1
|
Hughes TM, Tanley J, Chen H, Schaich CL, Yeboah J, Espeland MA, Lima JAC, Ambale-Venkatesh B, Michos ED, Ding J, Hayden K, Casanova R, Craft S, Rapp SR, Luchsinger JA, Fitzpatrick AL, Heckbert SR, Post WS, Burke GL. Subclinical vascular composites predict clinical cardiovascular disease, stroke, and dementia: The Multi-Ethnic Study of Atherosclerosis (MESA). Atherosclerosis 2024; 392:117521. [PMID: 38552474 DOI: 10.1016/j.atherosclerosis.2024.117521] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Revised: 02/26/2024] [Accepted: 03/14/2024] [Indexed: 04/09/2024]
Abstract
BACKGROUND AND AIMS Subclinical cardiovascular disease (CVD) measures may reflect biological pathways that contribute to increased risk for coronary heart disease (CHD) events, stroke, and dementia beyond conventional risk scores. METHODS The Multi-Ethnic Study of Atherosclerosis (MESA) followed 6814 participants (45-84 years of age) from baseline in 2000-2002 to 2018 over 6 clinical examinations and annual follow-up interviews. MESA baseline subclinical CVD procedures included: seated and supineblood pressure, coronary calcium scan, radial artery tonometry, and carotid ultrasound. Baseline subclinical CVD measures were transformed into z-scores before factor analysis to derive composite factor scores. Time to clinical event for all-cause CVD, CHD, stroke and ICD code-based dementia events were modeled using Cox proportional hazards models reported as area under the curve (AUC) with 95% Confidence Intervals (95%CI) at 10 and 15 years of follow-up. All models included all factor scores together, and adjustment for conventional risk scores for global CVD, stroke, and dementia. RESULTS After factor selection, 24 subclinical measures aggregated into four distinct factors representing: blood pressure, atherosclerosis, arteriosclerosis, and cardiac factors. Each factor significantly predicted time to CVD events and dementia at 10 and 15 years independent of each other and conventional risk scores. Subclinical vascular composites of atherosclerosis and arteriosclerosis best predicted time to clinical events of CVD, CHD, stroke, and dementia. These results were consistent across sex and racial and ethnic groups. CONCLUSIONS Subclinical vascular composites of atherosclerosis and arteriosclerosis may be useful biomarkers to inform the vascular pathways contributing to events of CVD, CHD, stroke, and dementia.
Collapse
Affiliation(s)
- Timothy M Hughes
- Department of Internal Medicine, Section on Gerontology and Geriatric Medicine, Wake Forest University School of Medicine, Winston-Salem, NC, United States.
| | - Jordan Tanley
- Department of Internal Medicine, Section on Gerontology and Geriatric Medicine, Wake Forest University School of Medicine, Winston-Salem, NC, United States
| | - Haiying Chen
- Department of Biostatistics and Data Science, Division of Public Health Sciences, Wake Forest University School of Medicine, Winston-Salem, NC, United States
| | - Christopher L Schaich
- Department of Surgery, Hypertension and Vascular Research Center, Wake Forest University School of Medicine, Winston-Salem, NC, United States
| | - Joseph Yeboah
- Department of Internal Medicine, Section on Cardiovascular Medicine, Wake Forest University School of Medicine, Winston-Salem, NC, United States
| | - Mark A Espeland
- Department of Biostatistics and Data Science, Division of Public Health Sciences, Wake Forest University School of Medicine, Winston-Salem, NC, United States
| | - Joao A C Lima
- Department of Medicine, Division of Cardiology, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Bharath Ambale-Venkatesh
- Department of Medicine, Division of Cardiology, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Erin D Michos
- Department of Medicine, Division of Cardiology, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Jingzhong Ding
- Department of Internal Medicine, Section on Gerontology and Geriatric Medicine, Wake Forest University School of Medicine, Winston-Salem, NC, United States
| | - Kathleen Hayden
- Department of Social Sciences and Health Policy, Division of Public Health Sciences, Wake Forest University School of Medicine, Winston-Salem, NC, United States
| | - Ramon Casanova
- Department of Biostatistics and Data Science, Division of Public Health Sciences, Wake Forest University School of Medicine, Winston-Salem, NC, United States; Department of Psychiatry and Behavioral Medicine, Wake Forest University School of Medicine, Winston-Salem, NC, United States
| | - Suzanne Craft
- Department of Internal Medicine, Section on Gerontology and Geriatric Medicine, Wake Forest University School of Medicine, Winston-Salem, NC, United States
| | - Stephen R Rapp
- Department of Psychiatry and Behavioral Medicine, Wake Forest University School of Medicine, Winston-Salem, NC, United States
| | - José A Luchsinger
- Departments of Medicine and Epidemiology, Columbia University Medical Center, New York, NY, United States
| | | | - Susan R Heckbert
- Department of Epidemiology, University of Washington, Seattle, WA, United States
| | - Wendy S Post
- Department of Medicine, Division of Cardiology, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Gregory L Burke
- Division of Public Health Sciences, Wake Forest University School of Medicine, Winston-Salem, NC, United States
| |
Collapse
|
2
|
Hughes TM, Tanley J, Chen H, Schaich CL, Yeboah J, Espeland MA, Lima JAC, Ambale-Venkatesh B, Michos ED, Ding J, Hayden K, Casanova R, Craft S, Rapp SR, Luchsinger JA, Fitzpatrick AL, Heckbert SR, Post WS, Burke GL. Subclinical Vascular Composites Predict Clinical Cardiovascular Disease, Stroke, and Dementia: The Multi-Ethnic Study of Atherosclerosis (MESA). medRxiv 2023:2023.05.01.23289364. [PMID: 37205504 PMCID: PMC10187443 DOI: 10.1101/2023.05.01.23289364] [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: 05/21/2023]
Abstract
Background Subclinical cardiovascular disease (CVD) measures may reflect biological pathways that contribute to increased risk for coronary heart disease (CHD) events, stroke, and dementia beyond conventional risk scores. Methods The Multi-Ethnic Study of Atherosclerosis (MESA) followed 6,814 participants (45-84 years of age) from baseline in 2000-2002 to 2018 over 6 clinical examinations and annual follow-up interviews. MESA baseline subclinical CVD procedures included: seated and supine blood pressure, coronary calcium scan, radial artery tonometry, and carotid ultrasound. Baseline subclinical CVD measures were transformed into z-scores before factor analysis to derive composite factor scores. Time to clinical event for all CVD, CHD, stroke and ICD code-based dementia events were modeled using Cox proportional hazards models reported as area under the curve (AUC) with 95% Confidence Intervals (95%CI) at 10 and 15 years of follow-up. All models included all factor scores together and adjustment for conventional risk scores for global CVD, stroke, and dementia. Results After factor selection, 24 subclinical measures aggregated into four distinct factors representing: blood pressure, arteriosclerosis, atherosclerosis, and cardiac factors. Each factor significantly predicted time to CVD events and dementia at 10 and 15 years independent of each other and conventional risk scores. Subclinical vascular composites of arteriosclerosis and atherosclerosis best predicted time to clinical events of CVD, CHD, stroke, and dementia. These results were consistent across sex and racial and ethnic groups. Conclusions Subclinical vascular composites of arteriosclerosis and atherosclerosis may be useful biomarkers to inform the vascular pathways contributing to events of CVD, CHD, stroke, and dementia.
Collapse
|
3
|
Jiang K, Coresh J, Hayden K, Jack, Jr. C, Mosley T, Pankow J, Lin F, Deal J. ASSOCIATIONS OF AUDIOMETRIC HEARING, BRAIN MRI, AND COGNITIVE PERFORMANCE WITH SPEECH-IN-NOISE PERFORMANCE. Innov Aging 2022. [DOI: 10.1093/geroni/igac059.606] [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: 12/24/2022] Open
Abstract
Abstract
Speech-in-noise performance is fundamental to daily communications and comprehensive characterization is needed. We studied 590 dementia-free participants aged 70-84 years, including 428 hearing-impaired participants from the Aging and Cognitive Health Evaluation in Elders (ACHIEVE) study baseline (2018-19), which is a randomized controlled trial partially nested within the Atherosclerosis Risk in Communities (ARIC) Study, and 162 normal-hearing ARIC Visit 6/7 (2016-17/2018-19) participants. The Quick Speech-in-Noise (QuickSIN) test was used to measure speech-in-noise performance. Predictors included (1) Four-frequency better-ear pure-tone average (PTA); (2) Magnetic resonance imaging (MRI) measures (total and lobar volumes, diffusion tensor imaging, white matter hyperintensities); (3) Global and domain-specific (language, memory, executive function) cognitive performance. All predictors were standardized to Z-scores. We used multivariable-adjusted linear regression, adjusting for demographic and disease covariates. PTA and cognitive performance, but not MRI measures, were independently associated with speech-in-noise performance, with PTA explaining the largest variance, indicating the promising role of hearing aids.
Collapse
Affiliation(s)
- Kening Jiang
- Johns Hopkins Cochlear Center for Hearing and Public Health , Baltimore, Maryland , United States
| | - Josef Coresh
- Johns Hopkins University , Baltimore, Maryland , United States
| | - Kathleen Hayden
- Department of Social Sciences and Health Policy, Wake Forest School of Medicine, Winston-Salem, North Carolina, United States
| | | | - Thomas Mosley
- UMMC-The MIND Center , Jackson, Mississippi , United States
| | - James Pankow
- University of Minnesota , Minneapolis, Minnesota , United States
| | - Frank Lin
- Johns Hopkins Cochlear Center for Hearing and Public Health , Baltimore, Maryland , United States
| | - Jennifer Deal
- Johns Hopkins University , Baltimore, Maryland , United States
| |
Collapse
|
4
|
Hirsch JA, Michael YL, Moore KA, Melly S, Hughes TM, Hayden K, Luchsinger JA, Jimenez MP, James P, Besser LM, Sánchez B, Diez Roux AV. Longitudinal neighbourhood determinants with cognitive health and dementia disparities: protocol of the Multi-Ethnic Study of Atherosclerosis Neighborhoods and Aging prospective cohort study. BMJ Open 2022; 12:e066971. [PMID: 36368762 PMCID: PMC9660618 DOI: 10.1136/bmjopen-2022-066971] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
INTRODUCTION The burden of Alzheimer's disease (AD) and AD-related dementias (ADRD) is increasing nationally and globally, with disproportionate impacts on lower-income, lower education and systematically marginalised older adults. Presence of inequalities in neighbourhood factors (eg, social context, physical and built environments) may affect risk of cognitive decline and be key for intervening on AD/ADRD disparities at the population level. However, existing studies are limited by a dearth of longitudinal, detailed neighbourhood measures linked to rich, prospective cohort data. Our main objective is to identify patterns of neighbourhood change related to prevalence of-and disparities in-cognitive decline and dementia. METHODS AND ANALYSES We describe the process of collecting, processing and linking extensive neighbourhood data to the Multi-Ethnic Study of Atherosclerosis (MESA), creating a 25+ years dataset. Within the MESA parent study, the MESA Neighborhoods and Aging cohort study will characterise dynamic, longitudinal neighbourhood social and built environment variables relevant to cognition for residential addresses of MESA participants. This includes administering new surveys, expanding residential address histories, calculating new measures derived from spatial data and implementing novel deep learning algorithms on street-level imagery. Applying novel statistical techniques, we will examine associations of neighbourhood environmental characteristics with cognition and clinically relevant AD/ADRD outcomes. We will investigate determinants of disparities in outcomes by socioeconomic position and race/ethnicity and assess the contribution of neighbourhood environments to these disparities. This project will provide new evidence about pathways between neighbourhood environments and cognitive outcomes, with implications for policies to support healthy ageing. ETHICS AND DISSEMINATION This project was approved by the University of Washington and Drexel University Institutional Review Boards (protocols #00009029 and #00014523, and #180900605). Data will be distributed through the MESA Coordinating Center. Findings will be disseminated in peer-reviewed scientific journals, briefs, presentations and on the participant website.
