn Biggs Institute for Alzheimer's & Neurodegenerative Diseases (J.J.H., C.L.S., S.S.), University of Texas Health Sciences Center, San Antonio; The Turner Institute for Brain and Mental Health (M.P.P.), Monash University, Victoria, Australia; and Harvard T.H. Chan School of Public Health (M.P.P.), Boston, MA
| | - Claudia L Satizabal
- From the HRB Clinical Research Facility (E.R.M.) and School of Medicine, National University of Ireland Galway; The Framingham Heart Study (E.R.M., A.S.B., A.O., J.J.H., M.P.P., C.L.S., S.S.); Boston University School of Public Health (A.S.B., A.O., J.J.H.); Boston University School of Medicine (A.S.B., J.J.H., S.S.), MA; Glenn Biggs Institute for Alzheimer's & Neurodegenerative Diseases (J.J.H., C.L.S., S.S.), University of Texas Health Sciences Center, San Antonio; The Turner Institute for Brain and Mental Health (M.P.P.), Monash University, Victoria, Australia; and Harvard T.H. Chan School of Public Health (M.P.P.), Boston, MA
| | - Sudha Seshadri
- From the HRB Clinical Research Facility (E.R.M.) and School of Medicine, National University of Ireland Galway; The Framingham Heart Study (E.R.M., A.S.B., A.O., J.J.H., M.P.P., C.L.S., S.S.); Boston University School of Public Health (A.S.B., A.O., J.J.H.); Boston University School of Medicine (A.S.B., J.J.H., S.S.), MA; Glenn Biggs Institute for Alzheimer's & Neurodegenerative Diseases (J.J.H., C.L.S., S.S.), University of Texas Health Sciences Center, San Antonio; The Turner Institute for Brain and Mental Health (M.P.P.), Monash University, Victoria, Australia; and Harvard T.H. Chan School of Public Health (M.P.P.), Boston, MA
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Hendriks S, Peetoom K, Bakker C, Koopmans R, van der Flier W, Papma J, Verhey F, de Vugt M, Köhler S. Global incidence of young-onset dementia: A systematic review and meta-analysis. Alzheimers Dement 2022; 19:831-843. [PMID: 35715891 DOI: 10.1002/alz.12695] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Revised: 03/19/2022] [Accepted: 04/27/2022] [Indexed: 11/06/2022]
Abstract
INTRODUCTION Reliable data on the incidence rates for young-onset dementia (YOD) are lacking, but are necessary for research on disease etiology and to raise awareness among health care professionals. METHODS We performed a systematic review and meta-analysis on population-based studies on the incidence of YOD, published between January 1, 1990 and February 1, 2022, according to Meta-analyses of Observational Studies in Epidemiology (MOOSE) guidelines. Data were analyzed using random-effects meta-analyses. Results were age-standardized, and heterogeneity was assessed by subgroup analyses and meta-regression. RESULTS Sixty-one articles were included. Global age-standardized incidence rates increased from 0.17/100,000 in age 30 to 34 years, to 5.14/100,000 in age 60 to 64 years, giving a global total age-standardized incidence rate of 11 per 100,000 in age 30 to 64. This corresponds to 370,000 new YOD cases annually worldwide. Heterogeneity was high and meta-regression showed geographic location significantly influenced this heterogeneity. DISCUSSION This meta-analysis shows the current best estimate of YOD incidence. New prospective cohort studies are needed.
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Affiliation(s)
- Stevie Hendriks
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Alzheimer Centre Limburg, Maastricht University, Maastricht, The Netherlands
| | - Kirsten Peetoom
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Alzheimer Centre Limburg, Maastricht University, Maastricht, The Netherlands
| | - Christian Bakker
- Department of Primary and Community Care, Radboud UMC Alzheimer Center, Radboud University Medical Center, Nijmegen, The Netherlands
- Groenhuysen, Center for Specialized Geriatric Care, Roosendaal, The Netherlands
| | - Raymond Koopmans
- Department of Primary and Community Care, Radboud UMC Alzheimer Center, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Wiesje van der Flier
- Department of Neurology, Department of Epidemiology and Data Science, Vrije Universiteit Amsterdam, Amsterdam UMC, Amsterdam, The Netherlands
| | - Janne Papma
- Department of Neurology, Erasmus MC University Medical Center, Rotterdam, The Netherlands
| | - Frans Verhey
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Alzheimer Centre Limburg, Maastricht University, Maastricht, The Netherlands
| | - Marjolein de Vugt
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Alzheimer Centre Limburg, Maastricht University, Maastricht, The Netherlands
| | - Sebastian Köhler
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Alzheimer Centre Limburg, Maastricht University, Maastricht, The Netherlands
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Abstract
Sex and gender differences are seen in cognitive disturbances in a variety of neurological and psychiatry diseases. Men are more likely to have cognitive symptoms in schizophrenia whereas women are more likely to have more severe cognitive symptoms with major depressive disorder and Alzheimer's disease. Thus, it is important to understand sex and gender differences in underlying cognitive abilities with and without disease. Sex differences are noted in performance across various cognitive domains - with males typically outperforming females in spatial tasks and females typically outperforming males in verbal tasks. Furthermore, there are striking sex differences in brain networks that are activated during cognitive tasks and in learning strategies. Although rarely studied, there are also sex differences in the trajectory of cognitive aging. It is important to pay attention to these sex differences as they inform researchers of potential differences in resilience to age-related cognitive decline and underlying mechanisms for both healthy and pathological cognitive aging, depending on sex. We review literature on the progressive neurodegenerative disorder, Alzheimer's disease, as an example of pathological cognitive aging in which human females show greater lifetime risk, neuropathology, and cognitive impairment, compared to human males. Not surprisingly, the relationships between sex and cognition, cognitive aging, and Alzheimer's disease are nuanced and multifaceted. As such, this chapter will end with a discussion of lifestyle factors, like education and diet, as modifiable factors that can alter cognitive aging by sex. Understanding how cognition changes across age and contributing factors, like sex differences, will be essential to improving care for older adults.
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25
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Wilkinson T, Schnier C, Bush K, Rannikmäe K, Lyons RA, McTaggart S, Bennie M, Sudlow CL. Drug prescriptions and dementia incidence: a medication-wide association study of 17000 dementia cases among half a million participants. J Epidemiol Community Health 2022; 76:223-229. [PMID: 34706926 PMCID: PMC8862053 DOI: 10.1136/jech-2021-217090] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Accepted: 08/30/2021] [Indexed: 11/24/2022]
Abstract
BACKGROUND Previous studies have suggested that some medications may influence dementia risk. We conducted a hypothesis-generating medication-wide association study to investigate systematically the association between all prescription medications and incident dementia. METHODS We used a population-based cohort within the Secure Anonymised Information Linkage (SAIL) databank, comprising routinely-collected primary care, hospital admissions and mortality data from Wales, UK. We included all participants born after 1910 and registered with a SAIL general practice at ≤60 years old. Follow-up was from each participant's 60th birthday to the earliest of dementia diagnosis, deregistration from a SAIL general practice, death or the end of 2018. We considered participants exposed to a medication if they received ≥1 prescription for any of 744 medications before or during follow-up. We adjusted for sex, smoking and socioeconomic status. The outcome was any all-cause dementia code in primary care, hospital or mortality data during follow-up. We used Cox regression to calculate hazard ratios and Bonferroni-corrected p values. RESULTS Of 551 344 participants, 16 998 (3%) developed dementia (median follow-up was 17 years for people who developed dementia, 10 years for those without dementia). Of 744 medications, 221 (30%) were associated with dementia. Of these, 217 (98%) were associated with increased dementia incidence, many clustering around certain indications. Four medications (all vaccines) were associated with a lower dementia incidence. CONCLUSIONS Almost a third of medications were associated with dementia. The clustering of many drugs around certain indications may provide insights into early manifestations of dementia. We encourage further investigation of hypotheses generated by these results.
