1
|
Desai P, Ng TKS, Krueger KR, Wilson RS, Evans DA, Rajan KB. Perceived Stress, Blood Biomarkers, and Cognitive Functioning in Older Adults. Psychosom Med 2024:00006842-990000000-00214. [PMID: 38648023 DOI: 10.1097/psy.0000000000001317] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/25/2024]
Abstract
INTRODUCTION There is a substantial gap in knowledge regarding how perceived stress may influence the relationship between serum-measured biomarkers for Alzheimer's disease and cognitive decline. METHODS This study consists of 1,118 older adult participants from the Chicago Health and Aging Project (CHAP) (60% Black participants and 63% female participants). Linear mixed effects regression models were conducted to examine the role of perceived stress in the association between three blood biomarkers: total tau (t-tau), glial fibrillary acid protein (GFAP), and neurofilament light chain (NfL) on global cognitive decline. Stratified analysis by stress level was also conducted to evaluate the associations between each blood biomarker and baseline cognitive function and decline. All models adjusted for age, race, sex, education, time, and their interactions with time. RESULTS The interaction of stress, NfL concentration, and time was statistically significant on global cognition (β = -0.064 (SE = 0.028), p-value = 0.023) and on episodic memory (β = -0.097 (SE = 0.036), p-value = 0.007). CONCLUSIONS Greater stress level worsens the association between high NfL concentration and cognitive decline. Stress management interventions may be helpful to reduce rate of cognitive decline in individuals with high concentrations of NfL.
Collapse
Affiliation(s)
- Pankaja Desai
- Rush Institute for Healthy Aging, Rush University Medical Center, Chicago, IL
| | - Ted K S Ng
- Rush Institute for Healthy Aging, Rush University Medical Center, Chicago, IL
| | - Kristin R Krueger
- Rush Institute for Healthy Aging, Rush University Medical Center, Chicago, IL
| | - Robert S Wilson
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL
| | - Denis A Evans
- Rush Institute for Healthy Aging, Rush University Medical Center, Chicago, IL
| | | |
Collapse
|
2
|
Rajan KB, Mcaninch EA, Wilson RS, Dhana A, Evans-Lacko S, Evans DA. Statin Initiation and Risk of Incident Alzheimer Disease and Cognitive Decline in Genetically Susceptible Older Adults. Neurology 2024; 102:e209168. [PMID: 38447103 DOI: 10.1212/wnl.0000000000209168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Accepted: 01/08/2024] [Indexed: 03/08/2024] Open
Abstract
BACKGROUND AND OBJECTIVES The association of statin initiation with incident Alzheimer disease (AD) dementia and cognitive decline by the APOE ε4 allele is unknown. Our objective was to examine whether the association of statin initiation with incident AD dementia and cognitive decline differs by the APOE ε4 allele. METHODS This population-based longitudinal cohort study was conducted in 4 urban communities in Chicago, IL, United States, consisting of 4,807 participants. Statin initiation is based on the inspection of medications during home assessments. Clinical diagnosis for incident AD used the NINCDS-ADRDA criteria, and longitudinal measurements of global cognition consisted of episodic memory, perceptual speed, and the Mini-Mental State Examination tests. RESULTS The study participants had a mean age of 72 years, consisting of 63% female individuals and 61% non-Hispanic Black individuals. During the study period, 1,470 (31%) participants reported statin initiation. In a covariate-adjusted competing risk model, statin initiation was associated with a reduced risk of incident clinical AD [hazard ratio (HR) 0.81 (95% CI 0.70-0.94)] compared with nonusers. This association was statistically significantly lower (p interaction = 0.015) among participants with the APOE ε4 allele [HR 0.60 (95% CI 0.49-0.74)] compared with those without the APOE ε4 allele [HR 0.96 (95% CI 0.82-1.12)]. The annual decline in global cognition (β = 0.021, 95% CI 0.007-0.034) and episodic memory (β = 0.020, 95% CI 0.007-0.033) was also substantially slower among participants with the APOE ε4 allele after statin initiation compared with nonusers. However, the association of statin initiation with cognitive decline was not significant among those without the APOE ε4 allele. DISCUSSION Our findings suggest that statins might be associated with a lower risk of incident AD among individuals with the APOE ε4 allele. The benefits of statin therapy need further consideration in randomized clinical trials, especially among those with the APOE ε4 allele. CLASSIFICATION OF EVIDENCE This study provides Class II evidence that among those aged 65 years or older, statin initiation was associated with a reduced risk of Alzheimer disease, especially in the presence of an APOE-e4 allele.
Collapse
Affiliation(s)
- Kumar B Rajan
- From the Rush Institute for Healthy Aging (K.B.R., A.D., D.A.E.), Department of Internal Medicine, Rush University Medical Center, Chicago, IL; Division of Endocrinology (E.A.M.), Gerontology and Metabolism, Stanford University Medical Center, CA; Rush Alzheimer's Disease Center (R.S.W.), Rush University Medical Center, Chicago, IL; and Care Policy and Evaluation Centre (S.E.-L.), London School of Economics and Political Science, United Kingdom
| | - Elizabeth A Mcaninch
- From the Rush Institute for Healthy Aging (K.B.R., A.D., D.A.E.), Department of Internal Medicine, Rush University Medical Center, Chicago, IL; Division of Endocrinology (E.A.M.), Gerontology and Metabolism, Stanford University Medical Center, CA; Rush Alzheimer's Disease Center (R.S.W.), Rush University Medical Center, Chicago, IL; and Care Policy and Evaluation Centre (S.E.-L.), London School of Economics and Political Science, United Kingdom
| | - Robert S Wilson
- From the Rush Institute for Healthy Aging (K.B.R., A.D., D.A.E.), Department of Internal Medicine, Rush University Medical Center, Chicago, IL; Division of Endocrinology (E.A.M.), Gerontology and Metabolism, Stanford University Medical Center, CA; Rush Alzheimer's Disease Center (R.S.W.), Rush University Medical Center, Chicago, IL; and Care Policy and Evaluation Centre (S.E.-L.), London School of Economics and Political Science, United Kingdom
| | - Anisa Dhana
- From the Rush Institute for Healthy Aging (K.B.R., A.D., D.A.E.), Department of Internal Medicine, Rush University Medical Center, Chicago, IL; Division of Endocrinology (E.A.M.), Gerontology and Metabolism, Stanford University Medical Center, CA; Rush Alzheimer's Disease Center (R.S.W.), Rush University Medical Center, Chicago, IL; and Care Policy and Evaluation Centre (S.E.-L.), London School of Economics and Political Science, United Kingdom
| | - Sara Evans-Lacko
- From the Rush Institute for Healthy Aging (K.B.R., A.D., D.A.E.), Department of Internal Medicine, Rush University Medical Center, Chicago, IL; Division of Endocrinology (E.A.M.), Gerontology and Metabolism, Stanford University Medical Center, CA; Rush Alzheimer's Disease Center (R.S.W.), Rush University Medical Center, Chicago, IL; and Care Policy and Evaluation Centre (S.E.-L.), London School of Economics and Political Science, United Kingdom
| | - Denis A Evans
- From the Rush Institute for Healthy Aging (K.B.R., A.D., D.A.E.), Department of Internal Medicine, Rush University Medical Center, Chicago, IL; Division of Endocrinology (E.A.M.), Gerontology and Metabolism, Stanford University Medical Center, CA; Rush Alzheimer's Disease Center (R.S.W.), Rush University Medical Center, Chicago, IL; and Care Policy and Evaluation Centre (S.E.-L.), London School of Economics and Political Science, United Kingdom
| |
Collapse
|
3
|
Liu X, Beck T, Dhana K, Tangney CC, Desai P, Krueger K, Evans DA, Rajan KB. Dietary fats and the APOE-e4 risk allele in relation to cognitive decline: a longitudinal investigation in a biracial population sample. J Nutr Health Aging 2024; 28:100211. [PMID: 38507884 DOI: 10.1016/j.jnha.2024.100211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2024] [Revised: 03/05/2024] [Accepted: 03/06/2024] [Indexed: 03/22/2024]
Abstract
BACKGROUND APOE-e4 is the strongest genetic risk factor for Alzheimer's disease. However, the influence of APOE-e4 on dietary fat intake and cognition has not been investigated. OBJECTIVE We aim to examine the association of types of dietary fat and their association to cognitive decline among those with and without the APOE-e4 allele. METHODS The study included 3,360 Chicago Health and Aging Project (CHAP) participants from four Southside Chicago communities. Global cognition was assessed using a composite score of episodic memory, perceptual speed, MMSE, and diet using a 144-item food frequency questionnaire. APOE genotype was assessed by the hME Sequenom mass-array platform. Longitudinal mixed-effect regression models were used to examine the association of dietary fat and the APOE-e4 allele with cognitive decline, adjusted for age, sex, education, smoking status, and calorie intake. RESULTS The present study involved 3,360 participants with a mean age of 74 at baseline, 62% African Americans, 63% females, and a mean follow-up of 7.8 years. Among participants with the APOE-e4 risk allele, higher intakes of total and saturated fat (SFA) were associated with a faster decline in global cognition. Among individuals with the APOE-e4 risk allele, a 5% increase in calories from SFA was associated with a 21% faster decline (β = -0.0197, P = 0.0038). In contrast, a higher intake of long-chain n-3 polyunsaturated fatty acids (LC-n3 PUFA) was associated with a slower rate of decline in global cognition among APOE-e4 carriers. Specifically, for every 1% energy increment from LC-n3 PUFA, the annual rate of global cognitive decline was slower by 0.024 standardized unit (SD 0.010, P = 0.023), about 30.4% slower annual cognitive decline. Higher SFA or other types of dietary fat were not associated with cognitive decline among APOE-e4 non-carriers. CONCLUSIONS Our study found a significant association between SFA and faster cognitive decline, LC-n3 PUFA and slower cognitive decline among those with the APOE-e4 allele. Our findings suggested that higher intake of SFA might contribute faster cognitive decline in combination with APOE-e4 whereas LC-n3 PUFA might compensate the adverse effects of APOE-e4. The interaction between intakes of different types of dietary fat and APOE-e4 on cognitive function warrants further research.
Collapse
Affiliation(s)
- Xiaoran Liu
- Rush Institute for Healthy Aging, Rush University Medical Center, Chicago, IL, USA; Department of Internal Medicine, Rush University Medical Center, Chicago, IL, USA.
| | - Todd Beck
- Rush Institute for Healthy Aging, Rush University Medical Center, Chicago, IL, USA; Department of Internal Medicine, Rush University Medical Center, Chicago, IL, USA
| | - Klodian Dhana
- Rush Institute for Healthy Aging, Rush University Medical Center, Chicago, IL, USA; Department of Internal Medicine, Rush University Medical Center, Chicago, IL, USA
| | - Christy C Tangney
- Department of Clinical Nutrition & Preventive Medicine, Rush University Medical Center, Chicago, IL, USA
| | - Pankaja Desai
- Rush Institute for Healthy Aging, Rush University Medical Center, Chicago, IL, USA; Department of Internal Medicine, Rush University Medical Center, Chicago, IL, USA
| | - Kristin Krueger
- Rush Institute for Healthy Aging, Rush University Medical Center, Chicago, IL, USA; Department of Internal Medicine, Rush University Medical Center, Chicago, IL, USA
| | - Denis A Evans
- Rush Institute for Healthy Aging, Rush University Medical Center, Chicago, IL, USA; Department of Internal Medicine, Rush University Medical Center, Chicago, IL, USA
| | - Kumar B Rajan
- Rush Institute for Healthy Aging, Rush University Medical Center, Chicago, IL, USA; Department of Internal Medicine, Rush University Medical Center, Chicago, IL, USA
| |
Collapse
|
4
|
Desai P, Halloway S, Krueger KR, Rajan KB, Evans DA. Temporal Patterns of Change in Physical and Cognitive Performance. J Gerontol A Biol Sci Med Sci 2024; 79:glad274. [PMID: 38071669 PMCID: PMC10878249 DOI: 10.1093/gerona/glad274] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Indexed: 02/22/2024] Open
Abstract
BACKGROUND This study examined the relation between declines in physical and cognitive performance in older people. METHODS A population-based cohort of 7 483 adults (average age 72 years) were interviewed. Physical performance was assessed with 3 standardized tests and a combination of 4 cognitive tests was used to assess cognitive function. Rate of change in physical and cognitive performance was determined for each interval between interviews. In mixed effects linear regression models adjusted for age, sex, race, and study time, and change in each factor was used to predict change in the other factor. We examined time associations by using changes in the predictor measured at 1, 2, or 3 intervals before the outcome change. RESULTS Decline in cognitive function was most strongly predicted by physical decline in the same 3-year interval. The decline in cognitive function was weaker in the 1-time interval after the decline in physical function and was not significant in later intervals. When a decline in cognitive function was used to predict a decline in physical function, the results were similar. The strongest association occurred in the same time interval so that declines in cognitive and physical performance tend to occur together. CONCLUSIONS Decline in cognition and physical function seem to occur together in a short timeframe. It is important to investigate the reasons for these changes that are short-term to guide the development of interventions.
Collapse
Affiliation(s)
- Pankaja Desai
- Internal Medicine, Rush Institute for Healthy Aging, Rush University Medical Center, Chicago, Illinois, USA
| | - Shannon Halloway
- Department of Biobehavioral Nursing Science, College of Nursing, University of Illinois at Chicago, Chicago, Illinois, USA
| | - Kristin R Krueger
- Internal Medicine, Rush Institute for Healthy Aging, Rush University Medical Center, Chicago, Illinois, USA
| | - Kumar B Rajan
- Internal Medicine, Rush Institute for Healthy Aging, Rush University Medical Center, Chicago, Illinois, USA
- Department of Neurology, University of California at Davis, Davis, California, USA
| | - Denis A Evans
- Internal Medicine, Rush Institute for Healthy Aging, Rush University Medical Center, Chicago, Illinois, USA
| |
Collapse
|
5
|
Desai P, Krueger KR, Mendes de Leon C, Wilson RS, Evans DA, Rajan KB. Depressive Symptoms, Glial Fibrillary Acid Protein Concentrations, and Cognitive Decline in a Cohort Study. J Gerontol A Biol Sci Med Sci 2024; 79:glad129. [PMID: 37209409 PMCID: PMC10799753 DOI: 10.1093/gerona/glad129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Indexed: 05/22/2023] Open
Abstract
BACKGROUND Little is known about how depressive symptoms and glial fibrillary acid protein (GFAP) concentrations taken together may influence cognitive functioning. Understanding this relationship may inform strategies for screening and early intervention to decrease the rate of cognitive decline. METHODS This study sample includes 1 169 participants from the Chicago Health and Aging Project (CHAP), consisting of 60% Black participants and 40% White participants, and 63% female participants and 37% male participants. CHAP is a population-based cohort study of older adults with a mean age of 77 years. Linear mixed-effects regression models tested the main effects of depressive symptoms and GFAP concentrations and their interactions on baseline cognitive function and cognitive decline over time. Models included adjustments for age, race, sex, education, chronic medical conditions, body mass index, smoking status, alcohol use, and their interactions with time. RESULTS The interaction of depressive symptomology and GFAP (β = -0.105 [standard error = 0.038], p = .006) on global cognitive function was statistically significant. Participants with depressive symptoms including and above the cutoff and high log of GFAP concentrations had more cognitive decline over time, followed by participants with depressive symptoms below the cutoff and high log of GFAP concentrations, depressive symptom scores including and above the cutoff and low log of GFAP concentrations, and depressive symptom scores below the cutoff and low log of GFAP concentrations. CONCLUSIONS Depressive symptoms have an additive effect on the association between the log of GFAP and baseline global cognitive function.
Collapse
Affiliation(s)
- Pankaja Desai
- Rush Institute for Healthy Aging, Rush University Medical Center, Chicago, Illinois, USA
| | - Kristin R Krueger
- Rush Institute for Healthy Aging, Rush University Medical Center, Chicago, Illinois, USA
| | | | - Robert S Wilson
- Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, Illinois, USA
| | - Denis A Evans
- Rush Institute for Healthy Aging, Rush University Medical Center, Chicago, Illinois, USA
| | - Kumar B Rajan
- Rush Institute for Healthy Aging, Rush University Medical Center, Chicago, Illinois, USA
- Department of Neurology, University of California at Davis, Davis, USA
| |
Collapse
|
6
|
Halloway S, Evans DA, Desai P, Dhana K, Beck T, Rajan KB. Serum total tau, neurofilament light, and glial fibrillary acidic protein are associated with mortality in a population study. J Am Geriatr Soc 2024; 72:149-159. [PMID: 37818793 PMCID: PMC10842309 DOI: 10.1111/jgs.18632] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Revised: 08/04/2023] [Accepted: 09/16/2023] [Indexed: 10/13/2023]
Abstract
BACKGROUND Total tau (t-tau), neurofilament light (NfL), and glial fibrillary acidic protein (GFAP) are neuronal cytoskeletal biomarkers that may indicate greater risk of poor outcomes in age-related conditions, including mortality. Health disparities experienced by some racial minority subgroups may influence biomarker expression and effects on longevity. We aimed to examine (a) associations of serum t-tau, NfL, and GFAP with overall and cardiovascular mortality and (b) differences in associations by racial background. METHODS Data came from 1327 older participants from the Chicago Health and Aging Project (CHAP), a longitudinal population-based study. Cox proportional hazards regression models were used to examine associations between concentrations of serum t-tau, NfL, and GFAP biomarker(s) and mortality (overall/cardiovascular mortality based on age at death). Interaction terms were used to examine differences between African-American and European-American participants. Models were adjusted for age, sex, education, the APOE-ε4 allele, body mass index, chronic health conditions, and cognitive and physical functioning. RESULTS Models showed that fivefold higher concentrations of t-tau (HR = 1.46, 95% CI: 1.27, 1.68), NfL (HR = 2.13, 95% CI: 1.76, 2.58), and GFAP (HR = 1.43, 95% CI: 1.08, 1.90) were separately associated with increased risk of overall mortality, with higher risk in African Americans in t-tau or NfL. In models with all biomarkers, NfL (HR = 2.17, 95% CI: 1.65, 2.85) was associated with risk of overall mortality, with racial differences in t-tau. Higher concentrations of t-tau (HR = 1.32, 95% CI: 1.02, 1.70), NfL (HR = 1.95, 95% CI: 1.40, 2.72), and GFAP (HR = 1.87, 95% CI: 1.18, 2.98) were separately associated with risk of cardiovascular mortality, with racial differences in t-tau, NfL, or GFAP. In combined models, NfL (HR = 1.73, 95% CI: 1.08, 2.78) was associated with cardiovascular mortality. CONCLUSIONS Serum t-tau, NfL, and GFAP may be early indicators for mortality outcomes among older adults, with racial differences among associations.
Collapse
Affiliation(s)
- Shannon Halloway
- University of Illinois Chicago College of Nursing, University of Illinois Chicago, Chicago, IL
| | - Denis A. Evans
- Rush Institute for Healthy Aging, Rush University Medical Center, Chicago, IL
- Department of Internal Medicine, Rush University Medical Center, Chicago, IL
| | - Pankaja Desai
- Rush Institute for Healthy Aging, Rush University Medical Center, Chicago, IL
- Department of Internal Medicine, Rush University Medical Center, Chicago, IL
| | - Klodian Dhana
- Rush Institute for Healthy Aging, Rush University Medical Center, Chicago, IL
- Department of Internal Medicine, Rush University Medical Center, Chicago, IL
| | - Todd Beck
- Rush Institute for Healthy Aging, Rush University Medical Center, Chicago, IL
- Department of Internal Medicine, Rush University Medical Center, Chicago, IL
| | - Kumar B. Rajan
- Rush Institute for Healthy Aging, Rush University Medical Center, Chicago, IL
- Department of Internal Medicine, Rush University Medical Center, Chicago, IL
- Department of Neurology, University of California at Davis, Davis, CA
| |
Collapse
|
7
|
Liu X, Beck T, Dhana K, Desai P, Krueger KR, Tangney CC, Holland TM, Agarwal P, Evans DA, Rajan KB. Association of Whole Grain Consumption and Cognitive Decline: An Investigation From a Community-Based Biracial Cohort of Older Adults. Neurology 2023; 101:e2277-e2287. [PMID: 37993270 PMCID: PMC10727204 DOI: 10.1212/wnl.0000000000207938] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Accepted: 09/13/2023] [Indexed: 11/24/2023] Open
Abstract
BACKGROUND AND OBJECTIVES To examine the association of whole grain consumption and longitudinal change in global cognition, perceptual speed, and episodic memory by different race/ethnicity. METHODS We included 3,326 participants from the Chicago Health and Aging Project who responded to a Food Frequency Questionnaire (FFQ), with 2 or more cognitive assessments. Global cognition was assessed using a composite score of episodic memory, perceptual speed, and the Mini Mental State Examination (MMSE). Diet was assessed by a 144-item FFQ. Linear mixed-effects models were used to estimate the association of intakes of whole grains and cognitive decline. RESULTS This study involved 3,326 participants (60.1% African American [AA], 63.7% female) with a mean age of 75 years at baseline and a mean follow-up of 6.1 years. Higher consumption of whole grains was associated with a slower rate of global cognitive decline. Among AA participants, those in the highest quintile of whole grain consumption had a slower rate of decline in global cognition (β = 0.024, 95% CI [0.008-0.039], p = 0.004), perceptual speed (β = 0.023, 95% CI [0.007-0.040], p = 0.005), and episodic memory (β = 0.028, 95% CI [0.005-0.050], p = 0.01) compared with those on the lowest quintile. Regarding the amount consumed, in AA participants, those who consumed >3 servings/d vs those who consumed <1 serving/d had a slower rate of decline in global cognition (β = 0.021, 95% CI [0.005-0.036], p = 0.0093). In White participants, with >3 servings/d, we found a suggestive association of whole grains with global cognitive decline when compared with those who consumed <1 serving/d (β = 0.025, 95% CI [-0.003 to 0.053], p = 0.08). DISCUSSION Among AA participants, individuals with higher consumption of whole grains and more frequent consumption of whole grain had slower decline in global cognition, perceptual speed, and episodic memory. We did not see a similar trend in White adults.
