Fish intake and MRI burden of cerebrovascular disease in older adults

AbstractAntidepressant outcomes in older adults with depression is poor, possibly because of comorbidities such as cerebrovascular disease. Therefore, we leveraged multiple genome-wide approaches to understand the genetic architecture of antidepressant response. Our sample included 307 older adults (≥60 years) with current major depression, treated with venlafaxine extended-release for 12 weeks. A standard genome-wide association study (GWAS) was conducted for post-treatment remission status, followed by in silico biological characterization of associated genes, as well as polygenic risk scoring for depression, neurodegenerative and cerebrovascular disease. The top-associated variants for remission status and percentage symptom improvement were PIEZO1 rs12597726 (OR = 0.33 [0.21, 0.51], p = 1.42 × 10−6) and intergenic rs6916777 (Beta = 14.03 [8.47, 19.59], p = 1.25 × 10−6), respectively. Pathway analysis revealed significant contributions from genes involved in the ubiquitin-proteasome system, which regulates intracellular protein degradation with has implications for inflammation, as well as atherosclerotic cardiovascular disease (n = 25 of 190 genes, p = 8.03 × 10−6, FDR-corrected p = 0.01). Given the polygenicity of complex outcomes such as antidepressant response, we also explored 11 polygenic risk scores associated with risk for Alzheimer’s disease and stroke. Of the 11 scores, risk for cardioembolic stroke was the second-best predictor of non-remission, after being male (Accuracy = 0.70 [0.59, 0.79], Sensitivity = 0.72, Specificity = 0.67; p = 2.45 × 10−4). Although our findings did not reach genome-wide significance, they point to previously-implicated mechanisms and provide support for the roles of vascular and inflammatory pathways in LLD. Overall, significant enrichment of genes involved in protein degradation pathways that may be impaired, as well as the predictive capacity of risk for cardioembolic stroke, support a link between late-life depression remission and risk for vascular dysfunction.

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Fish Intake and MRI Burden of Cerebrovascular Disease in Older Adults

Neurology ◽

10.1212/wnl.0000000000012916 ◽

2021 ◽

pp. 10.1212/WNL.0000000000012916

Author(s):

Aline Thomas ◽

Fabrice Crivello ◽

Bernard Mazoyer ◽

Stephanie Debette ◽

Christophe Tzourio ◽

...

Keyword(s):

Factor Analysis ◽

Cerebrovascular Disease ◽

Brain Mri ◽

Large Population ◽

Population Based ◽

Fish Intake ◽

Mixed Data ◽

Perivascular Spaces ◽

Intracranial Volume ◽

Cross Sectional

Background and Objective:Fish intake may prevent cerebrovascular disease (CVD), yet the mechanisms are unclear, especially regarding its impact on subclinical damage. Assuming that fish may have pleiotropic effect on cerebrovascular health, we investigated the association of fish intake with global CVD burden based on brain MRI markers.Methods:This cross-sectional analysis included participants from the Three-City Dijon population-based cohort (aged ≥65 years) without dementia, stroke, or history of hospitalized cardiovascular disease, who underwent brain MRI with automated assessment of white matter hyperintensities, visual detection of covert infarcts, and grading of dilated perivascular spaces. Fish intake was assessed through a frequency questionnaire and the primary outcome measure was defined as the first component of a factor analysis of mixed data applied to MRI markers. The association of fish intake with the CVD burden indicator was studied using linear regressions.Results:In total, 1,623 participants (mean age, 72.3 years; 63% women) were included. The first component of factor analysis (32.4% of explained variance) was associated with higher levels of all three MRI markers. Higher fish intake was associated with lower CVD burden. In a model adjusted for total intracranial volume, compared to participants consuming fish <1 per week, those consuming fish 2-3 and ≥4 times per week had a β = -0.19 (95% CI, -0.37; -0.01) and β = -0.30 (-0.57; -0.03) lower indicator of CVD burden, respectively (P trend <0.001). We found evidence of effect modification by age, so that the association of fish to CVD was stronger in younger participants (65-69 years) and not significant in participants aged ≥75 years. For comparison, in the younger age group, consuming fish 2-3 times a week was roughly equivalent (in opposite direction) to the effect of hypertension.Discussion:In this large population-based study, higher frequency of fish intake was associated with lower CVD burden, especially among participants younger than 75 years, suggesting a beneficial effect on brain vascular health before manifestation of overt brain disease.Classification of Evidence:This study provides Class II evidence that in individuals without stroke or dementia, higher fish intake is associated with lower subclinical CVD at MRI.

