scholarly journals Examining the causal mediating role of brain pathology on the relationship between diabetes and cognitive impairment: the Cardiovascular Health Study

2020 ◽  
Vol 183 (4) ◽  
pp. 1705-1726
Author(s):  
Ryan M. Andrews ◽  
Ilya Shpitser ◽  
Oscar Lopez ◽  
William T. Longstreth ◽  
Paulo H. M. Chaves ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Cardiovascular Health ◽  
Health Study ◽  
Cardiovascular Health Study ◽  
Brain Pathology ◽  
Mediating Role ◽  
The Relationship

Abstract 5011: Role of Autonomic Nervous System Dysregulation and Inflammation in the Increased Risk of Depression for Cardiovascular Mortality: The Cardiovascular Health Study

Circulation ◽  
2008 ◽  
Vol 118 (suppl_18) ◽  
Author(s):  
Willem J Kop ◽  
Phyllis K Stein ◽  
Joshua I Barzilay ◽  
Russell P Tracy ◽  
John S Gottdiener
Keyword(s):  
Nervous System ◽  
Autonomic Nervous System ◽  
Cardiovascular Mortality ◽  
Inflammatory Markers ◽  
Cardiovascular Health ◽  
Health Study ◽  
Cardiovascular Health Study ◽  
Scaling Exponent ◽  
Autonomic Nervous

The increased cardiovascular (CV) risk associated with depression is hypothesized to be explained by autonomic nervous system (ANS) dysregulation and inflammatory processes. This study determines the role of ANS dysregulation and inflammation in the predictive value of depression for CV mortality. 908 participants of the Cardiovascular Health Study (age 71±5 yrs) free of CV disease were evaluated for depression (CES-D scale), ANS dysregulation by abnormal non-linear heart rate variability (decreased short-term fractal scaling exponent), and inflammation (IL-6, CRP, fibrinogen and WBC). Predictors of CV mortality were examined using Cox regression analysis, adjusting for age, sex, race, systolic blood pressure, diabetes, subclinical disease, use of beta-blockers, smoking status, BMI, and physical activity (median follow-up=13.3 yrs). Risks were calculated for subgroups based on the presence or absence of depression, and ANS or inflammatory CV risk factors (Figure ). Depression was predictive of CV mortality (RR=1.88, CI=1.23–2.86), ANS dysregulation (p=0.014) and inflammatory markers (IL-6 p=0.072; WBC p=0.033; and fibrinogen p=0.050) were correlated with depression. The association of depression with CV mortality occurred primarily in the presence of ANS dysregulation and/or inflammation (Figure ). Addition of ANS and inflammatory markers to the multivariate model did not substantially reduce the CV mortality risk of depression (adjusted RR=1.65, CI=1.03–2.65). Depression is predictive of cardiovascular mortality, and the elevated risk is additive to autonomic nervous system dysregulation and inflammation

Abstract MP03: Plasma Sphingolipids and Risks of Heart Failure and Atrial Fibrillation in Older Adults: The Cardiovascular Health Study

Circulation ◽  
2018 ◽  
Vol 137 (suppl_1) ◽  
Author(s):  
Rozenn N Lemaitre ◽  
Paul N Jensen ◽  
Barbara McKnight ◽  
Andrew Hoofnagle ◽  
Irena B King ◽  
...  
Keyword(s):  
Heart Failure ◽  
Atrial Fibrillation ◽  
Fatty Acid ◽  
Lower Risk ◽  
Cardiovascular Health ◽  
Biological Activities ◽  
Experimental Studies ◽  
Health Study ◽  
Cardiovascular Health Study

Introduction: Ceramides and sphingomyelins (sphingolipids) are circulating lipids involved in multiple physiological pathways relevant to heart failure (HF) and atrial fibrillation (AF), including apoptosis, oxidative stress, and inflammation. Experimental studies suggest that sphingolipids with different saturated fatty acids exhibit different biological activities, but their relationships with HF and AF are unknown. Hypothesis: Higher levels of plasma ceramide and sphingomyelin that contain the fatty acid 16:0 are associated with higher risks of HF and AF; and higher levels of ceramides and sphingomyelins that contain the fatty acid 20:0, 22:0 or 24:0 are associated with lower risks. Methods: We measured sphingolipids in the Cardiovascular Health Study (CHS) in plasma samples from 1994-95 (N=4026) or from 1992-93 (N=586). We assessed the separate associations of the levels of 8 sphingolipids with risks of incident HF and incident AF using Cox regression. A p-value threshold of 0.006 was used to account for multiple testing. Results: Among 4,612 participants, 1179 incident HF and 1198 incident AF occurred during >40,000 person-years of follow-up. In adjusted analyses, higher levels of Cer-16 (ceramide with 16:0) and SM-16 (sphingomyelin with 16:0) were associated with higher risk of incident HF, but not with risk of incident AF (Table). In contrast, higher levels of Cer-20, Cer-22 and Cer-24 were each associated with lower risk of AF, but not with risk of HF. Higher levels of SM-20, SM-22, and SM-24 tended to be associated with lower risks of AF and HF, with only the association of SM-20 with AF significant. Conclusions: Plasma levels of ceramide and sphingomyelin with 16:0 show different associations with HF and AF than species with 20:0, 22:0 or 24:0. Associations of Cer-16 and SM-16 specifically with higher risk of HF may be due to a role of apoptosis in HF. The novel findings that Cer-20, Cer-22, and Cer-24 are associated with lower risk of AF warrant further examination of the role of these sphingolipids in protecting from AF.

