scholarly journals A cross-sectional analysis of alcohol consumption, sex, and the odds of Alzheimer's disease and other dementias in the community-dwelling Canadian population

2020 ◽  
Author(s):  
◽  
Jennifer Tippett

Background: The prevalence of Alzheimer’s disease (AD) and other dementias is perpetually increasing in Canada and worldwide with the aging baby boomer population. It is, therefore, important to identify risk factors for these major neurocognitive disorders, such as alcohol consumption, to mitigate the future burden on caregivers and the economy. The purpose of this study was to replicate previous research regarding the dose-response relationship between alcohol consumption and the odds of currently having AD or another dementia. The possibility of a sex effect moderating this relationship was also explored. Participants: Data were obtained for respondents to the combined 2015/16 cycles of the Canadian Community Health Survey who were aged 41 years or older at the time of the survey’s conduction (nweighted = 16,715,618). Methods: Logistic regression was used to crossectionally assess the relationship between various time- and frequency-related alcohol consumption exposures to outcome dementia status, while controlling for a number of demographic and risk factor variables. Results: A sex effect was identified for drinking at an average frequency of four to six times per week over the past year (p = 0.019, 95% CI: 0.03, 0.73) where women (ORw = 0.13) were more protected against currently having AD or dementia than men (ORm = 0.89) when compared to alcohol abstainers. Binge drinking two to three times per month (OR = 0.19, p = 0.015, 95% CI: 0.05, 0.73) and more than once per week over the past year (OR = 0.16, p = 0.007, 95% CI: 0.04, 0.61) significantly lessened the odds of currently having AD or dementia when compared against alcohol abstainers. A sex effect was present for those who were classified as very heavy drinkers (♂: 6+ drinks/day, ♀: 4+ drinks/day) over the past week (p = 0.018, 95% CI: 1.14, 39.41) where alcohol was protective against currently having AD or dementia in men (ORm = 0.29) and alcohol was a risk factor for currently having AD or dementia in women (ORw = 2.15) when both were referenced with alcohol abstainers. Conclusions: With the exception of very heavy drinker women, drinking alcohol was associated with a reduced likelihood of currently having AD or dementia and sex effects were identified for drinking at a moderate frequency over the past year and very heavy drinkers. However, these results should be interpreted with caution due to the possibility of selection, sparse data, and abstainer biases as well as misclassification error. The primary implication of this research is to inform future studies that a more thorough exploration of a sex effect influencing the relationship between alcohol consumption and having AD or dementia is warranted.

2017 ◽  
Vol 6 (2) ◽  
pp. 22-28
Author(s):  
Dereck L. Salisbury ◽  
Fang Yu

Background: Alzheimer's disease (AD) currently affects 5.4 million Americans and is the sixth leading cause of death in the United States. The mechanism of exercise-induced brain adaptations are not fully understood, but enhanced aerobic fitness has been postulated as an essential physiological mechanism and is beginning to be studied. The purpose of this analysis was to examine the relationship between changes in aerobic fitness and cognition following 6 months of aerobic exercise training in older adults with AD. Methods: Twenty-seven community-dwelling older adults with mild to moderate AD completed a 6-month, 3 times per week, moderate-vigorous intensity cycling exercise program in 2 identical studies using a single-group repeated-measures designs. AD symptoms were measured with the AD Assessment Scale–cognitive subscale (ADAS-cog), while aerobic fitness was assessed by the intermittent shuttle walk test (ISWT) at baseline and 6 months. Pearson's correlation coefficient tests and linear regression were used to assess the relationship between changes in aerobic fitness and cognition. Results: Adjusted for age, the 6-month change in ISWT distance had an inverse relationship with the 6-month change in ADAS-Cog (r = −0.49; P = .01), indicating that enhanced aerobic fitness was associated with improved cognitive changes. Linear regression was statistically significant when adjusted by age (F([2,14] =5.33, P =.01, R2 = .31). Conclusion: Enhanced aerobic fitness may attenuate cognitive decline in persons with mild to moderate AD.


2018 ◽  
Vol 15 (14) ◽  
pp. 1277-1282 ◽  
Author(s):  
Blanka Klimova ◽  
Kamil Kuca ◽  
Petra Maresova