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APOE genotypes as a risk factor for age-dependent accumulation of cerebrovascular disease in older adults

Alzheimer s & Dementia ◽

10.1016/j.jalz.2018.08.007 ◽

2018 ◽

Vol 15 (2) ◽

pp. 258-266 ◽

Cited By ~ 4

Author(s):

Melissa Lamar ◽

Lei Yu ◽

Leah H. Rubin ◽

Bryan D. James ◽

Lisa L. Barnes ◽

...

Keyword(s):

Older Adults ◽

Risk Factor ◽

Cerebrovascular Disease ◽

Age Dependent ◽

Apoe Genotypes

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Carotid Artery and Cerebral Atherosclerosis, Transient Ischemic Attacks, Symptoms and Signs Correlated with Lesions at Various Brain Locations, Cervical and Cranial Arterial Dissections, and Hydrocephalus and Gait Abnormalities

C. Miller Fisher ◽

10.1093/med/9780190603656.003.0011 ◽

2020 ◽

pp. 192-212

Author(s):

Louis R. Caplan

Keyword(s):

Internal Medicine ◽

Older Adults ◽

Carotid Artery ◽

Cerebrovascular Disease ◽

Brain Ischemia ◽

Transient Ischemic Attacks ◽

Cerebral Atherosclerosis ◽

Gait Abnormalities ◽

Symptoms And Signs

Abstract: This chapter describes Fisher’s contributions in regard to the presence, nature, and severity of carotid artery and cerebral atherosclerosis and the symptoms and signs in patients with brain ischemia and infarction; transient ischemic attacks; the nature and symptoms related to dissection of brain-supplying arteries; and hydrocephalus and gait abnormalities in older adults. Fisher made many contributions to medicine. Arguably his major contribution to the care of patients with cerebrovascular disease and brain ischemia and strokes was his lengthy descriptions and diagrams of the symptoms and signs in patients with occlusive cerebrovascular disease that appeared in textbooks of internal medicine and neurology.

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Fish Intake Is Associated with Slower Cognitive Decline in Chinese Older Adults

Journal of Nutrition ◽

10.3945/jn.114.193854 ◽

2014 ◽

Vol 144 (10) ◽

pp. 1579-1585 ◽

Cited By ~ 31

Author(s):

Bo Qin ◽

Brenda L. Plassman ◽

Lloyd J. Edwards ◽

Barry M. Popkin ◽

Linda S. Adair ◽

...

Keyword(s):

Older Adults ◽

Cognitive Decline ◽

Fish Intake ◽

Chinese Older Adults

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Oily Fish Intake and Cognitive Performance in Community-Dwelling Older Adults: The Atahualpa Project

Journal of Community Health ◽

10.1007/s10900-015-0070-9 ◽

2015 ◽

Vol 41 (1) ◽

pp. 82-86 ◽

Cited By ~ 12

Author(s):

Oscar H. Del Brutto ◽

Robertino M. Mera ◽

Jennifer Gillman ◽

Mauricio Zambrano ◽

Jung-eun Ha

Keyword(s):

Older Adults ◽

Cognitive Performance ◽

Fish Intake ◽

Community Dwelling ◽

Oily Fish ◽

Atahualpa Project ◽

Community Dwelling Older Adults

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Apolipoprotein E Genotype, Meat, Fish, and Egg Intake in Relation to Mortality Among Older Adults: A Longitudinal Analysis in China

Frontiers in Medicine ◽

10.3389/fmed.2021.697389 ◽

2021 ◽

Vol 8 ◽

Author(s):

Xurui Jin ◽

Shangzhi Xiong ◽

Changzheng Yuan ◽

Enying Gong ◽

Xian Zhang ◽

...

