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  • Wiley  (20)
  • Zhao, Qianhua  (20)
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  • Wiley  (20)
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  • 1
    In: Alzheimer's & Dementia, Wiley, Vol. 19, No. S3 ( 2023-06)
    Abstract: Mild cognitive impairment (MCI) is a critical prodromal stage of Alzheimer’s disease (AD) with high risk of conversion. It is of great challenge to construct reliable biomarkers for predicting conversion from MCI to AD, while the underlying mechanism is still not fully explored. Inter‐dataset generalizability is a prerequisite for clinical use of biomarkers and always a shortage of neuroimaging‐based studies. Method In this study, we propose a novel framework by integrating structural MRI (sMRI) and both static and dynamic resting‐state functional MRI (fMRI) measurements to investigate the differences between MCI converters (MCI_C) and non‐converters (MCI_NC), and then utilized support vector machine (SVM) to construct the prediction models based on selected features. A total of 186 MCI patients with both MRI and three‐year outcome data were selected from two independent cohorts: Shanghai Memory Study (SMS) cohort for selection of MRI predictors and internal cross‐validation, and ADNI cohort for external validation on the generalizability of these MRI predictors. Result In comparison with MCI_NC, the MRI converters were mainly characterized by alterations of medial temporal lobe (MTL) with atrophy extending to lateral temporal and regional hyperactivity and instability, posterior parietal cortex (PPC) with atrophy and inter‐regional hypo‐connectivity and connectional instability, and occipital cortex with functional instability. All of the imaging‐based prediction models achieved an AUC above 0.7 and ACC above 70% in both SMS and ADNI cohorts. The combination of static and dynamic fMRI features resulted in overall good performance as relative to static or dynamic fMRI solely, supporting the contribution of dynamic features into the fMRI model. In both cohorts, the best imaging model was the multi‐modality MRI model which provided excellent performance with AUC above 0.85 and average ACC/sensitivity/specificity around 80%. Conclusion This inter‐cohort validation study provides a new insight into the mechanisms of MCI conversion and paves a way for eventual clinical use of MRI biomarkers.
    Type of Medium: Online Resource
    ISSN: 1552-5260 , 1552-5279
    URL: Issue
    Language: English
    Publisher: Wiley
    Publication Date: 2023
    detail.hit.zdb_id: 2201940-6
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  • 2
    In: Alzheimer's & Dementia, Wiley, Vol. 19, No. S2 ( 2023-06)
    Abstract: Previous studies indicated that blood‐based biomarkers could predict cognitive decline in Alzheimer’s disease (AD) continuum. Method Two hundred and fifty‐one participants with amnestic mild cognitive impairment (aMCI) from the Shanghai Memory Study were followed up for a maximum of 8 years. Baseline blood biomarkers were measured with the single‐molecule array (Simoa) platform. Multipoint clinical diagnosis and domain‐specific cognitive functions were assessed to investigate the longitudinal relationship between blood biomarkers and clinical AD progression. Result Participants with high‐risk plasma Aβ42/Aβ40 (A) and p‐tau181 (T) level demonstrated the highest probability of incident AD (HR 5.54, 95% CI 2.99‐10.27), and the most dramatic decline in global cognition, attention, executive function, visuospatial function, and language. Comparing to young‐old participants, the old‐old ones with low‐ and moderate‐risk AT showed higher AD risks (HR 3.70, 95% CI 1.16‐11.81; HR 3.15, 95% CI 1.37‐7.26), and faster cognitive deterioration. Conclusion The results supported the use of plasma Aβ42/Aβ40 and p‐tau181 as accessible and feasible indicators of AD progression and the long‐term cognitive deterioration, especially in patients with older age.