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Affiliation(s)
- Tim Wilkinson
- Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK .,Usher Institute, The University of Edinburgh, Edinburgh, UK
| | | | - Kathryn Bush
- Usher Institute, The University of Edinburgh, Edinburgh, UK
| | | | - Ronan A Lyons
- National Centre for Population Health and Wellbeing Research, Swansea University, Swansea, UK.,HDR UK Wales and Northern Ireland, Health Data Research UK, London, UK
| | - Stuart McTaggart
- Public Health and Intelligence Strategic Business Unit, NHS National Services Scotland, Edinburgh, UK
| | - Marion Bennie
- Public Health and Intelligence Strategic Business Unit, NHS National Services Scotland, Edinburgh, UK.,Strathclyde Institute of Pharmacy and Biomedical Sciences, University of Strathclyde, Glasgow, UK
| | - Cathie Lm Sudlow
- Usher Institute, The University of Edinburgh, Edinburgh, UK.,HDR UK Scotland, Health Data Research UK, London, UK
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26
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Kramer P. Mitochondria-Microbiota Interaction in Neurodegeneration. Front Aging Neurosci 2022; 13:776936. [PMID: 35002678 PMCID: PMC8733591 DOI: 10.3389/fnagi.2021.776936] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Accepted: 11/30/2021] [Indexed: 11/13/2022] Open
Abstract
Alzheimer’s and Parkinson’s are the two best-known neurodegenerative diseases. Each is associated with the excessive aggregation in the brain and elsewhere of its own characteristic amyloid proteins. Yet the two afflictions have much in common and often the same amyloids play a role in both. These amyloids need not be toxic and can help regulate bile secretion, synaptic plasticity, and immune defense. Moreover, when they do form toxic aggregates, amyloids typically harm not just patients but their pathogens too. A major port of entry for pathogens is the gut. Keeping the gut’s microbe community (microbiota) healthy and under control requires that our cells’ main energy producers (mitochondria) support the gut-blood barrier and immune system. As we age, these mitochondria eventually succumb to the corrosive byproducts they themselves release, our defenses break down, pathogens or their toxins break through, and the side effects of inflammation and amyloid aggregation become problematic. Although it gets most of the attention, local amyloid aggregation in the brain merely points to a bigger problem: the systemic breakdown of the entire human superorganism, exemplified by an interaction turning bad between mitochondria and microbiota.
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Affiliation(s)
- Peter Kramer
- Department of General Psychology, University of Padua, Padua, Italy
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27
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Schindler LS, Subramaniapillai S, Barth C, van der Meer D, Pedersen ML, Kaufmann T, Maximov II, Linge J, Leinhard OD, Beck D, Gurholt TP, Voldsbekk I, Suri S, Ebmeier KP, Draganski B, Andreassen OA, Westlye LT, de Lange AMG. Associations between abdominal adipose tissue, reproductive span, and brain characteristics in post-menopausal women. Neuroimage Clin 2022; 36:103239. [PMID: 36451350 PMCID: PMC9668664 DOI: 10.1016/j.nicl.2022.103239] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2022] [Revised: 10/06/2022] [Accepted: 10/17/2022] [Indexed: 11/06/2022]
Abstract
The menopause transition involves changes in oestrogens and adipose tissue distribution, which may influence female brain health post-menopause. Although increased central fat accumulation is linked to risk of cardiometabolic diseases, adipose tissue also serves as the primary biosynthesis site of oestrogens post-menopause. It is unclear whether different types of adipose tissue play diverging roles in female brain health post-menopause, and whether this depends on lifetime oestrogen exposure, which can have lasting effects on the brain and body even after menopause. Using the UK Biobank sample, we investigated associations between brain characteristics and visceral adipose tissue (VAT) and abdominal subcutaneous adipose tissue (ASAT) in 10,251 post-menopausal females, and assessed whether the relationships varied depending on length of reproductive span (age at menarche to age at menopause). To parse the effects of common genetic variation, we computed polygenic scores for reproductive span. The results showed that higher VAT and ASAT were both associated with higher grey and white matter brain age, and greater white matter hyperintensity load. The associations varied positively with reproductive span, indicating more prominent associations between adipose tissue and brain measures in females with a longer reproductive span. The effects were in general small, but could not be fully explained by genetic variation or relevant confounders. Our findings indicate that associations between abdominal adipose tissue and brain health post-menopause may partly depend on individual differences in cumulative oestrogen exposure during reproductive years, emphasising the complexity of neural and endocrine ageing processes in females.
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Affiliation(s)
- Louise S Schindler
- LREN, Centre for Research in Neurosciences, Department of Clinical Neurosciences, Lausanne University Hospital (CHUV) and University of Lausanne, Lausanne, Switzerland; Department of Psychology, University of Oslo, Oslo, Norway.
