White Blood Cell Count Mediates the Association Between Periodontal Inflammation and Cognitive Performance Measured by Digit Symbol Substitution Test Among Older U.S. Adults

Abstract Background Systemic effects of periodontal infection may increase the risk of central neuroinflammation, aggravating impaired cognition. This study aims to examine whether systemic inflammatory factors mediate the possible association between periodontal inflammation and cognitive function. Methods We conducted a cross-sectional analysis of 766 participants aged ≥ 60 years and who had completed periodontal and cognitive examinations in the National Health and Nutrition Examination Survey (NHANES) 2001–2002. We used multivariable linear regression to investigate the overall association between periodontal health and cognitive function as measured by the digit symbol substitution test (DSST). Bleeding on probing (BOP) and periodontal inflamed surface area (PISA) were used to assess the periodontal inflammatory activity and burden, respectively. Mediation analyses were used to test the indirect effects of the BOP/PISA on DSST via C-reactive protein, white blood cell (WBC) count, and fibrinogen. Results Participants with superior periodontal health obtained higher DSST scores than those with poorer periodontal health, adjusting for demographic factors and chronic conditions. Concerning the inflammatory activity, WBC count acted as a full mediator in the association between BOP and DSST (β = −0.091; 95% confidence interval [CI] = −0.174 to −0.008) and mediated 27.5% of the total association. Regarding the inflammatory burden, WBC count acted as a partial mediator in the association between PISA and DSST (β = −0.059; 95% CI = −0.087 to −0.031) and mediated 20.3% of the total association. Conclusion Our study indicated the potential role of systemic inflammatory factors as a mediator of associations between periodontal inflammation and cognitive function in the U.S. geriatric population.

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Association of White Blood Cell Count With Metabolic Syndrome in Obese Men and Women

The Journal of Qazvin University of Medical Sciences ◽

10.32598/jqums.24.5.7 ◽

2020 ◽

Vol 24 (5) ◽

pp. 444-453

Author(s):

Sima Hashemipour ◽

◽

Azam Ghorbani ◽

Niloofar Jafari Aref ◽

◽

...

Keyword(s):

Metabolic Syndrome ◽

Blood Cell ◽

White Blood Cell ◽

Inflammatory Factors ◽

Obese Women ◽

Obese People ◽

Cross Sectional ◽

Men And Women ◽

Wbc Count ◽

Fourth Quartile

Background: Despite the widespread obesity epidemic in the world, not all obese people are equally susceptible to the complications of obesity. Inflammatory factors play an important role in the complications of obesity. Objective: This study aims to evaluate the association of White Blood Cell (WBC) count with metabolic syndrome in overweight/obese men and women. Methods: This cross-sectional study is a part of the Qazvin Metabolic Disease Study (QMDS) conducted in 2010 in Qazvin, Iran. Participants were 622 obese people with a body mass index (BMI) ≥25 kg/m2, recruited from the QMDS. Metabolic syndrome was defined according to the Adult Treatment Panel III criteria. Data were analyzed using chi-square test, t-test, and logistic regression analysis (to evaluate the relationship between WBC count quartiles and metabolic syndrome). Findings: Prevalence of metabolic syndrome was not significantly different between men and women. In men, prevalence of metabolic syndrome and its components were not different between WBC quartiles. In women, 2.23% and 5.06% had metabolic syndrome in the first and fourth quartiles of WBC count, respectively (P<0.001). Moreover, the prevalence of insulin resistance was higher in fourth quartile compared to the first quartile (7.74% vs. 6.52%, P<0.001). After controlling the effects of age and BMI factors, the risk of metabolic syndrome in the fourth quartile of WBC count remained significant in women (OR=2.56, P<0.01). Conclusion: Association of WBC count with metabolic syndrome is significant in obese women compared to obese men.

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Longitudinal Associations of Midlife Accelerometer Determined Sedentary Behavior and Physical Activity With Cognitive Function: The CARDIA Study

Journal of the American Heart Association ◽

10.1161/jaha.120.018350 ◽

2021 ◽

Vol 10 (3) ◽

Author(s):

Kara M. Whitaker ◽

Dong Zhang ◽

Kelley Pettee Gabriel ◽

Monica Ahrens ◽

Barbara Sternfeld ◽

...