Collapse
Affiliation(s)
- Jana A Hirsch
- Urban Health Collaborative and Department of Epidemiology and Biostatistics, Drexel University, Philadelphia, Pennsylvania, USA
| | - Yvonne L Michael
- Department of Epidemiology and Biostatistics, Drexel University, Philadelphia, Pennsylvania, USA
| | - Kari A Moore
- Urban Health Collaborative, Drexel University, Philadelphia, Pennsylvania, USA
| | - Steven Melly
- Urban Health Collaborative, Drexel University, Philadelphia, Pennsylvania, USA
| | - Timothy M Hughes
- Department of Internal Medicine, Medical Center Boulevard, Winston-Salem, Carolina, USA
| | - Kathleen Hayden
- Department of Social Sciences and Health Policy, Bowman Gray Center for Medical Education, Winston-Salem, Carolina, USA
| | - Jose A Luchsinger
- Department of Medicine, Columbia University, New York, New York, USA
| | - Marcia P Jimenez
- Department of Epidemiology, Boston University School of Public Health, Boston, Massachusetts, USA
| | - Peter James
- Department of Population Medicine, Harvard Medical School, Boston, Massachusetts, USA
- Department of Population Medicine, Harvard TH Chan School of Public Health, Boston, Massachusetts, USA
| | - Lilah M Besser
- Department of Neurology, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Brisa Sánchez
- Department of Epidemiology and Biostatistics, Drexel University, Philadelphia, Pennsylvania, USA
| | - Ana V Diez Roux
- Department of Epidemiology and Biostatistics, Drexel University, Philadelphia, Pennsylvania, USA
| |
Collapse
|
5
|
Simpson F, Justice J, Bahnson J, Evans J, Hayden K, Krtichevsky S, Johnson K, Espeland M. 8-Year Changes in Frailty in Adults: Links to Cognitive and Physical Function and Mortality. Innov Aging 2021. [PMCID: PMC8680720 DOI: 10.1093/geroni/igab046.2190] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Deficit accumulation frailty indices are being evaluated as clinical markers of biological aging. In this context, it is to be expected that changes over time in such indices should be predictive of downstream changes in cognition, physical function, and mortality. We derived a frailty index (FI) based on deficit accumulation in 38 functional, behavioral, and clinical characteristics and examined associations between 8-year changes in FI and subsequent standardized measures of cognitive and physical function and mortality collected over years 8-18. We drew data from the Look AHEAD clinical trial of a multidomain intensive lifestyle intervention (ILI) in 3841 adults, aged 45-76 years at baseline with overweight/obesity and type 2 diabetes mellitus. Greater FI increases tended to occur among individuals who were older, non-Hispanic White, heavier, and who had greater baseline multimorbidity. Greater increases in FI were associated with subsequently worse levels of composite cognitive function and 400m walk speed (all p<0.001). Additionally, compared with the lowest tertile of FI change, hazard ratios [95% confidence intervals] for 10-year mortality for the middle and highest tertiles of FI change were 1.28 [1.03.1.58] and 1.56 [1.24,1.96], respectively. While assignment to ILI was associated with smaller 8-year increases in FI, this did not translate overall to better cognitive functioning compared to the Diabetes Support and Education control condition across years 8-18. Increase in FI over 8 years predicts subsequent reduced function and greater mortality. However, whether interventions generally targeting FI reduce risks for downstream outcomes remains to be seen.
Collapse
Affiliation(s)
- Felicia Simpson
- Department of Mathematics, Winston-Salem State University, Winston-Salem, North Carolina, United States
| | - Jamie Justice
- Wake Forest School of Medicine, Wake Forest School of Medicine, North Carolina, United States
| | - Judy Bahnson
- Wake Forest School of Medicine, Winston-Salem, North Carolina, United States
| | - Joni Evans
- Wake Forest School of Medicine, Winston-Salem, North Carolina, United States
| | - Kathleen Hayden
- Wake Forest School of Medicine, Winston-Salem, North Carolina, United States
| | - Stephen Krtichevsky
- Wake Forest School of Medicine, Wake Forest School of Medicine, North Carolina, United States
| | - Karen Johnson
- University of Tennessee Health Science Center, Memphis, Tennessee, United States
| | - Mark Espeland
- Wake Forest School of Medicine, Winston-Salem, North Carolina, United States
| |
Collapse
|
6
|
Jiang K, Coresh J, Hayden K, Jack C, Mosley T, Pankow J, Lin F, Deal J. Associations of Central Auditory Processing With Brain Volumes. Innov Aging 2021. [PMCID: PMC8969688 DOI: 10.1093/geroni/igab046.597] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
We investigated the cross-sectional associations of speech-in-noise performance with magnetic resonance imaging brain volumes among 588 cognitively normal participants (77±4 years, 56% female) from the Aging and Cognitive Health Evaluation in Elders Study (randomized trial embedded in the Atherosclerosis Risk in Communities (ARIC) Study) baseline in 2018-19 (N=427, with hearing loss) and ARIC (N=161, normal hearing) Visit 6/7 in 2016-17/2018-19. Central auditory processing was measured by Quick Speech-in-Noise (QuickSIN) test; range: 0 to 30, lower scores=worse performance. In models adjusted for demographic and disease covariates, every 5-point decrease in QuickSIN score was associated with smaller volumes of the temporal lobe overall (-0.07SD, 95% CI:-0.13,-0.01) as well as subregions including but not limited to those important for auditory processing (amygdala:-0.13SD, 95% CI:-0.21,-0.04; middle temporal gyrus:-0.08SD, 95% CI:-0.15,-0.00; superior temporal gyrus:-0.08SD, 95% CI:-0.15,-0.01). Further research is needed to understand the mechanisms underlying these observed associations.
Collapse
Affiliation(s)
- Kening Jiang
- Johns Hopkins Cochlear Center for Hearing and Public Health, Baltimore, Maryland, United States
| | - Josef Coresh
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States
| | - Kathleen Hayden
- Wake Forest School of Medicine, Winston-Salem, North Carolina, United States
| | - Clifford Jack
- Department of Radiology, Mayo Clinic, Rochester, Minnesota, United States
| | - Thomas Mosley
- The University of Mississippi Medical Center, Jackson, Mississippi, United States
| | - James Pankow
- Division of Epidemiology and Community Health, University of Minnesota School of Public Health, Minneapolis, Minnesota, United States
| | - Frank Lin
- Johns Hopkins University, Johns Hopkins University, Maryland, United States
| | - Jennifer Deal
- Johns Hopkins University, Baltimore, Maryland, United States
| |
Collapse
|
7
|
Blue EE, Thornton TA, Kooperberg C, Liu S, Wactawski-Wende J, Manson J, Kuller L, Hayden K, Reiner AP. Non-coding variants in MYH11, FZD3, and SORCS3 are associated with dementia in women. Alzheimers Dement 2021; 17:215-225. [PMID: 32966694 PMCID: PMC7920533 DOI: 10.1002/alz.12181] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [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: 03/02/2020] [Revised: 07/17/2020] [Accepted: 08/03/2020] [Indexed: 12/17/2022]
Abstract
INTRODUCTION Recent studies suggest that both sex-specific genetic risk factors and those shared between dementia and stroke are involved in dementia pathogenesis. METHODS We performed both single-variant and gene-based genome-wide association studies of >11,000 whole genome sequences from the Women's Health Initiative cohort to discover loci associated with dementia, with adjustment for age, ethnicity, stroke, and venous thromboembolism status. Evidence for prior evidence of association and differential gene expression in dementia-related tissues and samples was gathered for each locus. RESULTS Our multiethnic studies identified significant associations between variants within APOE, MYH11, FZD3, SORCS3, and GOLGA8B and risk of dementia. Ten genes implicated by these loci, including MYH11, FZD3, SORCS3, and GOLGA8B, were differentially expressed in the context of Alzheimer's disease. DISCUSSION Our association of MYH11, FZD3, SORCS3, and GOLGA8B with dementia is supported by independent functional studies in human subjects, model systems, and associations with shared risk factors for stroke and dementia.
