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Chang HT, Chan PC, Chiu PY. Non-linear relationship between serum cholesterol levels and cognitive change among older people in the preclinical and prodromal stages of dementia: a retrospective longitudinal study in Taiwan. BMC Geriatr 2024; 24:474. [PMID: 38816835 PMCID: PMC11138028 DOI: 10.1186/s12877-024-05030-0] [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: 01/31/2024] [Accepted: 04/30/2024] [Indexed: 06/01/2024] Open
Abstract
BACKGROUND Adverse effects of rigorously lowering low-density lipoprotein cholesterol on cognition have been reported; therefore, we aimed to study the contribution of serum cholesterol in cognitive decline in older people with or without dementia. METHODS Cognitive function was assessed by the Cognitive Abilities Screening Instrument (CASI). We investigated associations between serum cholesterol with cognitive decline using multiple regressions controlling for the effects of demographics, vascular risk factors, and treatments. RESULTS Most associations between cholesterol and CASI scores could be explained by non-linear and inverted U-shaped relationships (R2 = 0.003-0.006, p < 0.016, Šidákcorrection). The relationships were most evident between changes in cholesterol and CASI scores in older people at the preclinical or prodromal stages of dementia (R2 = 0.02-0.064, p values < 0.016). There were no differences in level of changes in CASI scores between individuals in 1st decile and 10th decile groups of changes in cholesterol (p = 0.266-0.972). However, individuals in the 1st decile of triglyceride changes and with stable and normal cognitive functions showed significant improvement in CASI scores compared to those in the 10th decile (t(202) = 2.275, p values < 0.05). CONCLUSION These findings could implicate that rigorously lowering cholesterol may not be suitable for the prevention of cognitive decline among older people, especially among individuals in preclinical or prodromal stages of dementia.
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Affiliation(s)
- Hsin-Te Chang
- Department of Psychology, College of Science, Chung Yuan Christian University, Taoyuan, Taiwan
- Research Assistant Center, Show Chwan Memorial Hospital, Changhua City, Changhua, Taiwan
| | - Po-Chi Chan
- Department of Neurology, Show Chwan Memorial Hospital, Changhua City, Changhua, Taiwan
| | - Pai-Yi Chiu
- Department of Neurology, Show Chwan Memorial Hospital, Changhua City, Changhua, Taiwan.
- Department of Applied Mathematics, College of Science, Tunghai University, Taichung, Taiwan.
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2
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Sartorio A, Dal Pont C, Romano S. Standard and New Echocardio Techniques, Such as Global Longitudinal Strain, to Monitor the Impact of Diets on Cardiovascular Diseases and Heart Function. Nutrients 2024; 16:1471. [PMID: 38794710 PMCID: PMC11124322 DOI: 10.3390/nu16101471] [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: 03/04/2024] [Revised: 04/29/2024] [Accepted: 05/10/2024] [Indexed: 05/26/2024] Open
Abstract
"The Seven Countries Study", published in 1984, was the first study to find a correlation between diet and mortality related to cardiovascular diseases (CVDs). Since then, many investigations have addressed the relationship between type of diet, or specific nutrients, and CVDs. Based on these findings, some traditional dietary models, such as the Mediterranean or Nordic diet, are recommended to prevent CVDs. Meanwhile, new diets have been proposed for optimal nutrition therapy, for example, the Dietary Approaches to Stop Hypertension (DASH) and the Mediterranean-DASH Intervention Diet for Neurodegenerative Delay (MIND). The main outcomes evaluated after implementing these dietary models are as follows: CVD-related death; the development of specific CVDs, such as myocardial infarction and hypertension; or biochemical parameters related to CVDs, i.e., non-HDL cholesterol, C-reactive protein (CPR) and homocysteine. However, the early impact of diet on heart functionality is less evaluated. Recently, the echographic measurement of left ventricle (LV) deformation by global longitudinal strain (GLS) has been introduced as a novel marker of clinical and subclinical cardiac dysfunction. This technology allows a subclinical evaluation of heart functionality since, differently from the traditional evaluation of left ventricle ejection fraction (LVEF), it is capable of detecting early myocardial dysfunction. In this review, we analyzed the available studies that correlate dietetic regimens to cardiovascular diseases, focusing on the relevance of LV strain to detect subclinical myocardial alteration related to diet. Evidence is presented that DASH and MIND can have a positive impact on heart functionality and that myocardial strain is useful for early detection of diet-related changes in cardiac function.
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Affiliation(s)
| | | | - Simone Romano
- Division of Internal Medicine C, Department of Internal Medicine, University of Verona, 37134 Verona, Italy; (A.S.); (C.D.P.)
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3
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Márquez F, Tarraf W, Stickel AM, González KA, Testai FD, Cai J, Gallo LC, Talavera GA, Daviglus ML, Wassertheil-Smoller S, DeCarli C, Schneiderman N, González HM. Hypertension, Cognitive Decline, and Mild Cognitive Impairment Among Diverse Hispanics/Latinos: Study of Latinos-Investigation of Neurocognitive Aging Results (SOL-INCA). J Alzheimers Dis 2024; 97:1449-1461. [PMID: 38250769 DOI: 10.3233/jad-230424] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2024]
Abstract
BACKGROUND Hypertension can have deleterious effects on cognitive function; however, few studies have examined its effects on cognition among Hispanics/Latinos. OBJECTIVE To assess associations between hypertension status with 1) change in cognitive performance, and 2) having mild cognitive impairment (MCI) among diverse Hispanics/Latinos. METHODS This population-based, prospective cohort, multisite study included Hispanic/Latino adults aged 45 to 72 years in enrolled in the Hispanic Community Health Study/Study of Latinos at Visit 1 (2008-2011; mean age of 63.40±8.24 years), and the Study of Latinos-Investigation of Neurocognitive Aging at Visit 2 (2016-2018), with a mean follow-up duration of 7 years (n = 6,173). Hypertension status was assessed at both visits: normotension (no hypertension), incident hypertension (only at Visit 2), and persistent hypertension (at both visits). We examined change in cognitive performance and having MCI (only assessed at Visit 2) relative to hypertension status and adjusted for demographics and cardiovascular disease risk factors. RESULTS Compared to normotension, persistent hypertension was associated with significantly increased decline in verbal fluency (β= -0.08; CI = [-0.16;-0.01]; p < 0.05), and processing speed (β= -0.11; CI = [-0.20;-0.02]; p < 0.05). Incident hypertension was not associated with significant change in cognitive performance. Both incident (OR = 1.70; CI = [1.16;2.50]; p < 0.01) and persistent hypertension (OR = 2.13; CI = [1.57;2.88]; p < 0.001) were associated with significantly higher odds ratios of having MCI. CONCLUSIONS These findings indicate that persistent hypertension is associated with clinical impairment and domain-specific cognitive decline in middle-aged and older Hispanics/Latinos. It underscores the importance of monitoring blood pressure in routine healthcare visits beginning at midlife in this population to reduce the burden of cognitive decline.
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Affiliation(s)
- Freddie Márquez
- Department of Neurosciences and the Shiley-Marcos Alzheimer's Disease Research Center, UC San Diego, San Diego, CA, USA
| | - Wassim Tarraf
- Institute of Gerontology & Department of Healthcare Sciences, Wayne State University, Detroit, MI, USA
| | - Ariana M Stickel
- Department of Neurosciences and the Shiley-Marcos Alzheimer's Disease Research Center, UC San Diego, San Diego, CA, USA
- Department of Psychology, San Diego State University, San Diego, CA, USA
| | - Kevin A González
- Department of Neurosciences and the Shiley-Marcos Alzheimer's Disease Research Center, UC San Diego, San Diego, CA, USA
| | - Fernando D Testai
- Department of Neurology and Rehabilitation, University of Illinois at Chicago, College of Medicine, Chicago, IL, USA
| | - Jianwen Cai
- Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA
| | - Linda C Gallo
- Department of Psychology, San Diego State University, San Diego, CA, USA
| | - Gregory A Talavera
- Department of Psychology, San Diego State University, San Diego, CA, USA
| | - Martha L Daviglus
- Institute for Minority Health Research, University of Illinois at Chicago, College of Medicine, Chicago, IL, USA
| | - Sylvia Wassertheil-Smoller
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine, New York, NY, USA
| | - Charles DeCarli
- Department of Neurology and Alzheimer's Disease Center, UC Davis, Sacramento, CA, USA
| | | | - Hector M González
- Department of Neurosciences and the Shiley-Marcos Alzheimer's Disease Research Center, UC San Diego, San Diego, CA, USA
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4
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Zúñiga Salazar G, Zúñiga D, Balasubramanian S, Mehmood KT, Al-Baldawi S. The Relation Between Arterial Hypertension and Cognitive Impairment: A Literature Review. Cureus 2024; 16:e52782. [PMID: 38389623 PMCID: PMC10882260 DOI: 10.7759/cureus.52782] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/22/2024] [Indexed: 02/24/2024] Open
Abstract
The global increase in dementia cases, driven by improved life expectancy and reduced elderly mortality rates, presents a significant public health challenge. Dementia, characterized by a gradual and irreversible decline in cognitive abilities, affects individuals aged 65 and older, disrupting lives and straining healthcare systems. Hypertension significantly influences dementia development. Research consistently links midlife hypertension to cognitive decline, mild cognitive impairment (MCI), and dementia, but findings in older adults vary. While some studies suggest that late-life hypertension accelerates cognitive decline and dementia risk, others propose a protective effect. The impact of hypertension on cognition varies across age groups, spanning from childhood to late life. High blood pressure during midlife and earlier life stages consistently predicts poorer cognitive outcomes. Executive function, attention, and motor speed are the cognitive domains most affected by hypertension, particularly in subcortical diseases. Memory impairments in hypertension-related dementias are complex, often overlapping with other causes. Understanding the inconsistent findings in older adults regarding hypertension, cognitive decline, and dementia risk requires comprehensive exploration of methodological and biological factors. Addressing hypertension and its management may hold the key to reducing the risk of cognitive decline and dementia, especially in midlife and earlier life stages.
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Affiliation(s)
| | - Diego Zúñiga
- Medicine, Universidad Católica de Santiago de Guayaquil, Guayaquil, ECU
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5
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Gong F, Shi Q, Mou X, Wang K, Wang Q, Wang H. Atorvastatin mitigates memory deficits and brain monocyte infiltration in chronic hypercholesterolemia. Aging (Albany NY) 2023; 15:13669-13679. [PMID: 38048213 PMCID: PMC10756112 DOI: 10.18632/aging.205217] [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: 04/21/2023] [Accepted: 09/08/2023] [Indexed: 12/06/2023]
Abstract
Mild cognitive impairment (MCI) is a common symptom observed in people over 60 years old and is found to be aggravated by hypercholesterolemia. Severe neuroinflammation induced by BBB dysfunction and monocyte infiltration might be responsible for neuron damage and cognitive impairment. Atorvastatin is a lipid-lowering drug that is widely applied for the treatment of cardiovascular diseases. However, the potential function of Atorvastatin in hypercholesterolemia-induced MCI remains uncertain. Our research will explore the potential therapeutic function of Atorvastatin in memory deficits induced by chronic hypercholesterolemia. ApoE-/- mice were utilized to mimic the state of chronic hypercholesterolemia and were divided into four groups. Animals in the WT and ApoE-/-groups were orally administered with normal saline, while WT mice in the Atorvastatin group and ApoE-/- mice in the ApoE-/-+ Atorvastatin group were orally administered with 10 mg/kg/day Atorvastatin. Markedly increased plasma cholesterol levels reduced RI in the long-term memory test and the spatial short-term memory test, declined mobility in the open field test, and downregulated PSD-95 and BDNF were observed in ApoE-/- mice, all of which were signally reversed by Atorvastatin. Moreover, the percentages of brain Ly6Chi CD45+ cells and CD3+ CD45+ cells, as well as the blood Ly6Chi CD45+ cells, plasma IL-12/IL-23 levels and IL-17 level were found notably increased in ApoE-/- mice, all of which were largely repressed by Atorvastatin. Lastly, the increased BBB permeability, decreased ZO-1 and occludin levels, and reduced KLF2 level were markedly abolished by Atorvastatin. Collectively, Atorvastatin mitigated memory deficits and brain monocyte infiltration in ApoE-/- mice.
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Affiliation(s)
- Fengchao Gong
- Department of Neurology, The Second Affiliated Hospital of Shandong First Medical University, Tai'an 271000, Shandong, China
| | - Qian Shi
- Department of Ultrasound, The Second Affiliated Hospital of Shandong First Medical University, Tai'an 271000, Shandong, China
| | - Xiaojie Mou
- Department of Neurology, The Second Affiliated Hospital of Shandong First Medical University, Tai'an 271000, Shandong, China
| | - Kang Wang
- Department of Neurology, The Second Affiliated Hospital of Shandong First Medical University, Tai'an 271000, Shandong, China
| | - Qianqian Wang
- Department of Ultrasound, The Second Affiliated Hospital of Shandong First Medical University, Tai'an 271000, Shandong, China
| | - Haitao Wang
- Department of Neurology, The Second Affiliated Hospital of Shandong First Medical University, Tai'an 271000, Shandong, China
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6
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Rudajev V, Novotny J. Cholesterol-dependent amyloid β production: space for multifarious interactions between amyloid precursor protein, secretases, and cholesterol. Cell Biosci 2023; 13:171. [PMID: 37705117 PMCID: PMC10500844 DOI: 10.1186/s13578-023-01127-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Accepted: 09/05/2023] [Indexed: 09/15/2023] Open
Abstract
Amyloid β is considered a key player in the development and progression of Alzheimer's disease (AD). Many studies investigating the effect of statins on lowering cholesterol suggest that there may be a link between cholesterol levels and AD pathology. Since cholesterol is one of the most abundant lipid molecules, especially in brain tissue, it affects most membrane-related processes, including the formation of the most dangerous form of amyloid β, Aβ42. The entire Aβ production system, which includes the amyloid precursor protein (APP), β-secretase, and the complex of γ-secretase, is highly dependent on membrane cholesterol content. Moreover, cholesterol can affect amyloidogenesis in many ways. Cholesterol influences the stability and activity of secretases, but also dictates their partitioning into specific cellular compartments and cholesterol-enriched lipid rafts, where the amyloidogenic machinery is predominantly localized. The most complicated relationships have been found in the interaction between cholesterol and APP, where cholesterol affects not only APP localization but also the precise character of APP dimerization and APP processing by γ-secretase, which is important for the production of Aβ of different lengths. In this review, we describe the intricate web of interdependence between cellular cholesterol levels, cholesterol membrane distribution, and cholesterol-dependent production of Aβ, the major player in AD.
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Affiliation(s)
- Vladimir Rudajev
- Department of Physiology, Faculty of Science, Charles University, Prague, Czech Republic
| | - Jiri Novotny
- Department of Physiology, Faculty of Science, Charles University, Prague, Czech Republic
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7
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Tarawneh R. Microvascular Contributions to Alzheimer Disease Pathogenesis: Is Alzheimer Disease Primarily an Endotheliopathy? Biomolecules 2023; 13:830. [PMID: 37238700 PMCID: PMC10216678 DOI: 10.3390/biom13050830] [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: 03/13/2023] [Revised: 05/07/2023] [Accepted: 05/08/2023] [Indexed: 05/28/2023] Open
Abstract
Alzheimer disease (AD) models are based on the notion that abnormal protein aggregation is the primary event in AD, which begins a decade or longer prior to symptom onset, and culminates in neurodegeneration; however, emerging evidence from animal and clinical studies suggests that reduced blood flow due to capillary loss and endothelial dysfunction are early and primary events in AD pathogenesis, which may precede amyloid and tau aggregation, and contribute to neuronal and synaptic injury via direct and indirect mechanisms. Recent data from clinical studies suggests that endothelial dysfunction is closely associated with cognitive outcomes in AD and that therapeutic strategies which promote endothelial repair in early AD may offer a potential opportunity to prevent or slow disease progression. This review examines evidence from clinical, imaging, neuropathological, and animal studies supporting vascular contributions to the onset and progression of AD pathology. Together, these observations support the notion that the onset of AD may be primarily influenced by vascular, rather than neurodegenerative, mechanisms and emphasize the importance of further investigations into the vascular hypothesis of AD.
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Affiliation(s)
- Rawan Tarawneh
- Department of Neurology, Center for Memory and Aging, University of New Mexico, Albuquerque, NM 87106, USA
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8
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Zhang G, Ye X, Wang X, Lin Y, Zhu C, Pan J, Yin X, Ye M, Lv W, Tang W, Liu J, Yang X, Hui L, Zheng K. Serum total cholesterol levels associated with immediate memory performance in patients with chronic schizophrenia. Schizophr Res 2023; 255:256-260. [PMID: 37060796 DOI: 10.1016/j.schres.2023.03.046] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Revised: 03/13/2023] [Accepted: 03/26/2023] [Indexed: 04/17/2023]
Abstract
Cognitive impairments are common in patients with schizophrenia. Changes in total cholesterol (TC) may be involved in the development of schizophrenia and associated with cognitive function. This study aimed to investigate differences in serum TC level and cognitive function between schizophrenia patients and healthy controls and explore the relationship between serum TC level and cognitive function in patients with schizophrenia. A total of 105 schizophrenia patients and 105 healthy controls were recruited. Results showed that patients with schizophrenia had significantly lower scores on the overall RBANS scale and subscales (i.e., immediate memory, language, attention, and delayed memory) than those of healthy controls. Pearson's correlation analyses showed that in patients with schizophrenia, serum TC levels were positively associated with RBANS subscale scores of immediate memory and language. Furthermore, multivariate regression analyses showed that serum TC level was positively associated with the immediate memory index in patients with schizophrenia. However, no significant association was found between serum TC level and RBANS score in the healthy control group. Our results suggest that elevated serum TC level may be related to improved cognitive function in patients with schizophrenia, especially that of immediate memory.
