Little is known about the association between obesity and sarcopenia - age-related loss of muscle mass and function - among patients with cardiovascular disease. We investigated the association ...between overweight, obesity, and sarcopenia among community-dwelling men in Israel with cardiovascular disease.
A subset of 337 men (mean age at baseline 56.7 SD, 6.5) who previously (1990-1997) participated in the Bezafibrate Infarction Prevention trial underwent a neurovascular evaluation as part of the Bezafibrate Infarction Prevention Neurocognitive Study 15.0 (SD, 3.0) years after baseline and a sarcopenia evaluation 19.9 (SD, 1.0) years after baseline. We applied a multinomial logistic model to estimate odds ratios and 95% CIs for 3 categories of sarcopenia: no evidence of sarcopenia (ie, robust), probable sarcopenia, and sarcopenia.
We found sarcopenia among 54.3% of participants with obesity (body mass index BMI, in kg/m
≥30.0), 37.0% of participants who were overweight (25.0 ≤ BMI ≤29.9), and 24.8% of participants with normal weight (BMI 18.5 to 24.9). In a comparison of BMI ≥25.0 and BMI <25.0, adjusting for covariates, the odds ratio of having probable sarcopenia was 3.27 (95% CI, 1.68-6.36) and having sarcopenia was 5.31 (95% CI, 2.50-11.27).
We found a positive association between obesity and late-life sarcopenia and suggest that obesity might be an important modifiable risk factor related to sarcopenia among men with cardiovascular disease.
OBJECTIVE:To evaluate the possible early consequences of impaired glucose metabolism on the brain by assessing the relationship of diabetes, fasting blood glucose (FBG) levels, and insulin resistance ...with cognitive performance and brain integrity in healthy young and middle-aged adults.
METHODS:The sample included dementia-free participants (mean age 40 ± 9 years; 53% women) of the Framingham Heart Study third-generation cohort with cognitive testing of memory, abstract reasoning, visual perception, attention, and executive function (n = 2,126). In addition, brain MRI examination (n = 1,597) was used to determine white matter, gray matter, and white matter hyperintensity (WMH) volumes and fractional anisotropy measures. We used linear regression models to assess relationships between diabetes, FBG, and insulin resistance with cognition, lobar gray matter, and WMH volumes as well as voxel-based microstructural white matter integrity and gray matter density, adjusting for potential confounders. Mediating effect of brain lesions on the association of diabetes with cognitive performance was also tested.
RESULTS:Diabetes was associated with worse memory, visual perception, and attention performance; increased WMH; and decreased total cerebral brain and occipital lobar gray matter volumes. The link of diabetes with attention and memory was mediated through occipital and frontal atrophy, and the latter also through hippocampal atrophy. Both diabetes and increased FBG were associated with large areas of reductions in gray matter density and fractional anisotropy on voxel-based analyses.
CONCLUSIONS:We found that hyperglycemia is associated with subtle brain injury and impaired attention and memory even in young adults, indicating that brain injury is an early manifestation of impaired glucose metabolism.
Objectives
To compare inpatient burden (i.e. likelihood of hospitalization, number of admissions and length of stay) in persons with newly diagnosed dementia to the general population without ...dementia. Additionally, to evaluate whether inpatient burden is increased during the years prior to and post dementia diagnosis, and to identify factors associated with increased inpatient burden.
Method
The Israeli National Dementia Dataset (2016) was cross‐linked with the National Hospital Discharge Database of the Israeli Ministry of Health (2014–2018). Dementia definition was based on documented dementia diagnoses and/or the purchase of medications during 2016. Mixed‐effects models were applied to identify demographic and health characteristics associated with inpatient burden in the one and 2 years prior to and after dementia diagnosis.
Results
The dataset included 11,625 individuals aged ≥65 years, identified as incident dementia cases. Compared to the general population of older‐adults without dementia, those with newly diagnosed dementia had a higher age‐standardized proportion of hospitalizations (26.4% vs. 40%). The odds for hospitalization were highest during the year preceding dementia diagnosis (OR = 3.19, 95% CI 2.51–4.06) compared to 2 years prior to diagnosis, and remained high (although slightly decreased) after dementia diagnosis. Older age was associated with inpatient burden after, but not prior to dementia diagnosis.
Conclusions
Older persons with dementia are a vulnerable population group with increased utilization of inpatient burden compared to those without dementia, particularly in the years surrounding dementia diagnosis. Sociodemographic risk factors may differ with respect to the time surrounding dementia diagnosis.