Collapse
Affiliation(s)
- Elizabeth E. Blue
- Division of Medical Genetics, University of Washington, Seattle, Washington, USA
| | - Timothy A. Thornton
- Department of Biostatistics, University of Washington, Seattle, Washington, USA
| | - Charles Kooperberg
- Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA
| | - Simin Liu
- Department of Epidemiology, Brown University, Providence, Rhode Island, USA
- Department of Surgery, Brown University, Providence, Rhode Island, USA
- Department of Medicine, Brown University, Providence, Rhode Island, USA
| | - Jean Wactawski-Wende
- Department of Epidemiology and Environmental Health, University at Buffalo, Buffalo, New York, USA
| | - JoAnn Manson
- Department of Medicine, Harvard Medical School, Boston, Massachusetts, USA
| | - Lew Kuller
- Department of Epidemiology, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Kathleen Hayden
- Department of Social Science and Health Policy, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA
| | - Alexander P. Reiner
- Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA
- Department of Epidemiology, University of Washington, Seattle, Washington, USA
| |
Collapse
|
8
|
Deal J, Reed N, Couper D, Hayden K, Mosley T, Pankow J, Lin F, Coresh J. The ACHIEVE Trial: Lessons Learned From Nesting a Randomized Controlled Trial Within an Observational Cohort Study. Innov Aging 2020. [PMCID: PMC7743505 DOI: 10.1093/geroni/igaa057.2950] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Hearing impairment in older adults is linked to accelerated cognitive decline and a 94% increased risk of incident dementia in population-based observational studies. Whether hearing treatment can delay cognitive decline is unknown but could have substantial clinical and public health impact. The NIH-funded ACHIEVE randomized controlled trial of 977 older adults aged 70-84 years with untreated mild-to-moderate hearing loss, is testing the efficacy of hearing treatment versus health education on cognitive decline over 3 years in community-dwelling older adults (Clinicaltrials.gov Identifier: NCT03243422.) This presentation will describe lessons learned from ACHIEVE’s unique study design. ACHIEVE is nested within a large, well-characterized multicenter observational study, the Atherosclerosis Risk in Communities Study. Such nesting within an observational study maximizes both operational and scientific efficiency. With trial results expected in 2022, this presentation will focus on the benefits gained in design and recruitment/retention, including dedicated study staff, well-established protocols, and established study staff-participant relationships. Part of a symposium sponsored by Sensory Health Interest Group.
Collapse
Affiliation(s)
- Jennifer Deal
- Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States
| | - Nicholas Reed
- Johns Hopkins University, Baltimore, Maryland, United States
| | - David Couper
- University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, United States
| | - Kathleen Hayden
- Wake Forest School of Medicine, Winston-Salem, North Carolina, United States
| | - Thomas Mosley
- University of Mississippi Medical Center, Jackson, Mississippi, United States
| | - Jim Pankow
- University of Minnesota, Minneapolis, Minnesota, United States
| | - Frank Lin
- Johns Hopkins University School of Medicine, Baltimore, Maryland, United States
| | - Josef Coresh
- Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, United States
| |
Collapse
|
9
|
Jassam N, Luvai A, Narayanan D, Turnock D, Lee G, Earp K, West J, Day A, Jeffery J, Zouwail S, El-Farhan N, Dearman R, Hayden K, Willett S, Osborne J, Barth JH. Albumin and calcium reference interval using healthy individuals and a data-mining approach. Ann Clin Biochem 2020; 57:373-381. [PMID: 32646226 DOI: 10.1177/0004563220944204] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Harmonization of reference intervals for analytes that have a sound calibration and metrological traceability is a widely recommended practice. The UK Pathology Harmony has recently harmonized reference intervals for calcium and albumin. In this study, we have determined the reference intervals for calcium and albumin on the UK's most commonly used analytical platforms. METHOD A prospective reference population of healthy individuals was recruited according to the IFCC CRIDL criteria. A second indirect population was collected from 14 primary care setting and measured in laboratories using various analytical platforms and methods (Roche, Abbott, Beckman and Siemens analytical platforms). RESULTS In total, 299 subjects were recruited; the central 95th centile values for calcium for three out of four analytical platforms were in a close agreement with UK Pathology Harmony reference intervals of 2.2-2.6 mmol/L. Reference intervals of BCG methods from both cohorts and irrespective of analytical platforms were higher for both lower and upper reference limits than those for BCP. In comparison, the indirect study showed an age-related variation. The younger population reference intervals varied by up to 5.7% at the lower reference limit and up to 12% at the upper reference limit compared with Pathology Harmony reference intervals, and the older population showed a variation of up to 14% at both limits. CONCLUSION While calcium reference intervals can be a subject for harmonization, albumin reference intervals studied showed large variation which is unsupportive of embracing a common reference interval for albumin.
Collapse
Affiliation(s)
- N Jassam
- Department of Clinical Biochemistry, Harrogate Foundation Trust, Harrogate, UK
| | - A Luvai
- Department of Clinical Biochemistry, The Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
| | - D Narayanan
- Department of Blood Sciences, Hull Royal Infirmary, Hull, UK
| | - D Turnock
- Department of Clinical Biochemistry, York Teaching Hospital NHS Foundation Trust, York, UK
| | - G Lee
- Department of Clinical Biochemistry, Mater Misericordiae University Hospital, Dublin, Ireland
| | - K Earp
- Department of Clinical Chemistry, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
| | - J West
- Department of Clinical Biochemistry and Immunology, Peterborough City Hospital, Peterborough, UK
| | - A Day
- Department of Clinical Biochemistry, University Hospitals Bristol NHS Foundation Trust, Bristol, UK
| | - J Jeffery
- Derriford Combined Laboratory, Derriford Hospital, Plymouth, UK
| | - S Zouwail
- Department of Biochemistry & Immunology, University Hospital of Wales, Cardiff, UK
| | - N El-Farhan
- Department of Biochemistry, Aneurin Bevan University Health Board, Newport, UK
| | - R Dearman
- Faculty of Biology, Medicine and Health, Manchester University, Manchester, UK
| | - K Hayden
- Department of Clinical Biochemistry, Manchester University Hospital, Manchester, UK
| | - S Willett
- Department of Clinical Biochemistry, North Cumbria University Hospitals, Carlisle, UK
| | - J Osborne
- Department of Clinical Biochemistry, Manchester University Hospital, Manchester, UK
| | - J H Barth
- Department of Clinical Biochemistry, Leeds Teaching Hospitals Trust, Leeds, UK
| |
Collapse
|
10
|
Jassam N, Thomas A, Hayden K, Dearman R, Barth JH. The impact of the analytical performance specifications of calcium and albumin on adjusted calcium. Ann Clin Biochem 2020; 57:382-388. [DOI: 10.1177/0004563220944426] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
AimThe generation of accurate, comparable results from traceable measurement procedures is a primary goal in harmonization efforts. In this study, the analytical performance of routine methods for calcium and albumin measurement is assessed to define the impact of the analytical bias of calcium and albumin on adjusted calcium equation performance and on reference intervals.MethodIn collaboration with the Wales External Quality Assurance Scheme, six months’ worth of anonymized data that cover a concentration range of clinical interest were collected. The data were grouped by analytical platforms/methods.ResultsAlbumin BCG methods are positively biased (8%) to BCP methods. The overall bias for BCP methods ranges from 5.1 to –4.3% and the overall bias for BCG methods is from 2 to –6.7%. Bias for both methods is higher than the allowable minimal bias for albumin. Calcium concentrations for Roche Cobas CPC and NM-BAPTA, Beckman Arsenazo III, Abbott Architect Arsenazo III were within bias of 1.5 to –1%. However, Siemens calcium methods CPC and Arsenazo III appear to suffer from concentration-dependent bias ranging from +3 to –6%, which exceeds even the minimal allowable limits for calcium (1.3%). Adjusted calcium shows significant bias of 11%. Even with the exclusion of Siemens Advia, the scatter of adjusted calcium results exceeds that for total calcium.ConclusionThis study shows wider than acceptable analytical variation for albumin and calcium. This variation may contribute to overall adjusted calcium equations variation and invalidate the application of a harmonized reference interval for calcium and albumin.
Collapse
Affiliation(s)
- N Jassam
- Department of Clinical Biochemistry, Harrogate Foundation Trust, Harrogate, UK
| | - A Thomas
- Weqas, Cardiff and Vale University Health Board, Cardiff, UK
| | - K Hayden
- Faculty of Biology, Medicine and Health, Manchester University, Manchester, UK
| | - R Dearman
- Department Clinical Biochemistry, Manchester University Hospital, Manchester, UK
| | - JH Barth
- Departments of Clinical Biochemistry, Leeds Teaching Hospitals Trust, Leeds, UK
| |
Collapse
|
11
|
Jassam N, Narayanan D, Turnock D, Lee G, Earp K, West J, Day A, Jeffery J, Zouwail S, El-Farhan N, Dearman R, Hayden K, Osborne J, Willett S, Barth JH. The effect of different analytical platforms and methods on the performance of population-specific adjusted calcium equation. Ann Clin Biochem 2020; 57:300-311. [DOI: 10.1177/0004563220931876] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BackgroundA recent attempt to improve the diagnostic value of adjusted calcium addressed a primary care-specific adjusted calcium equation, but validated the new equation for Roche Cobas, BCG and NM-BAPTA methods only. In this study, we aim to validate a population-specific equation for other methods and platforms.MethodWe collected retrospective patient data-sets from 15 hospital laboratories using a range of commercially available analytical platforms and methods for calcium and albumin measurements. Raw data-sets were collected and filtered according to Payne’s criteria, and separate adjusted calcium equations were derived for hospitalized and primary care patients.ResultsMean albumin and calcium results were significantly higher in primary care populations ( P < 0.0001). The prevalence of hypocalcaemia using adjusted calcium ranged between 6% and 44% for inpatient data-sets and was higher in users of BCG methods. The application of community-specific adjustment equation to primary care data-sets reduced the prevalence of hypocalcaemia (mean 1.7%, range 0.8–3.7%).ConclusionWe demonstrated that the use of a community-specific calcium adjustment equation to a primary care population reduces both the percentage and the variation of hypocalcaemia between different laboratories.