The incidence of both diabetes and Alzheimer’s disease (AD) is increasing and is becoming a social and economic threat worldwide. Recent research studies indicate that both diseases share some pathophysiological features and that specifically, Type 2 Diabetes Mellitus (T2DM) is a risk factor of Alzheimer’s disease. The aim of this study is to explore the relationship between diabetes mellitus and AD, explore the efficacy of selected drugs on patients with diabetes and AD, and compare the relative risk of diabetes for Alzheimer’s disease within different clinical studies. The method of literature search in several acknowledged databases such as Web of Science, Elsevier Science Direct, PubMed and Scopus in the period from 2000 to 2015 for the following keywords: “Alzheimer’s AND disease AND diabetes AND mellitus” was used. The identified studies were divided into two basic groups, based on their focus: efficacy of the selected drugs on patients suffering from AD and diabetes, and a link between diabetes and AD; as diabetes is seen as a risk factor of AD. The findings of this study confirm that there is a close and direct link between diabetes and AD, which indicates that there is a need for early diagnosis of metabolic syndrome, insulin resistance, and T2DM. In fact, the reviewed clinical trials have proved an increase in the risk of AD. However, the values of this risk are relatively low. The results also illustrate that both pharmacological (e.g., the antidiabetic drugs together with insulin dosing) and nonpharmacological (e.g., being intensively engaged in physical activities) treatments can have a positive effect. The results of this study confirm that diabetes and AD are not independent disorders since they share some common pathophysiological mechanisms. In addition, more clinical randomized control trials are needed to explore the efficacy of both pharmacological and non-pharmacological approaches to the treatment of T2DM and AD.


2019 ◽  
Vol 18 (3) ◽  
pp. 612-642 ◽  
Author(s):  
Rebeca Montoiro Rodriguez ◽  
Alba Elena Martínez Santos ◽  
Raquel Rodríguez-González

Introducción: La depresión y la demencia son dos patologías con una alta prevalencia a nivel mundial y multitud de rasgos en común. La demencia es un trastorno de carácter progresivo, siendo la Enfermedad de Alzheimer (EA) el tipo más común. Por su parte, la depresión representa la principal causa mundial de discapacidad. El objetivo de esta revisión es analizar la depresión como factor de riesgo para la EA resaltando, además, el papel de enfermería a nivel preventivo.Métodos: Se realizó una búsqueda bibliográfica sistemática en diversas fuentes de información. Es necesario destacar Pubmed como la principal base de datos a partir de la cual se obtuvieron la mayoría de artículos.Resultados y discusión: Existen principalmente tres hipótesis acerca de la relación depresión-demencia: depresión como factor de riesgo, depresión como pródromo, o depresión y demencia patologías independientes. Son múltiples los aspectos que deben valorarse en cada caso, agregándose así mayor complejidad a las investigaciones. A nivel neurobiológico también está probada la presencia de mecanismos patológicos comunes. Se destaca la prevención como punto clave en el abordaje de estos trastornos, donde enfermería desempeña un importante papel en la detección precoz y la educación para salud.Conclusiones: La depresión como factor de riesgo para la EA ha sido corroborada en numerosos estudios. Pese a ello, sigue sin existir acuerdo definitivo y, por lo tanto, resulta crucial continuar investigando y profundizando en el binomio depresión-demencia Introduction: Depression and dementia are two diseases with a high prevalence worldwide and many features in common. Dementia is a progressive disorder being Alzheimer's Disease the most frequent type. On the other hand, depression represents the first worldwide cause of disability. The objective of this review is to analyze depression as a risk factor in the development of Alzheimer's Disease and to highlight the role of nurses regarding prevention in this field. Methods: A bibliographic systematic search in diverse data bases was done. It is necessary to highlight PubMed as the main data base from which the majority of articles included were obtained.Results and discussion: There are mainly three hypotheses about the relationship between depression and dementia: depression as a risk factor, depression as a prodrome or depression and dementia as two independent pathologies. Moreover, there are a lot of aspects that must be taken into account in each case adding more complexity to the investigations. At the neurobiological level there is also evidence of common pathological mechanisms for both diseases. In addition, prevention has to be emphasized as a key point in the treatment of these disorders and nurses play a crucial role in early diagnosis and health education.Conclusions: Depression as a risk factor to Alzheimer's Disease has been demonstrated in many studies. However, there is not a conclusive agreement and, therefore, it is crucial to continue investigating the relation between depression and dementia.


Author(s):  
Jena N Moody ◽  
, Kate E Valerio ◽  
M S, Alexander N Hasselbach ◽  
Sarah Prieto ◽  
M S, Mark W Logue ◽  
...  

Abstract Body mass index (BMI) is a risk factor for Alzheimer’s disease (AD) although the relationship is complex. Obesity in midlife is associated with increased risk for AD, whereas evidence supports both higher and lower BMI increasing risk for AD in late life. This study examined the influence of individual differences in genetic risk for AD to further clarify the relationship between late-life BMI and conversion to AD. Participants included 52 individuals diagnosed as having mild cognitive impairment (MCI) at baseline who converted to AD within 24 months and 52 matched MCI participants from the Alzheimer’s Disease Neuroimaging Initiative (ADNI) cohort. BMI was measured at baseline. Genetic risk for AD was assessed via genome-wide polygenic risk scores. Conditional logistic regression models were run to determine if BMI and polygenic risk predicted conversion to AD. Results showed an interaction between BMI and genetic risk, such that individuals with lower BMI and higher polygenic risk were more likely to convert to AD relative to individuals with higher BMI. These results remained significant after adjusting for cerebrospinal fluid biomarkers of AD. Exploratory sex-stratified analyses revealed this relationship only remained significant in males. These results show that higher genetic risk in the context of lower BMI predicts conversion to AD in the next 24 months, particularly among males. These findings suggest that genetic risk for AD in the context of lower BMI may serve as a prodromal risk factor for future conversion to AD.


