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Smagula SF, Zhang G, Krafty RT, Ramos A, Sotres-Alvarez D, Rodakowski J, Gallo LC, Lamar M, Gujral S, Fischer D, Tarraf W, Mossavar-Rahmani Y, Redline S, Stone KL, Gonzalez HM, Patel SR. Sleep-wake behaviors associated with cognitive performance in middle-aged participants of the Hispanic Community Health Study/Study of Latinos. Sleep Health 2024:S2352-7218(24)00027-5. [PMID: 38693044 DOI: 10.1016/j.sleh.2024.02.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Revised: 01/26/2024] [Accepted: 02/20/2024] [Indexed: 05/03/2024]
Abstract
OBJECTIVES Many sleep-wake behaviors have been associated with cognition. We examined a panel of sleep-wake/activity characteristics to determine which are most robustly related to having low cognitive performance in midlife. Secondarily, we evaluate the predictive utility of sleep-wake measures to screen for low cognitive performance. METHODS The outcome was low cognitive performance defined as being >1 standard deviation below average age/sex/education internally normalized composite cognitive performance levels assessed in the Hispanic Community Health Study/Study of Latinos. Analyses included 1006 individuals who had sufficient sleep-wake measurements about 2years later (mean age=54.9, standard deviation= 5.1; 68.82% female). We evaluated associations of 31 sleep-wake variables with low cognitive performance using separate logistic regressions. RESULTS In individual models, the strongest sleep-wake correlates of low cognitive performance were measures of weaker and unstable 24-hour rhythms; greater 24-hour fragmentation; longer time-in-bed; and lower rhythm amplitude. One standard deviation worse on these sleep-wake factors was associated with ∼20%-30% greater odds of having low cognitive performance. In an internally cross-validated prediction model, the independent correlates of low cognitive performance were: lower Sleep Regularity Index scores; lower pseudo-F statistics (modellability of 24-hour rhythms); lower activity rhythm amplitude; and greater time in bed. Area under the curve was low/moderate (64%) indicating poor predictive utility. CONCLUSION The strongest sleep-wake behavioral correlates of low cognitive performance were measures of longer time-in-bed and irregular/weak rhythms. These sleep-wake assessments were not useful to identify previous low cognitive performance. Given their potential modifiability, experimental trials could test if targeting midlife time-in-bed and/or irregular rhythms influences cognition.
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Affiliation(s)
- Stephen F Smagula
- Department of Psychiatry, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA; Department of Epidemiology, School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
| | - Gehui Zhang
- Department of Biostatistics, School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Robert T Krafty
- Department of Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
| | - Alberto Ramos
- Department of Neurology, University of Miami, Miller School of Medicine, Miami, Florida, USA
| | - Daniela Sotres-Alvarez
- Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Juleen Rodakowski
- Department of Occupational Therapy, School of Health and Rehabilitation Sciences, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Linda C Gallo
- Department of Psychology, University of California San Diego, San Diego, California, USA
| | - Melissa Lamar
- Institute of Minority Health Research, Department of Medicine, University of Illinois at Chicago, Chicago, Illinois, USA; Rush Alzheimer's Disease Center, Rush University Medical Center, Chicago, Illinois, USA
| | - Swathi Gujral
- Department of Psychiatry, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Dorothee Fischer
- Department of Sleep and Human Factors Research, Institute for Aerospace Medicine, German Aerospace Center, Cologne, Germany
| | - Wassim Tarraf
- Institute of Gerontology, Wayne State University, Detroit, Michigan, USA
| | - Yasmin Mossavar-Rahmani
- Department of Epidemiology & Population Health, Albert Einstein College of Medicine, New York, New York, USA
| | - Susan Redline
- Division of Sleep Medicine, Harvard Medical School, Harvard University, Boston, Massachusetts, USA
| | - Katie L Stone
- California Pacific Medical Center Research Institute, San Francisco, California, USA; Department of Epidemiology and Biostatistics, University of California, San Francisco, San Francisco, California, USA
| | - Hector M Gonzalez
- Department of Neurosciences and the Shiley-Marcos Alzheimer's Disease Research Center, UC San Diego, San Diego, California, USA
| | - Sanjay R Patel
- Division of Pulmonary, Allergy, Critical Care and Sleep Medicine, School of Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
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Stickel AM, Tarraf W, Kuwayama S, Wu B, Sundermann EE, Gallo LC, Lamar M, Daviglus M, Zeng D, Thyagarajan B, Isasi CR, Lipton RB, Cordero C, Perreira KM, Gonzalez HM, Banks SJ. Connections between reproductive health and cognitive aging among women enrolled in the HCHS/SOL and SOL-INCA. Alzheimers Dement 2024; 20:1944-1957. [PMID: 38160447 PMCID: PMC10947951 DOI: 10.1002/alz.13575] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2023] [Revised: 11/01/2023] [Accepted: 11/13/2023] [Indexed: 01/03/2024]
Abstract
INTRODUCTION Reproductive health history may contribute to cognitive aging and risk for Alzheimer's disease, but this is understudied among Hispanic/Latina women. METHODS Participants included 2126 Hispanic/Latina postmenopausal women (44 to 75 years) from the Study of Latinos-Investigation of Neurocognitive Aging. Survey linear regressions separately modeled the associations between reproductive health measures (age at menarche, history of oral contraceptive use, number of pregnancies, number of live births, age at menopause, female hormone use at Visit 1, and reproductive span) with cognitive outcomes at Visit 2 (performance, 7-year change, and mild cognitive impairment [MCI] prevalence). RESULTS Younger age at menarche, oral contraceptive use, lower pregnancies, lower live births, and older age at menopause were associated with better cognitive performance. Older age at menarche was protective against cognitive change. Hormone use was linked to lower MCI prevalence. DISCUSSION Several aspects of reproductive health appear to impact cognitive aging among Hispanic/Latina women.
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Affiliation(s)
- Ariana M. Stickel
- Department of PsychologySan Diego State UniversitySan DiegoCaliforniaUSA
| | - Wassim Tarraf
- Institute of Gerontology & Department of Healthcare SciencesWayne State UniversityDetroitMichiganUSA
| | - Sayaka Kuwayama
- Department of NeurosciencesUniversity of California, San DiegoLa JollaCaliforniaUSA
| | - Benson Wu
- Department of NeurosciencesUniversity of California, San DiegoLa JollaCaliforniaUSA
| | - Erin E. Sundermann
- Department of PsychiatryUniversity of California, San DiegoLa JollaCaliforniaUSA
| | - Linda C. Gallo
- Department of PsychologySan Diego State UniversitySan DiegoCaliforniaUSA
| | - Melissa Lamar
- Institute for Minority Health ResearchUniversity of Illinois at ChicagoCollege of MedicineChicagoIllinoisUSA
- Rush Alzheimer's Disease Research Center and the Department of Psychiatry and Behavioral SciencesRush University Medical CenterChicagoIllinoisUSA
| | - Martha Daviglus
- Institute for Minority Health ResearchUniversity of Illinois at ChicagoCollege of MedicineChicagoIllinoisUSA
| | - Donglin Zeng
- Department of BiostatisticsUniversity of North CarolinaChapel HillNorth CarolinaUSA
| | - Bharat Thyagarajan
- Department of Laboratory Medicine and PathologyUniversity of Minnesota Medical SchoolMinneapolisMinnesotaUSA
| | - Carmen R. Isasi
- Department of Epidemiology & Population HealthAlbert Einstein College of MedicineBronxNew YorkUSA
| | - Richard B. Lipton
- Department of Epidemiology & Population HealthAlbert Einstein College of MedicineBronxNew YorkUSA
- Department of NeurologyAlbert Einstein College of MedicineBronxNew YorkUSA
| | | | - Krista M. Perreira
- Department of Social MedicineUniversity of North CarolinaChapel HillNorth CarolinaUSA
| | - Hector M. Gonzalez
- Department of NeurosciencesUniversity of California, San DiegoLa JollaCaliforniaUSA
| | - Sarah J. Banks
- Department of NeurosciencesUniversity of California, San DiegoLa JollaCaliforniaUSA
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Zheng DD, Lam BL, Joslin CE, Gonzalez HM, Baiduc RR, Tarraf W, Stickel A, Daviglus M, Garcia-Bedoya O, Schneiderman N, Gonzalez F, Lee DJ. Associations Between Self-Reported Visual and Hearing Functioning and Cognitive Function Among Hispanics/Latino: Hispanic Community Health Study. Innov Aging 2024; 8:igae006. [PMID: 38496829 PMCID: PMC10941314 DOI: 10.1093/geroni/igae006] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2023] [Indexed: 03/19/2024] Open
Abstract
Background and Objectives To investigate the associations between self-reported visual functioning (VF) and hearing functioning with cognition in the Hispanic/Latino population. Research Design and Methods We utilized data from the Miami Ocular Study of Latinos ancillary study to Hispanic Community Health Study/Study of Latinos with 1,056 participants aged 45 and older. The outcomes were cognitive performances assessed by the Digit Symbol Substitution Test (DSST), Word Fluency, Brief-Spanish English Verbal Learning Test-recall (B-SEVLT recall), words recalled over 3 trials, and the Six-Item Screener. VF was measured by National Eye Institute Visual Function Questionnaire (NEI-VFQ), and hearing function was measured by Hearing Handicap Inventory Screening Questionnaire for Adults and Elderly (HHIA/E-S). Multiple regressions were performed for each cognitive outcome while controlling for covariates and complex sampling design. Results NEI-VFQ was associated with 3 of the 5 cognitive outcomes. A 4-point NEI-VFQ score difference was associated with a 0.56-point difference in DSST (standard error [SE] = 0.27, p < .001), 0.17 in Word fluency (SE = 0.16, p < .01), and 0.08 in B-SEVLT-recall (SE = 0.07, p < .01). HHIA/E-S was not associated with any of the cognitive measures examined. Discussion and Implications These data suggest that impaired VF is associated with worse cognition in the Hispanic/Latino population. Although previous work in this cohort indicated hearing loss assessed by pure tone audiometry was associated with worse cognition, we found self-perceived hearing function was not associated with cognition, suggesting the potential limitation of self-reported hearing function as a proxy for hearing loss in epidemiological research in Hispanic/Latino populations. Results also imply impaired VF and hearing function may be linked to cognition differently in the Hispanic population, and more research is needed to better understand the underlying linking mechanisms. Visual and hearing impairments are common and treatable and represent important modifiable risk factors that can be treated to preserve cognitive function in Hispanics/Latinos.
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Affiliation(s)
- D Diane Zheng
- Department of Psychiatry and Behavioral Science, Center for Cognitive Neurosciences & Aging, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Byron L Lam
- Bascom Palmer Eye Institute, University of Miami Miller School of Medicine, Miami, Florida, USA
| | - Charlotte E Joslin
- Department of Ophthalmology, University of Illinois College of Medicine, Chicago, Illinois, USA
| | - Hector M Gonzalez
- Department of Neurosciences, University of California San Diego, San Diego, California, USA
| | - Rachael R Baiduc
- Department of Speech, Language, & Hearing Sciences, University of Colorado Boulder, Boulder, Colorado, USA
| | - Wassim Tarraf
- Institute of Gerontology and Department of Healthcare Sciences, Wayne State University, Detroit, Michigan, USA
| | - Ariana Stickel
- Department of Psychology, San Diego State University, San Diego, California, USA
| | - Martha Daviglus
- Institute for Minority Health Research, University of Illinois College of Medicine, Chicago, Illinois, USA
| | - Olga Garcia-Bedoya
- Division of Academic Internal Medicine, University of Illinois College of Medicine, Chicago, Illinois, USA
| | | | - Franklyn Gonzalez
- Department of Biostatistics, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina, USA
| | - David J Lee
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami Florida, USA
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Filigrana P, Moon JY, Gallo LC, Fernández-Rhodes L, Perreira KM, Daviglus ML, Thyagarajan B, Garcia-Bedoya OL, Cai J, Lipton RB, Kaplan RC, Gonzalez HM, Isasi CR. Childhood and Life-Course Socioeconomic Position and Cognitive Function in the Adult Population of the Hispanic Community Health Study/Study of Latinos. Am J Epidemiol 2023; 192:2006-2017. [PMID: 37420108 PMCID: PMC10988221 DOI: 10.1093/aje/kwad157] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Revised: 07/03/2023] [Accepted: 07/04/2023] [Indexed: 07/09/2023] Open
Abstract
The Hispanic/Latino population experiences socioeconomic adversities across the lifespan and is at greater risk of cognitive impairment, yet little is known about the role of life-course socioeconomic position (SEP) in cognitive function in this population. Using baseline data (2008-2011) from adults (aged 45-74 years) of the Hispanic Community Health Study/Study of Latinos, we assessed the association between childhood SEP and socioeconomic mobility with cognitive function, and whether this association was mediated by midlife SEP. Childhood SEP was assessed using parental education. An index combining participants' education and household income represented midlife SEP. Socioeconomic mobility was categorized as stable low, downward or upward mobility, and stable high-SEP. Cognitive function measures were modeled using survey linear regression with inverse-probability weighting, accounting for covariates. We used mediation analysis to estimate the indirect effect of childhood SEP on cognition through midlife SEP. High childhood SEP was associated with global cognition in adulthood (coefficient for parental education beyond high school vs. less than high school = 0.26, 95% confidence interval: 0.15, 0.37). This association was partially mediated through midlife SEP (indirect effect coefficient = 0.16, 95% confidence interval: 0.15, 0.18). Low SEP through the life course was associated with the lowest cognitive function. This study provides evidence that life-course SEP influences cognitive performance in adulthood.