Collapse
Affiliation(s)
- N Jassam
- Department of Clinical Biochemistry, Harrogate Foundation Trust, Harrogate, UK
| | - D Narayanan
- Department of Blood Sciences, Hull University Teaching Hospitals NHS Trust, Hull, UK
| | - D Turnock
- Department of Clinical Biochemistry, York Teaching Hospital NHS Foundation Trust, York, UK
| | - G Lee
- Department of Clinical Biochemistry, Mater Misericordiae University Hospital, Dublin, Ireland
| | - K Earp
- Department of Clinical Chemistry, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
| | - J West
- Department of Clinical Biochemistry and Immunology, Peterborough City Hospital, Peterborough, UK
| | - A Day
- Department of Clinical Biochemistry, University Hospitals Bristol NHS Foundation Trust, Bristol, UK
| | - J Jeffery
- Derriford Combined Laboratory, Derriford Hospital, Plymouth, UK
| | - S Zouwail
- Department of Biochemistry & Immunology, University Hospital of Wales, Cardiff, UK
| | - N El-Farhan
- Department of Biochemistry, Aneurin Bevan University Health Board, Newport, UK
| | - R Dearman
- Faculty of Biology, Medicine and Health, Manchester University, Manchester, UK
| | - K Hayden
- Department Clinical Biochemistry, Manchester University Hospital, Manchester, UK
| | - J Osborne
- Department Clinical Biochemistry, Manchester University Hospital, Manchester, UK
| | - S Willett
- Department of Clinical Biochemistry, North Cumbria University Hospitals, Carlisle, UK
| | - JH Barth
- Department of Clinical Biochemistry, Leeds Teaching Hospitals Trust, Leeds, UK
| |
Collapse
|
12
|
Jassam N, Hayden K, Dearman R, Allgar V, Barth JH. Prospective study comparing the outcome of a population-specific adjusted calcium equation to ionized calcium. Ann Clin Biochem 2020; 57:316-324. [DOI: 10.1177/0004563220926542] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Background Calcium circulates bound to albumin and changes in albumin concentration will therefore affect total calcium measurements. In order to mitigate this, correction factors are frequently used. The most widely used correction equation was described by Payne and colleagues in 1973. This equation was derived from well-defined hospitalized patients’ data. Current clinical practice is consistent with the general application of the adjusted calcium equation irrespective of clinical setting. This study aims to assess the validity of this approach by the derivation of a community care-specific adjusted calcium equation (‘community equation’) and the comparison of its performance to a hospitalized patient equation and ionized calcium. Method Retrospective data were collected according to Payne’s criteria from an inpatient and community care setting. Data were used to derive the two equations: the in-patient equation and community equation. The outcome of these equations was compared with ionized calcium obtained from 123 healthy participants. Results The community equation correctly identified the calcium status of 92% of the 123 healthy participants, while the inpatient equation identified 46% only. Regression analysis against ionized calcium showed a higher R2 for the community equation than for the inpatient equation. Furthermore, we have shown that mean albumin and calcium concentrations are significantly different between these two populations. Conclusion In this study, we found that the diagnostic accuracy of the adjusted calcium equation in ambulant patients was improved by the derivation of a population-specific equation for the community care setting.
Collapse
Affiliation(s)
- N Jassam
- Department of Clinical Biochemistry, Harrogate Foundation Trust, Harrogate, UK
| | - K Hayden
- Department of Clinical Biochemistry, Manchester University NHS Foundation Trust, Manchester, UK
| | - R Dearman
- Faculty of Biology, Medicine and Health, Manchester University, Manchester, UK
| | - V Allgar
- Department of Health Sciences, Hull York Medical School, University of York, York, UK
| | - JH Barth
- Department of Clinical Biochemistry, Leeds Teaching Hospitals Trust, Leeds, UK
| |
Collapse
|
13
|
Chlebowski RT, Rapp S, Aragaki AK, Pan K, Neuhouser ML, Snetselaar LG, Manson JE, Wactawski-Wende J, Johnson KC, Hayden K, Baker LD, Henderson VW, Garcia L, Qi L, Prentice RL. Low-fat dietary pattern and global cognitive function: Exploratory analyses of the Women's Health Initiative (WHI) randomized Dietary Modification trial. EClinicalMedicine 2020; 18:100240. [PMID: 31938786 PMCID: PMC6953641 DOI: 10.1016/j.eclinm.2019.100240] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2019] [Revised: 11/17/2019] [Accepted: 12/10/2019] [Indexed: 12/23/2022] Open
Abstract
BACKGROUND Meta-analyses of observational studies associate adherence to several dietary patterns with cognitive health. However, limited evidence from full scale, randomized controlled trials precludes causal inference regarding dietary effects on cognitive function. METHODS The Women's Health Initiative (WHI) Dietary Modification (DM) randomized trial, in 48,835 postmenopausal women, included a subset of 1,606 WHI Memory Study (WHIMS) participants >= 65 years old, to assess low-fat dietary pattern influence on global cognitive function, evaluated with annual screening (Modified Mini-Mental State Examinations [3MSE]). Participants were randomized by a computerized, permuted block algorithm, stratified by age group and center, to a dietary intervention (40%) to reduce fat intake to 20% of energy and increase fruit, vegetable and grain intake or usual diet comparison groups (60%). The study outcome was possible cognition impairment (failed cognitive function screening) through the 8.5 year (median) dietary intervention. Those failing screening received a comprehensive, multi-phase cognitive function assessment to classify as: no cognitive impairment, mild cognitive impairment, or probable dementia. Exploratory analyses examined the composite endpoint of death after possible cognitive impairment through 18.7 years (median) follow-up. The WHI trials are registered at ClinicalTrials.gov:NCT00000611. FINDINGS Among the 1,606 WHIMS participants, the dietary intervention statistically significantly reduced the incidence of possible cognitive impairment (n = 126; hazard ratio [HR] 0.59 95% confidence interval [CI] 0.38-0. 91, P = 0.01) with HR for dietary influence on subsequent mild cognitive impairment of 0.65 (95% CI 0.35-1.19) and HR of 0.63 (95% CI 0.19-2.10) for probable dementia (PD). Through 18.7 years, deaths from all-causes after possible cognitive impairment were non-significantly lower in the dietary intervention group (0.56% vs 0.77%, HR 0.83 95% CI 0.35 to 2.00, P = 0.16). INTERPRETATION Adoption of a low-fat eating pattern, representing dietary moderation, significantly reduced risk of possible cognitive impairment in postmenopausal women. FUNDING Several Institutes of the US National Institutes of Health.
Collapse
Affiliation(s)
- Rowan T Chlebowski
- Lundquist Institute for Biomedical Innovation and Harbor-UCLA, Torrance, CA, United States
| | - Steve Rapp
- Wake Forest School of Medicine, Winston-Salem, NC, United States
| | - Aaron K Aragaki
- Fred Hutchinson Cancer Research Center, Seattle, WA, United States
| | - Kathy Pan
- Lundquist Institute for Biomedical Innovation and Harbor-UCLA, Torrance, CA, United States
| | | | | | | | | | | | - Kathleen Hayden
- Wake Forest School of Medicine, Winston-Salem, NC, United States
| | - Laura D Baker
- Wake Forest School of Medicine, Winston-Salem, NC, United States
| | | | | | - Lihong Qi
- UC Davis Health, Davis, CA, United States
| | - Ross L Prentice
- Wake Forest School of Medicine, Winston-Salem, NC, United States
| |
Collapse
|
14
|
Handing E, Leng I, Hayden K, Rosano C, Kritchevsky S. PREDICTORS OF CONCOMITANT COGNITIVE AND PHYSICAL FUNCTION DECLINE: RESULTS FROM THE HEALTH ABC STUDY. Innov Aging 2019. [PMCID: PMC6844686 DOI: 10.1093/geroni/igz038.303] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Although many individual risk factors for cognitive and physical decline have been identified, less is known about factors that predict concomitant or “dual decline”. Utilizing data from the Health ABC study (n=2,553), we examined trajectories of decline based on repeated measures of the Modified Mini-Mental State Exam (3MS) and Short Physical Performance Battery (SPPB) across 5 years. Next, we calculated four mutually exclusive trajectories of decline derived from the slope: no decline (change in slope ≥ 0, n= 1,190), cognitive decline (lowest quartile of slope in 3MS; n=445), physical decline (lowest quartile of slope in SPPB; n= 407), and dual decline (lowest quartile for both cognitive and physical decline; n= 211). Logistic regression tested the association of 23 baseline risk factors with dual decline. Odds of dual decline where higher in relation with depression (CES-D >16) (Odds Ratio [OR]: OR:2.77, 95% Confidence Interval [95% CI] [1.25- 6.15]), and lower for individuals with a better score on the Digit Symbol Substitution Test (DSST) (OR: 0.97 [0.95-0.98]), grip strength (OR: 0.97 [0.94-1.00]), and 400m gait speed (OR: 0.11 [0.03-0.40]). Among the predictors identified, depressive mood at baseline nearly tripled the odds of developing dual decline, but was not associated with decline in either the cognitive or physical domains. Depressive mood is uniquely associated with dual decline; future studies should focus on the overlap between mood states and function, as mood may be modifiable.