Collapse
Affiliation(s)
- Xiaoran Liu
- From the Rush Institute for Healthy Aging (X.L., T.B., K.D., P.D., K.R.K., T.M.H., D.A.E., K.B.R.), Rush University Medical Center; Department of Internal Medicine (X.L., T.B., K.D., P.D., K.R.K., T.M.H., P.A., D.A.E., K.B.R.), Rush University Medical Center; Department of Clinical Nutrition & Preventive Medicine (C.C.T.), Rush University Medical Center; and Rush Alzheimer's Disease Center (P.A.), Rush University Medical Center, Chicago, IL.
| | - Todd Beck
- From the Rush Institute for Healthy Aging (X.L., T.B., K.D., P.D., K.R.K., T.M.H., D.A.E., K.B.R.), Rush University Medical Center; Department of Internal Medicine (X.L., T.B., K.D., P.D., K.R.K., T.M.H., P.A., D.A.E., K.B.R.), Rush University Medical Center; Department of Clinical Nutrition & Preventive Medicine (C.C.T.), Rush University Medical Center; and Rush Alzheimer's Disease Center (P.A.), Rush University Medical Center, Chicago, IL
| | - Klodian Dhana
- From the Rush Institute for Healthy Aging (X.L., T.B., K.D., P.D., K.R.K., T.M.H., D.A.E., K.B.R.), Rush University Medical Center; Department of Internal Medicine (X.L., T.B., K.D., P.D., K.R.K., T.M.H., P.A., D.A.E., K.B.R.), Rush University Medical Center; Department of Clinical Nutrition & Preventive Medicine (C.C.T.), Rush University Medical Center; and Rush Alzheimer's Disease Center (P.A.), Rush University Medical Center, Chicago, IL
| | - Pankaja Desai
- From the Rush Institute for Healthy Aging (X.L., T.B., K.D., P.D., K.R.K., T.M.H., D.A.E., K.B.R.), Rush University Medical Center; Department of Internal Medicine (X.L., T.B., K.D., P.D., K.R.K., T.M.H., P.A., D.A.E., K.B.R.), Rush University Medical Center; Department of Clinical Nutrition & Preventive Medicine (C.C.T.), Rush University Medical Center; and Rush Alzheimer's Disease Center (P.A.), Rush University Medical Center, Chicago, IL
| | - Kristin R Krueger
- From the Rush Institute for Healthy Aging (X.L., T.B., K.D., P.D., K.R.K., T.M.H., D.A.E., K.B.R.), Rush University Medical Center; Department of Internal Medicine (X.L., T.B., K.D., P.D., K.R.K., T.M.H., P.A., D.A.E., K.B.R.), Rush University Medical Center; Department of Clinical Nutrition & Preventive Medicine (C.C.T.), Rush University Medical Center; and Rush Alzheimer's Disease Center (P.A.), Rush University Medical Center, Chicago, IL
| | - Christy C Tangney
- From the Rush Institute for Healthy Aging (X.L., T.B., K.D., P.D., K.R.K., T.M.H., D.A.E., K.B.R.), Rush University Medical Center; Department of Internal Medicine (X.L., T.B., K.D., P.D., K.R.K., T.M.H., P.A., D.A.E., K.B.R.), Rush University Medical Center; Department of Clinical Nutrition & Preventive Medicine (C.C.T.), Rush University Medical Center; and Rush Alzheimer's Disease Center (P.A.), Rush University Medical Center, Chicago, IL
| | - Thomas M Holland
- From the Rush Institute for Healthy Aging (X.L., T.B., K.D., P.D., K.R.K., T.M.H., D.A.E., K.B.R.), Rush University Medical Center; Department of Internal Medicine (X.L., T.B., K.D., P.D., K.R.K., T.M.H., P.A., D.A.E., K.B.R.), Rush University Medical Center; Department of Clinical Nutrition & Preventive Medicine (C.C.T.), Rush University Medical Center; and Rush Alzheimer's Disease Center (P.A.), Rush University Medical Center, Chicago, IL
| | - Puja Agarwal
- From the Rush Institute for Healthy Aging (X.L., T.B., K.D., P.D., K.R.K., T.M.H., D.A.E., K.B.R.), Rush University Medical Center; Department of Internal Medicine (X.L., T.B., K.D., P.D., K.R.K., T.M.H., P.A., D.A.E., K.B.R.), Rush University Medical Center; Department of Clinical Nutrition & Preventive Medicine (C.C.T.), Rush University Medical Center; and Rush Alzheimer's Disease Center (P.A.), Rush University Medical Center, Chicago, IL
| | - Denis A Evans
- From the Rush Institute for Healthy Aging (X.L., T.B., K.D., P.D., K.R.K., T.M.H., D.A.E., K.B.R.), Rush University Medical Center; Department of Internal Medicine (X.L., T.B., K.D., P.D., K.R.K., T.M.H., P.A., D.A.E., K.B.R.), Rush University Medical Center; Department of Clinical Nutrition & Preventive Medicine (C.C.T.), Rush University Medical Center; and Rush Alzheimer's Disease Center (P.A.), Rush University Medical Center, Chicago, IL
| | - Kumar B Rajan
- From the Rush Institute for Healthy Aging (X.L., T.B., K.D., P.D., K.R.K., T.M.H., D.A.E., K.B.R.), Rush University Medical Center; Department of Internal Medicine (X.L., T.B., K.D., P.D., K.R.K., T.M.H., P.A., D.A.E., K.B.R.), Rush University Medical Center; Department of Clinical Nutrition & Preventive Medicine (C.C.T.), Rush University Medical Center; and Rush Alzheimer's Disease Center (P.A.), Rush University Medical Center, Chicago, IL
| |
Collapse
|
8
|
Desai P, Beck T, Krueger KR, Wilson RS, Evans DA, Rajan KB. Neuroticism, physical activity, and cognitive functioning in a population-based cohort of older adults. BMC Geriatr 2023; 23:717. [PMID: 37926833 PMCID: PMC10626783 DOI: 10.1186/s12877-023-04399-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2023] [Accepted: 10/10/2023] [Indexed: 11/07/2023] Open
Abstract
BACKGROUND Little is known about how physical activity influences the relationship between neuroticism and cognitive function and cognitive decline. METHODS Data from the Chicago Health and Aging Project (CHAP) was utilized to conduct this study. CHAP is a population-based cohort study of chronic conditions in older adults. Participants completed in-home interviews cycles of three years from 1993-2012. Mixed effects regression models were conducted to test the associations between physical activity, neuroticism, and the interaction between neuroticism and physical activity on outcomes: global cognitive function, global cognitive decline, episodic memory, decline in episodic memory, perceptual speed, and decline in perceptual speed. Stratified mixed effects regression models by physical activity level were conducted to test the associations between neuroticism and global cognitive function and global cognitive decline. RESULTS A total of 7,685 participants were eligible for this study. Participants were 62% female and 64% African American. We found statistically significant associations for the interaction of high physical activity and neuroticism on baseline global cognitive function (β = 0.017 (SE = 0.007), p = .010) and on the interaction of neuroticism and high physical activity on baseline episodic memory (β = 0.020 (SE = .009), p = .021) and on decline in episodic memory over time (β = -0.003 (SE = .001), p = .039). CONCLUSION Higher physical activity lessened the association between higher neuroticism and poor cognitive outcomes.
Collapse
Affiliation(s)
- Pankaja Desai
- Rush Institute for Healthy Aging, Rush University Medical Center, Triangle Office Building, 1700 W Van Buren, Suite 245, Chicago, IL, 60612, USA.
| | - Todd Beck
- Rush Institute for Healthy Aging, Rush University Medical Center, Triangle Office Building, 1700 W Van Buren, Suite 245, Chicago, IL, 60612, USA
| | - Kristin R Krueger
- Rush Institute for Healthy Aging, Rush University Medical Center, Triangle Office Building, 1700 W Van Buren, Suite 245, Chicago, IL, 60612, USA
| | - Robert S Wilson
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, USA
| | - Denis A Evans
- Rush Institute for Healthy Aging, Rush University Medical Center, Triangle Office Building, 1700 W Van Buren, Suite 245, Chicago, IL, 60612, USA
| | - Kumar B Rajan
- Rush Institute for Healthy Aging, Rush University Medical Center, Triangle Office Building, 1700 W Van Buren, Suite 245, Chicago, IL, 60612, USA
- Department of Neurology, University of California at Davis, Davis, CA, USA
| |
Collapse
|
9
|
Dhana K, Beck T, Desai P, Wilson RS, Evans DA, Rajan KB. Prevalence of Alzheimer's disease dementia in the 50 US states and 3142 counties: A population estimate using the 2020 bridged-race postcensal from the National Center for Health Statistics. Alzheimers Dement 2023; 19:4388-4395. [PMID: 37458371 PMCID: PMC10593099 DOI: 10.1002/alz.13081] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Revised: 03/13/2023] [Accepted: 03/14/2023] [Indexed: 07/28/2023]
Abstract
INTRODUCTION This study estimates the prevalence and number of people living with Alzheimer's disease (AD) dementia in 50 US states and 3142 counties. METHODS We used cognitive data from the Chicago Health and Aging Project, a population-based study, and combined it with the National Center for Health Statistics 2020 bridged-race population estimates to determine the prevalence of AD in adults ≥65 years. RESULTS A higher prevalence of AD was estimated in the east and southeastern regions of the United States, with the highest in Maryland (12.9%), New York (12.7%), and Mississippi (12.5%). US states with the highest number of people with AD were California, Florida, and Texas. Among larger counties, those with the highest prevalence of AD were Miami-Dade County in Florida, Baltimore city in Maryland, and Bronx County in New York. DISCUSSION The state- and county-specific estimates could help public health officials develop region-specific strategies for caring for people with AD.
Collapse
Affiliation(s)
- Klodian Dhana
- Rush Institute for Healthy Aging, Rush University Medical Center, Chicago, IL 60612
- Department of Internal Medicine, Rush University Medical Center, Chicago, IL 60612
| | - Todd Beck
- Rush Institute for Healthy Aging, Rush University Medical Center, Chicago, IL 60612
- Department of Internal Medicine, Rush University Medical Center, Chicago, IL 60612
| | - Pankaja Desai
- Rush Institute for Healthy Aging, Rush University Medical Center, Chicago, IL 60612
- Department of Internal Medicine, Rush University Medical Center, Chicago, IL 60612
| | - Robert S. Wilson
- Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, IL 60612
| | - Denis A. Evans
- Rush Institute for Healthy Aging, Rush University Medical Center, Chicago, IL 60612
- Department of Internal Medicine, Rush University Medical Center, Chicago, IL 60612
| | - Kumar B. Rajan
- Rush Institute for Healthy Aging, Rush University Medical Center, Chicago, IL 60612
- Department of Internal Medicine, Rush University Medical Center, Chicago, IL 60612
| |
Collapse
|
10
|
Dhana A, DeCarli CS, Dhana K, Desai P, Holland TM, Evans DA, Rajan KB. Cardiovascular health and cognitive outcomes: Findings from a biracial population-based study in the United States. Alzheimers Dement 2023; 19:4446-4453. [PMID: 37534894 PMCID: PMC10592212 DOI: 10.1002/alz.13421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Revised: 07/11/2023] [Accepted: 07/12/2023] [Indexed: 08/04/2023]
Abstract
INTRODUCTION The aim of this study was to evaluate the association of cardiovascular health (CVH) with cognitive outcomes, including incident Alzheimer's dementia, rate of cognitive decline, and measures of brain injury and structure. METHODS This study consisted of 1702 Black or African American and White participants living in the south side of Chicago, Illinois, and enrolled in the Chicago Health and Aging Project, a population-based cohort since 1993. CVH was based on seven risk factors, including diet, physical activity, body mass index, smoking, dyslipidemia, hypertension, and diabetes. RESULTS In a multivariable-adjusted model, CVH was associated with a lower risk of Alzheimer's dementia. The hazard ratio per 1 additional point in CVH score was 0.84 (95% CI 0.76, 0.94). CVH was also associated with a slower rate of cognitive decline and less volume (injury) in white matter hyperintensities. DISCUSSION Promoting CVH in communities with Black residents may lower the future risk of Alzheimer's dementia.
Collapse
Affiliation(s)
- Anisa Dhana
- Rush Institute for Healthy Aging, Rush University Medical Center, Chicago, IL 60612
- Department of Internal Medicine, Rush University Medical Center, Chicago, IL 60612
| | - Charles S. DeCarli
- Department of Neurology, University of California at Davis, Sacramento, CA 95817
| | - Klodian Dhana
- Rush Institute for Healthy Aging, Rush University Medical Center, Chicago, IL 60612
- Department of Internal Medicine, Rush University Medical Center, Chicago, IL 60612
| | - Pankaja Desai
- Rush Institute for Healthy Aging, Rush University Medical Center, Chicago, IL 60612
- Department of Internal Medicine, Rush University Medical Center, Chicago, IL 60612
| | - Thomas M. Holland
- Rush Institute for Healthy Aging, Rush University Medical Center, Chicago, IL 60612
- Department of Internal Medicine, Rush University Medical Center, Chicago, IL 60612
| | - Denis A. Evans
- Rush Institute for Healthy Aging, Rush University Medical Center, Chicago, IL 60612
- Department of Internal Medicine, Rush University Medical Center, Chicago, IL 60612
| | - Kumar B. Rajan
- Rush Institute for Healthy Aging, Rush University Medical Center, Chicago, IL 60612
- Department of Internal Medicine, Rush University Medical Center, Chicago, IL 60612
- Department of Neurology, University of California at Davis, Sacramento, CA 95817
| |
Collapse
|
11
|
Rajabli F, Benchek P, Tosto G, Kushch N, Sha J, Bazemore K, Zhu C, Lee WP, Haut J, Hamilton-Nelson KL, Wheeler NR, Zhao Y, Farrell JJ, Grunin MA, Leung YY, Kuksa PP, Li D, Lucio da Fonseca E, Mez JB, Palmer EL, Pillai J, Sherva RM, Song YE, Zhang X, Iqbal T, Pathak O, Valladares O, Kuzma AB, Abner E, Adams PM, Aguirre A, Albert MS, Albin RL, Allen M, Alvarez L, Apostolova LG, Arnold SE, Asthana S, Atwood CS, Ayres G, Baldwin CT, Barber RC, Barnes LL, Barral S, Beach TG, Becker JT, Beecham GW, Beekly D, Benitez BA, Bennett D, Bertelson J, Bird TD, Blacker D, Boeve BF, Bowen JD, Boxer A, Brewer J, Burke JR, Burns JM, Buxbaum JD, Cairns NJ, Cantwell LB, Cao C, Carlson CS, Carlsson CM, Carney RM, Carrasquillo MM, Chasse S, Chesselet MF, Chin NA, Chui HC, Chung J, Craft S, Crane PK, Cribbs DH, Crocco EA, Cruchaga C, Cuccaro ML, Cullum M, Darby E, Davis B, De Jager PL, DeCarli C, DeToledo J, Dick M, Dickson DW, Dombroski BA, Doody RS, Duara R, Ertekin-Taner NI, Evans DA, Faber KM, Fairchild TJ, Fallon KB, Fardo DW, Farlow MR, Fernandez-Hernandez V, Ferris S, Foroud TM, Frosch MP, Fulton-Howard B, Galasko DR, Gamboa A, Gearing M, Geschwind DH, Ghetti B, Gilbert JR, Goate AM, Grabowski TJ, Graff-Radford NR, Green RC, Growdon JH, Hakonarson H, Hall J, Hamilton RL, Harari O, Hardy J, Harrell LE, Head E, Henderson VW, Hernandez M, Hohman T, Honig LS, Huebinger RM, Huentelman MJ, Hulette CM, Hyman BT, Hynan LS, Ibanez L, Jarvik GP, Jayadev S, Jin LW, Johnson K, Johnson L, Kamboh MI, Karydas AM, Katz MJ, Kauwe JS, Kaye JA, Keene CD, Khaleeq A, Kim R, Knebl J, Kowall NW, Kramer JH, Kukull WA, LaFerla FM, Lah JJ, Larson EB, Lerner A, Leverenz JB, Levey AI, Lieberman AP, Lipton RB, Logue M, Lopez OL, Lunetta KL, Lyketsos CG, Mains D, Margaret FE, Marson DC, Martin ERR, Martiniuk F, Mash DC, Masliah E, Massman P, Masurkar A, McCormick WC, McCurry SM, McDavid AN, McDonough S, McKee AC, Mesulam M, Miller BL, Miller CA, Miller JW, Montine TJ, Monuki ES, Morris JC, Mukherjee S, Myers AJ, Nguyen T, O'Bryant S, Olichney JM, Ory M, Palmer R, Parisi JE, Paulson HL, Pavlik V, Paydarfar D, Perez V, Peskind E, Petersen RC, Pierce A, Polk M, Poon WW, Potter H, Qu L, Quiceno M, Quinn JF, Raj A, Raskind M, Reiman EM, Reisberg B, Reisch JS, Ringman JM, Roberson ED, Rodriguear M, Rogaeva E, Rosen HJ, Rosenberg RN, Royall DR, Sager MA, Sano M, Saykin AJ, Schneider JA, Schneider LS, Seeley WW, Slifer SH, Small S, Smith AG, Smith JP, Sonnen JA, Spina S, St George-Hyslop P, Stern RA, Stevens AB, Strittmatter SM, Sultzer D, Swerdlow RH, Tanzi RE, Tilson JL, Trojanowski JQ, Troncoso JC, Tsuang DW, Van Deerlin VM, van Eldik LJ, Vance JM, Vardarajan BN, Vassar R, Vinters HV, Vonsattel JP, Weintraub S, Welsh-Bohmer KA, Whitehead PL, Wijsman EM, Wilhelmsen KC, Williams B, Williamson J, Wilms H, Wingo TS, Wisniewski T, Woltjer RL, Woon M, Wright CB, Wu CK, Younkin SG, Yu CE, Yu L, Zhu X, Kunkle BW, Bush WS, Wang LS, Farrer LA, Haines JL, Mayeux R, Pericak-Vance MA, Schellenberg GD, Jun GR, Reitz C, Naj AC. Multi-ancestry genome-wide meta-analysis of 56,241 individuals identifies LRRC4C, LHX5-AS1 and nominates ancestry-specific loci PTPRK , GRB14 , and KIAA0825 as novel risk loci for Alzheimer's disease: the Alzheimer's Disease Genetics Consortium. medRxiv 2023:2023.07.06.23292311. [PMID: 37461624 PMCID: PMC10350126 DOI: 10.1101/2023.07.06.23292311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/25/2023]
Abstract
Limited ancestral diversity has impaired our ability to detect risk variants more prevalent in non-European ancestry groups in genome-wide association studies (GWAS). We constructed and analyzed a multi-ancestry GWAS dataset in the Alzheimer's Disease (AD) Genetics Consortium (ADGC) to test for novel shared and ancestry-specific AD susceptibility loci and evaluate underlying genetic architecture in 37,382 non-Hispanic White (NHW), 6,728 African American, 8,899 Hispanic (HIS), and 3,232 East Asian individuals, performing within-ancestry fixed-effects meta-analysis followed by a cross-ancestry random-effects meta-analysis. We identified 13 loci with cross-ancestry associations including known loci at/near CR1 , BIN1 , TREM2 , CD2AP , PTK2B , CLU , SHARPIN , MS4A6A , PICALM , ABCA7 , APOE and two novel loci not previously reported at 11p12 ( LRRC4C ) and 12q24.13 ( LHX5-AS1 ). Reflecting the power of diverse ancestry in GWAS, we observed the SHARPIN locus using 7.1% the sample size of the original discovering single-ancestry GWAS (n=788,989). We additionally identified three GWS ancestry-specific loci at/near ( PTPRK ( P =2.4×10 -8 ) and GRB14 ( P =1.7×10 -8 ) in HIS), and KIAA0825 ( P =2.9×10 -8 in NHW). Pathway analysis implicated multiple amyloid regulation pathways (strongest with P adjusted =1.6×10 -4 ) and the classical complement pathway ( P adjusted =1.3×10 -3 ). Genes at/near our novel loci have known roles in neuronal development ( LRRC4C, LHX5-AS1 , and PTPRK ) and insulin receptor activity regulation ( GRB14 ). These findings provide compelling support for using traditionally-underrepresented populations for gene discovery, even with smaller sample sizes.