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Affiliation(s)
- Paola Filigrana
- Correspondence to Dr. Paola Filigrana, Department of Epidemiology and Population Health, Albert Einstein College of Medicine, 1300 Morris Park Avenue, Belfer Building-Room 1308, Bronx, NY 10461 (e-mail: )
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Sofer T, Kurniansyah N, Granot-Hershkovitz E, Goodman MO, Tarraf W, Broce I, Lipton RB, Daviglus M, Lamar M, Wassertheil-Smoller S, Cai J, DeCarli CS, Gonzalez HM, Fornage M. A polygenic risk score for Alzheimer's disease constructed using APOE-region variants has stronger association than APOE alleles with mild cognitive impairment in Hispanic/Latino adults in the U.S. Alzheimers Res Ther 2023; 15:146. [PMID: 37649099 PMCID: PMC10469805 DOI: 10.1186/s13195-023-01298-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Accepted: 08/24/2023] [Indexed: 09/01/2023]
Abstract
INTRODUCTION Polygenic Risk Scores (PRSs) are summaries of genetic risk alleles for an outcome. METHODS We used summary statistics from five GWASs of AD to construct PRSs in 4,189 diverse Hispanics/Latinos (mean age 63 years) from the Study of Latinos-Investigation of Neurocognitive Aging (SOL-INCA). We assessed the PRS associations with MCI in the combined set of people and in diverse subgroups, and when including and excluding the APOE gene region. We also assessed PRS associations with MCI in an independent dataset from the Mass General Brigham Biobank. RESULTS A simple sum of 5 PRSs ("PRSsum"), each constructed based on a different AD GWAS, was associated with MCI (OR = 1.28, 95% CI [1.14, 1.41]) in a model adjusted for counts of the APOE-[Formula: see text] and APOE-[Formula: see text] alleles. Associations of single-GWAS PRSs were weaker. When removing SNPs from the APOE region from the PRSs, the association of PRSsum with MCI was weaker (OR = 1.17, 95% CI [1.04,1.31] with adjustment for APOE alleles). In all association analyses, APOE-[Formula: see text] and APOE-[Formula: see text] alleles were not associated with MCI. DISCUSSION A sum of AD PRSs is associated with MCI in Hispanic/Latino older adults. Despite no association of APOE-[Formula: see text] and APOE-[Formula: see text] alleles with MCI, the association of the AD PRS with MCI is stronger when including the APOE region. Thus, APOE variants different than the classic APOE alleles may be important predictors of MCI in Hispanic/Latino adults.
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Affiliation(s)
- Tamar Sofer
- Division of Sleep and Circadian Disorders, Brigham and Women's Hospital, Boston, MA, USA.
- Department of Medicine, Harvard Medical School, Boston, MA, USA.
- CardioVascular Institute, Beth Israel Deaconess Medical Center, Boston, MA, USA.
| | - Nuzulul Kurniansyah
- Division of Sleep and Circadian Disorders, Brigham and Women's Hospital, Boston, MA, USA
| | - Einat Granot-Hershkovitz
- Division of Sleep and Circadian Disorders, Brigham and Women's Hospital, Boston, MA, USA
- Department of Medicine, Harvard Medical School, Boston, MA, USA
| | - Matthew O Goodman
- Division of Sleep and Circadian Disorders, Brigham and Women's Hospital, Boston, MA, USA
- Department of Medicine, Harvard Medical School, Boston, MA, USA
| | - Wassim Tarraf
- Institute of Gerontology, Wayne State University, Detroit, MI, USA
| | - Iris Broce
- Department of Neurosciences, University of California San Diego, San Diego, CA, USA
| | | | - Martha Daviglus
- Department of Medicine, Institute for Minority Health Research, University of Illinois at Chicago, Chicago, IL, USA
| | - Melissa Lamar
- Department of Medicine, Institute for Minority Health Research, University of Illinois at Chicago, Chicago, IL, USA
- Rush Alzheimer's Disease Research Center, Rush University Medical Center, Chicago, IL, USA
| | - Sylvia Wassertheil-Smoller
- Department of Epidemiology & Population Health, Department of Pediatrics, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Jianwen Cai
- Department of Biostatistics, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Charles S DeCarli
- Department of Neurology, University of California at Davis, Sacramento, CA, USA
| | - Hector M Gonzalez
- Department of Neurosciences, University of California San Diego, San Diego, CA, USA
- Shiley-Marcos Alzheimer's Disease Center, University of California San Diego, La Jolla, CA, USA
| | - Myriam Fornage
- Institute of Molecular Medicine, The University of Texas Health Science Center at Houston, Houston, TX, USA
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Granot-Hershkovitz E, He S, Bressler J, Yu B, Tarraf W, Rebholz CM, Cai J, Chan Q, Garcia TP, Mosley T, Kristal BS, DeCarli C, Fornage M, Chen GC, Qi Q, Kaplan R, Gonzalez HM, Sofer T. Plasma metabolites associated with cognitive function across race/ethnicities affirming the importance of healthy nutrition. Alzheimers Dement 2023; 19:1331-1342. [PMID: 36111689 PMCID: PMC10017373 DOI: 10.1002/alz.12786] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2022] [Revised: 06/08/2022] [Accepted: 07/22/2022] [Indexed: 11/05/2022]
Abstract
INTRODUCTION We studied the replication and generalization of previously identified metabolites potentially associated with global cognitive function in multiple race/ethnicities and assessed the contribution of diet to these associations. METHODS We tested metabolite-cognitive function associations in U.S.A. Hispanic/Latino adults (n = 2222) from the Community Health Study/ Study of Latinos (HCHS/SOL) and in European (n = 1365) and African (n = 478) Americans from the Atherosclerosis Risk In Communities (ARIC) Study. We applied Mendelian Randomization (MR) analyses to assess causal associations between the metabolites and cognitive function and between Mediterranean diet and cognitive function. RESULTS Six metabolites were consistently associated with lower global cognitive function across all studies. Of these, four were sugar-related (e.g., ribitol). MR analyses provided weak evidence for a potential causal effect of ribitol on cognitive function and bi-directional effects of cognitive performance on diet. DISCUSSION Several diet-related metabolites were associated with global cognitive function across studies with different race/ethnicities. HIGHLIGHTS Metabolites associated with cognitive function in Puerto Rican adults were recently identified. We demonstrate the generalizability of these associations across diverse race/ethnicities. Most identified metabolites are related to sugars. Mendelian Randomization (MR) provides weak evidence for a causal effect of ribitol on cognitive function. Beta-cryptoxanthin and other metabolites highlight the importance of a healthy diet.
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Affiliation(s)
- Einat Granot-Hershkovitz
- Division of Sleep and Circadian Disorders, Brigham and Women’s Hospital, Boston, MA, USA
- Department of Medicine, Harvard Medical School, Boston, MA, USA
| | - Shan He
- Division of Sleep and Circadian Disorders, Brigham and Women’s Hospital, Boston, MA, USA
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Jan Bressler
- Human Genetics Center, School of Public Health University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Bing Yu
- Human Genetics Center, School of Public Health University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Wassim Tarraf
- Institute of Gerontology, Wayne State University, Detroit, MI, USA
| | - Casey M. Rebholz
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Jianwen Cai
- Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, CA, USA
| | - Queenie Chan
- Department of Epidemiology and Biostatistics, School of Public Health, Imperial College London, London, UK
| | - Tanya P. Garcia
- Department of Neurology, School of medicine, University of Mississippi Medical Center, Jackson, MS, USA
| | - Thomas Mosley
- Department of Neurology, School of medicine, University of Mississippi Medical Center, Jackson, MS, USA
| | - Bruce S. Kristal
- Division of Sleep and Circadian Disorders, Brigham and Women’s Hospital, Boston, MA, USA
- Department of Medicine, Harvard Medical School, Boston, MA, USA
| | - Charles DeCarli
- Alzheimer’s Disease Center, Department of Neurology, University of California, Davis, Sacramento, CA, USA
| | - Myriam Fornage
- Brown Foundation Institute of Molecular Medicine, McGovern Medical School, The University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Guo-Chong Chen
- Department of Epidemiology & Population Health, Albert Einstein College of Medicine, Bronx, NY, USA
- Department of Nutrition and Food Hygiene, School of Public Health, Soochow University, Suzhou, China
| | - Qibin Qi
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle WA, USA
| | - Robert Kaplan
- Department of Epidemiology & Population Health, Albert Einstein College of Medicine, Bronx, NY, USA
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle WA, USA
| | - Hector M. Gonzalez
- Department of Neurosciences and Shiley-Marcos Alzheimer’s Disease Center, University of California, San Diego, La Jolla, CA, USA
| | - Tamar Sofer
- Division of Sleep and Circadian Disorders, Brigham and Women’s Hospital, Boston, MA, USA
- Department of Medicine, Harvard Medical School, Boston, MA, USA
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA, USA
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Granot-Hershkovitz E, Xia R, Yang Y, Spitzer B, Tarraf W, Vásquez PM, Lipton RB, Daviglus M, Argos M, Cai J, Kaplan R, Fornage M, DeCarli C, Gonzalez HM, Sofer T. Interaction analysis of ancestry-enriched variants with APOE-ɛ4 on MCI in the Study of Latinos-Investigation of Neurocognitive Aging. Sci Rep 2023; 13:5114. [PMID: 36991100 PMCID: PMC10060219 DOI: 10.1038/s41598-023-32028-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Accepted: 03/21/2023] [Indexed: 03/30/2023] Open
Abstract
AbstractAPOE-ɛ4 risk on Mild Cognitive Impairment (MCI) and Alzheimer’s Disease (AD) differs between race/ethnic groups, presumably due to ancestral genomic background surrounding the APOE locus. We studied whether African and Amerindian ancestry-enriched genetic variants in the APOE region modify the effect of the APOE-ɛ4 alleles on Mild Cognitive Impairment (MCI) in Hispanics/Latinos. We defined African and Amerindian ancestry-enriched variants as those common in one Hispanic/Latino parental ancestry and rare in the other two. We identified such variants in the APOE region with a predicted moderate impact based on the SnpEff tool. We tested their interaction with APOE-ɛ4 on MCI in the Study of Latinos-Investigation of Neurocognitive Aging (SOL-INCA) population and African Americans from the Atherosclerosis Risk In Communities (ARIC) study. We identified 5 Amerindian and 14 African enriched variants with an expected moderate effect. A suggestive significant interaction (p-value = 0.01) was found for one African-enriched variant, rs8112679, located in the ZNF222 gene fourth exon. Our results suggest there are no ancestry-enriched variants with large effect sizes of interaction effects with APOE-ɛ4 on MCI in the APOE region in the Hispanic/Latino population. Further studies are needed in larger datasets to identify potential interactions with smaller effect sizes.