    Type of Medium: Online Resource
    ISSN: 1552-5260 , 1552-5279
    URL: Issue
    Language: English
    Publisher: Wiley
    Publication Date: 2023
    detail.hit.zdb_id: 2201940-6
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  • 3
    In: Human Brain Mapping, Wiley, Vol. 42, No. 6 ( 2021-04-15), p. 1910-1919
    Abstract: White matter hyperintensities (WMH) are common in elderly individuals and cause brain network deficits. However, it is still unclear how the global brain network is affected by the focal WMH. We aimed to investigate the diffusion of WMH‐related deficits along the connecting white matters (WM). Brain magnetic resonance imaging data and neuropsychological evaluations of 174 participants (aged 74 ± 5 years) were collected and analyzed. For each participant, WMH lesions were segmented using a deep learning method, and 18 major WM tracts were reconstructed using automated quantitative tractography. The diffusion characteristics of distal WM tracts (with the WMH penumbra excluded) were calculated. Multivariable linear regression analysis was performed. We found that a high burden of tract‐specific WMH was related to worse diffusion characteristics of distal WM tracts in a wide range of WM tracts, including the forceps major (FMA), forceps minor (FMI), anterior thalamic radiation (ATR), cingulum cingulate gyrus (CCG), corticospinal tract (CST), inferior longitudinal fasciculus (ILF), superior longitudinal fasciculus‐parietal (SLFP), superior longitudinal fasciculus‐temporal (SLFT), and uncinate fasciculus (UNC). Furthermore, a higher mean diffusivity (MD) of distal tracts was linked to worse attention and executive function in the FMI, right CCG, left ILF, SLFP, SLFT, and UNC. The effect of WMH on the microstructural integrity of WM tracts may propagate along tracts to distal regions beyond the penumbra and might eventually affect attention and executive function.
    Type of Medium: Online Resource
    ISSN: 1065-9471 , 1097-0193
    URL: Issue
    Language: English
    Publisher: Wiley
    Publication Date: 2021
    detail.hit.zdb_id: 1492703-2
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  • 4
    In: Alzheimer's & Dementia, Wiley, Vol. 19, No. 2 ( 2023-02), p. 560-568
    Abstract: The impacts of education on cognitive decline across different neighborhood environments (NEs) have rarely been studied. Methods We investigated and compared the associations between educational attainment and cognitive decline using data of 1286 participants from the Taizhou Imaging Study (TIS) and the Shanghai Aging Study (SAS). Results Compared with low‐educated participants, in TIS with disadvantaged NE, high‐educated participants manifested a significantly slower decline in global cognition (.062 Z score per year, P 〈 .001), memory (.054 Z score per year, P 〈 .05), and attention (.065 Z score per year, P 〈 .01), whereas in SAS with advanced NE, highly educated individuals exhibited a slower decline only in attention (.028 Z score per year, P 〈 .05). Discussion We observed the additive effect of educational attainment and NE on cognitive decline in older adults. Education is especially important for maintaining cognitive health in a disadvantaged environment.
    Type of Medium: Online Resource
    ISSN: 1552-5260 , 1552-5279
    URL: Issue
    Language: English
    Publisher: Wiley
    Publication Date: 2023
    detail.hit.zdb_id: 2201940-6
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  • 5
    In: Alzheimer's & Dementia, Wiley, Vol. 17, No. S5 ( 2021-12)
    Abstract: The plasma biomarkers showed a promising value in the disease management of Alzheimer’s disease (AD). However, the profiles of the plasma biomarkers and the association with cognitive domains along the spectrum of AD have seldom been reported. Method A total of 451 participants were recruited from a memory clinic cohort and a cohort with community‐dwellings. The global and domain‐specific neuropsychological tests were administrated in all participants. The Clinical Dementia Rating (CDR) was used to assess the severity of cognitive impairment. The diagnosis of mild cognitive impairment (MCI) and dementia were based on the Petersen’s criteria and DSM‐IV criteria. The AD was diagnosed according to the NINCDS‐ADRDA criteria. We described the continuum of AD based on the combination of CDR and the cognitive diagnosis: NC (CDR = 0), aMCI‐s (CDR = 0.5), aMCI‐m (CDR = 0.5), AD (CDR = 1), AD (CDR = 2), and AD (CDR = 3). The plasma Aβ 40, Aβ 42, Aβ 42/Aβ 40, t‐Tau, neurofilament protein light chain, and p‐Tau 181 were quantified using the Single molecule array platform. One‐way Analysis of Variance and Welch test were used for comparison among plasma markers. The association between domain z scores and log‐transformed plasma biomarker indexes were examined using partial Pearson correlation analysis with the adjustment for confounding variables. Result The concentration of plasma p‐Tau 181 basically increased along the clinical cognitive status, from normal cognition (CDR = 0) to AD (CDR = 3). There are varying degrees of correlation between six plasma biomarkers and different cognitive domains. Plasma p‐Tau 181 had the strongest correlation with MMSE (r = ‐0.494, P 〈 0.001), Memory (r = ‐0.417, P 〈 0.001), Attention (r = ‐0.388, P 〈 0.001), Visuospatial function (r = ‐0.328, P 〈 0.001), and Language (r = ‐0.123, P = 0.014). There was significant negative correlation between plasma p‐Tau 181 and four subgroups of cognitive domains, including MMSE in CDR 〉 =1 group, Memory in CDR = 0.5 group & CDR 〉 =1 group, and Attention in CDR 〉 = 1 group. Conclusion Plasma p‐Tau 181 increased along the clinical continuum of AD, and had the strongest correlation with cognitive domains among all plasma biomarkers.