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Affiliation(s)
- Guohua Zhang
- School of Mental Health, Zhejiang Provincial Clinical Research Center for Mental Disorders, The Affiliated Kangning Hospital, Wenzhou Medical University, Wenzhou 325035, PR China.
| | - Xiaodan Ye
- The affiliated Kangning Hospital, Wenzhou Medical University, Wenzhou 325000, PR China
| | - Xin Wang
- Center for Health Behaviours Research, JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China.
| | - Yixuan Lin
- School of Psychology and Cognitive Science, East China Normal University, Shanghai, PR China
| | - Cheng Zhu
- The affiliated Kangning Hospital, Wenzhou Medical University, Wenzhou 325000, PR China
| | - Jianshe Pan
- The affiliated Kangning Hospital, Wenzhou Medical University, Wenzhou 325000, PR China
| | - Xiaoli Yin
- The affiliated Kangning Hospital, Wenzhou Medical University, Wenzhou 325000, PR China
| | - Minjie Ye
- The affiliated Kangning Hospital, Wenzhou Medical University, Wenzhou 325000, PR China
| | - Wei Lv
- The affiliated Kangning Hospital, Wenzhou Medical University, Wenzhou 325000, PR China
| | - Wei Tang
- The affiliated Kangning Hospital, Wenzhou Medical University, Wenzhou 325000, PR China
| | - Jiahong Liu
- The affiliated Kangning Hospital, Wenzhou Medical University, Wenzhou 325000, PR China
| | - Xue Yang
- Center for Health Behaviours Research, JC School of Public Health and Primary Care, Faculty of Medicine, The Chinese University of Hong Kong, Hong Kong, China.
| | - Li Hui
- Institute of Mental Health, Suzhou Psychiatric Hospital, The Affiliated Guangji Hospital of Soochow University, Suzhou 215137, PR China.
| | - Ke Zheng
- The affiliated Kangning Hospital, Wenzhou Medical University, Wenzhou 325000, PR China.
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Sochocka M, Karska J, Pszczołowska M, Ochnik M, Fułek M, Fułek K, Kurpas D, Chojdak-Łukasiewicz J, Rosner-Tenerowicz A, Leszek J. Cognitive Decline in Early and Premature Menopause. Int J Mol Sci 2023; 24:6566. [PMID: 37047549 PMCID: PMC10095144 DOI: 10.3390/ijms24076566] [Citation(s) in RCA: 16] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2023] [Revised: 03/22/2023] [Accepted: 03/27/2023] [Indexed: 04/05/2023] Open
Abstract
Early and premature menopause, or premature ovarian insufficiency (POI), affects 1% of women under the age of 40 years. This paper reviews the main aspects of early and premature menopause and their impact on cognitive decline. Based on the literature, cognitive complaints are more common near menopause: a phase marked by a decrease in hormone levels, especially estrogen. A premature reduction in estrogen puts women at a higher risk for cardiovascular disease, parkinsonism, depression, osteoporosis, hypertension, weight gain, midlife diabetes, as well as cognitive disorders and dementia, such as Alzheimer's disease (AD). Experimental and epidemiological studies suggest that female sex hormones have long-lasting neuroprotective and anti-aging properties. Estrogens seem to prevent cognitive disorders arising from a cholinergic deficit in women and female animals in middle age premature menopause that affects the central nervous system (CNS) directly and indirectly, both transiently and in the long term, leads to cognitive impairment or even dementia, mainly due to the decrease in estrogen levels and comorbidity with cardiovascular risk factors, autoimmune diseases, and aging. Menopausal hormone therapy from menopause to the age of 60 years may provide a "window of opportunity" to reduce the risk of mild cognitive impairment (MCI) and AD in later life. Women with earlier menopause should be taken care of by various specialists such as gynecologists, endocrinologists, neurologists, and psychiatrists in order to maintain their mental health at the highest possible level.
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Affiliation(s)
- Marta Sochocka
- Hirszfeld Institute of Immunology and Experimental Therapy, Polish Academy of Sciences, 53-114 Wroclaw, Poland
| | - Julia Karska
- Department of Psychiatry, Wroclaw Medical University, 50-367 Wroclaw, Poland
| | | | - Michał Ochnik
- Hirszfeld Institute of Immunology and Experimental Therapy, Polish Academy of Sciences, 53-114 Wroclaw, Poland
| | - Michał Fułek
- Department of Internal Medicine, Occupational Diseases, Hypertension and Clinical Oncology, Wroclaw Medical University, 50-556 Wroclaw, Poland
| | - Katarzyna Fułek
- Department and Clinic of Otolaryngology, Head and Neck Surgery, Wroclaw Medical University, 50-556 Wroclaw, Poland
| | - Donata Kurpas
- Department of Family Medicine, Wroclaw Medical University, 51-141 Wroclaw, Poland
| | | | - Anna Rosner-Tenerowicz
- 2nd Department of Gynecology and Obstetrics, Wroclaw Medical University, 50-556 Wroclaw, Poland
| | - Jerzy Leszek
- Department of Psychiatry, Wroclaw Medical University, 50-367 Wroclaw, Poland
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Chuang SY, Liu WL, Chang HY, Hsu CC, Pan WH. Central obesity and elevated blood pressure in middle life are associated with physical and cognitive impairment in later life: A retrospective design with repeated measures. Exp Gerontol 2023; 173:112093. [PMID: 36669710 DOI: 10.1016/j.exger.2023.112093] [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] [Received: 09/15/2022] [Revised: 01/11/2023] [Accepted: 01/16/2023] [Indexed: 01/19/2023]
Abstract
BACKGROUND AND AIMS Physical and cognitive function decline indicates the prestage of disability and is associated with mortality among older adults. We investigated the association of metabolic disorders in midlife with physical and cognitive function decline in later life in a retrospective cohort. MATERIAL AND METHODS A total of 618 older adults aged ≥60 years in wave-6 (2014-2017) were enrolled in the Cardiovascular Disease Risk Factor Two-Township Study to evaluate physical (hand grip strength and 4-m walking speed) and cognitive function (Mine-Mental State Examination [MMSE] score). Repeated metabolic disorder measures in wave-2, wave-3, and wave-5 were obtained to identify three trajectory pattern groups according to each metabolic disorder through group-based trajectory modeling. Linear and logistic regressions were conducted to investigate the association of metabolic disorders in middle life with physical and cognitive function decline in later life. RESULTS The prevalence rates of a weak hand grip (<28 kg for men and <18 kg for women), slow walking speed (<0.8 m/s), and poor cognitive function (MMSE <25) were 24.43 %, 16.83 % and 10.5 %, respectively, among the older adults. In the retrospective cohort with 15-year follow-up, those with a waist circumference of ≥95 cm for men and ≥85 cm for women in middle life exhibited a significantly weak hand grip (odds ratio: 2.78 [95 % confidence interval: 1.26, 6.11]) and slow walking speed (2.26 [1.15, 4.43]) in later life compared with those with a smaller waist circumference (<85 cm for men and <75 cm for women). Elevated blood pressure (systolic blood pressure [BP] ≥130 mmHg or diastolic BP ≥80 mmHg) was significantly associated with a higher risk of cognitive function decline in later life. Furthermore, the high-trajectory and middle-trajectory groups' body mass index (3.17 [1.25, 8.04] and 2.27 [1.28, 4.00], respectively) and waist circumference (4.39 [2.07, 9.31] and 2.54 [1.39, 4.67], respectively) were significantly associated with a weak hand grip and slow walking speed, respectively, compared with those of the low-trajectory group. The high-trajectory diastolic BP group was significantly associated with a higher risk of cognitive function decline compared with the low-trajectory diastolic BP group. CONCLUSION Waist circumference and BP in middle life were associated with physical function decline and poor cognitive function in later life. The management of central obesity and BP in midlife may slow the decline of physical and cognitive function in later life.
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Affiliation(s)
- Shao-Yuan Chuang
- Institute of Population Health Sciences, National Health Research Institutes, Miaoli, Taiwan, ROC.
| | - Wen-Ling Liu
- Institute of Population Health Sciences, National Health Research Institutes, Miaoli, Taiwan, ROC
| | - Hsing-Yi Chang
- Institute of Population Health Sciences, National Health Research Institutes, Miaoli, Taiwan, ROC
| | - Chih-Cheng Hsu
- Institute of Population Health Sciences, National Health Research Institutes, Miaoli, Taiwan, ROC; National Center for Geriatrics and Welfare Research, National Health Research Institutes, Yunlin, Taiwan
| | - Wen-Harn Pan
- Institute of Population Health Sciences, National Health Research Institutes, Miaoli, Taiwan, ROC; Institute of Biomedical Sciences, Academia Sinica, Taipei, Taiwan, ROC; Department of Nutrition Food and Health Biotechnology, Asia University, Taichung, Taiwan
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11
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Hong SY, Jeong WM, Rhyu HS. Effects of multimodal cognitive exercise program on cognitive function, bone density, blood lipid, fitness, and depression in old women with mild cognitive impairment. J Exerc Rehabil 2023; 19:27-34. [PMID: 36910679 PMCID: PMC9993012 DOI: 10.12965/jer.2244514.257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2022] [Accepted: 01/31/2023] [Indexed: 02/25/2023] Open
Abstract
The purpose of this study is to verify the effects of participation in 12-week multimodal cognitive exercise program on cognitive function, bone mineral density, blood lipids, senior functional fitness, and depression of the old women with mild cognitive impairment and osteopenia. As a result, the exercise group showed significant effects in cognitive function, depression, bone mineral density, blood lipid, lower extremity flexibility, upper extremity flexibility, dynamic balance, and body endurance. Such results prove that multimodal cognitive exercise program is an effective interventional exercise program for improving cognitive function in the old women with mild cognitive impairment.
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Affiliation(s)
- Seo-Youn Hong
- Department of Physical Education, Seoul National University of Education, Seoul, Korea
| | | | - Hyun-Seung Rhyu
- Department of Physical Education, Jungwon University, Goesan, Korea
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12
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The Role of the JAK/STAT Signaling Pathway in the Pathogenesis of Alzheimer's Disease: New Potential Treatment Target. Int J Mol Sci 2023; 24:ijms24010864. [PMID: 36614305 PMCID: PMC9821184 DOI: 10.3390/ijms24010864] [Citation(s) in RCA: 30] [Impact Index Per Article: 30.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Revised: 12/19/2022] [Accepted: 12/29/2022] [Indexed: 01/05/2023] Open
Abstract
Alzheimer's disease is characterized by the accumulation of amyloid plaques and neurofibrillary tangles in the brain. However, emerging evidence suggests that neuroinflammation, mediated notably by activated neuroglial cells, neutrophils, and macrophages, also plays an important role in the pathogenesis of Alzheimer's disease. Therefore, understanding the interplay between the nervous and immune systems might be the key to the prevention or delay of Alzheimer's disease progression. One of the most important mechanisms determining gliogenic cell fate is the Janus kinase/signal transducer and activator of transcription (JAK/STAT) signaling pathway that is influenced by the overactivation of microglia and astrocytes. The JAK/STAT signaling pathway is one of the critical factors that promote neuroinflammation in neurodegenerative diseases such as Alzheimer's disease by initiating innate immunity, orchestrating adaptive immune mechanisms, and finally, constraining neuroinflammatory response. Since a chronic neuroinflammatory environment in the brain is a hallmark of Alzheimer's disease, understanding the process would allow establishing the underlying role of neuroinflammation, then estimating the prognosis of Alzheimer's disease development and finding a new potential treatment target. In this review, we highlight the recent advances in the potential role of JAK/STAT signaling in neurological diseases with a focus on discussing future research directions regarding novel therapeutic approaches and predictive biomarkers for Alzheimer's disease.
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Wee J, Sukudom S, Bhat S, Marklund M, Peiris NJ, Hoyos CM, Patel S, Naismith SL, Dwivedi G, Misra A. The relationship between midlife dyslipidemia and lifetime incidence of dementia: A systematic review and meta-analysis of cohort studies. ALZHEIMER'S & DEMENTIA (AMSTERDAM, NETHERLANDS) 2023; 15:e12395. [PMID: 36911359 PMCID: PMC9993469 DOI: 10.1002/dad2.12395] [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: 08/19/2022] [Revised: 12/18/2022] [Accepted: 12/20/2022] [Indexed: 03/14/2023]
Abstract
Introduction We conducted a systematic review and meta-analysis to review the relationship between midlife dyslipidemia and lifetime incident dementia. Methods The databases Medline, Embase, Scopus, Web of Science, and Cochrane were searched from inception to February 20, 2022. Longitudinal studies examining the relationship between midlife lipid levels on dementia, dementia subtypes, and/or cognitive impairment were pooled using inverse-variance weighted random-effects meta-analysis. Results Seventeen studies (1.2 million participants) were included. Midlife hypercholesterolemia was associated with increased incidence of mild cognitive impairment (effect size [ES] = 2.01; 95% confidence interval [CI] 1.19 to 2.84; I2 = 0.0%) and all-cause dementia (ES = 1.14; 95% CI: 1.07 to 1.21; I2 = 0.0%). Each 1 mmol/L increase in low-density lipoprotein was associated with an 8% increase (ES = 1.08, 95% CI: 1.03 to 1.14; I2 = 0.3%) in incidence of all-cause dementia. Discussion Midlife dyslipidemia is associated with an increased risk of cognitive impairment in later life.
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Affiliation(s)
- Jason Wee
- Fiona Stanley HospitalSouth Metropolitan Health ServicePerthWestern AustraliaAustralia
| | - Sara Sukudom
- University of Western AustraliaPerthWestern AustraliaAustralia
- Faculty of Medicine and HealthThe University of SydneySydneyNew South WalesAustralia
| | - Saiuj Bhat
- Royal Perth HospitalPerthWestern AustraliaAustralia
| | - Matti Marklund
- The George Institute for Global HealthUniversity of New South WalesSydneyNew South WalesAustralia
- Department of EpidemiologyJohns Hopkins Bloomberg School of Public HealthBaltimoreMarylandUSA
- Department of Public Health and Caring SciencesUppsala UniversityUppsalaSweden
| | - Niridu Jude Peiris
- Faculty of Medicine and HealthThe University of SydneySydneyNew South WalesAustralia
| | - Camilla M Hoyos
- Faculty of Science and School of Psychology and Centre for Sleep and ChronobiologyWoolcock Institute of Medical ResearchThe University of SydneySydneyNew South WalesAustralia
| | - Sanjay Patel
- Heart Research InstituteSydneyNew South WalesAustralia
| | - Sharon L Naismith
- Faculty of Science and School of PsychologyCharles Perkins CentreUniversity of SydneySydneyNew South WalesAustralia
| | - Girish Dwivedi
- University of Western AustraliaPerthWestern AustraliaAustralia
| | - Ashish Misra
- Faculty of Medicine and HealthThe University of SydneySydneyNew South WalesAustralia
- Heart Research InstituteSydneyNew South WalesAustralia
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Systolic blood pressure at age 40 and cognitive function 25 years later: the Akershus Cardiac Examination (ACE) 1950 Study. J Hypertens 2023; 41:132-139. [PMID: 36453656 DOI: 10.1097/hjh.0000000000003312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
Abstract
OBJECTIVES Hypertension in midlife is a risk factor for cognitive impairment. Still, the ideal midlife blood pressure (BP) remains unknown. We examined associations between different systolic blood pressure (SBP) levels at the age of 40-43 years and change in SBP over a 25-year period with cognitive function at age 62-65 years. METHODS We included 2424 individuals born in 1950 who had participated both in the Age 40 Program (1990-1993) and the Akershus Cardiac Examination (ACE) 1950 Study (2012-2015). The exposure was SBP at age 40-43 years and the outcome was cognitive function at age 62-65 years, assessed with Montreal Cognitive Assessment, Delayed recall trial from the Consortium to Establish a Registry for Alzheimer's Disease Word List Memory Task, and Trail Making Test part B (TMT B). RESULTS Participants were 40.1 ± 0.3 years old with mean SPB 128 ± 13 mmHg at the Age 40 Program, and 63.9 ± 0.6 years old with mean SPB 138 ± 18 at the ACE 1950 Study. Adjusted linear regressions showed no associations between SBP and subsequent cognitive function. In logistic regressions, individuals with SBP ≥140 mmHg, compared to individuals with SBP <120 mmHg (odds ratio 2.29, 95% confidence interval 1.28-4.10, P-value 0.005) had increased risk of an abnormal TMT B-score. Change in SBP during the 25-year follow-up was not associated with cognitive function. CONCLUSIONS SBP ≥140 mmHg at age 40-43 was associated with reduced capacity on TMT B, a domain specific cognitive test sensitive to vascular impairment. No other associations were found between SBP, or change in SBP, and cognitive function.
