Biomarkers of microvascular endothelial dysfunction predict incident dementia: a population‐based prospective study

Introduction: We aimed to investigate whether long-term body weight variability (BWV) is associated with late-life dementia and to further assess their potential temporal relationships. Methods: In 5,547 participants in Health and Retirement Study (HRS), a population-based prospective cohort, we quantified BWV as coefficient of variation using self-reported body weight from 1992 to 2008 and followed their dementia status from 2008 to 2016. Results: A total of 427 incident dementia cases were identified. Larger long-term BWV was significantly associated with higher risk of dementia (HR comparing extreme quartiles: 2.01, 95% CI: 1.48-2.72; HR of each SD increment: 1.21, 95% CI,1.10-1.32; p-trend<0.001). This significant association was even observed for BWV estimated approximately 15 years preceding dementia diagnosis (HR of each SD increment: 1.13, 95% CI: 1.03-1.23) and was more pronounced for that closer to diagnosis. Discussion: Our findings suggested that large BWV could be a novel risk factor for dementia.

Download Full-text

Grief Symptoms in Family Caregivers during the Patient's End-of-Life Period and the Development of Adverse Grief Trajectories. A Population-Based, Prospective Study

10.26226/morressier.5c76c8b4e2ea5a7237611fc8 ◽

2019 ◽

Author(s):

Mette Kjærgaard Nielsen

Keyword(s):

Prospective Study ◽

End Of Life ◽

Family Caregivers ◽

Population Based ◽

Life Period

Download Full-text

Faculty Opinions recommendation of Causes of encephalitis and differences in their clinical presentations in England: a multicentre, population-based prospective study.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.6146957.8184054 ◽

2011 ◽

Author(s):

Larry Bush ◽

Victor Okeh

Keyword(s):

Prospective Study ◽

Population Based ◽

Clinical Presentations

Download Full-text

Faculty Opinions recommendation of Causes of encephalitis and differences in their clinical presentations in England: a multicentre, population-based prospective study.

Faculty Opinions – Post-Publication Peer Review of the Biomedical Literature ◽

10.3410/f.6146957.7807060 ◽

2011 ◽

Author(s):

Lyle Petersen ◽

James Sejvar

Keyword(s):

Prospective Study ◽

Population Based ◽

Clinical Presentations

Download Full-text

Elevation of pulse pressure in middle age is associated with the risk of dementia: data from a population-based cohort

European Heart Journal ◽

10.1093/ehjci/ehaa946.2738 ◽

2020 ◽

Vol 41 (Supplement_2) ◽

Author(s):

D Kim ◽

H Jung ◽

P.S Yang ◽

H.T Yu ◽

T.H Kim ◽

...

Keyword(s):

Blood Pressure ◽

Pulse Pressure ◽

Middle Age ◽

Population Based ◽

Entire Cohort ◽

Incident Dementia ◽

Increased Risk ◽

Diagnosis Of Dementia ◽

History Of ◽

The Mean

Abstract Aims Pulse pressure (PP) is a well-known risk factor for cardiovascular disease. However, the association between the PP and dementia is not well identified. This study aimed to determine the effect of PP on the risk of dementia development in different age subgroups using a longitudinal, population-based, and stroke-free cohort from the general population. Methods The association of PP with the development of incident dementia was assessed from January 1, 2005, to December 31, 2013, in 433,154 participants without a history of dementia or stroke from the Korea National Health Insurance Service-Health Screening cohort. The diagnosis of dementia was defined using the 10th revision of the International Classification of Disease codes. Results The mean age of the cohort was 55.7±9.2 years, 45.7% were women. Hypertension was 23.6%. The mean systolic and diastolic blood pressure of the entire cohort were 125.9±16.6 and 78.4±10.7 mmHg, respectively. Mean PP was 47.5±10.9 mmHg. In the middle-age group (40 to 50 year-old), increasing of 10 mmHg of PP was associated with incident dementia after adjusting mean blood pressure and clinical variables with a hazard ratio (HR) of 1.21 (95% confidence interval [CI]: 1.19–1.23, p<0.001). The association was still significant even after censoring for stroke (HR: 1.16, 95% CI: 1.08–1.22, p<0.001). In the older population, elevation of PP was not associated with dementia development (HR: 0.98, 95% CI: 0.95–1.01, p=0.247) Conclusion PP was associated with increased risk of dementia only in middle-aged population beyond that of mean arterial pressure. Funding Acknowledgement Type of funding source: None

Download Full-text

Sense of Purpose in Life Is Associated with Lower Risk of Incident Dementia: A Meta-Analysis

Journal of Alzheimer s Disease ◽

10.3233/jad-210364 ◽

2021 ◽

pp. 1-10

Author(s):

Angelina R. Sutin ◽

Damaris Aschwanden ◽

Martina Luchetti ◽

Yannick Stephan ◽

Antonio Terracciano

Keyword(s):

Lower Risk ◽

Meta Analysis ◽

Random Effect ◽

Purpose In Life ◽

Population Based ◽

Primary Data ◽

Or Education ◽

Total N ◽

Sense Of Purpose ◽

Incident Dementia

Background: A sense of purpose in life has been associated with healthier cognitive outcomes across adulthood, including risk of dementia. The robustness and replicability of this association, however, has yet to be evaluated systematically. Objective: To test whether a greater sense of purpose in life is associated with lower risk of dementia in four population-based cohorts and combined with the published literature. Methods: Random-effect meta-analysis of prospective studies (individual participant data and from the published literature identified through a systematic review) that examined sense of purpose and risk of incident dementia. Results: In six samples followed up to 17 years (four primary data and two published; total N = 53,499; n = 5,862 incident dementia), greater sense of purpose in life was associated with lower dementia risk (HR = 0.77, 95%CI = 0.73–0.81, p < 0.001). The association was generally consistent across cohorts (I2 = 47%), remained significant controlling for clinical (e.g., depression) and behavioral (e.g., physical inactivity) risk factors, and was not moderated by age, gender, or education. Conclusion: Sense of purpose is a replicable and robust predictor of lower risk of incident dementia and is a promising target of intervention for cognitive health outcomes.