    Type of Medium: Online Resource
    ISSN: 1552-5260 , 1552-5279
    URL: Issue
    Language: English
    Publisher: Wiley
    Publication Date: 2021
    detail.hit.zdb_id: 2201940-6
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  • 6
    In: Alzheimer's & Dementia, Wiley, Vol. 15, No. 7S_Part_28 ( 2019-07)
    Type of Medium: Online Resource
    ISSN: 1552-5260 , 1552-5279
    Language: English
    Publisher: Wiley
    Publication Date: 2019
    detail.hit.zdb_id: 2201940-6
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  • 7
    In: Alzheimer's & Dementia: Diagnosis, Assessment & Disease Monitoring, Wiley, Vol. 4, No. 1 ( 2016-01), p. 28-36
    Abstract: The Shanghai Aging Study is a community‐based study aiming to investigate the incidence and progression of cognitive decline in Chinese elderly, with the operational procedures and diagnostic criteria similar to cohort studies in developed countries. Methods We prospectively evaluated 362 individuals with mild cognitive impairment (MCI) diagnosed at baseline through a clinical and neuropsychological interview. Diagnoses of dementia and MCI were made using standard criteria via consensus diagnosis. Results The conversion rate to dementia was 6.0 per 100 person‐years, while the reversion rate to cognitive normal was 7.8 per 100 person‐years. Amnestic MCI multiple domains was the most risky type for dementia (conversion rate: 14.2 per 100 person‐years). Older age (hazard ratio [HR] = 1.09), apolipoprotein E ( APOE ε4) (HR = 2.15), and low MMSE score (HR = 1.18) were predictors for dementia. Discussion Approximately 6% of elderly with MCI progress to dementia annually. Prospective studies are needed to further examine risk and protective predictors and to seek proper interventions for cognitive decline.
    Type of Medium: Online Resource
    ISSN: 2352-8729 , 2352-8729
    Language: English
    Publisher: Wiley
    Publication Date: 2016
    detail.hit.zdb_id: 2832898-X
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  • 8
    Online Resource
    Online Resource
    Wiley ; 2019
    In:  Alzheimer's & Dementia: Diagnosis, Assessment & Disease Monitoring Vol. 11, No. 1 ( 2019-12), p. 405-414
    In: Alzheimer's & Dementia: Diagnosis, Assessment & Disease Monitoring, Wiley, Vol. 11, No. 1 ( 2019-12), p. 405-414
    Abstract: The aim of this study was to investigate retinal thickness as a biomarker for identifying patients with mild cognitive impairment (MCI) and Alzheimer's disease (AD). Methods The retinal thickness, utilizing the spectral domain optical coherence tomography, was compared among 73 patients with AD, 51 patients with MCI, 67 cognitive normal control (NC) subjects. Results The retinal thickness of ganglion cell complex and peripapillary retinal nerve fiber layer decreased in both AD and MCI patients, in comparison with NC subjects (AD vs. NC, P 〈 .01; MCI vs. NC, P 〈 .01). The inner retinal layers in macular area in MCI exhibited significant thinning compared with NC ( P 〈 .001). Remarkable association was found between the retinal thickness and brain volume ( P 〈 .05). Better correlation was seen between the inner perifovea retinal thickness and the hippocampal and entorhinal cortex volume (r: 0.427–0.644, P 〈 .01). Discussion The retinal thickness, especially the inner retinal layer thickness, is a potentially early AD marker indicating neurodegeneration.