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Zhang X, Tong T, Chang A, Ang TFA, Tao Q, Auerbach S, Devine S, Qiu WQ, Mez J, Massaro J, Lunetta KL, Au R, Farrer LA. Midlife lipid and glucose levels are associated with Alzheimer's disease. Alzheimers Dement 2023; 19:181-193. [PMID: 35319157 PMCID: PMC10078665 DOI: 10.1002/alz.12641] [Citation(s) in RCA: 19] [Impact Index Per Article: 19.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Revised: 02/03/2022] [Accepted: 02/04/2022] [Indexed: 01/31/2023]
Abstract
INTRODUCTION It is unknown whether vascular and metabolic diseases assessed in early adulthood are associated with Alzheimer's disease (AD) later in life. METHODS Association of AD with lipid fractions, glucose, blood pressure, body mass index (BMI), and smoking obtained prospectively from 4932 Framingham Heart Study (FHS) participants across nine quadrennial examinations was evaluated using Cox proportional hazard and Kaplan-Meier models. Age-, sex-, and education-adjusted models were tested for each factor measured at each exam and within three adult age groups (early = 35-50, middle = 51-60, and late = 61-70). RESULTS A 15 mg/dL increase in high density lipoprotein (HDL) cholesterol was associated with decreased AD risk during early (15.4%, P = 0.041) and middle (17.9%, P = 0.014) adulthood. A 15 mg/dL increase in glucose measured during middle adulthood was associated with 14.5% increased AD risk (P = 0.00029). These findings remained significant after adjusting for treatment. DISCUSSION Our findings suggest that careful management of cholesterol and glucose beginning in early adulthood can lower AD risk.
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Affiliation(s)
- Xiaoling Zhang
- Department of Medicine (Biomedical Genetics)Boston University School of MedicineBostonMassachusettsUSA
- Department of BiostatisticsBoston University School of Public HealthBostonMassachusettsUSA
| | - Tong Tong
- Department of Medicine (Biomedical Genetics)Boston University School of MedicineBostonMassachusettsUSA
| | - Andrew Chang
- Department of Physiology & BiophysicsBoston University School of MedicineBostonMassachusettsUSA
| | - Ting Fang Alvin Ang
- Department of Anatomy & NeurobiologyBoston University School of MedicineBostonMassachusettsUSA
- Framingham Heart StudyBoston University School of MedicineFraminghamMassachusettsUSA
| | - Qiushan Tao
- Department of Pharmacology & Experimental TherapeuticsBoston University School of MedicineBostonMassachusettsUSA
| | - Sanford Auerbach
- Department of NeurologyBoston University School of MedicineBostonMassachusettsUSA
| | - Sherral Devine
- Department of Anatomy & NeurobiologyBoston University School of MedicineBostonMassachusettsUSA
- Framingham Heart StudyBoston University School of MedicineFraminghamMassachusettsUSA
| | - Wei Qiao Qiu
- Department of Pharmacology & Experimental TherapeuticsBoston University School of MedicineBostonMassachusettsUSA
- Department of PsychiatryBoston University School of MedicineBostonMassachusettsUSA
- Alzheimer's Disease Research CenterBoston University School of MedicineBostonMassachusettsUSA
| | - Jesse Mez
- Framingham Heart StudyBoston University School of MedicineFraminghamMassachusettsUSA
- Department of NeurologyBoston University School of MedicineBostonMassachusettsUSA
- Alzheimer's Disease Research CenterBoston University School of MedicineBostonMassachusettsUSA
| | - Joseph Massaro
- Department of BiostatisticsBoston University School of Public HealthBostonMassachusettsUSA
- Framingham Heart StudyBoston University School of MedicineFraminghamMassachusettsUSA
| | - Kathryn L. Lunetta
- Department of BiostatisticsBoston University School of Public HealthBostonMassachusettsUSA
| | - Rhoda Au
- Department of Anatomy & NeurobiologyBoston University School of MedicineBostonMassachusettsUSA
- Framingham Heart StudyBoston University School of MedicineFraminghamMassachusettsUSA
- Department of NeurologyBoston University School of MedicineBostonMassachusettsUSA
- Alzheimer's Disease Research CenterBoston University School of MedicineBostonMassachusettsUSA
- Department of EpidemiologyBoston University School of Public HealthBostonMassachusettsUSA
| | - Lindsay A. Farrer
- Department of Medicine (Biomedical Genetics)Boston University School of MedicineBostonMassachusettsUSA
- Department of BiostatisticsBoston University School of Public HealthBostonMassachusettsUSA
- Framingham Heart StudyBoston University School of MedicineFraminghamMassachusettsUSA
- Department of NeurologyBoston University School of MedicineBostonMassachusettsUSA
- Alzheimer's Disease Research CenterBoston University School of MedicineBostonMassachusettsUSA
- Department of EpidemiologyBoston University School of Public HealthBostonMassachusettsUSA
- Department of OphthalmologyBoston University School of MedicineBostonMassachusettsUSA
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Cong L, Ren Y, Wang Y, Hou T, Dong Y, Han X, Yin L, Zhang Q, Feng J, Wang L, Tang S, Grande G, Laukka EJ, Du Y, Qiu C. Mild cognitive impairment among rural-dwelling older adults in China: A community-based study. Alzheimers Dement 2023; 19:56-66. [PMID: 35262288 PMCID: PMC10078715 DOI: 10.1002/alz.12629] [Citation(s) in RCA: 34] [Impact Index Per Article: 34.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Revised: 01/24/2022] [Accepted: 01/26/2022] [Indexed: 01/18/2023]
Abstract
BACKGROUND Epidemiological studies of mild cognitive impairment (MCI) and subtypes of MCI have rarely focused on rural residents in China. METHODS This population-based study included 5068 participants (age ≥60 years) who were living in rural communities. We defined MCI, amnestic MCI (aMCI), and non-amnestic MCI (naMCI) following the Petersen's criteria that integrated neuropsychological assessments with in-person clinical evaluations. RESULTS The overall prevalence of MCI, aMCI, and naMCI was 26.48%, 22.30%, and 4.18%, respectively. The prevalence of MCI increased with age. The adjusted odds ratio (OR) of MCI was 0.71 (95% confidence interval [CI] 0.61 to 0.82) for primary school (vs. illiteracy), 0.30 (0.24 to 0.39) for middle school or above, 1.35 (1.09 to 1.67) for being farmers, 0.65 (0.54 to 0.78) for alcohol consumption, 1.43 (1.20 to 1.70) for stroke history, and 1.14 (0.95 to 1.36) for any apolipoprotein E (APOE) ε4 allele (vs ε3/ε3). CONCLUSIONS MCI affects over one-fourth of rural older adults in China. Overall MCI was associated with demographic factors, non-alcohol consumption, and stroke, but not with APOE genotype and cardiometabolic factors.
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Affiliation(s)
- Lin Cong
- Department of Neurology, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, P. R. China.,Department of Neurology, Shandong Provincial Hospital affiliated to Shandong First Medical University, Jinan, Shandong, P. R. China.,Shandong Provincial Clinical Research Center for Neurological Diseases, Jinan, Shandong, P. R. China
| | - Yifei Ren
- Department of Neurology, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, P. R. China
| | - Yongxiang Wang
- Department of Neurology, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, P. R. China.,Department of Neurology, Shandong Provincial Hospital affiliated to Shandong First Medical University, Jinan, Shandong, P. R. China.,Shandong Provincial Clinical Research Center for Neurological Diseases, Jinan, Shandong, P. R. China
| | - Tingting Hou
- Department of Neurology, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, P. R. China.,Department of Neurology, Shandong Provincial Hospital affiliated to Shandong First Medical University, Jinan, Shandong, P. R. China.,Shandong Provincial Clinical Research Center for Neurological Diseases, Jinan, Shandong, P. R. China
| | - Yi Dong
- Department of Neurology, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, P. R. China.,Department of Neurology, Shandong Provincial Hospital affiliated to Shandong First Medical University, Jinan, Shandong, P. R. China.,Shandong Provincial Clinical Research Center for Neurological Diseases, Jinan, Shandong, P. R. China
| | - Xiaojuan Han
- Department of Neurology, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, P. R. China.,Department of Neurology, Shandong Provincial Hospital affiliated to Shandong First Medical University, Jinan, Shandong, P. R. China.,Shandong Provincial Clinical Research Center for Neurological Diseases, Jinan, Shandong, P. R. China
| | - Ling Yin
- Department of Neurology, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, P. R. China.,Department of Neurology, Shandong Provincial Hospital affiliated to Shandong First Medical University, Jinan, Shandong, P. R. China.,Shandong Provincial Clinical Research Center for Neurological Diseases, Jinan, Shandong, P. R. China
| | - Qinghua Zhang
- Department of Neurology, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, P. R. China.,Department of Neurology, Shandong Provincial Hospital affiliated to Shandong First Medical University, Jinan, Shandong, P. R. China.,Shandong Provincial Clinical Research Center for Neurological Diseases, Jinan, Shandong, P. R. China
| | - Jianli Feng
- Department of Neurology, Shandong Second Provincial General Hospital, Jinan, Shandong, P. R. China
| | - Lidan Wang
- Department of Neurology, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, P. R. China
| | - Shi Tang
- Department of Neurology, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, P. R. China.,Department of Neurology, Shandong Provincial Hospital affiliated to Shandong First Medical University, Jinan, Shandong, P. R. China.,Shandong Provincial Clinical Research Center for Neurological Diseases, Jinan, Shandong, P. R. China
| | - Giulia Grande
- Aging Research Center and Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet-Stockholm University, Stockholm, Sweden
| | - Erika J Laukka
- Aging Research Center and Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet-Stockholm University, Stockholm, Sweden
| | - Yifeng Du
- Department of Neurology, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, P. R. China.,Department of Neurology, Shandong Provincial Hospital affiliated to Shandong First Medical University, Jinan, Shandong, P. R. China.,Shandong Provincial Clinical Research Center for Neurological Diseases, Jinan, Shandong, P. R. China
| | - Chengxuan Qiu
- Department of Neurology, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, P. R. China.,Aging Research Center and Center for Alzheimer Research, Department of Neurobiology, Care Sciences and Society, Karolinska Institutet-Stockholm University, Stockholm, Sweden
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Lauder L, Mahfoud F, Azizi M, Bhatt DL, Ewen S, Kario K, Parati G, Rossignol P, Schlaich MP, Teo KK, Townsend RR, Tsioufis C, Weber MA, Weber T, Böhm M. Hypertension management in patients with cardiovascular comorbidities. Eur Heart J 2022:6808663. [DOI: 10.1093/eurheartj/ehac395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Revised: 06/23/2022] [Accepted: 07/08/2022] [Indexed: 11/09/2022] Open
Abstract
Abstract
Arterial hypertension is a leading cause of death globally. Due to ageing, the rising incidence of obesity, and socioeconomic and environmental changes, its incidence increases worldwide. Hypertension commonly coexists with Type 2 diabetes, obesity, dyslipidaemia, sedentary lifestyle, and smoking leading to risk amplification. Blood pressure lowering by lifestyle modifications and antihypertensive drugs reduce cardiovascular (CV) morbidity and mortality. Guidelines recommend dual- and triple-combination therapies using renin–angiotensin system blockers, calcium channel blockers, and/or a diuretic. Comorbidities often complicate management. New drugs such as angiotensin receptor-neprilysin inhibitors, sodium–glucose cotransporter 2 inhibitors, glucagon-like peptide-1 receptor agonists, and non-steroidal mineralocorticoid receptor antagonists improve CV and renal outcomes. Catheter-based renal denervation could offer an alternative treatment option in comorbid hypertension associated with increased sympathetic nerve activity. This review summarises the latest clinical evidence for managing hypertension with CV comorbidities.
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Affiliation(s)
- Lucas Lauder
- Klinik für Innere Medizin III, Universitätsklinikum des Saarlandes, Saarland University , Kirrberger Str. 1, 66421 Homburg , Germany
| | - Felix Mahfoud
- Klinik für Innere Medizin III, Universitätsklinikum des Saarlandes, Saarland University , Kirrberger Str. 1, 66421 Homburg , Germany
| | - Michel Azizi
- Université Paris Cité, INSERM CIC1418 , F-75015 Paris , France
- AP-HP, Hôpital Européen Georges-Pompidou, Hypertension Department, DMU CARTE , F-75015 Paris , France
- FCRIN INI-CRCT , Nancy , France
| | - Deepak L Bhatt
- Brigham and Women’s Hospital Heart and Vascular Center, Harvard Medical School , Boston, MA , USA
| | - Sebastian Ewen
- Klinik für Innere Medizin III, Universitätsklinikum des Saarlandes, Saarland University , Kirrberger Str. 1, 66421 Homburg , Germany
| | - Kazuomi Kario
- Division of Cardiovascular Medicine, Department of Medicine, Jichi Medical University School of Medicine , Tochigi , Japan
| | - Gianfranco Parati
- Department of Medicine and Surgery, Cardiology Unit, University of Milano-Bicocca and Istituto Auxologico Italiano, IRCCS , Milan , Italy
| | - Patrick Rossignol
- FCRIN INI-CRCT , Nancy , France
- Université de Lorraine, INSERM, Centre d'Investigations Cliniques - Plurithématique 14-33 and INSERM U1116 , Nancy , France
- CHRU de Nancy , Nancy , France
| | - Markus P Schlaich
- Dobney Hypertension Centre, Medical School—Royal Perth Hospital Unit, Medical Research Foundation, The University of Western Australia , Perth, WA , Australia
- Departments of Cardiology and Nephrology, Royal Perth Hospital , Perth, WA , Australia
| | - Koon K Teo
- Population Health Research Institute, McMaster University , Hamilton, ON , Canada
| | - Raymond R Townsend
- Perelman School of Medicine, University of Pennsylvania , Philadelphia, PA , USA
| | - Costas Tsioufis
- National and Kapodistrian University of Athens, 1st Cardiology Clinic, Hippocratio Hospital , Athens , Greece
| | | | - Thomas Weber
- Department of Cardiology, Klinikum Wels-Grieskirchen , Wels , Austria
| | - Michael Böhm
- Klinik für Innere Medizin III, Universitätsklinikum des Saarlandes, Saarland University , Kirrberger Str. 1, 66421 Homburg , Germany
- Cape Heart Institute (CHI), Faculty of Health Sciences, University of Cape Town , Cape Town , South Africa
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Zhang H, Tian W, Qi G, Sun Y. Hypertension, dietary fiber intake, and cognitive function in older adults [from the National Health and Nutrition Examination Survey Data (2011–2014)]. Front Nutr 2022; 9:1024627. [PMID: 36337616 PMCID: PMC9634641 DOI: 10.3389/fnut.2022.1024627] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Accepted: 10/10/2022] [Indexed: 12/02/2022] Open
Abstract
Background Dietary fiber was associated with hypertension (HYP) and cognitive function, but it was unknown whether the effect of HYP on cognitive function in older adults was modified by dietary fiber intake. Methods We recruited 2,478 participants from the 2011–2012 and 2013–2014 National Health and Nutrition Examination Survey (NHANES), with cognitive performance measured by Registry for Alzheimer's disease (CERAD), the Animal Fluency test (AFT), and the Digit Symbol Substitution test (DSST). Multivariate General linear model was used to estimate the interaction between dietary fiber intake and HYP status in association with low cognitive performance. Results Among 2,478 participants, 36% was Controlled HYP, 25% was Low uncontrolled HYP, 11% was High uncontrolled HYP, and 86% was low dietary fiber intake. The association between HYP status and DSST impairment differed by dietary fiber intake for those with high uncontrolled HYP compared to those without HYP. Among participants with low dietary fiber intake, those with uncontrolled HYP had higher risk of DSST impairment compared to those without HYP [HYP ≥ 90/140: OR (95% CI), 1.68 (1.15–2.45); HYP ≥ 100/160: OR (95%CI), 2.05 (1.29–3.23)]; however, there was no association between HYP status and DSST impairment among participants with high dietary fiber intake. Moreover, the interaction of HYP status and dietary fiber intake on DSST was close to statistical significance (P for interaction = 0.057). Conclusions Uncontrolled HYP was associated with poorer cognitive performance in older adults with low, but not high dietary fiber intake. Sufficient dietary fiber intake might be as a new nutrition strategy for the prevention of cognitive impairment in older adults with uncontrolled HYP.
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Higher Total Cholesterol Concentration May Be Associated with Better Cognitive Performance among Elderly Females. Nutrients 2022; 14:nu14194198. [PMID: 36235850 PMCID: PMC9571708 DOI: 10.3390/nu14194198] [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: 09/14/2022] [Revised: 10/04/2022] [Accepted: 10/06/2022] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND The brain contains the highest level of cholesterol in the body, and the total amount of serum cholesterol in the blood has a huge impact on brain aging and cognitive performance. However, the association of total serum cholesterol with cognitive function remains uncertain. This study determines whether there is an association between the total amount of cholesterol in the blood and cognitive performance in elderly females without a history of stroke. METHODS This population-based cross-sectional study was conducted on elderly (over 60 years old) females and males without a history of stroke from 2011 to 2014 in the US National Health and Nutrition Examination Survey (NHANES). The primary exposure was total blood cholesterol, and the main outcome was cognitive performance; this association was assessed with logistic regression analysis and restricted cubic splines. RESULTS 1309 female and 1272 male participants were included. In females, higher total cholesterol was significantly associated with higher cognitive scores, particularly in the digit symbol substitution test (OR 0.51, 95% CI (0.36-0.72)) and the animal fluency test (OR 0.64, 95% CI (0.45-0.91)). This association remained significant in models adjusted for age, race, smoking status, education level, and chronic conditions (OR 0.40, 95% CI (0.25-0.63)). This association was not significant in males, however. CONCLUSIONS A higher concentration of total cholesterol measured in later life may be a protective factor for cognitive performance among females over 60 years old without a history of stroke. Further, this association was more pronounced among women with higher levels of education than women with lower or no education.