| | - Sivaniya Subramaniapillai
- LREN, Centre for Research in Neurosciences, Department of Clinical Neurosciences, Lausanne University Hospital (CHUV) and University of Lausanne, Lausanne, Switzerland; Department of Psychology, University of Oslo, Oslo, Norway
| | - Claudia Barth
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway; Department of Psychiatric Research, Diakonhjemmet Hospital, Oslo, Norway
| | - Dennis van der Meer
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway; School of Mental Health and Neuroscience, Faculty of Health Medicine and Life Sciences, Maastricht University, The Netherlands
| | - Mads L Pedersen
- Department of Psychology, University of Oslo, Oslo, Norway; NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Tobias Kaufmann
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway; Department of Psychiatry and Psychotherapy, University of Tübingen, Germany
| | - Ivan I Maximov
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway; Department of Health and Functioning, Western Norway University of Applied Sciences, Bergen, Norway
| | - Jennifer Linge
- AMRA Medical AB, Linköping, Sweden; Department of Health, Medicine, and Caring Sciences, Linköping University, Linköping, Sweden
| | - Olof Dahlqvist Leinhard
- AMRA Medical AB, Linköping, Sweden; Department of Health, Medicine, and Caring Sciences, Linköping University, Linköping, Sweden; Center for Medical Image Science and Visualization (CMIV), Linköping University, Linköping, Sweden
| | - Dani Beck
- Department of Psychology, University of Oslo, Oslo, Norway; NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Tiril P Gurholt
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Irene Voldsbekk
- Department of Psychology, University of Oslo, Oslo, Norway; NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Sana Suri
- Department of Psychiatry, University of Oxford, Oxford, UK; Wellcome Centre for Integrative Neuroimaging, University of Oxford, Oxford, UK
| | | | - Bogdan Draganski
- LREN, Centre for Research in Neurosciences, Department of Clinical Neurosciences, Lausanne University Hospital (CHUV) and University of Lausanne, Lausanne, Switzerland; Dept. of Neurology, Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
| | - Ole A Andreassen
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway; KG Jebsen Centre for Neurodevelopmental Disorders, University of Oslo, Oslo, Norway
| | - Lars T Westlye
- Department of Psychology, University of Oslo, Oslo, Norway; NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway; KG Jebsen Centre for Neurodevelopmental Disorders, University of Oslo, Oslo, Norway
| | - Ann-Marie G de Lange
- LREN, Centre for Research in Neurosciences, Department of Clinical Neurosciences, Lausanne University Hospital (CHUV) and University of Lausanne, Lausanne, Switzerland; Department of Psychology, University of Oslo, Oslo, Norway; Department of Psychiatry, University of Oxford, Oxford, UK
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28
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Petermann-Rocha F, Lyall DM, Gray SR, Gill JMR, Sattar N, Welsh P, Quinn TJ, Stewart W, Pell JP, Ho FK, Celis-Morales C. Dose-response association between device-measured physical activity and incident dementia: a prospective study from UK Biobank. BMC Med 2021; 19:305. [PMID: 34852818 PMCID: PMC8638378 DOI: 10.1186/s12916-021-02172-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2021] [Accepted: 10/26/2021] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Previous cohort studies have investigated the relationship between self-reported physical activity (PA) and dementia. Evidence from objective device-measured PA data is lacking. This study aimed to explore the association of device-measured PA with the risk of dementia incidence and common subtypes (Alzheimer's disease [AD] and vascular dementia) using the UK Biobank study. METHODS 84,854 participants (55.8% women), invited to participate in the device-measured PA between 2013 and 2015, were included in this prospective cohort study. Wrist accelerometers were used to measure light, moderate, vigorous, moderate-to-vigorous PA (MVPA) and total PA intensity and duration (MET/min/week). Incident dementia (fatal and non-fatal) was extracted from hospital episodes records for incidence and death register for mortality. Incidence follow-up was carried out until the end of March 2021in England and Scotland and the end of March 2018 in Wales. Mortality data were available until February 2021. Nonlinear associations were first investigated using penalised cubic splines fitted in the Cox proportional hazard models. In addition, using MVPA, five categories were created. Associations of these categories with the outcomes were investigated using Cox proportional hazard models. Analyses were adjusted for sociodemographic, lifestyle and health-related factors. RESULTS After a median follow-up of 6.3 years, 678 individuals were diagnosed with dementia. Evidence of nonlinearity was observed for all PA modes and all-cause dementia. For categories of MVPA, there was a significant trend towards a low risk of overall dementia when higher levels of MVPA were achieved (HRtrend 0.66 [95% CI 0.62 to 0.70]. The lowest risk was identified in individuals who performed more than 1200 MET/min/week, those who had 84% (95% CI 0.12 to 0.21) lower risk of incident dementia compared to those who performed < 300 MET/min/week. CONCLUSIONS Participants with higher PA levels had a lower risk of incident dementia than those less active, independently of sociodemographic, lifestyle factors and comorbidity. Considering that the majority of previous studies have reported this association using self-reported data, our findings highlight the strong inverse association between PA objectively measured and incident dementia.
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Affiliation(s)
- Fanny Petermann-Rocha
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, G12 8TA, UK
- British Heart Foundation Glasgow Cardiovascular Research Centre, Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, G12 8TA, UK
- Faculty of Medicine, Universidad Diego Portales, Santiago, Chile
| | - Donald M Lyall
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, G12 8TA, UK
| | - Stuart R Gray
- British Heart Foundation Glasgow Cardiovascular Research Centre, Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, G12 8TA, UK
| | - Jason M R Gill
- British Heart Foundation Glasgow Cardiovascular Research Centre, Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, G12 8TA, UK
| | - Naveed Sattar
- British Heart Foundation Glasgow Cardiovascular Research Centre, Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, G12 8TA, UK
| | - Paul Welsh
- British Heart Foundation Glasgow Cardiovascular Research Centre, Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, G12 8TA, UK
| | - Terence J Quinn
- British Heart Foundation Glasgow Cardiovascular Research Centre, Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, G12 8TA, UK
| | - William Stewart
- Institute of Neuroscience & Psychology, University of Glasgow, Glasgow, G12 8TA, UK
| | - Jill P Pell
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, G12 8TA, UK
| | - Frederick K Ho
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, G12 8TA, UK
| | - Carlos Celis-Morales
- British Heart Foundation Glasgow Cardiovascular Research Centre, Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, G12 8TA, UK.
- Centre of Exercise Physiology Research (CIFE), Universidad Mayor, Providencia, Chile.
- Human Performance Lab, Education, Physical Activity and Health Research Unit, Universidad Católica del Maule, 3466706, Talca, Chile.
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29
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Potential causal effect of physical activity on reducing the risk of dementia: a 6-year cohort study from the Japan Gerontological Evaluation Study. Int J Behav Nutr Phys Act 2021; 18:140. [PMID: 34715877 PMCID: PMC8555243 DOI: 10.1186/s12966-021-01212-w] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Accepted: 10/08/2021] [Indexed: 12/03/2022] Open
Abstract
Background The causal effect of physical activity on reducing dementia risk has been questioned due to the possibility of reverse causation. This study examined the potential causal effects of physical activity on reducing dementia risk using residency in a snowy area as an instrumental variable (IV) representing the physical activity of older adults. Methods We used cohort data from the Japan Gerontological Evaluation Study, a longitudinal cohort enrolling people aged 65 or older who were physically and cognitively independent in 2013; study participants were followed for an average of 5.7 years. Participants in the present study included 73,260 individuals living in 19 municipalities in Japan. Physical activity was measured by self-report questionnaires and the incidence of dementia was ascertained by linking participants to the public registries of long-term care insurance. IV estimation was obtained from a piecewise Cox proportional hazard model using a two-stage regression procedure. Results During the study period, we ascertained 8714 cases (11.9%) of dementia onset. In the IV analysis, we found that the frequency of physical activity per week was negatively associated with dementia risk, though the association weakened over time (Year 1: hazard ratio = 0.53, 95% confidence interval: 0.39–0.74; Year 4: 0.69, 0.53–0.90; Year 6: 0.85, 0.66–1.10). Conclusions Our IV analysis indicated a potential causal effect of physical activity on reducing dementia risk that persisted for at least 4 years of follow-up. Thus, we conclude that physical activity should be recommended for older adults to reduce dementia risk. Supplementary Information The online version contains supplementary material available at 10.1186/s12966-021-01212-w.