Keyword(s):

Older Adults ◽

Apolipoprotein E ◽

Cox Regression ◽

Population Based ◽

Fish Intake ◽

Chinese Older Adults ◽

Healthy Longevity ◽

All Cause Mortality ◽

Diet Pattern ◽

Interactive Relationship

Introduction: The interactions between apolipoprotein E (APOE) genotype and diet pattern changes were found significant in several trials, implying that APOE gene may modify the effect of animal protein-rich food on health outcomes. We aim to study the interaction of APOE genotype with the effect of meat, fish and egg intake on mortality.Methods: This population-based study enrolled 8,506 older adults (mean age: 81.7 years, 52.3% female) from the Chinese Longitudinal Healthy Longevity Study. The intake frequency of meat, fish and egg was assessed by 3-point questions at baseline. Cox regression was conducted to calculate the hazard ratios for all-cause mortality of intake levels of meat, fish and egg. The analyses were stratified by APOE genotype and sex. The analyses were performed in 2020.Results: In the multivariable-adjusted models, meat and fish intake was associated with all-cause mortality (high vs. low intake: meat: HR: 1.14, 95% CI: 1.01, 1.28; fish: HR: 0.83, 95% CI: 0.73, 0.95). APOE genotype have significant interactions with meat and fish intake (Ps < 0.05). Compared with low fish intake, high fish intake was associated with lower risk of mortality (HR: 0.74, 95% CI: 0.56–0.98) only among the APOE ε4 carriers. High meat intake was significantly associated with higher risks of mortality (HR: 1.13, 95% CI: 1.04–1.25) only among the APOE ε4 non-carriers. The interactive relationship was restricted among the male. No significant findings were observed between egg and mortality among carriers or non-carriers.Conclusions: Among Chinese older adults, the significance of associations of mortality with reported meat or fish intake depended on APOE-E4 carriage status. If validated by other studies, our findings provide evidence for gene-based “precision” lifestyle recommendations.

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The impact of smoke-free air laws and conventional cigarette taxes on cardiovascular hospitalizations

Nicotine & Tobacco Research ◽

10.1093/ntr/ntab158 ◽

2021 ◽

Author(s):

Jon F Oliver

Keyword(s):

Myocardial Infarction ◽

Older Adults ◽

Acute Myocardial Infarction ◽

Cerebrovascular Disease ◽

Local Level ◽

National Level ◽

State Level ◽

Cigarette Taxes ◽

Free Air ◽

Working Age

Abstract Introduction Smoke-free air legislation and conventional cigarette taxes have long been used to reduce smoking initiation, prevalence, and conventional cigarette consumption. However, the extent to which these policies affect population health across a range of diagnoses and age groups remains less well understood. Methods Analyses use 2005-2014 hospital inpatient discharge data from up to 40 US states to estimate the effects of smoke-free air laws and conventional cigarette taxes on cardiovascular hospitalizations among working age and older adults. Results An increase in the percent of a county’s population covered by smoke-free air laws yielded a significant decline of 2.4% (RR: 0.976, 95%CI: 0.954, 0.997) in acute cerebrovascular disease hospitalizations among older adults. Moreover, significant declines of 2.0% (RR: 0.980, 95%CI: 0.967, 0.994) and 2.8% (RR: 0.972, 95%CI:0.949, 0.996) in acute cerebrovascular disease were observed among older adults in the first year and subsequent years after smoke-free air legislation was implemented, respectively. Conventional cigarette taxes did not yield a significant change in acute cerebrovascular disease hospitalizations, nor did either tobacco control policy lead to a significant decline in acute myocardial infarction hospitalizations. Conclusions Smoke-free air laws play an important role in reducing adult cardiovascular hospitalizations. These findings confirm existing research on acute cerebrovascular disease outcomes, as well as the modest effects on acute myocardial infarction hospitalizations observed in state- and national-level analyses. Implications Current research at the local level finds smoke-free air laws yield 40% declines in acute myocardial infarction hospitalizations and 29% declines in acute cerebrovascular disease.State- and national-level analyses find smaller effects of smoke-free air laws, and largely omits analyses of working age adults. Existing research likely suffers from omitted variable bias, including state-level tobacco control funding and local-level conventional cigarette taxes. Using adult hospitalization data from up to 40 states, this study confirms existing evidence at the national and state level, and provides new evidence that smoke-free air laws significantly reduce acute cerebrovascular disease hospitalizations among older adults.

