scholarly journals Five-Year Change in Body Mass Index Predicts Conversion to Mild Cognitive Impairment or Dementia Only in APOE ɛ4 Allele Carriers

2021 ◽  
pp. 1-11
Author(s):  
Kylie R. Kadey ◽  
John L. Woodard ◽  
Allison C. Moll ◽  
Kristy A. Nielson ◽  
J. Carson Smith ◽  
...  

Background: Body mass index (BMI) has been identified as an important modifiable lifestyle risk factor for dementia, but less is known about how BMI might interact with Apolipoprotein E ɛ4 (APOE ɛ4) carrier status to predict conversion to mild cognitive impairment (MCI) and dementia. Objective: The aim of this study was to investigate the interaction between APOE ɛ4 status and baseline (bBMI) and five-year BMI change (ΔBMI) on conversion to MCI or dementia in initially cognitively healthy older adults. Methods: The associations between bBMI, ΔBMI, APOE ɛ4 status, and conversion to MCI or dementia were investigated among 1,289 cognitively healthy elders from the National Alzheimer’s Coordinating Center (NACC) database. Results: After five years, significantly more carriers (30.6%) converted to MCI or dementia than noncarriers (17.6%), p <  0.001, OR = 2.06. Neither bBMI (OR = 0.99, 95%CI = 0.96–1.02) nor the bBMI by APOE interaction (OR = 1.02, 95%CI = 0.96–1.08) predicted conversion. Although ΔBMI also did not significantly predict conversion (OR = 0.90, 95%CI = 0.78–1.04), the interaction between ΔBMI and carrier status was significant (OR = 0.72, 95%CI = 0.53–0.98). For carriers only, each one-unit decline in BMI over five years was associated with a 27%increase in the odds of conversion (OR = 0.73, 95%CI = 0.57–0.94). Conclusion: A decline in BMI over five years, but not bBMI, was strongly associated with conversion to MCI or dementia only for APOE ɛ4 carriers. Interventions and behaviors aimed at maintaining body mass may be important for long term cognitive health in older adults at genetic risk for AD.

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. 114-115
Author(s):  
Adrienne Aiken Morgan ◽  
Ana Capuano ◽  
Robert Wilson ◽  
Lisa Barnes

Abstract Previous research suggests a decline in body mass index (BMI) among older adults is associated with negative health outcomes, including mild cognitive impairment (MCI) and incident dementia (Gao et al., 2011). However, few studies have examined BMI longitudinal trajectories and how they change after MCI diagnosis among older African Americans. To characterize trajectories of change in BMI among older African American participants with no cognitive impairment at baseline we used data from the Minority Aging Research Study, MARS (N=408, 76.5% women, mean age = 73.5, mean education = 15.0). We constructed piecewise linear mixed-effects models that included a random intercept and two random slopes. The first slope began at baseline. The second slope began at MCI diagnosis allowing for acceleration in the rate of decline after the diagnosis. The results showed BMI declined over time (B=-0.19, SE=0.04, p&lt;.001), and there was a faster decline after MCI (additional decline, B=-0.18, SE=0.068, p=.007). In a second model controlling for age, higher education was associated with a lower BMI at baseline (B=-0.36, SE=0.092, p&lt;.001) but slower decline before MCI (B=0.02, SE=0.006, p=.001). However, after MCI the decline of participants with higher education was faster (B=-0.06, SE=0.022, p=.003). These results suggest an accelerated decline in BMI following MCI diagnosis, with higher education related to an even faster BMI decline, possibly a consequence of cognitive reserve.


2021 ◽  
pp. 1-11
Author(s):  
Lee Smith ◽  
Jae Il Shin ◽  
Hans Oh ◽  
Christina Carmichael ◽  
Louis Jacob ◽  
...  