Key points
Older persons with dementia are a vulnerable population group with increased inpatient burden compared to those without dementia.
The odds for hospitalization were highest during the year preceding dementia diagnosis (compared to 2 years prior to diagnosis, and remained high after dementia diagnosis.
Some associations of age, sex, comorbidity burden and BMI with hospitalization of individuals with newly diagnosed dementia were modified by time respective to the dementia diagnosis.
Older age was associated with inpatient burden after, but not prior to dementia diagnosis.
Full text
Available for:
FZAB, GIS, IJS, KILJ, NLZOH, NUK, OILJ, SAZU, SBCE, SBMB, UL, UM, UPUK
Background
Ultra‐processed foods (UPFs) are industrialy‐processed formulations that constitute a large and increasing amount of the food supply in high and middle‐income countries. Accumulating ...evidence suggests that UPFs are related to increased risk of mortality and morbidity, including cardiovascular and metabolic health conditions, however its association with dementia risk has rarely been studied. We investigated the association of UPF sonsumption with risk of dementia and Alzheimer’s disease (AD) in the Framingham Heart Study.
Method
The sample for this cohort study included participants of the Offspring cohort who were ≥60y of age, completed a food‐frequency questionnaire (FFQ) and were dementia‐free at baseline. Food items included in the Harvard semi‐quantitative FFQ were classified as UPFs using the NOVA classification system. Participants were followed‐up for dementia incidence starting from exam 7 for a mean duration of 12.7±6.0 years. Cox regression models were used to assess the link of UPF levels with dementia and AD risk while adjusting for potential confounders, including diet quality and total calorie consumtion. Effect modification by age, BMI, diabetes and ApoEɛ4 genotype were additionally assessed.
Result
The study sample included 1,519 participants (mean age 68±6 years, 53% women). The average consumption of UPF at baseline was 6.1±3.4 servings per day. During the follow‐up, 253 and 196 were diagnosed with dementia and AD, respectively. Overall, no statistically significant associations were observed between UPF consumption and dementia or AD risk. However, an effect‐modification by age was identified (p‐for interaction = 0.016 and 0.007, for dementia and AD, respectively). Among participants younger, but not older than 68 years of age (i.e. median), the risk of dementia was increased comparing individuals at the top four quartiles to the bottom quartile (HR = 2.9; p‐value = 0.015). Each serving per week of UPF derived from low‐calorie soft drinks was significantly associated with 4% increase in risk of AD (HR = 1.04; p‐value = 0.012), but not all‐cause dementia (HR = 1.03; p = 0.074). However, the association of total UPF with dementia risk remained robust after omitting UPF from low‐calorie soft drinks (HR = 2.4; p‐value = 0.029).
Conclusion
Our findings suggest that UPF consumption in middle‐age and young‐old adulthood may be related to increased risk of all‐cause dementia.
Full text
Available for:
FZAB, GIS, IJS, KILJ, NLZOH, NUK, OILJ, SAZU, SBCE, SBMB, UL, UM, UPUK
Background
Evidence of the association between Attention‐Deficit/Hyperactivity Disorder (ADHD) and the risk of dementia is scarce, inconsistent, and subject to potential sources of bias that are as ...yet unconsidered. Our objective was to examine the association between ADHD and dementia risk.
Method
A prospective national cohort study born 1933‐1952, without a dementia diagnosis for two years, were followed up for incident dementia from 2002‐2020. Information was from electronic health records in a healthcare maintenance organization in Israel. ADHD diagnosis was classified as present from the age of the first diagnosis, otherwise absent. Competing risk Cox regression models were fit to quantify the risk of incident dementia with the Hazard Ratio (HR) and their associated 95% Confidence Intervals (CI) with inverse probability weights, age as the underlying time‐scale, unadjusted and, in the primary analysis, adjusted by 18 covariates.
Result
Of 110,196 participants aged 50‐70 years in 2002, 56,914 (51.6%) were female. During follow‐up there were a total of 746 (0.7%) cases of ADHD, and 8,339 (7.6%) of incident dementia. The percentage of incident dementia was 13.1% (N = 98) among those with ADHD present and 7.5% (N = 8,241) among those with ADHD absent. In the primary analysis, the group with ADHD was statistically significantly (P<.05) associated with a higher risk of dementia (unadjusted: HR = 3.57, CI = 2.89, 4.42; adjusted HR = 2.73, CI = 2.04, 3.65) compared to the group with ADHD absent. Eight of ten sensitivity analyses replicated the statistically significant association observed in the primary analysis. Psychostimulant medication offset the association between ADHD and dementia risk to null, and evidence of reverse causation was mild.