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The joint association of physical activity and fine particulate matter exposure with incident dementia in elderly Hong Kong residents. ENVIRONMENT INTERNATIONAL 2021; 156:106645. [PMID: 34015665 DOI: 10.1016/j.envint.2021.106645] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/01/2021] [Revised: 04/13/2021] [Accepted: 05/12/2021] [Indexed: 02/05/2023]
Abstract
OBJECTIVE The evidence for the beneficial effects of physical activity (PA) and potentially detrimental effects of long-term exposure to fine particulate matter (PM2.5) on neurodegeneration diseases is accumulating. However, their joint effects remain unclear. We evaluated joint associations of habitual PA and PM2.5 exposure with incident dementia in a longitudinal elderly cohort in Hong Kong. METHODS A total of 57,775 elderly participants (≥65 years) without dementia were enrolled during 1998-2001 and followed up till 2011. Their information on PA and other relevant covariates were collected at baseline (1998-2001) by a standard self-administered questionnaire, including PA volumes (high, moderate, low, and inactive) and types (aerobic exercise, traditional Chinese exercise, stretching exercise, walking slowly, and no exercise). Their annual mean PM2.5 exposures at the residential address were estimated using a satellite-based spatiotemporal model. We then adopted the Cox proportional hazards model to examine the joint associations with the incidence of all-cause dementia, Alzheimer's diseases, and vascular dementia on additive and multiplicative scales. RESULTS During the follow-up period, we identified 1,157 incident cases of dementia, including 642 cases of Alzheimer's disease and 324 cases of vascular dementia. A higher PA level was associated with a lower risk of incident all-cause dementia (hazard ratio (HR) for the high-PA volume was 0.59 (95% CI, 0.47, 0.75), as compared with the inactive-PA), whereas a high level of PM2.5 was related to the higher risk with an HR of 1.15 (95%CI: 1.00, 1.33) compared with the low-level of PM2.5. No clear evidence was observed of interaction between habitual PA (volume and type) and PM2.5 inhalation to incident dementia on either additive or multiplicative scale. CONCLUSION Habitual PA and long-term PM2.5 exposure were oppositely related to incident dementia in the Hong Kong aged population. The benefits of PA remain in people irrespective of exposure to air pollution.
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Grau-Rivera O, Navalpotro-Gomez I, Sánchez-Benavides G, Suárez-Calvet M, Milà-Alomà M, Arenaza-Urquijo EM, Salvadó G, Sala-Vila A, Shekari M, González-de-Echávarri JM, Minguillón C, Niñerola-Baizán A, Perissinotti A, Simon M, Kollmorgen G, Zetterberg H, Blennow K, Gispert JD, Molinuevo JL. Association of weight change with cerebrospinal fluid biomarkers and amyloid positron emission tomography in preclinical Alzheimer's disease. ALZHEIMERS RESEARCH & THERAPY 2021; 13:46. [PMID: 33597012 PMCID: PMC7890889 DOI: 10.1186/s13195-021-00781-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/29/2020] [Accepted: 02/01/2021] [Indexed: 11/16/2022]
Abstract
Background Recognizing clinical manifestations heralding the development of Alzheimer’s disease (AD)-related cognitive impairment could improve the identification of individuals at higher risk of AD who may benefit from potential prevention strategies targeting preclinical population. We aim to characterize the association of body weight change with cognitive changes and AD biomarkers in cognitively unimpaired middle-aged adults. Methods This prospective cohort study included data from cognitively unimpaired adults from the ALFA study (n = 2743), a research platform focused on preclinical AD. Cognitive and anthropometric data were collected at baseline between April 2013 and November 2014. Between October 2016 and February 2020, 450 participants were visited in the context of the nested ALFA+ study and underwent cerebrospinal fluid (CSF) extraction and acquisition of positron emission tomography images with [18F]flutemetamol (FTM-PET). From these, 408 (90.1%) were included in the present study. We used data from two visits (average interval 4.1 years) to compute rates of change in weight and cognitive performance. We tested associations between these variables and between weight change and categorical and continuous measures of CSF and neuroimaging AD biomarkers obtained at follow-up. We classified participants with CSF data according to the AT (amyloid, tau) system and assessed between-group differences in weight change. Results Weight loss predicted a higher likelihood of positive FTM-PET visual read (OR 1.27, 95% CI 1.00–1.61, p = 0.049), abnormal CSF p-tau levels (OR 1.50, 95% CI 1.19–1.89, p = 0.001), and an A+T+ profile (OR 1.64, 95% CI 1.25–2.20, p = 0.001) and was greater among participants with an A+T+ profile (p < 0.01) at follow-up. Weight change was positively associated with CSF Aβ42/40 ratio (β = 0.099, p = 0.032) and negatively associated with CSF p-tau (β = − 0.141, p = 0.005), t-tau (β = − 0.147 p = 0.004) and neurogranin levels (β = − 0.158, p = 0.002). In stratified analyses, weight loss was significantly associated with higher t-tau, p-tau, neurofilament light, and neurogranin, as well as faster cognitive decline in A+ participants only. Conclusions Weight loss predicts AD CSF and PET biomarker results and may occur downstream to amyloid-β accumulation in preclinical AD, paralleling cognitive decline. Accordingly, it should be considered as an indicator of increased risk of AD-related cognitive impairment. Trial registration NCT01835717, NCT02485730, NCT02685969.
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Affiliation(s)
- Oriol Grau-Rivera
- Barcelonaβeta Brain Research Center (BBRC), Pasqual Maragall Foundation, Barcelona, Spain. .,Servei de Neurologia, Hospital del Mar, Barcelona, Spain. .,IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain. .,Centro de Investigación Biomédica en Red de Fragilidad y Envejecimiento Saludable (CIBERFES), Madrid, Spain.
