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  • Dhana, Anisa  (4)
  • Rajan, Kumar B  (4)
  • 1
    Online Resource
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    White matter hyperintensity, neurofilament light chain, and cognitive decline
    Wiley ; 2023
    In:  Alzheimer's & Dementia Vol. 19, No. S3 ( 2023-06)
    Details
    In: Alzheimer's & Dementia, Wiley, Vol. 19, No. S3 ( 2023-06)
    Abstract: White matter hyperintensity (WMH), assessed by magnetic resonance imaging (MRI), is a marker of cerebrovascular disease. Neurofilament light chain (NFL), assessed in the blood, is a biomarker of neurodegeneration. While both measures, WMH and NFL, are associated with cognitive impairment, we aimed to evaluate which of the two measurements is most advantageous in determining the risk of cognitive impairment. Method We conducted this investigation in Chicago Health and Aging Project (CHAP), a prospective population‐based cohort study in the United States. The study included 1,323 participants with data on NFL serum concentrations and 923 who underwent an MRI scan and had data on WMH volumes. NFL was measured using an ultrasensitive immunoassay, single‐molecule array technology. MRI scans of the brain were acquired using 1.5‐T systems. Global cognitive function was created as a composite measure of 4 neuropsychological tests, standardized and averaged to z‐scores. Linear mixed‐effects models were used to examine associations of the NFL, WMH, and cognitive decline adjusting for age, sex, race, education, and APOE e4. Result Of 1,323 participants, 808 (61%) were African Americans, and 38% were men, with an average age of 78.5 years. WMH and NFL were associated with faster cognitive decline in a multivariable‐adjusted model. Individuals in the third tertile of WMH had a faster cognitive decline by 0.029 (95%CI ‐0.052, ‐0.006) units per year compared to the first tertile. Also, compared to the first tertile of NFL, individuals in the third tertile had a faster cognitive decline by 0.029 (95%CI ‐0.046, ‐0.011) units per year. The stratified analysis by the tertiles of WMH showed that NFL was associated with a cognitive decline only in participants in the lowest tertile of WMH (‐0.089; 95%CI ‐0.159, ‐0.02). Similarly, when we stratified analysis by the tertiles of the NFL, we found a significant association of WMH with cognitive decline only participants in the lowest tertile of the NFL (‐0.052; 95%CI ‐0.008, ‐0.024). Conclusion While both biomarkers, NFL and WMH, are associated with cognitive decline, our findings suggest that within individuals with low values of NFL, WMH may identify people with a faster rate of decline in cognitive functioning.
    Type of Medium: Online Resource
    ISSN: 1552-5260 , 1552-5279
    URL: Issue
    URL: Article
    DOI: 10.1002/alz.v19.S3
    DOI: 10.1002/alz.066979
    Language: English
    Publisher: Wiley
    Publication Date: 2023
    detail.hit.zdb_id: 2201940-6
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  • 2
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    Healthy lifestyle and life expectancy with and without Alzheimer’s dementia: population based cohort study
    BMJ ; 2022
    In:  BMJ
    Details
    In: BMJ, BMJ
    Abstract: To determine the impact of lifestyle factors on life expectancy lived with and without Alzheimer’s dementia. Design Prospective cohort study. Setting The Chicago Health and Aging Project, a population based cohort study in the United States. Participants 2449 men and women aged 65 years and older. Main exposure A healthy lifestyle score was developed based on five modifiable lifestyle factors: a diet for brain health (Mediterranean-DASH Diet Intervention for Neurodegenerative Delay—MIND diet score in upper 40% of cohort distribution), late life cognitive activities (composite score in upper 40%), moderate or vigorous physical activity (≥150 min/week), no smoking, and light to moderate alcohol consumption (women 1-15 g/day; men 1-30 g/day). Main outcome Life expectancy with and without Alzheimer’s dementia in women and men. Results Women aged 65 with four or five healthy factors had a life expectancy of 24.2 years (95% confidence interval 22.8 to 25.5) and lived 3.1 years longer than women aged 65 with zero or one healthy factor (life expectancy 21.1 years, 19.5 to 22.4). Of the total life expectancy at age 65, women with four or five healthy factors spent 10.8% (2.6 years, 2.0 to 3.3) of their remaining years with Alzheimer’s dementia, whereas women with zero or one healthy factor spent 19.3% (4.1 years, 3.2 to 5.1) with the disease. Life expectancy for women aged 65 without Alzheimer’s dementia and four or five healthy factors was 21.5 years (20.0 to 22.7), and for those with zero or one healthy factor it was 17.0 years (15.5 to 18.3). Men aged 65 with four or five healthy factors had a total life expectancy of 23.1 years (21.4 to 25.6), which is 5.7 years longer than men aged 65 with zero or one healthy factor (life expectancy 17.4 years, 15.8 to 20.1). Of the total life expectancy at age 65, men with four or five healthy factors spent 6.1% (1.4 years, 0.3 to 2.0) of their remaining years with Alzheimer’s dementia, and those with zero or one healthy factor spent 12.0% (2.1 years, 0.2 to 3.0) with the disease. Life expectancy for men aged 65 without Alzheimer’s dementia and four or five healthy factors was 21.7 years (19.7 to 24.9), and for those with zero or one healthy factor life expectancy was 15.3 years (13.4 to 19.1). Conclusion A healthy lifestyle was associated with a longer life expectancy among men and women, and they lived a larger proportion of their remaining years without Alzheimer’s dementia. The life expectancy estimates might help health professionals, policy makers, and stakeholders to plan future healthcare services, costs, and needs.
