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  • 1
    In: Alzheimer's & Dementia, Wiley, Vol. 17, No. S10 ( 2021-12)
    Abstract: Early onset dementia (EOD) has significant impact on patients and families. In a recent epidemiological study conducted in the province of Modena, Italy, we reported that the most frequent EOD in persons aged 30‐64 years was the amnestic variant of Alzheimer’s Disease (AD), followed by the behavioral variant of frontotemporal dementia (FTD). Previous studies have shown that ageing increases prevalence of AD even in patients younger than 65. However, it is not known whether different variants of AD and other causes of EOD are equally affected by ageing. Here we studied prevalence of the different clinical variants of EOD by age group. Method We identified all EOD patients seen in the network of dementia services of the Modena province, from 2006 to 2019. We included all patients with a diagnosis of dementia with symptom onset before age 65 alive on census date. We stratified them according to their age group and computed crude and sex‐adjusted prevalence rates. Result Prevalence of all AD showed a nearly exponential growth ranging from 1.8/100,000 in the 40‐44 age group to 141.4/100,000 in the 59‐64 group. Among AD variants, prevalence of the amnestic variant was the most influenced by the age, increasing from 17.5/100,000 in the 40‐44 group to 102.6/100,000 in the 59‐64 group, while prevalence of posterior cortical atrophy and logopenic variant of primary progressive aphasia (PPA) showed an almost flat growth curve. Prevalence of all FTD increased linearly from 1.8/100,000 in the 40‐44 group to 86.6/100,000 in the 59‐64 group, with such increase being all driven by the behavioral variant (bvFTD), which increased from 1.8/100,000 to 66.1/100,00. Non‐fluent and semantic variants of PPA did not increase with age, although an association with age may have been underestimated by their low frequency. Conclusion In patients younger than 65, prevalence rates of amnestic AD and bvFTD increase with ageing, while other clinical variants of AD and FTD does not seem to show that pattern. These results contribute to a better understanding of the different clinical variants of EOD and their risk factors.
    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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  • 2
    In: Nutrients, MDPI AG, Vol. 12, No. 12 ( 2020-11-29), p. 3682-
    Abstract: Risk of early-onset dementia (EOD) might be modified by environmental factors and lifestyles, including diet. The aim of this study is to evaluate the association between dietary habits and EOD risk. We recruited 54 newly-diagnosed EOD patients in Modena (Northern Italy) and 54 caregivers as controls. We investigated dietary habits through a food frequency questionnaire, assessing both food intake and adherence to dietary patterns, namely the Greek-Mediterranean, the Dietary Approaches to Stop Hypertension (DASH), and the Mediterranean-DASH Intervention for Neurodegenerative Delay (MIND) diets. We modeled the relation between dietary factors and risk using the restricted cubic spline regression analysis. Cereal intake showed a U-shaped relation with EOD, with risk increasing above 350 g/day. A high intake ( 〉 400 g/day) of dairy products was also associated with excess risk. Although overall fish and seafood consumption showed no association with EOD risk, we found a U-shaped relation with preserved/tinned fish, and an inverse relation with other fish. Similarly, vegetables (especially leafy) showed a strong inverse association above 100 g/day, as did citrus and dry fruits. Overall, sweet consumption was not associated with EOD risk, while dry cake and ice-cream showed a positive relation and chocolate products an inverse one. For beverages, we found no relation with EOD risk apart from a U-shaped relation for coffee consumption. Concerning dietary patterns, EOD risk linearly decreased with the increasing adherence to the MIND pattern. On the other hand, an inverse association for the Greek-Mediterranean and DASH diets emerged only at very high adherence levels. To the best of our knowledge, this is the first study that explores the association between dietary factors and EOD risk, and suggests that adherence to the MIND dietary pattern may decrease such risk.