| | - Irene Navalpotro-Gomez
- Barcelonaβeta Brain Research Center (BBRC), Pasqual Maragall Foundation, Barcelona, Spain.,Servei de Neurologia, Hospital del Mar, Barcelona, Spain.,IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
| | - Gonzalo Sánchez-Benavides
- Barcelonaβeta Brain Research Center (BBRC), Pasqual Maragall Foundation, Barcelona, Spain.,IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain.,Centro de Investigación Biomédica en Red de Fragilidad y Envejecimiento Saludable (CIBERFES), Madrid, Spain
| | - Marc Suárez-Calvet
- Barcelonaβeta Brain Research Center (BBRC), Pasqual Maragall Foundation, Barcelona, Spain.,Servei de Neurologia, Hospital del Mar, Barcelona, Spain.,IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain.,Centro de Investigación Biomédica en Red de Fragilidad y Envejecimiento Saludable (CIBERFES), Madrid, Spain
| | - Marta Milà-Alomà
- Barcelonaβeta Brain Research Center (BBRC), Pasqual Maragall Foundation, Barcelona, Spain.,IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain.,Centro de Investigación Biomédica en Red de Fragilidad y Envejecimiento Saludable (CIBERFES), Madrid, Spain.,Universitat Pompeu Fabra, Barcelona, Spain
| | - Eider M Arenaza-Urquijo
- Barcelonaβeta Brain Research Center (BBRC), Pasqual Maragall Foundation, Barcelona, Spain.,IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain.,Centro de Investigación Biomédica en Red de Fragilidad y Envejecimiento Saludable (CIBERFES), Madrid, Spain
| | - Gemma Salvadó
- Barcelonaβeta Brain Research Center (BBRC), Pasqual Maragall Foundation, Barcelona, Spain.,IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain.,Centro de Investigación Biomédica en Red de Fragilidad y Envejecimiento Saludable (CIBERFES), Madrid, Spain
| | - Aleix Sala-Vila
- Barcelonaβeta Brain Research Center (BBRC), Pasqual Maragall Foundation, Barcelona, Spain.,IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
| | - Mahnaz Shekari
- Barcelonaβeta Brain Research Center (BBRC), Pasqual Maragall Foundation, Barcelona, Spain.,IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain.,Universitat Pompeu Fabra, Barcelona, Spain
| | - José Maria González-de-Echávarri
- Barcelonaβeta Brain Research Center (BBRC), Pasqual Maragall Foundation, Barcelona, Spain.,IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
| | - Carolina Minguillón
- Barcelonaβeta Brain Research Center (BBRC), Pasqual Maragall Foundation, Barcelona, Spain.,IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain.,Centro de Investigación Biomédica en Red de Fragilidad y Envejecimiento Saludable (CIBERFES), Madrid, Spain
| | - Aida Niñerola-Baizán
- Servei de Medicina Nuclear, Hospital Clínic, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN), Madrid, Spain
| | - Andrés Perissinotti
- Servei de Medicina Nuclear, Hospital Clínic, Barcelona, Spain.,Centro de Investigación Biomédica en Red de Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN), Madrid, Spain
| | - Maryline Simon
- Roche Diagnostics International Ltd, Rotkreuz, Switzerland
| | | | - Henrik Zetterberg
- Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden.,UK Dementia Research Institute at UCL, London, UK.,Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, University of Gothenburg, Mölndal, Sweden.,Department of Neurodegenerative Disease, UCL Queen Square Institute of Neurology, London, UK
| | - Kaj Blennow
- Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, Mölndal, Sweden.,Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, University of Gothenburg, Mölndal, Sweden
| | - Juan Domingo Gispert
- Barcelonaβeta Brain Research Center (BBRC), Pasqual Maragall Foundation, Barcelona, Spain.,IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain.,Centro de Investigación Biomédica en Red de Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN), Madrid, Spain
| | - José Luis Molinuevo
- Barcelonaβeta Brain Research Center (BBRC), Pasqual Maragall Foundation, Barcelona, Spain. .,Current affiliation: H. Lundbeck A/S, Copenhagen, Denmark.
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Floud S, Balkwill A, Sweetland S, Brown A, Reus EM, Hofman A, Blacker D, Kivimaki M, Green J, Peto R, Reeves GK, Beral V. Cognitive and social activities and long-term dementia risk: the prospective UK Million Women Study. Lancet Public Health 2021; 6:e116-e123. [PMID: 33516288 PMCID: PMC7848753 DOI: 10.1016/s2468-2667(20)30284-x] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Revised: 11/20/2020] [Accepted: 11/25/2020] [Indexed: 02/09/2023]
Abstract
BACKGROUND Although dementia is associated with non-participation in cognitive and social activities, this association might merely reflect the consequences of dementia, rather than any direct effect of non-participation on the subsequent incidence of dementia. Because of the slowness with which dementia can develop, unbiased assessment of any such direct effects must relate non-participation in such activities to dementia detection rates many years later. Prospective studies with long-term follow-up can help achieve this by analysing separately the first and second decade of follow-up. We report such analyses of a large, 20-year study. METHODS The UK Million Women Study is a population-based prospective study of 1·3 million women invited for National Health Service (NHS) breast cancer screening in median year 1998 (IQR 1997-1999). In median year 2001 (IQR 2001-2003), women were asked about participation in adult education, groups for art, craft, or music, and voluntary work, and in median year 2006 (IQR 2006-2006), they were asked about reading. All participants were followed up through electronic linkage to NHS records of hospital admission with mention of dementia, the first mention of which was the main outcome. Comparing non-participation with participation in a particular activity, we used Cox regression to assess fully adjusted dementia risk ratios (RRs) during 0-4, 5-9, and 10 or more years, after information on that activity was obtained. FINDINGS In 2001, 851 307 women with a mean age of 60 years (SD 5) provided information on participation in adult education, groups for art, craft, or music, and voluntary work. After 10 years, only 9591 (1%) had been lost to follow-up and 789 339 (93%) remained alive with no recorded dementia. Follow-up was for a mean of 16 years (SD 3), during which 31 187 (4%) had at least one hospital admission with mention of dementia, including 25 636 (3%) with a hospital admission with dementia mentioned for the first time 10 years or more after follow-up began. Non-participation in cognitive or social activities was associated with higher relative risks of dementia detection only during the first decade after participation was recorded. During the second decade, there was little association. This was true for non-participation in adult education (RR 1·04, 99% CI 0·98-1·09), in groups for art, craft, or music (RR 1·04, 0·99-1·09), in voluntary work (RR 0·96, 0·92-1·00), or in any of these three (RR 0·99, 0·95-1·03). In 2006, 655 118 women provided information on reading. For non-reading versus any reading, there were similar associations with dementia, again with strong attenuation over time since reading was recorded, but longer follow-up is needed to assess this reliably. INTERPRETATION Life has to be lived forwards, but can be understood only backwards. Long before dementia is diagnosed, there is a progressive reduction in various mental and physical activities, but this is chiefly because its gradual onset causes inactivity and not because inactivity causes dementia. FUNDING UK Medical Research Council, Cancer Research UK.
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Affiliation(s)
- Sarah Floud
- Cancer Epidemiology Unit, University of Oxford, Oxford, UK.
| | | | - Siân Sweetland
- Cancer Epidemiology Unit, University of Oxford, Oxford, UK
| | - Anna Brown
- Cancer Epidemiology Unit, University of Oxford, Oxford, UK
| | | | - Albert Hofman
- Department of Epidemiology, Harvard T H Chan School of Public Health, Boston, MA, USA
| | - Deborah Blacker
- Department of Epidemiology, Harvard T H Chan School of Public Health, Boston, MA, USA; Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Mika Kivimaki
- Department of Epidemiology and Public Health, University College London, London, UK
| | - Jane Green
- Cancer Epidemiology Unit, University of Oxford, Oxford, UK
| | - Richard Peto
- Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | | | - Valerie Beral
- Cancer Epidemiology Unit, University of Oxford, Oxford, UK
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Stickel AM, Tarraf W, Gonzalez KA, Isasi CR, Kaplan R, Gallo LC, Zeng D, Cai J, Pirzada A, Daviglus ML, Goodman ZT, Schneiderman N, González HM. Central Obesity, Cardiometabolic Risk, and Cognitive Change in the Study of Latinos - Investigation of Neurocognitive Aging. J Alzheimers Dis 2021; 82:1203-1218. [PMID: 34151803 PMCID: PMC10792520 DOI: 10.3233/jad-210314] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND The relationships between obesity and cognitive decline in aging are mixed and understudied among Hispanics/Latinos. OBJECTIVE To understand associations between central obesity, cognitive aging, and the role of concomitant cardiometabolic abnormalities among Hispanics/Latinos. METHODS Participants included 6,377 diverse Hispanics/Latinos enrolled in the Hispanic Community Health Study/Study of Latinos (HCHS/SOL) and SOL-Investigation for Neurocognitive Aging (SOL-INCA). Participants were 45 years and older at the first cognitive testing session (Visit 1). Cognitive outcomes (z-score units) included global composite and domain specific (learning, memory, executive functioning, processing speed) measures at a second visit (SOL-INCA, on average, 7 years later), and 7-year change. We used survey linear regression to examine associations between central obesity (waist circumference≥88 cm and≥102 cm for women and men, respectively) and cognition. We also tested whether the relationships between obesity and cognition differed by cardiometabolic status (indication of/treatment for 2 + of the following: high triglycerides, hypertension, hyperglycemia, low high-density lipoprotein cholesterol). RESULTS Central obesity was largely unassociated with cognitive outcomes, adjusting for covariates. However, among individuals with central obesity, cardiometabolic abnormality was linked to poorer cognitive function at SOL-INCA (ΔGlobalCognition =-0.165, p < 0.001) and to more pronounced cognitive declines over the average 7 years (ΔGlobalCognition = -0.109, p < 0.05); this was consistent across cognitive domains. CONCLUSION Central obesity alone was not associated with cognitive function. However, presence of both central obesity and cardiometabolic abnormalities was robustly predictive of cognition and 7-year cognitive declines, suggesting that in combination these factors may alter the cognitive trajectories of middle-aged and older Hispanics/Latinos.