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de Erausquin GA, Snyder H, Brugha TS, Seshadri S, Carrillo M, Sagar R, Huang Y, Newton C, Tartaglia C, Teunissen C, Håkanson K, Akinyemi R, Prasad K, D'Avossa G, Gonzalez‐Aleman G, Hosseini A, Vavougios GD, Sachdev P, Bankart J, Mors NPO, Lipton R, Katz M, Fox PT, Katshu MZ, Iyengar MS, Weinstein G, Sohrabi HR, Jenkins R, Stein DJ, Hugon J, Mavreas V, Blangero J, Cruchaga C, Krishna M, Wadoo O, Becerra R, Zwir I, Longstreth WT, Kroenenberg G, Edison P, Mukaetova‐Ladinska E, Staufenberg E, Figueredo‐Aguiar M, Yécora A, Vaca F, Zamponi HP, Re VL, Majid A, Sundarakumar J, Gonzalez HM, Geerlings MI, Skoog I, Salmoiraghi A, Boneschi FM, Patel VN, Santos JM, Arroyo GR, Moreno AC, Felix P, Gallo C, Arai H, Yamada M, Iwatsubo T, Sharma M, Chakraborty N, Ferreccio C, Akena D, Brayne C, Maestre G, Blangero SW, Brusco LI, Siddarth P, Hughes TM, Zuñiga AR, Kambeitz J, Laza AR, Allen N, Panos S, Merrill D, Ibáñez A, Tsuang D, Valishvili N, Shrestha S, Wang S, Padma V, Anstey KJ, Ravindrdanath V, Blennow K, Mullins P, Łojek E, Pria A, Mosley TH, Gowland P, Girard TD, Bowtell R, Vahidy FS. Chronic neuropsychiatric sequelae of SARS-CoV-2: Protocol and methods from the Alzheimer's Association Global Consortium. Alzheimers Dement (N Y) 2022; 8:e12348. [PMID: 36185993 PMCID: PMC9494609 DOI: 10.1002/trc2.12348] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/15/2021] [Revised: 04/11/2022] [Accepted: 06/14/2022] [Indexed: 12/27/2022]
Abstract
Introduction Coronavirus disease 2019 (COVID-19) has caused >3.5 million deaths worldwide and affected >160 million people. At least twice as many have been infected but remained asymptomatic or minimally symptomatic. COVID-19 includes central nervous system manifestations mediated by inflammation and cerebrovascular, anoxic, and/or viral neurotoxicity mechanisms. More than one third of patients with COVID-19 develop neurologic problems during the acute phase of the illness, including loss of sense of smell or taste, seizures, and stroke. Damage or functional changes to the brain may result in chronic sequelae. The risk of incident cognitive and neuropsychiatric complications appears independent from the severity of the original pulmonary illness. It behooves the scientific and medical community to attempt to understand the molecular and/or systemic factors linking COVID-19 to neurologic illness, both short and long term. Methods This article describes what is known so far in terms of links among COVID-19, the brain, neurological symptoms, and Alzheimer's disease (AD) and related dementias. We focus on risk factors and possible molecular, inflammatory, and viral mechanisms underlying neurological injury. We also provide a comprehensive description of the Alzheimer's Association Consortium on Chronic Neuropsychiatric Sequelae of SARS-CoV-2 infection (CNS SC2) harmonized methodology to address these questions using a worldwide network of researchers and institutions. Results Successful harmonization of designs and methods was achieved through a consensus process initially fragmented by specific interest groups (epidemiology, clinical assessments, cognitive evaluation, biomarkers, and neuroimaging). Conclusions from subcommittees were presented to the whole group and discussed extensively. Presently data collection is ongoing at 19 sites in 12 countries representing Asia, Africa, the Americas, and Europe. Discussion The Alzheimer's Association Global Consortium harmonized methodology is proposed as a model to study long-term neurocognitive sequelae of SARS-CoV-2 infection. Key Points The following review describes what is known so far in terms of molecular and epidemiological links among COVID-19, the brain, neurological symptoms, and AD and related dementias (ADRD)The primary objective of this large-scale collaboration is to clarify the pathogenesis of ADRD and to advance our understanding of the impact of a neurotropic virus on the long-term risk of cognitive decline and other CNS sequelae. No available evidence supports the notion that cognitive impairment after SARS-CoV-2 infection is a form of dementia (ADRD or otherwise). The longitudinal methodologies espoused by the consortium are intended to provide data to answer this question as clearly as possible controlling for possible confounders. Our specific hypothesis is that SARS-CoV-2 triggers ADRD-like pathology following the extended olfactory cortical network (EOCN) in older individuals with specific genetic susceptibility.The proposed harmonization strategies and flexible study designs offer the possibility to include large samples of under-represented racial and ethnic groups, creating a rich set of harmonized cohorts for future studies of the pathophysiology, determinants, long-term consequences, and trends in cognitive aging, ADRD, and vascular disease.We provide a framework for current and future studies to be carried out within the Consortium. and offers a "green paper" to the research community with a very broad, global base of support, on tools suitable for low- and middle-income countries aimed to compare and combine future longitudinal data on the topic.The Consortium proposes a combination of design and statistical methods as a means of approaching causal inference of the COVID-19 neuropsychiatric sequelae. We expect that deep phenotyping of neuropsychiatric sequelae may provide a series of candidate syndromes with phenomenological and biological characterization that can be further explored. By generating high-quality harmonized data across sites we aim to capture both descriptive and, where possible, causal associations.
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He S, Granot-Hershkovitz E, Zhang Y, Bressler J, Tarraf W, Yu B, Huang T, Zeng D, Wassertheil-Smoller S, Lamar M, Daviglus M, Marquine MJ, Cai J, Mosley T, Kaplan R, Boerwinkle E, Fornage M, DeCarli C, Kristal B, Gonzalez HM, Sofer T. Blood metabolites predicting mild cognitive impairment in the study of Latinos-investigation of neurocognitive aging (HCHS/SOL). Alzheimers Dement (Amst) 2022; 14:e12259. [PMID: 35229015 PMCID: PMC8865745 DOI: 10.1002/dad2.12259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/13/2021] [Revised: 09/17/2021] [Accepted: 09/21/2021] [Indexed: 11/19/2022]
Abstract
Introduction Blood metabolomics‐based biomarkers may be useful to predict measures of neurocognitive aging. Methods We tested the association between 707 blood metabolites measured in 1451 participants from the Hispanic Community Health Study/Study of Latinos (HCHS/SOL), with mild cognitive impairment (MCI) and global cognitive change assessed 7 years later. We further used Lasso penalized regression to construct a metabolomics risk score (MRS) that predicts MCI, potentially identifying a different set of metabolites than those discovered in individual‐metabolite analysis. Results We identified 20 metabolites predicting prevalent MCI and/or global cognitive change. Six of them were novel and 14 were previously reported as associated with neurocognitive aging outcomes. The MCI MRS comprised 61 metabolites and improved prediction accuracy from 84% (minimally adjusted model) to 89% in the entire dataset and from 75% to 87% among apolipoprotein E ε4 carriers. Discussion Blood metabolites may serve as biomarkers identifying individuals at risk for MCI among US Hispanics/Latinos.
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Affiliation(s)
- Shan He
- Department of Biostatistics Harvard T.H Chan School of Public Health Boston Massachusetts USA.,Division of Sleep and Circadian Disorders Brigham and Women's Hospital Boston Massachusetts USA
| | - Einat Granot-Hershkovitz
- Division of Sleep and Circadian Disorders Brigham and Women's Hospital Boston Massachusetts USA.,Department of Medicine Harvard Medical School Boston Massachusetts USA
| | - Ying Zhang
- Division of Sleep and Circadian Disorders Brigham and Women's Hospital Boston Massachusetts USA
| | - Jan Bressler
- Human Genetics Center School of Public Health, University of Texas Health Science Center at Houston Houston Texas USA
| | - Wassim Tarraf
- Institute of Gerontology Wayne State University Detroit Michigan USA
| | - Bing Yu
- Human Genetics Center School of Public Health, University of Texas Health Science Center at Houston Houston Texas USA
| | - Tianyi Huang
- Channing Division of Network Medicine Brigham and Women's Hospital Boston Massachusetts USA
| | - Donglin Zeng
- Department of Biostatistics Gillings School of Global Public Health University of North Carolina Chapel Hill North Carolina USA
| | - Sylvia Wassertheil-Smoller
- Department of Epidemiology & Population Health Department of Pediatrics Albert Einstein College of Medicine Bronx New York USA
| | - Melissa Lamar
- Department of Medicine Institute for Minority Health Research University of Illinois at Chicago Chicago Illinois USA.,Rush Alzheimer's Disease Research Center Rush University Medical Center Chicago Illinois USA
| | - Martha Daviglus
- Department of Medicine Institute for Minority Health Research University of Illinois at Chicago Chicago Illinois USA
| | - Maria J Marquine
- Department of Psychiatry University of California, San Diego San Diego California USA
| | - Jianwen Cai
- Department of Biostatistics Gillings School of Global Public Health University of North Carolina Chapel Hill North Carolina USA
| | - Thomas Mosley
- Department of Medicine University of Mississippi Medical Center Jackson Mississippi USA
| | - Robert Kaplan
- Department of Epidemiology & Population Health Department of Pediatrics Albert Einstein College of Medicine Bronx New York USA.,Division of Public Health Sciences Fred Hutchinson Cancer Research Center Seattle Washington USA
| | - Eric Boerwinkle
- Human Genetics Center School of Public Health, University of Texas Health Science Center at Houston Houston Texas USA.,Human Genome Sequencing Center Baylor College of Medicine Houston Texas USA
| | - Myriam Fornage
- Brown Foundation Institute of Molecular Medicine McGovern Medical School The University of Texas Health Science Center at Houston Houston Texas USA
| | - Charles DeCarli
- Department of Neurology, Alzheimer's Disease Center University of California, Davis Sacramento California USA
| | - Bruce Kristal
- Burke Medical Research Institute, White Plains New York USA.,Departments of Biochemistry and Neuroscience Weill Medical College of Cornell University New York New York USA
| | - Hector M Gonzalez
- Department of Neurosciences and Shiley-Marcos Alzheimer's Disease Center University of California, San Diego La Jolla California USA
| | - Tamar Sofer
- Department of Biostatistics Harvard T.H Chan School of Public Health Boston Massachusetts USA.,Division of Sleep and Circadian Disorders Brigham and Women's Hospital Boston Massachusetts USA.,Department of Medicine Harvard Medical School Boston Massachusetts USA
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Yang Y, Sofer T, Tarraf W, DeCarli CS, Gonzalez HM, Fornage M. Genome‐wide association study of mild cognitive impairment in diverse Hispanic/Latinos identifies novel loci and reveals heterogeneous associations across genetic backgrounds. Alzheimers Dement 2021. [DOI: 10.1002/alz.051424] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Yunju Yang
- The University of Texas Health Science Center at Houston Houston TX USA
| | | | | | - Charles S DeCarli
- University of California, Davis School of Medicine Sacramento CA USA
| | | | - Myriam Fornage
- The University of Texas Health Science Center at Houston Houston TX USA
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11
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Stickel AM, Tarraf W, Gonzalez KA, Breton J, Keamy AJ, Morlett A, Gallo LC, Medina LD, Cai J, Pirzada A, Daviglus ML, Isasi CR, Kaplan R, Wassertheil‐Smoller S, Lamar M, Gonzalez HM. Links between acculturation and level and change in cognition among middle‐aged and older Hispanics/Latinos: Findings from the HCHS/SOL and SOL‐INCA. Alzheimers Dement 2021. [DOI: 10.1002/alz.051196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
| | | | | | | | | | | | | | | | - Jianwen Cai
- University of North Carolina Chapel Hill NC USA
| | - Amber Pirzada
- University of Illinois at Chicago, College of Medicine Chicago IL USA
| | - Martha L Daviglus
- University of Illinois at Chicago, College of Medicine Chicago IL USA
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12
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DeCarli CS, Tarraf W, Gonzalez KA, Stickel AM, Fletcher EM, Knaack A, Maillard P, Gallo LC, Daviglus ML, Testai FD, Isasi CR, Schneiderman N, Sofer T, Fornage M, Gonzalez HM. Association of Hispanic/Latino background and brain structure in Hispanics/Latinos from the SOL‐INCA MRI study. Alzheimers Dement 2021. [DOI: 10.1002/alz.053150] [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]
Affiliation(s)
| | | | | | | | | | | | | | | | - Martha L Daviglus
- University of Illinois at Chicago, College of Medicine Chicago IL USA
| | - Fenando D Testai
- University of Illinois at Chicago, College of Medicine Chicago IL USA