Conclusion
ADHD is associated with increased dementia risk. Policymakers, caregivers, patients, and clinicians may wish to monitor ADHD in old age reliably.
Full text
Available for:
FZAB, GIS, IJS, KILJ, NLZOH, NUK, OILJ, SAZU, SBCE, SBMB, UL, UM, UPUK
Cardiovascular health (CVH) factors are associated with lower risk of cardiovascular disease, stroke, and mortality. We investigated the association between a modified CVH metrics score and change in ...cognitive functions 2 decades later in patients with pre-existing coronary artery disease. A subset of 200 men (mean age at baseline 57.3 ± 6.3 years) who previously participated in a secondary prevention trial (1990 to 1997) underwent cognitive evaluation 14.6 ± 1.9 years after baseline (mean age 72.3 ± 6.2 years, T1 evaluation), and were re-evaluated for cognitive performance 19.9 ± 1.0 years after baseline (mean age 77.2 ± 6.4 years, T2 evaluation). A CVH metrics score at baseline was calculated, including 3 health parameters and 4 health behaviors. We have scored each of these CVH metrics into best (2 points), intermediate (1 point), and poor (0 points) levels. Cognitive function was assessed using the NeuroTrax Computerized Battery. A linear mixed model was used to assess change in cognitive functions between T1 and T2 cognitive evaluations. Among the 200 patients, 68 (34.0 %) had ≤7 (bottom group), 85 (42.5%) had 8 to 9 (middle group), and 47 (23.5%) had ≥10 (top group) CVH metrics points. After adjustments, the top group of CVH score versus others was associated with slower decline in the overall cognitive performance composite z-score (0.23 ± 0.09, p = 0.009) and on tests of executive and visual spatial functions (0.23 ± 0.11, p = 0.047, and 0.49 ± 0.17, p = 0.004, respectively). In conclusion, an inverse association was observed between the score of best CVH metrics and cognitive decline. Lifestyle factors are important predictors of late-life decline in cognitive function among high-risk patients.
Full text
Available for:
GEOZS, IJS, IMTLJ, KILJ, KISLJ, NLZOH, NUK, OILJ, PNG, SAZU, SBCE, SBJE, UL, UM, UPCLJ, UPUK, ZRSKP
Abstract
Background
Medical cannabis (MC) policies are currently undergoing rapid changes, with increasingly more jurisdictions around the world legalizing MC for various indications, including ...chronic pain. These developments make it increasingly likely that the general population, and in particular older populations, will consume cannabis regularly. Indeed, MC treatment is particularly prevalent among older individuals. A major concern related to cannabis use, and particularly in aging populations, is potential effects on brain health. Yet, there is a dearth of studies examining cognitive effects of cannabis in older adults.
Method
We recruited 63 MC and 62 non‐MC chronic pain patients over the age of 50 years with chronic neuropathic pain of organic origin from the Rambam Pain Medicine clinic in Haifa, Israel. Cognitive performance was assessed after abstinence of 8h in the MC users through CogState, a computerized battery designed to assess psychomotor reaction time, attention, working memory and learning. Linear regression models were used to test differences in cognitive performance between the two groups. Models adjusted for age, sex, education, cardiovascular disease and depression. Among MC users, the associations of dosage, cannabinoid concentrations, length and frequency of use and hours since last use with cognition were also examined.
Result
Mean age was 63±6 and 60±5 years in the non‐MC and MC patients respectively. MC patients were more likely to have cardiovascular disease (3% vs. 11%, respectively, p=0.025) and depression (7% vs. 21%, respectively, p=0.003). Sex, education levels, alcohol and cigarette use patterns and pain levels were similar. After adjustment, there were no significant difference between MC and non‐MC patients in any of the cognitive performance measures. Furthermore, years of MC use, frequency of use, hours since last use, number of strains used, THC/CBD concentration or dose were not related to cognitive performance on the different tests.
Conclusion
These results suggest that use of whole plant MC cannabis does not have a widespread impact on cognition in older patients. Considering the accumulating evidence showing efficacy of cannabis use for multiple health conditions, the lack of adverse effects on the brain can eliminate concerns and contribute to a better risk‐benefit assessment of MC treatment.