Collapse
Affiliation(s)
- Elizabeth Handing
- Wake Forest School of Medicine, Winston-Salem, North Carolina, United States
| | - Iris Leng
- Wake Forest School of Medicine, Winston-Salem, North Carolina, United States
| | - Kathleen Hayden
- Wake Forest School of Medicine, Winston-Salem, North Carolina, United States
| | - Caterina Rosano
- University of Pittsburgh, PIttsburgh, Pennsylvania, United States
| | - Stephen Kritchevsky
- Wake Forest School of Medicine, Winston-Salem, North Carolina, United States
| |
Collapse
|
15
|
Hayden K, Connolly M. Knowledge of Palliative Radiation Therapy Amongst Oncology and Palliative Care Nurses. Int J Radiat Oncol Biol Phys 2018. [DOI: 10.1016/j.ijrobp.2018.07.1954] [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: 10/28/2022]
|
16
|
Handing E, Leng I, Hayden K, Rosano C, Harris TB, Kritchevsky SB. COGNITIVE AND PHYSICAL FUNCTION TRAJECTORIES ASSOCIATED WITH MORTALITY: RESULTS FROM THE HEALTH ABC STUDY. Innov Aging 2018. [DOI: 10.1093/geroni/igy023.2246] [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: 11/14/2022] Open
Affiliation(s)
- E Handing
- Wake Forest School of Medicine, Winston-Salem, North Carolina,United States
| | - I Leng
- Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - K Hayden
- Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - C Rosano
- University of Pittsburgh, Pittsburgh, PA, USA
| | - T B Harris
- Intramural Research Program of the National Institute on Aging, Baltimore, MD, USA
| | | |
Collapse
|
17
|
Chen C, Xun P, Hayden K, Whitsel E, Espeland M, Wang X, Chen J, He K. INTAKE OF B VITAMINS REDUCES THE ADVERSE EFFECT OF PM2.5 EXPOSURE ON DEMENTIA RISK IN OLDER WOMEN. Innov Aging 2018. [DOI: 10.1093/geroni/igy023.2628] [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: 11/14/2022] Open
Affiliation(s)
- C Chen
- Department of Epidemiology and Biostatistics, School of Public Health -- Bloomington, Indiana University
| | - P Xun
- Department of Epidemiology and Biostatistics, School of Public Health -- Bloomington, Indiana University
| | - K Hayden
- Department of Social Sciences and Health Policy, Wake Forest School of Medicine
| | - E Whitsel
- UNC Gillings School of Global Public Health
| | | | - X Wang
- Department of Research and Evaluation, Kaiser Permanente Southern California
| | - J Chen
- Department of Preventive Medicine Keck School of Medicine, University of Southern California
| | - K He
- Department of Epidemiology and Biostatistics, School of Public Health -- Bloomington, Indiana University
| |
Collapse
|
18
|
Espeland M, Chen J, Weitlauf J, Hayden K, Rapp S, Resnick S, Garcia L, Casanova R. TRAJECTORIES OF RELATIVE PERFORMANCE ACROSS TWO MEASURES OF GLOBAL COGNITIVE FUNCTION. Innov Aging 2018. [DOI: 10.1093/geroni/igy023.1887] [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: 11/12/2022] Open
Affiliation(s)
| | - J Chen
- Department of Preventive Medicine Keck School of Medicine, University of Southern California
| | | | - K Hayden
- Department of Social Sciences and Health Policy, Wake Forest School of Medicine
| | - S Rapp
- Wake Forest School of Medicine
| | - S Resnick
- Laboratory of Behavioral Neuroscience, NIA
| | - L Garcia
- Department of Public Health Sciences, University of California at Davis
| | | |
Collapse
|
19
|
Affiliation(s)
- Michelle M. Mielke
- Department of Health Sciences ResearchMayo Clinic College of Medicine and ScienceRochesterMNUSA
| | - Maria Teresa Ferretti
- Institute for Regenerative Medicine – IREMUniversity of ZurichSchlierenSwitzerland
- Women's Brain ProjectGuntershausenSwitzerland
| | - M. Florencia Iulita
- Women's Brain ProjectGuntershausenSwitzerland
- Université de MontréalMontrealCanada
| | - Kathleen Hayden
- Wake Forest School of MedicineDepartment of Social Sciences and Health PolicyDivision of Public Health SciencesSticht Center for Healthy Aging and Alzheimer's PreventionWinston‐SalemNCUSA
| | - Ara S. Khachaturian
- Executive Editor, Alzheimer's & Dementia: The Journal of the Alzheimer's AssociationRockvilleMDUSA
| |
Collapse
|
20
|
Espeland MA, Carmichael O, Hayden K, Neiberg RH, Newman AB, Keller JN, Wadden TA, Rapp SR, Hill JO, Horton ES, Johnson KC, Wagenknecht L, Wing RR. Long-term Impact of Weight Loss Intervention on Changes in Cognitive Function: Exploratory Analyses from the Action for Health in Diabetes Randomized Controlled Clinical Trial. J Gerontol A Biol Sci Med Sci 2018; 73:484-491. [PMID: 28958022 PMCID: PMC5861893 DOI: 10.1093/gerona/glx165] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2016] [Accepted: 08/23/2017] [Indexed: 11/13/2022] Open
Abstract
Background Diabetes adversely impacts cognition. Lifestyle change can improve diabetes control and potentially improve cognition. We examined whether weight loss through reduced caloric intake and increased physical activity was associated with slower cognitive aging in older adults with type 2 diabetes mellitus. Methods The Look AHEAD randomized controlled clinical trial delivered 10 years of intensive lifestyle intervention (ILI) that yielded long-term weight losses. During 5 years spanning the end of intervention and postintervention follow-up, repeated cognitive assessments were obtained in 1,091 individuals who had been assigned to ILI or a control condition of diabetes support and education (DSE). We compared the means and slopes of scores on cognitive testing over these repeated assessments. Results Compared with DSE, assignment to ILI was associated with a -0.082 SD deficit in mean global cognitive function across repeated assessments (p = .010). However, overweight (body mass index [BMI] < 30 kg/m2) ILI participants had 0.099 (95% confidence interval [CI]: -0.006, 0.259) better mean global cognitive function compared with overweight DSE participants, while obese (BMI ≥ 30 kg/m2) ILI participants had -0.117 (-0.185, -0.049) SD worse mean composite cognitive function scores (interaction p = .014) compared to obese DSE participants. For both overweight and obese participants, cognitive decline was marginally (-0.014 SD/y overall) steeper for ILI participants (p = .068), with 95% CI for differences in slopes excluding 0 for measures of attention and memory. Conclusions The behavioral weight loss intervention was associated with small relative deficits in cognitive function among individuals who were obese and marginally greater cognitive decline overall compared to control. ClinicalTrials.gov Identifier: NCT00017953.
Collapse
Affiliation(s)
- Mark A Espeland
- Department of Biostatistical Sciences, Wake Forest School of Medicine, Winston-Salem, NC
| | - Owen Carmichael
- Brain and Metabolism Imaging in Chronic Disease Laboratory, Pennington Biomedical Research Center, Baton Rouge, LA
| | - Kathleen Hayden
- Department of Social Sciences and Health Policy, Wake Forest School of Medicine, Winston-Salem, NC
| | - Rebecca H Neiberg
- Department of Biostatistical Sciences, Wake Forest School of Medicine, Winston-Salem, NC
| | - Anne B Newman
- Healthy Aging Research Program, University of Pittsburgh, PA
| | - Jeffery N Keller
- Institute for Dementia Research and Prevention, Pennington Biomedical Research Center, Baton Rouge, LA
| | - Thomas A Wadden
- Center for Weight and Eating Disorders, University of Pennsylvania, Philadelphia
| | - Stephen R Rapp
- Department of Social Sciences and Health Policy, Wake Forest School of Medicine, Winston-Salem, NC
| | - James O Hill
- Center for Human Nutrition, University of Colorado Anschutz Medical Campus, Denver
| | | | - Karen C Johnson
- Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis
| | - Lynne Wagenknecht
- Department of Epidemiology and Prevention, Wake Forest School of Medicine, Winston-Salem, NC
| | - Rena R Wing
- Weight Control and Diabetes Research Center, Miriam Hospital, Providence, RI
| | | |
Collapse
|
21
|
Buehrle Light A, Hayden K. Using Informatics to Control Food Costs in Foodservice Operations. J Acad Nutr Diet 2017. [DOI: 10.1016/j.jand.2017.06.229] [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: 10/19/2022]
|
22
|
Dasgupta B, Cherkas Y, Lamberth S, Hayden K, Brodmerkel C, Marotta A, Curran M. FRI0009 Serum 14-3-3 ETA Is An RA Specific Mechanistic Marker. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.4292] [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: 11/03/2022]
|
23
|
Affiliation(s)
- Lin Cao
- North Carolina School of Science and Mathematics, Durham, NC (L.C.)
| | - Sean D Pokorney
- Duke Clinical Research Institute, Duke University Medical Center, Durham, NC (S.D.P., K.N.) Duke University School of Medicine, Durham, NC (S.D.P., K.H., K.W.B., K.N.)
| | - Kathleen Hayden
- Duke University School of Medicine, Durham, NC (S.D.P., K.H., K.W.B., K.N.)
| | | | - L Kristin Newby
- Duke Clinical Research Institute, Duke University Medical Center, Durham, NC (S.D.P., K.N.) Duke University School of Medicine, Durham, NC (S.D.P., K.H., K.W.B., K.N.)
| |
Collapse
|
24
|
Chuang YF, Breitner JCS, Chiu YL, Khachaturian A, Hayden K, Corcoran C, Tschanz J, Norton M, Munger R, Welsh-Bohmer K, Zandi PP. Use of diuretics is associated with reduced risk of Alzheimer's disease: the Cache County Study. Neurobiol Aging 2014; 35:2429-2435. [PMID: 24910391 DOI: 10.1016/j.neurobiolaging.2014.05.002] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.7] [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: 10/31/2013] [Revised: 03/27/2014] [Accepted: 05/02/2014] [Indexed: 10/25/2022]
Abstract
Although the use of antihypertensive medications has been associated with reduced risk of Alzheimer's disease (AD), it remains unclear which class provides the most benefit. The Cache County Study of Memory Health and Aging is a prospective longitudinal cohort study of dementing illnesses among the elderly population of Cache County, Utah. Using waves I to IV data of the Cache County Study, 3417 participants had a mean of 7.1 years of follow-up. Time-varying use of antihypertensive medications including different class of diuretics, angiotensin converting enzyme inhibitors, β-blockers, and calcium channel blockers was used to predict the incidence of AD using Cox proportional hazards analyses. During follow-up, 325 AD cases were ascertained with a total of 23,590 person-years. Use of any antihypertensive medication was associated with lower incidence of AD (adjusted hazard ratio [aHR], 0.77; 95% confidence interval [CI], 0.61-0.97). Among different classes of antihypertensive medications, thiazide (aHR, 0.7; 95% CI, 0.53-0.93), and potassium-sparing diuretics (aHR, 0.69; 95% CI, 0.48-0.99) were associated with the greatest reduction of AD risk. Thiazide and potassium-sparing diuretics were associated with decreased risk of AD. The inverse association of potassium-sparing diuretics confirms an earlier finding in this cohort, now with longer follow-up, and merits further investigation.