Collapse
|
12
|
Augustianath T, Evans DA, Anisha GS. Teratogenic effects of radiofrequency electromagnetic radiation on the embryonic development of chick: A study on morphology and hatchability. Res Vet Sci 2023; 159:93-100. [PMID: 37104994 DOI: 10.1016/j.rvsc.2023.04.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2023] [Revised: 04/16/2023] [Accepted: 04/20/2023] [Indexed: 04/29/2023]
Abstract
The present study was aimed at studying the effects of RF-EMR in causing teratogenic changes in the embryonic development of organisms using chick embryo as a model. The fertilized eggs of the hen were incubated in a digital humidified incubator and exposed to RF-EMR from 2G and 4G mobile phones by ringing at regular time intervals. The dose of RF-EMR was varied by increasing the call duration and number of calls per day, with the lower dose being a call duration of 50 min/day and the higher dose being 90 min/day. The phone kept had a range of radiofrequency between 900 and 1800 MHz and SAR (Specific Absorption Rate) 1.355 (2G) and 1.12 (4G) watts/ kg respectively. The batch of eggs incubated without any exposure to RF-EMR was taken as control. The hatchability of 2G and 4G experimental groups were respectively, 65% and 75% at lower radiation exposure and 40% and 55% at higher radiation exposure. The teratogenic effects of RF-EMR on the morphology of chick embryos manifested as the cross beak, non-retracted yolk sac, macrocephaly, malformed legs and toes, disability in standing and balancing the body and variations in body weight, body length and beak length. The results indicate that the RF-EMR poses potential threats to the developing stages of organisms.
Collapse
Affiliation(s)
- Tessy Augustianath
- Post-graduate and Research Department of Zoology (Research Centre Affiliated to University of Kerala), Government College for Women, Thiruvananthapuram, Kerala 695014, India
| | - D A Evans
- Department of Zoology, University College, Thiruvananthapuram, Kerala 695034, India
| | - G S Anisha
- Post-graduate and Research Department of Zoology (Research Centre Affiliated to University of Kerala), Government College for Women, Thiruvananthapuram, Kerala 695014, India.
| |
Collapse
|
13
|
Dhana K, Barnes LL, Agarwal P, Liu X, Dhana A, Desai P, Aggarwal N, Evans DA, Rajan KB. Vitamin D intake and cognitive decline in Blacks and Whites: The role of diet and supplements. Alzheimers Dement 2023; 19:1135-1142. [PMID: 35867354 PMCID: PMC9867781 DOI: 10.1002/alz.12729] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Revised: 05/12/2022] [Accepted: 06/01/2022] [Indexed: 01/26/2023]
Abstract
INTRODUCTION To determine the role of vitamin D intake on cognitive decline among Blacks and Whites. METHODS Using data from the population-based Chicago Health and Aging Project, we studied 2061 Blacks and 1329 Whites with dietary vitamin D data and cognitive testing over 12 years of follow-up. Multivariable linear mixed-effects models were used to determine the association of vitamin D intake with cognitive decline. RESULTS Vitamin D intake, particularly dietary vitamin D, was associated with a slower rate of decline in cognitive function among Blacks. In Blacks, comparing individuals in the lowest tertile of dietary intake, those in the highest tertile had a slower cognitive decline of 0.017 units/year (95% confidence interval 0.006, 0.027), independently of supplementation use. In Whites, vitamin D intake was not associated with cognitive decline. DISCUSSION Dietary vitamin D may help to slow the decline in cognitive abilities among Blacks as they age.
Collapse
Affiliation(s)
- Klodian Dhana
- Rush Institute for Healthy Aging, Rush University Medical Center, Chicago, IL
- Department of Internal Medicine, Rush University Medical Center, Chicago, IL
| | - Lisa L Barnes
- Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, IL
- Department of Neurology, Rush University Medical Center, Chicago, IL
| | - Puja Agarwal
- Department of Internal Medicine, Rush University Medical Center, Chicago, IL
- Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, IL
| | - Xiaoran Liu
- Rush Institute for Healthy Aging, Rush University Medical Center, Chicago, IL
- Department of Internal Medicine, Rush University Medical Center, Chicago, IL
| | - Anisa Dhana
- Rush Institute for Healthy Aging, Rush University Medical Center, Chicago, IL
- Department of Internal Medicine, Rush University Medical Center, Chicago, IL
| | - Pankaja Desai
- Rush Institute for Healthy Aging, Rush University Medical Center, Chicago, IL
- Department of Internal Medicine, Rush University Medical Center, Chicago, IL
| | - Neelum Aggarwal
- Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, IL
- Department of Neurology, Rush University Medical Center, Chicago, IL
| | - Denis A. Evans
- Rush Institute for Healthy Aging, Rush University Medical Center, Chicago, IL
- Department of Internal Medicine, Rush University Medical Center, Chicago, IL
| | - Kumar B. Rajan
- Rush Institute for Healthy Aging, Rush University Medical Center, Chicago, IL
- Department of Internal Medicine, Rush University Medical Center, Chicago, IL
| |
Collapse
|
14
|
Desai P, Krueger KR, Mendes de Leon C, Wilson RS, Evans DA, Rajan KB. Race and Apolipoprotein E-e4 Allele Status Differences in the Association Between Loneliness and Cognitive Decline. Psychosom Med 2023; 85:231-237. [PMID: 36626598 PMCID: PMC10073257 DOI: 10.1097/psy.0000000000001168] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
OBJECTIVE This study aimed to examine race and apolipoprotein E-e4 allele (APOE-e4) status differences in the longitudinal associations between loneliness and cognitive decline. METHODS The study sample is composed of participants ( N = 7696, 64% Black participants and 36% White participants) from the Chicago Health and Aging Project, a population-based cohort study. Mixed-effects regression models were conducted to examine the longitudinal associations between loneliness on global cognitive function and individual tests of cognitive function. Models were also stratified by race and APOE-e4. RESULTS A greater percentage of Black participants (17%) reported loneliness at baseline visit compared with White participants (12%). Black and White participants who were lonely individuals had a similar rate of decline in global cognitive function at 0.075 (95% confidence interval [CI] = -0.082 to -0.068) standard deviation unit (SDU) per year for Black participants and at 0.075 (95% CI = -0.086 to -0.063) SDU per year for White participants. Lonely participants with APOE-e4 had a higher rate of global cognitive decline at -0.102 (95% CI = -0.115 to -0.088) SDU per year than for lonely participants without APOE-e4 at -0.052 (95% CI = -0.059 to -0.045) SDU per year. CONCLUSIONS The burden of loneliness and its relation to cognitive decline is higher among participants with APOE-e4 compared with those without APOE-e4. Loneliness is associated with cognitive decline in both Black and White participants.
Collapse
Affiliation(s)
- Pankaja Desai
- Rush Institute for Healthy Aging, Rush University Medical Center, Chicago, IL
| | - Kristin R. Krueger
- Rush Institute for Healthy Aging, Rush University Medical Center, Chicago, IL
| | | | - Robert S. Wilson
- Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, IL
| | - Denis A. Evans
- Rush Institute for Healthy Aging, Rush University Medical Center, Chicago, IL
| | - Kumar B. Rajan
- Rush Institute for Healthy Aging, Rush University Medical Center, Chicago, IL
- Department of Neurology, University of California at Davis, Davis, CA
| |
Collapse
|
15
|
Dhana A, DeCarli C, Aggarwal NT, Dhana K, Desai P, Evans DA, Rajan KB. Serum neurofilament light chain, brain infarcts, and the risk of stroke: a prospective population-based cohort study. Eur J Epidemiol 2023; 38:427-434. [PMID: 36867286 PMCID: PMC10081967 DOI: 10.1007/s10654-023-00978-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Accepted: 02/17/2023] [Indexed: 03/04/2023]
Abstract
Neurofilament light chain (NfL), a neuron-specific protein, has been related to several neurodegenerative diseases. In addition, elevated levels of NfL have also been observed in patients admitted to the hospital for stroke, suggesting that NfL as a biomarker may extend well beyond neurodegenerative diseases. Therefore, using data from the Chicago Health and Aging Project (CHAP), a population-based cohort study, we prospectively investigated the association of serum NfL levels with incident stroke and brain infarcts. During a follow-up of 3603 person-years, 133 (16.3%) individuals developed incident stroke, including ischemic and hemorrhagic. The HR (95%CI) of incident stroke was 1.28 (95%CI 1.10-1.50) per 1 standard deviation (SD) increase of log10 NfL serum levels. Compared to participants in the first tertile of NfL (i.e., lower levels), the risk of stroke was 1.68 times higher (95%CI 1.07-2.65) in those in the second tertile and 2.35 times higher (95%CI 1.45-3.81) in those in the third tertile of NfL. NfL levels were also positively associated with brain infarcts; 1-SD in log10 NfL levels was associated with 1.32 (95%CI 1.06-1.66) higher odds of one or more brain infarcts. These results suggest that NfL may serve as a biomarker of stroke in older adults.
Collapse
Affiliation(s)
- Anisa Dhana
- Rush Institute for Healthy Aging, Rush University Medical Center, 1700 W Van Buren, Suite 245, Chicago, IL, 60612, US.
- Department of Internal Medicine, Rush University Medical Center, Chicago, IL, US.
| | - Charles DeCarli
- Department of Neurology, University of California at Davis, Sacramento, CA, US
| | - Neelum T Aggarwal
- Department of Neurological Sciences and the Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, US
- Department of Neurology, Rush University Medical Center, Chicago, IL, US
| | - Klodian Dhana
- Rush Institute for Healthy Aging, Rush University Medical Center, 1700 W Van Buren, Suite 245, Chicago, IL, 60612, US
- Department of Internal Medicine, Rush University Medical Center, Chicago, IL, US
| | - Pankaja Desai
- Rush Institute for Healthy Aging, Rush University Medical Center, 1700 W Van Buren, Suite 245, Chicago, IL, 60612, US
- Department of Internal Medicine, Rush University Medical Center, Chicago, IL, US
| | - Denis A Evans
- Rush Institute for Healthy Aging, Rush University Medical Center, 1700 W Van Buren, Suite 245, Chicago, IL, 60612, US
- Department of Internal Medicine, Rush University Medical Center, Chicago, IL, US
| | - Kumar B Rajan
- Rush Institute for Healthy Aging, Rush University Medical Center, 1700 W Van Buren, Suite 245, Chicago, IL, 60612, US
- Department of Internal Medicine, Rush University Medical Center, Chicago, IL, US
| |
Collapse
|
16
|
Ajitha T, Gayathri RVA, Evans DA. Antixenosis by a resistant Musa cultivar to stem borer Odoiporus longicollis attack and expression of microsomal α-amylase by the pest. J Biosci 2023. [DOI: 10.1007/s12038-023-00331-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/12/2023]
|
17
|
Dhana A, DeCarli C, Dhana K, Desai P, Wilson RS, Evans DA, Rajan KB. White matter hyperintensity, neurofilament light chain, and cognitive decline. Ann Clin Transl Neurol 2023; 10:321-327. [PMID: 36542548 PMCID: PMC10014007 DOI: 10.1002/acn3.51720] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Revised: 12/05/2022] [Accepted: 12/07/2022] [Indexed: 12/24/2022] Open
Abstract
OBJECTIVE We aimed to determine whether combining white matter hyperintensity (WMH) with neurofilament light chain (NfL) could provide additional information for cognition in older adults. METHODS Utilizing data from the population-based Chicago Health and Aging Project, we studied 701 individuals with both biomarkers and cognitive data during the follow-up period. NfL was measured using an ultrasensitive immunoassay, single-molecule array technology. MRI scans of the brain were acquired using 1.5-T systems. Global cognitive function was created as a composite measure of four neuropsychological tests, standardized and averaged to z-scores. Multivariable linear mixed-effects models were used to evaluate the association of WMH and NfL with the rate of cognitive decline. RESULTS Higher WMH and NfL were associated with a faster rate of cognitive decline during the follow-up; β -coefficients (95%CIs) were -0.011 (-0.02, -0.001) and -0.010 (-0.017, -0.003), respectively. In individuals with lower concentration of NfL (i.e., bottom tertile), a higher WMH volume was associated with a faster cognitive decline ( β : -0.030; 95%CI -0.046, -0.014). Similarly, in individuals with lower volumes of WMH (i.e., bottom tertile), a higher concentrations of NfL was associated with a faster cognitive decline ( β : -0.023; 95%CI -0.042, -0.005). When we combined WMH with NfL, we noted a graded association with increasing volumes of WMH, particularly in people with lower NfL values. INTERPRETATION While both biomarkers, WMH and NfL, were similarly associated with the annual rate of cognitive decline, our study suggests that they provide different underlying mechanisms affecting cognition.
Collapse
Affiliation(s)
- Anisa Dhana
- Rush Institute for Healthy Aging, Rush University Medical Center, Chicago, Illinois, USA.,Department of Internal Medicine, Rush University Medical Center, Chicago, Illinois, USA
| | - Charles DeCarli
- Department of Neurology, University of California at Davis, Sacramento, California, USA
| | - Klodian Dhana
- Rush Institute for Healthy Aging, Rush University Medical Center, Chicago, Illinois, USA.,Department of Internal Medicine, Rush University Medical Center, Chicago, Illinois, USA
| | - Pankaja Desai
- Rush Institute for Healthy Aging, Rush University Medical Center, Chicago, Illinois, USA.,Department of Internal Medicine, Rush University Medical Center, Chicago, Illinois, USA
| | - Robert S Wilson
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, Illinois, USA
| | - Denis A Evans
- Rush Institute for Healthy Aging, Rush University Medical Center, Chicago, Illinois, USA.,Department of Internal Medicine, Rush University Medical Center, Chicago, Illinois, USA
| | - Kumar B Rajan
- Rush Institute for Healthy Aging, Rush University Medical Center, Chicago, Illinois, USA.,Department of Internal Medicine, Rush University Medical Center, Chicago, Illinois, USA.,Department of Neurology, University of California at Davis, Sacramento, California, USA
| |
Collapse
|
18
|
Rajan KB, McAninch EA, Aggarwal NT, Barnes LL, Wilson RS, Weuve J, DeCarli CS, Evans DA. Longitudinal Changes in Blood Biomarkers of Clinical Alzheimer Disease in a Biracial Population Sample. Neurology 2023; 100:e874-e883. [PMID: 36446595 PMCID: PMC9984218 DOI: 10.1212/wnl.0000000000201289] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Accepted: 08/10/2022] [Indexed: 12/03/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Recent studies suggest the utility of blood biomarkers in detecting changes in neurodegenerative disorders. The objective of our research was to test the hypothesis that the longitudinal changes in total tau (t-tau), neurofilament light chain (Nf-L), and glial fibrillary acidic protein (GFAP) are associated with structural MRI and the development of clinical Alzheimer disease (AD) and cognitive decline. METHODS Data came from a population-based sample with serum concentrations of t-tau, Nf-L, and GFAP and cognitive characteristics measured over 17 years. The inclusion criteria for this investigation were based on participants with blood samples, cognitive function testing, and clinical diagnosis for AD. The longitudinal changes in the serum biomarkers were examined using linear mixed models for log10-transformed concentrations. RESULTS In 1,327 participants (60% Black participants and 60% women, the concentration of t-tau increased annually by 4.8% (95% CI = 4.0-5.6) and Nf-L by 5.9% (95% CI = 5.4-6.4). The longitudinal change in GFAP was higher among Black participants than among White participants (4.4% vs 3.5% per year, p = 0.028). Baseline MRI characteristics were associated with the longitudinal changes in serum biomarkers of clinical AD. Specifically, a higher baseline third ventricular volume was associated with a higher rate of increase in the concentration of t-tau, and white matter hyperintensities predicted a higher rate of increase in Nf-L. The rate of change in concentrations of t-tau, Nf-L, and GFAP was significantly higher among those who developed clinical AD than in those with no cognitive impairment. For each standard deviation unit decline in global cognition, longitudinal change in t-tau increased by 81% (95% CI = 76-86), Nf-L by 113% (95% CI = 105-120), and GFAP by 66% (95% CI = 62-70). DISCUSSION Blood biomarkers showed significant longitudinal changes corresponding to cognitive decline, clinical AD, and structural MRI characteristics. Our findings show that longitudinal changes in serum biomarkers were associated with several cognitive endophenotypes. CLASSIFICATION OF EVIDENCE The study found Class II evidence that longitudinal changes in serum t-tau, Nf-L, and GFAP were associated with cognitive decline and the development of clinical AD in people older than 65 years.
Collapse
Affiliation(s)
- Kumar B Rajan
- From the Rush Institute for Healthy Aging (K.R., D.E.), Rush University Medical Center, Chicago IL; Stanford University (E.A.M.), Palo Alto, CA; Rush Alzheimer's Disease Center (N.A., L.L.B., R.W.), Chicago IL; Boston University (J.W.), Boston, MA; and Department of Neurology (C.S.D.), University of California, Davis.
| | - Elizabeth A McAninch
- From the Rush Institute for Healthy Aging (K.R., D.E.), Rush University Medical Center, Chicago IL; Stanford University (E.A.M.), Palo Alto, CA; Rush Alzheimer's Disease Center (N.A., L.L.B., R.W.), Chicago IL; Boston University (J.W.), Boston, MA; and Department of Neurology (C.S.D.), University of California, Davis
| | - Neelum T Aggarwal
- From the Rush Institute for Healthy Aging (K.R., D.E.), Rush University Medical Center, Chicago IL; Stanford University (E.A.M.), Palo Alto, CA; Rush Alzheimer's Disease Center (N.A., L.L.B., R.W.), Chicago IL; Boston University (J.W.), Boston, MA; and Department of Neurology (C.S.D.), University of California, Davis
| | - Lisa L Barnes
- From the Rush Institute for Healthy Aging (K.R., D.E.), Rush University Medical Center, Chicago IL; Stanford University (E.A.M.), Palo Alto, CA; Rush Alzheimer's Disease Center (N.A., L.L.B., R.W.), Chicago IL; Boston University (J.W.), Boston, MA; and Department of Neurology (C.S.D.), University of California, Davis
| | - Robert S Wilson
- From the Rush Institute for Healthy Aging (K.R., D.E.), Rush University Medical Center, Chicago IL; Stanford University (E.A.M.), Palo Alto, CA; Rush Alzheimer's Disease Center (N.A., L.L.B., R.W.), Chicago IL; Boston University (J.W.), Boston, MA; and Department of Neurology (C.S.D.), University of California, Davis
| | - Jennifer Weuve
- From the Rush Institute for Healthy Aging (K.R., D.E.), Rush University Medical Center, Chicago IL; Stanford University (E.A.M.), Palo Alto, CA; Rush Alzheimer's Disease Center (N.A., L.L.B., R.W.), Chicago IL; Boston University (J.W.), Boston, MA; and Department of Neurology (C.S.D.), University of California, Davis
| | - Charles S DeCarli
- From the Rush Institute for Healthy Aging (K.R., D.E.), Rush University Medical Center, Chicago IL; Stanford University (E.A.M.), Palo Alto, CA; Rush Alzheimer's Disease Center (N.A., L.L.B., R.W.), Chicago IL; Boston University (J.W.), Boston, MA; and Department of Neurology (C.S.D.), University of California, Davis
| | - Denis A Evans
- From the Rush Institute for Healthy Aging (K.R., D.E.), Rush University Medical Center, Chicago IL; Stanford University (E.A.M.), Palo Alto, CA; Rush Alzheimer's Disease Center (N.A., L.L.B., R.W.), Chicago IL; Boston University (J.W.), Boston, MA; and Department of Neurology (C.S.D.), University of California, Davis
| |
Collapse
|
19
|
Ajitha T, Gayathri RVA, Evans DA. Antixenosis by a resistant Musa cultivar to stem borer Odoiporus longicollis attack and expression of microsomal α-amylase by the pest. J Biosci 2023; 48. [PMID: 36924206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/18/2023]
Abstract
Banana pseudo-stem weevil (BPW) Odoiporus longicollis Olivier is a serious pest of Musa cultivars which completes its lifecycle as an internal parasite in the pseudo-stem of susceptible host plants. The larval stage of BPW is destructive and difficult to control as larvae are endophytic. Plantains (bananas), resistant to infestation by BPW, exhibited antixenosis against the larvae. Experimental maintenance of the larvae for 4 days in the live pseudo-stem of the resistant plantain resulted in the disruption of carbohydrate metabolism and imbalance of protein-free amino acid turnover. The pseudo-stem possesses three larvicides: stigmasterol-3-O-glucoside (SOG), sulfoquinovosyl diacylglycerol (SQDG), and betulinic acid (BA). Larvicides cause significant elevation in hemolymph protein and reduction in total free amino acids. Larvae treated with larvicides showed elevated activities of hexokinase, trehalase, and lactic acid dehydrogenase, which resulted in significant decrease of glucose and trehalose but sharp increase of lactic acid. Also, inhibition in the activity of glycogen phosphorylase caused significant increase of fat body glycogen in affected larvae. At LD20 concentration, toxicities by SOG, SQDG, and BA were similar but antixenosis by the resistant host plant was more severe due to the simultaneous action of three larvicides present in the resistant, live pseudo-stem. Disruption of carbohydrate metabolism and imbalance of protein-amino acid turnover due to toxicity by larvicides resulted in slow death of the larvae. The larval body responded against toxicity through the induction of the amy gene, which resulted in increased synthesis of α-amylase. The protein was sequenced as ID AHN 92452.2 with 496 amino acids, and the gene has 1491 nucleotides. Defense mechanisms by the larvae are not sufficient to resist antixenosis by the host plant. SOG, SQDG, and BA can be used synergistically as a larvicide for the control of BPW.
