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Wang L, Xian X, Zhou M, Xu K, Cao S, Cheng J, Dai W, Zhang W, Ye M. Anti-Inflammatory Diet and Protein-Enriched Diet Can Reduce the Risk of Cognitive Impairment among Older Adults: A Nationwide Cross-Sectional Research. Nutrients 2024; 16:1333. [PMID: 38732579 PMCID: PMC11085298 DOI: 10.3390/nu16091333] [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: 04/04/2024] [Revised: 04/26/2024] [Accepted: 04/27/2024] [Indexed: 05/13/2024] Open
Abstract
BACKGROUND Cognitive impairment (CI) is a common mental health disorder among older adults, and dietary patterns have an impact on cognitive function. However, no systematic researches have constructed anti-inflammatory diet (AID) and protein-enriched diet (PED) to explore their association with CI among older adults in China. METHODS The data used in this study were obtained from the 2018 waves of the China Longitudinal Health and Longevity Survey (CLHLS). We construct AID, PED, and calculate scores for CI. We use binary logistic regression to explore the relationship between them, and use restrictive cubic splines to determine whether the relationships are non-linear. Subgroup analysis and sensitivity analysis were used to demonstrate the robustness of the results. RESULTS A total of 8692 participants (mean age is 83.53 years) were included in the analysis. We found that participants with a higher AID (OR = 0.789, 95% confidence interval: 0.740-0.842, p < 0.001) and PED (OR = 0.910, 95% confidence interval: 0.866-0.956, p < 0.001) score showed lower odds of suffering from CI. Besides, the relationship between the two dietary patterns and CI is linear, and the results of subgroup analysis and sensitivity analysis are also significant. CONCLUSION Higher intakes of AID and PED are associated with a lower risk of CI among older adults, which has important implications for future prevention and control of CI from a dietary and nutritional perspective.
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Affiliation(s)
- Liang Wang
- School of Public Health, Chongqing Medical University, Chongqing 400016, China; (L.W.); (X.X.); (M.Z.); (K.X.); (J.C.); (W.Z.)
| | - Xiaobing Xian
- School of Public Health, Chongqing Medical University, Chongqing 400016, China; (L.W.); (X.X.); (M.Z.); (K.X.); (J.C.); (W.Z.)
| | - Mengting Zhou
- School of Public Health, Chongqing Medical University, Chongqing 400016, China; (L.W.); (X.X.); (M.Z.); (K.X.); (J.C.); (W.Z.)
| | - Ke Xu
- School of Public Health, Chongqing Medical University, Chongqing 400016, China; (L.W.); (X.X.); (M.Z.); (K.X.); (J.C.); (W.Z.)
| | - Shiwei Cao
- School of the Second Clinical, Chongqing Medical University, Chongqing 400016, China;
| | - Jingyu Cheng
- School of Public Health, Chongqing Medical University, Chongqing 400016, China; (L.W.); (X.X.); (M.Z.); (K.X.); (J.C.); (W.Z.)
| | - Weizhi Dai
- School of the First Clinical, Chongqing Medical University, Chongqing 400016, China;
| | - Wenjia Zhang
- School of Public Health, Chongqing Medical University, Chongqing 400016, China; (L.W.); (X.X.); (M.Z.); (K.X.); (J.C.); (W.Z.)
| | - Mengliang Ye
- School of Public Health, Chongqing Medical University, Chongqing 400016, China; (L.W.); (X.X.); (M.Z.); (K.X.); (J.C.); (W.Z.)