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Abstract P185: Fish Intake is Associated with Slower Cognitive Decline in Chinese Older Adults: a Longitudinal Study from the China Health and Nutrition Survey

Circulation ◽

10.1161/circ.129.suppl_1.p185 ◽

2014 ◽

Vol 129 (suppl_1) ◽

Author(s):

Bo Qin ◽

Brenda L Plassman ◽

Linda S Adair ◽

Lloyd J Edwards ◽

Barry M Popkin ◽

...

Keyword(s):

Older Adults ◽

Cognitive Decline ◽

Average Rate ◽

Fish Intake ◽

Cognitive Screening ◽

Nutrition Survey ◽

Chinese Older Adults ◽

Health And Nutrition ◽

Rate Of Decline

Introduction: With global population aging, identifying public health strategies to prevent or reduce cognitive decline is of increasing importance. This study explores the potential role of a modifiable dietary behavior, fish consumption, to reduce the rate of cognitive decline in a cohort of Chinese older adults. Methods: This study comprised adults aged ≥55 who completed a brief cognitive screening test at two or more waves of the China Health and Nutrition Survey (CHNS) from 1997 to 2004. The cognitive screening test had a maximum of 31 points and assessed immediate and delayed memory, attention, calculation, and orientation. Diet was measured by 3-day 24-hour recalls. Multivariable-adjusted linear mixed-effects models were used to evaluate the relation of fish intake at baseline with changes in cognitive scores, adjusting for age, gender, region, urbanization index, education, household income, energy intake, physical activity, current alcohol use, current smoking, and consumption of fresh vegetables, fruits, fresh legumes, and high-fat meat, as well as time, and time interactions with each covariate. Based on the distribution of fish intake, we compared consumption ≥1 vs. <1 serving/week. Sensitivity analysis included 1) removing shellfish and/or preserved fish; 2) exploring potential confounding by or interactions with hypertension or body mass index; 3) excluding those with the lowest 10% baseline cognitive scores; 4) adjusting for dietary patterns to determine if associations were independent of overall eating patterns; 5) using propensity score analysis to ensure comparability of the fish intake groups. Results: The average follow-up among 1566 older adults was 5.3 years, with a mean annual rate of decline 0.40 points. Since age significantly modified the fish-cognitive change association (p=0.003), we stratified analysis by adults <65 (n=968) at first measure, and ≥65 (n=598). No significant associations were found among adults <65. Among adults ≥65, compared with persons who consumed fish <1 serving/week, the average rate of global cognitive decline was reduced by 0.35 points per year or 55% (p = 0.001) among those consuming fish ≥1 serving/week. Results remained consistent in sensitivity analysis. When the cognitive test items were analyzed based on the domain assessed, fish intake was associated with a significantly slower rate of decline in memory scores among adults ≥65. The average rate of memory decline was reduced by 60% among persons who consumed fish ≥1 serving/week. Conclusions: Fish intake of at least 1 serving per week predicted a slower rate of cognitive decline among Chinese adults ≥65 years old, particularly for immediate and delayed memory. The cognitive benefits of fish intake were not apparent among Chinese adults aged 55 to 64. This is the first study in Chinese older adults to evaluate the role of fish consumption on cognitive decline.

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