Collapse
Affiliation(s)
- T Ajitha
- Department of Zoology, University College, Thiruvananthapuram 695034, India
| | | | | |
Collapse
|
20
|
Liu X, Finno CJ, Beck T, Dhana K, Tangney C, Desai P, Krueger K, Evans DA, Rajan KB. Association of Vitamin E and Cognitive Decline in Older Adults with and without the APOEɛ4 Allele: A Biracial Population-Based Community Study. J Alzheimers Dis 2023; 96:1129-1138. [PMID: 37955092 PMCID: PMC10947793 DOI: 10.3233/jad-230797] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2023]
Abstract
BACKGROUND The association of different types of tocopherols (vitamin E) with cognition might vary by the APOEɛ4 allele status. OBJECTIVE We examined the association of dietary tocopherols with cognitive decline among participants with and without the APOEɛ4 allele over a median of 12 years. METHODS 2,193 participants from the Chicago Health and Aging Project were included in the analyses. Global cognition was assessed in three-year cycles. We used a 144-item FFQ to assess dietary intakes of tocopherols and hME Sequenom mass-array platform to assess APOE genotype. We used linear mixed effects models to examine the relationship between tocopherol from food sources and global cognitive decline. RESULTS The mean baseline age was 74.1 (SD = 5.9) years. Among APOEɛ4 carriers, participants in the highest quintile of intakes of dietary vitamin E had a slower cognitive decline of 0.022 SDU (95% CI: 0.000, 0.043) compared to those in the lowest quintile. A higher intake of dietary α-tocopherol from food sources only was associated with slower cognitive decline in APOEɛ4 carriers (p for trend 0.002) but not among the non-carriers (p for trend 0.937). Among APOEɛ4 carriers, those in the highest quintile of intake of α-tocopherol had a 16.4% slower rate of decline of global cognition compared to those in the lowest quintile (β= 0.034, 95% CI: 0.013, 0.054). CONCLUSIONS Individuals consuming high α-tocopherol from food sources had slower cognitive decline among APOEɛ4 carriers. In older adults, different forms of vitamin E might moderate the relationship of APOEɛ4 with global cognition.
Collapse
Affiliation(s)
- Xiaoran Liu
- Department of Internal Medicine, Rush University Medical Center, Chicago, IL, 60612, USA
- Rush Institute for Healthy Aging, Chicago, IL, 60612, USA
| | - Carrie J. Finno
- Department of Population, Health & Reproduction, School of Veterinary Medicine, UC Davis, Davis, CA, 95616, USA
| | - Todd Beck
- Department of Internal Medicine, Rush University Medical Center, Chicago, IL, 60612, USA
- Rush Institute for Healthy Aging, Chicago, IL, 60612, USA
| | - Klodian Dhana
- Department of Internal Medicine, Rush University Medical Center, Chicago, IL, 60612, USA
- Rush Institute for Healthy Aging, Chicago, IL, 60612, USA
| | - Christy Tangney
- Department of Clinical Nutrition & Preventive Medicine, Rush University Medical Center, Chicago, IL, 60612, USA
| | - Pankaja Desai
- Department of Internal Medicine, Rush University Medical Center, Chicago, IL, 60612, USA
- Rush Institute for Healthy Aging, Chicago, IL, 60612, USA
| | - Kristin Krueger
- Department of Internal Medicine, Rush University Medical Center, Chicago, IL, 60612, USA
- Rush Institute for Healthy Aging, Chicago, IL, 60612, USA
| | - Denis A Evans
- Department of Internal Medicine, Rush University Medical Center, Chicago, IL, 60612, USA
- Rush Institute for Healthy Aging, Chicago, IL, 60612, USA
| | - Kumar B Rajan
- Department of Internal Medicine, Rush University Medical Center, Chicago, IL, 60612, USA
- Rush Institute for Healthy Aging, Chicago, IL, 60612, USA
| |
Collapse
|
21
|
Agarwal P, Ford CN, Leurgans SE, Beck T, Desai P, Dhana K, Evans DA, Halloway S, Holland TM, Krueger KR, Liu X, Rajan KB, Bennett DA. Dietary Sugar Intake Associated with a Higher Risk of Dementia in Community-Dwelling Older Adults. J Alzheimers Dis 2023; 95:1417-1425. [PMID: 37694364 PMCID: PMC10921393 DOI: 10.3233/jad-230013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/12/2023]
Abstract
BACKGROUND We have limited evidence for the relationship of high sugar intake with dementia risk. OBJECTIVE To determine whether high sugar intake is associated with an increased risk of dementia in community-dwelling older adultsMethods:This study included 789 participants of the Rush Memory and Aging Project (community-based longitudinal cohort study of older adults free of known dementia at enrollment), with annual clinical assessments and complete nutrient data (obtained by validated food frequency questionnaire). Clinical diagnosis of dementia is based on the criteria of the joint working group of the National Institute of Neurological and Communicative Disorders and Stroke and the Alzheimer's Disease and Related Disorders Association. We used Cox proportional hazard models. RESULTS 118 participants developed dementia during 7.3±3.8 years of follow-up. Those in the highest quintile of total sugar intake were twice as likely to develop dementia than those in the lowest quintile (Q5 versus Q1:HR=2.10 (95% CI: 1.05, 4.19) when adjusted for age, sex, education, APOEɛ4 allele, calories from sources other than sugar, physical activity, and diet score. Higher percent calories from sugar were positively associated with dementia risk (β=0.042, p = 0.0009). In exploratory analyses, the highest versus lowest quintile of fructose and sucrose in the diet had higher dementia risk by 2.8 (95% CI: 1.38, 5.67) and 1.93 (95% CI: 1.05, 3.54) times, respectively. CONCLUSIONS A higher intake of total sugar or total calories from sugar is associated with increased dementia risk in older adults. Among simple sugars, fructose (e.g., sweetened beverages, snacks, packaged desserts) and sucrose (table sugar in juices, desserts, candies, and commercial cereals) are associated with higher dementia risk.
Collapse
Affiliation(s)
- Puja Agarwal
- Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, IL, USA
- Department of Internal Medicine, Rush University Medical Center, Chicago, IL, USA
- Department of Clinical Nutrition, Rush University Medical Center, Chicago, IL, USA
| | - Christopher N. Ford
- Department of Internal Medicine, Rush University Medical Center, Chicago, IL, USA
- Rush Institute for Healthy Aging (Section of Community Epidemiology), Rush University Medical Center, Chicago, IL, USA
| | - Sue E. Leurgans
- Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, IL, USA
- Department of Neurology, Rush University Medical Center, Chicago, IL, USA
| | - Todd Beck
- Department of Internal Medicine, Rush University Medical Center, Chicago, IL, USA
- Rush Institute for Healthy Aging (Section of Community Epidemiology), Rush University Medical Center, Chicago, IL, USA
| | - Pankaja Desai
- Department of Internal Medicine, Rush University Medical Center, Chicago, IL, USA
- Rush Institute for Healthy Aging (Section of Community Epidemiology), Rush University Medical Center, Chicago, IL, USA
| | - Klodian Dhana
- Department of Internal Medicine, Rush University Medical Center, Chicago, IL, USA
- Rush Institute for Healthy Aging (Section of Community Epidemiology), Rush University Medical Center, Chicago, IL, USA
| | - Denis A. Evans
- Department of Internal Medicine, Rush University Medical Center, Chicago, IL, USA
- Rush Institute for Healthy Aging (Section of Community Epidemiology), Rush University Medical Center, Chicago, IL, USA
| | - Shannon Halloway
- Department of Biobehavioral Nursing Science, College of Nursing, University of Illinois Chicago, Chicago, IL, USA
| | - Thomas M. Holland
- Department of Internal Medicine, Rush University Medical Center, Chicago, IL, USA
- Rush Institute for Healthy Aging (Section of Community Epidemiology), Rush University Medical Center, Chicago, IL, USA
| | - Kristin R. Krueger
- Department of Internal Medicine, Rush University Medical Center, Chicago, IL, USA
- Rush Institute for Healthy Aging (Section of Community Epidemiology), Rush University Medical Center, Chicago, IL, USA
| | - Xiaoran Liu
- Department of Internal Medicine, Rush University Medical Center, Chicago, IL, USA
- Rush Institute for Healthy Aging (Section of Community Epidemiology), Rush University Medical Center, Chicago, IL, USA
| | - Kumar Bharat Rajan
- Department of Internal Medicine, Rush University Medical Center, Chicago, IL, USA
- Rush Institute for Healthy Aging (Section of Community Epidemiology), Rush University Medical Center, Chicago, IL, USA
| | - David A. Bennett
- Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, IL, USA
- Department of Neurology, Rush University Medical Center, Chicago, IL, USA
| |
Collapse
|
22
|
Liu X, Beck T, Dhana K, Evans DA, Rajan KB. Different associations of varying types of Vitamin E and cognitive function in older adults with or without APOE Ɛ4 allele. Alzheimers Dement 2022. [DOI: 10.1002/alz.067805] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Affiliation(s)
- Xiaoran Liu
- Rush University Medical Center Chicago IL USA
- Rush Institute for Healthy Aging Chicago IL USA
| | - Todd Beck
- Rush University Medical Center Chicago IL USA
- Rush Institute for Healthy Aging Chicago IL USA
| | - Klodian Dhana
- Rush University Medical Center Chicago IL USA
- Rush Institute for Healthy Aging Chicago IL USA
| | - Denis A Evans
- Rush University Medical Center Chicago IL USA
- Rush Institute for Healthy Aging Chicago IL USA
| | - Kumar B Rajan
- Rush University Medical Center Chicago IL USA
- Rush Institute for Healthy Aging Chicago IL USA
| |
Collapse
|
23
|
Dhana K, Aggarwal NT, Beck T, Holland TM, Dhana A, Cherian LJ, Desai P, Evans DA, Rajan KB. Lifestyle and Cognitive Decline in Community-Dwelling Stroke Survivors. J Alzheimers Dis 2022; 89:745-754. [PMID: 35938251 DOI: 10.3233/jad-220305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background: Patients with stroke are at a higher risk of cognitive impairment and Alzheimer’s disease dementia. Objective: To quantify the role of lifestyle pre-stroke, post-stroke, and changes in lifestyle before and after stroke with cognitive decline in community-dwelling stroke survivors. Methods: Utilizing data from the Chicago Health and Aging Project, a population-based cohort study, we studied 1,078 individuals with stroke (662 incident and 416 prevalent) who underwent cognitive testing during the study period. A healthy lifestyle score was defined by scoring four behaviors: non-smoking, exercising, being cognitively active, and having a high-quality diet. The global cognitive score was derived from a comprehensive battery of 4 standardized tests. Results: The mean age at incident stroke was 78.2 years, and 60.1% were women. A healthy lifestyle pre-incident stroke was associated with a slower rate of cognitive decline after stroke. Participants with 3–4 healthy lifestyle factors pre-incident stroke had a slower cognitive decline after stroke by 0.046 units/year (95% CI 0.010, 0.083), or 47.7% slower, than participants with 0–1 healthy lifestyle factor. Lifestyle score post-prevalent stroke was not associated with cognitive decline. Changes in lifestyle behaviors from pre- to post-incident stroke were related to cognitive decline after stroke. Individuals who deteriorated their lifestyle quality after stroke had a faster cognitive decline by 0.051 units/year (β –0.051, 95% CI –0.090, –0.012) than participants with no change in lifestyle score. Conclusion: A healthy lifestyle pre-stroke was associated with a slower rate of cognitive decline in stroke survivors, highlighting the importance of primary prevention. After the stroke, changes in lifestyle behaviors may influence the cognitive abilities of older adults as they age.
Collapse
Affiliation(s)
- Klodian Dhana
- Rush Institute for Healthy Aging, Rush University Medical Center, Chicago, IL, USA
- Department of Internal Medicine, Rush University Medical Center, Chicago, IL USA
| | - Neelum T. Aggarwal
- Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, IL, USA
- Department of Neurology, Rush University Medical Center, Chicago, IL, USA
| | - Todd Beck
- Rush Institute for Healthy Aging, Rush University Medical Center, Chicago, IL, USA
- Department of Internal Medicine, Rush University Medical Center, Chicago, IL USA
| | - Thomas M. Holland
- Rush Institute for Healthy Aging, Rush University Medical Center, Chicago, IL, USA
- Department of Internal Medicine, Rush University Medical Center, Chicago, IL USA
| | - Anisa Dhana
- Rush Institute for Healthy Aging, Rush University Medical Center, Chicago, IL, USA
- Department of Internal Medicine, Rush University Medical Center, Chicago, IL USA
| | - Laurel J. Cherian
- Department of Neurology, Rush University Medical Center, Chicago, IL, USA
| | - Pankaja Desai
- Rush Institute for Healthy Aging, Rush University Medical Center, Chicago, IL, USA
- Department of Internal Medicine, Rush University Medical Center, Chicago, IL USA
| | - Denis A. Evans
- Rush Institute for Healthy Aging, Rush University Medical Center, Chicago, IL, USA
- Department of Internal Medicine, Rush University Medical Center, Chicago, IL USA
| | - Kumar B. Rajan
- Rush Institute for Healthy Aging, Rush University Medical Center, Chicago, IL, USA
- Department of Internal Medicine, Rush University Medical Center, Chicago, IL USA
| |
Collapse
|
24
|
Liu X, Dhana K, Barnes LL, Tangney CC, Agarwal P, Aggarwal N, Holland TM, Beck T, Evans DA, Rajan KB. A healthy plant-based diet was associated with slower cognitive decline in African American older adults: a biracial community-based cohort. Am J Clin Nutr 2022; 116:875-886. [PMID: 35906190 PMCID: PMC9535523 DOI: 10.1093/ajcn/nqac204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Revised: 04/21/2022] [Accepted: 07/22/2022] [Indexed: 01/26/2023] Open
Abstract
BACKGROUND African American (AA) adults have about twice the risk of developing dementia compared with white adults. However, evidence on dietary modification in preventing cognitive decline from diverse populations focusing on AA adults is minimal. OBJECTIVES We aimed to evaluate the association between a plant-based diet and the rate of cognitive decline in a population-based sample of AA and white adults. METHODS This study consisted of 3337 participants from the Chicago Health and Aging Project (60% AA participants, 64% female). Plant-based diet quality was evaluated by the overall plant-based diet index (PDI), the healthful PDI (hPDI), and the unhealthful PDI (uPDI). Global cognition was assessed using a composite score of 4 individual tests of cognition. We used mixed models to examine the associations of PDI, hPDI, and uPDI with the rates of decline in global cognition, perceptual speed, and episodic memory. Models were adjusted for age, sex, presence of apoE e4 allele, lifestyle factors including education, cognitive activities, smoking status, calorie intake, risk factors for cardiovascular disease, time, and the interaction terms of time × each covariate. RESULTS AA and white participants had various dietary patterns. Higher hPDI was associated with a slower rate of decline in global cognition, perceptual speed, and episodic memory in AA participants but not white participants. AA study participants in the highest quintile of hPDI had significantly slower rates of global cognitive decline (β: 0.0183 ± 0.0086; P = 0.032), perceptual speed (β: 0.0179 ± 0.0088; P = 0.04), and episodic memory (β: 0.0163 ± 0.0118; P = 0.04) than individuals in the lowest quintile of hPDI. There were no associations of either PDI or uPDI with the rate of cognitive decline in either racial group. CONCLUSIONS A healthy plant-based diet was associated with a slower rate of decline in global cognition, perceptual speed, and episodic memory in AA adults.
Collapse
Affiliation(s)
| | - Klodian Dhana
- Rush Institute for Healthy Aging, Rush University Medical Center, Chicago, IL, USA,Department of Internal Medicine, Rush University Medical Center, Chicago, IL, USA
| | - Lisa L Barnes
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, USA,Department of Neurology, Rush University Medical Center, Chicago, IL, USA
| | - Christy C Tangney
- Department of Clinical Nutrition & Preventive Medicine, Rush University Medical Center, Chicago, IL, USA
| | - Puja Agarwal
- Department of Internal Medicine, Rush University Medical Center, Chicago, IL, USA,Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, USA
| | - Neelum Aggarwal
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, USA,Department of Neurology, Rush University Medical Center, Chicago, IL, USA
| | - Thomas M Holland
- Rush Institute for Healthy Aging, Rush University Medical Center, Chicago, IL, USA,Department of Internal Medicine, Rush University Medical Center, Chicago, IL, USA
| | - Todd Beck
- Rush Institute for Healthy Aging, Rush University Medical Center, Chicago, IL, USA,Department of Internal Medicine, Rush University Medical Center, Chicago, IL, USA
| | - Denis A Evans
- Rush Institute for Healthy Aging, Rush University Medical Center, Chicago, IL, USA,Department of Internal Medicine, Rush University Medical Center, Chicago, IL, USA
| | - Kumar B Rajan
- Rush Institute for Healthy Aging, Rush University Medical Center, Chicago, IL, USA,Department of Internal Medicine, Rush University Medical Center, Chicago, IL, USA
| |
Collapse
|
25
|
Dhana K, Franco OH, Ritz EM, Ford CN, Desai P, Krueger KR, Holland TM, Dhana A, Liu X, Aggarwal NT, Evans DA, Rajan KB. Healthy lifestyle and life expectancy with and without Alzheimer's dementia: population based cohort study. BMJ 2022; 377:e068390. [PMID: 35418416 PMCID: PMC9006322 DOI: 10.1136/bmj-2021-068390] [Citation(s) in RCA: 40] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
OBJECTIVE To determine the impact of lifestyle factors on life expectancy lived with and without Alzheimer's dementia. DESIGN Prospective cohort study. SETTING The Chicago Health and Aging Project, a population based cohort study in the United States. PARTICIPANTS 2449 men and women aged 65 years and older. MAIN EXPOSURE A healthy lifestyle score was developed based on five modifiable lifestyle factors: a diet for brain health (Mediterranean-DASH Diet Intervention for Neurodegenerative Delay-MIND diet score in upper 40% of cohort distribution), late life cognitive activities (composite score in upper 40%), moderate or vigorous physical activity (≥150 min/week), no smoking, and light to moderate alcohol consumption (women 1-15 g/day; men 1-30 g/day). MAIN OUTCOME Life expectancy with and without Alzheimer's dementia in women and men. RESULTS Women aged 65 with four or five healthy factors had a life expectancy of 24.2 years (95% confidence interval 22.8 to 25.5) and lived 3.1 years longer than women aged 65 with zero or one healthy factor (life expectancy 21.1 years, 19.5 to 22.4). Of the total life expectancy at age 65, women with four or five healthy factors spent 10.8% (2.6 years, 2.0 to 3.3) of their remaining years with Alzheimer's dementia, whereas women with zero or one healthy factor spent 19.3% (4.1 years, 3.2 to 5.1) with the disease. Life expectancy for women aged 65 without Alzheimer's dementia and four or five healthy factors was 21.5 years (20.0 to 22.7), and for those with zero or one healthy factor it was 17.0 years (15.5 to 18.3). Men aged 65 with four or five healthy factors had a total life expectancy of 23.1 years (21.4 to 25.6), which is 5.7 years longer than men aged 65 with zero or one healthy factor (life expectancy 17.4 years, 15.8 to 20.1). Of the total life expectancy at age 65, men with four or five healthy factors spent 6.1% (1.4 years, 0.3 to 2.0) of their remaining years with Alzheimer's dementia, and those with zero or one healthy factor spent 12.0% (2.1 years, 0.2 to 3.0) with the disease. Life expectancy for men aged 65 without Alzheimer's dementia and four or five healthy factors was 21.7 years (19.7 to 24.9), and for those with zero or one healthy factor life expectancy was 15.3 years (13.4 to 19.1). CONCLUSION A healthy lifestyle was associated with a longer life expectancy among men and women, and they lived a larger proportion of their remaining years without Alzheimer's dementia. The life expectancy estimates might help health professionals, policy makers, and stakeholders to plan future healthcare services, costs, and needs.