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Serum TG/HDL-C level at the acute phase of ischemic stroke is associated with post-stroke cognitive impairment. Neurol Sci 2022; 43:5977-5984. [DOI: 10.1007/s10072-022-06267-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2022] [Accepted: 07/04/2022] [Indexed: 11/30/2022]
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Rudajev V, Novotny J. Cholesterol as a key player in amyloid β-mediated toxicity in Alzheimer’s disease. Front Mol Neurosci 2022; 15:937056. [PMID: 36090253 PMCID: PMC9453481 DOI: 10.3389/fnmol.2022.937056] [Citation(s) in RCA: 28] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2022] [Accepted: 07/27/2022] [Indexed: 11/13/2022] Open
Abstract
Alzheimer’s disease (AD) is a neurodegenerative disorder that is one of the most devastating and widespread diseases worldwide, mainly affecting the aging population. One of the key factors contributing to AD-related neurotoxicity is the production and aggregation of amyloid β (Aβ). Many studies have shown the ability of Aβ to bind to the cell membrane and disrupt its structure, leading to cell death. Because amyloid damage affects different parts of the brain differently, it seems likely that not only Aβ but also the nature of the membrane interface with which the amyloid interacts, helps determine the final neurotoxic effect. Because cholesterol is the dominant component of the plasma membrane, it plays an important role in Aβ-induced toxicity. Elevated cholesterol levels and their regulation by statins have been shown to be important factors influencing the progression of neurodegeneration. However, data from many studies have shown that cholesterol has both neuroprotective and aggravating effects in relation to the development of AD. In this review, we attempt to summarize recent findings on the role of cholesterol in Aβ toxicity mediated by membrane binding in the pathogenesis of AD and to consider it in the broader context of the lipid composition of cell membranes.
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Angom RS, Kulkarni T, Wang E, Kumar Dutta S, Bhattacharya S, Das P, Mukhopadhyay D. Vascular Endothelial Growth Factor Receptor-1 Modulates Hypoxia-Mediated Endothelial Senescence and Cellular Membrane Stiffness via YAP-1 Pathways. Front Cell Dev Biol 2022; 10:903047. [PMID: 35846360 PMCID: PMC9283904 DOI: 10.3389/fcell.2022.903047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2022] [Accepted: 06/13/2022] [Indexed: 11/23/2022] Open
Abstract
Hypoxia-induced endothelial cell (EC) dysfunction has been implicated as potential initiators of different pathogenesis, including Alzheimer’s disease and vascular dementia. However, in-depth structural, mechanical, and molecular mechanisms leading to EC dysfunction and pathology need to be revealed. Here, we show that ECs exposed to hypoxic conditions readily enter a senescence phenotype. As expected, hypoxia upregulated the expression of vascular endothelial growth factor (VEGFs) and its receptors (VEGFRs) in the ECs. Interestingly, Knockdown of VEGFR-1 expression prior to hypoxia exposure prevented EC senescence, suggesting an important role of VEGFR-1 expression in the induction of EC senescence. Using atomic force microscopy, we showed that senescent ECs had a flattened cell morphology, decreased membrane ruffling, and increased membrane stiffness, demonstrating unique morphological and nanomechanical signatures. Furthermore, we show that hypoxia inhibited the Hippo pathway Yes-associated protein (YAP-1) expression and knockdown of YAP-1 induced senescence in the ECs, supporting a key role of YAP-1 expression in the induction of EC senescence. And importantly, VEGFR-1 Knockdown in the ECs modulated YAP-1 expression, suggesting a novel VEGFR-1-YAP-1 axis in the induction of hypoxia-mediated EC senescence. In conclusion, VEGFR-1 is overexpressed in ECs undergoing hypoxia-mediated senescence, and the knockdown of VEGFR-1 restores cellular structural and nanomechanical integrity by recovering YAP-1 expression.
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Affiliation(s)
| | - Tanmay Kulkarni
- Department of Biochemistry and Molecular Biology, Jacksonville, FL, United States
| | - Enfeng Wang
- Department of Biochemistry and Molecular Biology, Jacksonville, FL, United States
| | - Shamit Kumar Dutta
- Department of Biochemistry and Molecular Biology, Jacksonville, FL, United States
| | - Santanu Bhattacharya
- Department of Biochemistry and Molecular Biology, Jacksonville, FL, United States
- Department of Physiology and Biomedical Engineering, Mayo Clinic College of Medicine and Science, Jacksonville, FL, United States
| | - Pritam Das
- Department of Biochemistry and Molecular Biology, Jacksonville, FL, United States
| | - Debabrata Mukhopadhyay
- Department of Biochemistry and Molecular Biology, Jacksonville, FL, United States
- Department of Physiology and Biomedical Engineering, Mayo Clinic College of Medicine and Science, Jacksonville, FL, United States
- *Correspondence: Debabrata Mukhopadhyay,
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23
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Schaich CL, Yeboah J, Espeland MA, Baker LD, Ding J, Hayden KM, Sachs BC, Craft S, Rapp SR, Luchsinger JA, Fitzpatrick AL, Heckbert SR, Post WS, Burke GL, Allen NB, Hughes TM. Association of Vascular Risk Scores and Cognitive Performance in a Diverse Cohort: The Multi-Ethnic Study of Atherosclerosis. J Gerontol A Biol Sci Med Sci 2022; 77:1208-1215. [PMID: 34216214 PMCID: PMC9159669 DOI: 10.1093/gerona/glab189] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Vascular risk scores are associated with incident dementia. Information regarding their association with cognitive performance and decline in racially/ethnically diverse cohorts is lacking. METHOD In 4 392 Multi-Ethnic Study of Atherosclerosis participants (aged 60.1 ± 9.4 years; 53% women; 41% White, 11% Chinese American, 26% African American, 21% Hispanic), we compared associations of Exam 1 (2000-2002) Cardiovascular Risk Factors, Aging, and Incidence of Dementia (CAIDE), Framingham Stroke Risk Profile (FSRP), and atherosclerotic cardiovascular disease pooled cohort equation (ASCVD-PCE) risk scores with Exam 5 (2010-2012) Cognitive Abilities Screening Instrument (CASI), Digit Symbol Coding (DSC), and Digit Span (DS) cognitive test performance using multivariable linear regression, and examined racial/ethnic interactions. In 1 838 participants with repeat CASI data at Exam 6 (2016-2018), we related risk scores to odds of a 1-SD decline in CASI performance using multivariable logistic regression. RESULTS SD increments in each risk score were associated with worse cognitive performance. CAIDE had stronger associations with CASI performance than the FSRP and ASCVD-PCE, but associations of ASCVD-PCE with the DSC and DS were similar to CAIDE (difference in β [95% CI] = -0.57 [-1.48, 0.34] and -0.21 [-0.43, 0.01], respectively). Race/ethnicity modified associations. For example, associations between CAIDE and CASI were greater in African Americans and Hispanics than in Whites (difference in β = 0.69 [0.02, 1.36] and 1.67 [0.95, 2.39], respectively). Risk scores were comparably associated with decline in CASI performance. CONCLUSIONS Antecedent vascular risk scores are associated with cognitive performance and decline in the 4 most common U.S. racial/ethnic groups, but associations differ among risk scores and by race/ethnicity.
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Affiliation(s)
- Christopher L Schaich
- Department of Surgery/Hypertension, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Joseph Yeboah
- Department of Internal Medicine, Section on Cardiovascular Medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Mark A Espeland
- Department of Biostatistics and Data Science, Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Laura D Baker
- Department of Internal Medicine, Section on Gerontology and Geriatric Medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Jingzhong Ding
- Department of Internal Medicine, Section on Gerontology and Geriatric Medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Kathleen M Hayden
- Department of Social Sciences and Health Policy, Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Bonnie C Sachs
- Department of Internal Medicine, Section on Gerontology and Geriatric Medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
- Department of Neurology, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Suzanne Craft
- Department of Internal Medicine, Section on Gerontology and Geriatric Medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Stephen R Rapp
- Department of Psychiatry and Behavioral Medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - José A Luchsinger
- Department of Medicine, Columbia University Irving Medical Center, New York, New York, USA
- Department of Epidemiology, Columbia University Irving Medical Center, New York, New York, USA
| | - Annette L Fitzpatrick
- Department of Epidemiology, University of Washington, Seattle, USA
- Department of Family Medicine, University of Washington, Seattle, USA
- Department of Global Health, University of Washington, Seattle, USA
| | - Susan R Heckbert
- Department of Epidemiology, University of Washington, Seattle, USA
| | - Wendy S Post
- Department of Medicine, Division of Cardiology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Gregory L Burke
- Division of Public Health Sciences, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Norrina B Allen
- Department of Preventive Medicine, Feinberg School of Medicine, Northwestern University, Chicago, Illinois, USA
| | - Timothy M Hughes
- Department of Internal Medicine, Section on Gerontology and Geriatric Medicine, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
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24
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Chang YS, Lin CL, Lee CW, Lin HC, Wu YT, Shih YH. Exercise Normalized the Hippocampal Renin-Angiotensin System and Restored Spatial Memory Function, Neurogenesis, and Blood-Brain Barrier Permeability in the 2K1C-Hypertensive Mouse. Int J Mol Sci 2022; 23:ijms23105531. [PMID: 35628344 PMCID: PMC9146761 DOI: 10.3390/ijms23105531] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Revised: 05/14/2022] [Accepted: 05/14/2022] [Indexed: 02/04/2023] Open
Abstract
Hypertension is associated with blood-brain barrier alteration and brain function decline. Previously, we established the 2-kidney,1-clip (2K1C) hypertensive mice model by renin-angiotensin system (RAS) stimulating. We found that 2K1C-induced hypertension would impair hippocampus-related memory function and decrease adult hippocampal neurogenesis. Even though large studies have investigated the mechanism of hypertension affecting brain function, there remains a lack of efficient ways to halt this vicious effect. The previous study indicated that running exercise ameliorates neurogenesis and spatial memory function in aging mice. Moreover, studies showed that exercise could normalize RAS activity, which might be associated with neurogenesis impairment. Thus, we hypothesize that running exercise could ameliorate neurogenesis and spatial memory function impairment in the 2K1C-hypertension mice. In this study, we performed 2K1C surgery on eight-weeks-old C57BL/6 mice and put them on treadmill exercise one month after the surgery. The results indicate that running exercise improves the spatial memory and neurogenesis impairment of the 2K1C-mice. Moreover, running exercise normalized the activated RAS and blood-brain barrier leakage of the hippocampus, although the blood pressure was not decreased. In conclusion, running exercise could halt hypertension-induced brain impairment through RAS normalization.
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Affiliation(s)
- Ying-Shuang Chang
- Department of Anatomy, School of Medicine, College of Medicine, Kaohsiung Medical University, 100, Shih-Chuan 1st Road, Sanmin District, Kaohsiung 80708, Taiwan; (Y.-S.C.); (H.-C.L.)
- Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, 100, Shih-Chuan 1st Road, Sanmin District, Kaohsiung 80708, Taiwan;
| | - Chih-Lung Lin
- Graduate Institute of Medicine, College of Medicine, Kaohsiung Medical University, 100, Shih-Chuan 1st Road, Sanmin District, Kaohsiung 80708, Taiwan;
- Department of Neurosurgery, Kaohsiung Medical University Hospital, 100, Tzyou 1st Road, Sanmin District, Kaohsiung 80756, Taiwan
| | - Chu-Wan Lee
- Department of Nursing, National Tainan Junior College of Nursing, 78, Section 2, Minzu Road, West Central District, Tainan 70043, Taiwan;
| | - Han-Chen Lin
- Department of Anatomy, School of Medicine, College of Medicine, Kaohsiung Medical University, 100, Shih-Chuan 1st Road, Sanmin District, Kaohsiung 80708, Taiwan; (Y.-S.C.); (H.-C.L.)
- Department of Medical Research, Kaohsiung Medical University Hospital, 100, Tzyou 1st Road, Sanmin District, Kaohsiung 80756, Taiwan
| | - Yi-Ting Wu
- Department of Nursing, Tzu Hui Institute of Technology, Pingtung County 92641, Taiwan;
| | - Yao-Hsiang Shih
- Department of Anatomy, School of Medicine, College of Medicine, Kaohsiung Medical University, 100, Shih-Chuan 1st Road, Sanmin District, Kaohsiung 80708, Taiwan; (Y.-S.C.); (H.-C.L.)
- Department of Medical Research, Kaohsiung Medical University Hospital, 100, Tzyou 1st Road, Sanmin District, Kaohsiung 80756, Taiwan
- Correspondence: ; Tel.: +886-7-3121101 (ext. 2144)
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25
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Wirth M, Gaubert M, Köbe T, Garnier-Crussard A, Lange C, Gonneaud J, de Flores R, Landeau B, de la Sayette V, Chételat G. Vascular Health Is Associated With Functional Connectivity Decline in Higher-Order Networks of Older Adults. Front Integr Neurosci 2022; 16:847824. [PMID: 35558154 PMCID: PMC9088922 DOI: 10.3389/fnint.2022.847824] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2022] [Accepted: 03/14/2022] [Indexed: 12/03/2022] Open
Abstract
Background Poor vascular health may impede brain functioning in older adults, thus possibly increasing the risk of cognitive decline and Alzheimer’s disease (AD). The emerging link between vascular risk factors (VRF) and longitudinal decline in resting-state functional connectivity (RSFC) within functional brain networks needs replication and further research in independent cohorts. Method We examined 95 non-demented older adults using the IMAP+ cohort (Caen, France). VRF were assessed at baseline through systolic and diastolic blood pressure, body-mass-index, and glycated hemoglobin (HbA1c) levels. Brain pathological burden was measured using white matter hyperintensity (WMH) volumes, derived from FLAIR images, and cortical β-Amyloid (Aβ) deposition, derived from florbetapir-PET imaging. RSFC was estimated from functional MRI scans within canonical brain networks at baseline and up to 3 years of follow-up. Linear mixed-effects models evaluated the independent predictive value of VRF on longitudinal changes in network-specific and global RSFC as well as a potential association between these RSFC changes and cognitive decline. Results We replicate that RSFC increased over time in global RSFC and in the default-mode, salience/ventral-attention and fronto-parietal networks. In contrast, higher diastolic blood pressure levels were independently associated with a decrease of RSFC over time in the default-mode, salience/ventral-attention, and fronto-parietal networks. Moreover, higher HbA1c levels were independently associated with a reduction of the observed RSFC increase over time in the salience/ventral-attention network. Both of these associations were independent of brain pathology related to Aβ load and WMH volumes. The VRF-related changes in RSFC over time were not significantly associated with longitudinal changes in cognitive performance. Conclusion Our longitudinal findings corroborate that VRF promote RSFC alterations over time within higher-order brain networks, irrespective of pathological brain burden. Altered RSFC in large-scale cognitive networks may eventually increase the vulnerability to aging and AD.
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Affiliation(s)
- Miranka Wirth
- German Center for Neurodegenerative Diseases (DZNE), Dresden, Germany
- *Correspondence: Miranka Wirth,
| | - Malo Gaubert
- German Center for Neurodegenerative Diseases (DZNE), Dresden, Germany
| | - Theresa Köbe
- German Center for Neurodegenerative Diseases (DZNE), Dresden, Germany
| | - Antoine Garnier-Crussard
- Clinical and Research Memory Center of Lyon, Lyon Institute for Aging, Hospices Civils de Lyon, Lyon, France
- INSERM 1048, CNRS 5292, Neuroscience Research Centre, Lyon, France
- UNICAEN, INSERM, U1237, PhIND “Physiopathology and Imaging of Neurological Disorders,” Institut Blood and Brain @ Caen-Normandie, Cyceron, Normandy University, Caen, France
| | - Catharina Lange
- German Center for Neurodegenerative Diseases (DZNE), Dresden, Germany
- Department of Nuclear Medicine, Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
| | - Julie Gonneaud
- UNICAEN, INSERM, U1237, PhIND “Physiopathology and Imaging of Neurological Disorders,” Institut Blood and Brain @ Caen-Normandie, Cyceron, Normandy University, Caen, France
| | - Robin de Flores
- UNICAEN, INSERM, U1237, PhIND “Physiopathology and Imaging of Neurological Disorders,” Institut Blood and Brain @ Caen-Normandie, Cyceron, Normandy University, Caen, France
| | - Brigitte Landeau
- UNICAEN, INSERM, U1237, PhIND “Physiopathology and Imaging of Neurological Disorders,” Institut Blood and Brain @ Caen-Normandie, Cyceron, Normandy University, Caen, France
| | - Vincent de la Sayette
- UNICAEN, INSERM, U1237, PhIND “Physiopathology and Imaging of Neurological Disorders,” Institut Blood and Brain @ Caen-Normandie, Cyceron, Normandy University, Caen, France
- Department of Neurology, CHU de Caen, Caen, France
| | - Gaël Chételat
- UNICAEN, INSERM, U1237, PhIND “Physiopathology and Imaging of Neurological Disorders,” Institut Blood and Brain @ Caen-Normandie, Cyceron, Normandy University, Caen, France
- Gaël Chételat,
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26
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Arce Rentería M, Manly JJ, Vonk JM, Mejia Arango S, Michaels Obregon A, Samper-Ternent R, Wong R, Barral S, Tosto G. Midlife Vascular Factors and Prevalence of Mild Cognitive Impairment in Late-Life in Mexico. J Int Neuropsychol Soc 2022; 28:351-361. [PMID: 34376262 PMCID: PMC8831650 DOI: 10.1017/s1355617721000539] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
OBJECTIVE To estimate the prevalence of mild cognitive impairment (MCI) and its subtypes and investigate the impact of midlife cardiovascular risk factors on late-life MCI among the aging Mexican population. METHOD Analyses included a sample of non-demented adults over the age of 55 living in both urban and rural areas of Mexico (N = 1807). MCI diagnosis was assigned based on a comprehensive cognitive assessment assessing the domains of memory, executive functioning, language, and visuospatial ability. The normative sample was selected by means of the robust norms approach. Cognitive impairment was defined by a 1.5-SD cut-off per cognitive domain using normative corrections for age, years of education, and sex. Risk factors included age, education, sex, rurality, depression, insurance status, workforce status, hypertension, diabetes, stroke, and heart disease. RESULTS The prevalence of amnestic MCI was 5.9%. Other MCI subtypes ranged from 4.2% to 7.7%. MCI with and without memory impairment was associated with older age (OR = 1.01 [1.01, 1.05]; OR = 1.03 [1.01, 1.04], respectively) and residing in rural areas (OR = 1.49 [1.08, 2.06]; OR = 1.35 [1.03, 1.77], respectively). Depression (OR = 1.07 [1.02, 1.12]), diabetes (OR = 1.37 [1.03, 1.82]), and years of education (OR = 0.94 [0.91, 0.97]) were associated with MCI without memory impairment. Midlife CVD increased the odds of MCI in late-life (OR = 1.76 [1.19, 2.59], which was driven by both midlife hypertension and diabetes (OR = 1.70 [1.18, 2.44]; OR = 1.88 [1.19, 2.97], respectively). CONCLUSIONS Older age, depression, low education, rurality, and midlife hypertension and diabetes were associated with higher risk of late-life MCI among older adults in Mexico. Our findings suggest that the causes of cognitive impairment are multifactorial and vary by MCI subtype.