Background: The effect of weight modification on future dementia risk is currently a subject of debate and may be modified by age. Objective: The aim of the present study was to investigate the association between body mass index (BMI) status with mild cognitive impairment (MCI) (a preclinical stage of dementia) in middle-aged and older adults residing in six low- and middle-income countries using nationally representative data. Methods: Cross-sectional data from the Study on Global Ageing and Adult Health (SAGE) were analyzed. MCI was defined using the National Institute on Aging-Alzheimer’s Association criteria. BMI (kg/m2) was based on measured weight and height and categorized as: underweight (<18.5), normal (18.5–24.9), overweight (25.0–29.9), and obese (≥30.0). Multivariable logistic regression analysis and meta-analysis were conducted to assess associations. Results: Data on 32,715 individuals aged ≥50 years with preservation in functional abilities were analyzed [mean (SD) age 62.1 (15.6) years; 51.7% females]. Among those aged 50–64 years, compared to normal weight, underweight (OR = 1.44; 95% CI = 1.14–1.81), overweight (OR = 1.17; 95% CI = 1.002–1.37), and obesity (OR = 1.46; 95% CI = 1.09–1.94) were all significantly associated with higher odds for MCI. In those aged ≥65 years, underweight (OR = 0.71; 95% CI = 0.54–0.95) and overweight (OR = 0.72; 95% CI = 0.55–0.94) were associated with significantly lower odds for MCI, while obesity was not significantly associated with MCI. Conclusion: The results of the study suggest that the association between BMI and MCI is likely moderated by age. Future longitudinal studies are required to confirm or refute the present findings before recommendations for policy and practice can be made.


2020 ◽  
Vol 17 (2) ◽  
pp. 185-195
Author(s):  
Jianxiong Xi ◽  
Ding Ding ◽  
Qianhua Zhao ◽  
Xiaoniu Liang ◽  
Li Zheng ◽  
...  

Background: Approximately 40 independent Single Nucleotide Polymorphisms (SNPs) have been associated with Alzheimer’s Disease (AD) or cognitive decline in genome-wide association studies. Methods: We aimed to evaluate the joint effect of genetic polymorphisms and environmental factors on the progression from Mild Cognitive Impairment (MCI) to AD (MCI-AD progression) in a Chinese community cohort. Conclusion: Demographic, DNA and incident AD diagnosis data were derived from the follow-up of 316 participants with MCI at baseline of the Shanghai Aging Study. The associations of 40 SNPs and environmental predictors with MCI-AD progression were assessed using the Kaplan-Meier method with the log-rank test and Cox regression model. Results: Rs4147929 at ATP-binding cassette family A member 7 (ABCA7) (AG/AA vs. GG, hazard ratio [HR] = 2.43, 95% confidence interval [CI] 1.24-4.76) and body mass index (BMI) (overweight vs. non-overweight, HR = 0.41, 95% CI 0.22-0.78) were independent predictors of MCI-AD progression. In the combined analyses, MCI participants with the copresence of non-overweight BMI and the ABCA7 rs4147929 (AG/AA) risk genotype had an approximately 6-fold higher risk of MCI-AD progression than those with an overweight BMI and a non-risk genotype (HR = 6.77, 95% CI 2.60-17.63). However, a nonsignificant result was found when participants carried only one of these two risk factors (nonoverweight BMI and AG/AA of ABCA7 rs4147929). Conclusion: ABCA7 rs4147929 and BMI jointly affect MCI-AD progression. MCI participants with the rs4147929 risk genotype may benefit from maintaining an overweight BMI level with regard to their risk for incident AD.


Author(s):  
Liselotte De Wit ◽  
Vitoria Piai ◽  
Pilar Thangwaritorn ◽  
Brynn Johnson ◽  
Deirdre O’Shea ◽  
...  

AbstractThe literature on repetition priming in Alzheimer’s disease (AD) is inconsistent, with some findings supporting spared priming while others do not. Several factors may explain these inconsistencies, including AD severity (e.g., dementia vs. Mild Cognitive Impairment; MCI) and priming paradigm-related characteristics. This systematic review and meta-analysis provides a quantitative summary of repetition priming in AD. We examined the between-group standard mean difference comparing repetition priming in AD dementia or amnestic MCI (aMCI; presumably due to AD) to controls. Thirty-two studies were selected, including 590 individuals with AD dementia, 267 individuals with amnestic MCI, and 703 controls. Our results indicated that both individuals with aMCI and AD dementia perform worse on repetition priming tasks than cognitively older adults. Paradigm-related moderators suggested that the effect size between studies comparing the combined aMCI or AD dementia group to cognitively healthy older adults was the highest for paradigms that required participants to produce, rather than identify, primes during the test phase. Our results further suggested that priming in AD is impaired for both conceptual and perceptual priming tasks. Lastly, while our results suggested that priming in AD is impaired for priming tasks that require deep processing, we were unable to draw firm conclusions about whether priming is less impaired in aMCI or AD dementia for paradigms that require shallow processing.


2021 ◽  
Vol 11 (1) ◽  
pp. 68
Author(s):  
Sara G. Aguilar-Navarro ◽  
Itzel I. Gonzalez-Aparicio ◽  
José Alberto Avila-Funes ◽  
Teresa Juárez-Cedillo ◽  
Teresa Tusié-Luna ◽  
...  

