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Lifestyle and vascular risk effects on MRI-based biomarkers of Alzheimer's disease: a cross-sectional study of middle-aged adults from the broader New York City area.
Mosconi, L, Walters, M, Sterling, J, Quinn, C, McHugh, P, Andrews, RE, Matthews, DC, Ganzer, C, Osorio, RS, Isaacson, RS, et al
BMJ open. 2018;8(3):e019362
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Alzheimer’s disease (AD) is the most common form of dementia, affecting nearly 34 million people worldwide. It has been estimated that one in every three cases of AD may be attributable to diet and lifestyle factors. The aim of this study was to investigate the effects of lifestyle and vascular-related risk factors for AD. Researchers studied the brain scans of 116 healthy adults aged 30-60 years. They collected information on factors related to lifestyle, such as diet, physical activity and intellectual enrichment. They also looked at markers for vascular risk such as body mass index (BMI), cholesterol and homocysteine, as well as cognitive function. The researchers found that a Mediterranean-style diet and good insulin sensitivity were both associated with a healthier brain structure. A better score for intellectual enrichment and lower BMI were both associated with better cognition. They concluded that adopting a Mediterranean-style diet and maintaining a healthy weight might reduce the risk of developing AD.
Abstract
OBJECTIVE To investigate the effects of lifestyle and vascular-related risk factors for Alzheimer's disease (AD) on in vivo MRI-based brain atrophy in asymptomatic young to middle-aged adults. DESIGN Cross-sectional, observational. SETTING Broader New York City area. Two research centres affiliated with the Alzheimer's disease Core Center at New York University School of Medicine. PARTICIPANTS We studied 116 cognitively normal healthy research participants aged 30-60 years, who completed a three-dimensional T1-weighted volumetric MRI and had lifestyle (diet, physical activity and intellectual enrichment), vascular risk (overweight, hypertension, insulin resistance, elevated cholesterol and homocysteine) and cognition (memory, executive function, language) data. Estimates of cortical thickness for entorhinal (EC), posterior cingulate, orbitofrontal, inferior and middle temporal cortex were obtained by use of automated segmentation tools. We applied confirmatory factor analysis and structural equation modelling to evaluate the associations between lifestyle, vascular risk, brain and cognition. RESULTS Adherence to a Mediterranean-style diet (MeDi) and insulin sensitivity were both positively associated with MRI-based cortical thickness (diet: βs≥0.26, insulin sensitivity βs≥0.58, P≤0.008). After accounting for vascular risk, EC in turn explained variance in memory (P≤0.001). None of the other lifestyle and vascular risk variables were associated with brain thickness. In addition, the path associations between intellectual enrichment and better cognition were significant (βs≥0.25 P≤0.001), as were those between overweight and lower cognition (βs≥-0.22, P≤0.01). CONCLUSIONS In cognitively normal middle-aged adults, MeDi and insulin sensitivity explained cortical thickness in key brain regions for AD, and EC thickness predicted memory performance in turn. Intellectual activity and overweight were associated with cognitive performance through different pathways. Our findings support further investigation of lifestyle and vascular risk factor modification against brain ageing and AD. More studies with larger samples are needed to replicate these research findings in more diverse, community-based settings.
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Helicobacter pylori moderates the association between 5-MTHF concentration and cognitive function in older adults.
Berrett, AN, Gale, SD, Erickson, LD, Brown, BL, Hedges, DW
PloS one. 2018;13(1):e0190475
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Helicobacter pylori (H. pylori) is a bacterium that can cause infection in the digestive tract. H. pylori can reduce the uptake of nutrients such as folate and iron and cause inflammation. The aim of this study was to explore potential interactions between certain nutrients and H. pylori in cognitive function. Blood samples were taken from adults aged 60 to 85, and tested for H. pylori, active folate as 5-Methyltetrahydrofolate (5-MTHF), vitamin B12 and homocysteine. Cognitive function was measured using a digit symbol coding (DSC) test. 41% of the participants tested positive for H. pylori. H. pylori, 5-MTHF, vitamin B-12 and homocysteine were not associated individually with performance on the DSC task. However, H. pylori interacted with 5-MTHF concentration to predict performance on the DSC task; those with H. pylori performed worse on the DSC task as 5-MTHF concentration decreased. The authors concluded that the interaction between H. pylori and 5-MTHF might impair aspects of cognitive function. This finding might be especially relevant to vulnerable groups such as pregnant women and the elderly.
Abstract
OBJECTIVE To explore potential interactions between folate-cycle factors and Helicobacter pylori seropositivity in the prediction of cognitive function. METHODS We used data obtained from the 1999-2000 continuous National Health and Nutrition Examination Survey produced by the United States' Centers for Disease Control and Prevention. Using Ordinary Least Squares regression, we tested for associations between multiple folate-cycle factors, Helicobacter pylori seropositivity, and cognitive function assessed by the digit symbol coding subtest of the Wechsler Adult Intelligence Scale-III. We then tested for interactions between each of the folate-cycle factors and Helicobacter pylori in the prediction of cognitive function. RESULTS Although Helicobacter pylori seropositivity, 5-methyltetrahydrofolate, vitamin B-12, and homocysteine were not associated with performance on the digit symbol coding task, Helicobacter pylori seropositivity interacted with 5-methyltetrahydrofolate concentration to predict performance on the digit symbol coding task. The Helicobacter pylori seropositive group performed worse on the digit symbol coding task as 5-methyltetrahydrofolate concentration decreased. CONCLUSION The interaction between Helicobacter pylori seropositivity and reduced folate-cycle factor 5-methyltetrahydrofolate might impair aspects of cognitive function.