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Affiliation(s)
- Miguel Arce Rentería
- Taub Institute for Research on Alzheimer’s Disease and the Aging Brain, Department of Neurology, Columbia University College of Physicians and Surgeons, New York City, NY, USA
| | - Jennifer J. Manly
- Taub Institute for Research on Alzheimer’s Disease and the Aging Brain, Department of Neurology, Columbia University College of Physicians and Surgeons, New York City, NY, USA
| | - Jet M.J. Vonk
- Taub Institute for Research on Alzheimer’s Disease and the Aging Brain, Department of Neurology, Columbia University College of Physicians and Surgeons, New York City, NY, USA
- Julius Center for Health Sciences and Primary Care, Department of Epidemiology, University Medical Center Utrecht and Utrecht University, Utrecht, The Netherlands
| | - Silvia Mejia Arango
- Department of Population Studies, El Colegio de la Frontera Norte, Tijuana, Baja California, Mexico
| | | | - Rafael Samper-Ternent
- Sealy Center on Aging, University of Texas Medical Branch at Galveston, Galveston, Texas, USA
- Department of Internal Medicine, University of Texas Medical Branch at Galveston, Galveston, TX, USA
| | - Rebeca Wong
- Sealy Center on Aging, University of Texas Medical Branch at Galveston, Galveston, Texas, USA
| | - Sandra Barral
- Taub Institute for Research on Alzheimer’s Disease and the Aging Brain, Department of Neurology, Columbia University College of Physicians and Surgeons, New York City, NY, USA
| | - Giuseppe Tosto
- Taub Institute for Research on Alzheimer’s Disease and the Aging Brain, Department of Neurology, Columbia University College of Physicians and Surgeons, New York City, NY, USA
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27
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Abstract
As life expectancy grows, brain health is increasingly seen as central to what we mean by successful aging-and vascular brain health as central to overall brain health. Cerebrovascular pathologies are highly prevalent independent contributors to age-related cognitive impairment and at least partly modifiable with available treatments. The current Focused Update addresses vascular brain health from multiple angles, ranging from pathophysiologic mechanisms and neuroimaging features to epidemiologic risk factors, social determinants, and candidate treatments. Here we highlight some of the shared themes that cut across these distinct perspectives: 1) the lifetime course of vascular brain injury pathogenesis and progression; 2) the scientific and ethical imperative to extend vascular brain health research in non-White and non-affluent populations; 3) the need for improved tools to study the cerebral small vessels themselves; 4) the potential role for brain recovery mechanisms in determining vascular brain health and resilience; and 5) the cross-pathway mechanisms by which vascular and neurodegenerative processes may interact. The diverse perspectives featured in this Focused Update offer a sense of the multidisciplinary approaches and collaborations that will be required to launch our populations towards improved brain health and successful aging.
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Affiliation(s)
- Steven M Greenberg
- J. Philip Kistler Stroke Research Center, Massachusetts General Hospital, Harvard Medical School, Boston
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28
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Moberg L, Leppert J, Liljeström S, Rehn M, Kilander L, Chabok A. Blood pressure screening in midlife aids in prediction of dementia later in life. Ups J Med Sci 2022; 127:7860. [PMID: 35140874 PMCID: PMC8788652 DOI: 10.48101/ujms.v127.7860] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2021] [Revised: 10/06/2021] [Accepted: 11/07/2021] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND There is substantial evidence that midlife hypertension is a risk factor for late life dementia. Our aim was to investigate if even high blood pressure at a single timepoint in midlife can predict an increased risk for all-cause dementia, Alzheimer's disease (AD), or vascular dementia (VaD) later in life. METHODS The community-based study population comprised 30,102 dementia-free individuals from the Westmannia Cardiovascular Risk Factors Study. The participants were aged 40 or 50 years when the health examination took place in 1990-2000. Diagnose registers from both hospitals and primary healthcare centers were used to identify individuals who after inclusion to the study developed dementia. The association between midlife high blood pressure (defined as systolic blood pressure >140 and/or diastolic blood pressure >90 mmHg) at a single timepoint and dementia was adjusted for age, gender, body mass index (BMI), fasting blood glucose, education, smoking, and physical activity level. Multivariate binary cox regression analyses were used. RESULTS After a mean follow-up time of 24 years resulting in 662,244 person/years, 761 (2.5%) individuals had been diagnosed with dementia. Midlife high blood pressure at a single timepoint predicted all-cause dementia (hazard ratio [HR]: 1.22, 95% confidence interval [CI]: 1.02-1.45) and VaD (HR: 2.10, 95% CI: 1.47-3.00) but not AD (HR: 1.06, 95% CI: 0.81-1.38). CONCLUSION This study suggests that even midlife high blood pressure at a single timepoint predicts all-cause dementia and more than doubles the risk for VaD later in life independently of established confounders. Even though there was no such association with AD, this strengthens the importance of midlife health examinations in order to identify individuals with hypertension and initiate treatment.
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Affiliation(s)
- Linn Moberg
- Centre for Clinical Research, Uppsala University, Västmanland County Hospital, Västerås, Sweden
| | - Jerzy Leppert
- Centre for Clinical Research, Uppsala University, Västmanland County Hospital, Västerås, Sweden
| | - Simon Liljeström
- Centre for Clinical Research, Uppsala University, Västmanland County Hospital, Västerås, Sweden
| | - Mattias Rehn
- Centre for Clinical Research, Uppsala University, Västmanland County Hospital, Västerås, Sweden
| | - Lena Kilander
- Department of Public Health and Caring Sciences/Geriatrics, Uppsala University, Uppsala, Sweden
| | - Abbas Chabok
- Centre for Clinical Research, Uppsala University, Västmanland County Hospital, Västerås, Sweden
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29
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Baradaran H, Peloso GM, Polak JF, Killiany RJ, Ghosh S, DeCarli CS, Thibault EG, Sperling RA, Johnson KA, Beiser A, Romero JR, Seshadri S. Association of Carotid Intima Media Thickening with Future Brain Region Specific Amyloid-β Burden. J Alzheimers Dis 2022; 89:223-232. [PMID: 35871328 PMCID: PMC11371395 DOI: 10.3233/jad-215679] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Carotid atherosclerosis is associated with cognitive impairment and dementia, though there is limited evidence of a direct link between carotid disease and amyloid-β (Aβ) burden. OBJECTIVE We studied the association of baseline and progressive carotid intima media thickness (CIMT) with Aβ on 11C-Pittsburgh Compound B (PiB) to determine if those with carotid atherosclerosis would have higher Aβ burden. METHODS We studied 47 participants from the Framingham Offspring cohort with carotid ultrasounds measuring CIMT at their 6th clinic examination (aged 49.5±5.7 years) and an average of 9.6 years later, and PiB imaging measuring Aβ on average 22.1 years post baseline. We used multivariate linear regression analyses to relate baseline, follow-up, mean, and progression of internal carotid artery (ICA) and common carotid artery (CCA) CIMT to Aβ in brain regions associated with Alzheimer's disease (AD) and related dementias (ADRD), adjusting for age, sex, and other vascular risk factors. RESULTS Participants with higher mean ICA IMT had more Aβ in the precuneus (beta±standard error [β±SE]: 0.466±0.171 mm, p = 0.01) and the frontal, lateral, and retrosplenial regions (β±SE: 0.392±0.164 mm, p = 0.022) after adjusting for age, sex, vascular risk factors, and medication use. We did not find an association between any CCA IMT measures and Aβ or progression of ICA or CCA IMT and Aβ. CONCLUSION Carotid atherosclerosis, as measured by ICA IMT, is associated with increased Aβ burden later in life. These findings support a link between vascular disease and AD/ADRD pathophysiology.
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Affiliation(s)
- Hediyeh Baradaran
- Department of Radiology, University of Utah, Salt Lake City, UT, USA
| | - Gina M. Peloso
- Department of Biostatistics, Boston University School of Public Health, Boston, MA, USA
| | - Joseph F. Polak
- Department of Radiology, Tufts University School of Medicine, Boston, MA, USA
| | - Ronald J. Killiany
- Department of Neurology, Boston University School of Medicine, Boston, MA, USA
- Department of Anatomy and Neurobiology, Boston University School of Medicine, Boston, MA, USA
| | - Saptaparni Ghosh
- Department of Neurology, Boston University School of Medicine, Boston, MA, USA
- NHLBI’s Framingham Heart Study, Framingham, MA, USA
| | - Charles S. DeCarli
- Department of Neurology, School of Medicine & Imaging of Dementia and Aging Laboratory, Center for Neuroscience, University of California Davis, Davis, CA, USA
| | - Emma G. Thibault
- Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Reisa A. Sperling
- Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Keith A. Johnson
- Athinoula A. Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
- Department of Neurology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Alexa Beiser
- Department of Biostatistics, Boston University School of Public Health, Boston, MA, USA
- Department of Neurology, Boston University School of Medicine, Boston, MA, USA
- NHLBI’s Framingham Heart Study, Framingham, MA, USA
| | - Jose R. Romero
- Department of Neurology, Boston University School of Medicine, Boston, MA, USA
- NHLBI’s Framingham Heart Study, Framingham, MA, USA
| | - Sudha Seshadri
- Department of Neurology, Boston University School of Medicine, Boston, MA, USA
- NHLBI’s Framingham Heart Study, Framingham, MA, USA
- Glenn Biggs Institute for Alzheimer’s and Neurodegenerative Diseases, University of Texas Health Sciences Center, San Antonio, TX, USA
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30
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Seshadri S, Caunca MR, Rundek T. Vascular Dementia and Cognitive Impairment. Stroke 2022. [DOI: 10.1016/b978-0-323-69424-7.00018-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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31
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Bishnoi A, Chaparro GN, Hernandez ME. Effect of Heart Rate Reserve on Prefrontal Cortical Activation While Dual-Task Walking in Older Adults. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 19:47. [PMID: 35010305 PMCID: PMC8751037 DOI: 10.3390/ijerph19010047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Revised: 12/15/2021] [Accepted: 12/17/2021] [Indexed: 06/14/2023]
Abstract
Hypertension is considered a risk factor for cardiovascular health and non-amnestic cognitive impairment in older adults. While heart rate reserve (HRR) has been shown to be a risk factor for hypertension, how impaired HRR in older adults can lead to cognitive impairment is still unclear. The objective of this study was to examine the effects of HRR on prefrontal cortical (PFC) activation under varying dual-task demands in older adults. Twenty-eight older adults (50-82 years of age) were included in this study and divided into higher (n = 14) and lower (n = 14) HRR groups. Participants engaged in the cognitive task which was the Modified Stroop Color Word Test (MSCWT) on a self-paced treadmill while walking. Participants with higher HRR demonstrated increased PFC activation in comparison to lower HRR, even after controlling for covariates in analysis. Furthermore, as cognitive task difficulty increased (from neutral to congruent to incongruent to switching), PFC activation increased. In addition, there was a significant interaction between tasks and HRR group, with older adults with higher HRR demonstrating increases in PFC activation, faster gait speed, and increased accuracy, relative to those with lower HRR, when going from neutral to switching tasks. These results provide evidence of a relationship between HRR and prefrontal cortical activation and cognitive and physical performance, suggesting that HRR may serve as a biomarker for cognitive health of an older adult with or without cardiovascular risk.
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Affiliation(s)
- Alka Bishnoi
- Department of Kinesiology and Community Health, College of Applied Health Science, University of Illinois at Urbana-Champaign, Urbana, IL 61801, USA;
| | - Gioella N. Chaparro
- Department of Kinesiology, California State University, Dominguez Hills, Carson, CA 90747, USA;
| | - Manuel E. Hernandez
- Department of Kinesiology and Community Health, College of Applied Health Science, University of Illinois at Urbana-Champaign, Urbana, IL 61801, USA;
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Paulo SL, Miranda-Lourenço C, Belo RF, Rodrigues RS, Fonseca-Gomes J, Tanqueiro SR, Geraldes V, Rocha I, Sebastião AM, Xapelli S, Diógenes MJ. High Caloric Diet Induces Memory Impairment and Disrupts Synaptic Plasticity in Aged Rats. Curr Issues Mol Biol 2021; 43:2305-2319. [PMID: 34940136 PMCID: PMC8929079 DOI: 10.3390/cimb43030162] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2021] [Revised: 12/08/2021] [Accepted: 12/13/2021] [Indexed: 12/26/2022] Open
Abstract
The increasing consumption of sugar and fat seen over the last decades and the consequent overweight and obesity, were recently linked with a deleterious effect on cognition and synaptic function. A major question, which remains to be clarified, is whether obesity in the elderly is an additional risk factor for cognitive impairment. We aimed at unravelling the impact of a chronic high caloric diet (HCD) on memory performance and synaptic plasticity in aged rats. Male rats were kept on an HCD or a standard diet (control) from 1 to 24 months of age. The results showed that under an HCD, aged rats were obese and displayed significant long-term recognition memory impairment when compared to age-matched controls. Ex vivo synaptic plasticity recorded from hippocampal slices from HCD-fed aged rats revealed a reduction in the magnitude of long-term potentiation, accompanied by a decrease in the levels of the brain-derived neurotrophic factor receptors TrkB full-length (TrkB-FL). No alterations in neurogenesis were observed, as quantified by the density of immature doublecortin-positive neurons in the hippocampal dentate gyrus. This study highlights that obesity induced by a chronic HCD exacerbates age-associated cognitive decline, likely due to impaired synaptic plasticity, which might be associated with deficits in TrkB-FL signaling.
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Affiliation(s)
- Sara L. Paulo
- Instituto de Farmacologia e Neurociências, Faculdade de Medicina, Universidade de Lisboa, 1649-028 Lisboa, Portugal; (S.L.P.); (C.M.-L.); (R.F.B.); (R.S.R.); (J.F.-G.); (S.R.T.); (A.M.S.); (S.X.)
- Instituto de Medicina Molecular João Lobo Antunes, Faculdade de Medicina, Universidade de Lisboa, 1649-028 Lisboa, Portugal
| | - Catarina Miranda-Lourenço
- Instituto de Farmacologia e Neurociências, Faculdade de Medicina, Universidade de Lisboa, 1649-028 Lisboa, Portugal; (S.L.P.); (C.M.-L.); (R.F.B.); (R.S.R.); (J.F.-G.); (S.R.T.); (A.M.S.); (S.X.)
- Instituto de Medicina Molecular João Lobo Antunes, Faculdade de Medicina, Universidade de Lisboa, 1649-028 Lisboa, Portugal
| | - Rita F. Belo
- Instituto de Farmacologia e Neurociências, Faculdade de Medicina, Universidade de Lisboa, 1649-028 Lisboa, Portugal; (S.L.P.); (C.M.-L.); (R.F.B.); (R.S.R.); (J.F.-G.); (S.R.T.); (A.M.S.); (S.X.)
- Instituto de Medicina Molecular João Lobo Antunes, Faculdade de Medicina, Universidade de Lisboa, 1649-028 Lisboa, Portugal
| | - Rui S. Rodrigues
- Instituto de Farmacologia e Neurociências, Faculdade de Medicina, Universidade de Lisboa, 1649-028 Lisboa, Portugal; (S.L.P.); (C.M.-L.); (R.F.B.); (R.S.R.); (J.F.-G.); (S.R.T.); (A.M.S.); (S.X.)
- Instituto de Medicina Molecular João Lobo Antunes, Faculdade de Medicina, Universidade de Lisboa, 1649-028 Lisboa, Portugal
| | - João Fonseca-Gomes
- Instituto de Farmacologia e Neurociências, Faculdade de Medicina, Universidade de Lisboa, 1649-028 Lisboa, Portugal; (S.L.P.); (C.M.-L.); (R.F.B.); (R.S.R.); (J.F.-G.); (S.R.T.); (A.M.S.); (S.X.)