Collapse
Affiliation(s)
- Klodian Dhana
- Rush Institute for Healthy Aging, Rush University Medical Center, Chicago, Illinois, USA
- Department of Internal Medicine, Rush University Medical Center, Chicago, Illinois, USA
| | - Oscar H Franco
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Ethan M Ritz
- Rush Institute for Healthy Aging, Rush University Medical Center, Chicago, Illinois, USA
- Department of Internal Medicine, Rush University Medical Center, Chicago, Illinois, USA
| | - Christopher N Ford
- Rush Institute for Healthy Aging, Rush University Medical Center, Chicago, Illinois, USA
- Department of Internal Medicine, Rush University Medical Center, Chicago, Illinois, USA
| | - Pankaja Desai
- Rush Institute for Healthy Aging, Rush University Medical Center, Chicago, Illinois, USA
- Department of Internal Medicine, Rush University Medical Center, Chicago, Illinois, USA
| | - Kristin R Krueger
- Rush Institute for Healthy Aging, Rush University Medical Center, Chicago, Illinois, USA
- Department of Internal Medicine, Rush University Medical Center, Chicago, Illinois, USA
| | - Thomas M Holland
- Rush Institute for Healthy Aging, Rush University Medical Center, Chicago, Illinois, USA
- Department of Internal Medicine, Rush University Medical Center, Chicago, Illinois, USA
| | - Anisa Dhana
- Rush Institute for Healthy Aging, Rush University Medical Center, Chicago, Illinois, USA
- Department of Internal Medicine, Rush University Medical Center, Chicago, Illinois, USA
| | - Xiaoran Liu
- Rush Institute for Healthy Aging, Rush University Medical Center, Chicago, Illinois, USA
- Department of Internal Medicine, Rush University Medical Center, Chicago, Illinois, USA
| | - Neelum T Aggarwal
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, Illinois, USA
- Department of Neurology, Rush University Medical Center, Chicago, Illinois, USA
| | - Denis A Evans
- Rush Institute for Healthy Aging, Rush University Medical Center, Chicago, Illinois, USA
- Department of Internal Medicine, Rush University Medical Center, Chicago, Illinois, USA
| | - Kumar B Rajan
- Rush Institute for Healthy Aging, Rush University Medical Center, Chicago, Illinois, USA
- Department of Internal Medicine, Rush University Medical Center, Chicago, Illinois, USA
| |
Collapse
|
26
|
Dhana A, DeCarli C, Dhana K, Desai P, Krueger K, Evans DA, Rajan KB. Association of Subjective Memory Complaints With White Matter Hyperintensities and Cognitive Decline Among Older Adults in Chicago, Illinois. JAMA Netw Open 2022; 5:e227512. [PMID: 35426922 PMCID: PMC9012965 DOI: 10.1001/jamanetworkopen.2022.7512] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Accepted: 02/28/2022] [Indexed: 11/26/2022] Open
Abstract
Importance Subjective memory complaints (SMCs) are associated with a faster cognitive decline; whether this association is also associated with structural brain alterations, such as white matter hyperintensity (WMH) volumes, requires investigation. Objective To evaluate the association of SMCs with WMH volumes and cognitive decline and investigate the role of WMH volumes in the association between SMCs and cognitive decline. Design, Setting, and Participants The Chicago Health and Aging Project, a population-based cohort study, enrolled adults aged 65 years or older. Data collection occurred in 3-year cycles from 1993 until 2012. Our study comprised 975 participants with magnetic resonance imaging assessments, of which 900 participants had data on SMCs and covariates, and 713 participants provided 2 or more cognitive assessments during the follow-up. Statistical analyses were conducted from May to October 2021. Exposures SMCs were obtained from self-reported questionnaire data during clinical evaluations, and the cycle, when reported, constituted the baseline of our study. Based on the frequency and severity of concerns, we categorized participants into 3 groups, (1) no concerns, (2) moderate concerns, and (3) very worried. Main Outcomes and Measures Volumetric magnetic resonance imaging measures of WMH volume and neuropsychological testing assessments of global cognition. Linear regression analysis was used to investigate the association between SMCs and WMH volumes in a multivariable model adjusted for age, sex, race and ethnicity, education, APOE4 status, and total intracranial volume. The association of SMCs with cognitive decline was investigated using linear mixed-effects models for age, sex, race and ethnicity, education, APOE4 status, follow-up time, and each variable in interaction with time to estimate the annual longitudinal change in cognitive function. Results Of the 900 participants with data on SMCs, covariates, and WMH volumes, 553 (61.4%) were women, 539 (59.9%) were African American, and the mean (SD) age was 79.5 (6.2) years. SMCs were associated with a larger WMH volume and faster cognitive decline. Compared with participants with no concerns, participants who were very worried had higher WMH volumes (β = 0.833; 95% CI, 0.203-1.463) and 174% faster cognitive decline (β = -0.049; 95% CI, -0.076 to -0.022). The association between SMCs and cognitive decline remained statistically significant among individuals with large WMH volumes (ie, within the fourth quartile). Within the fourth quartile of WMH volumes, participants who were very worried had 428% faster cognitive decline (β = -0.077; 95% CI, -0.144 to -0.011) compared with participants with no concerns. Conclusions and Relevance This cohort study suggests that SMCs, frequently reported by older individuals, are an important sign of cognitive impairment, especially among people with abnormalities in brain structure, such as larger WMH volumes.
Collapse
Affiliation(s)
- Anisa Dhana
- Rush Institute for Healthy Aging, Rush University Medical Center, Chicago, Illinois
- Department of Internal Medicine, Rush University Medical Center, Chicago, Illinois
| | - Charles DeCarli
- Department of Neurology, University of California at Davis, Sacramento
| | - Klodian Dhana
- Rush Institute for Healthy Aging, Rush University Medical Center, Chicago, Illinois
- Department of Internal Medicine, Rush University Medical Center, Chicago, Illinois
| | - Pankaja Desai
- Rush Institute for Healthy Aging, Rush University Medical Center, Chicago, Illinois
- Department of Internal Medicine, Rush University Medical Center, Chicago, Illinois
| | - Kristin Krueger
- Rush Institute for Healthy Aging, Rush University Medical Center, Chicago, Illinois
- Department of Internal Medicine, Rush University Medical Center, Chicago, Illinois
| | - Denis A. Evans
- Rush Institute for Healthy Aging, Rush University Medical Center, Chicago, Illinois
- Department of Internal Medicine, Rush University Medical Center, Chicago, Illinois
| | - Kumar B. Rajan
- Rush Institute for Healthy Aging, Rush University Medical Center, Chicago, Illinois
- Department of Internal Medicine, Rush University Medical Center, Chicago, Illinois
| |
Collapse
|
27
|
Desai P, Dhana K, DeCarli C, Wilson RS, McAninch EA, Evans DA, Rajan KB. Examination of Neurofilament Light Chain Serum Concentrations, Physical Activity, and Cognitive Decline in Older Adults. JAMA Netw Open 2022; 5:e223596. [PMID: 35315915 PMCID: PMC8941360 DOI: 10.1001/jamanetworkopen.2022.3596] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
IMPORTANCE Little is known about the association of serum neurofilament light chain (NfL) concentrations and physical activity with the rate of cognitive decline in older adults. OBJECTIVE To examine the association of physical activity and NfL concentrations with cognitive decline in older adults over time. DESIGN, SETTING, AND PARTICIPANTS This cohort study used data from the Chicago Health and Aging Project (CHAP), a population-based cohort study that recruited participants through door-to-door census in 4 Chicago-area communities and collected data between 1993 and 2012 in cycles of 3 years. Participants in CHAP who had 2 or more cognitive function assessments and at least 1 blood sample collected for NfL measurement were selected for inclusion in the current study. Data were analyzed from January to December 2021. EXPOSURES Self-reported physical activity (minutes per week) and serum NfL concentration (pg/mL). MAIN OUTCOMES AND MEASURES Associations of baseline physical activity and NfL concentrations with changes in global cognitive function over time as evaluated using the East Boston Memory Test for episodic memory, the Symbol Digit Modalities Test for perceptual speed, and the Mini-Mental State Examination. Mixed-effects regression analyses were conducted to examine associations at baseline and longitudinally. RESULTS The study sample included 1158 participants (695 [60%] African American; 728 [63%] female), with a mean (SD) age of 77.4 (6.0) years and a mean educational level of 12.6 (3.5) years. Among participants with high NfL concentrations (>25 pg/mL), those who engaged in medium physical activity (<150 minutes per week) had a 12% slower rate of global cognitive decline (SD units, or β, -0.065; 95% CI, -0.099 to -0.032) and participants who engaged in high physical activity (≥150 minutes per week) had a 36% slower rate of decline (β, -0.048; 95% CI, -0.080 to -0.016) than did participants with low physical activity (no reported participation) (β, -0.075; 95% CI, -0.108 to -0.041). For participants with low NfL concentrations (≤25 pg/mL), those who took part in medium physical activity had 43% slower global cognitive decline (β, -0.025; 95% CI, -0.043 to -0.007) and individuals who participated in high physical activity had 30% slower decline (β, -0.031; 95% CI, -0.048 to -0.014) than did those who participated in low physical activity (β, -0.046; 95% CI, -0.066 to -0.025). CONCLUSIONS AND RELEVANCE The findings suggest that physical activity is associated with diminished cognitive decline among older adults with increased serum NfL concentrations. The results support the potential use of blood biomarkers in measuring the benefits of health behaviors, such as physical activity, and early intervention for older adults at risk for cognitive decline.
Collapse
Affiliation(s)
- Pankaja Desai
- Rush Institute for Healthy Aging, Rush University Medical Center, Chicago, Illinois
| | - Klodian Dhana
- Rush Institute for Healthy Aging, Rush University Medical Center, Chicago, Illinois
| | | | - Robert S. Wilson
- Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, Illinois
| | | | - Denis A. Evans
- Rush Institute for Healthy Aging, Rush University Medical Center, Chicago, Illinois
| | - Kumar B. Rajan
- Rush Institute for Healthy Aging, Rush University Medical Center, Chicago, Illinois
- Department of Neurology, University of California at Davis
| |
Collapse
|
28
|
Krueger KR, Wilson RS, Barnes LL, McAninch EA, Evans DA, DeCarli CS, Fletcher EM, Rajan KB. Cognitive activity, cognitive function, and structural MRI findings. Alzheimers Dement 2021. [DOI: 10.1002/alz.052370] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
- Kristin R. Krueger
- Rush University Medical Center Chicago IL USA
- Rush Institute for Healthy Aging Chicago IL USA
| | - Robert S. Wilson
- Rush University Medical Center Chicago IL USA
- Rush Alzheimer's Disease Center Rush University Medical Center Chicago IL USA
| | - Lisa L. Barnes
- Rush University Medical Center Chicago IL USA
- Rush Alzheimer's Disease Center Rush University Medical Center Chicago IL USA
| | - Elizabeth A. McAninch
- Rush University Medical Center Chicago IL USA
- Rush Institute for Healthy Aging Chicago IL USA
| | - Denis A. Evans
- Rush University Medical Center Chicago IL USA
- Rush Institute for Healthy Aging Chicago IL USA
| | | | | | - Kumar B. Rajan
- Rush University Medical Center Chicago IL USA
- Rush Institute for Healthy Aging Chicago IL USA
| |
Collapse
|
29
|
Desai P, Evans DA, Dhana K, Aggarwal NT, Wilson RS, Rajan KB. Longitudinal evaluation of total tau and physical activity on cognitive decline in a population‐based study. Alzheimers Dement 2021. [DOI: 10.1002/alz.052310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Pankaja Desai
- Rush Institute for Healthy Aging Chicago IL USA
- Rush University Medical Center Chicago IL USA
| | | | | | | | - Robert S. Wilson
- Rush Alzheimer's Disease Center Rush University Medical Center Chicago IL USA
| | | |
Collapse
|
30
|
Halloway S, Desai P, Aggarwal NT, Agarwal P, Evans DA, Rajan KB. Blood neurofilament light, Parkinson’s disease, Parkinsonism, and physical function in a longitudinal population study. Alzheimers Dement 2021. [DOI: 10.1002/alz.051174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Shannon Halloway
- Rush University College of Nursing Chicago IL USA
- Rush University Medical Center Chicago IL USA
| | - Pankaja Desai
- Rush University Medical Center Chicago IL USA
- Rush Institute for Healthy Aging Chicago IL USA
| | - Neelum T Aggarwal
- Rush University Medical Center Chicago IL USA
- Rush Medical College Chicago IL USA
- Rush Alzheimer’s Disease Center Chicago IL USA
| | - Puja Agarwal
- Rush University Medical Center Chicago IL USA
- Rush Alzheimer’s Disease Center Chicago IL USA
| | - Denis A Evans
- Rush University Medical Center Chicago IL USA
- Rush Institute for Healthy Aging Chicago IL USA
| | - Kumar B Rajan
- Rush University Medical Center Chicago IL USA
- Rush Institute for Healthy Aging Chicago IL USA
- University of California Davis Davis CA USA
| |
Collapse
|
31
|
Dhana K, Aggarwal NT, Beck T, Desai P, Liu X, Barnes LL, Evans DA, Rajan KB. Healthy lifestyle and cognitive decline in people living with stroke in the community. Alzheimers Dement 2021. [DOI: 10.1002/alz.054337] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
| | | | - Todd Beck
- Rush University Medical Center Chicago IL USA
| | | | - Xiaoran Liu
- Rush University Medical Center Chicago IL USA
| | | | | | | |
Collapse
|
32
|
Ford CN, Agarwal P, Beck T, Evans DA, Bennett DA. Total sugar intake and cognition in community‐dwelling older adults. Alzheimers Dement 2021. [DOI: 10.1002/alz.051754] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Affiliation(s)
| | | | - Todd Beck
- Rush University Medical Center Chicago IL USA
| | | | - David A Bennett
- Rush Alzheimer's Disease Center, Rush University Chicago IL USA
| |
Collapse
|
33
|
D'Souza J, Weuve J, Brook RD, Evans DA, Kaufman JD, Adar SD. Long-Term Exposures to Urban Noise and Blood Pressure Levels and Control Among Older Adults. Hypertension 2021; 78:1801-1808. [PMID: 34689591 DOI: 10.1161/hypertensionaha.121.17708] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
[Figure: see text].
Collapse
Affiliation(s)
- Jennifer D'Souza
- School of Public Health, University of Michigan, Ann Arbor (J.D., S.D.A.)
| | | | - Robert D Brook
- Division of Cardiovascular Diseases, Wayne State University, Detroit, MI (R.D.B.)
| | - Denis A Evans
- Rush University School of Medicine, Chicago, IL (D.A.E.)
| | - Joel D Kaufman
- School of Public Health, University of Washington, Seattle (J.D.K.)
| | - Sara D Adar
- School of Public Health, University of Michigan, Ann Arbor (J.D., S.D.A.)
| |
Collapse
|
34
|
Dhana K, Barnes LL, Liu X, Agarwal P, Desai P, Krueger KR, Holland TM, Halloway S, Aggarwal NT, Evans DA, Rajan KB. Genetic risk, adherence to a healthy lifestyle, and cognitive decline in African Americans and European Americans. Alzheimers Dement 2021; 18:572-580. [PMID: 34310036 DOI: 10.1002/alz.12435] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Revised: 07/02/2021] [Accepted: 07/05/2021] [Indexed: 11/08/2022]
Abstract
INTRODUCTION We investigated the role of genetic risk and adherence to lifestyle factors on cognitive decline in African Americans and European Americans. METHODS Using data from the Chicago Health and Aging Project (1993-2012; n = 3874), we defined the genetic risk based on presence of apolipoprotein E (APOE) ε 4 allele and determined a healthy lifestyle using a scoring of five factors: non-smoking, exercising, being cognitively active, having a high-quality diet, and limiting alcohol use. We used linear mixed-effects models to estimate cognitive decline by genetic risk and lifestyle score. RESULTS APOE ε 4 allele was associated with faster cognitive decline in both races. However, within APOE ε 4 carriers, adherence to a healthy lifestyle (eg., 4 to 5 healthy factors) was associated with a slower cognitive decline by 0.023 (95% confidence interval [CI] 0.004, 0.042) units/year in African Americans and 0.044 (95% CI 0.008, 0.080) units/year in European Americans. DISCUSSION A healthy lifestyle was associated with a slower cognitive decline in African and European Americans.
Collapse
Affiliation(s)
- Klodian Dhana
- Rush Institute for Healthy Aging, Rush University Medical Center, Chicago, Illinois, USA.,Department of Internal Medicine, Rush University Medical Center, Chicago, Illinois, USA
| | - Lisa L Barnes
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, Illinois, USA.,Department of Neurology, Rush University Medical Center, Chicago, Illinois, USA
| | - Xiaoran Liu
- Rush Institute for Healthy Aging, Rush University Medical Center, Chicago, Illinois, USA.,Department of Internal Medicine, Rush University Medical Center, Chicago, Illinois, USA
| | - Puja Agarwal
- Department of Internal Medicine, Rush University Medical Center, Chicago, Illinois, USA.,Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, Illinois, USA
| | - Pankaja Desai
- Rush Institute for Healthy Aging, Rush University Medical Center, Chicago, Illinois, USA.,Department of Internal Medicine, Rush University Medical Center, Chicago, Illinois, USA
| | - Kristin R Krueger
- Rush Institute for Healthy Aging, Rush University Medical Center, Chicago, Illinois, USA.,Department of Internal Medicine, Rush University Medical Center, Chicago, Illinois, USA
| | - Thomas M Holland
- Rush Institute for Healthy Aging, Rush University Medical Center, Chicago, Illinois, USA.,Department of Internal Medicine, Rush University Medical Center, Chicago, Illinois, USA
| | - Shannon Halloway
- Department of Community, Systems and Mental Health Nursing, Rush University College of Nursing, Chicago, Illinois, USA
| | - Neelum T Aggarwal
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, Illinois, USA.,Department of Neurology, Rush University Medical Center, Chicago, Illinois, USA
| | - Denis A Evans
- Rush Institute for Healthy Aging, Rush University Medical Center, Chicago, Illinois, USA.,Department of Internal Medicine, Rush University Medical Center, Chicago, Illinois, USA
| | - Kumar B Rajan
- Rush Institute for Healthy Aging, Rush University Medical Center, Chicago, Illinois, USA.,Department of Internal Medicine, Rush University Medical Center, Chicago, Illinois, USA
| |
Collapse
|
35
|
Dhana K, Aggarwal NT, Rajan KB, Barnes LL, Evans DA, Morris MC. Impact of the Apolipoprotein E ε4 Allele on the Relationship Between Healthy Lifestyle and Cognitive Decline: A Population-Based Study. Am J Epidemiol 2021; 190:1225-1233. [PMID: 33585904 DOI: 10.1093/aje/kwab033] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Revised: 02/02/2021] [Accepted: 02/09/2021] [Indexed: 02/07/2023] Open
Abstract
Adherence to a healthy lifestyle-characterized by abstaining from smoking, being physically and cognitively active, having a high-quality diet, and limiting alcohol use-is associated with slower cognitive decline in older adults, but whether this relationship extends to persons with a genetic predisposition (e.g., carriers of the ε4 allele of the apolipoprotein E gene (APOE*E4)) remains uncertain. Using data from a population-based study, the Chicago Health and Aging Project (Chicago, Illinois), we followed 3,886 individuals who underwent regular clinical and cognitive assessments from 1993 to 2012. Of 3,886 older adults, 1,269 (32.7%) were APOE*E4 carriers. Compared with noncarriers, APOE*E4 carriers had faster cognitive decline (β = -0.027 units/year, 95% confidence interval (CI): -0.032, -0.023). In contrast, persons with 2-3 and 4-5 healthy lifestyle factors had slower cognitive decline (β = 0.008 units/year (95% CI: 0.002, 0.014) and β = 0.019 units/year (95% CI: 0.011, 0.026), respectively) compared with those with 0-1 factor. In analyses stratified by APOE*E4 status, adherence to a healthy lifestyle (e.g., 4-5 factors vs. 0-1 factors) was associated with a slower rate of cognitive decline in both APOE*E4 carriers (β = 0.029, 95% CI: 0.013, 0.045) and noncarriers (β = 0.013, 95% CI: 0.005, 0.022). These results underscore the impact of a healthy lifestyle on cognition, particularly among persons with a genetic predisposition, who are more vulnerable to cognitive decline as they age.
Collapse
|
36
|
Ho JK, Moriarty F, Manly JJ, Larson EB, Evans DA, Rajan KB, Hudak EM, Hassan L, Liu E, Sato N, Hasebe N, Laurin D, Carmichael PH, Nation DA. Blood-Brain Barrier Crossing Renin-Angiotensin Drugs and Cognition in the Elderly: A Meta-Analysis. Hypertension 2021; 78:629-643. [PMID: 34148364 DOI: 10.1161/hypertensionaha.121.17049] [Citation(s) in RCA: 33] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
[Figure: see text].