| | | | | | | | - Myriam Fornage
- The University of Texas Health Science Center at Houston Houston TX USA
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13
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Stickel AM, Tarraf W, Gonzalez KA, Paredes AM, Zeng D, Cai J, Isasi CR, Kaplan R, Lipton RB, Daviglus ML, Testai FD, Lamar M, Gallo LC, Talavera GA, Gellman MD, Ramos AR, Gonzalez HM, DeCarli CS. Stroke and cardiovascular disease risk exacerbate brain aging among middle‐age and older Hispanics/Latinos: Preliminary findings from the Study of Latinos‐Investigation of Neurocognitive Aging‐MRI (SOL‐INCA‐MRI). Alzheimers Dement 2021. [DOI: 10.1002/alz.056409] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Affiliation(s)
| | | | | | | | | | - Jianwen Cai
- University of North Carolina Chapel Hill NC USA
| | | | | | | | | | - Fenando D. Testai
- University of Illinois at Chicago, College of Medicine Chicago IL USA
| | - Melissa Lamar
- University of Illinois at Chicago, College of Medicine Chicago IL USA
- Rush Alzheimer's Disease Center Chicago IL USA
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14
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Morlett A, Guareña‐Espinosa LA, Gonzalez HM. Perceptions and attitudes of brain donation for Alzheimer’s disease research among older Latinos. Alzheimers Dement 2021. [DOI: 10.1002/alz.051183] [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: 11/06/2022]
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15
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Estrella ML, Tarraf W, Wu B, Gallo LC, Marquine MJ, Perreira KM, Vasquez PM, Isasi CR, Zeng D, Lipton RB, Gonzalez HM, Daviglus ML, Lamar M. Psychosocial factors associated with changes in cognition among middle‐aged and older Hispanics/Latinos: Findings from the HCHS/SOL and the sociocultural and SOL‐Investigation of Neurocognitive Aging (SOL‐INCA) ancillary studies. Alzheimers Dement 2021. [DOI: 10.1002/alz.056157] [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: 11/06/2022]
Affiliation(s)
- Mayra L Estrella
- Institute for Minority Health Research, University of Illinois at Chicago Department of Medicine Chicago IL USA
| | | | - Benson Wu
- University of California San Diego La Jolla CA USA
| | | | | | | | | | | | | | | | | | - Martha L Daviglus
- University of Illinois at Chicago, College of Medicine Chicago IL USA
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16
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Stickel AM, Tarraf W, Gonzalez KA, Paredes AM, Zeng D, Cai J, Isasi CR, Kaplan R, Lipton RB, Daviglus ML, Testai FD, Lamar M, Gallo LC, Talavera GA, Gellman MD, Ramos AR, Gonzalez HM, DeCarli CS. Characterizing brain structure among middle‐age and older Hispanics/Latinos in the Hispanic Community Health Study/Study of Latinos (HCHS/SOL) and SOL‐Investigation of Neurocognitive Aging (SOL‐INCA): Preliminary findings. Alzheimers Dement 2021. [DOI: 10.1002/alz.056341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Affiliation(s)
| | | | | | | | | | - Jianwen Cai
- University of North Carolina Chapel Hill NC USA
| | | | | | | | | | - Fenando D. Testai
- University of Illinois at Chicago, College of Medicine Chicago IL USA
| | - Melissa Lamar
- University of Illinois at Chicago, College of Medicine Chicago IL USA
- Rush Alzheimer's Disease Center Chicago IL USA
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Ivanovic V, Seiler S, Tarraf W, Crivello E, Martinez O, Lipton RB, Isasi CR, Copello TG, Talavera GA, Gallo LC, Lamar M, Testai F, Schneiderman N, Gellman MD, Daviglus M, Gonzalez HM, DeCarli C, Lipton ML. Prevalence of incidental brain MRI findings of clinical relevance in a diverse Hispanic/Latino population. J Neuroimaging 2021; 31:1166-1175. [PMID: 34288226 PMCID: PMC10332335 DOI: 10.1111/jon.12910] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2021] [Revised: 07/09/2021] [Accepted: 07/09/2021] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND AND PURPOSE There is limited literature on the prevalence of incidental brain MRI findings in the Hispanic/Latino population, despite their increased prevalence of vascular disease and undertreatment of chronic conditions. The purpose of our study was to determine the prevalence of clinically relevant incidental findings on brain MRI examinations obtained as a part of the Study of Latinos-Investigation of NeuroCognitive Aging MRI (SOL-INCA-MRI) study. METHODS Brain MRI examinations were obtained on 1389 participants in the SOL-INCA-MRI study, a cross-sectional ancillary study of the Hispanic Community Health Study, Study of Latinos, which is a longitudinal, community-based study. Study design of SOL-INCA-MRI involves imaging cognitively normal and participants with mild cognitive impairment. Brain MRI findings were categorized as Level 1 (normal), Level 1.5 (findings of unclear medical significance), Level 2 (potential medical concern), or Level 3 (medically urgent). This article focuses on Level 2 and Level 3 findings. RESULTS The average age of the sample was 60.8 years (+/- 10.3 years), 66.1% were females. Level 2 and 3 findings were identified in 117 participants, (8.4%), of which 109 (7.8%) were recommended for medical follow-up (Level 2), and 8 (0.6%) were recommended for immediate medical attention (Level 3). Brain MRI findings consisted of chronic infarction in 33 (2.4%), vascular abnormality in 27 (1.9%), intracranial mass in 20 (1.4%), other intracranial findings in 28 (2.0%), and skull base/extracranial findings in 26 (1.9%) patients. CONCLUSION Incidental findings of clinical relevance were common among SOL-INCA-MRI participants, but rarely required urgent medical intervention.
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Affiliation(s)
- Vladimir Ivanovic
- Department of Radiology, University of California Davis School of Medicine, Sacramento, CA, USA
| | - Stephan Seiler
- Department of Neurology, University of California Davis School of Medicine, Sacramento, CA, USA
| | - Wassim Tarraf
- Wayne State University, Institute of Gerontology, Detroit, MI, USA
| | - Emily Crivello
- Department of Neurology, University of California Davis School of Medicine, Sacramento, CA, USA
| | - Oliver Martinez
- Department of Neurology, University of California Davis School of Medicine, Sacramento, CA, USA
| | - Richard B. Lipton
- Department of Neurology, Albert Einstein College of Medicine, Bronx, NY, USA
| | - Carmen R. Isasi
- Department of Neurology, Albert Einstein College of Medicine, Bronx, NY, USA
| | | | | | - Linda C. Gallo
- Department of Psychology, San Diego State University, San Diego, CA, USA
| | - Melissa Lamar
- Department of Psychiatry & Behavioral Sciences, Rush University Medical Center, Rush Alzheimer’s Disease Center, Chicago, IL, USA
| | - Fernando Testai
- Department of Neurology, University of Illinois at Chicago, Chicago, IL, USA
| | | | - Marc D. Gellman
- Department of Psychology, University of Miami, Miami, FL, USA
| | - Martha Daviglus
- University of Illinois at Chicago, Institute for Minority Health Research, Chicago, IL, USA
| | - Hector M. Gonzalez
- Department of Neurosciences, Shiley-Marcos Alzheimer’s Disease Research Center, University of California San Diego, San Diego, CA, USA
| | - Charles DeCarli
- Department of Neurology, University of California Davis School of Medicine, Sacramento, CA, USA
| | - Michael L. Lipton
- Departments of Radiology, Psychiatry and Behavioral Sciences and The Dominick P Purpura Department of Neuroscience, Albert Einstein College of Medicine and Montefiore Health System, Bronx, NY, USA
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18
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Karazurna NA, Porter CM, Aytur S, Scott T, Mattei J, Noel SE, Gonzalez HM, Mossavar-Rahmani Y, Sotres-Alvarez D, Gallo LC, Daviglus ML, Van Horn L, Elfassy T, Gellman MD, Moncrieft AE, Tucker KL, Kaplan RC, Bigornia SJ. Associations between dietary fatty acid patterns and cognitive function in the Hispanic Community Health Study/Study of Latinos. Br J Nutr 2021; 129:1-35. [PMID: 34433507 DOI: 10.1017/s0007114521003275] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Our objective was to quantify the cross-sectional associations between dietary fatty acid (DFA) patterns and cognitive function among Hispanic/Latino adults. This study included data from 8,942 participants of the Hispanic Community Health Study/Study of Latinos, a population-based cohort study (weighted age 56.2 y and proportion female 55.2%). The NCI (National Cancer Institute) method was used to estimate dietary intake from two 24-hr recalls. We derived DFA patterns using principal components analysis with 26 fatty acid and total plant and animal monounsaturated fatty acid (MUFA) input variables. Global cognitive function was calculated as the average z-score of 4 neurocognitive tests. Survey linear regression models included multiple potential confounders such as age, sex, education, depressive symptoms, physical activity, energy intake, and cardiovascular disease. DFA patterns were characterized by consumption of long-chain saturated fatty acids (SFA), animal-based MUFA, and trans fatty acids (Factor 1); short to medium-chain SFA (Factor 2); very-long-chain omega-3 polyunsaturated fatty acids (PUFA) (Factor 3); very-long-chain SFA and plant-based MUFA and PUFA (Factor 4). Factor 2 was associated with greater scores for global cognitive function (β=0.037 ± 0.012) and the Digit Symbol Substitution (DSS) (β=0.56±0.17), Brief Spanish English Verbal Learning-Sum (B-SEVLT) (β=0.23 ± 0.11), and B-SEVLT-Recall (β=0.11 ± 0.05) tests (P<0.05 for all). Factors 1 (β=0.04 ± 0.01) and 4 (β=0.70 ± 0.18) were associated with the DSS test (P<0.05 for all). Consumption of short to medium-chain SFA may be associated with higher cognitive function among U.S.-residing Hispanic/Latino adults. Prospective studies are necessary to confirm these findings.
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Affiliation(s)
- Nicole A Karazurna
- Department of Agriculture Nutrition and Food Systems, University of New Hampshire
| | - Caitlin M Porter
- Department of Agriculture Nutrition and Food Systems, University of New Hampshire
| | - Semra Aytur
- Department of Health Management and Policy, University of New Hampshire
| | | | - Josiemer Mattei
- Department of Nutrition, Harvard T.H. Chan School of Public Health
| | - Sabrina E Noel
- Department of Biomedical and Nutritional Sciences, University of Massachusetts Lowell
| | | | | | - Daniela Sotres-Alvarez
- Department of Biostatistics, University of North Carolina, Gillings School of Public Health
| | - Linda C Gallo
- Department of Psychology, San Diego State University
| | | | - Linda Van Horn
- Department of Preventative Medicine, Northwestern University
| | | | | | - Ashley E Moncrieft
- Department of Center for Applied Research Care, University of South Carolina
| | - Katherine L Tucker
- Department of Biomedical and Nutritional Sciences, University of Massachusetts Lowell
| | - Robert C Kaplan
- Department of Epidemiology and Population Health, Albert Einstein College of Medicine
- Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA 98109
| | - Sherman J Bigornia
- Department of Agriculture Nutrition and Food Systems, University of New Hampshire
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19
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Kaur SS, Tarraf W, Wu B, Gonzalez KA, Daviglus M, Shah N, Sotres-Alvarez D, Gallo LC, Wohlgemuth W, Redline S, Gonzalez HM, Ramos AR. Modifying pathways by age and sex for the association between combined sleep disordered breathing and long sleep duration with neurocognitive decline in the Hispanic Community Health Study/Study of Latinos (HCHS/SOL). Alzheimers Dement 2021; 17:1950-1965. [PMID: 34032354 DOI: 10.1002/alz.12361] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [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: 06/22/2020] [Revised: 02/09/2021] [Accepted: 04/07/2021] [Indexed: 12/10/2022]
Abstract
INTRODUCTION We aimed to determine whether obesity or metabolic syndrome (MetS) modify associations between sleep-disordered breathing (SDB), self-reported sleep duration (SD), and phenotypes of combined SDB/SD with 7-year neurocognitive decline (ND) in a community based-cohort of U.S. Hispanic/Latinos (N = 5500) in different age and sex groups. METHODS The exposures were baseline SDB (respiratory event index ≥ 15), sleepiness (Epworth Sleepiness Scale ≥ 10), SD (< 6 hours, 6-9 hours, ≥ 9 hours). The outcome was 7-year ND. RESULTS Mean age was 56.0 years, 54.8% were females. Obesity modified the association between SDB/SD and ND in memory (F = 21.49, P < 0.001) and global cognition (F = 9.14, P < 0.001) in the oldest age group. Women without MetS with combined long sleep/SDB exhibited most pronounced decline in global cognition (F = 3.07, P = 0.010). DISCUSSION The association between combined SDB/long sleep and declines in memory and global cognition was most pronounced in obese older adults. Among women, MetS status modified the association between long sleep/SDB and decline in global cognition.