Collapse
Affiliation(s)
- Yi-Fang Chuang
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - John C S Breitner
- Department of Psychiatry, McGill University Faculty of Medicine, Montreal, Quebec, Canada
| | - Yen-Ling Chiu
- Department of Pathology, Johns Hopkins School of Medicine, Baltimore, MD, USA; Department of Medicine, Far-Eastern Memorial Hospital, New Taipei City, Taiwan
| | - Ara Khachaturian
- National Supercomputing Center (NSCEE) for Energy and the Environment, University of Nevada, Las Vegas, NV, USA
| | - Kathleen Hayden
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA
| | - Chris Corcoran
- Center for Epidemiologic Studies, Utah State University, Logan, UT, USA; Department of Mathematics and Statistics, Utah State University, Logan, UT, USA
| | - JoAnn Tschanz
- Center for Epidemiologic Studies, Utah State University, Logan, UT, USA; Department of Psychology, Utah State University, Logan, UT, USA
| | - Maria Norton
- Center for Epidemiologic Studies, Utah State University, Logan, UT, USA; Department of Psychology, Utah State University, Logan, UT, USA; Department of Family, Consumer, and Human Development, Utah State University, Logan, UT, USA
| | - Ron Munger
- Center for Epidemiologic Studies, Utah State University, Logan, UT, USA
| | - Kathleen Welsh-Bohmer
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA
| | - Peter P Zandi
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
| | | |
Collapse
|
25
|
Welsh‐Bohmer K, Romero H, Hayden K, Plassman B, Germain C, Sano M, Espeland M, Craft S, Monsch A, Schneider L, Chiang C, Haneline S, Oneil J, Malholtra M, Brannan S, Burns D, Roses AD. O1–06–01: Challenges in international clinical trials to delay early symptomatic Alzheimer's disease. Alzheimers Dement 2013. [DOI: 10.1016/j.jalz.2013.04.079] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
| | - Heather Romero
- Duke University Medical Center Durham North Carolina United States
| | - Kathleen Hayden
- Bryan ADRC Duke University Medical Center Durham North Carolina United States
| | - Brenda Plassman
- Duke University Medical Center Durham North Carolina United States
| | | | - Mary Sano
- Mount Sinai School of Medicine and James J. Peters VAMC New York New York United States
| | - Mark Espeland
- Wake Forest School of Medicine Winston‐Salem North Carolina United States
| | - Suzanne Craft
- Wake Forest School of Medicine Winston‐Salem North Carolina United States
| | | | - Lon Schneider
- University of Southern California Los Angeles California United States
| | - Carl Chiang
- Zinfandel Pharmaceuticals, Inc. Durham North Carolina United States
| | - Stephen Haneline
- Zinfandel Pharmaceuticals, Inc. Research Triangle Park North Carolina United States
| | - Janet Oneil
- Takeda Pharmaceuticals International, Inc. Deerfield Illinois United States
| | - Manoj Malholtra
- Takeda Pharmaceuticals International, Inc. Deerfield Illinois United States
| | - Stephen Brannan
- Takeda Pharmaceuticals International, Inc. Deerfield Illinois United States
| | - Daniel Burns
- Zinfandel Pharmaceuticals, Inc. Research Triangle Park North Carolina United States
| | - Allen D. Roses
- Zinfandel Pharmaceuticals, Inc. Research Triangle Park North Carolina United States
| |
Collapse
|
26
|
Plassman B, Germain C, Hayden K, Potter G, Romero H, Welsh‐Bohmer K, Burke JR. P4–213: Misdiagnosis using brief cognitive screening instruments in a population‐representative sample. Alzheimers Dement 2013. [DOI: 10.1016/j.jalz.2013.05.1605] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Brenda Plassman
- Duke University Medical Center Durham North Carolina United States
| | | | - Kathleen Hayden
- Bryan ADRC Duke University Medical Center Durham North Carolina United States
| | - Guy Potter
- Duke University Medical Center Durham North Carolina United States
| | - Heather Romero
- Duke University Medical Center, Bryan ADRC Durham North Carolina United States
| | | | - James R. Burke
- Duke University Medical Center Durham North Carolina United States
| |
Collapse
|
27
|
Shao H, Breitner JCS, Whitmer RA, Wang J, Hayden K, Wengreen H, Corcoran C, Tschanz J, Norton M, Munger R, Welsh-Bohmer K, Zandi PP. Hormone therapy and Alzheimer disease dementia: new findings from the Cache County Study. Neurology 2012; 79:1846-52. [PMID: 23100399 DOI: 10.1212/wnl.0b013e318271f823] [Citation(s) in RCA: 178] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
Abstract
OBJECTIVES Observational studies suggest reduced risk of Alzheimer disease (AD) in users of hormone therapy (HT), but trials show higher risk. We examined whether the association of HT with AD varies with timing or type of HT use. METHODS Between 1995 and 2006, the population-based Cache County Study followed 1,768 women who had provided a detailed history on age at menopause and use of HT. During this interval, 176 women developed incident AD. Cox proportional hazard models evaluated the association of HT use with AD, overall and in relation to timing, duration of use, and type (opposed vs unopposed) of HT. RESULTS Women who used any type of HT within 5 years of menopause had 30% less risk of AD (95% confidence interval 0.49-0.99), especially if use was for 10 or more years. By contrast, AD risk was not reduced among those who had initiated HT 5 or more years after menopause. Instead, rates were increased among those who began "opposed" estrogen-progestin compounds within the 3 years preceding the Cache County Study baseline (adjusted hazard ratio 1.93; 95% confidence interval 0.94-3.96). This last hazard ratio was similar to the ratio of 2.05 reported in randomized trial participants assigned to opposed HT. CONCLUSIONS Association of HT use and risk of AD may depend on timing of use. Although possibly beneficial if taken during a critical window near menopause, HT (especially opposed compounds) initiated in later life may be associated with increased risk. The relation of AD risk to timing and type of HT deserves further study.
Collapse
Affiliation(s)
- Huibo Shao
- Department of Public Health, Weill Cornell Medical College, New York, NY, USA
| | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
28
|
Browndyke JN, Giovanello K, Petrella J, Hayden K, Chiba-Falek O, Tucker KA, Burke JR, Welsh-Bohmer KA. Phenotypic regional functional imaging patterns during memory encoding in mild cognitive impairment and Alzheimer's disease. Alzheimers Dement 2012; 9:284-94. [PMID: 22841497 DOI: 10.1016/j.jalz.2011.12.006] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2011] [Revised: 12/10/2011] [Accepted: 12/28/2011] [Indexed: 10/28/2022]
Abstract
BACKGROUND Reliable blood-oxygen-level-dependent (BOLD) functional magnetic resonance imaging (fMRI) phenotypic biomarkers of Alzheimer's disease (AD) or mild cognitive impairment (MCI) are likely to emerge only from a systematic, quantitative, and aggregate examination of the functional neuroimaging research literature. METHODS A series of random-effects activation likelihood estimation (ALE) meta-analyses were conducted on studies of episodic memory encoding operations in AD and MCI samples relative to normal controls. ALE analyses were based on a thorough literature search for all task-based functional neuroimaging studies in AD and MCI published up to January 2010. Analyses covered 16 fMRI studies, which yielded 144 distinct foci for ALE meta-analysis. RESULTS ALE results indicated several regional task-based BOLD consistencies in MCI and AD patients relative to normal control subjects across the aggregate BOLD functional neuroimaging research literature. Patients with AD and those at significant risk (MCI) showed statistically significant consistent activation differences during episodic memory encoding in the medial temporal lobe, specifically parahippocampal gyrus, as well superior frontal gyrus, precuneus, and cuneus, relative to normal control subjects. CONCLUSIONS ALE consistencies broadly support the presence of frontal compensatory activity, medial temporal lobe activity alteration, and posterior midline "default mode" hyperactivation during episodic memory encoding attempts in the diseased or prospective predisease condition. Taken together, these robust commonalities may form the foundation for a task-based fMRI phenotype of memory encoding in AD.
Collapse
Affiliation(s)
- Jeffrey N Browndyke
- Joseph and Kathleen Bryan Alzheimer's Disease Research Center, Duke University, Durham, NC, USA.
| | | | | | | | | | | | | | | |
Collapse
|
29
|
Affiliation(s)
- Kathleen Hayden
- Duke University Medical CenterADRCDurhamNorth CarolinaUnited States
| | - Heather Romero
- Duke University Medical CenterADRCDurhamNorth CarolinaUnited States
| | - Brenda Plassman
- Duke University Medical CenterADRCDurhamNorth CarolinaUnited States
| | - James R. Burke
- Duke University Medical CenterADRCDurhamNorth CarolinaUnited States
| | | |
Collapse
|
30
|
Makeeva O, Markova V, Zhukova I, Melikyan Z, Minaycheva L, Buikin S, Osinova E, Abushaeva M, Botkina O, Musina N, Starinskaya E, Zhukova N, Maruyama Y, McCart M, MacDonald H, Whitley L, Romero H, Hayden K, Plassman B, Welsh‐Bohmer K. P4‐327: Montreal Cognitive Assessment (MoCA) population‐based study of Russian elderly. Alzheimers Dement 2012. [DOI: 10.1016/j.jalz.2013.08.108] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | | | | | - Michelle McCart
- Bryan Alzheimer's Disease Research CenterDuke University Medical CenterDurhamNorth CarolinaUnited States
| | - Heather MacDonald
- Bryan Alzheimer's Disease Research CenterDuke University Medical CenterDurhamNorth CarolinaUnited States
| | - Lawrence Whitley
- Bryan Alzheimer's Disease Research CenterDuke University Medical CenterDurhamNorth CarolinaUnited States
| | - Heather Romero
- Bryan Alzheimer's Disease Research CenterDuke University Medical CenterDurhamNorth CarolinaUnited States
| | - Kathleen Hayden
- Bryan Alzheimer's Disease Research CenterDuke University Medical CenterDurhamNorth CarolinaUnited States
| | - Brenda Plassman
- Bryan Alzheimer's Disease Research CenterDuke University Medical CenterDurhamNorth CarolinaUnited States
| | - Kathleen Welsh‐Bohmer
- Bryan Alzheimer's Disease Research CenterDuke University Medical CenterDurhamNorth CarolinaUnited States
| |
Collapse
|
31
|
Romero H, Hayden K, Plassman B, Welsh‐Bohmer K, Burke JR. P3‐239: Vascular risk and cognition in the Alzheimer's Disease Prevention Registry. Alzheimers Dement 2012. [DOI: 10.1016/j.jalz.2012.05.1461] [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: 10/28/2022]
Affiliation(s)
- Heather Romero
- Duke University Medical CenterDurhamNorth CarolinaUnited States
| | - Kathleen Hayden
- DUMCJoseph and Kathleen Bryan ADRCDurhamNorth CarolinaUnited States
| | - Brenda Plassman
- Duke University Medical CenterDurhamNorth CarolinaUnited States
| | | | - James R. Burke
- Duke University Medical CenterDurhamNorth CarolinaUnited States
| |
Collapse
|
32
|
Tschanz J, Hatch D, Croasdell S, Wanzek J, Kauwe J, Corcoran C, Norton M, Green R, Munger R, Hayden K, Breitner J, Welsh‐Bohmer K, Lyketsos C. P2‐168: Family history of non‐Alzheimer's Demeutia memory problems predicts rate of cognitive decline in APOE E4 non‐carriers in Alzheimer's disease: The Cache County Dementia Progression Study. Alzheimers Dement 2011. [DOI: 10.1016/j.jalz.2011.05.1054] [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: 11/29/2022]
Affiliation(s)
| | | | | | | | - John Kauwe
- Brigham Young UniversityProvoUtahUnited States
| | | | | | - Robert Green
- Boston UniversityBostonMassachusettsUnited States
| | | | | | | | | | | |
Collapse
|
33
|
Hayden K, Lutz M, Saunders A, Romero H, Burke J, Welsh‐Bohmer K, Roses A. P1‐235: TOMM40 “523” Genotype Affects Age of Alzheimer's Disease Onset Differentially by Race. Alzheimers Dement 2011. [DOI: 10.1016/j.jalz.2011.05.515] [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: 10/17/2022]
Affiliation(s)
- Kathleen Hayden
- Duke University Medical CenterDurhamNorth CarolinaUnited States
| | - Michael Lutz
- Duke University Medical CenterDurhamNorth CarolinaUnited States
| | - Ann Saunders
- Duke University Medical CenterDurhamNorth CarolinaUnited States
| | - Heather Romero
- Duke University Medical CenterDurhamNorth CarolinaUnited States
| | - James Burke
- Duke University Medical CenterDurhamNorth CarolinaUnited States
| | | | - Allen Roses
- Duke University Medical CenterDurhamNorth CarolinaUnited States
| |
Collapse
|
34
|
Huda MSB, Dovey TM, Wong SP, English PJ, Halford JCG, McCulloch P, Cleator J, Martin B, Cashen J, Hayden K, Ghatei MA, Bloom SR, Wilding JPH, Pinkney JH. Ghrelin does not orchestrate the metabolic changes seen in fasting but has significant effects on lipid mobilisation and substrate utilisation. Eur J Endocrinol 2011; 165:45-55. [PMID: 21558141 DOI: 10.1530/eje-10-1122] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [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] [Indexed: 11/08/2022]
Abstract
OBJECTIVE Short-term fasting is associated with increased GH pulsatility and mobilisation of fats, but underlying mechanisms are unclear. We studied ghrelin's role during fasting and the effects of exogenous ghrelin on lipid mobilisation. DESIGN Randomised placebo-controlled study. METHODS In this study, ten controls (body mass index (BMI) 23.3±3.2), ten morbidly obese subjects (BMI 50.1±10.6) and six post-gastrectomy subjects (BMI 25.2±1.0) were fasted for 36 h undergoing regular blood sampling. On a separate occasion, subjects were infused with either i.v. ghrelin (5 pmol/kg per min) or saline over 270 min. RESULTS Obese and post-gastrectomy subjects had lower ghrelin compared with controls (ANOVA, P=0.02) during the fast. Controls and gastrectomy subjects showed a similar increase in GH pulsatility, circulating non-esterified fatty acids (NEFA) and 3β-hydroxybutyrate (3 HB). Obese subjects had an impaired GH response (P<0.001), reduced excursions of 3 HB (P=0.01) but no change in NEFA excursions (P=0.09) compared with controls. Ghrelin infusion increased GH, NEFA and ketone bodies (ANOVA, P<0.0001) in all the three groups, but GH response was impaired in the obese subjects (P=0.001). Ghrelin also induced a significant (ANOVA, P=0.004) biphasic NEFA response to meals in all the subjects. CONCLUSIONS Despite low circulating ghrelin, gastrectomy subjects maintain a normal metabolic response to fasting, implying that ghrelin plays a minimal role. In contrast, infused ghrelin has significant effects on lipid mobilisation and induces a marked biphasic NEFA response to meals. Hence, ghrelin may play a significant role in meal-related substrate utilisation and metabolic flexibility.