scholarly journals Sex Differences in the Association Between Pentraxin 3 and Cognitive Decline: The Cardiovascular Health Study

2019 ◽  
Vol 75 (8) ◽  
pp. 1523-1529
Author(s):  
Lindsay M Miller ◽  
Nancy S Jenny ◽  
Andreea M Rawlings ◽  
Alice M Arnold ◽  
Annette L Fitzpatrick ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Cognitive Decline ◽  
Cardiovascular Health ◽  
Vascular Inflammation ◽  
Effect Modification ◽  
Health Study ◽  
Cardiovascular Health Study ◽  
Minor Effect ◽  
Pentraxin 3 ◽  
A Minor

Abstract Background The importance of systemic inflammation, measured by C-reactive protein, in cognitive decline has been demonstrated; however, the role of vascular inflammation is less understood. Pentraxin 3 (PTX3) is a novel marker of vascular inflammation. Methods We followed adults 65 and older, free of cardiovascular disease (CVD) for up to 9 years (n = 1,547) in the Cardiovascular Health Study. We evaluated the relationship between PTX3 and change in cognitive function, measured using the Modified Mini-Mental State Examination (3MSE), and incident cognitive impairment (3MSE < 80). Mediation by CVD events, and effect modification by sex and apolipoprotein E ɛ4 allele (APOE4) were also examined. Results The average decline in 3MSE was 0.77 points per year. The association between PTX3 and change in 3MSE differed between women and men (p = .02). In the adjusted model, each standard deviation higher in PTX3 was associated with a 0.20 greater decline in 3MSE score per year in women over follow-up (95% CI: −0. 37, −0.03; p = .02), compared to no change in men (β = 0.07; 95% CI: −0.08, 0.22). CVD events had a minor effect on the associations. No effect modification by APOE4 was found, although we observed the association of PTX3 and cognitive impairment in women was attenuated and nonsignificant after adjustment for APOE4. There was a paradoxical protective association between PTX3 and reduced cognitive impairment in men, even after adjustment for APOE4. Conclusions We found that vascular inflammation was significantly associated with cognitive decline in older women, but not men.

scholarly journals Incidence of Dementia in Mild Cognitive Impairment in the Cardiovascular Health Study Cognition Study

2007 ◽  
Vol 64 (3) ◽  
pp. 416 ◽  
Author(s):  
Oscar L. Lopez ◽  
Lewis H. Kuller ◽  
James T. Becker ◽  
Corinne Dulberg ◽  
Robert A. Sweet ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Cardiovascular Health ◽  
Health Study ◽  
Cardiovascular Health Study ◽  
Incidence Of Dementia

scholarly journals Association between cognitive impairment and criteria for frailty syndrome among older adults

2020 ◽  
Vol 78 (1) ◽  
pp. 2-8 ◽  
Author(s):  
Allan Gustavo BRIGOLA ◽  
Ana Carolina OTTAVIANI ◽  
Danilo Henrique Trevisan CARVALHO ◽  
Nathalia Alves OLIVEIRA ◽  
Érica Nestor SOUZA ◽  
...  
Keyword(s):  
Older Adults ◽  
Cognitive Impairment ◽  
Cardiovascular Health ◽  
Functional Dependence ◽  
Health Study ◽  
Cardiovascular Health Study ◽  
Multinomial Regression ◽  
Cognitive Frailty ◽  
Elderly Caregivers ◽  
State Examination

Abstract The association between cognitive impairment and physical frailty has been studied in older adults. The criteria degree of frailty may be keys to associated cognitive impairment. Objective: To analyze the association between cognitive impairment and the criteria for frailty. Methods: We cross-sectionally examined data from 667 older adults (≥60 years of age) from a study entitled ‘Variables associated to cognition in elderly caregivers’ involving patients in an urban and rural primary healthcare center. We defined cognitive impairment based on different groups of scores on the Mini Mental State Examination, and defined frailty and prefrailty using the criteria by the Cardiovascular Health Study. We performed multinomial regression models to analyze the association between levels of frailty and cognitive impairment. Results: Similar proportions of women (54.8%) and men (45.2%) participated in the study (mean age: 71 years old). We found cognitive impairment, prefrailty and frailty in 34, 54, and 24% of the participants, respectively. Concomitant cognitive impairment and frailty was found in 13% of them. The chances of cognitive impairment increased up to 330% (Odds Ratio [OR]: 4.3; 95% confidence interval [95%CI] 2.4‒7.7; p<0.001) among frail individuals, and 70% (OR: 1.7; 95%CI 1.0‒2.8; p=0.033) among prefrail individuals compared to robust/non-frail individuals. After controlling for age, education, place of residence and functional dependence, slowness and fatigue criteria were significantly associated with cognitive impairment. Conclusion: Older adults with frailty have a greater likelihood of concomitant cognitive impairment than prefrail and robust older adults. The prevalence of cognitive impairment and frailty is consistent with data reported in literature. The present findings contribute to the investigation of cognitive frailty.