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Rosenberg R, Thorpy MJ, Doghramji K, Morse AM. Brain fog in central disorders of hypersomnolence: a review. J Clin Sleep Med 2024; 20:643-651. [PMID: 38217475 PMCID: PMC10985301 DOI: 10.5664/jcsm.11014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Revised: 01/04/2024] [Accepted: 01/04/2024] [Indexed: 01/15/2024]
Abstract
Brain fog is an undefined term describing a cluster of symptoms related to fatigue and impaired memory, attention, and concentration. Brain fog or brain fog-like symptoms have been reported in central disorders of hypersomnolence and in a range of seemingly unrelated disorders, including coronavirus disease 2019, major depressive disorder, multiple sclerosis, lupus, and celiac disease. This narrative review summarizes current evidence and proposes a consensus definition for brain fog. Brain fog is prevalent in narcolepsy and idiopathic hypersomnia, with more than three-quarters of patients with either disorder reporting this symptom in a registry study; it has also been reported as particularly difficult to treat in idiopathic hypersomnia. Studies directly evaluating brain fog are rare; tools for evaluating this symptom cluster typically are patient reports, with few objective measures validated in any disorder. Evaluating brain fog is further complicated by confounding symptoms, such as excessive daytime sleepiness, which is a hallmark of hypersomnolence disorders. No treatments specifically address brain fog. The paucity of literature, assessment tools, and medications for brain fog highlights the need for research leading to better disambiguation and treatment. Until a clear consensus definition is established, we propose brain fog in hypersomnia disorders be defined as a cognitive dysfunction that may or may not be linked with excessive sleepiness, related to an underlying neuronal dysfunction, which reduces concentration and impairs information processing, leading to a complaint of lack of clarity of mental thinking and awareness. CITATION Rosenberg R, Thorpy MJ, Doghramji K, Morse AM. Brain fog in central disorders of hypersomnolence: a review. J Clin Sleep Med. 2024;20(4):643-651.
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Affiliation(s)
| | | | - Karl Doghramji
- Jefferson Sleep Disorders Center, Thomas Jefferson University, Philadelphia, Pennsylvania
| | - Anne Marie Morse
- Department of Child Neurology and Sleep Medicine, Geisinger Medical Center, Janet Weis Children’s Hospital, Danville, Pennsylvania
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Cognitive Impairment in Celiac Disease Patients: Scoping Review Exploring Psychological Triggers in a Chronic Condition. GASTROINTESTINAL DISORDERS 2023. [DOI: 10.3390/gidisord5010009] [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] [Indexed: 03/05/2023] Open
Abstract
Celiac disease (CD), also known as gluten-sensitive enteropathy, is an inflammatory autoimmune reaction triggered by ingestion of gluten in genetically predisposed subjects. Celiac disease is often associated with a wide range of disorders, caused by immune responses and by malabsorption with subsequent nutritional deficiencies. Prevalent neurologic manifestations are ataxia, epilepsy, cerebral calcification, cerebral white matter lesions, peripheral neuropathy and myopathy, but also cognitive impairment. The study aimed to identify emerging and urgent research domains in order to establish a CD-specific patient-tailored protocol that includes both psychological and neuropsychological evaluations. We performed a systematic search of MEDLINE, PubMed, SCOPUS, Web of Science and Cochrane library in November 2022. We conducted a descriptive analysis of the characteristics of the included literature. Based on the exclusion/inclusion criteria, a total of seven articles were included in the scoping review process. This review demonstrated the lack of research on CD-related cognitive impairment key features and tries to focus on both cognitive and psychological manifestations as well as their two-way interaction. We tried to establish the specific areas involved, in order to have a comprehensive view of this condition and trying to determine a correct way of assessing CD cognitive impairment and its correlations with psychological distress and personal coping skills to a chronic condition. Nevertheless, research on this topic is progressively increasing and future studies should address specific key points.