Keyword(s):

Physical Activity ◽

Cognitive Function ◽

Verbal Learning ◽

Digit Symbol Substitution Test ◽

Digit Symbol ◽

Auditory Verbal Learning Test ◽

Digit Symbol Substitution ◽

Auditory Verbal Learning ◽

Symbol Substitution ◽

Learning Test

Background To determine if accelerometer measured sedentary behavior (SED), light‐intensity physical activity (LPA), and moderate‐to‐vigorous–intensity physical activity (MVPA) in midlife is prospectively associated with cognitive function. Methods and Results Participants were 1970 adults enrolled in the CARDIA (Coronary Artery Risk Development in Young Adults) study who wore an accelerometer in 2005 to 2006 (ages 38–50 years) and had cognitive function assessments completed 5 and/or 10 years later. SED, LPA, and MVPA were measured by an ActiGraph 7164 accelerometer. Cognitive function tests included the Digit Symbol Substitution Test, Rey Auditory Verbal Learning Test, and Stroop Test. Compositional isotemporal substitution analysis examined associations of SED, LPA, and MVPA with repeated measures of the cognitive function standardized scores. In men, statistical reallocation of 30 minutes of LPA with 30 minutes of MVPA resulted in an estimated difference of SD 0.07 (95% CI, 0.01–0.14), SD 0.09 (95% CI, 0.02–0.17), and SD −0.11 (95% CI, −0.19 to −0.04) in the Digit Symbol Substitution Test, Rey Auditory Verbal Learning Test, and Stroop scores, respectively, indicating better performance. Associations were similar when reallocating time in SED with MVPA, but results were less robust. Reallocation of time in SED with LPA resulted in an estimated difference of SD −0.05 (95% CI, −0.06 to −0.03), SD −0.03 (95% CI, −0.05 to −0.01), and SD 0.05 (95% CI, 0.03– 0.07) in the Digit Symbol Substitution Test, Rey Auditory Verbal Learning Test, and Stroop scores, respectively, indicating worse performance. Associations were largely nonsignificant among women. Conclusions Our findings support the idea that for men, higher‐intensity activities (MVPA) may be necessary in midlife to observe beneficial associations with cognition.

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Abstract 007: Treadmill Duration Predicts Cognitive Function

Circulation ◽

10.1161/circ.125.suppl_10.a007 ◽

2012 ◽

Vol 125 (suppl_10) ◽

Author(s):

Na Zhu ◽

David R Jacobs ◽

Pamela J Schreiner ◽

R. Nick Bryan ◽

Lenore J Launer ◽

...

Keyword(s):