Download Full-text

Comparison of biomarkers of endothelial dysfunction and microvascular endothelial function in patients with primary aldosteronism and essential hypertension

Journal of the Renin-Angiotensin-Aldosterone System ◽

10.1177/1470320321999491 ◽

2021 ◽

Vol 22 (1) ◽

pp. 147032032199949

Author(s):

Miaomiao Sang ◽

Yu Fu ◽

Chenmin Wei ◽

Jing Yang ◽

Xueting Qiu ◽

...

Keyword(s):

Essential Hypertension ◽

Endothelial Dysfunction ◽

Endothelial Function ◽

Primary Aldosteronism ◽

Cardiovascular Events ◽

Statistical Significance ◽

Enzyme Linked Immunosorbent Assay ◽

Microvascular Endothelial ◽

Pai 1 ◽

Microvascular Endothelial Function

Introduction: Studies have shown that primary aldosteronism (PA) has a higher risk of cardiovascular events than essential hypertension (EH). Endothelial dysfunction is an independent predictor of cardiovascular events. Whether PA and EH differ in the endothelial dysfunction is uncertain. Our study was designed to investigate the levels of biomarkers of endothelial dysfunction (Asymmetric dimethylarginine, ADMA; E-selectin, and Plasminogen activator inhibitor-1, PAI-1) and assess the microvascular endothelial function in patients with PA and EH, respectively. Methods: The biomarkers of endothelial dysfunction were measured by enzyme-linked immunosorbent assay (ELISA). Microvascular endothelial function was evaluated by Pulse amplitude tonometry (PAT). Results: Thirty-one subjects with EH and 36 subjects with PA including 22 with aldosterone-producing adenoma (APA) and 14 with idiopathic hyperaldosteronism (IHA) were enrolled in our study. The ADMA levels among the three groups were different (APA 47.83 (27.50, 87.74) ng/ml vs EH 25.08 (22.44, 39.79) ng/ml vs IHA 26.00 (22.23, 33.75) ng/ml; p = 0.04), however, when the APA group was compared with EH and IHA group, there was no statistical significance (47.83 (27.50, 87.74) ng/ml vs 25.08 (22.44, 39.79) ng/ml for EH, p = 0.11; 47.83 (27.50, 87.74) ng/ml vs IHA 26.00 (33.75) ng/ml, p = 0.07). The results of ADMA levels are presented as Median (p25, p75). Whereas, levels of PAI-1 and E-selectin, microvascular endothelial function were not significantly different between PA and EH subjects. Conclusions: Our study shows no significant differences between PA and EH in terms of biomarkers of endothelial dysfunction and microvascular endothelial function. The microvascular endothelial function of PA and EH patients is comparable.

Download Full-text

Exercise and the Risk of Dementia in Patients with Newly Diagnosed Atrial Fibrillation: A Nationwide Population-Based Study

Journal of Clinical Medicine ◽

10.3390/jcm10143126 ◽

2021 ◽

Vol 10 (14) ◽

pp. 3126

Author(s):

Jaehyun Lim ◽

So-Ryoung Lee ◽

Eue-Keun Choi ◽

Kyung-Do Han ◽

Jin-Hyung Jung ◽

...

Keyword(s):

Atrial Fibrillation ◽

Risk Reduction ◽

Lower Risk ◽

Population Based ◽

Newly Diagnosed ◽

Incident Dementia ◽

Before And After ◽

Korean National Health Insurance ◽

New Diagnosis ◽

New Onset

Background: It is unclear whether exercise would reduce dementia in patients with a new diagnosis of atrial fibrillation (AF). Therefore, we aimed to evaluate the association between the change in physical activity (PA) before and after new-onset AF and the risk of incident dementia. Methods: Using the Korean National Health Insurance Service database, we enrolled a total of 126,555 patients with newly diagnosed AF between 2010 and 2016, who underwent health examinations within two years before and after their diagnosis of AF. The patients were divided into four groups: persistent non-exercisers, exercise starters, exercise quitters, and exercise maintainers. Results: Based on a total of 396,503 person-years of follow-up, 5943 patients were diagnosed with dementia. Compared to persistent non-exercisers, exercise starters (adjusted hazard ratio (aHR) 0.87; 95% confidence interval (CI) 0.81–0.94), and exercise maintainers (aHR 0.66; 95% CI 0.61–0.72) showed a lower risk of incident dementia; however, the risk was similar in exercise quitters (aHR 0.98; 95% CI 0.92–1.05) (p-trend < 0.001). There was a J-shaped relationship between the dose of exercise and the risk of dementia, with the risk reduction maximized at 5–6 times per week of moderate-to-vigorous PA among exercise starters. Conclusion: Patients who initiated or continued regular exercise after diagnosis of AF were associated with a lower risk of dementia than persistent non-exercisers, with no risk reduction associated with exercise cessation. Our findings may provide evidence for the benefit of exercise prescription to patients with new-onset AF to prevent incident dementia regardless of their current exercise status.

Download Full-text