Collapse
Affiliation(s)
- M S B Huda
- University of Liverpool Diabetes and Endocrinology Research Group, Clinical Sciences Centre, University Hospital Aintree, Liverpool L9 7AL, UK.
| | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
35
|
Zandi P, Norton M, Tschanz J, Welsh‐Bohmer K, Breitner J, Hayden K, Munger R, Whitmer R, Shao H, Szekely C, Wang J. O1‐02‐07: Timing and type of hormone replacement therapy and the risk of Alzheimer's disease: New findings from the cache county study. Alzheimers Dement 2011. [DOI: 10.1016/j.jalz.2011.05.237] [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: 10/17/2022]
Affiliation(s)
- Peter Zandi
- Johns Hopkins UniversityBaltimoreMl.United States
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
36
|
Nair S, Mishra V, Hayden K, Lisboa PJG, Pandya B, Vinjamuri S, Hardy KJ, Wilding JPH. The four-variable modification of diet in renal disease formula underestimates glomerular filtration rate in obese type 2 diabetic individuals with chronic kidney disease. Diabetologia 2011; 54:1304-7. [PMID: 21359581 DOI: 10.1007/s00125-011-2085-9] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2010] [Accepted: 01/17/2011] [Indexed: 11/28/2022]
Abstract
AIMS/HYPOTHESIS GFR is commonly estimated using the four-variable Modification of Diet in Renal Disease (MDRD) formula and this forms the basis for classification of chronic kidney disease (CKD). We investigated the effect of obesity on the estimation of glomerular filtration rate in type 2 diabetic participants with CKD. METHODS We enrolled 111 patients with type 2 diabetes mellitus in different stages of CKD. GFR was measured using (51)Cr-labelled EDTA plasma clearance and was estimated using the four-variable MDRD formula. RESULTS The bias between estimated and measured GFR was -22.4 (-33.8 to -11.0) p < 0.001 in the obese group compared with -6.04 (-17.6 to -5.5) p = 0.299 in the non-obese group. When GFR was indexed to body surface area of 1.73 m(2), the bias remained significant at -9.4 (-13.4 to -5.4) p < 0.001 in the obese participants. CONCLUSIONS/INTERPRETATION This study suggests that the four-variable MDRD formula significantly underestimates GFR in obese type 2 diabetic participants with CKD.
Collapse
Affiliation(s)
- S Nair
- Obesity & Endocrinology Research Unit, Clinical Sciences Centre, University Hospital Aintree, University of Liverpool, Longmoor Lane, Liverpool L9 7AL, UK
| | | | | | | | | | | | | | | |
Collapse
|
37
|
Marshall J, Lohmann U, Leaitch WR, Lehr P, Hayden K. Aerosol scattering as a function of altitude in a coastal environment. ACTA ACUST UNITED AC 2007. [DOI: 10.1029/2006jd007793] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
|
38
|
Abstract
INTRODUCTION Pegvisomant use in acromegaly negates the use of GH levels to monitor disease activity. To achieve antagonism, plasma concentrations must be approximately 1000-fold greater than GH which with the high homology between the peptides makes GH measurement a challenge when pegvisomant is present. OBJECTIVE We investigated the effect of pegvisomant on GH measured using commercially available assays. METHODS Pooled serum samples with GH concentrations <0.38, 3.85 and 7.69 microg/l were spiked with increasing pegvisomant concentrations (9000-494 000 microg/l). Samples were analysed by the Nichols Advantage, DPC Immulite 2000, Diasorin IRMA, Beckman Access Dxl, Tosoh AIA and Wallac Delfia assays. RESULTS With baseline GH <0.38 microg/l measured levels were <0.38 in all assays except Nichols, Diasorin and Beckman where GH peaked at 1.5, 9.6 and 17.7 micarog/l respectively at low pegvisomant concentrations, falling thereafter. With the other two samples, measured GH levels progressively fell with increasing pegvisomant concentrations, except the Beckman assay where an increase (30.8 microg/l) was seen at a pegvisomant concentration of 9000 microg/l; and Diasorin and Tosoh where smaller increases were seen at lower pegvisomant concentrations, levels gradually falling thereafter. CONCLUSION The presence of pegvisomant resulted in artefactually low measured GH in most assays. We speculate this fall is due to assay antibody-binding pegvisomant, reducing the amount of available antibody to bind actual GH thereby producing less sandwich formation: the 'high-dose hook' effect. In most assays, this effect is modest and results in lower GH, but the level of interference makes them unsuitable for studies on the influence of pegvisomant on GH neuroregulation.
Collapse
Affiliation(s)
- A N Paisley
- Department of Endocrinology, Christie NHS Trust, Wilmslow Road, Withington, Manchester M20 4BX, UK
| | | | | | | | | | | |
Collapse
|
39
|
Swain S, Harnik T, Mejia-Chang M, Hayden K, Bakx W, Creque J, Garbelotto M. Composting is an effective treatment option for sanitization of Phytophthora ramorum-infected plant material. J Appl Microbiol 2006; 101:815-27. [PMID: 16968293 DOI: 10.1111/j.1365-2672.2006.03008.x] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
AIMS To determine the effects of heat and composting treatments on the viability of the plant pathogen Phytophthora ramorum grown on both artificial and various natural substrates. METHODS AND RESULTS Phytophthora ramorum was grown on V8 agar, inoculated on bay laurel leaves (Umbellularia californica) and on woody tissues of coast live oak (Quercus agrifolia). Effects on growth, viability and survival were measured as a result of treatment in ovens and compost piles. Direct plating onto PARP medium and pear-baiting techniques were used to determine post-treatment viability. No P. ramorum was recovered at the end of the composting process, regardless of the isolation technique used. By using a PCR assay designed to detect the DNA of P. ramorum, we were able to conclude the pathogen was absent from mature compost and not merely suppressed or dormant. CONCLUSIONS Some heat and composting treatments eliminate P. ramorum to lower than detectable levels on all substrates tested. SIGNIFICANCE AND IMPACT OF THE STUDY Composting is an effective treatment option for sanitization of P. ramorum-infected plant material. Assaying for pathogen viability in compost requires a direct test capable of differentiating between pathogen suppression and pathogen elimination.
Collapse
Affiliation(s)
- S Swain
- Department of Environmental Science, Policy, and Management, University of California, Berkeley, CA 94720-3110, USA
| | | | | | | | | | | | | |
Collapse
|
40
|
Tschanz JT, Welsh-Bohmer KA, Lyketsos CG, Corcoran C, Green RC, Hayden K, Norton MC, Zandi PP, Toone L, West NA, Breitner JCS. Conversion to dementia from mild cognitive disorder: the Cache County Study. Neurology 2006; 67:229-34. [PMID: 16864813 DOI: 10.1212/01.wnl.0000224748.48011.84] [Citation(s) in RCA: 112] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVE To examine 3-year rates of conversion to dementia, and risk factors for such conversion, in a population-based sample with diverse types of cognitive impairment. METHODS All elderly (aged 65 or older) residents of Cache County, UT, were invited to undergo two waves of dementia screening and assessment. Three-year follow-up data were available for 120 participants who had some form of mild cognitive impairment at baseline. Of these, 51 had been classified at baseline with prodromal Alzheimer disease (proAD), and 69 with other cognitive syndromes (CS). RESULTS Three-year rates of conversion to dementia were 46% among those with cognitive impairment at baseline. By comparison, 3.3% without impairment converted to dementia in the interval. Among converters, AD was the most common type of dementia. In individuals with at least one APOE epsilon4 allele, those with proAD or CS exhibited a 22- to 25-fold higher risk of dementia than cognitively unimpaired individuals (vs 5- to 10-fold higher risk in those without epsilon4). CONCLUSIONS Individuals with all types of mild cognitive impairment have an elevated risk of dementia over 3 years, more so in those with an APOE epsilon4 allele. These results suggest value in dementia surveillance for broad groups of cognitively impaired individuals beyond any specific category, and utility of APOE genotyping as a prognostic method.