Cognitive Function ◽

Verbal Learning ◽

Stroop Test ◽

Test Duration ◽

Digit Symbol Substitution Test ◽

Digit Symbol ◽

Digit Symbol Substitution ◽

Auditory Verbal Learning ◽

Diabetes Status ◽

Symbol Substitution

Evidence is scarce for an association between treadmill performance and cognitive function in healthy young and middle-aged adults. We assessed the hypothesis that duration on treadmill predicts cognitive function 25 years later. Participants were from the population-based Coronary Artery Risk Development in Young Adults (CARDIA) study, a multi-center study of black and white men and women aged 18-30 at recruitment in 1985-86 (year 0). The main independent variable of interest was baseline symptom-limited maximal treadmill test duration as a measure of treadmill performance potential, including its major subcomponent cardiorespiratory fitness (CRF/TPP). Cognitive functions measured were verbal memory (with the Rey auditory-verbal learning (AVLT)), psychomotor speed (Digit Symbol Substitution Test (DSST)) and executive function (modified Stroop interference test, where lower is better). We analyzed 2444 participants who had y0 treadmill testing and y25 cognitive testing. For each additional SD of treadmill duration (2.8 minutes), the DSST was 2.4 digits correctly substituted higher, the AVLT was 0.36 words recalled higher, and the Stroop test time 1.7 seconds less, after accounting for race, sex, age, highest attained education level and center of clinic visit( Table ). Further adjustment for dietary pattern, physical activity, smoking, BMI, alcohol consumption, glomerular filtration rate, blood pressure, cholesterol and diabetes status yielded similar trends for these cognitive function tests. In conclusion, CRF/TPP predicts cognitive function 25 years later independently of other factors among apparently healthy adults. Prospective estimation of cognitive function by treadmill duration at baseline in minimally and fully adjusted model (see text for details), N=2444. Year 25 Digit Symbol Substitution Test: Digits correctly substituted mean±SD: 70.1±15.9 Year 25 Rey Auditory-Verbal Learning Test: Words correctly recalled mean±SD: 8.3±3.3 Year 25 Stroop Test : Seconds to correctly name colors mean±SD: 43.9±12.8 Slope * SE P Slope * SE P Slope * SE P Year 0 treadmill duration (SD) mean±SD: 10.0±2.8 minutes Minimally adjusted 2.4 0.36 <.0001 0.36 0.08 <.0001 -1.7 0.31 <.0001 Fully adjusted 2.3 0.45 <.0001 0.39 0.08 <.0001 -1.2 0.39 0.001 * “Slope” is the difference in the indicated cognitive function per SD (2.8 minutes) of treadmill duration.

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Early-but Not Late-Onset Hypertension Is Related to Midlife Cognitive Function

Hypertension ◽

10.1161/hypertensionaha.120.16556 ◽

2021 ◽

Vol 77 (3) ◽

pp. 972-979

Author(s):

Karri Suvila ◽

Joao A.C. Lima ◽

Yuichiro Yano ◽

Zaldy S. Tan ◽

Susan Cheng ◽

...

Keyword(s):

Blood Pressure ◽

Cognitive Function ◽

Cognitive Decline ◽

Early Onset ◽

Cognitive Assessment ◽

Late Onset ◽

Montreal Cognitive Assessment ◽

Digit Symbol Substitution Test ◽

Digit Symbol ◽

Symbol Substitution

Hypertension is related to increased risk of cognitive decline in a highly age-dependent manner. However, conflicting evidence exists on the relation between age of hypertension onset and cognition. Our goal was to investigate the association between early- versus late-onset hypertension and midlife cognitive performance in 2946 CARDIA study (Coronary Artery Risk Development in Young Adults) participants (mean age 55±4, 57% women). The participants underwent 9 repeat examinations, including blood pressure measurements, between 1985 to 1986 and 2015 to 2016. The participants underwent brain magnetic resonance imaging and completed Digit Symbol Substitution Test, Rey Auditory Verbal Learning Test, Stroop interference test, and the Montreal Cognitive Assessment to evaluate cognitive function at the year 30 exam. We assessed the relation between age of hypertension onset and cognitive function using linear regression models adjusted for cognitive decline risk factors, including systolic blood pressure. We observed that individuals with early-onset hypertension (onset at <35 years) had 0.24±0.09, 0.22±0.10, 0.27±0.09, and 0.19±0.07 lower standardized Z-scores in Digit Symbol Substitution Test, Stroop test, Montreal Cognitive Assessment, and a composite cognitive score than participants without hypertension ( P <0.05 for all). In contrast, hypertension onset at ≥35 years was not associated with cognitive function ( P >0.05 for all). In a subgroup of 559 participants, neither early- nor late-onset hypertension was related to macrostructural brain alterations ( P >0.05 for all). Our results indicate that early-onset hypertension is a potent risk factor for midlife cognitive impairment. Thus, age of hypertension onset assessment in clinical practice could improve risk stratification of cognitive decline in patients with hypertension.

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Association Between White Blood Cell Counts and Brachial-Ankle Pulse Wave Velocity in Chinese Hypertensive Adults: A Cross-Sectional Study

Angiology ◽

10.1177/00033197211021199 ◽

2021 ◽

pp. 000331972110211

Author(s):

Buyun Jia ◽

Chongfei Jiang ◽

Yun Song ◽

Chenfangyuan Duan ◽

Lishun Liu ◽

...