    Type of Medium: Online Resource
    ISSN: 2072-6643
    Language: English
    Publisher: MDPI AG
    Publication Date: 2020
    detail.hit.zdb_id: 2518386-2
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  • 3
    In: International Journal of Environmental Research and Public Health, MDPI AG, Vol. 17, No. 21 ( 2020-10-29), p. 7941-
    Abstract: Background: Early-onset dementia (EOD) is defined as dementia with symptom onset before 65 years. The role of environmental risk factors in the etiology of EOD is still undefined. We aimed at assessing the role of environmental risk factors in EOD etiology, taking into account its different clinical types. Methods: Using a case-control study, we recruited all EOD cases referred to Modena hospitals from 2016 to 2019, while the referent population was drawn from cases’ caregivers. We investigated residential history, occupational and environmental exposures to chemicals and lifestyle behaviors through a self-administered questionnaire. We computed the odds ratios of EOD risk (overall and restricting to the Alzheimer’s dementia (AD) or frontotemporal dementia (FTD) diagnoses) and the corresponding 95% confidence intervals using an unconditional logistic regression model. Results: Fifty-eight EOD patients (19 FTD and 32 AD) and 54 controls agreed to participate. Most of the investigated exposures, such as occupational exposure to aluminum, pesticides, dyes, paints or thinners, were associated with an increased odds ratio (OR) for FTD but not for AD. Long-term use of selenium-containing dietary supplements was associated with increased OR for EOD and, particularly, for FTD. For both EOD forms, smoking and playing football showed an increased odds ratio, while cycling was associated with increased risk only in FTD. Overall sports practice appeared to be a protective factor for both types. Conclusions: Our results suggest a role of environmental and behavioral risk factors such as some chemical exposures and professional sports in EOD etiology, in particular with reference to FTD. Overall sports practice may be associated with a reduced EOD risk.
    Type of Medium: Online Resource
    ISSN: 1660-4601
    Language: English
    Publisher: MDPI AG
    Publication Date: 2020
    detail.hit.zdb_id: 2175195-X
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  • 4
    In: Journal of the Neurological Sciences, Elsevier BV, Vol. 429 ( 2021-10), p. 118999-
    Type of Medium: Online Resource
    ISSN: 0022-510X
    Language: English
    Publisher: Elsevier BV
    Publication Date: 2021
    detail.hit.zdb_id: 1500645-1
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  • 5
    In: Environmental Science & Technology, American Chemical Society (ACS), Vol. 42, No. 7 ( 2008-04-01), p. 2618-2623
    Type of Medium: Online Resource
    ISSN: 0013-936X , 1520-5851
    RVK:
    Language: English
    Publisher: American Chemical Society (ACS)
    Publication Date: 2008
    detail.hit.zdb_id: 280653-8
    detail.hit.zdb_id: 1465132-4
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  • 6
    In: Alzheimer's & Dementia, Wiley, Vol. 17, No. 1 ( 2021-01), p. 81-88
    Abstract: Patients with early onset dementia (EOD), defined as dementia with symptom onset at age 〈 65, frequently present with atypical syndromes. However, the epidemiology of different EOD presentations, including variants of Alzheimer's disease (AD) and frontotemporal dementia (FTD), has never been investigated all together in a population‐based study. Epidemiologic data of all‐cause EOD are also scarce. Methods We investigated EOD epidemiology by identifying patients with EOD seen in the extended network of dementia services of the Modena province, Northern Italy (≈700,000 inhabitants) from 2006 to 2019. Results In the population age 30 to 64, incidence was 13.2 per 100,000/year, based on 160 new cases from January 2016 to June 2019, and prevalence 74.3 per 100,000 on June 30, 2019. The most frequent phenotypes were the amnestic variant of AD and behavioral variant of FTD. Discussion EOD affects a significant number of people. Amnestic AD is the most frequent clinical presentation in this understudied segment of the dementia population.