scholarly journals Cognitive health risks posed by social isolation and loneliness in older Korean Americans

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Yuri Jang ◽  
Eun Young Choi ◽  
Nan Sook Park ◽  
David A. Chiriboga ◽  
Lei Duan ◽  
...  
Keyword(s):  
Cognitive Impairment ◽  
Social Isolation ◽  
Health Risks ◽  
Korean Americans ◽  
Cognitive Health ◽  
Subjective Cognitive Impairment ◽  
Mediating Role ◽  
The Relationship ◽  
Older Korean Americans

Abstract Background This study examines associations among social isolation, loneliness, and cognitive health risks in older Korean Americans, focusing on the mediating role of loneliness in the relationship between social isolation and objective and subjective measures of cognitive impairment. Methods Data are from 2061 participants in the Study of Older Korean Americans, a multi-state survey of Korean immigrants age 60 and older (Mage = 73.2, SD = 7.93). Social isolation was indexed with the Lubben Social Network Scale− 6; loneliness, with the short-form UCLA Loneliness Scale. Objective and subjective measures of cognitive impairment included the Mini-Mental State Examination and a single-item self-rating of cognitive health. Results In the logistic regression model for objective cognitive impairment, social isolation was significantly associated, but loneliness was not. In the model for subjective cognitive impairment, both social isolation and loneliness were significant factors. However, the effect of social isolation became non-significant when loneliness was considered, suggesting a potential mediating role of loneliness. The subsequent mediation analysis confirmed that the indirect effect of social isolation on subjective cognitive impairment through loneliness was significant (B = .20, SE = .03, 95% CI = .12, .28). Conclusion Our analyses provide evidence for the proposed mediating effect of loneliness in the relationship between social isolation and subjective cognitive impairment. Intervention efforts should focus on reducing feelings of loneliness experienced by older immigrants, possibly by engaging them in socially meaningful and cognitively stimulating activities.

scholarly journals Risk Factors for Mild Cognitive Impairment in the Cardiovascular Health Study Cognition Study

2003 ◽  
Vol 60 (10) ◽  
pp. 1394 ◽  
Author(s):  
Oscar L. Lopez ◽  
William J. Jagust ◽  
Corinne Dulberg ◽  
James T. Becker ◽  
Steven T. DeKosky ◽  
...  
Keyword(s):  
Risk Factors ◽  
Cognitive Impairment ◽  
Mild Cognitive Impairment ◽  
Cardiovascular Health ◽  
Health Study ◽  
Cardiovascular Health Study

The UGT1A1*28 gene variant predicts long-term mortality in patients undergoing coronary angiography

2018 ◽  
Vol 56 (4) ◽  
pp. 560-564 ◽  
Author(s):  
Barbara Zulus ◽  
Gerda Grünbacher ◽  
Marcus E. Kleber ◽  
Winfried März ◽  
Wilfried Renner
Keyword(s):  
Cardiovascular Health ◽  
Multivariate Regression Analysis ◽  
Health Study ◽  
Cardiovascular Health Study ◽  
Uridine Diphosphate ◽  
Gene Variant ◽  
Bilirubin Metabolism ◽  
Exogenous Compounds

AbstractBackground:Uridine diphosphate glycosyltransferases 1A1 (UGT1A1) plays an essential role in detoxification and excretion of several endogenous and exogenous compounds. A functional polymorphism in the promoter of theUGT1A1gene (TA repeat insertion,UGT1A1*28, rs3064744) has been associated with reducedUGT1A1enzyme activity. The purpose of the present study was to investigate the role ofUGT1A1genotypes in mortality.Methods:UGT1A1genotypes as well as baseline plasma bilirubin levels were analyzed in participants of the Ludwigshafen Risk and Cardiovascular Health study (n=3316).UGT1A1*28 genotypes were determined on an ABI PRISM 3730 genetic analyzer.Results:As expected,UGT1A1genotypes were associated with baseline bilirubin levels (*1/*1 genotype: 9.1±4.6 µmol/L; *1/*28 genotype: 10.8±5.3; *28/*28: 16.9±9.2; p<0.001). During a median follow-up of 10.4 years, 995 subjects (30.0%) died. In a multivariate regression analysis adjusting for age, sex, smoking, type 2 diabetes, dyslipidemia, alanine aminotransferase (ALT) levels and bilirubin levels, theUGT1A1*28 variant predicted lower overall mortality (hazard ratio [HR], 0.86; 95% confidence interval [CI], 0.78–0.95; p=0.003). Contrary to expected, higher baseline bilirubin levels predicted increased mortality (HR, 1.014; 95% CI, 1.002–1.025; p=0.019).Conclusions:TheUGT1A1*28 gene variant is associated with lower mortality rates. The protective effect of theUGT1A1*28 variant likely includes mechanism other than bilirubin metabolism.

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