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Affiliation(s)
- Ariana M. Stickel
- Department of Neurosciences and Shiley-Marcos Alzheimer’s Disease Research Center, University of California, San Diego, La Jolla, CA
| | - Wassim Tarraf
- Institute of Gerontology & Department of Healthcare Sciences, Wayne State University, Detroit, Michigan
| | - Kevin A. Gonzalez
- Department of Neurosciences and Shiley-Marcos Alzheimer’s Disease Research Center, University of California, San Diego, La Jolla, CA
| | - Carmen R. Isasi
- Department of Epidemiology & Population Health, Albert Einstein College of Medicine
| | - Robert Kaplan
- Department of Epidemiology & Population Health, Albert Einstein College of Medicine
| | - Linda C. Gallo
- Department of Psychology, San Diego State University, San Diego, CA
| | - Donglin Zeng
- Department of Biostatistics, University of North Carolina, Chapel Hill, NC
| | - Jianwen Cai
- Department of Biostatistics, University of North Carolina, Chapel Hill, NC
| | - Amber Pirzada
- Institute for Minority Health Research, University of Illinois at Chicago, College of Medicine, Chicago, IL
| | - Martha L. Daviglus
- Institute for Minority Health Research, University of Illinois at Chicago, College of Medicine, Chicago, IL
| | | | | | - Hector M. González
- Department of Neurosciences and Shiley-Marcos Alzheimer’s Disease Research Center, University of California, San Diego, La Jolla, CA
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Delli Pizzi S, Granzotto A, Bomba M, Frazzini V, Onofrj M, Sensi SL. Acting Before; A Combined Strategy to Counteract the Onset and Progression of Dementia. Curr Alzheimer Res 2020; 17:790-804. [PMID: 33272186 DOI: 10.2174/1567205017666201203085524] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2019] [Revised: 09/10/2020] [Accepted: 10/16/2020] [Indexed: 11/22/2022]
Abstract
Brain aging and aging-related neurodegenerative disorders are posing a significant challenge for health systems worldwide. To date, most of the therapeutic efforts aimed at counteracting dementiarelated behavioral and cognitive impairment have been focused on addressing putative determinants of the disease, such as β-amyloid or tau. In contrast, relatively little attention has been paid to pharmacological interventions aimed at restoring or promoting the synaptic plasticity of the aging brain. The review will explore and discuss the most recent molecular, structural/functional, and behavioral evidence that supports the use of non-pharmacological approaches as well as cognitive-enhancing drugs to counteract brain aging and early-stage dementia.
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Affiliation(s)
- Stefano Delli Pizzi
- Behavioral Neurology and Molecular Neurology Units, Center for Advanced Studies and Technology, CAST, University G. d'Annunzio of Chieti-Pescara, Pescara, Italy
| | - Alberto Granzotto
- Behavioral Neurology and Molecular Neurology Units, Center for Advanced Studies and Technology, CAST, University G. d'Annunzio of Chieti-Pescara, Pescara, Italy
| | - Manuela Bomba
- Behavioral Neurology and Molecular Neurology Units, Center for Advanced Studies and Technology, CAST, University G. d'Annunzio of Chieti-Pescara, Pescara, Italy
| | - Valerio Frazzini
- AP-HP, Epilepsy Unit, Pitie-Salpetriere Hospital and Brain and Spine Institute (INSERM UMRS1127, CNRS UMR7225, Sorbonne Universite), Pitie-Salpetriere Hospital, Paris, France
| | - Marco Onofrj
- Behavioral Neurology and Molecular Neurology Units, Center for Advanced Studies and Technology, CAST, University G. d'Annunzio of Chieti-Pescara, Pescara, Italy
| | - Stefano L Sensi
- Behavioral Neurology and Molecular Neurology Units, Center for Advanced Studies and Technology, CAST, University G. d'Annunzio of Chieti-Pescara, Pescara, Italy
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Calvin CM, de Boer C, Raymont V, Gallacher J, Koychev I. Prediction of Alzheimer's disease biomarker status defined by the 'ATN framework' among cognitively healthy individuals: results from the EPAD longitudinal cohort study. Alzheimers Res Ther 2020; 12:143. [PMID: 33168064 PMCID: PMC7650169 DOI: 10.1186/s13195-020-00711-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Accepted: 10/20/2020] [Indexed: 12/30/2022]
Abstract
BACKGROUND The Amyloid/Tau/Neurodegeneration (ATN) framework has been proposed as a means of evidencing the biological state of Alzheimer's disease (AD). Predicting ATN status in pre-dementia individuals therefore provides an important opportunity for targeted recruitment into AD interventional studies. We investigated the extent to which ATN-defined biomarker status can be predicted by known AD risk factors as well as vascular-related composite risk scores. METHODS One thousand ten cognitively healthy older adults were allocated to one of five ATN-defined biomarker categories. Multinomial logistic regression tested risk factors including age, sex, education, APOE4, family history of dementia, cognitive function, vascular risk indices (high systolic blood pressure, body mass index (BMI), high cholesterol, physical inactivity, ever smoked, blood pressure medication, diabetes, prior cardiovascular disease, atrial fibrillation and white matter lesion (WML) volume), and three vascular-related composite scores, to predict five ATN subgroups; ROC curve models estimated their added value in predicting pathology. RESULTS Age, APOE4, family history, BMI, MMSE and white matter lesions (WML) volume differed between ATN biomarker groups. Prediction of Alzheimer's disease pathology (versus normal AD biomarkers) improved by 7% after adding family history, BMI, MMSE and WML to a ROC curve that included age, sex and APOE4. Risk composite scores did not add value. CONCLUSIONS ATN-defined Alzheimer's disease biomarker status prediction among cognitively healthy individuals is possible through a combination of constitutional and cardiovascular risk factors but established dementia composite risk scores do not appear to add value in this context.