Author(s):  
Keng Yoon Yeong ◽  
Christine Law

Alzheimer’s disease (AD) is a neurodegenerative disorder that has affected millions of people worldwide. However, currently there is no treatment to cure the disease. The AD drugs available in the market only manage the disease symptomatically and the effects are usually short-term. Thus, there is a need to look at alternatives AD therapies. Mid-life hypertension has not only been recognised as a risk factor for AD, but its relation with AD has also been well established. Thus, antihypertensives are postulated to be beneficial in managing AD. This literature review aims to shed some light on the potential of repurposing antihypertensives to treat AD, considering recent updates. Four classes of antihypertensives, as well as their potential limitations and future prospects in being utilised as AD therapeutics are discussed in this review.


2020 ◽  
Vol 17 (1) ◽  
pp. 93-101 ◽  
Author(s):  
Dan Wang ◽  
Zhifu Fei ◽  
Song Luo ◽  
Hai Wang

Objectives: Alzheimer's disease (AD), also known as senile dementia, is a common neurodegenerative disease characterized by progressive cognitive impairment and personality changes. Numerous evidences have suggested that microRNAs (miRNAs) are involved in the pathogenesis and development of AD. However, the exact role of miR-335-5p in the progression of AD is still not clearly clarified. Methods: The protein and mRNA levels were measured by western blot and RNA extraction and quantitative real-time PCR (qRT-PCR), respectively. The relationship between miR-335-5p and c-jun-N-terminal kinase 3 (JNK3) was confirmed by dual-luciferase reporter assay. SH-SY5Y cells were transfected with APP mutant gene to establish the in vitro AD cell model. Flow cytometry and western blot were performed to evaluate cell apoptosis. The APP/PS1 transgenic mice were used as an in vivo AD model. Morris water maze test was performed to assess the effect of miR- 335-5p on the cognitive deficits in APP/PS1 transgenic mice. Results: The JNK3 mRNA expression and protein levels of JNK3 and β-Amyloid (Aβ) were significantly up-regulated, and the mRNA expression of miR-335-5p was down-regulated in the brain tissues of AD patients. The expression levels of miR-335-5p and JNK3 were significantly inversely correlated. Further, the dual Luciferase assay verified the relationship between miR-335- 5p and JNK3. Overexpression of miR-335-5p significantly decreased the protein levels of JNK3 and Aβ and inhibited apoptosis in SH-SY5Y/APPswe cells, whereas the inhibition of miR-335-5p obtained the opposite results. Moreover, the overexpression of miR-335-5p remarkably improved the cognitive abilities of APP/PS1 mice. Conclusion: The results revealed that the increased JNK3 expression, negatively regulated by miR-335-5p, may be a potential mechanism that contributes to Aβ accumulation and AD progression, indicating a novel approach for AD treatment.


2018 ◽  
Vol 15 (5) ◽  
pp. 429-442 ◽  
Author(s):  
Nishant Verma ◽  
S. Natasha Beretvas ◽  
Belen Pascual ◽  
Joseph C. Masdeu ◽  
Mia K. Markey ◽  
...  

Background: Combining optimized cognitive (Alzheimer's Disease Assessment Scale- Cognitive subscale, ADAS-Cog) and atrophy markers of Alzheimer's disease for tracking progression in clinical trials may provide greater sensitivity than currently used methods, which have yielded negative results in multiple recent trials. Furthermore, it is critical to clarify the relationship among the subcomponents yielded by cognitive and imaging testing, to address the symptomatic and anatomical variability of Alzheimer's disease. Method: Using latent variable analysis, we thoroughly investigated the relationship between cognitive impairment, as assessed on the ADAS-Cog, and cerebral atrophy. A biomarker was developed for Alzheimer's clinical trials that combines cognitive and atrophy markers. Results: Atrophy within specific brain regions was found to be closely related with impairment in cognitive domains of memory, language, and praxis. The proposed biomarker showed significantly better sensitivity in tracking progression of cognitive impairment than the ADAS-Cog in simulated trials and a real world problem. The biomarker also improved the selection of MCI patients (78.8±4.9% specificity at 80% sensitivity) that will evolve to Alzheimer's disease for clinical trials. Conclusion: The proposed biomarker provides a boost to the efficacy of clinical trials focused in the mild cognitive impairment (MCI) stage by significantly improving the sensitivity to detect treatment effects and improving the selection of MCI patients that will evolve to Alzheimer’s disease.


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