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Affiliation(s)
- Sonya S Kaur
- University of Miami Miller School of Medicine, Miami, Florida, USA.,Evelyn F. McKnight Brain Institute, University of Miami Miller School of Medicine, Miami, Florida, USA
| | | | - Benson Wu
- University of California San Diego, San Diego, California, USA
| | | | | | - Neomi Shah
- Mount Sinai Icahn School of Medicine, New York, New York, USA
| | | | - Linda C Gallo
- San Diego State University, San Diego, California, USA
| | | | - Susan Redline
- Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | | | - Alberto R Ramos
- University of Miami Miller School of Medicine, Miami, Florida, USA.,Evelyn F. McKnight Brain Institute, University of Miami Miller School of Medicine, Miami, Florida, USA
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20
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McIntosh RC, Khambaty T, Llabre MM, Perreira KM, Gonzalez HM, Kansal MM, Tarraf W, Schneiderman N. Paradoxical effect of cumulative stress exposure on information processing speed in Hispanics/Latinos with elevated heart rate variability. Int J Psychophysiol 2021; 164:1-8. [PMID: 33524438 DOI: 10.1016/j.ijpsycho.2021.01.019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Revised: 01/24/2021] [Accepted: 01/26/2021] [Indexed: 11/19/2022]
Abstract
Chronic stress has a deleterious effect on prefrontal lobe functioning. Empirical evidence suggests elevated vagal tone, indexed by elevated heart rate variability (HRV), mitigates the effect of mental stress on frontal lobe function. Here, the mitigating effect of HRV on stress-related decrements in cognitive performance is assessed based on information processing speed (DSST), word fluency and verbal learning task performance. Artifact free electrocardiogram (ECG) data was analyzed from 1420 Hispanic/Latino adults from the Sociocultural Ancillary of the Hispanic Community Health Study/Study of Latinos (HCHS/SOL). A 12-lead ECG was used to collect short-term recordings of the root mean square of successive differences in all normal R-peak to R-peak intervals (RMSSD) and the change between adjacent beats and the standard deviation of those intervals (SDNN) as indices of total HRV. As predicted, an interaction emerged for HRV and stress on the task presumed to require the greatest prefrontal lobe involvement, i.e., the DSST. After accounting for sociodemographic factors, chronic stress was associated with better DSST performance amongst individuals at higher quartile of SDNN, but not RMSSD. The paradoxical effect for greater stress exposure on DSST performance may in part be explained by increased speed of information processing and decision making often reported in high-stress cohorts. The nature of this interaction highlights the importance of examining the relationship between stress and cognition across a spectrum of vagal tone.
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Affiliation(s)
- Roger C McIntosh
- Department of Psychology, University of Miami, Coral Gables, FL 33124, United States of America.
| | - Tasneem Khambaty
- Department of Psychology, University of Maryland, Baltimore County, MD 21250, United States of America.
| | - Maria M Llabre
- Department of Psychology, University of Miami, Coral Gables, FL 33124, United States of America.
| | - Krista M Perreira
- Department of Social Medicine, UNC at Chapel Hill, Chapel Hill 27599, United States of America.
| | - Hector M Gonzalez
- Department of Neurosciences, University of California San Diego, San Diego, CA 92093, United States of America.
| | - Mayank M Kansal
- Internal Medicine/Cardiology, University of Illinois at Chicago, Chicago, IL 60612, United States of America.
| | - Wassim Tarraf
- Institute of Gerontology and Department of Healthcare Sciences, Wayne State University, Detroit, MI 48202, United States of America.
| | - Neil Schneiderman
- Department of Psychology, University of Miami, Coral Gables, FL 33124, United States of America.
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Tarraf W, Wu B, Ramos AR, Gallo L, Stickel A, Gonzalez HM, Vasquez PM, Daviglus M, Zeng D, Schneiderman N, Lipton RB, Isasi CR, Lamar M, Smoller S, Cai J. Cardiovascular and stroke risk, cognitive change, and mild cognitive impairment: Results from the HCHS/SOL and SOL‐INCA. Alzheimers Dement 2020. [DOI: 10.1002/alz.044166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Affiliation(s)
| | - Benson Wu
- University of California San Diego La Jolla CA USA
| | | | | | - Ariana Stickel
- VA Greater Los Angeles Healthcare System Los Angeles CA USA
| | | | | | - Martha Daviglus
- University of Illinois at Chicago College of Medicine Chicago IL USA
| | - Donglin Zeng
- Gillings School of Global Public Health University of North Carolina Chapel Hill NC USA
| | | | | | | | | | | | - Jianwen Cai
- UNC Gillings School of Global Public Health Chapel Hill NC USA
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Stickel A, Tarraf W, Wu B, Marquine MJ, Vasquez PM, Daviglus M, Estrella ML, Perreira K, Gallo L, Lipton RB, Isasi CR, Kaplan R, Zeng D, Schneiderman N, Gonzalez HM. Daily functioning and cognition: Results from the Hispanic Community Health Study/Study of Latinos (HCHS/SOL) and Study of Latinos‐Investigation of Neurocognitive Aging (SOL‐INCA). Alzheimers Dement 2020. [DOI: 10.1002/alz.044165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
- Ariana Stickel
- Department of Neurosciences University of California, San Diego San Diego CA USA
| | | | - Benson Wu
- University of California San Diego La Jolla CA USA
| | | | | | - Martha Daviglus
- University of Illinois at Chicago College of Medicine Chicago IL USA
| | | | - Krista Perreira
- University of North Carolina School of Medicine Chapel Hill NC USA
| | | | | | | | | | - Donglin Zeng
- Gillings School of Global Public Health University of North Carolina Chapel Hill NC USA
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Zlatar Z, Tarraf W, Chai A, Vasquez PM, Marquine MJ, Lipton RB, Gallo L, Khambaty T, Zeng D, Youngblood M, Estrella ML, Isasi CR, Daviglus M, Gonzalez HM. Subjective cognitive decline is associated with neurocognition in the SOL‐INCA study. Alzheimers Dement 2020. [DOI: 10.1002/alz.044167] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
| | | | - Albert Chai
- University of California San Diego La Jolla CA USA
| | | | | | | | | | | | - Donglin Zeng
- Gillings School of Global Public Health University of North Carolina Chapel Hill NC USA
| | - Marston Youngblood
- Gillings School of Global Public Health University of North Carolina Chapel Hill NC USA
| | | | | | - Martha Daviglus
- University of Illinois at Chicago College of Medicine Chicago IL USA
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Gonzalez HM, Tarraf W, Gonzalez KA, Fornage M, Zeng D, Gallo L, Talavera GA, Daviglus M, Lipton RB, Kaplan R, Ramos AR, Lamar M, Cai J, DeCarli C, Schneiderman N. Diabetes, cognitive decline and mild cognitive impairment among diverse Hispanics/Latinos: Hispanic Community Health Study/Study of Latinos (HCHS‐SOL) investigation of cognitive aging results. Alzheimers Dement 2020. [DOI: 10.1002/alz.044601] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
| | | | | | - Myriam Fornage
- The University of Texas Health Science Center at Houston Houston TX USA
| | - Donglin Zeng
- Gillings School of Global Public Health University of North Carolina Chapel Hill NC USA
| | | | | | - Martha Daviglus
- University of Illinois at Chicago College of Medicine Chicago IL USA
| | | | | | | | | | - Jianwen Cai
- UNC Gillings School of Global Public Health Chapel Hill NC USA
| | - Charles DeCarli
- IDeA Laboratory Department of Neurology UC Davis Davis CA USA
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25
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Granot‐Hershkovitz E, Tarraf W, Kurniansyah N, Daviglus M, Isasi CR, Kaplan R, Lamar M, Perreira K, Smoller S, Stickel A, Thyagarajan B, Zeng D, Fornage M, DeCarli C, Gonzalez HM, Sofer T. APOE alleles' association with neurocognitive function differ across Hispanic background groups. Alzheimers Dement 2020. [DOI: 10.1002/alz.044169] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Affiliation(s)
| | | | | | - Martha Daviglus
- University of Illinois at Chicago College of Medicine Chicago IL USA
| | | | | | | | - Krista Perreira
- University of North Carolina School of Medicine Chapel Hill NC USA
| | | | - Ariana Stickel
- VA Greater Los Angeles Healthcare System Los Angeles CA USA
| | | | - Donglin Zeng
- Gillings School of Global Public Health University of North Carolina Chapel Hill NC USA
| | - Myriam Fornage
- The University of Texas Health Science Center at Houston Houston TX USA
| | - Charles DeCarli
- IDeA Laboratory Department of Neurology, UC Davis Davis CA USA
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Gonzalez HM, Wheat JE, Dengler KL, Barbier HM, Gehrich AP, Gruber DD, Warner WB. Does symptom severity predict response to low-dose onabotulinumtoxinA for the treatment of urgency urinary incontinence? Eur J Obstet Gynecol Reprod Biol 2020; 256:118-124. [PMID: 33212321 DOI: 10.1016/j.ejogrb.2020.10.052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Revised: 10/18/2020] [Accepted: 10/23/2020] [Indexed: 11/28/2022]
Abstract
OBJECTIVE Intradetrusor onabotulinumtoxinA is a third-line treatment for urgency urinary incontinence (UUI) which is customarily reserved for severe disease. We sought to determine if symptom severity predicts the proportional response to onabotulinumtoxinA and whether low-dose injection may be an appropriate treatment for mild-moderate symptoms. STUDY DESIGN This prospective cohort study compared patients with urgency urinary incontinence who were recruited from the Urogynecology Clinic with mild-moderate (2-9 episodes/3-day diary) and severe UUI (>9 episodes/3-day diary) symptoms. Twenty-eight subjects were treated (11 mild-moderate, 17 severe) with 50 units of intradetrusor onabotulinumtoxinA. Voiding diaries and validated questionnaires (UDI-6 and IIQ-7) were collected at baseline and one, six, and twelve months post-treatment. The primary outcome was the difference in percent reduction in UUI episodes per 3-day diary at one month. Secondary outcomes included differences in absolute reduction of UUI events, treatment success rate (defined as greater than 50% reduction in UUI episodes), changes in UDI-6 and IIQ-7 questionnaire scores, and rates of urinary retention, self-catheterization, and urinary tract infection. Normally distributed data are presented as means with standard deviations (SD) and groups were compared using the two sample t-test. Data that were not normally distributed are presented as medians with the interquartile range (IQR) and were compared using the Wilcoxon rank sum test. RESULTS The mild-moderate group showed median improvement; 100% (IQR: 100%, 100%) and severe group; 81% (IQR: 35%, 100%), p < 0.019. Both had significant improvement in UUI episodes; the mild-moderate group decreased by four and the severe group by 15. No differences were noted in percent reduction between groups. There was no association between baseline severity and percent reduction in UUI episodes (rs = 0.127, p = 0.544); however, absolute reduction was highly correlated (rs = -0.821, p < 0.001). Treatment success was 90% in mild-moderate and 73% in the severe group (p = 0.615). Complications included urinary tract infections (25%) and intermittent catheterization (3.6%). CONCLUSIONS Patients with both mild-moderate and severe symptoms showed a statistically significant improvement in UUI events from baseline to one month, but no difference between the groups in proportional improvement or treatment success.
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Affiliation(s)
- Hector M Gonzalez
- Department of Obstetrics and Gynecology, Walter Reed National Military Medical Center, 8901 Rockville Pike, Bethesda, MD 20852, United States; Institution of Study: Walter Reed National Military Medical Center, 8901 Rockville Pike, Bethesda, MD 20852, United States
| | - Joy E Wheat
- Department of Obstetrics and Gynecology, Walter Reed National Military Medical Center, 8901 Rockville Pike, Bethesda, MD 20852, United States; Institution of Study: Walter Reed National Military Medical Center, 8901 Rockville Pike, Bethesda, MD 20852, United States.
| | - Katherine L Dengler
- Department of Obstetrics and Gynecology, Walter Reed National Military Medical Center, 8901 Rockville Pike, Bethesda, MD 20852, United States; Institution of Study: Walter Reed National Military Medical Center, 8901 Rockville Pike, Bethesda, MD 20852, United States
| | - Heather M Barbier
- Department of Obstetrics and Gynecology, Walter Reed National Military Medical Center, 8901 Rockville Pike, Bethesda, MD 20852, United States; Institution of Study: Walter Reed National Military Medical Center, 8901 Rockville Pike, Bethesda, MD 20852, United States
| | - Alan P Gehrich
- Department of Obstetrics and Gynecology, Tripler Army Medical Center, 1 Jarrett White Rd, Tripler Army Medical Center, HI 96859, United States; Institution of Study: Walter Reed National Military Medical Center, 8901 Rockville Pike, Bethesda, MD 20852, United States
| | - Daniel D Gruber
- Department of Obstetrics and Gynecology, Walter Reed National Military Medical Center, 8901 Rockville Pike, Bethesda, MD 20852, United States; Institution of Study: Walter Reed National Military Medical Center, 8901 Rockville Pike, Bethesda, MD 20852, United States
| | - William B Warner
- Department of Obstetrics and Gynecology, Walter Reed National Military Medical Center, 8901 Rockville Pike, Bethesda, MD 20852, United States; Institution of Study: Walter Reed National Military Medical Center, 8901 Rockville Pike, Bethesda, MD 20852, United States
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27
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Wu B, Tarraf W, Wallace DM, Stickel A, Schneiderman N, Redline S, Patel SR, Gallo LC, Mossavar-Rahmani Y, Daviglus M, Zee PC, Talavera GA, Sotres-Alvarez D, Gonzalez HM, Ramos AR. 0609 Sleep Phenotypes in Middle-Aged and Older Hispanics/Latinos. Results from the Hispanic Community Health Study/Study of Latinos (HCHS/SOL). Sleep 2020. [DOI: 10.1093/sleep/zsaa056.606] [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: 11/15/2022] Open
Abstract
Abstract
Introduction
Identifying sleep phenotypes in the diverse and understudied US Hispanic/Latino population is critical to developing interventions and mitigating distal clinical outcomes (e.g. dementias).