Keyword(s):

Arterial Stiffness ◽

Blood Cell ◽

Pulse Wave Velocity ◽

Wave Velocity ◽

White Blood Cell ◽

Pulse Wave ◽

Final Analysis ◽

Cross Sectional ◽

Cell Counts ◽

Wbc Count

Increased arterial stiffness is highly prevalent in patients with hypertension and is associated with cardiovascular (CV) risk. Increased white blood cell (WBC) counts may also be an independent risk factor for arterial stiffness and CV events. The aim of the study was to investigate the relationship between differential WBC counts and brachial-ankle pulse wave velocity (baPWV) in hypertensive adults. A total of 14 390 participants were included in the final analysis. A multivariate linear regression model was applied for the correlation analysis of WBC count and baPWV. Higher WBC counts were associated with a greater baPWV: adjusted β = 10 (95% CI, 8-13, P < .001). The same significant association was also found when WBC count was assessed as categories or quartiles. In addition, the effect of differential WBC subtypes, including neutrophil count and lymphocyte count on baPWV, showed the similar results. These findings showed that baPWV has positive associations with differential WBC counts in hypertensive adults.

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Predictive values of Alvarado score, serum C-reactive protein, and white blood cell count in the diagnosis of acute appendicitis: a prospective study

Annals of Pediatric Surgery ◽

10.1186/s43159-021-00074-y ◽

2021 ◽

Vol 17 (1) ◽

Author(s):

Ademola Olusegun Talabi ◽

Tewogbade Adeoye Adedeji ◽

Oludayo Adedapo Sowande ◽

Olusanya Adejuyigbe

Keyword(s):

Acute Appendicitis ◽

Blood Cell ◽

Cell Count ◽

White Blood Cell Count ◽

White Blood Cell ◽

C Reactive Protein ◽

Blood Cell Count ◽

Alvarado Score ◽

Reactive Protein ◽

Wbc Count

Abstract Background The diagnosis of acute appendicitis in children is quite challenging as the rate of negative appendectomy varies between 15 and 57%. Increased utilization of imaging diagnostic facilities in advanced countries seems to have reduced the incidence of operating on normal appendix to a single digit. In low- and middle-income countries, the incidence remains unacceptably high (double digits). Inflammatory markers and scoring systems may be a suitable adjunct to increase diagnostic yield in most third world countries. Thus, the aim of this study was to evaluate the diagnostic value of Alvarado score, white blood cell count, and serum C-reactive protein in children with acute appendicitis. Results The ages of patients ranged between 4 and 15 years with a mean of 11.2 ± 2.8 years. The male to female ratio was 1.4 to 1.0. Nineteen percent of patients had negative appendiceal findings on histological examination. The sensitivity and specificity of Alvarado score, C-reactive protein estimation, total white blood cell count in diagnosing acute appendicitis were 86.4% and 63.2%, 98.8% and 36.8%, and 51.9% and 89.5% respectively. Alvarado score has the highest area under ROC curve analysis 0.824, 95% CI of 0.724 to 0.924 compared with CRP, 0.769. 95% CI of = 0.647 to 0.891 and WBC count, 0.765, 95% CI of 0.643 to 0.887. Both CRP and WBC count showed higher discriminatory values between complicated and uncomplicated appendicitis, p < 0.001. Conclusion Alvarado score outperformed other tests in setting the diagnosis of acute appendicitis. However, none of the tests can be relied on wholly for operative decision. Clinical judgement remains the bedrock for diagnosis and operative management.

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Discriminant Validity of the WAIS-R Digit Symbol Substitution Test in Subjective Cognitive Decline, Mild Cognitive Impairment (Amnestic Subtype) and Alzheimer’s Disease Dementia (ADD) in Greece

Brain Sciences ◽

10.3390/brainsci11070881 ◽

2021 ◽

Vol 11 (7) ◽

pp. 881

Author(s):

Marianna Tsatali ◽

Eleni Poptsi ◽

Despina Moraitou ◽

Christina Agogiatou ◽

Evaggelia Bakoglidou ◽

...