Collapse
Affiliation(s)
- J T Tschanz
- Department of Psychology, Utah State University, Logan, USA.
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|
41
|
Østbye T, Krause KM, Norton MC, Tschanz J, Sanders L, Hayden K, Pieper C, Welsh-Bohmer KA. Ten dimensions of health and their relationships with overall self-reported health and survival in a predominately religiously active elderly population: the cache county memory study. J Am Geriatr Soc 2006; 54:199-209. [PMID: 16460369 DOI: 10.1111/j.1532-5415.2005.00583.x] [Citation(s) in RCA: 40] [Impact Index Per Article: 2.2] [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] [Indexed: 11/28/2022]
Abstract
OBJECTIVES To document the extent of healthy aging along 10 different dimensions in a population known for its longevity. DESIGN A cohort study with baseline measures of overall self-reported health and health along 10 specific dimensions; analyses investigated the 10 dimensions as predictors of self-reported health and 10-year mortality. SETTING Cache County, Utah, which is among the areas with the highest conditional life expectancy at age 65 in the United States. PARTICIPANTS Inhabitants of Cache County aged 65 and older (January 1, 1995). MEASUREMENTS Self-reported overall health and 10 specific dimensions of healthy aging: independent living, vision, hearing, activities of daily living, instrumental activities of daily living, absence of physical illness, cognition, healthy mood, social support and participation, and religious participation and spirituality. RESULTS This elderly population was healthy overall. With few exceptions, 80% to 90% of persons aged 65 to 75 were healthy according to each measure used. Prevalence of excellent and good self-reported health decreased with age, to approximately 60% in those aged 85 and older. Even in the oldest old, the majority of respondents were independent in activities of daily living. Although vision, hearing, and mood were significant predictors of overall self-reported health in the final models, age, sex, and cognition were significant only in the final survival models. CONCLUSION This population has a high prevalence of most factors representing healthy aging. The predictors of overall self-reported health are distinct from the predictors of survival in this age group and, being potentially modifiable, are amenable to clinical and public health efforts.
Collapse
Affiliation(s)
- Truls Østbye
- Department of Community and Family Medicine, Duke University Medical Center, Durham, North Carolina 27710, USA.
| | | | | | | | | | | | | | | |
Collapse
|
42
|
Charoonruk G, Munger R, Wengreen H, Corcoran C, Hayden K, Bastian L, Tschanz J, Norton M, Welsh-Bohmer K. [O1‐01‐05]: Diabetes mellitus and risk of Alzheimer's disease in the Cache County study on memory, health, and aging. Alzheimers Dement 2005. [DOI: 10.1016/j.jalz.2005.06.280] [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: 11/25/2022]
|
43
|
Charoonruk G, Munger R, Wengreen H, Corcoran C, Hayden K, Bastian L, Tschanz J, Norton M, Breitner J, Welsh-Bohmer K. 362-S: Prospective Study of Diabetes, Gender, and Subsequent Risk of Alzheimer's Disease: The Cache County Study on Memory, Health, and Aging. Am J Epidemiol 2005. [DOI: 10.1093/aje/161.supplement_1.s91a] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
| | - R Munger
- Utah State University, Logan, UT 84335
| | | | | | - K Hayden
- Utah State University, Logan, UT 84335
| | - L Bastian
- Utah State University, Logan, UT 84335
| | - J Tschanz
- Utah State University, Logan, UT 84335
| | - M Norton
- Utah State University, Logan, UT 84335
| | | | | |
Collapse
|
44
|
Norton MC, Steffens DC, Toone L, Tschanz JT, Hayden K, Corcoran C, Klein L, Zandi P, Breitner JC, Welsh-Bohmer KA. P3-108 Late-life depression, mild cognitive impairment, APOE and their interactive effects on conversion to dementia in a population-based study. The Cache County Study. Neurobiol Aging 2004. [DOI: 10.1016/s0197-4580(04)81260-0] [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: 11/30/2022]
|
45
|
Williams G, Waterhouse J, Mugarza J, Minors D, Hayden K. Therapy of circadian rhythm disorders in chronic fatigue syndrome: no symptomatic improvement with melatonin or phototherapy. Eur J Clin Invest 2002; 32:831-7. [PMID: 12423324 DOI: 10.1046/j.1365-2362.2002.01058.x] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
BACKGROUND Patients with chronic fatigue syndrome (CFS) show evidence of circadian rhythm disturbances. We aimed to determine whether CFS symptoms were alleviated by melatonin and bright-light phototherapy, which have been shown to improve circadian rhythm disorders and fatigue in jet-lag and shift workers. DESIGN Thirty patients with unexplained fatigue for > 6 months were initially assessed using placebo and then received melatonin (5 mg in the evening) and phototherapy (2500 Lux for 1 h in the morning), each for 12 weeks in random order separated by a washout period. Principal symptoms of CFS were measured by visual analogue scales, the Shortform (SF-36) Health Survey, Mental Fatigue Inventory and Hospital Anxiety and Depression Scale. We also determined the circadian rhythm of body temperature, timing of the onset of melatonin secretion, and the relationship between these. RESULTS Neither intervention showed any significant effect on any of the principal symptoms or on general measures of physical or mental health. Compared with placebo, neither body temperature rhythm nor onset of melatonin secretion was significantly altered by either treatment, except for a slight advance of temperature phase (0.8 h; P = 0.04) with phototherapy. CONCLUSION Melatonin and bright-light phototherapy appear ineffective in CFS. Both treatments are being prescribed for CFS sufferers by medical and alternative practitioners. Their unregulated use should be prohibited unless, or until, clear benefits are convincingly demonstrated.
Collapse
Affiliation(s)
- G Williams
- Diabetes and Endocrinology Research Group, Department of Medicine, University Hospital Aintree, Liverpool, UK.
| | | | | | | | | |
Collapse
|
46
|
Hayden K, van Heyningen C. Measurement of total protein is a useful inclusion in liver function test profiles. Clin Chem 2001; 47:793-4. [PMID: 11274045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/19/2023]
|
47
|
Hayden K, Tetlow L, Byrne G, Bundred N. Radioimmunoassay for the measurement of thrombospondin in plasma and breast cyst fluid: validation and clinical application. Ann Clin Biochem 2000; 37 ( Pt 3):319-25. [PMID: 10817245 DOI: 10.1258/0004563001899212] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Thrombospondin is an adhesive protein that has been implicated in malignancy, specifically in tumour progression and angiogenesis. We developed a radioimmunoassay for the measurement of thrombospondin in plasma and breast cyst fluid. The assay exhibited high accuracy, with recoveries of 102-136% and acceptable imprecision, with an intra-assay coefficient of variation (CV) of <7.5% across the analytical range 30-1000 ng/mL and inter-assay CV of 4.4% and 7.7% at 152 and 224 ng/mL, respectively. Thrombospondin measured in the breast cyst fluid of patients with gross cystic disease of the breast showed that patients with type II (Na+) cysts had significantly higher concentrations than type I (K+) cysts. The plasma thrombospondin reference range was determined as 131-274 ng/mL. Patients with breast cancer had significantly higher plasma thrombospondin concentrations than normal individuals or patients with benign breast disease. Plasma thrombospondin was higher in breast cancer patients with lymph node involvement.
Collapse
Affiliation(s)
- K Hayden
- Department of Chemical Pathology, Withington Hospital, Manchester, UK.
| | | | | | | |
Collapse
|
48
|
Beck JT, Hsu SM, Wijdenes J, Bataille R, Klein B, Vesole D, Hayden K, Jagannath S, Barlogie B. Brief report: alleviation of systemic manifestations of Castleman's disease by monoclonal anti-interleukin-6 antibody. N Engl J Med 1994; 330:602-5. [PMID: 8302342 DOI: 10.1056/nejm199403033300904] [Citation(s) in RCA: 259] [Impact Index Per Article: 8.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Affiliation(s)
- J T Beck
- Department of Medicine, Arkansas Cancer Research Center, University of Arkansas for Medical Sciences, Little Rock 72205
| | | | | | | | | | | | | | | | | |
Collapse
|
49
|
Webb SR, Hutchinson J, Hayden K, Sprent J. Expansion/deletion of mature T cells exposed to endogenous superantigens in vivo. The Journal of Immunology 1994. [DOI: 10.4049/jimmunol.152.2.586] [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] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Abstract
Previous studies have shown that in thymectomized hosts exposure of mature T cells to Mlsa (mtv-7) Ag in vivo leads to specific tolerance and the disappearance of Mlsa-reactive V beta 6+ T cells after an initial phase of T cell expansion. To investigate the factors controlling postthymic elimination of mature T cells, we examined T cell responses to Mlsa and other endogenous superantigens in a number of different strain combinations. The results show that the extent of T cell expansion/deletion is influenced by various factors, including the H-2 haplotype of the host and the particular V beta studied. Collectively, the results suggest that the extent of elimination of mature T cells is variable and may be a function of high avidity interactions with APC.
Collapse
Affiliation(s)
- S R Webb
- Department of Immunology, Scripps Research Institute, La Jolla, CA 92037
| | - J Hutchinson
- Department of Immunology, Scripps Research Institute, La Jolla, CA 92037
| | - K Hayden
- Department of Immunology, Scripps Research Institute, La Jolla, CA 92037
| | - J Sprent
- Department of Immunology, Scripps Research Institute, La Jolla, CA 92037
| |
Collapse
|
50
|
Webb SR, Hutchinson J, Hayden K, Sprent J. Expansion/deletion of mature T cells exposed to endogenous superantigens in vivo. J Immunol 1994; 152:586-97. [PMID: 8283040] [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] [Grants] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
Previous studies have shown that in thymectomized hosts exposure of mature T cells to Mlsa (mtv-7) Ag in vivo leads to specific tolerance and the disappearance of Mlsa-reactive V beta 6+ T cells after an initial phase of T cell expansion. To investigate the factors controlling postthymic elimination of mature T cells, we examined T cell responses to Mlsa and other endogenous superantigens in a number of different strain combinations. The results show that the extent of T cell expansion/deletion is influenced by various factors, including the H-2 haplotype of the host and the particular V beta studied. Collectively, the results suggest that the extent of elimination of mature T cells is variable and may be a function of high avidity interactions with APC.
Collapse
Affiliation(s)
- S R Webb
- Department of Immunology, Scripps Research Institute, La Jolla, CA 92037
| | | | | | | |
Collapse
|