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Laurikka P, Kivelä L, Kurppa K, Kaukinen K. Review article: Systemic consequences of coeliac disease. Aliment Pharmacol Ther 2022; 56 Suppl 1:S64-S72. [PMID: 35815828 PMCID: PMC9543231 DOI: 10.1111/apt.16912] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/18/2022] [Revised: 02/08/2022] [Accepted: 03/18/2022] [Indexed: 12/09/2022]
Abstract
BACKGROUND The best-known symptoms of coeliac disease are related to the gastrointestinal tract, but the disease may also present with various systemic manifestations outside the intestine. Some of these consequences may remain permanent in undiagnosed individuals or if the diagnostic delay is prolonged. However, for many of the systemic manifestations, the scientific evidence remains scant and contradictory. AIMS AND METHODS We conducted a narrative review of the most thoroughly studied and clinically relevant systemic consequences of coeliac disease, especially those that could be prevented or alleviated by early diagnosis. The review is intended particularly for physicians encountering these patients in daily clinical practice. RESULTS The possible systemic consequences of coeliac disease extend to multiple organ systems, the best studied of which are related to skeletal, reproductive, cardiovascular and neurological systems. Furthermore, the disease is associated with an elevated risk of psychiatric comorbidities, non-Hodgkin lymphomas and intestinal adenocarcinoma. CONCLUSIONS The various systemic consequences of coeliac disease play a significant role in the overall health of patients. Early diagnosis and treatment with a gluten-free diet appear to be beneficial for most, but not all of these conditions. The possible negative metabolic and psychosocial effects of the diet should be acknowledged during follow-up.
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Affiliation(s)
- Pilvi Laurikka
- Celiac Disease Research Center, Faculty of Medicine and Health TechnologyTampere UniversityTampereFinland,Department of Internal MedicineTampere University HospitalTampereFinland
| | - Laura Kivelä
- Celiac Disease Research Center, Faculty of Medicine and Health TechnologyTampere UniversityTampereFinland,Children’s Hospital, and Paediatric Research CentreUniversity of Helsinki and Helsinki University HospitalHelsinkiFinland
| | - Kalle Kurppa
- Tampere Center for Child, Adolescent and Maternal Health ResearchTampere University and Tampere University HospitalTampereFinland,The University Consortium of Seinäjoki and Seinäjoki Central HospitalSeinäjokiFinland
| | - Katri Kaukinen
- Celiac Disease Research Center, Faculty of Medicine and Health TechnologyTampere UniversityTampereFinland,Department of Internal MedicineTampere University HospitalTampereFinland
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Hadjivassiliou M, Zis P. Neurological manifestations of gluten-related disorders. COELIAC DISEASE AND GLUTEN-RELATED DISORDERS 2022:209-222. [DOI: 10.1016/b978-0-12-821571-5.00008-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
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Intracortical and Intercortical Motor Disinhibition to Transcranial Magnetic Stimulation in Newly Diagnosed Celiac Disease Patients. Nutrients 2021. [PMID: 34062843 DOI: 10.3390/nu13051530.] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Celiac disease (CD) may present or be complicated by neurological and neuropsychiatric manifestations. Transcranial magnetic stimulation (TMS) probes brain excitability non-invasively, also preclinically. We previously demonstrated an intracortical motor disinhibition and hyperfacilitation in de novo CD patients, which revert back after a long-term gluten-free diet (GFD). In this cross-sectional study, we explored the interhemispheric excitability by transcallosal inhibition, which has never been investigated in CD. METHODS A total of 15 right-handed de novo, neurologically asymptomatic, CD patients and 15 age-matched healthy controls were screened for cognitive and depressive symptoms to the Montreal Cognitive Assessment (MoCA) and the 17-item Hamilton Depression Rating Scale (HDRS), respectively. TMS consisted of resting motor threshold, amplitude, latency, and duration of the motor evoked potentials, duration and latency of the contralateral silent period (cSP). Transcallosal inhibition was evaluated as duration and latency of the ipsilateral silent period (iSP). RESULTS MoCA and HDRS scored significantly worse in patients. The iSP and cSP were significantly shorter in duration in patients, with a positive correlation between the MoCA and iSP. CONCLUSIONS An intracortical and interhemispheric motor disinhibition was observed in CD, suggesting the involvement of GABA-mediated cortical and callosal circuitries. Further studies correlating clinical, TMS, and neuroimaging data are needed.