Collapse
Affiliation(s)
- Jean K Ho
- Institute for Memory Impairments and Neurological Disorders (J.K.H., D.A.N.), University of California, Irvine
| | - Frank Moriarty
- School of Pharmacy and Biomolecular Sciences, Royal College of Surgeons in Ireland, Dublin (F.M.).,The Irish Longitudinal Study on Ageing, Trinity College Dublin, Ireland (F.M.)
| | - Jennifer J Manly
- Department of Neurology, Gertrude H. Sergievsky Center, Taub Institute for Research on Alzheimer's Disease and the Aging Brain, Columbia University, New York (J.J.M.)
| | - Eric B Larson
- Kaiser Permanente Washington Health Research Institute, Seattle, WA (E.B.L.)
| | - Denis A Evans
- Department of Internal Medicine, Rush University Medical Center, Chicago, IL (D.A.E., K.B.R.)
| | - Kumar B Rajan
- Department of Internal Medicine, Rush University Medical Center, Chicago, IL (D.A.E., K.B.R.)
| | - Elizabeth M Hudak
- Department of Psychiatry and Behavioral Neurosciences, University of South Florida, Tampa (E.M.H.)
| | - Lamiaa Hassan
- Institute of Medical Epidemiology, Biometrics and Informatics, Interdisciplinary Center for Health Sciences, Martin-Luther-University Halle-Wittenberg, Halle/Saale, Saxony-Anhalt, Germany (L.H.)
| | - Enwu Liu
- Mary MacKillop Institute for Health Research, Australian Catholic University (E.L.)
| | - Nobuyuki Sato
- Department of Cardiovascular Medicine, Asahikawa Medical University, Japan (N.S., N.H.)
| | - Naoyuki Hasebe
- Department of Cardiovascular Medicine, Asahikawa Medical University, Japan (N.S., N.H.)
| | - Danielle Laurin
- Centre d'excellence sur le vieillissement de Québec, Centre de recherche du CHU de Québec and VITAM-Centre de recherche en santé durable, Canada (D.L., P-H.C.)
| | - Pierre-Hugues Carmichael
- Centre d'excellence sur le vieillissement de Québec, Centre de recherche du CHU de Québec and VITAM-Centre de recherche en santé durable, Canada (D.L., P-H.C.)
| | - Daniel A Nation
- Institute for Memory Impairments and Neurological Disorders (J.K.H., D.A.N.), University of California, Irvine.,Department of Psychological Science (D.A.N.), University of California, Irvine
| |
Collapse
|
37
|
Rajan KB, Weuve J, Barnes LL, McAninch EA, Wilson RS, Evans DA. Population estimate of people with clinical Alzheimer's disease and mild cognitive impairment in the United States (2020-2060). Alzheimers Dement 2021; 17:1966-1975. [PMID: 34043283 DOI: 10.1002/alz.12362] [Citation(s) in RCA: 338] [Impact Index Per Article: 112.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2020] [Revised: 03/29/2021] [Accepted: 04/05/2021] [Indexed: 02/04/2023]
Abstract
INTRODUCTION The estimate of people with clinical Alzheimer's disease (AD) and mild cognitive impairment provides an understanding of the disease burden. METHODS We estimated people with cognitive impairment using a quasibinomial regression model in 10,342 participants with cognitive test scores. RESULTS The 2020 US Census-adjusted prevalence of clinical AD was 11.3% (95% confidence interval [CI] = 10.7-11.9): 10.0% among non-Hispanic Whites, 14.0% among Hispanics, and 18.6% among non-Hispanic Blacks. We estimate that in 2020, 6.07 (95% CI = 5.75-6.38) million people were living with clinical AD, which increases to 13.85 (95% CI = 12.98-14.74) million in 2060, 423% higher among Hispanics, 192% higher among Blacks, and 63% higher among Whites. However, there are predicted to be more significant increases in later years among those over 85 and women compared to men. DISCUSSION The number of people with clinical AD will increase as the "baby boom" generation reaches older ages, exerting a strong upward influence on disease burden.
Collapse
Affiliation(s)
- Kumar B Rajan
- Rush Institute for Healthy Aging, Rush University Medical Center, Chicago, Illinois, USA
| | - Jennifer Weuve
- Department of Epidemiology, Boston University School of Public Health, Boston, Massachusetts, USA
| | - Lisa L Barnes
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, Illinois, USA
| | - Elizabeth A McAninch
- Rush Institute for Healthy Aging, Rush University Medical Center, Chicago, Illinois, USA
| | - Robert S Wilson
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, Illinois, USA
| | - Denis A Evans
- Rush Institute for Healthy Aging, Rush University Medical Center, Chicago, Illinois, USA
| |
Collapse
|
38
|
Weuve J, D’Souza J, Beck T, Evans DA, Kaufman JD, Rajan KB, de Leon CFM, Adar SD. Long-term community noise exposure in relation to dementia, cognition, and cognitive decline in older adults. Alzheimers Dement 2021; 17:525-533. [PMID: 33084241 PMCID: PMC8720224 DOI: 10.1002/alz.12191] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2020] [Revised: 07/31/2020] [Accepted: 08/18/2020] [Indexed: 01/09/2023]
Abstract
INTRODUCTION Exposure to noise might influence risk of Alzheimer's disease (AD) dementia. METHODS Participants of the Chicago Health and Aging Project (≥65 years) underwent triennial cognitive assessments. For the 5 years preceding each assessment, we estimated 5227 participants' residential level of noise from the community using a spatial prediction model, and estimated associations of noise level with prevalent mild cognitive impairment (MCI) and AD, cognitive performance, and rate of cognitive decline. RESULTS Among these participants, an increment of 10 A-weighted decibels (dBA) in noise corresponded to 36% and 29% higher odds of prevalent MCI (odds ratio [OR] = 1.36; 95% confidence interval [CI], 1.15 to 1.62) and AD (OR = 1.29, 95% CI, 1.08 to 1.55). Noise level was associated with worse global cognitive performance, principally in perceptual speed (-0.09 standard deviation per 10 dBA, 95% CI: -0.16 to -0.03), but not consistently associated with cognitive decline. DISCUSSION These results join emerging evidence suggesting that noise may influence late-life cognition and risk of dementia.
Collapse
Affiliation(s)
- Jennifer Weuve
- School of Public Health, Boston University, Boston, Massachusetts, USA
| | - Jennifer D’Souza
- School of Public Health, University of Michigan, Ann Arbor, Michigan, USA
| | - Todd Beck
- Institute for Healthy Aging, Rush University, Chicago, Illinois, USA
| | - Denis A. Evans
- Institute for Healthy Aging, Rush University, Chicago, Illinois, USA
| | - Joel D. Kaufman
- School of Public Health, University of Washington, Seattle, Washington, USA
| | - Kumar. B. Rajan
- Department of Public Health Sciences, UC Davis, Davis, California, USA
| | | | - Sara D. Adar
- School of Public Health, University of Michigan, Ann Arbor, Michigan, USA
| |
Collapse
|
39
|
Hall NJ, Rees CM, Rhodes H, Williams A, Vipond M, Gordon A, Evans DA, Wood RJ, Bytheway J, Sutcliffe J. Consensus exercise identifying priorities for research in the field of general surgery of childhood in the UK. BJS Open 2021; 5:6174410. [PMID: 33728468 PMCID: PMC7966780 DOI: 10.1093/bjsopen/zraa062] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Accepted: 12/01/2020] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND The evidence base underlying clinical practice in children's general surgery is poor and high-quality collaborative clinical research is required to address current treatment uncertainties. The aim of this study was, through a consensus process, to identify research priorities for clinical research in this field amongst surgeons who treat children. METHODS Questions were invited in a scoping survey amongst general surgeons and specialist paediatric surgeons. These were refined by the study team and subsequently prioritized in a two-stage modified Delphi process. RESULTS In the scoping survey, a total of 226 questions covering a broad scope of children's elective and emergency general surgery were submitted by 76 different clinicians. These were refined to 71 research questions for prioritization. A total of 168 clinicians took part in stage one of the prioritization process, and 157 in stage two. A 'top 10' list of priority research questions was generated for both elective and emergency general surgery of childhood. These cover a range of conditions and concepts, including inguinal hernia, undescended testis, appendicitis, abdominal trauma and enhanced recovery pathways. CONCLUSION Through consensus amongst surgeons who treat children, 10 priority research questions for each of the elective and emergency fields have been identified. These should provide a basis for the development of high-quality multicentre research projects to address these questions, and ultimately improve outcomes for children requiring surgical care.
Collapse
Affiliation(s)
- N J Hall
- University Surgery Unit, Faculty of Medicine, University of Southampton, Southampton, UK.,Department of Paediatric Surgery and Urology, Southampton Children's Hospital, Southampton, UK
| | - C M Rees
- Department of Paediatric Surgery, Imperial College Healthcare NHS Trust, London, UK
| | - H Rhodes
- Department of Paediatric Surgery, Bristol Royal Hospital for Children, Bristol, UK.,Bristol Renal, University of Bristol, Bristol, UK
| | - A Williams
- Department of Paediatric Surgery and Urology, Nottingham University Hospitals NHS Trust, Queen's Medical Centre, Nottingham, UK
| | - M Vipond
- Department of Surgery, Gloucestershire Royal Hospital, Gloucester, UK
| | - A Gordon
- Department of Surgery, The Belford Hospital, Fort William, UK
| | - D A Evans
- Department of Surgery, East Lancashire Hospitals NHS Trust, Blackburn, UK
| | - R J Wood
- Department of Pediatric Surgery, Nationwide Children's Hospital, Columbus, Ohio, USA
| | | | - J Sutcliffe
- Department of Paediatric Surgery, Leeds General Infirmary, Leeds, UK
| | | |
Collapse
|
40
|
Agarwal P, Dhana K, Barnes LL, Holland TM, Zhang Y, Evans DA, Morris MC. Unhealthy foods may attenuate the beneficial relation of a Mediterranean diet to cognitive decline. Alzheimers Dement 2021; 17:1157-1165. [DOI: 10.1002/alz.12277] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Revised: 11/07/2020] [Accepted: 11/19/2020] [Indexed: 12/21/2022]
Affiliation(s)
- Puja Agarwal
- Rush Institute of Healthy Aging, Department of Internal Medicine Rush University Medical Center Chicago Illinois USA
| | - Klodian Dhana
- Rush Institute of Healthy Aging, Department of Internal Medicine Rush University Medical Center Chicago Illinois USA
| | - Lisa L. Barnes
- Rush Alzheimer's Disease Center Rush University Medical Center Chicago Illinois USA
- Department of Neurological Sciences Rush University Medical Center Chicago Illinois USA
| | - Thomas M Holland
- Rush Institute of Healthy Aging, Department of Internal Medicine Rush University Medical Center Chicago Illinois USA
| | - Yanyu Zhang
- Rush Institute of Healthy Aging, Department of Internal Medicine Rush University Medical Center Chicago Illinois USA
| | - Denis A. Evans
- Rush Institute of Healthy Aging, Department of Internal Medicine Rush University Medical Center Chicago Illinois USA
| | - Martha Clare Morris
- Rush Institute of Healthy Aging, Department of Internal Medicine Rush University Medical Center Chicago Illinois USA
| |
Collapse
|
41
|
Kunkle BW, Schmidt M, Klein HU, Naj AC, Hamilton-Nelson KL, Larson EB, Evans DA, De Jager PL, Crane PK, Buxbaum JD, Ertekin-Taner N, Barnes LL, Fallin MD, Manly JJ, Go RCP, Obisesan TO, Kamboh MI, Bennett DA, Hall KS, Goate AM, Foroud TM, Martin ER, Wang LS, Byrd GS, Farrer LA, Haines JL, Schellenberg GD, Mayeux R, Pericak-Vance MA, Reitz C. Novel Alzheimer Disease Risk Loci and Pathways in African American Individuals Using the African Genome Resources Panel: A Meta-analysis. JAMA Neurol 2021; 78:102-113. [PMID: 33074286 PMCID: PMC7573798 DOI: 10.1001/jamaneurol.2020.3536] [Citation(s) in RCA: 52] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2019] [Accepted: 04/09/2020] [Indexed: 12/11/2022]
Abstract
Importance Compared with non-Hispanic White individuals, African American individuals from the same community are approximately twice as likely to develop Alzheimer disease. Despite this disparity, the largest Alzheimer disease genome-wide association studies to date have been conducted in non-Hispanic White individuals. In the largest association analyses of Alzheimer disease in African American individuals, ABCA7, TREM2, and an intergenic locus at 5q35 were previously implicated. Objective To identify additional risk loci in African American individuals by increasing the sample size and using the African Genome Resource panel. Design, Setting, and Participants This genome-wide association meta-analysis used case-control and family-based data sets from the Alzheimer Disease Genetics Consortium. There were multiple recruitment sites throughout the United States that included individuals with Alzheimer disease and controls of African American ancestry. Analysis began October 2018 and ended September 2019. Main Outcomes and Measures Diagnosis of Alzheimer disease. Results A total of 2784 individuals with Alzheimer disease (1944 female [69.8%]) and 5222 controls (3743 female [71.7%]) were analyzed (mean [SD] age at last evaluation, 74.2 [13.6] years). Associations with 4 novel common loci centered near the intracellular glycoprotein trafficking gene EDEM1 (3p26; P = 8.9 × 10-7), near the immune response gene ALCAM (3q13; P = 9.3 × 10-7), within GPC6 (13q31; P = 4.1 × 10-7), a gene critical for recruitment of glutamatergic receptors to the neuronal membrane, and within VRK3 (19q13.33; P = 3.5 × 10-7), a gene involved in glutamate neurotoxicity, were identified. In addition, several loci associated with rare variants, including a genome-wide significant intergenic locus near IGF1R at 15q26 (P = 1.7 × 10-9) and 6 additional loci with suggestive significance (P ≤ 5 × 10-7) such as API5 at 11p12 (P = 8.8 × 10-8) and RBFOX1 at 16p13 (P = 5.4 × 10-7) were identified. Gene expression data from brain tissue demonstrate association of ALCAM, ARAP1, GPC6, and RBFOX1 with brain β-amyloid load. Of 25 known loci associated with Alzheimer disease in non-Hispanic White individuals, only APOE, ABCA7, TREM2, BIN1, CD2AP, FERMT2, and WWOX were implicated at a nominal significance level or stronger in African American individuals. Pathway analyses strongly support the notion that immunity, lipid processing, and intracellular trafficking pathways underlying Alzheimer disease in African American individuals overlap with those observed in non-Hispanic White individuals. A new pathway emerging from these analyses is the kidney system, suggesting a novel mechanism for Alzheimer disease that needs further exploration. Conclusions and Relevance While the major pathways involved in Alzheimer disease etiology in African American individuals are similar to those in non-Hispanic White individuals, the disease-associated loci within these pathways differ.
Collapse
Affiliation(s)
- Brian W. Kunkle
- The John P. Hussman Institute for Human Genomics, University of Miami, Miami, Florida
- Dr. John T. MacDonald Foundation, Department of Human Genetics, University of Miami, Miami, Florida
| | - Michael Schmidt
- The John P. Hussman Institute for Human Genomics, University of Miami, Miami, Florida
- Dr. John T. MacDonald Foundation, Department of Human Genetics, University of Miami, Miami, Florida
| | - Hans-Ulrich Klein
- Taub Institute for Research on Alzheimer’s Disease and the Aging Brain, Columbia University, New York, New York
- Gertrude H. Sergievsky Center, Columbia University, New York, New York
- Department of Neurology, Columbia University, New York, New York
| | - Adam C. Naj
- Department of Biostatistics and Epidemiology, University of Pennsylvania Perelman School of Medicine, Philadelphia
- Penn Neurodegeneration Genomics Center, Department of Pathology and Laboratory Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia
| | | | - Eric B. Larson
- Department of Medicine, University of Washington, Seattle
- Group Health Research Institute, Group Health, Seattle, Washington
| | - Denis A. Evans
- Rush Institute for Healthy Aging, Rush University Medical Center, Chicago, Illinois
- Department of Internal Medicine, Rush University Medical Center, Chicago, Illinois
| | - Phil L. De Jager
- Taub Institute for Research on Alzheimer’s Disease and the Aging Brain, Columbia University, New York, New York
- Gertrude H. Sergievsky Center, Columbia University, New York, New York
- Department of Neurology, Columbia University, New York, New York
| | - Paul K. Crane
- Penn Neurodegeneration Genomics Center, Department of Pathology and Laboratory Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia
| | - Joe D. Buxbaum
- Department of Psychiatry, Mount Sinai School of Medicine, New York, New York
- Department of Genetics and Genomics Sciences, Mount Sinai School of Medicine, New York, New York
- Department of Neuroscience, Mount Sinai School of Medicine, New York, New York
- Friedman Brain Institute, Mount Sinai School of Medicine, New York, New York
| | - Nilufer Ertekin-Taner
- Department of Neuroscience, Mayo Clinic, Jacksonville, Florida
- Department of Neurology, Mayo Clinic, Jacksonville, Florida
| | - Lisa L. Barnes
- Department of Neurological Sciences, Rush University Medical Center, Chicago, Illinois
- Department of Behavioral Sciences, Rush University Medical Center, Chicago, Illinois
- Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, Illinois
| | - M. Daniele Fallin
- Department of Epidemiology, Johns Hopkins University School of Public Health, Baltimore, Maryland
| | - Jennifer J. Manly
- Taub Institute for Research on Alzheimer’s Disease and the Aging Brain, Columbia University, New York, New York
- Gertrude H. Sergievsky Center, Columbia University, New York, New York
- Department of Neurology, Columbia University, New York, New York
| | - Rodney C. P. Go
- Department of Epidemiology, University of Alabama at Birmingham, Birmingham
| | | | - M. Ilyas Kamboh
- Department of Human Genetics, University of Pittsburgh, Pittsburgh, Pennsylvania
- Alzheimer’s Disease Research Center, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - David A. Bennett
- Department of Neurological Sciences, Rush University Medical Center, Chicago, Illinois
- Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, Illinois
| | - Kathleen S. Hall
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis
| | - Alison M. Goate
- Department of Genetics and Genomics Sciences, Mount Sinai School of Medicine, New York, New York
- Department of Neuroscience, Mount Sinai School of Medicine, New York, New York
- Friedman Brain Institute, Mount Sinai School of Medicine, New York, New York
- Ronald M. Loeb Center for Alzheimer’s Disease, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Tatiana M. Foroud
- Department of Medical and Molecular Genetics, Indiana University, Indianapolis
| | - Eden R. Martin
- The John P. Hussman Institute for Human Genomics, University of Miami, Miami, Florida
- Dr. John T. MacDonald Foundation, Department of Human Genetics, University of Miami, Miami, Florida
| | - Li-Sao Wang
- Penn Neurodegeneration Genomics Center, Department of Pathology and Laboratory Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia
| | - Goldie S. Byrd
- Maya Angelou Center for Health Equity, Wake Forest School of Medicine, Winston-Salem, North Carolina
| | - Lindsay A. Farrer
- Department of Medicine (Biomedical Genetics), Boston University School of Medicine, Boston, Massachusetts
- Department of Neurology, Boston University School of Medicine, Boston, Massachusetts
- Department of Biostatistics, Boston University School of Public Health, Boston, Massachusetts
- Department of Ophthalmology, Boston University School of Medicine, Boston, Massachusetts
- Department of Epidemiology, Boston University School of Public Health, Boston, Massachusetts
| | - Jonathan L. Haines
- Department of Population and Quantitative Health Sciences, Institute for Computational Biology, Case Western Reserve University, Cleveland, Ohio
| | - Gerard D. Schellenberg
- Penn Neurodegeneration Genomics Center, Department of Pathology and Laboratory Medicine, University of Pennsylvania Perelman School of Medicine, Philadelphia
| | - Richard Mayeux
- Taub Institute for Research on Alzheimer’s Disease and the Aging Brain, Columbia University, New York, New York
- Gertrude H. Sergievsky Center, Columbia University, New York, New York
- Department of Neurology, Columbia University, New York, New York
- Department of Psychiatry, Columbia University, New York, New York
- Epidemiology, College of Physicians and Surgeons, Columbia University, New York, New York
| | - Margaret A. Pericak-Vance
- The John P. Hussman Institute for Human Genomics, University of Miami, Miami, Florida
- Dr. John T. MacDonald Foundation, Department of Human Genetics, University of Miami, Miami, Florida
| | - Christiane Reitz
- Taub Institute for Research on Alzheimer’s Disease and the Aging Brain, Columbia University, New York, New York
- Gertrude H. Sergievsky Center, Columbia University, New York, New York
- Department of Neurology, Columbia University, New York, New York
- Epidemiology, College of Physicians and Surgeons, Columbia University, New York, New York
| | | |
Collapse
|
42
|
Sargurupremraj M, Suzuki H, Jian X, Sarnowski C, Evans TE, Bis JC, Eiriksdottir G, Sakaue S, Terzikhan N, Habes M, Zhao W, Armstrong NJ, Hofer E, Yanek LR, Hagenaars SP, Kumar RB, van den Akker EB, McWhirter RE, Trompet S, Mishra A, Saba Y, Satizabal CL, Beaudet G, Petit L, Tsuchida A, Zago L, Schilling S, Sigurdsson S, Gottesman RF, Lewis CE, Aggarwal NT, Lopez OL, Smith JA, Valdés Hernández MC, van der Grond J, Wright MJ, Knol MJ, Dörr M, Thomson RJ, Bordes C, Le Grand Q, Duperron MG, Smith AV, Knopman DS, Schreiner PJ, Evans DA, Rotter JI, Beiser AS, Maniega SM, Beekman M, Trollor J, Stott DJ, Vernooij MW, Wittfeld K, Niessen WJ, Soumaré A, Boerwinkle E, Sidney S, Turner ST, Davies G, Thalamuthu A, Völker U, van Buchem MA, Bryan RN, Dupuis J, Bastin ME, Ames D, Teumer A, Amouyel P, Kwok JB, Bülow R, Deary IJ, Schofield PR, Brodaty H, Jiang J, Tabara Y, Setoh K, Miyamoto S, Yoshida K, Nagata M, Kamatani Y, Matsuda F, Psaty BM, Bennett DA, De Jager PL, Mosley TH, Sachdev PS, Schmidt R, Warren HR, Evangelou E, Trégouët DA, Ikram MA, Wen W, DeCarli C, Srikanth VK, Jukema JW, Slagboom EP, Kardia SLR, Okada Y, Mazoyer B, Wardlaw JM, Nyquist PA, Mather KA, Grabe HJ, Schmidt H, Van Duijn CM, Gudnason V, Longstreth WT, Launer LJ, Lathrop M, Seshadri S, Tzourio C, Adams HH, Matthews PM, Fornage M, Debette S. Cerebral small vessel disease genomics and its implications across the lifespan. Nat Commun 2020; 11:6285. [PMID: 33293549 PMCID: PMC7722866 DOI: 10.1038/s41467-020-19111-2] [Citation(s) in RCA: 83] [Impact Index Per Article: 20.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2020] [Accepted: 09/10/2020] [Indexed: 12/14/2022] Open
Abstract
White matter hyperintensities (WMH) are the most common brain-imaging feature of cerebral small vessel disease (SVD), hypertension being the main known risk factor. Here, we identify 27 genome-wide loci for WMH-volume in a cohort of 50,970 older individuals, accounting for modification/confounding by hypertension. Aggregated WMH risk variants were associated with altered white matter integrity (p = 2.5×10-7) in brain images from 1,738 young healthy adults, providing insight into the lifetime impact of SVD genetic risk. Mendelian randomization suggested causal association of increasing WMH-volume with stroke, Alzheimer-type dementia, and of increasing blood pressure (BP) with larger WMH-volume, notably also in persons without clinical hypertension. Transcriptome-wide colocalization analyses showed association of WMH-volume with expression of 39 genes, of which four encode known drug targets. Finally, we provide insight into BP-independent biological pathways underlying SVD and suggest potential for genetic stratification of high-risk individuals and for genetically-informed prioritization of drug targets for prevention trials.