- Instituto de Medicina Molecular João Lobo Antunes, Faculdade de Medicina, Universidade de Lisboa, 1649-028 Lisboa, Portugal
| | - Sara R. Tanqueiro
- Instituto de Farmacologia e Neurociências, Faculdade de Medicina, Universidade de Lisboa, 1649-028 Lisboa, Portugal; (S.L.P.); (C.M.-L.); (R.F.B.); (R.S.R.); (J.F.-G.); (S.R.T.); (A.M.S.); (S.X.)
- Instituto de Medicina Molecular João Lobo Antunes, Faculdade de Medicina, Universidade de Lisboa, 1649-028 Lisboa, Portugal
| | - Vera Geraldes
- Instituto de Fisiologia, Faculdade de Medicina, Universidade de Lisboa, 1649-028 Lisboa, Portugal; (V.G.); (I.R.)
- Centro Cardiovascular da Universidade de Lisboa, 1649-028 Lisboa, Portugal
| | - Isabel Rocha
- Instituto de Fisiologia, Faculdade de Medicina, Universidade de Lisboa, 1649-028 Lisboa, Portugal; (V.G.); (I.R.)
- Centro Cardiovascular da Universidade de Lisboa, 1649-028 Lisboa, Portugal
| | - Ana M. Sebastião
- Instituto de Farmacologia e Neurociências, Faculdade de Medicina, Universidade de Lisboa, 1649-028 Lisboa, Portugal; (S.L.P.); (C.M.-L.); (R.F.B.); (R.S.R.); (J.F.-G.); (S.R.T.); (A.M.S.); (S.X.)
- Instituto de Medicina Molecular João Lobo Antunes, Faculdade de Medicina, Universidade de Lisboa, 1649-028 Lisboa, Portugal
| | - Sara Xapelli
- Instituto de Farmacologia e Neurociências, Faculdade de Medicina, Universidade de Lisboa, 1649-028 Lisboa, Portugal; (S.L.P.); (C.M.-L.); (R.F.B.); (R.S.R.); (J.F.-G.); (S.R.T.); (A.M.S.); (S.X.)
- Instituto de Medicina Molecular João Lobo Antunes, Faculdade de Medicina, Universidade de Lisboa, 1649-028 Lisboa, Portugal
| | - Maria J. Diógenes
- Instituto de Farmacologia e Neurociências, Faculdade de Medicina, Universidade de Lisboa, 1649-028 Lisboa, Portugal; (S.L.P.); (C.M.-L.); (R.F.B.); (R.S.R.); (J.F.-G.); (S.R.T.); (A.M.S.); (S.X.)
- Instituto de Medicina Molecular João Lobo Antunes, Faculdade de Medicina, Universidade de Lisboa, 1649-028 Lisboa, Portugal
- Correspondence: ; Tel.: +351-217-985-183
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Liver-Unrelated Comorbid Conditions Do Not Affect Cognitive Performance or Hepatic Encephalopathy Progression in Cirrhosis. Am J Gastroenterol 2021; 116:2385-2389. [PMID: 34140445 PMCID: PMC8683569 DOI: 10.14309/ajg.0000000000001346] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2021] [Accepted: 05/21/2021] [Indexed: 12/11/2022]
Abstract
INTRODUCTION We aimed to determine the effect of comorbidities on covert hepatic encephalopathy (CHE) diagnosis and overt hepatic encephalopathy (OHE) development. METHODS Cirrhotic outpatients underwent CHE testing and 2-year follow-up. Cox regression was performed for time to OHE. In total, 700 patients (60 years, 84% men, model for end-stage liver disease 11) and 33% prior OHE underwent testing and follow-up. RESULTS Major comorbidities were hypertension (54%), diabetes (35%), and depression (29%). Common medications were proton pump inhibitor (49%), beta-blockers (32%), and opioids (21%). Approximately 90 (40%) prior-OHE patients developed recurrence 93 (30,206) days post-testing predicted only by liverrelated variables. DISCUSSION Demographics, cirrhosis characteristics, and opioid use, but not other comorbid conditions, were associated with CHE diagnosis and OHE progression.
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Wang S, Wang X, Wang Z, Wang Z, Jiang L, Liu J, Wu J, Liu Y. Highly sensitive and selective detection of cytochrome P450 46A1 activity by a ultra-high-performance liquid chromatography-tandem mass spectrometry method. Biomed Chromatogr 2021; 36:e5291. [PMID: 34854105 DOI: 10.1002/bmc.5291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2021] [Revised: 11/11/2021] [Accepted: 11/15/2021] [Indexed: 11/09/2022]
Abstract
Cytochrome P450 46A1 (CYP46A1) is a key enzyme responsible for metabolizing cholesterol to 24-hydroxycholesterol in the brain, and thus might serve as a therapeutic target for several neurodegenerative disorders including Parkinson's disease, Alzheimer's disease and Huntington's disease. However, an applicable, sensitive and reliable method for the precise measurement of CYP46A1 activities in complex biological samples remains limited. In this study, a novel ultra-high-performance liquid chromatography-tandem mass spectrometry (UPLC-MS/MS) method for highly sensitive and selective determination of 24-hydroxycholesterol was developed to characterize CYP46A1 activity. The mass spectrometric detection was performed using multiple reaction monitoring for 24-hydroxcholesterol at m/z 385.2 → 367.2. The limit of quantification for 24-hydroxycholesterol using this UPLC-MS/MS method was as low as 10 nM, which is lower than those reported previously. The method also showed favorable accuracy and precision. Meanwhile, the short- and long-term stability of this method was fully validated. In addition, the method was successfully applied to investigate the kinetic properties of 24-hydroxycholesterol formation by CYP46A1.
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Affiliation(s)
- Shujuan Wang
- School of Life and Pharmaceutical Sciences, Dalian University of Technology, Panjin, China
| | - Xiaoyu Wang
- School of Life and Pharmaceutical Sciences, Dalian University of Technology, Panjin, China
| | - Zhe Wang
- School of Life and Pharmaceutical Sciences, Dalian University of Technology, Panjin, China
| | - Zhen Wang
- School of Life and Pharmaceutical Sciences, Dalian University of Technology, Panjin, China
| | - Lili Jiang
- School of Life and Pharmaceutical Sciences, Dalian University of Technology, Panjin, China
| | - Jing Liu
- College of Pharmacy, Dalian Medical University, Dalian, China
| | - Jingjing Wu
- College of Pharmacy, Dalian Medical University, Dalian, China
| | - Yong Liu
- School of Life and Pharmaceutical Sciences, Dalian University of Technology, Panjin, China
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Pallangyo P, Mkojera ZS, Komba M, Mgopa LR, Bhalia S, Mayala H, Wibonela S, Misidai N, Swai HJ, Millinga J, Chavala E, Kisenge PR, Janabi M. Burden and correlates of cognitive impairment among hypertensive patients in Tanzania: a cross-sectional study. BMC Neurol 2021; 21:433. [PMID: 34749692 PMCID: PMC8573988 DOI: 10.1186/s12883-021-02467-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Accepted: 10/25/2021] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND The evolution of cognitive impairment of vascular origin is increasingly becoming a prominent health threat particularly in this era where hypertension is the leading contributor of global disease burden and overall health loss. Hypertension is associated with the alteration of the cerebral microcirculation coupled by unfavorable vascular remodeling with consequential slowing of mental processing speed, reduced abstract reasoning, loss of linguistic abilities, and attention and memory deficits. Owing to the rapidly rising burden of hypertension in Tanzania, we sought to assess the prevalence and correlates of cognitive impairment among hypertensive patients attending a tertiary cardiovascular hospital in Tanzania. METHODOLOGY A hospital-based cross-sectional study was conducted at Jakaya Kikwete Cardiac Institute, a tertiary care public teaching hospital in Dar es Salaam, Tanzania between March 2020 and February 2021. A consecutive sampling method was utilized to recruit consented hypertensive outpatients during their scheduled clinic visit. General Practitioner Assessment of Cognition (GPCOG) Score was utilized in the assessment of cognitive functions. All statistical analyses utilized STATA v11.0 software. Pearson Chi square and Student's T-test were used to compare categorical and continuous variables respectively. Logistic regression analyses were used to assess for factors associated with cognitive impairment. Odd ratios with 95% confidence intervals and p-values are reported. All tests were 2-sided and p < 0.05 was used to denote a statistical significance. RESULTS A total of 1201 hypertensive patients were enrolled in this study. The mean age was 58.1 years and females constituted nearly two-thirds of the study population. About three quarters had excess body weight, 16.6% had diabetes, 7.7% had history of stroke, 5.7% had heart failure, 16.7% had renal dysfunction, 53.7% had anemia, 27.7% had hypertriglyceridemia, 38.5% had elevated LDL, and 2.4% were HIV-infected. Nearly two-thirds of participants had uncontrolled blood pressure and 8.7% had orthostatic hypotension. Overall, 524 (43.6%) of participants had cognitive impairment. During bivariate analysis in a logistic regression model of 16 characteristics, 14 parameters showed association with cognitive functions. However, after controlling for confounders, multivariate analysis revealed ≤primary education (OR 3.5, 95%CI 2.4-5.2, p < 0.001), unemployed state (OR 1.7, 95%CI 1.2-2.6, p < 0.01), rural habitation (OR 1.8, 95%CI 1.1-2.9, p = 0.01) and renal dysfunction (OR 1.7, 95%CI 1.0-2.7, p = 0.04) to have independent association with cognitive impairment. CONCLUSION This present study underscore that cognitive decline is considerably prevalent among individuals with systemic hypertension. In view of this, it is pivotal to incorporate cognitive assessment in routine evaluation of hypertensive patients.
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Affiliation(s)
- Pedro Pallangyo
- PédPäl Research Initiative, P.O Box 65066, Dar es Salaam, Tanzania
- Directorate of Cardiology, Jakaya Kikwete Cardiac Institute, P.O Box 65141, Dar es Salaam, Tanzania
| | | | - Makrina Komba
- PédPäl Research Initiative, P.O Box 65066, Dar es Salaam, Tanzania
| | - Lucy R. Mgopa
- PédPäl Research Initiative, P.O Box 65066, Dar es Salaam, Tanzania
- Department of Psychiatry and Mental Health, Muhimbili University of Health and Allied Sciences, P.O Box 65001, Dar es Salaam, Tanzania
| | - Smita Bhalia
- Directorate of Cardiology, Jakaya Kikwete Cardiac Institute, P.O Box 65141, Dar es Salaam, Tanzania
| | - Henry Mayala
- Directorate of Clinical Support Services, Jakaya Kikwete Cardiac Institute, P.O Box 65141, Dar es Salaam, Tanzania
| | - Salma Wibonela
- Directorate of Nursing, Jakaya Kikwete Cardiac Institute, P.O Box 65141, Dar es Salaam, Tanzania
| | - Nsajigwa Misidai
- PédPäl Research Initiative, P.O Box 65066, Dar es Salaam, Tanzania
| | | | - Jalack Millinga
- PédPäl Research Initiative, P.O Box 65066, Dar es Salaam, Tanzania
- Directorate of Nursing, Jakaya Kikwete Cardiac Institute, P.O Box 65141, Dar es Salaam, Tanzania
| | - Ester Chavala
- PédPäl Research Initiative, P.O Box 65066, Dar es Salaam, Tanzania
- Directorate of Nursing, Jakaya Kikwete Cardiac Institute, P.O Box 65141, Dar es Salaam, Tanzania
| | - Peter R. Kisenge
- Directorate of Cardiology, Jakaya Kikwete Cardiac Institute, P.O Box 65141, Dar es Salaam, Tanzania
| | - Mohamed Janabi
- Directorate of Cardiology, Jakaya Kikwete Cardiac Institute, P.O Box 65141, Dar es Salaam, Tanzania
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Carbone MG, Pagni G, Tagliarini C, Imbimbo BP, Pomara N. Can platelet activation result in increased plasma Aβ levels and contribute to the pathogenesis of Alzheimer's disease? Ageing Res Rev 2021; 71:101420. [PMID: 34371202 DOI: 10.1016/j.arr.2021.101420] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2021] [Revised: 07/18/2021] [Accepted: 08/02/2021] [Indexed: 12/12/2022]
Abstract
One of the central lesions in the brain of subjects with Alzheimer's disease (AD) is represented by aggregates of β-amyloid (Aβ), a peptide of 40-42 amino acids derived from the amyloid precursor protein (APP). The reasons why Aβ accumulates in the brain of individuals with sporadic forms of AD are unknown. Platelets are the primary source of circulating APP and, upon activation, can secrete significant amounts of Aβ into the blood which can be actively transported to the brain across the blood-brain barrier and promote amyloid deposition. Increased platelet activity can stimulate platelet adhesion to endothelial cells, trigger the recruitment of leukocytes into the vascular wall and cause perivascular inflammation, which can spread inflammation in the brain. Neuroinflammation is fueled by activated microglial cells and reactive astrocytes that release neurotoxic cytokines and chemokines. Platelet activation is also associated with the progression of carotid artery disease resulting in an increased risk of cerebral hypoperfusion which may also contribute to the AD neurodegenerative process. Platelet activation may thus be a pathophysiological mechanism of AD and for the strong link between AD and cerebrovascular diseases. Interfering with platelet activation may represent a promising potential adjunct therapeutic approach for AD.
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Affiliation(s)
- Manuel Glauco Carbone
- Department of Medicine and Surgery, Division of Psychiatry, University of Insubria, Viale Luigi Borri 57, 21100, Varese, Italy; Pisa-School of Experimental and Clinical Psychiatry, University of Pisa, Via Roma 57, 56100, Pisa, Italy.
| | - Giovanni Pagni
- Pisa-School of Experimental and Clinical Psychiatry, University of Pisa, Via Roma 57, 56100, Pisa, Italy.
| | - Claudia Tagliarini
- Pisa-School of Experimental and Clinical Psychiatry, University of Pisa, Via Roma 57, 56100, Pisa, Italy.
| | | | - Nunzio Pomara
- Geriatric Psychiatry Department, Nathan Kline Institute, and Departments of Psychiatry and Pathology, NYU Grossman School of Medicine, 140 Old Orangeburg Road Orangeburg, New York, 10962, United States.
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Tomoto T, Repshas J, Zhang R, Tarumi T. Midlife aerobic exercise and dynamic cerebral autoregulation: associations with baroreflex sensitivity and central arterial stiffness. J Appl Physiol (1985) 2021; 131:1599-1612. [PMID: 34647828 PMCID: PMC8616602 DOI: 10.1152/japplphysiol.00243.2021] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Revised: 10/04/2021] [Accepted: 10/11/2021] [Indexed: 12/20/2022] Open
Abstract
Midlife aerobic exercise may significantly impact age-related changes in the cerebro- and cardiovascular regulations. This study investigated the associations of midlife aerobic exercise with dynamic cerebral autoregulation (dCA), cardiovagal baroreflex sensitivity (BRS), and central arterial stiffness. Twenty middle-aged athletes (MA) who had aerobic training for >10 yr were compared with 20 young (YS) and 20 middle-aged sedentary (MS) adults. Beat-to-beat cerebral blood flow velocity, blood pressure (BP), and heart rate were measured at rest and during forced BP oscillations induced by repeated sit-stand maneuvers at 0.05 Hz. Transfer function analysis was used to calculate dCA and BRS parameters. Carotid distensibility was measured by ultrasonography. MA had the highest peak oxygen uptake (V̇o2peak) among all groups. During forced BP oscillations, MS showed lower BRS gain than YS, but this age-related reduction was absent in MA. Conversely, dCA was similar among all groups. At rest, BRS and dCA gains at low frequency (∼0.1 Hz) were higher in the MA than in MS and YS groups. Carotid distensibility was similar between MA and YS groups, but it was lower in the MS. Across all subjects, V̇o2peak was positively associated with BRS gains at rest and during forced BP oscillations (r = 0.257∼0.382, P = 0.003∼0.050) and carotid distensibility (r = 0.428∼0.490, P = 0.001). Furthermore, dCA gain at rest and carotid distensibility were positively correlated with BRS gain at rest in YS and MA groups (all P < 0.05). These findings suggest that midlife aerobic exercise improves central arterial elasticity and BRS, which may contribute to cerebral blood flow (CBF) regulation through dCA.NEW & NOTEWORTHY Middle-aged athletes (MA) showed intact dynamic cerebral autoregulation (dCA) during sit-stand maneuvers when compared with young (YS) and middle-aged sedentary (MS) adults. Conversely, MA showed the significant attenuation of age-related carotid distensibility and baroreflex sensitivity (BRS) impairments. In MA and YS groups, BRS was positively associated with dCA gain at rest and carotid distensibility. Our findings suggest that midlife aerobic exercise improves BRS by reducing central arterial stiffness, which contributes to CBF regulation through dCA.