Methods
Using latent class analyses (LCA), we identify empirically derived and clinically meaningful sleep phenotypes using data on community dwelling middle-aged/older adults (ages ≥45-years) from the HCHS/SOL (2008-2011) - Investigation of Neurocognitive Aging (n=6,377). Sleep variables used included Apnea/Hypopnea Index (AHI), percent time SpO2<90%, Epworth Sleepiness Scale (ESS), Women’s Health Initiative Insomnia Rating Scale (WHIIRS), self-reported average sleep duration, restless legs symptoms, napping frequency, and sleep quality.
Results
Mean (M) age was 56.4±8.1 years, and 54.7% were female. Average AHI, ESS, WHIIRS, and sleep duration were 8.7±13.1, 6.0±5.0, 7.6±5.5, and 7.8±1.4, respectively, and 25.8% had zero percent time SpO2 <90%. Fit statistics indicated that a four-class solution provided the best data fit. The derived classes, adjusting for age, sex, income, and acculturation, corresponded with four clinically meaningful groups: (1) 28.8% were asymptomatic [(M) AHI=0.8; (M) ESS=5.6; (M)WHIIRS=7.6; (M) sleep duration=7.8; 0% SpO2<90%=74.1%], (2) 25.7 % were asymptomatic mild sleep apnea [(M) AHI=6.2; (M) ESS=3.8; (M) WHIIRS=2.9; (M) sleep duration=7.8; 0% SpO2<90%=8.8%], (3) 19.4% were symptomatic sleep apnea [(M) AHI=25.6; (M) ESS=8.5; (M) WHIIRS=7.2; (M) sleep duration=7.7; 0% SpO2<90%= 0.5%], and (4) 26.1% were insomnia [(M) AHI=5.7; (M) ESS=6.7; (M) WHIIRS=13.0; (M) sleep duration=7.8; 0% SpO2<90%=10.3%]. Classification into groups 3 and 4 were primarily driven by elevated AHI and WHIIRS scores, respectively. The distribution of scores in the derived groups suggest variations relative to current clinical thresholds.
Conclusion
We identified 4-groups using LCA in a community-based sample of diverse U.S. Hispanic/Latino adults. Better characterization of sleep phenotypes for Hispanics/Latinos can help in developing targeted interventions studies and ameliorate health disparities.
Support
5R01AG048642-05; R21AG056952; R21HL140437.
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Affiliation(s)
- B Wu
- Department of Neurosciences and Shiley-Marcos Alzheimer’s Disease Research Center, University of California, San Diego, La Jolla, CA, University of California San Diego, CA
| | - W Tarraf
- Institute of Gerontology & Department of Healthcare Sciences, Wayne State University, Detroit, Michigan, Wayne State University, MI
| | - D M Wallace
- University of Miami, Miller School of Medicine, University of Miami, FL
| | - A Stickel
- Department of Neurosciences and Shiley-Marcos Alzheimer’s Disease Research Center, University of California, San Diego, La Jolla, CA, University of California San Diego, CA
| | - N Schneiderman
- University of Miami, Department of Psychology, University of Miami, FL
| | - S Redline
- Harvard Medical School, Harvard University, MA
| | - S R Patel
- University of Pittsburgh, School of Medicine, University of Pittsburgh, PA
| | - L C Gallo
- Institute for Behavioral and Community Health, Graduate School of Public Health, San Diego State University, San Diego, California, San Diego, CA
| | - Y Mossavar-Rahmani
- Albert Einstein College of Medicine, Department of Epidemiology & Population Health, Bronx, NY
| | - M Daviglus
- Institute for Minority Health Research, University of Illinois at Chicago, College of Medicine, Chicago, Illinois, Chicago, IL
| | - P C Zee
- Northwestern University, Feinberg School of Medicine, Department of Neurology, Chicago, IL
| | - G A Talavera
- Institute for Behavioral and Community Health, Graduate School of Public Health, San Diego State University, San Diego, California, San Diego, CA
| | - D Sotres-Alvarez
- University of North Carolina, Department of Biostatistics, Chapel Hill, NC
| | - H M Gonzalez
- Department of Neurosciences and Shiley-Marcos Alzheimer’s Disease Research Center, University of California, San Diego, La Jolla, CA, University of California San Diego, CA
| | - A R Ramos
- University of Miami, Miller School of Medicine, Miami, FL
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Gonzalez KT, Tarraf W, Wallace DM, Stickel A, Schneiderman N, Redline S, Patel SR, Gallo LC, Mossavar-Rahmani Y, Daviglus M, Zee PC, Talavera GA, Sotres-Alvarez D, Gonzalez HM, Ramos AR. 0607 Clinical Phenotypes of OSA in Diverse Hispanics/Latinos: Results from the Hispanic Community Health Study/Study of Latinos. Sleep 2020. [DOI: 10.1093/sleep/zsaa056.604] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Introduction
Recent work on US non-Latino Whites and Europeans from clinical samples used obstructive sleep apnea (OSA) symptoms to generate OSA phenotypes for individuals with moderate-severe OSA and proposed between 3-5 clusters. Validating these clusters in a diverse Hispanic/Latino community-based population with different biopsychosocial characteristics is crucial for early OSA identification and more personalized treatment.
Methods
This work is based on baseline data from The Hispanic Community Health Study/Study of Latinos (HCHS/SOL). HCHS/SOL is a prospective cohort study designed using a multisite (Bronx, NY, Chicago, IL, Miami, FL, San Diego, CA) multistage probability sample. The subpopulation of interest included adults 18-74 years (unweighted n=1,623) meeting criteria for moderate-severe OSA symptoms (≥15 Apnea-Hypopnea index (AHI) events per hour). We performed latent class analysis (LCA) using 15 common OSA symptoms to identify phenotype clusters.
Results
Average age was 52.4 ± 13.9 years and 34.1% were female. Mean AHI was 33.8 ± 22.5 events per hour. Fit statistics and clinical significance suggested that a three-class solution provided best fit to the data. The symptom profiles were consistent with (1) a Minimally Symptomatic group (46.8%), (2) a Disturbed Sleep group (38.1%), and (3) a Daytime Sleepiness group (15.1%). Validation analyses using alternative hierarchical and partitioning algorithms also suggested support for a three-class solution.
Conclusion
Sleep apnea phenotypes among diverse Hispanics/Latinos were consistent with recent findings from the Sleep Apnea Global Interdisciplinary Consortium. However, we found notable differences in the prevalence of these clusters relative to Whites. This suggests that other biopsychosocial factors may be contributing to OSA phenotypes among Hispanics/Latinos. Identification of OSA phenotypes in Hispanics/Latinos could inform better sleep interventions and therapeutics and help better align public health resources.
Support
5R01AG048642-05; R21AG056952; R21HL140437.
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Affiliation(s)
- K T Gonzalez
- Department of Neurosciences and Shiley-Marcos Alzheimer’s Disease Research Center, University of California, San Diego, La Jolla, CA
| | - W Tarraf
- Wayne State University, Detroit, MI
| | | | - A Stickel
- Department of Neurosciences and Shiley-Marcos Alzheimer’s Disease Research Center, University of California, San Diego, La Jolla, CA
| | | | - S Redline
- Harvard Medical School, Harvard University, MA
| | - S R Patel
- University of Pittsburgh, School of Medicine, University of Pittsburgh, PA
| | - L C Gallo
- Institute for Behavioral and Community Health, Graduate School of Public Health, San Diego State University, San Diego, California
| | - Y Mossavar-Rahmani
- Albert Einstein College of Medicine, Department of Epidemiology & Population Health, Bronx, NY
| | - M Daviglus
- Institute for Minority Health Research, University of Illinois at Chicago, College of Medicine, Chicago, Illinois
| | - P C Zee
- Northwestern University, Feinberg School of Medicine, Department of Neurology, Chicago, IL
| | - G A Talavera
- Institute for Behavioral and Community Health, Graduate School of Public Health, San Diego State University, San Diego, California
| | | | - H M Gonzalez
- Department of Neurosciences and Shiley-Marcos Alzheimer’s Disease Research Center, University of California, San Diego, La Jolla, CA
| | - A R Ramos
- University of Miami, Miller School of Medicine, Miami, FL
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Ramos AR, Tarraf W, Wu B, Redline S, Cai J, Daviglus ML, Gallo L, Mossavar-Rahmani Y, Perreira KM, Zee P, Zeng D, Gonzalez HM. Sleep and neurocognitive decline in the Hispanic Community Health Study/Study of Latinos. Alzheimers Dement 2020; 16:305-315. [PMID: 31606367 DOI: 10.1016/j.jalz.2019.08.191] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
INTRODUCTION To determine if sleep-disordered breathing (SDB), daytime sleepiness, insomnia, and sleep duration predict seven-year neurocognitive decline in US Hispanics/Latinos (N = 5247). METHODS The exposures were baseline SDB, daytime sleepiness, insomnia, and sleep duration. The outcomes were change in episodic learning and memory (B-SEVLT-Sum and SEVLT-Recall), language (word fluency [WF]), processing speed (Digit Symbol Substitution), and a cognitive impairment screener (Six-item Screener [SIS]). RESULTS Mean age was 63 ± 8 years, with 55% of the population being female with 7.0% Central American, 24.5% Cuban, 9.3% Dominican, 35.9% Mexican, 14.4% Puerto Rican, and 5.1% South American background. Long sleep (>9 hours), but not short sleep (<6 hours), was associated with decline (standard deviation units) in episodic learning and memory (βSEVLT-Sum = -0.22 [se = 0.06]; P < .001; βSEVLT-Recall = -0.13 [se = 0.06]; P < .05), WF (Pwf = -0.20 [se 5 0.06]; P < .01), and SIS (βSIS = -0.16 [se = 0.06]; P < .01), but not processing speed, after adjusting for covariates. SDB, sleepiness, and insomnia were not associated with neurocognitive decline. CONCLUSION Long sleep duration predicted seven-year cognitive decline.