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Affiliation(s)
- Catherine M. Calvin
- grid.4991.50000 0004 1936 8948Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford, OX3 7JX UK
| | - Casper de Boer
- Alzheimer Center Amsterdam, Amsterdam UMC, Amsterdam, Netherlands
| | - Vanessa Raymont
- grid.4991.50000 0004 1936 8948Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford, OX3 7JX UK
| | - John Gallacher
- grid.4991.50000 0004 1936 8948Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford, OX3 7JX UK
| | - Ivan Koychev
- grid.4991.50000 0004 1936 8948Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford, OX3 7JX UK
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Abstract
Life expectancy in most developed countries has been rising over the past century. In the UK alone, there are about 12 million people over 65 years old and centenarians have increased by 85% in the past 15 years. As a result of the ageing population, which is due mainly to improvements in medical treatments, public health, improved housing and lifestyle choices, there is an associated increase in the prevalence of pathological conditions, such as metabolic disorders, type 2 diabetes, cardiovascular and neurodegenerative diseases, many types of cancer and others. Statistics suggest that nearly 54% of elderly people in the UK live with at least two chronic conditions, revealing the urgency for identifying interventions that can prevent and/or treat such disorders. Non-pharmacological, dietary interventions such as energetic restriction (ER) and methionine restriction (MR) have revealed promising outcomes in increasing longevity and preventing and/or reversing the development of ageing-associated disorders. In this review, we discuss the evidence and mechanisms that are involved in these processes. Fibroblast growth factor 1 and hydrogen sulphide are important molecules involved in the effects of ER and MR in the extension of life span. Their role is also associated with the prevention of metabolic and cognitive disorders, highlighting these interventions as promising modulators for improvement of health span.
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Fu J, Liu Q, Du Y, Zhu Y, Sun C, Lin H, Jin M, Ma F, Li W, Liu H, Zhang X, Chen Y, Sun Z, Wang G, Huang G. Age- and Sex-Specific Prevalence and Modifiable Risk Factors of Mild Cognitive Impairment Among Older Adults in China: A Population-Based Observational Study. Front Aging Neurosci 2020; 12:578742. [PMID: 33192471 PMCID: PMC7662098 DOI: 10.3389/fnagi.2020.578742] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2020] [Accepted: 09/23/2020] [Indexed: 12/11/2022] Open
Abstract
Background Minimal data are available on the prevalence of mild cognitive impairment (MCI) in older Chinese adults. Moreover, the current information on MCI shows important geographical variations. Objective We aimed to assess the prevalence and risk factors for MCI by age and sex among older adults in a North Chinese population. Methods In this population-based cross-sectional study, we enrolled a random sample of 4,943 adults aged ≥ 60 years between March 2018 and June 2019 in Tianjin, China. Of these, 312 individuals were excluded due to a lack of data (e.g., fasting blood test). As a result, 4,631 subjects were assessed. Individuals with MCI were identified using neuropsychological assessments, including the Mini-Mental State Examination and Activities of Daily Living scale, based on a modified version of the Petersen’s criteria. Results The mean (SD) age of the 4,631 participants was 67.6 (4.89) years, and 2,579 (55.7%) were female. The overall age- and sex-standardized prevalence of MCI in our study population was 10.7%. There were significant associations of MCI with age [65–69 vs. 60–64 years, OR = 0.74; 95% confidence interval (CI): 0.58, 0.96], physical activity (≥23.0 vs. <23.0 MET-hours/week, OR = 0.79; 95% CI: 0.64, 0.96), body mass index (BMI) (OR = 0.92; 95% CI: 0.89, 0.95), grip strength (OR = 0.50; 95% CI: 0.38, 0.67), hypertension (yes vs. no, OR = 1.44; 95% CI: 1.18, 1.77), higher levels of sleepiness (OR = 1.80; 95% CI: 1.36, 2.37), and longer sleep duration (OR = 1.40; 95% CI: 1.14, 1.72). The inverse association between BMI and MCI was stronger in older age groups (P for heterogeneity = 0.003). Moreover, the magnitude of association between triglycerides and MCI was different between the sexes (P for heterogeneity = 0.029). Conclusion The age- and sex-standardized prevalence of MCI was 10.7% in the study sample. Physical activity, BMI, grip strength, sleepiness, sleep duration, and hypertension were associated with the prevalence of MCI. Additionally, triglycerides and BMI might be differently associated with the presence of MCI for different sexes and age stages, respectively.
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Affiliation(s)
- Jingzhu Fu
- Department of Nutrition and Food Science, School of Public Health, Tianjin Medical University, Tianjin, China.,Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin, China
| | - Qian Liu
- Department of Nutrition and Food Science, School of Public Health, Tianjin Medical University, Tianjin, China.,Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin, China
| | - Yue Du
- Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin, China.,Department of Social Medicine and Health Management, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Yun Zhu
- Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin, China.,Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Changqing Sun
- Neurosurgical Department of Baodi Clinical College of Tianjin Medical University, Tianjin, China
| | - Hongyan Lin
- Department of Nutrition and Food Science, School of Public Health, Tianjin Medical University, Tianjin, China.,Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin, China
| | - Mengdi Jin
- Department of Nutrition and Food Science, School of Public Health, Tianjin Medical University, Tianjin, China.,Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin, China
| | - Fei Ma
- Department of Nutrition and Food Science, School of Public Health, Tianjin Medical University, Tianjin, China.,Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin, China
| | - Wen Li
- Department of Nutrition and Food Science, School of Public Health, Tianjin Medical University, Tianjin, China.,Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin, China
| | - Huan Liu
- Department of Nutrition and Food Science, School of Public Health, Tianjin Medical University, Tianjin, China.,Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin, China
| | - Xumei Zhang
- Department of Nutrition and Food Science, School of Public Health, Tianjin Medical University, Tianjin, China.,Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin, China
| | - Yongjie Chen
- Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin, China.,Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Zhuoyu Sun
- Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin, China.,Department of Epidemiology and Biostatistics, School of Public Health, Tianjin Medical University, Tianjin, China
| | - Guangshun Wang
- Department of Tumor, Baodi Clinical College of Tianjin Medical University, Tianjin, China
| | - Guowei Huang
- Department of Nutrition and Food Science, School of Public Health, Tianjin Medical University, Tianjin, China.,Tianjin Key Laboratory of Environment, Nutrition and Public Health, Tianjin, China
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Association of Late Life Depression, (Non-) Modifiable Risk and Protective Factors with Dementia and Alzheimer's Disease: Literature Review on Current Evidences, Preventive Interventions and Possible Future Trends in Prevention and Treatment of Dementia. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17207475. [PMID: 33066592 PMCID: PMC7602449 DOI: 10.3390/ijerph17207475] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Revised: 10/04/2020] [Accepted: 10/06/2020] [Indexed: 02/07/2023]
Abstract
The number of people living with dementia and Alzheimer’s disease is growing rapidly, making dementia one of the biggest challenges for this century. Many studies have indicated that depression plays an important role in development of dementia, including Alzheimer’s disease; depression, especially, during the late life may either increase the risk of dementia or even being its prodromal stage. Despite a notably large number of carried observational studies and/or clinical trials, the association between the late life depression and dementia remains, due to the complexity of their relationship, still unclear. Moreover, during past two decades multiple other (non-)modifiable risk and possibly protective factors such as the hypertension, social engagement, obesity, level of education or physical (in)activity have been identified and their relationship with the risk for development of dementia and Alzheimer’s disease has been extensively studied. It has been proposed that to understand mechanisms of dementia and Alzheimer’s disease pathogeneses require their multifactorial nature represented by these multiple factors to be considered. In this review, we first summarize the recent literature findings on roles of the late life depression and the other known (non-)modifiable risk and possibly protective factors in development of dementia and Alzheimer’s disease. Then, we provide evidences supporting hypotheses that (i) depressive syndromes in late life may indicate the prodromal stage of dementia (Alzheimer’s disease) and, (ii) the interplay among the multiple (non-)modifiable risk and protective factors should be considered to gain a better understanding of dementia and Alzheimer’s disease pathogeneses. We also discuss the evidences of recently established interventions considered to prevent or delay the prodromes of dementia and provide the prospective future directions in prevention and treatment of dementia and Alzheimer’s disease using both the single-domain and multidomain interventions.