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Fisicaro F, Lanza G, D’Agate CC, Ferri R, Cantone M, Falzone L, Pennisi G, Bella R, Pennisi M. Intracortical and Intercortical Motor Disinhibition to Transcranial Magnetic Stimulation in Newly Diagnosed Celiac Disease Patients. Nutrients 2021; 13:nu13051530. [PMID: 34062843 PMCID: PMC8147364 DOI: 10.3390/nu13051530] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Revised: 04/24/2021] [Accepted: 04/28/2021] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Celiac disease (CD) may present or be complicated by neurological and neuropsychiatric manifestations. Transcranial magnetic stimulation (TMS) probes brain excitability non-invasively, also preclinically. We previously demonstrated an intracortical motor disinhibition and hyperfacilitation in de novo CD patients, which revert back after a long-term gluten-free diet (GFD). In this cross-sectional study, we explored the interhemispheric excitability by transcallosal inhibition, which has never been investigated in CD. METHODS A total of 15 right-handed de novo, neurologically asymptomatic, CD patients and 15 age-matched healthy controls were screened for cognitive and depressive symptoms to the Montreal Cognitive Assessment (MoCA) and the 17-item Hamilton Depression Rating Scale (HDRS), respectively. TMS consisted of resting motor threshold, amplitude, latency, and duration of the motor evoked potentials, duration and latency of the contralateral silent period (cSP). Transcallosal inhibition was evaluated as duration and latency of the ipsilateral silent period (iSP). RESULTS MoCA and HDRS scored significantly worse in patients. The iSP and cSP were significantly shorter in duration in patients, with a positive correlation between the MoCA and iSP. CONCLUSIONS An intracortical and interhemispheric motor disinhibition was observed in CD, suggesting the involvement of GABA-mediated cortical and callosal circuitries. Further studies correlating clinical, TMS, and neuroimaging data are needed.
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Affiliation(s)
- Francesco Fisicaro
- Department of Biomedical and Biotechnological Sciences, University of Catania, Via Santa Sofia 97, 95123 Catania, Italy; (F.F.); (M.P.)
| | - Giuseppe Lanza
- Department of Surgery and Medical-Surgery Specialties, University of Catania, Via Santa Sofia 78, 95123 Catania, Italy;
- Department of Neurology IC, Oasi Research Institute-IRCCS, Via Conte Ruggero 73, 94018 Troina, Italy;
- Correspondence: ; Tel.: +39-095-3782448
| | - Carmela Cinzia D’Agate
- Gastroenterology and Endoscopy Unit, University Hospital “Policlinico G. Rodolico-San Marco”, Via Santa Sofia 78, 95123 Catania, Italy;
| | - Raffaele Ferri
- Department of Neurology IC, Oasi Research Institute-IRCCS, Via Conte Ruggero 73, 94018 Troina, Italy;
| | - Mariagiovanna Cantone
- Department of Neurology, Sant’Elia Hospital, ASP Caltanissetta, Via Luigi Russo 6, 93100 Caltanissetta, Italy;
| | - Luca Falzone
- Epidemiology and Biostatistics Unit, Instituto Nazionale Tumori-IRCCS “Fondazione G. Pascale”, Via Mariano Semmola 53, 80131 Napoli, Italy;
| | - Giovanni Pennisi
- Department of Surgery and Medical-Surgery Specialties, University of Catania, Via Santa Sofia 78, 95123 Catania, Italy;
| | - Rita Bella
- Department of Medical and Surgical Sciences and Advanced Technologies, University of Catania, Via Santa Sofia 87, 95123 Catania, Italy;
| | - Manuela Pennisi
- Department of Biomedical and Biotechnological Sciences, University of Catania, Via Santa Sofia 97, 95123 Catania, Italy; (F.F.); (M.P.)
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