    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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  • 7
    In: Environmental Science & Technology, American Chemical Society (ACS), Vol. 42, No. 22 ( 2008-11-15), p. 8613-8613
    Type of Medium: Online Resource
    ISSN: 0013-936X , 1520-5851
    RVK:
    Language: English
    Publisher: American Chemical Society (ACS)
    Publication Date: 2008
    detail.hit.zdb_id: 280653-8
    detail.hit.zdb_id: 1465132-4
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  • 8
    Online Resource
    Online Resource
    American Association for Cancer Research (AACR) ; 2020
    In:  Cancer Epidemiology, Biomarkers & Prevention Vol. 29, No. 6 ( 2020-06-01), p. 1095-1106
    In: Cancer Epidemiology, Biomarkers & Prevention, American Association for Cancer Research (AACR), Vol. 29, No. 6 ( 2020-06-01), p. 1095-1106
    Abstract: Acrylamide is a probable human carcinogen. Aside from occupational exposures and smoking, diet is the main source of exposure in humans. We performed a systematic review of the association between estimated dietary intake of acrylamide and risk of female breast, endometrial, and ovarian cancers in nonexperimental studies published through February 25, 2020, and conducted a dose–response meta-analysis. We identified 18 papers covering 10 different study populations: 16 cohort and two case–control studies. Acrylamide intake was associated with a slightly increased risk of ovarian cancer, particularly among never smokers. For endometrial cancer, risk was highest at intermediate levels of exposure, whereas the association was more linear and positive among never smokers. For breast cancer, we found evidence of a null or inverse relation between exposure and risk, particularly among never smokers and postmenopausal women. In a subgroup analysis limited to premenopausal women, breast cancer risk increased linearly with acrylamide intake starting at 20 μg/day of intake. High acrylamide intake was associated with increased risks of ovarian and endometrial cancers in a relatively linear manner, especially among never smokers. Conversely, little association was observed between acrylamide intake and breast cancer risk, with the exception of premenopausal women.
    Type of Medium: Online Resource
    ISSN: 1055-9965 , 1538-7755
    Language: English
    Publisher: American Association for Cancer Research (AACR)
    Publication Date: 2020
    detail.hit.zdb_id: 2036781-8
    detail.hit.zdb_id: 1153420-5
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  • 9
    In: Alzheimer's & Dementia, Wiley, Vol. 16, No. S10 ( 2020-12)
    Abstract: It is known that patients with Early Onset Dementia (EOD), defined as dementia with symptoms onset before the age of 65, frequently present with atypical clinical syndromes. However, the epidemiology of the different presentations of EOD, including the clinical variants of Alzheimer’s dementia (AD) and frontotemporal dementia (FTD), has never been investigated altogether in the same population‐based study, probably because their characterisation is relatively recent, and subsequent to the advent of AD biomarkers. Epidemiologic data on all‐causes of EOD are also scarce, inconsistent, and mostly based on low‐level clinical assessment. Method We investigated the epidemiology of EOD in the province of Modena, Northern Italy (700,000 inhabitants), by identifying newly‐diagnosed EOD patients retrospectively from January 2006 to December 2016, and prospectively from January 2017 to June 2019. Diagnosis was based on extended clinical and neuropsychological assessment, and supported by the use of imaging and cerebrospinal fluid biomarkers in the majority of cases. Result EOD age‐ and sex‐adjusted incidence was 6.45/100000 inhabitants/year during the 2016‐2019 period, corresponding to 46 new cases per year in the overall study population. At census day (30 th June 2019), there were 258 patients with a clinical diagnosis of EOD (123 males) in the province of Modena. Crude Prevalence was 74.3/100000 (71.2 in males and 77.4 in females) in the population aged 30‐64, and 119.9/100000 (117.1 in males and 122.6 in females) in the population aged 45‐64. Overall crude prevalence was 36.4/100000 inhabitants (35.5/100000 in males, 37.4/100000 in females). The most frequent EOD was the amnestic variant of AD (crude incidence of 21.6/100000 and prevalence of 5/100000 persons aged 30‐64 years), followed by the behavioural variant of FTD (crude incidence of 14.1/100000 and prevalence of 2.8/100000 persons aged 30‐64 years), and logopenic variant of primary progressive aphasia (crude incidence of 5.8/100000 and prevalence of 0.8/100000 persons aged 30‐64 years). Conclusion We provide the first report on incidence and prevalence of all the clinical presentations of EOD including different variants of AD and FTD. These epidemiological data will benefit the clinical reasoning of clinicians faced with dementia in young patients and will allow to improve dementia care organisation.