    Type of Medium: Online Resource
    ISSN: 1756-1833
    URL: Article
    DOI: 10.1136/bmj-2021-068390
    Language: English
    Publisher: BMJ
    Publication Date: 2022
    detail.hit.zdb_id: 1479799-9
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  • 3
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    Subjective memory complaints, white matter hyperintensities, and cognitive decline in a population‐based cohort study
    Wiley ; 2023
    In:  Alzheimer's & Dementia Vol. 19, No. S8 ( 2023-06)
    Details
    In: Alzheimer's & Dementia, Wiley, Vol. 19, No. S8 ( 2023-06)
    Abstract: Subjective memory complaints (SMCs) are associated with a faster cognitive decline and dementia; whether this relationship results from irreversible structural brain alterations, such as white matter hyperintensities (WMH), requires investigation. We aimed to determine the association of SMCs with WMH and cognitive decline and investigate the role of WMH on the relationship between SMCs and cognitive decline. Method We studied 917 participants (63% African Americans and 60% women) from the population‐based Chicago Health and Aging Project (CHAP), who responded to questions about SMCs, underwent magnetic resonance imaging of the brain, and had valid cognitive data on two or more visits during the follow‐up period. SMCs were obtained by self‐report questionnaire, and based on frequency and severity of concerns, we categorized participants into three groups: not concerned, moderately concerned, and very concerned. Result Of 917 participants eligible for the study, 158 (17.2%) had no SMCs concerns, 671 (73.2%) had moderate concerns, and 88 (9.6%) were very concerned. SMCs were associated with larger WMH volumes and faster cognitive decline. Compared to participants with no concerns, those very concerned had 0.833 (95%CI 0.203, 1.463) units higher WMH volumes and 174% faster cognitive decline (‐0.049; 95%CI ‐0.076, ‐0.022). The association between SMCs and cognitive decline was statistically significant only among individuals with large WMH volumes; that is, very concerned individuals with large WMH volumes had 428% faster cognitive decline annually (‐0.077; 95%CI ‐0.144, ‐0.011) than participants with no concerns. In participants with low volumes of WMH, SMCs were not associated with a faster cognitive decline ( P ‐value = 0.595). Conclusion Our study suggests that SMCs, frequently reported by the elderly, are an important sign of cognitive impairment, especially in people with brain atrophies, such as large WMH volumes.
    Type of Medium: Online Resource
    ISSN: 1552-5260 , 1552-5279
    URL: Issue
    URL: Article
    DOI: 10.1002/alz.v19.S8
    DOI: 10.1002/alz.066704
    Language: English
    Publisher: Wiley
    Publication Date: 2023
    detail.hit.zdb_id: 2201940-6
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  • 4
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    Online Resource
    Vitamin D intake and cognitive decline in African Americans and European Americans: The role of diet and supplements
    Wiley ; 2023
    In:  Alzheimer's & Dementia Vol. 19, No. S8 ( 2023-06)
    Details
    In: Alzheimer's & Dementia, Wiley, Vol. 19, No. S8 ( 2023-06)
    Abstract: Vitamin D intake and supplementation has received considerable interest in dementia research because the prevalence of vitamin D deficiency is higher among older adults, particularly among older African Americans and cognitively impaired individuals. We prospectively examined the role of vitamin D intake, from both diet and supplements, in association with cognitive decline in African Americans and European Americans. Method Utilizing data from the population‐based Chicago Health and Aging Project, we studied 2,061 African Americans and 1,329 European Americans with dietary vitamin D data and cognitive testing over 18 years of follow‐up. Multivariable linear mixed‐effects models adjusted for age, sex, education, APOE e4, body mass index, late‐life cognitive activities, physical activity, comorbidities, total energy intake, and their respective interactions with follow‐up time were used to determine the association of vitamin D intake with cognitive decline. Result On average, the vitamin D intake was lower in African Americans than European Americans (210.2 IU/d vs. 348.7 IU/d). In African Americans, participants in the highest tertile had a slower cognitive decline of 0.019 units/year (95%CI 0.009, 0.030) compared to those in the lowest tertile of dietary intake. The use of vitamin D supplementation was not associated with cognitive decline in African Americans (β 0.004, 95%CI ‐0.006, 0.013). In European Americans, vitamin D intake was not associated with cognitive decline. Conclusion Dietary vitamin D may help slow the rate of cognitive decline in African Americans as they age.
    Type of Medium: Online Resource
    ISSN: 1552-5260 , 1552-5279
    URL: Issue
    URL: Article
    DOI: 10.1002/alz.v19.S8
    DOI: 10.1002/alz.066910
    Language: English
    Publisher: Wiley
    Publication Date: 2023
    detail.hit.zdb_id: 2201940-6
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