Full text
Available for:
FZAB, GIS, IJS, KILJ, NLZOH, NUK, OILJ, SAZU, SBCE, SBMB, UL, UM, UPUK
Background
Exceptional long‐lived individuals (ELLI) are known for their improved health status and independence regardless of life‐style and health behaviors. Yet, little is known about their ...cognitive function correlates. The aim of the present study was to assess the correlation between social, clinical, behavioral and personality factors and cognitive impairment in a sample of Ashkenazi Jews (AJ) ELLIs.
Method
The study sample included 401 AJ participants, aged 95 years or older, of the Longevity Genes Project at Einstein, who were residents of the northeastern United States and lived independently in the community. Socio‐demographic, medical history data and life‐style factors were collected via mailed questionnaires, telephone calls, or in‐person visits. Personality was assessed through the Personality Outlook Profile Scale. In the event that participants had difficulty responding to questions in a reliable manner, their children or legal guardian assisted them. Cognitive status was assessed using the Mini Mental State Exam (MMSE) with a score of 24 or lower considered as cognitive impairment. Cross‐sectional associations of medical, social, life‐style and personality characteristics with odds for cognitive impairment were assessed using logistic regression models while adjusting for potential confounders.
Result
Of the total sample (mean age=97.72.8 years, 84% women), 178 (44%) were cognitively impaired. Following adjustment for age, sex and education, prevalent skin cancer (OR, 95% CI: 0.40, 0.22‐0.74) as well as being conservative religious (OR, 95% CI: 0.18, 0.03‐0.97) and attending temple in Holidays only (OR, 95% CI=0.25, 0.07‐0.88) and weekly (OR, 95% CI: 0.25, 0.06‐0.97) at age ∼70 years were associated with lower odds for cognitive impairment.
Conclusion
Cognitive impairment correlates in ELLI may differ from those in the general population. Future studies are warranted to explore the role of religious involvement in brain aging. Furthermore, the strong link between a history of skin cancer and cognition in the oldest‐old should be examined.
Full text
Available for:
FZAB, GIS, IJS, KILJ, NLZOH, NUK, OILJ, SAZU, SBCE, SBMB, UL, UM, UPUK
Background
Medical cannabis (MC) policies are currently undergoing rapid changes, with increasingly more jurisdictions around the world legalizing MC for various indications, including chronic pain. ...These developments make it increasingly likely that the general population, and in particular older populations, will consume cannabis regularly. Indeed, MC treatment is particularly prevalent among older individuals. A major concern related to cannabis use, and particularly in aging populations, is potential effects on brain health. Yet, there is a dearth of studies examining cognitive effects of cannabis in older adults.
Method
We recruited 63 MC and 62 non‐MC chronic pain patients over the age of 50 years with chronic neuropathic pain of organic origin from the Rambam Pain Medicine clinic in Haifa, Israel. Cognitive performance was assessed after abstinence of 8h in the MC users through CogState, a computerized battery designed to assess psychomotor reaction time, attention, working memory and learning. Linear regression models were used to test differences in cognitive performance between the two groups. Models adjusted for age, sex, education, cardiovascular disease and depression. Among MC users, the associations of dosage, cannabinoid concentrations, length and frequency of use and hours since last use with cognition were also examined.
Result
Mean age was 63±6 and 60±5 years in the non‐MC and MC patients respectively. MC patients were more likely to have cardiovascular disease (3% vs. 11%, respectively, p=0.025) and depression (7% vs. 21%, respectively, p=0.003). Sex, education levels, alcohol and cigarette use patterns and pain levels were similar. After adjustment, there were no significant difference between MC and non‐MC patients in any of the cognitive performance measures. Furthermore, years of MC use, frequency of use, hours since last use, number of strains used, THC/CBD concentration or dose were not related to cognitive performance on the different tests.
Conclusion
These results suggest that use of whole plant MC cannabis does not have a widespread impact on cognition in older patients. Considering the accumulating evidence showing efficacy of cannabis use for multiple health conditions, the lack of adverse effects on the brain can eliminate concerns and contribute to a better risk‐benefit assessment of MC treatment.
Full text
Available for:
FZAB, GIS, IJS, KILJ, NLZOH, NUK, OILJ, SAZU, SBCE, SBMB, UL, UM, UPUK
PDF