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Baumeister SE, Karch A, Bahls M, Teumer A, Leitzmann MF, Baurecht H. Physical activity and risk of Alzheimer disease: A 2-sample mendelian randomization study. Neurology 2020; 95:e1897-e1905. [PMID: 32680943 PMCID: PMC7963349 DOI: 10.1212/wnl.0000000000010013] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2019] [Accepted: 04/10/2020] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE Evidence from observational studies for the effect of physical activity on the risk of Alzheimer disease (AD) is inconclusive. We performed a 2-sample mendelian randomization analysis to examine whether physical activity is protective for AD. METHODS Summary data of genome-wide association studies on physical activity and AD were used. The primary study population included 21,982 patients with AD and 41,944 cognitively normal controls. Eight single nucleotide polymorphisms (SNPs) known at p < 5 × 10-8 to be associated with average accelerations and 8 SNPs associated at p < 5 × 10-7 with vigorous physical activity (fraction of accelerations >425 milligravities) served as instrumental variables. RESULTS There was no association between genetically predicted average accelerations with the risk of AD (inverse variance weighted odds ratio [OR] per SD increment: 1.03, 95% confidence interval 0.97-1.10, p = 0.332). Genetic liability for fraction of accelerations >425 milligravities was unrelated to AD risk. CONCLUSION The present study does not support a causal association between physical activity and risk of AD.
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Affiliation(s)
- Sebastian E Baumeister
- From Epidemiology (S.E.B.), LMU München, UNIKA-T Augsburg; Independent Research Group, Clinical Epidemiology (S.E.B.), Helmholtz Zentrum München, German Research Center for Environmental Health, Munich; Institute of Epidemiology and Social Medicine (A.K.), University of Münster; Department of Internal Medicine B (M.B.) and Institute for Community Medicine (A.T.), University Medicine Greifswald; DZHK (German Centre for Cardiovascular Research) (M.B., A.T.), Partner Site Greifswald; and Department of Epidemiology and Preventive Medicine (M.F.L., H.B.), University of Regensburg, Germany.
| | - André Karch
- From Epidemiology (S.E.B.), LMU München, UNIKA-T Augsburg; Independent Research Group, Clinical Epidemiology (S.E.B.), Helmholtz Zentrum München, German Research Center for Environmental Health, Munich; Institute of Epidemiology and Social Medicine (A.K.), University of Münster; Department of Internal Medicine B (M.B.) and Institute for Community Medicine (A.T.), University Medicine Greifswald; DZHK (German Centre for Cardiovascular Research) (M.B., A.T.), Partner Site Greifswald; and Department of Epidemiology and Preventive Medicine (M.F.L., H.B.), University of Regensburg, Germany
| | - Martin Bahls
- From Epidemiology (S.E.B.), LMU München, UNIKA-T Augsburg; Independent Research Group, Clinical Epidemiology (S.E.B.), Helmholtz Zentrum München, German Research Center for Environmental Health, Munich; Institute of Epidemiology and Social Medicine (A.K.), University of Münster; Department of Internal Medicine B (M.B.) and Institute for Community Medicine (A.T.), University Medicine Greifswald; DZHK (German Centre for Cardiovascular Research) (M.B., A.T.), Partner Site Greifswald; and Department of Epidemiology and Preventive Medicine (M.F.L., H.B.), University of Regensburg, Germany
| | - Alexander Teumer
- From Epidemiology (S.E.B.), LMU München, UNIKA-T Augsburg; Independent Research Group, Clinical Epidemiology (S.E.B.), Helmholtz Zentrum München, German Research Center for Environmental Health, Munich; Institute of Epidemiology and Social Medicine (A.K.), University of Münster; Department of Internal Medicine B (M.B.) and Institute for Community Medicine (A.T.), University Medicine Greifswald; DZHK (German Centre for Cardiovascular Research) (M.B., A.T.), Partner Site Greifswald; and Department of Epidemiology and Preventive Medicine (M.F.L., H.B.), University of Regensburg, Germany
| | - Michael F Leitzmann
- From Epidemiology (S.E.B.), LMU München, UNIKA-T Augsburg; Independent Research Group, Clinical Epidemiology (S.E.B.), Helmholtz Zentrum München, German Research Center for Environmental Health, Munich; Institute of Epidemiology and Social Medicine (A.K.), University of Münster; Department of Internal Medicine B (M.B.) and Institute for Community Medicine (A.T.), University Medicine Greifswald; DZHK (German Centre for Cardiovascular Research) (M.B., A.T.), Partner Site Greifswald; and Department of Epidemiology and Preventive Medicine (M.F.L., H.B.), University of Regensburg, Germany
| | - Hansjörg Baurecht
- From Epidemiology (S.E.B.), LMU München, UNIKA-T Augsburg; Independent Research Group, Clinical Epidemiology (S.E.B.), Helmholtz Zentrum München, German Research Center for Environmental Health, Munich; Institute of Epidemiology and Social Medicine (A.K.), University of Münster; Department of Internal Medicine B (M.B.) and Institute for Community Medicine (A.T.), University Medicine Greifswald; DZHK (German Centre for Cardiovascular Research) (M.B., A.T.), Partner Site Greifswald; and Department of Epidemiology and Preventive Medicine (M.F.L., H.B.), University of Regensburg, Germany
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Beydoun MA, Kivimaki M. Midlife obesity, related behavioral factors, and the risk of dementia in later life. Neurology 2020; 94:53-54. [PMID: 31852812 DOI: 10.1212/wnl.0000000000008775] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
- May A Beydoun
- From the Laboratory of Epidemiology and Population Sciences (M.A.B.), National Institute on Aging, NIA/NIH/IRP, Baltimore, MD; and Department of Epidemiology and Public Health (M.K.), University College London, UK.
| | - Mika Kivimaki
- From the Laboratory of Epidemiology and Population Sciences (M.A.B.), National Institute on Aging, NIA/NIH/IRP, Baltimore, MD; and Department of Epidemiology and Public Health (M.K.), University College London, UK
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