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Affiliation(s)
- Alberto R Ramos
- University of Miami, Miller School of Medicine, Miami, FL, USA
| | | | - Benson Wu
- University of California San Diego, San Diego, CA, USA
| | | | - Jianwen Cai
- University of North Carolina, Chapel Hill, NC, USA
| | | | - Linda Gallo
- San Diego State University, San Diego, CA, USA
| | | | | | - Phyllis Zee
- Feinberg School of Medicine, Chicago, IL, USA
| | - Donglin Zeng
- University of North Carolina, Chapel Hill, NC, USA
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30
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Ramos AR, Tarraf W, Cai J, Daviglus M, Gallo L, Mossavar-Rahmani Y, Perreira KM, Redline S, Zee P, Zeng D, Gonzalez HM. 0695 Sleep And Neurocognitive Change In The Hispanic Community Health Study/Study Of Latinos (HCHS/SOL). Sleep 2019. [DOI: 10.1093/sleep/zsz067.693] [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)
- Alberto R Ramos
- Neurology, University of Miami, Miller School of Medicine, Miami, FL, USA
| | | | - Jianwen Cai
- University of North Carolina, Chapel Hill, NC, USA
| | - Martha Daviglus
- University of Illinois College of Medicine, Chicago, IL, USA
| | - Linda Gallo
- San Diego State University, San Diego, CA, USA
| | | | | | | | - Phyllis Zee
- Feinberg School of Medicine, Chicago, IL, USA
| | - Donglin Zeng
- University of North Carolina, Chapel Hill, NC, USA
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31
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Estrella ML, Rosenberg NI, Durazo-Arvizu RA, Gonzalez HM, Loop MS, Singer RH, Lash JP, Castañeda SF, Perreira KM, Eldeirawi K, Daviglus ML. The association of employment status with ideal cardiovascular health factors and behaviors among Hispanic/Latino adults: Findings from the Hispanic Community Health Study/Study of Latinos (HCHS/SOL). PLoS One 2018; 13:e0207652. [PMID: 30481192 PMCID: PMC6258516 DOI: 10.1371/journal.pone.0207652] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2017] [Accepted: 11/05/2018] [Indexed: 12/04/2022] Open
Abstract
Background The American Heart Association’s 2020 Impact Goals propose to improve cardiovascular health (CVH) and reduce deaths from cardiovascular diseases and stroke in the US. Targeted health promotion efforts in workplaces and communities are needed to achieve these population-level changes. The present study examined the sex-specific cross-sectional associations between employment status and ideal CVH among Hispanics/Latinos, and whether these associations were modified by age (i.e., younger adults [aged 18–44] compared to middle-aged and older adults [aged 45–74]). Methods This study included 4,797 males and 7,043 females (aged 18–74) from the Hispanic Community Health Study / Study of Latinos. Employment status was categorized as employed full-time (FT), employed part-time (PT), employed (FT or PT) and homemakers, homemakers only, and unemployed. CVH metrics, operationalized as ‘ideal’ versus ‘less than ideal,’ included health factors (i.e., blood pressure, cholesterol, and fasting glucose) and health behaviors (i.e., body mass index, smoking, physical activity [PA], and diet). A total CVH score was derived based on the seven CVH metrics, and dichotomized as ideal vs. less than ideal (score of 11–14 vs. 0–10). Survey-based generalized linear regression models with Gaussian binomial distribution were used to estimate adjusted prevalence differences (APDs) and their 95% confidence intervals (CIs) for the associations between employment status (with employed FT as referent) and ideal CVH (total score and each metric), adjusting for socio-demographic characteristics. Effect modification by age was examined. Results Among males, compared to their employed FT counterparts, those who were employed PT had a higher prevalence of ideal CVH score (APD = 6.8, 95% CI = 1.7, 11.8), ideal BMI (APD = 8.5, 95% CI = 3.0, 14.0), and ideal PA (APD = 4.8, 95% CI = 0.9, 8.7). Age modified the associations of employment type with ideal CVH score and ideal BMI, i.e., younger males who were employed PT had a higher prevalence of ideal CVH score and ideal BMI. Among females, employment status was not associated with ideal CVH score. Compared to females employed FT, females who were homemakers had a lower prevalence of ideal (non-) smoking (APD = -4.7, 95% CI = -8.5, -1.0) and ideal PA (APD = -7.9, 95% CI = -12.7, -3.0), and females who were unemployed had a lower prevalence of ideal PA (APD = -10.4, 95% CI = -16.7, -4.1). Age modified the associations of employment type with ideal fasting glucose and ideal PA, i.e., middle-aged and older females who were homemakers or unemployed had a lower prevalence of ideal fasting glucose and ideal PA. Conclusions Hispanic/Latino males who were employed PT had the most favorable CVH profiles but these associations were mostly driven by better CVH (total score and metrics) among younger males. Hispanic/Latino females who were homemakers or unemployed had lower rates of ideal CVH metrics.
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Affiliation(s)
- Mayra L. Estrella
- Institute for Minority Health Research, College of Medicine, University of Illinois at Chicago, Chicago, IL, United States of America
- * E-mail:
| | - Natalya I. Rosenberg
- Institute for Minority Health Research, College of Medicine, University of Illinois at Chicago, Chicago, IL, United States of America
| | - Ramon A. Durazo-Arvizu
- Institute for Minority Health Research, College of Medicine, University of Illinois at Chicago, Chicago, IL, United States of America
- Department of Public Health Sciences, Loyola University Medical Center, Maywood, IL, United States of America
| | - Hector M. Gonzalez
- Department of Neurosciences, University of California San Diego, San Diego, CA, United States of America
| | - Matthew S. Loop
- Department of Biostatistics, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States of America
| | - Richard H. Singer
- Department of Public Health Sciences, University of Miami Miller School of Medicine, Miami, FL, United States of America
| | - James P. Lash
- Division of Nephrology, College of Medicine, University of Illinois at Chicago, Chicago, IL, United States of America
| | - Sheila F. Castañeda
- Graduate School of Public Health, San Diego State University, San Diego, CA, United States of America
| | - Krista M. Perreira
- Department of Social Medicine, School of Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC, United States of America
| | - Kamal Eldeirawi
- Department of Health Systems Science, College of Nursing, University of Illinois at Chicago, Chicago, IL, United States of America
| | - Martha L. Daviglus
- Institute for Minority Health Research, College of Medicine, University of Illinois at Chicago, Chicago, IL, United States of America
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Gonzalez HM, Tarraf W. P1‐595: AN INTRODUCTION TO AND OVERVIEW OF THE STUDY OF LATINOS–INVESTIGATION OF NEUROCOGNITIVE AGING (SOL‐INCA). Alzheimers Dement 2018. [DOI: 10.1016/j.jalz.2018.06.607] [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]
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Tarraf W, Gonzalez HM. O5‐07‐02: U.S. RACE/ETHNIC MINORITIES AT HIGH COGNITIVE RISK USE LESS HEALTHCARE RESOURCES. Alzheimers Dement 2018. [DOI: 10.1016/j.jalz.2018.06.3032] [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]
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Rascovsky K, Teylan M, McMillan CT, Barlow N, Gonzalez HM, Salmon DP, Galasko DR, Besser LM, Kukull WA, Grossman M. P3‐565: RISK FACTORS FOR CLINICAL AD IN U.S. LATINO POPULATIONS: AN ANALYSIS OF THE NACC DATABASE. Alzheimers Dement 2018. [DOI: 10.1016/j.jalz.2018.06.1931] [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)
- Katya Rascovsky
- Perelman School of MedicineUniversity of PennsylvaniaPhiladelphiaPAUSA
| | - Merilee Teylan
- National Alzheimer's Coordinating CenterUniversity of WashingtonSeattleWAUSA
| | - Corey T. McMillan
- Perelman School of MedicineUniversity of PennsylvaniaPhiladelphiaPAUSA
| | - Nicole Barlow
- National Alzheimer's Coordinating CenterUniversity of WashingtonSeattleWAUSA
| | | | | | | | - Lilah M. Besser
- National Alzheimer's Coordinating CenterUniversity of WashingtonSeattleWAUSA
| | - Walter A. Kukull
- National Alzheimer's Coordinating CenterUniversity of WashingtonSeattleWAUSA
| | - Murray Grossman
- Perelman School of MedicineUniversity of PennsylvaniaPhiladelphiaPAUSA
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Fornage M, Jian X, Sofer T, Tarraf W, Laurie C, Gonzalez HM. [O1–03–03]: GENOME‐WIDE ASSOCIATION STUDY IDENTIFIES NOVEL GENETIC VARIANTS FOR NEUROCOGNITIVE FUNCTION AMONG HISPANICS/LATINOS: THE HCHS/SOL STUDY. Alzheimers Dement 2017. [DOI: 10.1016/j.jalz.2017.07.047] [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)
- Myriam Fornage
- University of Texas Health Science Center at Houston McGovern Medical SchoolHoustonTXUSA
| | - Xueqiu Jian
- University of Texas Health Science Center at Houston McGovern Medical SchoolHoustonTXUSA
| | - Tamar Sofer
- University of Texas Health Science Center at Houston McGovern Medical SchoolHoustonTXUSA
| | - Wassim Tarraf
- University of Texas Health Science Center at Houston McGovern Medical SchoolHoustonTXUSA
- Michigan State UniversityEast LansingMIUSA
| | - Cathy Laurie
- University of Texas Health Science Center at Houston McGovern Medical SchoolHoustonTXUSA
- Wayne State UniversityDetroitMIUSA
| | - Hector M. Gonzalez
- University of Texas Health Science Center at Houston McGovern Medical SchoolHoustonTXUSA
- University of WashingtonSeattleWAUSA
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Gonzalez HM. [FTS5–02–10]: DISPARITIES DISCUSSION. Alzheimers Dement 2017. [DOI: 10.1016/j.jalz.2017.07.503] [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: 10/18/2022]
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Lamar M, Wu D, Durazo-Arvizu RA, Brickman AM, Gonzalez HM, Tarraf W, Daviglus ML. Cognitive Associates of Current and More Intensive Control of Hypertension: Findings From the Hispanic Community Health Study/Study of Latinos. Am J Hypertens 2017; 30:624-631. [PMID: 28402388 DOI: 10.1093/ajh/hpx023] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2016] [Accepted: 01/30/2017] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Hypertension control in Hispanics/Latinos lag behind general US trends by 10-15%. Intensive systolic blood pressure (SBP) management <120 mm Hg may significantly reduce morbidity/mortality risk in adults with hypertension; less is known about cognition. We investigated cross-sectional associations of cognition with observed hypertension control at currently recommended (SBP < 140 mm Hg) and more intensive (SBP < 120 mm Hg) levels using baseline data from the Hispanic Community Health Study/Study of Latinos. METHODS From this multicenter cohort study, we focused on 1,735 Hispanic/Latino men and women ages 45-74 years with hypertension and verified antihypertensive use. Verbal fluency, information processing speed, learning, and memory were tested in Spanish or English. RESULTS Separate linear regressions revealed that being on 1 vs. >1 antihypertensive medication was not associated with cognition; however, individuals with SBP controlled to currently recommended levels outperformed individuals with uncontrolled SBP on verbal fluency [Beta = 1.44 (0.52), P < 0.01] and information processing speed [Beta = 3.01 (0.89), P < 0.001] in age-adjusted regression analyses; only information processing speed remained significant (P < 0.05) after additional adjustments including acculturation, health insurance, and other cardiovascular disease risk factors. When regrouping individuals based on more intensive SBP control, individuals with levels <120 mm Hg outperformed individuals with higher SBP on verbal fluency regardless of adjustments (P < 0.01). More intensive rather than currently recommended levels of control associated with higher verbal fluency performance regardless of adjustments (P < 0.05). CONCLUSIONS Individual cognitive test scores related to distinct SBP management with more intensive management appearing more robust against confounders. While cognitive associations with hypertension in Hispanics/Latinos may be multifactorial, different levels of SBP control should be considered in future prospective intervention studies.
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Affiliation(s)
- Melissa Lamar
- Department of Medicine, University of Illinois at Chicago, Chicago, Illinois, USA
- Institute for Minority Health Research, University of Illinois at Chicago, Chicago, Illinois, USA
| | - Donghong Wu
- Institute for Minority Health Research, University of Illinois at Chicago, Chicago, Illinois, USA
| | - Ramon A. Durazo-Arvizu
- Institute for Minority Health Research, University of Illinois at Chicago, Chicago, Illinois, USA
| | - Adam M. Brickman
- Taub Institute for Research on Alzheimer’s Disease and the Aging Brain and the Gertrude H. Sergievsky Center, Columbia University, New York, New York, USA
| | - Hector M. Gonzalez
- Department of Epidemiology and Biostatistics, Michigan State University, East Lansing, Michigan, USA
| | - Wassim Tarraf
- Institute of Gerontology, Wayne State University, Detroit, Michigan, USA
| | - Martha L. Daviglus
- Department of Medicine, University of Illinois at Chicago, Chicago, Illinois, USA
- Institute for Minority Health Research, University of Illinois at Chicago, Chicago, Illinois, USA
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McCauley JF, Gonzalez HM, Osborn DJ. OnabotulinumtoxinA vs Sacral Neuromodulation for Urgency Incontinence. JAMA 2017; 317:535. [PMID: 28170474 DOI: 10.1001/jama.2016.19563] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
- John F McCauley
- Department of Urology, Walter Reed National Military Medical Center, Bethesda, Maryland
| | - Hector M Gonzalez
- Department of Obstetrics and Gynecology, Walter Reed National Military Medical Center, Bethesda, Maryland
| | - David James Osborn
- Department of Urology, Walter Reed National Military Medical Center, Bethesda, Maryland
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Williams DR, Gonzalez HM, Williams S, Mohammed SA, Moomal H, Stein DJ. Perceived discrimination, race and health in South Africa. Soc Sci Med 2008; 67:441-52. [PMID: 18486292 DOI: 10.1016/j.socscimed.2008.03.021] [Citation(s) in RCA: 194] [Impact Index Per Article: 12.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2007] [Indexed: 10/22/2022]
Abstract
To assess the levels of perceived acute and chronic racial and non-racial discrimination in South Africa, their association with health, and the extent to which they contribute to racial differences in physical and mental health, data were used from a national probability sample of adults, the South African Stress and Health Study (SASH). All Black groups in South Africa (African, Coloured and Indian) were two to four times more likely than Whites to report acute and chronic experiences of racial discrimination. Africans and Coloureds report higher levels of ill health than Whites, but acute and chronic racial discrimination were unrelated to ill health and unimportant in accounting for racial differences in self-rated health. In contrast, all Black groups had higher levels of psychological distress than Whites, and perceived chronic discrimination was positively associated with distress. Moreover, these experiences accounted for some of the residual racial differences in distress after adjustment for socioeconomic status. Our main findings indicate that, in a historically racialized society, perceived chronic racial and especially non-racial discrimination acts independently of demographic factors, other stressors, psychological factors (social desirability, self-esteem and personal mastery), and multiple SES indicators to adversely affect mental health.