Collapse
Affiliation(s)
- Muralidharan Sargurupremraj
- University of Bordeaux, Inserm, Bordeaux Population Health Research Center, team VINTAGE, UMR 1219, 33000, Bordeaux, France
| | - Hideaki Suzuki
- Tohoku Medical Megabank Organization, Tohoku University, 2-1, Seiryo, Aoba, Sendai, 980-8573, Japan
- Department of Cardiovascular Medicine, Tohoku University Hospital, 1-1, Seiryo, Aoba, Sendai, 980-8574, Japan
- Department of Brain Sciences, Imperial College London, London, W12 0NN, UK
| | - Xueqiu Jian
- University of Texas Health Science Center at Houston McGovern Medical School, Houston, TX, 77030, USA
- Glenn Biggs Institute for Alzheimer's & Neurodegenerative Diseases, University of Texas Health Sciences Center, San Antonio, TX, 78229, USA
| | - Chloé Sarnowski
- Department of Biostatistics, Boston University School of Public Health, Boston, MA, 02118, USA
| | - Tavia E Evans
- Department of Clinical Genetics, Erasmus MC, 3015 GE, Rotterdam, The Netherlands
- Department of Radiology & Nuclear Medicine, Erasmus MC, 3015 GE, Rotterdam, The Netherlands
| | - Joshua C Bis
- Cardiovascular Health Research Unit, Department of Medicine, University of Washington, Seattle, WA, 98101, USA
| | | | - Saori Sakaue
- Department of Statistical Genetics, Osaka University Graduate School of Medicine, Suita, 565-0871, Japan
- Laboratory for Statistical Analysis, RIKEN Center for Integrative Medical Sciences, Tsurumi-ku, Yokohama City, Kanagawa, 230-0045, Japan
- Department of Allergy and Rheumatology, Graduate School of Medicine, the University of Tokyo, Tokyo, 113-0033, Japan
| | - Natalie Terzikhan
- Department of Epidemiology, Erasmus MC, 3015 GE, Rotterdam, The Netherlands
| | - Mohamad Habes
- Glenn Biggs Institute for Alzheimer's & Neurodegenerative Diseases, University of Texas Health Sciences Center, San Antonio, TX, 78229, USA
- Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, 19104, USA
- Institute for Community Medicine, University Medicine Greifswald, 17475, Greifswald, Germany
| | - Wei Zhao
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, 48109-2029, USA
| | - Nicola J Armstrong
- Mathematics and Statistics, Murdoch University, Murdoch, WA, 6150, Australia
| | - Edith Hofer
- Clinical Division of Neurogeriatrics, Department of Neurology, Medical University of Graz, 8036, Graz, Austria
- Institute for Medical Informatics, Statistics and Documentation, Medical University of Graz, 8036, Graz, Austria
| | - Lisa R Yanek
- GeneSTAR Research Program, Division of General Internal Medicine, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, 21205, USA
| | - Saskia P Hagenaars
- Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, EH8 9JZ, UK
- Social Genetic and Developmental Psychiatry Research Centre, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, SE5 8AF, UK
| | - Rajan B Kumar
- Department of Public Health Sciences, University of California at Davis, Davis, CA, 95616, USA
| | - Erik B van den Akker
- Section of Molecular Epidemiology, Biomedical Sciences, Leiden university Medical Center, 2333 ZA, Leiden, The Netherlands
- Pattern Recognition & Bioinformatics, Delft University of Technology, Delft, NL, 2629 HS, USA
- Leiden Computational Biology Centre, Leiden University Medical Centre, 2333 ZA, Leiden, The Netherlands
| | - Rebekah E McWhirter
- Centre for Law and Genetics, Faculty of Law, University of Tasmania, Hobart, TAS, 7005, Australia
- Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS, 7000, Australia
| | - Stella Trompet
- Department of Internal Medicine, section of gerontology and geriatrics, Leiden University Medical Center, 2333 ZA, Leiden, The Netherlands
- Department of Cardiology, Leiden University Medical Center, 2333 ZA, Leiden, The Netherlands
| | - Aniket Mishra
- University of Bordeaux, Inserm, Bordeaux Population Health Research Center, team VINTAGE, UMR 1219, 33000, Bordeaux, France
| | - Yasaman Saba
- University of Bordeaux, Inserm, Bordeaux Population Health Research Center, team VINTAGE, UMR 1219, 33000, Bordeaux, France
- Gottfried Schatz Research Center, Department of Molecular Biology and Biochemistry, Medical University of Graz, 8010, Graz, Austria
| | - Claudia L Satizabal
- Glenn Biggs Institute for Alzheimer's & Neurodegenerative Diseases, University of Texas Health Sciences Center, San Antonio, TX, 78229, USA
- Boston University and the NHLBI's Framingham Heart Study, Boston, MA, 02215, USA
- Department of Neurology, Boston University School of Medicine, Boston, MA, 02118, USA
| | - Gregory Beaudet
- University of Bordeaux, IMN, UMR 5293, 33000, Bordeaux, France
| | - Laurent Petit
- University of Bordeaux, IMN, UMR 5293, 33000, Bordeaux, France
| | - Ami Tsuchida
- University of Bordeaux, IMN, UMR 5293, 33000, Bordeaux, France
| | - Laure Zago
- University of Bordeaux, IMN, UMR 5293, 33000, Bordeaux, France
| | - Sabrina Schilling
- University of Bordeaux, Inserm, Bordeaux Population Health Research Center, team VINTAGE, UMR 1219, 33000, Bordeaux, France
| | | | | | - Cora E Lewis
- University of Alabama at Birmingham School of Medicine, Birmingham, AL, 35233, USA
| | - Neelum T Aggarwal
- Department of Neurological Sciences, Rush University Medical Center, Chicago, IL, 60612, USA
| | - Oscar L Lopez
- Departments of Neurology and Psychiatry, University of Pittsburgh, Pittsburgh, PA, 15213, USA
| | - Jennifer A Smith
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, 48109-2029, USA
- Survey Research Center, Institute for Social Research, University of Michigan, Ann Arbor, MI, 48104, USA
| | - Maria C Valdés Hernández
- Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, EH8 9JZ, UK
- Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, EH16 4SB, UK
- Row Fogo Centre for Ageing and The Brain, University of Edinburgh, Edinburgh, EH8 9JZ, UK
| | - Jeroen van der Grond
- Department of Radiology, Leiden University medical Center, 2333 ZA, Leiden, The Netherlands
| | - Margaret J Wright
- Queensland Brain Institute, The University of Queensland, St Lucia, QLD, 4072, Australia
- Centre for Advanced Imaging, The University of Queensland, St Lucia, QLD, 4072, Australia
| | - Maria J Knol
- Department of Epidemiology, Erasmus MC, 3015 GE, Rotterdam, The Netherlands
| | - Marcus Dörr
- Department of Internal Medicine B, University Medicine Greifswald, 17475, Greifswald, Germany
- DZHK (German Center for Cardiovascular Research), partner site Greifswald, 17475, Greifswald, Germany
| | - Russell J Thomson
- Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS, 7000, Australia
- Centre for Research in Mathematics and Data Science, Western Sydney University, Penrith, NSW, 2751, Australia
| | - Constance Bordes
- University of Bordeaux, Inserm, Bordeaux Population Health Research Center, team VINTAGE, UMR 1219, 33000, Bordeaux, France
| | - Quentin Le Grand
- University of Bordeaux, Inserm, Bordeaux Population Health Research Center, team VINTAGE, UMR 1219, 33000, Bordeaux, France
| | - Marie-Gabrielle Duperron
- University of Bordeaux, Inserm, Bordeaux Population Health Research Center, team VINTAGE, UMR 1219, 33000, Bordeaux, France
| | | | | | - Pamela J Schreiner
- University of Minnesota School of Public Health, Minneapolis, MN, 55455, USA
| | - Denis A Evans
- Department of Internal Medicine, Rush University Medical Center, Chicago, IL, 60612, USA
| | - Jerome I Rotter
- Institute for Translational Genomics and Population Sciences, Los Angeles Biomedical Research Institute and Pediatrics at Harbor-UCLA Medical Center, Torrance, CA, 90502, USA
| | - Alexa S Beiser
- Department of Biostatistics, Boston University School of Public Health, Boston, MA, 02118, USA
- Boston University and the NHLBI's Framingham Heart Study, Boston, MA, 02215, USA
- Department of Neurology, Boston University School of Medicine, Boston, MA, 02118, USA
| | - Susana Muñoz Maniega
- Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, EH8 9JZ, UK
- Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, EH16 4SB, UK
| | - Marian Beekman
- Section of Molecular Epidemiology, Biomedical Sciences, Leiden university Medical Center, 2333 ZA, Leiden, The Netherlands
| | - Julian Trollor
- Centre for Healthy Brain Ageing, School of Psychiatry, University of New South Wales, Sydney, NSW, 2052, Australia
- Department of Developmental Disability Neuropsychiatry, School of Psychiatry, University of New South Wales, Sydney, NSW, 2052, Australia
| | - David J Stott
- Institute of Cardiovascular and Medical Sciences, College of Medical, Veterinary and Life Sciences, University of Glasgow, Glasgow, G12 8QQ, UK
| | - Meike W Vernooij
- Department of Radiology & Nuclear Medicine, Erasmus MC, 3015 GE, Rotterdam, The Netherlands
- Department of Epidemiology, Erasmus MC, 3015 GE, Rotterdam, The Netherlands
| | - Katharina Wittfeld
- German Center for Neurodegenerative Diseases (DZNE), Rostock/Greifswald, 17489, Greifswald, Germany
| | - Wiro J Niessen
- Department of Radiology & Nuclear Medicine, Erasmus MC, 3015 GE, Rotterdam, The Netherlands
- Faculty of Applied Sciences, Delft University of Technology, Delft, NL, 2629 HS, USA
| | - Aicha Soumaré
- University of Bordeaux, Inserm, Bordeaux Population Health Research Center, team VINTAGE, UMR 1219, 33000, Bordeaux, France
| | - Eric Boerwinkle
- University of Texas Health Science Center at Houston School of Public Health, Houston, TX, 77030, USA
| | - Stephen Sidney
- Kaiser Permanente Division of Research, Oakland, CA, 94612, USA
| | - Stephen T Turner
- Division of Nephrology and Hypertension, Mayo Clinic, Rochester, MN, 55905, USA
| | - Gail Davies
- Institute for Medical Informatics, Statistics and Documentation, Medical University of Graz, 8036, Graz, Austria
- Department of Psychology, University of Edinburgh, Edinburgh, EH8 9JZ, UK
| | - Anbupalam Thalamuthu
- Institute for Translational Genomics and Population Sciences, Los Angeles Biomedical Research Institute and Pediatrics at Harbor-UCLA Medical Center, Torrance, CA, 90502, USA
| | - Uwe Völker
- Interfaculty Institute for Genetics and Functional Genomics, University Medicine Greifswald, 17475, Greifswald, Germany
| | - Mark A van Buchem
- Row Fogo Centre for Ageing and The Brain, University of Edinburgh, Edinburgh, EH8 9JZ, UK
| | - R Nick Bryan
- The University of Texas at Austin Dell Medical School, Austin, TX, 78712, USA
| | - Josée Dupuis
- Glenn Biggs Institute for Alzheimer's & Neurodegenerative Diseases, University of Texas Health Sciences Center, San Antonio, TX, 78229, USA
- Department of Cardiology, Leiden University Medical Center, 2333 ZA, Leiden, The Netherlands
| | - Mark E Bastin
- Institute for Medical Informatics, Statistics and Documentation, Medical University of Graz, 8036, Graz, Austria
- Survey Research Center, Institute for Social Research, University of Michigan, Ann Arbor, MI, 48104, USA
| | - David Ames
- National Ageing Research Institute Royal Melbourne Hospital, Parkville, VIC, 3052, Australia
- Academic Unit for Psychiatry of Old Age, University of Melbourne, St George's Hospital, Kew, VIC, 3101, Australia
| | - Alexander Teumer
- Department of Epidemiology, Erasmus MC, 3015 GE, Rotterdam, The Netherlands
- Department of Internal Medicine B, University Medicine Greifswald, 17475, Greifswald, Germany
| | - Philippe Amouyel
- Inserm U1167, 59000, Lille, France
- Department of Epidemiology and Public Health, Pasteur Institute of Lille, 59000, Lille, France
| | - John B Kwok
- Brain and Mind Centre - The University of Sydney, Camperdown, NSW, 2050, Australia
- School of Medical Sciences, University of New South Wales, Sydney, NSW, 2052, Australia
| | - Robin Bülow
- Department of Diagnostic Radiology and Neuroradiology, University Medicine Greifswald, 17489, Greifswald, Germany
| | - Ian J Deary
- Institute for Medical Informatics, Statistics and Documentation, Medical University of Graz, 8036, Graz, Austria
- Department of Psychology, University of Edinburgh, Edinburgh, EH8 9JZ, UK
| | - Peter R Schofield
- School of Medical Sciences, University of New South Wales, Sydney, NSW, 2052, Australia
- Neuroscience Research Australia, Randwick, NSW, 2031, Australia
| | - Henry Brodaty
- Institute for Translational Genomics and Population Sciences, Los Angeles Biomedical Research Institute and Pediatrics at Harbor-UCLA Medical Center, Torrance, CA, 90502, USA
- Dementia Centre for Research Collaboration, University of New South Wales, Sydney, NSW, 2052, Australia
| | - Jiyang Jiang
- Institute for Translational Genomics and Population Sciences, Los Angeles Biomedical Research Institute and Pediatrics at Harbor-UCLA Medical Center, Torrance, CA, 90502, USA
| | - Yasuharu Tabara
- Center for Genomic Medicine, Kyoto University Graduate School of Medicine, Kyoto, 606-8501, Japan
| | - Kazuya Setoh
- Department of Neurosurgery, Kyoto University Graduate School of Medicine, Kyoto, 606-8501, Japan
| | - Susumu Miyamoto
- Department of Neurosurgery, Kyoto University Graduate School of Medicine, Kyoto, 606-8501, Japan
| | - Kazumichi Yoshida
- Department of Neurosurgery, Kyoto University Graduate School of Medicine, Kyoto, 606-8501, Japan
| | - Manabu Nagata
- Department of Neurosurgery, Kyoto University Graduate School of Medicine, Kyoto, 606-8501, Japan
| | - Yoichiro Kamatani
- Laboratory for Statistical and Translational Genetics, RIKEN Center for Integrative Medical Sciences, Tsurumi-ku, Yokohama City, Kanagawa, 230-0045, Japan
| | - Fumihiko Matsuda
- Center for Genomic Medicine, Kyoto University Graduate School of Medicine, Kyoto, 606-8501, Japan
| | - Bruce M Psaty
- Departments of Epidemiology, Medicine and Health Services, University of Washington, Seattle, WA, 98195, USA
- Kaiser Permanente Washington Health Research Institute, Seattle, WA, 98101, USA
| | - David A Bennett
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, 60612, USA
| | - Philip L De Jager
- Center for Translational and Computational Neuroimmunology, Department of Neurology, Columbia University Medical Center, New York, NY, 10032, USA
- Program in Population and Medical Genetics, Broad Institute of MIT and Harvard, Cambridge, MA, 02142, USA
| | - Thomas H Mosley
- Memory Impairment and Neurodegenerative Dementia (MIND) Center, University of Mississippi Medical Center, Jackson, MS, 39216, USA
| | - Perminder S Sachdev
- Institute for Translational Genomics and Population Sciences, Los Angeles Biomedical Research Institute and Pediatrics at Harbor-UCLA Medical Center, Torrance, CA, 90502, USA
- Neuropsychiatric Institute, Prince of Wales Hospital, Sydney, NSW, 2031, Australia
| | - Reinhold Schmidt
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, 48109-2029, USA
| | - Helen R Warren
- William Harvey Research Institute, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, E1 4NS, UK
- National Institute for Health Research Barts Cardiovascular Biomedical Research Unit, Queen Mary University of London, London, EC1M 6BQ, UK
| | - Evangelos Evangelou
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, SW7 2AZ, UK
- Department of Hygiene and Epidemiology, University of Ioannina Medical School, Ioannina, Mpizani, 455 00, Greece
| | - David-Alexandre Trégouët
- University of Bordeaux, Inserm, Bordeaux Population Health Research Center, team VINTAGE, UMR 1219, 33000, Bordeaux, France
| | - Mohammad A Ikram
- Department of Epidemiology, Erasmus MC, 3015 GE, Rotterdam, The Netherlands
| | - Wei Wen
- Centre for Healthy Brain Ageing, School of Psychiatry, University of New South Wales, Sydney, NSW, 2052, Australia
| | - Charles DeCarli
- Department of Neurology and Center for Neuroscience, University of California at Davis, Sacramento, CA, 95817, USA
| | - Velandai K Srikanth
- Menzies Institute for Medical Research, University of Tasmania, Hobart, TAS, 7000, Australia
- Peninsula Clinical School, Central Clinical School, Monash University, Melbourne, VIC, 3004, Australia
| | - J Wouter Jukema
- Department of Cardiology, Leiden University Medical Center, 2333 ZA, Leiden, The Netherlands
| | - Eline P Slagboom
- Section of Molecular Epidemiology, Biomedical Sciences, Leiden university Medical Center, 2333 ZA, Leiden, The Netherlands
| | - Sharon L R Kardia
- Department of Epidemiology, School of Public Health, University of Michigan, Ann Arbor, MI, 48109-2029, USA
| | - Yukinori Okada
- Department of Statistical Genetics, Osaka University Graduate School of Medicine, Suita, 565-0871, Japan
- Laboratory for Statistical Analysis, RIKEN Center for Integrative Medical Sciences, Tsurumi-ku, Yokohama City, Kanagawa, 230-0045, Japan
- Laboratory of Statistical Immunology, Immunology Frontier Research Center (WPI-IFReC), Osaka University, Suita, 565-0871, Osaka, Japan
| | - Bernard Mazoyer
- University of Bordeaux, IMN, UMR 5293, 33000, Bordeaux, France
| | - Joanna M Wardlaw
- Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, EH8 9JZ, UK
- Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, EH16 4SB, UK
- Row Fogo Centre for Ageing and The Brain, University of Edinburgh, Edinburgh, EH8 9JZ, UK
- MRC UK Dementia Research Institute at the University of Edinburgh, Edinburgh, EH8 9YL, UK
| | - Paul A Nyquist
- Department of Neurology, Johns Hopkins School of Medicine, Baltimone, MD, 21205, USA
- General Internal Medicine, Johns Hopkins School of Medicine, Baltimore, MD, 21205, USA
| | - Karen A Mather
- Centre for Healthy Brain Ageing, School of Psychiatry, University of New South Wales, Sydney, NSW, 2052, Australia
- Neuroscience Research Australia, Randwick, NSW, 2031, Australia
| | - Hans J Grabe
- Department of Psychiatry and Psychotherapy, University Medicine Greifswald, 17475, Greifswald, Germany
- German Center for Neurodegenerative Diseases (DZNE), Rostock/Greifswald, 17475, Greifswald, Germany
| | - Helena Schmidt
- Gottfried Schatz Research Center, Department of Molecular Biology and Biochemistry, Medical University of Graz, 8010, Graz, Austria
| | - Cornelia M Van Duijn
- Nuffield Department of Population Health, University of Oxford, Oxford, OX3 7LF, UK
| | - Vilmundur Gudnason
- Icelandic Heart Association, IS-201, Kópavogur, Iceland
- University of Iceland, Faculty of Medicine, 101, Reykjavík, Iceland
| | - William T Longstreth
- Departments of Neurology and Epidemiology, University of Washington, Seattle, WA, 98104-2420, USA
| | - Lenore J Launer
- Laboratory of Epidemiology, Demography, and Biometry, National Institute of Aging, The National Institutes of Health, Bethesda, MD, 20892, USA
- Intramural Research Program/National Institute on Aging/National Institutes of Health, Bethesda, MD, 20892, USA
| | - Mark Lathrop
- University of McGill Genome Center, Montreal, QC, H3A 0G1, Canada
| | - Sudha Seshadri
- Glenn Biggs Institute for Alzheimer's & Neurodegenerative Diseases, University of Texas Health Sciences Center, San Antonio, TX, 78229, USA
- Boston University and the NHLBI's Framingham Heart Study, Boston, MA, 02215, USA
- Department of Neurology, Boston University School of Medicine, Boston, MA, 02118, USA
| | - Christophe Tzourio
- University of Bordeaux, Inserm, Bordeaux Population Health Research Center, team VINTAGE, UMR 1219, 33000, Bordeaux, France
- CHU de Bordeaux, Pole de santé publique, Service d'information médicale, 33000, Bordeaux, France
| | - Hieab H Adams
- Department of Clinical Genetics, Erasmus MC, 3015 GE, Rotterdam, The Netherlands
- Department of Radiology & Nuclear Medicine, Erasmus MC, 3015 GE, Rotterdam, The Netherlands
| | - Paul M Matthews
- Department of Brain Sciences, Imperial College London, London, W12 0NN, UK
- UK Dementia Research Institute, London, WC1E 6BT, UK
- Data Science Institute, Imperial College London, London, SW7 2AZ, UK
| | - Myriam Fornage
- University of Texas Health Science Center at Houston McGovern Medical School, Houston, TX, 77030, USA.
| | - Stéphanie Debette
- University of Bordeaux, Inserm, Bordeaux Population Health Research Center, team VINTAGE, UMR 1219, 33000, Bordeaux, France.