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Affiliation(s)
- Tsubasa Tomoto
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas, Dallas, Texas
- Department of Neurology, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Justin Repshas
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas, Dallas, Texas
| | - Rong Zhang
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas, Dallas, Texas
- Department of Neurology, University of Texas Southwestern Medical Center, Dallas, Texas
- Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, Texas
| | - Takashi Tarumi
- Institute for Exercise and Environmental Medicine, Texas Health Presbyterian Hospital Dallas, Dallas, Texas
- Department of Neurology, University of Texas Southwestern Medical Center, Dallas, Texas
- Human Informatics and Interaction Research Institute, National Institute of Advanced Industrial Science and Technology, Tsukuba, Japan
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Kaur D, Behl T, Chigurupati S, Sehgal A, Singh S, Sharma N, Badavath VN, Vargas-De-La-Cruz C, Bhatia S, Al-Harrasi A, Dey A, Aleya L, Bungau S. Deciphering the focal role of endostatin in Alzheimer's disease. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2021; 28:61998-62011. [PMID: 34561808 DOI: 10.1007/s11356-021-16567-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Accepted: 09/12/2021] [Indexed: 06/13/2023]
Abstract
Alzheimer's disease (AD) is a paramount chronic neurodegenerative condition that has been affecting elderly people since the 1900s. It causes memory loss, disorientation, and poor mental function. AD is considered to be one of the most serious problems that dementia sufferers face. Despite extensive investigation, the pathological origin of Alzheimer's disease remains a mystery. The amyloid cascade theory and the vascular hypothesis, which stresses the buildup of Aβ plaques, have dominated research into dementia and aging throughout history. However, research into this task failed to yield the long-awaited therapeutic miracle lead for Alzheimer's disease. Perhaps a hypothetical fragility in the context of Alzheimer's disease was regarded as a state distinct from aging in general, as suggested by the angiogenesis hypothesis, which suggests that old age is one state associated with upregulation of angiogenic growth factors, resulting in decreased microcirculation throughout the body. There has also been evidence that by controlling or inhibiting the components involved in the sequence of events that cause angiogenesis, there is a visible progression in AD patients. In Alzheimer's disease, one such antiangiogenic drug is being used.
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Affiliation(s)
- Dapinder Kaur
- Chitkara College of Pharmacy, Chitkara University, Chandigarh, Punjab, India
| | - Tapan Behl
- Chitkara College of Pharmacy, Chitkara University, Chandigarh, Punjab, India.
| | - Sridevi Chigurupati
- Department of Medicinal Chemistry and Pharmacognosy, College of Pharmacy, Qassim University, Buraidah, Saudi Arabia
| | - Aayush Sehgal
- Chitkara College of Pharmacy, Chitkara University, Chandigarh, Punjab, India
| | - Sukhbir Singh
- Chitkara College of Pharmacy, Chitkara University, Chandigarh, Punjab, India
| | - Neelam Sharma
- Chitkara College of Pharmacy, Chitkara University, Chandigarh, Punjab, India
| | | | - Celia Vargas-De-La-Cruz
- Faculty of Pharmacy and Biochemistry, Academic Department of Pharmacology, Bromatology and Toxicology, Centro Latinoamericano de Ensenanza e Investigacion en Bacteriologia Alimentaria, Universidad Nacinol Mayor de San Marcos, Lima, Peru
- E-Health Research Center, Universidad de Ciencias y Humanidades, Lima, Peru
| | - Saurabh Bhatia
- Natural & Medical Sciences Research Centre, University of Nizwa, Nizwa, Oman
- School of Health Science, University of Petroleum and Energy Studies, Dehradun, Uttarakhand, India
| | - Ahmed Al-Harrasi
- Natural & Medical Sciences Research Centre, University of Nizwa, Nizwa, Oman
| | - Abhijit Dey
- Department of Life Sciences, Presidency University, Kolkata, India
| | - Lotfi Aleya
- Chrono-Environment Laboratory, UMR CNRS 6249, Bourgogne Franche-Comté University, Besançon, France
| | - Simona Bungau
- Department of Pharmacy, Faculty of Pharmacy, University of Oradea, Oradea, Romania
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Ma Y, Hua R, Yang Z, Zhong B, Yan L, Xie W. Different hypertension thresholds and cognitive decline: a pooled analysis of three ageing cohorts. BMC Med 2021; 19:287. [PMID: 34724953 PMCID: PMC8561998 DOI: 10.1186/s12916-021-02165-4] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2021] [Accepted: 10/21/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The 2017 American College of Cardiology (ACC)/American Heart Association (AHA) guidelines for high blood pressure (BP) in adults came up with a new definition of hypertension with a threshold BP level of 130/80 mmHg. But the 2018 European Society of Cardiology (ESC)/European Society of Hypertension (ESH) guidelines adhered to a conventional hypertension definition as BP ≥ 140/90 mmHg. We aimed to compare the trajectories of cognitive decline between participants with BP < 130/80 mmHg in all BP measurement waves and others with all BP < 140/90 mmHg. METHODS This pooled analysis involved middle-aged and older participants from three nationally representative ageing cohorts, including the Health and Retirement Study (HRS), the English Longitudinal Study of Ageing (ELSA), and the China Health Retirement Longitudinal Study (CHARLS). Participants were divided into the Normal (BP < 130/80 mmHg on all occasions throughout the study), the Borderline (BP < 140/90 mmHg on all occasions throughout the study but not in the Normal group), and the High (the rest of participants) BP groups. Global cognitive Z score was calculated from tests on memory, executive function, and orientation. RESULTS A total of 17,590 participants (HRS 6964, median follow-ups 12 years; ELSA 5334, median follow-ups 16 years; CHARLS 5292, median follow-ups 7 years) were included. No significant difference in global cognitive decline rate was detected between the Normal and the borderline groups (men, pooled β = - 0.006 standard deviation [SD]/year; 95% confidence interval [CI], - 0.020 to 0.008; P = 0.377; women, pooled β = 0.006 SD/year; 95% CI - 0.005 to 0.018; P = 0.269). Participants in the High group had a significantly faster cognitive decline (men, pooled β = - 0.011 SD/year; 95% CI - 0.020 to - 0.002; P = 0.013; women, pooled β = - 0.017 SD/year; 95% CI - 0.026 to - 0.008; P < 0.001) than that in the Borderline group. CONCLUSIONS Individuals in the Borderline group did not experience significantly faster cognitive decline compared with those in the Normal group. It might not be necessary for individuals with borderline BP (between 130/80 and 140/90 mmHg) to initiate antihypertension therapy in consideration of cognitive decline.
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Affiliation(s)
- Yanjun Ma
- Peking University Clinical Research Institute, Peking University First Hospital, Beijing, China
- PUCRI Heart and Vascular Health Research Center at Peking University Shougang Hospital, Beijing, China
- Key Laboratory of Molecular Cardiovascular Sciences (Peking University), Ministry of Education, Beijing, China
| | - Rong Hua
- Peking University Clinical Research Institute, Peking University First Hospital, Beijing, China
- PUCRI Heart and Vascular Health Research Center at Peking University Shougang Hospital, Beijing, China
| | - Zhenchun Yang
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
| | - Baoliang Zhong
- Department of Geriatric Psychiatry, Affiliated Wuhan Mental Health Center, Tongji Medical College of Huazhong University of Science & Technology, Wuhan, China
| | - Li Yan
- National School of Development, Peking University, Beijing, China.
| | - Wuxiang Xie
- Peking University Clinical Research Institute, Peking University First Hospital, Beijing, China.
- PUCRI Heart and Vascular Health Research Center at Peking University Shougang Hospital, Beijing, China.
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40
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Shang X, Hill E, Zhu Z, Liu J, Ge BZ, Wang W, He M. The Association of Age at Diagnosis of Hypertension With Brain Structure and Incident Dementia in the UK Biobank. Hypertension 2021; 78:1463-1474. [PMID: 34601962 DOI: 10.1161/hypertensionaha.121.17608] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
[Figure: see text].
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Affiliation(s)
- Xianwen Shang
- Guangdong Eye Institute, Department of Ophthalmology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China (X.S., Z.Z., M.H.).,Guangdong Cardiovsacular Institute, Guangzhou, China (X.S., Z.Z.)
| | - Edward Hill
- Department of Medicine (Royal Melbourne Hospital) (E.H.), University of Melbourne, VIC, Australia.,Wicking Dementia Research and Education Centre, University of Tasmania, Australia (E.H.)
| | - Zhuoting Zhu
- Guangdong Eye Institute, Department of Ophthalmology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China (X.S., Z.Z., M.H.).,Guangdong Cardiovsacular Institute, Guangzhou, China (X.S., Z.Z.)
| | - Jiahao Liu
- Melbourne School of Population and Global Health (J.L.), University of Melbourne, VIC, Australia
| | - B Zongyuan Ge
- Monash e-Research Center, Faculty of Engineering, Airdoc Research, Nvidia AI Technology Research Center, Monash University, Melbourne, VIC, Australia (Z.G.)
| | - Wei Wang
- State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China (W.W., M.H.)
| | - Mingguang He
- Guangdong Eye Institute, Department of Ophthalmology, Guangdong Provincial People's Hospital, Guangdong Academy of Medical Sciences, Guangzhou, China (X.S., Z.Z., M.H.).,State Key Laboratory of Ophthalmology, Zhongshan Ophthalmic Center, Sun Yat-sen University, Guangzhou, China (W.W., M.H.).,Centre for Eye Research Australia, Royal Victorian Eye and Ear Hospital, Melbourne, VIC, Australia (M.H.)
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41
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Chronic Kidney Disease and Cognitive Impairment. J Stroke Cerebrovasc Dis 2021; 30:105529. [DOI: 10.1016/j.jstrokecerebrovasdis.2020.105529] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Revised: 11/05/2020] [Accepted: 12/01/2020] [Indexed: 12/21/2022] Open
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42
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Ong PA, Annisafitrie FR, Purnamasari N, Calista C, Sagita N, Sofiatin Y, Dikot Y. Dementia Prevalence, Comorbidities, and Lifestyle Among Jatinangor Elders. Front Neurol 2021; 12:643480. [PMID: 34367043 PMCID: PMC8345013 DOI: 10.3389/fneur.2021.643480] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Accepted: 06/22/2021] [Indexed: 11/13/2022] Open
Abstract
Introduction: Research on dementia prevalence and the potentially related risk factors from Indonesia is scarce. We sought to identify the prevalence of dementia, health risk factors, and lifestyle in Jatinangor elders. Methods: A total of 686 participants completed questionnaires on lifestyle, health risk factors, and cognitive and functional tests from September 2013 to December 2013. We determined the prevalence of dementia; and the associations between health, leisure activities, dietary pattern, and dementia were analyzed using logistic regression. Results: The prevalence of dementia was 29.15%. The risk factors differed between age groups. Those aged 60–74 years and who have a lower education level, lower occupational attainment, and less active intellectual and recreational activities were associated with higher dementia risk. Those aged > 75 years living in a rural area and who take less fruit were associated with a higher risk of dementia. Conclusions: The prevalence of dementia in Jatinangor is high. The identified modifiable risk factors are a potential target for intervention and valuable for designing public health policies.
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Affiliation(s)
- Paulus Anam Ong
- Department of Neurology, Hasan Sadikin Hospital, Universitas Padjadjaran, Bandung, Indonesia
| | - Febby Rosa Annisafitrie
- Department of Neurology, Hasan Sadikin Hospital, Universitas Padjadjaran, Bandung, Indonesia
| | - Novita Purnamasari
- Department of Neurology, Hasan Sadikin Hospital, Universitas Padjadjaran, Bandung, Indonesia
| | - Chandra Calista
- Department of Neurology, Hasan Sadikin Hospital, Universitas Padjadjaran, Bandung, Indonesia
| | - Noveline Sagita
- Department of Neurology, Immanuel Hospital, Maranatha Christian University, Bandung, Indonesia
| | - Yulia Sofiatin
- Department of Public Health, Faculty of Medicine, Universitas Padjadjaran, Bandung, Indonesia
| | - Yustiani Dikot
- Department of Neurology, Faculty of Medicine, Achmad Yani University, Bandung, Indonesia
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43
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Tsuchida A, Laurent A, Crivello F, Petit L, Joliot M, Pepe A, Beguedou N, Gueye MF, Verrecchia V, Nozais V, Zago L, Mellet E, Debette S, Tzourio C, Mazoyer B. The MRi-Share database: brain imaging in a cross-sectional cohort of 1870 university students. Brain Struct Funct 2021; 226:2057-2085. [PMID: 34283296 DOI: 10.1007/s00429-021-02334-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Accepted: 06/11/2021] [Indexed: 01/04/2023]
Abstract
We report on MRi-Share, a multi-modal brain MRI database acquired in a unique sample of 1870 young healthy adults, aged 18-35 years, while undergoing university-level education. MRi-Share contains structural (T1 and FLAIR), diffusion (multispectral), susceptibility-weighted (SWI), and resting-state functional imaging modalities. Here, we described the contents of these different neuroimaging datasets and the processing pipelines used to derive brain phenotypes, as well as how quality control was assessed. In addition, we present preliminary results on associations of some of these brain image-derived phenotypes at the whole brain level with both age and sex, in the subsample of 1722 individuals aged less than 26 years. We demonstrate that the post-adolescence period is characterized by changes in both structural and microstructural brain phenotypes. Grey matter cortical thickness, surface area and volume were found to decrease with age, while white matter volume shows increase. Diffusivity, either radial or axial, was found to robustly decrease with age whereas fractional anisotropy only slightly increased. As for the neurite orientation dispersion and densities, both were found to increase with age. The isotropic volume fraction also showed a slight increase with age. These preliminary findings emphasize the complexity of changes in brain structure and function occurring in this critical period at the interface of late maturation and early ageing.
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Affiliation(s)
- Ami Tsuchida
- Groupe d'Imagerie Neurofonctionnelle, Institut des Maladies Neurodégénératives, UMR5293, Université de Bordeaux, Bordeaux, France.,Groupe d'Imagerie Neurofonctionnelle, Institut des Maladies Neurodégénératives, UMR5293, CNRS, Bordeaux, France.,Groupe d'Imagerie Neurofonctionnelle, Institut des Maladies Neurodégénératives, UMR5293, CEA, Bordeaux, France
| | - Alexandre Laurent
- Groupe d'Imagerie Neurofonctionnelle, Institut des Maladies Neurodégénératives, UMR5293, Université de Bordeaux, Bordeaux, France.,Groupe d'Imagerie Neurofonctionnelle, Institut des Maladies Neurodégénératives, UMR5293, CNRS, Bordeaux, France.,Groupe d'Imagerie Neurofonctionnelle, Institut des Maladies Neurodégénératives, UMR5293, CEA, Bordeaux, France
| | - Fabrice Crivello
- Groupe d'Imagerie Neurofonctionnelle, Institut des Maladies Neurodégénératives, UMR5293, Université de Bordeaux, Bordeaux, France.,Groupe d'Imagerie Neurofonctionnelle, Institut des Maladies Neurodégénératives, UMR5293, CNRS, Bordeaux, France.,Groupe d'Imagerie Neurofonctionnelle, Institut des Maladies Neurodégénératives, UMR5293, CEA, Bordeaux, France
| | - Laurent Petit
- Groupe d'Imagerie Neurofonctionnelle, Institut des Maladies Neurodégénératives, UMR5293, Université de Bordeaux, Bordeaux, France.,Groupe d'Imagerie Neurofonctionnelle, Institut des Maladies Neurodégénératives, UMR5293, CNRS, Bordeaux, France.,Groupe d'Imagerie Neurofonctionnelle, Institut des Maladies Neurodégénératives, UMR5293, CEA, Bordeaux, France
| | - Marc Joliot
- Groupe d'Imagerie Neurofonctionnelle, Institut des Maladies Neurodégénératives, UMR5293, Université de Bordeaux, Bordeaux, France.,Groupe d'Imagerie Neurofonctionnelle, Institut des Maladies Neurodégénératives, UMR5293, CNRS, Bordeaux, France.,Groupe d'Imagerie Neurofonctionnelle, Institut des Maladies Neurodégénératives, UMR5293, CEA, Bordeaux, France.,Ginesislab, Fealinx and Université de Bordeaux, Bordeaux, France
| | - Antonietta Pepe
- Groupe d'Imagerie Neurofonctionnelle, Institut des Maladies Neurodégénératives, UMR5293, Université de Bordeaux, Bordeaux, France.,Groupe d'Imagerie Neurofonctionnelle, Institut des Maladies Neurodégénératives, UMR5293, CNRS, Bordeaux, France.,Groupe d'Imagerie Neurofonctionnelle, Institut des Maladies Neurodégénératives, UMR5293, CEA, Bordeaux, France
| | - Naka Beguedou
- Groupe d'Imagerie Neurofonctionnelle, Institut des Maladies Neurodégénératives, UMR5293, Université de Bordeaux, Bordeaux, France.,Groupe d'Imagerie Neurofonctionnelle, Institut des Maladies Neurodégénératives, UMR5293, CNRS, Bordeaux, France.,Groupe d'Imagerie Neurofonctionnelle, Institut des Maladies Neurodégénératives, UMR5293, CEA, Bordeaux, France
| | - Marie-Fateye Gueye
- Groupe d'Imagerie Neurofonctionnelle, Institut des Maladies Neurodégénératives, UMR5293, Université de Bordeaux, Bordeaux, France.,Groupe d'Imagerie Neurofonctionnelle, Institut des Maladies Neurodégénératives, UMR5293, CNRS, Bordeaux, France.,Groupe d'Imagerie Neurofonctionnelle, Institut des Maladies Neurodégénératives, UMR5293, CEA, Bordeaux, France.,Ginesislab, Fealinx and Université de Bordeaux, Bordeaux, France
| | - Violaine Verrecchia
- Groupe d'Imagerie Neurofonctionnelle, Institut des Maladies Neurodégénératives, UMR5293, Université de Bordeaux, Bordeaux, France.,Groupe d'Imagerie Neurofonctionnelle, Institut des Maladies Neurodégénératives, UMR5293, CNRS, Bordeaux, France.,Groupe d'Imagerie Neurofonctionnelle, Institut des Maladies Neurodégénératives, UMR5293, CEA, Bordeaux, France.,Ginesislab, Fealinx and Université de Bordeaux, Bordeaux, France
| | - Victor Nozais
- Groupe d'Imagerie Neurofonctionnelle, Institut des Maladies Neurodégénératives, UMR5293, Université de Bordeaux, Bordeaux, France.,Groupe d'Imagerie Neurofonctionnelle, Institut des Maladies Neurodégénératives, UMR5293, CNRS, Bordeaux, France.,Groupe d'Imagerie Neurofonctionnelle, Institut des Maladies Neurodégénératives, UMR5293, CEA, Bordeaux, France.,Ginesislab, Fealinx and Université de Bordeaux, Bordeaux, France
| | - Laure Zago
- Groupe d'Imagerie Neurofonctionnelle, Institut des Maladies Neurodégénératives, UMR5293, Université de Bordeaux, Bordeaux, France.,Groupe d'Imagerie Neurofonctionnelle, Institut des Maladies Neurodégénératives, UMR5293, CNRS, Bordeaux, France.,Groupe d'Imagerie Neurofonctionnelle, Institut des Maladies Neurodégénératives, UMR5293, CEA, Bordeaux, France
| | - Emmanuel Mellet
- Groupe d'Imagerie Neurofonctionnelle, Institut des Maladies Neurodégénératives, UMR5293, Université de Bordeaux, Bordeaux, France.,Groupe d'Imagerie Neurofonctionnelle, Institut des Maladies Neurodégénératives, UMR5293, CNRS, Bordeaux, France.,Groupe d'Imagerie Neurofonctionnelle, Institut des Maladies Neurodégénératives, UMR5293, CEA, Bordeaux, France
| | - Stéphanie Debette
- Université de Bordeaux, INSERM, Bordeaux Population Health Research Center, U1219, CHU Bordeaux, Bordeaux, France.,Centre Hospitalier Universitaire Pellegrin, Bordeaux, France
| | - Christophe Tzourio
- Université de Bordeaux, INSERM, Bordeaux Population Health Research Center, U1219, CHU Bordeaux, Bordeaux, France.,Centre Hospitalier Universitaire Pellegrin, Bordeaux, France
| | - Bernard Mazoyer
- Groupe d'Imagerie Neurofonctionnelle, Institut des Maladies Neurodégénératives, UMR5293, Université de Bordeaux, Bordeaux, France. .,Groupe d'Imagerie Neurofonctionnelle, Institut des Maladies Neurodégénératives, UMR5293, CNRS, Bordeaux, France. .,Groupe d'Imagerie Neurofonctionnelle, Institut des Maladies Neurodégénératives, UMR5293, CEA, Bordeaux, France. .,Ginesislab, Fealinx and Université de Bordeaux, Bordeaux, France. .,Centre Hospitalier Universitaire Pellegrin, Bordeaux, France.