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Affiliation(s)
- David R Williams
- Harvard School of Public Health Boston, Department of Society, Human Development and Health, Boston, MA 02115, USA.
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Gonzalez HM. P3–058: Executive function and functional impairment in a community–dwelling sample with low education and literacy. Alzheimers Dement 2006. [DOI: 10.1016/j.jalz.2006.05.1325] [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: 10/24/2022]
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Haan MN, Young EA, Gonzalez HM, Ranjit N, Jagust WJ. P2-279 Does type 2 diabetes attenuate cortisol variability in demented Mexican Americans? Neurobiol Aging 2004. [DOI: 10.1016/s0197-4580(04)81024-8] [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: 10/26/2022]
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Wu JH, Haan MN, Liang J, Ghosh D, Gonzalez HM, Herman WH. Impact of diabetes on cognitive function among older Latinos: a population-based cohort study. J Clin Epidemiol 2003; 56:686-93. [PMID: 12921938 DOI: 10.1016/s0895-4356(03)00077-5] [Citation(s) in RCA: 77] [Impact Index Per Article: 3.7] [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: 11/19/2022]
Abstract
BACKGROUND AND OBJECTIVES Type 2 diabetes, which is highly prevalent in older Mexican Americans, may influence cognitive functioning. We examined the association of diabetes with decline in global cognitive function and memory function over a 2-year period. METHODS Study subjects were derived from an existing cohort of Latinos aged 60 and over in the SALSA project (n=1,789). Statistical analysis was conducted using logistic regression and a generalized estimating equation (GEE). RESULTS Logistic regression analysis indicated that baseline diabetes was a significant predictor of major cognitive impairment in Modified Mini Mental State Exam (3MSE) (OR=1.68, 95% CI=1.21, 2.34) and word-list test (OR=1.31, 95% CI=0.99, 1.75). GEE analysis showed that there was no significant difference between diabetic and nondiabetic subjects in change of cognitive scores over 2 years (3MSE, mean=-0.58, 95% CI=-1.48, 0.32; word-list test, mean=-0.10, 95% CI=-0.32, 0.11). CONCLUSIONS More diabetic complications were associated with major cognitive decline among diabetic subjects. Research on long-term impact of treatment for type 2 diabetes is warranted.
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Affiliation(s)
- Jasmanda H Wu
- University of Michigan, School of Public Health, Department of Epidemiology, 611 Church St., Ann Arbor, MI 48104, USA
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Wu JH, Haan MN, Liang J, Ghosh D, Gonzalez HM, Herman WH. Impact of antidiabetic medications on physical and cognitive functioning of older Mexican Americans with diabetes mellitus: a population-based cohort study. Ann Epidemiol 2003; 13:369-76. [PMID: 12821276 DOI: 10.1016/s1047-2797(02)00464-7] [Citation(s) in RCA: 49] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
PURPOSE The current study was designed to evaluate the utility of antidiabetic medications in affecting changes in physical and cognitive functioning among older Mexican Americans with diabetes over a 2-year period. METHODS A longitudinal analysis with repeated measurements between 1999 and 2001 was performed in a cohort of Mexican Americans, 60 or older, in the SALSA Project. Statistical analysis was conducted using a generalized estimating equation. RESULTS For subjects with diagnosed diabetes </= 5 years (N = 381), there was less decline in physical and cognitive functioning over 2 years among subjects on treatment, compared to those without treatment. For subjects with diagnosed diabetes of 5+ years (N = 337), the effect of antidiabetic medications was more significant in preventing the decline in physical and cognitive functioning (ADL: mean in log scale = -0.10, 95% CI = -0.16, -0.04, 3MS: mean = 6.35, 95% CI = 3.23, 9.48). Combination therapy of antidiabetic agents appeared to be more effective than monotherapy in preventing the decline in physical and cognitive functioning for subjects. CONCLUSIONS Antidiabetic drugs appear to be useful in alleviating the decline in physical and cognitive functioning among older Mexican Americans with diabetes, especially for those with a longer duration of the disease.
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Affiliation(s)
- Jasmanda H Wu
- University of Michigan, School of Public Health, Epidemiology, Ann Arbor, MI 48109, USA
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Wu JH, Haan MN, Liang J, Ghosh D, Gonzalez HM, Herman WH. Diabetes as a predictor of change in functional status among older Mexican Americans: a population-based cohort study. Diabetes Care 2003; 26:314-9. [PMID: 12547855 DOI: 10.2337/diacare.26.2.314] [Citation(s) in RCA: 74] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVE Epidemiological studies have demonstrated that older Mexican Americans are at high risk for type 2 diabetes and its complications. Type 2 diabetes leads to a more rapid decline in functional status among older Mexican Americans with diabetes. This study was designed to examine the impact of diabetes on change in self-reported functional status over a 2-year period among older Mexican Americans with diabetes. RESEARCH DESIGN AND METHODS We performed a longitudinal analysis with repeated measurements of functional limitations in a cohort of Mexican Americans aged > or =60 years in the Sacramento Area Latino Study on Aging (SALSA). Diabetes was diagnosed on the basis of self-report of physician diagnosis, medication use, and fasting plasma glucose. Functional status was measured by assessment of activities of daily living (ADL) and instrumental activities of daily living (IADL) at baseline and 1 and 2 years. RESULTS Of 1,789 SALSA participants, 585 (33%) had diabetes at baseline. Diabetic subjects reported 74% more limitations than nondiabetic subjects in ADL (summary score for number of limitations, 0.99 vs. 0.57; P = 0.002) and 50% more limitations in IADL (summary score for number of limitations, 7.83 vs. 5.25; P < 0.0001). The annual rate of increase in limitations of ADL and IADL was 0.046 and 0.033 (log scale) on each scale among diabetic subjects compared with 0.013 and 0.003 (log scale) among nondiabetic subjects (P < 0.0005). Complications of diabetes were found to increase ADL and IADL limitations among diabetic subjects. Longer duration of diabetes was also associated with an increase in ADL and IADL limitations. CONCLUSIONS There was lower baseline functional status and a more rapid decline in functional status among older Mexican Americans with diabetes versus those without diabetes.
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Affiliation(s)
- Jasmanda H Wu
- Department of Epidemiology, University of Michigan, School of Public Health, Ann Arbor 48109, USA
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Haan MN, Mungas DM, Gonzalez HM, Ortiz TA, Acharya A, Jagust WJ. Prevalence of dementia in older latinos: the influence of type 2 diabetes mellitus, stroke and genetic factors. J Am Geriatr Soc 2003; 51:169-77. [PMID: 12558712 DOI: 10.1046/j.1532-5415.2003.51054.x] [Citation(s) in RCA: 308] [Impact Index Per Article: 14.7] [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: 11/20/2022]
Abstract
OBJECTIVES To estimate dementia prevalence in older Mexican Americans, determine the distribution of dementia by etiology, and evaluate the contribution of type 2 diabetes mellitus, stroke, and apolipoprotein E (ApoE) genotype to dementia. DESIGN Analysis of baseline data from an epidemiological cohort study. SETTING Sacramento Valley, California. PARTICIPANTS One thousand seven hundred eighty-nine Latinos aged 60 and older residing in targeted census tracts during 1998-99. MEASUREMENTS Each subject was interviewed and screened for dementia and cardiovascular risk factors and diseases. Fasting blood samples were drawn for glucose, insulin, and lipids. Buccal cells were obtained for genetic analysis of ApoE. A three-stage process of screening was used to diagnose dementia, including cognitive testing, a clinical examination, and imaging to determine etiology. Presence of dementia was established according to National Institute of Neurological Disorders and Stroke/Alzheimers and Related Disorders Association criteria and California Alzheimer's Disease Diagnostic and Treatment Criteria. RESULTS Overall dementia prevalence was 4.8%. Prevalence in those aged 85 and older was 31%. Education and Anglo cultural orientation was negatively associated with dementia risk. Risk of dementia was nearly eight times higher in those with both type 2 diabetes mellitus and stroke. Forty-three percent of dementia was attributable to type 2 diabetes mellitus, stroke, or a combination of the two. ApoE allele frequency was E2 5.9%, E3 90.1%, and E4 4%. Those with any E4 and 4-4 combinations had a higher risk for dementia than those with the E3-3 combination. CONCLUSIONS Dementia prevalence in this ethnic group is similar to that reported in Canadian and European studies but lower than in Caribbean-Hispanics residing in the United States. The etiological fraction of dementia attributable to type 2 diabetes mellitus and stroke is substantial and points toward the need for intervention research and treatment with the goal of reducing neurological sequelae in groups with high prevalence of type 2 diabetes mellitus. The allele frequency of ApoE was similar to that in other published studies on Mexican Americans. The low frequency of the E4 allele may contribute to the difference in etiology of dementia in older Mexican Americans and older people of European background. Dementia in this ethnic group may be related to preventable causes, with a smaller genetic component than in Europeans.
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Affiliation(s)
- Mary N Haan
- Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, Michigan 48109, USA.
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Wu JH, Haan, Liang J, Ghosh D, Gonzalez HM, Jagust WJ, Mungas DM, Herman WH. #27 Diabetes as a predictor of change in cognitive functioning among older mexican americans – a population-based cohort study. Ann Epidemiol 2002. [DOI: 10.1016/s1047-2797(02)00315-0] [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]
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Wu JH, Haan, Liang J, Ghosh D, Gonzalez HM, Jagust WJ, Herman WH. #28 Impact of antidiabetic medications on physical and cognitive functioning of older mexican americans with diabetes mellitus. Ann Epidemiol 2002. [DOI: 10.1016/s1047-2797(02)00316-2] [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: 10/27/2022]
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Leon BR, Carrillo FJ, Gonzalez HM, Franco JL. Mandibular reconstruction with the free vascularized fibular flap: utility of three-dimensional computerized tomography. J Reconstr Microsurg 1999; 15:91-7; discussion 97-9. [PMID: 10088918 DOI: 10.1055/s-2007-1000076] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.4] [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: 10/21/2022]
Abstract
Oncologic management in the mandibular area leaves important osseous defects, that require reconstructive procedures with vascularized osseous tissues. Mandibular reconstructions with free vascularized fibular flaps have well-defined indications and some advantages over various other types of vascularized osseous grafts, because the fibular graft permits the reconstruction of large mandibular defects. This study demonstrates the usefulness of three-dimensional (3D) tomography as a tool to determine the size of the defect, and with angiotomography, to define the anatomic pattern of the vascular pedicle. Five patients with varying mandibular tumors and osseous defects were evaluated with 3D tomography in the pre- and postoperative periods. Two patients were immediately reconstructed with vascularized fibular flaps. 3D preoperative tomography showed the dimensions of the tumor, the dimensions of the mandibular resection, and the graft vascular pattern. Three patients were secondarily reconstructed, two of them with partial mandibular defects, and one patient with total mandibular reconstruction. In the preoperative period, 3D tomography was used to determine the dimensions of the mandibular defect, as well as the area of the osteotomies. The technology permits an exact knowledge of the dimension of mandibular defects, allowing better planning of reconstructive procedures.
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Affiliation(s)
- B R Leon
- Department of Plastic and Reconstructive Surgery, Instituto Nacional de Cancerologia, Mexico City, Mexico
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