- Department of Neurology, Boston University School of Medicine, Boston, MA, 02118, USA.
- Department of Neurology, CHU de Bordeaux, 33000, Bordeaux, France.
| |
Collapse
|
43
|
Aggarwal NT, Barnes LL, Wilson RS, Weuve J, McAninch EA, Evans DA, Rajan KB. Sex differences in the association of APOE E4 allele and cognitive decline in a biracial population sample. Alzheimers Dement 2020. [DOI: 10.1002/alz.046743] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
| | | | - Robert S. Wilson
- Rush Alzheimer’s Disease Center Rush University Medical Center Chicago IL USA
| | | | | | | | - Kumar B. Rajan
- Rush University Medical Center Chicago IL USA
- University of California Davis Davis CA USA
| |
Collapse
|
44
|
Desai P, Halloway S, Dhana K, Holland TM, de Leon CM, Evans DA, Morris MC. Examination of a composite walking measure to inform physical activity guidelines for improving or maintaining cognitive functioning. Alzheimers Dement 2020. [DOI: 10.1002/alz.044064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
|
45
|
Dhana K, Aggarwal NT, Rajan KB, Barnes LL, Evans DA, Morris MC. APOE4, lifestyle factors, and cognitive decline: A population‐based cohort study. Alzheimers Dement 2020. [DOI: 10.1002/alz.043228] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
| | | | | | - Lisa L Barnes
- Rush Alzheimer's Disease Center Rush University Medical Center Chicago IL USA
| | | | | |
Collapse
|
46
|
Rajan KB, McAninch EA, Wilson RS, Weuve J, Barnes LL, Evans DA. Race, APOEɛ4, and Long-Term Cognitive Trajectories in a Biracial Population Sample. J Alzheimers Dis 2020; 72:45-53. [PMID: 31561363 DOI: 10.3233/jad-190538] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND The association of the APOEɛ4 allele with incident Alzheimer's dementia is higher among European Americans (EAs) than African Americans (AAs), but similar for the rate of cognitive decline. OBJECTIVE To examine the racial differences in the association of the APOEɛ4 allele with incident Alzheimer's dementia and cognitive decline. METHODS Using a population-based sample of 5,117 older adults (66% AAs and 63% females), we identified cognitive trajectory groups from a latent class mixed model and examined the association of the APOEɛ4 allele with these groups. RESULTS The frequency of the APOEɛ4 allele was higher among AAs than EAs (37% versus 26%). Four cognitive trajectories were identified: slow, mild, moderate, and rapid. Overall, AAs had a lower baseline global cognition than EAs, and a higher proportion had rapid (7% versus 5%) and moderate (20% versus 15%) decline, but similar mild (44% versus 46%), and lesser slow (29% versus 34%) decline compared to EAs. Additionally, 25% of AAs (13% of EAs) with mild and 5% (<1% of EAs) with slow decline were diagnosed with incident Alzheimer's dementia. The APOEɛ4 allele was associated with higher odds of rapid and moderate decline compared to slow decline among AAs and EAs, but not with mild decline. CONCLUSIONS AAs had lower cognitive levels and were more likely to meet the cognitive threshold for Alzheimer's dementia among mild and slow decliners, explaining the attenuated association of the ɛ4 allele with incident Alzheimer's dementia among AAs.
Collapse
Affiliation(s)
- Kumar B Rajan
- Department of Public Health Sciences, UC Davis, Davis, CA, USA
| | - Elizabeth A McAninch
- Department of Internal Medicine, Rush University Medical Center, Chicago, IL, USA
| | - Robert S Wilson
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, USA.,Department of Neurological Sciences, Rush University Medical Center, Chicago, IL, USA.,Department of Behavioral Sciences, Rush University Medical Center, Chicago, IL, USA
| | - Jennifer Weuve
- Department of Epidemiology, Boston University, Boston, MA, USA
| | - Lisa L Barnes
- Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, IL, USA.,Department of Neurological Sciences, Rush University Medical Center, Chicago, IL, USA.,Department of Behavioral Sciences, Rush University Medical Center, Chicago, IL, USA
| | - Denis A Evans
- Department of Internal Medicine, Rush University Medical Center, Chicago, IL, USA
| |
Collapse
|
47
|
Rajan KB, Aggarwal NT, McAninch EA, Weuve J, Barnes LL, Wilson RS, DeCarli C, Evans DA. Remote Blood Biomarkers of Longitudinal Cognitive Outcomes in a Population Study. Ann Neurol 2020; 88:1065-1076. [PMID: 32799383 DOI: 10.1002/ana.25874] [Citation(s) in RCA: 71] [Impact Index Per Article: 17.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2020] [Revised: 07/11/2020] [Accepted: 08/09/2020] [Indexed: 01/09/2023]
Abstract
OBJECTIVE The longitudinal association of the blood biomarkers total tau (t-tau), neurofilament light (Nf-L), and glial fibrillary acidic protein (GFAP) with common sporadic Alzheimer disease (AD) and cognitive decline is not established. METHODS Using a single molecule array technology, ultrasensitive immunoassays for serum concentrations of t-tau, Nf-L, and GFAP were measured in a population sample of 1,327 participants (60% African Americans and women) who had a clinical evaluation for AD, had completed in-home cognitive assessments, and had undergone 1.5T structural magnetic resonance imaging. RESULTS Higher concentrations of serum biomarkers were associated with the development of clinical AD; especially, the time-specific associations were notable: t-tau 8 to 16 years, and Nf-L and GFAP 4 to 8 years prior to clinical AD. Serum biomarkers were associated with faster cognitive decline over 16 years; baseline t-tau > 0.40pg/ml had 30% faster decline, Nf-L > 25.5pg/ml had 110% faster decline, and GFAP > 232pg/ml had 130% faster decline compared to those in the lowest quartile. Participants with baseline GFAP > 232pg/ml showed 160% faster decline in hippocampal volume compared to those with values < 160pg/ml. Additionally, higher baseline t-tau was associated with faster increase in 3rd ventricular volume, and baseline Nf-L and GFAP were associated with faster decline in cortical thickness. INTERPRETATION Serum t-tau, Nf-L, and GFAP predict the development of sporadic AD and cognitive decline, and changes in structural brain characteristics, suggesting their usefulness not only as screening and predictive biomarkers, but also in capturing the pathogenesis of Alzheimer dementia. ANN NEUROL 2020;88:1065-1076.
Collapse
Affiliation(s)
- Kumar B Rajan
- Department of Public Health Sciences, University of California, Davis, CA, USA.,Alzheimer's Disease Center, University of California, Sacramento, CA, USA
| | | | - Elizabeth A McAninch
- Department of Internal Medicine, Rush University Medical Center, Chicago, IL, USA
| | - Jennifer Weuve
- Department of Epidemiology, Boston University School of Public Health, Boston, MA, USA
| | | | | | - Charles DeCarli
- Department of Neurology, University of California at Davis, Sacramento, CA, USA
| | - Denis A Evans
- Department of Internal Medicine, Rush University Medical Center, Chicago, IL, USA
| |
Collapse
|
48
|
Dhana K, Evans DA, Rajan KB, Bennett DA, Morris MC. Healthy lifestyle and the risk of Alzheimer dementia: Findings from 2 longitudinal studies. Neurology 2020; 95:e374-e383. [PMID: 32554763 PMCID: PMC7455318 DOI: 10.1212/wnl.0000000000009816] [Citation(s) in RCA: 99] [Impact Index Per Article: 24.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2019] [Accepted: 01/05/2020] [Indexed: 12/13/2022] Open
Abstract
OBJECTIVE To quantify the impact of a healthy lifestyle on the risk of Alzheimer dementia. METHODS Using data from the Chicago Health and Aging Project (CHAP; n = 1,845) and the Rush Memory and Aging Project (MAP; n = 920), we defined a healthy lifestyle score on the basis of nonsmoking, ≥150 min/wk moderate/vigorous-intensity physical activity, light to moderate alcohol consumption, high-quality Mediterranean-DASH Diet Intervention for Neurodegenerative Delay diet (upper 40%), and engagement in late-life cognitive activities (upper 40%), giving an overall score ranging from 0 to 5. Cox proportional hazard models were used for each cohort to estimate the hazard ratio (HR) and 95% confidence interval (CI) of the lifestyle score with Alzheimer dementia, and a random-effect meta-analysis was used to pool the results. RESULTS During a median follow-up of 5.8 years in CHAP and 6.0 years in MAP, 379 and 229 participants, respectively, had incident Alzheimer dementia. In multivariable-adjusted models, the pooled HR (95% CI) of Alzheimer dementia across 2 cohorts was 0.73 (95% CI 0.66-0.80) per each additional healthy lifestyle factor. Compared to participants with 0 to 1 healthy lifestyle factor, the risk of Alzheimer dementia was 37% lower (pooled HR 0.63, 95% CI 0.47-0.84) in those with 2 to 3 healthy lifestyle factors and 60% lower (pooled HR 0.40, 95% CI 0.28-0.56) in those with 4 to 5 healthy lifestyle factors. CONCLUSION A healthy lifestyle as a composite score is associated with a substantially lower risk of Alzheimer's dementia.
Collapse
Affiliation(s)
- Klodian Dhana
- From the Rush Institute for Healthy Aging (K.D., D.A.E., M.C.M.) and Rush Alzheimer's Disease Center (D.A.B.), Rush University Medical Center, Chicago, IL; and Department of Public Health Sciences (K.B.R.), University of California at Davis.
| | - Denis A Evans
- From the Rush Institute for Healthy Aging (K.D., D.A.E., M.C.M.) and Rush Alzheimer's Disease Center (D.A.B.), Rush University Medical Center, Chicago, IL; and Department of Public Health Sciences (K.B.R.), University of California at Davis
| | - Kumar B Rajan
- From the Rush Institute for Healthy Aging (K.D., D.A.E., M.C.M.) and Rush Alzheimer's Disease Center (D.A.B.), Rush University Medical Center, Chicago, IL; and Department of Public Health Sciences (K.B.R.), University of California at Davis
| | - David A Bennett
- From the Rush Institute for Healthy Aging (K.D., D.A.E., M.C.M.) and Rush Alzheimer's Disease Center (D.A.B.), Rush University Medical Center, Chicago, IL; and Department of Public Health Sciences (K.B.R.), University of California at Davis
| | - Martha C Morris
- From the Rush Institute for Healthy Aging (K.D., D.A.E., M.C.M.) and Rush Alzheimer's Disease Center (D.A.B.), Rush University Medical Center, Chicago, IL; and Department of Public Health Sciences (K.B.R.), University of California at Davis
| |
Collapse
|
49
|
Kazlauskaite R, Janssen I, Wilson RS, Appelhans BM, Evans DA, Arvanitakis Z, El Khoudary SR, Kravitz HM. Is Midlife Metabolic Syndrome Associated With Cognitive Function Change? The Study of Women's Health Across the Nation. J Clin Endocrinol Metab 2020; 105:5735651. [PMID: 32083676 PMCID: PMC7059989 DOI: 10.1210/clinem/dgaa067] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2020] [Accepted: 02/11/2020] [Indexed: 02/08/2023]
Abstract
CONTEXT Metabolic syndrome (MetS) affects cognitive function in late life, particularly in women. But longitudinal research is scarce on associations of MetS with cognitive function during midlife. OBJECTIVE To determine associations between MetS exposure and cognitive function trajectories in midlife women. DESIGN AND SETTING This is a 17-year prospective, longitudinal study of multiracial/ethnic women in 7 US communities, with annual/biennial assessments. PARTICIPANTS Participants were 2149 US women traversing menopause. EXPOSURE Exposure consisted of MetS assessments (median 4 assessments over 4 years). MAIN OUTCOME MEASURES Main outcome measures were assessments of cognitive function in 3 domains: perceptual speed (symbol digit modalities test, SDMT), episodic memory (East Boston Memory Test, EBMT), and working memory (Digit Span Backward Test, DSB). RESULTS By their first cognitive assessment (age 50.7 ± 2.9 years), 29.5% met the criteria for MetS. Women completed a median (interquartile range [IQR]) of 6 (IQR 4-7) follow-up cognitive assessments over 11.2 (IQR 9.2-11.5) years. Women with MetS, compared with those without, had a larger 10-year decline in SDMT z-score (estimate -0.087, 95% confidence interval, -0.150 to -0.024; P = 0.007), after adjustment for cognitive testing practice effects, sociodemographics, lifestyle, mood, and menopause factors. As such, MetS accelerated the 10-year loss of perceptual speed by 24%. MetS did not differentially affect the rate of decline in either immediate (P = 0.534) or delayed (P = 0.740) episodic memory or in working memory (P = 0.584). CONCLUSIONS In midlife women MetS exposure was associated with accelerated decline in perceptual speed, but not episodic or working memory.
Collapse
Affiliation(s)
- Rasa Kazlauskaite
- Department of Medicine, Rush University Medical Center, Chicago, Illinois
- Correspondence and Reprint Requests: Rasa Kazlauskaite, MD, Rush University Medical Center, 1750 W. Harrison St. (Jelke) Ste. 604w | Chicago, IL 60612. E-mail:
| | - Imke Janssen
- Department of Preventive Medicine, Rush University Medical Center, Chicago, Illinois
| | - Robert S Wilson
- Department of Neurological Sciences, Rush University Medical Center, Chicago, Illinois
- Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, Chicago, Illinois
- Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, Illinois
| | - Bradley M Appelhans
- Department of Preventive Medicine, Rush University Medical Center, Chicago, Illinois
- Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, Chicago, Illinois
| | - Denis A Evans
- Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, Illinois
| | - Zoe Arvanitakis
- Department of Neurological Sciences, Rush University Medical Center, Chicago, Illinois
- Rush Alzheimer’s Disease Center, Rush University Medical Center, Chicago, Illinois
| | - Samar R El Khoudary
- Department of Epidemiology, University of Pittsburgh Graduate School of Public Health, Pittsburgh, Pennsylvania
| | - Howard M Kravitz
- Department of Preventive Medicine, Rush University Medical Center, Chicago, Illinois
- Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, Chicago, Illinois
| |
Collapse
|
50
|
Rajan KB, Weuve J, Wilson RS, Barnes LL, McAninch EA, Evans DA. Temporal changes in the likelihood of dementia and MCI over 18 years in a population sample. Neurology 2019; 94:e292-e298. [PMID: 31806693 DOI: 10.1212/wnl.0000000000008731] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2018] [Accepted: 07/18/2019] [Indexed: 12/12/2022] Open
Abstract
OBJECTIVE To examine the temporal changes in the likelihood of dementia and mild cognitive impairment (MCI) between 1993 and 2012 using a short battery of cognitive tests. METHODS A cohort of 10,342 participants underwent a short battery of cognitive tests collected during triennial in-home interviews with 2,794 of those evaluated for the clinical diagnosis of dementia and MCI. We used a generalized logit regression model to estimate the likelihood of dementia and MCI, and a quasibinomial regression model to examine the temporal changes in those likelihood scores. RESULTS A short battery of cognitive tests-delayed story recall test, Symbol Digit Modalities Test, and the Mini-Mental State Examination-were associated with the clinical diagnosis of dementia and MCI. The classification accuracy of likelihood scores was 0.92 for dementia and 0.85 for MCI. After adjusting for age, race/ethnicity, and education, the likelihood of dementia in the population decreased from 21.6% (95% confidence interval [CI] 20.9%-22.3%) to 18.9% (95% CI 18.1%-19.7%) between 1993-1996 and 2000-2002 and showed no significant decline between 2000-2002 and 2009-2012 (-0.2%, 95% CI -1.1% to 0.7%). The estimated likelihood of MCI remained similar between 1993-1996 and 2009-2012 (29.0%, 95% CI 27.9%-30.1%), but showed a nonsignificant decrease in 2000-2002. CONCLUSION The likelihood scores based on a short battery of cognitive tests can serve as a measure of dementia and MCI in epidemiologic studies. The decline in the likelihood of dementia and MCI over earlier years was not sustained in later years.
Collapse
Affiliation(s)
- Kumar B Rajan
- From the Department of Public Health Sciences (K.B.R.) and Alzheimer's Disease Center (K.B.R.), University of California at Davis; Department of Epidemiology (J.W.), Boston University School of Public Health, MA; Rush Alzheimer's Disease Center (R.S.W., L.L.B.); and Department of Internal Medicine (E.A.M., D.A.E.), Rush University Medical Center, Chicago, IL.
| | - Jennifer Weuve
- From the Department of Public Health Sciences (K.B.R.) and Alzheimer's Disease Center (K.B.R.), University of California at Davis; Department of Epidemiology (J.W.), Boston University School of Public Health, MA; Rush Alzheimer's Disease Center (R.S.W., L.L.B.); and Department of Internal Medicine (E.A.M., D.A.E.), Rush University Medical Center, Chicago, IL
| | - Robert S Wilson
- From the Department of Public Health Sciences (K.B.R.) and Alzheimer's Disease Center (K.B.R.), University of California at Davis; Department of Epidemiology (J.W.), Boston University School of Public Health, MA; Rush Alzheimer's Disease Center (R.S.W., L.L.B.); and Department of Internal Medicine (E.A.M., D.A.E.), Rush University Medical Center, Chicago, IL
| | - Lisa L Barnes
- From the Department of Public Health Sciences (K.B.R.) and Alzheimer's Disease Center (K.B.R.), University of California at Davis; Department of Epidemiology (J.W.), Boston University School of Public Health, MA; Rush Alzheimer's Disease Center (R.S.W., L.L.B.); and Department of Internal Medicine (E.A.M., D.A.E.), Rush University Medical Center, Chicago, IL
| | - Elizabeth A McAninch
- From the Department of Public Health Sciences (K.B.R.) and Alzheimer's Disease Center (K.B.R.), University of California at Davis; Department of Epidemiology (J.W.), Boston University School of Public Health, MA; Rush Alzheimer's Disease Center (R.S.W., L.L.B.); and Department of Internal Medicine (E.A.M., D.A.E.), Rush University Medical Center, Chicago, IL
| | - Denis A Evans
- From the Department of Public Health Sciences (K.B.R.) and Alzheimer's Disease Center (K.B.R.), University of California at Davis; Department of Epidemiology (J.W.), Boston University School of Public Health, MA; Rush Alzheimer's Disease Center (R.S.W., L.L.B.); and Department of Internal Medicine (E.A.M., D.A.E.), Rush University Medical Center, Chicago, IL
| |
Collapse
|