Mild cognitive impairment (MCI) (amnestic or non-amnestic) has different clinical and neuropsychological characteristics, and its evolution is heterogeneous. Cardiovascular risk factors (CVRF), such as hypertension, diabetes, or dyslipidemia, and the presence of the Apolipoprotein E ε4 (ApoE ε4) polymorphism have been associated with an increased risk of developing Alzheimer’s disease (AD) and other dementias but the relationship is inconsistent worldwide. We aimed to establish the association between the ApoE ε4 carrier status and CVRF on MCI subtypes (amnestic and non-amnestic) in Mexican older adults. Cross-sectional study including 137 older adults (n = 63 with normal cognition (NC), n = 24 with amnesic, and n = 50 with non-amnesic MCI). Multinomial logistic regression models were performed in order to determine the association between ApoE ε4 polymorphism carrier and CVRF on amnestic and non-amnestic-MCI. ApoE ε4 carrier status was present in 28.8% participants. The models showed that ApoE ε4 carrier status was not associated neither aMCI nor naMCI condition. The interaction term ApoE ε4 × CVRF was not statistically significant for both types of MCI. However, CVRF were associated with both types of MCI and the association remained statistically significant after adjustment by sex, age, and education level. The carrier status of the ApoE genotype does not contribute to this risk.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Yemin Yuan ◽  
Jie Li ◽  
Nan Zhang ◽  
Peipei Fu ◽  
Zhengyue Jing ◽  
...  

Abstract Background Evidence concerning the association between body mass index (BMI) and cognitive function among older people is inconsistent. This study aimed to investigate gender and age as moderators in association between BMI and mild cognitive impairment (MCI) among rural older adults. Methods Data were derived from the 2019 Health Service for Rural Elderly Families Survey in Shandong, China. In total, 3242 people aged 60 years and above were included in the analysis. Multilevel mixed-effects logistic regression was used to examine the moderating roles of gender and age, then further to explore the relationship between BMI and MCI. Results There were 601 (18.5%) participants with MCI. Compared with normal BMI group, low BMI group had a higher risk of MCI among older people [adjusted odds ratio (aOR) = 2.08, 95% confidence interval (CI): 1.26–3.44], women (aOR = 2.06, 95% CI: 1.35–3.12), or the older elderly aged ≥75 years old (aOR = 3.20, 95% CI: 1.34–7.45). This effect remained statistically significant among older women (aOR = 3.38, 95% CI: 1.69–6.73). Among older men, elevated BMI group had a higher risk of MCI (aOR = 2.32, 95% CI: 1.17–4.61) than normal BMI group. Conclusions Gender and age moderated the association between BMI and MCI among Chinese rural older adults. Older women with low BMI were more likely to have MCI, but older men with elevated BMI were more likely to have MCI. These findings suggest rural community managers strengthen the health management by grouping the weight of older people to prevent the risk of dementia.


Author(s):  
Alexandre Chauvin ◽  
Shari Baum ◽  
Natalie A. Phillips

Purpose Speech perception in noise becomes difficult with age but can be facilitated by audiovisual (AV) speech cues and sentence context in healthy older adults. However, individuals with Alzheimer's disease (AD) may present with deficits in AV integration, potentially limiting the extent to which they can benefit from AV cues. This study investigated the benefit of these cues in individuals with mild cognitive impairment (MCI), individuals with AD, and healthy older adult controls. Method This study compared auditory-only and AV speech perception of sentences presented in noise. These sentences had one of two levels of context: high (e.g., “Stir your coffee with a spoon”) and low (e.g., “Bob didn't think about the spoon”). Fourteen older controls ( M age = 72.71 years, SD = 9.39), 13 individuals with MCI ( M age = 79.92 years, SD = 5.52), and nine individuals with probable Alzheimer's-type dementia ( M age = 79.38 years, SD = 3.40) completed the speech perception task and were asked to repeat the terminal word of each sentence. Results All three groups benefited (i.e., identified more terminal words) from AV and sentence context. Individuals with MCI showed a smaller AV benefit compared to controls in low-context conditions, suggesting difficulties with AV integration. Individuals with AD showed a smaller benefit in high-context conditions compared to controls, indicating difficulties with AV integration and context use in AD. Conclusions Individuals with MCI and individuals with AD do benefit from AV speech and semantic context during speech perception in noise (albeit to a lower extent than healthy older adults). This suggests that engaging in face-to-face communication and providing ample context will likely foster more effective communication between patients and caregivers, professionals, and loved ones.


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