    Type of Medium: Online Resource
    ISSN: 2352-8729 , 2352-8729
    Language: English
    Publisher: Wiley
    Publication Date: 2019
    detail.hit.zdb_id: 2832898-X
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  • 9
    In: Brain and Behavior, Wiley, Vol. 10, No. 11 ( 2020-11)
    Abstract: Previous studies suggest that olfactory dysfunction is associated with cognitive decline or dementia. Objective To find a potential association between the olfactory identification (OI) and dementia onset, and build a prediction model for dementia screening in the older population. Methods Nine hundred and forty‐seven participants from the Shanghai Aging Study were analyzed. The participants were dementia‐free and completed OI test using the Sniffin’ Sticks Screening Test‐12 at baseline. After an average of 4.9‐year follow‐up, 75 (8%) of the participants were diagnosed with incident dementia. Discrete Bayesian network (DBN) and multivariable logistic regression (MLR) models were used to explore the dependencies of the incident dementia on the baseline demographics, lifestyles, and OI test results. Results In DBN analysis, odors of orange, cinnamon, peppermint, and pineapple, combined with age and Mini‐mental State Examination (MMSE), achieved a high predictive ability for incident dementia, with an area under the receiver operating characteristic curve (AUC) larger than 0.8. The odor cinnamon showed the highest AUC of 0.838 (95% CI: 0.731–0.946) and a high accuracy of 0.867. The DBN incorporating age, MMSE, and one odor test had an accuracy (0.760–0.872 vs. 0.835) comparable to that of the MLR model and revealed the dependency between the variables. Conclusion The DBN using OI test may have predictive ability comparable to MLR analysis and suggest potential causal relationship for further investigation. Identification of odor cinnamon might be a useful indicator for dementia screening and deserve further investigation.
    Type of Medium: Online Resource
    ISSN: 2162-3279 , 2162-3279
    URL: Issue
    Language: English
    Publisher: Wiley
    Publication Date: 2020
    detail.hit.zdb_id: 2623587-0
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  • 10
    Online Resource
    Online Resource
    Wiley ; 2020
    In:  International Journal of Geriatric Psychiatry Vol. 35, No. 7 ( 2020-07), p. 712-718
    In: International Journal of Geriatric Psychiatry, Wiley, Vol. 35, No. 7 ( 2020-07), p. 712-718
    Abstract: This study aimed to demonstrate the association between adverse life events (ALEs) and the risk of late‐life cognitive decline in older community‐dwelling individuals in China. Methods We prospectively followed up 1657 dementia‐free participants with ALE data at baseline in the Shanghai Aging Study. The cohort was categorized into four subgroups (depression with ALEs, depression without ALEs, no depression with ALEs, and no depression without ALEs). Cox regressions were conducted to estimate the hazard ratio (HR) for incident dementia stratified by all participants and depressed and nondepressed participants. Results We identified 168 incident dementia cases over a mean period of 5.2 years. The cumulative dementia incidence in nondepressed participants with ALEs was the lowest among the four subgroups. Nondepressed participants with ALEs had a lower risk of incident dementia (HR [95% CI]: 0.50 [0.27‐0.92] , P = .0267) than those without ALEs, adjusted for age, sex, education, apolipoprotein E ε4 (APOE ε4), body mass index, cigarette smoking, heart disease, hypertension, diabetes, stroke, Mini‐Mental State Examination (MMSE) at baseline, and anxiety. Conclusions This study explored a significant inverse association between ALEs and the risk of incident cognitive decline among older adults without depression in China. Interventions for depression prevention immediately after ALEs may reduce the risk of cognitive decline later in life.
    Type of Medium: Online Resource
    ISSN: 0885-6230 , 1099-1166
    URL: Issue
    RVK:
    Language: English
    Publisher: Wiley
    Publication Date: 2020
    detail.hit.zdb_id: 1500455-7
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