    Type of Medium: Online Resource
    ISSN: 1552-5260 , 1552-5279
    URL: Issue
    Language: English
    Publisher: Wiley
    Publication Date: 2020
    detail.hit.zdb_id: 2201940-6
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  • 10
    In: Neuroepidemiology, S. Karger AG, Vol. 54, No. 1 ( 2020), p. 1-23
    Abstract: 〈 b 〉 〈 i 〉 Background: 〈 /i 〉 〈 /b 〉 Parkinson’s disease (PD) is the most common neurodegenerative disease after Alzheimer’s dementia. Whereas the exact etiology of PD remains unknown, risk of developing PD seems to be related to a combination of genetic and environmental factors. This also includes abnormal exposure to trace elements of nutritional and toxicological interest. 〈 b 〉 〈 i 〉 Objectives: 〈 /i 〉 〈 /b 〉 In this systematic review and meta-analysis, we summarized the results of case–control studies comparing levels of selenium, copper, iron, and zinc in PD patients and controls in either blood (whole blood, serum/plasma) or cerebrospinal fluid (CSF). 〈 b 〉 〈 i 〉 Methods: 〈 /i 〉 〈 /b 〉 We performed a systematic PubMed search selecting studies reporting trace element levels in different specimens of patients and controls. We performed a meta-analysis using a random-effect model to compute the weighted mean differences (WMD) and corresponding 95% CI of selenium, copper, iron, and zinc levels in the blood or CSF of patients and their matched controls. 〈 b 〉 〈 i 〉 Results: 〈 /i 〉 〈 /b 〉 We retrieved 56 papers reporting data for selenium (cases/controls: 588/721), copper (2,190/2,522), iron (2,956/3,469), and zinc (1,798/1,913) contents in CSF and blood. Cases showed considerably higher levels of selenium in CSF compared with controls (+51.6%; WMD 5.49; 95% CI 2.82 to 8.15), while levels in serum were similar (–0.2%; WMD –0.22; 95% CI –8.05 to 7.62). For copper, cases showed slightly higher levels in CSF and slightly lower concentrations in serum (+4.5%; WMD 1.87; 95% CI –3.59 to 7.33, and –4.5%; WMD –42.79; 95% CI –134.35 to 48.76, respectively). A slight increase was also found for CSF iron ­levels (+9.5%; WMD 9.92; 1.23 to 18.61), while levels were ­decreased in serum/plasma (–5.7%; WMD –58.19; 95% CI –106.49 to –9.89) and whole blood (–10.8%; WMD –95.69; 95% CI –157.73 to –33.65). Conversely, for zinc cases exhibited lower levels both in CSF (–10.8%; WMD –7.34; 95% CI –14.82 to 0.14) and serum/plasma (–7.5%; WMD –79.93; 95% CI –143.80 to –16.06). A longer duration of the disease tends to be associated with overall lower trace element levels in either CSF or blood. 〈 b 〉 〈 i 〉 Conclusions: 〈 /i 〉 〈 /b 〉 Due to the study findings and the greater relevance of the CSF compartment compared with the circulating peripheral ones, this meta-analysis suggests that overexposure in the central nervous system to selenium, and possibly to copper and iron, may be a risk factor of the disease, while zinc might have a protective ­effect.
    Type of Medium: Online Resource
    ISSN: 0251-5350 , 1423-0208
    Language: English
    Publisher: S. Karger AG
    Publication Date: 2020
    detail.hit.zdb_id: 1483032-2
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