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44
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How much should LDL cholesterol be lowered in secondary prevention? Clinical efficacy and safety in the era of PCSK9 inhibitors. Prog Cardiovasc Dis 2021; 67:65-74. [DOI: 10.1016/j.pcad.2020.12.008] [Citation(s) in RCA: 16] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Accepted: 12/22/2020] [Indexed: 12/20/2022]
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45
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Zhu D, Montagne A, Zhao Z. Alzheimer's pathogenic mechanisms and underlying sex difference. Cell Mol Life Sci 2021; 78:4907-4920. [PMID: 33844047 PMCID: PMC8720296 DOI: 10.1007/s00018-021-03830-w] [Citation(s) in RCA: 95] [Impact Index Per Article: 31.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Revised: 03/09/2021] [Accepted: 03/29/2021] [Indexed: 01/01/2023]
Abstract
AD is a neurodegenerative disease, and its frequency is often reported to be higher for women than men: almost two-thirds of patients with AD are women. One prevailing view is that women live longer than men on average of 4.5 years, plus there are more women aged 85 years or older than men in most global subpopulations; and older age is the greatest risk factor for AD. However, the differences in the actual risk of developing AD for men and women of the same age is difficult to assess, and the findings have been mixed. An increasing body of evidence from preclinical and clinical studies as well as the complications in estimating incidence support the sex-specific biological mechanisms in diverging AD risk as an important adjunct explanation to the epidemiologic perspective. Although some of the sex differences in AD prevalence are due to differences in longevity, other distinct biological mechanisms increase the risk and progression of AD in women. These risk factors include (1) deviations in brain structure and biomarkers, (2) psychosocial stress responses, (3) pregnancy, menopause, and sex hormones, (4) genetic background (i.e., APOE), (5) inflammation, gliosis, and immune module (i.e., TREM2), and (6) vascular disorders. More studies focusing on the underlying biological mechanisms for this phenomenon are needed to better understand AD. This review presents the most recent data in sex differences in AD-the gateway to precision medicine, therefore, shaping expert perspectives, inspiring researchers to go in new directions, and driving development of future diagnostic tools and treatments for AD in a more customized way.
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Affiliation(s)
- Donghui Zhu
- Department of Biomedical Engineering, Stony Brook University, Stony Brook, NY, USA.
- Neuroscience Graduate Program, Renaissance School of Medicine, Stony Brook University, Stony Brook, NY, USA.
| | - Axel Montagne
- UK Dementia Research Institute, Edinburgh Medical School, University of Edinburgh, Edinburgh, UK
- Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK
| | - Zhen Zhao
- Department of Physiology and Neuroscience, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
- Zilkha Neurogenetic Institute, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
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46
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Wang C, Huang X, Tian S, Huang R, Guo D, Lin H, Wang J, Wang S. High Plasma Resistin Levels Portend the Insulin Resistance-Associated Susceptibility to Early Cognitive Decline in Patients with Type 2 Diabetes Mellitus. J Alzheimers Dis 2021; 75:807-815. [PMID: 32333593 DOI: 10.3233/jad-200074] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
BACKGROUND Metabolic disorders, including insulin resistance, obesity, and hyperlipidemia occur frequently prior to hyperglycemia in patients with type 2 diabetes mellitus (T2DM) and cause mild cognitive impairment (MCI). OBJECTIVE We investigated the involvement of resistin in these metabolic abnormalities contributes to MCI in patients with T2DM. METHODS A total of 138 hospitalized patients with T2DM were enrolled and categorized into MCI and non-MCI groups according to the Montreal Cognitive Assessment (MoCA) score. Metabolic indicators and cognitive state were assessed, and plasma resistin levels were determined by ELISA. RESULTS The resistin levels and homeostasis model assessment of insulin resistance (HOMA-IR) scores of MCI and gender-stratified subgroups were significantly higher than those of controls without MCI (all p < 0.01). Correlation analysis showed that the resistin level was negatively associated with majority of cognitive domains, e.g., MoCA (r = -0.693, p < 0.001) and Mini-Mental State Examination (r = -0.571, p < 0.001), and was related to HOMA-IR (r = 0.667, p < 0.001) but not to obesity and lipid indices. Multivariable regression analysis indicated that resistin (β= -0.675, p < 0.001) and educational level (β= 0.177, p = 0.003) were independent risk factors of MoCA in patients with T2DM. CONCLUSIONS High plasma resistin levels portend the insulin resistance-related susceptibility to early cognitive decline in Chinese patients with T2DM. The involvement of this adipokine in other metabolic disorders leading to diabetic MCI and its clinical value for early disease screening must be further studied.
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Affiliation(s)
- Chenchen Wang
- School of Medicine, Southeast University, Nanjing, China
| | - Xi Huang
- Department of Endocrinology, The Affiliated ZhongDa Hospital of Southeast University, Nanjing, China
| | - Sai Tian
- School of Medicine, Southeast University, Nanjing, China
| | - Rong Huang
- School of Medicine, Southeast University, Nanjing, China
| | - Dan Guo
- School of Medicine, Southeast University, Nanjing, China
| | - Hongyan Lin
- School of Medicine, Southeast University, Nanjing, China
| | - Jiaqi Wang
- School of Medicine, Southeast University, Nanjing, China
| | - Shaohua Wang
- Department of Endocrinology, The Affiliated ZhongDa Hospital of Southeast University, Nanjing, China
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47
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Arrieta Antón E, Baz Rodríguez PG. [Cognitive impairment in patients with cardiovascular risk: DECOG study]. Semergen 2021; 47:174-180. [PMID: 33863650 DOI: 10.1016/j.semerg.2021.01.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Revised: 12/29/2020] [Accepted: 01/12/2021] [Indexed: 10/21/2022]
Abstract
OBJECTIVE To evaluate the correlation between cardiovascular risk factors (CRF) and mild cognitive impairment (MCI) in the primary care setting. MATERIALS AND METHODS Observational, cross-sectional and multicenter study conducted in the setting of primary care. Information regarding demographic variables, CRF, comorbidities, and cognitive impairment determined by Mini-Mental State Examination (MMSE) score was collected. These data were correlated by multivariate analysis. RESULTS Data from a total of 458 patients were collected. CRFs significantly negative correlated with MCI were patient age, presence of cardiovascular disease, family history of dyslipemia, diastolic blood pressure and cholesterol levels; while factors such as education level and folic acid levels were significant and positive related to higher MMSE scores. CONCLUSIONS This study confirms that the presence of CRF impacts on MCI development, already detectable in the primary care setting. High cholesterol levels and high blood pressure are key elements in MCI, and therefore, measures to control these two conditions from primary care should be reinforced in order to stop the development of dementias.
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Affiliation(s)
- E Arrieta Antón
- Medicina Familiar y Comunitaria, Centro de Salud Segovia Rural. Grupo de Trabajo de Neurología de Semergen, Segovia, España.
| | - P G Baz Rodríguez
- Medicina Familiar y Comunitaria, Centro de Salud Ciudad Rodrigo. Coordinador Grupo de Trabajo de Neurología de Semergen, Salamanca, España
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48
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Lütjohann D, Stellaard F, Bölükbasi B, Kerksiek A, Parhofer KG, Laufs U. Anti-PCSK 9 antibodies increase the ratios of the brain-specific oxysterol 24S-hydroxycholesterol to cholesterol and to 27-hydroxycholesterol in the serum. Br J Clin Pharmacol 2021; 87:4252-4261. [PMID: 33792095 DOI: 10.1111/bcp.14841] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2020] [Revised: 02/28/2021] [Accepted: 03/15/2021] [Indexed: 11/27/2022] Open
Abstract
AIMS The serum ratios of the brain-specific oxysterol 24S-hydroxycholesterol (24S-OHC) to cholesterol and to 27-OHC reflect brain cholesterol turnover. We studied the effect of proprotein convertase subtilisin/kexin type 9 monoclonal antibodies (PCSK9ab) that enhance low-density lipoprotein receptor activity on serum cholesterol and oxysterol concentrations. METHODS Twenty-eight hypercholesterolaemic patients (15 males and 13 females) responding insufficiently to maximally tolerated statin and/or ezetimibe therapy were additionally subcutanously treated biweekly with either the PCSK9ab alirocumab (150 mg, n = 13) or evolocumab (140 mg, n = 15). Fasting serum cholesterol was measured by gas chromatography and the oxysterols 24S-OHC and 27-OHC using gas chromatography-mass spectrometry before, after 1-month (n = 28) and after 3-month (n = 13) treatment. RESULTS As expected, PCSK9ab treatment lowered serum cholesterol and oxysterol levels after 1 month. The serum ratio of 24S-OHC to cholesterol increased after 1 month by 17 ± 28% (mean ± standard deviation; 95% confidence interval [CI]: 5.8 to 28%; P < .01) and 24S-OHC to 27-OHC by 15 ± 39% (95% CI: 0.2 to 30%; P < .01). Within 3 months, 24S-OHC to cholesterol increased by 2.8 μg g-1 mo-1 (95% CI: 2.1 to 3.6; P < .01) and 24S-OHC to 27-OHC by 0.019 mo-1 (95% CI: 0.007 to 0.032; P < .01). CONCLUSION The serum ratios of 24S-OHC to cholesterol and to 27-OHC increased after treatment with PCSK9ab. We hypothesize that this is caused by a reduced entrance of 27-OHC into the brain, increased synthesis of brain cholesterol, increased production of 24S-OHC and its secretion across the blood-brain barrier.
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Affiliation(s)
- Dieter Lütjohann
- Institut für Klinische Chemie und Klinische Pharmakologie, Universitätsklinikum Bonn, Bonn, Germany
| | - Frans Stellaard
- Institut für Klinische Chemie und Klinische Pharmakologie, Universitätsklinikum Bonn, Bonn, Germany
| | - Bediha Bölükbasi
- Klinik für Innere Medizin III (Kardiologie, Angiologie und Internistische Intensivmedizin), Universitätsklinikum des Saarlandes, Homburg, Germany
| | - Anja Kerksiek
- Institut für Klinische Chemie und Klinische Pharmakologie, Universitätsklinikum Bonn, Bonn, Germany
| | - Klaus G Parhofer
- Medizinische Klinik IV-Campus Großhadern, Klinikum der Universität München, Munich, Germany
| | - Ulrich Laufs
- Klinik für Innere Medizin III (Kardiologie, Angiologie und Internistische Intensivmedizin), Universitätsklinikum des Saarlandes, Homburg, Germany.,Klinik und Poliklinik für Kardiologie, Universitätsklinikum Leipzig, Leipzig, Germany
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49
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Rajna Z, Mattila H, Huotari N, Tuovinen T, Krüger J, Holst SC, Korhonen V, Remes AM, Seppänen T, Hennig J, Nedergaard M, Kiviniemi V. Cardiovascular brain impulses in Alzheimer's disease. Brain 2021; 144:2214-2226. [PMID: 33787890 PMCID: PMC8422353 DOI: 10.1093/brain/awab144] [Citation(s) in RCA: 31] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2020] [Revised: 03/13/2021] [Accepted: 03/23/2021] [Indexed: 11/30/2022] Open
Abstract
Accumulation of amyloid-β is a key neuropathological feature in brain of
Alzheimer’s disease patients. Alterations in cerebral haemodynamics,
such as arterial impulse propagation driving the (peri)vascular CSF flux,
predict future Alzheimer’s disease progression. We now present a
non-invasive method to quantify the three-dimensional propagation of
cardiovascular impulses in human brain using ultrafast 10 Hz magnetic
resonance encephalography. This technique revealed spatio-temporal abnormalities
in impulse propagation in Alzheimer’s disease. The arrival latency and
propagation speed both differed in patients with Alzheimer’s disease.
Our mapping of arterial territories revealed Alzheimer’s
disease-specific modifications, including reversed impulse propagation around
the hippocampi and in parietal cortical areas. The findings imply that pervasive
abnormality in (peri)vascular CSF impulse propagation compromises vascular
impulse propagation and subsequently glymphatic brain clearance of
amyloid-β in Alzheimer’s disease.
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Affiliation(s)
- Zalán Rajna
- Center for Machine Vision and Signal Analysis, University of Oulu, 90570 Oulu, Finland
| | - Heli Mattila
- Oulu Functional Neuroimaging Group, Research Unit of Medical Imaging, Physics and Technology, University of Oulu, 90570 Oulu, Finland
| | - Niko Huotari
- Oulu Functional Neuroimaging Group, Research Unit of Medical Imaging, Physics and Technology, University of Oulu, 90570 Oulu, Finland
| | - Timo Tuovinen
- Oulu Functional Neuroimaging Group, Research Unit of Medical Imaging, Physics and Technology, University of Oulu, 90570 Oulu, Finland
| | - Johanna Krüger
- Research Unit of Clinical Neuroscience, Neurology, University of Oulu, 90570 Oulu, Finland
| | - Sebastian C Holst
- Neurobiology Research Unit, Copenhagen University Hospital, 2100 Copenhagen, Denmark
| | - Vesa Korhonen
- Department of Diagnostic Radiology, Medical Research Center, Oulu University Hospital, 90220 Oulu, Finland
| | - Anne M Remes
- Research Unit of Clinical Neuroscience, Neurology, University of Oulu, 90570 Oulu, Finland
| | - Tapio Seppänen
- Center for Machine Vision and Signal Analysis, University of Oulu, 90570 Oulu, Finland
| | - Jürgen Hennig
- Department of Radiology, Medical Physics, Medical Center University of Freiburg, Faculty of Medicine, University of Freiburg, 79110 Freiburg, Germany
| | - Maiken Nedergaard
- Center for Translational Neuromedicine, University of Rochester Medical Center, Rochester, NY 14642, USA
| | - Vesa Kiviniemi
- Oulu Functional Neuroimaging Group, Research Unit of Medical Imaging, Physics and Technology, University of Oulu, 90570 Oulu, Finland
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50
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Abstract
PURPOSE OF REVIEW The relationship between hypertension and Alzheimer's disease (AD) is complex and varies across the lifespan. Studies have suggested that midlife hypertension is a risk factor for AD, although studies of late life hypertension have suggested that it either has no effect or a weak protective effect. RECENT FINDINGS Animal models of induced and spontaneous hypertension have found that AD pathological change (β-amyloid plaques and tau tangles) occurs within weeks of a hypertensive insult. Human imaging and autopsy studies indicate that midlife and late life hypertension are associated with increased AD pathological change. Meta-analyses of longitudinal studies indicate that midlife rather than late life hypertension is a risk factor for AD. New areas of research have suggested that rather than mean blood pressure (BP), it is the negative BP trajectories or the variability of BP that contributes to AD. In a number of meta-analyses of antihypertensive medications and their effect on AD, there were weak associations between improved AD outcomes and treatment. SUMMARY The combined analysis of animal, human clinical/pathological, epidemiological and drug trial data indicates that hypertension increases the risk of AD and treatment of hypertension may be an appropriate preventive measure.
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