Keyword(s):

Alzheimer’S Disease ◽

Cognitive Impairment ◽

Mild Cognitive Impairment ◽

Cognitive Decline ◽

Subjective Cognitive Decline ◽

Digit Symbol Substitution Test ◽

Digit Symbol ◽

Digit Symbol Substitution ◽

Symbol Substitution ◽

Alzheimer’S Disease Dementia

Objective: The aim of the current study was to estimate the discriminant potential and validity of the Digit Symbol Substitution Test (DSST) of the WAIS-R in the Greek elderly population meeting criteria for subjective cognitive decline (SCD), mild cognitive impairment (aMCI; amnestic subtype), or Alzheimer’s disease dementia (ADD). Method: Four hundred eighty-eight community-dwelling older adults, visitors of the Day Center of Alzheimer Hellas, participated in the study. Two hundred forty-three of them met the criteria for ADD, one hundred eighty-two for aMCI and sixty-three for SCD. Results: Path analysis indicated that the DSST score is affected by age group, educational level, and diagnostic category, but is not affected by gender. The ROC curve analysis showed that the DSST sum score could perfectly differentiate SCD from ADD patients, whereas test’s discriminant potential between aMCI and dementia ADD’s subtype was satisfactory. However, DSST was unable to separate the SCD from the aMCI group. Conclusion: It appears that the DSST is unable to separate the SCD from aMCI population. Therefore, the test in question may be insensitive to incipient cognitive decline. On the contrary, the discriminant potential of the DSST as regards SCD and ADD is excellent, while discrimination between aMCI and ADD is good.

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Decrease in white blood cell counts after thiopentone barbiturate therapy for refractory intracranial hypertension: A common complication

Journal of Neurosciences in Rural Practice ◽

10.4103/0976-3147.116441 ◽

2013 ◽

Vol 04 (S 01) ◽

pp. S31-S34 ◽

Cited By ~ 1

Author(s):

Shin Yi Ng ◽

Ki Jinn Chin ◽

Tong Kiat Kwek

Keyword(s):

Statistical Analysis ◽

Blood Cell ◽

Intracranial Hypertension ◽

White Blood Cell ◽

Retrospective Review ◽

T Test ◽

Barbiturate Coma ◽

Barbiturate Therapy ◽

The Mean ◽

Wbc Count

ABSTRACT Background: Leucopenia has been reported after induction of thiopentone barbiturate therapy for refractory intracranial hypertension. However, the incidence and characterisitics are not well described. Aims: We performed a retrospective review to describe the incidence and characteristics of leucopenia after induction of thiopentone barbiturate therapy. Setting and Design: Our centre is a national referral centre for neurotrauma and surgery in a tertiary medical institution.Materials and Methods: We performed a retrospective review of all patients who received thiopentone barbiturate therapy for refractory intracranial hypertension during an 18 month period from January 2004 to June 2005 in our neurosurgical intensive care unit. Statistical Analysis Used: Statistical analysis was performed using SPSS version 15.0. All data are reported as mean ± standard deviation or median (interquartile range). The Chi square test was used to analyze categorical data and student t test done for comparison of means. For paired data, the paired t?test was used.-test was used. Results: Thirty eight (80.9%) out of 47 patients developed a decrease in white blood cell (WBC) count after induction of thiopentone barbiturate coma. The mean decrease in WBC from baseline to the nadir was 6.4 × 10 9 /L (P <lt; 0.001) and occurred 57 (3-147) h after induction. The mean nadir WBC was 8.6 < 3.6 × 10 9 /L. Three (6.4%) patients were leucopenic, with a WBC count of 2.8, 3.1, and 3.6 < 10 9 /L. None of them were neutropenic. We did not find an association between decrease in WBC count and clinical diagnosis of infection. We did not find any association between possible risk factors such as admission GCS, maximum ICP prior to induction of barbiturate coma, APACHE II score, total duration and dose of thiopentone given, and decrease in WBC count. Conclusions: Decrease in WBC count is common, while development of leucopenia is rare after thiopentone barbiturate coma. Regular monitoring of WBC counts is recommended.

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