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Association between cognitive function and supplementation with omega-3 PUFAs and other nutrients in ≥ 75 years old patients: A randomized multicenter study.
Baleztena, J, Ruiz-Canela, M, Sayon-Orea, C, Pardo, M, Añorbe, T, Gost, JI, Gomez, C, Ilarregui, B, Bes-Rastrollo, M
PloS one. 2018;13(3):e0193568
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Nutrition may play an important role in the prevention of dementia. The aim of this study was to evaluate the effect of a multinutrient supplementation rich in omega-3 fatty acids on the cognitive function of adults aged 75 years and over with either no, or mild, cognitive impairment. Participants were given either a multinutrient capsule (each containing DHA 250 mg, EPA 40 mg, vitamin E 5 mg, phosphatidylserine 15 mg, tryptophan 95 mg, vitamin B 12 5 μg, folate 250 μg and ginkgo biloba 60 mg) or a placebo, three times a day for one year. Supplementation with the multinutrient did not improve overall cognitive function in the group. However, it did result in an improvement in memory in a sub-group of older people who were previously well nourished, but not in those with worse nutritional status.
Abstract
A few studies have assessed the association between omega-3 polyunsaturated fatty acids (n-3 PUFA) and cognitive impairment (CI) in very old adults. The aim of this study was to evaluate the effect of a multinutrient supplementation rich in n-3 PUFA on the cognitive function in an institutionalized ≥75-year-old population without CI or with mild cognitive impairment (MCI). A multicenter placebo-controlled double-blind randomized trial was conducted between 2012 and 2013. Cognitive function was assessed at baseline and after one year using 4 neuropsychological tests. Nutritional status was assessed using Mini Nutritional Assessment (MNA). Interaction between Mini-Mental State Examination (MMSE) score and nutritional status were analyzed using linear regression models. A total of 99 participants were randomized to receive placebo or pills rich in n-3 PUFA. After 1-year follow-up, both groups decreased their MMSE score (-1.18, SD:0. 53 and -0.82, SD:0. 63, p = 0.67 for the control and the intervention group respectively). The memory subscale of the MMSE showed an improvement (+0.26, SD:0.18) in the intervention group against a worsening in the control group (-0.11, SD: 0.14; p = 0.09 for differences between groups). Patients at intervention group with normal nutritional status (MNA ≥24) showed an improvement in the MMSE (+1.03, p = 0.025 for differences between 1-y and baseline measurements) against a worsening in the group with malnutrition (MNA<24) (-0.4, p = 0.886 for differences between 1-y and baseline; p of interaction p = 0.05). Supplementation with n-3 PUFA did not show an improvement in the global cognitive function in institutionalized elderly people without CI or with MCI. They only suggest an apparent improvement in memory loss if previously they were well nourished.
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Effect of protein and carbohydrate solutions on running performance and cognitive function in female recreational runners.
Gui, Z, Sun, F, Si, G, Chen, Y
PloS one. 2017;12(10):e0185982
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Research has shown that consuming a carbohydrate-electrolyte solution (CES) during endurance exercise can improve performance, delay fatigue and ameliorate post-exercise cognitive dysfuction when compared with a noncaloric placebo (PLA). The addition of protein to the CES (CPES) has been suggested to increase these benefits however the current data is limited. The aim of this crossover study was to investigate whether the added protein to a CES would improve exercise performance and cognitive function in 11 female recreational marathon runners. Participants were randomised to consume one of the three solutions (CES, CPES or PLA) every 2.5km during a 21km run, with a 28-day interval, and their VO2max and cognitive function were recorded after the run. This study showed that CES improved endurance performance compared with PLA, however adding protein to the CES did not provide any additional performance benefit. The CPES solution did benefit visual motor speed compared to PLA, but no differences were found in the other cognitive function tests.
Abstract
This study compared the effects of a carbohydrate-electrolyte-protein solution (CEPS, 2% protein plus 4% carbohydrate), carbohydrate-electrolyte solution (CES, 6% carbohydrate), and noncaloric sweetened placebo (PLA) on both 21-km running performance and cognitive function. Eleven female recreational endurance runners performed a 21-km time-trial running on three occasions, separated by at least 28 days. In a randomized cross-over design, they ingested CEPS, CES, or PLA at a rate of 150 mL every 2.5 km with no time feedback. A cognitive function test was performed before and after the run. Participants ingested approximately 24 g/h carbohydrate plus 12 g/h protein in CEPS trial, and 36 g/h carbohydrate in CES trial during each 21-km trial. Time to complete the time-trial was slightly shorter (P < 0.05) during CES (129.6 ± 8.8 min) than PLA (134.6 ± 11.5 min), with no differences between CEPS and the other two trials. The CEPS trial showed higher composite of visual motor speed than the PLA trial (P < 0.05). In conclusion, CES feedings might improve 21-km time-trial performance in female recreational runners compared with a PLA. However, adding protein to the CES provided no additional time-trial performance benefit. CEPS feeding during prolonged exercise could benefit visual motor speed compared to PLA alone, but no differences in the performance of the other cognitive function tests were found.